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1. Usability of the experience sampling method in specialized mental healthcare: Pilot Evaluation Study

Author

Weermeijer, J.D.M., Wampers, M., de Thurah, L., Bonnier, R., Piot, M., Kuppens, P., Myin-Germeys, I., Kiekens, G., Weermeijer, J.D.M., Wampers, M., de Thurah, L., Bonnier, R., Piot, M., Kuppens, P., Myin-Germeys, I., and Kiekens, G.

Abstract

Background: Mental health problems occur in interactions in daily life. Yet, it is challenging to bring contextual information into the therapy room. The experience sampling method (ESM) may facilitate this by assessing clients’ thoughts, feelings, symptoms, and behaviors as they are experienced in everyday life. However, the ESM is still primarily used in research settings, with little uptake in clinical practice. One aspect that may facilitate clinical implementation concerns the use of ESM protocols, which involves providing practitioners with ready-to-use ESM questionnaires, sampling schemes, visualizations, and training. Objective: This pilot study’s objective was to evaluate the usability of an ESM protocol for using the ESM in a specialized mental health care setting. Methods: We created the ESM protocol using the m-Path software platform and tested its usability in clinical practice. The ESM protocol consists of a dashboard for practitioners (ie, including the setup of the template and data visualizations) and an app for clients (ie, for completing the ESM questionnaires). A total of 8 practitioners and 17 clients used the ESM in practice between December 1, 2020, and July 31, 2021. Usability was assessed using questionnaires, ESM compliance rates, and semistructured interviews. Results: The usability was overall rated reasonable to good by practitioners (mean scores of usability items ranging from 5.33, SD 0.91, to 6.06, SD 0.73, on a scale ranging from 1 to 7). However, practitioners expressed difficulty in personalizing the template and reported insufficient guidelines on how to use the ESM in clinical practice. On average, clients completed 55% (SD 25%) of the ESM questionnaires. They rated the usability as reasonable to good, but their scores were slightly lower and more variable than those of the practitioners (mean scores of usability items ranging from 4.18, SD 1.70, to 5.94, SD 1.50 on a scale ranging from

Published
2023

7. Modeling psychological function in patients with schizophrenia with the PANSS: An international multi-center study

Author

Fountoulakis, K.N. Dragioti, E. Theofilidis, A.T. Wiklund, T. Atmatzidis, X. Nimatoudis, I. Thys, E. Wampers, M. Hranov, L. Hristova, T. Aptalidis, D. Milev, R. Iftene, F. Spaniel, F. Knytl, P. Furstova, P. From, T. Karlsson, H. Walta, M. Salokangas, R.K.R. Azorin, J.-M. Bouniard, J. Montant, J. Juckel, G. Haussleiter, I.S. Douzenis, A. Michopoulos, I. Ferentinos, P. Smyrnis, N. Mantonakis, L. Nemes, Z. Gonda, X. Vajda, D. Juhasz, A. Shrivastava, A. Waddington, J. Pompili, M. Comparelli, A. Corigliano, V. Rancans, E. Navickas, A. Hilbig, J. Bukelskis, L. Stevovic, L.I. Vodopic, S. Esan, O. Oladele, O. Osunbote, C. Rybakowski, J.K. Wojciak, P. Domowicz, K. Figueira, M.L. Linhares, L. Crawford, J. Panfil, A.-L. Smirnova, D. Izmailova, O. Lecic-Tosevski, D. Temmingh, H. Howells, F. Bobes, J. Garcia-Portilla, M.P. García-Alvarez, L. Erzin, G. Karadaǧ, H. De Sousa, A. Bendre, A. Hoschl, C. Bredicean, C. Papava, I. Vukovic, O. Pejuskovic, B. Russell, V. Athanasiadis, L. Konsta, A. Stein, D. Berk, M. Dean, O. Tandon, R. Kasper, S. De Hert, M.

Abstract

Background The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model. Methods Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ±Â 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed. Results The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage. Conclusions The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct cores of schizophrenia, the Positive and the Negative, while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition. © 2021 Cambridge University Press. All rights reserved.

Published
2021

8. Gender, age at onset, and duration of being ill as predictors for the long-term course and outcome of schizophrenia: an international multicenter study

Author

Fountoulakis, KN, Dragioti, E, Theofilidis, AT, Wiklund, T, Atmatzidis, X, Nimatoudis, I, Thys, E, Wampers, M, Hranov, L, Hristova, T, Aptalidis, D, Milev, R, Iftene, F, Spaniel, F, Knytl, P, Furstova, P, From, T, Karlsson, H, Walta, M, Salokangas, RKR, Azorin, J-M, Bouniard, J, Montant, J, Juckel, G, Haussleiter, IS, Douzenis, A, Michopoulos, I, Ferentinos, P, Smyrnis, N, Mantonakis, L, Nemes, Z, Gonda, X, Vajda, D, Juhasz, A, Shrivastava, A, Waddington, J, Pompili, M, Comparelli, A, Corigliano, V, Rancans, E, Navickas, A, Hilbig, J, Bukelskis, L, Stevovic, LI, Vodopic, S, Esan, O, Oladele, O, Osunbote, C, Rybakowski, JK, Wojciak, P, Domowicz, K, Figueira, ML, Linhares, L, Crawford, J, Panfil, A-L, Smirnova, D, Izmailova, O, Lecic-Tosevski, D, Temmingh, H, Howells, F, Bobes, J, Garcia-Portilla, MP, Garcia-Alvarez, L, Erzin, G, Karadag, H, De Sousa, A, Bendre, A, Hoschl, C, Bredicean, C, Papava, I, Vukovic, O, Pejuskovic, B, Russell, V, Athanasiadis, L, Konsta, A, Fountoulakis, NK, Stein, D, Berk, M, Dean, O, Tandon, R, Kasper, S, De Hert, M, Fountoulakis, KN, Dragioti, E, Theofilidis, AT, Wiklund, T, Atmatzidis, X, Nimatoudis, I, Thys, E, Wampers, M, Hranov, L, Hristova, T, Aptalidis, D, Milev, R, Iftene, F, Spaniel, F, Knytl, P, Furstova, P, From, T, Karlsson, H, Walta, M, Salokangas, RKR, Azorin, J-M, Bouniard, J, Montant, J, Juckel, G, Haussleiter, IS, Douzenis, A, Michopoulos, I, Ferentinos, P, Smyrnis, N, Mantonakis, L, Nemes, Z, Gonda, X, Vajda, D, Juhasz, A, Shrivastava, A, Waddington, J, Pompili, M, Comparelli, A, Corigliano, V, Rancans, E, Navickas, A, Hilbig, J, Bukelskis, L, Stevovic, LI, Vodopic, S, Esan, O, Oladele, O, Osunbote, C, Rybakowski, JK, Wojciak, P, Domowicz, K, Figueira, ML, Linhares, L, Crawford, J, Panfil, A-L, Smirnova, D, Izmailova, O, Lecic-Tosevski, D, Temmingh, H, Howells, F, Bobes, J, Garcia-Portilla, MP, Garcia-Alvarez, L, Erzin, G, Karadag, H, De Sousa, A, Bendre, A, Hoschl, C, Bredicean, C, Papava, I, Vukovic, O, Pejuskovic, B, Russell, V, Athanasiadis, L, Konsta, A, Fountoulakis, NK, Stein, D, Berk, M, Dean, O, Tandon, R, Kasper, S, and De Hert, M

Abstract

BACKGROUND: The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia. METHODS: Twenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 ± 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects. RESULTS: There was a 3-year later age at onset for females (P < .001) and lower rates of negative symptoms (P < .01) and higher depression/anxiety measures (P < .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages (P = .001). No significant effects were found concerning duration of illness. DISCUSSION: Our results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples.

Published
2021

9. Modeling psychological function in patients with schizophrenia with the PANSS : An international multi-center study

Author

Fountoulakis, K.N., Dragioti, Elena, Theofilidis, A.T., Wiklund, Tobias, Atmatzidis, Xenofon, Nimatoudis, I., Thys, E., Wampers, M., Hranov, L., Hristova, T., Aptalidis, D., Milev, R., Iftene, F., Spaniel, F., Knytl, P., Furstova, P., From, T., Karlsson, H., Walta, M., Salokangas, R.K.R., Azorin, J.-M., Bouniard, J., Montant, J., Juckel, G., Haussleiter, I.S., Douzenis, A., Michopoulos, I., Ferentinos, P., Smyrnis, N., Mantonakis, L., Nemes, Z., Gonda, X., Vajda, D., Juhasz, A., Shrivastava, A., Waddington, J., Pompili, M., Comparelli, A., Corigliano, V., Rancans, E., Navickas, A., Hilbig, J., Bukelskis, L., Stevovic, L.I., Vodopic, S., Esan, O., Oladele, O., Osunbote, C., Rybakowski, J.K., Wojciak, P., Domowicz, K., Figueira, M.L., Linhares, L., Crawford, J., Panfil, A.-L., Smirnova, D., Izmailova, O., Lecic-Tosevski, D., Temmingh, H., Howells, F., Bobes, J., Garcia-Portilla, M.P., Garciá-Alvarez, L., Erzin, G., Karada, H., De, Sousa A., Bendre, A., Hoschl, C., Bredicean, C., Papava, I., Vukovic, O., Pejuskovic, B., Russell, V., Athanasiadis, L., Konsta, A., Stein, D., Berk, M., Dean, O., Tandon, R., Kasper, S., De, Hert M., Fountoulakis, K.N., Dragioti, Elena, Theofilidis, A.T., Wiklund, Tobias, Atmatzidis, Xenofon, Nimatoudis, I., Thys, E., Wampers, M., Hranov, L., Hristova, T., Aptalidis, D., Milev, R., Iftene, F., Spaniel, F., Knytl, P., Furstova, P., From, T., Karlsson, H., Walta, M., Salokangas, R.K.R., Azorin, J.-M., Bouniard, J., Montant, J., Juckel, G., Haussleiter, I.S., Douzenis, A., Michopoulos, I., Ferentinos, P., Smyrnis, N., Mantonakis, L., Nemes, Z., Gonda, X., Vajda, D., Juhasz, A., Shrivastava, A., Waddington, J., Pompili, M., Comparelli, A., Corigliano, V., Rancans, E., Navickas, A., Hilbig, J., Bukelskis, L., Stevovic, L.I., Vodopic, S., Esan, O., Oladele, O., Osunbote, C., Rybakowski, J.K., Wojciak, P., Domowicz, K., Figueira, M.L., Linhares, L., Crawford, J., Panfil, A.-L., Smirnova, D., Izmailova, O., Lecic-Tosevski, D., Temmingh, H., Howells, F., Bobes, J., Garcia-Portilla, M.P., Garciá-Alvarez, L., Erzin, G., Karada, H., De, Sousa A., Bendre, A., Hoschl, C., Bredicean, C., Papava, I., Vukovic, O., Pejuskovic, B., Russell, V., Athanasiadis, L., Konsta, A., Stein, D., Berk, M., Dean, O., Tandon, R., Kasper, S., and De, Hert M.

Abstract

Background. The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model. Methods. Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed. Results. The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage. Conclusions. The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.

Published
2021
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14. Staging of Schizophrenia With the Use of PANSS: An International Multi-Center Study

Author

Fountoulakis, KN, Dragioti, E, Theofilidis, AT, Wikilund, T, Atmatzidis, X, Nimatoudis, I, Thys, E, Wampers, M, Hranov, L, Hristova, T, Aptalidis, D, Milev, R, Iftene, F, Spaniel, F, Knytl, P, Furstova, P, From, T, Karlsson, H, Walta, M, Salokangas, RKR, Azorin, J-M, Bouniard, J, Montant, J, Juckel, G, Haussleiter, IS, Douzenis, A, Michopoulos, I, Ferentinos, P, Smyrnis, N, Mantonakis, L, Nemes, Z, Gonda, X, Vajda, D, Juhasz, A, Shrivastava, A, Waddington, J, Pompili, M, Comparelli, A, Corigliano, V, Rancans, E, Navickas, A, Hilbig, J, Bukelskis, L, Stevovic, LI, Vodopic, S, Esan, O, Oladele, O, Osunbote, C, Rybakowski, JK, Wojciak, P, Domowicz, K, Figueira, ML, Linhares, L, Crawford, J, Panfil, A-L, Smirnova, D, Izmailova, O, Lecic-Tosevski, D, Temmingh, H, Howells, F, Bobes, J, Garcia-Portilla, MP, Garcia-Alvarez, L, Erzin, G, Karadag, H, De Sousa, A, Bendre, A, Hoschl, C, Bredicean, C, Papava, I, Vukovic, O, Pejuskovic, B, Russell, V, Athanasiadis, L, Konsta, A, Stein, D, Berk, M, Dean, O, Tandon, R, Kasper, S, De Hert, M, Fountoulakis, KN, Dragioti, E, Theofilidis, AT, Wikilund, T, Atmatzidis, X, Nimatoudis, I, Thys, E, Wampers, M, Hranov, L, Hristova, T, Aptalidis, D, Milev, R, Iftene, F, Spaniel, F, Knytl, P, Furstova, P, From, T, Karlsson, H, Walta, M, Salokangas, RKR, Azorin, J-M, Bouniard, J, Montant, J, Juckel, G, Haussleiter, IS, Douzenis, A, Michopoulos, I, Ferentinos, P, Smyrnis, N, Mantonakis, L, Nemes, Z, Gonda, X, Vajda, D, Juhasz, A, Shrivastava, A, Waddington, J, Pompili, M, Comparelli, A, Corigliano, V, Rancans, E, Navickas, A, Hilbig, J, Bukelskis, L, Stevovic, LI, Vodopic, S, Esan, O, Oladele, O, Osunbote, C, Rybakowski, JK, Wojciak, P, Domowicz, K, Figueira, ML, Linhares, L, Crawford, J, Panfil, A-L, Smirnova, D, Izmailova, O, Lecic-Tosevski, D, Temmingh, H, Howells, F, Bobes, J, Garcia-Portilla, MP, Garcia-Alvarez, L, Erzin, G, Karadag, H, De Sousa, A, Bendre, A, Hoschl, C, Bredicean, C, Papava, I, Vukovic, O, Pejuskovic, B, Russell, V, Athanasiadis, L, Konsta, A, Stein, D, Berk, M, Dean, O, Tandon, R, Kasper, S, and De Hert, M

Abstract

INTRODUCTION: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. METHODS: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. RESULTS: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. DISCUSSION: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.

Published
2019

20. Pharmacological treatment of ambulatory schizophrenic patients in Belgium

Author

Hanssens, L, De Hert, M, Wampers, M, Reginster, J-Y, and Peuskens, J

Subjects
Research
Abstract

BACKGROUND : the objective of this study was twofold:1) Describe the use of antipsychotic treatments in ambulatory patients suffering from schizophrenia in Belgium.2) Evaluate to which extend antipsychotic treatment prescribing patterns are in accordance with published treatment guidelines. METHOD : A cross-sectional survey was carried out in 16 Belgian hospitals selected from a sample of 67 hospitals. The hospitals were equally distributed between the north and south part of the country and were representative of Belgian practice. During 2 months, participating psychiatrists were asked to record the medication use as well as demographic parameters of all consecutive ambulatory patients seen at their consultation or attending a day-hospital. Data concerning 1000 ambulatory patients with schizophrenia or schizoaffective disorder were collected. RESULTS : In Belgium, the use of atypical antipsychotics is frequent (69%) in ambulatory patients with schizophrenia. In the overall sample, 73% receive only one antipsychotic drug. The majority of patients are treated with drugs of only one antipsychotic drug group, either first- typical (29.8%) or second-generation, atypical antipsychotics (53.2%). 15.8% of patients combine different types of antipsychotics. Antipsychotic dosing is adequate for the majority of patients but about one fifth receives a higher than recommended dose as per package inserts. Polypharmacy remains within reasonable limits. The use of concomitant medication varies according the antipsychotic treatment: patients who take second-generation antipsychotics only, receive the least additional drugs. CONCLUSION : Atypical antipsychotics appear to be the first line treatment for schizophrenic psychosis. Psychiatrists working with ambulatory patients are well aware of treatment guidelines and follow them quite adequately. ispartof: Clinical Practice and Epidemiology in Mental Health vol:2 issue:11 pages:1-10 ispartof: location:United Arab Emirates status: published

Published
2006

50. Sex Differences in Subclinical Psychotic Experiences: The Role of Daily-Life Social Interactions.

Author

Akcaoglu Z, Myin-Germeys I, Vaessen T, Janssens JJ, Wampers M, Bamps E, Lafit G, Kirtley OJ, and Achterhof R

Abstract

Background and Hypothesis: Sex differences in psychosis are reported across the psychosis spectrum, including in subclinical stages. An important factor in understanding these variations is the subjective experience of everyday social interactions (SI). We investigated whether the presence of psychotic experiences (PEs), as well as associated distress, differs between men and women. We focused on the role of daily-life SI quality and whether its association with PEs varies by sex., Study Design: We included adolescents from SIGMA, a general youth population study in Flanders, Belgium (n = 344; mean age = 18.7; 63.4% female). Psychotic experiences were measured using the PQ-16. We used Experience Sampling Methodology to assess daily-life SI. A multilevel model and multiple linear regressions were used to assess, respectively, the relationship between sex and SI quality and whether PEs and their association with SI quality differ between young men and women., Study Results: The results of the multilevel linear regression model indicate that the prevalence of and distress associated with PEs were higher in women. No significant difference was observed in the subjective quality of daily SI. Social interaction quality was strongly related to PEs. This association did not seem to vary for the prevalence of PEs, though women's distress about PEs appeared to be more affected by SI quality., Conclusions: Present findings highlight the role of the subjective quality of SI in subclinical psychosis. More research is needed to investigate the mechanisms through which SI quality relates to PEs, and whether these differ between young men and women., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Published
2024
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