Insight And Treatment Attitude Questionnaire Research Articles

Application of machine learning in predicting aggressive behaviors from hospitalized patients with schizophrenia.

To establish a predictive model of aggressive behaviors from hospitalized patients with schizophrenia through applying multiple machine learning algorithms, to provide a reference for accurately predicting and preventing of the occurrence of aggressive behaviors. The cluster sampling method was used to select patients with schizophrenia who were hospitalized in our hospital from July 2019 to August 2021 as the survey objects, and they were divided into an aggressive behavior group (611 cases) and a non-aggressive behavior group (1,426 cases) according to whether they experienced obvious aggressive behaviors during hospitalization. Self-administered General Condition Questionnaire, Insight and Treatment Attitude Questionnaire (ITAQ), Family APGAR (Adaptation, Partnership, Growth, Affection, Resolve) Questionnaire (APGAR), Social Support Rating Scale Questionnaire (SSRS) and Family Burden Scale of Disease Questionnaire (FBS) were used for the survey. The Multi-layer Perceptron, Lasso, Support Vector Machine and Random Forest algorithms were used to build a predictive model for the occurrence of aggressive behaviors from hospitalized patients with schizophrenia and to evaluate its predictive effect. Nomogram was used to build a clinical application tool. The area under the receiver operating characteristic curve (AUC) values of the Multi-Layer Perceptron, Lasso, Support Vector Machine, and Random Forest were 0.904 (95% CI: 0.877-0.926), 0.901 (95% CI: 0.874-0.923), 0.902 (95% CI: 0.876-0.924), and 0.955 (95% CI: 0.935-0.970), where the AUCs of the Random Forest and the remaining three models were statistically different (p < 0.0001), and the remaining three models were not statistically different in pair comparisons (p > 0.5). Machine learning models can fairly predict aggressive behaviors in hospitalized patients with schizophrenia, among which Random Forest has the best predictive effect and has some value in clinical application.

Two-year cohort-up study of clozapine prescription in Chinese patients with schizophrenia treated in rural primary care.

Few studies have examined the clozapine in cohort studies of Chinese patients with schizophrenia in rural primary care. The objective of this two-year cohort study was to describe the usage of clozapine and investigate and identify the demographic, clinical correlations and risk variables which affect the use of clozapine in patients with schizophrenia. A random cluster sampling technique was used, and participants were collected from China National Psychiatric Management System (CNPMS). The variables for clozapine use in individuals with schizophrenia who had undergone a two-year follow-up were determined using the generalized estimating equation (GEE). In this study, 742 patients with schizophrenia were invited, and 491 completed the two-year follow-up study. Being married, more years of education, more waist circumference, using mood stabilizer, using anticholinergic, higher ITAQ (Insight and Treatment Attitude Questionnaire) scores were more significantly related to the use of clozapine. Older age of onset, using second-generation antipsychotics (SGAs) except clozapine predicted a lower prevalence of using clozapine. The usage of clozapine was very common in patients with schizophrenia treated by primary care physicians, and was influenced by a variety of factors, including price of drugs, clinical factors, health regulations, and the characteristics of treatment environment. Further examination of the rationale and appropriateness of clozapine in primary care in China is necessary.

Influence of Continuous Nursing Intervention on Treatment Compliance of Patients with Depression.

Objective This study mainly discusses the influence of the continuous nursing intervention on the treatment compliance of patients with depression. Methods The clinical data of 120 patients with depression admitted to our hospital were collected by retrospective analysis. According to the different implementation of nursing methods, patients were subordinated to the conventional group (n = 48, conventional nursing) and the continuous group (n = 72, continuous nursing). The treatment compliance, depression degree, quality of life, nursing satisfaction, Insight and Treatment Attitude Questionnaire (ITAQ), and recurrence rate of patients in the two groups were compared. Results The continuous group had a higher treatment compliance rate, slighter depression, higher physiological function, psychological function, social function, environmental adaptability, total quality of life, nursing satisfaction, and ITAQ score, and lower recurrence rate, with statistically significant differences (P < 0.05). Conclusion The implementation of continuous nursing intervention for patients with depression could enhance their treatment compliance and relieve depressive symptoms; improve the quality of life and self-awareness; reduce the risk of relapse; and improve nursing satisfaction.

Group cognitive behavioral therapy as an effective approach for patients with alcohol dependence: A perspective study.

Alcohol dependence (AD) syndrome refers to a strong addiction to alcohol and high tolerance physiologically or psychologically, due to the repeated consumption of alcohol-based substances. This study aimed to examine the efficacy of group cognitive behavioral therapy (GCBT) on patients with AD. A total of 128 patients with AD were randomly assigned to the GCBT or control group. Patients in the GCBT group underwent an 8-week GCBT in addition to conventional treatment, and patients in the control group only received conventional treatment. The insight and treatment attitude questionnaire (ITAQ) score, chronic disease self-cognition evaluation score (CDSCES), treatment adherence, and relapse rate at 6 and 12 months were compared among the 2 groups. The ITAQ scores of the GCBT group, after treatment, increased significantly compared to those of the control group (19.69% vs 13.26%, P < .001). The CDSCES in the GCBT group increased significantly compared to those in the control group after treatment (3.98 vs 2.18, P = .001 for problem-solving ability; 8.08 vs 5.08, P = .001 for self-management efficacy; 4.29 vs 3.30, P = .005 for a positive response, and 4.84 vs 3.44, P = .008 for a social function, respectively). After treatment, the percentage of patients with AD with full compliance in the GCBT group was much higher than in the control group (93.8% vs 65.6%, P < .001). Contrastingly, the percentage of patients with AD with partial compliance in the GCBT group was much lower than that in the control group (3.2% vs 34.4%, P < .001). The relapse rate (%) of drinking in patients with AD in the GCBT group was much lower than that in the control group (1.56% vs 21.8%, P = .001 for 6 months and 4.7% vs 51.6%, P < .001 for 12 months). The results suggest that GCBT for 8 weeks is an effective approach for patients with AD, improving problem-solving ability, self-management efficacy, positive response, and social function, leading to increase in treatment compliance, and reducing relapse rate.

The Effect of Yijinjing on the Cognitive Function of Patients With Chronic Schizophrenia.

Background: Patients with chronic schizophrenia present cognitive impairment, which affects their social function and prevents them from reintegrating into society. Yijinjing is a traditional Chinese aerobic exercise that has a putative psychosomatic effect on improving cognitive function.Methods: From January to May 2021, 40 patients with chronic schizophrenia were recruited and randomly divided into a control group and a Yijinjing group. In the 12-week intervention, the patients in the control group received conventional treatment, whereas patients in the Yijinjing group performed Yijinjing exercise (40 min/session, twice a week) in addition to receiving conventional treatment. The Positive and Negative Syndrome Scale (PANSS), the Insight and Treatment Attitude Questionnaire (ITAQ), the Rosenberg Self-esteem Scale (SES), and the Mini Mental State Examination (MMSE) were used to measure clinical symptoms and cognitive function at 0, 6, and 12 weeks.Results: The demographic information was not significantly different between groups. At baseline, the scores of all the scales were not statistically different between groups. After 12 weeks of intervention, compared to those at baseline, the scores of the negative scale (t = 19.00, p < 0.0001), general psychopathology scale (t = 15.98, p < 0.0001), and total score (t = 15.47, p < 0.0001) of the PANSS and SES (t = 5.378, p < 0.0001) had significantly decreased, and the scores of the ITAQ (t = 7.984, p < 0.0001) and MMSE (t = 6.750, p < 0.0001) had significantly increased in Yijinjing group; the score of the MMSE increased in the control group as well (t = 2.491, p = 0.0222). Compared to the respective scores in the control group, the negative scale score (t = 2.953, p = 0.0054) significantly decreased, and the ITAQ (t = 3.043, p = 0.0042) and MMSE (t = 2.2.68, p = 0.0291) scores significantly increased in the Yijinjing group after 12 weeks of intervention.Conclusion: These results provide a preliminary indication that Yijinjing exercise had the potential to improve cognitive function and negative symptoms in patients with chronic schizophrenia. A larger-scale study to determine the trajectory of change in the longer term should be undertaken.

Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [11C]DASB.

BackgroundPrevious studies suggested a link between serotonergic neurotransmission and impaired insight in schizophrenia. In this study, we examined the relationship between serotonin transporter (SERT) availability in regions of the prefrontal cortex (dorsolateral, ventrolateral, ventromedial, and orbitofrontal cortices) and insight deficits in antipsychotic-free patients with schizophrenia using high-resolution positron emission tomography (PET) with [11C]DASB.MethodsNineteen patients underwent [11C]DASB PET and 7-Tesla magnetic resonance imaging scans. To assess SERT availability, the binding potential with respect to non-displaceable compartment (BPND) was derived using the simplified reference tissue model. Patients’ level of insight was assessed using the Insight and Treatment Attitude Questionnaire (ITAQ). The relationship between ITAQ scores and [11C]DASB BPND values was examined using the region-of-interest (ROI)- and voxel-based analyses with relevant variables as covariates. The prefrontal cortex and its four subregions were selected as a priori ROIs since the prefrontal cortex has been implicated as the critical neuroanatomical substrate of impaired insight in schizophrenia.ResultsThe ROI-based analysis revealed that the ITAQ illness insight dimension had significant negative correlations with the [11C]DASB BPND in the left dorsolateral, left orbitofrontal, and bilateral ventrolateral prefrontal cortices. The ITAQ treatment insight dimension had significant negative correlations with the [11C]DASB BPND in the bilateral dorsolateral, left orbitofrontal, and bilateral ventrolateral prefrontal cortices. The ITAQ total score showed significant negative correlations with the [11C]DASB BPND in the bilateral prefrontal cortex and three subregions (dorsolateral, ventrolateral, and orbitofrontal cortices). A supplementary voxel-based analysis corroborated a significant negative association between the ITAQ score and the [11C]DASB BPND in the prefrontal cortices.ConclusionOur study provides in vivo evidence of significant negative correlations between insight deficits and prefrontal SERT availability in patients with schizophrenia, suggesting significant involvement of prefrontal serotonergic signaling in impaired insight, one of the core symptoms of schizophrenia.

Effects of Mindfulness-Based Cognitive Therapy on Stigma in Female Patients With Schizophrenia.

Mindfulness-based cognitive therapy (MBCT) has been increasingly recognized as effective in different mental illnesses, but these effects are limited in schizophrenia. For patients with schizophrenia, stigma is one of the most negative factors that affects treatment, rehabilitation and social function. This research aimed to determine the effects of MBCT on stigma in patients with schizophrenia. In total, 62 inpatients with schizophrenia were recruited and randomly assigned to the experimental group or control group. The experimental group received an 8-week MBCT intervention, and the control group were treated as usual. Link's Stigma Scales (with three subscales, including perceived devaluation-discrimination (PDD), stigma-coping orientation, and stigma-related feeling), Five Facet Mindfulness Questionnaire (FFMQ), and Insight and Treatment Attitudes Questionnaire (ITAQ) were used to collect data before and after intervention. After intervention, the post-test score of PDD, stigma-coping orientation, FFMQ, and ITAQ were significantly different between the experimental group and the control group. In the experimental group, the PDD and stigma-coping orientation scores significantly decreased, and FFMQ and ITAQ scores increased remarkably (P < 0.05). In addition, correlation analysis revealed a significant negative correlation between mindfulness and stigma. MBCT was effective in reducing stigma in patients with schizophrenia, which mainly manifested as changes in the patients' perception of stigma as well as the withdrawal and avoidance caused by schizophrenia. Enhancing mindfulness will help reduce the stigma level. MBCT is worthy of promotion and application in patients with schizophrenia.

The mediating role of internalized stigma between insight and self-esteem among patients with schizophrenia

Objective To explore the relationship between internalized stigma and insight, self-esteem in patients with schizophrenia. Methods A total of 144 schizophrenic patients were investigated by the general information questionnaire, insight and treatment attitude questionnaire (ITAQ), internalized stigma of mental illness scale-Chinese version (ISMI-C) and the self-esteem scale (SES). Pearson correlative analysis and Bootstrap program mediation effect test were used to data analysis. Results There was a significantly positively correlation between insight score(11.24±4.08) and internalized stigma score(2.18±0.65) of 144 schizophrenic patients(r=0.236, P<0.05). The Self-esteem score(27.57±3.76) was negatively correlated with insight score(r=-0.177, P<0.05) and internalized stigma score(r=-0.661, P<0.05). The mediation effect test analysis showed that the internalized stigma played a full mediating role in the relationship between insight and self-esteem, and the effect size was -0.143. Conclusion Insight can indirectly affect self-esteem via internalized stigma in patients with schizophrenia.Taking measures to decrease inpatients' internalized stigma level and improve their illness awareness should be paid attention in clinical practice. Key words: Schizophrenia; Internalized stigma; Insight; Self-esteem

Application of home visit directed by Peplau interpersonal relationship model in elderly bronchial asthma patients

Objective To explore the effects of home visit directed by Peplau interpersonal relationship model on negative emotions and medication adherence in elderly bronchial asthma patients. Methods From May 2015 to May 2017, we selected 90 elderly bronchial asthma patients in the First Affiliated Hospital of Zhengzhou University as subjects by convenience sampling. All of the patients were divided into observation group and control group with the method of random number table, 45 cases in each group. Observation group carried out home visit nursing based on the Peplau interpersonal relationship model for elderly bronchial asthma patients. Control group adopted routine follow-up care. The medication adherence and disease cognition of patients both groups were recorded with the Medication Adherence Report Scale for Asthma (MARS-A) as well as Insight and Treatment Attitude Questionnaire (ITAQ) , and the anxiety and depression of patients both groups before and after intervention were assessed with the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) . We also observed the incidence of bronchial asthma acute attack in patients one year after discharge. Results When home visit was completed and one year after discharge, the medication adherence of observation group was higher than that of control group, and the score of ITAQ was higher than that of control group and that at discharge with statistical differences (P<0.05) . One year after discharge, the incidence of bronchial asthma acute attack of observation group was lower than that of control group with a statistical difference (P<0.05) . When home visit was completed and one year after discharge, the scores of HAMA and HAMD of observation group were lower than those of control group with statistical differences (P<0.05) . Conclusions Home visit directed by Peplau interpersonal relationship model help to reduce the incidence of acute attack of elderly bronchial asthma patients external hospital, relieve the negative emotions and improve disease cognition as well as medication adherence. Key words: Aged; Bronchial asthma; Home visit; Interpersonal relationship model; Medication adherence

Comparison of Olanzapine versus Other Second-Generation Antipsychotics in the Improvement of Insight and Medication Discontinuation Rate in Schizophrenia.

BackgroundIn the last decade, olanzapine became widely used in mental health service worldwide even after being criticized for its metabolic side effects. Patients with schizophrenia on olanzapine were usually found to stay on their medications longer than the other second-generation antipsychotics (SGAs) except clozapine. The reason for this is unknown.ObjectiveThis prospective study compared the influences of olanzapine and other SGAs except clozapine on improving insight and medication discontinuation rate in schizophrenia.MethodsA total of 148 patients with schizophrenia medically indicated for initiation of treatment with olanzapine or other SGAs were evaluated for symptoms, insight, attitudes toward medication, side effects, body weight and fasting lipid and glucose parameters at admission and before discharge, and follow-up calls one-year after discharge documented whether they were regularly taking prescribed psychotropic medication or not.ResultsAfter an average of 72.8 days of inpatient treatment, the olanzapine and other SGAs group exhibited similar levels of symptom improvement with an average reduction of 28.7 in the Positive and Negative Syndrome Scale (PANSS) total score. The Olanzapine group exhibited better improvement in insight assessed using the G12 item of PANSS and Insight and Treatment Attitudes Questionnaire (ITAQ), more metabolic side effects indexed with total cholesterol, triglycerides levels and weight gain, and a lower medication discontinuation rate than the other SGAs group.ConclusionAlthough general symptom improvement was similar, olanzapine significantly improved insight and presented less medication discontinuation compared to other SGAs, which might partially explain why patients on olanzapine stayed longer on their medications.

The Association of Insight and Change in Insight with Clinical Symptoms in Depressed Inpatients.

BackgroundLack of insight has been extensively studied and was found to be adversely correlated with impaired treatment compliance and worse long term clinical outcomes among patients with schizophrenia, while not much is known about this phenonmenon in patients with severe depression.AimTo explore the correlates of insight and its relation to symptom changes among the most seriously ill patients with affective disorders, those who require hospitalization.MethodsPatients hospitalized in a large psychiatric hospital in south China with either major depressive disorder (MDD)(N=55) or bipolar depression (BD) (N=85) based on ICD-10 diagnostic criteria were assessed with the Insight and Treatment Attitudes Questionnaire (ITAQ) one week after admission and at the time of discharge. Clinical symptoms were measured at the same time with the Hamilton Rating Scale for Depression (HAMD-17) and the Depression subscale of the Symptom Check list-90 (SCL-90). Length of stay (LOS), duration of illness, duration of untreated mood disorder, number of previous episodes of depression and previous admissions for depression were documented during interviews with patients and their families and from a review of medical records. Bivariate correlations and multiple regression analysis were used to examine the relationship of sociodemographic characteristics, clinical symptomatology and clinical history, to insight at the time of admission. The relationships between change in clinical symptoms and change in insight from admission to discharge were also examined.ResultsStepwise multiple regression models suggested that any previous admissions for depression and higher anxiety factor scores on the HAMD-17 are significant independent predictors of insight accounting for 22.9% of the variance. Multiple regression analysis residual change scores (change scores adjusted for baseline values) on the ITAQ showed that improved insight over average stays of 51 days were inversely related to the residual psychomotor retardation factor on the HAMD-17 accounting for 9.1% of the variance.ConclusionsMore severe anxiety symptoms and previous hospitalization for depression were associated with greater insight into illness at admission. Reduction of motor retardation symptoms during treatment was associated with greater improvement in insight to the time of discharge. The patients who are sicker at admission and who show more improvement in psychomotor retardation show the greatest insight.

Application of WeChat-based self-management education in patients with depression

Objective To explore the effects of WeChat-based self-management education on patients with depression. Methods Totally 108 patients with depression who were discharged from a municipal mental health center between January and December 2016 received self-management education with the WeChat platform for six months. The frequency of reading push contents on WeChat, Insight and Treatment Attitude Questionnaire (ITAQ) , Medication Adherence Questionnaire and Beliefs About Medical Questionnaire (BMQ) were used to assess the patients one month and six months after the management. The patients' insight and treatment attitude as well as medication adherence before and after the introduction of WeChat-based self-management education was compared. Results After six months of WeChat-based self-management education, the patients with depression showed better frequency of reading disease publicity materials, personized guidance, WeChat games and watching video and pictures in push contents of WeChat than that after one month of self-management (P<0.05) ; the patients showed higher insight and treatment attitude scores, lower medication adherence scores and better scores in the dimensions of beliefs about medical than that after one month of self-management (P<0.01) . Conclusions WeChat-based self-management education can effectively improve the adherence, perception to disease and rehabilitation of those depression patients discharged from hospital. Key words: Depression; Medication adherence; WeChat; Self-management education

알코올 사용장애 환자의 임파워먼트가 치료순응과 삶의 질에 미치는 영향 : 대인관계의 매개효과를 중심으로

Purpose: The purpose of this study was to investigate the mediating effect of interpersonal relationships in associations between empowerment, quality of life, and treatment compliance for patients with alcohol use disorder. Method: The participants were patients with alcohol use disorder (n=160) who were admitted in the psychiatric hospital in D city. Data were collected using self-report questionnaires including the Empowerment scale, Relationship Change Scale (RCS), Insight and Treatment Attitude Questionnaire (ITAQ), and WHO Quality of Life Scale abbreviated version (WHOQOL-BREF). Data were analyzed with t-test, one-way ANOVA, Tukey test, Pearson correlation coefficient, and simple and multiple regression using the SPSS 20.0 program. The Baron and Kenny method and Sobel test were used to analyze the mediating effect. Results: Interpersonal relationships showed perfect mediating effect in the association between empowerment and treatment compliance, and had partial mediating effect in the association between empowerment and quality of life. Conclusion: The results of this study suggest that the development of nursing intervention is necessary for improvement of empowerment with regard to interpersonal relationships, and that it can improve treatment compliance and quality of life.

Research on related factors of troublemaking risk in schizophrenia patients

Objective To explore the related factors of troublemaking risk in schizophrenia patients. Methods Investigation and analysis on demology, insight, treatment attitude and social function defects were conducted among 110 patients with schizophrenia and their families by general information scale, insight and treatment attitude questionnaire (ITAQ) and social disability screening schedule (SDSS) . Results The score of troublemaking was (0.49±1.03) , the score of social function defect was (11.94±3.92) , and the score of insight and treatment attitude was (12.84±5.93) . The risk of troublemaking in patients with schizophrenia less than one year was significantly lower than the risk of troublemaking in patients with schizophrenia more than one year, and the higher of the score of social function defect, the higher of the risk of patients′ troublemaking. Conclusions As for the prevention of troublemaking in patients with schizophrenia, we should pay attention to two aspects: giving more attention to patients with schizophrenia more than one year, and improving patients′ social function, in order to reduce the risk of troublemaking. Key words: Schizophrenia; Troublemaking; Insight; Social function defect

The efficacy of metacognitive training in inpatients with schizophrenia: a randomized controlled study

Objective To explore the feasibility and efficiency of metacognitive training (MCT) in inpatients with schizophrenia, as well as the short-term effects of metacognitive training on symptoms, cognitive function, and insight. Methods Sixty inpatients that met the DSM-IV criteria for schizophrenia were randomly assigned to either MCT (research group, n=30) or an active controlled intervention (control group, n=30). Positive and Negative Syndrome Scale(PANSS), Schizophrenia Cognition Rating Scale (SCoRS), Insight and Treatment Attitude Questionnaire(ITAQ) and beads task are assessed at baseline and after completion of the training. Results After treatment, the scores of the two groups in PANSS, SCoRS, ITAQ and the bead task were significantly improved(P<0.05). The improvement of positive symptoms, cognitive function and insight in research group(12.8±4.2, 31.7±13.9, 9.2±6.1 respectively) was significantly better than that in control group(15.6±5.9, 38.1±18.1, 5.5±5.8 respectively), and the difference was statistically significant(P<0.05). Conclusion Metacognitive training can effectively improve the clinical symptoms, cognitive function and insight for inpatients with schizophrenia. Key words: Schizophrenia; Metacognitive training; Psychotherapy

Gender differences in attitudes towards antipsychotic medications in patients with schizophrenia.

Non-adherence was more frequent in male than in female psychiatric patients. This multi-center study in China examined the gender difference with regard to attitude towards antipsychotic medications and its associations with socio-demographic variables, insight, and psychopathology. Patients' basic socio-demographic and clinical data were collected. Psychopathology and insight were measured with the Symptom Checklist-90 (SCL-90) and the Insight and Treatment Attitudes Questionnaire (ITAQ), respectively. Their attitudes towards antipsychotic medications were assessed by two standardized questions. Nearly 39.6% (109/275) males and 31.1% (70/225) females reported negative attitudes towards antipsychotic medications. Binary logistic regression revealed that in males single marital status (OR=2.9, 95% CI=1.3-6.4), rural residence (OR=0.4, 95% CI=0.2-0.7), longer duration of schizophrenia (OR=1.0, 95% CI=1.0-1.1), knowledge of medication (OR=1.5, 95% CI=1.3-1.6) and the SCL-90 hostility subscale (OR=0.9, 95% CI=0.9-1.0) were contributors to negative attitudes. In female patients, knowledge about medications (OR=1.4, 95% CI=1.3-1.6), the SCL-90 somatization (OR=0.8, 95% CI=0.8-0.9) and anxiety (OR=1.1, 95% CI=1.0-1.2) subscales were contributors to negative attitudes. The study suggested that different psychosocial and clinical factors accounted for the negative attitude towards antipsychotic treatment in male and female patients.

Effects of caring follow-up on insight and medication adherence in post-discharge patients first diagnosed with schizophrenia

Objective To explore the effects of caring follow-up insight and medication adherence in post-discharge patients first diagnosed with schizophrenia. Methods A total of 106 schizophrenic were assigned to observation group and control group admitted from January to December 2014, with 53 cases in each group. All participants received routine care during hospitalization. The patients of control group received routine follow-up and the patients of observation group received caring follow-up for 6 months self-insight and medication adherence which were assessed by brief psychiatric rating scale (BPRS), insight and treatment attitude questionnaire (ITAQ), and medication adherence questionnaire. Results At the end of 6 months follow up, scores of BPRS, ITAQ and medication adherence in two groups were significantly higher than that of at discharge, and the scores of observation group were higher than that of control group (P<0.05). Conclusions Caring follow-up can improve insight and medication adherence in post-discharge patients first diagnosed with schizophrenia. Key words: Schizophrenia; Continuing nursing; Follow-up; Insight; Medication adherence

Influences of guided education training on quality of life of long-term inpatients with schizophrenia

Objective To explore the influences of guided education training on quality of life of long-term inpatients with schizophrenia. Methods A total of 79 inpatients (at last one year for being hospitalized) with schizophrenia were divided into control group (routine treatment and nursing) and observation group (routine treatment and nursing combined with guided education rehabilitation training) according to random number table method from April 2013 to March 2014. Patients between two groups were evaluated with insight and treatment attitude questionnaire (ITAQ), scale of social function for psychosis in-patients (SSFPI), social support rating scale (SSRS), generic quality of life inventory (GQOLI) one day before intervention and twelve, twenty-four weeks after intervention. Results Twelve weeks after intervention, quality of life of patients in observation group was higher than that in control group with a significant difference (P 0.05). Twenty-four weeks after intervention, the scores of ITAQ, SSFPI, SSRS, GQOLI in observation group were better than those in control group with significant differences (P<0.05). Conclusions The guided education training can effectively improve the quality of life of long-term inpatients with schizophrenia. Key words: Schizophrenia; Quality of life; Guided education training

Voluntary and Involuntary Psychiatric Admissions in China.

This study examined admission patterns, including voluntary, involuntary, and partly voluntary admissions to Chinese psychiatric hospitals, in relation to sociodemographic and clinical factors, before a new mental health law was implemented in 2013. Previously admitted patients were interviewed within one week after discharge from 16 psychiatric hospitals across China. Patients' basic sociodemographic and clinical data, including results from the Modified Overt Aggression Scale (MOAS) and the Insight and Treatment Attitudes Questionnaire (ITAQ), were collected. Among 797 patients, 224 (28%) had voluntary admissions, 336 (42%) had involuntary admissions, and 237 (30%) had partly voluntary admissions. Male gender, history of hospitalization, diagnosis of schizophrenia and related disorders, and high MOAS score were the risk factors for involuntary admissions, whereas more years of education, higher ITAQ score, and outpatient treatment before the index admission were its protective factors. A diagnosis of schizophrenia-related disorder and high MOAS score were the risk factors for partly voluntary admission, whereas more education and high ITAQ score were its protective factors. Perception of dangerousness and poor insight about mental illness were significant factors in involuntary psychiatric admissions in China. Factors contributing to the changes in patterns of psychiatric admissions after China's implementation of the mental health law are important topics for further research.

Controlled trial of the effectiveness of community rehabilitation for patients with schizophrenia in Shanghai, China.

BackgroundThe ‘Sunshine Soul Park’ is a network of social welfare institutions that provides communitybased rehabilitation services for individuals with mental illness.AimsAssess the effectiveness of the rehabilitation services provided at the ‘Sunshine Soul Park’ on the psychotic symptoms and social functioning of individuals with schizophrenia and, based on these findings, provide a theoretical model of community-based rehabilitation.MethodsSixty individuals with schizophrenia in the Huangpu District of Shanghai volunteered for the rehabilitation training program provided at six ‘Sunshine Soul Park’ community centers that involves day treatment, medication monitoring, biweekly rehabilitation training, and other recreational, social, and intellectual activities. A matched control group was recruited from individuals with schizophrenia registered on the Huangpu District registry of the ‘Severe Mental Illness Prevention and Rehabilitation System’. All participants continued their medication without change for the full year of follow-up. Both groups were assessed at baseline, and 3, 6, and 12 months after enrollment using the Insight and Treatment Attitude Questionnaire (ITAQ), Social Disability Screening Schedule (SDSS), Generic Quality of Life Inventory-74 (GQOLI-74), and Positive and Negative Syndrome Scale (PANSS).ResultsIn the intervention group the ITAQ, SDSS, GQOLI-74, and PANSS scores showed statistically significant improvement compared to baseline at each follow-up assessment. Moreover, the trend in improvement in the interventions group is significantly faster than that in the control group.ConclusionsThe ‘Sunshine Soul Park’ rehabilitation training program enhances patients’ knowledge about their disorder and improves their social functioning and quality of life. Further studies to assess methods for up-scaling this intervention to other areas of China are warranted.