A cross-continental analysis of weight gain, psychiatric diagnoses and medication use during inpatient psychiatric treatment. The international study on physical illness in mentally ill.

Weight gain among psychiatric inpatients is a widespread phenomenon. This change in body mass index (BMI) can be caused by several factors. Based on recent research, we assume the following factors are related to weight gain during psychiatric inpatient treatment: psychiatric medication, psychiatric diagnosis, sex, age, weight on admission and geographic region of treatment.

Financial incentives to improve adherence to antipsychotic maintenance medication in non-adherent patients: a cluster randomised controlled trial.

Background: Poor adherence to long-term antipsychotic injectable (LAI) medication in patients with psychotic disorders is associated with a range of negative outcomes. No psychosocial intervention has been found to be consistently effective in improving adherence.

Objectives: To test whether or not offering financial incentives is effective and cost-effective in improving adherence and to explore patient and clinician experiences with such incentives.

Clinical effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia: a multicentre randomised controlled trial.

Background: The negative symptoms of schizophrenia significantly impact on quality of life and social functioning, and current treatment options are limited. In this study the clinical effectiveness and cost-effectiveness of group body psychotherapy as a treatment for negative symptoms were compared with an active control.

Design: A parallel-arm, multisite randomised controlled trial.

Where are patients who have co-occurring mental and physical diseases located?

Background: Patients with a psychiatric illness have a higher prevalence of physical diseases and thus a higher morbidity and mortality.

Aim: The main aim was to investigate where patients with co-occurring physical diseases and mental disorders (psychotic spectrum or mood) in the health and social service system are identified most frequently before admission into psychiatry. The second aim was to compare the differences in the treatment routes taken by the patients before entry into psychiatric services in all the participating countries (Denmark, Germany, Japan, Nigeria and Switzerland).

Evaluation of a new person-centered integrated care model in psychiatry.

The present study evaluated a new integrated treatment concept offering inpatient care, acute psychiatric day hospital and outpatient treatment by the same therapeutic team. 178 patients participated in this randomized controlled trial. Data on psychopathology, global and social functioning, patient satisfaction, continuity of care and administrative data was gathered on admission, throughout the course of treatment, upon discharge and at 1-year follow-up.

Effectiveness of financial incentives to improve adherence to maintenance treatment with antipsychotics: cluster randomised controlled trial.

Objective: To test whether offering financial incentives to patients with psychotic disorders is effective in improving adherence to maintenance treatment with antipsychotics.

Design: Cluster randomised controlled trial.

Setting: Community mental health teams in secondary psychiatric care in the United Kingdom.

Supported employment: cost-effectiveness across six European sites.

A high proportion of people with severe mental health problems are unemployed but would like to work. Individual Placement and Support (IPS) offers a promising approach to establishing people in paid employment. In a randomized controlled trial across six European countries, we investigated the economic case for IPS for people with severe mental health problems compared to standard vocational rehabilitation.

Effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia--a multi-centre randomised controlled trial.

Background: Negative symptoms of schizophrenia are frequently associated with poor long term outcomes. Established interventions have little, if any, positive effects on negative symptoms. Arts Therapies such as Body Psychotherapy (BPT) have been suggested to reduce negative symptoms, but the existing evidence is limited.

Volunteering in the care of people with severe mental illness: a systematic review.

Background: Much of the literature to date concerning public attitudes towards people with severe mental illness (SMI) has focused on negative stereotypes and discriminatory behaviour. However, there also exists a tradition of volunteering with these people, implying a more positive attitude. Groups with positive attitudes and behaviours towards people with SMI have received relatively little attention in research.

Cultural diversity in physical diseases among patients with mental illnesses.

Objective: People with psychiatric diseases have a severely increased risk for physical morbidity and premature death from physical diseases. The aims of the study were to investigate the occurrence of cardiovascular diseases (CVD), diabetes (DM) and obesity in schizophrenia and depression in three different geographical areas - Asia (Japan), Africa (Nigeria) and Western Europe (Switzerland, Germany and Denmark) - and to search for possible transcultural differences in these correlations, which would also reflect the differences between low-income areas in Africa (Nigeria) and high-income areas in Europe and Japan.

Method: Patients with International Classification of Diseases (ICD-10) F2 diseases (schizophrenia spectrum disorders) and F3 diseases (affective disorders) admitted to one Nigerian, one Japanese, two Swiss, two German and six Danish centres during 1 year were included.

Physical illness in psychiatric inpatients: comparison of patients with and without substance use disorders.

Background: Physical comorbidities and substance use are commonly reported in patients with mental disorders.

Aim: To examine somatic comorbidity in patients with substance use disorders (SUD) compared to patients with mental disorders but no SUD.

Methods: Lifetime prevalence data on mental and physical health status were collected from inpatients in 12 mental health care facilities in five different countries.

The therapeutic relationship and adherence to antipsychotic medication in schizophrenia.

Objective: Previous research has shown that a better therapeutic relationship (TR) predicts more positive attitudes towards antipsychotic medication, but did not address whether it is also linked with actual adherence. This study investigated whether the TR is associated with adherence to antipsychotics in patients with schizophrenia.

Methods: 134 clinicians and 507 of their patients with schizophrenia or a related psychotic disorder participated in a European multi-centre study.

Validation of the Integrative Hope Scale in people with psychosis.

Hope is an important variable in mental health, particularly in the emergent field of research focused on recovery and well-being. This study validates the "Integrative Hope Scale" (IHS) for use in people with severe mental illness. Two hundred participants diagnosed with schizophrenia or schizoaffective disorder were assessed using the IHS, the Centre for Epidemiological Studies Depression Scale, and the Positive and Negative Syndrome Scale.

The relationships between employment, clinical status, and psychiatric hospitalisation in patients with schizophrenia receiving either IPS or a conventional vocational rehabilitation programme.

Purpose: Positive relationships between employment and clinical status have been found in several studies. However, an unequivocal interpretation of these relationships is difficult on the basis of common statistical methods.

Methods: In this analysis, a structural equation model approach for longitudinal data was applied to identify the direction of statistical relationships between hours worked, clinical status and days in psychiatric hospital in 312 persons with schizophrenia who participated in a multi-centre randomised controlled trial comparing the effectiveness of Individual Placement and Support (IPS) with conventional vocational services in six study settings across Europe.

Development and validation of an integrative scale to assess hope.

Background: Hope includes the dimensions of time, goals, control, relations and personal characteristics. Existing tools that measure it vary in length and psychometric properties and cover different parts of its overall concept.

Objectives: This study aimed to develop an instrument that integrates all relevant aspects of hope is concise, easy to use and shows good psychometric properties.

Therapeutic relationships in vocational rehabilitation: predicting good relationships for people with psychosis.

Therapeutic relationships between clients and vocational rehabilitation workers have been shown to predict entering competitive employment. We aimed to determine predictors of good relationships, using data from an international randomized controlled trial of supported employment (n=312). Baseline predictors of early therapeutic relationships with vocational workers were assessed, along with the impact of vocational status and changing clinical and social functioning variables on relationship ratings over time.

Low mood and employment: when affective disorders are intertwined with the workplace--a UK perspective.

Working is undoubtedly an important aspect of western life. As well as structuring time, it provides financial security, meaning, identity and social participation, and has a beneficial effect on long-term physical and mental well-being. Despite this, people with mental health conditions have the lowest employment rate of any disabled group, although many of them want to work and work is highly beneficial for their physical and mental health.

Non-uniform effectiveness of structured patient-clinician communication in community mental healthcare: an international comparison.

Background: The effectiveness of psychosocial interventions in community mental healthcare has been shown to depend on the setting in which they are implemented. Recently structured patient-clinician communication was found to be effective in a multi-centre trial in six European countries, the DIALOG trial. In the overall study, differences between centres were controlled for, not studied.

Therapeutic relationships: their specificity in predicting outcomes for people with psychosis using clinical and vocational services.

Objective: To determine the distinctions between the client-keyworker relationship and the client-vocational worker relationship by assessing their impact on clinical outcomes and exploring the associations between the two.

Methods: As part of an international randomised controlled trial of supported employment (n = 312), client-keyworker relationship and client-vocational worker relationship were each tested against clinical and social functioning 6 months later. Associations between the two relationships over time were explored.

Cost of treatment of schizophrenia in six European countries.

Background And Aims: As part of an RCT in six European sites, the direct mental health care cost for 422 patients with schizophrenia was analysed according to how total and medication costs differed across sites and which variables were likely to predict total or service-specific costs.

Method: Service use was recorded continuously during a 12-month follow-up. Prescribed psychotropic medication was recorded at baseline and 12 months later.

Working with mental health problems: clients' experiences of IPS, vocational rehabilitation and employment.

Background: Although the effectiveness of individual placement and support (IPS) has been well established, little is known about clients' perceptions of the model compared to usual vocational rehabilitation, nor about their experiences of searching for and returning to work with this kind of support. This qualitative study aimed to explore clients' views of the difficulties of obtaining and maintaining employment, their experiences of the support received from their IPS or Vocational Service workers and the perceived impact of work on clients' lives.

Method: Semi-structured interviews were conducted with 48 people with psychotic disorders participating in a six-centre international randomised controlled trial of IPS compared to usual vocational rehabilitation.

Beliefs about the mentally ill: a comparative study between healthcare professionals in Brazil and in Switzerland.

Objective: Little is known in our own as well as in other cultures about the knowledge and prejudices mental health professionals have about mental illness and those affected. We therefore: 1) assessed mental health literacy and general attitudes towards people with mental illness in a sample of Brazilian mental health professionals; 2) compared the outcomes among the different professional groups; and 3) compared the data with a sample of Swiss mental health professionals.

Methods: A questionnaire used to assess knowledge and attitudes towards the mentally ill among mental health professionals in Switzerland was translated into Portuguese.