The Effectiveness and Applicability of Compensatory Cognitive Training for Japanese Patients with Schizophrenia: A Pilot Study

Although cognitive remediation or training for schizophrenia has been developed, few studies on the subject have focused on Japanese patients. The aim of the present study was to examine the effectiveness and applicability of compensatory cognitive training (CCT) in Japanese patients with schizophrenia. Twenty-six participants diagnosed with schizophrenia were assigned to either the CCT plus treatment as usual group (n=13) or the treatment as usual alone group (n=13). CCT is a 12-session, manualized, group-based training that coaches compensatory strategies in four cognitive domains (prospective memory, attention, verbal memory, and executive functions). Cognitive, functional, and clinical symptom measures were implemented at baseline, after treatment, and at 3-month follow-up. Mixed design analyses of variance with group and time for each measure demonstrated that effects of CCT on verbal memory, processing speed, and social functioning at postintervention were significant, and the effects on processing speed were maintained at follow-up. Our study suggests that CCT has beneficial effects on cognitive performance, improving functional outcomes in Japanese patients with schizophrenia. Additionally, the high degrees of attendance rates and level of satisfaction rated by the CCT participants ensure the applicability of this methodology to this population.

Factors in Mental Health Problems among Japanese Dialysis Patients Living in Heavily Damaged Prefectures Two Years after the Great East Japan Earthquake

This study examined the prevalence of mental health problems and related factors among dialysis patients living in prefectures that were heavily damaged by the Great East Japan Earthquake. Research was conducted two years following the disaster, and data of 1500 residents of the prefectures were analyzed. This study examined disaster related stressors, gender, socioeconomic status, health problems prior the earthquake, and social support, all of which have been identified as aggravating/mitigating factors in previous research on disaster survivors. We also examined advanced awareness of emergency planning as a dialysis specific factor. Mental health problems after the disaster were categorized into three types: PTSD and depression comorbidity, PTSD only, and depression only. Results indicated that people with comorbidity, PTSD, and depression comprised 7.5%, 25.0%, and 2.9% of the sample, respectively. Not only disaster related stressors but also health problems prior to the disaster had an aggravating direct effect on comorbidity and PTSD. In addition, social support and advanced awareness of disaster planning had a mitigating effect on comorbidity. These results suggest that advanced awareness of disaster planning is a dialysis specific factor that could decrease the occurrence of comorbidity among dialysis patients following a disaster.

The Dimensional Structure of the Schizotypal Personality Questionnaire Adapted for Children (SPQ-C-D): An Evaluation in the Dutch Population and a Comparison to Adult Populations

The increasing interest in dimensional approaches towards schizophrenia spectrum pathology calls for instruments that can be used to study developmental markers conveying risk for psychopathology prior to onset of the disorder. In this study we evaluated the Dutch child version (SPQ-C-D) of the Schizotypal Personality Questionnaire (SPQ) developed by Raine, in terms of reliability and factorial structure in comparison to SPQ data from two studies with adults. The 74-item SPQ-C-D was completed by 219 children and adolescents aged 9 to 18 years. Internal consistency was assessed and the factorial structure was analyzed using principal component analysis (PCA) and confirmatory factor analysis. Results showed that most of the subscales had high Cronbach’s alphas, indicating good internal consistency. PCA resulted in three components, similar to the adult studies: Cognitive-Perceptual, Interpersonal, and Disorganization. The pattern of individual subscales loading on each of the components was identical to the original Raine study, except for one additional subscale loading on the Disorganization component. In addition, forcing Raine’s factorial structure on our data with confirmatory factor analysis resulted in an overall adequate model fit. In conclusion, the SPQ-C-D appears to be a suitable dimensional measure of schizotypal traits in populations aged 9 to 18 years.

The Psychosocial Consequences of Sports Participation for Individuals with Severe Mental Illness: A Metasynthesis Review

The purpose of the current metasynthesis review was to explore the psychosocial benefits of sport and psychosocial factors which impact on sports participation for individuals with severe mental illness. AMED, CINAHL Plus, Medline, EMBASE, ProQuest Nursing & Allied Health Source, and Science Citation Index were searched from inception until January 2014. Articles included use qualitative methods to examine the psychosocial effects of sports participation in people with severe mental illness. Methodological quality was assessed using the Consolidated Criteria for Reporting Qualitative Studies and a case study tool. Included studies were analysed within a metasynthesis approach. Eight articles involving 56 patients met the inclusion criteria. The results identified the broader and direct psychosocial benefits of sport. Sport provided a “normal” environment and interactions that were not associated with an individual’s mental illness. Sport provided individuals with a sense of meaning, purpose, belonging, identity, and achievement. Other findings are discussed. Direct psychosocial benefits are a consequence of sports participation for the vast majority of individuals with severe mental illness. Further to this, sports participation was associated with a reduction in social isolation and an increase in social confidence, autonomy, and independence.

Valproate Prescribing in Women of Childbearing Age: An Audit of Clinical Practice

Background. Evidence is accruing regarding the risks of valproate exposure in women of childbearing age. Recommendations have recently been made for a higher standard of prenatal counselling and prescribing practice in respect of valproate use in this patient group. Aim and Method. A reaudit was carried out to review the standard of clinical discussion around teratogenic risk and pregnancy planning offered to women of child-bearing age prescribed valproate. Case notes and prescription charts of women 45 years old or less were examined and compared with the results of a previous audit in 2005. Results. The use of valproate was increased overall by 64% and there was an 18% increase in off-label valproate use. The rate of clinical discussion carried out during commencement declined from 70% to 35% and at annual review from 50% to 22%. There was less clinical discussion in outpatients and in older patients. More than 40% of doctors surveyed were not confident about giving information to women. Clinical Implication. There is a need for a multidisciplinary approach and action at Healthcare Trust level, to increase awareness and reduce risks associated with valproate prescribing in childbearing women.

Occupational Performance and Affective Symptoms for Patients with Depression Disorder

The aim of this study was to describe recovering over time in occupational performance and in affective symptoms for patients with depression disorder by using different assessments and methods for collecting data. A longitudinal design with data collections on repeated occasions was used. The Occupational Circumstances Assessment Interview and Rating Scale and Occupational Self-Assessment were used for measuring occupational performance, and for affective symptoms, a Comprehensive Psychopathological Rating Scale Self-Assessment was used. Fourteen patients with depression disorder were included in the study. The result indicates that affective symptoms improve earlier than occupational performance. Furthermore, self-assessment seems to reflect more improvement to the patient than interview-based assessment. Different kinds of assessment and different kinds of data collection methods seem to facilitate the understanding of the patients recovering. In addition habituation was the most important item for the patients to manage. One implication for practice is that patients may need an extended period of treatment supporting occupational performance.

The Cloninger Type I/Type II Typology: Configurations and Personality Profiles in Socially Stable Alcohol Dependent Patients

Many attempts have been made to derive alcohol use typologies or subtypes of alcohol dependence and this study aimed at validating the type I/type II typology in a treatment sample of socially stable alcohol dependent males and females. A second aim was to compare the two types with respect to their temperament profiles. Data was part of a larger ongoing longitudinal study, the Gothenburg Alcohol Research Project, and included 269 alcohol dependent males and females recruited from three treatment centers. The results showed that type II alcoholism occurred as a more homogenous type than type I alcoholism, and type I alcoholism seemed too heterogeneous to be summarized into one single type. When adapting a strict classification, less than a third of the study population could be classified in accordance with the typology, suggesting that the typology is not applicable, at least in socially stable individuals with alcohol dependence. The results also showed that type II alcoholics showed higher levels of novelty seeking than did the individuals that were classified as type I alcoholics. Quite surprisingly, the individuals classified as type II alcoholics also showed higher levels of harm avoidance than did the individuals that were classified as type I alcoholics.

Rate of Nonadherence to Antipsychotic Medications and Factors Leading to Nonadherence among Psychiatric Patients in Gondar University Hospital, Northwest Ethiopia

Objective. The main aim of this study was to assess the rate of medication nonadherence among psychiatry patients at University of Gondar Hospital. Materials and Methods. Cross-sectional, descriptive method was conducted over a period of one month in May, 2013, at University of Gondar Hospital. Rate of nonadherence was computed using Medication Adherence Rating Scale questionnaire and self-reporting via a structured patient interview. Chi-square was used to determine the statistical significance of the association of variables with adherence. Result. Out of 209 respondents, 105 (50.2%) were found to be nonadherent. Patients who were forced to take their medication against their will (P<0.001), those who did not believe they require medication (P=0.026), and those who discontinued their medication without consulting their prescriber (P<0.001) had significant association with nonadherence. Adherence among schizophrenia was 75.7%; psychotic was 46.7%; bipolar disorder was 37.5%; and psychosis with depression was 52.6%. Reasons for nonadherence included recovery from the illness (26.7%), seeking alternative therapy and unavailability of drugs (18.1% each), adverse drug reaction (12.7%), forgetfulness (10.6%), and being busy (8.6%). Conclusion. The observed rate of antipsychotic medication nonadherence in this study was high. Interventions to increase adherence are therefore crucial.

Emotional Intelligence and Personality in Anxiety Disorders

Anxiety disorders (AD) are by far the most frequent psychiatric disorders, and according to epidemiologic data their chronicity, comorbidities, and negative prognostic constitute a public health problem. This is why it is necessary to continue exploring the factors which contribute to the incidence, appearance, and maintenance of this set of disorders. The goal of this study has been to analyze the possible relationship between Emotional Intelligence (EI) and personality disorders (PersD) in outpatients suffering from AD. The sample was made up of 146 patients with AD from the Mental Health Center at the Health Consortium of Maresme, who were evaluated with the STAI, MSCEIT, and MCMI-II questionnaires. The main findings indicate that 89,4% of the patients in the sample met the criteria for the diagnosis of some PersD. The findings also confirm that patients with AD present a low EI, especially because of difficulties in the skills of emotional comprehension and regulation, and the lack of these skills is related to a higher level of anxiety and the presence of PersD. These findings suggest the need to consider emotional skills of EI and personality as central elements for the diagnosis and treatment of AD.

Cytokine Serum Levels as Potential Biological Markers for the Psychopathology in Schizophrenia

We discuss the role of immune system disturbance in schizophrenia and especially changes of serum levels of cytokines in patients with schizophrenia. The cytokines are essential to wide range of functions related to the defense of the organisms from infectious and environmental dangers. However it is not known whether cytokines influence the presentation of psychotic symptoms. Identification of changes in the serum level of certain cytokines and their correlation with distinct psychopathological symptoms may facilitate the identification of subgroups of patients who are likely to benefit from immunotherapy or anti-inflammatory therapy. Such patients may benefit from tailored immunotherapy designed for modulation of abnormal cytokine levels related to specific positive or negative symptoms of schizophrenia.