scholarly journals Decrease of Hospitalizations and Length of Hospital Stay in Patients with Schizophrenia Spectrum Disorders or Bipolar Disorder Treated in a Mobile Mental Health Service in Insular Greece

Psych ◽  
2021 ◽  
Vol 3 (4) ◽  
pp. 780-791
Author(s):  
Aikaterini Garbi ◽  
Ioannis Tiniakos ◽  
Zacharenia Mikelatou ◽  
Ioannis Drakatos
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Treatment Engagement ◽  
Time Interval ◽  
Inpatient Setting ◽  
Schizophrenia Spectrum Disorders ◽  
Community Based ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Mobile Mental Health

In recent years serious mental health issues, such as schizophrenia spectrum disorders and bipolar disorder, have been treated in the community by community-based mental health services. In the present study our goal was to estimate the modification in the number of hospitalizations and duration of admissions in either psychotic patients or patients with bipolar disorder, treated by a Mobile Mental Health Unit in the islands of Kefalonia, Zakynthos and Ithaca (MMHU-KZI). Data were collected from a total of 108 patients with schizophrenia spectrum disorders and bipolar disorder. For each patient comparison was made for the same time interval prior and after engagement to treatment with the MMHU-KZI and not for the total hospitalizations that patients had in their history. There was a statistically significant reduction (45.9%) in hospitalizations after treatment engagement with the MMHU-KZI, as the Wilcoxon signed ranks test indicated. Furthermore, a major decrease (54.5%) of hospitalization days was noted after treatment engagement with the unit. This pattern of mental health provision may be beneficial for the reduction of the number and duration of psychiatric hospitalizations. Despite the beneficial contribution of community-based mental health units, hospital based treatment should always be available, since severe relapses are better treated in inpatient setting.

Independence through Community Access and Navigation in adults with schizophrenia spectrum disorders Part 2: Treatment planning and implementation

2011 ◽  
Vol 10 (1) ◽  
pp. 35-45
Author(s):  
Gretchen Snethen, PhD, LRT/CTRS ◽  
Bryan P. McCormick, PhD, CTRS ◽  
Rachel L. Smith, MS ◽  
Marieke Van Puymbroeck, PhD, CTRS
Keyword(s):  
Treatment Planning ◽  
Skill Acquisition ◽  
Schizophrenia Spectrum Disorders ◽  
Community Based ◽  
Community Environment ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
The Individual ◽  
Community Access ◽  
Over Time

Social isolation and nonparticipation in the community are chronic issues for adults with schizophrenia spectrum disorders that can lead to poorer health outcomes. The Independence through Community Access and Navigation (I-CAN) intervention was developed as a theoretically grounded intervention that uses motivational interviewing to understand the interests and motivations of clients for participation. The intervention is designed to support participation in community-based activities by providing access and skill acquisition in a community environment. Participation between the recreational therapist and the participant decreases over time to encourage the individual to begin to independently access his or her community. This article presents the treatment planning steps and the implementation protocol for the I-CAN intervention.

Altered systemic cortisol metabolism in bipolar disorder and schizophrenia spectrum disorders

2014 ◽  
Vol 52 ◽  
pp. 57-62 ◽  
Author(s):  
Nils Eiel Steen ◽  
Paal Methlie ◽  
Steinar Lorentzen ◽  
Ingrid Dieset ◽  
Monica Aas ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Schizophrenia Spectrum Disorders ◽  
Cortisol Metabolism ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Violent offending in schizophrenia spectrum disorders preceding and following diagnosis

2018 ◽  
Vol 52 (8) ◽  
pp. 782-792 ◽  
Author(s):  
Henning Hachtel ◽  
Cieran Harries ◽  
Stefan Luebbers ◽  
James RP Ogloff
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Substance Use ◽  
Schizophrenia Spectrum Disorders ◽  
Violent Offending ◽  
Schizophrenia Spectrum ◽  
History Of ◽  
Spectrum Disorders ◽  
Violent Victimisation ◽  
Violent Offences

Objective: People affected by schizophrenia spectrum disorders are at a higher risk of offending violently. This study aims to investigate risk factors in relation to the peri-diagnostic period and possible predictors of post-diagnostic violence of people diagnosed for the first time in the public mental health system. Methods: The study compared various risk factors for post-diagnostic violence in patients ( n = 1453) diagnosed with a schizophrenia spectrum disorder. Patients were grouped according to the occurrence of peri-diagnostic violence. Of the 246 violent offenders, 164 committed their first offence pre-diagnosis. Mental health and criminological variables were evaluated across the lifespan (median age at end of follow-up = 34.22 years, range = 17.02–55.80 years). Results: Gender, employment, non-violent offending, family incidents, violent and non-violent victimisation, substance use, personality disorder, number of in-patient admissions and history of non-compliance differed significantly across violent and non-violent subgroups (all p ⩽ 0.01 and at least small effect size). More frequent and longer inpatient admissions were found in the violent subgroups (all p ⩽ 0.01). For the whole sample, sex, number of violent offences, non-violent offences, violent victimisation, substance use and number of inpatient admissions predicted post-diagnostic violence (χ2 (6) = 188.13, p < 0.001). Among patients with a history of pre-diagnostic violence, a history of non-violent offending in the 18-month period pre-diagnosis was the strongest predictor of future violence (odds ratio = 3.08, 95% confidence interval [1.32, 7.21]). Conclusion: At triage, violence risk assessment should consider the presence of antisocial behaviour and violent victimisation, substance use, male gender and frequency of inpatient admissions. Common treatment targets for the prevention of post-diagnostic violence include criminality and victimisation. Treatment of positive symptoms should be of greater emphasis for individuals without a history of pre-diagnostic violence.

scholarly journals Effectiveness of Community-Based Interventions for Patients with Schizophrenia Spectrum Disorders: A Study Protocol for a Systematic Review

2021 ◽  
Author(s):  
Soo-Yeon Kim ◽  
Ah Rim Kim
Keyword(s):  
Systematic Review ◽  
Community Mental Health Services ◽  
Secondary Outcome ◽  
Continuous Variables ◽  
Schizophrenia Spectrum Disorders ◽  
Community Based Interventions ◽  
Community Based ◽  
Schizophrenia Spectrum ◽  
Comparison Groups ◽  
Spectrum Disorders

Abstract Background: Schizophrenia requires a community-based intervention approach combined with standard treatment to prevent relapses. A literature review is required to understand the effectiveness of community-based interventions and to enhance quality in countries where they have not been fully established. This is a protocol for a systematic review of the effectiveness of community-based interventions for patients with schizophrenia spectrum disorders. Methods: Studies on community-based interventions for patients with schizophrenia spectrum disorders that were published any time until January 2021 will be searched on six databases, using the primary words: “schizophrenia” and “community mental health services.” The comparison groups will include patients with schizophrenia spectrum disorders who are only receiving the usual care and those who also receive community-based interventions. The schizophrenia spectrum disorders referred to in this study are defined according to the DSM-5; delusional disorders, schizophrenic disorders, and schizoaffective disorder will be included. Relapse/re-hospitalization rates (primary outcome) and quality of life (secondary outcome) will be identified for each group. The study design will consider only randomized controlled trials (RCT). To assess bias, RCT will be analyzed via the Cochrane RoB 2.0. Results will be descriptively synthesized and statistically analyzed, and will be structured according to patients’ characteristics, intervention type and exposure, and outcome type. Discrete variables will be calculated via odds ratio, and continuous variables will be calculated via standardized mean difference using RevMan 5.3 software. Discussion: We will provide a summary of the available evidence on the effectiveness of community-based interventions and specific guidelines to improve their outcomes. Systematic review registration: The protocol for this systematic review was registered on PROSPERO database; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145660.

scholarly journals Abnormal bodily experiences detected by Abnormal Bodily Phenomena questionnaire are more frequent and severe in schizophrenia than in bipolar disorder with psychotic features

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Giovanni Stanghellini ◽  
Davide Palumbo ◽  
Massimo Ballerini ◽  
Armida Mucci ◽  
Francesco Catapano ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Type I ◽  
Semistructured Interview ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Bodily Experiences ◽  
Spectrum Disorders ◽  
Psychotic Features

Abstract Background: Patients with schizophrenia display experiential anomalies in their feelings and cognitions arising in the domain of their lived body. These abnormal bodily phenomena (ABP) are not part of diagnostic criteria for schizophrenia. One of the reasons is the difficulty to assess specific ABP for schizophrenia spectrum disorders. The present study aimed to explore the presence in patients with schizophrenia of specific ABP. Methods: We used a semistructured interview—the Abnormal Bodily Phenomena questionnaire (ABPq), an instrument devised to detect and measure ABP specific to patients with schizophrenia. Fifty-one outpatients affected by schizophrenia and 28 euthymic outpatients affected by bipolar disorder type I with psychotic features (BD-pf-e) were recruited. Before assessing the specificity for schizophrenia of the observed ABP, we tested the internal consistency and the convergent validity of the ABPq in patients with schizophrenia. Specificity was assessed by examining potential differences in ABPq among the patients with schizophrenia in remission (SCZ-r) and BD-pf-e. Results: The ABPq shows strong internal consistency and convergent validity. As to the specificity, ABP measured by ABPq were more frequent and severe in SCZ-r than in BD-pf-e. In particular, all ABPq dimensions, except “Coherence,” had at least mild severity in over 50% of SCZ-r, while dimensions with at least mild severity were observed in 5–10% of the BD-pf-e. Conclusions: These findings can contribute to establish more precise phenomenal boundaries between schizophrenia and bipolar disorder, to explore the borders between nonpsychotic and psychotic forms of ABP, between ABP and negative and disorganized symptoms, and to enlighten core aspects of schizophrenia.

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