scholarly journals From Wish to Reality: Soteria in Regular Care—Proof of Effectiveness of the Implementation of Soteria Elements in Acute Psychiatry

2021 ◽  
Vol 12 ◽  
Author(s):  
Theresa Wolf ◽  
Philine Fabel ◽  
Adrian Kraschewski ◽  
Maria C. Jockers-Scherübl
Keyword(s):  
Treatment Time ◽  
Psychiatric Ward ◽  
Schizophrenia Spectrum Disorders ◽  
Duration Of Treatment ◽  
Coercive Measures ◽  
Schizophrenia Spectrum ◽  
Regular Care ◽  
Quasi Experimental ◽  
Acute Psychiatric Ward ◽  
Mechanical Restraints

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.

scholarly journals Treatment Response Distinguishes Persistent Type of Methamphetamine Psychosis From Schizophrenia Spectrum Disorder Among Inmates at Japanese Medical Prison

2021 ◽  
Vol 12 ◽  
Author(s):  
Yosuke Sekiguchi ◽  
Takayuki Okada ◽  
Yusuke Okumura
Keyword(s):  
Treatment Response ◽  
Behavioral Problems ◽  
Clinical Symptoms ◽  
Group Differences ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum Disorder ◽  
Significant Group ◽  
Schizophrenia Spectrum ◽  
Quasi Experimental ◽  
Control Study

Introduction: Persistent methamphetamine-associated psychosis (pMAP) is a disorder similar to schizophrenia, so much so that the differences in clinical symptoms and treatment response between the two remain unknown. In this study, we compared the features of pMAP with those of schizophrenia spectrum disorders (SSD).Materials and Methods: This was a retrospective quasi-experimental case-control study of inmates in a medical prison. The behavioral problems, clinical symptoms, and chlorpromazine (CP)-equivalent doses of 24 patients with pMAP and 27 with SSD were compared.Results: Patients in the pMAP group were hospitalized for fewer days than those in the SSD group (281.5 vs. 509.5; p = 0.012), but there were no other significant group differences in behavioral problems or clinical symptoms. The pMAP group received fewer antipsychotics in CP-equivalent doses than the SSD group at 4, 8, and 12 weeks after admission and at the time of discharge (p = 0.018, 0.001, 0.007, and 0.023, respectively). The number of CP-equivalent doses in the SSD group tended to increase after admission, but not in the pMAP group.Discussion: These findings suggest that differentiation between pMAP and SSD based on behavior and symptoms alone may be difficult, and that patients with pMAP may respond better to treatment with a lower dose of antipsychotic medication than those with SSD. Further confirmatory studies are warranted.

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

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.

scholarly journals T158. NO ALTERATION OF PITUTARY VOLUME IN PATIENTS WITH FIRST-EPISODE SCHIZPHRENIA BUT A TREND OF ENLARGEMENT IN NON-PSYCHOTIC FIRST-DEGREE RELATIVES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S291-S291
Author(s):  
Min-yi Chu ◽  
Simon S Y Lui ◽  
Karen S Y Hung ◽  
P C Sham ◽  
Henry K F Mak ◽  
...  
Keyword(s):  
High Risk ◽  
Intraclass Correlation ◽  
First Episode ◽  
Healthy Controls ◽  
Schizophrenia Spectrum Disorders ◽  
Duration Of Treatment ◽  
First Degree Relatives ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

Abstract Background There is growing evidence suggesting that the abnormal pituitary volume (PV) may be an essential deficit in schizophrenia spectrum disorders, and PV may change depending on the stage of the illness. However, previous studies assessing PV in schizophrenia spectrum disorders, especially in ultra-high risk individuals, were confounding. The present study aimed to assess whether there would be alteration of the PV in patients with first-episode schizophrenia and their non-affected first-degree relatives. Methods This study recruited 147 subjects, including subjects with 62 first-episode schizophrenia (31 man, 31 female), 25 non-psychotic first-degree relatives (11 male, 14 female), and 60 healthy controls (30 male, 30 female). All of them underwent a T1 weighted image magnetic resonance imaging using 3T MRI Scanner (Siemens, Germany). All volumes were examined with the 3D-Slicer 4.10.1 (Surgical Planning Laboratory, Brigham and Women’s Hospital, USA; http://www. slicer.org/). The PV was traced in all coronal slices with well-defied boundaries (such as diaphragma sellae (superiorly), the sphenoid sinus (inferiorly), the cavernous sinuses(bilaterally)). The infundibular stalk was excluded while the bright posterior pituitary was included. All images were tranced manually by a trained rater who was blind to the participants’ group assignment. In a random subset of 24 cases, both the inter-rater reliability (intraclass correlation coefficient r=0.916, p&lt;0.001) and the intra-rater reliability (intraclass correlation coefficient r=0.924 p&lt;0.001) were high. We conducted MANCOVA with gender, and whole brain volumes (WBV) as covariates to compare the PV among the groups. Results We found no significant differences in gender ratio, age, and WBV (p&gt;0.05) among the three groups, but patients with first-episode schizophrenia showed shorter length of education than healthy controls (p&lt;0.001). As expected, we found that male participants in general (Mean ± SD: 486.85 ± 100.24) exhibited a prominently smaller PV than female participants (Mean ± SD: 562.13 ± 102.90) after controlling for WBV (t=25.087, p&lt;0.001). Findings from MANCOVA analysis showed that although first-episode schizophrenia patients (Mean ± SD: 523.81 ± 116.41) and healthy controls (Mean ± SD: 513.17 ± 103.57) showed no significant difference in PV (F=0.581, p=0.447), there was a trend of statistical significance in their non-psychotic first-degree relatives (Mean ± SD: 557.85 ± 93.58) compared with healthy controls (F=3.334, p=0.072). We also found a negative correlation between the duration of treatment and PV in female schizophrenia patients (r=-0.398, p=0.029), whose mean duration of treatment was 4.71 months (SD=2.18 months). No significant correlation was observed in in male patients. Discussion Our findings found no alteration of PV in first-episode schizophrenia patients but a trend of enlargement was observed in their non-psychotic first-degree relatives. Moreover, female schizophrenia patients with longer duration of treatment exhibited smaller PV. These findings suggested that the enlarged PV might be an early detection signal for individuals with potentially high risk of developing into schizophrenia, and such an enlargement of PV might be responsive to antipsychotic medications.

P03-14 - A quasi-experimental controlled intervention to reduce violence on an acute psychiatric ward

2010 ◽  
Vol 25 ◽  
pp. 873 ◽  
Author(s):  
J. Beezhold ◽  
P. Williams ◽  
J. Taylor ◽  
A. Harris ◽  
S. Kandasamy
Keyword(s):  
Psychiatric Ward ◽  
Quasi Experimental ◽  
Acute Psychiatric Ward

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

2015 ◽  
Vol 30 (7) ◽  
pp. 830-836 ◽  
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.

Structured Interview for Hoarding Disorder (SIHD)

2019 ◽  
Vol 35 (4) ◽  
pp. 512-520
Author(s):  
Caterina Novara ◽  
Paolo Cavedini ◽  
Stella Dorz ◽  
Susanna Pardini ◽  
Claudio Sica
Keyword(s):  
Convergent Validity ◽  
Structured Interview ◽  
Diagnostic Process ◽  
Schizophrenia Spectrum Disorders ◽  
Clinical Environment ◽  
Obsessive Compulsive ◽  
Rater Reliability ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum

Abstract. The Structured Interview for Hoarding Disorder (SIHD) is a semi-structured interview designed to assist clinicians in diagnosing a hoarding disorder (HD). This study aimed to validate the Italian version of the SIHD. For this purpose, its inter-rater reliability has been analyzed as well as its ability to differentiate HD from other disorders often comorbid. The sample was composed of 74 inpatients who had been diagnosed within their clinical environment: 9 with HD, 11 with obsessive-compulsive disorder (OCD) and HD, 22 with OCD, 19 with major depressive disorder (MDD), and 13 with schizophrenia spectrum disorders (SSD). The results obtained indicated “substantial” or “perfect” inter-rater reliability for all the core HD criteria, HD diagnosis, and specifiers. The SIHD differentiated between subjects suffering from and not suffering from a HD. Finally, the results indicated “good” convergent validity and high scores were shown in terms of both sensitivity and specificity for HD diagnosis. Altogether, the SIHD represents a useful instrument for evaluating the presence of HD and is a helpful tool for the clinician during the diagnostic process.

Screening Adolescents for Schizophrenia-Spectrum Disorders

2000 ◽  
Author(s):  
B. Cornblatt ◽  
M. Obuchowski ◽  
S. Roberts ◽  
S. Pollack ◽  
L. Erienmeyer-Kimling
Keyword(s):  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders
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