Clinical Schizophrenia and Related Psychoses最新文献

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The impact of stigma on subjective well-being in people with mental disorders. 成见对精神障碍患者主观幸福感的影响。
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-08-04 DOI: 10.3371/CSRP.CBMF.071317
Clara I Morgades-Bamba, María José Fuster-Ruizdeapodaca, Fernando Molero
{"title":"The impact of stigma on subjective well-being in people with mental disorders.","authors":"Clara I Morgades-Bamba, María José Fuster-Ruizdeapodaca, Fernando Molero","doi":"10.3371/CSRP.CBMF.071317","DOIUrl":"10.3371/CSRP.CBMF.071317","url":null,"abstract":"<p><strong>Rationale: </strong>People diagnosed with a mental disorder are highly discriminated against, and when they internalize the social stigma they suffer severe consequences which have been associated with greater symptomatology and reduced recovery. This research was carried out in order to develop a predictive model about how discrimination contributes to subjective well-being (positive and negative affects experienced) by means of internalization of stigma (alienation, stereotype endorsement and social withdrawal) and deterioration of positive self-concept (self-esteem and self-efficacy).</p><p><strong>Method: </strong>We conducted a cross-sectional research design. We used Partial Least Squares (PLS) modelling to analyze the data from 94 Spanish participants diagnosed with a mental disorder.</p><p><strong>Results: </strong>A differential effect of blatant and subtle discrimination is found. Both internalized stigma and positive self-concept play a central role in the effects of discrimination on subjective well-being. Internalized stigma contributes to the explained variance of negative and positive affect, while positive self-concept contributes mainly to explain changes in positive affect.</p><p><strong>Conclusions: </strong>Positive self-concept protects the person from the harm that stigma may cause on his well-being. It especially protects positive affect, which we propose is an important resource in the recovery process. These findings have clinical and research implications.</p>","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35293621","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}
引用次数: 0
The Long-Term Effects of Cellular Telephone-Delivered Telephone Intervention Problem Solving (TIPS) for Schizophrenia Spectrum Disorders (SSDs): Rationale and Design. 蜂窝电话提供的电话干预问题解决(TIPS)对精神分裂症谱系障碍(ssd)的长期影响:理论基础和设计。
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 Epub Date: 2014-11-03 DOI: 10.3371/CSRP.BESM.103114
Lora H Beebe, Kathlene Smith, Chad Phillips, Dawn Velligan, Abbas Tavakoli
{"title":"The Long-Term Effects of Cellular Telephone-Delivered Telephone Intervention Problem Solving (TIPS) for Schizophrenia Spectrum Disorders (SSDs): Rationale and Design.","authors":"Lora H Beebe,&nbsp;Kathlene Smith,&nbsp;Chad Phillips,&nbsp;Dawn Velligan,&nbsp;Abbas Tavakoli","doi":"10.3371/CSRP.BESM.103114","DOIUrl":"https://doi.org/10.3371/CSRP.BESM.103114","url":null,"abstract":"Abstract Introduction. Although an extensive body of literature suggests that face-to-face problem-solving interventions are an effective means of fostering psychiatric medication adherence for persons with SSDs, the majority of outpatients with SSDs lack access to this proven intervention. There is a need for exploration of alternate delivery methods for problem solving. Design. This randomized controlled trial will examine the effectiveness of cellular telephone delivered Telephone Intervention - Problem Solving (TIPS) upon medication adherence, medication self efficacy and symptom management in outpatients with SSDs over 9 monthsMethods. To ensure consistent telephone access, all one hundred twenty eight participants will be provided a basic cellular telephone with unlimited local calling for 9 months. Participants will be randomly assigned to treatment as usual plus weekly TIPS or treatment as usual only (TAU). Assessment of serum medication levels, pill count medication adherence, medication attitudes and psychiatric symptoms will be conducted at baseline and every 3 months on all participants. Summary.In addition to testing the long term effect of TIPS, this study will provide information on the responses to our cellular telephone delivery method. We believe this information will be critical as we continue to explore a variety of cellular telephone technologies to provide needed interventions to persons with SSDs in a feasible, economical way.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32789122","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}
引用次数: 0
Multimodal Sensory Distortions in Postpartum Exacerbation of Schizophrenia. 产后精神分裂症加重中的多模态感觉扭曲。
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 Epub Date: 2013-11-25 DOI: 10.3371/CSRP.MEKU.112013
Urvakhsh Meherwan Mehta, C Naveen Kumar, Ganesan Venkatasubramanian, Jagadisha Thirthalli
{"title":"Multimodal Sensory Distortions in Postpartum Exacerbation of Schizophrenia.","authors":"Urvakhsh Meherwan Mehta,&nbsp;C Naveen Kumar,&nbsp;Ganesan Venkatasubramanian,&nbsp;Jagadisha Thirthalli","doi":"10.3371/CSRP.MEKU.112013","DOIUrl":"https://doi.org/10.3371/CSRP.MEKU.112013","url":null,"abstract":"<p><strong>Background: </strong>Sensory distortions of body image commonly occur during migraine, seizures, nondominant cortical infarcts and hallucinogen abuse.</p><p><strong>Methods: </strong>We report the case of a 30-year-old woman with paranoid schizophrenia presenting with postpartum onset multimodal sensory distortions in the absence of any neurological disorders or substance use.</p><p><strong>Results: </strong>Her symptoms involved persistent facial/body metamorphopsia (distorted images) and vocal paracousis (distorted voices), in the absence of visual hallucinations, illusions or agnosia. Neuropsychological assessments revealed deficits on visual processing tasks. Neuroimaging, electroencephalography and ophthalmological evaluation revealed no abnormalities. The multimodal sensory distortions responded to antipsychotic treatment, paralleling improvement in other schizophrenia psychopathology, over a period of one month.</p><p><strong>Conclusions: </strong>Prominent and persistent multimodal sensory distortions like metamorphopsia and paracousis in the presence of psychotic symptoms warrant a detailed neurological and general medical work-up. These symptoms presenting in the absence of neurological or substance use disorders may be a component of schizophrenia.</p>","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31901375","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}
引用次数: 2
Emotional, Cognitive and Behavioral Reactions to Paranoid Symptoms in Clinical and Nonclinical Populations. 临床和非临床人群对偏执症状的情绪、认知和行为反应
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 DOI: 10.3371/1935-1232-11.1.29
Célia Barreto Carvalho, Carolina da Motta, José Pinto-Gouveia, Ermelindo Manuel Bernardo Peixoto
{"title":"Emotional, Cognitive and Behavioral Reactions to Paranoid Symptoms in Clinical and Nonclinical Populations.","authors":"Célia Barreto Carvalho,&nbsp;Carolina da Motta,&nbsp;José Pinto-Gouveia,&nbsp;Ermelindo Manuel Bernardo Peixoto","doi":"10.3371/1935-1232-11.1.29","DOIUrl":"https://doi.org/10.3371/1935-1232-11.1.29","url":null,"abstract":"<p><strong>Background: </strong>Paranoia is a disruptive belief that can vary across a continuum, ranging from persecutory delusions presented in clinical settings to paranoid cognitions that are highly prevalent in the general population. The literature suggests that paranoid thoughts derive from the activation of a paranoid schema or information processing biases that can be sensitive to socially ambiguous stimuli and influence the processing of threatening situations.</p><p><strong>Methods: </strong>Four groups (schizophrenic participants in active psychotic phases, n=61; stable participants in remission, n=30; participants' relatives, n=32; and, healthy controls, n=64) were assessed with self-report questionnaires to determine how the reactions to paranoia of clinical patients differ from healthy individuals. Cognitive, emotional and behavioral dimensions of their reactions to these paranoid thoughts were examined.</p><p><strong>Results: </strong>Paranoid individuals were present in all groups. Most participants referred to the rejection by others as an important trigger of paranoid ideations, while active psychotics were unable to identify triggering situations to their thoughts and reactions. This may be a determinant to the different reactions and the different degree of invalidation caused by paranoid thoughts observed across groups.</p><p><strong>Conclusions: </strong>Clinical and nonclinical expressions of paranoid ideations differ in terms of their cognitive, emotional and behavioral components. It is suggested that, in socially ambiguous situations, paranoid participants (presenting lower thresholds of paranoid schema activation) lose the opportunity to disconfirm their paranoid beliefs by resourcing to more maladaptive coping strategies. Consequently, by dwelling on these thoughts, the amount of time spent thinking about their condition and the disability related to the disease increases.</p>","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35031356","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}
引用次数: 3
Clinical News. 临床的消息。
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 DOI: 10.3371/CSRP.BU.071717
Peter F Buckley
{"title":"Clinical News.","authors":"Peter F Buckley","doi":"10.3371/CSRP.BU.071717","DOIUrl":"https://doi.org/10.3371/CSRP.BU.071717","url":null,"abstract":"","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35197534","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}
引用次数: 0
Valbenazine for Tardive Dyskinesia. 缬那嗪治疗迟发性运动障碍。
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 DOI: 10.3371/CSRP.OFGR.071717
Oliver Freudenreich, Gary Remington
{"title":"Valbenazine for Tardive Dyskinesia.","authors":"Oliver Freudenreich,&nbsp;Gary Remington","doi":"10.3371/CSRP.OFGR.071717","DOIUrl":"https://doi.org/10.3371/CSRP.OFGR.071717","url":null,"abstract":"<p><p>Tardive dyskinesia (TD) remains a clinical concern for any patient who receives an antipsychotic. While the overall risk of developing TD is lower with newer antipsychotics compared to older agents, a significant number of patients who require long-term treatment will develop TD. Recently, valbenazine (brand name Ingrezza) became the first drug to be approved by the FDA specifically for the treatment of TD. In this New Drug Review, we summarize the basic pharmacology and clinical trial results for valbenazine. Valbenazine is a modified metabolite of the vesicular monoamine transporter 2 (VMAT-2) inhibitor tetrabenazine, which is approved for the treatment of the hyperkinetic movement disorder, Huntington's disease. In short-term clinical trials, valbenazine at a dose of 80 mg/day improved TD, with an effect size that is clinically significant (d=0.90). The effect size for the 40-mg/day dose was lower (d=0.52). Compared to tetrabenazine, valbenazine has better clinical characteristics (i.e., once-a-day dosing, better short-term side effect profile). However, only long-term experience in routine clinical populations can delineate valbenazine's full benefits, optimal dosing, and risks not identified during short-term registration trials.</p>","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35197538","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}
引用次数: 8
Psychosocial Approaches in the Treatment of Psychosis: Cognitive Behavior Therapy for Psychosis (CBTp) and Metacognitive Training (MCT). 精神病治疗中的社会心理方法:精神病认知行为疗法(CBTp)和元认知训练(MCT)。
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 Epub Date: 2015-02-24 DOI: 10.3371/CSRP.MEBA.022015
Mahesh Menon, Ryan P Balzan, Katy Harper, Devavrata Kumar, Devon Andersen, Steffen Moritz, Todd S Woodward
{"title":"Psychosocial Approaches in the Treatment of Psychosis: Cognitive Behavior Therapy for Psychosis (CBTp) and Metacognitive Training (MCT).","authors":"Mahesh Menon,&nbsp;Ryan P Balzan,&nbsp;Katy Harper,&nbsp;Devavrata Kumar,&nbsp;Devon Andersen,&nbsp;Steffen Moritz,&nbsp;Todd S Woodward","doi":"10.3371/CSRP.MEBA.022015","DOIUrl":"https://doi.org/10.3371/CSRP.MEBA.022015","url":null,"abstract":"<p><p>Although antipsychotic medication has been the most widely used and efficacious treatment in ameliorating the symptoms of psychosis, there has been a growing realization that pharmacological treatment has limitations. A significant minority of individuals continue to show \"treatment-resistant\" symptoms and significant relapse risk, while others show symptom reduction without the corresponding improvement in social and role functioning. Psychotherapy, in combination with medication, can help with symptom reduction, as well as improve functioning and quality of life. In this paper, we focus on two modalities of psychotherapy which have been shown to improve symptomatology and functioning in individuals with psychosis: Cognitive Behavior Therapy for psychosis (CBTp) and Metacognitive Training (MCT). Both treatment approaches focus on increasing the individuals' understanding of the psychological mechanisms associated with delusions and hallucinations, and helping them develop strategies to improve reality testing and belief evaluation. We aim to provide an overview of both treatments, examining not only the theoretical mechanisms and efficacy of each approach, but also the common therapeutic components they share.</p>","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33409872","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}
引用次数: 8
Disorganized Symptoms Predicted Worse Functioning Outcome in Schizophrenia Patients with Established Illness. 紊乱症状预示着有既定疾病的精神分裂症患者更差的功能结局
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 Epub Date: 2015-02-24 DOI: 10.3371/CSRP.ORGA.022015
Bruno Bertolucci Ortiz, Ary Gadelha, Cinthia Hiroko Higuchi, Cristiano Noto, Daiane Medeiros, José Cássio do Nascimento Pitta, Gerardo Maria de Araújo Filho, Jaime Eduardo Cecílio Hallak, Rodrigo Affonseca Bressan
{"title":"Disorganized Symptoms Predicted Worse Functioning Outcome in Schizophrenia Patients with Established Illness.","authors":"Bruno Bertolucci Ortiz,&nbsp;Ary Gadelha,&nbsp;Cinthia Hiroko Higuchi,&nbsp;Cristiano Noto,&nbsp;Daiane Medeiros,&nbsp;José Cássio do Nascimento Pitta,&nbsp;Gerardo Maria de Araújo Filho,&nbsp;Jaime Eduardo Cecílio Hallak,&nbsp;Rodrigo Affonseca Bressan","doi":"10.3371/CSRP.ORGA.022015","DOIUrl":"https://doi.org/10.3371/CSRP.ORGA.022015","url":null,"abstract":"<p><p>Most patients with schizophrenia will have subsequent relapses of the disorder, with continuous impairments in functioning. However, evidence is lacking on how symptoms influence functioning at different phases of the disease. This study aims to investigate the relationship between symptom dimensions and functioning at different phases: acute exacerbation, nonremission and remission.</p><p><strong>Methods: </strong>Patients with schizophrenia were grouped into acutely ill (n=89), not remitted (n=89), and remitted (n=69). Three exploratory stepwise linear regression analyses were performed for each phase of schizophrenia, in which the five PANSS factors and demographic variables were entered as the independent variables and the total Global Assessment of Functioning Scale (GAF) score was entered as the dependent variable. An additional exploratory stepwise logistic regression analysis was performed to predict subsequent remission at discharge in the inpatient population.</p><p><strong>Results: </strong>The Disorganized factor was the most significant predictor for acutely ill patients (p<0.001), while the Hostility factor was the most significant for not-remitted patients and the Negative factor was the most significant for remitted patients (p=0.001 and p<0.001, respectively). In the logistic regression, the Disorganized factor score presented a significant negative association with remission (p=0.007).</p><p><strong>Conclusions: </strong>Higher disorganization symptoms showed the greatest impact in functioning at acute phase, and prevented patients from achieving remission, suggesting it may be a marker of symptom severity and worse outcome in schizophrenia.</p>","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33409874","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}
引用次数: 13
Adherence to Diabetes Medication in Individuals with Schizophrenia: A Systematic Review of Rates and Determinants of Adherence. 精神分裂症患者对糖尿病药物的依从性:依从率和决定因素的系统回顾。
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 Epub Date: 2014-02-04 DOI: 10.3371/CSRP.GOPA.013114
Paul Gorczynski, Hiren Patel, Rohan Ganguli
{"title":"Adherence to Diabetes Medication in Individuals with Schizophrenia: A Systematic Review of Rates and Determinants of Adherence.","authors":"Paul Gorczynski,&nbsp;Hiren Patel,&nbsp;Rohan Ganguli","doi":"10.3371/CSRP.GOPA.013114","DOIUrl":"https://doi.org/10.3371/CSRP.GOPA.013114","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the importance of medication adherence for the effective treatment of type II diabetes mellitus (T2DM), little research has examined adherence with diabetes medication treatment in schizophrenia. The purpose of this systematic review was to: 1) evaluate rates of adherence and determinants of adherence with medication for T2DM in individuals with schizophrenia; and, where possible, 2) examine the relationship between medication adherence and glycemic control.</p><p><strong>Methods: </strong>Studies were included if they presented information on dosing regimens and adherence or compliance rates for T2DM and included samples where at least 50% of the participants were individuals with schizophrenia.</p><p><strong>Results: </strong>Six studies were included in this review that predominantly examined men over the age of 50 years. Studies confirmed that many individuals with schizophrenia were not adhering to their diabetes medication as adherence rates ranged from 51-85%. Two studies that compared medication adherence in individuals with and without schizophrenia found those with the mental illness had higher rates of adherence. One study reported that blood glucose control levels were not statistically different between those who did and did not adhere to their medication, indicating more research is necessary in this area. Factors that improved adherence included disease and medical service and medication-related factors.</p><p><strong>Conclusions: </strong>Interventions to increase diabetes medication adherence in schizophrenia need to address disease and medical service and medication-related factors. Further research needs to examine diabetes medication adherence in women, younger individuals, and those recently diagnosed with diabetes as these individuals have been underrepresented in the literature.</p>","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32089161","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}
引用次数: 15
The Development and Implementation of an Electronic Health Record Tool for Monitoring Metabolic Syndrome Indices in Patients with Serious Mental Illness. 监测严重精神疾病患者代谢综合征指数的电子健康记录工具的开发与实现。
Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 DOI: 10.3371/1935-1232.10.3.145
Ken Nash, F. Ghinassi, J. Brar, Abdulkader Alam, Mary Catherine Bohan, Kalyani Gopalan, A. Carter, K. Chengappa
{"title":"The Development and Implementation of an Electronic Health Record Tool for Monitoring Metabolic Syndrome Indices in Patients with Serious Mental Illness.","authors":"Ken Nash, F. Ghinassi, J. Brar, Abdulkader Alam, Mary Catherine Bohan, Kalyani Gopalan, A. Carter, K. Chengappa","doi":"10.3371/1935-1232.10.3.145","DOIUrl":"https://doi.org/10.3371/1935-1232.10.3.145","url":null,"abstract":"OBJECTIVES 1. A quality performance improvement (QI) project to implement an electronic screening and monitoring tool to record components of the metabolic syndrome (e-MSD) during clinic visits by persons with serious mental illness (SMI). 2. To encourage psychiatrists to use this tool in their documentation. METHODS Working with the information technology staff, five psychiatrists developed, tested, revised and embedded the e-MSD tool into the medication management document within the electronic health record. A continuing medical education program on metabolic syndrome was developed and released to psychiatrists and mental health clinicians. Psychiatrist offices at one clinic were equipped with weighing scales, sphygmomanometers, waist circumference tapes, and a QI project was initiated. RESULTS At one month, 9 to 12% of the anthropometric measures (height, weight, body mass index, waist circumference, and blood pressure) were recorded in 974 unique patient encounters, and one year later the numbers moved upward from 15 to 41%. Toward the end of Year 1, a Patient Care Associate was hired to measure the anthropometric measures and, one year later, the documented rates increased to 75-80%. Laboratory recordings (glucose and lipids) remained ≤8% throughout the first year, but moved upward to 25% in Year 2. DISCUSSION Notwithstanding significant administrative and technical support for this QI project, changing clinician practice to screen, monitor and document metabolic indices in persons with SMI in the ambulatory setting changed significantly after the hiring of a Patient Care Associate. Efforts to obtain laboratory measures in real time remain a challenge. Next steps include interventions to promote weight loss and smoking cessation in SMI patients, and effective communication with their primary care doctors.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81116911","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}
引用次数: 2
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