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Substance use is a significant factor associated with new arrests, detentions and compulsory admissions for patients in forensic assertive community teams (FACT). To enhance community tenure for forensic patients and facilitate their sustainable integration into society, a treatment that offers a community-based alternative to admission following substance use was developed. In this paper, the development of the project, FENIX + is described along with the reporting of a pilot study of all included patients during 12 months (N = 24). Recidivism risk and community integration were assessed utilizing the Short-Term Risk Assessment and Treatability (START) as well as the Measurements in Addiction for Triage and Evaluation (MATE) scales. The included patients avoided 60% of admissions, exhibited positive changes in their desire for assistance, and successfully reduced their risk of recidivism. By accessing the community-based alternative, they were able to delay admissions effectively. These promising results suggest that a community-based treatment could benefit patients at risk of reoffending following substance use. [ABSTRACT FROM AUTHOR]

Background: Depression is generally perceived from the perspective of the common‐cause disease model. However, the network perspective assumes mutual influence of individual symptoms and stresses the importance of investigating symptom dynamics. Gaining a better understanding of symptom dynamics within individuals might contribute to more effective treatments. Methods: Current exploratory longitudinal research studied the associations and directionality between 43 symptoms from the generic questionnaire Symptom Questionnaire‐48 (SQ‐48) using dynamic time warp (DTW) analyses, in which trajectories with similar time‐dependent patterns can be identified. Data from individuals were analysed first, yielding distance matrices for all symptom trajectories, after which the data were aggregated. Results: The 148 included patients were all admitted for the treatment of their clinical depression. Undirected DTW analyses of three patients with longer time series but otherwise randomly chosen showed large variability among individuals. Group‐level undirected DTW analyses showed numerous significant edges between symptoms, largely clustering symptoms according to the eight pre‐existing subscales of the SQ‐48. Group‐level directed DTW analyses showed five symptoms with significant outstrength: 'hopeless', 'restless', 'down/depressed', 'feeling tense' and 'no enjoyment', meaning that change in these key symptoms preceded change in other symptoms. Limitations: The 43 included symptoms of the SQ‐48 primarily focus on internalizing problems in severely depressed inpatients, potentially limiting generalizability. Conclusions: DTW networks provided us with five key symptoms based on the dynamics of symptom scores. Future studies could explore whether process‐based therapy targeted at symptoms with high outstrength might result in more effectivity as part of personalized treatment. [ABSTRACT FROM AUTHOR]

Background: The Cultural Formulation Interview (CFI) is designed to improve understanding of patients’ mental health care needs. The lack of empirical evidence on the impact and effectiveness of CFI use in clarifying people’s perspectives, experiences, context, and identity, and in preventing cultural misunderstandings between migrant patients and clinicians, inspired this study. The objective is to examine the effect of the CFI on the strength of therapeutic working alliances, and the potential mediating or moderating role of perceived empathy. Materials and methods: A multicenter randomized controlled trial will be conducted, involving migrant patients, their confidants, and clinicians. The CFI will be administered in the intervention group, but not in the control group. Validated questionnaires will be used to assess therapeutic working alliances and perceived empathy. T-tests and linear regression analyses will be conducted to investigate between-group differences and possible mediating or moderating effects. Results: This study will indicate whether or not the CFI strengthens the therapeutic working alliance between patients and clinicians, as moderated and/or mediated by perceived empathy. Discussion: Research on the effect and impact of using the CFI in mental health care for migrant patients is important to clarify whether its use strengthens the therapeutic working alliance with clinicians. This can lead to a reduction in cultural misunderstandings and improve mental health care for migrant patients. The results may also be important for the implementation of the CFI as a standard of care. Ethics and dissemination: This research protocol was tailored to the needs of patients in collaboration with experts by experience. It was approved by the Ethical Review Board of the Tilburg Law School and registered in the Clinical Trials Register under number NCT05788315. Positive results may stimulate further implementation of the CFI in clinical practice, and contribute to improving the impact of the CFI on the therapeutic working alliances. [ABSTRACT FROM AUTHOR]

Non-adherence to medication significantly affects bipolar disorder outcomes. Long-Acting Injectable antipsychotics show promise by ensuring adherence and averting relapses. This narrative review sought to evaluate the efficacy of second-generation injectable antipsychotics in bipolar disorder through searches in Embase, MEDLINE, and PsycInfo for randomized controlled trials and mirror-image studies. Risperidone and aripiprazole Long-Acting Injectables demonstrated effectiveness in preventing mood recurrences compared to placebos in adults with bipolar disorder. They showed superiority in preventing mania/hypomania relapses over placebos but did not appear to significantly outperform active oral controls. Notably, active controls seem to be more effective in preventing depression relapses than Long-Acting Injectables. Mirror-Image studies point toward the reduction of hospitalization rates following LAI initiation. The available evidence points thus toward the efficacy of LAIs, especially in managing manic episodes and reducing hospitalizations, The current evidence does not however immediately support prioritizing LAIs over oral medications in bipolar disorder treatment. More high-quality studies, especially comparing LAIs directly with active controls, are crucial to gain a comprehensive understanding of their efficacy. These findings highlight the need for further research to guide clinicians in optimizing treatment strategies for bipolar disorder. [ABSTRACT FROM AUTHOR]