المؤلفون: Apassa, Modupe.

مستخلص: Schizophrenia is a debilitating mental health illness that requires consistent provider monitoring and follow-up to improve symptoms and the quality of life of both the patients and their families. Due to its chronic nature, patients with schizophrenia suffer severe cognitive challenges that are a sequela of the disease and lead to difficulty maintaining medication adherence. To improve current outpatient psychiatric practice for patients diagnosed with schizophrenia, weekly phone consultations with patients were conducted to elicit the cause of medication non-adherence, follow-up with pharmacies to fill medications in a timely manner, and reiterate psychoeducation with an end-goal of ensuring medication adherence. This nurse practitioner doctoral project revealed that in addition to phone consultations, psychoeducation about benefits and risks of current medications, and patients’ recognition of their medications in more than 61% of the participants, are key to optimizing medication adherence in patients diagnosed with schizophrenia.

الموضوعات: Patient compliance., Mental illness Treatment., Schizophrenia., Mental Disorders therapy, Patients Coopération., Maladies mentales Traitement., Schizophrénie., Mental illness Treatment., Patient compliance., Schizophrenia.

مصطلحات الفهرس: adults, medication adherence, psychoeducation, schizophrenia

URL: http://cdm16397.contentdm.oclc.org/cdm/ref/collection/p15323coll5/id/64648
http://cdm16397.contentdm.oclc.org/utils/getthumbnail/collection/p15323coll5/id/64648
http://worldcat.org/oclc/1263187677/viewonline

المؤلفون: Bray, Patrick F., 1922-

مصطلحات موضوعية: Mental Disorders -- diagnosis., Nervous System Diseases -- diagnosis., Diagnosis, Differential., Mental Disorders -- therapy., Nervous System Diseases -- therapy., CD-ROMs.

المصدر: Tranberg , K , Jønsson , A , Due , T , Siersma , V , Brodersen , J B , Bissenbakker , K , Martiny , F , Davidsen , A , Kjellberg , P K , Doherty , K , Mercer , S W , Nielsen , M H , Reventlow , S , Møller , A , Rozing , M & SOFIA Study Group 2023 , ' The SOFIA pilot study : assessing feasibility and fidelity of coordinated care to reduce excess mortality and increase quality of life in patients with severe mental illness in a general practice setting; a cluster-randomised pilot trial ' , BMC Primary Care , vol. 24 , no. 1 , 188 .

مستخلص: OBJECTIVE: To evaluate the feasibility and fidelity of implementing and assessing the SOFIA coordinated care program aimed at lowering mortality and increasing quality of life in patients with severe mental illness by improving somatic health care in general practice.DESIGN: A cluster-randomised, non-blinded controlled pilot trial.SETTING: General Practice in Denmark.INTERVENTION: The SOFIA coordinated care program comprised extended structured consultations carried out by the GP, group-based training of GPs and staff, and a handbook with information on signposting patients to relevant municipal, health, and social initiatives.PATIENTS: Persons aged 18 years or older with a diagnosis of psychotic, bipolar, or severe depressive disorder.MAIN OUTCOME MEASURES: We collected quantitative data on the delivery, recruitment and retention rates of practices and patients, and response rates of questionnaires MMQ and EQ-5D-5 L.RESULTS: From November 2020 to March 2021, nine practices were enrolled and assigned in a 2:1 ratio to the intervention group (n = 6) or control group (n = 3). Intervention group practices included 64 patients and Control practices included 23. The extended consultations were delivered with a high level of fidelity in the general practices; however, thresholds for collecting outcome measures, and recruitment of practices and patients were not reached.CONCLUSION: Our findings suggest that delivering the coordinated care program in a fully powered trial in primary care is likely feasible. However, the recruitment methodology requires improvement to ensure sufficient recruitment and minimize selective inclusion.TRIAL REGISTRATION: The date of pilot trial protocol registration was 05/11/2020, and the registration number is NCT04618250.

مصطلحات الفهرس: Humans, Pilot Projects, Quality of Life, Feasibility Studies, General Practice, Mental Disorders/therapy, article

URL: https://curis.ku.dk/portal/da/publications/the-sofia-pilot-study(8d7d8ad0-7d36-4fa8-b30f-9a79ea669c5d).html
https://doi.org/10.1186/s12875-023-02141-2
https://curis.ku.dk/ws/files/368426709/Fulltext.pdf

المصدر: Bjørkedal , S-T B , Bejerholm , U , Hjorthøj , C , Møller , T & Eplov , L F 2023 , ' Meaningful Activities and Recovery (MA &R) : a co-led peer occupational therapy intervention for people with psychiatric disabilities. Results from a randomized controlled trial ' , BMC Psychiatry , vol. 23 , no. 1 , 406 .

مستخلص: Background Activity and participation are critical to health and wellbeing. Limited evidence exists on how to support people with mental illness in participating in everyday activities. Aim To investigate the effectiveness of Meaningful Activities and Recovery (MA&R), a co-led peer occupational therapy intervention focusing on activity engagement, functioning, quality of life, and personal recovery. Methods In a statistician blinded, multicenter RCT including 139 participants from seven community and municipal mental health services in Denmark, participants were randomly assigned to 1) MA&R and standard mental health care or 2) standard mental health care. The MA&R intervention lasted 8 months and consisted of 11 group sessions, 11 individual sessions, and support to engage in activities. The primary outcome, activity engagement, was measured using Profile of Occupational Engagement in People with Severe Mental Illness (POES-S). Outcomes were measured at baseline and post-intervention follow-up. Results Meaningful Activities and Recovery was delivered with high fidelity and 83% completed the intervention. It did not demonstrate superiority to standard mental health care, as intention-to treat analysis revealed no significant differences between the groups in activity engagement or any of the secondary outcomes. Conclusion We did not find positive effects of MA&R, possibly because of COVID-19 and related restrictions. Fidelity assessments and adherence rates suggest that MA&R is feasible and acceptable. However, future studies should focus on refining the intervention before investigating its effectiveness. Trial registration The trial was registered 24/05/2019 at ClinicalTrials.gov NCT03963245.
BACKGROUND: Activity and participation are critical to health and wellbeing. Limited evidence exists on how to support people with mental illness in participating in everyday activities.AIM: To investigate the effectiveness of Meaningful Activities and Recovery (MA&R), a co-led peer occupational therapy intervention focusing on activity engagement, functioning, quality of life, and personal recovery.METHODS: In a statistician blinded, multicenter RCT including 139 participants from seven community and municipal mental health services in Denmark, participants were randomly assigned to 1) MA&R and standard mental health care or 2) standard mental health care. The MA&R intervention lasted 8 months and consisted of 11 group sessions, 11 individual sessions, and support to engage in activities. The primary outcome, activity engagement, was measured using Profile of Occupational Engagement in People with Severe Mental Illness (POES-S). Outcomes were measured at baseline and post-intervention follow-up.RESULTS: Meaningful Activities and Recovery was delivered with high fidelity and 83% completed the intervention. It did not demonstrate superiority to standard mental health care, as intention-to treat analysis revealed no significant differences between the groups in activity engagement or any of the secondary outcomes.CONCLUSION: We did not find positive effects of MA&R, possibly because of COVID-19 and related restrictions. Fidelity assessments and adherence rates suggest that MA&R is feasible and acceptable. However, future studies should focus on refining the intervention before investigating its effectiveness.TRIAL REGISTRATION: The trial was registered 24/05/2019 at ClinicalTrials.gov NCT03963245.

مصطلحات الفهرس: Humans, Occupational Therapy, Quality of Life, Treatment Outcome, COVID-19, Mental Disorders/therapy, article

URL: https://curis.ku.dk/portal/da/publications/meaningful-activities-and-recovery-mar(d6792cdd-39ba-4737-ab60-c9c4a3d6fdbc).html
https://doi.org/10.1186/s12888-023-04875-w
https://curis.ku.dk/ws/files/356769932/Fulltext.pdf

عناروين إضافية: Unauthorized absence and recidivism during court ordered psychiatric treatment leave

المؤلفون: Bulten, B. H.

المصدر: Tijdschrift voor Psychiatrie vol.64 (2022) nr.10 p.657-662 [ISSN 0303-7339]

مستخلص: BACKGROUND: Leave is an essential part of treatment within the framework of the tbs measure (court ordered psychiatric treatment for offenders with a mental disorder). Traditionally, these leaves lead to concerns about safety.AIM: To study how often tbs-patients do not return from leave (on time) and how often they commit a crime during an unauthorized absence (UA). In addition, we investigate whether patient or offence characteristics can predict an UA.METHOD: All UA’s between 2009-2020 were examined. We also analysed the patient characteristics of 11,525 permit applications between 2010 and 2018 from the registration system of the Advisory Board for Permitting Leave TBS (AVT).RESULTS: 2.5% of the applications for leave between 2009 and 2020 involved an UA and 0.15% involved an UA with a recidivism. Patients with a cluster B personality disorder, substance use disorder, mood disorder, attention disorder, arson or a serious violent crime as an index offence had a significantly higher chance of having an UA. However, these associations were very weak. The risk factor violation of conditions (from the Dutch risk assessment tool, the HKT (Historical, Clinical, Future)) was also a significant but very weak predictor of UA.CONCLUSION: UA is a rare event. Despite the fact that some patient and offence characteristics were associated with an UA, this relationship is weak and predicting an UA is difficult.

مصطلحات الفهرس: Humans, Recidivism, Crime/psychology, Mental Disorders/therapy, Violence/psychology, Substance-Related Disorders, Criminals/psychology, Article

URL: https://cris.maastrichtuniversity.nl/en/publications/82d9c539-0bd9-4a2a-9774-a1f762b5e2da
https://cris.maastrichtuniversity.nl/ws/files/123293297/Vogel_2022_Onttrekkingen_en_recidive_tijdens_tbs_verlof.pdf
https://cris.maastrichtuniversity.nl/ws/files/123293297/Vogel_2022_Onttrekkingen_en_recidive_tijdens_tbs_verlof.pdf

المصدر: BMC Psychiatry vol.22 (2022) nr.1 [ISSN 1471-244X]

مستخلص: Background: As severe mental illness (SMI) is associated with a high disease burden and persistent nature, patients with SMI are often subjected to long-term mental healthcare and are in need of additional social support services. Community-based care and support services are organized via different providers and institutions, which are often lacking structural communication, resulting in a fragmented approach. To improve the efficiency of care provision and optimize patient wellbeing, an integrated multi-agency approach to community-based mental health and social services has been developed and implemented.Aim: To present a research protocol describing the evaluation of flexible assertive community teams integrated with social services in terms of effectiveness, cost-effectiveness, and implementation.Methods/design: A quasi-experimental study will be conducted using prospective and retrospective observational data in patients with severe mental illness. Patients receiving care from three teams, consisting of flexible assertive community treatment and separately provided social support services (care as usual), will be compared to patients receiving care from two teams integrating these mental and social services into a single team. The study will consist of three parts: 1) an effectiveness evaluation, 2) a health-economic evaluation, and 3) a process implementation evaluation. To assess (cost-)effectiveness, both real-world aggregated and individual patient data will be collected using informed consent, and analysed using a longitudinal mixed model. The economic evaluation will consist of a cost-utility analysis and a cost-effectiveness analysis. For the process and implementation evaluation a mixed method design will be used to describe if the integrated teams have been implemented as planned, if its predefined goals are achieved, and what the experiences are of its team members.Discussion: The integration of hea

مصطلحات الفهرس: Humans, Cost-Benefit Analysis, Prospective Studies, Retrospective Studies, Community Mental Health Services/methods, Mental Disorders/therapy, Article

URL: https://research.tilburguniversity.edu/en/publications/958cab5f-f739-4c61-8bbb-e052950fe21a
https://pure.uvt.nl/ws/files/67980113/Tranzo_Kroon_cost_effectiveness_and_implementation_of_integrated_community_based_cares_BMC_PS_2022.pdf
https://pure.uvt.nl/ws/files/67980113/Tranzo_Kroon_cost_effectiveness_and_implementation_of_integrated_community_based_cares_BMC_PS_2022.pdf

عناروين إضافية: Thinking inside the box: improving the lifestyle of inpatients with severe mental illness

المؤلفون: Deenik, J

المصدر: Tijdschrift voor Psychiatrie vol.62 (2020) nr.7 p.564-574 [ISSN 0303-7339]

مستخلص: BACKGROUND: An unhealthy lifestyle plays an important role in the substantially reduced life-expectancy of inpatients with severe mental illness (SMI). However, there is a lack of evidence on the long-term effectiveness and implementation of lifestyle improvements in inpatient mental healthcare. AIM: Increasing knowledge and understanding of (the implementation of) lifestyle changes in inpatients with SMI in longer-term clinical care. METHOD: Cross-sectional research followed by an observational study to evaluate a multidisciplinary lifestyle enhancing treatment (MULTI) for both changes in health-related outcomes after 18 months compared to treatment as usual (TAU), and the implementation barriers and facilitators. RESULTS: Patients were very sedentary and less physically active compared to people without SMI. After 18 months, MULTI showed significant improvements in total physical activity, cardiometabolic risk factors, psychosocial functioning and mediation use, compared to TAU. Physical health did not improve in TAU. The implementation of MULTI was hampered by organisational factors and facilitated by positive attitudes of healthcare professionals and patients towards MULTI and their own role in it. CONCLUSION: Using a multidisciplinary integrated approach, it is possible to improve the lifestyle, and thus the health status, of SMI inpatients, within the current context of routine mental healthcare.

مصطلحات الفهرس: Cross-Sectional Studies, Health Status, Humans, Inpatients, Life Style, Mental Disorders/therapy, Article

URL: https://cris.maastrichtuniversity.nl/en/publications/2e02be36-5ee0-4594-a127-5b19519821ff
https://cris.maastrichtuniversity.nl/ws/files/78507700/Van_Harten_2020_Thinking_inside_the_box_leefstijlverbetering.pdf
https://cris.maastrichtuniversity.nl/ws/files/78507700/Van_Harten_2020_Thinking_inside_the_box_leefstijlverbetering.pdf

عناروين إضافية: Electroconvulsive therapy: eighty years of Croatian and international experience

المصدر: Liječnički vjesnik; ISSN 0024-3477 (Print); ISSN 1849-2177 (Online); Volume 142; Issue 7-8

مستخلص: Elektrokonvulzivna terapija (EKT) i nakon više od 80 godina primjene i dalje predstavlja najučinkovitiju terapiju kod najtežih kliničkih slika psihijatrijskih poremećaja. U Hrvatskoj se EKT primjenjuje od 40-ih godina prošlog stoljeća. Danas se koristi samo u KBC-u Zagreb, najčešće u pacijenata sa shizofrenijom. Brojna istraživanja su utvrdila različite biološke učinke EKT-a koji pridonose antidepresivnom, antimaničnom, antipsihotičnom, antikonvulzivnom i antiparkinsonskom učinku. Konvulzije imaju snažan učinak na perfuziju i metabolizam pojedinih moždanih regija, povećanje propusnosti krvnomoždane barijere te imaju modulatorni učinak na glutamatnu, GABA, serotoninsku, dopaminsku i noradrenergičku neurotransmisiju, hormonalnu sekreciju, promjene u ekspresiji brojnih gena te potiču neuroplastičnost i u konačnici dovode do strukturnih promjena mozga. Neke su od ovih promjena kratkog vijeka, a neke traju mjesecima, poput neuroplastičnosti. Iako se EKT smatra medicinskim postupkom niskog rizika, mnoge teške somatske bolesti zahtijevaju pažljivu procjenu koristi i rizika. Najčešće su neželjene reakcije prolazne teškoće pamćenja i glavobolja. Prije prve aplikacije kandidati prolaze detaljnu dijagnostičku obradu u skladu s međunarodnim standardima. U postupku primjene EKT-a sudjeluje interdisciplinarni tim koji uključuje psihijatra, anesteziologa, anesteziološku sestru/tehničara i psihijatrijsku sestru/tehničara. Primjena opće anestezije omogućuje brz gubitak svijesti, kratkotrajnu mišićnu relaksaciju, smanjenje hiperdinamskog odgovora na električnu stimulaciju te brz oporavak spontane ventilacije i svijesti. Nedavno su predložene Hrvatske nacionalne smjernice o primjeni EKT-a. Zbog učinka u terapijskoj rezistenciji te kod vrlo teških kliničkih slika EKT može ostvariti značajan učinak u pažljivo odabranih bolesnika.
Electroconvulsive therapy (ECT), even more than 80 years since its introduction, continues to be the most effective treatment for severe mental disorders. Croatian psychiatrists have used ECT since 1940s. Today it is performed only at the University Hospital Centre Zagreb, predominantly in patients with schizophrenia. Extensive research reported numerous biological effects of ECT, which contribute to its antidepressant, antimanic, antipsychotic, anticonvulsive and antiparkinsonian effects. Convulsions trigger changes in the cerebral blood flow and metabolism, increase the permeability of the blood-brain barrier, modulate glutamatergic, GABAergic, serotonergic, noradrenergic and dopaminergic neurotransmission, affect hormone secretion, gene expression, stimulate neuroplasticity, and eventually induce brain structural changes. Some of these effects are short-lasting and others, such a neuroplasticity, last for at least several months. While ECT is generally considered a low-risk medical treatment, patients with severe somatic comorbidity require careful risk-benefit assessment. The most commonly observed adverse events are transient forgetfulness and headache. Prior to initiation, candidates undergo comprehensive diagnostic evaluation according to international standards. The procedure is performed by an interdisciplinary team, consisting of psychiatrist, anesthesiologist, and psychiatric and anesthesiological nurses. The application of general anesthesia enables rapid loss of consciousness, short-time muscular relaxation, suppression of hyperdynamic response to electrical current and fast recovery of breathing and awareness. Recently, the Croatian expert group has proposed national guidelines for the ECT treatment. Due to its efficacy in both treatment-refractory and very severe symptomatology, ECT might be of a great benefit in carefully selected patients.

مصطلحات الفهرس: ELEKTROKONVULZIVNA TERAPIJA – metode, neželjeni učinci, standardi; SHIZOFRENIJA – liječenje; MENTALNI POREMEĆAJI – liječenje; MOZAK – patofiziologija; OPĆA ANESTEZIJA; SMJERNICE; HRVATSKA, ELECTROCONVULSIVE THERAPY – adverse effects, methods, standards; SCHIZOPHRENIA – therapy; MENTAL DISORDERS – therapy; BRAIN – physiopathology; ANESTHESIA, GENERAL; PRACTICE GUIDELINES AS TOPIC; CROATIA, text, info:eu-repo/semantics/article, info:eu-repo/semantics/publishedVersion

URL: https://hrcak.srce.hr/243301
https://hrcak.srce.hr/file/353604
info:eu-repo/semantics/altIdentifier/doi/10.26800/LV-142-7-8-41

عناروين إضافية: In- and out-of-hospital emergency psychiatry: What is the best approach?

المصدر: Vrije Universiteit Amsterdam Repository

مستخلص: Acute presentaties van psychiatrische aandoeningen vragen zowel binnen als buiten het ziekenhuis om efficiënte en zorgvuldige diagnostiek en behandeling. Vanwege de hectiek van het acute moment, waarbij vaak agitatie, suïcidaliteit, communicatieve uitdagingen en juridische aspecten een rol spelen, kan het in de praktijk lastig zijn om optimale en adequate zorg te bieden. Aan de hand van drie casussen geven wij handreikingen voor de diagnostiek en behandeling in dit soort acute situaties. A range of clinical syndromes may present with psychiatric symptoms, both in and out of hospital settings. In such situations agitation, suicidality, communication difficulties and legal aspects often play a role, making diagnosis and treatment a challenge. Based on several case studies, we illustrate how the recently-published Dutch open access source 'Acute Psychiatry' (www.acutepsychiatrie.com) can be of help in acute psychiatric presentations both within and outside psychiatric hospitals.

مصطلحات الفهرس: Acute Disease, Emergency Medical Services/methods, Hospitals, Psychiatric, Humans, Mental Disorders/therapy, Mental Health Services, Netherlands, Article

URL: https://research.vu.nl/en/publications/21781e71-1041-420e-8af4-c371910b9131
https://research.vu.nl/ws/files/119990515/d2387_Acute_psychiatrie_binnen_en_buiten_het_ziekenhuis.pdf
https://research.vu.nl/ws/files/119990515/d2387_Acute_psychiatrie_binnen_en_buiten_het_ziekenhuis.pdf

المصدر: Dalum , H S , Waldemar , A K , Korsbek , L , Hjorthøj , C , Mikkelsen , J H , Thomsen , K , Kistrup , K , Olander , M , Lindschou , J , Nordentoft , M & Eplov , L F 2018 , ' Illness management and recovery : Clinical outcomes of a randomized clinical trial in community mental health centers ' , PLOS ONE , vol. 13 , no. 4 , e0194027 .

مستخلص: OBJECTIVE: Illness Management and Recovery (IMR) is a psychosocial intervention with a recovery-oriented approach. The program has been evaluated in different settings; however evidence for the effects of IMR is still deficient. The aim of this trial was to investigate the benefits and harms of the IMR program compared with treatment as usual in Danish patients with schizophrenia or bipolar disorder.METHOD: The trial was designed as a randomized, assessor-blinded, multi-center, clinical trial investigating the IMR program compared with usual treatment. 198 people diagnosed with schizophrenia or bipolar disorder participated. The primary outcome was the Global Assessment of Functioning (GAF-F) at the end of intervention and the secondary and explorative outcomes included severity of symptoms and service utilization.RESULTS: IMR had no significant effect on functioning, symptoms, substance use or service utilization.CONCLUSION: This randomized trial contributes to the evidence base of IMR by providing a methodological solid base for its conclusions; however the trial has some important limitations. More research is needed to get a firm answer on the effectiveness of the IMR.

مصطلحات الفهرس: Adult, Aged, Community Mental Health Centers/organization & administration, Female, Humans, Male, Mental Disorders/therapy, Middle Aged, Remission Induction/methods, Young Adult, article

URL: https://curis.ku.dk/portal/da/publications/illness-management-and-recovery(8334e4f0-57c9-471d-a3fc-34bed9f1001d).html
https://doi.org/10.1371/journal.pone.0194027
https://curis.ku.dk/ws/files/212999562/journal.pone.0194027.pdf