scholarly journals T186. IMPACT OF A STRUCTURED VALIDATED FAMILY PSYCHOEDUCATIONAL PROGRAM (PROFAMILLE) ON MENTAL HEALTH CARE OF PEOPLE WITH SCHIZOPHRENIA SPECTRUM DISORDERS: PRELIMINARY RESULTS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S302-S303
Author(s):  
Marie-Cécile Bralet ◽  
Dominique Willard ◽  
Yann Hodé ◽  
Laura Kremers ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Psychosocial Rehabilitation ◽  
Cognitive Remediation ◽  
Rehabilitation Program ◽  
Schizophrenia Spectrum Disorders ◽  
Psychoeducational Program ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Abstract Background Psychoeducational programs for caregivers are essential to support the rehabilitation process and recovery in patients with severe psychiatric disorders. PROFAMILLE is a French psychoeducational program first developed in 1987 in Quebec for caregivers of people suffering from schizophrenia spectrum disorders. Its efficacy has already been proven: increased mental well-being of caregivers, 50 % less hospitalisations and improvement of the rehabilitation process of their ill relatives. Nowadays, this program exists in 6 different countries. While psychosocial rehabilitation programs should be proposed to all patients with schizophrenia spectrum disorders, the access to them seems to be limited. Moreover, the adherence rate to mental health care is low, partially because of lack of motivation and insight. We postulate that proposing a psychoeducational intervention to caregivers with a validated psychoeducational program such as PROFAMILLE, could improve commitment of patients to their mental health care and also to more specific psychosocial rehabilitation interventions (psychoeducation, cognitive remediation, social skills, cognitive behavioural therapy, social and employment supports). This present study aims to analyse the effect of PROFAMILLE program on the quality of mental healthcare given to the ill relatives of participants. Methods We conducted in September 2019 a retrospective observational study in a Cognitive Remediation and Psychosocial Rehabilitation Department, CRISALID (area Hauts de France, France) which proposes PROFAMILLE program since 2010. PROFAMILLE is a groupal intervention program structured in two modules including first 14 sessions then 4 sessions with animators and 4 sessions without animators. There are home exercises between the sessions. All the caregivers are assessed with several socio-demographic, clinical and psychological tools during all the program. We used patient’s on-line medical files and caregivers phone calls to collect following data: first contact with the mental health care department, next contacts with mental health care departments, improvement of the quality of mental health care, participation to a cognitive remediation and psychosocial rehabilitation program. Results 94 caregivers who participated to the whole program were included (PROFAMILLE program between 2012 and 2019). We obtained data about ill relatives of 81 caregivers (86 %). Relatives report the following data: 14 % (11) patients were able to benefit for the first time health mental care after their caregiver followed the program. 57 % (25) of the already followed up patients (44) improved the quality of their health mental care. 44, 5 % (36) of the patients were participated to the integrative cognitive remediation and psychosocial rehabilitation program in CRISALID; 12, 4% (10/36) of the patients entered to this cognitive remediation and psychosocial rehabilitation program after their caregiver followed the PROFAMILLE program. Discussion These first preliminary results are interesting in several aspects of the mental health care, mostly concerning the first access to mental health care and the improvement of its quality, including the participation to cognitive and psychosocial rehabilitation programs. Thus, these results confirm the previous findings regarding PROFAMILLE Program: this program not only benefits directly to the caregivers, but also to their ill relatives by improving the quality and the access to mental health care. These results must be confirmed including more participants and a control group (without PROFAMILLE program). In conclusion, a validated psychoeducational program for caregivers represents an important stake in the rehabilitation process for people suffering from schizophrenia spectrum disorders on their way to recovery; these programs should be systematically implemented in mental health care.

Relationship of Compliance and Re-Hospitalisation of Patients with Schizophrenia Spectrum Disorders, Affective and Neurotic Spectrum Disorders with Patient Satisfaction of Received Care. Summary of the Doctoral Thesis

2021 ◽  
Author(s):  
◽  
Natālija Bērziņa ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Medication Use ◽  
Schizophrenia Spectrum Disorders ◽  
Patients Satisfaction ◽  
Schizophrenia Spectrum ◽  
Satisfaction With Treatment ◽  
Spectrum Disorders ◽  
The Relationship

Objective. Over the last 30 years, the issue of the relationship of satisfaction of patient care to compliance is becoming increasingly acute in the world. Numerous studies around the world have shown that it is the satisfaction of patient with inpatient care that correlates positively with the compliance and disease outcomes in the field of psychiatry, as well as in any medical sector as a whole and is one of the most important elements of treatment. The Action Plan 2013-2020 developed by the Ministry of Health of Latvia, in line with the initiative announced by the WHO in health care, has mentioned that one of the priorities in promoting health is by improving the quality of available health care, especially in the field of mental health care (World Health Organization, 2015), which emphasizes the importance of the doctoral thesis studying patients' satisfaction with treatment in mental health care hospital. The aim of the work was to evaluate the relationship between satisfaction and such factors as compliance indirect measures and re-hospitalisation rates of patients with schizophrenia spectrum disorders, affective and neurotic spectrum disorders. Material and methods. A cross-sectional study was conducted from 1 January 2018 to 1 December 2018 in patients with mental disorders who have been hospitalised in acute or subacute hospital units. The study tool was an adapted two-language questionnaire for self-assessment of patients' satisfaction of treatment. A total number of 1335 respondents have been analysed in the doctoral thesis work. The respondent rate was 62% (n=823). In statistical data processing, there the following methods were used: descriptive statistics for the respondents and non-respondents' groups, t-test or Welch test for comparing continuous variables, Chi-square test for comparing two categorical variables, linear regression for the relationship between socio-demographic factors with compliance undirect measures and Spearman correlation coefficient for the relationship between different indicators in diagnostic groups, satisfaction in questionnaire scales and surrogate ratios of compliance. Results. Respondents were elderly patients (p<0,001), women, with higher or secondary education (p<0,001), more often unemployed, with a status of disabled or retired (p<0.001), with relationship experience (p<0,001), more frequent with schizophrenia and affective spectrum disorders (p<0.001) with somatic co-diagnosis (p<0.001) and previous experience in mental health care (p<0.001). When compiling results for higher or lower satisfaction with treatment, older patients (p<0.001), women (p=0.003) with higher, secondary, and professional education (p=0.001), employees, patients with a disability or pensioner status (p<0,001), with relationship history (married, divorced, widowed) (p<0,001), patients with affective spectrum disorders and organic mental disorders (p<0,001), patients with somatic side diagnosis (p-0,010) were more satisfied in PIPEQ-OS questionnaire. Patients who scored treatment higher were more likely to take the medicine after discharge from inpatient (p<0.001). Age positively correlated with satisfaction in the interaction with patient (B 0.08, p=0.001) and in the structure and facility scale (B 0.10, p<0.001), lower education was positively correlated with satisfaction in the interaction with patient scale (B 0.569, p=0.003), the unemployed status negatively correlated with satisfaction in the outcomes scale (B -0.191, p=0.009). PIPEQ-OS questionnaire all three scales were identified for poor correlation of satisfaction with the number of subsequent outpatient visits in patients with affective spectrum disorders. In patients with affective spectrum disorders and schizophrenia spectrum disorders, a positive correlation was observed between satisfaction with interaction scale (rs 0.207, p=0.010; rs 0.151, p=0.000 as appropriate) and structure and facilities scale (rs 0.236, p=0.000; rs 0.184, p=0.001 as appropriate) and frequency of medication use. It was established that 3 questionnaire scales (interaction scale (rs -0.074, p=0.034), structure and facilities scale (rs -0.081, p=0.021) and outcome scale (rs -0.102, p=0.004) negatively correlated with the subsequent frequency of outpatient visits. A positive correlation was established for all questionnaire scales (interactions (rs 0.174, p<0.001), structure (rs 0.086, p<0.001) and outcomes (rs 0.073, p=0.039)) and further medication use. Conclusions. In the research work, we identified factors related to patients' satisfaction with treatment as well as we detected patients' satisfaction correlation with further outpatients visits and medication use. Higher satisfaction was detected among older age patients, women, those with professional and middle education, working, disabled or retired, patients with relationship history. The lowest score had questions about family involvement, possibilities to influence the treatment and provided information. Lowest satisfaction was among schizophrenia and neurotic and stress-related disorders. Higher satisfaction correlated with medication use. PIPEQ-OS can be used in inpatient mental health care to measure patients’ satisfaction with received care. Our findings could be used for improvements in the treatment process in inpatient care facilities and promoting personal to engage more in the care of patients. Our results could help to improve compliance in patients with different diagnoses and influence the treatment outcomes and patients' adjustment to their disorder.

Pathways to Inpatient Mental Health Care Among People With Schizophrenia Spectrum Disorders in South Africa

2010 ◽  
Vol 61 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Crick Lund ◽  
Piet Oosthuizen ◽  
Alan J. Flisher ◽  
Robin Emsley ◽  
Dan J. Stein ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Health Care ◽  
Mental Health Care ◽  
Schizophrenia Spectrum Disorders ◽  
Inpatient Mental Health ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Building A Psychosocial Rehabilitation Unit: The Experience of Centro Hospitalar Entre Douro e Vouga

2017 ◽  
Vol 41 (S1) ◽  
pp. s791-s791
Author(s):  
V. Pais ◽  
O. Pinto ◽  
J. Figueiredo ◽  
E. Larez ◽  
F. Lopes ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Psychotic Disorders ◽  
Medication Management ◽  
Psychosocial Rehabilitation ◽  
Psychometric Evaluation ◽  
Skills Training ◽  
Community Based ◽  
Rehabilitation Unit

IntroductionIn Portugal, the National Mental Health Plan sought to reform the mental health care system, decentralizing mental health care by promoting community based services. Guidelines point to treatment of Psychotic Disorders with collaborative, person directed and individualized approaches.ObjectiveThe authors propose to describe the development of a new psychosocial rehabilitation unit in a recently created psychiatric department.MethodsThe CHEDV's psychiatry department (2009) serves a population of around 340,000. The Psychosocial Rehabilitation Unit (2015) aims to ensure a multidisciplinary and integrated response to users with major psychiatric disorders. The Psychosocial Rehabilitation Unit structures 4 axes of response: detection and initial approach of the disease, intervention in crisis, psychosocial rehabilitation and management of difficult patients.ResultsCHEDV's psychosocial rehabilitation unit is responsible for the care of about 25 patients daily. Treatment activities range from specialized consultations, home visits, medication management and crisis telephone to social skills training, psycho-education, neurocognitive rehabilitation, occupational workshops and social intervention/orientation. The unit bases its work on constant communication within the team but also with all other carers of the patient (in or out of hospital).ConclusionsBringing to the population a set of previously unavailable responses is the most blatant success of this unit that is helping people getting a better and closer care. To improve our work we aim at integrating the quantitative and qualitative psychometric evaluation of the patients. The lack of resources, necessity of further training, insufficient funding, and low political priority remain as the main barriers to community based mental health care.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals A Short Course Computer-Based Cognitive Remediation in Patients With Schizophrenia Spectrum Disorders: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Azadeh Sedighnia ◽  
◽  
Samira Hatami ◽  
Mirsepassi Zahra ◽  
Mehdi Tehranidoost ◽  
...  
Keyword(s):  
Executive Function ◽  
Cognitive Performance ◽  
Cognitive Remediation ◽  
Schizophrenia Spectrum Disorders ◽  
Cohen’S D ◽  
Schizophrenia Spectrum ◽  
Short Course ◽  
Computer Based ◽  
Spectrum Disorders ◽  
Cohen's D

Introduction: Cognitive remediation is used to improve cognitive functioning in patients with schizophrenia. Most of the previous studies had incorporated a long duration of a rehabilitation program. This study aims to evaluate the effect of a short course and easy to implement computer-based cognitive remediation on the cognitive performance in patients with schizophrenia spectrum disorders using a randomized controlled trial design. Method: Sixty-two patients with schizophrenia spectrum disorders were enrolled in Roozbeh Hospital (Tehran, Iran) and were randomized to either receive a cognitive remediation program added to the standard pharmacological treatment (n=31) or the standard treatment alone (n=31). The remediation consisted of ten sessions of the cognitive training provided 2-3 times a week by applying the Cogpack software. The cognitive performance was assessed in attention, memory and executive function before and after the interventions by using the respective tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Results: This study did not demonstrate any significant improvement in attention and executive function in the experimental vs control group. Nonetheless, we observed modest improvements in some aspects of visual memory (first trial memory score, F=9.152, P< 0.001, Cohen’s d=0.40; Mean errors to success, F= 6.991, P= 0.011, Cohen’s d=0.14; stages completed on first trial, F= 7.155, P= 0. 010, Cohen’s d=0.71; Total errors, F= 5.730, P= 0.020, Cohen’s d=0.53). Conclusion: We observed only modest improvements in the patients' cognitive functioning after a short-course of cognitive remediation. The short duration of the training and lack of a comprehensive rehabilitation plan may explain the findings.

Violent offending in schizophrenia spectrum disorders preceding and following diagnosis

2018 ◽  
Vol 52 (8) ◽  
pp. 782-792 ◽  
Author(s):  
Henning Hachtel ◽  
Cieran Harries ◽  
Stefan Luebbers ◽  
James RP Ogloff
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Substance Use ◽  
Schizophrenia Spectrum Disorders ◽  
Violent Offending ◽  
Schizophrenia Spectrum ◽  
History Of ◽  
Spectrum Disorders ◽  
Violent Victimisation ◽  
Violent Offences

Objective: People affected by schizophrenia spectrum disorders are at a higher risk of offending violently. This study aims to investigate risk factors in relation to the peri-diagnostic period and possible predictors of post-diagnostic violence of people diagnosed for the first time in the public mental health system. Methods: The study compared various risk factors for post-diagnostic violence in patients ( n = 1453) diagnosed with a schizophrenia spectrum disorder. Patients were grouped according to the occurrence of peri-diagnostic violence. Of the 246 violent offenders, 164 committed their first offence pre-diagnosis. Mental health and criminological variables were evaluated across the lifespan (median age at end of follow-up = 34.22 years, range = 17.02–55.80 years). Results: Gender, employment, non-violent offending, family incidents, violent and non-violent victimisation, substance use, personality disorder, number of in-patient admissions and history of non-compliance differed significantly across violent and non-violent subgroups (all p ⩽ 0.01 and at least small effect size). More frequent and longer inpatient admissions were found in the violent subgroups (all p ⩽ 0.01). For the whole sample, sex, number of violent offences, non-violent offences, violent victimisation, substance use and number of inpatient admissions predicted post-diagnostic violence (χ2 (6) = 188.13, p < 0.001). Among patients with a history of pre-diagnostic violence, a history of non-violent offending in the 18-month period pre-diagnosis was the strongest predictor of future violence (odds ratio = 3.08, 95% confidence interval [1.32, 7.21]). Conclusion: At triage, violence risk assessment should consider the presence of antisocial behaviour and violent victimisation, substance use, male gender and frequency of inpatient admissions. Common treatment targets for the prevention of post-diagnostic violence include criminality and victimisation. Treatment of positive symptoms should be of greater emphasis for individuals without a history of pre-diagnostic violence.

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