The effect of rehabilitation combined with cognitive remediation on functioning in persons with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 49 (09) ◽  
pp. 1414-1425 ◽  
Author(s):  
Daniëlle van Duin ◽  
Lars de Winter ◽  
Matthijs Oud ◽  
Hans Kroon ◽  
Wim Veling ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Psychiatric Rehabilitation ◽  
Real Life ◽  
Cognitive Remediation ◽  
Beneficial Effects ◽  
Moderator Effects ◽  
Vocational Outcomes ◽  
Meta Regression Analysis

AbstractBackgroundPsychiatric rehabilitation (PR) can improve functioning in people with severe mental illness (SMI), but outcomes are still suboptimal. Cognitive impairments have severe implications for functioning and might reduce the effects of PR. It has been demonstrated that performance in cognitive tests can be improved by cognitive remediation (CR). However, there is no consistent evidence that CR as a stand-alone intervention leads to improvements in real-life functioning. The present study investigated whether a combination of PR and CR enhances the effect of a stand-alone PR or CR intervention on separate domains of functioning.MethodA meta-analysis of randomized controlled trials of PR combined with CR in people with SMI was conducted, reporting on functioning outcomes. A multivariate meta-regression analysis was carried out to evaluate moderator effects.ResultsThe meta-analysis included 23 studies with 1819 patients. Enhancing PR with CR had significant beneficial effects on vocational outcomes (e.g. employment rate: SMD = 0.41), and social skills (SMD = 0.24). No significant effects were found on relationships and outcomes of community functioning. Effects on vocational outcomes were moderated by years of education, intensity of the intervention, type of CR approach and integration of treatment goals for PR and CR. Type of PR was no significant moderator.ConclusionsAugmenting PR by adding cognitive training can improve vocational and social functioning in patients with SMI more than a stand-alone PR intervention. First indications exist that a synergetic mechanism also works the other way around, with beneficial effects of the combined intervention compared with a stand-alone CR intervention.

Cognitive remediation to improve the vocational outcomes of people with severe mental illness

2019 ◽  
pp. 1-23 ◽  
Author(s):  
Francisco Rodríguez Pulido ◽  
Nayra Caballero Estebaranz ◽  
Enrique González Dávila ◽  
Maria Jesús Melián Cartaya
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Cognitive Remediation ◽  
Vocational Outcomes

How Effective is Cognitive Remediation in Enhancing Vocational Outcomes for Job Seekers with Severe Mental Illness in Australia?

2016 ◽  
Vol 53 (2) ◽  
pp. 144-150 ◽  
Author(s):  
Natalia A. Contreras ◽  
David J. Castle ◽  
Caroline Crosse ◽  
Dea Morgain ◽  
Ellie Fossey ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Cognitive Remediation ◽  
Job Seekers ◽  
Vocational Outcomes

Nutrition interventions in people with severe mental illness: Novel strategies for addressing physical health co-morbidity in a high-risk population

2016 ◽  
Vol 33 (S1) ◽  
pp. S620-S620 ◽  
Author(s):  
S. Teasdale ◽  
P. Ward ◽  
K. Samaras ◽  
S. Rosenbaum ◽  
J. Curtis ◽  
...  
Keyword(s):  
Mental Illness ◽  
Weight Gain ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Nutrition Intervention ◽  
High Risk Population ◽  
List Type ◽  
Nutrition Interventions ◽  
Glucose Levels ◽  
Co Morbidity

IntroductionNutrition interventions are critical for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). As mental health teams evolve to incorporate nutrition interventions, evidence needs to guide clinical practice.AimsA systematic review and meta-analysis was performed to assess whether nutrition interventions improve:– anthropometric and biochemical measures,– nutritional intake of people experiencing SMI.To evaluate the effectiveness of a dietician-led nutrition intervention, as part of a broader lifestyle intervention, in the early stages of antipsychotic prescription.MethodAn electronic database search was conducted to identify all trials with nutritional components. Included trials were pooled for meta-analysis. Meta-regression analyses were run on potential anthropometric moderators. Weekly individualised dietetic consultations plus group cooking classes were then offered to clients attending a Community Early Psychosis Programme, who had recently commenced antipsychotics for a 12-week period.ResultsFrom pooled trials, nutrition interventions resulted in significant weight loss (19 studies, g = –0.39, P < 0.001), reduced BMI (17 studies, g = –0.40, P < 0.001), decreased waist circumference (10 studies, g = –0.27, P < 0.001) and lower blood glucose levels (5 studies, g = –0.37, P = 0.02). Dietician-led interventions (g = –0.90) and trials focussing on preventing weight gain (g = –0.61) were the most effective. The 12-week nutrition intervention resulted in a 47% reduction in discretionary (junk) food intake (P < 0.001) and reductions in daily energy (–24%, P < 0.001) and sodium intakes (–26%, P < 0.001), while improving diet quality (P < 0.05).ConclusionEvidence supports the inclusion of nutrition interventions as part of standard care for preventing weight gain and metabolic deterioration among people with SMI.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Predictors of employment for people with severe mental illness: results of an international six-centre randomised controlled trial

2008 ◽  
Vol 192 (3) ◽  
pp. 224-231 ◽  
Author(s):  
Jocelyn Catty ◽  
Pascale Lissouba ◽  
Sarah White ◽  
Thomas Becker ◽  
Robert E. Drake ◽  
...  
Keyword(s):  
Mental Illness ◽  
Randomised Controlled Trial ◽  
Severe Mental Illness ◽  
Controlled Trial ◽  
Patient Characteristics ◽  
Employment Outcomes ◽  
Social Needs ◽  
Vocational Outcomes ◽  
Randomised Controlled ◽  
Ips Model

BackgroundAn international six-centre randomised controlled trial comparing individual placement and support (IPS) with usual vocational rehabilitation for people with serious mental illness found IPS to be more effective for all vocational outcomes.AimsTo determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes.MethodPatient characteristics and early process variables were tested as predictors of employment outcomes. Service characteristics were explored as predictors of the effectiveness of IPS.ResultsPatients with previous work history, fewer met social needs and better relationships with their vocational workers were more likely to obtain employment and work for longer. Remission and swifter service uptake were associated with working more. Having an IPS service closer to the original IPS model was the only service characteristic associated with greater effectiveness.ConclusionsThe IPS service was found to be more effective for all vocational outcomes. In addition, maintaining high IPS fidelity and targeting relational skills would be a valuable focus for all vocational interventions, leading to improved employment outcomes. Motivation to find work may be decreased by satisfaction with current life circumstances.

Comorbidity of Physical Disorders Among Patients With Severe Mental Illness With and Without Substance Use Disorders: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 15 (3) ◽  
pp. 192-206 ◽  
Author(s):  
Ifeoma N. Onyeka ◽  
Margrethe Collier Høegh ◽  
Eldbjørg Marie Nåheim Eien ◽  
Bright I. Nwaru ◽  
Ingrid Melle
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Substance Use ◽  
Severe Mental Illness ◽  
Substance Use Disorders ◽  
Meta Analysis ◽  
Physical Disorders

scholarly journals Self-management interventions for people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Melanie Lean ◽  
Miriam Fornells-Ambrojo ◽  
Alyssa Milton ◽  
Brynmor Lloyd-Evans ◽  
Bronwyn Harrison-Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Health Problems ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

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