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There are several infectious agents in the environment that can cause persistent infections in the host. They usually cause their symptoms shortly after first infection and later persist as silent viruses and bacteria within the body. However, these chronic infections may play an important role in the pathogenesis of schizophrenia and Tourette's syndrome (TS). We investigated the distribution of different neurotrophic infectious agents in TS, schizophrenia and controls. A total of 93 individuals were included (schizophrenic patients, Tourette patients and controls). We evaluated antibodies against cytomegalovirus (CMV), herpes-simplex virus (HSV), Epstein-Barr virus, Toxoplasma, Mycoplasma and Chlamydia trachomatis/pneumoniae. By comparing schizophrenia and TS, we found a higher prevalence of HSV (P=0.017) and CMV (P=0.017) antibodies in schizophrenic patients. Considering the relationship between schizophrenia, TS and healthy controls, we showed that there are associations for Chlamydia trachomatis (P=0.007), HSV (P=0.027) and CMV (P=0.029). When all measured viruses, bacteria and protozoa were combined, schizophrenic patients had a higher rate of antibodies to infectious agents than TS patients (P=0.049). Tourette and schizophrenic patients show a different vulnerability to infectious agents. Schizophrenic patients were found to have a higher susceptibility to viral infections than individuals with TS. This finding might point to a modification in special immune parameters in these diseases.

Cognitive dysfunctions are a common clinical feature of schizophrenia and represent important indicators of outcome among patients who are affected. Therefore, a randomized, controlled, monocentric, single-blind trial was carried out to compare two different rehabilitation strategies adopted for the restoration and recovery of cognitive functioning of residential patients with schizophrenia. A sample of 110 residential patients were selected and, during the experimental period, a group of 55 patients was treated with sets of domain-specific exercises (SRT+CRT), whereas an equal control group was treated with sets of non-domain-specific exercises (SRT+PBO) belonging to the Cogpack® software. The effects on the scores (between T0 and T1) of the variables treatment and time and of the interaction time X treatment were analyzed: for the total BACS, the main effect of the between-factors variable treatment is statistically significant (F=201.562 P=0.000), as well as the effect of the within-factors variable “time” (F=496.68 P=0.000).The interaction of these two factors is also statistically significant (F=299.594 P=0.000). The addition of cognitive remediation therapy (CRT) to a standard treatment of metacognitive training (MCT) resulted in a significant improvement in global neurocognitive functioning and has reported positive effects with regard to the strengthening of verbal and working memory, selective and sustained attention at T1. A relevant result is the statistically significance of “time X treatment” for all the tests administered: we can assume that the domain-specific cognitive training amplifies the effects of SRT, as the primary and secondary goals of the present study were achieved.

The label of schizophrenia attracts a high level of stigma; consequently, people with schizophrenia are victims of unfair treatment and have limited access to decent livelihood and basic opportunities. However, most studies on stigma have overlooked the experiences of patients with schizophrenia. The purpose of this paper is to assess the experience of discrimination by patients with schizophrenia in Lagos, Nigeria.

A descriptive cross-sectional study. Out-patients with schizophrenia (n=150) were interviewed with the Discrimination and Stigma Scale (DISC 12) at the Federal Neuro-Psychiatric Hospital, Yaba, Lagos, Nigeria.

The majority of the respondents (86.7 per cent) had been avoided by people who knew they had schizophrenia. Unfair treatment was experienced by 71.3 per cent from family members, 62.7 per cent from friends, 32 per cent in social life and 28.7 per cent in intimate relationships, and 38.7 per cent in personal safety. The most commonly reported unfair treatment was inappropriate physical restraint (e.g. chains and ropes) applied by family members and beating. About eight out of ten (79.3 per cent) respondents concealed their illness.

The findings indicate that people with schizophrenia in Nigeria experience high levels of discrimination, some of which contravenes their basic human rights. The unfair treatment experienced within the family context excludes people with schizophrenia from engaging in basic social relationships, education and the pursuit of life opportunities. Legislations should be reviewed to protect patients from unfair treatment and violation of their human rights. There is also need to equip them with strategies to cope with stigma.

This exploratory survey aimed to investigate and to explore, using the vignette methodology, community perceptions of mental disorder in a rural area in Greece. The influence of the nature of the problematic behaviour depicted in the vignettes, the gender of the vignette actor and the demographic characteristics of respondents were also examined.A series of vignettes in combination with an open‐ended response format were used. Fifty face‐to‐face interviews were carried out with residents in a rural community area in Crete. A thematic analysis was employed.It was found that the type of symptomatology influenced respondents' reactions. Social environmental factors, childhood experiences and personality characteristics were more likely to be offered as ætiological factors for depression, anxiety and schizophrenia with negative symptoms. In contrast, the positive symptoms of schizophrenia and paranoia were more likely to be attributed to biological factors. The respondents expressed a remarkably reserved attitude towards psychiatrists and use of psychotropic drugs. Psychological assistance and social support were more likely to be recommended as treatment methods. The gender of the vignette actor influenced respondents' reactions in relation to schizophrenia with positive symptoms and schizophrenia with negative symptoms. Respondents' gender and age were found to have no influence.Vignette methodology was proved to be a valuable tool to demonstrate the complexity of lay perceptions concerning mental disorder. Respondents clearly expressed a need for mental health education indicating future implications for interventions in this area.

People with schizophrenia and related psychoses may be more likely to be ‘treatment‐resistant’ when dually diagnosed with intellectual disabilities. This case study highlights many of the difficulties which can occur in their assessment and management. Clozapine is currently the best available intervention for treatment‐resistant schizophrenia, and its use has increased in people with intellectual disabilities. However, it is not always effective, and a wide range of adjunctive strategies have been suggestive and tried. The evidence base for the specific use of these additional strategies in people with intellectual disabilities needs to be increased.

People who have schizophrenia have higher rates of morbidity and mortality and a shorter life expectancy partly due to less healthy lifestyle choices such as a diet lacking in fruit and vegetables and lack of exercise. This study attempts to improve our understanding about the factors that affect lifestyle choices in this group of people. This is a qualitative study in which seven people with schizophrenia were interviewed using semi‐structured interviews about their lifestyle, including their diet and exercise, and they were encouraged to talk about the various factors that might influence their decisions and behaviour with respect to these. The interviews were tape recorded, transcribed and then independently analysed by five analysts looking for themes. The themes were then cross‐referenced by the interviewer looking for common themes. Four common themes were identified and were grouped as lack of motivation, psychotic symptoms, lack of physical health‐related knowledge and side effects to medication. This study suggests that a holistic approach needs to be taken when considering physical health in these patients, and that physical health promotion and education should go hand in hand with physical health monitoring.

Medication adherence contributes significantly to symptom remission, recovery and wellbeing in mental illnesses. We evaluated how medication adherence correlates with clinico-demographic factors and quality of life (QoL) in a sample of Nigerians with schizophrenia. This descriptive cross-sectional study involved 160 randomly selected participants with confirmed diagnosis of schizophrenia based on MINI International Neuropsychiatric Interview. Data on socio-demographic and clinical characteristics of participants were collected with a questionnaire. Medication adherence was assessed with Morisky Medication Adherence Questionnaire, and participants completed the World Health Organization Quality of Life Scale-BREF. The mean age of participants was 38.54 (±11.30) years, and all the participants were on antipsychotics, but only 45% were adherent to their medication. Out of all the participants, 45 (28.2%) considered their overall QoL to be good, 97 (60.6%) considered theirs to be fair, while 18 (11.2%) reported poor QoL. Medication non-adherence correlated negatively with good QoL across multiple dimensions including overall QoL (r=−0.175), health satisfaction (r=-0.161), physical (r=-0.186) and psychological domain (r=-0.175). Again, participant's age (r=−0.190) and age of onset of illness (r=-0.172) correlated negatively with medication non-adherence, and a trend towards relapse delay with medication adherence was also observed (r=-0.155). The effect size of these correlations were however small. Our findings suggest a link between medication adherence and QoL in schizophrenia, such that strategy that addresses medication non-adherence and its determinants may have potential benefits on wellbeing. Further hypotheses-driven studies are desirable.

The purpose of this paper is to examine the mental health literacy (MHL) of British community pharmacists.

A survey instrument was sent by facsimile to a random sample of community pharmacists in England, Scotland and Wales. The survey instrument contained items concerning recognition of the symptoms of depression, bipolar disorder or schizophrenia, the helpfulness of a range of interventions, mental health stigma and the degree of comfort providing pharmaceutical care to people with mental health problems.

Among community pharmacists (n=329) symptom recognition was high for depression but lower for bipolar disorder and schizophrenia. Pharmacists showed a preference for evidence-based interventions and support for psychological therapies and physical activity for all three mental health problems. Pharmacists expressed less comfort providing pharmacy services to people with bipolar disorder, schizophrenia and depression than cardiovascular disease. Mental health stigma was higher for schizophrenia and bipolar disorder than depression, with many pharmacists holding misperceptions about schizophrenia and bipolar disorder.

The study findings indicate the need for enhanced mental health content in the undergraduate pharmacy curriculum which should challenge misperceptions of mental illness.

This is the first study to investigate the MHL of British community pharmacists.

Assistive technology (AT) has been highlighted as a tool that can support self-management for people living with schizophrenia. A gap in the literature exists regarding the views held by the stakeholders involved in the health care of an individual living with schizophrenia regarding the potential use of AT to enable the self-management of this condition. The purpose of this paper is to explore how individuals living with schizophrenia, their relatives and their mental health care professionals view AT as a tool to facilitate self-management.

This mixed methods research paper will discuss the findings of the second stage of a two-stage research study. The paper will discuss the findings of questionnaires that were disseminated to service users living with schizophrenia, their relatives and the health-care professionals of a community mental health service in the Greater Dublin area.

The results indicate that the introduction of AT for the self-management of schizophrenia would be accepted by key stakeholders.

As AT continues to develop, it is clear from the findings presented in this paper that the main stakeholder groups involved in the care of an individual living with schizophrenia are amenable to the use of AT to facilitate the self-management of this condition. Further research is required to explore correct policing and management of its implementation.

This study is the first study of its kind within an Irish context to explore the use of assistive technology as a tool for self-management from the perspective of those experiencing schizophrenia, their relatives and the health-care professionals working alongside them.

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.