Randomized trial of a brief peer support intervention for individuals with schizophrenia transitioning from hospital to community.

This phase 2 randomized trial examined the outcomes of a brief, transitional, peer support intervention designed to address the poor outcomes that are common for individuals with schizophrenia spectrum illnesses in the period immediately following hospitalization. In the context of treatment-as-usual, participants were provided with a peer support intervention, 'the Welcome Basket,' in which participants received 1-2 sessions of peer support in the two weeks before discharge and met weekly for a month post-discharge. The study also piloted a brief version of this intervention with only one community session post-discharge with the same pre-discharge process.

Thirty-Day and 5-Year Readmissions following First Psychiatric Hospitalization: A System-Level Study of Ontario's Psychiatric Care.

Objective: Analyses of representative, system-level data to examine trends in short- and longer-term readmission rates for psychiatric illnesses are largely absent. The objective of this article is to examine key trends and variables with implications for inpatient care as indicated by 30-day readmission and outpatient care as reflected by readmission within 5 years.

Methods: Using OMHRS data from 2005 to 2015, patients who had their first inpatient admission were followed for 5 years to examine their subsequent 30-day and overall admission rates stratified by discharge time and diagnosis.

Patient Characteristics, Length of Stay, and Functional Improvement for Schizophrenia Spectrum Disorders: A Population Study of Inpatient Care in Ontario 2005 to 2015.

Objectives: Schizophrenia and associated illnesses account for a large proportion of mental illness burden and health care expenditures, with the majority of expense involving inpatient care. To date, the literature exploring factors associated with length of stay (LOS) and functional improvement during inpatient care is underdeveloped. In response, this study examined the association between patient characteristics, LOS, and functional improvement using Ontario Mental Health Reporting System (OMHRS) data from 2005 to 2015.

The welcome basket revisited: Testing the feasibility of a brief peer support intervention to facilitate transition from hospital to community.

Objective: This paper describes outcome and feasibility findings for a novel, brief intervention to facilitate discharge from lengthy psychiatric hospitalization. The examination of such transitional interventions is important given the suboptimal outcomes for many individuals with severe mental illness at discharge, particularly in the first month.

Method: In this study a mixed methods design was used to examine a 6-week peer support worker-provided transitional intervention called the 'Welcome Basket.

A pilot study of a family cognitive adaptation training guide for individuals with schizophrenia.

Objective: There is a paucity of accessible, evidence-based tools for caregivers of individuals with schizophrenia. This study examines changes in the self-assessed and caregiver-assessed outcomes of people with schizophrenia after exposure to a cognitive adaptation training (CAT) guide that addressed pragmatic, in-home approaches to offset the cognitive impacts of the illness.

Method: This study examined the 4-month, pre-post outcomes of a CAT guide, as compared with a popular, general manual, for families of individuals with schizophrenia.

Integrated Care Pathways for Schizophrenia: A Scoping Review.

This paper summarizes the existing evidence for integrated care pathways (ICPs) for the treatment of schizophrenia. Scoping review methods following PRISMA guidelines were employed due to the variable nature of the evidence in this area. The review identified 13 papers.

Advancing the recovery orientation of hospital care through staff engagement with former clients of inpatient units.

Objectives: This study was undertaken to assess the impact of consumer narratives on the recovery orientation and job satisfaction of service providers on inpatient wards that focus on the treatment of schizophrenia. It was developed to address the paucity of literature and service development tools that address advancing the recovery model of care in inpatient contexts.

Methods: A mixed-methods design was used.

Specialized home treatment versus hospital-based outpatient treatment for first-episode psychosis: a randomized clinical trial.

Objective: This pilot study compared the effectiveness of specialized care that was home based versus hospital based for individuals experiencing their first psychotic episode.

Method: A randomized controlled trial design was used. A total of 29 subjects were interviewed at baseline, 3 and 9 months.

The use of electronic monitoring (MEMS) to evaluate antipsychotic compliance in outpatients with schizophrenia.

Compliance with antipsychotic treatment is a well-recognized concern in the ongoing management of individuals with schizophrenia. The present investigation incorporated the Medication Event Monitoring System (MEMS) to evaluate compliance in a group of outpatients (N=52) with schizophrenia or schizoaffective disorder. Evaluating compliance as a dichotomous variable and using a threshold of 80%, the rate of noncompliance as measured by MEMS was 52%, considerably higher than self-report (3%), clinician rating (24%) and pill count (25%).

The role of family work in early psychosis.

In keeping with the current clinical and research focus on early intervention and the rapid increase worldwide of programs for those experiencing a first episode of psychosis, the development of services for families has to be an integral part of any comprehensive program. Families can and do play a major role in the recovery from a first episode of psychosis. However, without support from and an alliance with professionals, they may find it difficult to see their way through the maze of emotions and challenges that inevitably accompany the first episode.

MT(1) melatonin receptor overexpression enhances the growth suppressive effect of melatonin in human breast cancer cells.

Melatonin inhibits the proliferation of estrogen receptor alpha (ERalpha)-positive (MCF-7), but not ERalpha-negative (MDA-MB-231) breast cancer cells. Here, we assessed the effect of MT(1) melatonin receptor stable overexpression in MCF-7 and MDA-MB-231 breast cancer cells on the growth-suppressive effects of melatonin. Parental and vector-transfected MCF-7 cells demonstrated a modest, but significant, growth-suppressive response to melatonin; however, melatonin treatment of MT(1)-transfected MCF-7 cells resulted in significantly enhanced growth-suppression.

The social construction of disability in schizophrenia.

Chronicity and disability can accompany a diagnosis of schizophrenia, but long-term follow-up studies are demonstrating that these outcomes are not inevitable. There is growing awareness that characteristics of long-term illness previously understood to be part of the disorder can be partially constructed through a convergence of physical, psychological, and social processes. In this study, the potential for social construction of disability was explored through secondary analysis of qualitative data.

Factors associated with insight among outpatients with serious mental illness.

This study examined the relationships between insight, severity of symptoms, diagnosis, locus of control, quality of life, and engulfment among 25 patients with a DSM-III-R diagnosis of schizophrenia and 33 patients with a diagnosis of bipolar disorder. Engulfment is the extent to which a person identifies with the patient role. Severity of symptoms and engulfment were significantly associated with insight.