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ABSTRACT Severe mental illnesses (SMIs) represent a significant public health challenge with substantial personal, economic and societal burdens. Despite treatment advances, recovery outcomes for SMI patients remain variable. This study aimed to investigate the influence of personal and psychosocial factors on recovery among SMI patients in community health settings. This cross‐sectional study was conducted in 23 community health service centres in Nanjing, China. We recruited 924 participants diagnosed with SMIs, using a random sampling method. The relationships between individual, psychosocial factors and patients' recovery status were analysed by multiple linear regression. The mediation effect of medication adherence was further tested by the Sobel test with bootstrapping. The mean score of the Morningside Rehabilitation Status Scale (MRSS) of 924 patients with SMIs was 49.82 ± 41.52. The main influencing personal factors of recovery status were age, marital status, education, average annual income and duration of illness. Patients who were accepted by their families tended to have better recovery outcomes, while stigma and social impairment may hinder recovery. Medication adherence played a mediating role between psychosocial factors and recovery status. This study highlights the crucial role of psychosocial factors in the treatment and recovery of SMI patients. Furthermore, medication adherence emerged as a mediating factor. Implementing targeted interventions and policies addressing identified psychosocial barriers can offer promising avenues for improving recovery outcomes for SMI patients in community settings. [ABSTRACT FROM AUTHOR]

Objective To explore the current situation and influencing factors of the family burden of patients with severe mental disorders. Methods The main guardians of 715 patients with severe mental disorders in Qingyang City were selected as the research object by the multi-stage stratified cluster random sampling method. A self-made questionnaire was applied to investigate the guardian's demographic data, family situation, health status, patient demographic data, and disease treatment. The current situation of family burden was investigated by the Family Burden Scale (FBS). Multiple linear regression analysis was applied to analyze the influencing factors of family burden for patients with severe mental disorders. Results The total FBS score was 22.36 ± 13.11, and the burden of medium and above accounted for 50.57%. The financial burden on the family was the heaviest. The results of multiple linear regression analysis revealed that the patient's education level, marital status, monthly medication expenses, current condition, medication adherence, medical security, guardian's health status, relationship with the patient, cohabitation time, and monthly family income were the influencing factors of family burden (P < 0.05). Conclusion The family burden of patients with serious mental disorders in Qingyang City is relatively heavy. Families with unstable patient conditions, high monthly medication expenses, low household income, guardians in sub-health or suffering from chronic disease, and long-term living with the patient require further attention. Providing these families with assistance and support is essential to alleviating their burden. [ABSTRACT FROM AUTHOR]

Objective: This systematic review aims to assess the impact of music therapy and musical interventions on neuropsychiatric outcomes among patients with moderate and severe mental disorders, in comparison with conventional treatment in isolation. Methods: The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted on November 16, 2021, using the following databases and search interfaces: Cumulative Index to Nursing and Allied Health Literature, Embase, SCOPUS, Web of Science; PubMed, PsycINFO, Literatura Latino-Americana e do Caribe em Ciências da Saúde, and Scientific Electronic Library Online. Two authors independently assessed the studies for inclusion criteria, extracted the data, and evaluated the quality of the included studies using critical appraisal tools. Results: In total, 17 studies were included, 9 of which were randomized controlled trials. The experimental studies involved 5,082 adult and elderly patients. The most prevalent symptoms assessed in the studies were anxiety, depression, and positive and negative symptoms of psychotic disorders. Music interventions were predominantly conducted by music therapists and nurses, providing passive interventions with the selection of musical repertoire by therapists and patients. The frequency with which musical interventions occurred varied greatly in terms of session duration, number of times per week, and number of times during the day. The identified study designs included clinical and quasi-experimental studies. In terms of methodological quality, clinical studies showed weaknesses regarding deviations from intended interventions. Conclusion: The effectiveness of music therapy and musical interventions for neuropsychiatric symptoms in patients with moderate and severe mental disorders was evident in quasi-experimental and clinical studies with satisfactory methodological quality. Musical interventions, in various forms of application, represent an interdisciplinary therapeutic tool that complements and enhances conventional treatment. Unlike conventional treatments, the immersive and integrative nature of music interventions allows access to both intrapersonal and interpersonal dimensions during periods of psychic suffering. These findings highlight the importance of researchers addressing methodological limitations, such as deviations from intended interventions, and advocate for the expansion the use of music in community treatment settings. [ABSTRACT FROM AUTHOR]

With the implementation of the 'Mental Health Law of the People's Republic of China' and relevant policies， governments at all levels have devoted more resources to community-based rehabilitation services for patients with mental disorders， making the mental health services more accessible and professional to the majority of patients with mental disorders. Monumental achievements have been made in community-based rehabilitation services for patients with severe mental disorders， while challenges have always existed in the China's community mental health service system for patients with severe mental disorders. Therefore， this article elaborated the achievements， challenges and prospects of China's community mental health service system for patients with severe mental disorders， aiming to provide references for future work and further improve the quality and accessibility of community mental health service for patients with mental disorders.

Patients with schizophrenia suffer from physical health conditions, culminating in reduced physical functioning with enormous costs for patients and society. Although aerobic endurance and skeletal muscle strength, typically reduced in this population, relate to cognition and function, no study has explored their respective contributions to performance of functional skills and everyday tasks. In a cross-sectional study, 48 outpatients (28/20 men/women; 35 ± 11(SD) years) with schizophrenia spectrum disorders (ICD-10; F20–25) were administered the UCSD Performance-based Skills Assessment-Brief (UPSA-B; functional skills), Specific Level of Functioning (SLOF; functional performance) and the Positive and Negative Syndrome (PANSS) scale. Peak oxygen uptake (V̇O 2peak) was assessed along with leg press maximal muscle strength (1RM) and mechanical power. UPSA-B performance was associated with V̇O 2peak (r = 0.28, p < 0.05), accounting for 8 % (p < 0.05) of shared variance, but was unrelated to 1RM and mechanical power. The SLOF physical functioning domain was associated with V̇O 2peak (r = 0.30, p < 0.05) and 1RM (r = 0.24,p < 0.05), while SLOF personal care (r = 0.27,p < 0.05) and activities (r = 0.30,p < 0.05) were related only to V̇O 2peak. Hierarchical regression analyses revealed that while V̇O 2peak and age combined to account for 20 % (p < 0.05) of the variance in physical functioning, the contribution of 1RM was eliminated after adjusting for age. V̇O 2peak and negative symptoms combined predicted 24 % and 35 % of the variance in personal care and activities, respectively. UPSA-B scores did not add to the prediction of SLOF scores. Although V̇O 2peak and 1RM both relate to functional outcomes, the combination of V̇O 2peak , age, and negative symptoms exert the greatest detrimental influence on functional performance beyond skills deficits. [Display omitted] [ABSTRACT FROM AUTHOR]

Abortion behaviors among individuals with mental disorders presented major obstacles to women's health. However, few studies reported the prevalence and associated factors of abortion among women with severe mental disorders in China. Consequently, this study aims to investigate the prevalence of abortion among female patients in rural communities and identify potential health risks. This was a cross-sectional study of 276 women aged 18 years and older with severe mental disorders in rural areas of Shandong Province, China. The pregnancy history, abortion history and socio-demographic characteristics of women were investigated by questionnaire. Logistic regression analysis was employed to examine the associated factors for different abortion behaviors. The study showed that 82.61 % (228/276) of patients had a pregnancy history. Among the patients with a pregnancy history, 43.42 % (99/228) reported having had at least one abortion, and 15.79 % (36/228) had more than one. In the other side, 31.58 % (72/228) of them experienced spontaneous abortion, while 12.72 % (29/228) experienced induced abortion. Age at first gestation (aOR 0.80, 95 % CI 0.70–0.90) and age at last gestation (aOR 1.17, 95 % CI 1.07–1.27) were both associated with abortion. Anxiety was related to spontaneous (aOR 1.08, 95 % CI 1.02–1.15) and repeat abortions (aOR 1.10, 95 % CI 1.01–1.19). In addition, religion (aOR 10.47, 95 % CI 2.81–39.01), number of children≥2 (aOR 0.18, 95 % CI 0.04–0.77), and family functioning (aOR 1.31, 95 % CI 1.06–1.63) were associated with induced abortion. Women with severe mental disorders in rural regions have notably higher rates of abortion compared to the general female population, particularly for spontaneous abortions. Gestational age and anxiety of pregnant patients deserve attention and preventive measures to avoid the outcomes of abortion. • The prevalence of spontaneous abortion in SMDs patients was 31.58%, and the prevalence of induced abortion was 12.72%. • There were 15.79% of women with SMDs who reported having two or more abortions. • Patients with better family functioning were more likely to have an induced abortion than those with poorer. • Gestational age and anxiety symptoms were significantly associated with abortion. [ABSTRACT FROM AUTHOR]

AIM: This study aimed to adopt the use of the Health Improvement Profile in the Turkish context and to report the findings obtained during its pilot implementation. METHODS: This descriptive cross-sectional study consisted of 280 individuals, and data were collected using the Patient and Disease Characteristics Form and the Health Improvement Profile between May and December 2019 ın community mental health centers. The total content validity index of the Health Improvement Profile (Female-Male) was 0.97. RESULTS: Among the participants, 57.1% had a physical health problem, 58.1% had a diagnosis of a physical condition, and 41.9% had physical symptoms only. Intergroup comparisons showed that individuals diagnosed with schizophrenia and other psychotic disorders slept for less than 3 hours, individuals diagnosed with bipolar disorder consumed more alcohol, and individuals diagnosed with major depressive disorders slept for more than 8 hours, smoked more, consumed more caffeine, and practiced safe sex less consistently than individuals diagnosed with other psychiatric disorders (p < .05). CONCLUSION: The Health Improvement Profile is an assessment tool that psychiatric mental health nurses can use to evaluate the physical health of individuals diagnosed with serious mental illness. The use of Health Improvement Profile in routine practice may allow determining the red-flagged parameters and provide an opportunity improving these parameters with evidence-based interventions. [ABSTRACT FROM AUTHOR]

Objectives: To highlight the critical need for integrated healthcare approaches for individuals with severe mental disorders and poor oral health. Materials and methods: Review and discussion of factors contributing to elevated DMFT (decayed, missing, and filled primary teeth) indices in individuals with severe mental disorders. Results: Higher DMFT indices are reported in individuals with schizophrenia and bipolar disorder due to medication side effects, cognitive impairments, and socio-economic challenges. Conclusions: Emphasis on the necessity of combining mental and dental health services through regular dental check-ups, specialized education programs, and professional collaboration. Clinical Relevance: Integrated healthcare strategies are essential to improve overall patient care and well-being for those with severe mental disorders. [ABSTRACT FROM AUTHOR]

Family caregivers who live with and care for individuals with severe mental disorders face serious issues. This study aimed to investigate the burdens of these family caregivers. This descriptive phenomenological study involved 15 family caregivers who looked after persons with mental disorders in Malang City, Indonesia; the participants were selected using a purposive sampling technique. Data were gathered using individual in-depth interviews and observations, and then analyzed inductively. Based on the findings, the burdens of family caregivers can be grouped into four main themes: 1) families encountered challenges and stigma in caring for persons with severe mental disorders, 2) there was a lack of support from the community and healthcare providers, 3) family caregivers reported experiencing various negative emotions and interpreting negative implications from their caregiving experiences, and 4) family caregivers employed coping strategies to alleviate their burdens. The researchers conclude that family caregivers experience complex burdens when caring for persons with severe mental disorders; hence, family caregivers need the support of healthcare personnel and community presence in situations of caring for persons with chronic mental disorders. Keywords: burden of disease, caregiver, family, Indonesia, severe mental disorders Abstrak Beban Berat Caregiver Keluarga dalam Merawat Orang dengan Gangguan Jiwa Berat. Caregiver keluarga yang hidup bersama orang dengan gangguan jiwa berat menghadapi masalah yang serius. Penelitian ini bertujuan untuk mengetahui secara mendalam beban para caregiver keluarga. Penelitian fenomenologi deskriptif ini melibatkan 15 caregiver keluarga yang merawat orang dengan gangguan jiwa di Kota Malang, Indonesia; partisipan dipilih dengan teknik purposive sampling. Pengumpulan data menggunakan metode wawancara mendalam secara individual dan observasi, serta selanjutnya dianalisis secara induktif. Hasil penelitian menunjukkan bahwa beban caregiver keluarga dapat dikelompokkan ke dalam empat tema utama: 1) keluarga menghadapi tantangan dan stigma dalam merawat orang dengan gangguan jiwa berat, 2) kurangnya dukungan masyarakat dan penyedia layanan kesehatan keluarga, 3) caregiver keluarga mengalami berbagai perasaan negatif dan memaknai secara negatif pengalamannya, dan 4) caregiver keluarga menggunakan strategi koping untuk meringankan beban keluarga. Peneliti menyimpulkan bahwa caregiver keluarga mengalami beban yang kompleks saat merawat orang dengan gangguan jiwa berat; oleh karena itu, caregiver keluarga sangat membutuhkan dukungan dari tenaga kesehatan dan kehadiran masyarakat sekitar dalam menghadapi situasi perawatan kronis bagi orang-orang dengan gangguan jiwa berat. Kata Kunci: beban penyakit, caregiver, gangguan jiwa berat, Indonesia, keluarga

With the implementation of the ′Mental Health Law of the People′s Republic of China′ and relevant policies, governments at all levels have devoted more resources to community-based rehabilitation services for patients with mental disorders, making the mental health services more accessible and professional to the majority of patients with mental disorders. Monumental achievements have been made in community-based rehabilitation services for patients with severe mental disorders, while challenges have always existed in the China′s community mental health service system for patients with severe mental disorders. Therefore, this article elaborated the achievements, challenges and prospects of China′s community mental health service system for patients with severe mental disorders, aiming to provide references for future work and further improve the quality and accessibility of community mental health service for patients with mental disorders. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to determine the association between severe mental disorders and oral health among individuals over 18 years of age. Methods: An electronic search was conducted in six electronic databases and gray literature. Qualitative and quantitative analyses were performed on studies that met the inclusion criteria. The methodology of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal tool. A meta-analysis of proportions with a random effect was carried out. The certainty of evidence was evaluated using the GRADE tool. Results: After searching the databases, 5,734 references were retrieved, and twenty articles were selected for synthesis. Considering the DMFT index between the groups with mental disorders and the control group, the values of the DMFT index were higher among individuals with schizophrenia [MD = 5.27; 95% CI = 4.13 – 6.42; I2 = 35%] and bipolar disorder [MD = 1.90; 95% CI = 0.87 – 2.93]. Values were lower among individuals with obsessive–compulsive disorder [MD = -0.85; 95% CI = -1.46—0.24]. The risk of bias was considered low for 16 studies, and four were classified with a moderate risk of bias. The certainty of evidence was very low. Conclusion: Patients with schizophrenia and bipolar disorder exhibit increased frequency in the number of decayed, missing, or filled teeth. There was no effect in relation to periodontal probing depth, plaque index, and TMD, but the evidence is still uncertain for this outcome. Clinical relevance: These findings underscore the need for a comprehensive health approach. [ABSTRACT FROM AUTHOR]

Background: People with schizophrenia have a higher risk of mortality compared to the general population, which has not improved over time. The majority of premature deaths are due to comorbid physical diseases, driven by interrelated factors operating at the individual level, through health systems and influenced by social determinants of health. A holistic understanding of this problem and the causal pathways linking these factors together is lacking. Aims: This study aims to understand why the mortality gap between people with schizophrenia and the general population is not improving by developing a causal loop diagram (CLD), a systems thinking approach which enables empirical research and theoretical knowledge to be combined into a visual representation of causal relationships and feedback loops. Method: The CLD was constructed using published literature, including both quantitative and qualitative studies, to identify key variables and relationships, and refined through consultation with experts in the topic area. Results: A total of 21 variables and 68 connections were included in the CLD, with 23 distinct feedback loops identified. Stigma and social support had the most connections, while unemployment was involved in the greatest number of feedback loops. Most feedback mechanisms served to reinforce behavioural risk factors, inadequate healthcare and social disadvantage. Conclusions: The CLD has created a holistic and dynamic understanding of the causal pathways driving the mortality gap between people with schizophrenia and the general population, providing insights into why it has persisted over time. One of the key findings was the critical role of social determinants in shaping health outcomes, highlighting the need for person-centred models of care and multisectoral government action. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

People with severe mental disorders often require special care. Other than institutionalized care, some organizations provide housing options and special care in the form of organized living. Few studies provide a detailed description of nutrient intake in this type of care. The aim of this prospective study was to assess nutritional status and adherence to dietary recommendations in both people with mental disorders (beneficiaries) and their caregivers. Across three levels of care, 46 beneficiaries and 19 caregivers participated in the study. The mean intakes of energy (kcal/day) and macro- and micronutrients (g/day) were estimated from a 3-day dietary record and compared with dietary reference values (DRVs) set by the European Food Safety Authority (EFSA). The majority of participants did not meet energy intake recommendations (kcal/day). The contribution of total fat to energy intake (% E) was higher than recommended in both beneficiaries and caregivers with 42.1 ± 4.4% and 38.5 ± 6.5%, respectively. A total of 45.2% of beneficiaries and 61.1% of caregivers had their carbohydrate intake within the recommended range. Fiber intake was well below the recommendations (25 g/day) in all groups. Across all levels of care, lower micronutrient intake for pantothenic acid, biotin, folate, potassium, magnesium, copper, selenium, and iodine was observed. Based on the current results, the development and implementation of nutritional guidelines may be targeted to specific populations and nutrient intakes. [ABSTRACT FROM AUTHOR]

Objective: Self-determination enhances well-being and quality of life. It is also considered a fundamental pillar in improving the efficacy of interventions used to treat people with severe mental disorders (SMD). Yet the assessment of self-determination in relation to mental health requires further research. The aim of this study was to analyze the adequacy and psychometric properties of the AUTODDIS scale in a Spanish population with SMD. Method: The scale was originally developed and validated to assess self-determination in people with intellectual disability. The scale was administered to a sample of 333 adults with SMD (M = 47.6 years, SD = 11.68), most of whom were receiving treatment in an outpatient setting or at long-stay care facilities in six specialized centers in Spain. Results: The quality of the items and the reliability of the scale and its subscales were analyzed. External validity was also explored, and confirmatory factor analysis was used to analyze the fit of the data to different models. The results indicate that the scale demonstrated sufficient evidence of reliability and validity, supporting the adequacy of its use in the field of mental health. Conclusions and Implications for Practice: The use of this scale as a tool to assess self-determination and its domains in the mental health field is warranted. The article also discusses the need for more research and assessment tools to facilitate decision making by clinical and organizational stakeholders in promoting self-determination. Impact and Implications: This study provides validation of the use of the AUTODDIS scale to assess self-determination and its domains in the mental health field. The individualized information of the measure may be used to inform clinicians, caregivers, relatives, and the individuals themselves about specific self-determination components that should be targeted in an intervention. [ABSTRACT FROM AUTHOR]

Xiaodan Zhu,1 Min Wen,1 Ying He,1 Jing Feng,2 Xuebing Xu,2 Juan Liu3 1School of Nursing, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China; 2Inpatient Department, Ningxia Mental Health Center, Ningxia Ning-An Hospital, Yinchuan, Ningxia, People’s Republic of China; 3General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of ChinaCorrespondence: Juan Liu, General Hospital of Ningxia Medical University, Shengli Road &num;804, Yinchuan, Ningxia, 750004, People’s Republic of China, Tel/Fax +86 09516744007, Email ryuken0518@163.com Xuebing Xu, Ningxia Mental Health Center, Ningxia Ning-An hospital, Jingbo Road &num;236, Yinchuan, Ningxia, 750011, People’s Republic of China, Tel/Fax +86 09512160739, Email nxnayyxuxuebing@126.comPurpose: Several studies have explored the relationship between level of education and medication adherence, as well as the relationship between level of education and cognitive function. However, there have been few studies on the relationships between level of education, cognitive function, and medication adherence. This study aimed to explore whether cognitive function has a mediating effect between level of education and medication adherence in patients with schizophrenia.Patients and Methods: A total of 329 participants were included in this study. Cognitive function was assessed using the Brief Assessment of Cognition in Schizophrenia, and medication adherence using the Medication Adherence Questionnaire. The relationships between the clinical factors and cognitive function that contributed to medication adherence were tested through multivariable linear regression analysis. The mediating effect of medication adherence was tested using the bootstrapping approach with the PROCESS macro.Results: Family history, insight and executive function were associated with medication adherence in individuals with schizophrenia, and executive function had a mediating effect between level of education and medication adherence.Conclusion: Adopting specific education programs that promote cognitive development as well as actively intervening in executive function might be conducive to improve medication adherence in patients with schizophrenia.Keywords: antipsychotic adherence, mediating effect, neurocognition, executive function, severe mental disorders

Abstract Objective: To determine the prevalence of overweight and obesity in patients with severe mental disorders (SMD) and the factors associated with their socio-demographic and disease characteristics in a cross-sectional population-based study. Design: This analysis examined the prevalence of overweight and obesity in 14 868 managed SMD patients in an urban area of Shenzhen city based on data from the health information monitoring system in 2021. Multivariate logistic regression were used to identify the factors associated with the prevalence of overweight and obesity in patients with SMD. Setting: China. Participants: 14 868 patients with SMD. Results: The prevalence of overweight and obesity in patients with SMD in this study was 32·6 % and 16·1 %, respectively. In multivariate analysis, married status, Shenzhen household registration, management durations of 5–10 years and >10 years, participation in family physician services, taking clozapine or aripiprazole, FPG > 6·1 mmol/l, hypertension, TC ≥ 5·2 mmol/l, TG ≥ 1·7 mmol/l, and more frequent follow-ups in the past year were associated with higher odds of overweight and obesity. Compared to their respective reference categories, living with parents, spouse and children, taking risperidone, aripiprazole, amisulpride and perphenazine, FPG > 6·1 mmol/l, hypertension, TC ≥ 5·2 mmol/l, TG ≥ 1·7 mmol/l, and more frequent follow-ups in the past year were associated with higher odds of obesity. Conclusion: We observed a high prevalence of overweight and obesity in patients with SMD in this study. The findings highlight the need for integrated management of overweight and obesity risk factors among patients with SMD.

In Brazil, two main mental health care sectors (public and academic) coexist, interact, and tension each other with distinct, antagonistic views and ethos, producing a scenario of distancing and mistreatment. All the leading players involved need to take a new stance to openly discuss the roots of their divergences and accept the challenge of formulating a minimally joint and integrated project for the Brazilian mental healthcare system policy and practices.Here we present and discuss five critical unmet needs of the mental health system that should be tackled through more integrated work between the public and university sectors aiming at: 1. Providing better emergency care, including, when required, inpatient treatment in general hospital psychiatric units for patients with severe mental disorders in acute episodes; 2. Optimizing the use of clozapine, granting a trial for all patients with treatment-resistant schizophrenia and other severe psychoses; 3. Updating the list and protocols of use of psychiatric drugs available in the Brazilian Unified Health System; 4. Updating psychosocial rehabilitation interventions; 5. Implementing a two-way collaboration between the network of mental health services, especially the CAPS, and Primary Care Centers to offer integrated healthcare, addressing thus the high physical morbidity of patients with severe mental disorders.Psychiatric reform in Brazil has gone a long way in the past few decades toward community-centered mental health care. It was never an easy process, proper funding was always a challenge, and the risk of political drawbacks loomed, particularly in the last years. We believe the country has the necessary resources to deliver high-quality and accessible mental health care. Now is the time to better integrate the public and university sectors to address the critical issues and move forward with the psychiatric reform agenda.

Persons with severe mental illness (PwSMI) are at risk of being victimized due to persistent cognitive, emotional, and behavioral symptoms, which can become potential threats for effective reintegration into the community. A total of 217 PwSMI, receiving outpatient psychiatric treatment from a tertiary hospital, were screened for abuse, and if they were identified as abuse, then information about contextual factors contributing to abuse, sociodemographic, family, and clinical and legal profiles was created. Overall, 150 PwSMI were victimized, of which 56% were females, 50.7% were married, 20.7% were educated up to middle school, and 31.4% were homemaker. The most common form of diagnosis was schizophrenia (43.3%), with a mean duration of illness of 14 years. All the victimized PwSMI were subjected to emotional abuse. PwSMI were more likely to be victimized by multiple family members due to poor knowledge and understanding about illness (24%). The majority of the PwSMI had disclosed abuse (62.7%) to nonformal sources (33.3%) with no documentation in the clinical file (82.7%). PwSMI experience ongoing abuse and are more likely to be re-victimized, which increases the need for regular screening and culturally sensitive and comprehensive community-coordinated care and support. [ABSTRACT FROM AUTHOR]

Background and Aims: Sleep problems such as insomnia are common in individuals with severe mental disorders. The sleep-enhancing interventions provided by occupational therapists can be used for primary prevention and health promotion. This study aims to explore the existing evidence on occupationbased sleep interventions for individuals with severe mental disorders. Methods: This is a scoping review, conducted based on Arksey and O'Malley' five-step method. A search was first conducted in eight online databases (MagIran, SID, IranDoc, Google Scholar, PubMed, Cochrane Library, Scopus, Web of Science, OT seeker, Psych INFO) to find articles that addressed sleep interventions for individuals with severe mental disorders Two raters reviewed all articles independently. Articles were categorized according to the type of sleep interventions. Results: Thirty-two studies were reviewed. Four categories of occupation-based sleep interventions were extracted, including cognitive behavioral therapy (n=12), physical activity (n=7), multicomponent interventions (n=5), and other interventions (n=8). Conclusion: The occupation-based sleep interventions can improve sleep quality and health in people with severe mental disorders. Occupational therapists and clinicians need to conduct more studies to provide evidence for occupation-based sleep interventions. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To explore psychological distress levels, using the validated Kessler 6 (K6), as well as the relationship between demographics and K6 scores, and incidence of mental health crises in a cohort of community-dwelling people living with severe and persistent mental illness (SPMI). Methods: People living with SPMI taking antipsychotic or mood stabiliser medications were recruited from Australian community pharmacies between September 2020 and Februrary 2021 and completed an electronic survey, including the K6 scale. Pharmacists were interviewed and supplied written reports with details of the consultation when participants obtained 'very high' (⩾19/30) K6 scores. Records were reviewed and coded by an independent coder. Multivariate linear regression was used to determine predictors of K6 scores. Results: The median K6 score was 16/30 (IQR = 11,21; range = 6–30). Younger age, unemployment and multimorbid mental health diagnoses were significant predictors of higher K6 scores (p <.01; R 2 =.24). Fifty-nine (39.3%) consumers scored ⩾19, of which 25/59 (42.4%) were reported to be exhibiting signs of psychological distress and none were experiencing mental health crises. Conclusion: People living with SPMI have high levels of psychological distress as measured by the K6. Further work is needed to understand the prevalence, extent, precipitating factors and impact of psychological distress in people living with SPMI. [ABSTRACT FROM AUTHOR]

In most Mediterranean countries, people diagnosed with severe mental disorders (SMDs) are typically cared for by the mother, causing a significant burden on people in this family role. Based on a broader mental health participatory action and qualitative research carried out in Catalonia (Spain) of 12 in-depth interviews and 3 focus groups, this article analyses the mother-caregivers' experience in the domestic space. The results show that patients and caregivers are engaged in a relationship of "nested dependencies", which create social isolation. This produces the conditions of "reactionary care", practices that limit the autonomy of those affected and that reproduce forms of disciplinary psychiatric institutions. We conclude that both institutional violence derived from economic rationality and that which stems from the gender mandate feed off each other into the domestic sphere. This research argues for placing care at the center of clinical practice and shows the need to consider the structural forces shaping it. [ABSTRACT FROM AUTHOR]

Background and Aims The importance of participatory health governance has been acknowledged by the World Health Organization. Studies have shown the positive effects of participation in occupationbased intervention in patients with severe mental disorders, including schizophrenia, in outpatient and inpatient wards. The purpose of this article is to review the studies on occupation-based interventions in patients with severe mental disorders. Methods This is a narrative review study. A search for related articles was conducted in PubMed, Google Scholar, Cochrane, ScienceDirect, Scopus, OTseeker, PsycInfo databases using the keywords "severe mental disorder", "serious mental illness", "schizophrenia", "Major depression disorder", "Bipolar disorder", "Occupational therapy", Occupation", and "Occupation-based intervention" without the time limitation. Titles and abstracts of 480 yielded articles were examined. Results Twelve articles were reviewed; Two were related to occupation-based interventions in psychiatric inpatients, five were related to occupation-based interventions in outpatients, and five were related to occupation-based interventions in both inpatients and outpatients. Among these articles, one studied the challenges of using occupation-based interventions. Conclusion It seems that occupation-based interventions in inpatients and outpatients with mental illness have been used more to reduce symptoms, and less attention has been paid to the effectiveness of these interventions in maintaining and or improving occupational performance in these patients. The Canadian model of occupational performance and the recovery framework have been used in the design of these interventions. To achieve better results in psychosocial rehabilitation where occupation-based interventions lead to an increase in quality of life, the challenges in this area should be solved. [ABSTRACT FROM AUTHOR]

Abstract Aim The aim of research was to assess the needs of patients with severe mental illness (SMI) attending follow‐up day hospital (DH) programmes from the patients', relatives' and experts' perspective. Design This triangulation research relies on three sources of information and two techniques of data collection. Methods Qualitative research was conducted comprising semi‐structured interviews (n = 15) and focus groups (n = 4) in three sequential rounds, triangulating patients', relatives' and experts' views. A content analysis was carried out. Results Study reveals a diverse spectrum of needs of SMI patients in follow‐up DH programmes. The analysis yielded six themes: optimal daily functioning, work and educational activities, social network inclusion, continuous treatment, support and guidance, long‐term care. DH programmes should assess the needs of patients with SMI and be adapted according to the findings. In addition to clinical treatment, requirements for continuous treatment, psychological and social needs, therapeutic relationship in less‐restrictive settings should be considered.

Sepsis is a severe condition, representing a significant public health concern, especially in the elderly. There is, however, little insight into the potential effects of sociodemographic factors and comorbidities on sepsis incidence and how these factors interact. This was a nationwide open cohort study including individuals (N = 6 746 010) in Sweden ≥ 18 years of age spanning from 1997 to 2018, with 116 175 995 person years of follow-up. The outcome was time to first occurrence of sepsis. The following variables were included in the analysis: sociodemographic factors (age, sex, income, education, marital status, region of residency, and country of origin), severe mental disorders (schizophrenia and bipolar disorders), and Charlson Comorbidity Index. Interaction tests were conducted. A total of 161 558 individuals were diagnosed with sepsis during the study period, corresponding to an incidence rate of 13.9 per 10 000 person years (95% CI: 13.8 – 14.0). The main findings were that male sex, high age, low education, and comorbid conditions were positively associated with sepsis, after adjustments for the other covariates. Being aged 80 years and above yielded a HR of 18.19 (95% CI: 17.84 – 18.55) and the effect of high age was more than twice as high in men than in women. In conclusion, this large nationwide cohort found that several sociodemographic factors and comorbid conditions were independently associated with sepsis and men were more affected by higher age than women. These findings can help improve sepsis awareness and preventive work in risk groups.

Aims: To understand the current patterns and experience of using internet among individuals with severe mental disorders and assess the impact of internet technology in their daily life, particularly mental health-related issues. Methods: In-depth interviews were conducted on individuals diagnosed with bipolar disorder (BD)/schizophrenia (DSM-5) (N=20), aged = 18 years who could read and write in Hindi/English, using an interview guide. HAM-D, YMRS, SAPS, and SANS were used as screening instruments. The interview guide contained questions related to internet use in daily life, internet use for health-related issues, particularly BD/schizophrenia. Results: All individuals used the internet in day-to-day life for the purpose of communication, entertainment and getting information. They predominantly use internet to find out about their illness & medications. For their illness, most common source of searching was Google (N=20), followed by YouTube (N=17). Three themes could be identified about patterns and experience of internet use: health/illness-related reasons for searching internet, beliefs about the suggestions on internet, risky practices regarding suggestions from internet. The impact of internet use was variable. They often believed that they were misinformed or unsure of the information available online. Most of them did not discuss about their internet use for their disease with their treating doctor. But they tend to follow advice that they perceive might be harmless. Conclusion: Patients with SMD commonly use internet for retrieving information about their illness. They tend to follow perceivably harmless advice available online. [ABSTRACT FROM AUTHOR]

This study aimed to develop and assess the acceptability of a digital program for training community health workers (CHWs) in the detection and referral of patients with schizophrenia in community settings in rural India. An iterative design process was employed. First, evidence-based content from existing community programs for schizophrenia care was incorporated into the curriculum, and reviewed by experts to ensure clinical utility and fidelity of the adapted content. Second, CHWs provided feedback on the appropriateness of language, content, and an initial prototype of the digital training program to ensure relevance for the local context. Focus group discussions were then used to understand the acceptability of the digital training prototype and to inform modifications to the design and layout. Qualitative data was analysed using a rapid thematic analysis approach based on predetermined topics pertaining to acceptability of the training content and digital platform. Development of the initial prototype involved content review by 13 subject matter experts with clinical expertise or experience accessing and receiving mental health services, and engagement of 23 CHWs, of which 11 provided feedback for contextualization of the training content and 12 participated in focus group discussions on the acceptability of the prototype. Additionally, 2 service-users with lived experience of schizophrenia contributed to initial testing of the digital training prototype and offered feedback in a focus group discussion. During contextualization of the training content, key feedback pertained to simplifying the language and presentation of the content by removing technical terms and including interactive content and images to enhance interest and engagement with the digital training. During prototype testing, CHWs shared their familiarity with similar symptoms but were unaware of schizophrenia as a treatable illness. They shared that training can help them identify symptoms of schizophrenia and connect patients with specialized care. They were also able to understand misconceptions and discrimination towards people with schizophrenia, and how to address these challenges by supporting others and spreading awareness in their communities. Participants also appreciated the digital training, as it could save them time and could be incorporated within their routine work. This study shows the acceptability of leveraging digital technology for building capacity of CHWs to support early detection and referral of schizophrenia in community settings in rural India. These findings can inform the subsequent evaluation of this digital training program to determine its impact on enhancing the knowledge and skills of CHWs. [ABSTRACT FROM AUTHOR]

Background and Aims: Patients with severe mental disorders (SMD) have been classically considered as a particularly high‐risk population for bloodborne virus infections. We performed a systematic screening of hepatitis B and C virus among the population with SMD in the area of influence of Hospital Clínic (Barcelona) in order to evaluate the real prevalence of these infections and achieve HCV microelimination in this subpopulation. Methods: We screened two cohorts for anti‐HCV and HBsAg: Cohort A (hospitalized patients with SMD, done systematically) and Cohort B (outpatients, mental health centre‐CSMA, done voluntarily). Risk factors and socio‐demographic variables were collected. In positive cases, telematic review was activated by Hepatology, calculation of FIB‐4 and prescription of direct‐acting agents (DAA) in HCV or follow‐up in HBV. Results: In Cohort A, 404 patients were screened. 3 HBV patients were detected (0.7%). In all of them, there was a history of drug use. 12 anti‐HCV positive patients were detected (3%); 8 of them had a history of drug use. Among the HCV positive, only 2 patients were viraemic (received DAA, both achieving SVR) as most of them (n = 6) had already been cured with DAA. In cohort B, 305 patients were screened, after 542 (64% of the target population) declined to participate. No cases of HCV or HBV were detected. Conclusions: HCV/HBV prevalence among SMD population with no history of drug use does not seem to be different from the general population. These data may be of interest for defining health policies. [ABSTRACT FROM AUTHOR]

Stimulus equivalence is a behavioral phenomenon that has been related to complex human behavior (e.g., remembering, cognitive functioning, and symbolic behavior). As a rule, people diagnosed with severe mental disorders (e.g., schizophrenia, bipolar disorder) that exhibit delusional and hallucinatory behavior, and disorganized speech have shown cognitive impairment (e.g., processing speed, reasoning/problem solving). Not enough research has analyzed the stimulus equivalence performance in this population. This study aims to investigate the stimulus equivalence performance in adults diagnosed with severe mental disorders. In particular, this study analyzes the many-to-one (MTO) and one-to-many (OTM) training structures effects, and the simultaneous (SIM) and the simple-to-complex (STC) training and testing protocol effects on equivalence class formation in this population. To achieve it, we analyzed the behavior of 18 participants diagnosed with severe mental disorders in three different conditions (Condition 1 OTM/SIM; 2 MTO/SIM; and 3 MTO/STC). Behavior consistent with stimulus equivalence was found in 11 out of 13 participants who had finished the study (5 participants decided to leave before completing the tasks). STC yielded better results than the SIM protocol. No differences were found between MTO and OTM training structures. Implications and suggestions for further research have been discussed. [ABSTRACT FROM AUTHOR]

ObjectiveTo analyze the causes of death and years of life lost among patients with severe mental disorders in Jining city， in order to provide references for improving the management level of the patients.MethodsA total of 3 638 patients with severe mental disorders who were recorded in the National Information System for Severe Mental Disorders in Jining and died between January 1， 2014 and December 31， 2020 were included in the study. The general information and the status of mortality were extracted via checking management files. Thereafter， the causes of death of patients with different characteristics were discussed， and the years of life lost due to severe mental disorders was analyzed through calculating potential years of life lost （PYLL）， average years of life lost （AYLL） and potential years of life lost rate （PYLLR）.ResultsThe majority of patients who died from severe mental disorders were those with schizophrenia， accounting for 77.68% （2 826/3 638）. The most common cause of death among patients with severe mental disorders was physical illness with 1 869 cases （51.37%）. Among the selected subjects， patients with mental retardation and comorbid mental disorders had the youngest age of disease onset ［（22.49±20.14） years］， the youngest age at death ［（51.72±18.32） years］ and the longest duration of disease ［（29.26±19.35） years］. The PYLL， AYLL and PYLLR of patients with severe mental disorders in Jining were 68 941.06 person-years， 18.95 years and 382.36‰， respectively. The mental retardation and comorbid mental disorders had the highest AYLL at 27.21 years， and epilepsy-induced mental disorder had the highest PYLLR at 892.73‰.ConclusionComorbid physical illness is the main causes of death in patients with severe mental disorders in Jining city， and epilepsy-induced mental disorder have occupied the first place in terms of the years of life lost.

Abstract Background Mental health legislation permits involuntary care of patients with severe mental disorders who meet set legal criteria. The Norwegian Mental Health Act assumes this will improve health and reduce risk of deterioration and death. Professionals have warned against potentially adverse effects of recent initiatives to heighten involuntary care thresholds, but no studies have investigated whether high thresholds have adverse effects. Aim To test the hypothesis that areas with lower levels of involuntary care show higher levels of morbidity and mortality in their severe mental disorder populations over time compared to areas with higher levels. Data availability precluded analyses of the effect on health and safety of others. Methods Using national data, we calculated standardized (by age, sex, and urbanicity) involuntary care ratios across Community Mental Health Center areas in Norway. For patients diagnosed with severe mental disorders (ICD10 F20-31), we tested whether lower area ratios in 2015 was associated with 1) case fatality over four years, 2) an increase in inpatient days, and 3) time to first episode of involuntary care over the following two years. We also assessed 4) whether area ratios in 2015 predicted an increase in the number of patients diagnosed with F20-31 in the subsequent two years and whether 5) standardized involuntary care area ratios in 2014–2017 predicted an increase in the standardized suicide ratios in 2014–2018. Analyses were prespecified (ClinicalTrials.gov NCT04655287). Results We found no adverse effects on patients’ health in areas with lower standardized involuntary care ratios. The standardization variables age, sex, and urbanicity explained 70.5% of the variance in raw rates of involuntary care. Conclusions Lower standardized involuntary care ratios are not associated with adverse effects for patients with severe mental disorders in Norway. This finding merits further research of the way involuntary care works.

Persons with severe mental illness (PwSMI) are at risk of being victimized due to persistent cognitive, emotional, and behavioral symptoms, which can become potential threats for effective reintegration into the community. A total of 217 PwSMI, receiving outpatient psychiatric treatment from a tertiary hospital, were screened for abuse, and if they were identified as abuse, then information about contextual factors contributing to abuse, sociodemographic, family, and clinical and legal profiles was created. Overall, 150 PwSMI were victimized, of which 56% were females, 50.7% were married, 20.7% were educated up to middle school, and 31.4% were homemaker. The most common form of diagnosis was schizophrenia (43.3%), with a mean duration of illness of 14 years. All the victimized PwSMI were subjected to emotional abuse. PwSMI were more likely to be victimized by multiple family members due to poor knowledge and understanding about illness (24%). The majority of the PwSMI had disclosed abuse (62.7%) to nonformal sources (33.3%) with no documentation in the clinical file (82.7%). PwSMI experience ongoing abuse and are more likely to be re-victimized, which increases the need for regular screening and culturally sensitive and comprehensive community-coordinated care and support.

ObjectiveTo analyze operational effectiveness and mechanism of management system for severe mental disorder (SMD) prevention and control in China for providing references to subsequent policy formulation. MethodsThrough searching official websites, we retrieved policy documents relevant to management on SMDs issued by governmental departments and professional institutions as of December 31, 2018 in 31 provincial-level administrative divisions (PLADs) across mainland China and analyzed the completeness and operation mechanism of the management scheme from four perspectives: management and monitoring, planning and evaluation, financing and compensation, and coordination and motivation based on evaluation standards for effectiveness of a public health system. The indicator data on management of SMD from 2014 through 2018 were also collected from National Severe Mental Disorder Information System and research literatures. The relationships between management implementation and effectiveness were analyzed using fixed effects model. ResultsFor 31 PLADs in 2018, the average appropriate degree of SMD management scheme was 43.87%, with an increment of 22.08% to that in 2014 and a gap of 48.39% to the appropriate standard (85%). The dimensional appropriate degree of the SMD management scheme was the highest (64.96%) for financing and compensation mechanism but the lowest (23.69%) for coordination and motivation mechanism. For the dimension of management and monitoring in 2018 at national level, the completeness degree of content and form was relatively high (89.29%) but the degree of clarity for responsibility assignment was relatively low (24.91%), and the degree of management procedure feasibility was only 6.48%; for the dimension of planning and evaluation, the coverage of long-term planning was as high as 96.24%. The results of fixed effect model analysis showed that after adjusting for gross domestic product, significant increase of 1.00 % for completeness of regional SMD scheme, 1.54% for average standardized management rate, and 0.28% for average regular medication of SMD patients were observed (all P < 0.05). ConclusionThe management mechanism of severe mental disorders has been steadily improved in China from 2014 to 2018; for the management scheme, the coverage of management standards and medium and long-term planning were relatively high, but the coordination and motivation mechanism and t responsibility assignment need to be improved.

ObjectiveTo investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders.MethodsFrom March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence.ResultsA total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ2=14.015， 7.502， 13.106， P

ObjectiveTo analyze the management and treatment for patients with severe mental disorders in Chengdu from 2016 to 2020， in order to provide references for the relevant authorities to formulate policies and improving the mental health service system.MethodsData relating to 22 districts （cities） and counties in Chengdu from January 1， 2016 to December 31， 2020 were extracted from the National Information System for Severe Mental Disorders. Indicators such as reported prevalence rate， management rate， standardized management rate， medication rate， regular medication rate and stable condition rate of patients with severe mental disorders were analyzed on a yearly basis.ResultsBy the end of 2020， there were 71 899 registered cases of severe mental disorders in Chengdu， with a reported prevalence rate of 0.34%， a standardized management rate of 95.53%， and a regular medication rate of 72.50%. From 2016 to 2020， except the reported prevalence rate （χ²=269.566， P

Abstract Objective To investigate the proportion of registered cases relative to size, distribution characteristics, medication status, and management status of patients diagnosed with severe mental disorders (SMD) in Fuzhou. The medication status and management status were compared between patients in urban and non-urban areas to provide scientific evidence for improving SMD care, control, and treatment in primary health care institutions. Methods Data (case types, demographic data, distribution data, medication status, and management status, etc.) of patients diagnosed with SMD in 12 districts, counties, and prefectures in the urban and non-urban areas of Fuzhou City were collected from October 2017 to September 2018. Three distributions (population, local, and districts/counties) were used to describe the proportion of registered cases relative to size and clinical characteristics of diagnosed SMD. Chi squared (χ2) test was used to compare the severity in urban and non-urban areas. Results A total of 30,362 registered SMD patients were identified in Fuzhou City of which schizophrenia accounted for the highest number of cases (26,204, 86.31%), and paranoid psychosis had the least number of cases (47, 0.15%). Moreover, approximately half of SMD patients were 18 to 44 years old (45.38%). Close to one third of patients were farmers (30.23%), had a primary school or lower education level (54.17%), were poor, with most below the poverty line (55.35%). The proportion of diagnosed SMD relative to size was highest in Minqing County (0.53%) and lowest in Mawei District (0.38%). A total of 22,989 (75.72%) of the patients were taking medications, and only 17,509 (57.67%) were taking medications regularly. Moreover, the percentage of cases taking medications and those taking medications regularly were higher in urban areas than in non-urban areas (P

Djin L Tay,1 Lau C Thygesen,2 Elissa Kozlov,3 Katherine A Ornstein4 1College of Nursing, University of Utah, Salt Lake City, UT, USA; 2National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; 3Department of Health Behavior, Society and Policy, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA; 4School of Nursing, Johns Hopkins University, Baltimore, MD, USACorrespondence: Djin L Tay, College of Nursing, University of Utah, 10S 2000 E, Salt Lake City, UT, 84112, USA, Tel +1 801-882-3037, Email Djin.Tay@nurs.utah.eduPurpose: The death of a close family member is commonly accompanied by intense grief, stress, and loss of social support. We hypothesized that recent bereavement would be associated with an increase in symptom exacerbations among adults with serious mental illness (SMI) whose partners or parents had died.Patients and Methods: Adults whose partners and parents had died in Denmark between January 1, 2010, and June 30, 2016, were identified using linked population-based registries. History of SMI was defined as having a diagnosis of schizophrenia and schizoaffective disorders, major depression, and bipolar disorder in the five years preceding their family member’s death in the Danish Psychiatric Central Research Register using International Classification of Diseases-10 codes. The odds of SMI exacerbation (ie, attempt or completion of suicide or psychiatric hospitalization) among partners and children in the first two years after death in 3-month intervals were estimated with generalized estimating equations.Results: 12.8% of partners and 15.0% of adult children with a history of SMI experienced any SMI exacerbation two years after bereavement. Among bereaved partners, older age (80+ years) was associated with a lower risk of experiencing an SMI exacerbation compared with partners aged 18– 49 years (ORadj=0.29, [0.18– 0.45]). Partners with a history of SMI had significantly increased odds of SMI exacerbations three months after their partners’ death compared to prior to their partners’ death (ORadj = 1.43, [1.13– 1.81]). There was no evidence that adult children with SMI experience increased SMI exacerbations after the death of their parents compared to prior to death.Conclusion: Adults with a history of SMI whose partners had died are at increased risk for an SMI exacerbation post bereavement. Additional bereavement resources and support should be provided to those with a history of SMI, especially in the period immediately after death.Keywords: severe mental disorders, bereavement, population register, suicide, emergency psychiatric services

Background: Maternal mental health has specific implications for bonding and infants' mental health. However, most of the evidence comes from mothers who are either symptomatic or did not have adequate mental health support. In this context, our objective was to explore if symptom status in mothers and bonding share any significant association with the infants' development and quality of life (QOL), in case of mothers with severe mental illnesses in remission. Methods: The study included 41 mother–infant dyads from the outpatient perinatal psychiatry services and the mother–baby unit of the current study center. Symptom status, self-reported bonding, mother–infant interactions, and infants' development and QOL were assessed with Clinical Global Impressions, Postpartum Bonding Questionnaire, Pediatric Infant-Parent Exam, Developmental Assessment Scales for Indian Infants, and Pediatric Quality of Life Scale, respectively. Results: Most mothers had a complete recovery or minimal symptoms. Nine (22%) infants had a significant developmental delay. Atypical play-based interactions were observed in nine (22%) mothers. Self-reported bonding and bonding as evinced over play-based interactions did not significantly correlate with the QOL or development of the infants. Mothers who have recovered and are functioning well reported good bonding with their infants, though objective assessment revealed specific difficulties. Symptom severity correlated with poor physical QOL in infants. Conclusion: The association between mothers' bonding and infants' mental health is domain-specific and differential than linear and robust. Infants of mothers with severe mental illnesses postpartum should be routinely monitored for mother–infant bonding, development, and quality of life. [ABSTRACT FROM AUTHOR]

Purpose: The traditional genetic epidemiological studies are necessary to improve accurate risk communication to service users and their families. This scoping review aimed to describe the volume and scope of existing research evidence on family, twin and adoption studies of severe mental disorders (SMDs) in SSA. This is with a view to identifying gaps in the literature and the adequacy of data for a systematic review and meta-analysis. Methods: Literature search was done for all original peer-reviewed research articles on the topic in SSA using PubMed and MEDLINE. Publications included were peer-reviewed original articles, irrespective of their quality, carried out in the region from the 1970s till 9th March, 2022, which were available in English or translated to English. Case reports, abstracts, and studies among populations living outside the region were excluded. Results: A total of five studies that met the inclusion criteria across the 46 countries in the region were identified. Of the three thematic areas of focus, only family studies on SMDs had research work in SSA. These studies provided evidence of familial clustering of SMDs in SSA. There were no twin and adoption studies on SMDs in the region. However, the review noted the establishment of two twin registries in Guinea-Bissau and Nigeria. A huge gap exists in the area of twin and adoption studies on SMDs in SSA. Conclusion: The volume of research evidence on traditional family genetic studies of SMDs is grossly inadequate to consider a systematic review in SSA. We have suggested studies to remedy the situation. [ABSTRACT FROM AUTHOR]

Aim: The aim of research was to assess the needs of patients with severe mental illness (SMI) attending follow‐up day hospital (DH) programmes from the patients', relatives' and experts' perspective. Design: This triangulation research relies on three sources of information and two techniques of data collection. Methods: Qualitative research was conducted comprising semi‐structured interviews (n = 15) and focus groups (n = 4) in three sequential rounds, triangulating patients', relatives' and experts' views. A content analysis was carried out. Results: Study reveals a diverse spectrum of needs of SMI patients in follow‐up DH programmes. The analysis yielded six themes: optimal daily functioning, work and educational activities, social network inclusion, continuous treatment, support and guidance, long‐term care. DH programmes should assess the needs of patients with SMI and be adapted according to the findings. In addition to clinical treatment, requirements for continuous treatment, psychological and social needs, therapeutic relationship in less‐restrictive settings should be considered. [ABSTRACT FROM AUTHOR]

Objective: The burden on caregivers of patients with severe mental disorders is significantly higher than the care burden of patients with other medical conditions. Substance use disorder is also one of the most common psychiatric disorders that has negative effects on people's quality of life. This study was designed to investigate caregiver burden in severe mental disorders versus substance use disorder. Method: First-degree relatives of patients admitted to the Razi Psychiatric Hospital of Tehran with a diagnosis of schizophrenia, bipolar disorder type1, schizoaffective disorder, or substance use disorder entered this study. They completed the sociodemographic questionnaire for patients and caregivers and the Zarit burden interview for caregivers. Results: Our study shows that caregiver burden in substance use disorder has no significant difference with that in severe mental disorders (P > 0.05). In both groups, the highest spectrum of burden was moderate to severe. To find caregiver burden related factors, a general linear regression model with multiple predictor variables was fitted. In this model, caregivers' burden was significantly higher in patients with comorbidity (P = 0.007), poor compliance (P < 0.001), and in female caregivers (P = 0.013). Conclusion: Statistically speaking, the caregiver burden in substance use disorders is as severe as other mental disorders. The considerable burden on both groups necessitates serious efforts to minimize its negative effects. [ABSTRACT FROM AUTHOR]

People with severe mental disorders often require special care. Other than institutionalized care, some organizations provide housing options and special care in the form of organized living. Few studies provide a detailed description of nutrient intake in this type of care. The aim of this prospective study was to assess nutritional status and adherence to dietary recommendations in both people with mental disorders (beneficiaries) and their caregivers. Across three levels of care, 46 beneficiaries and 19 caregivers participated in the study. The mean intakes of energy (kcal/day) and macro- and micronutrients (g/day) were estimated from a 3-day dietary record and compared with dietary reference values (DRVs) set by the European Food Safety Authority (EFSA). The majority of participants did not meet energy intake recommendations (kcal/day). The contribution of total fat to energy intake (% E) was higher than recommended in both beneficiaries and caregivers with 42.1 ± 4.4% and 38.5 ± 6.5%, respectively. A total of 45.2% of beneficiaries and 61.1% of caregivers had their carbohydrate intake within the recommended range. Fiber intake was well below the recommendations (25 g/day) in all groups. Across all levels of care, lower micronutrient intake for pantothenic acid, biotin, folate, potassium, magnesium, copper, selenium, and iodine was observed. Based on the current results, the development and implementation of nutritional guidelines may be targeted to specific populations and nutrient intakes.

Abstract Background To understand the magnitude and spatial–temporal distribution of the regional burden attributable to severe mental disorders is of great essential and high policy relevance. The study aimed to address the burden of severe mental disorders by evaluating the years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) in Guangdong, China. Methods We undertook a longitudinal study based on a multicenter database established by the Health Commission of Guangdong, involving a total of 21 prefectures and four economic regions in the Guangdong province. A total of 520,731 medical records from patients with severe mental disorders were collected for 2010–2020. Data were analyzed via an integrated evaluation framework by synthesizing prevalence estimates, epidemiological adjustment as well as comorbidity assessment to develop internally consistent estimates of DALY. DALY changes during 2010–2020 were decomposed by population growth and aging and further grouped by Socio-demographic Index (SDI). DALYs were projected to 2030 by the weighted median annualized rate of change in 2010–2020. Results In 2010–2020, the average DALYs for severe mental disorders reached 798,474 (95% uncertainty interval [UI]: 536,280–1,270,465) person-years (52.2% for males, and 47.8% for females). Severe mental disorders led to a great amount of disease burden, especially in Guangzhou, Shenzhen, and Foshan cities. Schizophrenia and mental retardation with mental disorders were the two leading sources of the burden ascribed to severe mental disorders. Population growth and aging could be accountable for the increasing burden of severe mental disorders. Economic regions with higher SDI carried a greater burden but had lower annualized rates of change in DALYs. The overall burden of severe mental disorders is projected to rise modestly over the next decade. Conclusions The findings urge prioritization of initiatives focused on public mental health, prevention strategies, health resources reallocation, and active involvement of authorities to effectively address the anticipated needs.