Comprehensive Psychosocial Intervention Research Articles

Self-Stigma in Patients with Endogenous Mental Disorders: A Cross-Sectional Comparative Study

BACKGROUND: Self-stigma remains one of the most vexing issues in psychiatry. It complicates the treatment and social functioning of patients with endogenous psychiatric disorders. Identifying the specific features of self-stigma depending on the type and duration of the endogenous mental illness can help solve this problem.
 AIM: The aim of this study was to establish the level and specific features of self-stigma in patients with various types of chronic endogenous psychiatric disorders at different disease stages and to establish the correlation between the level of self-stigma and the attitude of the patient to his/her disease and treatment.
 METHODS: Clinical psychopathology assessment, psychometric scales and questionnaires: “Positive and Negative Syndrome Scale” (PANSS), “Questionnaire for Self-Stigma Assessment in Mentally Ill Patients”, and Russian versions of the “Insight Scale for Psychosis” (ISP), and “Drug Attitude Inventory” (DAI-10). The cross-sectional study included 86 patients with endogenous mental illnesses (bipolar affective disorder and schizophrenia spectrum disorders.
 RESULTS: The analysis of the results of the “Questionnaire for Self-Stigma Assessment in Mentally Ill Patients” showed that at the initial disease stages the highest level of self-stigma is observed in patients with bipolar affective disorder (M±σ=1.22±0.73; Me [Q1; Q3]=1.10 [0.83; 1.60]), while the lowest level was observed in patients with schizophrenia spectrum disorders (M±σ=0.86±0.53; Me [Q1; Q3]=0.77 [0.31; 1.25]). Patients with schizophrenia and schizoaffective disorder and a disease duration more than five years participating in a long-term comprehensive psychosocial rehabilitation program also demonstrated high rates of self-stigma (M±σ=1.20±0.57, Me [Q1; Q3]=1.26 [0.89; 1.47]). The study groups showed differences in terms of the structure of components of self-stigma and their severity; significant correlations were uncovered between the self-stigma parameters and the attitude of patients to their disease and therapy.
 CONCLUSION: The results of this study contribute to a better understanding of the specific features of self-stigma in patients with various endogenous disorders at different stages of the disease. These data can be used as part of a comprehensive psychosocial treatment program for this patient cohort, as well as for future research.

Persons with mental disorders and assisted dying practices in Spain: In response to Ramos et al.

Ramos et al. paper offers a narrative review of Spanish Organic Law 3/2021, which regulates euthanasia, focusing on its application to individuals with mental disorders. Ramos et al. examine the application of legal prerequisites from an ethical-legal perspective to ascertain the conditions under which psychiatric euthanasia might be considered legitimate and compliant with legal stipulations. Nevertheless, it is apparent that the core ethical inquiries linked to this matter have not been exhaustively investigated. The criteria laid out are, in our assessment, still open to further debate and broader deliberation. Our article emphasizes the need for a comprehensive ethical and legal debate in Spain regarding psychiatric euthanasia. Competency assessment is central to the legislation, but there are concerns about the validity of assessment tools and the subjective nature of interviews. Furthermore, defining irreversible suffering in mental health contexts poses challenges. The article advocates for a deeper understanding of the needs of individuals with mental disorders before considering euthanasia and emphasizes the importance of comprehensive care and psychosocial interventions in reducing the desire for euthanasia. Ultimately, it underscores the ethical complexities of euthanasia in mental health and the necessity of prioritizing comprehensive care in addressing these complexities.

Psychosocial and digital intervention for patients with schizophrenia

Background: Schizophrenia is a severe mental disorder that significantly impairs the daily functioning of patients that causes substantial societal and economic burden. While drug therapy is crucial for schizophrenia treatment, relying solely on antipsychotic drugs does not yield the most favorable therapeutic outcomes.Current Concepts: Integrating psychosocial interventions could result in maximized therapeutic effects for individuals living with schizophrenia. Evidence-based psychosocial interventions for schizophrenia management include cognitive behavioral therapy, family involvement, psychoeducation, supported employment programs, lifestyle adjustments for physical health, and coordinated and comprehensive early intervention services. Incorporating peer support, allowing both service users and care providers to share knowledge and their illnessrelated personal experiences, facilitates mutual assistance along the path to recovery. Moreover, growing interest follows in using digital interventions, such as wearable technology and smartphone applications, as effective therapeutic tools for illness management.Discussion and Conclusion: The above-mentioned psychosocial interventions empower individuals with schizophrenia, helping them improve their functioning, enhance their life quality, and adapt more effectively to society. Combining early medication with comprehensive psychosocial interventions, including digital technology, is crucial for the best outcomes. This approach should begin as soon as schizophrenia is diagnosed, aiming to promote recovery and overall well-being in affected individuals.

Predictors of long-stay in a tertiary care psychiatry hospital in India.

Many psychiatric patients continue to stay for longer duration in psychiatric institutions. Community reintegration and rehabilitation of such patients needs to be explored to ensure appropriate bed occupancy rates and access to in-patient care for newer patients in need of the same. The aim is to identify the risk and protective factors leading to long-term admission of mentally ill patients in tertiary care hospital. A cross-sectional study was conducted with all patients in the long-stay ward between May 2018 and February 2023. A retrospective chart review followed by cross sectional assessment of risks and disability was carried out with all the patients living in a long-stay psychiatric ward (N = 101) at a tertiary hospital in Bangalore, India, between May 2018 and February 2023. The hospital's average length of stay (LOS) was 5.70 ± 8.30 years. The risk and protective factors for LOS in psychiatric hospitals were analyzed using the Poisson Regression model. The results revealed that the male gender, diagnosis of schizophrenia or psychosis, clinicians' knowledge of family information, good clinical improvement, and higher participation in ward activities are the protective factors for a shorter hospital stay. While higher age, family history of mental illness, being married and employed, absence of children, and/or having family members rarely visiting the patient at the hospital were some factors that increased the risk of LOS. This study highlighted the importance of possible LOS predictors in the tertiary care psychiatric hospital. The multi-disciplinary team may utilize risk and protective factors for delayed LOS to introduce comprehensive psychosocial interventions and policies that reduce the risk of delays or length of stay in mental health hospitals.

Child maltreatment mediates the relationship between HIV/AIDS family dysfunction trajectories and psychosocial problems among adolescents.

The relationship between parental HIV/AIDS status or death and child mental health is well known, although the role of child maltreatment as a confounder or mediator in this relationship remains uncertain. This study examined the potential path mechanism through child maltreatment mediating the link between HIV/AIDS family dysfunction trajectories and psychosocial problems. A cross-sectional survey was conducted in the Lower Manya Municipal Assembly of Ghana. A questionnaire which consisted of the Strengths and Difficulties Questionnaire (SDQ), Social and Health Assessment (SAHA), Rosenberg Self-Esteem Scale (RSES) and the Conflict Tactics Scale (CTS) was completed by 291 adolescents. Controlling for relevant sociodemographic confounders, mediation analyses using linear regression were fitted to examine whether the association between family dysfunction and psychosocial problems is mediated by child maltreatment. The results indicate that, among adolescents, child maltreatment fully mediated the association between being orphaned by AIDS and self-esteem (b = .59 [95%CI .32, .91]), delinquency and risky behaviours (b = .56 [95%CI .31, .86]) and peer problems (b = .74 [95%CI .48, 1.03]). Similarly, child maltreatment fully mediated the association between living with an HIV/AIDS-infected parent and self-esteem (b = .78 [95%CI .43, 1.23]), delinquency and risky behaviours (b = .76 [95%CI .45, 1.11]), depression/emotional problems (b = .64 [95%CI .40, .92]) and peer problems (b = .94 [95%CI .66, 1.26]). Partial mediation was found for hyperactivity. Child maltreatment mediates the association between the family dysfunction trajectories of parental HIV/AIDS or death and psychosocial problems among adolescents. This implies that efforts to address child maltreatment among families affected by HIV/AIDS may be helpful in the prevention of psychosocial problems among these children, thus enhancing their wellbeing. The findings therefore underscore the need for comprehensive psychosocial interventions that addresses both the unique negative exposures of HIV/AIDS and maltreatment for children affected by HIV.

Challenges of using a Fitbit smart wearable among people with dementia.

Limited research on using smart wearables such as Fitbit devices among people with dementia has shown favourable outcomes. The aim of this study was to explore the acceptability and feasibility of using a Fitbit Charge 3 among people with dementia, living in the community, who took part in the physical exercise component of the Comprehensive REsilience-building psychoSocial intervenTion pilot study. A mixed methods study was conducted; Quantitative data relating to wear rates for the Fitbit were recorded and qualitative data were collected by group and individual interviews with the people with dementia and their caregiver about their experience of wearing/using the Fitbit in the study. Nine people with dementia and their caregiver completed the intervention. Only one participant wore the Fitbit consistently. Supporting set-up and use of the devices was time consuming and caregiver involvement was essential for day-to-day support: none of the people with dementia owned a smartphone. Few of them engaged with the Fitbit features, primarily only using it to check the time and only a minority wanted to keep the device beyond the intervention. When designing a study using smart wearables such as a Fitbit among people with dementia, consideration should be given to the following: the possible burden on caregivers supporting the use of the device; a lack of familiarity with this technology in the target population; dealing with missing data, and the involvement of the researcher in setting up and supporting use of the device.

Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers.

Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model. The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention. The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful. Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.

Commentary on Nikoo et al.: Challenges in protocol development to optimize outcomes of opium tincture maintenance treatment.

Commentary on Nikoo et al.: Challenges in protocol development to optimize outcomes of opium tincture maintenance treatment.

Trends in Insomnia, Burnout, and Functional Impairment among Health Care Providers over the First Year of the COVID-19 Pandemic.

COVID-19 pandemic has negatively impacted the psychological well-being and quality of life of health care providers (HCPs). This study assessed the trends in prevalence and predictors of insomnia, burnout, and functional impairment among HCPs over the first year of the pandemic. An online survey was conducted one month after the pandemic's onset (onset group) and a year later (one-year group). The demographic features of participants were collected. Insomnia, burnout, and functional impairment were assessed using Insomnia Severity Index (ISI), Mini-Z survey, and Sheehan Disability Scale (SDS), respectively. The onset group included 211 HCPs (mean (SD) age 34.7 (9.3) years and 73% men), while 212 HCPs participated in the one-year survey (mean (SD) age 35.9 (10.5) years and 69% men). High prevalence estimates were found in both onset and one-year groups of symptoms of insomnia (52% vs. 49%), of diagnosis of clinical insomnia (15% vs. 18%), with a high mean ISI score (8.4 vs. 8.7), but with no significant difference between the onset and one-year groups. Risk factors for clinical insomnia included age in both groups, lower income and contact level with COVID-19 patients/samples in the onset group, and lower Mini-Z scores and higher SDS scores in the one-year group. Approximately one-third of respondents reported at least one or more burnout symptoms, with a higher percentage in the one-year group (35.4%) than in the onset group (24.2%) (p=0.012). Younger age, lower monthly income, and higher ISI and SDS scores were risk factors for burnout in both groups. Greater perceived changes in social life were associated with burnout in the onset group. In contrast, higher weekly working hours, worse participants' evaluation of their institution's preparation, and more changes in workload were risk factors for burnout in the one-year group. The SDS score and its subscales scores were higher in the one-year group than in the onset group. Changes in workload and social life predicted higher SDS scores among both groups. Living with older people predicted higher SDS scores among the onset group, while contact level and estimated number of COVID-19 patients that participants engaged in during caring predicted higher SDS scores among the one-year group. ISI scores were significantly correlated with the Mini-Z scores and SDS scores in both groups, while the Mini-Z and SDS scores were significantly correlated only in the one-year group. This study demonstrated high rates of insomnia, burnout, and functional impairment among HCPs during the pandemic. It reveals a significant rise in job burnout and functional impairment of HCPs overtime during the pandemic. Furthermore, high-risk subgroups are also highlighted for whom comprehensive psychosocial and occupational interventions might be warranted.

Compensatory Health Beliefs, Locus of Control, Social Support and Quality of Life in Oil Spills-Prone Environment

Abstract The role of compensatory health beliefs, locus of control and social support on quality of life in oil-spills prone environment in developing countries, especially Nigeria has not been explicated. This study examined the role of compensatory health beliefs, locus of control and social support on quality of life among 453 (age 21-50 years; M= 36.02; SD = 12.04) residents in Ilaje and Ese-Odo Local Government Area (LGA’s) in Ondo State of Nigeria. A purposive sampling technique was adopted in selecting participants. Data were collected through a self-administered questionnaire that measured socio-demographics, compensatory health beliefs, locus of control, social support and quality of life. Results revealed that compensatory health beliefs predict quality of life in the study area. Also, social support contributes to quality of life. We suggest that a comprehensive psychosocial intervention program should be carried out to improve quality of life in oil spill-prone communities.

523 - The design and implementation of Comprehensive Resilience-building psychosocial Intervention (CREST) for people with memory problems/dementia in the community: a pilot study

Background:In Ireland, approximately 65,000 people live with memory problems/dementia (PWMP). Most live in the community, supported by informal caregivers such as relatives. A comprehensive resilience-building psychosocial intervention (CREST) to strengthen intra- and interpersonal resources was piloted by PWMP and caregiver dyads, local GPs, and the community.Methodology:An advisory forum of PWMP, caregivers, and dementia advocacy representatives provided guidance on the intervention design and materials (e.g., interview guides), to ensure they addressed the needs of PWMP and caregivers. The 15-week CREST intervention comprised three components: cognitive stimulation therapy for PWMP (CST; 7 weeks), physical exercise for PWMP and partners from the community (8 weeks), and dementia education for key supporters of PWMP: caregivers (6 weeks), GPs, and the community (one-off events). Intervention processes (e.g., recruitment, data collection measures) were evaluated at each stage by PWMP and caregivers through qualitative (verbal feedback, interviews) and quantitative methods (ratings, questionnaires), to ensure they were feasible and acceptable.Findings:Nine PWMP/caregiver dyads were recruited and completed the CREST intervention; attendance was consistently high (90-95%) throughout. The dyads reported that the recruitment materials, phone calls, and letters from the research team were helpful and easy to understand. Feedback from PWMP, caregivers, event attendees, and programme facilitators confirmed that the intervention content and delivery were acceptable. Minor changes were recommended, and changes which facilitated participation by the PWMP during this pilot (e.g., giving verbal rather than written feedback, larger-print handouts) were implemented immediately. The PWMP enjoyed the CST activities (e.g., collages, tasting childhood sweets) and the “bit of fun” the group shared; some also perceived improvements in concentration and confidence. The PWMP enjoyed the group Exercise sessions, particularly the social aspects (e.g., “banter”, exercising with partners), and some reported improved fitness and feeling less breathless. Caregivers felt better informed about managing dementia and communicating with PWMP and enjoyed sharing experiences with other caregivers. Attendees at the community and GP education events reported improved knowledge of dementia.Conclusion:The involvement of the PWMP and caregivers was valuable to the iteration of the pilot CREST intervention. Consultations with both groups are ongoing to inform future research priorities.

Repeat self-harm among Chinese adolescents: 1-year incidence and psychosocial predictors.

Self-harm in adolescents is prevalent and is the most significant predictor of future self-harm and suicide. Longitudinal data on the incidence and predictors of repeat self-harm in the general population of adolescents are limited. This study investigated 1-year incidence and psychosocial predictors of repeat self-harm in Chinese adolescents. Shandong Adolescent Behavior and Health Cohort is a longitudinal study of behavior and health in adolescents in Shandong Province, China. Of 7072 participants who were assessed in 2015 and again 1year later in 2016, 1879 reported a history of self-harm at the baseline survey and were included for this analysis. A self-administered structured questionnaire was used to assess behavioral and emotionalproblems, sleep, life stress, previous history of self-harm and suicidal thought, and family factors at baseline and self-harm at 1-year follow-up. Mean age of the sample was 14.86 (SD 1.36) years and 54.6% were female. At 1-year follow-up, 22.1% participants engaged in repeat self-harm. Multiple logistic regression analyses showed that female gender (OR 1.45, 95% CI 1.11-1.89), alcohol use (OR 1.95, 95% CI 1.48-2.57), frequent nightmares (OR 1.61, 95% CI 1.14-2.28), elevated depression score (OR 1.59, 95% CI 1.05-2.42), and prior suicidal thought (OR 1.79, 95% CI 1.37-2.34) were independently and significantly associated with an increased risk of repeat self-harm. More than one in five Chinese adolescents who had a history of self-harm engaged in self-harm at 1-year follow-up. Multiple psychosocial factors including female gender, alcohol use, frequent nightmares, depression, and prior suicidal thought appeared to be significant predictors of repeat self-harm. Our findings highlight the importance of comprehensive psychosocial assessment and intervention of repeat self-harm in adolescents.

The feasibility of a Comprehensive Resilience-building psychosocial Intervention (CREST) for people with dementia in the community: protocol for a non-randomised feasibility study

BackgroundA dementia diagnosis can prevent people from participating in society, leading to a further decline in cognitive, social and physical health. However, it may be possible for people with dementia to continue to live meaningful lives and continue to participate actively in society if a supportive psychosocial environment exists. Resilience theory, which focuses on strengthening personal attributes and external assets in the face of serious challenges, may provide a scaffold on which an inclusive multifaceted psychosocial supportive environment can be built. This protocol paper describes a study to determine the feasibility of conducting a multifaceted complex resilience building psychosocial intervention for people with dementia and their caregivers living in the community.MethodsThis is a non-randomised feasibility study. Ten participants with dementia and their primary caregivers living in the community will be recruited and receive the CREST intervention. The intervention provides (a) a 7-week cognitive stimulation programme followed by an 8-week physical exercise programme for people with dementia and (b) a 6-week educational programme for caregivers. Members of the wider community will be invited to a dementia awareness programme and GP practices to a dementia training workshop. Trained professionals will deliver all intervention components. Outcomes will assess the feasibility and acceptability of all study processes. The feasibility and acceptability of a range of outcomes to be collected in a future definitive trial, including economic measurements, will also be explored. Finally, social marketing will be used to map a route toward stigma change in dementia for use in a subsequent trial. Quantitative feasibility outcome assessments will be completed at baseline and after completion of the 15-week intervention while qualitative data will be collected at recruitment, baseline, during and post-intervention delivery.ConclusionThis feasibility study will provide evidence regarding the feasibility and acceptability of a comprehensive multifaceted psychosocial intervention programme for people with dementia and their caregivers (CREST). The results will be used to inform the development and implementation of a subsequent RCT, should the findings support feasibility.Trial registrationISRCTN25294519 Retrospectively registered 07.10.2019

341 - Exploring the feasibility and acceptability of a Comprehensive Resilience-building psychosocial intervention (CREST) for people with dementia in the community: a non-randomised feasibility study

Presenting Author: Priscilla Doyle, MAOrganisation: National University of Ireland Galway, Galway city, Galway, IrelandCo-Authors:Name: Niamh GallagherDegrees: B.A (International), M.A Health PromotionOrganisation: National University of Ireland Galway, Galway city, Galway, IrelandName: Siobhán SmythDegrees: RPN, PhDOrganisation: National University of Ireland Galway, Galway city, Galway, IrelandName: Dympna CaseyDegrees: RGN, BA, MA, PhdOrganisation: National University of Ireland Galway, Galway city, Galway, IrelandBackground:A dementia diagnosis can prevent people from participating in society, leading to a further decline in cognitive, social and physical health. However, it may be possible for people with dementia to continue to live meaningful lives and continue to participate actively in society if a supportive psychosocial environment exists. This feasibility study seeks to create such an environment by determining the feasibility of conducting a multifaceted complex resilience-building psychosocial intervention for people with dementia and their caregivers living in the community.Method:Ten participants with dementia and their primary caregivers living in the community were recruited and received the CREST intervention. The intervention provided (a) a 7-week cognitive stimulation programme (CST) followed by an 8-week physical exercise programme for people with dementia and (b) a 6-week educational programme for caregivers. Members of the wider community were invited to a dementia awareness programme and GP practices to a dementia-training workshop. Trained professionals delivered all intervention components. Outcomes assessed the feasibility and acceptability of all study processes such as: recruitment; intervention content and delivery; and data collection methods.Results:Recruiting participants was difficult, with local community organisations/groups proving more successful than GP practices. Preliminary results indicate that participants (people with dementia and carers) enjoyed the content of the CREST intervention, that the delivery method and timing worked well and overall found the programme beneficial. Carers reported that the educational programme provided them with valuable information which was accessible and easy to understand. However, the group activities and learning from each other was identified as crucial to their enjoyment and learning. The people with dementia likewise enjoyed the CST and exercise components, some reporting that the CST enhanced their concentration and that exercising with an exercise buddy was more sociable and enjoyable.Conclusion:The evidence from participants indicates that CREST is feasible and acceptable to carers and people with dementia in the community.

Implementation and Evaluation of a Psychoactive Substance Use Intervention for Children in Afghanistan: Differences Between Girls and Boys at Treatment Entry and in Response to Treatment.

Psychoactive substance use among children in Afghanistan is an issue of concern. Somewhere around 300,000 children in the country have been exposed to opioids that either parents directly provided to them or by passive exposure. Evidence-based and culturally appropriate drug prevention and treatment programs are needed for children and families. The goals of this study were to: (1) examine lifetime psychoactive substance use in girls and boys at treatment entry; and (2) examine differential changes in substance use during and following treatment between girls and boys. Children ages 10-17 years old entering residential treatment were administered the Alcohol, Smoking and Substance Involvement Screening Test for Youth (ASSIST-Y) at pre- and post-treatment, and at three-month follow-up. Residential treatment was 45 days for children and 180 days for adolescents and consisted of a comprehensive psychosocial intervention that included education, life skills, individual and group counseling and, for older adolescents, vocational skills such as embroidery and tailoring. Girls and boys were significantly different regarding lifetime use of five substances at treatment entry, with girls less likely than boys to have used tobacco, cannabis, stimulants, and alcohol, and girls more likely than boys to have used sedatives. Differences between boys and girls were found for past-three-month use of four substances at treatment entry, with girls entering treatment with higher past-three-month use of opioids and sedatives, and boys with higher past-three-month use of tobacco, cannabis, and alcohol. Change over the course of treatment showed a general decline for both girls and boys in the use of these substances. Girls and boys in Afghanistan come to treatment with different substance use histories and differences in past-three-month use. Treatment of children for substance use problems must be sensitive to possible differences between girls and boys in substance use history.

LIVING WITH DIABETES MELLITUS II: IMPACTS ON NEUROPSYCHOLOGICAL FUNCTIONING DEPRESSION AND QUALITY OF LIFE

The aim of the present study was to examine the relationship between neuropsychological functioning, depression and quality of life among adults with diabetes mellitus-II. The study used a quantitative approach with an experimental, cross sectional matched group research design. The sample was divided into two groups; an experimental group of adults with diabetes mellitus and a control group of matched healthy individuals, with 30 participants in each group. The sample was recruited from Delhi using convenience and snowball sampling. A self designed questionnaire was administered for understanding about diabetes and its management in the experimental group. NIMHANS neuropsychological battery and WAIS- IV (Two subtests only), Beck Depression Inventory and WHOQOL questionnaire was used for examining neuropsychological functioning, depression and quality of life among adults with diabetes mellitus and matched healthy individuals. Participants among adults with diabetes mellitus group were provided a self –designed brochure on the self-management of diabetes. Descriptive statistics like frequency, percentage etc and inferential statistics like MNOVA and correlations were used for analysis of the data. Results indicated a significant relationship on total neuropsychological functioning between the two groups. Significant differences were found in some components of neuropsychological functioning, viz. executive functions, attention and working memory. Non-significant relationships were found on depression and quality of life. The experimental group was aware about diabetes and its management. Awareness and motivation for self- management provides better health outcomes. Comprehensive psychosocial and behavioural interventions by psychologists can delay complications of neuropsychological functioning of individuals with diabetes mellitus.

The Effects of a Comprehensive Psychosocial Intervention on Secondary Stressors and Social Support for Adult Child Caregivers of Persons With Dementia

Background and ObjectivesMany evaluations of nonpharmacologic interventions for family members of persons with Alzheimer’s disease or related dementias (ADRDs) exist, but few consider effects on outcomes that are pertinent to caregivers’ roles and relationships. The current study evaluated the efficacy of the New York University Caregiver Intervention-Adult Child (NYUCI-AC) on perceptions of family conflict, role conflict (effects of family caregiving and time, family, and social life), and perceived social support for adult child caregivers of relatives with ADRD over a 3-year period.Research Design and MethodsA single-blinded randomized controlled trial design was used. One-hundred and seven adult child caregivers were enrolled in the NYUCI-AC and randomly assigned to a treatment or contact control group. Assessments were scheduled to be completed every 4 months during the first year of participation and every 6 months thereafter for up to 3 years. Individual growth curve models were utilized to ascertain the effects of the NYUCI-AC on change in family conflict, role conflict, and perceptions of social support.ResultsAmong the entire sample, role conflict significantly (p < .05) declined and satisfaction with instrumental assistance increased over the course of the study, whereas family conflict slightly increased over the initial study period and then declined slightly. The findings indicated that the NYUCI-AC did not exert statistically significant effects on changes in family conflict, role conflict, or perceptions of social support over the 3-year study period.Discussion and ImplicationsAlthough the clinical content of some dementia caregiver interventions is tailored to the specific needs of each caregiver and family, the outcomes selected to judge the efficacy of these interventions might not follow similar principles. Incorporating clinical content and evaluation outcomes that are family-centered will help to advance the state of the art of dementia caregiving interventions.

Syndemic Conditions, HIV Transmission Risk Behavior, and Transactional Sex Among Transgender Women.

This study examined the effect of four syndemic conditions-namely, polydrug use, depression, childhood sexual abuse, and intimate partner violence-on rates of HIV transmission risk behavior (TRB) and separately, transactional sex among transgender women. TRB was defined as the number of condomless penetrative sex events with a casual or main partner of discordant or unknown HIV status. Using data from 212 transgender women in New York City, multivariable analyses revealed that, compared to those with no syndemic conditions, dramatically higher rates of recent HIV TRB events (ARR = 8.84, p < 0.001) and recent transactional sex events (ARR = 8.32, p < 0.001) were reported by participants with all four syndemic conditions. These findings highlight the importance of considering the role of syndemic conditions in HIV risk among transgender women, and the need for comprehensive psychosocial interventions to improve sexual health among this population.

Psychosocial Intervention for Patients with Schizophrenia

Treatment of schizophrenia has as its ultimate goals, the functional recovery of the patients and improvement of their quality of life. While antipsychotic medication is the fundamental method for treating schizophrenia, it has certain limitations in terms of treating the illness beyond its positive symptoms. Therefore, psychosocial intervention should be used in tandem with pharmacological methods in treating schizophrenia. The efficacy of several modes of psychosocial intervention for improving outcomes in schizophrenia is well attested. Approximately 10 modes of psychosocial intervention have been recommended based on existing evidence, including family intervention, cognitive behavioral therapy, supported employment, early intervention services, lifestyle intervention for physical health enhancement, treatment of comorbid substance abuse, assertive community treatment, cognitive remediation, social skills training, and peer support. Ideally, these interventions are offered to patients in combination with one another. Over the last decade, increased emphasis has been placed on early detection and intervention, with particular focus on long-term recovery. Early intervention with comprehensive psychosocial interventions should be enacted promptly from the initial detection of schizophrenia.

Assessment and psychosocial intervention plan of a Syrian case with trauma history

We aimed to prepare a comprehensive psychosocial intervention plan in a case with multiple traumatic experiences and stress factors. Twenty-four years-old Syrian man applied with nervousness, insomnia, frequent nightmares, hypervigilance, flashbacks, feeling crying, unhappiness and unwillingness to outpatient clinic. There was torture, prison life and traumatic loss in history. In mental state examination, there were indications of disturbed attitude, depressed mood, guilty and worthlessness. It is important to assess all risk and stressor factors in refugee patients who are admitted to the clinic and to prepare a comprehensive psychosocial intervention plan combine with drug treatment.