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Original Article, Introduction: In recent years, various interventions for early stages of psychosis, such as first-episode psychosis (FEP) and an at-risk mental state for psychosis (ARMS), have been reported worldwide. Although the importance of psychosocial treatment has been emphasized, few studies have examined the effects of psychiatric day treatment for patients with early psychosis. The aim of the present study was to examine the effects of psychiatric day treatment, which is a comprehensive psychosocial service, for early psychosis. Methods: Eighty-one subjects with early psychosis (59 FEP and 22 ARMS) who regularly participated in a psychiatric day treatment service known as “Il Bosco" were consecutively recruited. The subjects underwent various clinical assessments at baseline and after 12 months. Cognitive function, psychiatric symptoms, social functioning, quality of life (QOL), global functioning, and dosage of antipsychotics at the two time points were then evaluated. Results: Significant improvements were observed in various domains, such as cognitive function, psychiatric symptoms, social functioning, QOL, and global functioning, at the follow-up time point, compared with the baseline. There were significant correlations in the frequency of attendance, with changes in memory, positive and negative symptoms, QOL, and global functioning. Conclusions: Psychiatric day treatment specific for young people with early psychosis can contribute to improvements in various clinical domains.

Takashi Uchino,1,2 Takahiro Nemoto,1 Taiju Yamaguchi,1 Naoyuki Katagiri,1 Naohisa Tsujino,1 Yoshitaka Murakami,3 Kuniaki Tanaka,2 Masafumi Mizuno1 1Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan; 2Tokyo Adachi Hospital, Tokyo 121-0064, Japan; 3Department of Medical Statistics, Toho University School of Medicine, Tokyo 143-8540, JapanCorrespondence: Takahiro NemotoDepartment of Neuropsychiatry, Toho University Graduate School of Medicine, 5-21-16 Omori-Nishi, Ota-ku, Tokyo 143-8540, JapanTel +81 3 37624151Fax +81 3 54715774Email takahiro.nemoto@med.toho-u.ac.jpObjective: Functional capacity, which indicates one’s ability to perform everyday living tasks, contributes to real-world functional performance in patients with schizophrenia. However, functional capacity is sometimes not comparable with functional performance in clinical settings. We hypothesized that specific personality traits are related to this capacity-performance discrepancy of functional outcome.Methods: The measures in this study were the UCSD Performance-based Skills Assessment Brief (UPSA-B) for functional capacity, the Social Functioning Scale (SFS) for functional performance, and the Temperament and Character Inventory-140 (TCI-140) for personality traits. A total of 94 stable outpatients with schizophrenia were divided into four groups based on combinations of their UPSA-B and SFS cut-off points, as follows: a high capacity and high performance (HH) group, a high capacity but low performance (HL) group, a low capacity but high performance (LH) group, and a low capacity and low performance (LL) group.Results: There were no significant differences in demographics among the four groups. The LH group showed a significantly lower harm avoidance level than the LL group. The HL group showed a significantly lower persistence level than the HH group.Conclusion: Lower harm avoidance may enhance functional performance, and lower persistence can limit functional performance, regardless of the primary levels of functional capacity in patients with schizophrenia. Novel and individualized psychosocial treatments considering the individual’s personality traits seem to be helpful for maximizing their functional performance in the community.Keywords: functional capacity, performance-based assessment, real-world functioning, social functioning, Temperament and Character Inventory

The presently reported patient was a 37-year-old married primipara with peripartum depression comorbid with bonding disorder. Care anxiety and a lack of affection towards her baby first appeared at around the time of delivery, and the patient developed major depression at one month after the birth of her healthy baby. At first, standard treatment for major depression including the use of antidepressants, electroconvulsive therapy, and supportive psychotherapy were provided. However, bonding problems appeared to impede and obstruct the amelioration of depression. Although treatment methods for bonding disorder have not yet been established, Kangaroo Care was introduced to facilitate skin-to-skin contact. We also educated her in better parenting behavior and provided repeated motivational interviews with her family because a lack of partner and social support and personal temperament (low self-directedness and cooperativeness) were thought to be related to her bonding disorder. This case suggests the effectiveness of Kangaroo Care, which promotes a humanizing maturation of both baby and parent alike, for mothers with postpartum depression and comorbid severe bonding disorder.