Psychosocial Risk Factors for Inconsistent Condom Use in Young People with First Episode Psychosis

Objetivo: Ainda não está claro quais são os fatores de risco para a esquizofrenia resistente ao tratamento (ERT) em primeiro episódio psicótico (PEP). O objetivo deste trabalho é investigar indicadores de risco para ERT em PEP. Métodos: Foram selecionados 53 pacientes em primeiro episódio psicótico, com diagnóstico de esquizofrenia, que deram entrada à enfermaria de psiquiatria do Hospital das Clínicas Luzia de Pinho Melo entre 2011 e 2015. Ao ser admitido na enfermaria, o paciente era avaliado com a Escala de Sintomas para as Síndromes Positiva e Negativa (Positive and Negative Syndrome Scale – PANSS) e recebia tratamento inicial por 4 semanas. Caso sua resposta fosse inferior a 40% de redução na PANSS, o antipsicótico era trocado, e as escalas eram aplicadas novamente após mais 4 semanas. Após a falha com dois antipsicóticos, em doses plenas, por 4 semanas cada, a clozapina era introduzida, e o paciente era considerado ERT. Uma regressão logística foi aplicada onde sexo, idade de início, tempo de doença não tratada, uso de substâncias, avaliação global do funcionamento inicial e PANSS inicial total foram inseridos como variáveis independentes, e ERT foi inserida como variável dependente. Resultados: Tempo de doença não tratada apresentou significância de p = 0,038 e Exp (B) = 4,29, enquanto que PANSS total apresentou p = 0,012 e Exp (B) = 1,06. Conclusão: Identificar os fatores associados à resistência precoce ao tratamento poderia permitir aos clínicos evitar o atraso na introdução da clozapina e prevenir um pior prognóstico para esses pacientes.

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Views of Young People in Early Intervention Services for First-Episode Psychosis in England

Psychiatric Services ◽

10.1176/ps.62.8.pss6208_0882 ◽

2011 ◽

Vol 62 (8) ◽

pp. 882-887 ◽

Cited By ~ 41

Author(s):

Helen Lester ◽

Max Marshall ◽

Peter Jones ◽

David Fowler ◽

Tim Amos ◽

...

Keyword(s):

Early Intervention ◽

Young People ◽

First Episode Psychosis ◽

First Episode ◽

Early Intervention Services ◽

Episode Psychosis ◽

Intervention Services

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Suicide Prevention in First Episode Psychosis: The Development of a Randomised Controlled Trial of Cognitive Therapy for Acutely Suicidal Patients With Early Psychosis

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.2003.01209.x ◽

2003 ◽

Vol 37 (4) ◽

pp. 414-420 ◽

Cited By ~ 94

Author(s):

P.J.R. Power ◽

R.J. Bell ◽

R. Mills ◽

T. Herrman-Doig ◽

M. Davern ◽

...

Keyword(s):

Early Intervention ◽

Treatment Group ◽

Young People ◽

Controlled Trial ◽

First Episode Psychosis ◽

Early Psychosis ◽

First Episode ◽

Episode Psychosis ◽

Randomised Controlled ◽

Suicidal Patients

Background: Young people with early psychosis are at particularly high risk of suicide. However, there is evidence that early intervention can reduce this risk. Despite these advances, first episode psychosis patients attending these new services still remain at risk. To address this concern, a program called LifeSPAN was established within the Early Psychosis Prevention and Intervention Centre (EPPIC). The program developed and evaluated a number of suicide prevention strategies within EPPIC and included a cognitively oriented therapy (LifeSPAN therapy) for acutely suicidal patients with psychosis. We describe the development of these interventions in this paper. Method: Clinical audit and surveys provided an indication of the prevalence of suicidality among first episode psychosis patients attending EPPIC. Second, staff focus groups and surveys identified gaps in service provision for suicidal young people attending the service. Third, a suicide risk monitoring system was introduced to identify those at highest risk. Finally, patients so identified were referred to and offered LifeSPAN therapy whose effectiveness was evaluated in a randomised controlled trial. Results: Fifty-six suicidal patients with first episode psychosis were randomly assigned to standard clinical care or standard care plus LifeSPAN therapy. Forty-two patients completed the intervention. Clinical ratings and measures of suicidality and risk were assessed before, immediately after the intervention, and 6 months later. Benefits were noted in the treatment group on indirect measures of suicidality, e.g., hopelessness. The treatment group showed a greater average improvement (though not significant) on a measure of suicide ideation. Conclusions: Early intervention in psychosis for young people reduces the risk of suicide. Augmenting early intervention with a suicide preventative therapy may further reduce this risk.

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Characterising Usage of a Multicomponent Digital Intervention to Predict Treatment Outcomes in First-Episode Psychosis: A Cluster Analysis (Preprint)

10.2196/preprints.29211 ◽

2021 ◽

Author(s):

Shaunagh O'Sullivan ◽

Lianne Schmaal ◽

Simon D'Alfonso ◽

Yara J Toenders ◽

Lee Valentine ◽

...

Keyword(s):

Young People ◽

Treatment Outcomes ◽

Social Functioning ◽

Negative Symptoms ◽

User Profile ◽

First Episode Psychosis ◽

First Episode ◽

User Profiles ◽

Episode Psychosis ◽

Social Components

BACKGROUND Multicomponent digital interventions offer the potential for tailored and flexible interventions that aim to address high attrition rates and increase engagement, an area of concern in digital mental health. However, increased flexibility in usage makes it difficult to determine which components lead to improved treatment outcomes. OBJECTIVE This study aimed to identify user profiles on Horyzons, an 18-month digital relapse prevention intervention that incorporates therapeutic content and social networking, along with clinical, vocational and peer support, and to examine the predictive value of these user profiles for treatment outcomes. A secondary objective was to compare each user profile with young people receiving treatment as usual (TAU). METHODS Participants comprised 82 young people (16-27 years of age) with access to Horyzons and 84 receiving TAU, recovering from first-episode psychosis. Six-month usage data from the therapy and social networking components of Horyzons were used as features for K-means clustering for joint trajectories to identify user profiles. Social functioning, psychotic symptoms, depression and anxiety were assessed at baseline and six-month follow-up. General linear mixed models were used to examine the predictive value of user profiles for treatment outcomes, and between each user profile with TAU. RESULTS Three user profiles were identified based on system usage metrics including: (a) low usage; (b) maintained usage of social components; and (c) maintained usage of both therapy and social components. The maintained therapy and social group showed improvements in social functioning (F (2, 51) = 3.58; P = .04), negative symptoms (F (2, 51) = 4.45; P = .02) and overall psychiatric symptom severity (F (2, 50) = 3.23; P = .048) compared to the other user profiles. This group also showed improvements in social functioning (F (1, 62) = 4.68; P = .03), negative symptoms (F (1, 62) = 14.61; P = <.001) and overall psychiatric symptom severity (F (1, 63) = 5.66; P = .02) compared to TAU. Conversely, the maintained social group showed increases in anxiety compared to TAU (F (1, 57) = 7.65; P = .01). No differences were found between the low usage group and TAU on treatment outcomes. CONCLUSIONS Continued engagement with both therapy and social components might be key in achieving long-term recovery. Maintained social usage and low usage outcomes were broadly comparable to TAU, emphasizing the importance of maintaining engagement for improved treatment outcomes. Although the social network may be a key ingredient to increase sustained engagement, as users engaged with this more consistently, it should be leveraged as a tool to engage young people with therapeutic content to bring about social and clinical benefits.

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Psychosocial factors of suicidal behavior of adolescents: review of foreign studies

BULLETIN Series of Sociological and Political sciences ◽

10.51889/2020-4.1728-8940.09 ◽

2020 ◽

Vol 72 (4) ◽

pp. 55-63

Author(s):

S.E Myrzabaev ◽

◽

M.S. Sadyrova ◽

Keyword(s):

Risk Factors ◽

Young People ◽

Psychosocial Factors ◽

Suicidal Behavior ◽

Psychosocial Risk Factors ◽

Psychosocial Risk ◽

Sociological Research ◽

Risk Factors For Suicide

This article aims to review research that seeks to find psychosocial factors of suicidal behavior among adolescents. The article deals with the sociological research of European authors who dealt with the problem of suicidal behavior of adolescents and young people aged 14-24 years. Studying these studies, the article shows the psychosocial risk factors for suicide and suicidal behavior among progeny.

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Rates, determinants and outcomes associated with the use of community treatment orders in young people experiencing first episode psychosis

International Journal of Law and Psychiatry ◽

10.1016/j.ijlp.2018.11.007 ◽

2019 ◽

Vol 62 ◽

pp. 85-89 ◽

Cited By ~ 2

Author(s):

Melissa Bardell-Williams ◽

Scott Eaton ◽

Linglee Downey ◽

Meghan Bowtell ◽

Kristen Thien ◽

...

Keyword(s):

Young People ◽

First Episode Psychosis ◽

Community Treatment ◽

First Episode ◽

Community Treatment Orders ◽

Episode Psychosis

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“I enjoy sex more without condoms": revisiting barriers and facilitators of consistent condom use among adolescents and young adults in South Africa

10.21203/rs.3.rs-271620/v2 ◽

2021 ◽

Author(s):

Anthony Ajayi ◽

Olumuyiwa Omonaiye ◽

Charlotte Nwogwugwu

Keyword(s):

South Africa ◽

Young People ◽

Condom Use ◽

Financial Support ◽

Consistent Condom ◽

Sexually Active ◽

Partner Communication ◽

Consistent Condom Use ◽

Inconsistent Condom ◽

Inconsistent Condom Use

Abstract Background Previous studies have examined consistent condom use correlates in South Africa, focusing on sociodemographic factors, HIV risk perceptions, relationship conflict, multiple sexual partners, and masculinity. However, the effect of family financial support, HIV testing, partner communication and self-efficacy for HIV prevention is less studied. We drew from a cross-sectional survey to address this gap and highlight the key barriers and facilitators of consistent condom use among young people. Methods We analysed data obtained from 631 unmarried sexually active male and females students selected using stratified sampling from a university in Eastern Cape Province of South Africa. Consistent condom use was defined as regular use of condoms in all sexual encounters in the past year. We used an open-ended question to probe the reasons for inconsistent condom use. Adjusted and unadjusted regression analysis were fitted to examine factors associated with consistent condom use. Results The prevalence of consistent condom use was 39.3% (CI: 35.5%-43.2%), with no significant gender and age differences. After adjusting for relevant covariates, living with foster parents (AOR; 1.80 95% CI; 1.09-2.97), adequate family financial support (AOR; 2.49 95% CI; 1.71-3.62), partner knew status (AOR; 1.91 95% CI; 1.09-3.37) and feeling confident in one's ability to prevent HIV (AOR; 1.77 95% CI; 1.09-2.86) were associated with increased odds of consistent condom use. However, self-report of low condom self-efficacy (AOR; 0.58 95% CI; 0.40-0.85) and alcohol use (AOR; 0.83 95% CI; 0.58-1.19) were associated with lower odds of consistent condom use. Young people who inconsistently used condoms reiterated that sex is often unplanned and condoms are not always available. The desire for maximum pleasure, partner's objection, trust, and use of hormonal contraceptives were further reasons others inconsistently use condoms. Conclusions Inconsistent condom use remains a challenge among unmarried sexually active young people in South Africa. Education of young people on the need for partner communication about HIV, HIV testing uptake, and condom use should happen more rigorously in school and through the media to improve their consistent use of condoms.

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What Is Psychosis?

The First Episode of Psychosis ◽

10.1093/med-psych/9780190920685.003.0001 ◽

2021 ◽

pp. 3-16

Author(s):

Beth Broussard ◽

Michael T. Compton

Keyword(s):

Mental Illness ◽

Young People ◽

First Episode Psychosis ◽

Initial Evaluation ◽

Treatment Programs ◽

First Episode ◽

Her Family ◽

Episode Psychosis ◽

The Individual ◽

Work Goals

This first chapter explains what psychosis is. Psychosis is a treatable mental illness. For many people with first-episode psychosis, symptoms begin to clear up partially or completely within weeks of starting treatment. Although the symptoms of psychosis may be frightening to the individual and his or her family, there are treatments for these symptoms. First-episode psychosis is the period of time when a person first begins to experience psychosis. It is during this time that young people and their families need detailed information about the initial evaluation and treatment. People who get into treatment earlier often do better. In many places, specialty treatment programs now exist that specifically focus on first-episode psychosis. Those programs often provide treatments designed to help young people get back on track in terms of school and work goals.

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