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The aim of this a quasi-experimental study is to test the changes in the Quality of Life of chronic mental disorders (schizophrenia) treated with psychodrama. Total sample consisted of 60 subjects, aged 21-38. From these, 30 subjects were in the experimental group, while 30 subjects were in the control group. All subjects were previously psychologically tested, as well as basic demographic data has been taken. The instrument we used was Life Quality Scale in Schizophrenia (21 items form). Qualitative and quantitative analysis of the obtained data indicates a statistically significant improvement of social and communicative abilities of participants of experimental groups, better impulse control and activation in the work area. The disadvantage of this research is: the small sample. Future examination is needed, as well as a more advanced data processing methodology.

Evaluation of the physician-patient relationship is very important in determining priorities in medical practice and medicine. For this purpose, in this study the psychiatrist's communication with psychotic patients as a sensitive group was evaluated. A questionnaire was administered to 210 patients in a psychiatric clinic of Inonu University Hospital in Turkey to determine how the examination is performed in the facility for outpatients in the psychosis unit. According to the study conducted, it was observed that the evaluation score of the psychiatrist's communication with psychotic patients increased positively with increasing consultation duration. Our work is particularly noteworthy because it deals with a sensitive area, such as a group of psychiatric patients. The scores were obtained based on data from the evaluation of the questionnaires, which showed that the communication between the psychiatrist and the psychotic patient was conducted in a sensitive and careful manner, and without ethical problems. [ABSTRACT FROM AUTHOR]

Suicide, a deliberate act of self-harm with the intention to die, is an emerging health concern but, unfortunately, the most under-researched subject in Pakistan, especially in Khyber Pukhtunkhwa (KPK). In this study, we aimed to identify risk factors that can be associated with suicidal behavior (SB) and to evaluate the prevailing treatment practices for therapeutic efficacy and drug-related problems (DRPs) in psychotic patients among the local population of KPK. A prospective, multicenter study was conducted for suicidal cases admitted to the study centers by randomized sampling. Socio-demographics and data on suicidal behavior were assessed using the Columbia-Suicide Severity Rating Scale (C-SSRS), socioeconomic condition by Kuppuswamy socioeconomic scale (KSES) and treatment adherence by Morisky Medication-Taking Adherence Scale (MMAS-4). Drug-related problems and the therapeutic efficacy of prevailing treatment practices were assessed at baseline and follow-up after 3 months of treatment provided. Regarding suicidality (N = 128), females reported more ideations (63.1%), while males witnessed more suicidal behavior (66.6%, p < 0.001). Suicide attempters were mostly married (55.6%, p < 0.002); highly educated (53.9%, p = 0.004); dissatisfied with their life and had a previous history (p < 0.5) of suicide attempt (SA) (20.6%), self-injurious behavior (SIB) (39.7%) and interrupted (IA) or aborted attempts (AA) (22.2%). A greater improvement was observed in patients receiving combination therapy (p = 0.001) than pharmacotherapy (p = 0.006) or psychotherapy (p = 0.183), alone. DRPs were also detected, including drug-selection problems (17.88%), dose-related problems (20.64%), potential drug–drug interactions (24.31%), adverse drug reactions (11.46%) and other problems like inadequate education and counseling (21.55%). Furthermore, it was also found that psychotic patients with suicidal ideations (SI) were significantly (p = 0.01) more adherent to the treatment as compared to those with suicidal attempts. We concluded that suicide attempters differed significantly from patients with suicidal ideations in psychotic patients and presented with peculiar characteristics regarding socio-demographic factors. A combination of therapies and adherence to the treatment provided better outcomes, and targeted interventions are warranted to address drug-related problems. [ABSTRACT FROM AUTHOR]

Background: The covert or indirect type of aggression has a risk of converting in violent acts and, considering that, it is very important to identify it in order to apply effective preventive measures. In cases of psychotic patients, the risk of becoming violent is harder to predict, as even neuter stimuli may be perceived as threat and trigger aggression. Treating all the psychiatric patients as potential aggressive subjects is not the best preventive measure as only a few of them are aggressive and this measure may further enhance the stigma on mentally ill patients. There is a current need for better understanding of covert aggression and to find objective measures, such as biological markers, that could be indicative of potential violent behavior. In this work, we try to investigate the role of cortisol and oxytocin as potential biomarkers of aggression in patients with psychosis. Material and Methods: We analyzed the level of peripheral oxytocin (pg/mL) and cortisol level (ng/mL) in 28 psychotic patients (they were not on psychotropic treatment at the moment of admission and those with substance abuse or personality disorder were excluded from the study) and correlated it with the intensity of aggression reported by the patient (overt and covert type) using the Overt Covert Aggression Inventory and the level of observed aggression of the patient in the past 7 days (rated by the health care provider) using the Modified Overt Aggression Scale. Results: We found that psychotic patients with a higher level of covert aggression had a lower level of cortisol (61.05 ± 8.04 ng/mL vs. 216.33 ± 12.6.9 ng/mL, p < 0.01) and a higher level of oxytocin (102.87 ± 39.26 vs. 70.01 ± 25.07, p = 0.01) when compared with patients with a lower level of covert aggression. Furthermore, we observed significant negative correlation between cortisol and covert aggression (r = -0.676, p < 0.001) and between oxytocin and covert type of aggression (r = 0.382, p = 0.04). Moreover, we found that a lower level of cortisol together with a higher level of oxytocin are significant predictors of a style of internalized manifestation of aggression, with the predictive model explaining 55% of the variant of the internalized manifestation of aggression (F (2.25) = 17.6, p < 0.001, β = 0.35, R2 = 55.2). We did not find significant correlations between cortisol and overt aggression, and neither between oxytocin and overt aggression. Positive correlations were also found between the overt type of self-reported aggression and overt aggression reported by the rater (r = 0.459, p = 0.01). Conclusions: The importance of a predictive model in understanding covert aggression is imperative and the results of our study show that oxytocin and cortisol warrant to be further investigated in establishing a definitive predictive model for covert aggression. [ABSTRACT FROM AUTHOR]

Suicide, a deliberate act of self-harm with the intention to die, is an emerging health concern but, unfortunately, the most under-researched subject in Pakistan, especially in Khyber Pukhtunkhwa (KPK). In this study, we aimed to identify risk factors that can be associated with suicidal behavior (SB) and to evaluate the prevailing treatment practices for therapeutic efficacy and drug-related problems (DRPs) in psychotic patients among the local population of KPK. A prospective, multicenter study was conducted for suicidal cases admitted to the study centers by randomized sampling. Socio-demographics and data on suicidal behavior were assessed using the Columbia-Suicide Severity Rating Scale (C-SSRS), socioeconomic condition by Kuppuswamy socioeconomic scale (KSES) and treatment adherence by Morisky Medication-Taking Adherence Scale (MMAS-4). Drug-related problems and the therapeutic efficacy of prevailing treatment practices were assessed at baseline and follow-up after 3 months of treatment provided. Regarding suicidality (N = 128), females reported more ideations (63.1%), while males witnessed more suicidal behavior (66.6%, p < 0.001). Suicide attempters were mostly married (55.6%, p < 0.002); highly educated (53.9%, p = 0.004); dissatisfied with their life and had a previous history (p < 0.5) of suicide attempt (SA) (20.6%), self-injurious behavior (SIB) (39.7%) and interrupted (IA) or aborted attempts (AA) (22.2%). A greater improvement was observed in patients receiving combination therapy (p = 0.001) than pharmacotherapy (p = 0.006) or psychotherapy (p = 0.183), alone. DRPs were also detected, including drug-selection problems (17.88%), dose-related problems (20.64%), potential drug–drug interactions (24.31%), adverse drug reactions (11.46%) and other problems like inadequate education and counseling (21.55%). Furthermore, it was also found that psychotic patients with suicidal ideations (SI) were significantly (p = 0.01) more adherent to the treatment as compared to those with suicidal attempts. We concluded that suicide attempters differed significantly from patients with suicidal ideations in psychotic patients and presented with peculiar characteristics regarding socio-demographic factors. A combination of therapies and adherence to the treatment provided better outcomes, and targeted interventions are warranted to address drug-related problems.

Background: The relapse in mental disorders is extremely painful and costly for the patient and his family as well as for the community. These frequent readmissions are strain on the health institutions and on the Ministry of Health Budget. Objectives: To find out the relationship between the social factors of relapse and sociodemographic data of psychotic patients attending teaching hospitals in AL-Furat Al-Awsat Governorates. Methodology: The design was (Descriptive-Correlational) used to describe the variables and the relationships that occur among them in this study. The sample was (a non-probability) purposive of (181) relapsed psychotic patients were selected from our patients centers from teaching hospitals in AL-Furat Al-Awsat Governorates, during the period from 9th May 2019 to 20th August 2019. The instrument included two parts: sociodemographic variables and the social factors associated with relapse. The researcher used descriptive statistics tools such as frequency, percentage, mean of score and used in inferential statistics such as Chi-Square. Results: The findings of the study indicate that (45.86%) of the sample their diagnosis was schizophrenia, (25.97%) were schizoaffective and (11.60%) were major depressive disorder with psychotic features. Also, the findings of the study indicate that (58.6%) of the study samples they have poor social factors, while (24.3%) they have moderate social factors and (17.1%) they have good social factors. Conclusion: There is a high significant relationship between the most sociodemographic data and social factor (that included family support and financial factors). [ABSTRACT FROM AUTHOR]

Background: Relapse demonstrates a large problem in general health; the relapse effects on the family and the client together social contact with other people and financially. Objectives: To find out the relationship between the Psychological factors of relapse and sociodemographic data of psychotic patients attending teaching hospitals in AL_Furat Al-Awsat Governorates. Methodology: The design was (Descriptive-Correlational) used to describe the variables and the relationships that occur among them in this study. The sample was (a non-probability) purposive of (181) relapsed psychotic patients were selected from our patients centers from teaching hospitals in AL_Furat Al-Awsat Governorates, during the period from 9th May 2019 to 20th August 2019. The instrument included two parts: sociodemographic variables and the psychological factors associated with relapse. The researcher used descriptive statistics tools such as frequency, percentage, mean of score and used in inferential statistics such as Chi-Square. Results: The findings of the study indicate that (45.86%) of the sample their diagnosis was schizophrenia, (25.97%) were schizoaffective and (11.60%) were major depressive disorder with psychotic features. Also, the findings of the study indicate that (39.2%) of the study samples they have poor psychological factors, (34.8%) they have moderate psychological factors and (26%) they have good psychological factors. Conclusion: There is a high significant relationship between the most sociodemographic data and psychological factor (that included high express emotion and stigma factors). [ABSTRACT FROM AUTHOR]

Objectives: To analyze the status of management of psychotic patients receiving community involuntary follow-up in Shanghai and to provide data support data inmental health policy making. Methods: The data were from "Shanghai Information System for Psychosis" up to 14, November of 2017. Descriptive analysis was used to analyze the rates of involuntary follow-up. Component ratio was used to describe the type of diseases, duration of untreated psychosis and course of disease. Results: Among the patients with involuntaiy follow-up, those who were young men(≤40 years old)with low education nevel, divorced, with residence management, with an acute onset and poor were more likely to be followed up by community involuntary follow-up. The proportion of patients with schizophrenia was the highest (69. 24% ,403/582), the proportion of patients with untreated period of more than 2 years was higher (40. 38%, 235/582), and the proportion of patients with course of more than 10 years was the highest (62. 89%, 366/582). The patients receiving the community involuntary follow-up had higher regular management rate (98. 99%, 393/397) and regular medication-taking rate (84. 63%, 336/397). Conclusions: The community involuntary follow-up system could effectively regulate the psychotic patients and monitor the disease conditions in Shanghai. It suggests that the community involuntary follow-up system should be further promoted in other regions. [ABSTRACT FROM AUTHOR]

Objective: To analyze the factors associated with violent behavior of psychotic patients receiving the community involuntary follow-up in Shanghai. Methods: Descriptive analysis was used to analyze the demographic characteristics, clinical history and violent behavior history of patients with severe mental disorders in Shanghai from 2015 to 2017. Logistic regression analysis was used to explore the factors to the violent behavior. Results: Thirty-five (10. 6%) patients committed at least one act of severe violence during the 12-month follow-up in 331 patients receiving the community involuntary follow-up. Logistic regression analysis showed that bipolar disorder (OR =2. 97, P<0. 05), noncompliant with medications (OR = 2. 56, P <0. 05), unstable condition (OR=20. 14, P <0.01), serious violence history (OR=3.47, P <0.05) were the risk factors to the violent behavior. Conclusions: It suggests that community involuntary follow-up should strengthen the assessment of patients'violence related risk factors, and based on predictive variables to carry out stratified management. [ABSTRACT FROM AUTHOR]

Background: The covert or indirect type of aggression has a risk of converting in violent acts and, considering that, it is very important to identify it in order to apply effective preventive measures. In cases of psychotic patients, the risk of becoming violent is harder to predict, as even neuter stimuli may be perceived as threat and trigger aggression. Treating all the psychiatric patients as potential aggressive subjects is not the best preventive measure as only a few of them are aggressive and this measure may further enhance the stigma on mentally ill patients. There is a current need for better understanding of covert aggression and to find objective measures, such as biological markers, that could be indicative of potential violent behavior. In this work, we try to investigate the role of cortisol and oxytocin as potential biomarkers of aggression in patients with psychosis. Material and Methods: We analyzed the level of peripheral oxytocin (pg/mL) and cortisol level (ng/mL) in 28 psychotic patients (they were not on psychotropic treatment at the moment of admission and those with substance abuse or personality disorder were excluded from the study) and correlated it with the intensity of aggression reported by the patient (overt and covert type) using the Overt Covert Aggression Inventory and the level of observed aggression of the patient in the past 7 days (rated by the health care provider) using the Modified Overt Aggression Scale. Results: We found that psychotic patients with a higher level of covert aggression had a lower level of cortisol (61.05 ± 8.04 ng/mL vs. 216.33 ± 12.6.9 ng/mL, p ˂ 0.01) and a higher level of oxytocin (102.87 ± 39.26 vs. 70.01 ± 25.07, p = 0.01) when compared with patients with a lower level of covert aggression. Furthermore, we observed significant negative correlation between cortisol and covert aggression (r = −0.676, p < 0.001) and between oxytocin and covert type of aggression (r = 0.382, p = 0.04). Moreover, we found that a lower level of cortisol together with a higher level of oxytocin are significant predictors of a style of internalized manifestation of aggression, with the predictive model explaining 55% of the variant of the internalized manifestation of aggression (F (2.25) = 17.6, p < 0.001, β = 0.35, R2 = 55.2). We did not find significant correlations between cortisol and overt aggression, and neither between oxytocin and overt aggression. Positive correlations were also found between the overt type of self-reported aggression and overt aggression reported by the rater (r = 0.459, p = 0.01). Conclusions: The importance of a predictive model in understanding covert aggression is imperative and the results of our study show that oxytocin and cortisol warrant to be further investigated in establishing a definitive predictive model for covert aggression.

Objectives: According to the previous findings, the third-person technique improved the clinical insight of psychotic patients, therefore the present study aims to examine the effect of a third-person interview compared to a first-person interview on the level of cognitive insight of psychotic patients with an insight at the denial level. Materials and Methods: In this study, using interviews and questionnaires, a total number of 44 patients of Razi Psychiatric Educational and Treatment Center with an insight at the denial level being assessed using diagnostic interviews were divided randomly into two groups. Then, the two groups of patients' cognitive insights were evaluated using Beck Cognitive Insight Scale. Results: The findings indicated that in psychotic patients with an insight at the denial level, the third-person technique of interview compared to the first-person had little effect on the improvement of overall cognitive insight and its components, including self-reflection and self-assurance; however, this effect was not strong enough to make a significant difference between the two groups of patients. Conclusion: According to the study findings, we can conclude that the third-person interview compared to the first-person interview has no effect on the improvement of the cognitive insight of psychotic patients with an insight at the denial level. This finding is consistent with the previous studies indicating that although the theory of mind has some correlations with the clinical insight of patients, it has no effect on their cognitive insight.

Mental rotation is an abstract operation whereby a person imagines rotating an object or a body part to place it in a different position. The ability to perform mental rotation was attributed to right hemisphere for objects, to the left for one’s own body images. Mental rotation seems to be basic for imitation in anatomical mode. Previous studies showed that control subjects, callosotomized and psychotic patients chose the mirror-mode when imitating without instructions; when asked to use the same or opposite limb as the model, controls chose the anatomical mode, callosotomized patients mainly used mirror mode, psychotic patients were in between. The preference of callosotomized subjects is likely due to defective mental rotation, because of the lack of the corpus callosum (CC), thus suggesting an asymmetry in the hemispheric competence for mental rotation. Present research investigated the mental rotation ability in control subjects, callosotomized and psychotic patients. All subjects were shown pictures of a model, in first or third person perspective, with a cup in her right or left hand. They had to indicate which model’s hand held the cup, by answering with a verbal or motor modality in separate experimental sessions. In both sessions, control subjects produced 99% of correct responses, callosotomy patients 62%, and psychotic patients 91%. The difference was statistically significant, suggesting a role of the CC in the integration of the two hemispheres’ asymmetric functions in mental rotation.

The aims of this study are to investigate the attitudes of co-patients accompanying mental health patients attending traditional healing centres regarding mental illness and interactions with patients. The researchers apply the open-ended interview to qualitatively collect data from 25 co-patients accompanying psychotic patients of whom 7 were males and 18 were females at Wad Alfadni Traditional Healing Center in Khartoum North. The researchers found out that variables including gender and economic status are not considered significant causal factors in mental illness. The study also showed that co-patients think that some of the factors that cause mental illness are explained in relations to cultural factors and in that context the traditional healers are relevant to enhance the health of those seeking medication. The researchers recommended that traditional healers need awareness raising to help them identify the correct medical procedures for the patients and to address those medical problems that have to be transferred to counselors or therapists, as well as to enhance the capacity of traditional religious healers to treat those patients who approach them for medication in the best possible ways. [ABSTRACT FROM AUTHOR]

The aim of this paper is to outline some considerations about the efficacy and applicability of Eye Movement Desensibilization and Reprocessing (EMDR) approach on psychotic patients. EMDR is receiving great attention from different scholars and across different approaches. Several meta-analyses have shown the effectiveness of EMDR therapy in treating Post-Traumatic Stress Disorder (see Jonas et al. 2013; Chen et al. 2014, 2015). According to contemporary scientific literature it is have been noticed that a diagnosis of psychotic disorder does not always represent an exclusion criterion for applying an EMDR intervention (van der Vleugen et al. 2015). A comorbidity exists between psychosis and Post-traumatic Stress Disorder (PTSD), and this could mean that a common landscape between these two dimensions may be explored (Kim and Lee 2016, Millan et al. 2017). PTSD patients that later develop psychotic symptoms have often a story of early abuse and they could probably benefit of an EMDR approach. The authors of the present paper evaluate the existing scientific literature about the use of EMDR for psychotic patients, showing how the available data seem to indicate it as part of a more complex intervention, able not only to reduce the impact of explicit symptoms, but also to make a change of a pervasive imagery and core negative believes that maintain a kind distortion in the inner and external world of the patient. Also if no real evidence is still available about the use of EMDR in psychosis, there are a few promising studies regarding its applicability for the post-traumatic aspects often existing in psychotic disorders (Hardy and van den Berg 2017). [ABSTRACT FROM AUTHOR]

Awareness about illness is defined in terms of a patient’s psychological attitude toward the psychiatric situation, and is to be evaluated from the standpoint of the person’s sick-role concept, by assessing the recognition of the need for treatment and acceptance of the treatment situation. Previous researches have suggested that lack of psychiatric patients’ awareness of their illness may have considerable power in predicting the long-term course of chronic mental disorders, and have an impact on patients compliance with treatment plans and relapses of psychosis. The aim of this study was to find out the psychotic patients’ awareness of their illness and its correlates. The results suggest that self-awareness deficits are a prevalent feature in mentally ill patients, perhaps stemming from the neuropsychological dysfunction associated with the disorders, and deficits in illness awareness are associated with greater number and longer duration of hospitalizations, and is considered one of the most important reasons for non-compliance.

Objectives: According to the previous findings, the third-person technique improved the clinical insight of psychotic patients, therefore the present study aims to examine the effect of a third-person interview compared to a first-person interview on the level of cognitive insight of psychotic patients with an insight at the denial level. Materials and Methods: In this study, using interviews and questionnaires, a total number of 44 patients of Razi Psychiatric Educational and Treatment Center with an insight at the denial level being assessed using diagnostic interviews were divided randomly into two groups. Then, the two groups of patients' cognitive insights were evaluated using Beck Cognitive Insight Scale. Results: The findings indicated that in psychotic patients with an insight at the denial level, the third-person technique of interview compared to the first-person had little effect on the improvement of overall cognitive insight and its components, including self-reflection and self-assurance; however, this effect was not strong enough to make a significant difference between the two groups of patients. Conclusion: According to the study findings, we can conclude that the third-person interview compared to the first-person interview has no effect on the improvement of the cognitive insight of psychotic patients with an insight at the denial level. This finding is consistent with the previous studies indicating that although the theory of mind has some correlations with the clinical insight of patients, it has no effect on their cognitive insight. [ABSTRACT FROM AUTHOR]

Some of the medications used for the management of schizophrenia are associated with clinically significant increases in weight and adverse alterations in serum lipid levels. The aim of the study was to investigate the effect of short-term (two months) treatment with atypical anti-psychotics on coronary heart disease risk factors, including the functional properties of high-density lipoprotein (HDL), in psychiatric patients. Nineteen patients diagnosed with schizophrenia, schizoaffective, and bipolar disorder and ten healthy volunteers were enrolled in the study. In the present study blood was drawn at baseline and after two months of atypical anti-psychotic treatment. Wilcoxon non-parametric-test was used to examine differences in the psychotic group before and two months after treatment.Waist circumference and oxidative stress in psychiatric patients were higher compared with the control group. Serum-mediated cholesterol efflux capacity was lower in psychotic patients compared to controls. Two months of anti-psychotic therapy was associated with increased abdominal obesity, decreased paraoxonase lactonase activity, but with no further change in serum-mediated cholesterol efflux from macrophages. Psychotic patients have low serum-mediated cholesterol efflux from macrophages as a parameter of HDL functionality. Atypical anti-psychotic treatment for two months increased metabolic derangements in these patients but without further decrement in serum-mediated cholesterol efflux. [ABSTRACT FROM AUTHOR]

This paper is part of my research into psychotic transference and is also related to the psychotic aspect of any adult or infantile patient in analysis. In my research, I studied the origin of the concept of transference in Charcot's time before Freud, and the transformation of this concept in psychoanalysis. Freud thought that psychotic patients were not able to establish a transference relationship, but some of his early papers show the opposite. In fact, Freud himself and then several other analysts were able to develop a personal experience regarding the possibility of contact and transferring feelings and delusional experiences in a therapeutic context – individual, group, or institution. I provide some clinical examples in this paper, as well as some theoretical, personal views regarding intrapersonal and interpersonal transference. Like Freud and Melanie Klein, I believe that transference starts with life, but that in psychoanalysis it has a particular meaning. [ABSTRACT FROM PUBLISHER]

The author sees H.S. Sullivan's (1892–1949) interpersonal theory as the best theoretical framework for the contemporary intersubjective perspective in psychoanalysis and presents the former in its pluridimensional articulation. After having extended Freud's therapeutic approach to psychotic patients, Sullivan developed both a developmental psychology and a psychoanalytic and psychotherapeutic technique based on the “interpersonal field” as the basic unit of study. To the pluridimensional character of his theory also belongs its application to the cultural and social aspects of our personal identity. Having the contemporary psychoanalytic authors who shaped the intersubjective perspective limited themselves to the clinical dimension, Sullivan's interpersonal theory can still provide the theoretical framework that any psychoanalytic perspective needs. [ABSTRACT FROM AUTHOR]

The author suggests that the function of the setting is particularly important in group psychotherapy for psychotic patients in the Public Mental Health Service. The setting of the group is important as it is in continuity with the concrete aspects that characterize the service. What is defined as 'coherence function' is the therapist's ability to transform inside the setting every concrete element that characterizes the service. According to this point of view, the birth of a group in the history of a Public Mental Health Service takes on meaning as a factor in the psychotherapeutic function of the institution. The group, like a fractal, contains within itself all the possible characteristics of the institution, but in a dynamic sense. Finally, the setting of the group extends beyond the therapy room and uses every other situations that take place outside also, thanks to the therapists ability to report them within the group. The decision to prescribe drugs and to hospitalize patients made by the group conductors become elements that characterize the setting of the group in a positive way which allows us to treat even severe psychotic patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate the psychometric properties of the 10 subscales of the Ward Atmosphere Scale (WAS) in a Russian psychiatric hospital. Methods: A total of 212 patients and 96 staff members at five wards for acute psychiatric patients completed the WAS. We calculated Cronbach's alpha, the Corrected Item Total Subscale Correlation (CITC), and item-revised subscale intercorrelations. Results: By removing a total of 32 items, the psychometric properties for all subscales except 'Autonomy', reached an acceptable level for the patient scores. Although several of the revised subscales were highly intercorrelated, the specificity of the items of the revised scales appeared acceptable. Conclusions: The revised WAS version appeared applicable within this Russian psychiatric hospital context. Several of the items that were dropped appeared inapplicable because of differences between Russian and Western culture and psychiatry. [ABSTRACT FROM AUTHOR]

The ideal of trust pervades nursing. This article uses empirical material from acute psychiatry that reveals that it is distrust rather than trust that is prevalent in this field. Our data analyses show how distrust is expressed in the therapeutic environment and in the relationship between nurse and patient. We point out how trust can nonetheless be created in an environment that is characterized by distrust. Both trust and distrust are exposed as 'fragile' phenomena that can easily 'tip over' towards their opposites. Trust is not something that nurses possess or are given; it is rather something that they earn and have to work hard to achieve. Regarding themselves as potential causes of distrust and active wielders of power can contribute to nurses developing a more realistic view of their practice. Assuming a realistic middle-way perspective can help to manoeuvre between the extremities of excellence and resignation, which in turn can lead to processes that create trust between psychotic patients and nurses. [ABSTRACT FROM AUTHOR]

In this article the authors document their experiences in small and median groups of supervision of conductors and therapeutic teams who are engaged in group psychotherapy with psychotic patients within different institutional frameworks, and discuss dynamics, as well as the enlarging of therapeutic possibilities of group psychotherapy of group-analytic orientation for application in these settings. They propose the possibility that at times the group itself can become the supervisor, i.e. that the supervision might be effectuated by the group, under guidance of an experienced conductor. [ABSTRACT FROM AUTHOR]

Psychodynamic therapy with psychotics has been reviewed and studied by different analysts such as Searles (1965), Rosenfeld (1988), and others. Nevertheless, there are almost no updated articles on supervision of this therapy. The article addresses this issue and the different aspects of supervision of psychodynamic therapy of psychotics. Therapy-related issues, such as holding, communications and interpretations, differentiation, boundaries, psychotic transference, and countertransference are discussed extensively. We also explore some of the difficulties involved in these processes and the implications for the supervision process. [ABSTRACT FROM AUTHOR]

This article focuses on the difficulty in empathizing with a psychotic patient, explaining that such a difficulty is determined by the distressing transformations which the state of the Self of this very particular type of patient undergoes. The concept of a narrative scenario is examined by illustrating that the scenarios produced by the group represent a particular sense of Self of these patients, with clinical examples taken from the group that the author documented during the course of regular supervision. [ABSTRACT FROM AUTHOR]

Nine psychotic patients under continuous oral treatment with haloperidol were randomly given a test dose of 1.5-5 mg haloperidol orally and/or intravenously. Serum levels of haloperidol were determined by high performance liquid chromatography and serum concentration data obtained were submitted to pharmacokinetic analysis. The steady state concentration ratio between blood and plasma was determined and found to be 0.79±0.03. The blood clearance was then calculated to be 550±133 ml/min. The mean hepatic extraction ratio was intermediate (0.37). Consequently, for a drug mainly eliminated by hepatic metabolism like haloperidol, the total blood clearance and the extent of oral bioavailability can be affected by changes in hepatic blood flow, hepatic enzyme activities and drug binding. During continuous oral treatment with haloperidol, however, it can be shown that changes in the total metabolic capacity of the liver due to hepatic enzyme induction or inhibition should be important for the therapeutic effects of haloperidol. The volume of distribution at steady state ( Vdss) was large (7.9±2.5 l/kg). The terminal half-life was 18.8 h after intravenous and 18.1 h after oral administration. The oral bioavailability (0.60±0.18) were in accordance with previous results in healthy subjects. A mean lag time after oral dose was 1.3±1.1 h and a longer absorption half-life (1.9±1.4 h) was found in the patients compared with healthy volunteers. [ABSTRACT FROM AUTHOR]

Mental rotation is an abstract operation whereby a person imagines rotating an object or a body part to place it in a different position. The ability to perform mental rotation was attributed to right hemisphere for objects, to the left for one's own body images. Mental rotation seems to be basic for imitation in anatomical mode. Previous studies showed that control subjects, callosotomized and psychotic patients chose the mirror-mode when imitating without instructions; when asked to use the same or opposite limb as the model, controls chose the anatomical mode, callosotomized patients mainly used mirror mode, psychotic patients were in between. The preference of callosotomized subjects is likely due to defective mental rotation, because of the lack of the corpus callosum (CC), thus suggesting an asymmetry in the hemispheric competence for mental rotation. Present research investigated the mental rotation ability in control subjects, callosotomized and psychotic patients. All subjects were shown pictures of a model, in first or third person perspective, with a cup in her right or left hand. They had to indicate which model's hand held the cup, by answering with a verbal or motor modality in separate experimental sessions. In both sessions, control subjects produced 99% of correct responses, callosotomy patients 62%, and psychotic patients 91%. The difference was statistically significant, suggesting a role of the CC in the integration of the two hemispheres' asymmetric functions in mental rotation. [ABSTRACT FROM AUTHOR]

Aim: To assess presence and severity of associative stigma in family members of psychotic patients and factors for higher associative stigma., Methods: Standardized semi-structured interview of 150 family members of psychotic patients receiving full time treatment. This study on associative stigma in family members of psychotic patients was part of a larger research program on the burden of the family, using "Interview for the Burden of the Family" and the chapters stigma, treatment and attribution from the "Family interview Schedule". The respondents were relatives, one per patient, either partner or parent. The patients had been diagnosed with schizophrenia or schizo-affective disorder. All contacts with patients and relatives were in Dutch. Relatives were deemed suitable to participate in this research if they saw the patient at least once a week. Recruitment took place in a standardized way: after obtaining the patient's consent, the relatives were approached to participate. The results were analyzed using SPSS Version 18.0., Results: The prevalence of associative stigma in this sample is 86%. Feelings of depression in the majority of family members are prominent. Twenty-one point three percent experienced guilt more or less frequent, while shame was less pronounced. Also, 18.6% of all respondents indicated that they tried to hide the illness of their family member for others regularly or more. Three six point seven percent really kept secret about it in certain circumstances and 29.3% made efforts to explain what the situation or psychiatric condition of their family member really is like. Factors with marked significance towards higher associative stigma are a worsened relationship between the patient and the family member, conduct problems to family members, the patients' residence in a residential care setting, and hereditary attributional factors like genetic hereditability and character. The level of associative stigma has significantly been predicted by the burden of aggressive disruptions to family housemates of the psychotic patient., Conclusion: Family members of psychotic patients in Flanders experience higher associative stigma compared to previous international research. Disruptive behavior by the patient towards in-housing family members is the most accurate predictor of higher associative stigma.