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The purpose of this paper is to provide a social construction of remission in relation to schizophrenia by the people affected most. The qualitative perspective utilised is a contrast to the majority of papers around, which have been quantitative when addressing the concept of remission for people with a diagnosis of schizophrenia. This paper acknowledges and demonstrates evidence of listening to the stakeholder groups affected by the issues associated with remission and recovery, and delivers clarity around the phenomena of remission in relation to recovery.

A constructivist grounded theory approach was employed, exploring participants’ interpretation of the concept of remission in schizophrenia. A purposive sample, of nine professionals, ten service users and seven carers, was recruited from two community mental health teams in the UK. Semi-structured interviews were employed to yield the data and all interview transcripts were analysed utilising “qualitative codes” thereby defining what is seen in the data. Diagramming and concept mapping was employed. Theoretical sensitivity was applied to demonstrate remission in abstract terms and to illustrate the openness, transparency and intention of the study.

The findings resulted in a conceptual map of the themes generated from the data. From this map four possible trajectories were developed, each highlighting a route which could be taken and the issues faced along the way. Positive and negative aspects of the trajectories offer discussion points for service users and practitioners alike to consider in their professional relationship. In addition a representation of the current interplay between recovery and remission is highlighted to offer clarity in relation to present service provision.

The perspective and opinion from practitioners in Primary Care services was not proposed or included within this study. To gain an improved and realistic insight into this perspective a range of practitioners from primary care could provide valuable data for any future study as this would prove to be a valuable enhancement. This study offered a broad overview of professional groups with the ability to discuss mental health services, although it did not allow for a concentration from specific professional groups and therefore they were not able to fully represent their professional group.

This paper has illuminated the area of remission for people with schizophrenia and will therefore have practical implications in respect of on-going service development. In particular the interface between primary and secondary services which have struggled to employ consistent terminology serving only to confuse service users and service providers alike. The trajectories illustrated in this study offer clarity and understanding and direction for improved practice to facilitate recovery for people with a diagnosis of schizophrenia. Shared understanding of concepts between service users and providers could be a large move in a positive direction.

The movement of people formerly diagnosed with schizophrenia from secondary mental health services back to primary care may have huge social implications. Resistance, stigma and ignorance play a large part in services “having to” retain people within secondary mental health services. Misunderstandings around diagnosis, and terms such as remission and recovery fuel such confusion resulting in a risk averse position for most. This study clarifies some of the issues in relation to the transition back to society and citizenship for people and offers scope for further research of a qualitative nature too.

Previous studies around the concept of remission for people with a diagnosis of schizophrenia have centred on medication efficacy, utilising remission criteria to determine changes in symptomolotolgy. These quantitative papers have not addressed service users, carers or practitioners in healthcare in relation to their understanding of the term remission, in relation to recovery; or whether they feel it would be of use in clinical practice. This study addressed those issues gaining valuable in-depth data from participants, deriving the social construction of remission and the impact it may have in clinical practice in a non-pathologising perspective.

We previously examined the efficacy of rTMS for major depressive disorder in an applied clinical practice. Clinical response was related to severity of depression as well as the rTMS instrument utilized suggesting a relationship to instrument or magnetic field parameters and individual factors. The effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder was further evaluated using Log-Rank statistics for time to remission outcomes. A follow-up retrospective medical records study was carried out on patients with major depressive disorder undergoing rTMS therapy at AwakeningsKC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. Cox Proportional Hazard with Log-Rank statistics were applied and the time course to clinical remission was evaluated over a 6-week period with respect to age, gender, and depression severity. Clinical response was observed referencing two different rTMS instruments (MagVenture; NeuroStar). Time to remission studies of 247 case reports (N=98 males; N=149 females) showed consistently greater clinically defined remission rates after 6 weeks of rTMS treatment for patients using the MagVenture vs NeuroStar instrument. Patients previously admitted for inpatient psychiatric hospitalization exhibited higher response rates when treated with the MagVenture rTMS unit. Stepwise Cox Proportional Hazards Regression final model of time to remission included rTMS unit, inpatient psychiatric hospitalization and obese body habitus. Response to rTMS in applied clinical practice is related to severity of psychiatric illness and may require consideration of magnetic field parameters of the rTMS unit with respect to individual factors such as sex or body composition.

This study is a follow-up of inpatients diagnosed with severe depression/melancholia between 1956 and 1969. During this period, all inpatients at the Department of Psychiatry, University Hospital, Lund, were rated on a multidimensional diagnostic schedule on discharge. There were 471 patients born from 1920 onward. In the present follow-up, 2006 to 2010, 169 survivors could be traced. They were asked to participate in the study involving a telephone interview, in which a structured life chart was used. Of the patients contacted, 16 were ill or confused and 3 did not remember ever being depressed, leaving 150 who could participate. Seventy-five of these agreed to participate in the study. Long-term course of depression was evaluated by cluster analysis and compared to background variables, such as heredity for depression, perceived parental rearing behaviour, and treatment of index depressive episode. Using a cluster analysis the patients could be separated into six clusters describing the course: i) single or few episodes followed by long-lasting remission; ii) single or few episodes followed by long-lasting remission, although shorter; iii) single or few episodes followed by late recurrence; iv) single or few episodes, but more frequently ill, followed by late recurrence; v) several episodes followed by lasting remission; vi) chronic course of episodes. Remission or recurrence could therefore occur even after more than a decade. In summary, there was a short-term course with or without recurrence or a chronic course with or without late remission. Heredity for depression was significantly related to a chronic course with or without late remission.

Repetitive transcranial magnetic stimulation (rTMS) is a neurostimulatory technique used to modulate orbital frontal corticostriatal (OFC) activity and clinical symptomatology for psychiatric disorders involving OFC dysfunction. We examined the effectiveness of rTMS in the treatment of major depressive disorder in an applied clinical setting (Awakening KC CNI) to assess efficacy and optimize rTMS parameters within clinical practice. A retrospective review of medical records was carried out on patients with major depressive disorder undergoing rTMS therapy at Awakenings KC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. A detailed de-identified data set of clinical outcomes was compiled. Patient Health Questionnaire 9 (PHQ-9) total score, clinical remission rate and week achieved were evaluated over 6 weeks of treatment to assess clinical response referencing two different rTMS instruments (MagVenture; NeuroStar). Our survey included 247 participants from males (N=98) and females (N=149) with average baseline PHQ-9 scores of 21.7±4, classified as severe depression. Clinically rated remission rates of 72% were achieved in 3.1±1.0 weeks and associated with prior history of psychiatric hospitalization, suicide attempts and substance use disorder. Average baseline PHQ-9 scores decreased significantly over time with proportionately greater remission rates achieved for patients treated using the MagVenture over NeuroStar instrument. rTMS in applied clinical practice is efficacious over a wide range of settings and patients. Clinical response was related to severity of depression symptoms (e.g., prior hospitalization; suicide attempts) validating efficacy in critically ill groups. Clinical response may be impacted by rTMS instrument, magnetic field parameters or individual factors.

Repetitive transcranial magnetic stimulation (rTMS) has been proven to be efficacious in the treatment of Major Depressive Disorder (MDD). We previously examined the effectiveness of rTMS for MDD in an applied clinical setting, AwakeningsKC Clinical Neuroscience Institute (CNI) and found high remission rates for patients diagnosed with MDD following rTMS treatment. An unexpected relationship with body composition and rTMS unit was discovered. This sub-study extends the previous investigation through a focused analysis of the effects of body composition on response to rTMS in the treatment of MDD. We utilized data collected from a retrospective review of medical records for patients diagnosed with MDD undergoing rTMS therapy at AwakeningsKC CNI. Patient Health Questionnaire 9 (PHQ-9) scores, time to remission status and body mass index (BMI) at baseline were considered while referencing two different rTMS instruments (MagVenture; NeuroStar). We found 23 (9%) of 247 participants met criteria for obese status (BMI?30) with an average baseline PHQ-9 score of 22±4, classified as “severe depression”. Obesity status was differentially impacted by the rTMS instrument used for treatment. Patients with obesity showed a shorter time to remission (mean 2.7±0.27 vs. mean 3.4±0.3 weeks) and proportionately greater remission rate (100% vs. 71%) when treated using the MagVenture relative to the NeuroStar instrument. Clinical response to rTMS therapy for MDD appears to be guided by individual factors including body composition and rTMS parameters such as the unit used for treatment. Further study of these influences could aid in the optimization of clinical response to rTMS.

Heavy penalties may be imposed on a defaulting taxpayer in terms of section 76(1) of the Income Tax Act, 58 of 1962 (the “Act”), unless “extenuating circumstances” are found to prevail, in which case any penalty imposed may be remitted partly or even in toto. This article examines the defence or plea of adverse personal circumstances, such as education, intelligence, financial means, hardship, age, influence of others, provocation and the death, insolvency or liquidation of a taxpayer, and whether such adverse personal circumstances could be considered to be “extenuating” for the purposes of section 76(2)(a) of the Act and lead to a remission of the penalties imposed.

People with pre-existing mental health conditions are more likely to be affected by global crises. The Covid-19 pandemic has presented them with unique challenges, including reduced contact with the psychiatric rehabilitation and support systems. Thus, understanding the emotional experience of this population may assist mental health organizations in future global crises.

In this paper, researchers analyzed the discourse of the mentally ill during the Covid-19 pandemic, as reflected in Israeli Facebook groups: three private groups and one public group. Researchers explored the language, reactions, emotions and sentiments used in these groups during the year before the pandemic, outbreak periods and remission periods, as well as the period before the vaccine’s introduction and after its appearance.

Analyzing groups’ discourse using the collective emotion theory suggests that the group that expressed the most significant difficulty was the Depression group, while individuals who suffer from social phobia/anxiety and PTSD were less affected during the lockdowns and restrictions forced by the outbreak.

Findings may serve as a tool for service providers during crises to monitor patients’ conditions, and assist individuals who need support and help.

The additional tax (referred to as a “penalty” by the judiciary), which may be imposed in terms of section 76(1) of the Income Tax Act (“the Act”) when a taxpayer is in default, can be very harsh (Up to 200% of the tax correctly chargeable). The Commissioner may remit any penalty imposed as he sees fit. However, when there was intent on the part of the taxpayer to evade the payment of tax, the Commissioner may not remit the 200% penalty, unless he is of the opinion that there are “extenuating circumstances”. This article examines the general meaning, as interpreted by the courts, of the “extenuating circumstances” that may be taken into account for the purposes of remission of penalties in terms of section 76(2)(a) of the Act.

While Washington University in St. Louis (the University) has enjoyed success in recruiting higher numbers of low-income students, it has not achieved comparable results in ensuring an equally successful college experience for this underrepresented group. Data shows that low-income students, as compared to their financially unaided peers, have an inequitable undergraduate experience at Washington University that includes performance gaps in STEM-intensive curricula and less-robust co-curricular experiences. This chapter presents the outcomes of a report entitled “Honoring Our Investment” that focused on how, from an institutional perspective, to best support the academic and co-curricular success of low-income students at Washington University. The Undergraduate Representatives to the Board of Trustees of the 2015–2016 academic year wrote this report and compiled information, research, and data about the low-income student experience as part of a dialogue focused on improvement. Additionally, this chapter recommends changes for improving outcomes.