Psychiatric and Mental Health Commons^™

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 …

An Interventional Pilot Of Customized Adherence Enhancement Combined With Long-Acting Injectable Antipsychotic Medication (Cae-L) For Poorly Adherent Patients With Chronic Psychotic Disorder In Tanzania, Christopher J. Burant, Carol E. Blixen, Kristin A. Cassidy, Jennifer B. Levin, Martha Sajatovic

Faculty Scholarship

Background: Chronic psychotic disorders (CPD) impose a particularly significant burden in resource-limited settings. Combining long-acting antipsychotic medication (LAI) with a customized adherence enhancement intervention (CAE-L) has potential to advance care. Methods: Nineteen adults ≥ age 18 with CPD who self-reported missing ≥20% of antipsychotic medication within the last month were stabilized on oral haloperidol prior to transitioning to monthly haloperidol decanote for 25 weeks. Outcome evaluations were conducted at baseline and Week 25. Primary outcomes were oral medication adherence assessed via the Tablet Routines Questionnaire (TRQ) and LAI injection frequency. Secondary outcomes included CPD symptoms measured by the Brief Psychiatric …

The Rhythm Of Your Life: The Effects Of Daily Routine On Mental Health, Kristen Brown

Graduate Research Projects

No abstract provided.

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 …

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 …

Alcohol Use In Tanzanians With Chronic Psychotic Disorders And Poor Medication Adherence, Emily Simon, Jennifer B. Levin, Carol Blixen, Michelle Aebi, Kristin Cassidy, Martha Sajatovic

Faculty Scholarship

Background: The burden of chronic psychotic disorders (CPDs) in sub-Saharan Africa (SSA) is significant. Poorly medically adherent patients are more likely to have worse outcomes and require more resources. However, factors impacting effective treatment of CPD in this population are unclear. Aim: Examine the relationship between alcohol use and disease management and compare alcohol risk stratification between the Alcohol Use Disorders Identification Test (AUDIT) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in poorly medication adherent Tanzanians with CPD. Setting: Muhimbili National Hospital and ambulatory clinics in Dar es Salaam, Tanzania. Methods: 100 Tanzanians with CPDs and suboptimal medication …

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 …

Antipsychotic Treatment Experiences Of People With Schizophrenia: Patient Perspectives From An Online Survey, Martha Sajatovic

Faculty Scholarship

Background: This survey examined the experiences of people living with schizophrenia who have used oral antipsychotics (APs). Methods: Adults with self-reported physician-diagnosed schizophrenia (N=200), who were members of an online research participation panel and reported taking one or more oral APs within the last year, completed a cross-sectional online survey that focused on direct report of their experiences regarding APs (eg, symptoms, side effects, adherence). Descriptive analyses were conducted for the total survey sample and for subgroups defined a priori by experience with specific, prevalent side effects. Results: The mean age of the sample was 41.9 (SD=11.0) years, 50% of …

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 …

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: …

Correlates Of Poor Medication Adherence In Chronic Psychotic Disorders, Martha Sajatovic, Carol Blixen, Michelle E. Aebi, Betsy Wilson, Christopher J. Burant, Kristin A. Cassidy, Jennifer B. Levine

Faculty Scholarship

Background Chronic psychotic disorders (CPDs) occur worldwide and cause significant burden. Poor medication adherence is pervasive, but has not been well studied in sub-Saharan Africa. Aims This cross-sectional survey of 100 poorly adherent Tanzanian patients with CPD characterised clinical features associated with poor adherence. Method Descriptive statistics characterised demographic and clinical variables, including barriers to adherence, adherence behaviours and attitudes, and psychiatric symptoms. Measures included the Tablets Routine Questionnaire, Drug Attitudes Inventory, the Brief Psychiatric Rating Scale, the Clinical Global Impressions scale, the Alcohol Use Disorders Identification Test and Alcohol, Smoking and Substance Involvement Screening Test. The relationship between adherence …

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 …

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

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 …

Perspectives Of Older Blacks And Whites Living With Serious Mental Illness About Outpatient Mental Health Services, Rosalyn Roker

USF Tampa Graduate Theses and Dissertations

In the United States, over three million adults, age 50 and older, reported a diagnosis of serious mental illness (SMI) in the past year. Most of them live in community-settings and are less likely than younger adults to utilize mental health treatment. Lack of and insufficient treatment for SMI places them at increased risk of morbidity, earlier mortality, cognitive decline, and diminished quality of life. The current study aimed to: (1) examine the factors that influence Black and White older adults, who live with SMI, to seek and engage in outpatient mental health treatment; (2) identify the perspectives of Black …

Initiating/Maintaining Long-Acting Injectable Antipsychotics In Schizophrenia/Schizoaffective Or Bipolar Disorder – Expert Consensus Survey Part 2, Martha Sajatovic

Faculty Scholarship

Objective: The aim of this study was to provide recommendations on initiating and maintaining long-acting injectable antipsychotics (LAIs) in individuals with schizophrenia/schizoaffective or bipolar disorder. Methods: A 50-question survey comprising 916 response options was completed by 34 expert researchers and high prescribers with extensive LAI experience, rating relative appropriateness/importance on a 9-point scale. Consensus was determined using chi-square test of score distributions. Results of 21 questions comprising 339 response options regarding LAI initiation, maintenance treatment, adequate trial definition, identifying treatment nonresponse, and switching are reported. Results: Experts agreed that the most important LAI selection factor was patient response/tolerability to previous …

Identifying Patients And Clinical Scenarios For Use Of Long-Acting Injectable Antipsychotics – Expert Consensus Survey Part 1, Martha Sajatovic

Faculty Scholarship

Objective: To assess expert consensus on barriers and facilitators for long-acting injectable antipsychotic (LAI) use and provide clinical recommendations on issues where clinical evidence is lacking, including identifying appropriate clinical situations for LAI use. Methods: A 50-question survey comprising 916 response options was distributed to 42 research experts and high prescribers with extensive LAI experience. Respondents rated options on relative appropriateness/importance using a 9-point scale. Consensus was determined using chi-square test of score distributions. Mean (standard deviation) ratings were calculated. Responses to 29 questions (577 options) relating to appropriate patients and clinical scenarios for LAI use are reported. Results: Recommendations …

Multinational Comparative Cross-Sectional Survey Of Views Of Medical Students About Acceptable Terminology And Subgroups In Schizophrenia, Shanaya Rathod, Muhammad Irfan, Rachna Bhargava, Narsimha Pinninti, Joseph Scott, Haifa Mohammad Algahtani, Zhihua Guo, Rishab Gupta, Pallavi Nadkarni, Farooq Naeem, Fleur Howells, Katherine Sorsdahi, Kerensa Thorne, Victoria Osman-Hicks, Sasee Pallikadavath, Peter Phiri, Hannah Carr, Lizi Graves, David Kingdon

Rowan-Virtua School of Osteopathic Medicine Departmental Research

AIM: The aim of this study was to inform thinking around the terminology for 'schizophrenia' in different countries.

OBJECTIVES: The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma.

DESIGN: This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups.

SETTING: The study …

Neurocognitive Markers Of Cognitive Control In Schizophrenia And Functional Outcomes, Sephira Ryman

Psychology ETDs

Impaired cognitive function results in decreased objective quality of life and community functioning in schizophrenia, resulting in the largest indirect costs from the disease. Disrupted proactive cognitive control, a form of early selection and active goal maintenance, is hypothesized to underlie the broad cognitive deficits observed in patients with schizophrenia. The current study utilized novel electrophysiological (EEG) analytic approach to examine proactive and reactive cognitive control deficits in schizophrenia patients. Behavioral results highlight that patients exhibited a general reduction in reaction time across two multisensory cognitive control tasks, with selective deficits on proactive conditions relative to reactive conditions. The relative …

Association Between A Single Nucleotide Polymorphism In Neuregulin-1 And Schizophrenia In Pakistani Patients, Haider Ali Naqvi, Shafqat Huma, Hira Waseem, Kashaf Aqeel Zaidi, Hina Saeed Zuberi, Syed Hani Abidi

Department of Biological & Biomedical Sciences

Objective: To determine the association of single-nucleotide polymorphism8nrg433E1006 in the neuregulin-1 gene associated with schizophrenia.
Methods: This case-control study was conducted at the Fountain House, Lahore, and the psychiatric clinics at the Aga Khan University, Karachi, from 2010 to 2013.The total genomic deoxyribonucleic acid was isolated and single-nucleotide polymorphism8nrg433E1006 was screened by nested polymerase chain reaction followed by sequencing. These sequences, from patients and controls, were aligned with the human neuregulin-1-glial growth factor 2 gene sequence, which served as a reference sequence. The single nucleotide polymorphism genetic algorithm was characterised at position 433 in the neuregulin-1 gene by …

Effort-Related Decision Making In Comt Variant Mice: Pharmacological Studies And Genetic Susceptibility To Motivational Dysfunction, Suzanne Cayer

Honors Scholar Theses

Effort-related decision making tasks in animals can model motivational symptoms in humans, which are a set of symptoms spanning a multitude of neuropsychiatric disorders, such as major depressive disorder and the negative symptoms of schizophrenia. The present studies aimed to evaluate the effort-related effects of the Val158Met polymorphism of human catechol-methyltransferase (COMT), by testing mice carrying either the human COMT Val (n=8) or Met allele (n=8) with Wild-Type control mice (n=15) by using concurrent FR2 and FR4/pellet choice tasks in a touchscreen operant conditioning apparatus. The Val158Met polymorphism has been repeatedly associated with neuropsychiatric disorders, and the Val allele has …