European Journal of Psychiatry最新文献

Background and Objectives

Veterans Treatment Courts (VTCs) are alternative to incarceration programs for veterans involved in the criminal legal system. VTC participants have high rates of co-occurring mental health and substance use disorders (COD). Maintaining Independence and Sobriety Through Systems Integration, Outreach and Networking – Criminal Justice (MISSIONCJ) is an evidence-based, multicomponent intervention offered alongside VTCs to support veterans’ complex needs. Multicomponent interventions are often difficult to implement nationally, let alone when care is offered and coordinated across multiple systems. This protocol offers an overview of an implementation-effectiveness trial of MISSIONCJ in VTCs.

Methods

This quality improvement (QI) project will involve an adaptive, randomized design, in which VA staff in four geographically-dispersed regions across the U.S. will be invited to participate and receive varying implementation facilitation (IF) support (i.e., low/passive and high/active) for implementing MISSIONCJ. Sites will have a 9-month run-in period (e.g., orientation) followed by 9-months of low/passive IF. Sites that meet an implementation benchmark will then be randomized to continue low/passive IF or discontinue; and sites that do not meet the benchmark will be randomized to continue low/passive IF, or receive high/active IF for 12-months. Implementation outcomes are based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework (e.g., reaching eligible veterans, adoption rates, fidelity to MISSIONCJ, and maintenance/sustainment). MISSIONCJ effectiveness outcomes include treatment engagement and COD improvements.

Discussion

This QI project aims to determine the most effective type and intensity of IF to increase MISSIONCJ, while improving outcomes among VTC participants. As the first national trial to implement MISSIONCJ in VTCs, it has important implications for the criminal legal and implementation science fields.

Trial Registration

Background and objectives

Methods

Results

Conclusions

Objectives

Method

Results

Conclusion

Background and objectives

Methods

Results

Conclusion

Background and objectives

Methods

Results

Conclusion

Background and objectives

Methods

Results

Conclusions

Background and objectives

Advances in knowledge have contributed to the global understanding of nutritional patterns' influence on mental health. The aim was to determine the impact of a high-symbiotic diet on cardio-metabolic and psychopathological outcomes in schizophrenia.

Methods

A randomised clinical trial (two-arm, double-blind, balanced-block, six-month intervention) was conducted on 50 individuals diagnosed with schizophrenia spectrum disorder. The control group received conventional dietary advice individually. The intervention group received intensive dietary advice based on the increasing consumption of food with high symbiotic content (fermented foods, whole grains, green leafy vegetables and fruits high in dietary fibre, among others). Researchers collected data on cardiovascular and psychopathological status at baseline, three and six months. In addition, anthropometric parameters were analysed monthly.

Results

Forty-four subjects were analysed. Compared to the control group, the intervention group demonstrated improvements in the PANSS-GP subscale and the PSP scale scores over 3–6 months (p < 0.05). Anthropometric values were decreased in all the variables (p < 0.05). Systolic blood pressure decreased between 3 and 6 months (p = 0.049).

Conclusions

Nutrition education for increasing the consumption of foods with high symbiotic content has positively impacted the cardio-metabolic and psychopathological profile in patients with schizophrenia spectrum disorders. In addition, advanced practice mental health nurses have been shown to play a prominent role in developing nutrition education and promoting healthy lifestyles in these patients.

This study employed the Delphi method to identify the ideal characteristics of a clozapine adverse drug reaction (ADR) scale, engaging 34 clozapine specialists at the 6th NEMEA meeting. Participants emphasized the integration of clinician-rated (CROM) and patient-rated (PROM) outcomes in the scale, aiming for a balance between comprehensiveness and practicality. Key consensus points included the inclusion of specific ADRs like somnolence, sialorrhea, and compulsivity, while metabolic complications were considered less relevant. This research highlights the need for a practical, patient-inclusive tool for monitoring clozapine ADRs, reflective of both clinical expertise and patient experiences in managing treatment-resistant schizophrenia.

Currently, there is a growing interest in exploring the underlying processes that explain how and why therapeutic approaches work. This study aims to investigate whether Mindfulness-Based Cognitive Therapy (MBCT) can enhance direct experience compared to a control intervention. 72 women diagnosed with eating disorders were assigned to either MBCT or a control treatment. Pre- and post-intervention, participants were asked to eat an orange slice and write down thoughts about the eating experience, classifying the focus of each experience as either experiential or analytical. Compared with the control group, participants who underwent MBCT showed a statistically significant increase in direct experience.