When Belief Meets Biology: Cultural Interpretations of Psychosis as Spirit Possession – A Narrative Study

Understanding and Preventing Criminal Recidivism Among Adults With Psychotic Disorders

Parole Revocation Among Prison Inmates With Psychiatric and Substance Use Disorders

Relationship Between Diabetes and Mortality Among Persons With Co-occurring Psychotic and Substance Use Disorders

Abstract: The purpose of this study was to test out the alliance and treatment adherence as explanatory factors that contribute to the effectiveness of family therapy. Seven family therapists and four clients participated voluntarily. A system for observing family therapy alliances (SOFTA-o) and self-reports (SOFTA-s) were used to measure therapeutic alliance. Therapeutic adherence was measured using a Family Therapy Adherence Scale and Goal Attainment Scale to measure outcome. Third and fifth therapy sessions were recorded and scales were applied at the end of these sessions. Findings indicated a low relationship between clients’ perception of the therapeutic alliance and therapeutic adherence, a strong relationship between therapeutic alliance, adherence and outcome was found. Clinical, training and research implications are discussed.Keywords: Therapeutic alliance, adherence, outcome, family therapy.

This abstract provides a concise overview of the prevalence of cultural beliefs and their impact on the recognition and treatment of schizophrenia symptoms in Kenya, drawing from a review of relevant literature including "A survey of psychosis risk symptoms in Kenya," "Cultural Aspects of Major Mental Disorders: A Critical Review from an Indian Perspective," "Psychotic Symptoms in Kenya – Prevalence, Risk Factors, and Relationship with Common Mental Disorders," and "Exploring mental health practice among traditional health practitioners: a qualitative study in rural Kenya." This review reveals a complex interaction between traditional cultural beliefs that are held by many Kenyan communities and Western biomedical viewpoints on schizophrenia. Results of a survey conducted in Kenya on psychosis risk symptoms highlight the substantial overlap between symptoms that are distinctive to a culture and those that meet Western psychiatric standards. This overlap emphasizes how crucial it is to use culturally aware methods when diagnosing and treating schizophrenia in Kenya. Studies conducted on psychotic symptoms in Kenya show that a significant proportion of schizophrenia patients experience symptoms that are culturally specific, such as spirit possession and witchcraft beliefs. These culturally particular symptoms frequently impact behavior related to seeking help and adhering with treatment, with traditional healers having a significant role in the treatment of mental illness. Reliance on conventional healers, however, may impede treatment outcomes for people with schizophrenia and prolong the time it takes to receive evidence-based psychiatric therapy. It is important to consider the cultural perceptions and beliefs around the symptoms of schizophrenia in Kenya highlight the critical need for culturally competent methods to mental health treatment. Schizophrenia treatment initiatives must strike a careful balance between honoring various cultural viewpoints and encouraging cooperation between conventional healers and biological professionals. The creation of culturally appropriate therapies and the improvement of mental health literacy in Kenyan communities ought to be the top priorities for future research in order to guarantee that people with schizophrenia have fair access to high-quality mental health care.

This article systematically reviews the evidence from randomized controlled trials (RCTs) for pharmacologic and psychological approaches to the treatment of cannabis use among individuals with psychotic or depressive disorders. A systematic literature search was conducted using the PubMed and PsychINFO databases from inception to December 2008. Individual searches in cannabis use (search terms: marijuana, cannabis, marijuana abuse, cannabis abuse, marijuana usage, cannabis usage), mental disorders (search terms: mood disorders, affective disorders, anxiety disorders, anxiety, depressive disorder, depression, psychotic disorders, psychosis, mental disorders), and pharmacotherapy (search terms: medication, drug therapy, pharmacotherapy, psychopharmacology, clinical trials, drug trial, treatment trial) were conducted and limited to humans, adolescents and adults. A search combining the individual cannabis use, mental disorder and pharmacotherapy searches produced 1,713 articles (PubMed = 1,398; PsychINFO = 315). Combining the cannabis use and mental disorder searches while limiting them to English articles and RCTs produced a total of 286 articles (PubMed = 228; PsychINFO = 58). From this literature, there were 7 RCTs conducted among mental health clients that reported cannabis use outcomes using pharmacologic or psychological interventions. While few RCTs have been conducted, there is evidence that pharmacologic and psychological interventions are effective for reducing cannabis use in the short-term among people with psychotic disorders or depression. Although it is difficult to make evidence-based treatment recommendations due to the paucity of research in this area, available studies indicate that effectively treating the mental health disorder with standard pharmacotherapy may be associated with a reduction in cannabis use and that longer or more intensive psychological interventions rather than brief interventions may be required, particularly among heavier users of cannabis and those with more chronic mental disorders. Specific recommendations regarding the type and length of specific psychological treatments cannot be made at this time, although motivational interviewing and cognitive-behavioral therapy approaches appear most promising.

Schizophrenia and Co-Occurring Substance Use Disorder

The aim of this study is to investigate the effect of COVID-19 pandemic and the restrictions taken on the medication, thus treatment adherence of patients with psychiatric disorders. A semi-structured form prepared by the authors and the Morisky treatment adherence scale were applied to the patients who were regularly followed up in Gaziantep University Medical Faculty Psychiatry outpatient clinic for 6 months before March 11, 2020, which was the first date of the COVID-19 case in Turkey and who visited the outpatient clinic for follow-up after the pandemic. 206 patients who met the study criteria were evaluated. Of these patients, it was found that 29 (14.1%) had their medication adherence impaired due to non-pandemic reasons. Analysis was performed with the remaining 177 patients. The average age of patients was 41.73 ± 13.48. According to the general characteristics of the participants, 117 were women and 60 men. With regard to the treatment adherence rates, 69 patients (39%) were not affected by the pandemic in which treatment adherence was high, 46 (26%) had moderate treatment adherence, and 62 (35%) showed poor treatment adherence. The comparison of patients in terms of treatment adherence according to their diagnosis revealed no statistically significant difference (p = 0.100). To the best of our knowledge, this is the first study investigating the medication (treatment) adherence of patients with psychiatric disorders who were on treatment before the pandemic. Studies with large samples are warranted to better understand the effect of the pandemic on treatment adherence.

Health, Mental Health, Substance use, and Service Utilization among Rural and Urban Incarcerated Women

Working alliance and its relationship with treatment outcome

Examining the Relation Between the Therapeutic Alliance, Treatment Adherence, and Outcome of Cognitive Behavioral Therapy for Children With Anxiety Disorders

Aims: Menstrual irregularities (MI) are a frequently overlooked yet clinically significant concern among women with psychiatric disorders. Several psychiatric conditions, particularly schizophrenia and bipolar disorder, involve dopaminergic dysregulation, which may contribute to hormonal disturbances. Antipsychotic medications, especially typical antipsychotics, are known to impact menstrual cycles through their effects on dopamine pathways, leading to hyperprolactinemia and subsequent menstrual dysfunction. However, research on the prevalence of MI and its relationship with psychiatric illness and treatment adherence remains limited, particularly in the Indian context. This study aims to assess the prevalence of MI among female psychiatric inpatients and explore its association with socio-clinical factors, antipsychotic medication use, and treatment adherence.Methods: A cross-sectional study was conducted at a tertiary care mental health institute, recruiting 100 female inpatients diagnosed with psychiatric disorders. MI was defined as any deviation from a regular menstrual cycle, including oligomenorrhea, amenorrhea, or irregular bleeding. Menstrual distress was assessed using the MEDI-Q (Menstrual Distress Questionnaire) scale, while treatment adherence was evaluated with the Brief Adherence Rating Scale (BARS). Statistical analysis examined associations between MI, antipsychotic use, prolactin levels, psychiatric diagnosis, and treatment adherence.Results: The mean age of participants was 36.5 years, with an average illness duration of 3.6 years. Psychiatric diagnoses included psychotic disorders (62%), bipolar disorder (22%), depressive disorder (10%), and neurotic disorders (6%). Antipsychotic medication use was recorded in 82% of participants. The overall prevalence of MI was 37%. Among patients with psychotic disorders, 50% exhibited MI, with a significantly higher prevalence in those on typical antipsychotics (80.7%) compared with atypical antipsychotics (27.7%). MI was also observed in 31.5% of bipolar patients on atypical antipsychotics. Patients with poor treatment adherence (<50% on BARS – Brief Adherence Rating Scale) showed significantly higher score for MEDI-Q Total Score (16.51 ± 12.99 vs. 10.86 ± 12.36; p < 0.01) as well as for the subscales MSD (Menstrual Symptom Distress) and MESI (Menstrual Specificity Index). The menstrual distress was associated to being on antipsychotics; in fact, MEDI-Q Total Score was significantly higher in women on antipsychotics as compared with those not on antipsychotics.Conclusion: Menstrual irregularities are prevalent among female psychiatric inpatients, particularly those with psychotic disorders and those on typical antipsychotics. These disturbances negatively impact medication adherence, highlighting the need for routine menstrual health assessments, prolactin monitoring, and personalized treatment approaches to balance psychiatric stability with reproductive health. Addressing patient concerns regarding menstrual side effects may improve adherence and overall treatment outcomes.

Background: Mental illness is multifactorial in its occurrence varying from place to place, thereby listing different opinions among communities. Religious, cultural beliefs play an important role in the perception of mental illness. This study aims to understand the community perceptions of urban, rural, and tribal areas and associate with sociodemographic factors. Aims: (1) To explore the knowledge, attitude, cultural beliefs, and practices with regard to mental illness among urban, rural, and tribal population of Mysuru. (2) To compare the knowledge, attitude, cultural beliefs, and practices with regard to mental illness among urban, rural and tribal population of Mysuru. Materials and Methods: Study design: It was a cross-sectional study conducted between January 2021 and March 2021 in urban (n = 100), Rural (n = 100), and Tribal (n = 100) field practise areas in Mysuru district among participants aged >18 years. A semi-structured questionnaire regarding their attitude, beliefs, and understanding about mental illness was drafted, and data were obtained from participants after taking their informed consent. Ethical clearance was obtained from the institute. Statistics: Chi-square analysis was done to see the association between sociodemographic variables and perceptions. Results: Participants held different opinions across three different zones. A significant association was seen between their age, place, education, occupation, and type of family with their perception about mental illness. Conclusion: We can conclude that age, place, education, and occupation play an important role in the varied perception regarding mental illness. Continuous and focused interventions have to be done among the community for a positive acceptance and reducing stigma toward mental illness.

This study examined medical emergency department utilization for patterns among uninsured patients with psychiatric disorders. Billing records of 15,672 uninsured adult patients treated in the emergency department of an academic medical center in southeast Texas over a 12-month period were analyzed for information on demographic characteristics, diagnosis, number of emergency department visits, and hospitalization. Overall, 11.8% of the population was diagnosed as having at least one psychiatric disorder during an emergency department visit. Patients with psychiatric disorders had an increased risk of having multiple emergency department visits and hospitalization compared with patients without psychiatric disorders. The risk of multiple emergency department visits was particularly high for patients with either bipolar disorder or psychotic disorders. Uninsured patients with psychiatric disorders appear to be heavy users of medical emergency department services. These findings may be helpful in developing more efficient strategies to serve the mental health needs of the uninsured.

Impact of a Mental Health Training Course for Correctional Officers on a Special Housing Unit