Psychiatric and Mental Health Commons^™

The Image Of Schizophrenia In Spain's Healthcare System, Meghan Webb

CISLA Senior Integrative Projects

Schizophrenia affects thousands of people in Spain and is one of the most serious mental health disorders in existence. Despite its this characteristic, schizophrenia did not always get the proper attention it deserved within the country’s healthcare system. This was largely due to the influence that the Spanish government had, and continues to have, over the healthcare system, giving it the power to choose how the disorder was represented. Therefore, what does that mean for schizophrenia in Spain’s healthcare system today? This essay will explore the ways in which schizophrenia was represented in Spain’s healthcare system through an examination of …

Illness Trajectory From Prodromal Symptoms To Incident Bipolar Disorder And Schizophrenia, Manuel A. Gardea Resendez, Javier Ortiz-Orendain, Brandon J. Coombes, Aysegul Ozerdem, Monica J. Taylor-Desir, Balwinder Singh, Alastair J. Mckean, Mark Frye

Research Symposium

Background: The concept of prodrome is highly variable but, when applied retrospectively in cohorts who progress to meet diagnostic criteria for bipolar disorder (BD) and schizophrenia (SZ), it can contribute to clarify early origins and trajectory of the illness. In the context of race and ethnicity, studies with population-based and registry-based cohorts, such as the Rochester Epidemiology Project (REP), can potentially identify, through retrospective assessment of the prodromes of BD and SZ, differences while addressing the heterogeneous nature of the illness.

Objective: We aim to describe and compare the illness trajectories of individuals with BD or SZ prior to the …

Representation Of Racial And Ethnic Minorities And Their Preferences For Mood Stabilizing Treatment Selection For Bipolar Disorder: A Systematic Review, Francisco J. Barrera, Manuel Gardea, Juan Garzon, Ryan Toledo, Ana Paula Bonner, Andrea Maraboto, Mark Frye, Ihsan Salloum

Research Symposium

Background: The use of second-generation antipsychotics for bipolar disorder (BD) has increased in the past years¹Concerns on potential serious medical side effects and need for blood level monitoring of some traditional mood stabilizers along with other factors have influenced this change. Shared decision-making (SDM) strategies have been implemented in clinical settings due to their ability to engage patients in the process of treatment selection.² Within minority groups with mental illnesses, socioeconomic factors, individual concerns, and cultural variations in clinical presentations, are often overlooked or misrepresented when assessing the patient’s treatment preferences. Although several studies evaluating the …

Implementing A Medication Preference Questionnaire In Schizophrenia To Decrease The Risk Of Relapse, Chelsea Aldridge

Doctoral Projects

Schizophrenia is a debilitating disorder that affects the mind causing individuals to have delusions, hallucinations, disorganized thought processing, and or negative symptoms ranging from isolation to anhedonia. Schizophrenia has capabilities of becoming a disabling disorder if symptoms are not properly managed with appropriate psychotropic medications. Psychiatrists, Primary Care Providers (PCPs), and Psychiatric- Mental Health Nurse Practitioners (PMHNPs) typically treat the symptoms of schizophrenia with antipsychotics. Antipsychotics fall into two drug classes: first- generation or typical antipsychotics and second- generation or atypical antipsychotics that can be given orally or intramuscularly. Typical antipsychotics generally have more side effects than atypical antipsychotics. However, …

Development Of Schizophrenia In A Genetically Predisposed Individual Following Covid-19, Sung Kang, Jonathan Yuh, Timothy Wong

Rowan-Virtua Research Day

We present a patient who is a 56-year-old female with a psychiatric history of anxiety disorder and a medical history of hypercholesterolemia and hyperthyroidism, who was admitted to the hospital after a witnessed seizure at an inpatient psychiatric facility. This patient’s family history is significant for her mother experiencing unspecified psychotic disorder that required psychiatric hospitalization. Our patient was first admitted to the psychiatric hospital after exhibiting worsening paranoid delusions and hallucinations that began several months prior. The patient had reportedly begun locking herself in the restroom and screaming “get out, they’re spying on me”, referring to her next-door neighbors …

Considerations And Strategies For Incorporating Lived Experience In Mental Health Research, Elizabeth Bernier, Elias Peirce, Elizabeth M. Mutina, Saras Yerlig, Kristen A. Woodberry

Costas T. Lambrew Research Retreat 2023

Introduction: Incorporating lived experience in mental health research deserves special focus due to the unique stigma faced by those with lived experience and the unique gap between the experience and expression of mental health struggle.

Interaction Between Fluoxetine And Risperidone And Its Association With Clinical Outcomes In Schizophrenic Patients, Fitri Rachmaini, Dian Ayu Juwita, Rahmad Abdillah, Rezy Dwi Afrianti, Fatma Sri Wahyuni

Pharmaceutical Sciences and Research

The concurrent use of fluoxetine and risperidone to treat schizophrenia may result in drug interactions. This study aims to analyse the clinical outcomes of fluoxetine-risperidone therapy and the possibility of their interaction in schizophrenic patients. The clinical outcomes are patient status at the time of hospital discharge, the length of hospitalisation and the Positive and Negative Syndrome Scale- Excitement Component (PANSS-EC). This study was conducted prospectively in psychiatric ward of HB Saanin Mental Hospital from May to October 2021 and study subjects were selected using consecutive sampling technique with inclusion criteria. Forty-three patients were eligible for this study. Research data …

The Relationship Between Quality Of Life And Functionality In Patients With Schizophrenia – A Preliminary Report, Vlad Dionisie, Mihnea Costin Manea, Manea Mirela, Lavinia Steluta Bonciu, Sorin Riga, Maria Gabriela Puiu

Journal of Mind and Medical Sciences

This research aimed to investigate the relationship between quality of life and level of functioning in a group of Romanian patients with schizophrenia. A cross-sectional, observational, prospective study on 47 patients with schizophrenia was conducted. Socio-demographic and clinical data were documented and WHOQOL-BREF and Life Skills Profile-16 instruments were further administered. To examine the correlation between variables, Person correlation test was employed. The mean age of the sample was 38.32±12.32 years and 66% of the patients were males. Significant correlations were found between all aspects of the quality of life (physical health, psychological, social relationships and environmental health) and total …

A Phenomenological Take On Mirror Self-Face Perception In Schizophrenia, Giovanni Pennisi

Journal of Mind and Medical Sciences

Studies concerning social deficits in schizophrenia has often been restrained to exploring facial recognition. Various investigations have shown that those diagnosed with schizophrenia have difficulties in perceiving the identities and emotions of those around them merely through observing their facial features. A few others have also taken into account the issue of self-face recognition in individuals with schizophrenia, finding that their capacity to associate photos or videos of their own face to themselves is hindered due to the illness. However, to my knowledge, only a few studies have so far delved into the intricacies of how individuals with schizophrenia or …

Data-Driven Neuroanatomical Subtypes In Various Stages Of Schizophrenia: Linking Cortical Thickness, Glutamate, And Language Functioning, Liangbing Liang

Electronic Thesis and Dissertation Repository

The considerable variation in the spatial distribution of cortical thickness changes has been used to parse heterogeneity in schizophrenia. We aimed to recover a ‘cortical impoverishment’ subgroup with widespread cortical thinning. We applied hierarchical cluster analysis to cortical thickness data of three datasets in different stages of psychosis and studied the cognitive, functional, neurochemical, language and symptom profiles of the observed subgroups. Our consensus-based clustering procedure consistently produced a subgroup characterized by significantly lower cortical thickness. This ‘cortical impoverishment’ subgroup was associated with a higher symptom burden in a clinically stable sample and higher glutamate levels with language impairments in …

Associations Between Cannabis, Psychosis, And Schizophrenia In Adolescents, Lauren Moment

Academic Leadership Journal in Student Research

The effects of cannabis use on the brain, mind, and body have been studied for decades. The developing brain, particularly the adolescent and young adult brain, undergoes critical development that makes it especially susceptible to the effects of cannabis use. Among the adverse effects of cannabis use in adolescence and young adulthood, psychosis and psychotic disorders (e.g., schizophrenia) have been examined. The association of cannabis use with schizophrenia was first elucidated in a Swedish study of army conscripts. Specifically, conscripts reported their cannabis use exposure and were followed longitudinally to assess the emergence of schizophrenia. The authors found that those …

Gender Dysphoria Versus Acute Psychosis: Can One Properly Diagnose Gender Dysphoria Solely During Acute Psychosis?, Kristy A. Fisher, Samantha Scemla, Clara L. Alvarez Villalba, Jessica Kroin

HCA Healthcare Journal of Medicine

Gender dysphoria occurs when a discrepancy between one’s sex assigned at birth and one’s gender identity causes distress or impairment in function, which can lead ultimately to seeking treatment in the forms of psychotherapy, hormonal therapy, and/or gender-affirming surgery. Clinical care guidelines also recommend pharmacological treatment of psychiatric comorbidities if indicated. A review of the current literature demonstrates comorbidity between gender dysphoria and psychosis, including cases of gender dysphoria with schizophrenia and the occurrence of gender dysphoria symptoms during manic or psychotic episodes. The existing literature has yet to specifically examine gender dysphoria amongst individuals with schizoaffective disorder. The authors …

Through The Cracks: The Disposition Of Patients With Schizophrenia Spectrum Disorders In The Post-Asylum Era, Briana Tillman, Erin Smith, Alicia Cho, Colt Kennington, Alexandra Kreis

HCA Healthcare Journal of Medicine

This paper aims to explore current disposition options for patients with psychosis in light of shifts toward community care and changes in mental healthcare funding in the post-asylum era and to propose systemic-level improvements based upon local successes. It evaluates critiques of long-term psychiatric care programs, claims of transinstitutionalization to incarceration, shelters, and emergency rooms, and programs initiated to address deinstitutionalization. The authors conclude that while Assertive Community Treatment, Partial Hospitalization Programs, intermediate-level care, and housing interventions can improve outcomes for many persons with psychotic illness, a significant portion of these patients would still be best served in long-term psychiatric …

Schizophrenia And Social Stigma: How Society Views Those With Mental Illness, Rebecca Littrel

Undergraduate Research Symposium

Mental Illness is one of the most stigmatized diseases in the media today. Patients diagnosed with schizophrenia are more likely to have depression, more likely to commit suicide, and less likely to hold a job and be covered by insurance companies. How society views mental illness needs to change. Mental health professionals often feel stigmatized for their jobs as well.

Evaluating The Use Of Long-Acting Injectables As A Method To Improve Treatment Adherence In Patients With Schizophrenia: A Scoping Review, Britney Michelle Holton Msn, Fnp-Bc, Patricia Rena Jones-Purdy Msn, Cnrn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background Medication adherence is a major issue for patients suffering from schizophrenia and medication non-adherence can lead to psychiatric morbidity. Although long-acting injectable (LAI) antipsychotics have been shown to improve treatment adherence, most clinicians continue to rely on oral therapies to manage schizophrenia. This scoping review will assess evidence-based literature to determine the relationship between the use of LAIs and medication adherence in patients with schizophrenia.

Methods A literature review was conducted between August 2020 and January 2021 to find studies that have evaluated medication adherence with the use of long-acting injectables in patients with schizophrenia. Relevant literature initially selected …

Hallermann-Streiff Syndrome And Psychosis: A Case Report, Tarvis Peacock, Ubaid Khokhar, Jaclyn Murphy, Zach Murphy

HCA Healthcare Journal of Medicine

Hallermann-Streiff syndrome is a rare genetic congenital disorder, with fewer than 200 cases reported to date, that is characterized by brachycephaly with frontal bossing, micrognathia, a “bird-like” beaked nose, microphthalmia with congenital cataracts, dental abnormalities, hypotrichosis, skin atrophy, and short stature. There is limited data on psychosis in individuals with Hallermann-Streiff syndrome; the information available depicts mania rather than psychosis. This case report reviews the presentation and treatment of psychosis in a 32-year-old male with Hallermann-Streiff syndrome who was involuntarily admitted to an inpatient psychiatric unit for persecutory delusions and hallucinations. The patient’s psychosis responded well to risperidone with a …

Mental Health Professionals And Family Burden: Ways To Improve Training And Treatment, Johnnie Lee Jenkins, Iii

Walden Dissertations and Doctoral Studies

During deinstitutionalization, schizophrenia treatment shifted from state facilities to communities and families. This change stressed families. This study investigated mental health professionals' (MHPs) knowledge and training about this stress also called family burden (FB). The study had three research questions. These addressed MHPs’ view of FB, what barriers exist in treating FB, can multiple viewpoints define FB, and if these views influence MHPs to reduce it. This grounded theory study used 22 MHPs in seven focus groups (FGs). The participant recruitment process included email, list serves, phone calls, and one state conference. The participants were MHPs licensed for 3 years …

Among Patients With A Dual Diagnosis Of Schizophrenia And Substance Use Disorder What Current Treatments Provide Optimal Outcomes?, Drew Mcnamara

Theses and Graduate Projects

Introduction: This research was conducted on the topic of dual diagnosis (DD) patients with co-occurring schizophrenia (SZ) and substance use disorder (SUD). The research question posed for this topic: among patients with a DD of SZ and SUD what current treatments offer optimal outcomes?

Methods: The research for this paper was predominantly a literature review. Forty-five sources were utilized in its construction. The majority of sources were peer-reviewed studies obtained from an online service via the Lindell Library at Augsburg University. Three textbooks were utilized. One expert interview was conducted.

Results: Three key findings within the research identified first, SUD …

Incidence Of Cancer And Stage At Diagnosis Among People With Recent-Onset Psychotic Disorders, Jared C. Wootten

Electronic Thesis and Dissertation Repository

Evidence on cancer incidence in people with psychotic disorders, compared to the general population, is equivocal, although those with psychotic disorders so have more advanced stage of cancer at the time of diagnosis. The objective of this thesis was to compare cancer incidence and stage at diagnosis for people with psychotic disorders, relative to the general population. Our systematic review did not observe a significant difference in overall cancer incidence among people diagnosed with psychotic disorders (RR = 1.08, 95% CI: 1.00 to 1.16), however people with psychotic disorders were more likely to be present with advanced stage cancer at …

Understanding Factors Relevant To Poor Sleep And Coping Methods In People With Schizophrenia, Yen-Ching Chang, Megan C. Chang, Yun-Jou Chang, Ming-De Chen

Faculty Research, Scholarly, and Creative Activity

Background

Sleep disruption is pervasive in people with schizophrenia, but few studies have explored their sleep experiences. This study aims to identify factors relevant to sleep problems and explore coping methods used by community-dwelling people with schizophrenia.

Methods

Eighteen participants with schizophrenia were recruited from three mental health centers in Taiwan. They completed a semi-structured interview and the Pittsburgh Sleep Quality Index (PSQI) assessment. The Person-Environment-Occupation model offered a framework to assess factors related to sleep. Thematic analysis was used for the qualitative data analysis.

Results

Factors related to sleep were classified under person, environment, and occupation domains. The person …

The Efficacy Of Combination Of Psychosocial Interventions And Pharmacotherapeutic Intervention Compared To Standard Care In Patients Age 16-40 Diagnosed With Schizophrenia When Looking At Functional Capacity, Lisa Roth

Capstone Showcase

Introduction: Schizophrenia is a complex mental illness that arises from a combination of genetic factors, brain chemistry, substance use and environmental factors that affects the way a person behaves, thinks, and perceives. Schizophrenia has no cure, but it has several options for treatment including antipsychotic medications, psychotherapy, and education. Medication is frequently prescribed, and there is little evidence of how often psychotherapy is practiced to properly treat negative symptoms. The combination of these symptoms can have an impact on the functional capacity of an individual; this means that they may have less of an ability to proceed in a typical …

Schizophrenia And Genomics, Tiffini Lasch

Nursing Student Class Projects (Formerly MSN)

There are several advancements in genomics under specific categories, such as cancer and autism. Mental health is one of the leading diseases to cause a significant debt burden in today's society. However, genomics has not translated well into mental health treatment. One area of focus is schizophrenia. Those with schizophrenia suffer from severe and devastating symptoms. The symptoms can lead to harsh complications. Which can make it impossible to function in everyday life. Many believe it is not just genetics alone, but also environmental factors that contribute to schizophrenia. Through large genome-wide associated studies, discoveries are being made. There have …

Assessing The Effect Of Chronic Dopamine Receptor 2 Blockade As A Potential Model Of Secondary Negative Symptoms In Rats Using The Fr5/Chow Feeding Choice Task, Cyrene Nicholas

Honors Scholar Theses

Haloperidol, a dopamine (DA) D2 receptor antagonist, is an antipsychotic drug which is commonly used to treat schizophrenia and other psychiatric disorders. These disorders are often characterized by elevated striatal dopamine, which is speculated to have a role in producing positive symptoms such as hallucinations, delusions, and paranoia, as well as symptoms related to motivational salience and reward prediction. Individuals with schizophrenia also exhibit negative symptoms, such as amotivation, anergia, fatigue, and apathy among others. While some negative symptoms of schizophrenia are inherent to the pathophysiology, other negative symptoms are hypothesized to be partially induced by chronic exposure to antipsychotic …

Barriers That Influence The Underuse Of Mental Health Services By African Americans Diagnosed With Schizophrenia, Pamela Gail Stackhouse-Hinsey

Walden Dissertations and Doctoral Studies

African Americans diagnosed with schizophrenia have longer wait times to be treated by mental health care professionals, resulting in their underuse of mental health services. This problem has motivated medical professionals to reexamine the ways in which services are rendered and then make appropriate improvements. The purpose of the study was to explore the lived experiences of African Americans diagnosed with schizophrenia and identify the reasons for their underuse of mental health services. A phenomenological research design was used to understand and explore the participants’ lived experiences of the phenomenon. Participants were recruited from an independent living facility. Purposive sampling …

Awareness Of The Unaware: Anosognosia As A Comorbidity In Mental Health Conditions, Tiffany L. Baula

Honors Undergraduate Theses

The primary purpose of this integrative review of the literature is to describe healthcare provider’s recognition of anosognosia in individuals with comorbid mental health disorders, as a differentiating diagnosis needing preeminent early intervention. The secondary purpose is to examine how anosognosia influences outcomes in the population of individuals with severe mental illness. It is expected that early recognition by clinicians and implementation of additional interventions to address anosognosia as the most influential comorbidity of schizophrenia, will decrease exacerbations and improve treatment and patient outcomes.

A literature review exploring clinician’s acknowledgement of anosognosia was performed using various databases. Search terms included: …

Ontrack: A Program Evaluation, Justin Mynatt

Doctoral Projects

OnTrack is a program that provides coordinated specialty care (CSC) services for patients who have experienced their first episode of psychosis (FEP). Appropriately identifying and aggressively treating this vulnerable population, while providing support to both them and their families is critical for improved outcomes. Appropriate treatment of FEP patients can improve their quality of life, preserve brain matter, improve overall functioning, and lessen the burden of the clients’ family who may be involved in their care, such as caregiver strain or financial hardship. The purpose of this project is to evaluate the success of OnTrack, a FEP program, at improving …

Do Not Miss Your Shot: Improving Follow-Up In Patients Receiving Long-Acting Injectable Medications, Mary O'Hara

Doctor of Nursing Practice Final Manuscripts

Background: Serious mental illness including schizophrenia and bipolar disorder affects 1 in 24 adults in California. These chronic disorders are difficult to treat and often sabotaged by medication nonadherence. Long-acting injectable (LAI) medications are one strategy to combat medication nonadherence. Effectively providing treatment with LAI medications can be challenging at the clinic level.

Objectives: Reduce the number of days without medication by reducing the number of days between injection due date and injection administration for patients receiving LAI medications.

Design: Establish appointments for all injection visits. Standardize visit protocol for injection encounters to optimize provider time. Arrange immediate follow-up and …

Survey Of Primary Care Physicians’ And Pediatricians’ Competency In Identifying Prodromal Symptoms In Schizophrenia And Psychotic Disorders, Mark Shephard, Joanna Petrides Psy.D.

Rowan-Virtua Research Day

• To address whether primary care physicians and pediatricians are equipped to recognize the prodromal symptoms of psychotic disorders

• Patients of primary care physicians exhibited increased help seeking behaviors prior to schizophrenia diagnosis [1]

• Primary care physicians in numerous countries have shown a lack of sufficient knowledge related to diagnosing and treating schizophrenia [2,3,4,5,6]

• Unclear if primary care physicians in the United States are adequately trained and prepared to recognize prodromal signs of schizophrenia, and diagnose and treat a variety of psychotic disorders

Predicting Educational Attainment Based On Forensic Psychiatric Patients' Age At First Hospitalization, Malinda Marie Lawson

Walden Dissertations and Doctoral Studies

Education during recovery could impact a forensic psychiatric patient's community reintegration; however, individual education goals for patients can be difficult due to the lack of available parameters. The purpose of this study was to test whether age at first hospitalization is predictive of educational attainment among forensic psychiatric patients and to determine which ages of first hospitalization best predict 8 levels of educational attainment. Cattell's intelligence theory served as the theoretical framework for this study because mental illness requiring early hospitalization may affect education and learning. This quantitative, nonexperimental study involved a predictive design with data from the Canadian Institute …

Quality Of Life In Romanian Patients With Schizophrenia Based On Gender, Type Of Schizophrenia, Therapeutic Approach, And Family History, Elena Alina Rosca, Ovidiu Eugen Alexinschi, Călin Brîncuș, Valentin Petre Matei, Ana Giurgiuca

Journal of Mind and Medical Sciences

The low quality of life of patients with schizophrenia has been extensively discussed and investigated. Various aspects from gender, socio-demographic profile, and/or type of neuroleptic treatment have been taken into account in describing this condition. The purpose of this study is to assess the perceived quality of life of Romanian patients suffering from schizophrenia and to correlate it with gender differences, type of schizophrenia, family history of psychiatric illness, and type of antipsychotic treatment. 143 patients diagnosed with schizophrenia according to DSM IV-TR and ICD 10 were included in the study. Social demographic data were documented and further assessment was …