Association between suicide attempts and insight among patients with bipolar disorders

IntroductionInsight is an important factor associated with non-compliance and poor outcome. Poor level of insight has been described as a characteristic in patients with acute bipolar disorder with more unawareness in social consequences. In contrast, awareness of having a mental disorder, of its symptoms, of its consequences, and/or of the need for treatment is associated with a number of positive prognostic indicators. Insight is also linked, however, to depression and suicidal ideation in bipolar disorder.Objectives(1) Assess the illness perception. (2) Assess the impact of insight in suicidal tendencies.AimsContribute to development measures to improve the insight in bipolar disorders.MethodsIn this cross sectional study we use a convenience sample of patients with bipolar disorder attending in the mental health departments of three general hospitals in Lisbon great area. We have applied clinical and socio-demographic questionnaire and additional measures to assess symptom severity, treatment adherence and illness perception.ResultsA samples was composed by 64 patients with bipolar disorder (mean age = 38.7; SD ± 10.1). A total of 48.4% patients (n = 31) had made a suicide attempted and 23.4% (n = 15) of this patient done 5 or more attempted suicide. We found a significant correlation with symptoms and insight (rs = 0.56; P < 0.01).ConclusionMental health professionals often utilize insight as an indicator of prognosis, because of its association with treatment adherence. The findings of the current study suggest that having intact or good insight may be an indicator for suicidal ideation among patients with bipolar disorders. A brief psychoeducational approach could potentially be effective. We recommend a combined approach to Improve clinical insight in bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Working alliance and its relationship with treatment outcome

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.739 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s277-s277

Author(s):

A. Cardoso ◽

P. Aguiar ◽

M. Byrne ◽

M. Xavier

Keyword(s):

Mental Health ◽

Treatment Outcome ◽

Therapeutic Alliance ◽

Treatment Adherence ◽

Mental Health Professionals ◽

Clinical Skills ◽

Skills Training ◽

Future Research ◽

Convenience Sample ◽

The Impact

IntroductionThe therapeutic alliance might be the most important part of beginning clinical relationship and may have an important impact in treatment adherence. In fact, many studies indicate that the therapeutic alliance is the best predictor of treatment outcome.ObjectivesTo assess clinical skills and attitudes in mental health professionals(MHP).AimsThis study explore the impact of clinical skills and socio-demographic factors related MHP may have on treatment adherence of patients with mental health disorders (MHD).MethodsIn this cross sectional study, we use a convenience sample of MHP working in the mental health departments of three general hospitals in Lisbon great area. Data is being collected through individual interviews. We used a optimism scale (ETOS), Medication Alliance Beliefs Questionnaire (MABQ), and socio-demographic and clinical questionnaire.ResultsA convenience sample composed of sixty-five mental health clinician working in a variety of settings is being collected. We don’t found statistically significant differences between the therapeutic optimism and the socio-demographic and clinical characteristics of MHP. The average values of optimism found in MHP with additional training in skills training it was higher (t test = 1,64). The results demonstrate that the most of clinicians (n = 42; agree 64,6%; strongly agree, n = 19; 29,2%) believe that have the capacity to positively influence outcomes for people with mental disorders.ConclusionThis topic, along with a detailed examination of the relationship between therapeutic alliance and treatment adherence, will be the subject of future research projects.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The Impacts of Working with People Experiencing Suicidal Ideation: Mental Health Nurses Describe Their Experience

10.26686/wgtn.16959181 ◽

2021 ◽

Author(s):

◽

Lynley Murtagh

Keyword(s):

Mental Health ◽

Suicidal Ideation ◽

Mental Health Professionals ◽

Qualitative Description ◽

Work Place ◽

National Guidelines ◽

Graduate Studies ◽

Mental Health Nurses ◽

Suicidal Crisis ◽

The Impact

<p>New Zealand has one of the highest suicide rates in the world and mental health nurses are the most likely professionals to assess a person presenting with suicidal ideation. Managing a suicidal crisis is acknowledged as being one of the most difficult and frightening challenges facing mental health professionals. This research aimed to have mental health nurses who work in acute mental health settings describe the impact that working with people experiencing suicidal ideation has on their personal and professional lives. This study followed the tenets of fundamental qualitative description as presented by Sandelowski (2000). Five mental health nurses participated in individual semi structured interviews. The data collected under-went systematic thematic analysis and the extracted findings were presented as a straight description. The findings from this study revealed that personal philosophies of care, the work place culture, organisational and professional expectations and their personal concepts about suicide all influenced the experiences of these participants. Mental exhaustion, tension and feelings of isolation and alienation from family and society were universal experiences. Two recommendations have been made based on the insights gained from this research. These are; tertiary institutions should offer post graduate studies on the subject of suicide as it relates to mental health nursing and national guidelines for the provision of supervision to mental health nurses need to be developed.</p>

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The Impacts of Working with People Experiencing Suicidal Ideation: Mental Health Nurses Describe Their Experience

10.26686/wgtn.16959181.v1 ◽

2021 ◽

Author(s):

◽

Lynley Murtagh

Keyword(s):

Mental Health ◽

Suicidal Ideation ◽

Mental Health Professionals ◽

Qualitative Description ◽

Work Place ◽

National Guidelines ◽

Graduate Studies ◽

Mental Health Nurses ◽

Suicidal Crisis ◽

The Impact

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The Impact of Bipolar Disorder on Couple Functioning: Implications for Care and Treatment. A Systematic Review

Medicina ◽

10.3390/medicina57080771 ◽

2021 ◽

Vol 57 (8) ◽

pp. 771

Author(s):

Jean-Michel Azorin ◽

Antoine Lefrere ◽

Raoul Belzeaux

Keyword(s):

Mental Health ◽

Bipolar Disorder ◽

Mental Health Professionals ◽

Health Professionals ◽

Negative Impact ◽

Bipolar Illness ◽

Couple Functioning ◽

Negative Impacts ◽

The Impact ◽

The Relationship

If there is an abundant literature on the impact of bipolar illness on the family and/or caregivers of patients, few studies have addressed its impact on marital relationship and couple functioning. Uncovering information relating specifically to this topic may be particularly relevant due to the unusually high divorce rate among individuals with bipolar disorder. We therefore conducted a systematic literature search to evaluate the existing data on bipolar disorder and marital issues, with a special focus on the help and support that can be provided by mental health professionals in this regard. We identified quantitative studies with pre-defined outcomes as well as qualitative investigations trying to understand the experiences of partners. A total of 27 articles were included in the review. The literature was found to capture the impact of bipolar disorder on partners as well as on the marital relationship itself or the children. Bipolar illness has a negative impact on the lives of partners including self-sacrifice, caregiver burden, emotional impact, and health problems. This negative impact can be aggravated by a lack of care and a lack of information from health personnel. The negative impact on the relationship includes volatility in the relationship, stigmatization, dissatisfaction with sexual life, and lower rates of childbearing. Negative impacts are likely to favor disease relapses for the patient. Children may also be negatively impacted. However, the illness may sometimes have positive impacts such as personal evolution, strengthening relationship, or new hope and perspectives. Based on these findings, the interventions of mental health professionals should be aimed at minimizing the negative impacts while favoring the positive ones.

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Managing Bipolar Disorder in Time of COVID-19 Pandemic

Medical and Clinical Research: Open Access ◽

10.52106/2766-3213.1006 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Rabie KARROURI ◽

Zakaria HAMMANI ◽

Yassine OTHEMAN

Keyword(s):

Mental Health ◽

Bipolar Disorder ◽

Mental Health Professionals ◽

Health Professionals ◽

Clinical Characteristics ◽

Health Condition ◽

Daily Schedule ◽

Bipolar Patients ◽

Problematic Situations ◽

The Impact

People with bipolar disorder are at high risk of serious complications during the COVID-19 pandemic. Limited access to care, lifestyle, health condition and other clinical characteristics increase the risk of contracting the new coronavirus disease, with more risk of developing severe forms, as well as that of bipolar relapse. Here, we will describe some problematic situations that may be encountered by bipolar patients during this pandemic period, and the measures that can be taken to reduce the impact of such problems on bipolar disorder course. Maintaining a daily schedule with relaxing and pleasing activities, getting enough sleep, keeping contact with mental health professionals and continuing prescribed medication, are important measures to prevent relapse. Family and friends, have also a key role in accompanying and supporting patients in these crisis time.

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How we can enhance treatment adherence? Perspective of patients and clinicians

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.587 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s234-s235

Author(s):

A. Cardoso ◽

P. Aguiar ◽

M. Byrne ◽

M. Xavier

Keyword(s):

Mental Health ◽

Treatment Adherence ◽

Mental Health Professionals ◽

Cross Sectional Study ◽

Cross Sectional ◽

Convenience Sample ◽

Individual Interviews ◽

Effective Strategies ◽

Demographic Questionnaire ◽

Competing Interest

IntroductionNon-adherence to antipsychotic medication is commonly found in mental health disorders (MHD), thus forming a major obstacle to long-term maintenance treatment and contributing to high relapse rates and also can influence the attitudes and beliefs of mental health professionals (MHP).Objectives–assess the beliefs of MHP;–assess perception of illness in patients with MHD.AimsContribute to treatment adherence of patients with MHD, through developing adequate strategies to their needs.MethodsIn this cross-sectional study, we use a convenience sample of patients with MHD attending in the mental health departments of three general hospitals in Lisbon great area. Data is being collected through individual interviews. We have applied clinical and socio-demographic questionnaire and additional measures to assess symptom severity, treatment adherence and attitudes towards medication. For MHP, we used a optimism scale (ETOS), Difficulty Implementing Adherence Strategies (DIAS); Medication Alliance Beliefs Questionnaire (MABQ).ResultsTwo convenience samples were composed by 150 patients with MHD (mean age: 39.7; SD ± 9.8) and 65 MHP (mean age: 37.0; sd 8.3) working in a variety of settings is being collected. From the perspective of patients, the most important reason for adherence is to accept the illness (54,7%, n = 82). 50.8% (n = 33) of MHP believes that if patients are unmotivated for treatment, adherence strategies are unlikely to be effective. 43.1 (n = 28) of MHP agrees that if patients do not accept their illness, any adherence strategies that result.ConclusionWith this study, we expect to gain further knowledge on the factors related patients and MHP that might influence compliance and, therefore, contribute to the development of effective strategies to promote treatment adherence in MHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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What Gives a Diagnostic Label Value? Common Use Over Informativeness

10.31234/osf.io/er6ku ◽

2019 ◽

Author(s):

Babak Hemmatian ◽

Sze Yu Yu Chan ◽

Steven A. Sloman

Keyword(s):

Mental Health ◽

Mental Health Professionals ◽

Health Professionals ◽

Causal Relation ◽

Causal Beliefs ◽

Diagnostic Categories ◽

Diagnostic Labels ◽

Diagnostic Label ◽

The Impact ◽

Practical Implications

A label’s entrenchment, its degree of use by members of a community, affects its perceived explanatory value even if the label provides no substantive information (Hemmatian & Sloman, 2018). In three experiments, we show that laypersons and mental health professionals see entrenched psychiatric and non-psychiatric diagnostic labels as better explanations than non-entrenched labels even if they are circular. Using scenarios involving experts who discuss unfamiliar diagnostic categories, we show that this preference is not due to violations of conversational norms, lack of reflectiveness or attentiveness, and the characters’ familiarity or unfamiliarity with the label. In Experiment 1, whether a label provided novel symptom information or not had no impact on lay responses, while its entrenchment enhanced ratings of explanation quality. The effect persisted in Experiment 2 for causally incoherent categories and regardless of direct provision of mechanistic information. The effect of entrenchment was partly related to induced causal beliefs about the category, even when participants were informed there is no causal relation. Most participants in both experiments did not report any effect of entrenchment and the effect was present for those who did not. In Experiment 3, mental health professionals showed the effect using diagnoses that were mere shorthands for symptoms, despite a tendency to rate all explanations as unsatisfactory. The data suggest that bringing experts’ attention to the manipulation eliminates the effect. We discuss practical implications for mental health disciplines and potential ways to mitigate the impact of entrenchment.

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Assessment of Psychopathology in Adolescents with Insulin-Dependent Diabetes (IDD) and the Impact on Treatment Management

Children ◽

10.3390/children8050414 ◽

2021 ◽

Vol 8 (5) ◽

pp. 414

Author(s):

Maria Melania Lica ◽

Annamaria Papai ◽

Andreea Salcudean ◽

Maria Crainic ◽

Cristina Georgeta Covaciu ◽

...

Keyword(s):

Mental Health ◽

Treatment Adherence ◽

Diabetes Management ◽

Short Form ◽

Insulin Dependent Diabetes ◽

Control Group ◽

Treatment Management ◽

Insulin Dependent ◽

Impact On Treatment ◽

The Impact

Assessing mental health in children and adolescents with insulin-dependent diabetes (IDD) is an issue that is underperformed in clinical practice and outpatient clinics. The evaluation of their thoughts, emotions and behaviors has an important role in understanding the interaction between the individual and the disease, the factors that can influence this interaction, as well as the effective methods of intervention. The aim of this study is to identify psychopathology in adolescents with diabetes and the impact on treatment management. A total of 54 adolescents with IDD and 52 adolescents without diabetes, aged 12–18 years, completed APS–SF (Adolescent Psychopathology Scale–Short Form) for the evaluation of psychopathology and adjustment problems. There were no significant differences between adolescents with diabetes and control group regarding psychopathology. Between adolescents with good treatment adherence (HbA1c < 7.6) and those with low treatment adherence (HbA1c > 7.6), significant differences were found. In addition, results showed higher scores in girls compared with boys with IDD with regard to anxiety (GAD), Major Depression (DEP), Post-Traumatic Stress Disorder (PTSD), Eating Disturbance (EAT), Suicide (SUI) and Interpersonal Problems (IPP). No significant differences were found regarding the duration of the disease. Strategies such as maladaptive coping, passivity, distorted conception of the self and the surrounding world and using the negative problem-solving strategies of non-involvement and abandonment had positive correlation with poor glycemic control (bad management of the disease). The study highlighted the importance of promoting mental health in insulin-dependent diabetes management.

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Pre-Existing Inequality: The Impact of COVID-19 on Medicare Home Health Beneficiaries

Home Health Care Management & Practice ◽

10.1177/1084822321992380 ◽

2021 ◽

Vol 33 (2) ◽

pp. 130-136

Author(s):

William Cabin

Keyword(s):

Mental Health ◽

New York ◽

Home Care ◽

Population Based ◽

Home Health ◽

Physical And Mental Health ◽

Convenience Sample ◽

Medicare Population ◽

Home Health Agencies ◽

The Impact

There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the overall Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable than the overall Medicare population based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicates there is only 1 study on the impact of COVID-19 in Medicare home health on home care workers and none on the impact on home health beneficiaries. The current study is a qualitative study based on interviews of a convenience sample of 48 home care nurses from 9 different home health agencies in New York City between April 1 and August 31, 2020. Six major themes emerged: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; and there was a limited amount of staff and equipment to care for patients.

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Implementation of smoke-free policies in mental health in-patient settings in England

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.051052 ◽

2009 ◽

Vol 194 (6) ◽

pp. 547-551 ◽

Cited By ~ 26

Author(s):

Elena Ratschen ◽

John Britton ◽

Ann McNeill

Keyword(s):

Mental Health ◽

Policy Enforcement ◽

Convenience Sample ◽

Telephone Interviews ◽

Smoke Free Policy ◽

Safety Risks ◽

Mental Health Settings ◽

High Smoking Prevalence ◽

Systematic Sample ◽

The Impact

BackgroundMental health units in England had to become smoke-free by law from July 2008. Concerns regarding the implementation and enforcement of smoke-free policies in these settings have been raised.AimsTo study difficulties and challenges associated with smoke-free policy implementation in English National Health Service (NHS) mental health settings.MethodQuestionnaire survey of all 72 English NHS trusts providing mental health in-patient services and facilities, supplemented by semi-structured telephone interviews at a systematic sample of 7 trusts and site visits at a convenience sample of 5 trusts.ResultsQuestionnaires were returned by 79% of the trusts, all of whom had implemented smoke-free policies. Most respondents (91%) believed that mental health settings faced particular challenges, arising from the high smoking prevalence among patients (81%), related safety risks (70%), adverse effects on the clinician–patient relationship (36%), and potential interactions with antipsychotic medication (34%). Interviews indicated that sustained policy enforcement was perceived as difficult, but that despite challenges and concerns, the impact of the policy was regarded as beneficial, with some evidence of positive behavioural changes occurring in people.ConclusionsMany mental health trusts across England have implemented comprehensive smoke-free policies but the majority state that they are facing specific difficulties. Challenges and concerns need to be explored in depth and addressed to ensure that smoke-free policies implemented under the terms of the Health Act in July 2008 are not undermined.

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