Which Type Of Management Is Most Suited For Patients With A Diagnosis Of False Self Personality (FSP) Within A Psychodynamically-Oriented Institutional Day Hospital? A Study

IntroductionOur work team have already found that our Institutional Psychiatric Open Light Treatment (IPOLT) model allows the patient affected by severe mental illness (SMI) to more easily express her/his personal coping skills rather than behaving passively thanks to the “real free spaces” separating a structured intervention from another. Our work consisted in evaluating how patients with FSP respond to IPOLT.ObjectivesThis paper describes observations of psychotic patients operating from the position of FSP in order to evaluate how they respond to IPOLT compared with other patients according to three standards (day hospital attendance, psychotic episodes and hospital admissions).AimsIdentify the core factors for management of patients with FSP in the context of IPOLT.MethodsWe isolated a sample including patients affected by severe mental illness (SMI); within this sample, we selected a small group of patients with FSP. During the last three years, we have been evaluating patients with FSP in terms of day hospital attendance, number of psychotic episodes and number of hospital admissions compared with data obtained from other patients with SMI without diagnosis of FSP.ResultsThe two data sets revealed no statistically significant differences in terms of the three standards.ConclusionsOur preliminary study showed a good effect for IPOLT treatment on patients with SMI. We expected that patients affected by SMI with FSP would have a different response to IPOLT, but it was not. We do not know whether such results depend on a too small sample of patients or inappropriate descriptors.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Reducing hospitalisation among people living with severe mental illness

Australian Health Review ◽

10.1071/ah15073 ◽

2016 ◽

Vol 40 (2) ◽

pp. 124 ◽

Cited By ~ 3

Author(s):

Shannon McDermott ◽

Jasmine Bruce ◽

Kristy Muir ◽

Ioana Ramia ◽

Karen R. Fisher ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Severe Mental Illness ◽

Psychiatric Hospital ◽

Hospital Admissions ◽

Small Sample ◽

Supported Housing ◽

Health Records ◽

Individual Level ◽

Over Time

Objective People with severe mental illness have high rates of hospitalisation. The present study examined the role that permanent housing and recovery-oriented support can play in reducing the number and length of psychiatric hospital admissions for people with severe mental illness. Methods The study examined de-identified, individual-level health records of 197 people involved in the New South Wales Mental Health Housing and Accommodation Support Initiative (HASI) to compare changes in hospitalisation over a continuous 4-year period. Results On average, HASI consumers experienced significant reductions in the number of psychiatric hospital admissions and length of stay after entering the HASI program, and these reductions were sustained over the first 2 years in HASI. Male consumers and consumers under 45 years of age experienced the largest reductions in the number and length of hospital admissions. Conclusions The findings of the present study add support to the hypothesis that supported housing and recovery-oriented support can be effective approaches to reducing hospital admissions for people with chronic mental illness, and that these changes can be sustained over time. What is known about this topic? People living with severe mental illness are heavy users of health and hospitalisation services. Research into the effects of partnership programs on preventing unnecessary admissions is limited because of short periods of comparison and small sample sizes. What does this paper add? The present study extends previous research by analysing de-identified individual-level health records over a continuous 4-year period and showing that reductions in hospitalisation among people with severe mental illness can be sustained over time. What are the implications for practitioners? These findings provide further evidence that community-based recovery-oriented supported housing programs can assist consumers to manage their mental health and avoid hospital admissions. Although the provision of recovery-oriented community services requires an investment in community mental health, the reduction in consumers’ use of hospital services makes this investment worthwhile.

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Social stigma in severe mental illness in Tunisia: Clinical and socio-demographic correlates

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.861 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S577-S577 ◽

Cited By ~ 1

Author(s):

U. Ouali ◽

R. Jomli ◽

R. Nefzi ◽

H. Ouertani ◽

F. Nacef

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Cultural Context ◽

Social Inclusion ◽

Psychiatric Patients ◽

Social Stigma ◽

Cross Sectional Study ◽

Local Context ◽

Cross Sectional ◽

Competing Interest

IntroductionMental patients generally internalize some of the negative conceptions about how most people view them: they might be considered incompetent or untrustworthy or believe that people would not want to hire, or marry someone with mental illness. A lot of research on stigma has been conducted in western countries; however, little is still known on the situation in Arab-Muslim societies.ObjectivesTo evaluate social stigma as viewed by patients suffering from severe mental illness (SMI)MethodsThis is a cross-sectional study on clinically stabilized patients with schizophrenia and Bipolar Disorder (BD) according to DSM IV, who were interviewed in our out-patients clinic with the help of a semi-structured questionnaire, containing 8 opinions on the social inclusion and stigmatization of psychiatric patients, with special reference to the local cultural context (e.g.: “It is better to hide mental illness in order to preserve the reputation of my family”)ResultsWe included 104 patients, 51% with schizophrenia and 49% with BD. Mean age was 38.4 years (18–74 years); 59.6% were males. Overall social stigma scores were high. Social stigma in patients was correlated with gender, age, place of residence and diagnosis. Patients with BD showed significantly less social stigma than patients with schizophrenia.ConclusionOur results show the need for a better understanding of this phenomenon in patients with SMI, but also within Tunisian society, in order to elaborate anti stigma strategies adapted to the local context.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Multidisciplinary approach about contraception in a day hospital of mental health

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1678 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s848-s848

Author(s):

C.M. Calahorro ◽

M. Guerrero Jiménez ◽

B.M. Girela Serrano

Keyword(s):

Mental Illness ◽

Reproductive Health ◽

Mental Illnesses ◽

Healthy Population ◽

Day Hospital ◽

Attitudes And Practices ◽

Hospital Patients ◽

Unwanted Pregnancies ◽

Competing Interest ◽

Healthy Sexuality

BackgroundWomen with mental illness are a disadvantaged group both in terms of their gender and because of their mental disorders, and they experience serious problems related to reproductive health.The high rates of unplanned and unwanted pregnancies among women with schizophrenia underscore the importance of understanding their attitudes and practices related to family planning. Different studies reveal that even though many sexually active women with serious mental illnesses do not want to become pregnant, they do not use birth control.ObjectivesRelease last data about contraception methods among patients with severe mental illness after doing a bibliographical review. Also reflect present setup in Motril day hospital women patients and their relationship with sexuality and contraception. At the same time we intend to clarify and unify the proceedings on ethical problems respecting subject's autonomy, beneficence, qualification and minors’ protection.MethodsData were collected through face-to-face interviews and a questionnaire based on the literature and prepared by the researchers which was designed to determine the kinds of reproductive health issues the patients were experiencing.ResultsIt was found that female patients with psychiatric disorders had more negative attributes with regard to contraception approach and sexuality compared with a corresponding healthy population.ConclusionsWe reached an agreement about future contraception approaches in Motril day hospital users as part of the global treatment offered in our section.MotrilHospital gynaecology service has facilitated the proceedings for contraceptive subcutaneous implants insertion in those indicated women.Day hospital patients were instructed individually and through group work about healthy sexuality.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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“Hear me out”: Experiences of mothers suffering from severe mental illness with health care providers – A qualitative perspective

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1835 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s899-s899 ◽

Cited By ~ 1

Author(s):

D. Banerjee ◽

G. Desai ◽

P.S. Chandra

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Illness ◽

Severe Mental Illness ◽

Health Care Providers ◽

Service Providers ◽

Care Providers ◽

Structured Interviews ◽

Seeking Help ◽

Competing Interest

BackgroundContrary to popular myth, majority of mentally ill women are mothers with increasing number of them seeking help. Little is known about their own experiences in this regard and the extent to which their needs are met.ObjectivesTo assess the barriers and facilitators in seeking help from mental health care providers in matters of pregnancy and parenting.MethodsThe study used qualitative design with social constructivist paradigm. A purposive sample of 30 mothers with severe mental illness was obtained. Data was collected through one-to-one in-depth semi-structured interviews. After verbatim transcription, inductive thematic analysis was used to explore transcripts.ResultsMost women considered motherhood “central” to their lives and almost all of them experienced the burden of the “dual role”. Main barriers in seeking help were stigma, treatment side effects, wrong information and time constraints. Whereas self-advocacy, early engagement, education of women and involvement of the family with service providers were the facilitating factors. The prime expectations of the mothers as identified were early and direct communication, patient audience and basic guidance in regards to child health and parenting issues.ConclusionWomen who are mothers and also users of mental health services face special challenges in managing the contradictory aspects of their dual identity. Hearing their voices are essential for service provision and ensuring adequate mental health needs. Early and direct intervention along with understanding and addressing critical areas are necessary for proper care of both the mother and child.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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“Dangerous relationships”: Family dynamics among members with severe mental illness. about a case

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1200 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S687-S687

Author(s):

G. Hernande. Santillan ◽

E. Martin Ballesteros

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Family Of Origin ◽

Self Care ◽

Delusional Disorder ◽

Her Family ◽

Long Time ◽

History Of ◽

Competing Interest ◽

To Come

A 51-year-old woman from a Mediterranean location with a history of a brother diagnosed with schizophrenia, moved thirty years ago, away from her family of origin, when marrying a man suffering from severe untreated OCD, who in turn, has two brothers, both with OCD, and a nephew with OCD. She says that her husband is very unsociable, spends most of the day at work and comes home at night to clean for a long time until he does not see lint on the floor or a crumb on the table literally. They have a fifteen-year-old son, with needy materials, very attached to the mother and very little to the father. The patient consults, motivated by a former sister-in-law and a friend, because they have noticed deterioration in their self-care and tendency to isolation, which the patient explains because in the last year she has noticed exacerbation of the comments by her neighbours and even unknown people that tell her “look how dirty, your husband has to come after work to clean your house, and makes noise.” The companions are also concerned that the child has had school and social problems and admits hearing the same as his mother. Now, What possible diagnoses do we propose in this patient: Folie a deux, delusional disorder, paraphrenia, other? (Figure 1)Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Challenges to employment among latino population with severe mental illness

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1447 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S401-S401

Author(s):

M. O’Connell ◽

M. Costa ◽

A. Gonzalez ◽

G. Damio ◽

K. Ruiz ◽

...

Keyword(s):

Mental Illness ◽

Focus Groups ◽

Severe Mental Illness ◽

Supported Employment ◽

Case Managers ◽

Latino Population ◽

Adherence To Medication ◽

Addiction Services ◽

English Speaking ◽

Competing Interest

IntroductionUnemployment is common in persons with severe mental illness (SMI) and more in Latino population. Department of Mental Health and Addiction Services (DMHAS) of Connecticut offers a supported employment (SE) Program to help clients get competitive work in integrated settings with nondisabled workers in the community.ObjectiveCapture perspectives of key informant groups to describe barriers for linking Latinos with SMI to employment and adapt SE Services for subpopulations.MethodFour focus groups were conducted (employment specialists, case managers and peer support counselors/employers/two with clients-one in Spanish and other in English). They were conducted during January-February 2015, 70–90 minutes each one. A question guide was developed for each group. Participants per focus group ranged from 3–10, voluntarily. Two new questionnaires to the baseline pack were developed: challenges to Employment Assessment–provider and client version.ResultsThirty individuals participated. Several barriers to employment were reported. Clients and staff reported criminal record, lack of employment history and lack of motivation. Staff described client hygiene, mental status, physical health, substance abuse and discrimination. Clients, staff and employers reported language barrier for Latinos who don’t speak English. Non-adherence to medication was reported by clients and employers. About Spanish-Speaking Latinos with mental illness, medication, discrimination, previous abuse by employers, inappropriate employment, difficulties of the job interview and computer skills appeared as challenges. English-Speaking Latinos with mental illness identified transport, stability, support, keeping apartment and financial needs.ConclusionsFocus groups can help in knowledge about the diversity of Latino communities to improve SE Services and outcomes for Latinos.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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A Pharmacologic Option to Reduce Hospital Admissions and Relapses of Patients with Severe Mental Illness

10.26226/morressier.589b235bd462b8028d8918d6 ◽

2017 ◽

Author(s):

Nieves Gomez-Coronado

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Hospital Admissions

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New data of the theory of self-medication

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2402 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S638-S639

Author(s):

I. Prieto Sánchez ◽

M.D.L.C. Ramírez Domínguez ◽

N. Garrido Torres ◽

S. Fernández León ◽

M. Reina Domínguez ◽

...

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Self Medication ◽

Literature Research ◽

Competing Interest ◽

The Relationship

ObjectiveThe theory of self-medication in patients with severe mental illness has been exposed for years but to date has not been confirmed or ruled out. With this study, we intend to show the latest available evidence regarding this context.MethodsAn exhaustive literature research in Medline and the latest forth in APA 2015.ResultsMore and more evidence refute the veracity of this theory deeply rooted among some professionals.ConclusionThere are theoretical alternatives that relate more sustained manner the relationship between consumption and toxic psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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