Clinical Practice and Epidemiology in Mental Health最新文献

{"title":"Quality of Life of Mothers and Fathers of Children with Autism Spectrum Disorder in Jordan.","authors":"Eiman A Ahmed, Sireen M Alkhaldi, Hamza Alduraidi, Rania A Albsoul, Mohammad Z Alhamdan","doi":"10.2174/17450179-v19-e230529-2022-40","DOIUrl":"10.2174/17450179-v19-e230529-2022-40","url":null,"abstract":"<p><strong>Background: </strong>Parenting children with autism spectrum disorder (ASD) is widely identified to be associated with life-long impairment in parents' quality of life (QoL). However, there has been little information on the QoL of parents of children with ASD in the Jordanian context.</p><p><strong>Objective: </strong>This study aimed to assess the QoL among mothers and fathers who have children with ASD in Jordan and to identify factors associated with it.</p><p><strong>Methods: </strong>In this cross-sectional study, respondents were mothers and fathers of children with ASD attending autism rehabilitation centers in Amman. Data were collected from 206 participants using a validated questionnaire. Descriptive statistics, T-test, ANOVA and logistic regression, were applied.</p><p><strong>Results: </strong>Overall quality of life was low (mean= 2.32). The physical dimension scored the highest (mean =2.79), and the environmental dimension scored the lowest (mean= 2.06). Results indicated that fathers and parents with low education reported significantly lower QoL scores (p = .024 and 0.001, respectively).</p><p><strong>Conclusion: </strong>Among parents of children with ASD, parents at risk for low QoL were recognized. Our results can be utilized to design interventions to support mothers and fathers at risk in Jordan to enhance their QoL.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is a Genetic Variant associated with Bipolar Disorder Frequent in People without Bipolar Disorder but with Characteristics of Hyperactivity and Novelty Seeking?","authors":"Goce Kalcev,&nbsp;Alessandra Scano,&nbsp;Germano Orrù,&nbsp;Diego Primavera,&nbsp;Giulia Cossu,&nbsp;Antonio Egidio Nardi,&nbsp;Mauro Giovanni Carta","doi":"10.2174/17450179-v19-e230419-2022-53","DOIUrl":"https://doi.org/10.2174/17450179-v19-e230419-2022-53","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to verify whether a genetic condition associated with bipolar disorder (BD) is frequent in old adults adapted to their environment, without BD, but with aptitudes for hyperactivity and novelty seeking (H/NS).</p><p><strong>Methods: </strong>In this cross-sectional study, the study sample included healthy elderly people (40 participants, aged 60 or older) living in an urban area and recruited from a previous study on physical exercise and active aging, who were compared with 21 old adults with BD from the same area. The genetic methodology consisted of blood sampling, DNA extraction, real-time PCR jointly with FRET probes, and the SANGER sequencing method. The genetic variant RS1006737 of CACNA1C, found to be associated with bipolar disorder diagnosis, was investigated.</p><p><strong>Results: </strong>The frequency of the RS1006737 genetic variant in the study group (H/NS) is not higher than in the BD group and is statistically significantly higher than in all the control groups found in the literature. However, the familiarity for BD is higher in old adults with BD than in the H/NS sample without BD. The risk of BD in the family (also considering those without BD but with family members with BD) is not associated with the presence of the genetic variant examined.</p><p><strong>Conclusion: </strong>The study suggests that the gene examined is associated with characteristics of hyperactivity rather than just BD. Nevertheless, choosing to participate in an exercise program is an excessively general way to identify H/NS. The next step would be to identify the old adults with well-defined H/NS features with an adequate tool.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Mindfulness-acceptance-commitment based approach for Rumination, Cognitive Flexibility and Sports Performance of Elite Players of Beach Soccer: A Randomized Controlled Trial with 2-months Follow-up.","authors":"Fatemeh Sabzevari,&nbsp;Hossein Samadi,&nbsp;Farahnaz Ayatizadeh,&nbsp;Sergio Machado","doi":"10.2174/17450179-v19-e230419-2022-33","DOIUrl":"https://doi.org/10.2174/17450179-v19-e230419-2022-33","url":null,"abstract":"<p><strong>Background/objective: </strong>There is little research on the effectiveness of new approaches to psychology, including mindfulness-acceptance-commitment, especially in team disciplines. Therefore, this study compared mindfulness-acceptance and commitment-based approaches to rumination, cognitive flexibility, and sports performance of elite beach soccer players during a two-month follow-up.</p><p><strong>Methods: </strong>The research design consisted of a randomized controlled trial (RCT), with follow-up. Thus, 34 players of the premier league of beach soccer were randomly divided into intervention and control groups based on mindfulness acceptance and commitment. The experimental group exercises consisted of one session per week for 7 weeks and daily homework. Participants filled out the questionnaires of the Ruminative Response Scale, Cognitive Flexibility Inventory, and Sports Performance Questionnaire before, after, and at two months of follow-up of the intervention.</p><p><strong>Results: </strong>Multivariate Analysis of Variance (MANOVA) and Analysis of Variance (ANOVA) with repeated measures were used to evaluate the changes over time and compare the scores of the subjects of the two groups. The results showed a significant difference in mindfulness-acceptance and commitment intervention in the experimental group on pre- <i>vs.</i> post-test and pre-test <i>vs.</i> follow-up scores of research variables. Also, a comparison of groups using independent T-test analysis showed a significant effect of mindfulness-acceptance and commitment exercises on research variables in the experimental group in the post-test and follow-up stages.</p><p><strong>Conclusion: </strong>Findings suggest that mindfulness, commitment, and acceptance exercises can be used as a new method to reduce rumination and increase cognitive flexibility and sports performance of elite beach soccer players.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10487324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of the Questionnaire for Adaptive Hyperactivity and Goal Achievement (AHGA).","authors":"Goce Kalcev,&nbsp;Giulia Cossu,&nbsp;Antonio Preti,&nbsp;Maria Teresa Littera,&nbsp;Stèphanie Frau,&nbsp;Diego Primavera,&nbsp;Rosanna Zaccheddu,&nbsp;Veronica Matza,&nbsp;Marta Ermellino,&nbsp;Elisa Pintus,&nbsp;Mauro G Carta","doi":"10.2174/17450179-v19-e230419-2022-50","DOIUrl":"https://doi.org/10.2174/17450179-v19-e230419-2022-50","url":null,"abstract":"<p><strong>Objective: </strong>This paper illustrates the preliminary psychometric properties of the Questionnaire for Adaptive Hyperactivity and Goal Achievement (AHGA), aimed at measuring adaptive characteristics of hyperactivity and goal pursuit in older adults.</p><p><strong>Methods: </strong>The 12-item scale was administered to a sample of 120 subjects (older adults) between February 2022 and June 2022. The reliability of AHGA was measured using Cronbach's alpha, and factor structure was established using parallel analysis (PA) and principal component analysis (PCA). Convergent validity was tested against the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN).</p><p><strong>Results: </strong>All included subjects have an average age of 74.1±5.1 years. AHGA reliability was good (Cronbach's alpha: 0.713 [95%CI: 0.630 to 0.783]). Factor analysis suggested two main components: goal achievement and hyperactivity, which explained 41% of the variance in the data. The results support the convergent validity of the scale: AHGA measures adaptive characteristics of hyperactivity and goal pursuit, in contrast to BRIAN, which measures pathological characteristics.</p><p><strong>Conclusion: </strong>The reported findings represent an innovative approach to hyperthymic features by embracing a broader spectrum concept that conceptualizes the potential transition between pathological and adaptive aspects as a continuum.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Gender Based Violence (GBV) with Familial and Social Determinants and Mental Health Status of Bengali Married Working Women: A Cross-sectional Study","authors":"T. Akter, M. Haque, Md Zobaer Hasan, Faisal Muhammad, Sharmin Sultana, M. G. D. Harun, Md. Shahinuzzaman, Syeda Humayra, Md. Monirul Islam, Sabina Sharmin, Alauddin Chowdhury Abm","doi":"10.2174/17450179-v19-e230403-2022-29","DOIUrl":"https://doi.org/10.2174/17450179-v19-e230403-2022-29","url":null,"abstract":"\u0000 \u0000 Gender Based Violence (GBV) represents a severe violation of women's human rights beyond geographical, cultural, religious, social, and economic aspects. This study aimed to identify the prevalence of GBV, its association with mental health status, and familial and social determinants among the higher socio-economic married working women in Bangladesh.\u0000 \u0000 \u0000 \u0000 A cross-sectional study was conducted from June to November 2019 among the higher socio-economic married women working in Dhaka. To reach the targeted participants, five hundred sixty participants were recruited using multistage sampling. Women with a minimum graduate degree, monthly income >35000, and working outside were included in this study. A semi-structured questionnaire was used to collect data through a face-to-face interview. Mental health status was measured by 20 items on the CES-D scale. Descriptive statistics and bivariate (unadjusted) and multivariate (adjusted) logistic regression were used to explore the determinants and mental health status.\u0000 \u0000 \u0000 \u0000 The mean age of participants was 35.7 ± 4.8 years. Around 13.6% of women faced GBV. The age, marriage duration, family type, monthly income, parental status, number of children, and education level showed a significant association with GBV. The binary logistic regression model found that the status of mental health was strongly significant in both unadjusted and adjusted models, OR (95% CI) =2.589 (1.577-4.252) and 4.542 (2.362-8.734). Participation in the family's decision-making process was strongly associated with GBV OR (95% CI) = 4.529 (2.332- 8.796). The attitude of the husband or in-laws was strongly significant in both unadjusted OR (95% CI) = 10.605 (4.988 - 22.548) and adjusted models 5.972 (1.836-19.421). Having a good understanding of the husband was strongly significant in two models, OR (95% CI) = 27.383 (13.568 -55.263) and 17.553 (6.160 -50.018). The odds of GBV, if any family members are suffering from chronic disease, were around six-fold higher among married working women in the unadjusted model OR (95% CI) =5.935 (2.791 - 12.623) and almost eight-fold higher in adjusted model 7.679 (2.293 -25.719). Time for attending social obligation was strongly significant in both unadjusted OR (95% CI)= 11.633 (5.239 -25.832) and adjusted model 24.402 (7.511 -79.277).\u0000 \u0000 \u0000 \u0000 The GBV prevalence was comparatively low, and it was found to be related to working women with higher socio-economic status. This issue should not be neglected as it impedes the empowerment of women, which is a global concern and developmental plan. Hence, there is a need to formulate better policies and programs to attain a gender-based, violence-free society.\u0000","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75596493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Life Skills Enhancement Program on the Life Skills and Risk Behaviors of Social Media Addiction in Early Adolescence.","authors":"Jedbordin Kumkronglek,&nbsp;Pornpen Sirisatayawong,&nbsp;Supat Chupradit","doi":"10.2174/17450179-v19-e230113-2022-26","DOIUrl":"https://doi.org/10.2174/17450179-v19-e230113-2022-26","url":null,"abstract":"<p><strong>Objective: </strong>This research aimed to develop and investigate the effects of a life skills enhancement program on the life skills and risk behaviors of social media addiction in early adolescence.</p><p><strong>Methods: </strong>This research used a quasi-experimental design for a controlled study with a pre-test and post-test that collected data through a general information questionnaire, Social Media Addiction Screening Scale: S-MASS, and a life skills test. There were 48 samples recruited by purposive sampling from 5 schools in Chiang Mai, Thailand. The life skills enhancement program was developed under the theory of cognitive and behavioral therapy in combination with group therapy or occupational therapy. The program had a total of 10 sessions, with 1 session per week for 60 minutes and 10 weeks in total.</p><p><strong>Results: </strong>For the results, a statistically significant difference in post-test SMASS scores between the control and experimental group was found (p<0.01). Moreover, a statistically significant difference in the experimental group between pre-test and post-test using S-MASS scores decreased significantly after participating in the program but not in the control group. This result is similar to the comparative data of life skills scores that revealed there was a statistically significant difference between the pre-test and post-test only in the experimental group. For the comparative data between the control and experimental group, however, there were no statistically significant differences in pre-test and post-test life skills scores between the two groups.</p><p><strong>Conclusion: </strong>From the results, it can be summarized that the life skills enhancement program had affected an increase in life skills and a decrease in risky social media usage among adolescents.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sex Differences in Cortisol Concentrations, Anxiety, and Depressive Mood In Moroccan Youth","authors":"I. Rammouz, M. Nakajima, S. Boujraf, R. Aalouane, A. Lemieux, M. al’Absi","doi":"10.2174/17450179-v19-e230215-2022-24","DOIUrl":"https://doi.org/10.2174/17450179-v19-e230215-2022-24","url":null,"abstract":"\u0000 \u0000 Evidence indicates sex differences in stress response and mental health challenges. Psychobiological research of early symptoms of psychopathology has suggested that cortisol, as a marker of stress, is positively associated with depressive mood and anxiety in adolescents. To date, no study has examined sex differences in the relationships between cortisol levels and negative mood among Moroccan youth.\u0000 \u0000 \u0000 \u0000 A total of 332 Moroccan secondary students (171 female) aged 11 to 20 completed a range of psychological measures and provided two morning saliva samples across atwo-hour period. We hypothesized that females would show greater levels of depression and anxiety symptoms than males. We also anticipated positive relationships between cortisol and those symptoms.\u0000 \u0000 \u0000 \u0000 The results demonstrated the expected cortisol morning decline due to the diurnal pattern. Higher anxiety (p < .001), higher depressive mood (p < .001), and more clinically relevant depression were found in the females (47.7%) than the males (22.5%; p < .001). In addition, anxiety (p < .05) was positively associated with later morning cortisol in females but not males.\u0000 \u0000 \u0000 \u0000 Our results demonstrated sex differences in depressive mood among youth and the feasibility of psychobiological stress research in Morocco. More research is needed to identify sex-specific factors of depression and anxiety. Such effort would inform strategies to tailor treatment programs for females and males.\u0000","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84938257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review and Meta-Analysis of Health-Related Quality of Life in Patients with β-Thalassemia that Underwent Hematopoietic Stem Cell Transplantation","authors":"Olga Mulas, Ilaria Pili, Marco Sanna, Giorgio La Nasa","doi":"10.2174/17450179-v17-e211208-2021-ht2-1910-4","DOIUrl":"https://doi.org/10.2174/17450179-v17-e211208-2021-ht2-1910-4","url":null,"abstract":"Background: β-Thalassemia major (β-TM) represents one of the most important hemoglobinopathies worldwide. Remarkable improvements have been achieved in supportive therapy based on blood transfusions and iron chelation, and nowadays, this approach is capable of assuring a long life in these patients in industrialized countries. The only curative treatment is represented by hematopoietic stem cell transplantation (HSCT). However, this treatment may be burdened by deterioration in the Health-Related Quality of Life (HRQoL). This paper aimed to evaluate the role of HRQoL in transplanted β-TM patients with a systematic review and meta-analysis. Methods: PubMed database, Web of Science, and Scopus were systematically searched for studies published between January 1st, 2000 to September 2020. The following terms were entered in the database queries: β-thalassemia, HRQoL, and HSCT. The study was carried out according to the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA) statement. Results: We identified a total of 33 potential studies. Among these, 10 were finally considered in the systematic review and 5 in the meta-analysis. Overall, good scores in the principal domains of HRQoL were reported by transplanted patients. These data were confirmed by results of meta-analysis that showed significant difference between transplanted and β-TM patients treated with conventional therapy in the physical and emotional dimension, with a medium effect size [d=0.65, 95% CI (0.29-1.02), z = 3.52, p =0.0004, I 2 =75%; and d=0.59, 95% CI (0.43-0.76), z = 6.99, p <0.00001, I 2 =0%, respectively]. Conclusion: HRQoL is generally good in β-TM transplanted patients and may significantly contribute in deciding whether or not to transplant a β-TM patient treated with conventional therapy.","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135323989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Tyrosine Kinase Inhibitors (TKIs) in Monotherapy and with Add-on Treatments on Health-related Quality of Life of People with Chronic Myeloid Leukemia: A Systematic Review of Randomized-Controlled Trials","authors":"Antonio E. Nardi, Federica Sancassiani, Vanessa Barrui, Goce Kalcev, Veronica Uras, Giulia Meloni, Luigi Marongiu, Giorgio Tamburini, Alberto Maleci, Laiana A. Quagliato, Giorgio La Nasa, Mauro Giovanni Carta","doi":"10.2174/17450179-v17-e211118-2021-ht2-1910-12","DOIUrl":"https://doi.org/10.2174/17450179-v17-e211118-2021-ht2-1910-12","url":null,"abstract":"Background: The era of establishing tyrosine kinase inhibitors (TKIs) in the treatment of chronic myeloid leukemia (CML) changed the outcome and the course of this life-threatening malignancy. People suffering from CML have now a better prognosis and a longer life expectancy due to the development of TKIs, even if it requires long-term, often lifelong, treatments that are nonetheless associated with improved Health-related Quality of life (HRQoL). However, data on the effects of TKIs on HRQoL are not always systematic; sometimes the data have been obtained by studies different from RCTs, or without a clear definition of what HRQoL is. The main purpose of this systematic review is to summarize all randomized-controlled trials (RCTs) including HRQoL as main or secondary outcome in patients with CML treated with TKIs or with TKIs plus an add-on treatment. Methods: A systematic review has been conducted by searching the relevant papers in PubMed/Medline and Web of Science with the following keywords: “quality of life” OR “health-related quality of life” OR “QoL” OR “HRQoL” OR “H-QoL” AND “chronic myeloid leukemia”. Interval was set from January 2000 to December 2020. Results: 40 papers were identified through the search. Out of them, 7 RCTs were included. All the studies used standardized measures to assess HRQoL, even not always specific for CML. 5 RCTs randomized subjects to 2 or 3 arms to evaluate the effects of TKIs of the first, second and third generation in monotherapy. 2 RCTs randomized subjects to TKI therapy plus an add-on treatment versus TKI therapy as usual. The results of all these trials were examined and discussed. Conclusion: All the included RCTs pointed out significant findings regarding the positive effects of TKIs on HRQoL of people with CML, both when they were used in monotherapy or, notably, with an add-on treatment to enhance TKIs effects.","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135368715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Innovative Approach to the Dismantlement of a Forensic Psychiatric Hospital in Italy: A Ten-year Impact Evaluation.","authors":"Liliana Leone,&nbsp;Gaetano Giunta,&nbsp;Gaspare Motta,&nbsp;Giancarlo Cavallaro,&nbsp;Lucia Martinez,&nbsp;Angelo Righetti","doi":"10.2174/18740179-v18-e221221-2022-11","DOIUrl":"https://doi.org/10.2174/18740179-v18-e221221-2022-11","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to evaluate the impacts of a pilot project concerning the closure of a Forensic Psychiatric Hospital (FPH) inspired by Human Development Theory and the Capability Approach.</p><p><strong>Background: </strong>The dismantlement of the FPH of Barcellona Pozzo di Gotto (Sicily Region in Italy) began in 2010 with the pilot project Luce é Libertà and ended in 2017. With the closure of six FPHs, Italy officially became the first country worldwide to close such institutions. After the closure of FPHs, some critical issues emerged, and the debate shifted to developing small-scale facilities and residences for the execution of security measures (RESM). However, few studies have provided results on the cohort of patients discharged from FPHs.</p><p><strong>Objective: </strong>Following are the objectives of this study: a) Assessing the effectiveness of the pilot project in terms of better functioning accordingly to the Classification of Functioning of Disability and Health (ICF) framework, social and labour insertion, health conditions, level of dangerousness to other, rate of readmission in forensic services, b) cost analysis, and c) describing how the CA has been applied and translated into methodological and administrative devices and concrete intervention strategies.</p><p><strong>Methods: </strong>A pre-post evaluation design was performed with a comparison between the intervention and the control group for the healthcare cost analysis. Data were collected from 2010 to 2019 at three points: T0) as a baseline, T1 and T2) for the follow-up. The instruments are a structured questionnaire, the Scale HoNOS Secure, 4 sub-scales of ICF (Activity and participation dimensions: sociality, culture, and knowledge, daily life, income, and work) (Cronbach's Alpha from 0.76 to 0.94), and n.20 interviews with key stakeholders and beneficiaries.</p><p><strong>Results: </strong>Main results include a) the discharge of 55 patients through the use of a person-centered approach and the Personal Capability Budget (PCB), b) the expansion of substantial freedom of choice and the improvement of ICF score (t-test Sig. <, 02), c) the reduction of the risk for others and themselves (Mean Diff. -2,15 Sig. .000), d) at T2 42% of beneficiaries achieved a job placement and 36% were living in one's own home, e) at T2 the need of security measures has reduced from the initial 70% to 6.8%, and f) reduction of the healthcare costs from the fourth year onwards.</p><p><strong>Conclusion: </strong>Indications emerge to support processes of deinstitutionalisation and capabilities expansion through innovative models, a person-centered approach supported by PCBs, social finance, and social impact investments.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9637368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}