BMC Psychiatry最新文献

{"title":"Quality of cognitive-behavioural therapy in routine psychiatric care: therapist adherence and competence, and patient outcomes for depression and anxiety disorders.","authors":"Hillevi Bergvall, Johanna Linde, Sven Alfonsson, Rikard Sunnhed, Jacques P Barber, Tobias Lundgren, Gerhard Andersson, Benjamin Bohman","doi":"10.1186/s12888-024-06328-4","DOIUrl":"10.1186/s12888-024-06328-4","url":null,"abstract":"<p><strong>Background: </strong>Quality of care is essential for the dissemination of evidence-based practices, yet therapist adherence and competence are seldom assessed. We examined the quality of delivery of cognitive-behavioural therapy (CBT) in routine psychiatric care for depression and anxiety disorders, considering therapist adherence and competence, and therapy effectiveness, as well as their associations.</p><p><strong>Methods: </strong>Twenty-nine therapists recruited 85 patients with a principal diagnosis of depression or anxiety disorder from two routine psychiatric outpatient clinics in Stockholm, Sweden. Therapist adherence was assessed mid-CBT by observers and post-CBT by patients and therapists, respectively, using an instrument developed as part of the present study. Therapist competence was assessed using role-plays with a standardised patient. Patients rated symptoms, functional impairment, and global health pre- and post-CBT. Linear mixed models were used to analyse associations.</p><p><strong>Results: </strong>Therapist adherence was high according to patients, moderate to high according to therapists, and moderate according to observers. Most therapists demonstrated competence in CBT, as assessed using the Cognitive Therapy Scale-Revised (M = 40.5, SD = 6.5; 76% passed the ≥ 36 points competence threshold). Patients improved significantly from pre- to post-CBT across outcome measures (Cohen's ds = 0.80 - 1.36). Neither therapist adherence nor competence was associated with patient outcomes.</p><p><strong>Conclusions: </strong>In routine psychiatric care, therapists delivered CBT with adherence, competence, and improvements for patients with depression and anxiety disorders, on par with previous research results in controlled settings. The implications for quality assessment and improvement are discussed.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03625024 10/08/2018.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"887"},"PeriodicalIF":3.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theta power reduction and theta-gamma coupling desynchronization are associated with working memory interference and anxiety symptoms in panic disorder: a retrospective study.","authors":"Ji Seon Ahn, Hye-Jin Hong, Jee Hang Lee, Jin Young Park","doi":"10.1186/s12888-024-06272-3","DOIUrl":"10.1186/s12888-024-06272-3","url":null,"abstract":"<p><strong>Background: </strong>Theta-gamma coupling (TGC) describes the modulation of gamma oscillations by the theta phasic activity, which is crucial for processes such as the ordering of information during working memory (WM) performance. The mental arithmetic (MA), which involves performing calculations with numbers, is a crucial tool for evaluating and understanding the sensory processing and management abilities of WM. Evaluating TGC may provide greater insight into the neural mechanisms mediating WM deficits in panic disorder (PD).</p><p><strong>Methods: </strong>Medical and electroencephalography (EEG) records of psychiatric outpatient clinic between 1 March 2020 and 30 September 2023 were retrospectively reviewed. A total of 34 PD patients and 34 age- and sex-matched healthy controls (HCs) underwent EEG to assess the overall functional interaction of the brain using multi-channel EEG analysis, focusing on specific brain regions including the frontal, temporal, parietal, and occipital lobes. EEG recordings were conducted during two sessions: a 5-min eyes-closed resting-state (RS) and a subsequent 5-min eyes-closed MA. The TGC and the spectral power of the theta and gamma frequency bands, which are well known to be associated with WM, were analysed.</p><p><strong>Results: </strong>Compared to those in HCs, TGC and theta power were significantly attenuated in PD patients. When analysing both HCs and PD patients together, RS TGC and relative theta power were negatively correlated with state anxiety and perceived stress scores, respectively. In contrast, TGC and relative theta power during the MA condition were positively correlated with the MA performance. Specifically, in PD patients, RS theta power across all electrodes was significantly negatively correlated with the Hamilton Anxiety Scale (HAMA) score. Linear regression analysis revealed that theta power in the T5 channel remained negatively correlated with pathological anxiety as measured by the HAMA score, even after controlling for other confounding factors.</p><p><strong>Conclusions: </strong>This study highlights significant alterations in TGC and theta power in PD patients. PD patients exhibit reduced TGC and theta power compared to HCs, indicating deficits in the neural mechanisms underlying anxiety and/or WM in PD. These insights contribute to a better understanding of the neural basis of WM deficits in PD and suggest potential avenues for targeted therapeutic interventions.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"875"},"PeriodicalIF":3.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil/lymphocyte ratio is increased in the acute phase of schizophrenia and regardless the use and types of antipsychotic drugs.","authors":"Yali Zheng, Xianqin Zhou, Kai Chen, Zhengchuang Fu, Peng Zhang, Quanfeng Zhu","doi":"10.1186/s12888-024-06330-w","DOIUrl":"10.1186/s12888-024-06330-w","url":null,"abstract":"<p><strong>Background: </strong>It has been found that patients with schizophrenia are often accompanied by concomitant changes in inflammation levels during acute exacerbations, and some studies have suggested that the inflammatory indices neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) may be biomarkers of acute exacerbations in schizophrenia; however, few studies have simultaneously explored the differences in these inflammatory indices in the drug-free patients with schizophrenia in acute phase (DSA), medicated patients with schizophrenia in acute phase (MSA), medicated patients with schizophrenia in remission period (MSR), as well as the effects of different antipsychotic medications on inflammatory indices.</p><p><strong>Method: </strong>A total of 651 subjects including 184 healthy controls (HC), 167 DSA, 119 MSA, and 181 MSR were included in this study. Demographic and disease information was collected from each individual and venous blood was collected to detect immune cells and calculate the inflammatory indices NLR, PLR, and MLR, and statistical methods such as analysis of variance (ANOVA) and multiple comparisons were utilized to explore the alteration of these inflammatory indices under the influence of different antipsychotics and in HC, DSA, MSA, and MSR.</p><p><strong>Results: </strong>NLR was significantly higher in DSA and MSA than in HC after adjusting the confounders of sex, age, smoking, years of education, marital status, BMI, diabetes, and hypertension. PLR and MLR were not significantly different in patients with schizophrenia and in HC, and were not significantly different in patients with schizophrenia in any group. In MSA and MSR, NLR was positively correlated with disease duration and negatively correlated with the use of mood stabilizers.</p><p><strong>Conclusions: </strong>NLR was significantly increased in acute phase of schizophrenia, regardless of use of antipsychotic drugs, but not significantly increased in stable phase, which might be a promising biomarker for acute phase of schizophrenia.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"876"},"PeriodicalIF":3.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It's better I kill myself and rest in peace\": a qualitative study on suicide attempts among adolescents in Ghana.","authors":"Wisdom Kudzo Axame, Lebene Kpodo, James Kofi Bilabam, Rebecca Assiam, Nuworza Kugbey, Sitsofe Gbogbo","doi":"10.1186/s12888-024-06279-w","DOIUrl":"10.1186/s12888-024-06279-w","url":null,"abstract":"<p><strong>Background: </strong>Adolescent suicide is a serious global public health concern. In nations with limited resources like Ghana, an understanding of the risk factors for attempted suicide is crucial to the effectiveness of public health treatments. Relevant Ghanaian research has documented the prevalence of suicidal behaviour, particularly among in-school adolescents. However, the causes of adolescents' suicide attempts have not received enough in-depth investigation. In two Ghanaian municipalities, this study examined the family and social factors linked to suicide attempts in adolescents between the ages of 15 and 19 years.</p><p><strong>Methods: </strong>Twenty (20) adolescents with a history of attempted suicide were identified, information about their experiences was gathered through in-depth interviews and analysed using thematic analysis.</p><p><strong>Results: </strong>Three main themes emerged: meaning ascribed to suicide attempts, methods used for attempting suicide and factors influencing suicide attempts. It was observed that adolescents viewed suicide as a means to alleviate their pains (physical, social, emotional and economic). The key methods used in their suicidal attempts included ingestion of poisonous substances, hanging, suffocation, body cutting and jumping from tall buildings. Adolescents' suicide attempts were primarily sparked by social variables including broken relationships, fear of stigma associated with sickness, rejection by the community and familial concerns such as financial hardships, rejection, trust issues and unfulfilled family expectations.</p><p><strong>Conclusion: </strong>This study shows the social and familial factors influencing adolescent suicide attempts in Ghana. The findings emphasize the need for comprehensive mental health support, community-based interventions and strategies to address these specific risk factors.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"877"},"PeriodicalIF":3.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How individuals with psychosis develop and maintain resilience to suicidal experiences through psychological therapy: a qualitative study.","authors":"N Berry, S Peters, G Haddock, A Scott, K Harris, L Cook, Y Awenat, P A Gooding","doi":"10.1186/s12888-024-06071-w","DOIUrl":"10.1186/s12888-024-06071-w","url":null,"abstract":"<p><strong>Background: </strong>Almost half of people with psychosis have suicidal experiences. There is limited understanding of the processes underpinning psychological resilience to psychotic and suicidal experiences especially in people who have engaged with psychological talking therapies. Hence, the current study aimed to redress this gap by examining the perspectives of clients who had recent lived-experiences of psychosis, suicidality, and psychological therapy.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 35 participants who had psychosis and suicidal experiences in the three months prior to recruitment. Data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>There were four key psychological processes that contributed to resilience: (1) gaining a sense of control by nullifying perceptions of being controlled by overwhelming emotional and psychotic experiences, and instead, acquiring confident autonomy; (2) gaining a sense of hope facilitated by experiencing mental health problems on a fluctuating continuum, translating immersive positive memories into future possibilities, and embracing meaningful personal values; (3) developing genuine self-worth based on compassionate self-understanding, and affirmation of personal qualities; and (4) finding acceptance by being able to live alongside psychotic and suicidal experiences. Specific resilience components that participants developed through psychological therapy, together with their own knowledge and observations, were identified.</p><p><strong>Conclusions: </strong>People who live with psychotic and suicidal experiences can, and do, experience psychological change and psychological resilience in response to psychological therapy. To promote resilience, practitioners should pursue a person-based, client-directed approach; embrace acceptance; and be open to exploring different ways of working with clients' experiences of overwhelming thoughts and emotions.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"874"},"PeriodicalIF":3.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is it all about? An explorative study of patients' experiences with medication free treatment.","authors":"Elisabeth C Klæbo Reitan, Henriette Riley, Valentina C Iversen, Anne Høye","doi":"10.1186/s12888-024-06327-5","DOIUrl":"10.1186/s12888-024-06327-5","url":null,"abstract":"<p><strong>Background: </strong>As a response to the political decision by the Norwegian Ministry of Health and Care Services to establish some kind of \"medication free treatment\" for patients with severe mental illness throughout the country, a 6-bed ward unit dedicated to offer such treatment was in 2017 established in Tromsø, Norway by the North Norway Health Care Region. The aim of the present study was to explore the experiences of patients admitted to this ward unit.</p><p><strong>Method: </strong>Semi-structured interviews were conducted with 19 persons who had received treatment from the ward during the period January 2017 to October 2021. Analysis was done in line with Systematic Text Condensation and interviews were recorded, transcribed and analyzed using software NVivo.</p><p><strong>Results: </strong>The importance of engaging in a dialogue about the possibilities of living a life without medication was unanimously validated, along with a focus on empowerment, motivation, activity and flexibility. Not everyone reported fulfillment of their own wishes or the ward's goal of tapering down, and reflected upon emotions such as ambivalence or fear. Three core concepts were identified to describe the participants' experiences: 1) Tapering off, 2) Relations, and 3) Frames and content. A fourth concept overarches the process formed by these concepts; 4) Processes across categories.</p><p><strong>Conclusion: </strong>The study contributes to a deeper understanding of what \"medication free\" truly means, going beyond simply taking or not taking medications. It adds nuance to the debate surrounding medication free treatment. The ability to taper off medications is linked to intrapersonal factors, such as readiness and personal commitment, as well as the therapeutic environment, including the frames and values present on the ward. \"Medication free\" is more complex than it may initially appear, as many participants continue to use some form of psychotropic drugs. The sense of being part of something new and \"exclusive\" can be understood in light of what participants felt was lacking in previous treatment. It appears to be a need of rediscovering the significance of empowerment and empathic relationships in treatment of severe mental illness, in order to foster a sense of coherence and meaning.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"872"},"PeriodicalIF":3.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using machine learning to predict the probability of incident 2-year depression in older adults with chronic diseases: a retrospective cohort study.","authors":"Ying Zheng, Taotao Zhang, Shu Yang, Fuzhi Wang, Li Zhang, Yuwen Liu","doi":"10.1186/s12888-024-06299-6","DOIUrl":"10.1186/s12888-024-06299-6","url":null,"abstract":"<p><strong>Background: </strong>Older adults with chronic diseases are at higher risk of depressive symptoms than those without. For the onset of depressive symptoms, the prediction ability of changes in common risk factors over a 2-year follow-up period is unclear in the Chinese older population. This study aimed to build risk prediction models (RPMs) to estimate the probability of incident 2-year depression using data from the China Health and Retirement Longitudinal Study (CHARLS).</p><p><strong>Methods: </strong>Four ML algorithms (logistic regression [LR], AdaBoost, random forest [RF] and k-nearest neighbor [kNN]) were applied to develop RPMs using the 2011-2015 cohort data. These developed models were then validated with 2018-2020 survey data. We evaluated the model performance using discrimination and calibration metrics, including an area under the receiver operating characteristic curve (AUROC) and the precision-recall curve (AUPRC), accuracy, sensitivity and calibrations plot. Finally, we explored the key factors of depressive symptoms by the selected best predictive models.</p><p><strong>Results: </strong>This study finally included 7,121 participants to build models to predict depressive symptoms, finding a 21.5% prevalence of depression. Combining the Synthetic Minority Oversampling Technique (SMOTE) with the logistic regression model (LR-SM) exhibited superior precision to predict depression than other models, with an AUROC and AUPRC of 0.612 and 0.468, respectively, an accuracy of 0.619 and a sensitivity of 0.546. In additiona, external validation of the LR-SM model using data from the 2018-2020 data also demonstrated good predictive ability with an AUROC of 0.623 (95% CI: 0.555- 0.673). Sex, self-rated health status, occupation, eyesight, memory and life satisfaction were identified as impactful predictors of depression.</p><p><strong>Conclusions: </strong>Our developed models exhibited high accuracy, good discrimination and calibration profiles in predicting two-year risk of depression among older adults with chronic diseases. This model can be used to identify Chinese older population at high risk of depression and intervene in a timely manner.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"870"},"PeriodicalIF":3.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A structural equation modelling to explore the determinants of mental health disorders among reproductive-aged women in Nepal: a nation-wide cross-sectional survey.","authors":"Md Ashfikur Rahman, Mortuja Mahamud Tohan, Sayeeda Zaman, Md Amirul Islam, Md Sazedur Rahman, Md Hasan Howlader, Satyajit Kundu","doi":"10.1186/s12888-024-06249-2","DOIUrl":"https://doi.org/10.1186/s12888-024-06249-2","url":null,"abstract":"<p><strong>Background: </strong>Similar to other countries, reproductive-age women in Nepal frequently encounter diverse mental disorders, yet they receive inadequate screening and attention. This research seeks to address this gap by conducting a comprehensive examination of the prevalence and factors associated with mental disorders of reproductive-age women in Nepal.</p><p><strong>Methods: </strong>This study used the nationally representative Nepal Demographic and Health Survey 2022 dataset to examine the association between mental disorders and potential confounders. Screening tools for Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were employed, and descriptive and inferential statistics, including linear regression and structural equation modeling, were utilized in the analysis.</p><p><strong>Results: </strong>The study found that 22% of Nepalese women aged 15 to 49 reported anxiety symptoms, while 5% reported depressive symptoms. The Structural Equation Modeling (SEM) reveals that anxiety had the most significant positive effect on depression (β = 0.683, p < 0.001), followed by emotional violence (β = 0.139, p < 0.001). Marital status (β = 0.072, p < 0.001) and the presence of genital discharge (β = 0.084, p < 0.001) or ulcer (β = 0.058, p < 0.001) in the last 12 months were also associated with higher levels of depression. Conversely, self-rated health status (β=-0.121, p < 0.001) was negatively associated with depression, indicating that better-perceived health was linked to lower levels of depression.</p><p><strong>Conclusion: </strong>Although the prevalence of anxiety symptoms is higher than that of depression, there is a positive relationship between these two. Consequently, it is crucial to address the identified factors contributing to anxiety and depression in this population group through behavioral and policy interventions to enhance the mental well-being of reproductive-age women.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"867"},"PeriodicalIF":3.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of neurocognitive deficits in patients with first-episode schizophrenia in an African sample and its relationship with dimensions of psychopathology and psychosocial outcome.","authors":"Onyekachi Kingsley Ugwuonye, Justus Uchenna Onu, Theclar Ogochukwu Iyidobi, Jude Uzoma Ohaeri","doi":"10.1186/s12888-024-06315-9","DOIUrl":"https://doi.org/10.1186/s12888-024-06315-9","url":null,"abstract":"<p><strong>Background: </strong>Current evidence supports the idea that neurocognitive deficits (NCD) constitute a core dimension of schizophrenia. Studies on longitudinal changes in neurocognition among neuroleptic-naive first-episode schizophrenia (FES) from Africa are uncommon. We aimed to highlight the prevalence of, and changes in NCD among FES on naturalistic treatment follow-up for 8 weeks, and the relationship with psychopathological and psychosocial outcomes.</p><p><strong>Methods: </strong>Consecutive FES and Healthy Control (HC) were recruited. Diagnosis of schizophrenia was based on ICD-10 criteria. The HC (n = 86) consisted of nursing students in the same facility, recruited purposely to match the cases in age and gender. After the baseline assessment, 82 FES were followed up 4-weekly for changes in NCD, psychopathological and psychosocial ratings for a period of 8 weeks, using the 3 alternate forms of the Screen for Cognitive Impairment in Psychiatry (SCIP), the Wisconsin Card Test, the Mini Mental State Examination, as well as the Brief Psychiatric Rating Scale, the WHO Disability Assessment Scale, and the Global Assessment of Functioning scale. The control group was tested only once, and their scores were utilized for comparison with the patients' scores only at week 8. The prevalence of neurocognitive deficits in the two groups was described using percentages and 95% confidence interval. Predictors of cognitive function was determined using multivariate linear regression.</p><p><strong>Results: </strong>The prevalence of any NCD among FES at 8 weeks and HC was 62.9% (95% CI: 51.5%, 74.2%) and 1.2% (95% CI: 0.0%, 6.6%), respectively. With treatment, there was a significant improvement in cognitive function at each interval of follow-up. At week 8, the prevalence of any NCD among patients in remission was 55.1%. Total SCIP scores at week 8 had significant inverse moderate relationship with the dimensions of psychopathology. Conversely, total SCIP score was strongly positively correlated with functioning (rho_s= 0.71, p < 0.001) at week 8. At week 8, the baseline predictors of total SCIP score were, duration of untreated psychosis (β = -0.33, p = 0.01, variance = 19.8%), negative symptoms (β = -0.35, p = 0.03, variance = 4.9%) and positive symptoms (β = -0.43, p = 0.01, variance = 4.8%).</p><p><strong>Conclusion: </strong>The high prevalence of NCD when patients were in remission indicates that they are enduring and merit consideration as a domain of psychopathology.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"866"},"PeriodicalIF":3.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Putting measurement-based care into action: a multi-method study of the benefits of integrating routine client feedback in coordinated specialty care programs for early psychosis.","authors":"Piper Meyer-Kalos, Grace Owens, Melissa Fisher, Lionel Wininger, Anne Williams-Wengerd, Kimberleigh Breen, Josephine Pita Abate, Ariel Currie, Nathan Olinger, Sophia Vinogradov","doi":"10.1186/s12888-024-06258-1","DOIUrl":"10.1186/s12888-024-06258-1","url":null,"abstract":"<p><strong>Background: </strong>Measurement-based care (MBC) is an effective tool in the delivery of evidence-based practices (EBPs). MBC utilizes feedback loops to share information and drive changes throughout a learning healthcare system. Few studies have demonstrated this practice in team-based care for young people with early psychosis. This paper describes the development of a personalized feedback report derived from routine assessments that is shared with clients and clinicians as part of a MBC process.</p><p><strong>Methods: </strong>We used a multi-method approach to evaluate the implementation of a personalized feedback report at 5 early psychosis coordinated specialty care programs (CSC). We compared clients enrolled in CSC who did and did not receive a feedback report over the first 6 months of treatment. The sample included 204 clients: 146 who did not receive the feedback report (treatment as usual, TAU) and were enrolled over 2 years, and 58 who received the feedback report. A subset of 67 clients completed measures at both intake and 6-month follow-up, including 42 who received the personalized feedback report and 25 who did not. We compared the two groups with regard to self-reported symptoms, likelihood of completing treatment, and perception of shared decision making. We conducted qualitative interviews with 5 clients and 5 clinicians to identify the benefits and challenges associated with the personalized feedback report.</p><p><strong>Results: </strong>The total sample showed significant improvements in shared decision-making and in their intent to complete the program. Post hoc analyses revealed significant increases in the personalized feedback group, and non-significant changes in the TAU group, although group-by-time interactions did not reach statistical significance. The feedback report group engaged in significantly more sessions of Supported Employment and Education (SEE), case management, and peer support, and fewer medication visits over the first 6 months of treatment. Both groups showed significant improvement in symptoms and functioning. Results from the qualitative analysis indicated that the experience of receiving the reports was valuable and validating for both patients and clinicians.</p><p><strong>Conclusions: </strong>A personalized feedback report was integrated into standard of care for early psychosis programs. This process may improve shared decision-making, strengthen the likelihood to stay in treatment, and increase treatment attendance in psychosocial interventions. We posit that this process facilitates recovery-oriented care, strengths-focused treatment planning, enhances intrinsic motivation, and strengthens the therapeutic alliance.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"871"},"PeriodicalIF":3.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}