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With ongoing interest in the relationship between videogame and mental health alongside recent focus on gaming's role in coping with stressful life events, we sought to explore the relationship between videogame play and wellbeing among people experiencing their first episode of psychosis. Specifically, we aimed to explore the associations between videogame play and wellbeing among consumers of a first episode psychosis (FEP) service and further to compare their motivations for play, need satisfaction, passion for play and wellbeing to a control group. A sample of 88 people experiencing FEP (57 who played videogames and 31 who did not) and a control sample of 46 (all of whom played videogames) completed a survey containing a range of questionnaires related to the variables of interest. Key findings include that among those experiencing FEP, people who played videogames reported better wellbeing outcomes than those who did not. Among participants who played videogames, the FEP sample reported lower levels of need satisfaction through gaming, lower levels of harmonious passion, higher levels of external types of motivation and lower levels of internal types of motivation for play than the control group. Finally, the relationships between passion orientation (both harmonious and obsessive) and psychological distress were stronger in the control group than the FEP sample, suggesting that passion for gaming may be less influential on wellbeing for those experiencing FEP.

This study of 390 full-time Chinese managers examined the relationship between gender and work-to-family conflict. Guided by identity theory, we found that work centrality and family centrality med...

Objective: Rates of obstructive sleep apnoea (OSA) appear to be lower in the youth population (< 4%) compared to the general population (6%–17%); rates in people with psychotic illness are estimated at 13.5%–57.1%. We hypothesised that this comorbidity extends to early psychosis (EP) populations, and used previously validated OSA questionnaires to screen for OSA in an EP cohort. Method: Fifty-three patients were screened using the OSA50 and STOP-Bang questionnaires with collection of anthropometric measures. Patients who screened positively were referred for polysomnography. Results: Fifteen per cent (8/53) screened positively; most frequently endorsed measures included BMI > 25, snoring, hypertension, neck circumference (> 40 cm) and male gender. Only 2/8 patients accepted polysomnography. Conclusions: Screening indicates OSA may be more prevalent in EP populations than age-equivalent cohorts, but ongoing research is required.

BACKGROUND: CADENCE-BZ is a multi-centre, parallel-group, double-blind randomized controlled trial designed to examine the clinical efficacy and safety of an accessible food preservative, sodium benzoate, as an add-on treatment for patients with early psychosis. The original study protocol was published in 2017. Here, we describe the updated protocol along with the Statistical Analysis Plan (SAP) for the CADENCE-BZ trial prior to study completion.METHODS AND MATERIALS: Two important changes were made to the original protocol: (1) improvements to our statistical analysis plan permitted a reduction in sample size; and (2) a revision in the secondary outcomes with the intent of reducing redundancy and excluding those measures that were not appropriate as outcomes.CONCLUSIONS: We provide the updated SAP prior to the completion of the study with the intent of increasing the transparency of the data analyses for CADENCE-BZ. The final participants are currently completing the study and the results will be published in the near future.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ( ACTRN12615000187549 ). Registered on 26th February 2015.

This study examines how social support is linked to satisfaction by simultaneously testing a cross-domain effect and within-domain effect. Guided by domain-specific mechanism and conservation of re...

Background Psychological features associated with execution are not fully understood. Aims To analyse demographics of individuals executed in Texas and investigate whether there has been any change in common themes and psychological factors evident in last statements before execution between 2002 and 2017. Design Analysis of last statements from Death Row, Texas. Methods We (a) studied themes and psychological factors in last statements in Texas between August 2011 and May 2017; and (b) combined our 2011-17 data with our previous data (2002-06 and 2006-11) to present an overall analysis of last statements from 2002 to 2017. Results Between April 2002 and May 2017 (279 executions; 240 last statements), the execution rate in Texas fell from 25 per year to 12; median time on death row increased from 108.5 months to 149.5; median age at execution increased from 38 years to 40.5; and the proportion of offences involving multiple victims rose from 28.4% to 47.1%. The most common themes in last statements were love (78%), spirituality (58%), regret (35%) and apology (35%). The most common psychological factors were identification-egression (51%), unbearable psychological pain (47%) and rejection-aggression (40%). Two themes (forgiveness, use of poetry/literature) and three psychological factors (inability to adjust, interpersonal relations, identification-egression) became less common. Conclusions Between 2002 and 2017, executed prisoners in Texas became fewer and older, spent longer on death row and had committed more serious offences. Themes of love and spirituality were constants, but requests for forgiveness declined.

Worldwide, over 1000 people were executed in 2016 and over 3000 sentenced to death. Death row prisoners have high rates of mental illness, often combined with neurological impairment. Prolonged confinement has further negative effects on psychological function. There is a growing literature examining key themes and psychological constructs in death row prisoners immediately prior to execution. To date, this literature centres largely but not exclusively on last statements from death row in Texas, owing to ease of availability. The most common themes in last statements are love, spirituality and apology or regret. The most common psychological constructs are 'identification-egression' (e.g. attachment to a lost person or ideal, such as freedom), unbearable psychological pain and rejection-aggression. This is still a relatively new area of research and new techniques, such as computerised quantitative text analysis, are likely to complement rather than replace more traditional forms of thematic and textual analysis. For the future, it is essential that studies in this field continue to specify precisely, which last statements they use, so that overlap can be identified, and that more countries are studied (if possible). It would also be useful to expand the research frame to relate the content of last statements to additional variables relating to prisoners' offences, physical health, mental health, family structure and broader circumstances. Finally, ethical issues require continued consideration in this complex, fascinating, growing field.

Based on social role theory and a gender role orientation perspective, this study extended the two mechanisms (i.e. resource depletion and source attribution) that link work-to-family conflict to p...

Purpose– The purpose of this paper is to extend and test a theory of uncertainty and directional social comparisons. Prior studies have posited that uncertainty leads to increased upward and downward social comparisons. The authors ' view is that uncertainty affects upward and downward comparisons differentially. They test their theory in the Chinese workplace, and focus specifically on employees’ comparisons of career progress. Workplace consequences of social comparisons are also investigated.Design/methodology/approach– The authors achieve their objectives by collecting data from respondents in China that measure uncertainty, directional social comparisons, organizational commitment and job satisfaction. They use a longitudinal design to assess causality.Findings– This paper found that perceived organizational support, an antecedent that lowers uncertainty in the workplace, is related to upward social comparison, whereas psychological entitlement, an uncertainty-raising antecedent, is related to downward social comparison. Upward social comparison positively affected organizational commitment, whereas downward social comparison positively impacted job satisfaction.Research limitations/implications– The data collection relied on self-reports and hence the findings may be adversely affected by common method bias. Another limitation involves the generalizability of results, given that the respondents were drawn from three large firms in China.Originality/value– This paper indicates that directional social comparison processes serve as an important mechanism for understanding how employees’ work attitudes are developed. It also demonstrates the applicability of social comparison theory to the study of organizational behavior in China.

Purpose – The purpose of this paper is to examine the effects of gender and strength of gender identification on employees’ perception of gender discrimination. It also explores whether gender comparison and perceived gender bias against women act as mediators in the above relationships. It aims to advance the understanding of the processes leading to individual’s perception of gender discrimination in the Chinese workplace. Design/methodology/approach – Data were collected from 362 workers via an employee survey in three large companies in China. The human resource staff helped us to distribute a self-administered questionnaire to the employees, and the authors assured them of confidentiality and protected their anonymity. To test the hypotheses, the authors employed structural equation modeling. The authors first conducted confirmatory factor analysis on the measurement model, and then the authors estimated three nested structural models to test the mediating hypotheses. Findings – The results reveal that gender and strength of gender identification are related to perceived gender discrimination. The authors further found that gender comparison and perceived gender bias against women partially mediated the relationship between gender and perceived gender discrimination, while gender comparison fully mediated the relationship between strength of gender identification and perceived gender discrimination. Practical implications – The study helps managers understand why and how their subordinates form perceptions of gender discrimination. Given the findings, they should be aware of the importance of gender identity, gender comparison, and gender bias in organizational practices in affecting such perceptions. Originality/value – This study is the first exploration of the complex relationships among gender, gender identification, gender comparison, perceived gender bias against women, and perceived gender discrimination. It shows the salient role of gender comparison and gender bias against women in shaping employees’ perceptions of gender discrimination, apart from the direct effects of gender and strength of gender identification.

There is an unclear relationship between mental health literacy (MHL) and psychiatric stigma. MHL is associated with both positive and negative attitudes to mental illness. To our knowledge, no published peer reviewed study has examined this relationship in the Republic of Ireland.This study was conducted to assess MHL regarding schizophrenia and the degree of psychiatric stigma displayed by the general public in the Republic of Ireland.A face-to-face in-home omnibus survey was conducted with a representative sample of residents of the Republic of Ireland. Participants (N = 1001) were presented with a vignette depicting schizophrenia and were asked questions to determine their ability to recognise the condition and to ascertain their attitudes towards schizophrenia and mental illness.Among the participants, 34.1% correctly identified schizophrenia. Higher age, higher socioeconomic status, and an urban geographic location predicted identification. Those who did not correctly identify schizophrenia were significantly more optimistic about recovery and perceived people with schizophrenia as less dangerous. However, only the relationship with perceived dangerousness was considered robust.Participants with higher MHL displayed more negative attitudes to mental illness. Findings have implications internationally for MHL and anti-stigma campaigns.

Background Psychotic disorders affect up to 3% of the population and are often chronic and disabling. Innovation in the pharmacological treatment of psychosis has remained stagnant in recent decades. In order to improve outcomes for those with psychotic disorders, we present a protocol for the trial of a common food preservative, sodium benzoate, as an adjunctive treatment in early psychosis. Methods Persons experiencing early psychosis (n = 160) will be recruited through hospitals and community mental health services in Queensland, Australia. Patients will be randomized to receive either 12-week treatment with 1000 mg (500 mg twice daily (BD)) sodium benzoate or placebo. Patients will undergo fortnightly outcome assessments, in addition to weekly ongoing capacity to consent, drug compliance and safety assessments. The primary outcome measure is the Positive and Negative Syndrome Scale (PANSS) total score. Secondary outcomes are Global Assessment of Function (GAF), Assessment of Quality of Life Scale (AQOL), the Activity and Participation Questionnaire (APQ6), International Physical Activity Questionnaires (IPAQ), Simple Physical Activity Questionnaire (SIMPAQ), Physical Activity Questionnaire, Clinical Global Impression (CGI), Hamilton Depression rating Scale-17 items (HDRS), Opiate Treatment Index (OTI) and the Patients’ Global Impression of Improvement (PGI-I). As a tertiary objective, changes from baseline to endpoint in to serum markers related to D-alanine, L-alanine, D-serine, L-serine, glycine and glutamate will be investigated. Discussion Consumers and clinicians are keen to help develop better treatments for those with psychosis. This study, part of the wider Cadence clinical trials platform will examine if a safe and accessible food preservative can help optimize outcomes in those with psychosis. Trial Registration Australian New Zealand Clinical Trials registry (ANZCTR), ACTRN12615000187549. Registered on 26 February 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1908-5) contains supplementary material, which is available to authorized users.

Purpose – The purpose of this paper was to develop an indigenous understanding of work-family interface (WFI) that reflects the drastic changes and evolving social context in China over the past three decades and challenge the existing conceptualizations of WFI and identify societal impact of the changing nature of the WFI. Design/methodology/approach – We conducted literature review, content and thematic analyses. Findings – The core idea of prioritizing work for family (PWF) is that Chinese employees, especially Chinese male employees, tend to integrate work and family roles as well as deal with WFI issues at the family level. Thus, Chinese employees can be strongly committed to the family while simultaneously prioritizing work performance. Research limitations/implications – The proposed indigenous perspective of PWF may furnish a contextualized theory for future research. The proposed measurement approaches may help developing indigenous scales for the perspective of PWF for future empirical studies. Practical implications – Although Chinese employees tend to be more tolerant of work-family conflict (WFC) than their Western counterparts, such tolerance may be combined with the expectation of long-term returns to their families. Managers may assist employees with career planning and realistic goal setting to compensate for their endurance of WFC. Social implications – As a cornerstone of the society, the family plays an important role in building a “harmonious society” promoted by the government. A perceived balance of work and family is a significant factor for family harmony. We bring to the attention of policy makers the changing nature of the Chinese employees' WFI. A corresponding policy may be formulated to help Chinese employees balance their lives. Originality/value – We challenge the existing conceptualizations of WFI by proposing and elaborating a perspective of PWF for context-based conceptualization.

This study simultaneously examined the two mechanisms (i.e. spillover and crossover effects) that link work-to-family conflict and life satisfaction among Chinese married couples. Data were collected from a sample of 123 Chinese managers and their spouses. Work-to-family conflict was measured from two sources: self-reported ratings and spouse-reported ratings. The results provided support for the suggested direct spillover mechanism for both husbands and wives: work-to-family conflict to life satisfaction. In addition, we found that work-to-family conflict crossed over to life satisfaction from wives to husbands but not from husbands to wives. Practical implications and future research directions are discussed.

Aim We examined whether it is possible to use a television programme to improve mental health literacy about schizophrenia by investigating the impact of the introduction of a realistic portrayal of schizophrenia into a popular television soap opera. Method A population level omnibus survey method was used. A market research company conducted face-to-face interviews with a representative sample of the Irish population (n = 993). A specifically developed questionnaire was used which included a question on the extent to which the relevant television programme was watched. A grouping variable ‘viewers/non-viewers’ was then created. Groups were subsequently compared for differences in demographic characteristics, mental health literacy and attitudes towards schizophrenia. Results Of the sample, 370 were regarded as viewers. When compared, viewers and non-viewers did not differ on demographic characteristics but there were significant differences between the groups in both knowledge and attitudes regarding schizophrenia. Viewers were better informed on where to go for help and were more optimistic regarding the likelihood of recovery. However, on a question regarding willingness to have an intimate relationship with someone with a previous history of mental illness, viewers had greater concerns than non-viewers. Conclusion It is possible to use television dramas to educate the public about mental illnesses. Piloting of the educational material may offer an opportunity to refine the storyline so that the relevant messages are clearly communicated.

Objective: Social Cognition and Interaction Training (SCIT) is a Cognitive and Behavioural Therapy (CBT) informed group therapy with an emerging evidence base in addressing the social cognitive deficits associated with schizophrenia. This paper evaluates the application of this therapy within a community public mental health setting in Australia. Method: A mixed methods approach to the evaluation was undertaken, including survey data and thematic analysis. Results: Considerable challenges were met in the trial of SCIT in this ‘real-world’ setting. The qualitative data suggested that at least a subset of participants viewed the program as valuable and relevant to their needs. Conclusions: Further research is required to realise the benefits of SCIT found in research settings, in the real world of public community psychiatric practice.

BACKGROUND AND OBJECTIVES: Transfusion of blood products in particular older products is associated with patient morbidity. Previously, we demonstrated a higher incidence of acute lung injury in lipopolysaccharide-treated sheep transfused with stored blood products. As transfusion following haemorrhage is more common, we aimed to determine whether a 'first hit' of isolated haemorrhage would precipitate similar detrimental effects following transfusion and also disrupt haemostasis. MATERIALS AND METHODS: Anaesthetized sheep had 33% of their total blood volume collected into Leukotrap bags (Pall Medical), which were processed into packed red blood cells and cross-matched for transfusion into other sheep. After 30 mins, the sheep were resuscitated with either: fresh (

This study examines how perceptions of the work context affect the job and career satisfaction of Chinese employees. Perceived organizational support (POS), procedural justice, and gender bias against women are considered as antecedents. Gender is expected to moderate the relationships between these antecedents and the outcome variables. The results of hierarchical regression analysis on data from 591 Chinese employees indicated that POS and procedural justice are positively related to employees’ job and career satisfaction. Additionally, gender acts as a moderator in the relationship between POS and job satisfaction, and between gender bias against women and career satisfaction.

Aim Quality of life (QOL) has gained recognition as a valid measure of outcome in first-episode psychosis (FEP). This study aimed to determine the influence of specific groups of depressive symptoms on separate domains of subjectively appraised QOL. Methods We assessed 208 individuals with first-episode non-affective psychosis using measures of diagnosis (Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ), symptoms (Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, and Calgary Depression Scale for Schizophrenia), functioning (Global Assessment of Functioning), insight (Birchwood Scale), duration of untreated psychosis (Beiser Scale), and QOL World Health Organisation Quality of Life Instrument (WHOQOL-Bref). We used multiple regression to determine the contribution of depressive symptoms to QOL domains while controlling for socio-demographic and other clinical characteristics. Results There were complete data for 146 individuals with FEP. Quality-of-life domains were consistently predicted by depressive symptoms including depressive mood and hopelessness rather than biological symptoms of depression with those experiencing more depressive symptoms reporting worse QOL. Those who were treated as in-patients reported improved QOL, and hospitalization was an independent predictor of most QOL domains. In-patients displayed greater levels of positive symptoms with those involuntarily detained displaying greater levels of bizarre behavior, thought disorder, and delusions. Conclusions These findings suggest that QOL is heavily influenced by depressive symptoms at initial presentation; however, as QOL domains are also influenced by admission status with in-patients being more symptomatic in terms of positive symptoms, subjective QOL assessment may be compromised during the acute phase of illness by both positive and depressive symptom severity.

Background Extracorporeal circulation (ECC), the diversion of blood flow through a circuit located outside of the body, has been one of the major advances in modern medicine. Cardio-pulmonary bypass (CPB), renal dialysis, apheresis and extracorporeal membrane oxygenation (ECMO) are all different forms of ECC. Despite its major benefits, when blood comes into contact with foreign material, both the coagulation and inflammation cascades are activated simultaneously. Short periods of exposure to ECC e.g. CPB (∼2 h duration), are known to be associated with haemolysis, coagulopathies, bleeding and inflammation which demand blood product support. Therefore, it is not unexpected that these complications would be exaggerated with prolonged periods of ECC such as in ECMO (days to weeks duration). The variability and complexities of the underlying pathologies of patients requiring ECC makes it difficult to study the cause and effect of these complications. To overcome this problem we developed an ovine (sheep) model of ECC. Method Healthy female sheep (1–3 y.o.) weighing 40–50 kg were fasted overnight, anaesthetised, intubated and ventilated [1]. Half the group received smoke induced acute lung injury (S-ALI group) (n = 8) and the other half did not (healthy group) (n = 8). Sheep were subsequently cannulated (Medtronic Inc, Minneapolis, MN, USA) and veno-venous ECMO commenced using PLS ECMO circuit and Quadrox D oxygenator (Maquet Cardiopulmonary AG, Hechinger Strase, Germany). There was continuous physiological monitoring and blood was collected at specified time intervals for full blood counts, platelet function analysis (by Multiplate®), routine coagulation and assessment of clot formation and lysis (by ROTEM®). Preliminary results Full blood counts and routine coagulation results from normal healthy sheep were comparable to those of normal human adults. Within 15 min of initiating of ECMO, PT, PTT and EXTEM clot formation time increased, whilst EXTEM maximum clot firmness decreased in both cohorts. Discussion & Conclusions Preliminary results of sheep from both 2 h ECMO cohorts showed that the anatomy, haematology and coagulation parameters of an adult sheep are comparable to that a human adult. Experiments are currently underway with healthy (n = 8) and S-ALI (n = 8) sheep on ECMO for 24 h. In addition to characterising how ECMO alters haematology and coagulation parameters, we hope that it will also define which blood components will be most effective to correct bleeding or clotting complications during ECMO support.

Background: Extra corporeal membrane oxygenation (ECMO) is a complex rescue therapy used to provide cardiac and/or respiratory support for critically ill patients who have failed maximal conventional medical management. ECMO is based on a modified cardiopulmonary bypass (CPB) circuit, and can provide cardiopulmonary support for up-to several months. It can be used in a veno venous configuration for isolated respiratory failure, (VV-ECMO), or in a veno arterial configuration (VA-ECMO) where support is necessary for cardiac +/- respiratory failure. The ECMO circuit consists of five main components: large bore cannulae (access cannulae) for drainage of the venous system, and return cannulae to either the venous (in VV-ECMO) or arterial (in VA ECMO) system. An oxygenator, with a vast surface area of hollow filaments, allows addition of oxygen and removal of carbon dioxide; a centrifugal blood pump allows propulsion of blood through the circuit at upto 10 L/minute; a control module and a thermoregulatory unit, which allows for exact temperature control of the extra corporeal blood. Methods: The first successful use of ECMO for ARDS in adults occurred in 1972, and its use has become more commonplace over the last 30 years, supported by the improvement in design and biocompatibility of the equipment, which has reduced the morbidity associated with this modality. Whilst the use of ECMO in neonatal population has been supported by numerous studies, the evidence upon which ECMO was integrated into adult practice was substantially less robust. Results: Recent data, including the CESAR study (Conventional Ventilatory Support versus Extra corporeal membrane oxygenation for Severe Respiratory failure) has added a degree of evidence to the role of ECMO in such a patient population. The CESAR study analysed 180 patients, and confirmed that ECMO was associated with an improved rate of survival. More recently, ECMO has been utilized in numerous situations within the critical care area, including support in high-risk percutaneous interventions in cardiac catheter lab; the operating room, emergency department, as well in specialized inter-hospital retrieval services. The increased understanding of the risk:benefit profile of ECMO, along with a reduction in morbidity associated with its use will doubtless lead to a substantial rise in the utilisation of this modality. As with all extra-corporeal circuits, ECMO opposes the basic premises of the mammalian inflammation and coagulation cascade where blood comes into foreign circulation, both these cascades are activated. Anti-coagulation is readily dealt with through use of agents such as heparin, but the inflammatory excess, whilst less macroscopically obvious, continues un-abated. Platelet consumption and neutrophil activation occur rapidly, and the clinician is faced with balancing the need of anticoagulation for the circuit, against haemostasis in an acutely bleeding patient. Alterations in pharmacokinetics may result in inadequate levels of disease modifying therapeutics, such as antibiotics, hence paradoxically delaying recovery from conditions such as pneumonia. Key elements of nutrition and the innate immune system maysimilarly be affected. Summary: This presentation will discuss the basic features of ECMO to the nonspecialist, and review the clinical conundrum faced by the team treating these most complex cases.

Informed by social exchange theory and social identity theory, we developed a conceptual model that examines the mediating role of organizational identification in the relationship between employees’ perceptions of organizational context and their job attitudes. In our model, the antecedents include perceived organizational support (POS), procedural justice, and perceived job insecurity. The outcome variables consist of affective organizational commitment, job satisfaction, and intentions to leave. Our respondents were 591 workers employed in three different firms in China. The results of regression analyses showed that employees’ job attitudes are affected by their perceptions of organizational context and organizational identification. Further, organizational identification was found to mediate the effects of POS on the outcome variables.

AIM: Most national guidelines recommend psychological therapy for people with first-episode psychosis (FEP) but interventions proven effective in randomized control trials (RCTs) conducted in research settings do not always translate effectively to real-world clinical environments. In a limited health system, it is important to understand the system and patient barriers to participation in effective treatment. We sought to determine what patient characteristics influenced clinicians' decision to refer or not to refer to group cognitive behavioural therapy for FEP and what characteristics were associated with those referred attending/not attending and adhering/not adhering to the programme. METHODS: Between 2006 and 2008, all cases of confirmed FEP from a defined geographical region were examined using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses, the Scale for Assessment of Positive Symptoms, Scale for Assessment of Negative Symptoms, Calgary Depression Scale for Schizophrenia and Birchwood Insight Scale. Duration of untreated psychosis was established using the Beiser Scale. RESULTS: Of the 124 (77 males, 47 females) people in the final sample, 88 (72%) were referred for cognitive behavioural therapy (CBT), 52 (59%) attended and 12 (23%) did not complete CBT. Those with higher levels of insight into the need for treatment (U = 740.00, z = -2.63, P = 0.008) and higher levels of positive symptoms (t (120) = -3.064, P = 0.003) were more likely to be referred to CBT. Those with higher educational attainment (?(2) = 9.48, P = 0.03) and fewer negative symptoms, particularly in relation to global attention (t (85) = 2.32, P = 0.03), were more likely to attend and complete CBT. CONCLUSION: Within an early intervention service for FEP, it appears that individuals with less education, more negative symptoms and less insight experienced significant barriers to successfully completing group CBT. More information for referring clinicians about the benefits of CBT for FEP could help increase referral rates. Assertive outreach for people at risk of disengaging or non-adherence should also be considered.

Most studies of First Rank Symptoms (FRS) are based on cross-sectional inpatient samples of people with schizophrenia at various stages of illness. We sought to examine the prevalence of FRS in a representative sample of first episode psychosis patients and compare those with and without FRS clinically and in terms of duration of untreated illness. Information was gathered from 158 consecutive cases of first episode psychosis presenting in a defined geographical region through semi-structured interview tools. Of this sample, 40.5% of cases received a diagnosis of schizophrenia. The prevalence of FRS among the entire group was 52.5%. After controlling for multiple testing, no FRS contributed significantly to predicting a diagnosis of schizophrenia. There was no significant relationship between the duration of untreated illness and FRS.

This study of 390 full-time Chinese managers examined the relationship between gender and work-to-family conflict. Guided by identity theory, we found that work identity and family identity mediate...

IntroductionInternational best-practice guidelines for the management of first-episode psychosis have recommended the provision of psychoeducation for multifamily groups. While there is ample evidence of their efficacy in multiepisode psychosis, there is a paucity of evidence supporting this approach specifically for first-episode psychosis. We sought to determine whether a six-week caregiver psychoeducation programme geared specifically at first-episode psychosis improves caregiver knowledge and attitudes.MethodsCaregivers of people with first-episode psychosis completed a 23-item adapted version of the self-report Family Questionnaire (KQ) and a 17-item adapted version of the self-report Drug Attitudes Inventory (DAI) before and after the six-week DETECT Information and Support Course (DISC). Using a Generalised Linear Repeated Measures Model, we analyzed the differences in proportions of correct answers before and after the programme.ResultsOver a 24-month study period, 31 caregivers (13 higher socioeconomic; 13 lower socioeconomic; five unspecified socioeconomic; 19 female; 12 male) participated in the DISC programme and completed inventories before and after the course. Knowledge of psychosis and specific knowledge of medication treatment improved among caregivers overall (p < .01; effect sizes 0.78 and 0.94 respectively). There were no significant gender or socioeconomic differences in any improvement.DiscussionThis study confirms that caregiver psychoeducation specifically for first-episode psychosis directly improves knowledge of the illness overall and, in particular, knowledge of medication. Gender is not a factor in this, while the lack of any socioeconomic differences dispels the myth that patients in lower socioeconomic groups are disadvantaged because their caregivers know less.

People experience delays in receiving effective treatment for many illnesses including psychosis. These delays have adverse consequences in heart disease and cancer, and their causes have been the subject of much research but only in recent years have pathways to care in psychosis received such attention. We sought to establish if, when and where people seek help in the early phase of psychosis in a representative sample. One hundred and sixty-five people with first episode psychosis, referred from community-based psychiatric services and a private psychiatric facility to an early intervention service over 18 months, were interviewed with the Structured Clinical Interview for DSM-IV diagnoses. Symptoms were measured using the Schedule for the Assessment of Positive Symptoms, Schedule for the Assessment of Negative Symptoms and the Calgary Scale. Duration of untreated illness (DUI) and duration of untreated psychosis (DUP) were established using the Beiser Scale. Pathways to mental health services were systematically detailed through interviews with patients and their families. The final sample consisted of 142 (88M, 54F) cases after those with psychosis due to a general medical condition and those without pathway and DUP data were excluded. Less than half of participants initiated help seeking themselves. Of those who did seek help (n = 57) 25% did so during the DUI. Those who had a positive family history of mental illness and poorer premorbid adjustment were significantly less likely to seek help for themselves and those who did not seek help were more likely to require hospitalisation. Families were involved in help seeking for 50% of cases and in 1/3 of cases did so without the affected individual participating in the contact. Being younger and having more negative symptoms were associated with having one’s family involved in help seeking. Delays to effective treatment from the onset of psychosis were evenly split between “help-seeking delays” and “health-system delays”. Having a family member involved in help seeking and better premorbid adjustment were independently associated with shorter help-seeking delays when measured from the onset of psychosis. Being female, having better premorbid adjustment and fewer negative symptoms were associated with shorter help-seeking delays from the onset of illness. Those with a non-affective psychosis had significantly longer system delays. Many people with first episode psychosis do not initiate help-seeking for themselves particularly those with a relative affected by mental illness. Those with poor premorbid adjustment are at particular risk of longer delays. Poor premorbid adjustment compounded by long delays to effective treatment reduces the likelihood of a good outcome. Families play a vital role in hastening receipt of effective treatment.

Summary We developed and tested a conceptual model to examine the impact of family friendly work practices (FFWPs) at the organizational level. In our model, top management support for equal opportunities is considered an antecedent of FFWPs and positive organizational climate, and firm performance and employee turnover are considered outcome variables. Structural equation modeling (SEM) was used to analyze the data collected from a sample of HR managers in multinational corporations (MNCs) in Hong Kong. The results showed that top management support for equal opportunities was positively related to a firm’s level of FFWPs and organizational climate. In addition, FFWPs were positively related to organizational climate. We further found that organizational climate acted as a mediator between FFWPs and firm-level outcomes. Copyright # 2009 John Wiley & Sons, Ltd.

INTRODUCTION: Suicide and attempted suicide contribute significantly to the increased mortality and morbidity associated with psychotic illness. The period of highest risk is reportedly in the early years of illness. While the literature concentrates on completed suicide in chronic psychosis, less is understood about attempted suicide in first-episode psychosis (FEP). AIM: We aimed to examine rates and correlates of suicide attempts in individuals with FEP. METHOD: Individuals in this study were all those, both in- and outpatients, diagnosed with FEP over a 2-year period, from a defined catchment area. Assessment included Structured Clinical Interview for DSM-IV, Schedule for Assessment of Positive Symptoms, Schedule for Assessment of Negative Symptoms, Calgary Scale, Beiser Scale and Birchwood Insight Scale. RESULTS: Of 107 patients with FEP, 50 (47%) individuals reported suicidal ideation: 41 (38%) in the month prior to first presentation. Ten individuals (9%) made a suicide attempt. The only factor significantly associated with previous suicide attempt was higher insight scores at first presentation (P = 0.04). CONCLUSION: Individuals with a history of suicide attempt tend to have higher insight into having a mental illness at first presentation.

AIM: Although General Practitioners (GPs) have a pivotal role in early detection and treatment of psychosis, there is sparse information on their views of early intervention (EI) services and how information related to EI should be delivered. METHOD: Since inception, DETECT (Dublin East Treatment and Early Care Team), Ireland's pilot EI project, mailed information packs and provided information through the local GP continuing medical education (CME) network. After 1 year, we surveyed GPs within DETECT's catchment area for their views on the service being provided. RESULTS: One hundred and twenty-six (36%) responded and 80% found the EI service very/extremely useful. GPs reported that the combination of CME session and information packs were more useful than information packs alone. Those who attended CME meetings were significantly more likely to refer suspected cases (P < 0.01) and more likely to find the service useful (P < 0.001). CONCLUSION: The EI service for psychosis is well-received among GPs. Information about EI delivered through CME appears to have a greater impact on referral rates and satisfaction levels than mailed information.

Aims: Earlier detection and treatment of psychosis is associated with improved health outcomes. While the role of specialist services to facilitate early diagnosis and treatment has been extensively described internationally, little data on their impact on general practice has been reported. A new specialist service for psychosis – the ‘Dublin East Treatment and Early Care Team (DETECT)’– has recently been established. This study aimed to describe general practitioners' (GPs) attitudes towards working within the catchment area of an early intervention service. Methods: A purposive sample of GPs practising in DETECT's catchment area was identified from the Irish Medical Directory and invited to participate in a semi-structured interview. The sampling parameters were solo/practice and area of practice. Participants were provided with information regarding the new service and a range of educational material. Each interview was reviewed by two researchers who identified dominant themes. The study was approved by the Research Ethics Committee of the Irish College of GPs. Results: 16 GPs were interviewed. The DETECT early intervention model was identified as reducing the challenges of managing psychosis in primary care including the practical difficulties of accessing psychiatric assessment and the pervasive effect of stigma. Participants viewed communication between primary and specialist care as essential to the success of early intervention services. Conclusions: General Practice has an important role in early detection of psychosis and accessing timely psychiatric evaluations of suspected psychosis. Increasing awareness among GPs and ensuring the early intervention model is responsive to primary care can support this role.

We examined strategic human resource management (SHRM) and human resource practices in the People's Republic of China to assess the impact of these practices on firm performance and the employee relations climate. We also tested whether firm ownership moderates the above relationships. Empirical results from a sample of Chinese firms from various industries and regions showed that the levels of adoption of SHRM and HR practices were lower in state-owned enterprises (SOEs) than in foreign-invested enterprises (FIEs) and privately owned enterprises (POEs). Both SHRM and HR practices were found to have direct and positive effects on financial performance, operational performance, and the employee relations climate. However, the moderating effect of ownership type was significant for financial performance only. © 2008 Wiley Periodicals, Inc.

Patient suicide is a relatively common event: 50–70% of consultant psychiatrists and 40–50% of psychiatric trainees have experienced at least one patient suicide. Patient suicide can have significant personal and professional effects on psychiatrists, including increased stress, social withdrawal, disruption to relationships, symptoms of post-traumatic stress disorder and consideration of early retirement. Following patient suicide, psychiatrists derive most support from informal contacts with team members, family and friends; additional support may be available through formal support structures or local team initiatives. It is important to place appropriate emphasis on the effects of patient suicide in psychiatry training programmes; to maintain awareness of the importance of informal supports following patient suicide; to strengthen formal systems of support; to identify other potential forms of assistance (e.g. spiritual support); and to develop local team initiatives in this area.

Objective: To describe the prevalence and demographic, clinical and functional correlates of childhood trauma in patients attending early psychosis clinics. Method: Participants were recruited from outpatients attending four early psychosis services. Exposure to childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Psychopathology was measured using the Positive and Negative Syndrome Scale and the Depression, Anxiety and Stress Scale. Social and vocational functioning and substance use were also assessed. Results: Over three-quarters of the 100 patients reported exposure to any childhood trauma. Emotional, physical and sexual abuse were reported by 54%, 23% and 28% of patients, respectively, while 49% and 42% of patients reported emotional and physical neglect, respectively. Female participants were significantly more likely to be exposed to emotional and sexual abuse. Exposure to childhood trauma was correlated with positive psychotic symptoms and higher levels of depressive, anxiety and stress symptoms; however, it had no impact on social or vocational functioning or recent substance use. Conclusion: Exposure to childhood trauma was common in patients with early psychosis, and associated with increased symptomatology. Existing recommendations that standard clinical assessment of patients with early psychosis should include inquiry into exposure to childhood trauma are supported.

We examined the relationship between maternal employment and college students’ expected work–family conflict as well as the relationship between expected conflict and the anticipated use of family-altering and career-altering strategies. Results indicated a positive relationship between the extensiveness of maternal employment and expected work–family conflict only for men. In addition, students who expected extensive work–family conflict anticipated delaying marriage, limiting the number of children they will have, and, in the case of men, intending not to have children. There was no relationship between expected work–family conflict and the anticipated use of career-altering strategies. Implications of the findings and directions for future research are discussed.

Informed by social identity theory, we developed a model to examine the antecedents and consequences of perceptions of personal gender discrimination. In the model, gender, gender identity, and perceived gender bias against women are considered as salient predictors of perceived personal gender discrimination, and organizational commitment and intentions to leave are considered as the outcome variables. Structural equation modeling (SEM) was used to analyze the data collected from a sample of practicing solicitors in Hong Kong. We found that (a) women perceived more personal gender discrimination and gender bias against women than did men, (b) gender moderated the relationship between perceived gender bias against women and perceived personal gender discrimination, (c) the positive effect of gender bias against women on gender discrimination was more strongly positive for women than for men, and (d) perceived personal gender discrimination affected organizational commitment and intentions to leave. Theoretical and practical implications are discussed.

This study examines the relationship between demographic similarity in the supervisor-subordinate dyad and family-supportive supervision. The authors found that supervisors provided more family support to subordinates who were similar in either gender or race than to those subordinates who were dissimilar. In addition, family-supportive supervision was highest when subordinates were similar to supervisors in both gender and race. A family-supportive organizational culture was positively related to family-supportive supervision, although contrary to what was predicted, it did not attenuate the effects of gender similarity and racial similarity on family-supportive supervision. Implications of the findings and directions for future research are discussed.

This study uses the horizontal and vertical distinction within individualism and collectivism as a theoretical framework to predict differences in employee perceptions of organizational justice and gender inequity. In this study we survey 514 solicitors working in law firms in Hong Kong. Results of regression analysis indicated that horizontal-collectivism (HC) had a significant positive effect on procedural justice and vertical-individualism (VI) had a significant and positive effect on distributive justice. Vertical- and horizontal-individualism (VI and HI) had positive and significant effects on both perceived gender bias and perceived gender discrimination. We discuss the theoretical and practical implications of our findings and suggest future research directions.

Building on the social exchange perspective and organizational support theory, this study examined the relationships among employees' justice perceptions, perceived organizational support (POS), organizational commitment and intention to leave. A hypothesized model was developed and tested using hierarchical regression analyses on a sample of 514 practising solicitors in Hong Kong. The results showed that both procedural and distributive justice contributed to the development of POS, and POS mediated their effects on organizational commitment and intention to leave. As expected, organizational commitment was negatively related to intention to leave. Additional analyses revealed that these relationships held for both partners and non-partners in law firms.

Work and occupational stress have long been concerns for employees and human resource managers as they cause many negative outcomes. Most of the previous studies on work stress were conducted in Western countries, while limited research has addressed this important topic in the Asian context. In this study, we examine the effects of several work role stressors (i.e. role ambiguity, role conflict, role overload and work-family conflict) on emotional exhaustion, job satisfaction and intentions to leave. Additionally, we test the mediating effects of emotional exhaustion and job satisfaction between the relationship of role stressors and intentions to leave. Data were collected from a sample of 887 professional clergy in Hong Kong. The results of regression analysis show that role stressors have a significant impact on both emotional exhaustion and job satisfaction, which in turn affect respondents' intentions to leave their organization.