Association between Occupational Dysfunction and Social Isolation in Japanese Older Adults: A Cross-Sectional Study

We clarified the relationship between occupational dysfunction and social isolation among community-dwelling adults. We used a self-administered questionnaire with a cross-sectional study for 2879 independently living older adults in Kasama City, Japan. Participants responded to a self-reported questionnaire in November 2019. Occupational dysfunction and social isolation were assessed. The participants were classified into two groups: healthy occupational function group, and occupational dysfunction group. To examine the relationship between occupational dysfunction and social isolation, we performed a logistic regression analysis with social isolation as a dependent variable and occupational dysfunction as an independent variable. In the crude model, the occupational dysfunction group had a higher risk of social isolation than the healthy occupational function group (odds ratio (OR) = 2.04; 95% confidence interval (CI), 1.63–2.55; p < 0.001). In the adjusted model, the occupational dysfunction group had a higher risk of social isolation than the healthy occupational function group (OR = 1.51; 95% CI, 1.17–1.94; p = 0.001). The results showed that occupational dysfunction was significantly associated with social isolation. These results can be used in constructing a support method for social isolation from a new perspective.

Neurobiology Youth Follow-up Study: protocol to establish a longitudinal and prospective research database using multimodal assessments for current and past mental health treatment-seeking young people within an early intervention service

IntroductionApproximately 75% of major mental illness occurs before the age of 25 years. Despite this, our capacity to provide effective, early and personalised interventions is limited by insufficient evidence for characterising early-stage, and less specific, presentations of major mental disorders in youth populations. This article describes the protocol for setting up a large-scale database that will collect longitudinal, prospective data that incorporate clinical, social and occupational function, neuropsychological, circadian, metabolic, family history and genetic metrics. By collecting data in a research-purposed, standardised manner, the ‘Neurobiology Youth Follow-up Study’ should improve identification, characterisation and profiling of youth attending mental healthcare, to better inform diagnosis and treatment at critical time points. The overall goal is enhanced long-term clinical and functional outcomes.Methods and analysisThis longitudinal clinical cohort study will invite participation from youth (12–30 years) who seek help for mental health-related issues at an early intervention service (headspace Camperdown) and linked services. Participants will be prospectively tracked over 3 years with a series of standardised multimodal assessments at baseline, 6, 12, 24 and 36 months. Evaluations will include: (1) clinician-administered and self-report assessments determining clinical stage, pathophysiological pathways to illness, diagnosis, symptomatology, social and occupational function; (2) neuropsychological profile; (3) sleep–wake patterns and circadian rhythms; (4) metabolic markers and (5) genetics. These data will be used to: (1) model the impact of demographic, phenomenological and treatment variables, on clinical and functional outcomes; (2) map neurobiological profiles and changes onto a transdiagnostic clinical stage and pathophysiological mechanisms framework.Ethics and disseminationThis study protocol has been approved by the Human Research Ethics Committee of the Sydney Local Health District (2020/ETH01272, protocol V.1.3, 14 October 2020). Research findings will be disseminated through peer-reviewed journals and presentations at scientific conferences and to user and advocacy groups. Participant data will be de-identified.

From folk therapy to evidence-based psychiatry practice: The benefit of evidence-based psychiatry in treatment-naive psychotic patients

Background: As Taiwan’s Mental Health Act (MHA) clearly states that the human rights and legal rights of psychotic patients should be respected and guaranteed; however, a temple asylum violates the law in the 21st century. Hundreds of patients were constrained in the asylum for years without consent. Because of outbreak of infectious diseases, patients were evacuated from the asylum by the official intervention. Aims: To evaluate the outcomes of these patients from folk therapy to conventional treatment. Method: The study recruited the drug-naive psychotic patients constrained in an asylum for decades. Before and after the formal treatment, 253 patients were diagnosed with schizophrenia and other psychotic disorders with assessment of using the Mini Positive and Negative Syndrome Scale (Mini-PANSS) and Comprehensive Occupational Therapy Evaluation (COTE) scale. In addition, family function, self-care ability and nutritional status were also evaluated. Results: The initial data show the improvement in psychotic symptoms and occupational function in these patients. Furthermore, the ratio of patients who were classified as being at risk for malnutrition was decreased by 21.7% after treatment. There was no statistically significant difference in self-care ability before and after treatment. Conclusion: The psychotic symptoms and occupational function of these patients were improved after the formal treatment compared to the folk therapy. The care model for the psychotic patients in the temple asylum should be more thoroughly discussed in consideration of the medical ethics principles.

Developmental Disorders in Canada

In the completion of my practicum at the Public Health Agency of Canada (PHAC) this summer, I worked to develop a surveillance knowledge product to support the national surveillance of developmental disorders. This project used Statistics Canada’s 2017 Canadian Survey on Disability to investigate the burden of developmental disorders in Canada. Developmental disorders are conditions with onset in the developmental period. They are associated with developmental deficits and impairments of personal, social, academic, and occupational function. The project objectives are to estimate the prevalence of developmental disorders in Canadians 15 years of age or older, overall and by age and sex, as well as report on the age of diagnosis, disability severity, and disability co-occurrence in those with developmental disorders. The majority of the analysis has been completed and preliminary results completed, which cannot be released prior to PHAC publication. Although not highly prevalent, developmental disorders are associated with a high level of disability in young Canadians. Early detection and interventions have been shown to improve health and social outcomes among affected individuals. Understanding the burden of developmental disorders in Canada is essential to the development of public health policies and services.

Supportive counselling is ineffective for managing PTSD in youth

More than half of children and young people are exposed to potentially traumatic events,and a significant minority of those exposed go on to develop post-traumatic stress disorder (PTSD). Because PTSD can be chronic, it can have a notable impact on child development, as well as social, academic and occupational function - it is therefore imperative that effective treatments are identified and prioritized.

From Folk Therapy to Evidence-based Psychiatry Practice: The Benefit of Evidence-based Psychiatry in Treatment-naive Psychotic Patients

Background: Though Taiwan’s Mental Health Act clearly states that the human rights and legal rights of psychotic patients should be respected and guaranteed, a temple mental asylum violated those regulations in the 21st century. Hundreds of patients were constrained in the asylum and evacuated following a forcible, public right intervention. Method: The study conducted drug-naïve psychotic patients constrained in an asylum for decades. Before and after formal treatment, a total of 169 patients diagnosed with schizophrenia and other psychotic disorders were assessed with rating scales including the Mini Positive and Negative Syndrome Scale, Comprehensive Occupational Therapy Evaluation scale. In addition, family function, self-care and nutritional status were evaluated. Results: The initial data show improvement in psychotic symptoms and occupational function. Furthermore, the ratio of patients classified as being at risk for malnutrition was decreased by 21.7% after treatment. Conclusion: The psychotic symptoms and occupational function of these patients improved after undergoing formal treatment compared with folk therapy. The care model for psychotic patients in the temple asylum should be discussed while considering medical ethics principles. Trial registration: retrospectively registered.

Personal Social Capital and Socio-occupational Function of Persons with Schizophrenia: A Comparative Study

Background: Personal social capital is an individual’s networks and connections between individuals that can provide support which is characterized by reciprocity, trustworthiness and resources. Individuals who are excluded from accessing social capital have a higher risk of schizophrenia and may have informal social control. Social functioning of individuals with schizophrenia gets disturbed therefore improving the functioning levels is considered to be an important goal in treating schizophrenia. Aim: To assess and compare personal social capital and socio-occupational functioning of patients with schizophrenia and normal controls. Materials and Methods: The sample consisted of 60 individuals (30 patients diagnosed with schizophrenia and 30 normal population) selected from the outpatient department (OPD) of the Central Institute of Psychiatry, Ranchi by using purposive sampling method. Positive and negative syndrome scale (for study group) and General health questionnaire (for normal population) applied for screening. Participants who fulfilled inclusion criteria were informed about study and consent was obtained. Socio-demographic and clinical datasheet, Personal Social Capital Scale and socio-occupational functioning scale were administered. Results: Present study shows a significant difference in personal social capital and socio-occupational functioning of persons with schizophrenia and normal controls. Conclusion: The patients with schizophrenia hold lower personal social capital and socio-occupational functioning than the normal population. Personal social capital and socio-occupational functioning showed a significant positive correlation, therefore, improvement in socio-occupational functioning can help to enhance personal social capital. Keywords: Schizophrenia, personal social capital, socio-occupational functioning