Psychiatric Rehabilitation Center Research Articles

Changing Pattern of Substance Abuse in Patients Attending a Regional Psychiatric Rehabilitation Center at Al-Qassim, Saudi Arabia

Background and Purpose The aim of this study was to record the prevalence and the characteristics of substance abusers from the year 2007 to 2017 and also to find the most prevalent form of substance abuse and association, if any, between the abusers and their demographic characteristics. Materials and Methods Descriptive and retrospective medical record review included patients of substance abuse attending a rehabilitation center in Buraidah from January 2007 to December 2017. A majority of 5,639 patients (63.6%) belonged to the age group of 31–50 years. Twenty-five and thirty-nine percent patients had secondary and higher education, respectively. Notably, more than half of them were unemployed. The commonly abused single drugs were amphetamine (40%), cannabis (11%), and alcohol (7%). High school goers’ cases have continuously spiked over the years. Substance abuse over the years from 2007 to 2017 was above 11% in 2007 and 2015. From 2009 to 2014, it was between 8 and 10%. However, the number of cases reported dropped to below 9% from 2016 onward. Amphetamine saw a downfall except peaking in 2010 and 2015. On the other hand, there was no substantial jump in the abuse of alcohol and cannabis over the years, but an increasing use from 2015 onward was visible. There was also a gradual rise over the years in the abuse of polysubstance (more than three drugs). Conclusion There is a growing trend in the use of polysubstance and the combination of two substances. There is a high incidence of drug abuse in high schoolers and also in patients in the age groups of 10–30 years.

Relationship between changing cognitive domains and atypical antipsychotic treatment in bipolar disorders: a three-year observational study in a psychiatric rehabilitation center during COVID-19 pandemic

IntroductionBipolar Disorders have been consistently associated with cognitive dysfunction across a broad range of cognitive domains (patients, who usually took psychiatric drugs, sometimes presented changes of cognitive disorders). Many studies have focused on improving the illness severity of patients with MDD or BD by combining mood-stabilizing drugs with atypical antipsychotics (AA). However, the results are contradictory and have not confirmed the certain superiority of AA to other therapeutic strategies. Among these, the cognitive remedy has demonstrated important effectiveness on cognitive variations in this group of patients.ObjectivesIn our study, we tried to evaluate some changes in cognitive function in patients with BD treated with antipsychotics related to critical problems with typical cognitive tests.MethodsIn our observational study, we recruited forty-three inpatients (20 females, 23 males) affected by Bipolar Disorder (DSM-5 criteria; particularly 78.5% affected by BD-I), in a psychiatric rehabilitation center. All patients were included in the ordinary rehabilitation treatment. All patients were treated with mood stabilizers (lithium n. 14; valproate n. 29), and at least one AA. The AAs have been the following: quetiapine, aripiprazole, and olanzapine (authorized in Italy)(Table 1). The observation period lasted three years, during three significant waves of the COVID-19 pandemic.All patients at baseline (T0) (March-April 2020), T1 (Maj-June 2021), T2 (April-Maj 2022), and T3 (April – June 2023) were administered the following rating scales: BPRS, YMRS, GAF, and HAM-DThe data were statistically analyzed with the EZAnalyze 3.0 software for the Excel platform.ResultsIn Table 2 and Graphic the results obtained with the rating scales and statistical analysis are shown. In BRPS the data shows a statistically significant reduction in the total score in all periods analyzed. Similar results were found in the GAF and YRMS scales. However, with the HAM-D Scale, there was evidence of an increase in T2, although the differences were not statistically demonstrated. The differences in mean scores are more evident for quetiapine and olanzapine.Image:Image 2:Image 3:ConclusionsOur observational study showed that the atypical antipsychotics used in our work allowed a significant improvement of the symptoms in BD. However, the pandemic waves have no correlation with the treatment performed. New studies are necessary to highlight the relationship of the pharmacological treatment of BD with the progress of the COVID-19 pandemic.Disclosure of InterestNone Declared

Sociodemographic Association of Caregivers Burden with Schizophrenia Disorder

Objective: The aim of this study is to find out a relationship between life satisfaction and caregiver burden among patients who are suffering from psychiatric illness.
 Materials and methods: The sample size of this study was 170 psychiatric patients. Primarily consent was received from the higher authorities of the psychiatric hospitals and rehabilitation centers in Karachi. Zarit Burden Interview Scale (ZBIS) and Satisfaction with Life Scale (SWLS) were used. Psychiatric patients were divided into schizophrenia disorder (n = 85) and bipolar disorder (n = 85). Data were analyzed by statistics software (SPSS, version, 20.0). The sample was constituted with male 75 (44.1%) and females were 95 (55.9%). The average age range of caregivers was between 19 and 60 years with M = 44.74 and SD = 12.05 years.
 Results : The results indicated that caregiver burden was a significant predictor of satisfaction with life in patients with schizophrenia disorder [R2, .554; F (1.84) = 36.711, p<.000]. A significant difference was also observed between male and females caregivers of psychiatric patients on the variable of caregiver burden and satisfaction with life scale (i.e. t=-3.129; p=.<002; t=3.528; p=.<.001).
 Conclusion: It is concluded that caregiver burden significantly affects the level of mental health of the caregivers of patients with psychiatric disorders.
 Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 89-94

Awareness and utilization of complimentary and alternative medicine (CAM) therapies in managing mentally ill patients at Dorayi psychiatric rehabilitation center, Kano, Nigeria

Awareness and utilization of complimentary and alternative medicine (CAM) therapies in managing mentally ill patients at Dorayi psychiatric rehabilitation center, Kano, Nigeria

Effectiveness of Gatekeeper Training for Families of People With Mental Disorders in Korea: A Randomized Controlled Trial.

Given the high suicide risk among people with schizophrenia and other mental disorders and the significance of intervention in the daily life setting, tailored gatekeeper training is necessary for families of people with mental disorders. This study evaluated the effectiveness of a suicide prevention education program for families of people with mental disorders (SPEM-F), developed by the Korea Foundation for Suicide Prevention. Fifty-nine family members of people with mental disorders were recruited from eight community psychiatric rehabilitation centers in Korea and enrolled in a cluster randomized controlled trial. Four facilities were randomized to the experimental group (n=30) and four to the control group (n=29). The study parameters were measured at baseline, post-intervention, and 1-month follow-up; the effects of SPEM-F (90 minutes, conducted offline) were analyzed using repeated-measures analysis of variance. The dependent variables were suicide-related knowledge, attitude, self-efficacy, preventive behavioral intention, and family problem-solving communication. The experimental group showed significant increases in suicide-related knowledge (p<0.001), self-efficacy (p<0.05), and preventive behavioral intention (p<0.01) compared with the control group until the 1-month follow-up, including an upward trend in improved family problem-solving communication (p=0.069). The results confirm that SPEM-F is an effective evidence-based gatekeeper training program for families of people with mental disorders, as it focuses on knowledge, self-efficacy, preventive behavioral intention, and communication improvement. As families of people with mental disorders including schizophrenia, are both highly motivated and close to people at high risk for suicide, SPEM-F can effectively promote suicide prevention and gatekeeper activities.

Caregiver Burden in Substance Use Disorders Patients

Background: Substance Use Disorders (SUDs) impose significant challenges not only on individuals grappling with addiction but also on the caregivers who provide support and care. The caregiving role is associated with multifaceted burdens that require understanding and targeted interventions. Recognizing the diverse dimensions of caregiver burden is crucial for offering effective support. Objective: The study aimed to find out the caregiver burden in substance use disorder patients, examining severity and socio-demographic correlations, contributing insights into effective support strategies. Methodology: The cross-sectional observational study took place at Sylhet MAG Osmani Medical College's Psychiatry Department and a private psychiatric and drug rehabilitation center in Sylhet from September 1, 2018, to August 31, 2020. The research focused on substance use disorder patients and their caregivers, involving 50 eligible patients selected through inclusion and exclusions criteria. Diagnoses followed DSM IV criteria. Socio-demographics were gathered via semi-structured questionnaires. Caregiver burden was assessed using the Bengali Zarit Burden Interview (ZBI) scale through approximately hour-long interviews, with 1-2 daily. Ethical procedures encompassed informed consent and confidentiality assurance. Result: The study included 50 male participants. Patients mean age was 31.92 (±8.21) and caregivers mean age was 41.68 (±12.89). Mainly, caregivers were mothers (40%) and wives (34%). Caregivers experiencing moderate to severe burden were 58%, mild to moderate burden were 26%, and severe burden were 16%. Mean ZBI score was 48.22±13.55. Higher burden correlated with illiteracy, low family income, excessive drug spending, prolonged substance use, and multiple drug usage. Alcohol users faced more burden than other substance users. Female caregivers, younger age, and housewives experienced heightened burden. No burden links were found with marital status, habitat, religion, family type, or drug administration method. Conclusion: This study concluded that Substance use heightens caregiver burden, notably among female, young, and housewife caregivers. Addressing these trends is vital for effective care of substance use

The legacy of William (Bill) A. Anthony: Past, present and future.

William (Bill) A. Anthony was a pioneer in the field of psychosocial/psychiatric rehabilitation and recovery. He established the Center for Psychiatric Rehabilitation at Boston University and served as the editor/coeditor of the Psychosocial Rehabilitation Journal (later Psychiatric Rehabilitation Journal). He helped to clarify ideas, principles, policies, and practices that promoted the right and ability of people living with psychiatric disabilities and mental health challenges to aspire to and achieve their own vision of a meaningful life. This introductory article briefly overviews Bill's contributions to psychiatric rehabilitation and recovery of people with mental health challenges and his influence on recent work in this field, a sample of which is presented in the current special section dedicated to him. To conclude, the article overviews this special section, which reports on studies in the United States and elsewhere, addressing supported education, recovery colleges, photovoice to promote community integration, and policy developments in Israel. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sustainability in Dutch and Flemish mental healthcare: A descriptive and comparative study

Introduction There is an urgent need for sustainable thinking and practices in healthcare systems to meet the challenge of climate change (Charlesworth &amp; Jamieson, 2019; Corvalan et al., 2020; Luykx &amp; Voetterl, 2022; Madden et al., 2020). This need is accelerated by the recent energy crisis. According to an international NGO policy paper (Karliner et al., 2019) healthcare institutions are large energy consumers and major emitters. The (mental) health sectors of the Netherlands and Flanders, the northern part of Belgium, also greatly contribute to the global climate crisis. Both regions have per capita emissions (between the 0.50t and 1t) that fall just below the world’s healthcare top emitters.ObjectivesTo evaluate the state of sustainability in Dutch and Flemish mental health institutions (including psychiatric hospitals, rehabilitation centers, and community mental health centers) and assess whether certain differences can be found in the climate policies of these institutions between both regions.Methods Board members of mental health institutions were asked to complete a 20-item online survey in which concrete actions, objectives and ambitions in the field of sustainability were questioned. Frequencies and percentages were calculated for each question. For certain topics chi-squared tests were performed to test differences in sustainability issues addressed in the questionnaire between Dutch and Flemish mental healthcare institutions.Results Survey response rates for Dutch and Flemish mental health institutions were 38% and 20%, respectively. Ninety-five percent and 38% of respectively the Dutch and Flemish institutions fully agreed that sustainability is a very important theme (χ2(1)=2,25, p=0,13). Key focus areas in both regions included sustainable energy transition (with half of the mental health institutions sourcing at least half of their energy via renewable energy resources and technologies) and recycling (almost 80% of the institutions). Statistically significant differences were found between both regions with regard to monitoring the environmental impact (Flanders 24% vs. The Netherlands 60%, χ2(1)=6,41, p=0,01) and fostering more sustainable commutes (Flanders 72% vs. The Netherlands 15%, χ2(1)=17,35, p&lt;0,0001). The climate impact of medicines and food, as well as investments in sustainable projects, received little attention.ConclusionsAlthough a substantial part of Dutch and Flemish mental health institutions consider sustainability (very) important, a systemic ‘transformation’ will be necessary to make them climate neutral, as tenets of practicing mental healthcare sustainably include more than sustainable energy transition and recycling (Monsell et al., 2021). Moreover, a lack of sufficient investment opportunities, partly due to a lack of financial resources, seems to be the main barrier for many mental healthcare institutions for quickly reaching sustainability goals.Disclosure of InterestNone Declared

정신간호사의 인권감수성과 주도성이 정신장애인의 옹호태도와 옹호개입에 미치는 영향

The subjects of this study were 199 nurses attending the hospital and community mental health center or psychiatric rehabilitation center in B and K city. Data collected were analyzed using the SPSS/WIN 26.0 program. Correlations were calculated for the perception of proactivity, and human rights sensitivity and regression analysis were performed to examine the effect on advocacy attitudes and advocacy interventions. Factors having the greatest influence on nurses’ advocacy attitudes are “proactivity” (β =.532), and “human rights sensitivity” (β=.291), and the explanatory power was 60.5%. Factors having the greatest influence on nurses’ advocacy intervention are “proactivity” (β=.532), “human rights sensitivity” (β=.291), “turnover” (β=.121), “religion” (β=.092), “position” (β=.083) and the explanatory power was 72.6%. In addition, a continuous program should be developed and offered to psychiatric nurses who may have a positive approach toward advocacy.

A qualitative exploration of stakeholders' perspectives on the experiences, challenges, and needs of persons with serious mental illness as they consider finding a partner or becoming parent.

While many persons with serious mental illness (SMI) consider intimate relationships and becoming parent as central parts of their lives deeply affecting wellbeing and recovery, others anticipate facing multiple challenges in these life domains. This qualitative study sought to explore the perspectives of persons with SMI and mental health providers (MHPs) with diverse backgrounds and practices on the experiences, challenges, needs and expectations of persons with SMI as they consider finding a partner or becoming parent. For this qualitative study, we conducted five focus groups between March and December 2020 for a total number of 22 participants (nine persons with SMI and thirteen MHPs) recruited from a center for psychiatric rehabilitation and a community mental health center in France. We used the inductive six-step process by Braun and Clarke for the thematic analysis. Participants reported some challenges related to intimate relationships, stigma/self-stigma, disclosure and decision-making about start a family. Their expectations included: (i) psychoeducation about decision-making about finding a partner and starting a family; (ii) support in making empowered decisions about finding a partner, starting a family or disclosure to a prospective partner or their child; (iii) peer-support interventions; (iv) enhancing coping strategies; (v) integrated service provision including home treatment interventions, training to recovery-oriented practices and access to dedicated resources for providers. In short, intimate relationships and desire to start a family for persons with SMI should be more considered in psychiatric rehabilitation and additional support and interventions should therefore be provided.

Toward recovery-oriented perinatal healthcare: A participatory qualitative exploration of persons with lived experience and health providers' views and experiences.

Perinatal mental health disorders (PMHD) remain often undetected, undiagnosed, and untreated with variable access to perinatal mental health care (PMHC). To guide the design of optimal PMHC (i.e., coproduced with persons with lived experience [PLEs]), this qualitative participatory study explored the experiences, views, and expectations of PLEs, obstetric providers (OP), childcare health providers (CHPs), and mental health providers (MHPs) on PMHC and the care of perinatal depression. We conducted nine focus groups and 24 individual interviews between December 2020 and May 2022 for a total number of 84 participants (24 PLEs; 30 OPs; 11 CHPs; and 19 MHPs). The PLEs group included women with serious mental illness (SMI) or autistic women who had contact with perinatal health services. We recruited PLEs through social media and a center for psychiatric rehabilitation, and health providers (HPs) through perinatal health networks. We used the inductive six-step process by Braun and Clarke for the thematic analysis. We found some degree of difference in the identified priorities between PLEs (e.g., personal recovery, person-centered care) and HPs (e.g., common culture, communication between providers, and risk management). Personal recovery in PMHD corresponded to the CHIME framework, that is, connectedness, hope, identity, meaning, and empowerment. Recovery-supporting relations and peer support contributed to personal recovery. Other factors included changes in the socio-cultural conception of the peripartum, challenging stigma (e.g., integrating PMH into standard perinatal healthcare), and service integration. This analysis generated novel insights into how to improve PMHC for all users including those with SMI or autism.

Independent Living: A Phenomenological Study on the Experiences of People with Mental Illness

Purpose: This study is to understand the experiences of people with serious mental illness following adjustment to independent living.Methods: Aphenomenological research approach was used. Research participants were recruited from community psychiatric rehabilitation centers where they received the support for successfully independent living in the community. In-depth interviews were conducted with a total of 20 research participants from September 2019 to August 2021. The collected data were analyzed using the phenomenological analysis method previously described by Giorgi.Results: Four major themes emerged from our analysis: (1) feeling free in everyday life changed when they started living independently; (2) being the owner of my life; (3) feeling surrounded by barriers at the start of independent living; and (4) required efforts and support for fully living independently.Conclusion: Our study findings encourage fundamental understanding of benefits and difficulties in adjusting to independent living and the adjustment process among people with serious mental illness through in-depth analysis of their experiences. It is necessary to conduct further studies to develop interventions to support people with serious mental illness once they start living independently and instruments to measure their independence.

The Outcome of Psychiatric Rehabilitation Treatment Depends on Affective State at the Time of Admission.

In Austria, new approaches of rehabilitation programs focus on the prevention of mental illness and offer treatment not only for acute psychiatric patients, but also for those who are at risk of developing a mental disorder or have recovered from one.The aim of this study was to determine the effects of a psychiatric rehabilitation program on individuals with different mood states. 600 patients with a history of affective disorder were tested at the time of admission to an Austrian inpatient psychiatric rehabilitation center. Data of extreme groups - patients who were depressed (n=59; BDI-II<9 and HAMD<8) or euthymic (n=59; BDI<18 and HAMD>19) at the time of therapy start - were analyzed. The participants completed the Maslach Burnout Inventory - General Survey, the Symptom Checklist - Revised and the Stress Coping Questionnaire at the beginning and the end of the 6-weeks rehabilitation program. After 6 weeks, both groups showed significantly less psychiatric symptoms (BDI-II, HAMD, SCL-90, and negative coping strategies (SVF). Importantly, work-related stress symptoms ("burnout" symptoms) improved significantly in the euthymic group. Euthymic patients seem to be able to focus on work-related stress symptoms including reduced emotional exhaustion through treatment, while currently depressed patients primarily benefit by an improvement in general psychiatric symptomatology. The results indicate the crucial role of mood state validated with standardized psychological questionnaires BDI-II and HAMD at time of admission to such programs. These findings could have implications on treatment decisions for psychiatric patients and assist in making a forecast concerning ability to recover and treatment prognosis.

Specific Associations Between Type of Childhood Abuse and Elevated C-Reactive Protein in Young Adult Psychiatric Rehabilitation Participants.

Early-life adversity such as childhood emotional, physical, and sexual trauma is associated with later-life psychiatric and chronic medical conditions, including elevated inflammatory markers. Although previous research suggests a role for chronic inflammatory dysfunctions in several disease etiologies, specific associations between childhood trauma types and later-life inflammation and health status are poorly understood. We studied patients (n = 280) admitted to a psychiatric rehabilitation center. Self-reported histories of childhood emotional, physical, and sexual trauma were collected with a standard instrument. At the time of admission, we also assessed individuals' body mass index and collected blood samples used to examine inflammatory marker C-reactive protein (CRP) levels. The prevalence of all 3 types of abuse was relatively high at 21% or more. Fifty percent of the sample had elevations in CRP, with clinically significant elevations in 26%. We found that compared with a history of emotional or physical abuse, a history of childhood sexual trauma was more specifically associated with elevated CRP. This result held up when using linear regressions to examine the contribution of body mass index. Our sample was relatively young, with an average age of 27.2 years and minimal representation of ethnic and racial minority participants. Relative to childhood emotional and physical trauma, childhood sexual trauma may lead to elevated inflammatory responses, as confirmed in our finding of an association between CRP and sexual abuse. Future studies need to assess the causal link between childhood sexual trauma and poorer health outcomes later in life.

Examining the Autonomic Nervous System in the Relationship among Heart Rate Variability, Stress Coping, and Cognitive Ability in Individuals with Psychiatric Disorders.

Depression is one of the most severe psychiatric disorders and affects patients on emotional, physical, and cognitive levels. Comorbid somatic conditions, such as cardiovascular diseases, are frequent and affect the quality of life, as well as mortality. Underlying maladaptive autonomic nervous system regulation influences emotional and cognitive processes. This study, thus, aimed to investigate the relationship among heart rate variability (HRV), self-reported coping strategies, executive function, and inhibition in individuals with psychiatric disorders. Data of 97 patients treated in a multi-professional psychiatric rehabilitation center for 6 weeks were analyzed. Subjects underwent psychological tests (Stress Coping Style Questionnaire, Emotional Competence Questionnaire, and Becks Depression Inventory-II), a cognitive test (Color-Word Interference Test), and a 24 h electrocardiogram to record HRV. Patients with higher depression scores had significantly lower HRVs and decreased self-reported abilities for stress coping. Depression severity did not affect cognitive inhibitory abilities. HRV was related to neither coping strategies nor cognitive inhibition abilities. However, lower HRV was related to higher values of Negative Stress Coping (β = −0.21, p < 0.05). This relationship was fully mediated by depression severity (−4.79, 95% CI: −8.72, −0.72). HRV is not related to quantitative cognitive inhibition, but to the self-reported ability to cope with negative emotions in individuals with psychiatric disorders.

'Income Generation Programs' for Patients at Psychiatric Rehabilitation Centers

'Income Generation Programs (IGPs)' for patients are practiced at psychiatric rehabilitation centers for vocational training or productive engagement. IGPs are similar to work programs with the added benefit of the opportunity to generate revenue and contribute to patients' income. Based on our experience and visits to several psychiatric rehabilitation centers running IGPs, we conceptualize how existing work programs can be translated into IGPs and/or new IGPs can be established. We also discuss the benefits of IGPs, the facilitators and challenges, and various stakeholders' roles.

Development and Evaluation of an Integrated Health Management Program for Psychiatric Patients with Metabolic Syndrome

This study developed an integrated health management program for metabolic syndrome in psychiatric patients and examined its effects on self-efficacy, healthy lifestyle, physiological indicators, knowledge of metabolic syndrome, attitudes toward healthy behavior, and social support. A non-equivalent control group pretest posttest design was used. The participants were 65 psychiatric patients with metabolic syndrome in psychiatric rehabilitation centers, with 33 in the experimental group and 32 in the control group. The experimental group participants engaged in daily mobile application and walking exercises three times a week for more than 40 minutes over 8 weeks, while those in the control group were provided education booklets. The outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. Intervention effects were analyzed using the independent t-test, Mann-Whitney U test, ANCOVA, and Ranked ANCOVA. The experimental group showed a significant increase in self-efficacy (F = 8.85, p = .004, ηp² = .13) and knowledge of metabolic syndrome (t = 2.60, p = .012, d = 0.60) compared to the control group. Additionally, the experimental group demonstrated a significant decrease in waist circumference (Z = -2.34, p = .009, d = 0.58) and body mass index (Z = -1.91, p = .028, d = 0.47) compared to the control group. The integrated health management program for psychiatric patients with metabolic syndrome is effective in improving self-efficacy and knowledge of metabolic syndrome and decreasing physiological indicators such as waist circumference and body mass index.

EFFECTIVE THERAPEUTIC INTERVENTIONS TO PROMOTE RECOVERY FROM FIRST PSYCHOTIC EPISODE AND MINIMIZE ITS RELAPSE: A QUALITATIVE STUDY FROM PAKISTAN

Objective: To explore effective therapeutic strategies to promote recovery from first episode of psychosis and minimize its relapse.&#x0D; Study Design: Qualitative study.&#x0D; Place and Duration of Study: Karwan-e-Hayat Psychiatric Care and Rehabilitation Center, Karachi, from Mar to Jun 2019.&#x0D; Methodology: Seventeen participants were recruited through purposive sampling and data was collected through in-depth interviews. Qualitative thematic content analysis was done through generation of a coding scheme.&#x0D; Results: Almost half i.e., 8 (47%) had experience of 10 years, while 7 (41%) had 15 years’ experience, and 2 (12%) had 30 years’ experience as psychiatrists. Analysis of the interview transcripts revealed three main themes related to psychiatrists’ views on interventions for first episode of psychosis to prevent relapse: (1) duration of first episode of psychosis (2) compliance and rate of recovery after first episode (3) effective interventions for first episode psychosis.&#x0D; Conclusion: The effective interventions to promote recovery from first psychosis episode and minimize its relapse included multiple combinations of integrated stage-specific approaches necessitating antipsychotics (pharmacological) and psychosocial support (non-pharmacological).

Correlates of community rehabilitation service utilization among persons with psychiatric disabilities.

The use community psychiatric rehabilitation (CPR) service could facilitate community tenure, autonomy, and recovery among persons with psychiatric disabilities. Nevertheless, based on existing scientific evidence, the conformance rate with the treatment recommendations was modest and the existing services are underutilized in Taiwan. This study examined the correlates of CPR service utilization based on the Behavioral Model of Health Service Utilization. Especially, the effects of enabling factors were explored. Five hundred and ninety-two participants from 32 community psychiatric rehabilitation centers in Taiwan completed the questionnaire. There were three groups of independent variables: predisposing, enabling, and need factors. Multiple regression analysis with a hierarchical method of entry was performed. The hypothesized model was significant. Eight independent variables in the model explained 29.3% of the variances in the service utilization. Three enabling factors were significant after controlling for the effects of other factors. The most important correlate was professional relationships followed by family support and welfare subsidy. The findings support that factors associated with CPR service utilization need to be examined separately from general mental health service. CPR program design and service delivery should consider the three most important enabling factors and the extent of service utilization could be enhanced.

Association between satisfaction with life and caregiver burden, among psychiatric patients

Background: People who are dealing with psychological disorders are not able to take care of themselves; therefore, their family has to take care of them. While dealing with psychological issues is itself difficult for their family members. Schizophrenia and Bipolar disorder are psychological severe disorder that has a considerable influence not only in the patient but also for the entire family. This study aims to determine a relationship between life satisfaction and caregiver burden among caregivers of patients suffering from psychiatric illness.&#x0D; Methodology: We started the research after approval from the board of study and prior consent from the psychiatric hospitals' higher authorities and rehabilitation centers in Karachi. The authorities demonstrated the research objectives, the consent letter, and the questionnaire to be filled by the researcher. Zarit Burden Interview Scale (ZBIS) and Satisfaction with Life Scale (SWLS) (Pavot &amp; Diener) were used. The sample size of this study was 170 psychiatric patients. Psychiatric patients were divided into schizophrenia disorder (n=85) and bipolar disorder (n=85).&#x0D; Results: The result indicates that the caregiver burden is the predictor of satisfaction with life in patients with bipolar disorders. It also shows in results that there was a significant difference among the different levels of the duration of illness on the variable of caregiver burden scale and satisfaction life scale among the caregivers of patients with schizophrenia and bipolar disorders. Further, findings indicate significant differences between males' and females' caregivers of psychiatric patients on the variable of caregiver burden and satisfaction with life scale.&#x0D; Conclusion: We concluded that caregiver burden significantly affects the mental health of the caregivers of patients with psychiatric disorders. Also, caregivers of people who are mentally ill patients suffer a lot of burdens. Therefore, interventions that can assist them, such as providing them with a support system and counselling services, must be created.