Lower Levels Of Social Functioning Research Articles

0683 Sleep disturbance, social functioning, and suicidal ideation among preadolescent children admitted to intensive psychiatric care

Abstract Introduction Research on preadolescent childhood suicidality is sparse, with recent population-based studies providing support for sociodemographic and diagnostic correlates of preadolescent suicidal ideation. Sleep disturbance is of particular interest in the examination of preadolescent suicidal ideation because sleep health is interlinked with childhood psychosocial functioning; further, there are changes in preadolescent homeostatic regulation of sleep-wake and intrinsic circadian rhythm (i.e., delayed sleep onset), and psychosocial pressures in preadolescence, such as bedtime autonomy, that are increasingly manifested. There is a need to test models that begin to delineate associations between sleep disturbance and childhood suicidal ideation, specifically among youth with early-onset psychopathology. One possible explanatory factor in the association between sleep disturbance and suicidal ideation, grounded in existing theoretical frameworks of suicide, is social functioning (e.g., developmentally appropriate peer interactions and connectedness). The current study tested an indirect effects model in which sleep disturbance is associated with suicidal ideation via social functioning. Methods 223 children (ages 7–12) with severe psychopathology who presented for intensive hospital-based treatment and their caregivers completed an assessment battery at admission, including the parent-reported sleep disturbances via the Children’s Sleep Habits Questionnaire, and child-reported dysregulated negative affect, social functioning, and suicidal ideation. Indirect effects were examined via the PROCESS macro for SPSS Version 4.0. Binary logistic regression was used when suicidality served as the dependent variable. All models controlled for youth age and dysregulated negative affect. Results Higher levels of parent-reported youth sleep disturbances were related to lower levels of youth-report social functioning. Further, lower levels of social functioning and higher levels of sleep disturbances were associated with higher odds of endorsing suicidal ideation. Indirect effects analyses indicated that higher levels of sleep disturbances was associated with increased odds of reporting suicidal ideation via the detrimental impact of sleep disturbances on social functioning. Conclusion The findings support the novel extension of explanatory models of suicide to children and highlight the possible role of sleep disturbance in the etiology of early suicidality. Documenting these associations provides the impetus for fine-grained examination of sleep health and social functioning among children who experience suicidal ideation and severe psychopathology. Support (if any)

Kvalitet života korisnika dugoročne zdravstvene njege

Objective. Long-term care represents a series of health and social care services that are provided at home or in an institutional environment to people with reduced functional capacity (reduced physical and/or cognitive abilities) who need support in performing daily activities, and who depend on the help of others for a long time period. The goal of the research was to examine the quality of life of users with long-term health care, with a special focus on comparing the quality of life between people placed institutionally and outside of the institution. Methods. The research was designed according to the principle of a cross-sectional study. In the research, a general questionnaire and a scale for assessing the quality of life Short Form 36 Health Survey (SF-36) were used. Among the statistical tests, the ch2 square test was used. The usual value of p<0.05 was taken as the level of statistical significance. Results. Subjects who were institutionalized had statistically significantly lower values of domains and summary scores of quality of life compared to subjects whose health care took place outside of institutions, whereby the difference was observed in physical functioning (p<0.001), social functioning (p=0.003) and mental health summary score (p=0.015). Conclusion. Users of long-term health care placed in an institution had significantly worse physical functioning, a higher level of limitations due to physical problems, worse general health, a lower level of social functioning, as well as mental health.

Sample Bias in Web-Based Patient-Generated Health Data of Dutch Patients With Gastrointestinal Stromal Tumor: Survey Study.

Increasingly, social media is being recognized as a potential resource for patient-generated health data, for example, for pharmacovigilance. Although the representativeness of the web-based patient population is often noted as a concern, studies in this field are limited. This study aimed to investigate the sample bias of patient-centered social media in Dutch patients with gastrointestinal stromal tumor (GIST). A population-based survey was conducted in the Netherlands among 328 patients with GIST diagnosed 2-13 years ago to investigate their digital communication use with fellow patients. A logistic regression analysis was used to analyze clinical and demographic differences between forum users and nonusers. Overall, 17.9% (59/328) of survey respondents reported having contact with fellow patients via social media. Moreover, 78% (46/59) of forum users made use of GIST patient forums. We found no statistically significant differences for age, sex, socioeconomic status, and time since diagnosis between forum users (n=46) and nonusers (n=273). Patient forum users did differ significantly in (self-reported) treatment phase from nonusers (P=.001). Of the 46 forum users, only 2 (4%) were cured and not being monitored; 3 (7%) were on adjuvant, curative treatment; 19 (41%) were being monitored after adjuvant treatment; and 22 (48%) were on palliative treatment. In contrast, of the 273 patients who did not use disease-specific forums to communicate with fellow patients, 56 (20.5%) were cured and not being monitored, 31 (11.3%) were on curative treatment, 139 (50.9%) were being monitored after treatment, and 42 (15.3%) were on palliative treatment. The odds of being on a patient forum were 2.8 times as high for a patient who is being monitored compared with a patient that is considered cured. The odds of being on a patient forum were 1.9 times as high for patients who were on curative (adjuvant) treatment and 10 times as high for patients who were in the palliative phase compared with patients who were considered cured. Forum users also reported a lower level of social functioning (84.8 out of 100) than nonusers (93.8 out of 100; P=.008). Forum users showed no particular bias on the most important demographic variables of age, sex, socioeconomic status, and time since diagnosis. This may reflect the narrowing digital divide. Overrepresentation and underrepresentation of patients with GIST in different treatment phases on social media should be taken into account when sourcing patient forums for patient-generated health data. A further investigation of the sample bias in other web-based patient populations is warranted.

The Effect of Self-Determination Activities on Communication and Interaction Skills and Academic Success (Grade Point Average) of Students at Risk of Emotional-Behavioral Disorders: A Randomized Controlled Trial

Background: Students with emotional and behavioral disorders (EBD) have lower academic efficiency than students with other disabilities and exhibit high levels of problematic behaviors and low levels of social functioning. This research aims to investigate the impact of self-determination activities on communication skills and scholastic achievement of students at risk of emotional-behavioral disorders. Methods: The study was conducted through a randomized controlled trial during the academic year 2018-2019. The samples included 54 female students (14 to 16 years) at risk of emotional-behavioral disorders from secondary schools in Tehran, Iran. The sampling was conducted through a random cluster method. The applied tools encompass Youth Self-report and Assessment of Communication and Interaction Skills. Academic success was measured by students' grade point average (GPA) in two terms. The intervention was held in 8 sessions of 90 minutes, once a week, after the first term of academic of students for the intervention group and the control group did not receive any intervention during this period. The data were analyzed by SPSS-22, MANCOVA, T-test, and Chi-Square tests. Results: The results of the multivariate analysis of covariance analysis showed self-determination has an impact on communication skills (physicality, information exchange and relations) of students at risk of emotional-behavioral disorders (p<0.05). Comparing the difference between the averages of the two students' means, it was found that there was a significant difference in the two groups after the intervention (p<0.001). Also, after the intervention, there was no significant difference between the two groups but the GPA of students in the intervention group increased from 13.19 to 15.61. Conclusion: The findings suggested self-determination is effective for academic success and communication skills of students at risk of emotional-behavioral disorders and can be used in educational programs for these students.

Clinical and Therapeutic Factors Affecting the Social Adaptation of Patients with Schizophrenia

Background: сurrently, the question remains open about the factors that affect the social functioning of patients with schizophrenia, including the role of negative symptoms and neurocognitive deficits. The aim: to study factors that affect the social functioning of patients with schizophrenia. Patients and methods: 64 in-patient with schizophrenia (mean age 35.9 ± 10.9 years) were examined at the stage of remission. The disease duration was 9.71 ± 6.0 years. The majority of patients suffered from paranoid and hallucinatory-paranoid attacs (43 and 23%, respectively). The study used follow-up, clinical and psychopathological methods as well as psychometric scales: PANSS, SANS, ВАСS, Calgary scales and UKU scales. An integrative indicator was introduced to assess the social adaptation of patients. Results: it is shown that as the duration of the disease increases, the indicator of social adaptation decreases. The presence of side effects of antipsychotic therapy is associated with restrictions on the social functioning of patients, but the use of second-generation antipsychotics contributes to an increase in the level of social functioning of patients. Patients with more pronounced apathetic-abulic disorders, flattened affect, anhedonia-asociality and social isolation are characterized by a lower level of social functioning. Adapted patients differ from maladapted patients by better indicators of auditory-speech memory, motor skills, information processing speed, ability to plan and problem solving behavior. Conclusion: the integrative indicator of social adaptation of patients with schizophrenia is associated with a number of cognitive and negative symptoms, features of antipsychotic therapy and the duration of the disease.

Influence of depressive disorders on quality of life and three-year survival of patients with coronary heart disease

Abstract Background/Introduction Depressive disorders (DD) affect more than 350 million people in the general population, especially among patients with cardiovascular diseases. World Health Organization predicts that by 2030 coronary heart disease (CHD) and DD will become the leading causes of disability in the civilized countries of the world. This fact indicates the need to identify DR at the early stages of examination of patients with CHD for timely correction and improvement of prognosis. Purpose of the work To assess the quality of life and three-year survival rate of patients with CHD in combination with DR. Methods 122 patients with chronic CHD (with exertional angina of II-III functional classes) were included in the study on the basis of the cardiology department. The presence and level of depression, anxiety, and social adaptation were assessed using the Beck Depression Scales (BDI), Sheehan Anxiety (ShARS), Social Adaptation (Bosc). The three-year survival rate was also investigated. Two groups were formed: the first – 58 patients with CHD with DD and the second – 64 patients with CHD without DD. Data were presented as M ± SD. The difference was considered statistically significant at p&amp;lt;0.05. The 3-year survival rate of patients was assessed using the Kaplan-Meier method with the determination of differences between groups using the Wilcoxon-Gehan test. Results The groups were comparable in terms of the main clinical and demographic characteristics and concomitant therapy. In patients with depression, compared with patients without it, was identified an increased level of depression (BDI – 7.3±4.3 points vs 2.3±1.6 points, p=0.ehab724.275201) and anxiety (Shikhana – 37.6±20.3 points vs 18.3±12.4 points, p=0.0002); lower level of social functioning (Bosc – 35.0±7.3 points vs 39.3±5.8 points, p=0.04). The 3-year survival rate was 92.6% (113 people), of which in the first group – 87.9% (51 people), in the second – 96.9% (62 people). The worst survival rate (Gehan-Wilcoxon test, p=0.03) was noted in the group of CHD with DD. Conclusion(s) In patients with chronic CHD in combination with DD, an increased level of anxiety and a lower quality of life were revealed, which can worsen the course of CHD. The 3-year survival rate is significantly worse in patients with CHD with a DD in comparison with patients without mental disorders. Funding Acknowledgement Type of funding sources: None.

Formal Thought Disorder and Self-Disorder: An Empirical Study.

Background: Formal thought disorder was constitutively linked to the original concept of schizophrenia and has since been one of central features supporting its diagnosis. Bleuler considered formal thought disorder as a fundamental symptom of schizophrenia among other fundamental symptoms, including ego disorders. The contemporary concept of self-disorder represents a more developed, nuanced, and systematic approach to disturbances of self-experience than the Bleulerian concept of ego disorders. As fundamental symptoms, on Bleuler's account, are persistently present in every case, an association between these symptoms could be expected. The purpose of this study was to examine the association between self-disorder and formal thought disorder.Methods: A sample of 94 diagnostically heterogeneous patients was examined for formal thought disorder using clinical rating and a proverb test. The proverb test was analyzed for two different aspects of formal thought disorder: literal responses and bizarre responses. The sample was comprehensively assessed for psychopathology, including self-disorder as measured with the Examination of Anomalous Self-Experience scale.Results: The patients, who provided bizarre responses, had a higher level of self-disorder, more negative symptoms, lower level of social functioning, and lower level of intelligence. Bizarre answers aggregated in patients diagnosed within the schizophrenia spectrum compared with patients outside the schizophrenia spectrum. We found moderate correlations between the two measures of formal thought disorder (clinically rated and bizarre responses) and self-disorder (0.454 [p < 0.01] and 0.328 [p < 0.01]). Literal responses did not differ between diagnostic groups and also did not correlate with bizarre responses. Specificity of bizarre responses for a diagnosis within schizophrenia spectrum was 86.89%, whereas sensitivity was 40.85%.Conclusion: The close relation between formal thought disorder and self-disorder further adds to the notion of self-disorder as a unifying psychopathological core beneath the apparently heterogeneous symptoms of schizophrenia.

The relationship between quality of life and coping strategies of children with EB and their parents

BackgroundEpidermolysis bullosa (EB) is a group of rare genetic skin disorders that primarily manifest as blisters and erosions following mild mechanical trauma. Despite the crucial role of the parents of children with EB in managing the disease, studies focusing on the parent–child relationship remain a gap in the literature. To address this gap, the current quantitative study, involving 55 children with all types of EB and 48 parents, assessed the relationship between their quality of life and coping strategies. Quality of life was measured with the Pediatric Quality of Life Inventory and TNO-AZL Questionnaire for Adult’s Health- related Quality of Life, and coping strategies were assessed with the Coping with a Disease Questionnaire. The majority of the analyses were descriptive and the results were interpreted qualitatively because of the small sample size.ResultsOverall, the quality of life of children with EB and that of their parents was somewhat lower compared with the quality of life of healthy children and adults. Children with EB who more frequently used emotional reactions and cognitive-palliative strategies to cope with the disease demonstrated lower levels of emotional and social functioning, while children who showed more acceptance and distancing showed higher levels of functioning on all domains. Parents who frequently demonstrated emotional reactions reported lower levels of social functioning and experienced more depressive emotions and anger. Parents who used more avoidance showed higher levels of positive emotions. Within parent–child dyads, acceptance, cognitive-palliative strategies and distancing were positively related. Children’s emotional and social functioning were negatively associated with their parents’ depressive emotions. Parents’ acceptance was linked to higher physical functioning in children, whereas children’s avoidance was linked to a lower level of anger in parents.ConclusionChildren who are able to accept the disease or distance themselves from it appear to be better off in contrast to those who tend to engage in the cognitive-palliative strategies and expressing emotional reactions. Parents seem to be better off when they are able to use avoidance in contrast to those who tend to show emotional reactions. Further research is needed to substantiate these findings.

Effects of graduating during economic downturns on mental health

PurposeThis study examined the effects of economic downturns at the time of graduation on short-term and long-term mental health of graduates. MethodsUsing a large longitudinal dataset whose respondents graduated from their highest level of education between 2001 and 2018 in Australia, the study investigated the effects of initial labor market conditions on psychological distress measures, quality-of-life mental health scales, and diagnoses of depression or anxiety since graduation. ResultsEvidence suggests the presence of a scarring effect of graduating during a recession on the mental health of young adults, particularly significant and persistent for men. Higher unemployment rates at graduation were associated with increased risks of high psychological distress and diagnoses of depression or anxiety, and lower levels of social functioning and mental well-being among men lasting over a decade. The psychological effect was largely driven by young adults with vocational or secondary qualifications or receiving no government allowance at graduation. ConclusionsPolicies should consider the psychological effect of graduating during recessions and focus particularly on vulnerable groups who are susceptible to adverse labor market conditions, such as graduates who are in cyclically sensitive occupations and have less or no work benefits and social protection.

The impact of group psychological abuse on distress: the mediating role of social functioning and resilience

ABSTRACT Background: Previous studies indicate that social functioning and resilience can mitigate the adverse psychological effects of interpersonal violence. Unfortunately, the role of these variables has not been studied in survivors of groups, organizations, and communities in which psychological abusive strategies are inflicted to recruit and dominate their members. Objective: To examine the mediating role of social functioning and resilience in the relationship between psychological abuse experienced in the past while in a group and current psychosocial distress and psychopathological symptoms. Method: In this cross-sectional study, an online questionnaire was administered to 794 English-speaking former members of different kinds of groups, such as religious, pseudo therapeutic, pyramid scheme groups, and others. Among them, 499 were victims of group psychological abuse and 295 were non-victims. Results: Victims of group psychological abuse reported lower levels of social functioning and resilience than non-victims, and higher levels of psychosocial difficulties and psychopathological symptoms. Serial mediation analyses revealed that social functioning and resilience mediated part of the impact of group psychological abuse on psychosocial difficulties and psychopathological symptoms. Sex and age joining the group were included as covariates. Participants who had experienced higher levels of group psychological abuse tend to have poorer social functioning, which is related to lower resilience. In turn, lower levels of social functioning and resilience are related with higher distress. Conclusions: This research sheds light on the underlying mechanisms involved in the relationship between group psychological abuse and distress suffered following this kind of traumatic experiences. Findings highlight the protective role of social adjustment, which can help promote and enhance resilience and mitigate psychosocial difficulties and psychopathological symptoms in survivors of group psychological abuse.

Fall Injuries and Depressive Symptoms Among Older Adults and the Mediating Effects of Social Participation - China, 2011-2018.

What is already known on this topic?Prior studies found that fall events were associated with a higher level of depressive symptoms and a lower level of social functioning and social participation. In addition, social participation has also been significantly associated with better conditions of depressive symptoms.What is added by this report?This article implemented the literature in three ways. First, it examined the mechanisms of social participation in the association between fall injuries and depressive symptoms among older adults in China. Second, it specified the fall-injured older adults group from those who merely experienced fall events. Third, it compared the results between rural and urban China and discussed policy implications for both groups.What are the implications for public health practice?Based on the findings of this study, future policies could consider boosting social participation at both the household and community level while taking into account the challenges of mobilities and social capabilities after fall injuries. Meanwhile, it is essential to accelerate the construction of aging-friendly communities to improve the accessibility of social participation and broaden social services to health management and monitoring.

Клінічні особливості медикаментозного комплаєнса пацієнтів зі змішаною деменцією, ускладненою галюцинаторно-параноїдними розладами

У дослідженні взяли участь 72 пацієнти зі змішаною деменцією, ускладненою галюцинаторно-параноїдними розладами. В основну групу ввійшли 49 пацієнтів із частковим і неповним медичним комплаєнсом, у контрольну – 23 пацієнти з повним медичним комплаєнсом. У обстежених установлено особливості медикаментозного комплаєнса. Виявлено фактори, що впливають на зниження медичного комплаєнса: відмова / ухилення від прийому призначених лікарем ліків і процедур; негативне ставлення до препаратів, що приймають, та низька оцінка їхньої ефективності; відсутність або часткова критика хвороби та її проявів; коморбідність зі зловживанням алкоголю; низький рівень соціального функціонування та соціальної підтримки; низький рівень терапевтичного альянсу; високий рівень негативної симптоматики.

Social Functioning and Self-Esteem among Substance Abusers at Port-Said Psychiatric Health Hospital

Background: Substance abuse emerges as a significant social issue that negatively affects social functioning, disrupts social harmony. Individuals with low self-esteem have been determined to have a tendency to substance use to control their emotions, behavior and satisfy their need for self-esteem. Aim: To explore the relation between the levels of social functioning and self-esteem among substance abusers at Port-Said Psychiatric Health Hospital. Design: A descriptive correlation research design was utilized in this study. Subjects: were comprised of a sample of 133 substance abusers (males or females). Setting: substance abusers who attended the outpatient unit through the hotline for substance abuse at Port Said Psychiatric Health Hospital. Tools: Two tools were used to collect data in this study; which were Social Functioning Scale (SFS), and Rosenberg Self-Esteem Scale (RSS), in addition to personal and clinical data structured sheet. Results: Three-quarters of the studied substance abusers had a low level of social functioning. About two-thirds of the studied substance abusers had a low level of self-esteem. Conclusion: A statistically significant positive correlation between overall social functioning and total self-esteem among the studied substance abusers. Recommendations: psychosocial intervention should be addressed to substance abusers to improve particular areas of social functioning, such as communication, interpersonal relationships, and employment. Moreover,

Life Accomplishment, Social Functioning and Participation of South-Eastern Nigerians with Lower Limb Amputation

Purpose: For a better understanding of the possible impact of impairments and disabilities on the life of individuals with lower limb amputation,it is important to explore the levels of Life Accomplishment (LA), Social Functioning and Participation (SFP) among them.The present study, set in South-Eastern Nigeria, aimed to study these levels and the influence of selected clinical and demographic variables on these constructs. Method: This cross-sectional survey involved 60 individuals with lower limb amputation (46 unilateral, 14 bilateral) recruited from all the five South-Eastern Nigerian States. The Social Functioning Questionnaire (SFQ), Participation Scale and Life Habit Questionnaire were used for measuring levels of social functioning, social participation and life accomplishment, respectively. Data was analysed using descriptive statistics of frequency count, percentages, mean and standard deviation. Mann-Whitney U and Kruskal-Wallis tests were used to test the hypotheses. Alpha level was set at 0.05. Results: Most of the participants (51.7%-58.3%) had low levels of social functioning across SFQ domains. Most of them (61.7%) had severe participation restrictions, and they all had reduced life accomplishments. Participants with bilateral amputation had poorer levels of social functioning (P Conclusion and Implications: Low social functioning, severe participation restrictions, and reduced life accomplishments were prevalent among individuals with lower limb amputation, particularly amongthose with bilateral and above-knee amputations. There is a need to routinely evaluate the studied constructs among individuals with lower limb amputation. The provision of prosthetic aids may help to improve their levels of life accomplishment, social functioning and participation.

M56. ASSORTATIVE MATING IN SCHIZOPHRENIA AND BIPOLAR DISORDER: A NATIONWIDE COHORT STUDY EXPLORING THE CHARACTERISTICS OF INDIVIDUALS WHO HAVE CHILDREN BY PARTNERS WITH SCHIZOPHRENIA OR BIPOLAR DISORDER

BackgroundAssortative mating is common in patients with mental disorders, both for specific disorders and across the spectrum of mental disorders. Assortative mating may play a key role in mental disorders because the person with the close relation to an individual with a mental disorder is also likely to have mental disorders, poorer cognitive abilities or lower social functioning, which may further intensify problems for both partners and their offspring. When one parent is ill, the care for the child will often depend on the other parent. Thus, assortative mating will most likely contribute to outcomes in the offspring. Therefore, the objective of this study was to investigate possible diagnoses of a mental illness, cognitive ability and social functioning in individuals who have biological children by partners with schizophrenia or bipolar disorder. Further, we also aimed to explore differences in polygenic risk scores derived from genome-wide association studies for schizophrenia, bipolar disorder, and depression.MethodsThis study was based on data from The Danish High Risk and Resilience Study - VIA7, a population-based cohort study conducted in Denmark between 2013 and 2016. Subjects were identified through the Danish Civil registration System and the Danish Psychiatric Central Research register. The VIA7 cohort consists of 522 children aged 7 years with parents diagnosed with schizophrenia or bipolar disorder in the Danish registries (index parents) and their partners (non-index parents). This study focuses on the non-index parents (N = 492) without schizophrenia or bipolar disorder in the Danish registries. All participants were interviewed with a diagnostic interview (SCAN 2.0). Main outcomes were intelligence, processing speed, verbal working memory, and social functioning. A linear mixed effect model was applied for each of the outcomes, including parent status (index parent or non-index parent), group (schizophrenia, bipolar disorder, and control), and interaction between parent status and group.ResultsNon-index parents having children by a partner with schizophrenia or bipolar disorder more often fulfilled the criteria for a mental disorder compared to non-index parents in the control group. Non-index parents having children by a partner with schizophrenia or bipolar disorder had lower levels of social functioning compared to non-index parents in the control group and performed poorer on intelligence and processing speed.DiscussionIndividuals who have children by partners with schizophrenia or bipolar disorder are more likely to have a mental disorder and to have lower levels of cognitive and social functioning compared to individuals who have children by partners without schizophrenia or bipolar disorder. Assortative mating may have important implications for our understanding of the familial transmission of these disorders. The findings presented in this study should be considered in future genetic research in psychiatry, specifically in the investigation of potential risk factors for children with a parent with schizophrenia or bipolar disorder.

An observational study of clinical subtypes in treatment-resistant schizophrenia and its relation with cognitive insight

Background: Schizophrenia is a chronic disorder, and one-third of patients with schizophrenia can develop treatment resistance. Factors such as male gender, early age of onset, positive family history, and low level of social functioning are associated with refractoriness to treatment. However, very few Indian studies have tried to establish the predictors of outcome for schizophrenia. Aims: The aim of the study was to identify the subtypes of treatment-resistant schizophrenia (TRS) and its relation with sociodemographic profile, illness-related variables, and cognitive insight. Materials and Methods: The study was conducted after permission from the institutional review board. Fifty consecutive patients of TRS (treated with two antipsychotics from different classes with adequate doses for 6 weeks each and currently satisfying the Diagnostic and Statistical Manual of Mental Disorders 4th Edition, Text Revision criteria for schizophrenia) were included in the study. Patients were administered a semi-structured questionnaire to obtain details about sociodemographic status, and the Positive and Negative Syndrome Scale was administered to identify the subtypes of schizophrenia. Becks Cognitive Insight Scale was used to assess cognitive insight. Results: Almost half of the sample (46%) belonged to the positive subtype followed by negative subtype. There was a statistically significant difference in the age of onset, educational qualification, and suicidal ideation between the positive and negative subtypes. There was a significant association of cognitive insight between TRS subtypes, and it suggested that patients with positive subtype had poorer insight than those with negative subtype. Conclusions: It is important to identify the subtype of schizophrenia and the risk factors for treatment resistance. Early recognition and intervention with respect to these risk factors can improve the long-term course of TRS.

An integrative model of internalized stigma and recovery-related outcomes among people diagnosed with schizophrenia in rural China

Internalized stigma, an adverse psychological process, severely impedes the lives of people diagnosed with schizophrenia and restricts them from social integration and recovery. The aim of this study was to empirically evaluate an integrative model of relationship between internalized stigma and patients' recovery-related outcomes among people diagnosed with schizophrenia in a rural Chinese community. A total of 232 people diagnosed with schizophrenia in Xinjin, Chengdu, participated in this study and completed measures of internalized stigma, social interaction, perceived social support, social functioning, and symptoms. The internalized stigma of mental illness scale (ISMI) was used to measure the internalized stigma. Path analysis was used to test the association between internalized stigma and recovery-related outcomes. There were no significant differences in mean scores of ISMI by gender, age (18-64years and ≥ 65years), education, marital status, or economic capacity. Internalized stigma was negatively associated with perceived social support and social interaction. Furthermore, higher level of internalized stigma was associated with impaired social functioning, and a lower level of social functioning was significantly associated with more severe symptoms. Internalized stigma is associated with poor social interaction and weakened perceived social support in people diagnosed with schizophrenia, and is linked negatively to outcomes in their recovery. It is essential to tailor interventions related to reducing internalized stigma within a Chinese context and evaluate the effectiveness of anti-stigma intervention on recovery for people diagnosed with schizophrenia.

Evolutionism and involutionism in the ontogenesis of а late age

Individual human development from birth to death is defined as the ontogenesis. The ability of the human psyche to development and to system acquisition of mental and social functions is called evolutionism. The psyche property, causing a gradual loss in the process of ontogenesis of biological, psychological and social functions is defined as involutionism.Involutivitionism of higher mental functions manifests in their folding in the sequence reverse to the formation. Process of involution is uneven and abrupt. This is caused by their constant interaction with the evolution processes, that are struggling with age-related destruction and disruption and are responsible for the ongoing adaptation, although at a lower ontogenetical level.In the event of critical psycho traumatic situations, which are related to the impact of jet-psychological, somatoneurological factors, there is a failure of adaptation mechanisms, decompensation develops, the action of the involutive mechanisms increases, which leads to a lower level of social functioning. In this interaction biological and social factors act in their unity and predetermine disadaptation options, while the latter, in their turn, determine intensification of involutive processes.Because of the interaction of these processes mental aging unevenly affects higher mental functions with the advent of favorable (adamantix) and unfavorable forms, determined by the development of mental disorders and dementia. Favorable aging can manifest itself by specific quantitative somatoneurological and mental changes that do not lead to the loss of adaptation. Under favorable aging life experience, professional skills, biological, social, adaptive resources are preserved, evolutionary development of the older person continues.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Factors impacting the quality of peer relationships of youth with Tourette's syndrome.

BackgroundTourette’s syndrome (TS) is a poorly understood neurodevelopmental disorder consistently associated with impaired peer relationships. This research aimed to investigate the relationship between TS and the ability of diagnosed youth to form secure attachment relationships with peers. A quantitative study examined differences between youth with TS and typically developing peers in social functioning, relationship problems and attachment security. Qualitative studies sought to identify factors that enhanced or impeded the ability to form secure peer relationships, including the impact of tic severity, comorbidity and personality traits. All research was conducted from the parental perspective.MethodsThe research consisted of a controlled, survey-based qualitative and quantitative study (Study One) of parents of youth with TS (n = 86) and control group peers (n = 108), and a qualitative telephone interview-based study of TS group parents (Study Two, n = 22). Quantitative assessment of social functioning, peer problems and peer attachment security was conducted using the Paediatric Quality of Life inventory, the Strengths and Difficulties Questionnaire and the Attachment Questionnaire for Children. Qualitative data relating to personality was classified using the Five Factor Model.ResultsResults revealed significantly higher rates of insecure peer attachment, problems in peer relationships, difficulty making friends, stigmatisation and lower levels of social functioning for the TS group. Significant between-group differences in number and type of factors impacting peer relationships were also determined with ‘personality’ emerging as the most prevalent factor. Whilst Extraversion and Agreeableness facilitated friendships for both groups, higher rates of Neuroticism were barriers to friendship for individuals with TS. The TS group also identified multiple ‘non-personality’ factors impacting peer relationships, including TS and comorbid symptom severity, the child’s psychological and behavioural adjustment to their disorder, coping strategies and the behaviour and attitudes of peers.DiscussionOur findings suggest that, whilst Extraversion and Agreeableness facilitated friendships for both groups, higher rates of Neuroticism were barriers to friendship for individuals with TS. Notwithstanding the fact that these findings are based on parental report and not the perceptions of youth themselves, this study may help clinicians to identify youth at increased risk of developing insecure peer relationships and guide the development of targeted supports.ConclusionsThe findings from the study may help clinicians, parents and individuals with TS to better understand and cope with the difficulties experienced in interactions with peers.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-015-0090-3) contains supplementary material, which is available to authorized users.

Body mass, cardiovascular risk and metabolic characteristics of young persons presenting for mental healthcare in Sydney, Australia

ObjectivesTo determine the body mass, cardiovascular and metabolic characteristics of young people presenting for mental healthcare.DesignCross-sectional assessments of body mass, cardiovascular and metabolic risk factors.SettingTwo primary-care based sites in Sydney,...