Stigma in early detection of psychosis: Subjective experiences of those concerned

2017 ◽  
Vol 41 (S1) ◽  
pp. S387-S387
Author(s):  
M. Uttinger ◽  
C. Rapp ◽  
E. Studerus ◽  
K. Beck ◽  
A. Riecher-Rössler
Keyword(s):  
Early Detection ◽  
Social Withdrawal ◽  
Subjective Experiences ◽  
Scientific Debate ◽  
Increased Risk ◽  
Stereotype Endorsement ◽  
Stigma Resistance ◽  
Stigma Of Mental Illness ◽  
First Results ◽  
Competing Interest

IntroductionDespite the large scientific debate concerning potentially stigmatizing effects of informing an individual about being in an at-risk mental state (ARMS) for psychosis, studies investigating this topic are rare and quantitative assessment of this kind of stigmatization does not exist so far.ObjectivesThis study presents first results regarding potentially helpful or stigmatizing effects of being informed about an ARMS assessed with a newly developed quantitative self-rating (FePsy-Stigma questionnaire).MethodsForty ARMS patients participating in the prospective Basel Early Detection of Psychosis (FePsy) study as well as patients clinically assessed in the early detection service of the Psychiatric Services of Solothurn, completed the FePsy-Stigma questionnaire during their follow-up assessments at least six months after they had been informed about their increased risk of developing psychosis. The questionnaire was constructed based on a previous qualitative study and on adapted versions of formerly used instruments for assessing stigma in mental health (Internalized Stigma of Mental Illness Scale, Personal Beliefs and Experiences Questionnaire).ResultsStigmatization appeared to be low overall except for social withdrawal due to suspected stigma. Stigma resistance, stereotype awareness and expected discrimination scored considerably higher than actually experienced discrimination, alienation and stereotype endorsement.ConclusionsThe results suggest that early detection services help individuals cope with symptoms and build certain resilience toward potential stigmatization, rather than enhancing or causing the latter. In line with previous studies, our results indicate that there is a considerable difference between expected and actually experienced discrimination as well as between stereotype awareness and stereotype endorsement.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clinical Psychopathology of Negative Symptoms: A Phenomenological Perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. S14-S14
Author(s):  
A. Raballo
Keyword(s):  
Negative Symptoms ◽  
Clinical Decision Making ◽  
Personal Autonomy ◽  
Social Withdrawal ◽  
Clinical Decision ◽  
Phenotypic Characterization ◽  
Subjective Experiences ◽  
Substantial Impact ◽  
Phenomenological Perspective ◽  
Competing Interest

Negative symptoms encompass a broad constellation of psycho-behavioral phenomena, including affective flattening, poverty of speech, alogia, avolition, social withdrawal, apathy and anhedonia. These phenomena obviously exert a substantial impact on personal autonomy, quality of life and broad functional outcomes, ultimately being an important challenge for clinical decision-making and therapeutic support. In recent years, the attention to negative symptoms in schizophrenia has revamped, boosting the development of new rating tools as well as a broader conceptualization of derivative constructs (e.g. apathy, amotivation, anhedonia). However, despite its behavioral expressivity, the in-depth phenotypic characterization of negative symptoms remains partly unaddressed. Similarly, their clinical intertwining with other non-productive clinical features (e.g. anomalous subjective experiences, cognitive-perceptual basic symptoms and schizotypal features) is generally overlooked. Therefore, the current presentation specifically offers a stratified overview of the phenomenology of negative symptoms filtered through lens of clinical psychopathology.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals M231. INTERNALIZED STIGMA AS A PREDICTOR OF EMPLOYMENT STATUS IN PATIENTS WITH SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S224-S225
Author(s):  
Min Yi Sum ◽  
Sherry Kit Wa Chan ◽  
Samson Tse ◽  
John R Bola ◽  
Roger Man Kin Ng ◽  
...  
Keyword(s):  
Employment Status ◽  
Social Withdrawal ◽  
Mental Illnesses ◽  
Full Time ◽  
Internalized Stigma ◽  
Multiple Logistic Regression ◽  
Clinical Factors ◽  
Stereotype Endorsement ◽  
Stigma Resistance ◽  
The Unemployed

Abstract Background Employment is an important social determinant of health, especially for individuals with mental illnesses where it was found that gainful employment is crucial for both functional and clinical recovery. However, individuals with mental illnesses face significantly higher levels of unemployment compared to their counterparts without. Within different diagnoses of mental illnesses, it was found that patients with schizophrenia face higher levels of unemployment compared to patients with other diagnoses. Numerous qualitative studies have identified an association between internalized stigma and unemployment in individuals with schizophrenia, however, fewer quantitative studies have examined the specific relationship between the two factors. Therefore, we aim to elucidate the relationship between employment status and internalized stigma, and more specifically, its domains in patients with schizophrenia. Methods One hundred and seventy-nine patients with schizophrenia were included in this study. Illness severity was assessed using the Clinical Global Impression scale, internalized stigma was measured using the Internalized Stigma of Mental Illness scale (ISMI), and demographic information including employment status was collected. For the purpose of analysis, employment status was categorised into two groups, with the employed group consisting of those under full-time and part-time employment, as well as full-time students. While the unemployed group consisted of individuals who were unemployed at the time of assessment. The ISMI assesses five domains of internalized stigma, which are alienation, stereotype endorsement, discrimination experience, social withdrawal and stigma resistance. Multiple logistic regression, controlling for demographic and clinical factors, was conducted to identify the domains of internalized stigma associated with predictors of employment status. Results One hundred and two participants were employed and seventy-seven were unemployed. The employed group was younger, had shorter duration of illness, more years of education and less severe illness level (all p < .001). The unemployed group consisted of more females and divorced individuals (all p < .05). The unemployed group reported significantly higher levels of internalized stigma in the total score, as well as stereotype endorsement, discrimination experience, and social withdrawal domains (all p < .05). Mean total ISMI scores for employed and unemployed groups were 62.15 (SD = 13.69) and 67.52 (SD = 13.94) respectively. Multiple logistic regression analysis, controlling for demographic and clinical factors, found that years of education (OR = 0.835, p < .05), and two domains of the internalised stigma scale, stereotype endorsement (OR = 1.210, p < .05) and stigma resistance (OR = 0.854, p < .05), were associated with employment status. Discussion More years of education and higher level of stigma resistance were found to be associated with being employed, suggesting that stigma resistance along with education may play protective roles in both obtaining and sustaining employment in patients. Higher level of stereotype endorsement was found to be associated with being unemployed, suggesting that patients who agree with the stereotypes about mental illness may face greater difficulties in gaining and sustaining employment. Hence, tailored interventions focused on specific domains of internalized stigma may be crucial components of any services targeted at improvement of occupational functioning in patients with schizophrenia.

Internalized stigma, negative symptoms and global functioning in schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S574-S575
Author(s):  
O.O. Capatina ◽  
I.V. Miclutia
Keyword(s):  
Factor Structure ◽  
Negative Symptoms ◽  
Psychiatric Hospitals ◽  
Sociodemographic Characteristics ◽  
Internalized Stigma ◽  
Global Functioning ◽  
Stigma Resistance ◽  
Stigma Of Mental Illness ◽  
Competing Interest ◽  
The Relationship

IntroductionNegative symptoms (NS) of schizophrenia were usually described as a unitary construct and as a separable domain of pathology; however recent studies suggest, that they encompass 2 separable domains: Diminished Expression (DE) and Avolition-Apathy (AA). Research into the relationship between internalized stigma and NS have yielded mixed results up to present.ObjectiveThe objectives of this study was to assess the factor structure of NS and to examine the relationship between these factors and internalized stigma, global functioning and sociodemographic characteristics.AimsThe broad aim of this study was to gather greater understanding of the relationship between internalized stigma, NS and global functioning.MethodsA sample of 50 consecutive subjects were recruited from outpatient psychiatric hospitals meeting the criteria for schizophrenia according to ICD-10. The patients were evaluated using the Positive and Negative Symptoms Scale (PANSS), Negative Symptoms Assessment-16 items (NSA-16), Global Assessment of Functioning (GAF), Clinical Global Impression-Severity Scale (CGI-s), Internalized Stigma of Mental Illness Scale (ISMI) and were interviewed to assess sociodemographic characteristics.ResultsA two-factor structure for the domain of NS was found: an AA and DE profile group. AA and DE subgroups significantly differed on clinically relevant external validators and greater resistance to stigma is related to both fewer AA and DE symptoms in people with schizophrenia.ConclusionsOur findings suggest that the different subdomains of NS can be identified within the broader diagnosis of schizophrenia and that they should be analyzed as distinct domains and that stigma resistance can be a possible intervention target to ameliorate NS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Muscular strain as risk factor of somatic symptom of mix anxiety and depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S406-S406
Author(s):  
M. Bhadar ◽  
S. Asghar ◽  
Z. Mukhtar
Keyword(s):  
Poor Prognosis ◽  
Somatic Symptom ◽  
Somatic Symptoms ◽  
The Body ◽  
Anxiety And Depression ◽  
Body Parts ◽  
Muscular Tension ◽  
Increased Risk ◽  
Severity Of Depression ◽  
Competing Interest

IntroductionSomatic symptoms in depression are not uncommon. There is increased sicidality, poor prognosis, and increased risk of relapse. Neurological and l muscloskeletal symptoms can be explained on basis of increased muscular tension in the body.MethodsAn internet search was made using key words muscular tension, SSRIs depression, anxiety, somatic symptoms.ResultsNinety-eight percent patients reported at least one of somatic symptoms. Forty-five percent reported six somatic symptom. GIT symptoms in 67% patients. Fatigue in 78% % of patients. Weakness in body parts 45% and headache in 43% to 65%. Chest pain more common in male. Patient over 40 showed pain in limbs or joints. Number of symptoms was directly related to severity of depression.DiscussionIncreased muscular tension is one component of mix anxiety and depression. Main nerves and their branches pass in between muscular bellies. When there is increased muscular tone, it puts extra compression on major nerves and their branches. This will cause dysesthesia in body parts. Stretching of muscles produce pain due to hypoxia. This produces headache, strain neck and backache pain in chest. Fatigue is result of over consumption of energy due to hypertonia. One of their side effect is of SSRIs is muscular hypertonia which will not be very helpful for these symptoms. Drugs like tricyclics, SNRI can have better results when used alone, gabapentine, pregabline tinazidine used as adjunct can alleviate symptoms. Non-pharmacological treatment includes massage, relaxation technique, and warm water therapy.ConclusionSomatic symptoms of mix anxiety and depression should be important consideration in its treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The characteristics of prodromal symptoms in the development of the psychotic disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1423-1423
Author(s):  
J.S. Kostic ◽  
L. Milosavljevic ◽  
M. Stankovic
Keyword(s):  
Early Detection ◽  
Sleep Disorder ◽  
Attention Deficit ◽  
Clinical Picture ◽  
Attention Deficit Disorder ◽  
Psychotic Disorders ◽  
Social Withdrawal ◽  
Therapeutic Interventions ◽  
Prodromal Stage ◽  
Prodromal Symptoms

ObjectivesIn most cases, prodromal changes in behavior, lasting from several days to several years, often precede psychotic disorders and indicate the beginning of psychosis. Prodromal symptoms are nonspecific, making an accurate detection difficult. It is typical that the earlier stadium of the appearance of the disorder, the more insidious the prodromal stage is.MethodRetrospectively, authors analyzed periods of nonspecific symptoms in ten patients, aged 16 to 20 years, who developed a clinical picture of psychosis.ResultsThe most frequent prodromal symptoms in our research were anxiety, irritability and sleep disorder, which were followed by the attention deficit disorder, a sense of confusion and difficulty in dealing with the environment, accompanied by social withdrawal.ConclusionAuthors pay attention to the cognition and early detection of prodromal symptoms, which gives the opportunity for earlier therapeutic interventions in the course of the disorder and the possibility for a better outcome and prognosis of the disorder.

Cardiovascular complications of novel multiple myeloma treatments

ESC CardioMed ◽  
2018 ◽  
pp. 1176-1178
Author(s):  
Daniel J. Lenihan
Keyword(s):  
Heart Failure ◽  
Multiple Myeloma ◽  
Heart Disease ◽  
Early Detection ◽  
Antithrombotic Therapy ◽  
Cardiovascular Events ◽  
Cardiovascular Complications ◽  
Novel Therapies ◽  
Cardiac Events ◽  
Increased Risk

The treatment of multiple myeloma has dramatically changed in the last decade. Novel therapies have had an important impact on the overall outcome for patients but are associated with important cardiovascular events. There is certainly concern about the development of heart failure but also treatment-induced hypertension and a known increased risk of thrombotic events, including ischaemic heart disease. The management of these cardiac events includes prevention, early detection, and optimal treatment with antithrombotic therapy as well as medical therapy for heart failure.

Early detection of cognitive dysfunction in patients with multiple sclerosis: Implications on outcome

2019 ◽  
Vol 21 (2) ◽  
pp. 208-216
Author(s):  
Maged Abdel Naseer ◽  
Shereen Fathi ◽  
Dalia M. Labib ◽  
Dalia H. Khalil ◽  
Alshaimaa M. Aboulfotooh ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Early Detection ◽  
Negative Correlation ◽  
Cognitive Rehabilitation ◽  
Word Association ◽  
Significant Negative Correlation ◽  
Fiber Layer ◽  
Rnfl Thickness ◽  
Increased Risk

AbstractObjective:Cognitive impairment in multiple sclerosis (MS) has a complex relationship with disease progression and neurodegeneration. The aim of this study was to shed light on the importance of early detection of cognitive impairment in MS patients.Methods:The study comprised two groups of definite MS patients, relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), each with 25 patients. Physical disability was assessed using the Expanded Disability Status Scale (EDSS), while the risk of secondary progression was assessed using the Bayesian Risk Estimate for Multiple Sclerosis (BREMS). Cognitive functions were assessed using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and Controlled Oral Word Association Test (COWAT). Assessment of neurodegeneration was done using optical coherence tomography (OCT) via quantification of retinal nerve fiber layer (RNFL).Results:MS patients with higher RNFL thickness demonstrated a larger learning effect size than patients who had lower values in RNFL thickness regardless of MS type. RRMS patients showed significant improvement in delayed recall after giving cues than SPMS. The symbol digit modalities test was the only neuropsychological test that showed a significant negative correlation with EDSS (P = 0.009). There was a statistically significant negative correlation between BREMS scores and performance in all neuropsychological tests.Conclusion:Inclusion of neurocognitive evaluation in the periodic assessment of MS patients is mandatory to detect patients at increased risk of secondary progression. The thickness of RNFL is suggested as a method to estimate the expected benefit of cognitive rehabilitation, regardless of MS type.

scholarly journals Development and first results of a dedicated chronic total occlusion programme

2019 ◽  
Vol 29 (1) ◽  
pp. 14-21 ◽  
Author(s):  
H. W. van der Werf ◽  
P. J. Vlaar ◽  
P. van der Harst ◽  
E. Lipšic
Keyword(s):  
Chronic Total Occlusion ◽  
High Volume ◽  
Coronary Intervention ◽  
Technical Success ◽  
Total Occlusion ◽  
Technical Success Rate ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
First Results ◽  
Hospital Deaths

Abstract Objective To describe the development and first results of a dedicated chronic total occlusion (CTO) programme in a tertiary medical centre. Background Because of the complexity and the increased risk of complications during percutaneous coronary intervention (PCI) for CTO, it is essential that less experienced and evolving CTO centres perform regular quality analyses. Methods We therefore performed analyses to describe the results during the first 3 years of a dedicated CTO programme at a high-volume PCI centre. In addition, we discuss the strategies employed to develop such a programme. Results A total of 179 consecutive patients undergoing 187 CTO procedures were included in the study. The complexity of the CTO lesions increased from a mean J‑CTO (Japanese Multicentre CTO Registry) score of 1.3 in 2015 to 2.1 in 2017. In the majority of cases, the antegrade wire escalation technique was performed. Final technical success rate was 78.5% in 175 patients with a single CTO and 80.2% of all 187 CTO procedures. No peri-procedural or in-hospital deaths occurred. One peri-procedural myocardial infarction occurred. Cardiac tamponade occurred in 2 cases, both managed by pericardiocentesis. No urgent cardiac surgery was necessary. Survival and revascularisation rates at 30 days and 1 year were excellent. Conclusion Following initiation of a dedicated CTO programme, using up-to-date techniques and strategies, procedural and clinical outcome were comparable with current standards in established centres.

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