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The NICE Guidelines for Schizophrenia are designed to give guidance on the best practice in treatment and management of schizophrenia. These guidelines have 13 standards which services can use for the purpose of audit. As schizophrenia is our service's most common diagnosis, an audit against the guidelines was undertaken. The results indicated that we met three of the standards. Recommendations have been implemented to improve practice on standards that were not met, and this has led to some creative practice development. Despite the labour‐intensive nature of the audit, the results gave a clear indication of areas where there was a need for improvement and will act as a good baseline for re‐audit.

The purpose of this study is to explore social barriers affecting participation in chosen instrumental activities of daily living (IADL) among community-dwelling persons with schizophrenia in Rwanda.

A qualitative study used an embedded single case study design and constructivist epistemology paradigm. Purposive sampling and semistructured interviews of 10 persons with schizophrenia and their 10 caregivers were conducted. Data analysis was done thematically using an inductive analysis approach, following within-case and cross-case analysis.

The hindrances to participation and community negative attitudes were explored as the two themes. This study focuses on the community negative attitudes including family exclusion and stigmatization, which hinder the participation of persons with schizophrenia in their chosen IADLs.

This study highlights the need for psychoeducation about mental illness for the caregivers of the persons with schizophrenia, community outreach activities for sensitizing about mental illness to address stigma toward persons with mental illness and strengthening the activities which promote the social interaction and sense of belonging of persons with mental illness.

Persons with schizophrenia are facing maltreatment and stigma from the community members while participating in their chosen IADLs. Awareness raising of the support needs of persons living with schizophrenia will contribute to relevant stakeholders advocating for inclusion into families and communities.

This paper provides a summary of the current state of knowledge on the use of physical activity as an adjunctive treatment in schizophrenia. There is a well documented relationship between physical activity and mental health, which is reflected in numerous health policy recommendations for practice, in both the promotion of mental health and in the treatment of mental health problems. In schizophrenia, this association is also recognised, and research has suggested that participation in physical activity regimes can have beneficial effects on positive and negative symptoms, psychological well‐being and anxiety and tension. However, a neglected area of research is in the potential for physical activity to remediate the cognitive deficits in schizophrenia. Physical activity has been shown to enhance cognitive function in a wide variety of clinical and non‐clinical populations, however this body of research has not yet extended to schizophrenia populations. The authors argue that this should be a future priority.

The aim of this article is an analysis of the links between race and psychotic illness, psychiatric diagnosis and treatment, as well as psychiatric, police and prison violence against people with mental health problems. The analysis focuses on Black men who are more frequently diagnosed with schizophrenia and other psychotic disorders and who face more brutal treatment than other people with such diagnoses. We have adopted a multidisciplinary approach which draws insights from psychiatry, psychology, and sociology and challenges the biologistic interpretation of “mental illness.” We take into account the United States and Britain – two countries with large Black minorities and an established tradition of research on these groups. Among the crucial findings of this study are the facts that racial bias and stereotypes heavily influence the way Black men with a diagnosis of psychotic illness are treated by the psychiatric system, police and prison staff, and that the dominant approach to psychosis masks the connections between racism and mental health.

This study aims to compare the social support among patients with schizophrenia or methamphetamine dependency with healthy individuals.

Using convince sampling, the authors recruited 80 patients (schizophrenia, n = 40; methamphetamine dependency, n = 40) and their companions (healthy individuals, n = 40) who were referred to a psychiatric hospital in a cross-sectional study in Sari, Iran. In in-person interviews, the authors collected data on demographic characteristics and measured social support using a standardized questionnaire.

The three groups were similar regarding age and marital status, but different in gender distribution (p = 0.001). The average social support score was 58.0 in the schizophrenia group and 42.3 in the methamphetamine-dependent group, both significantly lower than 63.6 in the healthy group (p = 0.001). The social support scores in schizophrenia and methamphetamine-dependent groups were significantly lower than those in the healthy group across all subgroups of gender (p < 0.04), age (p < 0.05) and marital status (p < 0.001). The methamphetamine-dependent group had the lowest score overall and across all demographic groups and social support subdomains.

This study had two main limitations. First, the study samples were from one city and one hospital in the north of Iran and so may not be generalizable to other population and settings. Second, the authors did not study the causes or predictors of low social support like social stigma which should be studied in future studies.

Despite the limitations, this study found low social support for people diagnosed with schizophrenia or methamphetamine dependency. Intervention to increase social support for them, especially for those with substance use, is required.

Individuals with schizophrenia experience uncertainty due to the unpredictable symptoms, the course of the illness and poor knowledge about the disease, treatment and prognosis. Uncertainty in illness is linked with poor treatment outcomes, coping strategies, check-up decisions and psychological distress. This study aims to explore the uncertainty in illness among individuals with schizophrenia.

Eight individuals with schizophrenia living in the community were interviewed regarding their illness. The phenomenology approach was used to collect and analyze the data.

Three themes emerged from the findings of the study; the unpredictable course of the illness, compliance amid uncertainty and uncertainty of information about their illness. This study provides an essential overview of how patients with schizophrenia live in uncertain conditions.

It should be considered by various parties, particularly the community mental health nurses working with individuals with schizophrenia. Considering the uncertainty of illness while looking after or interacting with patients and their family is significant in improving adequate mental health-care delivery.

Schizophrenia, a chronic mental disorder, poses enormous threat to the individual, family and society. The advent of deinstitutionalization of the mentally ill transferred the burden of care to families especially close relatives. Few studies have described the families' subjective views in this context. Hence, this study aimed to explore impacts of caregiving and coping strategies for family caregivers of patients with schizophrenia in Enugu, South East Nigeria.

A descriptive qualitative design was employed, and 14 family caregivers of individuals with schizophrenia attending federal neuropsychiatric hospital Enugu were purposively selected. A semi-structured interview guide was used to generate information, and the transcribed data were content analyzed using a thematic approach.

Three major themes and 16 subthemes were derived to reflect the perceived impact of caregiving and coping strategies of family caregivers, which include burden of care (physical-self neglect, ill health, sleep deprivation; psychological-gross irritability, ruminations; social-stigmatization, social restrictions, diminished connections, reduced productivity); positive aspects (heightened understanding; empathetic attitude, strengthened ties) and adaptive resources (acceptance, optimism, social support, spiritual devotion).

Family caregivers of individuals with schizophrenia experience bio-psychosocial burden as a result of caregiving. Coping with challenges of caregiving can prevent distress and burnout. Hence, there is need for mental health professionals to recognize caregivers as person in need of emotional and practical support and care for the mentally ill in the context of a family-centered approach.

The risk of aggression is higher among people with psychiatric disorders. This study aims to determine the association of aggression with schizophrenia, bipolar disorder (BD) and major depressive disorder (MDD) in patients referred to Shahid Beheshti Teaching Hospital in Kerman.

This was a cross-sectional study of 518 patients diagnosed with schizophrenia, BD and MDD who met the inclusion criteria and were compared with a comparison group. All participants completed the Buss–Perry Aggression Questionnaire (BPAQ). Independent samples t-test and Pearson correlation coefficient were used to investigate the relationship between the score of BPAQ and other variables. The Beck Depression Inventory (BDI-13), Young Mania Rating Scale (YMRS) and Positive and Negative Symptom Scale (PANSS) were completed by MDD, BD and schizophrenia patients, respectively.

The mean score of total aggression and its components in the comparison group was significantly (P-value = 0.001) lower than that of the other groups. However, no significant difference was observed between the three schizophrenia, MDD and BD groups. The total aggression score of BPAQ had a significant positive correlation with BDI-13 and YMRS and a significant negative correlation with the PANSS score. Single patients with schizophrenia and people in the comparison group with lower education levels had a higher total aggression score.

Suffering from BD, MDD and schizophrenia, especially in single patients with a lower education level, is associated with physical and verbal aggression, anger and hostility, which emphasizes the need for periodic examination and screening of aggressive behaviors in these patients.

During the last few years the prevalence of autism and Autism Spectrum Disorder (ASD) has increased greatly. A recurring issue is the overlap and boundaries between Intellectual Developmental Disorder (IDD), ASD and Schizophrenia Spectrum Disorders (SSD). In clinical practice with people with IDD, the alternative or adjunctive diagnosis of ASD or SSD is particularly challenging. The purpose of this paper is to define the boundaries and overlapping clinical characteristics of IDD, ASD and SSD; highlight the most relevant differences in clinical presentation; and provide a clinical framework within which to recognize the impact of IDD and ASD in the diagnosis of SSD.

A systematic mapping of the international literature was conducted on the basis of the following questions: first, what are considered to be core and overlapping aspects of IDD, ASD and SSD; second, what are the main issues in clinical practice; and third, can key diagnostic flags be identified to assist in differentiating between the three diagnostic categories?

Crucial clinical aspects for the differentiation resulted to be age of onset, interest towards others, main positive symptoms, and anatomical anomalies of the central nervous system. More robust diagnostic criteria and semeiological references are desirable.

The present literature mapping provides a comprehensive description of the most relevant differences in the clinical presentation of ASD and SSD in persons with IDD.

The purpose of this survey was to describe the impact of the diagnosis of schizophrenia on the lives of people who receive the diagnosis.

The authors designed a questionnaire to investigate attitudes to and experiences of the diagnosis of schizophrenia. After a pilot study, they made the questionnaire available online and, through a network of service user and other organisations, solicited responses.

Of the 470 responses, 27.4 per cent were from service users. Content analysis of their responses revealed three main categories: concern with the consequences of the diagnosis and its negative impact on their lives, the life contexts of individuals before receiving the diagnosis, and concerns with medication and treatment. This paper deals with the first two.

It is impossible to generalise the results of this survey because respondents self‐selected, and thus might be expected to have strong feelings against (or for) the diagnosis of schizophrenia.

The diagnosis of schizophrenia in this sample had devastating negative implications. It was experienced as harmful and stigmatising. Very few people understood their experiences as a biomedical disorder.

A gulf exists between the experiences of people diagnosed with schizophrenia and the concerns of academics and others currently involved in debates about the merits of different systems of diagnosis.

This survey is valuable because it draws attention to experiences of diagnosis that are easily lost in the storm of academic controversies about diagnosis in psychiatry.