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The association between working alliance and clinical and functional outcome in a cohort of 400 patients with first-episode psychosis: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature261207
Source
J Clin Psychiatry. 2015 Jan;76(1):e83-90
Publication Type
Article
Date
Jan-2015
Author
Marianne Melau
Susanne Harder
Pia Jeppesen
Carsten Hjorthøj
Jens R M Jepsen
Anne Thorup
Merete Nordentoft
Source
J Clin Psychiatry. 2015 Jan;76(1):e83-90
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Adult
Case Management - standards
Cohort Studies
Cross-Sectional Studies
Denmark
Female
Humans
Male
Patient Compliance - psychology
Professional-Patient Relations
Psychotic Disorders - psychology - therapy
Randomized Controlled Trials as Topic
Schizophrenia - therapy
Schizophrenic Psychology
Young Adult
Abstract
Working alliance between patients with a first-episode psychosis and their case manager is regarded as a key element in specialized early intervention services. The impact of this patient-case manager dyad on functional and clinical outcome is unknown. We aimed to investigate if a strong working alliance was associated with fewer clinical symptoms and better social functioning.
In a cross-sectional design, patients with first-episode schizophrenia spectrum disorders (ICD-10, F20-29) were included after 18 months of treatment (N = 400). Baseline data were collected between June 2009 and December 2011. Symptoms were assessed using Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Global Assessment of Functioning (GAF), Brief Assessment of Cognition in Schizophrenia (BACS), Working Alliance Inventory (WAI), and General Self-Efficacy (GSE). Linear regression analyses were adjusted for age, sex, cognition, and self-efficacy.
Results revealed significant associations between working alliance and fewer negative (? = -0.12; 95% CI, -0.19 to -0.04) and disorganized symptoms (? = -0.06; 95% CI, -0.11 to -0.01), and between working alliance and better social functioning (? = 1.45; 95% CI, 0.55 to 2.36). General self-efficacy mediated the effect of working alliance, explaining 14%-18% of the variance in associated outcomes. Global level of cognitive functioning, compliance, and self-efficacy influenced clinical and functional outcome more strongly than working alliance.
Better working alliance was weakly associated with fewer negative and disorganized symptoms and better social functioning. A strong working alliance may be a prerequisite for adherence to the specialized early intervention services treatment, providing the basis for positive treatment outcome.
ClinicalTrials.gov identifier: NCT00914238.
PubMed ID
25650684 View in PubMed
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Development of an integrated clinical database system for a regional mental health service.

https://arctichealth.org/en/permalink/ahliterature214663
Source
Psychiatr Serv. 1995 Aug;46(8):826-8
Publication Type
Article
Date
Aug-1995
Author
G M McDougall
C E Adair-Bischoff
E. Grant
Author Affiliation
Department of Psychiatry, University of Calgary, Alberta, Canada.
Source
Psychiatr Serv. 1995 Aug;46(8):826-8
Date
Aug-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Alberta
Caregivers - psychology
Chronic Disease
Community Mental Health Services
Computer Security
Data Collection
Database Management Systems
Delivery of Health Care, Integrated
Female
Humans
Integrated Advanced Information Management Systems
Male
Medical Records Systems, Computerized
Mental Disorders - psychology - therapy
Middle Aged
Psychotic Disorders - psychology - therapy
Abstract
The authors describe development of an automated system to provide caregivers in a regional mental health service in Calgary, Alberta, with access to information about persons with chronic mental illness served by the system. All participating organizations provided input about system design features and data elements. Issues of confidentiality of records were addressed. A working model demonstrated to caregivers was rated as useful and understandable by more than 90 percent of respondents.
PubMed ID
7583486 View in PubMed
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Do personality traits matter when choosing a group therapy for early psychosis?

https://arctichealth.org/en/permalink/ahliterature116545
Source
Psychol Psychother. 2013 Mar;86(1):19-32
Publication Type
Article
Date
Mar-2013
Author
Marie-Chantal Beauchamp
Tania Lecomte
Conrad Lecomte
Claude Leclerc
Marc Corbière
Author Affiliation
Department of Psychology, Université de Montréal, Quebec, Canada.
Source
Psychol Psychother. 2013 Mar;86(1):19-32
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adolescent
Adult
Analysis of Variance
Canada
Cognitive Therapy - methods
Early Medical Intervention - methods
Female
Humans
Linear Models
Male
Models, Psychological
Outcome Assessment (Health Care) - statistics & numerical data
Patient Education as Topic - methods
Patient Selection
Personality
Personality Inventory
Psychiatric Status Rating Scales
Psychotherapy, Group - methods
Psychotic Disorders - psychology - therapy
Recurrence - prevention & control
Young Adult
Abstract
This study aimed at determining the predictive value of personality traits, based on the Five Factor Model (FFM) of personality, on therapeutic outcomes according to specific group treatments for first episode psychosis: cognitive-behavioural therapy (CBT) or skills training for symptom management (SM).
Individuals experiencing early psychosis were recruited to participate in a randomized- controlled trial (RCT). Participants were randomized to one of two group treatments or to a wait-list control group. Measures included a personality inventory (NEO-FFI) and outcome measures of symptomatology (BPRS-E) and coping strategies (CCS). Pearson correlation analyses were conducted on 78 individuals and linear regression analyses on 66.
Links were found between personality traits, symptoms, and coping outcome measures, according to specific group treatments. Personality traits were particularly linked to therapeutic changes in active coping strategies, with Conscientiousness accounting for 14% of the variance in the CBT group, Extraversion accounting for 41% of the variance in the SM group, and Openness to experience accounting for 22% of the variance in the control group.
Individual differences in personality traits for people experiencing early psychosis should be considered when offering psychosocial treatments, since it appears that those with specific traits might benefit more than others in specific group interventions, particularly for interventions that do not solely aim at improving symptoms.
PubMed ID
23386553 View in PubMed
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Effects of the two-way communication checklist (2-COM): a one-year cluster randomized study in a group of severely mentally ill persons.

https://arctichealth.org/en/permalink/ahliterature256605
Source
Int J Soc Psychiatry. 2014 Feb;60(1):95-102
Publication Type
Article
Date
Feb-2014
Author
Hans Arvidsson
Elisabeth Olin
Jennifer Strand
Inga Tidefors
Author Affiliation
1Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
Source
Int J Soc Psychiatry. 2014 Feb;60(1):95-102
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Ambulatory Care Facilities
Bipolar Disorder - psychology - therapy
Checklist
Communication
Female
Humans
Male
Mental Disorders - psychology - therapy
Middle Aged
Needs Assessment
Patient care team
Patient Participation
Physician-Patient Relations
Professional-Patient Relations
Psychotic Disorders - psychology - therapy
Sweden
Abstract
In a health-care service with the emphasis on improvement related to functioning and well-being, the communication process between patient and professionals is essential. There is a lack of research on this matter.
The aim was to investigate, in a group of severely mentally ill persons, whether the use of a simple communication tool could influence the sense of empowerment, satisfaction with care, therapeutic alliance and unmet needs.
The study had a cluster randomized design. The intervention was a communication tool (2-COM) applied in two teams during one year. In a comparison group of two other teams, the treatment was as usual. At baseline, after six months, and after one year, assessments were made.
After one year the 2-COM groups seemed to have a larger reduction in unmet needs compared to the treatment-as-usual group. However, there were large problems with attrition in the study, and it was not possible to draw relevant conclusions.
The methodological problems were substantial, and the study may be considered as a pilot study. In a main study the researchers ought to take control over the selection of patients on the basis of the experiences from this study.
PubMed ID
23266575 View in PubMed
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Effects of treatment and alternative care on length of stay on a general hospital psychiatric unit--results of an audit.

https://arctichealth.org/en/permalink/ahliterature221749
Source
Can J Psychiatry. 1993 Feb;38(1):39-45
Publication Type
Article
Date
Feb-1993
Author
F M Mai
J Y Gosselin
L. Varan
L. Bourgon
J R Navarro
Author Affiliation
Department of Psychiatry, Ottawa General Hospital, Ontario.
Source
Can J Psychiatry. 1993 Feb;38(1):39-45
Date
Feb-1993
Language
English
Publication Type
Article
Keywords
Adult
Chronic Disease
Combined Modality Therapy
Community Mental Health Services
Depressive Disorder - psychology - therapy
Female
Health Services Misuse
Hospitalization
Hospitals, General
Humans
Male
Medical Audit
Mental Disorders - psychology - therapy
Middle Aged
Mood Disorders - psychology - therapy
Ontario
Personality Disorders - psychology - therapy
Psychiatric Department, Hospital
Psychotic Disorders - psychology - therapy
Quality Assurance, Health Care
Abstract
Quality controls are becoming an important part of our health care system. A medical audit is one way of evaluating quality of care, and this paper describes the results of an audit conducted to investigate the reasons for a prolonged stay on a psychiatric inpatient unit. The results showed a decrease in the mean length of stay over a five year period, although the figure remained substantially above provincial norms. A review of the hospital charts of a random sample of one in six patients whose hospital stay exceeded 30 days was carried out. It revealed that in 50.0% of cases the reasons were "medically acceptable," in 10.3% the reasons were "medically unacceptable" and in 39.7% the reasons were "social and administrative" and beyond the control of the treating psychiatrist. The implication of these results are discussed.
PubMed ID
8448719 View in PubMed
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Electroconvulsive therapy in the Nordic countries, 1977-1987.

https://arctichealth.org/en/permalink/ahliterature46637
Source
Acta Psychiatr Scand. 1991 Nov;84(5):428-34
Publication Type
Article
Date
Nov-1991
Author
L S Strömgren
Author Affiliation
Aarhus University, Department of Psychiatry, Denmark.
Source
Acta Psychiatr Scand. 1991 Nov;84(5):428-34
Date
Nov-1991
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Cross-Sectional Studies
Depressive Disorder - psychology - therapy
Electroconvulsive Therapy - methods - trends
Humans
Mental Disorders - psychology - therapy
Psychotic Disorders - psychology - therapy
Scandinavia
Schizophrenia - therapy
Schizophrenic Psychology
Abstract
In 1977 a questionnaire was sent to all psychiatric departments in the Nordic countries: Sweden, Norway, Denmark, Finland and Iceland, concerning indications for electroconvulsive therapy (ECT) and the use of unilateral and bilateral treatment, respectively. The inquiry was repeated in 1987 and the answers compared with those obtained in 1977. In addition, the answers from Denmark were compared with previously performed inquiries. The use of exclusively unilateral treatment (U) and of both unilateral and bilateral treatment (UB) has increased in most of the countries and exclusively bilateral treatment (B) has decreased drastically. In Denmark the situation has not changed for ECT in endogenous depression and acute delirium, and the use in reactive psychosis, mania and schizophrenia decreased somewhat during the 1970s and then again stabilized or increased during the 1980s. Nearly all departments in the Nordic countries used ECT in endogenous depression in 1977 and were still doing it in 1987. In mania, about 50% of all departments have found ECT indicated occasionally or exceptionally both in 1977 and 1987. Manic-depressive mixed states have been regarded as an indication in somewhat more than two thirds of departments, increasing during the period. The use of ECT in schizophrenia has been rare and somewhat decreasing, but still about half of the departments apply it once in a while. In reactive psychosis the use of ECT decreased slightly, but in 1987 it was still in use for this indication in about 50% of all departments. In acute delirium there has been an overall increase in the use of ECT.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
1776495 View in PubMed
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Family members' involvement in psychiatric care: experiences of the healthcare professionals' approach and feeling of alienation.

https://arctichealth.org/en/permalink/ahliterature100550
Source
J Psychiatr Ment Health Nurs. 2010 Jun;17(5):422-32
Publication Type
Article
Date
Jun-2010
Author
M. Ewertzon
K. Lützén
E. Svensson
B. Andershed
Author Affiliation
School of Health Care and Social Sciences, Högskolan Dalarna, SE-791 88 Falun, Sweden. mew@du.se
Source
J Psychiatr Ment Health Nurs. 2010 Jun;17(5):422-32
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Attitude of Health Personnel
Attitude to Health
Cooperative Behavior
Cross-Sectional Studies
Family - psychology
Female
Humans
Male
Middle Aged
Nursing Methodology Research
Power (Psychology)
Professional-Family Relations
Prospective Studies
Psychotic Disorders - psychology - therapy
Qualitative Research
Self-Help Groups
Social Alienation - psychology
Social Isolation - psychology
Statistics, nonparametric
Sweden
Abstract
The involvement of family members in psychiatric care is important for the recovery of persons with psychotic disorders and subsequently reduces the burden on the family. Earlier qualitative studies suggest that the participation of family members can be limited by how they experience the professionals' approach, which suggests a connection to the concept of alienation. Thus, the aim of this study was in a national sample investigate family members' experiences of the psychiatric health care professionals' approach. Data were collected by the Family Involvement and Alienation Questionnaire. The median level and quartiles were used to describe the distributions and data were analysed with non-parametric statistical methods. Seventy family members of persons receiving psychiatric care participated in the study. The results indicate that a majority of the participants respond that they have experiencing a negative approach from the professionals, indicating lack of confirmation and cooperation. The results also indicate that a majority of the participants felt powerlessness and social isolation in the care being provided, indicating feelings of alienation. A significant but weak association was found between the family members' experiences of the professionals' approach and their feelings of alienation.
PubMed ID
20584239 View in PubMed
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Global assessment of functioning following assertive community treatment in Edmonton, Alberta: a longitudinal study.

https://arctichealth.org/en/permalink/ahliterature195181
Source
Can J Psychiatry. 2001 Mar;46(2):144-8
Publication Type
Article
Date
Mar-2001
Author
P. Tibbo
K. Joffe
P. Chue
A. Metelitsa
E. Wright
Author Affiliation
Alberta Heritage Foundation for Medical Research, Department of Psychiatry, University of Alberta, Edmonton, Alberta. ptibbo@pop.srv.ualberta.ca
Source
Can J Psychiatry. 2001 Mar;46(2):144-8
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adult
Alberta
Cohort Studies
Community Mental Health Services
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient care team
Psychotic Disorders - psychology - therapy
Social Adjustment
Treatment Outcome
Abstract
To examine longitudinally the effects of Assertive Community Treatment (ACT) on Global Assessment of Functioning (GAF) scores in Edmonton, Alberta.
We acquired GAF scores for all clients at initial registration in the ACT program and at subsequent 18- and 36-month time points while in ACT. We analyzed both the entire ACT cohort and separate diagnostic groups.
We obtained baseline and follow-up GAF scores for 411 clients, of whom the largest diagnostic group suffered from schizophrenia (n = 189), followed by bipolar disorder (n = 98). Collapsed across all groups, GAF scores significantly improved at both 18 (P
PubMed ID
11280083 View in PubMed
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Mental health professionals' attitudes towards people with mental illness: do they differ from attitudes held by people with mental illness?

https://arctichealth.org/en/permalink/ahliterature130936
Source
Int J Soc Psychiatry. 2013 Feb;59(1):48-54
Publication Type
Article
Date
Feb-2013
Author
Lars Hansson
Henrika Jormfeldt
Petra Svedberg
Bengt Svensson
Author Affiliation
Department of Health Sciences, Lund University, Lund, Sweden. lars.hansson@med.lu.se
Source
Int J Soc Psychiatry. 2013 Feb;59(1):48-54
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Cross-Sectional Studies
Culture
Female
Humans
Inpatients - psychology
Male
Mental health services
Mentally Ill Persons - psychology
Middle Aged
Patient care team
Professional-Patient Relations
Psychotic Disorders - psychology - therapy
Public Opinion
Questionnaires
Social Stigma
Stereotyping
Sweden
Young Adult
Abstract
Studies investigating mental health professionals' attitudes towards people with mental illness are scarce and there is a lack of comparative studies including both patients' and mental health professionals' attitudes. The aim of the present study was to investigate mental health staff's attitudes towards people with mental illness and compare these with the attitudes of patients in contact with mental health services. A further aim was to relate staff attitudes to demographic and work characteristics.
A cross-sectional study was performed including 140 staff and 141 patients. The study included a random sample of outpatients in contact with mental health services in the southern part of Sweden and staff working in these services. Attitudes were investigated using a questionnaire covering beliefs of devaluation and discrimination of people with a mental illness.
Negative attitudes were prevalent among staff. Most negative attitudes concerned whether an employer would accept an application for work, willingness to date a person who had been hospitalized, and hiring a patient to take care of children. Staff treating patients with a psychosis or working in inpatient settings had the most negative attitudes. Patient attitudes were overall similar to staff attitudes and there were significant differences in only three out of 12 dimensions. Patients' most negative attitudes were in the same area as the staff's.
This study points to the suggestion that mental health care staff may hold negative attitudes and beliefs about people with mental illness with tentative implications for treatment of the patient and development and implementation of evidence-based services. Since patients and staff in most respects share these beliefs, it is essential to develop interventions that have an impact on both patients and staff, enabling a more recovery-oriented staff-patient relationship.
Notes
Comment In: Int J Soc Psychiatry. 2013 Aug;59(5):52023887823
Comment In: Int J Soc Psychiatry. 2013 Aug;59(5):52223887825
PubMed ID
21954319 View in PubMed
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[Mother-child treatment in psychiatry. III. The author's own experiences--practical implementation and discussion]

https://arctichealth.org/en/permalink/ahliterature59008
Source
Psychiatr Prax. 1997 Nov;24(6):281-5
Publication Type
Article
Date
Nov-1997
Author
H P Hartmann
Author Affiliation
Klinik für Psychiatrie und Psychotherapie, Krankenhaus Weilmünster.
Source
Psychiatr Prax. 1997 Nov;24(6):281-5
Date
Nov-1997
Language
German
Publication Type
Article
Keywords
Adult
English Abstract
Female
Humans
Infant, Newborn
Mother-Child Relations
Mothers - psychology
Prognosis
Psychology, Social
Psychotherapy - methods
Psychotic Disorders - psychology - therapy
Puerperal Disorders - psychology - therapy
Abstract
With regard to experiences described in the literature, and the particular psychotherapeutic and paedagogic effects on mother and child in the inpatient treatment setup presented in this paper, we give an account of the preliminary deliberations and preconditions arising from this particular setup. Prognostically unfavourable aspects of joint admission and treatment are also presented. Finally, previous experiences are discussed, and suggestions for improvement of care for mentally ill mothers and their infants or toddlers are made, taking into consideration the facilities existing in England and Denmark.
PubMed ID
9490442 View in PubMed
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24 records – page 1 of 3.