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Early Intervention in Psychiatry最新文献

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Expanding Perspectives on Treatment Outcomes in Clinical High-Risk for Psychosis: The Role of Comorbidities and Individual Differences 拓展精神病临床高危人群治疗结果的视角:合并症和个体差异的作用。
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-10-27 DOI: 10.1111/eip.13621
Lien-Chung Wei, Kuo-Ping Li
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引用次数: 0
Reply to Wei and Li: Commentary on Expanding Perspectives on Treatment Outcomes in Clinical High-Risk for Psychosis 回复 Wei 和 Li:《拓展精神病临床高危人群治疗结果的视角》一文的评论。
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-10-15 DOI: 10.1111/eip.13620
Aubrey M. Moe, Heather M. Wastler, Nicholas J. K. Breitborde
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引用次数: 0
Intergenerational Injustice and Youth Mental Health: A Call to Action 代际不公正与青少年心理健康:行动呼吁书》。
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-10-11 DOI: 10.1111/eip.13619
Gerald Jordan, Farina Akhtar, Nimra Ahsan, Elizabeth Egharevba, Robyn Kimber, Noor Saffy, Eszter Horvath
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引用次数: 0
Response to ‘Letter to the Editor: Weight gain and metabolic screening in young people with early psychosis on long acting injectable antipsychotic medication’ 回应 "致编辑的信:服用长效注射抗精神病药物的早期精神病青少年的体重增加和代谢筛查
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-09-10 DOI: 10.1111/eip.13589
Flavie Waters, Gordon Shymko, Terina Grace, Daniel Hacking, Nicole Jolly, Arti Parmar, Louise Dobson, Puanna Kapi
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引用次数: 0
Do Non-Clinical Services Help to Improve Functional Outcomes Among Young Adults With Mental Disorders? A Systematic Review 非临床服务是否有助于改善患有精神障碍的年轻成年人的功能结果?系统性综述。
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-08-30 DOI: 10.1111/eip.13606
Kate Gossip, Julie John, Charlotte Comben, Holly E. Erskine, James G. Scott, Sandra Diminic

Introduction

Mental disorders during young adulthood can significantly impair functioning in daily activities. Non-clinical support services aim to improve functioning by helping people to build social and life skills, participate in education and employment and improve physical health. This study aims to examine and synthesise the evidence for non-clinical services on improving functional outcomes for young adults with mental disorders.

Methods

A systematic search was undertaken to identify quantitative and qualitative studies reporting on a non-clinical service component (vocational support, peer support, youth development, lifestyle interventions, family and network support) and examining functional outcomes (e.g., outcomes focussed on work and education, life skills, relationships and healthy behaviours).

Results

Seventeen studies met inclusion criteria. Identified studies focussed on vocational support services (n = 9), lifestyle interventions (n = 6) and family and network support services (n = 2). No studies on peer-support services or youth development services were found. More than half of the vocational support service studies reported increased employment rates among young adults (n = 6). Studies focussing on lifestyle interventions included a combination of physical activity, nutrition education, health coaching and motivation and behaviour change. However, the measures of functioning used across studies were too varied to determine whether lifestyle interventions may be useful in improving functional outcomes for young adults.

Conclusion

Further research is needed to understand the impact of non-clinical services on functioning. This evidence will provide pragmatic guidance for service planners to invest in supports and interventions that make a meaningful difference to the lives of young adults living with mental disorders.

简介青壮年时期的精神障碍会严重影响日常活动的功能。非临床支持服务旨在通过帮助人们建立社交和生活技能、参与教育和就业以及改善身体健康来改善他们的功能。本研究旨在审查和综合非临床服务在改善患有精神障碍的年轻成年人的功能结果方面的证据:方法:我们进行了系统性检索,以确定报告非临床服务内容(职业支持、同伴支持、青年发展、生活方式干预、家庭和网络支持)并检查功能性结果(例如,以工作和教育、生活技能、人际关系和健康行为为重点的结果)的定量和定性研究:结果:17 项研究符合纳入标准。已确定的研究侧重于职业支持服务(9 项)、生活方式干预(6 项)以及家庭和网络支持服务(2 项)。没有发现关于同伴支持服务或青少年发展服务的研究。半数以上的职业支持服务研究报告称,年轻成年人的就业率有所提高(n = 6)。以生活方式干预为重点的研究包括体育活动、营养教育、健康指导以及动机和行为改变的组合。然而,各项研究采用的功能测量方法差异太大,无法确定生活方式干预是否有助于改善青壮年的功能结果:结论:需要进一步研究了解非临床服务对功能的影响。这些证据将为服务规划者提供务实的指导,以投资于对患有精神障碍的年轻成年人的生活产生有意义影响的支持和干预措施。
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引用次数: 0
Discriminant diagnostic validity of paediatric bipolar disorder screening tests: A systematic review and meta-analysis 儿科双相情感障碍筛查测试的区分诊断有效性:系统回顾和荟萃分析。
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-08-05 DOI: 10.1111/eip.13592
Cristian Alcaíno, Aigli Raouna, Hamdullah Tunç, Angus MacBeth, Timothy Bird, Eric Youngstrom

Introduction

Bipolar disorders (BD) are among the most significantly impairing of childhood and adolescent psychiatric disorders. Although BD symptoms may begin in adolescence, they are frequently not diagnosed until adulthood, and accordingly BD scales could aid diagnostic assessment in paediatric populations. This review aims to synthesis the evidence for the accuracy of BD symptom index tests for discriminating BD from non-BD (other diagnoses or healthy controls) in paediatric population. Additionally, several theoretically relevant moderators of diagnostic accuracy were evaluated.

Methods

A systematic search across three databases were conducted from 1980 to 2022, augmented by grey literature database searches, citation chaining and contacting authors. Data from eligible studies were synthesized using meta-analysis. A multilevel model was fitted to account for nested effect sizes, with 31 potential moderators examined in univariate and multivariate models.

Results

Twenty-Eight studies were eligible, yielding 115 effect sizes for analysis. Meta-analytic modelling indicated BD symptom index tests have a high diagnostic accuracy (g = 1.300; 95% CI: 0.982 − 1.619; p < .001) in paediatric population. Accuracy was relative to the type of comparison group, index test content, index test informant and index test's scale or subscale.

Conclusions

Screening tests based on mania content, caregiver report and non-healthy comparison groups have clinical utility in identifying paediatric BD. Other informant-and-content combination may not accurately identify paediatric BD. Unlike healthy controls, tests derived from studies using non-healthy comparison groups, represent BD symptom non-specificity and BD symptom overlap with other disorders, providing external validity and clinical utility.

简介躁郁症(BD)是儿童和青少年精神疾病中危害最大的一种。虽然双相情感障碍的症状可能在青春期就已出现,但往往直到成年后才被诊断出来,因此,双相情感障碍量表可以帮助对儿科人群进行诊断评估。本综述旨在综述在儿科人群中区分 BD 与非 BD(其他诊断或健康对照)的 BD 症状指数测试准确性的证据。此外,还对诊断准确性的几个理论相关调节因素进行了评估:对 1980 年至 2022 年的三个数据库进行了系统检索,并通过灰色文献数据库检索、引文链检索和联系作者等方法进行了补充。对符合条件的研究数据进行了荟萃分析。为了考虑嵌套效应大小,我们拟合了一个多层次模型,并在单变量和多变量模型中考察了31个潜在的调节因子:结果:28 项研究符合条件,产生了 115 个效应大小供分析。元分析模型显示,BD 症状指数测试具有较高的诊断准确性(g = 1.300;95% CI:0.982 - 1.619;p 结论:基于躁狂症内容和症状的筛查测试具有较高的准确性:基于躁狂症内容、护理人员报告和非健康对比组的筛查测试在识别儿科 BD 方面具有临床实用性。其他信息和内容的组合可能无法准确识别儿科 BD。与健康对照组不同,使用非健康对照组的研究得出的测试结果代表了BD症状的非特异性以及BD症状与其他疾病的重叠性,从而提供了外部有效性和临床实用性。
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引用次数: 0
Integrated primary and community mental health care for young adults with serious mental illness: A program evaluation 为患有严重精神疾病的年轻成年人提供综合初级和社区精神健康护理:项目评估。
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-07-30 DOI: 10.1111/eip.13601
Gillian L. Sowden, Joelle C. Ferron, Sarah I. Pratt, Kerri R. Swenson, Julianne Carbin, Minda A. Gowarty, Alisa G. Tvorun Dunn, Todd A. MacKenzie, Mary F. Brunette

Aim

Young adults with serious mental illness (SMI) have poor physical health and high Emergency Department (ED) and hospital utilization. Integrating primary care into community mental health care may be an important form of early intervention.

Methods

Adjusted multivariable regressions assessed changes in self-reported annual primary care, ED and hospital utilization for 83 young adults with SMI enrolled in integrated care.

Results

Participants' mean annual per person utilization changed significantly as follows: primary care visits, from 1.8 to 3.6, p < .001; medical ED visits, from 1.0 to 0.6, p < .01; psychiatric ED visits from 0.6 to 0.2, p < .001; medical inpatient days, from 1.2 to 0.1, p < .001 and psychiatric inpatient days, from 6.3 to 2.6, p < .001.

Conclusions

Young adults with SMI receiving integrated care increased primary care and reduced ED and inpatient utilization. Future controlled research is warranted to further assess integrated care for young adults with SMI.

目的:患有严重精神疾病(SMI)的年轻成年人身体健康状况较差,急诊室(ED)和医院使用率较高。将初级保健与社区精神卫生保健相结合可能是一种重要的早期干预方式:方法:对 83 名接受综合治疗的 SMI 年轻成人进行调整后的多变量回归,评估他们自我报告的年度初级保健、急诊室和医院使用率的变化:结果:参与者每人每年的平均使用率发生了如下显著变化:初级保健就诊次数从 1.8 次增加到 3.6 次,p 结论:接受综合护理的年轻 SMI 患者的年平均使用率发生了显著变化:接受综合护理的 SMI 年轻成人增加了初级保健,减少了急诊室和住院病人的使用。未来有必要开展对照研究,进一步评估针对患有 SMI 的年轻成年人的综合护理。
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引用次数: 0
A pilot study investigating the effect of the BEGIN psychoeducation intervention for people at clinical high risk for psychosis on emotional and stigma-related experiences 一项试点研究,调查针对精神病临床高危人群的 BEGIN 心理教育干预对情绪和污名化相关体验的影响。
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-07-30 DOI: 10.1111/eip.13602
Maxwell Mikelic, Alexander Jusdanis, Zachary Bergson, Joseph S. DeLuca, Cansu Sarac, Matthew F. Dobbs, Sophia Shuster, Shreya Vaidya, Katarzyna Wyka, Lawrence H. Yang, Yulia Landa, Cheryl M. Corcoran, Shaynna N. Herrera

Aim

There is concern that the provision of the clinical high risk for psychosis (CHR) label is stigmatizing. Prior research suggests people have nuanced reactions to feedback involving the CHR label, including a positive experience receiving feedback and improvement in negative emotions (e.g., shame), while also exhibiting concerns about self-perception and perceptions from others related to the label. The current pilot study aimed to evaluate whether individuals at CHR showed changes in emotional and stigma-related experiences following a CHR psychoeducation intervention, BEGIN: Brief Educational Guide for Individuals in Need.

Method

Participants at CHR (N = 26) identified via the Structured Interview for Psychosis-Risk Syndromes completed the Mental Health Attitudes Interview measuring symptom-related and CHR label-related stigma at pre- and post-intervention.

Results

Stigma did not increase and participants had greater positive emotions (e.g., feeling hopeful and relieved), post-BEGIN.

Conclusion

This study suggests that standardized CHR psychoeducation does not increase stigma in individuals at CHR.

目的:有人担心,提供精神病临床高风险(CHR)标签会使人蒙受耻辱。先前的研究表明,人们对涉及 CHR 标签的反馈有细微的反应,包括接受反馈的积极体验和负面情绪(如羞耻感)的改善,同时也表现出对自我认知和他人与标签相关的认知的担忧。目前的试点研究旨在评估 CHR 的个人在接受 CHR 心理教育干预 "BEGIN:针对有需要的个人的简明教育指南 "后,在情绪和耻辱感相关体验方面是否有所变化:方法:CHR 的参与者(N = 26)通过 "精神病风险综合征结构化访谈 "确定身份,完成 "心理健康态度访谈",测量干预前和干预后与症状和 CHR 标签相关的成见:结果:成见没有增加,参与者在 BEGIN 后有更多的积极情绪(如感到有希望和宽慰):本研究表明,标准化的 CHR 心理教育不会增加 CHR 患者的耻辱感。
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引用次数: 0
The influence of complex psychiatric comorbidities on treatment for clinical high-risk for psychosis: A preliminary study 复杂的精神并发症对精神病临床高危人群治疗的影响:初步研究。
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-07-10 DOI: 10.1111/eip.13590
Aubrey M. Moe, Henry R. Cowan, Margaret Manges, Heather M. Wastler, Sarah Hamilton, Melissa Kilicoglu, Anne C. Holmes, Nicholas J. K. Breitborde

Aim

Despite increasingly refined tools for identifying individuals at clinical high-risk for psychosis (CHR-P), less is known about the effectiveness of CHR-P interventions. The significant clinical heterogeneity among CHR-P individuals suggests that interventions may need to be personalized during this emerging illness phase. We examined longitudinal trajectories within-persons during treatment to investigate whether baseline factors predict symptomatic and functional outcomes.

Method

A total of 36 CHR-P individuals were rated on attenuated positive symptoms and functioning at baseline and each week during CHR-P step-based treatment.

Results

Linear mixed-effects models revealed that attenuated positive symptoms decreased during the study period, while functioning did not significantly change. When examining baseline predictors, a significant group-by-time interaction emerged whereby CHR-P individuals with more psychiatric comorbidities at baseline (indicating greater clinical complexity) improved in functioning during the study period relative to CHR-P individuals with fewer comorbidities.

Conclusion

Individual differences in clinical complexity may predict functional response during the early phases of CHR-P treatment.

目的:尽管用于识别精神病临床高危人群(CHR-P)的工具日益完善,但人们对 CHR-P 干预措施的有效性却知之甚少。CHR-P患者的临床异质性很大,这表明在这一新兴疾病阶段可能需要个性化的干预措施。我们研究了治疗期间患者内部的纵向轨迹,以调查基线因素是否能预测症状和功能结果:结果:线性混合效应模型显示,基线因素对症状和功能结果有影响:线性混合效应模型显示,在研究期间,积极症状有所减轻,而功能则没有明显变化。在研究基线预测因素时,出现了显著的组间时间交互作用,即基线时精神疾病合并症较多(表明临床复杂性较高)的 CHR-P 患者在研究期间的功能相对于合并症较少的 CHR-P 患者有所改善:结论:临床复杂性的个体差异可能预示着 CHR-P 治疗早期阶段的功能反应。
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引用次数: 0
The peer mental health stigmatization scale-revised (PMHSS-R): Psychometric properties and cross-cultural factorial invariance in university students in Ireland and Argentina 朋辈心理健康污名化量表修订版(PMHSS-R):爱尔兰和阿根廷大学生的心理计量特性和跨文化因子不变性。
IF 2.1 4区 医学 Q3 PSYCHIATRY Pub Date : 2024-07-04 DOI: 10.1111/eip.13588
Franco Tisocco, Finiki Nearchou, Eilis Hennessy, Mercedes Fernández Liporace

Introduction

The study aimed to assess the psychometric quality of the Peer Mental Health Stigmatization Scale – Revised (PMHSS-R), by examining its factorial structure among young adults in Ireland and Argentina.

Method

A total of 429 participants aged between 18 and 25 years old were recruited (n = 187 Ireland, n = 242 Argentina). The PMHSS-R was completed by Irish participants and was translated, pilot-studied, and subsequently completed by Argentinian participants.

Results

A Confirmatory Factor Analysis demonstrated optimal factor loadings for an eight-item solution and acceptable internal consistency for both scale dimensions in the Argentinian sample. Satisfactory levels of partial scalar invariance were achieved between countries, indicating that the scale measures mental health stigma consistently across cultures.

Discussion and Conclusions

Our findings highlight the PMHSS-R as a cross-culturally valid and reliable psychometric instrument to evaluate interventions targeting stigma. In conclusion, the PMHSS-R can be used in cross-cultural research to compare levels of mental health stigma and investigate the interplay between stigma and other psychologically relevant constructs between different countries and cultural contexts.

简介:本研究旨在通过考察朋辈心理健康污名化量表(PMHSS-R)的因子结构,评估该量表在爱尔兰和阿根廷年轻人中的心理测量质量:本研究旨在通过考察爱尔兰和阿根廷年轻人的因子结构,评估同伴心理健康污名化量表-修订版(PMHSS-R)的心理测量质量:共招募了 429 名年龄在 18-25 岁之间的参与者(爱尔兰 187 人,阿根廷 242 人)。爱尔兰参与者填写了PMHSS-R,阿根廷参与者对其进行了翻译、试点研究,随后填写了PMHSS-R:确认性因子分析显示,在阿根廷样本中,8 个项目解决方案的因子载荷最优,两个量表维度的内部一致性均可接受。不同国家之间的部分标度不变量达到了令人满意的水平,这表明该量表在测量心理健康污名时具有跨文化的一致性:我们的研究结果表明,PMHSS-R 是一种跨文化的有效、可靠的心理测量工具,可用于评估针对成见的干预措施。总之,PMHSS-R可用于跨文化研究,以比较不同国家和文化背景下的心理健康成见水平,并调查成见与其他心理相关建构之间的相互作用。
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引用次数: 0
期刊
Early Intervention in Psychiatry
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