Sample Of Psychiatric Patients Research Articles

Судебная схема-терапия: теоретические основания подхода

<p style="text-align: justify;">The article discusses the theoretical model of schema therapy and provides an overview of research on its adaptation for individuals with convictions and those who have committed criminal acts under the influence of a mental illness. The main focus of this article is on research into the diagnostic and therapeutic potential of approaches. Based on the findings of foreign studies, forensic schema therapy has been shown to be effective. Current research directions are proposed, and the possibilities and limitations of the approach are discussed when applied to a sample of Russian-speaking convicts and psychiatric patients. The analysis suggests that forensic schema therapy may be a promising adaptation of the classic theoretical model of schema therapy for individuals who have committed criminal acts under the influence of a mental illness and have been involuntarily hospitalized in a psychiatric hospital. Based on a meta-analysis of the available data, forensic schema therapy has been shown to significantly reduce the risk of criminal recidivism in these populations. The presented review of research in the field of forensic schema therapy in Russian is published for the first time.</p>

The psychiatric nursing care quality questionnaire (PNCQQ)

Introduction: In response to the growing recognition of the importance of the quality care in psychiatric nursing, this study introduces the Psychiatric Nursing Care Quality Questionnaire (PNCQQ) designed to evaluate the quality of care provided to psychiatric patients from diverse cultural backgrounds. Aim: The aim of this research was to develop and validate a comprehensive tool that addresses the unique needs and perceptions of patients across various cultural contexts. Materials and Methods: The development of the PNCQQ involved a rigorous methodology encompassing item generation, expert review, and pilot testing to ensure its relevance and cultural appropriateness. Subsequently, a validation study was conducted with a diverse sample of psychiatric patients to assess the reliability, validity, and cultural sensitivity of the questionnaire. Results: A total of 932 psychiatric patients completed the Psychiatric Nursing Care Quality Questionnaire (PNCQQ) as part of the study. The sample consisted of 57.3% female and 42.7% male participants. The age of participants ranged from 18 to 75 years, with a mean age of 37.8 years. Results indicate robust psychometric properties, including high internal consistency and test-retest reliability, supporting the utility of the PNCQQ in assessing nursing care quality across diverse cultural populations. Conclusions: The implications of this research underscore the importance of culturally competent care in psychiatric nursing practice and highlight the value of utilizing validated instruments to enhance care delivery.

Syndrome or symptoms? Assessing cothymia, neuroticism and lifetime comorbidity in a sample of psychiatric patients

Syndrome or symptoms? Assessing cothymia, neuroticism and lifetime comorbidity in a sample of psychiatric patients

The role of suicide severity in the association between anxiety symptoms and suicidal ideation: a mediation analysis

IntroductionSuicide is one of the leading causes of death worldwide and scientific community investigates suicide risk factors relentlessly. Among these, anxiety symptoms were strongly related to suicidal ideation in several studies. Moreover, sleep and its disturbances are closely connected to mental well-being and psychiatric disorders in a bidirectional pathway.ObjectivesThe main purpose of the present study is to assess the relationship between anxiety symptoms and suicidal ideation in a sample of psychiatric patients and the mediational role of insomnia in this association.MethodsParticipants were 116 consecutive adult psychiatric inpatients (61 women and 55 men) enrolled to the psychiatric inpatient unit of Sant’Andrea Hospital in Rome. The measures used were a socio-anamnestic form, the Columbia Suicide Severity Rating Scale (C-SSRS), the Hamilton Anxiety Rating Scale (HAM-A), and the Insomnia Severity Index (ISI).Results Based on the results of statistical analysis, patients with suicidal ideation showed higher severity of insomnia and higher severity of anxiety symptoms than patients with no suicidal ideation. Moreover, the intensity of suicidal ideation was positively and significantly associated with the severity of anxiety symptoms and with the severity of insomnia. Finally, the mediation analysis showed that the effect of anxiety symptoms on suicidal ideation was completely mediated by insomnia severity.ConclusionsThe main result of the study indicates that patients who perceive more anxiety symptoms were more likely to experience higher suicidal ideation intensity through higher levels of insomnia. These findings implies that screening for sleep disturbances may help identify individuals at risk for suicide, and improving sleep quality through psychosocial and pharmacological treatments could mitigate the association between anxiety and suicidal ideation.Disclosure of InterestNone Declared

Sociodemographic and Clinical Determinants of Psychiatric Hospitalization in Northern Greece: A descriptive study

IntroductionAccording to data, psychiatric re-admissions rates vary from 10%-80%, while they negatively affect the patients’ quality of life and life expectancy. The limitation of multiple psychiatric hospitalizations represents a clinical challenge for all mental health professionals.ObjectivesTo investigate risk factors of hospitalization in a sample of psychiatric patients in Northern Greece.Methods 1,633 records of psychiatry inpatients were examined retrospectively throughout the 10-year records of the Psychiatry Department of Papanikolaou General Hospital in northern Greece. The research was conducted between 2013 and August 2023. The sample was divided into subgroups according to gender, diagnosis, and year of hospitalization. A bivariate analysis was performed to examine relationships between the examined variables: (a.) place of residence; (b.) age; (c.) type of admission; (c.) hospitalization duration; (d.) number of lifetime hospitalizations; (e.) lifetime prosecutor’s orders for coercive examination; and (f.) lifetime suicide attempts.Results A fairly equivalent number of males and females was included in the study (M: 874; F: 759).The mean age of the sample was 44.7 years with males being younger than females (males 43.23; females 46.39). Males residing out of the co-capital as well as females residing within the co-capital of Greece, Thessaloniki, disclosed higher odds of being hospitalized (p<0.03). Coercive hospitalizations represented 47% of cases, bore the highest duration (20.7 days), and involved the youngest patients. Coercively hospitalized male patients outnumbered their female counterparts (p<0.001). Voluntary urgent hospitalizations duration was estimated at 17.04 days, followed by outpatient admissions (12.64 days) and transfers from other clinics (11.35 days). 37% of patients experienced psychosis while 35% experienced affective disorders. Males were more affected by psychosis (Odds Ratio: 1.35; p<0.001). Females were more liable to affective disorders (OR: 1.78; p<0.001). 7% of the sample had committed suicide attempts, with single suicide attempts being ten times higher than multiple suicide attempts (p<0.001). Females were more than twice as likely as males to commit a suicide attempt (p<0.001). Females tended more to be hospitalized self-willingly (p=0.0015) and to voluntarily terminate hospitalizations prematurely (p=0.0014). Patients with a single hospitalization were seven-fold compared to those with multiple hospitalizations (p<0.001). The average lifetime hospitalization number for a patient was one hospitalization, while the average for a patient with previous hospitalizations was three.ConclusionsBeing in position to identify the patients in high-risk for hospitalization -as well as for suicide attempt- the clinician can proceed to initiatives such as treatment modifications or further involving the patient’s family.Disclosure of InterestNone Declared

Suicide risk, hopelessness, interpersonal needs, and mental health in a sample of migrant psychiatric patients: a case-control study

IntroductionSuicide is a multifactorial phenomenon characterized by many biological, psychological, and social-cultural factors. The study of this phenomenon in migrants is complex, with no theoretical framework that can describe the available heterogeneous data. Although Italy has the fourth largest migrant population of EU, only few studies have assessed suicidal risk in migrants.ObjectivesThe aim of his study is to assess suicide risk factors (hopelessness; interpersonal needs; traumatic experiences) in a sample of migrant patients, and to evaluate the possible application of the Interpersonal Theory of Suicide (ITS). Moreover, suicidal ideation and attempts were compared between migrants and natives. Lastly, a wider psychometric assessment has been conducted (depressive and anxiety symptoms; autistic traits).MethodsIn this case-control study, we included 50 migrants vs. 50 natives. Data were collected during the same period by gender, age, and diagnosis. We collected sociodemographic and clinical characteristics. We administered the following tests: Columbia Suicide Severity Rating Scale, Interpersonal Needs Questionnaire, Beck Hopelessness Scale, Beck Depression Inventory-II, Hamilton Anxiety Scale, Childhood Trauma Questionnaire, and Adult Autism Subthreshold Spectrum.ResultsThere were no differences in sociodemographic characteristics, except for ethnicity. Otherwise, there were significative differences between diagnosis (p:0.013), with native reporting more Mood Disorders, and migrants reporting more Anxiety, Obsessive-Compulsive, Trauma-Related, Eating, and Substance Use Disorders. Migrants were more prone to be on treatment with Mood Stabilizers (p:0.000). There were significative differences for interpersonal needs, trauma, anxiety, and autistic traits. Migrants show more perceived burdensomeness (p:0.05), more physical neglect (p:0.004), physical abuse (p:0.002), and sexual abuse (p:0.016), more anxiety symptoms (p:0.046), and more empathy alterations (p:0.014). No differences were found for suicidal ideation and attempts, hopelessness, and depressive symptoms.ConclusionsDespite there were no differences in suicide risk, migrants showed higher rates of perceived burdensomeness (PB) and childhood traumatic experiences (CTE). Both PB and CTE represent cardinal constructs of the ITS. No differences were found for hopelessness and depressive symptoms. Migrants showed higher rates of anxiety symptoms and empathy alterations. Even if suicide rates between migrants and natives were similar, accurate assessment of suicidal risk in migrants is crucial in improving suicide prevention strategies. Suicide risk evaluation in migrants should consider the application of ITS. For an appropriate clinical evaluation of the migrant patients, anxiety dimensions and autistic traits should be investigated.Disclosure of InterestNone Declared

Prevalence and risk factors for metabolic syndrome in schizophrenia, schizoaffective, and bipolar disorder

Background Metabolic Syndrome (MetS) is a risk for developing cardiovascular diseases and its prevalence is especially high in psychiatric patients. To date, there is limited data from the United Arab Emirates (UAE) on the prevalence of MetS. Therefore, we aimed to investigate its prevalence and possible risk factors in a large sample of psychiatric patients in the UAE. Methods A cross-sectional study was conducted at Al-Ain Hospital, in Al-Ain City, UAE. We collected demographic and clinical data on patients diagnosed with schizophrenia, schizoaffective, and bipolar affective disorder in the period between January 2017 and December 2020. This included their secondary diagnosis (psychiatric or medical), vital signs (heart rate, systolic and diastolic blood pressure, Body Mass Index [BMI]), metabolic parameters (fasting blood glucose, cholesterol, triglycerides, low-density lipoprotein, high-density lipoproteins), and prescribed medications. We used the American Association of Clinical Endocrinology (AACE) criteria to diagnose MetS. Results We included 889 subjects and of these, 79.8% (N = 709) had a BMI ≥25 kg/m2 and 9.8% (N = 87) had no abnormal metabolic parameters. Overall, 28.1% (N = 250) had MetS with no statistical difference between the three groups. Fasting blood glucose levels and abnormally elevated triglycerides were significant predictors for MetS. Conclusion Our study found that around one in three patients had MetS irrespective of the three diagnoses. Some variables were significant predictors for MetS. Our findings were consistent with other studies and warrant the need for regular screening and management of abnormal metabolic parameters.

A step-by-step and data-driven guide to index gender in psychiatry.

Beyond sex as a binary or biological variable, within-sex variations related to sociocultural gender variables are of increasing interest in psychiatric research to better understand individual differences. Using a data-driven approach, we developed a composite gender score based on sociodemographic and psychosocial variables showing sex differences in a sample of psychiatric emergency patients upon admission (N = 1708; 39.4% birth-assigned females; mean age = 40 years; age standard deviation = 14). This gender score was extracted from a confirmatory factor analysis (CFI = 0.966; RMSEA = 0.044, SRMR = 0.030) and could predict a person's birth-assigned sex with 67% accuracy. This score allowed the further identification of differences on impulsivity measures that were absent when looking solely at birth-assigned sex. Female birth-assigned sex was also associated with higher rates of mood and personality disorder diagnoses, while higher feminine gender scores were related to higher proportions of anxiety and mood disorder diagnoses. By contrast, male birth-assigned sex and higher masculine gender scores were associated with higher proportions of psychotic and substance use disorder diagnoses. Patients with undifferentiated gender scores (i.e., scoring between masculine and feminine threshold defined by terciles) were more represented in the psychotic disorder group. Considering both sex and gender in psychiatric research is essential and can be achieved even when using secondary data to index gender comprised of demographic and psychosocial variables.

Supplemental Material for A Comparison of the Associations of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Section II Personality Disorders and Section III Personality Domains With Clinical Dysfunction in a Psychiatric Patient Sample

Supplemental Material for A Comparison of the Associations of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Section II Personality Disorders and Section III Personality Domains With Clinical Dysfunction in a Psychiatric Patient Sample

Psychometric properties of the Youth Self-rated Insomnia Scale (YSIS) in adolescent psychiatric patients.

The 8-item Youth Self-rated Insomnia Scale (YSIS) was developed to assess insomnia severity in the past month among youths. The YSIS has satisfactory psychometric properties in the general adolescent population. This study examined psychometric properties of the YSIS in a large sample of adolescent psychiatric patients. A total of 536 patients aged 10-19years were consecutively recruited from the outpatient department of Shandong Mental Health Center between December 2021 and March 2022. Patients completed a structured questionnaire consisting of the YSIS scale and questions about sleep duration, nightmares, psychiatric history, depression, psychiatric and sleep medications, and demographics. Patients were diagnosed following the ICD-10 criteria. Of the participants, the mean age was 15.30 years(SD = 1.95), 61.0% were female, 60.9% were diagnosed with mood disorders, 65.7% were on antidepressants, and 49.0% were on anxiolytics or hypnotics. The mean YSIS score was 22.6 (SD = 8.07). Coefficient omega was 0.84. Exploratory factor analysis revealed one factor and two correlated residuals. The YSIS scores were significantly correlated with depression scores (r = 0.68) and significantly increased with sleep onset latency, short sleep duration, nightmare frequency, and sleep medication use. The YSIS demonstrated satisfactory internal consistency reliability, construct validity, and criteria-related validity in adolescent psychiatric patients. The YSIS appears to be a reliable and valid scale for measuring insomnia severity in adolescent psychiatric patients.

Out-of-home interventions for adolescents who were treated according to the Open Dialogue model for mental health care

BackgroundThe Open Dialogue approach (OD) emphasizes community-based psychiatric treatment for adolescents, but its success in achieving this is poorly documented. ObjectiveTo analyse out-of-home intervention usage in a national sample of adolescent psychiatric patients and determine if OD is linked to increased time until out-of-home intervention. Participants and settingThe register-based cohort study included all adolescents aged 13–20 who received psychiatric treatment in Finland between 2003 and 2008. The research group (n = 780) included adolescents whose treatment was initiated in the Western Lapland catchment area, where OD covered the entire psychiatric service. The comparison group (n = 44,088) included the rest of Finland. National register data encompassed the period from treatment onset until the end of the 10-year follow-up or death. The primary outcomes of interest were the times to the first and second out-of-home intervention, including foster care, supportive housing, and hospitalization. The secondary outcomes included the clinical/demographic characteristics of adolescents treated out-of-home. MethodsThe hypothesis was tested via an inverse probability of treatment–weighted Cox hazard model, plus within- and between-group comparisons to analyse the secondary outcome. ResultsOD was associated with increased time to the first (adjusted hazard ratio [aHR]: 0.61, 95%CI: 0.52–0.72) and second (aHR: 0.75, 95%CI: 0.58–0.96) out-of-home interventions. In both service types, there was a subgroup of adolescents with repeated out-of-home interventions, who also demonstrated poorer long-term outcomes. ConclusionOD-based psychiatric services for adolescents are associated with fewer out-of-home interventions. The clinical significance of the findings warrants further research.

Prevalence and correlates of subjective cognitive impairment in Chinese psychiatric patients during the fifth wave of COVID-19 in Hong Kong.

The extent of cognitive impairment and its association with psychological distress among people with pre-existing mental illness during COVID-19 is understudied. This study aimed to investigate prevalence and correlates of subjective cognitive impairment (SCI) in Chinese psychiatric patients during fifth-wave of COVID-19 in Hong Kong (HK). Four-hundred-eight psychiatric outpatients aged 18-64 years were assessed with questionnaires between 28 March and 8 April 2022, encompassing illness profile, psychopathological symptoms, coping-styles, resilience, and COVID-19 related factors. Participants were categorized into moderate-to-severe and intact/mild cognitive impairment (CI+ vs. CI-) groups based on severity of self-reported cognitive complaints. Univariate and multivariate regression analyses were conducted to determine variables associated with CI+ status. One-hundred-ninety-nine participants (48.8%) experienced CI+. A multivariate model on psychopathological symptoms found that depressive and post-traumatic-stress-disorder (PTSD)-like symptoms were related to CI+, while a multivariate model on coping, resilience and COVID-19 related factors revealed that avoidant coping, low resilience and more stressors were associated with CI+. Final combined model demonstrated the best model performance and showed that more severe depressive and PTSD-like symptoms, and adoption of avoidant coping were significantly associated with CI+. Almost half of the sample of psychiatric patients reported cognitive complaints during fifth-wave of COVID-19 in HK. Greater depressive and PTSD-like symptom severity, and maladaptive (avoidant) coping were found as correlates of SCI. COVID-19 related factors were not independently associated with SCI in psychiatric patients. Early detection with targeted psychological interventions may therefore reduce psychological distress, and hence self-perceived cognitive difficulties in this vulnerable population.

A long-term follow-up study of labor market marginalization in psychiatric patients with and without personality disorder.

Personality disorders (PDs) in adulthood are considered stable over time and are likely to have lasting psychosocial impact on the affected individual, including in areas like vocational functioning. The aim of this study was to study labor market marginalization (LMM) and receipt of social welfare benefits during 13 years from age 18 to 25 years in a sample of former psychiatric patients with and without PD. This study followed-up 186 former psychiatric patients who were thoroughly assessed in 2002-2004, including for PD, and compared them with controls. Participants were divided into three groups: former patients with PD, without PD, and a matched control group from the general population. Register data on employment, sick leave absence, disability pensioning, education, days of psychiatric care, income, and receipt of social welfare benefits in 2003-2016 were collected. Former patients had more days of unemployment, sick leave absence, and disability pensioning and received more social welfare benefits than controls during the study period. Differences between patients with and without PD were smaller than expected, but significant as regards receipt of social welfare benefits. PD also had an effect on income at age 30 years. Early onset of psychiatric disorders impairs vocational functioning up to 13 years after diagnosis, and most in those with PD.

Does the Five Facet Mindfulness Questionnaire measure the same constructs before and after ACT-based treatment? Examination of the longitudinal measurement invariance of the 24-item FFMQ-SF

Violations of longitudinal measurement invariance (LMI) suggest “response shifts” in individuals’ understanding and appraisal of items over time and result in misinterpretation of observed changes in outcome measures. These concerns are crucial to the validity of outcome measures and are particularly relevant in examining the effectiveness of mindfulness and other process-based interventions. In the current report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examine the LMI of the 24-item short form of the Five Factor Mindfulness Questionnaire from intake to discharge in a large, diagnostically heterogeneous sample of psychiatric patients (n = 2928) participating in an acceptance and commitment therapy-based partial hospitalization program. The original five-factor structure required correlated error terms for items with similar wording (Nonjudging of Experience and Describe scales) to achieve acceptable fit. Following these modifications, we found evidence of configural and weak invariance for all scales. We found evidence for strong invariance for Nonjudging of Experience, Nonreactivity to Inner Experiences, Describe, and Observing, but not for Acting with Awareness. Strict invariance was not supported. Results highlight the challenges of measuring constructs involving overt metacognitive processes via self-report. Implications for scale development and clinical practice are discussed.

A Suicide-Specific Diagnosis – The Case For

A Suicide-Specific Diagnosis – The Case For

Adverse childhood experiences as a risk factor for non-suicidal self-injury and suicide attempts in forensic psychiatric patients

BackgroundExposure to adverse childhood experiences (ACE) have been found to have profound negative consequences on an individuals’ health. Non-suicidal self-injury (NSSI) is a clinically complex and serious global health issue and is closely related to suicide attempts. Previous research has found associations between ACE and NSSI and suicide attempts in clinical samples. However, this association has to our knowledge not been studied to this extent in a sample of forensic psychiatric patients. The aim of this study was therefore to describe the prevalence of adverse childhood experiences (ACE) and their associations with non-suicidal self-injury (NSSI) and/or suicide attempts in forensic psychiatric patients.MethodsThe current study is a cross-sectional study of a consecutive cohort of 98 forensic psychiatric patients (86.7% male) in Sweden. We invited 184 patients with a predicted stay of > 8 weeks who had been cleared for participation by their treating psychiatrist. Of these, 83 declined and 98 eligible patients provided informed consent. Information on ACE, NSSI, and suicide attempts derived from files, self-reports (Childhood Trauma Questionnaire-Short Form; CTQ-SF), and interviews were compared separately among participants with and without NSSI or suicide attempts using t-tests. The dose–response association between ACE and NSSI/suicide attempts was analysed using binary logistic regression.ResultsIn file reviews, 57.2% of participants reported physical abuse, 20% sexual abuse, and 43% repeated bullying by peers during childhood. NSSI and suicide attempts were associated significantly with CTQ-SF total scores, with medium effect sizes (d = .60 to .63, p < .01), and strongly with several CTQ-SF subscales. Parental substance abuse was also associated with NSSI (p = .006, OR = 3.23; 95% confidence interval [CI] = 1.36 to 7.66) and suicide attempts (p = .018, OR = 2.75; 95% CI = 1.18 to 6.42). Each additional ACE factor predicted an increased probability of NSSI (p = .016, OR = 1.29; CI = 1.04 to 1.59) but not of suicide attempts. When anxiety and depressive disorders were included in the model, ACE remained a significant predictor of NSSI.ConclusionsWe report extensive ACE, from both files and self-reports. When comparing groups, correlations were found between ACE and NSSI, and ACE and suicide attempts among forensic psychiatric patients. ACE seem to predict NSSI but not suicide attempts in this group, even when controlling for affective and anxiety disorders. Early ACE among forensic psychiatric patients, especially physical and emotional abuse and parental substance abuse, have important impacts on self-harming behaviours that must be acknowledged both by the institutions that meet them as children and in their later assessment and treatment.

The Impact of Event Scale-Revised: Examining Its Cutoff Scores among Arab Psychiatric Patients and Healthy Adults within the Context of COVID-19 as a Collective Traumatic Event.

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD). It has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its determined six subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as a probable ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 & 0.91, p values = 0.001, 95% CI: 0.80-0.92 & 0.87-0.94, sensitivity = 0.85 & 0.87, specificity = 0.73 & 0.83, Youden index = 0.58 & 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by pandemic-related irritability expressed a stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability/dysphoric mood evolved as a direct and indirect effect of key PTSD symptoms (intrusion, hyperarousal, and numbing). The irritability dimension of the IES-R directly predicted the traumatic symptoms of sleep disturbance in both samples while sleep disturbance did not predict irritability. The findings suggest the usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/co-morbidities (e.g., sleep disturbance) in both healthy and diseased groups.

Temporal pathways from attachment insecurity to paranoia in a heterogeneous clinical sample: An experience sampling study.

There has been growing interest in the role of attachment mechanisms in the onset and maintenance of paranoia. The latest systematic reviews of mixed samples of healthy individuals and psychiatric patients have revealed that increased trait attachment anxiety and avoidance are associated with experiencing paranoia, with trait attachment anxiety showing a stronger association. Few studies have examined attachment and paranoia in naturalistic conditions via the Experience Sampling Method. The present study examined whether experiences of attachment anxiety and avoidance fluctuate in the flow of daily life, and whether a within-person change in both attachment states precedes the experience of momentary paranoia, and negative and positive emotions. Thirty-seven clinical participants and twenty-six healthy controls were studied over six consecutive days using the Experience Sampling Method (ESM). An experience-in-close-relationships questionnaire (ECR-R 16 SF) was used to capture trait attachment dimensions. Several ESM items were used to capture momentary negative and positive affect, paranoia and attachment insecurity states. The findings revealed that fluctuations in both attachment insecurity states were significantly higher in the clinical group. A prior elevated attachment anxiety and avoidance was followed by an increase in negative affect in the next moment and elevated attachment avoidance was additionally followed by a decrease in positive affect and an increase in paranoia. Our findings reveal the specific temporal associations between momentary attachment insecurity states as predictors of change in emotions/affects and paranoia, along with evidence that state attachment avoidance has a superior impact on momentary affect and paranoia compared to state attachment anxiety. These results contrast with those of recent cross-sectional studies.

Correlates of Social Isolation in Forensic Psychiatric Patients with Schizophrenia Spectrum Disorders: An Explorative Analysis Using Machine Learning

The detrimental effects of social isolation on physical and mental health are well known. Social isolation is also known to be associated with criminal behavior, thus burdening not only the affected individual but society in general. Forensic psychiatric patients with schizophrenia spectrum disorders (SSD) are at a particularly high risk for lacking social integration and support due to their involvement with the criminal justice system and their severe mental illness. The present study aims to exploratively evaluate factors associated with social isolation in a unique sample of forensic psychiatric patients with SSD using supervised machine learning (ML) in a sample of 370 inpatients. Out of >500 possible predictor variables, 5 emerged as most influential in the ML model: attention disorder, alogia, crime motivated by ego disturbances, total PANSS score, and a history of negative symptoms. With a balanced accuracy of 69% and an AUC of 0.74, the model showed a substantial performance in differentiating between patients with and without social isolation. The findings show that social isolation in forensic psychiatric patients with SSD is mainly influenced by factors related to illness and psychopathology instead of factors related to the committed offences, e.g., the severity of the crime.

Factors linked to suicide risk in a diverse sample of psychiatric patients

IntroductionSuicidal behavior is a global public health problem. Among the most investigated theories for the explanation of suicide there is the interpersonal-psychological theory of suicide (IPTS) by Thomas E. Joiner. IPTS focuses on 3 variables related to lethal suicide attempt: thwarted belongingness, perceived burdensomeness and acquired capability for suicide.ObjectivesWe aimed to understand which variables were mostly related to suicidal ideation (SI) and suicide attempts (SA) in a sample of psychiatric patients.MethodsA sample of 80 psychiatric patients including inpatients (n=18), outpatients (n=21) and patients from various Italian rehabilitative psychiatric communities (n=41) was recruited between June 7th, 2021 and September 12th, 2022. We administered a battery of various scales, including State-Trait Anxiety Inventory, STAI, Beck Depression Inventory, BDI, Reasons For Living Inventory, RFLI, Acquired Capability for Suicide Scale-Fearlessness About Death, ACSS-FAD, Rosenberg self-esteem scale, RSES, Mental pain questionnaire, MPQ, Interpersonal Needs Questionnaire, INQ. For each scale we compared a) patients with and without lifetime SI; b) patients with and without history of SA. Then, we performed two logistic regression models (stepwise backward method), one for SI and one for SA.ResultsBoth patients with SI and SA have higher anxiety (STAI), depression (BDI), mental pain (MPQ), perceived burdensomeness (INQ), thwarted belongingness (INQ), fearlessness about death (ACSS_FAD) and lower self-esteem (RSES), beliefs about coping strategies (RFLI) and moral objections (RFLI). Depression (BDI) and beliefs about coping strategies (RFLI) were the variables most strongly associated with SI; higher fearlessness about death (ACSS-FAD) and low self-esteem levels (RSES) were the variables most strongly associated with history of SA. The SI model was able to predict 84% of ideation cases; the SA model was able to predict 74% of the attempts.ConclusionsThe results supported that improving the ability to cope with suicidal thoughts is a key component of therapeutic work with suicidal patients. In addition, according to the IPTS, the history of SA has been particularly explained by fearlessness about death. Hence it may be important to focus on these aspects in suicide prevention.Disclosure of InterestNone Declared