Review

Authors: Mustafa Yildiz

Schizophrenia and bipolar disorder are chronic conditions with the early onset, higher relapse rate, and functional impairment that often persist despite optimum pharmacotherapy, underscoring the need for adjunctive psychosocial treatments and rehabilitation interventions. Evidence-based psychosocial treatment and rehabilitation interventions for both illnesses are adherence therapy, psychoeducation, cognitive-behavioral therapy, interpersonal and social rhythm therapy, cognitive remediation, social skills training, family education, vocational rehabilitation, case management, assertive community treatment, occupational/art therapy, and peer support. The efficacy of these interventions has been shown in many studies. Trials generally reveal that symptom reductions, relapse preventions, reduced hospitalizations, increased social functioning, increased employment rate, and satisfactory quality of life for patients with schizophrenia and bipolar disorder are possible by using these interventions adding to optimal pharmacotherapy. This review describes the psychosocial rehabilitation interventions that have been used successfully and extensively in patients with schizophrenia and bipolar disorder.

PubMed: 34658639
DOI: 10.29399/npa.27430

Review

Authors: Stefano Barlati, Gabriele Nibbio, Antonio Vita...

PURPOSE OF REVIEW

Schizophrenia Spectrum Disorders (SSD) are severe conditions that frequently produce significant impairment in cognitive performance, social skills and psychosocial functioning. As pharmacological treatment alone often provides only limited improvements on these outcomes, several psychosocial interventions are employed in psychiatric rehabilitation practice to improve of real-world outcomes of people living with SSD: the present review aims to provide a critical overview of these treatments, focusing on those that show consistent evidence of effectiveness.

RECENT FINDINGS

Several recent systematic reviews and meta-analyses have investigated in detail the acceptability, the effectiveness on several specific outcomes and moderators of response of different psychosocial interventions, and several individual studies have provided novel insight on their implementation and combination in rehabilitation practice.

SUMMARY

Cognitive remediation, metacognitive training, social skills training, psychoeducation, family interventions, cognitive behavioral therapy, physical exercise and lifestyle interventions, supported employment and some other interventions can be fully considered as evidence-based treatments in SSD. Psychosocial interventions could be of particular usefulness in the context of early intervention services. Future research should focus on developing newer interventions, on better understanding the barriers and the facilitators of their implementation in clinical practice, and exploring the opportunities provided by novel technologies.

Topics: Humans; Schizophrenia; Psychosocial Intervention; Cognitive Behavioral Therapy; Psychiatric Rehabilitation; Cognitive Remediation

PubMed: 38410981
DOI: 10.1097/YCO.0000000000000925

Review

Authors: Venetia Notara, Elissavet Vagka, Charalampos Gnardellis...

BACKGROUND

Nomophobia (No MObile PHone PhoBIA) refers to the worry or fear that individuals experience when they are without their mobile phone or they are unable to use it. The term was first coined in 2008 and it is considered a modern type of phobia. The aim of the present study was to retrieve and review the most relevant literature on the prevalence of nomophobia and its relationship with psychosocial and physical health among young adults.

METHODS

A systematic literature review was conducted according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for original papers on the phenomenon of nomophobia in young adults using the Nomophobia Questionnaire (NMP-Q) as the main measuring instrument. The literature was focused on the 3 main topics of prevalence and level of nomophobia, nomophobia and psychosocial effects, and nomophobia and physical health in young adults.

FINDINGS

The initial literature corpus consisted of 370 articles of which 40 met the inclusion criteria and were analyzed in detail. Nomophobia was observed among 15.2%-99.7% of the participants. Research findings indicated increased psychological, emotional, social, and physical side effects due to excessive smartphone use.

CONCLUSION

The excessive use of the smartphone is an emerging threat for social, mental, and physical health. There is an increased need for further research in this regard as it is evolving into an epidemic outbreak and concerns directly the field of public health.

PubMed: 34703533
DOI: 10.22122/ahj.v13i2.309

Review

Authors: Justyna Michalczyk, Agata Miłosz, Ewelina Soroka...

Postpartum psychosis is rare, but is a serious clinical and social problem. On its own, it is not included in DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) or ICD-10 (International Statistical Classification of Diseases and Related Health Problems) as a disease entity, and current diagnostic criteria equate it with other psychoses. This poses a serious legal problem and makes it difficult to classify. The disorder is caused by a complex combination of biological, environmental, and cultural factors. The exact pathophysiological mechanisms of postpartum psychosis remain very poorly understood. There is a need for further research and increased knowledge of the medical sector in the prevention and early detection of psychosis to prevent stigmatization of female patients during a psychiatric episode. It is necessary to regulate its position in the DSM5 and ICD-10. Attention should be paid to the social education of expectant mothers and their families. This article aims to review the current status of risk factors, prevention, and management of postpartum psychosis.

Topics: Humans; Female; Psychotic Disorders; Risk Factors; Postpartum Period

PubMed: 38155489
DOI: 10.12659/MSM.942520

Randomized Controlled Trial

Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial.

Authors: Gordon McGregor, Harbinder Sandhu, Julie Bruce...

OBJECTIVE

To evaluate whether a structured online supervised group physical and mental health rehabilitation programme can improve health related quality of life compared with usual care in adults with post-covid-19 condition (long covid).

DESIGN

Pragmatic, multicentre, parallel group, superiority randomised controlled trial.

SETTING

England and Wales, with home based interventions delivered remotely online from a single trial hub.

PARTICIPANTS

585 adults (26-86 years) discharged from NHS hospitals at least three months previously after covid-19 and with ongoing physical and/or mental health sequelae (post-covid-19 condition), randomised (1:1.03) to receive the Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN) intervention (n=298) or usual care (n=287).

INTERVENTIONS

Best practice usual care was a single online session of advice and support with a trained practitioner. The REGAIN intervention was delivered online over eight weeks and consisted of weekly home based, live, supervised, group exercise and psychological support sessions.

MAIN OUTCOME MEASURES

The primary outcome was health related quality of life using the patient reported outcomes measurement information system (PROMIS) preference (PROPr) score at three months. Secondary outcomes, measured at three, six, and 12 months, included PROMIS subscores (depression, fatigue, sleep disturbance, pain interference, physical function, social roles/activities, and cognitive function), severity of post-traumatic stress disorder, general health, and adverse events.

RESULTS

Between January 2021 and July 2022, 39 697 people were invited to take part in the study and 725 were contacted and eligible. 585 participants were randomised. Mean age was 56 (standard deviation (SD) 12) years, 52% were female participants, mean health related quality of life PROMIS-PROPr score was 0.20 (SD 0.17), and mean time from hospital discharge was 323 (SD 144) days. Compared with usual care, the REGAIN intervention led to improvements in health related quality of life (adjusted mean difference in PROPr score 0.03 (95% confidence interval 0.01 to 0.05), P=0.02) at three months, driven predominantly by greater improvements in the PROMIS subscores for depression (1.39 (0.06 to 2.71), P=0.04), fatigue (2.50 (1.19 to 3.81), P<0.001), and pain interference (1.80 (0.50 to 3.11), P=0.01). Effects were sustained at 12 months (0.03 (0.01 to 0.06), P=0.02). Of 21 serious adverse events, only one was possibly related to the REGAIN intervention. In the intervention group, 141 (47%) participants fully adhered to the programme, 117 (39%) partially adhered, and 40 (13%) did not receive the intervention.

CONCLUSIONS

In adults with post-covid-19 condition, an online, home based, supervised, group physical and mental health rehabilitation programme was clinically effective at improving health related quality of life at three and 12 months compared with usual care.

TRIAL REGISTRATION

ISRCTN registry ISRCTN11466448.

Topics: Adult; Female; Humans; Male; Middle Aged; Cost-Benefit Analysis; COVID-19; Pain; Post-Acute COVID-19 Syndrome; Psychiatric Rehabilitation; Quality of Life; Treatment Outcome

PubMed: 38325873
DOI: 10.1136/bmj-2023-076506

Authors: Xu Tian, Maria F Jimenez-Herrera

PubMed: 37868611
DOI: 10.3389/fpsyg.2023.1265258

Authors: Deepak Jayarajan, Thanapal Sivakumar, John B Torous...

The COVID-19 pandemic has interrupted the usual mechanisms of healthcare delivery and exacerbated symptoms of mental illnesses. Telemedicine has morphed from niche service to essential platform, with newly released guidelines that cover various aspects of tele-mental health delivery. Rehabilitation services, which incorporate a range of psychosocial interventions and liaison services, have been significantly impacted too. They are currently more institute-based than community-based in India. However, recent legislation has mandated that community-based rehabilitation options be available. While a large treatment gap for mental health issues has always existed, telemedicine provides an opportunity to scale services up to minimize this gap. Community-based rehabilitation can be delivered over various platforms, from text to phone to videoconferencing, and various devices. Telemedicine is cost-effective, and enables delivery of services where existing services are inadequate. The recent guidelines allow other healthcare workers to be involved in mental health service delivery. Hence, in addition to direct delivery of services, telerehabilitation can facilitate task-shifting, with mental health professionals mentoring and supervising existing human resources, such as ASHA workers, VRWs, DMHP programme staff, and others. Tele-rehabilitation also poses challenges - not all needs can be met; access and privacy can be a problem in resource-scarce settings; liaison with existing services is required; and organisations need to plan appropriately and re-allocate resources. Digital access to welfare benefits and interventions must be expanded without disadvantaging those without internet access. Yet, many rehabilitation interventions can be adapted to telemedicine platforms smoothly, and task-shifting can broaden access to care for persons with disability.

PubMed: 33354066
DOI: 10.1177/0253717620963202

Authors: Federica Sancassiani, Sergio Machado, Antonio Preti...

People with severe psychosocial disabilities have a 20-years shorter lifespan due to chronic somatic comorbidities and the long-term consequences of the side-effects of antipsychotic drugs. They often are sedentary and show lower levels of physical activity, factors which can contribute to their shorter lifespan, because of the greater cardiovascular risk. An increasing amount of evidence, including clinical trials, pointed out that sport, physical activity and structured exercise programs improve physical and psychological wellbeing of people with psychosocial disabilities, playing also an important role against their social isolation and self-stigma. The NICE and APA guidelines include exercise and physical activity for the management of depressive symptoms. Safe and effective programs require multidisciplinary teams that should always include mental health professionals, able to recognize the psychosocial needs, the impact of symptomatology, the role of secondary effects of psychotropic medication, the effect of previous exercise history, the lack of motivation, the inexperience with effort intensity and the frustration of people with psychosocial disabilities.

PubMed: 29515643
DOI: 10.2174/1745017901814010006

Authors: Ewelina Dziwota, Marian Zdzisław Stepulak, Anna Włoszczak-Szubzda...

INTRODUCTION

Schizophrenia to a considerably great degree impairs the social functioning of the persons affected in the spheres of interpersonal and occupational contacts, as well as self-care. It brings about serious cognitive, perceptual, motor and emotional deficits, inevitably leading to the social withdrawal of patients. This phenomenon may assume various forms, from the limitations in interpersonal relations, through narrowing these relations to only some circumstances, to the total cessation of social contacts.

OBJECTIVE

The objective of the study is presentation of the most important problems related with social functioning and quality of life of patients diagnosed with schizophrenia, based on scientific studies conducted in Poland and worldwide.

STATE OF KNOWLEDGE

The family of a schizophrenia patient exerts a great effect on the social functioning. While undertaking proper actions the family may become a co-therapist and significantly facilitate the patient's adjustment to life in society and his/her playing a specified role. Analysis of disorders in social functioning of patients with schizophrenia, in the context of social cognition, indicates the fact that these disorders have their source in the lack of capabilities for identification of own and other people's internal states, whereas mentalization is the essence of social cognition.

CONCLUSIONS

Therapy, any psychosocial impact as well as rehabilitation, neutralizes the causes for patients' withdrawal from social life. Training of social skills is necessary which teaches patients to return to the situation when they would be able to function properly in their environment.

Topics: Cognition; Female; Humans; Interpersonal Relations; Male; Poland; Quality of Life; Schizophrenia; Schizophrenic Psychology; Social Adjustment; Social Behavior

PubMed: 29575877
DOI: 10.5604/12321966.1233566

Authors: Santosh K Chaturvedi

PubMed: 32837863
DOI: 10.1007/s40737-020-00178-5