Tobacco smoking and nicotine vaping in persons with first episode psychosis.

Tobacco smoking is highly prevalent in persons with psychosis and is the leading cause of preventable mortality in this population. Less is known about tobacco smoking in persons with first episode psychosis (FEP) and there have been no estimates about the prevalence of nicotine vaping in FEP. This study reports rates of tobacco smoking and nicotine vaping in young people with FEP enrolled in Coordinated Specialty Care programs in Pennsylvania and Maryland.

Optimizing behavioral and pharmacological smoking cessation interventions among people with HIV.

Background: People with HIV/AIDS (PWH) smoke at nearly three times the rate of the general population. Interventions to promote sustained quitting among PWH are urgently needed.

Methods: Our study used a randomized factorial design to evaluate the effects of varenicline, compared with placebo, and behavioral cessation therapy, positively smoke free (PSF), compared with standard of care (SOC) among PWH who smoke.

Impact of a Targeted Intervention on Hepatitis C Care Among African Americans With Serious Mental Illness.

Objective: This study aimed to update findings on the continuum of care for hepatitis C virus (HCV) infection with follow-up data for individuals with serious mental illness and to identify predictors of decisions to decline vaccination.

Methods: The screening, testing, immunization, risk reduction, and referral (STIRR) intervention has been shown to increase testing and immunization rates. Prevalence of HCV diagnoses, HCV continuum of care, and hepatitis A (HAV) and B (HBV) vaccination were evaluated with laboratory results and chart review.

A Serious Game for Young People With First Episode Psychosis (OnTrack>The Game): Qualitative Findings of a Randomized Controlled Trial.

Background: Several studies have shown the benefits of coordinated specialty care (CSC) for individuals with first episode psychosis; however, pathways to care are marred by lack of knowledge, stigma, and difficulties with treatment engagement. Serious games or video interventions may provide a way to address these factors.

Objective: This study focuses on qualitative results of a randomized controlled trial comparing OnTrack>The Game (OTG) with recovery videos (RVs) on engagement, stigma, empowerment, hope, recovery, and understanding of psychosis in clients receiving CSC.

Lipophilic vs. hydrophilic statins and psychiatric hospitalizations and emergency room visits in US Veterans with schizophrenia and bipolar disorder.

Objective –: Psychiatric hospitalizations and emergency department (ED) visits are costly, stigmatizing, and often ineffective. Given the immune and kynurenine activation in bipolar disorder (BD) and schizophrenia, as well as the immune-modulatory effects of statins, we aimed to compare the relative risk (RRs) of psychiatric hospitalizations and ED visits between individuals prescribed lipophilic vs. hydrophilic statins vs.

Differences in Antipsychotic Treatment Discontinuation Among Veterans With Schizophrenia in the U.S. Department of Veterans Affairs.

Objective: Effectiveness of antipsychotic drugs is inferred from relatively small randomized clinical trials conducted with carefully selected and monitored participants. This evidence is not necessarily generalizable to individuals treated in daily clinical practice. The authors compared the clinical effectiveness between all oral and long-acting injectable (LAI) antipsychotic medications used in the treatment of schizophrenia in the U.

Implementation of peer specialist services in VA primary care: a cluster randomized trial on the impact of external facilitation.

Background: Over 1100 veterans work in the Veterans Health Administration (VHA) as peer specialists (PSs)-those with formal training who support other veterans with similar diagnoses. A White House Executive Action mandated the pilot reassignment of VHA PSs from their usual placement in mental health to 25 primary care Patient Aligned Care Teams (PACTs) in order to broaden the provision of wellness services that can address many chronic illnesses. An evaluation of this initiative was undertaken to assess the impact of outside assistance on the deployment of PSs in PACTs, as implementation support is often needed to prevent challenges commonly experienced when first deploying PSs in new settings.

Personal Approach to Treatment Choices for HIV (PATCH): Randomized Controlled Trial of a Brief Motivational Enhancement Intervention to Improve Medication Adherence in Persons with HIV.

This pilot randomized controlled trial evaluated the feasibility and efficacy of a brief motivational enhancement intervention to improve adherence to antiretroviral therapy in persons with HIV called Personal Approach to Treatment Choices for HIV (PATCH). We compared PATCH to an active control condition on self-reported adherence, clinical outcomes, and psychosocial outcomes. Participants were 34 individuals (61.

Results from a pilot study of a computer-based role-playing game for young people with psychosis.

Aim: Recent research on first episode psychosis (FEP) has demonstrated the effectiveness of coordinated specialty care (CSC) models to support young adults and their families, yet few tools exist to promote engagement in care. This study aimed to develop a prototype computer-based role-playing game (RPG) designed for young people who have experienced FEP, and conduct a pilot study to determine feasibility and test whether the game improves consumers' attitudes toward treatment and recovery.

Methods: Twenty young people with FEP who were receiving services at a CSC program enrolled in the study and played the game for 1 hour.

Association between sleep, childhood trauma and psychosis-like experiences.

Psychosis-like experiences (PLEs), or attenuated positive symptoms of psychosis, present along a severity continuum and have been associated with distressing thoughts and impairments in functioning. Although knowledge of the clinical importance of PLEs is expanding, risk factors for their expression are still poorly understood. Sleep disturbances are one known factor that exacerbate PLEs expression and distress, and trauma exposure is associated with occurrence of PLEs, as well as increased risk of later sleep difficulties.

Family Involvement in the Clinical Care of Clients With First-Episode Psychosis in the RAISE Connection Program.

Objective: This study described how families were involved in the RAISE Connection Program for clients with first-episode psychosis (FEP) and examined factors that predicted family involvement.

Methods: Presence of family members at clinical visits for 65 clients with FEP was described. Multiple regressions were conducted to determine whether demographic characteristics, clinical factors, or client-provider discussions regarding family predicted family involvement during the first six months of the program.

Provision of peer specialist services in VA patient aligned care teams: protocol for testing a cluster randomized implementation trial.

Background: Over 1100 Veterans work in the Veterans Health Administration (VHA) as peer specialists (PSs). PSs are Veterans with formal training who provide support to other Veterans with similar diagnoses, primarily in mental health settings. A White House Executive Action mandated the pilot reassignment of VHA PSs from mental health to 25 primary care Patient Aligned Care Teams (PACT) in order to broaden the provision of wellness services that can address many chronic illnesses.

Racial Differences in Mental Health Recovery among Veterans with Serious Mental Illness.

Black consumers with serious mental illness (SMI) face significant challenges in obtaining quality mental health care and are at risk for experiencing significant disparities in mental health care outcomes, including recovery from mental illness. Patient-provider interactions may partly contribute to this disparity. The purpose of the current study was to understand the effects of race, psychosis, and therapeutic alliance on mental health recovery orientation among Veterans with SMI.

Self-efficacy as a mediator of the relationship between social support and recovery in serious mental illness.

Objective: The purposes of this research were to assess relationships between social support and objective and subjective recovery in a sample of adults with serious mental illness and to examine self-efficacy as a potential mediator of these relationships.

Methods: In this cross-sectional study, a sample of 250 individuals completed measures tapping social support network size, satisfaction with social support, perceived support from the mental health system, self-efficacy, objective recovery (i.e.

Prevalence of diagnosed ocular disease in veterans with serious mental illness.

Objective: To compare the prevalence of diagnosed ocular disease and eye disease treatment between Veteran's Administration (VA) patients with and without serious mental illness (SMI).

Methods: Retrospective comparison of diagnosed ocular disease and treatment prevalence among patients with and without diagnosed SMI in fiscal year 2011 in the VA Capitol Health Care System (VISN 5).

Results: We identified 6462 VA patients with SMI and 137,933 without SMI.

Trends in Prevalence of Diagnosed Ocular Disease and Utilization of Eye Care Services in American Veterans.

Purpose: To assess trends in prevalence of diagnosed ocular disease and use of eye care services in the Veterans Affairs (VA) health care system.

Design: Prevalence study.

Methods: We performed a retrospective study of all eligible veterans in the VA Capitol Health Care Network from 2007 to 2011.

Incontinence in persons with Down Syndrome.

Aims: To assess the rates of incontinence and associated psychological problems in children, adolescents and adults with Down Syndrome, a genetic syndrome caused by partial or complete triplication (trisomy) of chromosome 21 and characterized by typical facial features, a physical growth delay and mild or moderate intellectual disability.

Methods: Three hundred and seventeen persons with Down Syndrome (4-51 years) were recruited through a German parent support group (59.6% male, mean age 19.

Development and Feasibility Testing of a Smartphone Intervention to Improve Adherence to Antipsychotic Medications.

Approximately 60% of individuals with schizophrenia do not take their antipsychotic medications as prescribed, and nonadherence is associated with exacerbation of psychotic symptoms, increased hospital and emergency room use, and increased healthcare costs. Behavioral-tailoring strategies that incorporate medication taking into the daily routine and use environmental supports have shown promise as adherence-enhancing interventions. Informed by the Information-Motivation-Behavioral (IMB) Skills Model and using the iterative process of user-centered design, we collaborated with individuals with schizophrenia and psychiatrists to develop an interactive smartphone application and web-based clinician interface, MedActive, for improving adherence to oral antipsychotic treatment.

The RAISE Connection Program: Psychopharmacological Treatment of People With a First Episode of Schizophrenia.

Objective: This study examined the adherence of psychiatrists to the Schedule of Recommended First and Second Line Antipsychotic Medications ("Antipsychotic Schedule"), which was implemented in two Recovery After an Initial Schizophrenia Episode (RAISE) Connection Program Implementation and Evaluation Study clinics.

Methods: Sixty-five individuals with a first episode of psychosis were enrolled in the RAISE Connection Program clinics. Two psychiatrists received training and ongoing consultation on use of a shared decision-making approach to prescribing antipsychotic medications according to the Antipsychotic Schedule.

Impacts of a Medicaid Wraparound Model Demonstration Program on Youth Specialty Mental Health Services Use.

Effective coordination of mental health care is critical in Medicaid wraparound model programs for youth. This study examined participation over time in mental health services for youth diverted or transitioned from residential care to a Medicaid wraparound demonstration program. Youth in wraparound had more sustained use of mental health outpatient clinic services than did propensity score matched youth who were not in wraparound.

Impact of a Casino Opening on Gambling Behaviors of People Engaged in Methadone Maintenance.

This study examined gambling behavior in the context of a newly opening casino, comparing disordered gamblers to non-disordered gamblers, in a population of individuals involved in methadone maintenance treatment. Disordered gamblers (N = 50) and non-disordered gamblers (N = 50) were surveyed before and after the opening of a new casino on gambling behaviors, substance use, and psychological symptoms. No statistically significant changes in gambling behaviors were observed for disordered gamblers or non-disordered gamblers across time points; however, non-disordered gamblers demonstrated non-significant increases in horse and dog race betting, electronic games, and casino table games.

Predictors of patient communication in psychiatric medication encounters among veterans with serious mental illnesses.

Objective: Person-centered psychiatric services rely on consumers actively sharing personal information, opinions, and preferences with their providers. This research examined predictors of consumer communication during appointments for psychiatric medication prescriptions.

Methods: The Roter Interaction Analysis System was used to code recorded Veterans Affairs psychiatric appointments with 175 consumers and 21 psychiatric medication prescribers and categorize communication by purpose: biomedical, psychosocial, facilitation, or rapport-building.