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Background: Much attention has been paid to psychological factors influencing characteristics, severity, and course of mental disorders. The objective of our investigation was to examine the interrelations among quality of life (QoL), self-stigma, and coping strategies, demographics and severity of the disorder in neurotic spectrum disorders, schizophrenia, and depressive spectrum disorders., Methods: A total of 343 clinically stable Czech outpatients with different mental disorders (153 with neurotic spectrum disorders; 81 with depression, and 109 with schizophrenia spectrum disorders) were included. The patients were examined by their outpatient psychiatrists during regular psychiatric checkup and completed a sociodemographic questionnaire, the Quality of Life Satisfaction and the Enjoyment Questionnaire (Q-LES-Q), the Internalized Stigma of Mental Illness Scale (ISMI), the Stress Coping Style Questionnaire (SVF-78), and the Clinical Global Impression scale (CGI)., Results: The study demonstrates that the self-stigma and coping strategies are significant factors linked to the QoL in all diagnostic groups of patients. Patients with schizophrenia spectrum disorders had lower scores in QoL compared to the other two groups. The patients with depression or neurotic spectrum disorders had a lesser degree of self-stigma than the patients with schizophrenia spectrum disorders. The severity of the illness significantly correlated with the QoL, self-stigma, and coping strategies., Conclusions: The investigation confirmed the connection between the quality of life, self-stigma, coping strategies, and the severity of the illness, in outpatients with schizophrenia spectrum disorders, depressive, and neurotic spectrum disorders. A further longitudinal study would be useful to determine the causative relationships of these variables.

Lack of insight is defined as a loss of ability to distinguish that one's unusual and unreal experiences should be the symptoms of the psychiatric disorder requiring treatment. Lack of insight may be considered as a core symptom of schizophrenia. The concept of insight has been regarded for a long time as necessary for treatment, which improves adherence and makes a better prognosis. Increased insight in schizophrenia has been associated not only with benefits, but also bring trouble in the form of self-stigma, low self-esteem, reduced patient's hope, diminished quality of life, and increased suicidality. Therefore, insight should be managed with sensitive monitoring of the risk factors, and be gradual, carefully supported by the encouragement of hope and confidence to managing everyday life.

Introduction: Treatment adherence is one of the main factors affecting the success of treatment and, secondarily, the quality of life and social adaptation of the patients. The aim of this study was to investigate the association between self-stigmatization, treatment adherence and history of discontinuation of drug treatment., Methods: The cross-sectional study was conducted on 120 (98 completed all the questionnaires) neurotic outpatients treated in the University Hospital Olomouc. The following variables were evaluated: the objective and subjective Clinical Global Impression (CGI) scale, Drug Attitude Inventory (DAI-10) questionnaire measuring adherence, Internalized Stigma of Mental Illness (ISMI) scale measuring self-stigma, and a demographic data questionnaire., Results: Data analysis showed no correlation between self-stigmatization and age, age of onset or length of the post-hospitalization phase. However, there were significant correlations between self-stigmatization and the severity of the disorder (assessed by both objective and subjective CGI), number of previous hospitalizations, total number of psychiatrists visited by the patient, the arbitrary discontinuation of medication in the past, and the dose of an antidepressant. Furthermore, self-stigma was significantly negatively correlated with the current treatment adherence. The rate of adherence was negatively correlated with both objective and subjective CGI only., Conclusions: Self-stigma significantly affects the current adherence to the treatment of neurotic spectrum disorders.

Background: Borderline personality disorder (BPD) is a disabling psychiatric condition with a chronic and challenging course. BPD is reflected as a disorder of self-regulation" and is associated with both psychological vulnerabilities and social relations that fail to support basic emotional needs. The objective of the paper is to provide the up-to-date data on the unmet needs of BPD patients and their families., Method: A computerized search of the literature printed between January 1990 and May 2017 was conducted in PubMed, and additional papers were extracted using keywords "borderline personality disorder,"needs," "pharmacotherapy," "psychotherapy," "CBT," and "family" in various combinations. According to the eligibility criteria, 57 articles were chosen. Secondary articles from the reference lists of primarily identified papers have been selected for the eligibility and added to the first list (N=151)., Results: The results were divided into three categories: the needs connected with (1) the symptom control; (2) the treatment; (3) the quality of life. The needs connected with symptoms were described issues such as emotional needs, social interactions, self-harm, parasuicide, suicidality, comorbidity, mentalization, identity disturbance, moreover, barriers to treatment. The needs connected with the treatment described are focused on needs for early diagnosis, early intervention, holding environment, therapeutic relation, assertive community treatment, destigmatization, hospitalization, and primary care. The needs connected with the quality of life involve family needs, physical health, spiritual needs, advocacy needs, and needs for the separation-individuation. The part focused on implications for the treatment presented several treatment approaches, focusing mostly on the their basics and efficacy., Conclusion: Observing the patients' needs may be essential to the treatment of the individuals suffering from BPD. However, many needs remain unmet in the areas linked to medical, personal, and social factors. A bigger focus on the patients' needs could be beneficial and should be targeted in the treatment.

Background: Obsessive compulsive disorder (OCD) is a disabling mental disorder with the chronic and difficult course. The disorder is accompanied by numerous limitations in personal and interpersonal functioning. OCD decreases the quality of life and the chance to maintain relationships and professional status. The patients with OCD often experience a severe disabling course of the disorder. Even the individuals, who follow treatment advice, are often still highly symptomatic. In the last decade, the concept of the needs has been assessed as an extent of the traditional outcome evaluation in order to focus on the identification of the specific needs of the patients and their relatives, improve the patients´ overall mental condition and quality of life, and also to increase the treatment effectiveness of the mental disorders. The objective of the article was to review the current literature about unmet needs of the OCD patients and their caregivers., Method: A computerized search of the literature published between January 2000 and June 2016 was conducted in MEDLINE, and additional papers were extracted using keywords "obsessive compulsive disorder","needs", "pharmacotherapy", "CBT", and "family" in various combinations. Primary selection selected the total of 449 articles. According to the established criteria, 168 articles were chosen. After a detailed examination of the full texts, 53 articles remained. Secondary articles from the reference lists of primarily selected papers were read and evaluated for the eligibility and added to the final list of the articles (n = 107)., Results: The needs of the OCD patients might differ at various stages and severity of the disorder. Four sets of the needs were identified: the needs connected with the symptoms, the treatment, the quality of life, and the family. The patients suffering from OCD often experience many limitations in the fulfillment of their fundamental human needs such as disturbed patients´ functioning in the common life, family, at work, in the ability to realize their goals, skills, potential, capacity to follow prescribed treatment, take medication, cooperate in addressing the root causes of their problems, reduce obsessive thoughts and compulsive behavior, as well as their willingness to realize exposures with the desire to resolve the situation., Conclusion: Monitoring the patients´ needs may be relevant for the treatment of the individuals suffering from OCD. A bigger focus on the patients´ needs could be beneficial and should be targeted in the treatment.

Objective: Inflammatory bowel diseases (IBD) are chronic diseases with a significant impact on quality of life (QoL). The aim of the study was to examine the QoL in children with IBD and their families, depression and anxiety for both the children and their parents., Methods: Participants were 29 adolescents with IBD (19 individuals suffered from the Crohn disease, another ten had ulcerative colitis) and 40 healthy controls of the same age (13-16 years). The probands and their parents completed questionnaires measuring the quality of life (KidScreen-10, PedsQL), depression (CDI, BDI-II), and anxiety (SAD, BAI)., Results: The QoL measured by questionnaires did not differ between the adolescent participants, but it was significantly lower in the parents of the children with IBD than in the parents of the healthy controls. The parents of the IBD children scored lower in the Family Impact Module Total Scale Score and the parental Health-Related QoL Summary Score. The fathers of the IBD children also had a lower level of the Family Functioning Summary Score. There wasn't any difference in the levels of anxiety and depressive symptoms among the IBD adolescents and the controls., Conclusions: The parents of the children with IBD experience lower QoL than the parents with the healthy children. The children with IBD show similar symptoms of depression, anxiety, and QoL as the healthy controls.

Michaela Holubova,1,2 Jan Prasko,1 Marie Ociskova,1 Ales Grambal,1 Milos Slepecky,3 Marketa Marackova,1 Dana Kamaradova,1 Marta Zatkova3 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, 2Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic; 3Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra-Chrenova, Slovak Republic Background: The quality of life (QoL) is a multidimensional view that represents all aspects of patient well-being in various areas of patient life. Specific coping strategies may be connected to both the QoL and the severity of mental disorder. The aim of this investigation was to examine the relationship between the QoL and the coping strategies of outpatients with a depressive disorder.Methods: Eighty-two outpatients, who met the criteria of the International Classification of Diseases, Tenth Revision, for a depressive disorder, were enrolled in the cross-sectional study. Data on sociodemographic and clinical variables were obtained from the medical records. Individuals filled the following standardized questionnaires: Quality of Life Satisfaction and Enjoyment Questionnaire, Stress Coping Style Questionnaire, and Clinical Global Impression. Multiple regression analyses with backward elimination were performed to discover the most influential factors contributing to QoL.Results: The participants with a depressive disorder showed an overuse of negative coping strategies, especially escape tendency and resignation. A positive self-instruction strategy was used by the patients less often. The coping strategies were significantly associated with the QoL. A more frequent use of positive coping strategies had a positive association with the QoL. The main factors related to QoL were the subjective severity of the disorder, employment, and positive coping strategies.Conclusion: The study confirmed the relationship between QoL and the coping strategies of outpatients with a depressive disorder. Keywords: coping strategies, quality of life, depressive disorder

Michaela Holubova, Jan Prasko, Klara Latalova, Marie Ociskova, Aleš Grambal, Dana Kamaradova, Kristyna Vrbova, Radovan Hruby Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic Background: Current research attention has been moving toward the needs of patients and their consequences for the quality of life (QoL). Self-stigma is a maladaptive psychosocial phenomenon disturbing the QoL in a substantial number of psychiatric patients. In our study, we examined the relationship between demographic data, the severity of symptoms, self-stigma, and QoL in patients with schizophrenia spectrum disorder.Methods: Probands who met International Classification of Diseases-10 criteria for schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder, or delusional disorder) were recruited in the study. We studied the correlations between the QoL measured by the QoL Satisfaction and Enjoyment Questionnaire, self-stigma assessed by the Internalized Stigma of Mental Illness, and severity of the disorder measured by the objective and subjective Clinical Global Impression severity scales in this cross-sectional study.Results: A total of 109 psychotic patients and 91 healthy controls participated in the study. Compared with the control group, there was a lower QoL and a higher score of self-stigmatization in psychotic patients. We found the correlation between an overall rating of self-stigmatization, duration of disorder, and QoL. The level of self-stigmatization correlated positively with total symptom severity score and negatively with the QoL. Multiple regression analysis revealed that the overall rating of objective symptom severity and the score of self-stigma were significantly associated with the QoL.Conclusion: Our study suggests a negative impact of self-stigma level on the QoL in patients suffering from schizophrenia spectrum disorders. Keywords: quality of life, self-stigma, schizophrenia, schizoaffective disorder, delusional disorder

Introduction Treatment adherence is one of the main factors affecting the success of treatment and, secondarily, the quality of life and social adaptation of the patients. The aim of this study was to investigate the association between self-stigmatization, treatment adherence and history of discontinuation of drug treatment. Methods The cross-sectional study was conducted on 120 (98 completed all the questionnaires) neurotic outpatients treated in the University Hospital Olomouc. The following variables were evaluated: the objective and subjective Clinical Global Impression (CGI) scale, Drug Attitude Inventory (DAI-10) questionnaire measuring adherence, Internalized Stigma of Mental Illness (ISMI) scale measuring self-stigma, and a demographic data questionnaire. Results Data analysis showed no correlation between self-stigmatization and age, age of onset or length of the post-hospitalization phase. However, there were significant correlations between self-stigmatization and the severity of the disorder (assessed by both objective and subjective CGI), number of previous hospitalizations, total number of psychiatrists visited by the patient, the arbitrary discontinuation of medication in the past, and the dose of an antidepressant. Furthermore, self-stigma was significantly negatively correlated with the current treatment adherence. The rate of adherence was negatively correlated with both objective and subjective CGI only. Conclusions Self-stigma significantly affects the current adherence to the treatment of neurotic spectrum disorders. [ABSTRACT FROM AUTHOR]

Introduction Self-stigma is a maladaptive psychosocial phenomenon that can disturb self-image and quality of life in psychiatric outpatients and may lead to dysphoria, social isolation and reduced adherence to treatment. Objectives Self-stigma and QoL could be reflected as important factors for patients, who suffer from schizophrenia spectrum disorders, their caregivers and mental health specialists. Focus on reducing the self-stigma in supportive and educational therapy could be an important factor in promoting a higher QoL. Aims Current research moved attention to the relationship between demographic data, the severity of symptoms, self-stigma and quality of life in schizophrenic outpatients compared to the QoL in healthy controls. Methods Patients who met ICD-10 criteria for schizophrenia spectrum disorder were recruited in the study. The Quality of Life Satisfaction and Enjoyment questionnaire (Q-LES-Q), Internalized Stigma of Mental Illness (ISMI) and severity of the disorder measured by objective and subjective Clinical Global Impression severity scales (CGI) were assessed. Results One hundred and nine psychotic patients and 91 healthy controls participated in the study. Compared to the control group, there was a lower QoL and a higher score of self-stigma in psychotic patients. We found the correlation between the self-stigma, duration of disorder and QoL. The level of self-stigma correlated positively with total symptom severity score and negatively with the QoL. Stepwise regression analysis revealed that the objective severity and self-stigma score were significantly associated with the quality of life ( Tables 1 and 2 , Fig. 1 ). Conclusions Our study suggests a negative impact of self-stigma level on the quality of life in patients suffering from schizophrenia spectrum disorders. [ABSTRACT FROM AUTHOR]

Introduction The modern psychiatric view of schizophrenia spectrum disorders and their treatment has led to an increasing focus on coping strategies and quality of life of these patients. Objectives Understanding the relationship between quality of life and coping strategies can help in finding those coping strategies that enhance the quality of life. It is important to study the inner experience and striving of patients because of connection with well-being and treatment adherence. Aims : In the present study, the authors examined the relationship between demographic data, the severity of symptoms, coping strategies, and quality of life in psychotic outpatients. Methods Psychiatric outpatients who met ICD-10 criteria for a psychotic disorder (schizophrenia, schizoaffective disorder, or delusional disorder) were recruited in the study. Questionnaires measuring the coping strategies (SVF-78), the quality of life (Q-LES-Q), and symptoms severity (objective and subjective clinical global impression–objCGI; subjCGI) were assessed. Data were analysed using one-way ANOVA, Mann-Whitney U-test, Pearson and Spearman correlation coefficients, and multiple regression analysis. Results One hundred and nine psychotic outpatients were included in the study. The QoL was significantly related to the Positive and Negative coping strategies. The severity of disorder highly negatively correlated with the QoL score. Stepwise regression analysis showed that symptoms severity (subjCGI), Positive coping strategies (especially Positive Self-instruction), Difference between the objCGI and subjCGI and Negative coping strategies explain totally 53.8% of variance of the QoL (Tables 1–3). Conclusions Our study suggests the importance of utilizing the Positive coping strategies in improving the quality of life in patients with psychotic disorders. [ABSTRACT FROM AUTHOR]

Introduction Adherence to treatment of mental disorders is one of the key factors influencing its success and, secondarily, the patients’ quality of life and social adaptation. Aims The cross-sectional study of 90 outpatients diagnosed with psychotic disorders aimed at determining if there was a relationship between discontinuation of medication in the past, current adherence to treatment and self-stigma. Methods The assessment was made with the objective and subjective Clinical Global Impression – Severity scale, Drug Attitude Inventory, Internalized Stigma of Mental Illness (ISMI) scale and demographic data. Results The questionnaires were filled out by 79 patients, of whom 5 handed in incomplete questionnaires. Complete sets of data were obtained from 74 patients. The data analysis showed that the levels of self-stigma as assessed by the total ISMI scores was not statistically significantly correlated with most of the demographic factors (age, age of illness onset, gender, education, marital status, employment, duration of the illness, number of hospitalizations and antipsychotic dosage). However, there was a significant negative correlation with current adherence to treatment. Conclusions Adherence to treatment is one of the most important prerequisites for successful therapy. Adherence may be enhanced through better motivation and education of patients on the necessity of adhering to treatment recommendations and the consequences of non-adherent behavior. Important factors in adherence also seem to be patients’ stigmatization and self-stigma. Adherence may be increased by promising self-stigma-reducing strategies performed by systematic psychoeducation of patients or as a part of psychotherapeutic counseling. [ABSTRACT FROM AUTHOR]

Introduction Patients with schizophrenia mightexperience panic attacks and meet the criteria for both schizophrenia and panicdisorder. Classification of mental disorders with hierarchical approach givesschizophrenia the first position before the panic disorder. The panic attacksmight not be well recognized and adequately treated. The aim of this study isto determine the prevalence of panic disorder in schizophrenic patients, torecognise the impact of comorbidity on the clinical picture and the course ofthe disease, and to determine the appropriate/possible treatment. Method The articles were identified by the keywords “schizophrenia” and “panic disorder”, or “agoraphobia”, using the Medline and Web of Science search. Additional sources were obtained by studying the references of summaries ofimportant articles. Results The prevalence of comorbid panic disorder inpatients with schizophrenia ranges from 16% to 63%, but the results are notconsistent. Etiopathogentical hypothesis of schizophrenia and panic disorderand also the concept of panic psychosis are discussed. There is a limitedbiological evidence to support those hypotheses. Data suggest that patientswith schizophrenia and panic disorder exhibit higher rates of depression, suicidal ideation and increased extrapyramidal side effects. Panic comorbiditymay worsen severity of positive and negative symptoms of schizophrenia and theoverall quality of life. Conclusion Panic disorder and schizophreniaoften occurs comorbid. It is found most commonly in patients with paranoidsubtype. Comorbid panic disorder may worsen positive symptoms and lead todepressive symptoms. It negatively affects the quality of life and add up tohigher level of suicidality. The pharmacotherapy with atypical antipsychoticsis preferred, or their combination with clonazepam or alprazolam. [ABSTRACT FROM AUTHOR]

Treatment adherence is one of the main factors affecting the success of treatment, quality of life and social adaptation of the patients. The cross sectional study was conducted on 120 neurotic outpatients treated in University hospital Olomouc, Czech Republic. The aim of the study was to investigate association between self-stigmatization, treatment adherence and history of discontinuation of drug treatment. The following variables were evaluated: were objective and subjective CGI (Clinical Global Impression – Severity), the adherence questionnaire DAI-10 (Drug Attitude Inventory), the self-stigma scale ISMI (Internalized Stigma of Mental Illness), and the demographic data questionnaire. 98 patients completed all the questionnaires, 22 patients completed questionnaires inadequately and or did not cooperate sufficiently. Data analysis showed no correlation between self-stigmatization and age, age of onset or length of post-hospitalization phase. However, there was a statistically significant correlation between self-stigmatization and the severity of psychopathology, the arbitrary discontinuation of medication in the past and the dose of an antidepressant. Furthermore, self-stigma significantly negatively correlated with the current treatment adherence. The level of adherence negatively correlated only with the subjective and objective CGI. Our results suggest strong association between self-stigmatization and adherence to treatment in neurotic patients. We may conclude that more attention should be paid to manage self-stigmatization in this patient group. [ABSTRACT FROM AUTHOR]

Background: In the past, the first goal of schizophrenia treatment was to reduce psychotic symptoms, mainly positive symptoms. Recently, as a result of an emphasis on patient needs, the concept of quality of life (QoL) has been brought into the treatment. The goal has therefore changed from the alleviation of symptoms to improvement of the patient's satisfaction with social activities. Self-evaluations by people with schizophrenia were previously thought to lack reliability because of the presence of psychopathological symptoms and poor awareness of the disease. Recently the importance of evaluating the satisfaction of patients themselves, however, has been recognized in schizophrenia. Studies on this field showed us, that QoL data from patients with chronic mental illness were reliable and concluded that subjective QoL evaluation was applicable to such patients. Aims: The purpose of the present study was to compare the QoL in patients suffering from schizophrenia in clinical remission with healthy controls and examine the extent of the effects of subjective cognitive functioning on QoL in these patients. Methods: Data were obtained using the quality of life questionnaire (Quality of Life Enjoyment and Satisfaction - Q-LES-Q), and subjective questionnaire for cognitive dysfunction (Cognitive Failures Questionnaire - CFQ) for 40 schizophrenia patients in clinical remission and 40 healthy controls. Results: Cognitive function correlates negatively with subjective QoL in patients with schizophrenia. Supported by grant IGA MZ ČR NT11047. [Copyright &y& Elsevier]

Host of studies have now examined QoL in patients with major depressive disorder and schizophrenia until recently few had specifically focused upon QoL in patients with bipolar disorder. The purpose of the present study was to find out the QoL data in patients suffering from bipolar disorder in clinical remission and examine the extent of the effects of the demographical and clinical data on QoL in these patients. The second aim was to compare the QoL data with the data of patients suffering from schizophrenia in clinical remission and with healthy controls. Data were obtained by using the quality of life questionnaire (Quality of Life Enjoyment and Satisfaction - Q-LES-Q) for 41 bipolar patients in clinical remission. The data of these subjects were compared with the data of 40 schizophrenic patients in clinical remission and with 40 healthy controls. There are statistically significant difference in comparison with schizophrenic patients, but not in comparison with healthy controls. There were higher mean scores in most Q-LES-Q summary scales in patients with bipolar disorder in comparison with schizophrenic patients and in some summary scales in comparison with healthy controls. Our results suggest the same or higher subjective quality of life in patients suffering with bipolar disorder in clinical remission in comparison with healthy controls and higher subjective quality of life in bipolar patients in clinical remission in comparison with schizophrenic patients in clinical remission. Supported by: Grant IGA MZ ČR NT11047 [Copyright &y& Elsevier]