Psychiatric research and clinical practice最新文献

{"title":"Association of Psychotic Experiences and Incident Depression in a Longitudinal Population-Based Community Survey.","authors":"Katrina M Rodriguez, Vandad Sharifi, William W Eaton","doi":"10.1176/appi.prcp.20220021","DOIUrl":"10.1176/appi.prcp.20220021","url":null,"abstract":"<p><strong>Objective: </strong>The present study aims to determine if psychotic experiences in a general population sample are a risk factor for depressive disorders at a 15-year follow-up visit.</p><p><strong>Method: </strong>A longitudinal population cohort of adults over age 18 from East Baltimore were followed from 1981 to 1996 with 1409 participants included in analyses. Delusions and hallucinations and depressive disorders were assessed using DSM-III criteria. Odds ratios were obtained using logistic regression with psychotic experiences modeled both dichotomously and as count variables as predictors of major and minor depressive disorders at wave three. Age, race, and sex were included as covariates in the model.</p><p><strong>Results: </strong>Both delusions and hallucinations were associated with an increased odds of incident depressive disorders. Delusions, but not hallucinations, were associated with increased odds of major depressive disorder (adjusted odds ratio, 3.04 [95% CI = 1.29-7.13]) and both delusions and hallucinations were associated with increased odds of minor depressive disorder (adjusted odds ratios, 4.6 [95% CI = 2.11-10.04] and 3.93 [95% CI = 2.11-7.32]). There was a dose-response relationship in number of psychotic experiences reported and odds of depressive disorders.</p><p><strong>Conclusions: </strong>Lifetime psychotic experiences, particularly delusions, in the absence of mental disorders, are associated with later depressive disorders. Results persist in a dose-response manner. Future research should determine whether transitory versus persistent psychotic experiences have a differential effect on later depression.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"5 1","pages":"16-23"},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/c6/RCP2-5-16.PMC9997072.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095559","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":"Examining the Relationship Between Trauma, Post-Traumatic Stress Disorder and Psychosis in Patients in a UK Secondary Care Service.","authors":"David Martin, Michelle Philips, Harriet Greenstone, Jonathan Davies, Guy Stewart, Elizabeth Ewins, Stan Zammit","doi":"10.1176/appi.prcp.20220028","DOIUrl":"10.1176/appi.prcp.20220028","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic experiences and post-traumatic stress disorder (PTSD) are common in schizophrenia. However, few studies screening for PTSD have established the temporality of PTSD-related traumatic events to psychosis onset. Furthermore, it is unclear how many patients attribute a trauma-based contribution to their psychosis or would find trauma-focused therapy acceptable. We examine the prevalence and timing of trauma in psychosis, as well as patient views on the relationship between their trauma experiences and mental health difficulties, and on receiving trauma-focused therapy.</p><p><strong>Methods: </strong>Sixty-eight patients with an at-risk mental state (ARMS) or psychotic disorder in a UK secondary-care setting completed self-report measures of trauma and PTSD, and undertook research interviews. Proportions and odds ratios were derived with 95% confidence intervals.</p><p><strong>Results: </strong>We recruited 68 participants (estimated response rate 62%; psychotic disorder <i>n</i> = 61, ARMS <i>n</i> = 7). Sixty three (95%) reported traumatic events and 32 (47%) reported childhood abuse. Twenty-six individuals (38%) met criteria for PTSD, though for >95% this was not recorded in their notes, and 25 (37%) had sub-threshold PTSD. For 69% of participants, their worst trauma occurred before the onset of their psychosis symptoms. Most (65%) believed their psychosis symptoms were related to past traumas and 82% of these were interested in receiving trauma-focused therapy.</p><p><strong>Conclusions: </strong>PTSD is common in and often pre-dates onset of psychosis. Most patients believe their symptoms and traumas are related and would be interested in trauma-focused therapy if available. Studies evaluating the effectiveness of trauma-focused therapies for those with or at high-risk of psychosis are required.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"5 2","pages":"51-59"},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10245461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9908228","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":"Recent Stressful Experiences and Suicide Risk: Implications for Suicide Prevention and Intervention in U.S. Army Soldiers.","authors":"Catherine L Dempsey, David M Benedek, Kelly L Zuromski, Matthew K Nock, David A Brent, Jingning Ao, Matthew W Georg, Katy Haller, Pablo A Aliaga, Steven G Heeringa, Ronald C Kessler, Murray B Stein, Robert J Ursano","doi":"10.1176/appi.prcp.20220027","DOIUrl":"10.1176/appi.prcp.20220027","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the extent to which the presence of recent stressful events are risk factors for suicide among active-duty soldiers as reported by informants.</p><p><strong>Methods: </strong>Next-of-kin (NOK) and supervisors (SUP) of active duty soldiers (<i>n</i> = 135) who died by suicide and two groups of living controls: propensity-matched (<i>n</i> = 128) and soldiers who reported suicidal ideation in the past year, but did not die (SI) (<i>n</i> = 108) provided data via structured interviews from the Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Multivariate logistic regression analyses were used to create a risk score for suicide.</p><p><strong>Results: </strong>The odds of suicide increased significantly for soldiers experiencing relationship problems, military punishment, and perceived failure or humiliation in the month prior to death. Suicide risk models with these risk factors predicted suicide death among those who reported SI in the past year (OR = 5.9, [95% CI = 1.5, 24.0] <i>χ</i> ² = 6.24, <i>p</i> = 0.0125, AUC, 0.73 (0.7, 0.8) NOK) and (OR = 8.6, [95% CI = 1.4, 51.5] <i>χ</i> ² = 5.49, <i>p</i> = 0.0191, AUC, 0.78 (0.7, 0.8); SUP) suggesting the combination of these recent stressors may contribute to the transition from ideation to action.</p><p><strong>Conclusions: </strong>Our findings suggest for the first time recent stressors distinguished suicide ideating controls from suicide decedents in the month prior to death as reported by informants. Implications for preventive intervention efforts for clinicians, supervisors and family members in identifying the transition from ideation to action are discussed.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"5 1","pages":"24-36"},"PeriodicalIF":0.0,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/19/RCP2-5-24.PMC9997076.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095555","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":"Significance and Interrelationship of the Symptoms Listed in the DSM Criteria for Premenstrual Dysphoric Disorder.","authors":"Erik Studer,&nbsp;Staffan Nilsson,&nbsp;Anna Westman,&nbsp;Nancy L Pedersen,&nbsp;Elias Eriksson","doi":"10.1176/appi.prcp.20220007","DOIUrl":"https://doi.org/10.1176/appi.prcp.20220007","url":null,"abstract":"<p><strong>Objective: </strong>While premenstrual dysphoric disorder (PMDD) as defined in DSM has become an established diagnosis, and a formal indication for drug treatment, the relative impact of the disparate symptoms named in the criteria, and to what extent they indeed constitute parts of one syndrome, remains insufficiently clarified. We have therefore explored the frequency, impact, and inter-relationship of different PMDD symptoms.</p><p><strong>Method: </strong>Using a web survey, 10,457 Swedish women of fertile age were asked to retrospectively assess if they experience reduced functioning due to symptoms clearly associated with the premenstrual phase. Those responding affirmatively reported presence, severity, and impact of each symptom named in the PMDD criteria.</p><p><strong>Result: </strong>Nine percent reported impairing premenstrual symptoms. Whereas irritability was reported to cause impairment in 77% of those passing the gate questions, somatic symptoms were common but seldom causing impairment. A vast majority reported presence of at least 5 different symptoms, as required to meet the PMDD criteria, but few reported each of 5 different symptoms to be severe or impairing. An analysis of the association between symptoms revealed clear-cut clustering of somatic and mood symptoms, respectively.</p><p><strong>Conclusion: </strong>While retrospective account suggested irritability to be the clinically most important premenstrual symptom, some of the complaints named in the PMDD criteria were not or only weakly associated with mood symptoms and also reported to be of limited clinical significance. It is concluded that regarding all symptoms listed in the DSM criteria as clinically relevant manifestations of one and the same syndrome may be questioned.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"5 3","pages":"105-113"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/86/RCP2-5-105.PMC10499188.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10268115","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":"Transgenerational Inheritance and Systemic Racism in America.","authors":"Joan Kaufman,&nbsp;Maria Khan,&nbsp;Jennifer Shepard Payne,&nbsp;Julia Mancini,&nbsp;Yvonne Summers White","doi":"10.1176/appi.prcp.20220043","DOIUrl":"https://doi.org/10.1176/appi.prcp.20220043","url":null,"abstract":"<p><strong>Objective: </strong>It is well established that personal experiences of trauma, adversity, and discrimination can \"get under the skin\" and increase risk for a whole host of negative mental and physical health outcomes. The aim of this article is to review emerging research on transgenerational epigenetic inheritance which suggests that negative exposures in one generation, can also be passed down to affect the health and well-being of future generations.</p><p><strong>Method: </strong>This paper reviews key concepts in transgenerational epigenetic inheritance research, select animal and human studies examining the role of epigenetic mechanisms in transmitting the impact of ancestral stress and trauma, poor nutrition, and toxicant exposure across generations, and factors that can mitigate the effects of these experiences.</p><p><strong>Results: </strong>The animal studies provide compelling evidence for a role for these mechanisms in the transmission of the negative effects associated with ancestral adversities. Animal and clinical studies also suggest that the negative impact of personal and ancestral traumas can be prevented, with a role for in humans for evidence-based trauma treatments, culturally adapted prevention and intervention programs, and enrichment opportunities strongly indicated.</p><p><strong>Conclusions: </strong>Although comparable definitive data is lacking in multigenerational human cohorts, preliminary data supports a potential role for transgenerational epigenetic mechanisms in explaining persistent health disparities in the absence of personal exposures, and further elucidation of these mechanisms may guide the design of novel interventions. In addressing ancestral traumas, however, true change and healing will require acknowledgement of the harms that were done, and broader systemic policy level changes.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"5 2","pages":"60-73"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/a1/RCP2-5-60.PMC10245464.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9613002","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":"Exploring the Use of Natural Language Processing for Objective Assessment of Disorganized Speech in Schizophrenia.","authors":"Lydia Jeong,&nbsp;Melissa Lee,&nbsp;Ben Eyre,&nbsp;Aparna Balagopalan,&nbsp;Frank Rudzicz,&nbsp;Cedric Gabilondo","doi":"10.1176/appi.prcp.20230003","DOIUrl":"https://doi.org/10.1176/appi.prcp.20230003","url":null,"abstract":"<p><strong>Objective: </strong>Measurement-based care tools in psychiatry are useful for symptom monitoring and detecting response to treatment, but methods for quick and objective measurement are lacking especially for acute psychosis. The aim of this study was to explore potential language markers, detected by natural language processing (NLP) methods, as a means to objectively measure the severity of psychotic symptoms of schizophrenia in an acute clinical setting.</p><p><strong>Methods: </strong>Twenty-two speech samples were collected from seven participants who were hospitalized for schizophrenia, and their symptoms were evaluated over time with SAPS/SANS and TLC scales. Linguistic features were extracted from the speech data using machine learning techniques. Spearman's correlation was performed to examine the relationship between linguistic features and symptoms. Various machine learning models were evaluated by cross-validation methods for their ability to predict symptom severity using the linguistic markers.</p><p><strong>Results: </strong>Reduced lexical richness and syntactic complexity were characteristic of negative symptoms, while lower content density and more repetitions in speech were predictors of positive symptoms. Machine learning models predicted severity of alogia, illogicality, poverty of speech, social inattentiveness, and TLC scores with up to 82% accuracy. Additionally, speech incoherence was quantifiable through language markers derived from NLP methods.</p><p><strong>Conclusions: </strong>These preliminary findings suggest that NLP may be useful in identifying clinically relevant language markers of schizophrenia, which can enhance objectivity in symptom monitoring during hospitalization. Further work is needed to replicate these findings in a larger data set and explore methods for feasible implementation in practice.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"5 3","pages":"84-92"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/c3/RCP2-5-84.PMC10499191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10260668","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":"Interactions Between Neuropsychiatric Symptoms and Alzheimer's Disease Neuroimaging Biomarkers in Predicting Longitudinal Cognitive Decline.","authors":"Anna Pink,&nbsp;Janina Krell-Roesch,&nbsp;Jeremy A Syrjanen,&nbsp;Luke R Christenson,&nbsp;Val J Lowe,&nbsp;Prashanthi Vemuri,&nbsp;Julie A Fields,&nbsp;Gorazd B Stokin,&nbsp;Walter K Kremers,&nbsp;Eugene L Scharf,&nbsp;Clifford R Jack,&nbsp;David S Knopman,&nbsp;Ronald C Petersen,&nbsp;Maria Vassilaki,&nbsp;Yonas E Geda","doi":"10.1176/appi.prcp.20220036","DOIUrl":"https://doi.org/10.1176/appi.prcp.20220036","url":null,"abstract":"<p><strong>Objective: </strong>To examine interactions between Neuropsychiatric symptoms (NPS) with Pittsburgh Compound B (PiB) and fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting cognitive trajectories.</p><p><strong>Methods: </strong>We conducted a longitudinal study in the setting of the population-based Mayo Clinic Study of Aging in Olmsted County, MN, involving 1581 cognitively unimpaired (CU) persons aged ≥50 years (median age 71.83 years, 54.0% males, 27.5% APOE ɛ4 carriers). NPS at baseline were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Brain glucose hypometabolism was defined as a SUVR ≤ 1.47 (measured by FDG-PET) in regions typically affected in Alzheimer's disease. Abnormal cortical amyloid deposition was measured using PiB-PET (SUVR ≥ 1.48). Neuropsychological testing was done approximately every 15 months, and we calculated global and domain-specific (memory, language, attention, and visuospatial skills) cognitive z-scores. We ran linear mixed-effect models to examine the associations and interactions between NPS at baseline and z-scored PiB- and FDG-PET SUVRs in predicting cognitive z-scores adjusted for age, sex, education, and previous cognitive testing.</p><p><strong>Results: </strong>Individuals at the average PiB and without NPS at baseline declined over time on cognitive z-scores. Those with increased PiB at baseline declined faster (two-way interaction), and those with increased PiB and NPS declined even faster (three-way interaction). We observed interactions between time, increased PiB and anxiety or irritability indicating accelerated decline on global z-scores, and between time, increased PiB and several NPS (e.g., agitation) showing faster domain-specific decline, especially on the attention domain.</p><p><strong>Conclusions: </strong>NPS and increased brain amyloid deposition synergistically interact in accelerating global and domain-specific cognitive decline among CU persons at baseline.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"5 1","pages":"4-15"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dd/29/RCP2-5-4.PMC9997077.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9214564","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":"A Qualitative Exploration of the Use of Service Dogs in Veterans with Post Traumatic Stress Disorder and Traumatic Brain Injury.","authors":"Jennifer J Shiroff, Kathy Gray, Gabrielle M Santulli, Stephen DiDonato, Patricia J Kelly, Jacqueline O'Rourke Fulford","doi":"10.1176/appi.prcp.20220029","DOIUrl":"10.1176/appi.prcp.20220029","url":null,"abstract":"<p><strong>Objective: </strong>This qualitative research was conducted to add to the body of knowledge that supports the benefits of service dogs (SDs), as a tertiary treatment modality, to veterans with post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI).</p><p><strong>Methods: </strong>This grounded theory research design utilized open-ended, semi-structured interviews with veterans (<i>n</i> = 10) who were using SDs as a treatment modality for PTSD and/or TBI. Transcripts were analyzed using NVivo qualitative software until data saturation was achieved.</p><p><strong>Results: </strong>Results from the data analysis identified 4 major themes with concurrent subthemes. The most prominent themes were functional status, impact of a SD, recognition of symptoms of PTSD and/or TBI by the SD, and barriers and challenges to the acquisition of a SD. Participants reported that the SD increased socialization and was a positive adjunct to treatment modalities for PTSD and/or TBI.</p><p><strong>Conclusions: </strong>Our study highlights the benefits of using a SD as a tertiary treatment for PTSD and/or TBI in veterans. Veterans in our study articulated the benefits of using a SD as a tertiary treatment option, and the need to make this a standard treatment option for all veterans who suffer from PTSD and/or TBI.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"5 2","pages":"40-50"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/62/RCP2-5-40.PMC10245458.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9609885","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":"Promoting Racial/Ethnic Equity in Psychosocial Treatment Outcomes for Child and Adolescent Anxiety and Depression.","authors":"V Robin Weersing, Araceli Gonzalez, Brigit Hatch, Frances L Lynch","doi":"10.1176/appi.prcp.20210044","DOIUrl":"10.1176/appi.prcp.20210044","url":null,"abstract":"<p><p>Anxiety and depression are the most prevalent and least treated pediatric mental health problems. Racial/ethnic minority youths face greater risks for developing anxiety and depression and experience higher burden as they are less likely to receive adequate mental health services for these conditions or to have their needs met. Further, standard evidence-based interventions for youth anxiety and depression may show diminished effects with racial/ethnic minority youths and with families of lower socioeconomic status. While community-level interventions to combat structural racism and reduce population-level risk are sorely needed, many youths will continue to require acute treatment services for anxiety and depression and interventionists must understand how to bring equity to the forefront of care. In this review, we adopt a health system framework to examine racial/ethnic disparities in system-, intervention-, provider-, and patient-level factors for psychosocial treatment of pediatric anxiety and depression. Current evidence on disparities in access and in efficacy of psychosocial intervention for anxious and depressed youths is summarized, and we use our work in primary care as a case example of adapting an intervention to mitigate disparities and increase equity. We conclude with recommendations for disparity action targets at each level of the health system framework and provide example strategies for intervening on these mechanisms to improve the outcomes of racial/ethnic minority youths.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"4 3","pages":"80-88"},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/64/RCP2-4-80.PMC9477232.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40386227","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":"Feasibility and Effectiveness of a Psychosis-Specific Intensive Outpatient Program.","authors":"Erin Samplin,&nbsp;Adrienne Grzenda,&nbsp;Alaina Vandervoort Burns","doi":"10.1176/appi.prcp.20210030","DOIUrl":"https://doi.org/10.1176/appi.prcp.20210030","url":null,"abstract":"<p><strong>Objective: </strong>Intensive outpatient programs (IOPs) are rarely designed specifically to treat psychosis. In 2016 UCLA established the Thought Disorders Intensive Outpatient Program (TD IOP), combining a time-limited, group-based intervention called cognitive behavioral social skills training (CBSST) and medication management to treat individuals with psychosis. The purpose of this study is to assess the feasibility of developing an IOP for individuals with psychosis and the effectiveness of the program in improving psychotic symptom severity.</p><p><strong>Methods: </strong>Adults were referred to the TD IOP from inpatient and outpatient settings. Programming included 3 hours of CBSST and 6 hours of additional groups weekly as well as individual psychiatry and social work services. Primary outcomes were symptom changes as measured at intake and discharge by the Clinician-Rated Dimensions of Psychosis Symptom Severity scale. Program feedback was solicited from a small subset of patients.</p><p><strong>Results: </strong>Of the 92 enrolled subjects, 71 completed the program (77.2%). Average length of stay was 52 ± 30 days across all enrolled. Participants showed significant (<i>p</i> < 0.05) improvement with small-moderate effect sizes across five of eight psychosis symptom domains (hallucinations, delusions, disorganized speech, depression, and mania). Patient-reported program satisfaction was high (86.6 ± 12.7 score, range 0-100).</p><p><strong>Conclusions: </strong>The current study indicates that targeted treatment for psychosis is successful within an IOP framework, with minimal additional training required for Master's level clinicians. Participants demonstrated significant symptomatic relief from group-based, time-limited treatment. Further work is needed to determine the full range of program benefits on patient well-being and illness morbidity.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"4 3","pages":"74-79"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4f/63/RCP2-4-74.PMC9477231.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40386228","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}