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An investigation of the construct of competence: a comparison of the FIT, the MacCAT-CA, and the MacCAT-T.

https://arctichealth.org/en/permalink/ahliterature174651
Source
Law Hum Behav. 2005 Apr;29(2):229-52
Publication Type
Article
Date
Apr-2005
Author
Patricia A Zapf
Ronald Roesch
Author Affiliation
Department of Psychology, John Jay College of Criminal Justice, The City University of New York, New York 10019, USA. pzapf@jjay.cuny.edu
Source
Law Hum Behav. 2005 Apr;29(2):229-52
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Adult
Canada
Commitment of Mentally Ill - legislation & jurisprudence
Criminal Law
Humans
Informed Consent - legislation & jurisprudence
Interview, Psychological
Male
Mental Competency - legislation & jurisprudence
Models, Statistical
Personality Assessment - statistics & numerical data
Prisoners - legislation & jurisprudence - psychology
Psychometrics - statistics & numerical data
Psychotic Disorders - diagnosis - psychology - therapy
Reproducibility of Results
Treatment Refusal - legislation & jurisprudence
United States
Violence - legislation & jurisprudence - psychology
Abstract
The 1990s witnessed Supreme Court decisions in both Canada and the United States on issues of competence that went against longstanding case law, psychological research, and common sense. These decisions held that there is to be one standard for all types of criminal competencies. The present research attempts to investigate whether this is an appropriate assumption and thus tests whether there are one or more constructs that underlie different types of competence. Two divergent types of competence were examined, competence to stand trial (both Canadian and American conceptualizations) and competence to consent to treatment, to determine if these different types of competence share a common underlying construct. Confirmatory factor analysis was used to test this question and results indicate that there is a common construct that underlies different types of competence.
PubMed ID
15912726 View in PubMed
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Associations between staff feelings toward patients and treatment outcome at psychiatric treatment homes.

https://arctichealth.org/en/permalink/ahliterature72133
Source
J Nerv Ment Dis. 2000 Jun;188(6):366-71
Publication Type
Article
Date
Jun-2000
Author
R. Holmqvist
Author Affiliation
Department of Education and Psychology, Linköping University, Sweden.
Source
J Nerv Ment Dis. 2000 Jun;188(6):366-71
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Attitude of Health Personnel
Borderline Personality Disorder - diagnosis - psychology - therapy
Community Mental Health Services
Countertransference (Psychology)
Female
Group Homes
Humans
Male
Mental Disorders - diagnosis - psychology - therapy
Personality Inventory - statistics & numerical data
Professional-Patient Relations
Psychiatric Status Rating Scales - statistics & numerical data
Psychotherapy
Psychotic Disorders - diagnosis - psychology - therapy
Questionnaires
Regression Analysis
Sweden
Treatment Outcome
Abstract
This paper presents, as part of a national Swedish research project, a study of associations between staff feelings toward patients and treatment outcome at 23 small psychiatric inpatient units. The outcome was measured with a composite scale based on structured interviews. Staff feelings were reported on a feeling checklist. Few and scattered correlations were found between staff feelings and treatment outcome when the whole group of patients was analyzed together. More meaningful patterns were found when data for psychotic and borderline patients were analyzed separately. For psychotic patients, positive outcome was associated with low levels of negative feelings throughout treatment. For borderline patients, positive outcome was associated with negative feelings at the beginning of treatment, followed by strong positive feelings in the later part. Staff feelings were more strongly associated with outcome for borderline patients than for psychotic patients. Patients with different structural diagnoses need different kinds of staff "feeling milieus."
PubMed ID
10890345 View in PubMed
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"Care or control?": a qualitative study of staff experiences with outpatient commitment orders.

https://arctichealth.org/en/permalink/ahliterature281965
Source
Soc Psychiatry Psychiatr Epidemiol. 2016 05;51(5):747-55
Publication Type
Article
Date
05-2016
Author
Bjørn Stensrud
Georg Høyer
Gro Beston
Arild Granerud
Anne Signe Landheim
Source
Soc Psychiatry Psychiatr Epidemiol. 2016 05;51(5):747-55
Date
05-2016
Language
English
Publication Type
Article
Keywords
Adult
Ambulatory Care
Attitude of Health Personnel
Awareness
Coercion
Commitment of Mentally Ill
Cooperative Behavior
Female
Focus Groups
Humans
Male
Norway
Patient Discharge
Psychotic Disorders - diagnosis - psychology - therapy
Abstract
Outpatient commitment orders are being increasingly used in many countries to ensure follow-up care of people with psychotic disorders after discharge from hospital. Several studies have examined outpatient commitment in relation to use of health care services, but there have been fewer studies of health professionals' experiences with the scheme. The purpose of this study was to examine health professionals' experiences with patients subject to outpatient commitment.
This was a focus group study using a descriptive and exploratory approach. The study was based on three focus group interviews with a total of 22 participants. Data were analysed using qualitative content analysis.
The study showed that health professionals had a positive attitude towards outpatient commitment and considered it necessary for patients with psychosis who lacked insight and did not collaborate on treatment. At the same time their attention to patients' lack of insight could lead to a paternalistic approach more than measures to enhance patient autonomy. This challenged their therapeutic relationship with the patient.
Health professionals found it difficult to combine control with therapeutic care, but gave greater emphasis to patients' need for treatment and continuity of care than to their autonomy. This dilemma indicates a need to discuss whether increased attention to patients' autonomy rather than insight into their illness would improve treatment cooperation and reduce the use of coercion.
Notes
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PubMed ID
26873613 View in PubMed
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[Cognitive-behavioural therapy in early psychosis: an open study in a clinical setting].

https://arctichealth.org/en/permalink/ahliterature137006
Source
Can J Psychiatry. 2011 Jan;56(1):51-61
Publication Type
Article
Date
Jan-2011
Author
Marie-Josée Marois
Nathalie Gingras
Martin D Provencher
Chantal Mérette
Claudia Emond
Julie Bourbeau
Valérie Jomphe
Marc-André Roy
Author Affiliation
Programme de Dépistage et intervention précoce des psychoses, Centre de pédopsychiatrie de Québec, Centre hospitalier universitaire de Québec, 1 avenuedu Sacré-Coeur, Québec, QC. mj.marois@mail.chuq.qc.ca
Source
Can J Psychiatry. 2011 Jan;56(1):51-61
Date
Jan-2011
Language
French
Publication Type
Article
Keywords
Adolescent
Antipsychotic Agents - therapeutic use
Cognitive Therapy - methods
Combined Modality Therapy
Delusions - diagnosis - psychology - therapy
Female
Follow-Up Studies
Hospitalization
Humans
Male
Patient satisfaction
Psychiatric Status Rating Scales
Psychotic Disorders - diagnosis - psychology - therapy
Quebec
Schizophrenia - diagnosis - therapy
Schizophrenic Psychology
Young Adult
Abstract
Meta-analysis results confirm that cognitive-behavioural therapy in psychosis (CBTp) is efficient for persistent symptoms. However, external validity remains unexplored. CBTp in early psychosis (in the first 5 years after diagnosis) seems especially relevant, given a possible impact on long-term course. However, the few studies that experimented with CBTp with this population had poor results. They all introduced therapy during an acute psychotic phase and most of them performed a limited number of sessions. Therefore, our introductory open study aimed to evaluate the efficiency of a 25-session Australian CBTp program, introduced during a stable phase in Quebec patients with early psychosis.
The Active Cognitive Psychotherapy for Early Psychosis program was offered to 20 patients aged 14 years or older, at a rate of 1 weekly session during 6 months.
The acceptance rate was 75%, the mean session compliance rate was 84%, and participants were satisfied with the program. Pre- and post-CBTp analyses indicated statistically significant improvements of psychotic symptomatology, which were maintained at 6-month follow-up. Self-criticism improvement was also statistically significant, post-CBTp.
CBTp seems to be appropriate in our clinical settings, including with adolescents. Moreover, the treatment dosage used seems to foster session compliance.
PubMed ID
21324243 View in PubMed
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Cognitive behaviour therapy for psychotic symptoms: a randomized controlled effectiveness trial.

https://arctichealth.org/en/permalink/ahliterature114231
Source
Behav Cogn Psychother. 2013 Oct;41(5):511-24
Publication Type
Article
Date
Oct-2013
Author
Bodil Kråkvik
Rolf W Gråwe
Roger Hagen
Tore C Stiles
Author Affiliation
St. Olavs University Hospital, Trondheim, Norway.
Source
Behav Cogn Psychother. 2013 Oct;41(5):511-24
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - therapeutic use
Cognitive Therapy - methods
Combined Modality Therapy
Delusions - diagnosis - psychology - therapy
Female
Follow-Up Studies
Hallucinations - diagnosis - psychology - therapy
Humans
Male
Norway
Psychiatric Status Rating Scales - statistics & numerical data
Psychometrics - statistics & numerical data
Psychotic Disorders - diagnosis - psychology - therapy
Reproducibility of Results
Schizophrenia - diagnosis - therapy
Schizophrenic Psychology
Young Adult
Abstract
Cognitive behavioural therapy for psychosis (CBTp) is currently a recommended form of psychosocial treatment for persons suffering from persistent psychotic symptoms. It has been argued that effect sizes from efficacy studies cannot be generalized to real clinical settings.
Our aim was to evaluate whether the positive results from randomized controlled trials conducted by experts could be replicated in clinical setting with a heterogeneous sample of patients with psychotic disorder.
Patients referred to the study were either randomized to CBTp+TAU (the treatment group) or to a waiting-list group, only receiving TAU. The patients were assessed on different outcome measures such as the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS), and the Psychotic Symptom Rating Scales (PSYRATS), at pretreatment, at posttreatment (6 months), and at 12 months follow-up. In total, 45 patients participated in the study.
The results showed that 20 sessions of CBTp performed significantly better than the waiting list controls with respect to the global score on the BPRS, the delusional scale on the PSYRATS, and the GAF symptom score at posttreatment. At 12 months follow-up only the GAF symptom score remained significantly changed for the total sample.
The study revealed that CBTp delivered by non-experts in routine clinical settings can produce improvements in positive psychotic symptoms, and also that some of these improvements can be maintained at one year follow-up.
Notes
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PubMed ID
23635846 View in PubMed
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Development of a brief screen for violence risk (V-RISK-10) in acute and general psychiatry: An introduction with emphasis on findings from a naturalistic test of interrater reliability.

https://arctichealth.org/en/permalink/ahliterature148840
Source
Eur Psychiatry. 2009 Sep;24(6):388-94
Publication Type
Article
Date
Sep-2009
Author
S. Bjørkly
P. Hartvig
F-A Heggen
H. Brauer
T A Moger
Author Affiliation
Institute of Health and Social Sciences, Molde University College, Box 2110, 6402 Molde, Norway. stal.bjorkly@himolde.no
Source
Eur Psychiatry. 2009 Sep;24(6):388-94
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Commitment of Mentally Ill - legislation & jurisprudence
Dangerous Behavior
Female
Humans
Interview, Psychological
Male
Mass Screening - legislation & jurisprudence
Middle Aged
Norway
Observer Variation
Patient Discharge - legislation & jurisprudence
Personality Assessment - statistics & numerical data
Psychometrics - statistics & numerical data
Psychotic Disorders - diagnosis - psychology - therapy
Reproducibility of Results
Risk Assessment - legislation & jurisprudence
Schizophrenia - diagnosis - therapy
Schizophrenic Psychology
Violence - legislation & jurisprudence - psychology
Young Adult
Abstract
Most violence risk assessment scales were originally developed for use in forensic settings at the time of discharge or release of patients into the community after long-term treatment. However, there is a considerable need for specialized, brief and structured risk assessment tools to inform risk decisions in short-term psychiatric treatment. The present study reports on research findings from the development and implementation of the violence risk screening-10 (V-RISK-10) in two acute psychiatric settings in Norway. The 10-item screen is easy to use, time-saving and may be used for screening of violence risk during hospital stay and after discharge into the community. Prospective validation studies of the screen concerning inpatient and post-release community violence have been conducted. Although data analyses are not yet complete, preliminary findings indicate that the screen has good predictive validity. This suggests that the screen is a promising tool in short-term acute psychiatric settings. However, the importance of reliability in mental health data and tests is well recognized, and a screen with good predictive validity is not worth much if clinicians are unable to agree on the scoring of one and the same patient. In this article we report results from a naturalistic interrater reliability investigation that involved 25 mental health professionals and 73 acute psychiatric patients. V-RISK-10 scoring was accomplished by two raters for each patient. The interrater reliability value for total scores was acceptable. Variations pertaining to the individual V-RISK-10 item, patient characteristics and rater characteristics are discussed.
PubMed ID
19716682 View in PubMed
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Dimensions of delusional experiences and their value as predictors of long-term outcome.

https://arctichealth.org/en/permalink/ahliterature162544
Source
Psychopathology. 2007;40(5):278-81
Publication Type
Article
Date
2007
Author
Stein Opjordsmoen
Nils Retterstøl
Author Affiliation
Division of Psychiatry, Ullevaal University Hospital, Oslo, Norway. s.e.o.ilner@ medisin.uio.no
Source
Psychopathology. 2007;40(5):278-81
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Affective Disorders, Psychotic - diagnosis - psychology - therapy
Aged
Brief Psychiatric Rating Scale
Delusions - diagnosis - psychology
Female
Humans
Long-Term Care
Male
Middle Aged
Norway
Outcome Assessment (Health Care)
Paranoid Disorders - diagnosis - psychology - therapy
Patient Discharge
Prognosis
Psychopathology
Psychotic Disorders - diagnosis - psychology - therapy
Schizophrenia - diagnosis - therapy
Schizophrenic Psychology
Abstract
Delusions are categorized as present or not in classificatory systems, but can fluctuate in intensity over time. They are sometimes difficult to describe, and might be better conceptualized as continuous on a number of dimensions. The predictive value of dimensional ratings of delusions was studied.
Out of 180 first-episode psychotic patients who had been personally followed up after 30 years, a subsample of 41 was randomly drawn, 21 of the 180, 10 of those with GAS scores of 70 or more, and 10 of those with GAS scores of 30 or less at follow-up. They represented three different groups - a good outcome (n = 17), an intermediate outcome (n = 12), and a poor outcome (n = 12) group. Based on case histories at first presentation, scores on the Dimensions of Delusional Experience Scale were recorded.
Poor compared to good outcome patients had delusions at index admission characterized by more conviction, extension, disorganization, bizarreness and pressure. Intermediate outcome patients had scores in between, but closer to the poor outcome group.
Dimensional rating scales for assessing delusions might have predictive power, and consequently they should be used in future research, and if replicated these findings might have clinical implications.
PubMed ID
17622706 View in PubMed
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Early detection of psychosis: positive effects on 5-year outcome.

https://arctichealth.org/en/permalink/ahliterature140097
Source
Psychol Med. 2011 Jul;41(7):1461-9
Publication Type
Article
Date
Jul-2011
Author
T K Larsen
I. Melle
B. Auestad
U. Haahr
I. Joa
J O Johannessen
S. Opjordsmoen
B R Rund
J I Rossberg
E. Simonsen
P. Vaglum
S. Friis
T. McGlashan
Author Affiliation
Stavanger University Hospital, Psychiatric Clinic, Stavanger, Norway. tkmaclarsen@mac.com
Source
Psychol Med. 2011 Jul;41(7):1461-9
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Denmark
Early Diagnosis
Female
Follow-Up Studies
Humans
Male
Middle Aged
Norway
Outcome Assessment (Health Care) - methods
Psychiatric Status Rating Scales
Psychotic Disorders - diagnosis - psychology - therapy
Young Adult
Abstract
During the last decades we have seen a new focus on early treatment of psychosis. Several reviews have shown that duration of untreated psychosis (DUP) is correlated to better outcome. However, it is still unknown whether early treatment will lead to a better long-term outcome. This study reports the effects of reducing DUP on 5-year course and outcome.
During 1997-2000 a total of 281 consecutive patients aged >17 years with first episode non-affective psychosis were recruited, of which 192 participated in the 5-year follow-up. A comprehensive early detection (ED) programme with public information campaigns and low-threshold psychosis detection teams was established in one healthcare area (ED-area), but not in a comparable area (no-ED area). Both areas ran equivalent treatment programmes during the first 2 years and need-adapted treatment thereafter.
At the start of treatment, ED-patients had shorter DUP and less symptoms than no-ED-patients. There were no significant differences in treatment (psychotherapy and medication) for the 5 years. Mixed-effects modelling showed better scores for the ED group on the Positive and Negative Syndrome Scale negative, depressive and cognitive factors and for global assessment of functioning for social functioning at 5-year follow-up. The ED group also had more contacts with friends. Regression analysis did not find that these differences could be explained by confounders.
Early treatment had positive effects on clinical and functional status at 5-year follow-up in first episode psychosis.
Notes
Comment In: Psychol Med. 2012 Mar;42(3):669-7022099925
PubMed ID
20942996 View in PubMed
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Early intervention in psychosis: specialized intervention and early case identification.

https://arctichealth.org/en/permalink/ahliterature139121
Source
Encephale. 2010 Mar;36 Suppl 3:S38-45
Publication Type
Article
Date
Mar-2010
Author
A. Malla
S. Lal
N C Vracotas
K. Goldberg
R. Joober
Author Affiliation
Douglas Mental Health University Institute, McGill University, Montréal, Quebec, Canada. ashok.malla@douglas.mcgill.ca
Source
Encephale. 2010 Mar;36 Suppl 3:S38-45
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Antipsychotic Agents - adverse effects - therapeutic use
Canada
Cognition Disorders - diagnosis - psychology - therapy
Combined Modality Therapy
Cooperative Behavior
Early Diagnosis
Health Services Accessibility
Humans
Interdisciplinary Communication
Mass Screening
Patient Acceptance of Health Care - psychology
Patient care team
Psychotherapy - methods
Psychotic Disorders - diagnosis - psychology - therapy
Referral and Consultation
Treatment Outcome
Young Adult
Abstract
Specialized early intervention (SEI) approach to treatment of a First Episode of Psychosis (FEP) consists of two equally important components, namely, a phase specific treatment program and early case identification. In this article we report a brief update on our knowledge about both aspects of SEI services. We then provide a description of a prototypical SEI service within the Canadian context, examine the pathways to care for patients with FEP and report on different methods of reducing delay in treatment. We also provide a description of a novel method of reducing delay in treatment using principles of academic detailing targeting all health care and educational services within a defined catchment area in combination with quick access to the SEI service.
PubMed ID
21095391 View in PubMed
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The effect of five years versus two years of specialised assertive intervention for first episode psychosis - OPUS II: study protocol for a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature136300
Source
Trials. 2011;12:72
Publication Type
Article
Date
2011
Author
Marianne Melau
Pia Jeppesen
Anne Thorup
Mette Bertelsen
Lone Petersen
Christian Gluud
Gertrud Krarup
Merete Nordentoft
Author Affiliation
Psychiatric Centre Copenhagen, Copenhagen University, Faculty of Health Sciences, Copenhagen, Denmark. marianne.melau@regionh.dk
Source
Trials. 2011;12:72
Date
2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Cognitive Therapy
Community Mental Health Services
Crisis Intervention
Denmark
Family Therapy
Humans
Psychiatric Status Rating Scales
Psychotherapy, Group
Psychotic Disorders - diagnosis - psychology - therapy
Research Design
Social Behavior
Time Factors
Treatment Outcome
Young Adult
Abstract
The Danish OPUS I trial randomized 547 patients with first-episode psychosis to a two-year early-specialised assertive treatment programme (OPUS) versus standard treatment. The two years OPUS treatment had significant positive effects on psychotic and negative symptoms, secondary substance abuse, treatment adherence, lower dosage of antipsychotic medication, and a higher treatment satisfaction. However, three years after end of the OPUS treatment, the positive clinical effects were not sustained, except that OPUS-treated patients were significantly less likely to be institutionalised compared with standard-treated patients. The major objective of the OPUS II trial is to evaluate the effects of five years of OPUS treatment versus two years of OPUS treatment.
The OPUS II trial is designed as a randomized, open label, parallel group trial with blinded outcome assessment. Based on our sample size estimation, 400 patients treated in OPUS for two years will be randomized to further three years of OPUS treatment versus standard treatment. The specialized assertive OPUS treatment consists of three core elements: assertive community treatment, psycho-educational family treatment, and social skills training.
It has been hypothesized that there is a critical period from onset up to five years, which represents a window of opportunity where a long-term course can be influenced. Extending the specialized assertive OPUS treatment up to five years may allow the beneficial effects to continue beyond the high-risk period, through consolidation of improved social and functional outcome.
Clinical Trial.gov NCT00914238.
Notes
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PubMed ID
21392377 View in PubMed
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23 records – page 1 of 3.