Beliefs about causes of schizophrenia among urban African American community members.

The public's causal attributions of schizophrenia have far-reaching effects on the community and affected individuals. This study investigated causal beliefs within a community of predominantly Protestant, low-income, urban, African Americans in the southeastern United States. Two hundred eighty-two patrons of an inner-city food court/farmers' market participated in a self-administered survey assessing causal beliefs through a 30-item survey and self-reported causal opinions.

Characteristics of the retrospectively assessed prodromal period in hospitalized patients with first-episode nonaffective psychosis: findings from a socially disadvantaged, low-income, predominantly African American population.

Objective: Because many heterogeneous symptoms and substantial psychosocial impairment develop during the prodrome of nonaffective psychosis, it is imperative to further characterize the prodrome, both retrospectively and prospectively. This study describes the prodromal period of 109 hospitalized first-episode patients from an urban, socially disadvantaged, predominantly African American population.

Method: Detailed data were gathered using established measures.

Overview and initial validation of two detailed, multidimensional, retrospective measures of substance use: the Lifetime Substance Use Recall (LSUR) and Longitudinal Substance Use Recall for 12 Weeks (LSUR-12) Instruments.

Research on comorbidities between substance use disorders and serious mental illnesses would be facilitated by new methods for collecting comprehensive data on substance use, including data on onset, progression, frequency, amounts, and consequential behaviors. Given substantial limitations of available instruments, and a nearly complete absence of methodologies that allow derivation of continuous measures that estimate dose or cumulative exposure, this report describes the development and initial validation of two interviewer-administered, multidimensional measures of substance use, the Lifetime Substance Use Recall (LSUR) and Longitudinal Substance Use Recall for 12 Weeks (LSUR-12) Instruments. Participants (n=60) in an ongoing study of first-episode psychosis were evaluated with the LSUR, LSUR-12, and a number of other concurrent measures pertaining to substance use, substance use disorder diagnoses, select demographic features, and two personality traits.

Dermatoglyphic indices and minor physical anomalies in patients with schizophrenia and related disorders, their first-degree biological relatives, and non psychiatric controls.

Abnormalities in dermatoglyphic indices and minor physical anomalies (MPAs) are two permanent markers of fetal development that have been studied in schizophrenia. This study sought to: (1) compare select dermatoglyphic indices across patients, first-degree relatives, and non psychiatric controls; (2) assess for associations between dermatoglyphic indices and symptoms in patients and schizotypal features in relatives and controls; and (3) examine correlations between dermatoglyphics and MPAs. The two types of markers were assessed in 62 patients with schizophrenia and related disorders, 36 of their unaffected first-degree relatives, and 47 non psychiatric controls.

Longitudinal changes in cortisol secretion and conversion to psychosis in at-risk youth.

Elevations in hypothalamic-pituitary-adrenal (HPA) axis activity have been implicated in the origins and exacerbation of mental disorders. Several lines of investigation suggest HPA activity, indexed by increased cortisol, is elevated in patients with schizophrenia and other psychotic disorders. This study examined the relation of cortisol levels and longitudinal changes with psychotic outcomes in at-risk adolescents.

Correlates of recovery of social functioning in types I and II bipolar disorder patients.

Since bipolar disorder (BPD) patients are often functionally impaired, and factors associated with recovery from disability are largely unknown, we investigated demographic, clinical, and neurocognitive correlates of current social functional recovery in 65 stable participants diagnosed with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) type I (n=42) or II (n=23) BPD. Regaining highest previous levels of social functioning was rated with the Interpersonal Relationships Questionnaire. We also considered neuropsychological test findings as well as demographic and clinical information including mania and depression symptom-ratings.

The impact of a family history of psychosis on age-at-onset and positive and negative symptoms of schizophrenia: a meta-analysis.

The results of research on the relation of family history (FH) of psychosis with clinical presentation in schizophrenia have been mixed. To date, there have been no comprehensive reviews that have examined this body of research. The current review quantitatively evaluates research on the relation of FH with two aspects of schizophrenia, age-at-onset and symptom presentation.

Stigma and treatment delay in first-episode psychosis: a grounded theory study.

Aim: A longer duration of untreated psychosis (DUP) is associated with greater morbidity in the early course of schizophrenia. This formative, hypothesis-generating study explored the effects of stigma, as perceived by family members, on DUP.

Methods: Qualitative interviews were conducted with 12 African American family members directly involved in treatment initiation for a relative with first-episode psychosis.

Characteristics of patients referred to psychiatric emergency services by crisis intervention team police officers.

The Crisis Intervention Team (CIT) program trains police officers in crisis intervention skills and local psychiatric resources. Because the safety and appropriateness of any new intervention is a crucial consideration, it is necessary to ensure that CIT training does not result in excessive or inappropriate referrals to psychiatric emergency services (PES). Yet, aside from one prior report by Strauss et al.

Home-based palliative care services for underserved populations.

Background: Kokua Kalihi Valley is one of the first federally qualified community health centers offering home-based palliative care (HBPC). Kokua Kalihi Valley serves low-income, immigrant populations from Asia and the Pacific Islands, whose end-of-life needs are rarely addressed. Our team includes a palliative medicine physician, nurse, case manager, psychologist, interpreter, and volunteers.

Social functioning in urban, predominantly African American, socially disadvantaged patients with first-episode nonaffective psychosis.

Background: Social functioning impairments develop and accumulate even prior to initial treatment-seeking for first-episode psychosis. This study, the first to examine social functioning in low-income, urban, predominantly African American first-episode patients: (1) assesses the internal consistency of Social Functioning Scale (SFS) subscales in this relatively unique sample; (2) identifies demographic and clinical variables that may be predictive of poor social functioning in this particular population; and (3) assesses changes in SFS scores in a subsample re-assessed six months after initial hospitalization.

Methods: 109 participants (age, 23.

The effects of response effort on safe performance by therapists at an autism treatment facility.

The effects of response effort on safe behaviors (i.e., glove wearing, hand sanitizing, and electrical outlet replacement) exhibited by therapists at an autism treatment center were examined.

A randomized trial of medical care management for community mental health settings: the Primary Care Access, Referral, and Evaluation (PCARE) study.

Objective: Poor quality of healthcare contributes to impaired health and excess mortality in individuals with severe mental disorders. The authors tested a population-based medical care management intervention designed to improve primary medical care in community mental health settings.

Method: A total of 407 subjects with severe mental illness at an urban community mental health center were randomly assigned to either the medical care management intervention or usual care.

Use of force preferences and perceived effectiveness of actions among Crisis Intervention Team (CIT) police officers and non-CIT officers in an escalating psychiatric crisis involving a subject with schizophrenia.

Background: Few studies have examined police officers' use of force toward individuals with schizophrenia, despite the widely disseminated Crisis Intervention Team (CIT) model of partnership between mental health and law enforcement that seeks to reduce use of force and enhance safety of officers and individuals with mental illnesses. This study tested the hypotheses that CIT-trained officers would select a lower level of force, identify nonphysical actions as more effective, and perceive physical force as less effective in an escalating psychiatric crisis, compared with non-CIT-trained officers.

Methods: Police officers (n = 135)-48 CIT trained and 87 non-CIT trained-completed a survey containing 3 scenario-based vignettes depicting an escalating situation involving a subject with psychosis.

Health services determinants of the duration of untreated psychosis among African-American first-episode patients.

Objective: The duration of untreated psychosis is associated with poor outcomes in multiple domains in the early course of nonaffective psychotic disorders, although relatively little is known about determinants of this critical period, particularly health services-level determinants. This study examined three hypothesized predictors of duration of untreated psychosis (lack of insurance, financial problems, and broader barriers) among urban, socioeconomically disadvantaged African Americans, while controlling for the effects of three patient-level predictors (mode of onset of psychosis, living with family versus alone or with others before hospitalization, and living above versus below the federally defined poverty level).

Methods: Analyses included data from 42 patient-family member dyads from a larger sample of 109 patients with a first episode of nonaffective psychosis.

Screening adults for depression in primary care: A position statement of the American College of Preventive Medicine.

The American College of Preventive Medicine (ACPM) maintains that primary care providers should screen all adults for depression and that all primary care providers should have systems in place, either within the primary care setting itself or through collaborations with mental health professionals, to ensure the accurate diagnosis and treatment of this condition. The earliest and best opportunities to identify depression are in the clinics of primary care providers. Thus, the ACPM supports the recommendations of the US Preventive Services Task Force (USPSTF), and further suggests that all primary care practices should have such systems of care in place.

Family-level predictors and correlates of the duration of untreated psychosis in African American first-episode patients.

Background: Little is known about how family-level factors are associated with duration of untreated psychosis (DUP), especially in ethnic/racial minority groups, such as African Americans. This study involved African American first-episode patients and their family members who initiated evaluation and treatment for them. It was hypothesized that a longer DUP would be predicted by family members' endorsement of: (1) less knowledge about schizophrenia, (2) greater perceptions of stigma, (3) lower levels of insight, (4) fewer family strengths, (5) more limited family coping capacity, and (6) lower levels of caregiver strain.

Associations between multiple dimensions of schizotypy and sociodemographic variables in a nonpsychiatric sample of young adults.

In several prior studies, self-reported schizotypy has been documented to vary by gender, age, race/ethnicity, and measures of social engagement. In this study, undergraduate students participated in an online survey, and data from 825 students were used to examine sociodemographic characteristics and past mental health treatment history as predictors of 6 schizotypy measures. History of mental health treatment was a significant independent predictor of paranoid, cognitive-perceptual, and interpersonal schizotypy; race, relationship status, and mental health treatment history were significant independent predictors of disorganized schizotypy; race was an independent significant predictor of perceptual aberrations; and race and gender were significant independent predictors of social anhedonia.

Association of pre-onset cannabis, alcohol, and tobacco use with age at onset of prodrome and age at onset of psychosis in first-episode patients.

Objective: Several reports suggest that cannabis use is associated with an earlier age at onset of psychosis, although not all studies have operationalized cannabis use as occurring prior to onset of symptoms. This study addressed whether pre-onset cannabis use, alcohol use, and tobacco use are associated with an earlier age at onset of prodromal and psychotic symptoms. Effects of the progression of frequency of use were examined through time-dependent covariates in survival analyses.

Race-ethnicity as a predictor of attitudes toward mental health treatment seeking.

Objective: Previous research on mental health disparities shows that persons from racial-ethnic minority groups have less access to mental health care, engage in less treatment, and receive poorer-quality treatment than non-Hispanic whites. Attitudes and beliefs about mental health treatment were examined to determine whether they contribute to these disparities.

Methods: Data from the National Comorbidity Survey Replication (NCS-R) were analyzed to determine attitudes toward treatment-seeking behavior among people of non-Hispanic white, African-American, and Hispanic or Latino race-ethnicity.

Prevalence and correlates of school drop-out prior to initial treatment of nonaffective psychosis: further evidence suggesting a need for supported education.

Background: Because dropping out of high school (i.e., secondary education) contributes prominently to numerous social, economic, and health conditions, formal public health initiatives promoting population health and social justice, especially in at-risk populations, are increasingly encouraged to address high school drop-out.

Key features of a unique community psychiatry fellowship: the emory university fellowship in community psychiatry/public health.

The Emory University Fellowship in Community Psychiatry/Public Health is a unique training opportunity whose mission is to train future leaders in the arena of community psychiatry. To complement the recent description of the Public Psychiatry Fellowship of New York State Psychiatric Institute at Columbia University Medical Center, this report describes the key features of Emory's fellowship-its academic curriculum, practicum experiences, site visits and other opportunities for collaboration, and ongoing mentoring and career development. Congruencies between these four key features and the seven core elements of Columbia's fellowship are highlighted, as are several important differences.

Crisis intervention team training and special weapons and tactics callouts in an urban police department.

Objective: This study tested a hypothesized inverse correlation between the number of crisis intervention team (CIT) officers and the number of Special Weapons and Tactics (SWAT) callouts in an urban police department.

Methods: Data for the number of accrued CIT-trained officers were combined with administrative data on the number of SWAT callouts during 27 four-month intervals.

Results: There were no significant correlations for the relationships examined, and implementation of CIT training was not associated with a decrease in SWAT callouts.

The psychosis continuum and categorical versus dimensional diagnostic approaches.

This overview briefly presents recent thinking on the dimensional approach to understanding psychotic experiences. First, evidence is provided for a continuum of psychosis ranging from self-reported infrequent psychotic symptoms in the general population, to schizotypal traits, to schizotypal personality disorder, and finally to full-blown psychosis resulting in a diagnosable primary psychotic disorder. Variation within each of these types of psychotic experience is discussed.