Independence through Community Access and Navigation in adults with schizophrenia spectrum disorders Part 2: Treatment planning and implementation

2011 ◽  
Vol 10 (1) ◽  
pp. 35-45
Author(s):  
Gretchen Snethen, PhD, LRT/CTRS ◽  
Bryan P. McCormick, PhD, CTRS ◽  
Rachel L. Smith, MS ◽  
Marieke Van Puymbroeck, PhD, CTRS
Keyword(s):  
Treatment Planning ◽  
Skill Acquisition ◽  
Schizophrenia Spectrum Disorders ◽  
Community Based ◽  
Community Environment ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
The Individual ◽  
Community Access ◽  
Over Time

Social isolation and nonparticipation in the community are chronic issues for adults with schizophrenia spectrum disorders that can lead to poorer health outcomes. The Independence through Community Access and Navigation (I-CAN) intervention was developed as a theoretically grounded intervention that uses motivational interviewing to understand the interests and motivations of clients for participation. The intervention is designed to support participation in community-based activities by providing access and skill acquisition in a community environment. Participation between the recreational therapist and the participant decreases over time to encourage the individual to begin to independently access his or her community. This article presents the treatment planning steps and the implementation protocol for the I-CAN intervention.

scholarly journals Effectiveness of Community-Based Interventions for Patients with Schizophrenia Spectrum Disorders: A Study Protocol for a Systematic Review

2021 ◽  
Author(s):  
Soo-Yeon Kim ◽  
Ah Rim Kim
Keyword(s):  
Systematic Review ◽  
Community Mental Health Services ◽  
Secondary Outcome ◽  
Continuous Variables ◽  
Schizophrenia Spectrum Disorders ◽  
Community Based Interventions ◽  
Community Based ◽  
Schizophrenia Spectrum ◽  
Comparison Groups ◽  
Spectrum Disorders

Abstract Background: Schizophrenia requires a community-based intervention approach combined with standard treatment to prevent relapses. A literature review is required to understand the effectiveness of community-based interventions and to enhance quality in countries where they have not been fully established. This is a protocol for a systematic review of the effectiveness of community-based interventions for patients with schizophrenia spectrum disorders. Methods: Studies on community-based interventions for patients with schizophrenia spectrum disorders that were published any time until January 2021 will be searched on six databases, using the primary words: “schizophrenia” and “community mental health services.” The comparison groups will include patients with schizophrenia spectrum disorders who are only receiving the usual care and those who also receive community-based interventions. The schizophrenia spectrum disorders referred to in this study are defined according to the DSM-5; delusional disorders, schizophrenic disorders, and schizoaffective disorder will be included. Relapse/re-hospitalization rates (primary outcome) and quality of life (secondary outcome) will be identified for each group. The study design will consider only randomized controlled trials (RCT). To assess bias, RCT will be analyzed via the Cochrane RoB 2.0. Results will be descriptively synthesized and statistically analyzed, and will be structured according to patients’ characteristics, intervention type and exposure, and outcome type. Discrete variables will be calculated via odds ratio, and continuous variables will be calculated via standardized mean difference using RevMan 5.3 software. Discussion: We will provide a summary of the available evidence on the effectiveness of community-based interventions and specific guidelines to improve their outcomes. Systematic review registration: The protocol for this systematic review was registered on PROSPERO database; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145660.

scholarly journals Effectiveness of community-based interventions for patients with schizophrenia spectrum disorders: a study protocol for a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Soo-Yeon Kim ◽  
Ah. Rim Kim
Keyword(s):  
Systematic Review ◽  
Risk Of Bias ◽  
Secondary Outcome ◽  
Continuous Variables ◽  
Schizophrenia Spectrum Disorders ◽  
Research Information ◽  
Community Based Interventions ◽  
Community Based ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Abstract Background Schizophrenia requires a community-based intervention approach combined with standard treatment to prevent relapses. A literature review is required to understand the effectiveness of community-based interventions and to enhance quality in countries where they have not been fully established. This is a protocol for a systematic review of the effectiveness of community-based interventions for patients with schizophrenia spectrum disorders. Methods We will search (from inception to January 2021) PubMed/MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, and Research Information Sharing Service/Korean databases. Randomized controlled trials on community-based interventions for patients with schizophrenia spectrum disorders will be eligible. The comparison groups will include patients with schizophrenia spectrum disorders who are only receiving the usual care and those who also receive community-based interventions. The schizophrenia spectrum disorders referred to in this study are defined according to the DSM-5: delusional disorders, schizophrenic disorders, and schizoaffective disorder will be included. Relapse/re-hospitalization rates (primary outcome) and quality of life (secondary outcome) will be identified for each group. Two reviewers will independently screen study titles, abstract data, and full-text articles and perform the data extraction process. Potential conflicts will be resolved through discussion. The study risk of bias will be appraised using the Cochrane Risk of Bias 2.0 tool. Results will be descriptively synthesized and will be structured according to patients’ characteristics, intervention type and exposure, and outcome type. If feasible and appropriate, outcome data will be used to perform random effects meta-analyses. Discrete variables will be calculated via odds ratio, and continuous variables will be calculated via standardized mean difference using RevMan 5.3 software. Discussion We will provide a summary of the available evidence on the effectiveness of community-based interventions and specific guidelines to improve their outcomes. Systematic review registration PROSPERO (CRD42019145660).

scholarly journals The Many Faces of Negative Symptoms in Schizophrenia

2021 ◽  
Author(s):  
Mihaela Fadgyas Stanculete ◽  
Octavia Capatina
Keyword(s):  
Negative Symptoms ◽  
Two Dimensions ◽  
Schizophrenia Spectrum Disorders ◽  
Diagnostic Categories ◽  
Recent Advances ◽  
Schizophrenia Spectrum ◽  
Core Feature ◽  
Spectrum Disorders ◽  
The Many ◽  
Over Time

Negative symptoms are relatively frequent across schizophrenia spectrum disorders diagnostic categories and they represent deficits in different domains such as emotional, volitional and experiential. Even though negative symptoms have long been recognized as a core feature of schizophrenia, their definition has been changing over time. Different conceptualization classified this category of symptoms as primary or secondary, persistent or transient. At the current moment there are five agreed upon domains of the concept of negative symptoms, which are separated into two dimensions—experience (anhedonia, avolition, asociality) and expression (blunted affect, alogia). Multiple mechanistic pathways have been proposed and investigated for each dimension and for each domain. The current chapter attempts to address recent advances in the literature regarding the concepts, definitions and classifications of negative symptoms and their etiological model.

scholarly journals Decrease of Hospitalizations and Length of Hospital Stay in Patients with Schizophrenia Spectrum Disorders or Bipolar Disorder Treated in a Mobile Mental Health Service in Insular Greece

Psych ◽  
2021 ◽  
Vol 3 (4) ◽  
pp. 780-791
Author(s):  
Aikaterini Garbi ◽  
Ioannis Tiniakos ◽  
Zacharenia Mikelatou ◽  
Ioannis Drakatos
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Treatment Engagement ◽  
Time Interval ◽  
Inpatient Setting ◽  
Schizophrenia Spectrum Disorders ◽  
Community Based ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Mobile Mental Health

In recent years serious mental health issues, such as schizophrenia spectrum disorders and bipolar disorder, have been treated in the community by community-based mental health services. In the present study our goal was to estimate the modification in the number of hospitalizations and duration of admissions in either psychotic patients or patients with bipolar disorder, treated by a Mobile Mental Health Unit in the islands of Kefalonia, Zakynthos and Ithaca (MMHU-KZI). Data were collected from a total of 108 patients with schizophrenia spectrum disorders and bipolar disorder. For each patient comparison was made for the same time interval prior and after engagement to treatment with the MMHU-KZI and not for the total hospitalizations that patients had in their history. There was a statistically significant reduction (45.9%) in hospitalizations after treatment engagement with the MMHU-KZI, as the Wilcoxon signed ranks test indicated. Furthermore, a major decrease (54.5%) of hospitalization days was noted after treatment engagement with the unit. This pattern of mental health provision may be beneficial for the reduction of the number and duration of psychiatric hospitalizations. Despite the beneficial contribution of community-based mental health units, hospital based treatment should always be available, since severe relapses are better treated in inpatient setting.

scholarly journals Suicidal Ideation and Schizophrenia: Contribution of Appraisal, Stigmatization, and Cognition

2017 ◽  
Vol 62 (10) ◽  
pp. 726-734 ◽  
Author(s):  
Emmanuel Stip ◽  
Jean Caron ◽  
Michel Tousignant ◽  
Yves Lecomte
Keyword(s):  
Suicidal Ideation ◽  
Multiple Regression ◽  
Cognitive Dysfunction ◽  
Stepwise Multiple Regression ◽  
Schizophrenia Spectrum Disorders ◽  
Convenience Sample ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
The Individual ◽  
The Relationship

Objective: To predict suicidal ideation in people with schizophrenia, certain studies have measured its relationship with the variables of defeat and entrapment. The relationships are positive, but their interactions remain undefined. To further their understanding, this research sought to measure the relationship between suicidal ideation with the variables of loss, entrapment, and humiliation. Method: The convenience sample included 30 patients with schizophrenia spectrum disorders. The study was prospective (3 measurement times) during a 6-month period. Results were analyzed by stepwise multiple regression. Results: The contribution of the 3 variables to the variance of suicidal ideation was not significant at any of the 3 times (T1: 16.2%, P = 0.056; T2: 19.9%, P = 0.117; T3: 11.2%, P = 0.109). Further analyses measured the relationship between the variables of stigmatization, perceived cognitive dysfunction, symptoms, depression, self-esteem, reason to live, spirituality, social provision, and suicidal ideation. Stepwise multiple regression demonstrated that the contribution of the variables of stigmatization and perceived cognitive dysfunction to the variance of suicidal ideation was significant at all 3 times (T1: 41.7.5%, P = 0.000; T2: 35.2%, P = 0.001; T3: 21.5%, P = 0.012). Yet, over time, the individual contribution of the variables changed: T1, stigmatization (β = 0.518; P = 0.002); T2, stigmatization (β = 0.394; P = 0.025) and perceived cognitive dysfunction (β = 0.349; P = 0.046). Then, at T3, only perceived cognitive dysfunction contributed significantly to suicidal ideation (β = 0.438; P = 0.016). Conclusion: The results highlight the importance of the contribution of the variables of perceived cognitive dysfunction and stigmatization in the onset of suicidal ideation in people with schizophrenia spectrum disorders.

scholarly journals Effectiveness of Community-Based Interventions for Patients with Schizophrenia Spectrum Disorders: A Study Protocol for a Systematic Review

2021 ◽  
Author(s):  
Soo-Yeon Kim ◽  
Ah Rim Kim
Keyword(s):  
Systematic Review ◽  
Community Mental Health Services ◽  
Secondary Outcome ◽  
Continuous Variables ◽  
Schizophrenia Spectrum Disorders ◽  
Community Based Interventions ◽  
Community Based ◽  
Schizophrenia Spectrum ◽  
Comparison Groups ◽  
Spectrum Disorders

Abstract Background: Schizophrenia requires a community-based intervention approach combined with standard treatment to prevent relapses. A literature review is required to understand the effectiveness of community-based interventions and to enhance quality in countries where they have not been fully established. This is a protocol for a systematic review of the effectiveness of community-based interventions for patients with schizophrenia spectrum disorders. Methods: Studies on community-based interventions for patients with schizophrenia spectrum disorders that were published any time until January 2021 will be searched in six databases, using the primary words: “schizophrenia” and “community mental health services.” The comparison groups will include patients with schizophrenia spectrum disorders who are only receiving the usual care and those who also receive community-based interventions. The schizophrenia spectrum disorders referred to in this study are defined according to the DSM-5; delusional disorders, schizophrenic disorders, and schizoaffective disorder will be included. Relapse/re-hospitalization rates (primary outcome) and quality of life (secondary outcome) will be identified for each group. The study design will consider only randomized controlled trials (RCT). To assess bias, RCTs will be analyzed via the Cochrane RoB 2.0. Results will be descriptively synthesized and statistically analyzed, and will be structured according to patients’ characteristics, intervention type and exposure, and outcome type. Discrete variables will be calculated via odds ratio, and continuous variables will be calculated via standardized mean difference using RevMan 5.3 software. Discussion: We will provide a summary of the available evidence on the effectiveness of community-based interventions and specific guidelines to improve their outcomes. Systematic review registration: The protocol for this systematic review was registered on PROSPERO database; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145660.

scholarly journals mHealth for Schizophrenia: Patient Engagement With a Mobile Phone Intervention Following Hospital Discharge

2016 ◽  
Vol 3 (3) ◽  
pp. e34 ◽  
Author(s):  
Dror Ben-Zeev ◽  
Emily A Scherer ◽  
Jennifer D Gottlieb ◽  
Armando J Rotondi ◽  
Mary F Brunette ◽  
...  
Keyword(s):  
High Risk ◽  
Mobile Phone ◽  
Hospital Discharge ◽  
Schizophrenia Spectrum Disorders ◽  
Mhealth Intervention ◽  
On Demand ◽  
Schizophrenia Spectrum ◽  
Risk Period ◽  
Spectrum Disorders ◽  
Over Time

Background mHealth interventions that use mobile phones as instruments for illness management are gaining popularity. Research examining mobile phone‒based mHealth programs for people with psychosis has shown that these approaches are feasible, acceptable, and clinically promising. However, most mHealth initiatives involving people with schizophrenia have spanned periods ranging from a few days to several weeks and have typically involved participants who were clinically stable. Objective Our aim was to evaluate the viability of extended mHealth interventions for people with schizophrenia-spectrum disorders following hospital discharge. Specifically, we set out to examine the following: (1) Can individuals be engaged with a mobile phone intervention program during this high-risk period?, (2) Are age, gender, racial background, or hospitalization history associated with their engagement or persistence in using a mobile phone intervention over time?, and (3) Does engagement differ by characteristics of the mHealth intervention itself (ie, pre-programmed vs on-demand functions)? Methods We examined mHealth intervention use and demographic and clinical predictors of engagement in 342 individuals with schizophrenia-spectrum disorders who were given the FOCUS mobile phone intervention as part of a technology-assisted relapse prevention program during the 6-month high-risk period following hospitalization. Results On average, participants engaged with FOCUS for 82% of the weeks they had the mobile phone. People who used FOCUS more often continued using it over longer periods: 44% used the intervention over 5-6 months, on average 4.3 days a week. Gender, race, age, and number of past psychiatric hospitalizations were associated with engagement. Females used FOCUS on average 0.4 more days a week than males. White participants engaged on average 0.7 days more a week than African-Americans and responded to prompts on 0.7 days more a week than Hispanic participants. Younger participants (age 18-29) had 0.4 fewer days of on-demand use a week than individuals who were 30-45 years old and 0.5 fewer days a week than older participants (age 46-60). Participants with fewer past hospitalizations (1-6) engaged on average 0.2 more days a week than those with seven or more. mHealth program functions were associated with engagement. Participants responded to prompts more often than they self-initiated on-demand tools, but both FOCUS functions were used regularly. Both types of intervention use declined over time (on-demand use had a steeper decline). Although mHealth use declined, the majority of individuals used both on-demand and system-prompted functions regularly throughout their participation. Therefore, neither function is extraneous. Conclusions The findings demonstrated that individuals with schizophrenia-spectrum disorders can actively engage with a clinically supported mobile phone intervention for up to 6 months following hospital discharge. mHealth may be useful in reaching a clinical population that is typically difficult to engage during high-risk periods.

Screening Adolescents for Schizophrenia-Spectrum Disorders

2000 ◽  
Author(s):  
B. Cornblatt ◽  
M. Obuchowski ◽  
S. Roberts ◽  
S. Pollack ◽  
L. Erienmeyer-Kimling
Keyword(s):  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders
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