Search

Introduction: International guidelines on cancer treatment recommend screening for early detection and treatment of distress. However, screening rates are insufficient. In the present study, a survey was developed to assess perceived systemic barriers to distress screening. Methods: A three-step approach was used for the study. Based on qualitative content analysis of interviews and an expert panel, an initial survey with 53 questions on barriers to screening was designed. It was completed by 98 nurses in a large comprehensive cancer center in Switzerland. From this, a short version of the survey with 24 questions was derived using exploratory principal component analysis. This survey was completed by 150 nurses in four cancer centers in Switzerland. A confirmatory factor analysis was then performed on the shortened version, yielding a final set of 14 questions. Results: The initial set of 53 questions was reduced to a set of 14 validated questions retaining 53% of the original variance. These 14 questions allow for an assessment within 2-3 min that identifies relevant barriers to distress screening from the perspective of those responsible for implementation of distress screening. Across several hospitals in Switzerland, the timing of the first distress screening, lack of capacity, patient and staff overload, and refusal of distressed patients to be referred to support services emerged as major problems. Conclusion: The validated 14 questions on barriers to screening cancer patients for distress enable clinicians and hospital administrators to quickly identify relevant issues and take action to improve screening programs. Keywords: cancer; distress screening; hospital administrators; principal component analysis; psycho-oncology.

Background: People with schizophrenia show a higher risk of committing violent offenses. Previous studies indicate that there are at least three subtypes of offenders with schizophrenia. Objectives: Employing latent class analysis, the goals of this study were to investigate the presence of homogeneous subgroups of offender patients in terms of remission in psychopathology during inpatient treatment and whether or not these are related to subtypes found in previous studies. Results should help identify patient subgroups benefitting insufficiently from forensic inpatient treatment and allow hypotheses on possibly more suitable therapy option for these patients. Methods: A series of latent class analyses was used to explore extensive and detailed psychopathological reports of 370 offender patients with schizophrenia before and after inpatient treatment. Results: A framework developed by Hodgins to identify subgroups of offenders suffering from schizophrenia is useful in predicting remission of psychopathology over psychiatric inpatient treatment. While "early starters" were most likely to experience remission of psychopathology over treatment, "late late starters" and a subgroup including patients from all three of Hodgins' subgroups in equal proportions benefited least. Negative symptoms generally seemed least likely to remit. Conclusion: Psychiatric treatment may have to be more tailored to offender patient subgroups to allow them to benefit more equally.

Background: Extant research has provided evidence for disparities between patients with schizophrenia spectrum disorder (SSD) who have and have not experienced childhood maltreatment (CM) in terms of treatment outcome, psychopathology and their propensity to engage in offending behavior. However, research addressing all phenomena is scarce.Objective: The current study aims to explore differences between offender patients with SSD and CM and those with SSD and no CM in terms of their offending, psychopathology at different points in time and treatment outcome.Method: In the present explorative study, latent class analysis was used to analyze differences between 197 offender patients with SSD and CM and 173 offender patients with SSD and no CM, who were admitted to forensic psychiatric inpatient treatment between 1982 and 2016 in Switzerland.Results: Three distinct homogenous classes of patients were identified, two of which were probable to have experienced significant CM. One third of patients with SSD and CM were probable to benefit from inpatient treatment, even surpassing results observable in the group without CM, whereas the other group with SSD and CM was probable to benefit less. Patients with SSD and no CM displayed more psychopathology at first diagnosis and prior to their index offense. Interclass differences in offending behavior were minimal.Conclusions: Offender patients with SSD and CM differ not only from offender patients with SSD and no CM, but also amongst themselves. While some with SSD and CM experience a remission in psychopathology and improve their prognosis for future offending behavior, others do not. Directions for future research on SSD and CM are discussed.

Background There is limited research with inconsistent findings on differences between female and male offender patients with a schizophrenia spectrum disorder (SSD), who behave aggressively towards others. This study aimed to analyse inhomogeneities in the dataset and to explore, if gender can account for those. Methods Latent class analysis was used to analyse a mixed forensic dataset consisting of 31 female and 329 male offender patients with SSD, who were accused or convicted of a criminal offence and were admitted to forensic psychiatric inpatient treatment between 1982 and 2016 in Switzerland. Results Two homogenous subgroups were identified among SSD symptoms and offence characteristics in forensic SSD patients that can be attributed to gender. Despite an overall less severe criminal and medical history, the female-dominated class was more likely to receive longer prison terms, similarly high antipsychotic dosages, and was less likely to benefit from inpatient treatment. Earlier findings were confirmed and extended in terms of socio-demographic variables, diseases and criminal history, comorbidities (including substance use), the types of offences committed in the past and as index offence, accountability assumed in court, punishment adjudicated, antipsychotic treatment received, and the development of symptoms during psychiatric inpatient treatment. Conclusions Female offender patients with schizophrenia might need a more tailored approach in prevention, assessment and treatment to diminish tendencies of inequity shown in this study.