The effects of intensive home treatment on self-efficacy in patients recovering from a psychiatric crisis

Abstract Background This study evaluated whether providing intensive home treatment (IHT) to patients experiencing a psychiatric crisis has more effect on self-efficacy when compared to care as usual (CAU). Self-efficacy is a psychological concept closely related to one of the aims of IHT. Additionally, differential effects on self-efficacy among patients with different mental disorders and associations between self-efficacy and symptomatic recovery or quality of life were examined. Methods Data stem from a Zelen double consent randomised controlled trial (RCT), which assesses the effects of IHT compared to CAU on patients who experienced a psychiatric crisis. Data were collected at baseline, 6 and 26 weeks follow-up. Self-efficacy was measured using the Mental Health Confidence Scale. The 5-dimensional EuroQol instrument and the Brief Psychiatric Rating Scale (BPRS) were used to measure quality of life and symptomatic recovery, respectively. We used linear mixed modelling to estimate the associations with self-efficacy. Results Data of 142 participants were used. Overall, no difference between IHT and CAU was found with respect to self-efficacy (B = − 0.08, SE = 0.15, p = 0.57), and self-efficacy did not change over the period of 26 weeks (B = − 0.01, SE = 0.12, t (103.95) = − 0.06, p = 0.95). However, differential effects on self-efficacy over time were found for patients with different mental disorders (F(8, 219.33) = 3.75, p < 0.001). Additionally, self-efficacy was strongly associated with symptomatic recovery (total BPRS B = − 0.10, SE = 0.02, p < 0.00) and quality of life (B = 0.14, SE = 0.01, p < 0.001). Conclusions Although self-efficacy was associated with symptomatic recovery and quality of life, IHT does not have a supplementary effect on self-efficacy when compared to CAU. This result raises the question whether, and how, crisis care could be adapted to enhance self-efficacy, keeping in mind the development of self-efficacy in depressive, bipolar, personality, and schizophrenia spectrum and other psychotic disorders. The findings should be considered with some caution. This study lacked sufficient power to test small changes in self-efficacy and some mental disorders had a small sample size. Trial registration This trial is registered at Trialregister.nl, number NL6020.

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MENTAL DISORDERS AND QUALITY OF LIFE IN PATIENTS AWAITING LIVER TRANSPLANTATION

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201900000-63 ◽

2019 ◽

Vol 56 (4) ◽

pp. 339-343

Author(s):

Lívia N F GUERREIRO-COSTA ◽

José Edson O ARAÚJO-FILHO ◽

Roberta Ferrari MARBACK ◽

Ana Paula JESUS-NUNES ◽

Mychelle MORAIS-DE-JESUS ◽

...

Keyword(s):

Quality Of Life ◽

Liver Transplantation ◽

Liver Disease ◽

Mental Disorders ◽

Liver Transplant ◽

Psychiatric Disorders ◽

Psychotic Disorders ◽

Psychiatric Comorbidities ◽

High Prevalence

ABSTRACT BACKGROUND: Liver transplantation is the main therapeutic alternative for patients with advanced liver disease. These patients have high prevalence of psychiatric comorbidities that may negatively interfere in clinical outcomes and quality of life. It is not clear in the literature whether the different etiologies of hepatic disease have the same prevalence of psychiatric disorders. OBJECTIVE: The aim of this study was to investigate whether patients in the liver transplant list showed differences in psychiatric characteristics, medical variables and quality of life among different etiological groups. METHODS: This is a cross-sectional study that evaluates quality of life, psychiatric and clinical comorbidities through the application of validated questionnaires and instruments in 248 patients who were on transplant waiting list from 2010 to 2014, assisted in a University Hospital and in a Private Hospital in Salvador/Bahia, Brazil. The patients were evaluated through the Mini International Neuropsychiatric Interview (M.I.N.I. PLUS 5.0) and Medical Outcomes Short-Form Health Survey (SF-36). RESULTS: The etiology of the most prevalent liver disease was hepatitis C virus. A prevalence of 50.8% of at least one mental disorder was identified. When alcohol abuse/dependence was excluded, the prevalence was 25.8%. Mental health did not show a statistically significant difference in the diverse etiological groups, but a higher prevalence of psychiatric comorbidities was detected among women and younger than 40 years. No cases of psychotic disorders were detected, possibly by exclusion prior to listing. There was no difference in the quality of life domains in the different liver etiological groups. CONCLUSION: A high-prevalence of psychiatric disorders was found among all clinical conditions most associated with indication for liver transplantation. Attention is drawn to the absence of patients with psychotic disorders, which suggests that transplantation may not have been indicated for this group of patients. For these reasons, professionals caring for liver transplant candidates should be highly vigilant for the presence of mental disorders, regardless of the etiology of liver disease. Specialized care is recommended to minimize the early exclusion of patients with no other therapeutic possibilities, as well as care of all people with mental disorders.

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Determinants of self-efficacy in patients with Parkinson’s disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x-anp-2020-0185 ◽

2021 ◽

Vol 79 (8) ◽

pp. 686-691

Author(s):

Ingrid Estrada-Bellmann ◽

Jesús Daniel Meléndez-Flores ◽

Carlos Rodrigo Cámara-Lemarroy ◽

Sergio Andrés Castillo-Torres

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Self Efficacy ◽

Rating Scale ◽

Motor Symptom ◽

Life Questionnaire ◽

Symptom Scale ◽

Cross Sectional

ABSTRACT Background: Self-efficacy is the individual’s assessment of his or hers ability to complete a specific task successfully and has been closely related to self-management and quality of life in several diseases. Objective: To investigate self-efficacy in a population of Parkinson’s disease (PD) patients in Mexico and study the factors that are associated with this measure. Methods: We carried out a cross-sectional observational study involving patients with PD in an outpatient neurology clinic in Mexico, using the following instruments: Spanish version of the Chronic Disease Self-Efficacy Scale (CDSES), Quality of Life Questionnaire PDQ-8, Movement Disorders Society-Unified Parkinson's disease Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment (MoCA), and Non-Motor Symptom Scale (NMSS). Clinical and demographic variables were also recorded. Results: We included 73 patients with a mean age of 65 years and most patients were male. Patients with lower CDSES scores (<7.75) had worse scores in MDS-UPDRS, NMSS, and PDQ-8 scales. CDSES scores were significantly correlated with MDS-UPDRS Part I (r=-0.497, p=<0.001), Part II (r= -0.271, p=0.020), Part III (r=-0.304, p=<0.001), PDQ-8 (r=-0.472, p=<0.001), and NMSS (r=-0.504, p=<0.001). Furthermore, when assessing the simultaneous effect of covariates associated with CDSES score, only Mood/Apathy domain of NMSS was significant (beta= -0.446, t= -3.807, p= 0.012). Conclusions: PD patients with lower self-efficacy scores had worse motor and non-motor symptomatology and quality of life. Mood/Apathy disorders were negatively associated with self-efficacy and contributed significantly to this measure.

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Evaluation of a Fatigue Self-Management Program for People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2015-019 ◽

2016 ◽

Vol 18 (3) ◽

pp. 116-121 ◽

Cited By ~ 10

Author(s):

Hilda Mulligan ◽

Amanda Wilkinson ◽

Amelia Barclay ◽

Hayley Whiting ◽

Christelle Heynike ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Self Efficacy ◽

Short Form ◽

Small Sample Size ◽

Management Program ◽

Small Sample ◽

Self Report ◽

Self Management

Background: Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS). The program “Minimise Fatigue, Maximise Life: Creating Balance with Multiple Sclerosis” (MFML) was created in New Zealand because of the lack of a fatigue management program for people with MS in that country. This program aims to empower individuals with MS to manage their own symptoms of fatigue. The objective of this study was to evaluate the MFML fatigue self-management program. Methods: Self-report questionnaires were used to measure impact of fatigue (5-item Modified Fatigue Impact Scale), self-efficacy (MS Self-efficacy Scale), and quality of life (12-item Short Form Health Status Survey [SF-12]) 1 month before (T1), at commencement of (T2) (to investigate the stability of questionnaire scores before the intervention), and at the end of (T3) the 6-week group-based program. Increased self-efficacy and quality of life scores and a decrease in reported impact of fatigue were the anticipated primary outcomes, with participants acting as their own controls. Results: Twenty-five women (aged 37–63 years) participated. Stability of scores for all the questionnaires was evidenced between T1 and T2. After the intervention (T3), scores showed a significant improvement in self-efficacy and impact of fatigue, with large effect sizes, but no change in either the physical or mental component summary of the SF-12. Conclusions: Despite the small sample size, this study showed an organized approach to the management of fatigue for people living with MS, and its outcomes demonstrated benefits for participants.

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P–486 Psychological determinants of the decision to attend couples infertility counselling

Human Reproduction ◽

10.1093/humrep/deab130.485 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

P Salvatori ◽

F Andrei ◽

L Cipriani ◽

G Damiano ◽

M Dirodi ◽

...

Keyword(s):

Quality Of Life ◽

Self Efficacy ◽

Social Life ◽

Small Sample Size ◽

Well Being ◽

Small Sample ◽

University Hospital ◽

Ministry Of Health ◽

Infertile Couples

Abstract Study question May specific psychological variables related to the experience of infertility have a predicting effect over the decision of accepting counselling? Summary answer Specific infertility related sources of sufferance including low levels of infertility self-efficacy and poor quality of life significantly predict the request for professional help. What is known already Available data on the access to infertility counselling services suggest that only 10–34% of patients who are offered such opportunity actually pursue it. Qualitative studies pointed out that this might be due to a lack of information about available support and to negative attitudes toward counselling. It seems also that women and men who accept counselling have worse levels of psychological distress. However, there is a lack of quantitative studies on the topic and among those available none used measures that are specific to the experience of infertility itself Study design, size, duration The data presented herein are part of a larger data collection promoted by the Italian Ministry of Health on the psychological impact of assisted reproduction. The present study is a cross-sectional research and involves a sample of 184 patients, composed by 92 women waiting for infertility treatment and their partners, enrolled between October 2019 and October 2020 at the Infertility and IVF Unit of the S. Orsola University Hospital in Bologna, Italy. Participants/materials, setting, methods Participants were voluntarily enrolled in the study at their first medical consult. They were informed about the possibility to attend free couples infertility counselling sessions and asked to fill in the following questionnaires: Infertility Self-Efficacy Scale (ISE); Fertility Quality of Life (FERTIQoL); Dyadic Adjustment Scale (DAS). To attend infertility counselling a shared agreement between partners was requested. Couples who agreed to the study but not to counselling sessions were provided only with questionnaires. Main results and the role of chance The 34.8% (n = 32 couples) of the sample accepted to receive counselling sessions. The two groups (counselling vs no-counselling) were comparable in all socio-demographic variables, aside for education, with higher education levels in the counselling group. Overall, the counselling group reported greater psychological sufferance than the no-counselling group, with lower scores at the ISE, FERTIQoL, and DAS questionnaires. Regarding which factors predicted the decision to attend counselling sessions, logistic regression analysis showed that: for the female partner’s dimensions low scores at the ISE and at the Emotional subscale of the FertiQoL were predictive of accepting counselling (when scores increased the odds of being in the counselling group would decrease by 46% and 8% respectively); for the male’s partner dimensions, predictive factors were low scores on the Social subscale and high scores on the Relational subscale of the FertiQoL (when scores increased the odds of being in the counselling group would decrease by 8% and increase by 10% respectively). In conclusion, impairments in self-efficacy, emotional well-being and social life may drive a greater need for help, but a close relationship with the partner may be also necessary to predispose men to accept couples infertility counselling. Limitations, reasons for caution Data were collected from a well enough homogeneous sample which may have helped in better enhancing the specificity of infertile couples’ needs. However, the small sample size and the fact that data were collected from a sole Italian clinic may impact the representativity of our results. Wider implications of the findings: Findings provide important information for clinical interventions with infertile couples. Patients accepting counselling might be having a worse adjustment to the experience of infertility. Besides, women and men may be affected in different ways. Men’s closeness to the partner might be a favourable factor and should be further studied. Trial registration number The study was approved by the Ethical Committee of the S. Orsola Hospital, University of Bologna (CE: 273/2018/Sper/AOUBO) and funded by the Italian Ministry of Health (J33C17000560001)

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Police Encounters, Agitation, Diagnosis, and Employment Predict Psychiatric Hospitalisation of Intensive Home Treatment Patients During a Psychiatric Crisis

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.602912 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ansam Barakat ◽

Matthijs Blankers ◽

Jurgen E. Cornelis ◽

Louk van der Post ◽

Nick M. Lommerse ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Employment Status ◽

Multiple Logistic Regression Analysis ◽

Home Treatment ◽

Individual Risk ◽

Psychiatric Hospitalisation ◽

Factors Associated ◽

Psychiatric Crisis

Objective: This study aims to determine factors associated with psychiatric hospitalisation of patients treated for an acute psychiatric crisis who had access to intensive home treatment (IHT).Methods: This study was performed using data from a randomised controlled trial. Interviews, digital health records and eight internationally validated questionnaires were used to collect data from patients on the verge of an acute psychiatric crisis enrolled from two mental health organisations. Thirty-eight factors were assigned to seven risk domains. The seven domains are “sociodemographic”, “social engagement”, “diagnosis and psychopathology”, “aggression”, “substance use”, “mental health services” and “quality of life”. Multiple logistic regression analysis (MLRA) was conducted to assess how much pseudo variance in hospitalisation these seven domains explained. Forward MLRA was used to identify individual risk factors associated with hospitalisation. Risks were expressed in terms of relative risk (RR) and absolute risk difference (ARD).Results: Data from 183 participants were used. The mean age of the participants was 40.03 (SD 12.71), 57.4% was female, 78.9% was born in the Netherlands and 51.4% was employed. The range of explained variance for the domains related to “psychopathology and care” was between 0.34 and 0.08. The “aggression” domain explained the highest proportion (R2 = 0.34) of the variance in hospitalisation. “Quality of life” had the lowest explained proportion of variance (R2 = 0.05). The forward MLRA identified four predictive factors for hospitalisation: previous contact with the police or judiciary (OR = 7.55, 95% CI = 1.10–51.63; ARD = 0.24; RR = 1.47), agitation (OR = 2.80, 95% CI = 1.02–7.72; ARD = 0.22; RR = 1.36), schizophrenia spectrum and other psychotic disorders (OR = 22.22, 95% CI = 1.74–284.54; ARD = 0.31; RR = 1.50) and employment status (OR = 0.10, 95% CI = 0.01–0.63; ARD = −0.28; RR = 0.66).Conclusion: IHT teams should be aware of patients who have histories of encounters with the police/judiciary or were agitated at outset of treatment. As those patients benefit less from IHT due to the higher risk of hospitalisation. Moreover, type of diagnoses and employment status play an important role in predicting hospitalisation.

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A Clinical Study of Psychiatric Morbidity and Quality of Life among Suicide Attempted Patients

International Journal of Indian Psychology ◽

10.25215/0401.063 ◽

2016 ◽

Vol 4 (1) ◽

Author(s):

Dr. Challa Venkata Suresh

Keyword(s):

Quality Of Life ◽

Psychiatric Disorders ◽

Psychotic Disorders ◽

Rating Scale ◽

Psychiatric Morbidity ◽

Poor Quality ◽

Control Group ◽

Suicide Attempters ◽

Suicide Attempted

Risk of suicide is more common in patients with psychiatric disorders and poor quality of life. The aim of this study was to find out the prevalence of psychiatric morbidity and its relationship with suicide attempters. Materials and Method- The cross sectional study was carried out in Psychiatric department of MNR Medical College and Hospital. A total 70 cases of first suicide attempts were included in this study. Psychiatric morbidity and quality of life were analysed by Schedule for clinical assessment in neuropsychiatric (SCAN), Montgomery Asberg’s depression rating scale (MADRS), Hamilton anxiety rating scale (HAM-A) and WHOQOL-BREF version. Statistical analysis was done by SPSS 20.0 software. Result- Among 70 cases, 92.85% of the suicide attempters had one or more psychiatric disorders compared to 21.43% among the controls. Major psychotic disorder was mood disorder (56.92%), followed by Neurotic and somatoform disorders (36.92%) and substance related disorders (32.3%). Schizophrenia and other psychotic disorders were diagnosed in 7.69% of cases. Quality of life score was assessed by WHOQOL-BREF questionnaire. The mean of total score in suicide attempters was 57.44 and in control group was 73.67. Conclusion- In the present study suicide attempters had higher psychotic morbidity and poor quality of life in comparison to the control groups.

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IMPROVED QUALITY OF LIFE OF PATIENTS WITH RHEUMATOID ARTHRITIS AND NONPSYCHOTIC MENTAL DISORDERS

Wiadomości Lekarskie ◽

10.36740/wlek201901109 ◽

2019 ◽

Vol 72 (1) ◽

pp. 47-51 ◽

Cited By ~ 1

Author(s):

Svitlana Savka

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Mental Disorders ◽

Rating Scale ◽

Life Quality ◽

Well Being ◽

Control Group ◽

Clinical Group ◽

Hamilton Rating Scale

Introduction: Somatic pathology of patients with rheumatoid arthritis (RA) combined with nonpsychotic mental disorders (NMD) leads to deterioration in the quality of life. The aim: We aimed to examine the quality of life of patients with rheumatoid arthritis and nonpsychotic mental disorders. Materials and methods: We formed two clinical groups of observation of the patients with rheumatoid arthritis and nonpsychotic mental disorders. First group (GA) included participants with duration of RA for 1-5 years, second group (GB) included those with duration of RA for 5-10 years. For assessment we used the Hamilton Rating Scale for Depression (HRSD), Hamilton Rating Scale for Anxiety (HRSA) and the Quality of Life Index developed by J.E. Mezzich (QLI). All patients received basic treatment, as well as antidepressants, anxiolytics, vitamin therapy and psychotherapy, depending on the form of nonpsychotic mental disorders. Results: Study of the life quality showed that for the examined patients the quality of life was significantly lower in comparison with the control group. Mainly, for GA partners the overall assessment of life quality after treatment improved by 12,1% and the positive effect was probable. The greatest positive changes for the first group included increasing of physical well-being points by 2,5 and psychological/emotional well-being – by 2,1 points(p<0,05). Mainly, for GB patients overall quality of life improved by 14,9%. Major positive changes were identified in psychological/emotional well-being - 2,93 points, physical well-being by 2,47 points, self-care and independent functioning by 2,09 points, and disability which increased by 2,06 points (p <0,05) Conclusions: The patients with rheumatoid arthritis and nonpsychotic mental disorders have a significant decline in quality of life based on all indicators. The general assessment of the life quality of the first basic clinical group surveyed was 62,2 ± 1,33, while for the second basic clinical group surveyed – 57,0 ± 1,47. The increase in the duration of the RA disease significantly weakens the general working capacity by 0,83 points p<0,05, self-service and independence of the patients by 0,80 points, p<0,05, psychological and emotional well-being by 0,75 points, p<0,05, interpersonal interaction at 0,91 points, p<0,05.The overall quality of life of the patients with duration of RA for 1-5 years and NMD after treatment was 74,1% ± 0,93, for the patients with duration of RA for 5-10 years and NMD after treatment was 71,9% ± 1,20 (p <0,05).

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