Understanding Of Mental Illness Research Articles

Schizophrenia and Bipolar Illness in the Relatives of University Scientists: An Epidemiological Report on the Creativity-Psychopathology Relationship.

A potential link between creativity and mental illness has been a longstanding topic for human studies and empirical research. The major problem is defining creativity and establishing its measurable indicators. A few high-quality epidemiological studies have been undertaken and point to a link between creativity and vulnerability to mental illness. Demonstrating such a shared vulnerability could expand our understanding of mental illnesses and open up new avenues of empirical research. In this epidemiological study, we defined scientists (academics) at the universities as individuals assumed to exhibit “more creativity” than the background population. In a register coupling with a population of 588,532 people, we examined successful university academics' first- and second-degree relatives for diagnosed mental disorders and compared those figures with controls from the background population controlling for educational level. The relatives of the academics had significantly increased risk of suffering from schizophrenia or bipolar disorder. For bipolar disorder, it is perhaps temperamental features and high energy levels that contribute to this association. In the case of schizophrenia, the mediating bridge may involve an amplification of human tendency to question the obvious and “taken-for-granted.” Creativity and an increased risk for mental disorders seem to be linked by a shared vulnerability that is not manifested by clinical mental disorders in the academics.

Cross-diagnostic analysis of cognitive control in mental illness: Insights from the CNTRACS consortium

BackgroundIn recent years, psychiatry research has increasingly focused on understanding mental illnesses from a cross-diagnostic, dimensional perspective in order to better align their neurocognitive features with underlying neurobiological mechanisms. In this multi-site study, we examined two measures of cognitive control (d-prime context and lapsing rate) during the Dot Probe Expectancy (DPX) version of the AX-Continuous Performance Task in patients with either schizophrenia (SZ), schizoaffective disorder (SZ-A), or Type I bipolar disorder (BD) as well as healthy control (HC) subjects. We hypothesized significantly lower d-prime context and higher lapsing rate in SZ and SZ-A patients and intermediate levels in BD patients relative to HC. Methods72 HC, 84 SZ, 77 SZ-A, and 58 BD patients (ages 18–56) were included in the final study sample. ResultsSignificant main effects of diagnosis were observed on d-prime context (F(3,279) = 9.59, p < 0.001) and lapsing (F(3,279) = 8.08, p < 0.001). A priori linear contrasts suggesting intermediate dysfunction in BD patients were significant (p < 0.001), although post-hoc tests showed the BD group was only significantly different from HC on d-prime context. Group results for d-prime context remained significant after covarying for lapsing rate. Primary behavioral measures were associated with mania and disorganization symptoms as well as everyday functioning. ConclusionsThese findings suggest a continuum of dysfunction in cognitive control (particularly d-prime context) across diagnostic categories in psychiatric illness. These results further suggest that lapsing and d-prime context, while related, make unique contributions towards explaining deficits in cognitive control in these disorders.

Toward understanding mental illness stigma and help-seeking: A social identity perspective

IntroductionPeople who experience mental illness are unlikely to seek help. Research suggests that mental illness stigma negatively impacts help-seeking, yet there is little information about factors that relate to stigma that are positively associated with help-seeking among those with compromised mental health. Emerging research suggests that aspects of the social identity perspective, namely group social identification and perceptions about the group, may provide insights as to how people who experience mental illness navigate help-seeking. ObjectiveIn two studies we aimed to: (1) identify factors (i.e., social identification and perceptions of the group) that relate to stigma that are also associated with the multi-step process of help-seeking; and (2) explore if these factors and aspects of the help-seeking process that occur prior to service utilization (such as illness and symptom recognition) are positively associated with behavioral service utilization. MethodStudy 1 employed Amazon's Mechanical Turk to recruit 90 participants who reported being diagnosed with a mental illness and not actively seeking treatment (i.e., medication or seeing a psychologist or psychiatrist). Study 2 employed Facebook to recruit 131 participants who self-reported a mental illness diagnosis. ResultsControlling for symptom severity, mental illness stigma was positively associated with social identification, which in turn positively impacted help-seeking in Study 1. Further, the relationship between social identification and help-seeking was strongest among those with a negative perception of the mental illness group. In Study 2, results indicated that social identification predicted behavioral service utilization, providing support for Study 1. ConclusionTaken together, these findings suggest that social identification as a person with a mental illness is positively associated with the multi-step process of help-seeking and may be important for those who experience mental illness stigma to get help that enables and facilitates better functioning.

Between medicalisation and normalisation: Antithetical representations of depression in the Greek-Cypriot press in times of financial crisis.

Media offer people ways of understanding mental health and illness, shaping their attitudes and behaviour towards it. Yet, the literature on media representations of depression is limited and fails to illuminate sufficiently the content of representations. In times of financial crisis, the prevalence of depression is increased and the particular meanings associated with depression are widely diffused. To unpack these meanings, we focused on the Greek-Cypriot press during the financial crisis of 2013. Two-hundred and three articles from seven widely circulating newspapers were thematically analysed. Two antithetical themes of representations of depression were identified: Biomedical Depression, which constructed depression as a biologically grounded illness treated through medical/pharmaceutical means, and Everyday Depression, which portrayed depression as something normal, encountered in anyone, attributed to psychosocial factors (e.g. the financial crisis), and treated through self-management. Biomedical Depression reflects a widespread medical and deterministic understanding of depression. Nevertheless, this understanding has not overridden, as the literature suggests, references to individual agency, which are present in the Everyday Depression and the more normalising understanding of depression it expresses. We argue, however, that both themes promote an individualistic understanding of depression, placing individuals in a tense position of being responsible for a condition perceived to be outside their control.

Working with Families of Emerging Adults: The Interface of Clinical and Legal Issues

ABSTRACTCommunity based clinicians are called upon increasingly to provide treatment to growing numbers of emerging adults with mental health needs. When compared with typical peers, individuals between ages 18-24 with emotional and behavioral challenges and/or intellectual disabilities fare worse in the transition to adulthood.Interpersonal tensions amongst family members are often fueled by limited understanding of mental illnesses; poor communication; disagreements about treatment options; and discord surrounding roles and obligations of both parent and child. Clinical work with family members requires understanding of emerging adulthood from developmental, ecological and legal perspectives. Case examples illuminate themes and practices as well as the occasional interface of legal issues that arise in therapeutic work with parents and adult children.

Adding the Missing Psychiatric Dimension to Cancer Care

Adding the Missing Psychiatric Dimension to Cancer Care

What does it take to be a brain disorder?

In this paper, I address the question whether mental disorders should be understood to be brain disorders and what conditions need to be met for a disorder to be rightly described as a brain disorder. I defend the view that mental disorders are autonomous and that a condition can be a mental disorder without at the same time being a brain disorder. I then show the consequences of this view. The most important of these is that brain differences underlying mental disorders derive their status as disordered from the fact that they realize mental dysfunction and are therefore non-autonomous or dependent on the level of the mental. I defend this view of brain disorders against the objection that only conditions whose pathological character can be identified independently of the mental level of description count as brain disorders. The understanding of brain disorders I propose requires a certain amount of conceptual revision and is at odds with approaches which take the notion of brain disorder to be fundamental or look to neuroscience to provide us with a purely physiological understanding of mental illness. It also entails a pluralistic understanding of psychiatric illness, according to which a condition can be both a mental disorder and a brain disorder.

Cultural concepts of the person and mental health in Africa.

People in different cultures have different concepts of the person that underlie self-understanding and self-representation. These concepts influence many aspects of individuals' life experience, including illness and expectations toward recovery. Psychotherapies aim to promote adaptive change in experience and behavior. This goal is embedded in a social and cultural context that promotes or sanctions a particular notion of personhood. If every system of psychotherapy depends on implicit models of personhood, which varies cross-culturally, then the goals and methods of therapeutic change must consider the cultural concept of the person. This paper reviews cultural concepts of the person in relation to communal values, practices, and systems of thought observed across many African cultural contexts. It presents a practical framework that can inform therapists working with African clients. Many African cultures promote a relational-oriented personhood, in which an individual manifests his or her personhood through connections to three distinct forms of agency: (a) spiritual agency, including God, ancestors, and spirits that influence the person; (b) social agency, including the family, the clan, and the community, with extension to humanity; and (c) self-agency, which is responsible for the person's inner experience. This distinctive form of personhood underlies concepts of the "normal" person, understandings of mental illness, help-seeking behavior, and clients' needs and expectations. Implications of this cultural concept of the person for psychotherapy with African clients are discussed.

Psychiatry and the media: from pitfalls to possibilities

In war, truth is said to be the first casualty. Something similar may be said for psychiatry. The ability of the media to distort public understanding of mental illness is well described (Wahl, 1995; Philo et al, 1994). Psychiatric disorders, their treatments and those who provide them are all subject to overwhelmingly negative portrayals in the print and broadcast media (Hyler et al, 1991). Dehumanisation, inaccuracy and sensationalism seem to be the media's stock-in-trade. Media professionals make no apology for this, citing the provision of impartial, emotionally-neutral accounts as one of their least pressing concerns (Salter & Byrne, 2000). They also reject the notion that they are responsible for the perpetuation of harmful stereotypes, claiming instead that they merely mirror the values and beliefs of our society (Bolton, 2000). This distorting mirror is of great relevance to psychiatry. It is probably no exaggeration to state that the celebrated cases of Christopher Clunis and Ben Silcock have done more to change the practice of community psychiatry than any College President or Secretary of State over the past 5 decades.

El papel de la teoría de la degeneración en la comprensión de las enfermedades mentales, Colombia primera mitad del siglo XX

Este artículo analiza el papel desempeñado por la teoría de la degeneración en la comprensión de las enfermedades mentales en Colombia, a partir de varias publicaciones periódicas y tesis médicas de la primera mitad del siglo XX. Interesa particularmente mostrar de qué manera los médicos colombianos se apropiaron desde comienzos del siglo XX de conceptos como degeneración, diátesis, herencia mórbida y estigmas de degeneración para describir, clasificar y definir las enfermedades mentales presentes en el territorio colombiano. Durante ese periodo la teoría de la degeneración sirvió como el marco conceptual y teórico para comprender la etiología, la génesis y la evolución de las enfermedades mentales

Promoting mental health recovery and improving clinical assessment using video technology.

Although individuals with medical problems (e.g., diabetes, hypertension) can monitor their symptoms using objective measures (e.g., blood glucose, blood pressure), objective measures are not typically used by individuals with psychotic disorders to monitor symptoms of mental illness. To examine the benefits and limitations of the use of video self-observation for treatment of individuals with psychotic disorders. The authors reviewed studies examining video self-observation among individuals with severe mental illnesses. Individuals with psychotic disorders who viewed videos of themselves while symptomatic reported some benefit to this approach, with 1 study showing sustained improvement in understanding of mental illness. Still, some individuals reported negative feelings about the process, and also attributed symptoms to stress or drug abuse rather than their psychotic disorder. The authors found no studies examining the potential for video self-observation as a strategy to improve clinical decision-making in the context of mental health care. Implications of this approach for mental health recovery and clinical practice are discussed. (PsycINFO Database Record

A systematic review of group work interventions in UK high secure hospitals

Abstract Background Rehabilitating high secure hospital patients poses significant challenges. Group work is thought to play a key role in patient recovery; however, there have been no reviews conducted specifically assessing group work interventions for high secure hospital patients. Objectives To review the focus of group work interventions that are being implemented and evaluated with high secure hospital patients in the UK, and to examine the effectiveness of these interventions and the methods used to assess intervention effectiveness. Method A systematic literature search combined with reference screening was conducted examining group work interventions with high secure hospital patients in the UK. Results In total, 28 manuscripts (outlining 29 group work intervention evaluations) were identified for review inclusion. Across these, ten focuses of group work intervention emerged: anger/aggression, offence-specific, enhancing insight and understanding of mental illness, thinking skills/problem solving, substance misuse, self-harm, relationships, self-esteem and well-being, relapse prevention, and moving on. Positive outcomes were generally reported across all ten areas. Conclusions Studies assessing the impact of group work interventions could be improved by increasing sample sizes, reducing sole reliance on self-report measures, employing clear statistical and clinical significance testing, and increasing the use of follow-up assessments and control groups.

Levels of Cognitive Control: A Functional Magnetic Resonance Imaging-Based Test of an RDoC Domain Across Bipolar Disorder and Schizophrenia.

In recent years, the boundaries of psychopathology as defined by diagnostic categories have been criticized as inadequately 'carving nature at its joints' with respect to the neurobiology of major mental disorders. In 2010 the NIMH launched the Research Domain Criteria (RDoC) framework for understanding mental illnesses as brain circuit disorders that extend beyond DSM-defined diagnoses. In the present study we focus on cognitive dysfunction, a core feature of schizophrenia (SZ) and bipolar disorder (BPD), and use functional magnetic resonance imaging (fMRI) during a cognitive control (CC) task in recent onset patients to test the hypothesis that at a behavioral and underlying neural circuitry level these deficits exist on a continuum (as opposed to showing categorical differences) across the two disorders. In total, 53 healthy controls, 24 recent (<1 y) onset patients with BPD Type I with psychotic features, and 70 recent onset patients with SZ performed the AX-Continuous Performance Task while undergoing event-related fMRI at 1.5 T. In addition to behavior task-associated response was examined in frontoparietal regions-of-interest. In an a priori contrast-based analysis, significant deficits across patient groups (vs controls) were observed on CC-associated performance as well as frontoparietal response. These analyses further revealed a continuum of deficits in which BPD showed intermediate levels of CC relative to controls and SZ. Poor CC was associated with poverty and disorganization symptoms across patient groups. These results support the hypothesis that CC dysfunction in BPD and SZ reflects a continuum of deficits that cuts across traditional, DSM-based classification. Implications for the neurobiology of these diseases are discussed.

Children's experiences of living with a parent with mental illness: A systematic review of qualitative studies using thematic analysis.

Introduction This paper brings together what is known about what it is like for children who live with a parent with a mental illness with a view to strengthening our understanding of their experiences. This paper presents an update on previous reviews that were completed in this area and used a systematic approach and stringent inclusion/exclusion criteria to ensure that the voices of children were central in the included papers. A systematic review of this nature could not be located in the literature. Aims This paper presents the findings of a systematic review which explored the experiences of children who were affected by parental mental illness. Methods CINAHL, PubMed, PsychINFO, Pubmesh and EMBASE were searched for qualitative studies which explored children's experiences, and eight studies were included following review and quality appraisal. Pertinent data were extracted, coded and analysed using a thematic approach. Results Four themes emerged from the analytic process which described the children's understanding of mental illness, their relationship with their parents, their coping strategies and their social connections. Implications for Practice Mental health nurses need to recognize the psychosocial needs of children, and to acknowledge, the wider impact mental illness has of the family.

Family group interventions in an early psychosis program: A re-evaluation of practice after 10 years of service delivery.

The role of family in supporting service users in coping with illness and engaging in relapse prevention in early psychosis is important. Taking on this caring though is stressful and challenging, and it has been found that support and information for carers assists in their coping and reduces isolation. To evaluate the current utility of a psychoeducation group program in a public adult mental health service, for the families of people experiencing early psychosis. A purpose-designed pre- and post-intervention questionnaire was administered to quantitatively measure group participants' changes in perceptions of their understanding of mental illness and its treatment through attending the group. Additional qualitative items were used to determine other knowledge, benefits and any critical feedback. The group program continues to result in highly significant improvements in family members' understanding of psychosis, recovery, medications, relapse prevention and substance co-morbidities. Additional feedback reaffirmed previous findings that family members find group peer support valuable and that this reduces isolation and the experience of stigma. The current evaluation, conducted following 10 years of early psychosis group work, found there to be efficacy in family peer support groups and that it is important to provide family interventions in public early psychosis mental health services.

Patients', Family Members', and Professional Carers' Experiences of Psychoeducational Multifamily Groups for Participants with Intellectual Disabilities and Mental Illness

There is a dearth of articles addressing psychoeducational multifamily groups for adults with intellectual disabilities. The objective of this study is to investigate the participants' experiences of being part of a group like this. The group intervention had been slightly modified due to the participants' intellectual disabilities. Four patients, their close relatives, and community professional caregivers were interviewed using a semi-structured scheme. The four patients had participated in different groups. Three of them had autism spectrum disorder in addition to intellectual disabilities and mental illness. None of the patients were in the most acute phase during the group intervention. Topics discussed in the group sessions encompassed friendship, personal economy, hygiene, understanding of mental illness, and the need for help. A basic meal was served at every group meeting. The experiences were favorable.

Legal Insanity: Towards an Understanding of Free Will Through Feeling in Modern Europe

The degree to which insanity or mental infirmity can be instrumentalized in legal debate is shaped by understandings of what insanity is, the currency of a specific diagnosis, as well as official and unofficial symptomatologies, all of which render the law, as a system of knowledge and social practices, porous and permeable in regards to what might be abstractly called »the human mind and heart«. This article explores the changing role of emotions in explaining, demonstrating, and adjudicating insanity during the nineteenth and early twentieth centuries. Over the course of the nineteenth century, the insanity plea became a matter of heated debate in relation to specific trials of capital offenses, which not only brought crime but also the subject of criminal insanity into the public eye. At the same time, the rise of expert scientific testimony and the modern medical sciences – specifically medical psychology and the advent of psychiatry – created different definitions and understandings of mental illness that challenged legal definitions of insanity. This led to interdisciplinary discussion and debate, as physicians sought to provide a serviceable system to the lawyers, and lawyers sought new ways to discover and prove cases. The medicalization and pathologization of emotions not only led to the introduction and interpretation of new kinds of emotional evidence in the courtroom, it also gave emotions a range of different potential meanings, challenging the psychological premises and assumptions of the law as well as the principles and purposes of criminal justice.

Les notes « Observations de l’infirmière » du Département de psychiatrie de l’Hôpital Montfort : une source archivistique incontournable en santé mentale

Introduction Nurses' notes are used primarily as a communication tool between nurses, doctors and member of the professional team to ensure continuity of patient care. They contain life-history of individuals with mental health disorders. This nurses' communication tool describes the patient care during hospitalization in acute psychiatric ward. In fact, these observations contained in the progress notes represent more than a simple picture of mental illness. They always tell a story constructed by socio-cultural norms.Objectives The purpose of this article is to demonstrate the value of these narratives data as a comprehensive source of information to understand the experience of mental health following the deinstitutionalization project.Results The use of nursing progress notes of the Psychiatric Department allows, among other things, a better understanding of the life course of some hospitalized patients. The narrative data in those documents enhance the intersection between personal experiences and social, institutional and professional structures. These primary sources offer a multitude of possibilities in mental health research and can be examined from different angles of analysis. They deserve to be exploited in future research project to increase our understanding of mental illness.

Mental Health Court Participants' Perspectives of Success: What Key Outcomes Are We Missing?

ABSTRACTMental health court research has largely assessed program effectiveness using criminal recidivism as an indicator of success. The present study expands this literature by exploring mental health court participants' perceptions of how the mental health court impacted them. We analyzed in-depth interviews with 26 participants from 2 different mental health courts using thematic analysis. Participants identified four salient successes that they perceived to result from mental health court participation: improved psychiatric stability, sobriety, improved relationships, and increased engagement in life and mental health. While reduced substance use and “staying out of trouble” were seen as successes, participants also reported recovery-oriented outcomes like improved relationships with family, mood stability, increased patience, ability to care about others, and greater understanding of mental illness as measures of their success. Although recidivism is an indicator of success, future mental health court research would benefit from utilizing additional measures of success that span criminal justice, recovery, and mental health outcomes.

The expansion of the Foundation Programme in psychiatry.

The Broadening the Foundation Programme report has led to an expansion in the number of psychiatry foundation placements. This change will have far-reaching benefits for foundation doctors doing psychiatry, no matter what their future career intentions. Doctors will develop a better understanding of mental illness, they will improve their communication skills and they will gain experience of working within multidisciplinary teams. Recruitment into psychiatry is also likely to improve. The Royal College of Psychiatrists is putting in place a number of measures to ensure that placements are of a high quality so that foundation doctors have a good experience of psychiatry.