Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this. Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process. Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences. Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.

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Impact of the COVID-19 pandemic on patients with pre-existing anxiety disorders attending secondary care

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2020.75 ◽

2020 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

R. Plunkett ◽

S. Costello ◽

M. McGovern ◽

C. McDonald ◽

B Hallahan

Keyword(s):

Anxiety Disorder ◽

Anxiety Disorders ◽

Social Impact ◽

International Classification Of Diseases ◽

Anxiety Symptoms ◽

Social Impairment ◽

Structured Interviews ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

The Impact

Objectives To examine the psychological and social impact of the COVID-19 pandemic on patients with established anxiety disorders during a period of stringent mandated social restrictions. Methods Semi-structured interviews were conducted with 30 individuals attending the Galway-Roscommon Mental Health Services with an International Classification of Diseases diagnosis of an anxiety disorder to determine the impact of the COVID-19 restrictions on anxiety and mood symptoms, social and occupational functioning and quality of life. Results Twelve (40.0%) participants described COVID-19 restrictions as having a deleterious impact on their anxiety symptoms. Likert scale measurements noted that the greatest impact of COVID-19 related to social functioning (mean = 4.5, SD = 2.9), with a modest deleterious effect on anxiety symptoms noted (mean = 3.8, SD = 2.9). Clinician rated data noted that 8 (26.7%) participants had disimproved and 14 (46.7%) participants had improved since their previous clinical review, prior to commencement of COVID-19 restrictions. Conditions associated with no ‘trigger’, such as generalised anxiety disorder, demonstrated a non-significant increase in anxiety symptoms compared to conditions with a ‘trigger’, such as obsessive compulsive disorder. Psychiatric or physical comorbidity did not substantially impact on symptomatology secondary to COVID-19 mandated restrictions. Conclusions The psychological and social impact of COVID-19 restrictions on individuals with pre-existing anxiety disorders has been modest with only minimal increases in symptomatology or social impairment noted.

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Reducing the Social Stigma Associated with Obsessive Compulsive Disorder: A Controlled Trial of an Intervention Program in a Turkish Community Sample

Journal of Evidence-Based Psychotherapies ◽

10.24193/jebp.2020.2.14 ◽

2020 ◽

Vol 20 (2) ◽

pp. 101-120

Author(s):

Ayça Aktaç Gürbüz ◽

Orçun YORULMAZ ◽

Gülşah DURNA

Keyword(s):

Obsessive Compulsive Disorder ◽

Intervention Program ◽

Controlled Trial ◽

Community Sample ◽

Case Vignette ◽

Control Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Significant Difference ◽

The Impact

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.

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Pupil with Obsessive-Compulsive Disorder

Lifelong Learning ◽

10.11118/lifele201707027 ◽

2017 ◽

Vol 7 (2) ◽

pp. 7-25

Author(s):

Karolina Diallo

Keyword(s):

Obsessive Compulsive Disorder ◽

School Performance ◽

School Environment ◽

Detrimental Effect ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

The Past ◽

And Performance ◽

The Impact

Pupil with Obsessive-Compulsive Disorder. Over the past twenty years childhood OCD has received more attention than any other anxiety disorder that occurs in the childhood. The increasing interest and research in this area have led to increasing number of diagnoses of OCD in children and adolescents, which affects both specialists and teachers. Depending on the severity of symptoms OCD has a detrimental effect upon child's school performance, which can lead almost to the impossibility to concentrate on school and associated duties. This article is devoted to the obsessive-compulsive disorder and its specifics in children, focusing on the impact of this disorder on behaviour, experience and performance of the child in the school environment. It mentions how important is the role of the teacher in whose class the pupil with this diagnosis is and it points out that it is necessary to increase teachers' competence to identify children with OCD symptoms, to take the disease into the account, to adapt the course of teaching and to introduce such measures that could help children reduce the anxiety and maintain (or increase) the school performance within and in accordance with the school regulations and curriculum.

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Sex Differences in Anxiety Disorders

The Oxford Handbook of Evolutionary Psychology and Behavioral Endocrinology ◽

10.1093/oxfordhb/9780190649739.013.21 ◽

2019 ◽

pp. 404-432

Author(s):

Teresa A. Piggott ◽

Alexandra N. Duran ◽

Isha Jalnapurkar ◽

Tyler Kimm ◽

Stephanie Linscheid ◽

...

Keyword(s):

Sex Differences ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Stress Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Considerable Research ◽

Psychosocial Influences ◽

Psychiatric Conditions ◽

The Impact

Women are more likely than men to meet lifetime criteria for an anxiety disorder. Moreover, anxiety is a risk factor for the development of other psychiatric conditions, including major depression. Numerous studies have identified evidence of sex differences in anxiety disorders, and there is considerable research concerning factors that may contribute to vulnerability for anxiety in females. In addition to psychosocial influences, biological components such as the female reproductive hormone cycle have also been implicated. Although psychotropic medication is more likely to be prescribed to women, there is little controlled data available concerning sex differences in the efficacy and/or tolerability of pharmacotherapy in anxiety disorders. This chapter provides an overview of the impact of gender in the epidemiology, phenomenology, course, and treatment response in generalized anxiety disorder (GAD), social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), panic disorder (PD), and obsessive-compulsive disorder (OCD).

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Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample

Harm Reduction Journal ◽

10.1186/s12954-021-00520-5 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Sinikka L. Kvamme ◽

Michael M. Pedersen ◽

Kristine Rømer Thomsen ◽

Birgitte Thylstrup

Keyword(s):

Side Effects ◽

Drug Use ◽

Prescription Drug ◽

Prescription Drugs ◽

Online Survey ◽

Convenience Sample ◽

Patient Organizations ◽

Public Media ◽

Prescription Drug Use ◽

The Impact

Abstract Background The use of cannabis as medicine (CaM) both prescribed and non-prescribed has increased markedly in the last decade, mirrored in a global shift in cannabis policy towards a more permissive stance. There is some evidence that cannabis functions as a substitute for prescription drugs, particularly opioids; however, more knowledge is needed on the motives of substitution users, their patterns of use, and perceived effects of substitution use. Aims To explore who substitutes prescription drugs with cannabis, the type of prescription drugs substituted and the type of cannabis used, and the impact that substitution with cannabis has on prescription drug use as well as the motives for substitution in terms of experienced effects and side effects. Methods A self-selected convenience sample was recruited through social media, public media, and patient organizations to take part in an anonymous online survey. Inclusion criteria were 18 years or older and use of cannabis (prescribed or non-prescribed) with a medical purpose. Results The final sample included 2.841 respondents of which the majority (91%) used non-prescribed cannabis, and more than half (54.6%) had used CaM with the purpose of replacing a prescribed drug. Compared to non-substitution users, substitution users were more likely to be women and to use CaM in the treatment of chronic pain and other somatic conditions. Pain medication (67.2%), antidepressants (24.5%), and arthritis medication (20.7%) were the most common types of drugs replaced with CaM. Among substitution users, 38.1% reported termination of prescription drug use, and 45.9% a substantial decrease in prescription drug use. The most frequent type of cannabis used as a substitute was CBD-oil (65.2%), followed by ‘hash, pot or skunk’ (36.6%). More than half (65.8%) found CaM much more effective compared to prescription drugs, and 85.5% that the side effects associated with prescription drug use were much worse compared to use of CaM. Conclusion CaM is frequently used as a substitute for prescription drugs, particularly opioids. More research is needed on the long-term consequences of use of CaM, including the impact from low and high THC cannabis products on specific somatic and mental health conditions.

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Relationships among the Degree of Participation in Physical Activity, Self-Concept Clarity, and COVID-19 Stress in Adolescents

Healthcare ◽

10.3390/healthcare9040482 ◽

2021 ◽

Vol 9 (4) ◽

pp. 482

Author(s):

Dae-Jung Lee

Keyword(s):

Physical Activity ◽

High School Students ◽

Local Governments ◽

Online Survey ◽

Self Concept ◽

Obsessive Compulsive ◽

School Students ◽

Compulsive Disorder ◽

Negative Effect ◽

State And Local

The COVID-19 pandemic situation threatens the health of people globally, especially adolescents facing mental problems such as depression, anxiety, and obsessive-compulsive disorder due to constant COVID-19 stress. The present study aimed to provide basic data highlighting the need to alleviate COVID-19 stress among adolescents by promoting physical activity participation and strengthening self-concept clarity (SCC). To examine the relationships among participation in physical activity, SCC, and COVID-19 stress in pandemic-like conditions, the study was conducted on middle and high school students aged 14 to 19 and an online survey was conducted on 1046 Korean adolescents (521 male and 525 female students in the preliminary survey and main survey). Frequency, reliability, confirmatory factor, descriptive, and path analyses were performed using SPSS and AMOS 18.0. Participation in physical activity exerted a positive effect on SCC (p < 0.001) as well as a negative effect on COVID-19 stress (p = 0.031). Our findings also indicated that SCC exerted a negative effect on COVID-19 stress (p < 0.001). Regular participation in physical activity and strong SCC are also fundamental elements for alleviating COVID-19 stress. Given these results, state and local governments and educational institutions should encourage youth to participate in sports by suggesting policies, providing guidelines, and offering education. Such information may allow adolescents to endure and overcome COVID-19 stress during this critical period of life.

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Experiences of Mental Distress during COVID-19: Thematic Analysis of Discussion Forum Posts for Anxiety, Depression, and Obsessive-Compulsive Disorder

Illness Crisis & Loss ◽

10.1177/10541373211023951 ◽

2021 ◽

pp. 105413732110239

Author(s):

G. Brewer ◽

L. Centifanti ◽

J. Castro Caicedo ◽

G. Huxley ◽

C. Peddie ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Mental Distress ◽

Psychological Impact ◽

Discussion Forum ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Care Workers ◽

Positive Experiences ◽

Anxiety Depression ◽

The Impact

The psychological impact of the COVID-19 pandemic on coronavirus patients, health care workers, and the general population is clear. Relatively few studies have, however, considered the impact of the pandemic on those with pre-existing mental health conditions. Therefore, the present study investigates the personal experiences of those with anxiety, depression, and obsessive-compulsive disorder during COVID-19. We conducted a qualitative study utilising Reddit discussion forum posts. We conducted three separate thematic analyses from 130 posts in subreddit forums aimed for people identifying with anxiety, depression, and obsessive-compulsive disorder. We identified a number of similar discussion forum themes (e.g., COVID-19 intensifying symptoms and a lack of social support), as well as themes that were unique to each forum type (e.g., hyperawareness and positive experiences during the pandemic). Findings should guide future practice and the support provided to those living with mental distress.

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Coping Strategies, Anxiety and Depression in OCD and Schizophrenia: Changes during COVID-19

Brain Sciences ◽

10.3390/brainsci11070926 ◽

2021 ◽

Vol 11 (7) ◽

pp. 926

Author(s):

Ángel Rosa-Alcázar ◽

José Luis Parada-Navas ◽

María Dolores García-Hernández ◽

Sergio Martínez-Murillo ◽

Pablo J. Olivares-Olivares ◽

...

Keyword(s):

Coping Strategies ◽

Experiential Avoidance ◽

Online Survey ◽

Anxiety And Depression ◽

Control Group ◽

Healthy Controls ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Survey Results ◽

And Coping

Background: The main aim was to examine changes in coping strategies, anxiety and depression in obsessive–compulsive and schizophrenia patients during COVID-19, in addition to controlling the influence of intolerance to uncertainty and experiential avoidance. Method: The first time, the study comprised (15–30 April 2020) 293 patients, 113 of whom were diagnosed with obsessive–compulsive disorder, 61 with schizophrenia and 119 healthy controls, aged 13–77 years (M = 37.89, SD = 12.65). The second time (15–30 November), the study comprised 195 participants (85 obsessive–compulsive patients, 42 schizophrenic patiens and 77 healthy controls participants). The evaluation was carried out through an online survey. Results: The clinical groups worsened over time in cognitive coping, anxiety and depression, while the control group only worsened in depression. Intergroup differences in anxiety, depression and coping strategies were maintained, highlighting the use of some maladaptive strategies (avoidance, spiritual) in clinical groups. Experiential avoidance and tolerance for uncertainty mainly affected coping. Conclusions: The duration of COVID-19 not only produced changes in anxiety and depression in clinical groups but also in coping strategies to face this pandemic and its consequences.

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How New Technologies Can Improve Prediction, Assessment, and Intervention in Obsessive-Compulsive Disorder (e-OCD): Review

JMIR Mental Health ◽

10.2196/11643 ◽

2019 ◽

Vol 6 (12) ◽

pp. e11643 ◽

Cited By ~ 3

Author(s):

Florian Ferreri ◽

Alexis Bourla ◽

Charles-Siegfried Peretti ◽

Tomoyuki Segawa ◽

Nemat Jaafari ◽

...

Keyword(s):

Machine Learning ◽

Virtual Reality ◽

Obsessive Compulsive Disorder ◽

New Technologies ◽

Assessment Tools ◽

Clinical Practices ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Pubmed Database ◽

The Impact

Background New technologies are set to profoundly change the way we understand and manage psychiatric disorders, including obsessive-compulsive disorder (OCD). Developments in imaging and biomarkers, along with medical informatics, may well allow for better assessments and interventions in the future. Recent advances in the concept of digital phenotype, which involves using computerized measurement tools to capture the characteristics of a given psychiatric disorder, is one paradigmatic example. Objective The impact of new technologies on health professionals’ practice in OCD care remains to be determined. Recent developments could disrupt not just their clinical practices, but also their beliefs, ethics, and representations, even going so far as to question their professional culture. This study aimed to conduct an extensive review of new technologies in OCD. Methods We conducted the review by looking for titles in the PubMed database up to December 2017 that contained the following terms: [Obsessive] AND [Smartphone] OR [phone] OR [Internet] OR [Device] OR [Wearable] OR [Mobile] OR [Machine learning] OR [Artificial] OR [Biofeedback] OR [Neurofeedback] OR [Momentary] OR [Computerized] OR [Heart rate variability] OR [actigraphy] OR [actimetry] OR [digital] OR [virtual reality] OR [Tele] OR [video]. Results We analyzed 364 articles, of which 62 were included. Our review was divided into 3 parts: prediction, assessment (including diagnosis, screening, and monitoring), and intervention. Conclusions The review showed that the place of connected objects, machine learning, and remote monitoring has yet to be defined in OCD. Smartphone assessment apps and the Web Screening Questionnaire demonstrated good sensitivity and adequate specificity for detecting OCD symptoms when compared with a full-length structured clinical interview. The ecological momentary assessment procedure may also represent a worthy addition to the current suite of assessment tools. In the field of intervention, CBT supported by smartphone, internet, or computer may not be more effective than that delivered by a qualified practitioner, but it is easy to use, well accepted by patients, reproducible, and cost-effective. Finally, new technologies are enabling the development of new therapies, including biofeedback and virtual reality, which focus on the learning of coping skills. For them to be used, these tools must be properly explained and tailored to individual physician and patient profiles.

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