Exploring construct validity of clinical staging in schizophrenia spectrum disorders in an acute psychiatric ward

Objective: This article examines the influence of the implementation of Soteria elements on coercive measures in an acute psychiatric ward after reconstruction in 2017, thereby comparing the year 2016 to the year 2019. The special feature is that this is the only acute psychiatric ward in Hennigsdorf Hospital, connected now both spatially and therapeutically to an open ward and focusing on the treatment of patients suffering from schizophrenia and schizophrenia spectrum disorders.Methods: The following parameters were examined: aggressive assaults, use of coercion (mechanical restraints), duration of treatment in open or locked ward, type of discharge, coercive medication, and dosage of applied antipsychotics. For this purpose, the data of all legally accommodated patients in the year 2016 (before the reconstruction) and 2019 (after the reconstruction) were statistically analyzed in a pre–post mirror quasi-experimental design.Results: In 2019, the criteria of the Soteria Fidelity Scale for a ward with Soteria elements were reached. In comparison to 2016 with a comparable care situation and a comparable patient clientele, there was now a significant decrease in aggressive behavior toward staff and fellow patients, a significantly reduced number of fixations, a significantly reduced overall duration of inpatient stay, and a significant increase in treatment time in the open area of our acute ward.Conclusion: The establishment of Soteria elements in the acute psychiatric ward leads to a verifiable less violent environment of care for severely ill patients and to a drastic reduction in coercive measures.

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Associations of Multiple Measures of Openness to Experience with a Brief Questionnaire of Positive, Negative, and Disorganized Schizotypy

Journal of Individual Differences ◽

10.1027/1614-0001/a000348 ◽

2021 ◽

pp. 1-9

Author(s):

Kathryn C. Kemp ◽

Michael L. Raulin ◽

Chris J. Burgin ◽

Neus Barrantes-Vidal ◽

Thomas R. Kwapil

Keyword(s):

Construct Validity ◽

Factor Structure ◽

Principal Components ◽

Openness To Experience ◽

Schizophrenia Spectrum Disorders ◽

Multidimensional Construct ◽

Schizophrenia Spectrum ◽

Components Analysis ◽

Spectrum Disorders ◽

Subclinical Symptoms

Abstract. The vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms and impairment known as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. Openness to experience offers a useful personality domain for exploring multidimensional schizotypy. This study examined the factor structure of openness and its relation to schizotypy using the Multidimensional Schizotypy Scale-Brief (MSS-B) in a sample of 2,236 adults. Positive schizotypy was broadly associated with elevated openness and negative schizotypy was generally associated with diminished openness. Principal components analysis of 15 openness facets replicated the four-factor structure of openness including Fantasy/Feelings, Eccentricity, Nontraditionalism, and Ideas factors. All three schizotypy dimensions were associated with Eccentricity. Positive schizotypy was associated with Fantasy/Feelings, whereas negative schizotypy was inversely associated with Fantasy/Feelings. Results support the construct validity of the MSS-B, use of alternative openness measures in examining schizotypy, and the multidimensional structures of schizotypy and openness.

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Clinical Staging in Schizophrenia Spectrum Disorders

10.5772/intechopen.98276 ◽

2021 ◽

Author(s):

Zsófia Borbála Dombi ◽

Ágota Barabássy ◽

Barbara Sebe ◽

István Laszlovszky ◽

György Németh

Keyword(s):

Gold Standard ◽

State Of The Art ◽

Treatment Strategies ◽

Clinical Staging ◽

Schizophrenia Spectrum Disorders ◽

The Past ◽

Schizophrenia Spectrum ◽

Appropriate Treatment ◽

Spectrum Disorders ◽

Staging Model

The aim of this chapter is to summarize the state-of-the-art knowledge of clinical staging in schizophrenia spectrum disorders. Clinical staging has been introduced to psychiatry in the past two decades. Its primary goal is to divide the course of the disorder into recognizable stages based on seriousness, development and symptom characteristics in order to better predict prognosis and to adopt the most appropriate treatment strategies. The first staging model was developed in 1982. Since then several distinct concepts of clinical staging in psychiatry have emerged. To date, there is no clinical consensus regarding which staging model is the gold standard, nonetheless when merging them together an integrated staging concept arises. The integrated staging model of schizophrenia spectrum disorders is composed of four stages. The chapter will introduce the different staging models in a historical order as well as present the integrated staging model detailing the characteristics, timeline and dominating symptoms of each stage. Appropriate treatment strategies for the distinct stages will also be outlined.

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Not the same old madness: Evaluating the clinical profile of the “schizophrenia spectrum” disorders

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1638 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s833-s834

Author(s):

A. Russo ◽

N. Verdolini ◽

G. Menculini ◽

P. Moretti ◽

R. Quartesan ◽

...

Keyword(s):

Negative Symptoms ◽

Psychiatric Ward ◽

Depression Symptom ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Axis I ◽

Dsm Iv ◽

Cluster A ◽

Spectrum Disorders ◽

The Impact

IntroductionThe “schizophrenia spectrum” concept allowed better identifying the psychopathology underpinning disorders including schizophrenia, schizoaffective disorder (SZA) and cluster A personality disorders (PD).AimsTo compare the clinical portrait of the schizophrenia spectrum disorders, focusing on the impact of the affective dimension.MethodsInpatients at the acute psychiatric ward of Perugia (Umbria-Italy) were evaluated with the structured clinical interview for DSM-IV Axis I and Axis II disorders and diagnosed with a “schizophrenia spectrum” disorder according to DSM-IV-TR. The clinical evaluation was conducted using the positive and negative syndrome scale (PANSS). Pearson correlations of the different subscales in the three groups and between the negative scales with the affective symptom “depression” were conducted.ResultsThe sample consisted of 72 inpatients (schizophrenia 55.6%, SZA 20% and cluster A PD 19.4%). The negative and the general psychopathology scales directly correlated at different degrees in the three groups (schizophrenia: r = 0.750; P < 0.001; SZA: r = 0.625, P = 0.006; cluster A PD: r = 0.541, P = 0.046). The symptom “depression” directly correlated with 5 out of 7 negative symptoms: blunted affect (r = 0.616, P < 0.001), emotional withdrawal (r = 0.643, P < 0.001), poor rapport (r = 0.389, P = 0.001), passive/apathetic social withdrawal (r = 0.538, P < 0.001), lack of spontaneity & flow of conversation (r = 0.399, P = 0.001).ConclusionsOur study confirmed the existence of the “schizophrenia spectrum” with combined different disorders lying on a continuum in which negative symptoms mainly correlated with the psychopathological functioning. Noteworthy, the symptoms of the negative scale strongly correlated with the “depression” symptom, underlying the impact of the affective symptoms on the severity of the “schizophrenia spectrum” disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Association of cognitive performance with clinical staging in schizophrenia spectrum disorders: a prospective 6-year follow-up study

Schizophrenia Research Cognition ◽

10.1016/j.scog.2021.100232 ◽

2021 ◽

pp. 100232

Author(s):

S. Berendsen ◽

E. Nummenin ◽

F. Schirmbeck ◽

L. de Haan ◽

M.J. van Tricht ◽

...

Keyword(s):

Cognitive Performance ◽

Clinical Staging ◽

Schizophrenia Spectrum Disorders ◽

Follow Up Study ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

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Suicidality in Schizophrenia Spectrum Disorders: The Relationship to Hallucinations and Persecutory Delusions

European Psychiatry ◽

10.1016/j.eurpsy.2015.07.003 ◽

2015 ◽

Vol 30 (7) ◽

pp. 830-836 ◽

Cited By ~ 39

Author(s):

E. Kjelby ◽

I. Sinkeviciute ◽

R. Gjestad ◽

R.A. Kroken ◽

E.-M. Løberg ◽

...

Keyword(s):

Suicidal Ideation ◽

Structural Equation ◽

Suicide Risk ◽

Negative Symptoms ◽

Psychotic Disorders ◽

Psychiatric Ward ◽

Schizophrenia Spectrum Disorders ◽

Persecutory Delusions ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

AbstractBackground:Assessment of suicide risk is crucial in schizophrenia and results concerning risk contributed by hallucinations and persecutory delusions are inconsistent. We aimed to determine factors associated with suicidal ideation and plans at the time of acute admission in patients suffering from schizophrenia spectrum disorders.Methods:One hundred and twenty-four patients older than 18 years admitted to an acute psychiatric ward due to psychosis were consecutively included. Predictors of suicidal ideation and suicide plans at the time of admission were examined with multinominal logistic regression and structural equation modelling (SEM). The study design was pragmatic, thus entailing a clinically relevant representation.Results:Depression Odds Ratio (OR) 12.9, Drug use OR 4.07, Hallucinations OR 2.55 and Negative symptoms OR 0.88 significantly predicted Suicidal ideation. Suspiciousness/ Persecution did not. Only Depression and Hallucinations significantly predicted Suicide plans. In the SEM-model Anxiety, Depression and Hopelessness connected Suspiciousness/Persecution, Hallucinations and Lack of insight with Suicidal ideation and Suicide plans.Conclusions:The study contributes to an increasing evidence base supporting an association between hallucinations and suicide risk. We want to emphasise the importance of treating depression and hallucinations in psychotic disorders, reducing hopelessness while working with insight and reducing drug abuse in order to lower suicide risk.Trial registration:ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/NCT00932529.

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