scholarly journals Creating Live Interactions to Mitigate Barriers (CLIMB): A Mobile Intervention to Improve Social Functioning in People With Chronic Psychotic Disorders

2016 ◽  
Vol 3 (4) ◽  
pp. e52 ◽  
Author(s):  
Bruno Biagianti ◽  
Danielle Schlosser ◽  
Mor Nahum ◽  
Josh Woolley ◽  
Sophia Vinogradov
Keyword(s):  
Quality Of Life ◽  
Social Cognition ◽  
Group Therapy ◽  
Social Functioning ◽  
Mobile Devices ◽  
Psychotic Disorders ◽  
Positive Effects ◽  
Randomized Controlled Studies ◽  
Therapy Sessions

Background Numerous psychosocial interventions for individuals with chronic psychotic disorders (CPD) have shown positive effects on social cognitive and functional outcome measures. However, access to and engagement with these interventions remains limited. This is partly because these interventions require specially trained therapists, are not available in all clinical settings, and have a high scheduling burden for participants, usually requiring a commitment of several weeks. Delivering interventions remotely via mobile devices may facilitate access, improve scheduling flexibility, and decrease participant burden, thus improving adherence to intervention requirements. To address these needs, we designed the Creating Live Interactions to Mitigate Barriers (CLIMB) digital intervention, which aims to enhance social functioning in people with CPD. CLIMB consists of two treatment components: a computerized social cognition training (SCT) program and optimized remote group therapy (ORGT). ORGT is an innovative treatment that combines remote group therapy with group texting (short message service, SMS). Objectives The objectives of this single-arm study were to investigate the feasibility of delivering 6 weeks of CLIMB to people with CPD and explore the initial effects on outcomes. Methods Participants were recruited, screened and enrolled via the Internet, and delivered assessments and interventions remotely using provided tablets (iPads). Participants were asked to complete 18 hours of SCT and to attend 6 remote group therapy sessions. To assess feasibility, adherence to study procedures, attrition rates, engagement metrics, and acceptability of the intervention were evaluated. Changes on measures of social cognition, quality of life, and symptoms were also explored. Results In total, 27 participants were enrolled over 12 months. Remote assessments were completed successfully on 96% (26/27) of the enrolled participants. Retention in the 6-week trial was 78% (21/27). Of all the iPads used, 95% (22/23) were returned undamaged at the end of the intervention. Participants on average attended 84% of the group therapy sessions, completed a median of 9.5 hours of SCT, and posted a median of 5.2 messages per week on the group text chat. Participants rated CLIMB in the medium range in usability, acceptability, enjoyment, and perceived benefit. Participants showed significant improvements in emotion identification abilities for prosodic happiness (P=.001), prosodic happiness intensity (P=.04), and facial anger (P=.04), with large within-group effect sizes (d=.60 to d=.86). Trend-level improvements were observed on aspects of quality of life (P values less than .09). No improvements were observed for symptoms. Conclusions It is feasible and acceptable to remotely deliver an intervention aimed at enhancing social functioning in people with CPD using mobile devices. This approach may represent a scalable method to increase treatment access and adherence. Our pilot data also demonstrate within-group gains in some aspects of social cognition after 6 weeks of CLIMB. Future randomized controlled studies in larger samples should evaluate the extent to which CLIMB significantly improves social cognition, symptoms, and quality of life in CPD.

Social functioning and cognition in patients with schizophrenia, their unaffected siblings and healthy controls: impact on quality of life

2011 ◽  
Vol 26 (S2) ◽  
pp. 1398-1398
Author(s):  
D.D. Achaval ◽  
K. Buglioni ◽  
J. Lopez ◽  
J. Douer ◽  
E. Costanzo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Skills ◽  
Social Cognition ◽  
Social Functioning ◽  
Social Performance ◽  
Adaptive Behaviour ◽  
Healthy Controls ◽  
Cognitive Screening ◽  
Intermediate Phenotypes

BackgroundPatients with schizophrenia show deficits in many cognitive domains and social functioning, social skills, and self management skills in their daily life activities.ObjectiveTo evaluate the relationship between general-social cognition, mental state and social functioning, and impact on quality of life.MethodsTwenty patients with chronic disorder of schizophrenia were evaluated and compared with 20 siblings and 20 healthy controls regarding performance in a series of tests: Cognitive Screening: Word Accentuation Test, MCCB (Matrics Consensus Cognitive Battery) Social Functioning: UPSA (University of California Performance Skills Assessment), TABS (Test of Adaptive Behaviour in Schizophrenia), SSPA (Social Skills Performance Assessment), Beck and Hamilton depression scales, Scale for Positive and Negative Syndrome of Schizophrenia, and SF-36 as indicator of quality of life.ResultsPatients showed significant differences from controls and siblings in MCCB total score (p < 0.001), whereas siblings showed significant differences compared to controls in MCCB total score (p = 0.053). Siblings performed differently from patients (p < 0.001) and controls (p = 0.019) in social functioning measured with TABS. A series of correlations between general cognition and social functioning were demonstrated for patients and their unaffected siblings (not shown).ConclusionResults suggest that the performance of nonpsychotic siblings is located between patients and healthy controls, suggesting that social performance measures are (or associated with) intermediate phenotypes of the disease. General and social cognition have a complex relationship with social functioning and quality of life.

A targeted remediation approach: The training of affect recognition (TAR)

2011 ◽  
Vol 26 (S2) ◽  
pp. 2158-2158
Author(s):  
G. Sachs ◽  
B. Winklbaur ◽  
R. Jagsch ◽  
N. Frommann ◽  
I. Kryspin-Exner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Cognition ◽  
Combined Treatment ◽  
Depression Scale ◽  
Recognition Task ◽  
Wisconsin Card Sorting Test ◽  
Affect Recognition ◽  
Positive Effects ◽  
New Antipsychotics

IntroductionAn increasing number of studies is focusing on general deficits in patients with schizophrenia in identifying, differentiating and recalling facial emotions which significantly impairs the patient's psychosocial functioning and quality of life.ObjectivesThese impairments seem not to be affected by conventional treatment. According to preliminary results antipsychotics alone show only little effects on social cognition.AimsThe present study investigated the efficacy of a computer based training focussing on facial affect recognition (Training of Affect recognition TAR, Wölwer et al. 2005) for the remediation of social cognitive dysfunctions.MethodsEffects on social cognition were tested with the Vienna Emotion Recognition Task (VERT-K, Pawelak 2004). Neurocognitive performance was assessed by the Wisconsin Card Sorting Test (WCST Heaton et al. 1993). Additional assessments were tests of alertness, vigilance and working memory (TAP Zimmermann and Fimm 2002), positive and negative symptoms (PANSS Kay et al. 1987), Beck Depression Scale (BDI Beck 1964) and Quality of Life (WHOQOL-Bref WHOQOL Group 1998).ResultsIn comparison to the TAU group, the TAR group achieved significant improvements in affect recognition in general as well as in recognizing sad faces (p < 0.01) (Fig.2). In addition, we found significant improvements for the TAR group in regard to vigilance and Quality of Life (p < 0.05).ConclusionsTreatment with new antipsychotics alone leads only to limited effects on social cognition and functioning. A specific combined treatment of new antipsychotics and TAR leads to improved cognition and emotional performance with additional positive effects on functional outcome.

Is change over time in psychotic symptoms related to social functioning?

2021 ◽  
pp. 002076402110392
Author(s):  
Sascha Kwakernaak ◽  
Wiepke Cahn ◽  
Richard Janssen ◽  
Keyword(s):  
Quality Of Life ◽  
Social Functioning ◽  
Repeated Measures ◽  
Psychotic Disorders ◽  
Medication Use ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Needs For Care ◽  
Over Time

Objective: In psychosis, treatment often focuses on symptom reduction whereas social functioning is also essential. In this study, we investigate positive psychotic symptoms and medication use in relation to social functioning over a 3-year time-period in 531 patients diagnosed with psychosis. Furthermore, relations of positive symptoms with needs for care and quality of life were also investigated. Method: Using repeated measures analysis, changes were measured over time. Hereafter, mixed model analyses were performed to determine the associations of social functioning, needs for care, and quality of life with psychotic symptoms and patient characteristics. Finally, we assessed differences in symptoms and medication dose between those with an increase and those with a decrease in social functioning. Results: Patients significantly improved in social functioning, while psychotic symptoms increased. Improvement in social functioning was associated with younger age, higher IQ, and lower social functioning at T1, but not with positive symptoms. Also, improvement in social functioning was found to be related to a decrease in the dose of clozapine. Improvement in social functioning occurs despite worsening of positive symptoms. Conclusions: The findings suggest the need to further explore the relation between symptomatology, social functioning, and medication use. In the treatment of psychotic disorders, one should reconsider the strong focus on reducing psychotic symptoms. The current focus needs to shift much more toward improving functional outcome, especially when the patient expresses a desire for change in this respect.

scholarly journals Personality Compensates for Impaired Quality of Life and Social Functioning in Patients With Psychotic Disorders Who Experienced Traumatic Events

2014 ◽  
Vol 40 (6) ◽  
pp. 1356-1365 ◽  
Author(s):  
L.-L. Boyette ◽  
D. van Dam ◽  
C. Meijer ◽  
E. Velthorst ◽  
W. Cahn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Functioning ◽  
Psychotic Disorders ◽  
Traumatic Events ◽  
Impaired Quality

Cognitive Dysfunctions in the Psychoses and their Impact on Patients’ Social Functioning

2017 ◽  
Vol 41 (S1) ◽  
pp. S48-S48
Author(s):  
A. Mucci ◽  
S. Galderisi
Keyword(s):  
Quality Of Life ◽  
Social Cognition ◽  
Theory Of Mind ◽  
Cognitive Deficits ◽  
Psychotic Disorders ◽  
Real Life ◽  
Advisory Board ◽  
Affect Recognition ◽  
Life Functioning

IntroductionImpairment of neurocognitive functions, such as attention, memory or executive functions, as well as of social cognition, particularly of affect recognition and theory of mind, are frequently observed in people with Schizophrenia or other psychotic disorders. These dysfunctions are associated with poor real-life functioning. Social cognition deficits mediate in part the impact of neurocognitive dysfunction on functional outcome.AimsTo review literature findings on prevalence, severity and association with functional outcome of neurocognitive and social cognitive deficits in schizophrenia and other psychotic disorders.MethodsWe searched PubMed for English/Italian or French full-text publications with the keywords.schizophr*/psychosis/psychot*/AND neurocognitive/cognitive/neuropsychological/memory/attention/”executive function”/learning/”social cognition”/”theory of mind”/”affect recognition”/”acial emotion recognition”/”emotional intelligence”/”emot* recognition”. Furthermore, we manually searched the reference lists of relevant papers, systematic reviews and meta-analyses.ResultsIn people with schizophrenia, schizoaffective disorder or bipolar disorder with psychotic features, neurocognitive and social cognition deficits were observed in all phases of the disorders, even after symptom remission. Some of these deficits were observed in subjects at high-risk to develop schizophrenia before psychotic onset. In all these subjects, cognitive deficits are associated with worse psychosocial functioning and poor quality of life. Pharmacological treatments do not alleviate cognitive deficits, which can also limit the benefit of other psychological or psychosocial interventions.ConclusionsNeurocognitive and social cognition deficits need to be targeted by specific interventions to improve real-life functioning and quality of life of people with schizophrenia or psychotic disorders.Disclosure of interestAM received honoraria or advisory board/consulting fees from the following companies: Janssen Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre.SG received honoraria or advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter.

Neuro-cognition and social cognition elements of social functioning and social quality of life

2017 ◽  
Vol 258 ◽  
pp. 538-543 ◽  
Author(s):  
Ilanit Hasson-Ohayon ◽  
Michal Mashiach-Eizenberg ◽  
Nitzan Arnon-Ribenfeld ◽  
Shlomo Kravetz ◽  
David Roe
Keyword(s):  
Quality Of Life ◽  
Social Cognition ◽  
Social Functioning ◽  
Social Quality ◽  
Social Quality Of Life

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

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ansam Barakat ◽  
Matthijs Blankers ◽  
Jurgen E Cornelis ◽  
Nick M Lommerse ◽  
Aartjan T F Beekman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Disorders ◽  
Self Efficacy ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Small Sample ◽  
Home Treatment ◽  
Differential Effects ◽  
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.

scholarly journals A Comparison of the Effect of Two Types of Whole Body Vibration Platforms on Fibromyalgia. A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3007
Author(s):  
José Antonio Mingorance ◽  
Pedro Montoya ◽  
José García Vivas Miranda ◽  
Inmaculada Riquelme
Keyword(s):  
Quality Of Life ◽  
Motor Function ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Control Group ◽  
Body Vibration ◽  
Positive Effects ◽  
Therapy Program

Whole body vibration has been proven to improve the health status of patients with fibromyalgia, providing an activation of the neuromuscular spindles, which are responsible for muscle contraction. The present study aimed to compare the effectiveness of two types of whole body vibrating platforms (vertical and rotational) during a 12-week training program. Sixty fibromyalgia patients (90% were women) were randomly assigned to one of the following groups: group A (n = 20), who performed the vibration training with a vertical platform; group B (n = 20), who did rotational platform training; or a control group C (n = 20), who did not do any training. Sensitivity measures (pressure pain and vibration thresholds), quality of life (Quality of Life Index), motor function tasks (Berg Scale, six-minute walking test, isometric back muscle strength), and static and dynamic balance (Romberg test and gait analysis) were assessed before, immediately after, and three months after the therapy program. Although both types of vibration appeared to have beneficial effects with respect to the control group, the training was more effective with the rotational than with vertical platform in some parameters, such as vibration thresholds (p < 0.001), motor function tasks (p < 0.001), mediolateral sway (p < 0.001), and gait speed (p < 0.05). Nevertheless, improvements disappeared in the follow-up in both types of vibration. Our study points out greater benefits with the use of rotational rather than vertical whole body vibration. The use of the rotational modality is recommended in the standard therapy program for patients with fibromyalgia. Due to the fact that the positive effects of both types of vibration disappeared during the follow-up, continuous or intermittent use is recommended.

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