scholarly journals Metabolic phenotyping reveals a potential link between elevated faecal amino acids, diet and symptom severity in individuals with severe mental illness

Author(s):  
Jack Jansma ◽  
Rogier van Essen ◽  
Bartholomeus C.M. Haarman ◽  
Anastasia Chrysovalantou Chatziioannou ◽  
Jenny Borkent ◽  
...  

The brain-gut axis is increasingly recognized as an important contributing factor in the onset and progression of severe mental illnesses such as schizophrenia spectrum disorders and bipolar disorder. This study investigates associations between levels of faecal metabolites identified using 1H-NMR, clinical parameters, and dietary components of forty-two individuals diagnosed in a transdiagnostic approach to have severe mental illness. Faecal levels of the amino acids; alanine, leucine, and valine showed a significant positive correlation with psychiatric symptom severity as well as with dairy intake. Overall, this study proposes a diet-induced link between the brain-gut axis and the severity of psychiatric symptoms, which could be valuable in the design of novel dietary or therapeutic interventions to improve psychiatric symptoms.

2018 ◽  
Author(s):  
Armando Rotondi ◽  
Jonathan Grady ◽  
Barbara H. Hanusa ◽  
Michael R. Spring ◽  
Kaleab Z. Abebe ◽  
...  

BACKGROUND E-health applications are an avenue to improve service responsiveness, convenience, and appeal, and tailor treatments to improve relevance, engagement, and use. It is critical to user engagement that the designs of e-health applications are intuitive to navigate. Limited research exists on designs that work for those with a severe mental illness, many of whom infrequently seek treatment, and tend to discontinuation medications and psychosocial treatments. OBJECTIVE The purpose of this study was to evaluate the influence of 12 design elements (e.g., website depth, reading level, use of navigational lists) on the usability of e-health application websites for those with, and without, mental health disorders (including severe mental illness). METHODS A 212-4 fractional factorial experimental design was used to specify the designs of 256 e-health websites, which systematically varied the 12 design elements. The final destination contents of all websites were identical, only the navigational pages varied. Three subgroups of participants comprising 226 individuals, were used to test these websites (those with schizophrenia-spectrum disorders, other mental illnesses, and no mental illness). Unique to this study was that the 12 design elements were manipulated systematically to allow assessment of combinations of design elements rather than only one element at a time. RESULTS The best and worst designs were identified for each of the three subgroups, and the sample overall. The depth of a website’s navigation, that is, the number of screens/pages users needed to navigate to find desired content, had the strongest influence on usability (ability to find information). The worst performing design for those with schizophrenia-spectrum disorders had an 8.6% success rate (ability to find information), the best had a 53.2% success rate. The navigational design made a 45% difference in usability. For the subgroup with other mental illnesses the design made a 52% difference, and for those with no mental illness a 50% difference in success rate. The websites with the highest usability all had several key similarities, as did the websites with the poorest usability. A unique finding is that the influences on usability of some design elements are variable. For these design elements, whether they had a positive or negative effect, and the size of its effect, could be influenced by the rest of the design environment, that is, the other elements in the design. This was not the case for navigational depth, a shallower hierarchy is better than a deeper hierarchy. CONCLUSIONS It is possible to identify evidence-based strategies for designing e-health applications that result in a high level of usability. Even for those with schizophrenia, or other severe mental illnesses, there are designs that are highly effective. The best designs have key similarities, but can also vary in some respects. Key words: schizophrenia, severe mental illness, e-health, design, website, usability, website design, website usability, fractional factorial design.


2005 ◽  
Vol 27 (4) ◽  
pp. 309-314 ◽  
Author(s):  
André Gulinelli ◽  
Lilian R C Ratto ◽  
Paulo Rossi Menezes

OBJECTIVE: To investigate the social adjustment of individuals with severe mental illness living in the community in a large urban center of a developing country, and the characteristics associated with poor social functioning. METHOD: A cross-sectional study was performed in the city of Sao Paulo. Eligible subjects were residents of a defined geographic area, aged between 18 and 65, with a diagnosis of functional psychosis who had had contact with any public psychiatric service during a defined period. Structured assessments were used to obtain information on social-demographic characteristics, diagnosis (ICD-10), psychiatric symptoms (PANSS), and social adjustment (DAS). RESULTS: One hundred and eighty-eight subjects were included, of whom, 120 (63.8%) had some degree of impairment in social functioning. The most frequently affected areas of social functioning were work performance and sexual role. Twenty-four patients (12.8%) showed poor or very poor social adjustment in the month prior to the interview. Negative symptoms, number of previous admissions and general symptoms showed statistically significant associations with global social adjustment scores. CONCLUSIONS: The proportion of patients showing any degree of impairment in social adjustment was as high as in more developed societies. In order to successfully implement the new mental health policy in Brazil, better provision of community-based mental health services for those with severe mental illnesses is needed.


2020 ◽  
Vol 42 (5) ◽  
pp. 435-444
Author(s):  
Reema Samuel ◽  
Abirame S. ◽  
K. S. Jacob

Background: Severe mental illnesses lead to deterioration in the life skills of the patient, resulting in socio-occupational dysfunction and low rates of employment. The purpose of this study was to explore attitudes, knowledge, and barriers to employment as experienced by patients and their caregivers in India. Method: Patients with schizophrenia or bipolar affective disorder, aged between 18 and 60 and undergoing inpatient treatment and their caregivers, were approached for written informed consent and recruited for focus group discussions. A total of eight focus groups were conducted until saturation of themes was seen to have been achieved. The data were transcribed, coded, synthesized, and organized into major findings and implications for practice. Results: Role expectations based on gender were seen to influence the decision to work. The possible recurrence of illness due to excess stress and unsupportive working environments was cited as the most common problem that could arise related to employment. Stigma and faulty attributions related to the illness were the most cited barriers to employment. Most participants felt that psychosocial rehabilitation and family and community support were essential for facilitating work. Most participants did not consider mental illness as a disability and were unaware of government schemes for the mentally ill. Conclusion: Considering gender-based role expectations, avenues for self/family employment and improving the awareness of benefits for mental illness both among consumers and health care professionals are essential to enhance economic productivity in people with severe mental illness.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Cherrie Galletly ◽  
Ashlee Rigby

Cognitive remediation refers to nonpharmacological methods of improving cognitive function in people with severe mental disorders. Cognitive remediation therapy (CRT) can be delivered via computerised programs, of varying length and complexity, or can be undertaken one-on-one by a trained clinician. There has been a considerable interest in cognitive remediation, driven by recognition that cognitive deficits are a major determinant of outcome in people with severe, chronic mental illnesses. CRT has been shown to be effective, especially if combined with vocational rehabilitation.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1983-1983
Author(s):  
M. Ferrara ◽  
G. Solignani ◽  
S. Ferrari ◽  
M. Rigatelli ◽  
G. Guaraldi

IntroductionHIV testing is not yet a routine procedure in most mental health settings although adults with severe mental illness (SMI) are disproportionately affected by HIV/AIDS.ObjectivesWe focused our attention to explore if the appropriate care of patients with SMI may include a routine HIV testing offering and thus contribute to diagnose HIV-infected persons earlier in the course of their infection.MethodsWe present three case histories related to primary HIV diagnosis in patients presenting with different psychiatric disorders, admitted to Modena teaching Hospital in the passed two years.ResultsPsychiatric symptoms delayed HIV diagnosis in all of the three reported cases.ConclusionsThe case histories here presented suggest that HIV testing is appropriate in the care of people with SMI, avoiding delay in HIV diagnosis with an obvious clinical benefit for the patient. Further studies are needed to assess the prevalence of HIV in those patients. These will be able to validate psychiatric diseases within a specific HIV indicator diseases list and help identifying a segment of the population in which HIV test must be routinely offered as a public health strategy, to face the burden of undiagnosed HIV infection.


2018 ◽  
Vol 25 (2) ◽  
pp. 122-133 ◽  
Author(s):  
Choochart Wong-Anuchit ◽  
Chutima Chantamit-o-pas ◽  
Joanne Kraenzle Schneider ◽  
Andrew C. Mills

BACKGROUND: Nonadherence is the leading cause of relapse in mental illness. No quantitative synthesis of multiple studies has been conducted to determine the effect of motivational interviewing (MI)–based compliance/adherence therapy (CAT) interventions on people with severe mental illness. OBJECTIVE: To synthesize the studies that examined the effectiveness of MI-based CAT interventions to improve psychiatric symptoms. DESIGN: Quantitative meta-analysis. RESULTS: Sixteen primary studies were retrieved ( N =1267 participants). MI-based CAT interventions significantly improved psychiatric symptoms with a moderate effect size (ES) of .45. Longer sessions and higher intervention doses showed significantly greater ESs than shorter sessions and lower doses. ESs were significantly lower when participants were older and when there was a longer period between the intervention and outcome measurement. CONCLUSIONS: These findings support the effectiveness of MI-based CAT interventions. Session length and dose effect should be considered when tailoring MI to clients.


2020 ◽  
Author(s):  
Tesfalem Amare ◽  
Natnael Seifu ◽  
Mirkat Shewangzaw

Abstract Background According to the World Health Organization (WHO), functional disability associated with severe mental illnesses was pervasive, affecting everyday life, and has a significant contribution to the global functional disability. The severe mental illnesses (schizophrenia, major depressive disorder, and bipolar disorder) were among the top ten leading causes of functional disability as indicated by years lived with a functional disability. These illnesses hurt the academic, occupational, social and family functioning of the patients. Despite this fact, functional disabilities and its contributing factors among severe mental illness were not clear. Therefore this study will assess the prevalence and associated factors of functional disabilities among patients with severe mental illnesses. Methods Institutional based cross-sectional study was conducted from Feb 03 to March 10, 2020, with a total of 423 participants in Mekelle, Ethiopia. A stratified random sampling method was included in the study. Functional disabilities were measured by WHO functional disability assessment schedule version two (WHODAS 2.0). Bivariate and multiple logistic regression analyses were performed to determine the association between independent and dependent variables. Results The prevalence of functional disability among severe mental ill patients was 88.1% (51.3% mild, 27.5% moderate & 9.3% sever functional disabilities). This study revealed that, being jobless [AOR=4.01, 95% CI (1.77, 12.35)], duration of illness ≥11 years [AOR=2.99, 95% CI(1.17,7.64)], those who had poor treatment adherence [AOR= 2.79, 95% CI (1.06, 7.35)], drug adverse effects [AOR= 4.61, 95% CI (1.79, 11.84)], poor social supports [AOR=6.58, 95% CI (2.01, 21.56)], and moderate social supports [AOR=4.16, 95% CI (1.88,9.20)] were significantly associated with functional disabilities. Conclusion The prevalence of functional disability was found to be high. Being jobless, duration of illness ≥11 years, medication non-adherent, having drug side effects and having poor or moderate social support were significantly associated with functional disabilities. Therefore, when treating patients with severe mental illness giving especial attention the bio-psycho-social aspect of treatment is essential.


Author(s):  
Christina Gallinat ◽  
Markus Moessner ◽  
Sandra Apondo ◽  
Philipp A. Thomann ◽  
Sabine C. Herpertz ◽  
...  

Schizophrenia is a severe mental illness associated with a heavy symptom burden and high relapse rates. Digital interventions are increasingly suggested as means to facilitate continuity of care, relapse prevention, and long-term disease management for schizophrenia spectrum disorders. In order to investigate the feasibility of a mobile and internet-based aftercare program, a 2-arm randomized controlled pilot study was conducted. The program could be used by patients for six months after inpatient treatment and included psychoeducation, an individual crisis plan, optional counseling via internet chat or phone and a supportive monitoring module. Due to the slow pace of enrollment, recruitment was stopped before the planned sample size was achieved. Reasons for the high exclusion rate during recruitment were analyzed as well as attitudes, satisfaction, and utilization of the program by study participants. The data of 25 randomized patients suggest overall positive attitudes towards the program, high user satisfaction and good adherence to the monitoring module. Overall, the results indicate that the digital program might be suitable to provide support following discharge from intensive care. In addition, the study provides insights into specific barriers to recruitment which may inform future research in the field of digital interventions for severe mental illness.


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