Advances in Psychiatry The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. The Effectiveness and Applicability of Compensatory Cognitive Training for Japanese Patients with Schizophrenia: A Pilot Study Tue, 07 Jul 2015 07:00:17 +0000 Although cognitive remediation or training for schizophrenia has been developed, few studies on the subject have focused on Japanese patients. The aim of the present study was to examine the effectiveness and applicability of compensatory cognitive training (CCT) in Japanese patients with schizophrenia. Twenty-six participants diagnosed with schizophrenia were assigned to either the CCT plus treatment as usual group () or the treatment as usual alone group (). CCT is a 12-session, manualized, group-based training that coaches compensatory strategies in four cognitive domains (prospective memory, attention, verbal memory, and executive functions). Cognitive, functional, and clinical symptom measures were implemented at baseline, after treatment, and at 3-month follow-up. Mixed design analyses of variance with group and time for each measure demonstrated that effects of CCT on verbal memory, processing speed, and social functioning at postintervention were significant, and the effects on processing speed were maintained at follow-up. Our study suggests that CCT has beneficial effects on cognitive performance, improving functional outcomes in Japanese patients with schizophrenia. Additionally, the high degrees of attendance rates and level of satisfaction rated by the CCT participants ensure the applicability of this methodology to this population. Sadao Otsuka, Mie Matsui, Takatoshi Hoshino, Kayoko Miura, Yuko Higuchi, and Michio Suzuki Copyright © 2015 Sadao Otsuka et al. All rights reserved. Factors in Mental Health Problems among Japanese Dialysis Patients Living in Heavily Damaged Prefectures Two Years after the Great East Japan Earthquake Tue, 28 Apr 2015 11:27:39 +0000 This study examined the prevalence of mental health problems and related factors among dialysis patients living in prefectures that were heavily damaged by the Great East Japan Earthquake. Research was conducted two years following the disaster, and data of 1500 residents of the prefectures were analyzed. This study examined disaster related stressors, gender, socioeconomic status, health problems prior the earthquake, and social support, all of which have been identified as aggravating/mitigating factors in previous research on disaster survivors. We also examined advanced awareness of emergency planning as a dialysis specific factor. Mental health problems after the disaster were categorized into three types: PTSD and depression comorbidity, PTSD only, and depression only. Results indicated that people with comorbidity, PTSD, and depression comprised 7.5%, 25.0%, and 2.9% of the sample, respectively. Not only disaster related stressors but also health problems prior to the disaster had an aggravating direct effect on comorbidity and PTSD. In addition, social support and advanced awareness of disaster planning had a mitigating effect on comorbidity. These results suggest that advanced awareness of disaster planning is a dialysis specific factor that could decrease the occurrence of comorbidity among dialysis patients following a disaster. Hidehiro Sugisawa, Hiroaki Sugisaki, Seiji Ohira, Toshio Shinoda, Yumiko Shimizu, and Tamaki Kumagai Copyright © 2015 Hidehiro Sugisawa et al. All rights reserved. The Dimensional Structure of the Schizotypal Personality Questionnaire Adapted for Children (SPQ-C-D): An Evaluation in the Dutch Population and a Comparison to Adult Populations Thu, 05 Mar 2015 13:11:03 +0000 The increasing interest in dimensional approaches towards schizophrenia spectrum pathology calls for instruments that can be used to study developmental markers conveying risk for psychopathology prior to onset of the disorder. In this study we evaluated the Dutch child version (SPQ-C-D) of the Schizotypal Personality Questionnaire (SPQ) developed by Raine, in terms of reliability and factorial structure in comparison to SPQ data from two studies with adults. The 74-item SPQ-C-D was completed by 219 children and adolescents aged 9 to 18 years. Internal consistency was assessed and the factorial structure was analyzed using principal component analysis (PCA) and confirmatory factor analysis. Results showed that most of the subscales had high Cronbach’s alphas, indicating good internal consistency. PCA resulted in three components, similar to the adult studies: Cognitive-Perceptual, Interpersonal, and Disorganization. The pattern of individual subscales loading on each of the components was identical to the original Raine study, except for one additional subscale loading on the Disorganization component. In addition, forcing Raine’s factorial structure on our data with confirmatory factor analysis resulted in an overall adequate model fit. In conclusion, the SPQ-C-D appears to be a suitable dimensional measure of schizotypal traits in populations aged 9 to 18 years. Sophie van Rijn, Pieter Kroonenberg, Tim Ziermans, and Hanna Swaab Copyright © 2015 Sophie van Rijn et al. All rights reserved. The Psychosocial Consequences of Sports Participation for Individuals with Severe Mental Illness: A Metasynthesis Review Mon, 23 Feb 2015 16:22:38 +0000 The purpose of the current metasynthesis review was to explore the psychosocial benefits of sport and psychosocial factors which impact on sports participation for individuals with severe mental illness. AMED, CINAHL Plus, Medline, EMBASE, ProQuest Nursing & Allied Health Source, and Science Citation Index were searched from inception until January 2014. Articles included use qualitative methods to examine the psychosocial effects of sports participation in people with severe mental illness. Methodological quality was assessed using the Consolidated Criteria for Reporting Qualitative Studies and a case study tool. Included studies were analysed within a metasynthesis approach. Eight articles involving 56 patients met the inclusion criteria. The results identified the broader and direct psychosocial benefits of sport. Sport provided a “normal” environment and interactions that were not associated with an individual’s mental illness. Sport provided individuals with a sense of meaning, purpose, belonging, identity, and achievement. Other findings are discussed. Direct psychosocial benefits are a consequence of sports participation for the vast majority of individuals with severe mental illness. Further to this, sports participation was associated with a reduction in social isolation and an increase in social confidence, autonomy, and independence. Andrew Soundy, Paul Freeman, Brendon Stubbs, Michel Probst, Carolyn Roskell, and Davy Vancampfort Copyright © 2015 Andrew Soundy et al. All rights reserved. Valproate Prescribing in Women of Childbearing Age: An Audit of Clinical Practice Thu, 12 Feb 2015 09:14:28 +0000 Background. Evidence is accruing regarding the risks of valproate exposure in women of childbearing age. Recommendations have recently been made for a higher standard of prenatal counselling and prescribing practice in respect of valproate use in this patient group. Aim and Method. A reaudit was carried out to review the standard of clinical discussion around teratogenic risk and pregnancy planning offered to women of child-bearing age prescribed valproate. Case notes and prescription charts of women 45 years old or less were examined and compared with the results of a previous audit in 2005. Results. The use of valproate was increased overall by 64% and there was an 18% increase in off-label valproate use. The rate of clinical discussion carried out during commencement declined from 70% to 35% and at annual review from 50% to 22%. There was less clinical discussion in outpatients and in older patients. More than 40% of doctors surveyed were not confident about giving information to women. Clinical Implication. There is a need for a multidisciplinary approach and action at Healthcare Trust level, to increase awareness and reduce risks associated with valproate prescribing in childbearing women. Harini Atturu and Adedeji Odelola Copyright © 2015 Harini Atturu and Adedeji Odelola. All rights reserved. Occupational Performance and Affective Symptoms for Patients with Depression Disorder Wed, 11 Feb 2015 14:07:37 +0000 The aim of this study was to describe recovering over time in occupational performance and in affective symptoms for patients with depression disorder by using different assessments and methods for collecting data. A longitudinal design with data collections on repeated occasions was used. The Occupational Circumstances Assessment Interview and Rating Scale and Occupational Self-Assessment were used for measuring occupational performance, and for affective symptoms, a Comprehensive Psychopathological Rating Scale Self-Assessment was used. Fourteen patients with depression disorder were included in the study. The result indicates that affective symptoms improve earlier than occupational performance. Furthermore, self-assessment seems to reflect more improvement to the patient than interview-based assessment. Different kinds of assessment and different kinds of data collection methods seem to facilitate the understanding of the patients recovering. In addition habituation was the most important item for the patients to manage. One implication for practice is that patients may need an extended period of treatment supporting occupational performance. Åsa Daremo, Anette Kjellberg, and Lena Haglund Copyright © 2015 Åsa Daremo et al. All rights reserved. The Cloninger Type I/Type II Typology: Configurations and Personality Profiles in Socially Stable Alcohol Dependent Patients Wed, 17 Dec 2014 12:44:02 +0000 Many attempts have been made to derive alcohol use typologies or subtypes of alcohol dependence and this study aimed at validating the type I/type II typology in a treatment sample of socially stable alcohol dependent males and females. A second aim was to compare the two types with respect to their temperament profiles. Data was part of a larger ongoing longitudinal study, the Gothenburg Alcohol Research Project, and included 269 alcohol dependent males and females recruited from three treatment centers. The results showed that type II alcoholism occurred as a more homogenous type than type I alcoholism, and type I alcoholism seemed too heterogeneous to be summarized into one single type. When adapting a strict classification, less than a third of the study population could be classified in accordance with the typology, suggesting that the typology is not applicable, at least in socially stable individuals with alcohol dependence. The results also showed that type II alcoholics showed higher levels of novelty seeking than did the individuals that were classified as type I alcoholics. Quite surprisingly, the individuals classified as type II alcoholics also showed higher levels of harm avoidance than did the individuals that were classified as type I alcoholics. Peter Wennberg, Kristina Berglund, Ulf Berggren, Jan Balldin, and Claudia Fahlke Copyright © 2014 Peter Wennberg et al. All rights reserved. Rate of Nonadherence to Antipsychotic Medications and Factors Leading to Nonadherence among Psychiatric Patients in Gondar University Hospital, Northwest Ethiopia Tue, 16 Dec 2014 11:28:50 +0000 Objective. The main aim of this study was to assess the rate of medication nonadherence among psychiatry patients at University of Gondar Hospital. Materials and Methods. Cross-sectional, descriptive method was conducted over a period of one month in May, 2013, at University of Gondar Hospital. Rate of nonadherence was computed using Medication Adherence Rating Scale questionnaire and self-reporting via a structured patient interview. Chi-square was used to determine the statistical significance of the association of variables with adherence. Result. Out of 209 respondents, 105 (50.2%) were found to be nonadherent. Patients who were forced to take their medication against their will (), those who did not believe they require medication (), and those who discontinued their medication without consulting their prescriber () had significant association with nonadherence. Adherence among schizophrenia was 75.7%; psychotic was 46.7%; bipolar disorder was 37.5%; and psychosis with depression was 52.6%. Reasons for nonadherence included recovery from the illness (26.7%), seeking alternative therapy and unavailability of drugs (18.1% each), adverse drug reaction (12.7%), forgetfulness (10.6%), and being busy (8.6%). Conclusion. The observed rate of antipsychotic medication nonadherence in this study was high. Interventions to increase adherence are therefore crucial. Abyot Endale Gurmu, Esileman Abdela, Bashir Allele, Ermias Cheru, and Bemnet Amogne Copyright © 2014 Abyot Endale Gurmu et al. All rights reserved. Emotional Intelligence and Personality in Anxiety Disorders Tue, 16 Dec 2014 06:51:49 +0000 Anxiety disorders (AD) are by far the most frequent psychiatric disorders, and according to epidemiologic data their chronicity, comorbidities, and negative prognostic constitute a public health problem. This is why it is necessary to continue exploring the factors which contribute to the incidence, appearance, and maintenance of this set of disorders. The goal of this study has been to analyze the possible relationship between Emotional Intelligence (EI) and personality disorders (PersD) in outpatients suffering from AD. The sample was made up of 146 patients with AD from the Mental Health Center at the Health Consortium of Maresme, who were evaluated with the STAI, MSCEIT, and MCMI-II questionnaires. The main findings indicate that 89,4% of the patients in the sample met the criteria for the diagnosis of some PersD. The findings also confirm that patients with AD present a low EI, especially because of difficulties in the skills of emotional comprehension and regulation, and the lack of these skills is related to a higher level of anxiety and the presence of PersD. These findings suggest the need to consider emotional skills of EI and personality as central elements for the diagnosis and treatment of AD. Nathalie P. Lizeretti, María Vázquez Costa, and Ana Gimeno-Bayón Copyright © 2014 Nathalie P. Lizeretti et al. All rights reserved. Cytokine Serum Levels as Potential Biological Markers for the Psychopathology in Schizophrenia Thu, 11 Dec 2014 00:10:14 +0000 We discuss the role of immune system disturbance in schizophrenia and especially changes of serum levels of cytokines in patients with schizophrenia. The cytokines are essential to wide range of functions related to the defense of the organisms from infectious and environmental dangers. However it is not known whether cytokines influence the presentation of psychotic symptoms. Identification of changes in the serum level of certain cytokines and their correlation with distinct psychopathological symptoms may facilitate the identification of subgroups of patients who are likely to benefit from immunotherapy or anti-inflammatory therapy. Such patients may benefit from tailored immunotherapy designed for modulation of abnormal cytokine levels related to specific positive or negative symptoms of schizophrenia. Dimitre H. Dimitrov, Shuko Lee, Jesse Yantis, Craig Honaker, and Nicole Braida Copyright © 2014 Dimitre H. Dimitrov et al. All rights reserved. Demographic and Clinical Characteristics of Patients with Dementia in Greece Mon, 17 Nov 2014 00:00:00 +0000 Introduction. Dementia’s prevalence increases due to population aging. The purpose of this study was to determine the demographic profile of Greek patients with dementia and the differences in management between the urban and rural population. Methods. A cross sectional study was carried out including 161 randomly selected specialists from different regions in Greece who filled in a structured questionnaire relating to patients with dementia, regarding various sociodemographic and clinical characteristics. Results. A total of 4580 patients (52% males) with dementia were recorded. Mean age was 73.6 years and 31% lived in rural areas. The Mini Mental Status Examination (MMSE) was used in 87% of cases. In the urban areas the diagnosis of dementia was made in an earlier stage of the disease in comparison to the rural areas . Higher comorbidity and a higher percentage of low education were evident in rural residents , while higher medication usage was observed in urban patients . Conclusions. The results implicate the need for improvement in health care delivery in Greek rural areas and health care professionals’ training to achieve a proper treatment of dementias and increase the quality of life among the elderly habitants of remote areas. Eleni Jelastopulu, Evangelia Giourou, Konstantinos Argyropoulos, Eleftheria Kariori, Eleftherios Moratis, Angeliki Mestousi, and John Kyriopoulos Copyright © 2014 Eleni Jelastopulu et al. All rights reserved. Neuropsychological Profiles and Behavioral Ratings in ADHD Overlap Only in the Dimension of Syndrome Severity Thu, 13 Nov 2014 06:53:58 +0000 Objectives. The aim of this study was to compare the cognitive neuropsychological and the behavioral rating profiles of attention deficit/hyperactivity disorder (ADHD). Methods. Forty-two children diagnosed with ADHD (  years, ) and 43 typically developing children ( years, ) participated. We measured symptom severity with behavioral rating scales, and we administered neuropsychological tasks to measure inhibitory performance, updating/working memory, and shifting ability. Results. On the basis of the three neuropsychological variables, the hierarchical cluster analytic method yielded a six-cluster structure. The clusters, according to the severity of the impairment, were labeled as follows: none or few symptoms, Moderate inhibition and mild shifting, moderate to severe shifting with moderate updating, moderate updating, severe updating with mild shifting, and severe updating with severe shifting. There were no systematic differences in inattention and hyperactive-impulsive behavior across the clusters. The comorbid learning disorder appeared more likely only in severe neuropsychological forms of ADHD. Conclusion. In sum, our results suggest that behavioral ratings and neuropsychological profiles converge only in the dimension of symptom severity and that atypicalities in executive functions may manifest in nonspecific everyday problems. Ádám Takács, Andrea Kóbor, Zsanett Tárnok, and András Vargha Copyright © 2014 Ádám Takács et al. All rights reserved. Limitations of Randomized Control Designs in Psychotherapy Research Thu, 06 Nov 2014 11:44:51 +0000 Despite the growing influence of lists of empirically supported therapies (ESTs) there are concerns about the design and conduct of this body of research. These concerns include limitations inherent in the requirements of randomized control trials (RCTs) that favor those psychotherapies that define problems and outcome in terms of uncomplicated symptoms. Additional concerns have to do with criteria for patient selection, lack of integration with research on psychotherapy process and effectiveness studies, limited outcome criteria, and lack of controls for experimenter bias. RCT designs have an important place in outcome research; however it is important to recognize that these designs also place restrictions on what and how psychotherapy can be studied. There is a need for large scale psychotherapy outcome research based on designs that allow for inclusion of process variables and the study of the effects of those idiographic approaches to therapy that do not lend themselves to RCT designs. Interpretative phenomenological analysis may provide a useful method for the evaluation of the effectiveness of idiographic approaches to psychotherapy where outcome is not understood solely in terms of symptom reduction. Glenn Shean Copyright © 2014 Glenn Shean. All rights reserved. Pharmacological Prevention of Posttraumatic Stress Disorder: A Systematic Review Sun, 12 Oct 2014 07:31:26 +0000 Introduction. Various interventions, both psychological and pharmacological, have been studied for their efficacy in preventing posttraumatic stress disorder (PTSD) following trauma exposure. However, the preventive effect of pharmacotherapy has not been systematically assessed. Methodology. A systematic review of all clinical trials of drug therapy to prevent PTSD, available through the PubMed and EMBASE databases, was conducted. This included an assessment of each study’s quality. Results. A total of 13 studies were reviewed. The drugs examined in these papers included propranolol, hydrocortisone, serotonin reuptake inhibitors, gabapentin, omega-3 fatty acids, and benzodiazepines. There was marked heterogeneity across studies in terms of quality, study populations, and methodology. Analysis of the outcomes revealed preliminary evidence for the efficacy of hydrocortisone, particularly in critical care settings. There was no consistent evidence to support the use of other drugs to prevent PTSD. Discussion. There may be a limited role for hydrocortisone in preventing the development of PTSD in specific settings. Results with other drugs are inconsistent. Further large-scale studies should assess the efficacy of these approaches in other contexts, such as natural disasters, and the time frame within which they should be used. Ravi Philip Rajkumar and Balaji Bharadwaj Copyright © 2014 Ravi Philip Rajkumar and Balaji Bharadwaj. All rights reserved. The Concept of Schizophrenia: From Unity to Diversity Mon, 15 Sep 2014 05:29:19 +0000 After over 100 years of research without clarifying the aetiology of schizophrenia, a look at the current state of knowledge in epidemiology, genetics, precursors, psychopathology, and outcome seems worthwhile. The disease concept, created by Kraepelin and modified by Bleuler, has a varied history. Today, schizophrenia is considered a polygenic disorder with onset in early adulthood, characterized by irregular psychotic episodes and functional impairment, but incident cases occur at all ages with marked differences in symptoms and social outcome. Men’s and women’s lifetime risk is nearly the same. At young age, women fall ill a few years later and less severely than men, men more rarely and less severely later in life. The underlying protective effect of oestrogen is antagonized by genetic load. The illness course is heterogeneous and depressive mood the most frequent symptom. Depression and schizophrenia are functionally associated, and affective and nonaffective psychoses do not split neatly. Most social consequences occur at the prodromal stage. Neither schizophrenia as such nor its main symptom dimensions regularly show pronounced deterioration over time. Schizophrenia is neither a residual state of a neurodevelopmental disorder nor a progressing neurodegenerative process. It reflects multifactorial CNS instability, which leads to cognitive deficits and symptom exacerbations. Heinz Häfner Copyright © 2014 Heinz Häfner. All rights reserved. Early Detection and Treatment of Psychosis: The Bern Child and Adolescent Psychiatric Perspective Tue, 09 Sep 2014 11:10:16 +0000 Commonly conceptualized as neurodevelopmental disorders of yet poorly understood aetiology, schizophrenia and other nonorganic psychoses remain one of the most debilitating illnesses with often poor outcome despite all progress in treatment of the manifest disorder. Drawing on the frequent poor outcome of psychosis and its association with the frequently extended periods of untreated first-episode psychosis (FEP) including its prodrome, an early detection and treatment of both the FEP and the preceding at-risk mental state (ARMS) have been increasingly studied. Thereby both approaches are confronted with different problems, for example, treatment engagement in FEP and predictive accuracy in ARMS. They share, however, the problems related to the lack of understanding of developmental, that is, age-related, peculiarities and of the presentation and natural course of their cardinal symptoms in the community. Most research on early detection and intervention in FEP and ARMS is still related to clinical psychiatric samples, and little is known about symptom presentation and burden and help-seeking in the general population related to these experiences. Furthermore, in particular in the early detection of an ARMS, studies often address adolescents and young adults alike without consideration of developmental characteristics, thereby applying risk criteria that have been developed predominately in adults. Combining our earlier experiences described in this paper in child and adolescent, and general psychiatry as well as in both lines of research, that is, on early psychosis and its treatment and on the early detection of psychosis, in particular in its very early states by subjective disturbances in terms of basic symptoms, age-related developmental and epidemiological aspects have therefore been made the focus of our current studies in Bern, thus making our line of research unique. Frauke Schultze-Lutter and Benno G. Schimmelmann Copyright © 2014 Frauke Schultze-Lutter and Benno G. Schimmelmann. All rights reserved. Temperament and Eating Attitudes in an Adolescent Community Sample: A Brief Report Mon, 08 Sep 2014 09:15:06 +0000 Objective. Temperament traits like high harm avoidance (HA) have been proposed as putative risk factors for the development of eating disorders (EDs). We aimed at studying the relationship between temperament and eating attitudes on a large community sample of adolescents. Method. We recruited 992 high school students aged 14–18. In addition to measuring body mass index (BMI), participants were asked to complete the temperament and character inventory and the food frequency questionnaire. Results. Sixty-two percent of the sample reported overeating, 22.8% reported normal eating, and 15.2% reported under eating. Under and normal eaters had higher BMI than that of over eaters. Harm avoidance was found to be significantly higher in those participants with lower eating intakes whilst novelty seeking was found to be higher in over eaters. Conclusion. An interesting association between temperament (high HA) and food approach (under eating) emerged. Longitudinal studies are needed to evaluate whether these traits represent a risk factor for the development of EDs. Enrica Marzola, Secondo Fassino, Federico Amianto, and Giovanni Abbate-Daga Copyright © 2014 Enrica Marzola et al. All rights reserved. Self-Determination Theory and First-Episode Psychosis: A Replication Mon, 08 Sep 2014 08:31:31 +0000 Self-determination theory (SDT) posits that human well-being depends on the satisfaction of three basic psychological needs: autonomy, competence, and relatedness. Although many scholars have suggested that SDT may be relevant to psychotic disorders, only one empirical study of SDT in individuals with psychosis has been completed to date by Breitborde and colleagues (2012). This study revealed that individuals with first-episode psychosis reported lower satisfaction of the three basic psychological needs as compared to individuals without psychosis. Moreover, greater satisfaction of basic psychological needs was modestly associated with lower general symptoms (e.g., anxiety and depression), greater social functioning, and better quality of life. Thus, the goal of this project was to replicate Breitborde et al.’s (2012) investigation of basic psychological need satisfaction among individuals with first-episode psychosis. Our results supported the conclusion that individuals with first-episode psychosis report lower autonomy, competence, and relatedness than individuals without psychosis. Moreover, our results comport with the finding that greater need satisfaction was associated with less severe symptomatology and better social functioning and quality of life. In total, the findings lend further credence to the hypothesis that SDT may help to inform the development of improved clinical services for individuals with psychotic disorders. Nicholas J. K. Breitborde, Cindy Woolverton, R. Brock Frost, and Nicole A. Kiewel Copyright © 2014 Nicholas J. K. Breitborde et al. All rights reserved. D-Serine in Neuropsychiatric Disorders: New Advances Thu, 19 Jun 2014 09:30:50 +0000 D-Serine (DSR) is an endogenous amino acid involved in glia-synapse interactions that has unique neurotransmitter characteristics. DSR acts as obligatory coagonist at the glycine site associated with the N-methyl-D-aspartate subtype of glutamate receptors (NMDAR) and has a cardinal modulatory role in major NMDAR-dependent processes including NMDAR-mediated neurotransmission, neurotoxicity, synaptic plasticity, and cell migration. Since either over- or underfunction of NMDARs may be involved in the pathophysiology of neuropsychiatric disorders; the pharmacological manipulation of DSR signaling represents a major drug development target. A first generation of proof-of-concept animal and clinical studies suggest beneficial DSR effects in treatment-refractory schizophrenia, movement, depression, and anxiety disorders and for the improvement of cognitive performance. A related developing pharmacological strategy is the indirect modification of DSR synaptic levels by use of compounds that alter the function of main enzymes responsible for DSR production and degradation. Accumulating data indicate that, during the next decade, we will witness important advances in the understanding of DSR role that will further contribute to elucidating the causes of neuropsychiatric disorders and will be instrumental in the development of innovative treatments. Andrea R. Durrant and Uriel Heresco-Levy Copyright © 2014 Andrea R. Durrant and Uriel Heresco-Levy. All rights reserved. Missing Motherhood: Jordanian Women's Experiences with Infertility Wed, 04 Jun 2014 11:17:22 +0000 Aim, Background, and Introduction. Bearing and rearing children are an important part of life in nearly all cultures and are a central role for Jordanian Muslim women. Infertility can create anxiety, stress, and depression for couples who are infertile. Women frequently bear the emotional stigma of a couple’s infertility. There is a paucity of literature focusing on Jordanian Muslim women experiencing infertility and failed assistive reproductive technology. Therefore, this study explored these women’s lived experience. Methods. Qualitative data were collected through interviews with 30 Jordanian Muslim women who experienced failed assistive reproductive technology for infertility. Perceptions of experiences with failed treatment of infertility were documented and analyzed. Results. Major themes were identified: missing out on motherhood and living with infertility, experiencing marital stressors, feeling social pressure, experiencing depression and disappointment, having treatment associated difficulties, appreciating support from family and friends, using coping strategies, and fear of an unknown future. Discussion, Conclusion, and Implications for Clinical Practice. Being infertile significantly influences the physical, emotional, social, and spiritual health of Jordanian Muslim women as well as their quality of life. Perceived social support and personal coping strategies were used by study participants to mediate failed attempts to conceive. Designing and implementing culturally appropriate interventions for Muslim women globally who are experiencing infertility are essential. Hala Mahmoud Obeidat, Adlah M. Hamlan, and Lynn Clark Callister Copyright © 2014 Hala Mahmoud Obeidat et al. All rights reserved. The Knowledge Concealed in Users’ Narratives, Valuing Clients’ Experiences as Coherent Knowledge in Their Own Right Wed, 28 May 2014 11:51:31 +0000 Objective. As the history of psychiatry has been written, users have told their stories and often presented pictures incompatible with the professional or official versions. We ask if such a gap still exists and what the ethical as well as epistemological implications may be. Study Design. The design is based on a hermeneutic-phenomenological approach, with a qualitative content analysis of the narratives. Data Sources. The paper draws on user narratives written after the year 2000, describing positive and negative experiences with the mental health services. Extraction Methods. Among 972 users answering a questionnaire, 492 also answered the open questions and wrote one or two stories. We received 715 stories. 610 contained enough information to be included in this narrative analysis. Principal Findings. The stories are coherent, containing traditional narrative plots, but reports about miscommunication, rejection, lack of responsiveness, and humiliation are numerous. Conclusions. The picture drawn from this material has ethical as well as epistemological implications and motivates reflections upon theoretical and practical consequences when users’ experiences do not influence professional knowledge to a larger degree. Ragnfrid Kogstad, Tor-Johan Ekeland, and Jan Kaare Hummelvoll Copyright © 2014 Ragnfrid Kogstad et al. All rights reserved. Screening for Psychiatric Disorders in Bariatric Surgery Candidates with the German Version of the Patient Health Questionnaire Sun, 27 Apr 2014 07:34:11 +0000 Objective. Obesity has been linked to psychiatric disorders in several studies. Prevalence and severity of psychiatric disorders are high in patients undergoing bariatric surgery. Thus, psychiatric assessment of bariatric surgery candidates has become a standard procedure. However, socially desirable responding leads to biased results in self-reported questionnaires. Here, bariatric surgery candidates were screened with the Patient Health Questionnaire (PHQ-D) additionally to the psychiatric examination. Method. 355 bariatric surgery candidates filled in the PHQ-D before the psychiatric examination as a part of the surgery assessment procedure. PHQ-D results were compared to psychiatric diagnoses and body mass index (BMI). Results. Gender ratio, mean BMI, and age were comparable to earlier studies. Depressive and somatization symptoms did not correlate to BMI. However, females showed higher prevalence of psychiatric disorders with elevated syndrome severity in depressive and somatization disorders, as well as more frequent antidepressant intake. Eating disorders and addiction disorders were rarely reported. Conclusion. The findings suggest a socially desirable responding when filling in the PHQ-D before bariatric surgery. The use of the PHQ-D in this patient sample could be augmented by psychometric tests with internal correction and validation scales. Furthermore, psychiatric examination should be separated from the surgery evaluation process. Ulrich Palm, Wolfgang E. Thasler, Peter Rittler, Ann Natascha Epple, Martin Lieb, Rabee Mokhtari-Nejad, Susanne Rospleszcz, Larissa de la Fontaine, Felix M. Segmiller, and Daniela Eser-Valeri Copyright © 2014 Ulrich Palm et al. All rights reserved. Aggression in Psychoses Wed, 12 Feb 2014 15:07:20 +0000 Most individuals diagnosed with a mental illness are not violent, but some mentally ill patients commit violent acts. PubMed database was searched for articles published between 1980 and November 2013 using the combination of key words “schizophrenia” or “bipolar disorder” with “aggression” or “violence.” In comparison with the general population, there is approximately a twofold increase of risk of violence in schizophrenia without substance abuse comorbidity and ninefold with such comorbidity. The risk in bipolar disorder is at least as high as in schizophrenia. Most of the violence in bipolar disorder occurs during the manic phase. Violence among adults with schizophrenia may follow two distinct pathways: one associated with antisocial conduct and another associated with the acute psychopathology, particularly anger and delusions. Clozapine is the most effective treatment of aggressive behavior in schizophrenia. Emerging evidence suggests that olanzapine may be the second most effective treatment. Treatment nonadherence greatly increases the risk of violent behavior, and poor insight as well as hostility is associated with nonadherence. Nonpharmacological methods of treatment of aggression in schizophrenia and bipolar disorder are increasingly important. Cognitive behavioral approaches appear to be effective in cases where pharmacotherapy alone is not sufficient. Jan Volavka Copyright © 2014 Jan Volavka. All rights reserved.