scholarly journals Sudden Complex Hallucinations in a 14-Year-Old Girl: Schizophrenia Spectrum Disorders Versus Dissociative Disorders-The Influence of Early Life Experiences on Future Mental Health: Retraction: Erratum

2020 ◽  
Vol 41 (9) ◽  
pp. 697-697
2018 ◽  
Vol 52 (8) ◽  
pp. 782-792 ◽  
Author(s):  
Henning Hachtel ◽  
Cieran Harries ◽  
Stefan Luebbers ◽  
James RP Ogloff

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.


2021 ◽  
Vol 9 (11) ◽  
pp. 775-780
Author(s):  
Nana Zavradashvili MD ◽  
◽  
Otar Toidze MD , PhD ◽  

Study of the relationship between mental disorder and violent behavior is critical both from a public health perspective and for the proper planning and development of mental health services.However, the complex contribution of clinical, historical and environmental risk factors for violence in persons with schizophrenia remains unclear. The aim of the study was to identify clinical and social risk factors for violence in patients with schizophrenia and schizophrenia spectrum disorders (SSD) using a case-control design. Cases were defined as patients with SSD who had committed at least one act of offence in the past (94 patients wereenrolled from forensic psychiatricward). Controls were genderand age matched patients with SSD who had never committed violent acts (106 patients from general psychiatric services).A standard set of instruments was used to assess patients exposure to a variety of risk factors. Data were collected through patient interviews and medical records.Study results showed, that increased risk of violence was associated with severity of positive psychotic symptoms, diagnosis of delusional disorder, irregular or no contacts with mental health services. Significant risk factors for serious violent acts were associated with comorbid alcohol misuse, impulsivity,persecutory delusions,decreased emotional responseand unsatisfactory living environment. Study confirmed that the interaction of social andclinicalfactorswith treatment related factors played an important role as determinants of violence. These factors should be the focus of treatment and management of patients with SSD to prevent violent behavior.


2019 ◽  
Vol 9 (2) ◽  
pp. 37-42 ◽  
Author(s):  
L. V. Romasenko ◽  
V. V. Vandysh-Bubko ◽  
S. S. Nikitin

Introduction. Particular problems in diagnosing hysteria are determined by its inordinate changeability, which explains the traditional ambiguity of ideas concerning its essence and the specific diagnostic problems. As we know, a significant number of patients with conversion and dissociative disorders present at neurological clinics, thus constituting the distinct cohort of “difficult patients”.Study aim. Identifying the current clinical-dynamic regular patterns of hysterical disorders (taking into account the temporal pathological morphosis) for purposes of providing substantiation for their psychopathological essence and the optimal therapeutic-diagnostic tactics in respect of the pertinent cohort of patients.Materials and methods. Between 2016 and 2018 at the “Practical Neurology” Medical Center we have examined 80 patients (71 women and 9 men) aged between 17 and 72. The criteria for inclusion into this group were the presence of hysterical symptoms as the main disorder in the clinical picture, and meeting the criteria for being the so-called «difficult patient», which are well-known in clinical practice. After having excluded the presence of organic neurological pathology, and taking into account the specifics of their current complaints (which correspond to conversion and somatoform disorders), the patients have been seen by a psychiatrist on condition of having obtained their informed consent. The examination was carried out by means of collecting anamnestic data from patients and people closely involved with them. Disorders were diagnosed in accordance with the ICD-10 criteria and with the use of the brief scale for assessing the mental status of MMSE (Mini-mental State Examination). Statistical processing of obtained data has been carried out with the use of Statistica 10. rus software. Comparative study of frequencies has been carried out with the F-test – φ* criterion; differences with р <0.05 were seen as reliable.Results. Hysterical disorders in the examined patients have been differentiated within four clusters: 1) motor disorder (n = 24 (30 %)); 2) sensory disorders (n = 29 (36.2 %)); 3) somatoform disorders (n =5 (6.3 %)); and 4) dissociative disorders (n = 22 (27.5 %)). Comorbid mental disorders in the examinees were represented by: 1) affective disorders F30–39 (n = 42 (52.5 %)); 2) schizophrenia  spectrum disorders F20–29 (n = 20 (25 %)); 3) personality disorders F60–69 (n = 14 (17.5 %)); 4) organic mental disorders F00–09 (n = 3 (3.75 %)); 5) posttraumatic stress disorder F43 (n = 1 (1.3 %)). Hysterical disorders manifest high comorbidity with other mental disorders, above all, – the affective ones, schizophrenia spectrum disorders, and the pathology of personality. The nature of comorbid pathology determines the clinical-dynamic regular patterns of hysterical syndromes, the diagnostic problems of prime concern, and the tactics of therapy. Conclusion. Interdisciplinary approach contributes to improving the effectiveness of therapeutic-diagnostic assistance provided to patients with hysterical and comorbid mental disorders.


2021 ◽  
Author(s):  
◽  
Natālija Bērziņa ◽  

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.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S302-S303
Author(s):  
Marie-Cécile Bralet ◽  
Dominique Willard ◽  
Yann Hodé ◽  
Laura Kremers ◽  

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.


2020 ◽  
Vol 66 (7) ◽  
pp. 693-699
Author(s):  
Vaios Peritogiannis ◽  
Panagiota Gioti ◽  
Afroditi Gogou ◽  
Maria Samakouri

Background: The treatment of severe and chronic mental disorders, such as schizophrenia and related syndromes, is largely based on community mental health services. Aims: The objective of the present study was to assess hospital admissions and length of hospital stay in patients with schizophrenia and related disorders, who are engaged to treatment with a Mobile Mental Health Unit (MMHU I-T) in a defined rural catchment area in Greece. Method: Data were retrieved retrospectively for 76 patients with schizophrenia and related disorders. For each patient, comparison was made for the same interval prior and after engagement to treatment with the MMHU I-T. Results: The average age of patients was 56 years and the mean illness duration was 28 years. The mean follow-up duration was 5.3 years. There was a statistically significant decrease in the annual average of the number of voluntary and involuntary hospitalizations and on days of hospital stay after treatment engagement with the MMHU I-T. Conclusions: Treatment of schizophrenia spectrum disorders in rural residents by the MMHUs may contribute to the reduction of patients’ admissions and length of hospital stay. Future research should address the cost-effectiveness of such interventions.


Author(s):  
Josef Parnas ◽  
Mads Gram Henriksen

This article explores some of the major views of selfhood in modern philosophical and psychopathological literature, including the distinction between minimal-experiential and narrative-personal self, and it presents a simplified classification of how different levels of selfhood can be disturbed in different mental disorders. It proposes that schizophrenia spectrum disorders primarily involve a trait-like disturbance of the minimal-experiential self, which also may affect the coherence and stability of the narrative-personal self. Melancholia may involve some state-like disturbances of the minimal-experiential self, but with largely intact ipseity, and these disturbances appear here to be secondary to disorders of mood, temporality, and embodiment. Personality disorders outside the schizophrenia spectrum involve disturbances of the personal-narrative self and here the minimal-experiential self is never at stake. Finally, it offers some critical reflections on the epidemic-like rise of diagnoses such as dissociative disorders and depersonalization.


Sign in / Sign up

Export Citation Format

Share Document