Abstract: Holistic management of schizophrenia involves mainstream pharmacological intervention, complimentary medicine intervention, therapeutic intervention and other psychosocial factors such as accommodation, education, job training, employment, relationship, friendship, exercise, overall well-being, smoking, substance abuse, suicide prevention, stigmatisation, recreation, entertainment, violent behaviour, arrangement of public trusteeship and guardianship, day-day-living skill, integration with community, and management of overweight due to medications and other health complications related to medications amongst others. Our review shows that there is no integrated survey by combining all these factors. An international web-based survey was conducted to evaluate the significance of all these factors and present them in a unified manner. It is believed this investigation will contribute positively towards holistic management of schizophrenia. There will be two surveys. In the pharmacological intervention survey, five popular drugs for schizophrenia will be chosen and their efficacy as well as harmful side effects will be evaluated on a scale of 0 -10. This survey will be done by psychiatrists. In the second survey, each element of therapeutic intervention and psychosocial factors will be evaluated according to their significance on a scale of 0 - 10. This survey will be done by care givers, psychologists, case managers and case workers. For the first survey, professional bodies of psychiatrists in English speaking countries will be contacted to request them to ask their members to participate in the survey. For the second survey, professional bodies of clinical psychologist and care givers in English speaking countries will be contacted to request them to ask their members to participate in the survey. Additionally, for both the surveys, relevant professionals will be contacted through personal contact networks. For both the surveys, mean, mode, median, standard deviation and net promoter score will be calculated for each factor and then presented in a statistically significant manner. Subsequently each factor will be ranked according to their statistical significance. Additionally, country specific variation will be highlighted to identify the variation pattern. The results of these surveys will identify the relative significance of each type of pharmacological intervention, each type of therapeutic intervention and each type of psychosocial factor. The determination of this relative importance will definitely contribute to the improvement in quality of life for individuals with schizophrenia.
Abstract: Background: Persons with schizophrenia patient and misusing methamphetamines suffering from social dysfunction that impact on their quality of life. Knowledge of factors related to social dysfunction will guide the effective intervention. Objectives: To determine the direct effect, indirect effect and total effect of an acerbate Psychotics’ Symptoms, Social Support, Stressful life events, Medication use self-efficacy impact on social dysfunction in Thai schizophrenic patient and methamphetamine misuse. Methods: Data were collected from schizophrenic and methamphetamine misuse patient by self report. A linear structural relationship was used to test the hypothesized path model. Results: The hypothesized model was found to fit the empirical data and explained 54% of the variance of the psychotic symptoms (X2 = 114.35, df = 92, p-value = 0.05, X2 /df = 1.24, GFI = 0.96, AGFI = 0.92, CFI = 1.00, NFI = 0.99, NNFI = 0.99, RMSEA = 0.02). The highest total effect on social dysfunction was psychotic symptoms (0.67, p
Abstract: Auditory hallucinations among the most invalidating
and distressing experiences reported by patients diagnosed with
schizophrenia, leading to feelings of powerlessness and helplessness
towards their illness. In more severe cases, these auditory
hallucinations can take the form of commanding voices, which are
often related to high suicidality rates in these patients. Several
authors propose that the meanings attributed to the hallucinatory
experience, rather than characteristics like form and content, can be
determinant in patients’ reactions to hallucinatory activity,
particularly in the case of voice-hearing experiences. In this study, 48
patients diagnosed with paranoid schizophrenia presenting auditory
hallucinations were studied. Multiple regression analyses were
computed to study the influence of several developmental aspects,
such as family and social dynamics, bullying, depression, and sociocognitive
variables on the auditory hallucinations, on patients’
attributions and relationships with their voices, and on the resulting
invalidation of hallucinatory experience. Overall, results showed how
relationships with voices can mirror several aspects of interpersonal
relationship with others, and how self-schemas, depression and actual
social relationships help shaping the voice-hearing experience. Early
experiences of victimization and submission help predict the
attributions of omnipotence of the voices, and increased hostility
from parents seems to increase the malevolence of the voices,
suggesting that socio-cognitive factors can significantly contribute to
the etiology and maintenance of auditory hallucinations. The
understanding of the characteristics of auditory hallucinations and the
relationships patients established with their voices can allow the
development of more promising therapeutic interventions that can be
more effective in decreasing invalidation caused by this devastating
mental illness.
Abstract: The aim of the current study was to develop and
validate a Response to Stressful Situations Scale (RSSS) for the
Portuguese population. This scale assesses the degree of stress
experienced in scenarios that can constitute positive, negative and
more neutral stressors, and also describes the physiological,
emotional and behavioral reactions to those events according to their
intensity. These scenarios include typical stressor scenarios relevant
to patients with schizophrenia, which are currently absent from most
scales, assessing specific risks that these stressors may bring on
subjects, which may prove useful in non-clinical and clinical
populations (i.e. Patients with mood or anxiety disorders,
schizophrenia). Results from Principal Components Analysis and
Confirmatory Factor Analysis of two adult samples from general
population allowed to confirm a three-factor model with good fit
indices: χ2 (144)= 370.211, p = 0.000; GFI = 0.928; CFI = 0.927; TLI =
0.914, RMSEA = 0.055, P(rmsea ≤0.005) = .096; PCFI = .781.
Further data analysis of the scale revealed that RSSS is an adequate
assessment tool of stress response in adults to be used in further
research and clinical settings, with good psychometric characteristics,
adequate divergent and convergent validity, good temporal stability
and high internal consistency.
Abstract: Oral health is particular important to the hospitalized
patients with chronic schizophrenia for an extreme high potential of the respiratory infections. Due to the degeneration of physical capability, patients of this kind typically fall dependent in the activity of daily living (ADL). A very high percentage of patients had dental
problems of which mostly could be easily avoid by easy regular tooth brushing. Purpose of the project is to develop a mechanism in helping the schizophrenia patients in rebuilding a tooth-cleaning habit. The
project observed and evaluated the tooth-cleaning behavior of 100
male patients in a psychiatric hospital, and found the majority of them
ignored such an activity in a three-month period of time. In the meantime, the primary care-givers were not aware or not convinced
the importance of such a need of dental hygiene, and thus few if any
tooth cleaning training or knowledge on dental hygiene were given to
the patients. The project then developed a program based on the numerous observations and discussions. The improvement program
included patients- group education, care-givers- training, and a
tool-kit for tooth-brush holding was erected. The project launched
with some incentive package. The outcomes were encouraging with
87% of the patients had rebuilt their tooth-brushing habits against
previous 22%, and the tooth cleaning kits were 100% kept against 22%
in the past. This project had significantly improved the oral health of
the patients. The project, included the procedure and the tool-kit
holder specific for this purpose, was a good examples for psychiatric
hospitals.