Opioid-induced neurotoxicity (OIN) is a significant complication in palliative care, presenting with symptoms of hypersomnolence, hallucinations, cognitive dysfunction (including delirium), myoclonus and hyperalgesia. Due to limited research studies, a consensus on recognising these clinical manifestations is yet to be reached, complicating both early diagnosis and management. This rapid review aims to synthesise current evidence on the prevalence, clinical manifestations, risk factors and management strategies of OIN in the palliative care setting to enhance clinical practice. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic search of Medline, Embase and the Cochrane Central Database, complemented by supplementary searches in ten palliative care journals. Studies with five or more palliative care patients were included, excluding those involving minors, animal models or substance misuse. Data were extracted, cross-checked and synthesised narratively. A total of 21 studies met the inclusion criteria. Prevalence of OIN varied widely from 6.4% to 38%, with common symptoms including delirium, myoclonus and hyperalgesia. Identified risk factors included age, renal and liver dysfunction, high opioid doses and concurrent use of specific medications. Opioid rotation and dose reduction emerged as potential management strategies, though patient responses varied significantly. OIN is under-diagnosed due to symptom overlap with other conditions. While opioid rotation and dose reduction show promise in managing OIN, further research is needed to establish standardised diagnostic criteria and effective treatment protocols. Enhanced clinical awareness and an individualised approach to opioid prescribing are crucial for improving patient outcomes in palliative care. CRD42024543988.

BACKGROUND Auditory hallucinations are common among patients undergoing mechanical ventilation, are often linked to sedation and stress, and may prolong recovery. As such, effective nonpharmacological nursing strategies are required. AIM To explore and evaluate the clinical effectiveness of non-pharmacological psychiatric nursing interventions for auditory hallucinations in patients undergoing mechanical ventilation. METHODS Retrospective clinical data from 110 patients with auditory hallucinations while undergoing mechanical ventilation were divided into 2 groups (n = 55 each): study (bundled rehabilitation nursing), and control (routine care). The Auditory Hallucination Rating Scale and Hamilton Anxiety and Depression Scales (HAM-A and HAM-D, respectively) were used to assess changes in hallucinations and psychological status. Duration of mechanical ventilation, single auditory hallucinations, and hospital stay were compared. Sedation levels were assessed using the Richmond Agitation-Sedation Scale. RESULTS The study group exhibited significantly shorter mean duration of mechanical ventilation (6.56 ± 1.13 days), single hallucinations (3.34 ± 1.08 minutes), and hospital stay (12.22 ± 1.07 days) compared with the control group (8.03 ± 1.04 days, 5.13 ± 1.22 min, and 14.18 ± 1.27 days, respectively) (P < 0.05). After nursing intervention(s), both groups exhibited reduced Auditory Hallucination Rating Scale, HAM-A, and HAM-D scores; however, the reductions were more pronounced in the intervention group (P < 0.05), with no significant baseline differences (P > 0.05). The study group exhibited lower Richmond Agitation-Sedation Scale scores both at and after extubation (P < 0.05). Satisfaction with nursing care was higher in the intervention group (92.72%) than in the control group (76.36%) (P < 0.05). CONCLUSION Bundled rehabilitation nursing interventions for auditory hallucinations in patients undergoing mechanical ventilation effectively improve hallucination symptoms and psychological status, shorten mechanical ventilation and hospitalization, promote recovery, and enhance patient satisfaction.

Auditory hallucinations are among the most disabling symptoms in individuals with schizophrenia (SZ) and are linked to aberrant signaling within deep-striatal circuits, such as the nucleus accumbens (NAc) and caudate head (CH). However, causal tests of striatal involvement have been limited by the inaccessibility of these structures using noninvasive neuromodulatory techniques. Low-intensity focused ultrasound (LIFU) provides millimeter-scale precision capable of modulating deep-brain circuits, but its feasibility and impact on hallucinations in SZ remain unknown. SZ participated in a within-subject cross-over feasibility trial including two active LIFU sessions (NAc, CH) and one sham control (unfocused sonication), spaced one-week apart. Resting-state fMRI and hallucination symptoms were acquired at baseline and immediately post-sonication. LIFU was delivered safely and well-tolerated in all patients. Acoustic simulations show consistent engagement of both striatal targets across subjects. Clinically, SZ demonstrated significant reductions in hallucination severity following active LIFU to NAc and CH, relative to baseline. Mechanistically, SZ exhibited abnormally high striatal-superior temporal cortex (STC) connectivity at baseline. Immediately after sonication, active LIFU to NAc and CH produced robust reductions in striatal-STC coupling in SZ. This first-in-human study demonstrates that deep striatal LIFU is safe, feasible, and produces functional-connectivity changes accompanied by hallucination severity reductions in SZ. The convergence of symptom improvement with reduced striatal-STC coupling provides mechanistic proof-of-concept evidence that this circuit provides a promising biomarker and therapeutic LIFU target in psychosis and motivates larger sham-controlled trials to test the causal role of striatal circuitry in hallucination generation in SZ.

In the context of acute psychiatric care characterized by severe hallucinatory symptoms, providing timely and effective interventions poses challenges. Therapy administered by Mental Health Nurses (TKN) emerges as a promising solution to comprehensively address these acute symptoms. This therapeutic approach is designed to alleviate hallucination symptoms during the acute phase. This study aimed to investigate the effectiveness of Therapy administered by Mental Health Nurses (TKN) as an intervention tailored for individuals facing acute hallucinatory challenges. The overarching goals include exploring the therapeutic dimensions of the intervention, assessing the potential for tailored interventions based on demographic factors, and translating findings into practical implications for mental health professionals. This study used a quasi-experimental design with a one-group pre-post-test structure. A total of 117 participants diagnosed with schizophrenia from outpatient psychiatric wards were selected in community setting, excluding individuals with concurrent mental retardation to maintain sample homogeneity. Data collection, conducted over two months from July to August 2023, included a pre-test assessment before any intervention to establish baseline hallucinatory symptoms. Therapy by Mental Health Nurses (TKN) was administered over two weeks, consisting of four 30- to 45-minute sessions for each participant. After each session, participants underwent reassessment for hallucinatory symptoms, totaling five assessments. Psychotic Syndrome Rating Scale (PSYRAT) was used to measure hallucination scores. The data analysis employed paired t-tests for baseline and post-intervention scores within a two-week period. A Repeated Measures Analysis of Variance (ANOVA) assessed the effect of interventions on hallucination scores, with age, gender, and adherence status as factors. Post hoc analyses, including pairwise comparisons, identified specific subgroup differences and assessed the time effect within the same group. The study cohort primarily consisted of adults (90.6%), maintaining a balanced gender distribution with 51.3% males and 48.7% females. A substantial portion had low educational backgrounds (59%), and the majority were unemployed (87.2%), with family members serving as the predominant primary caregivers (87.2%). Regarding medication adherence, over half adhered to the prescribed regimen (52.1%). Results demonstrated an improvement in hallucination symptoms for adolescents and the elderly compared to adults. While gender and adherence status did not individually influence symptoms significantly, age category emerged as a significant contributing factor (F = 3.991, p = 0.021). Interaction effects emphasized the substantial influence of time on symptom shifts over the intervention (F = 24.164, p <0.001). Particularly, the mean difference of 4.636 (p <0.001) from Time 1 to Time 5 signified a substantial decrease in hallucination scores, highlighting the cumulative impact of the therapy. These findings underscore the effectiveness of Therapy administered by Mental Health Nurses (TKN) across diverse demographic factors, providing valuable insights for tailored interventions in psychiatric emergencies. Therapy administered by Mental Health Nurses (TKN) demonstrates effectiveness in reducing schizophrenia symptoms, especially among adolescents and the elderly. The impact of time on the intervention's effectiveness is notable, with a cumulative effect observed over the intervention period. Sustained and consistent engagement with the therapy leads to more substantial improvements in hallucination symptoms. Therefore, tailored interventions considering age are crucial for optimal effectiveness. This understanding enables practitioners to optimize the therapy schedule, aligning it with the natural progression of symptom alleviation.

Hallucination is a manifestation of a mental problem, where individuals experience alterations in sensory perception, such as hearing voices, sometimes seeing things, and also feeling sensations, touch, and smell. Patients may experience hallucinations in the form of stimuli where they hear various sounds that practically do not exist, not even human voices. They may hear other voices that correspond to what the patient will later perceive as commanding them to harm themselves, others, or the community. The impact of auditory hallucinations is often accompanied by symptoms of depression and anxiety. The purpose of this scientific paper is to determine the effect of talking therapy and scheduled activities, specifically praying, on the ability to control hallucinations. This qualitative case study was conducted for 5 days, from April 6, 2023, to April 19, 2023. The data from the two respondents were collected using an instrument sheet to assess hallucination symptoms. The results of this case study show a decrease in hallucination symptoms in both respondents, with patient 1's initial score of 9 decreasing to 3, and patient 2's initial score of 13 decreasing to 6. In conclusion, this scientific paper indicates that talking therapy and scheduled activities, specifically praying, have an influence on reducing hallucination symptoms, as well as advice for families to always accompany the implementation of conversation therapy and carry out scheduled activities for patients and for puskesmas to always make regular visits to the community with schizophrenics.

ABSTRACT Introduction: Hallucinations are among the most prevalent psychiatric symptoms encountered in clinical settings and may compromise patient safety if left untreated. This review aims to synthesize evidence on the effectiveness of art therapy for patients experiencing hallucinations. Method: A narrative review was conducted using PubMed, ScienceDirect, and Google Scholar databases. Ten articles published between 2019 and 2024 were selected based on the keywords art therapy, hallucinations, and schizophrenia.Results: Ten studies met the inclusion criteria and were relevant to the objectives of this review. Conclusion: Art therapy demonstrates effectiveness in reducing hallucination symptoms and may be considered a complementary nursing intervention for patients with sensory perception disturbances.

Background: Patients experiencing auditory hallucinations are characterized by hearing whispers or seeing shadows and experiencing sensations through their senses of touch, smell, taste, sight, and hearing. Purpose: To evaluate the effectiveness of occupational drawing therapy in reducing auditory hallucinations in patients with schizophrenia. Method: Data collection on the respondents' cases used a descriptive case study design, with art therapy intervention provided. The intervention was conducted over three days. One respondent was treated with a nursing problem of sensory perception disorder (SPD) and hallucinations. Data collection was conducted before and after the procedure using the AHRS questionnaire and a checklist of signs and symptoms of hallucinations based on the Indonesian Child Health Association (IDHS). This intervention was administered over three days, with each session lasting 45 minutes. Results: Drawing therapy has been shown to reduce the signs and symptoms of hallucinations. Before therapy, the patient's AHRS score was 11, categorized as severe, and the observation of signs and symptoms was 9. After therapy, the score decreased to 4, categorized as mild, and the observation of signs and symptoms was 2. Conclusion: This additional intervention can be used as a reference for non-pharmacological therapy considerations because it has been proven effective in reducing the signs and symptoms of hallucinations. Keywords: Drawing Therapy; Hallucinations; Schizophrenia.

Mental health is a state of well-being that encompasses physical, psychological, and social aspects, and is not merely the absence of illness or disability. Mental disorders are serious mental health problems that can interfere with an individual's cognitive, affective, and social functioning. As a result, a person experiences difficulties in carrying out daily activities. One of the most common mental disorders is schizophrenia. Schizophrenia is a serious, chronic, and debilitating mental illness characterized by disorganized thinking, delusions, hallucinations, and strange or catatonic behavior. Auditory hallucinations are a stimulus disorder in which patients hear voices, especially human voices. Usually, patients hear people talking about what they are thinking and ordering them to do something. The purpose of this final nursing research paper is to overcome hallucination symptoms by applying occupational therapy (beading). The method used in this final nursing project is a descriptive case study explaining the nursing care provided over 5 days, including assessment, intervention by applying strategies such as scolding, controlling hallucinations, performing scheduled activities, and occupational therapy (bead stringing). From the evaluation results, the patient was able to recognize hallucinations, control hallucinations well, and reduce the frequency of hallucinations. The benefits for health services are to provide additional information on nursing services, improve service quality, and provide comprehensive nursing care for patients with mental disorders who experience auditory hallucinations. For the development of nursing science, it is hoped that this will enhance nurses' ability to provide nursing care and serve as an evaluation tool for nurses in delivering mental health nursing services. Keywords: mental health nursing care, auditory hallucinations, occupational therapy (stringing beads)

Pain identification and treatment are important for managing the neuropsychiatric symptoms of dementia and improving quality of life in people with the condition. Quantitative clarification of facilitators and barriers to pain identification and treatment is warranted for multi-component programme implementation. This study aimed to identify the factors related to pain identification and treatment in both care recipients and providers, through the implementation of a multi-component dementia care programme for managing neuropsychiatric symptoms. This study used longitudinal data from naturalistic long-term care settings between April 2022 and March 2025 in Tokyo, Japan. A total of 1,282 care recipients with 3,497 evaluations was included. Care professionals from community and residential care providers participated in a multi-component programme for managing neuropsychiatric symptoms associated with dementia. They provided information concerning care recipients using a web-based tool. Care professionals held interdisciplinary discussion meetings to evaluate neuropsychiatric symptoms, identify their underlying causes and establish an action plan to address the identified causes. We conducted a multilevel binomial regression analysis using pain identification and treatment as dependent variables. The independent variables included sex, type of dementia and type of provider at the between-person level. Within-person-level variables included the types of caregivers involved in the meetings, prescribed medications, the number of identified causes other than pain and the levels of neuropsychiatric symptoms per evaluation. Of the 3,497 evaluations, 1,617 (46%) identified pain, and 517 (32% of evaluations with pain identified) targeted pain in the action plans. Pain identification was more likely to occur in individuals with greater number of identified causes underlying neuropsychiatric symptoms, fewer symptoms of apathy and those in residential care providers compared to home care management agencies or individual home care providers. Pain treatment was significantly more likely to appear in action plans that included care managers in interdisciplinary discussion meetings, in individuals with fewer identified causes underlying neuropsychiatric symptoms, fewer symptoms of hallucinations, and in those receiving care from residential care providers rather than home care management agencies. The involvement of care managers in interdisciplinary discussion meetings may facilitate pain treatment to address the neuropsychiatric symptoms of dementia. Educational strategies are warranted to help front-line care workers improve their pain management skills.

Mental disorders are a health problem that remains a major challenge in Indonesia. Auditory hallucinations are a sensory perception disorder that often occurs in patients with schizophrenia. Patients have difficulty distinguishing between real and unreal stimuli, which can lead to risky behaviors such as harming themselves or others. One non-pharmacological intervention that can be applied to address hallucinations is the rebuke technique, which is a firm and directed verbal action to reject perceived hallucinations. The purpose of this study is to describe nursing care for patients with sensory perception disorders: auditory hallucinations with the application of the rebuke technique as the main intervention. This study uses a descriptive case study approach on one patient in the Flamboyan Ward of Dr. RM. Soedjarwadi Klaten Mental Hospital. Data collection was carried out through interviews, observations, and documentation studies, then analyzed based on the stages of the nursing process. The results showed that after the rebuke technique intervention was consistently implemented for three days, there was a decrease in the frequency of hallucinations from 3-4 times to 1-2 times a day. The patient also showed an increase in the ability to recognize and reject hallucinations independently. Furthermore, the patient began to engage in social interactions and participate more actively in daily activities. The conclusion is that the reprimand technique has proven effective as a nursing intervention in addressing auditory hallucinations. This intervention is simple, easy to implement, and can improve the patient's coping skills in dealing with hallucinatory symptoms.

ABSTRACTObjective:This study aimed to determine the efficacy and safety of low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) combined with risperidone in the treatment of schizophrenia patients with auditory verbal hallucinations (AVH).Methodology:This retrospective cohort study was conducted in Wenzhou Seventh People’s Hospital and included data from 100 schizophrenia patients with AVH, treated from May 2022 to May 2024. Among them, 50 patients who received low-frequency rTMS combined with risperidone were matched with the cohort of patients who received risperidone alone in a ratio of 1:1. The scores of the Psychotic Symptom Rating Scale (PSYRATS), Auditory Hallucination Rating Scale (AHRS) and Positive and Negative Syndrome Scale (PANNS) were compared between the two groups at baseline, at the end of treatment (five weeks) and after one month of follow-up.Results:PSYRATS, AHRS, and PANSS scores of the two groups decreased with time (p<0.05). After treatment, the general psychopathological symptoms, positive symptom scores, and PANSS total scores of the rTMS/risperidone group were lower than those of the risperidone group (p < 0.05). There was no difference between the two groups at one-month follow-up (p > 0.05). The incidence of adverse reactions during treatment was comparable in the two groups (p > 0.05).Conclusions:The results of this study showed that risperidone, combined with 1Hz rTMS, showed no benefit in improving the auditory hallucination symptoms of schizophrenia patients with AVH. However, the combined regimen could significantly improve the positive symptom scores of patients during treatment.

Based on data from the Sindangkasih Health Center, the number of cases of severe mental disorders, namely schizophrenia, is 43 cases from all cases of mental disorders. This case study is to determine the effectiveness of the application of rebuke therapy and positive affirmation therapy on hallucinations in patients with sensory perception disorders: Auditory Hallucinations. Schizophrenia is a neurological disease that affects the patient's perception, way of thinking, language, emotions, and social behavior. Hallucinations are a condition where an individual loses the ability to distinguish between stimuli (thoughts) and external stimuli (the outside world). The method used in this Scientific Paper is qualitative in the form of a comparative case study on two respondents. The implementation of this case study was carried out by means of a home visit to the homes of both respondents, the interventions given were in the form of rebuke techniques and positive affirmation therapy for 5 days of nursing to reduce the signs and symptoms of hallucinations. There was a decrease in signs and symptoms in both respondents after being given intervention, signs and symptoms in client 1 decreased from the initial 24 to 11, while in client 2 decreased from the initial 33 to 24. The technique of reprimanding and positive affirmation therapy is very influential in reducing signs and symptoms of hallucinations, this intervention can be done independently or assisted by family. Suggestions for the provision of reprimanding techniques and positive affirmation therapy can be further increased as an effort to control hallucinations.

Hallucinations are disturbances in sensory perception of an external stimulus object, this sensory disturbance penetrates all five senses. Hallucinations are one of the symptoms of mental disorders, patients experience changes in their sensory perception and experience false sensations of hearing, seeing, tasting, touching or smelling, feeling stimuli that are not actually psychiatric patients experiencing a change in reality orientation. The aim is to determine the characteristics of the patient before carrying out the scheduled activity of reading the Qur'an, implementing the scheduled activity of reading the Qur'an in schizophrenic patients with hallucinations, implementing the implementation stage of the description of the implementation of observing the implementation of Nursing Care with the Implementation of Medication Compliance and Scheduled Activities: Reading Al-Qur'an Against Decreasing Signs and Symptoms of Hallucinations with a percentage of 82 percennt. This scientific paper uses case studies on 2 patients who experience hallucinatory sensory perception disorders. The results of this case study showed that both patients experienced a decrease in signs and symptoms of hallucinations. The conclusion of this case study is that the strategy of medication adherence and activity therapy: reading the Qur'an is effective in reducing hallucinations. Suggestions for families to be able to participate in providing nursing care to patients with hallucinatory sensory perception disorders so that patients feel there is support that can accelerate the healing process of their illness.

IntroductionAcoustic-verbal hallucinations (AVH) occur in children and adolescents without psychotic disorders. They are often associated with anxiety, thymic and behavioral disorders and a history of trauma, notably post-traumatic stress disorder (PTSD). AVH may be transient, but their persistence increases the risk of progression to a psychotic disorder. The aim of this study was to observe the links between markers of emotional and social cognition and the presence of AVH in children with PTSD, as well as the evolution of post-traumatic and psychotic symptoms.MethodsThis was a prospective 6-month study, including children aged 8–16 with PTSD and without psychotic disorder (DSM-5). Participants were divided into two groups, with and without AVH. Emotional cognition markers were measured using the DES IV and BAVQ-R, while social cognition markers were assessed via the NEPSY II test.Results31 patients were included: 16 with AVH and 15 without. Results showed that at inclusion, markers of emotional and social cognition were not associated with AVH. At 6 months, markers of emotional cognition were significantly associated with the persistence of AVH, PTSD and psychotic disorders, unlike those of social cognition.ConclusionEmotional cognition markers play a central role in the evolution of hallucinatory, post-traumatic and psychotic symptoms, and could become a target for prevention and targeted therapy.Clinical trial registrationClinicalTrials.gov NCT03356028

Background: Hallucinations are symptoms of mental disorders that affect sensory perception and impair thought control, often leading to risky behaviors if not supported by family or friends. Purpose: To evaluate the effectiveness of occupational drawing therapy in reducing auditory hallucinations in patients with schizophrenia. Method: A qualitative case study aimed to examine changes in hallucinatory symptoms and the ability to control them through drawing occupational therapy. The intervention was conducted from January 25 to February 1, 2025, involving one patient who received daily sessions lasting 20–30 minutes. Instruments used included the Drawing Therapy SOP, Auditory Hallucination Rating Scale (AHRS), and a symptom observation sheet. Results: Before therapy, the patient's AHRS score was 19, and symptom observation was 12. After therapy, the scores decreased to 9 and 4, respectively. Conclusion: Drawing therapy helped divert attention from hallucinations, encouraged emotional expression, and reduced symptom intensity. Keywords: Hallucinations; Occupational Drawing Therapy; Schizophrenia.

Clinical care and research need to improve treatment availability for auditory verbal hallucinations (AVH). To provide further evidence, we examined the efficacy of an unguided six-weeks self-help intervention for AVH (MCTVoice) based on metacognitive training. N=78 participants with distressing AVH were recruited from clinical and non-clinical settings. We conducted a randomized controlled trial (RCT) that compared the MCTVoice with a waitlist control group (WLcontrol), both receiving additional treatment-as-usual. Outcomes were the frequency and distress of AVH, general hallucinatory and psychiatric symptoms, quality of life, and satisfaction with the intervention, following an intention-to-treat (ITT) and per-protocol (PP) principle. Besides, we conducted an explorative cluster analysis to examine subgroups of voice hearers. We found no significant differences between the groups on the frequency and distress of AVH. However, general hallucinatory experiences were significantly reduced in the MCTVoice compared to the WLcontrol group in PP-data (F(3,48)=39.51, p=.038, η2p=0.09). No other between group comparisons were significant. The cluster analysis revealed a two-cluster solution with a higher (type 1) and a lower (type 2) symptom burden group, with higher values of clinical and AVH characteristics in cluster 1. Besides, participants in cluster 1 showed significantly greater improvements in AVH compared to cluster 2 (F(1,44)=7.97; p=.007, η2p=0.15). Even though we found no effect of the MCTVoice on the main outcome, results showed promising outcomes on general hallucinatory experiences in PP data. The identification of AVH clusters could contribute to implement individualized interventions that target specific characteristics and needs of voice hearers.

Post-schizophrenic depression, a depressive episode that occurs in patients with schizophrenia, often presents with more prominent depressive symptoms than schizophrenic symptoms. Despite pharmacotherapy, additional therapies are essential to improve symptoms and overall functioning. This study explores the use of neurofeedback as an adjuvant therapy in a 50-year-old female patient with a history of paranoid schizophrenia. The patient presented with symptoms of sadness, withdrawal, auditory and visual hallucinations, and a PHQ-9 score of 22. Along with pharmacotherapy (escitalopram, risperidone, and trihexyphenidyl), the patient underwent five sessions of neurofeedback with an alpha/theta/beta2 protocol aimed at enhancing alpha waves, which are often deficient in depressed individuals. Results showed that the patient's alpha wave amplitude increased from 9.2% in the first session to 9.9% in the fifth session, and the PHQ-9 score decreased, indicating improvement in depressive symptoms. These findings suggest that neurofeedback is an effective non-invasive therapy for post-schizophrenic depression, enhancing treatment outcomes when used alongside pharmacological interventions, ultimately improving the patient's quality of life and mental health.

Background: Caregivers of dementia patients are at higher risk of coronary heart disease (CHD) than non-caregivers, and diastolic blood pressure of caregivers is reportedly associated with the frequency of disruptive behaviors in dementia patients. Factors related to the higher risk of CHD in caregivers include the impact of stress on the autonomic nervous system and glucose metabolism, as well as poor blood pressure control. Elevated HbA1c levels have been reported to correlate with the likelihood of developing hyperglycemia under stress. Thus, identifying caregivers’ psychological stressors may help control elevated glucose metabolism. The present study aimed to identify factors that influence the levels of HbA1c, an important stress-related health indicator, in caregivers. Methods: This cross-sectional study assessed the association between HbA1c and hallucinatory symptoms (a peripheral symptom of dementia patients). Subjects were caregivers who provided care at home (hereafter, “caregivers”) and their care recipients with dementia (hereafter, “patients”). Results: Factors significantly associated with caregiver HbA1c were patient sex (OR: 5.423, P = 0.013, 95%CI: 1.435, 20.500), patient age (OR: 0.894, P = 0.049, 95%CI: 0.800, 1.000), and patient hallucinatory symptoms (OR: 0.635, P = 0.070, 95%CI: 0.388, 1.037). Discussion: The proportion of spousal caregivers tended to be higher than other types of caregivers. Caregivers likely felt more difficulty caring for their loved ones and had more anxiety and stress based on their sex. As dementia patients aged, caregivers may have acquired coping skills not only to address physical caregiving but also psychological symptoms associated with dementia. Conclusion: Our findings suggest that monitoring biochemical data is important for understanding the physical condition of and preventing diabetes and cardiovascular disease in caregivers, and highlight the importance of caregivers being aware of their own stress from an early stage.

Causal Discovery Analysis Reveals Insights into Psychosis Proneness, Brain Function, and Environmental Factors among Young Individuals.

Hallucinations are one of the most common sensory perception disorders in patients with mental disorders, particularly schizophrenia. One non-pharmacological therapy that can be used to reduce hallucination symptoms is occupational drawing therapy. This study aims to analyze the effectiveness of occupational drawing therapy in reducing hallucination signs and symptoms through a literature review method. Literature searches were conducted using the Google Scholar database with relevant keywords and article selection was based on inclusion and exclusion criteria. The results show that occupational drawing therapy significantly reduces hallucination symptoms in patients, both in terms of symptom intensity reduction and changes in patient conditions. This therapy helps patients express emotions, distraction from hallucinations, and improve self-control. Therefore, occupational drawing therapy can be considered an effective non-pharmacological intervention for managing patients with hallucinations.