Study on covert administration of medications practices among persons with severe mental illness: A cross-sectional study

2021 ◽  
pp. 002076402110656
Author(s):  
Prakyath R Hegde ◽  
Guru S Gowda ◽  
Bhavika Vajawat ◽  
Vinay Basavaraju ◽  
Sydney Moirangthem ◽  
...  
Keyword(s):  
Mental Illness ◽  
Family Functioning ◽  
Severe Mental Illness ◽  
Self Care ◽  
Male Gender ◽  
Poor Adherence ◽  
Cross Sectional ◽  
Adherence To Medication ◽  
Medication Delivery ◽  
Delivery Practices

Background: Covert administration of medication (CoAdM) by caregivers to persons with severe mental illness (SMI) is a commonly observed medication delivery practice in India. Aims: This study aims to examine different medication delivery practices adopted by caregivers to provide care to SMI at times of medication refusal. Method: This study was conducted at the outpatient department between April 2019 and November 2019. A semi-structured questionnaire was used to interview the caregivers of persons with SMI to assess medication delivery practices. Results: A total of 300 caregivers were interviewed. CoAdM was practiced in 96 (32.0%) persons with SMI at least once during their lifetime, and other strategies used were pleading ( n = 105, 35.0%), lying ( n = 10, 3.3%), and threatening ( n = 154, 51.4%). Logistic regression showed that male gender (OR 4.75; CI 1.37–16.46), absent insight (OR 10.0; CI 2.01–47.56), and poor adherence to medication (OR 4.75; CI 1.31–16.92) were significantly associated with CoAdM in the last 1 year. Caregivers perceived significant improvement in self-care ( Z = −4.37, p < .01), interpersonal ( Z = −7.61, p < .01), work ( Z = −5.9, p < .01), family functioning ( Z = −7.82, p < .01) difficult behavior ( Z = −8.27, p < .01), and dependency ( Z = −6.34, p < .01) in persons with SMI with use of CoAdM. Conclusions: CoAdM was given to one in three persons with SMI at some point in their lives. Male gender, absent insight and poor adherence were predictive of CoAdM in the last 1 year. Caregiver perceived improvements in self-care, work, interpersonal, family functioning, problem behaviors, and dependency after CoAdM. Policies need to be evolved to serve all stakeholders while keeping these practices in mind.

Social stigma in severe mental illness in Tunisia: Clinical and socio-demographic correlates

2017 ◽  
Vol 41 (S1) ◽  
pp. S577-S577 ◽  
Author(s):  
U. Ouali ◽  
R. Jomli ◽  
R. Nefzi ◽  
H. Ouertani ◽  
F. Nacef
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Cultural Context ◽  
Social Inclusion ◽  
Psychiatric Patients ◽  
Social Stigma ◽  
Cross Sectional Study ◽  
Local Context ◽  
Cross Sectional ◽  
Competing Interest

IntroductionMental patients generally internalize some of the negative conceptions about how most people view them: they might be considered incompetent or untrustworthy or believe that people would not want to hire, or marry someone with mental illness. A lot of research on stigma has been conducted in western countries; however, little is still known on the situation in Arab-Muslim societies.ObjectivesTo evaluate social stigma as viewed by patients suffering from severe mental illness (SMI)MethodsThis is a cross-sectional study on clinically stabilized patients with schizophrenia and Bipolar Disorder (BD) according to DSM IV, who were interviewed in our out-patients clinic with the help of a semi-structured questionnaire, containing 8 opinions on the social inclusion and stigmatization of psychiatric patients, with special reference to the local cultural context (e.g.: “It is better to hide mental illness in order to preserve the reputation of my family”)ResultsWe included 104 patients, 51% with schizophrenia and 49% with BD. Mean age was 38.4 years (18–74 years); 59.6% were males. Overall social stigma scores were high. Social stigma in patients was correlated with gender, age, place of residence and diagnosis. Patients with BD showed significantly less social stigma than patients with schizophrenia.ConclusionOur results show the need for a better understanding of this phenomenon in patients with SMI, but also within Tunisian society, in order to elaborate anti stigma strategies adapted to the local context.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Oral health inequality in people with severe mental illness: a cross-sectional study using National Health and Nutrition Examination Survey 1999-2016

2021 ◽  
Author(s):  
Jing Kang ◽  
Jianhua Wu ◽  
Vishal Aggarwal ◽  
David Shiers ◽  
Tim Doran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Oral Health ◽  
General Population ◽  
Health Outcomes ◽  
Severe Mental Illness ◽  
Tooth Loss ◽  
List Type ◽  
Cross Sectional ◽  
Oral Health Outcomes

AbstractOBJECTIVETo explore whether people with severe mental illness (SMI) experience worse oral health compared to the general population, and the risk factors for poor oral health in people with SMI.METHODThis study used cross-sectional data from the National Health and Nutrition Examination Survey (1999-2016) including on self-rated oral health, ache in mouth, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. The authors used ordinal logistic regression and zero-inflated negative binomial models to explore predictors of oral health outcomes.RESULTS53,348 cases were included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.40, 95% CI: 1.12-1.75). In people with SMI, the risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes.CONCLUSIONSPeople with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Having a healthy lifestyle such as performing regular physical exercise and flossing may lower the risk of poor oral health. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes.Significant outcomes (x3)People with severe mental illness were at 40% higher risk of tooth loss when compared to the general population.Older adults, smokers and people with diabetes were at particularly high risk of poor oral health.Physical exercise and daily use of dental floss were associated with better oral health outcomes.Limitations (x3)The number of cases with data on periodontal disease was limited.The study was cross-sectional so causation could not be inferred.The analysis used prescriptions of antipsychotic and mood stabilising medication as a proxy measure of severe mental illness, as clinical diagnoses were not available in the dataset.Data availability statementThe NHANES 1999-2016 data is available at CDC website: https://www.cdc.gov/nchs/nhanes/index.htm, and is accessible and free to download for everyone.

scholarly journals Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

2020 ◽  
Vol 29 (8) ◽  
pp. 2073-2087 ◽  
Author(s):  
Anne Berghöfer ◽  
Luise Martin ◽  
Sabrina Hense ◽  
Stefan Weinmann ◽  
Stephanie Roll
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Care Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Care Model

scholarly journals Delays to diagnosis among people with severe mental illness in rural Vietnam, a population-based cross-sectional survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Trang Nguyen ◽  
Thach Tran ◽  
Sally Green ◽  
Arthur Hsueh ◽  
Tuan Tran ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Financial Burden ◽  
National Policy ◽  
Mental Health Program ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background People with severe mental illness (SMI) living in low and middle-income countries can experience extended delays to diagnosis, which hinder access to medical treatment. The aims of this study were to describe the interval to diagnosis among these people in rural Vietnam and its associated factors. Methods A population-based cross-sectional study was conducted among people with SMI in two provinces in Vietnam. The delay to diagnosis was defined as the time between the first abnormal behaviour being observed by family members and the formal diagnosis of psychosis. A multilevel linear regression was used to examine the factors associated with the delay to diagnosis. Results Among 404 people with SMI from 370 households, the median delay to diagnosis was 11.5 months (IQR 0–168.0). Overall, 53.7% had a delay to diagnosis of less than one year (95% CI: 48.81–58.54). The financial burden of these people on their families was nearly USD 470/year. After adjusting for other factors at individual and household levels, living in a Northern province; older age, and having psychotic diagnosis before the implementation of the National Community Mental Health program (2003) were associated with a delay of more than twelve months to diagnosis. Conclusions These data indicate that the implementation of a national policy for community-based care has been effective in reducing the delay to diagnosis in rural Vietnam. Therefore, there is a need for strengthening the program and mental health policies, focusing on public communication to improve mental health literacy and reduce stigma against SMI.

“Dangerous relationships”: Family dynamics among members with severe mental illness. about a case

2017 ◽  
Vol 41 (S1) ◽  
pp. S687-S687
Author(s):  
G. Hernande. Santillan ◽  
E. Martin Ballesteros
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Family Of Origin ◽  
Self Care ◽  
Delusional Disorder ◽  
Her Family ◽  
Long Time ◽  
History Of ◽  
Competing Interest ◽  
To Come

A 51-year-old woman from a Mediterranean location with a history of a brother diagnosed with schizophrenia, moved thirty years ago, away from her family of origin, when marrying a man suffering from severe untreated OCD, who in turn, has two brothers, both with OCD, and a nephew with OCD. She says that her husband is very unsociable, spends most of the day at work and comes home at night to clean for a long time until he does not see lint on the floor or a crumb on the table literally. They have a fifteen-year-old son, with needy materials, very attached to the mother and very little to the father. The patient consults, motivated by a former sister-in-law and a friend, because they have noticed deterioration in their self-care and tendency to isolation, which the patient explains because in the last year she has noticed exacerbation of the comments by her neighbours and even unknown people that tell her “look how dirty, your husband has to come after work to clean your house, and makes noise.” The companions are also concerned that the child has had school and social problems and admits hearing the same as his mother. Now, What possible diagnoses do we propose in this patient: Folie a deux, delusional disorder, paraphrenia, other? (Figure 1)Disclosure of interestThe authors have not supplied their declaration of competing interest.

Challenges to employment among latino population with severe mental illness

2016 ◽  
Vol 33 (S1) ◽  
pp. S401-S401
Author(s):  
M. O’Connell ◽  
M. Costa ◽  
A. Gonzalez ◽  
G. Damio ◽  
K. Ruiz ◽  
...  
Keyword(s):  
Mental Illness ◽  
Focus Groups ◽  
Severe Mental Illness ◽  
Supported Employment ◽  
Case Managers ◽  
Latino Population ◽  
Adherence To Medication ◽  
Addiction Services ◽  
English Speaking ◽  
Competing Interest

IntroductionUnemployment is common in persons with severe mental illness (SMI) and more in Latino population. Department of Mental Health and Addiction Services (DMHAS) of Connecticut offers a supported employment (SE) Program to help clients get competitive work in integrated settings with nondisabled workers in the community.ObjectiveCapture perspectives of key informant groups to describe barriers for linking Latinos with SMI to employment and adapt SE Services for subpopulations.MethodFour focus groups were conducted (employment specialists, case managers and peer support counselors/employers/two with clients-one in Spanish and other in English). They were conducted during January-February 2015, 70–90 minutes each one. A question guide was developed for each group. Participants per focus group ranged from 3–10, voluntarily. Two new questionnaires to the baseline pack were developed: challenges to Employment Assessment–provider and client version.ResultsThirty individuals participated. Several barriers to employment were reported. Clients and staff reported criminal record, lack of employment history and lack of motivation. Staff described client hygiene, mental status, physical health, substance abuse and discrimination. Clients, staff and employers reported language barrier for Latinos who don’t speak English. Non-adherence to medication was reported by clients and employers. About Spanish-Speaking Latinos with mental illness, medication, discrimination, previous abuse by employers, inappropriate employment, difficulties of the job interview and computer skills appeared as challenges. English-Speaking Latinos with mental illness identified transport, stability, support, keeping apartment and financial needs.ConclusionsFocus groups can help in knowledge about the diversity of Latino communities to improve SE Services and outcomes for Latinos.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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