The detection of psychiatric illness by questionnaire

https://usir.salford.ac.uk/9497/1/Tzoulas_et_al_2007.pdf

Promoting ecosystem and human health in urban areas using Green Infrastructure: A literature review

Background Expressed emotion (EE) is a measure of the family environment that has been demonstrated to be a reliable psychosocial predictor of relapse in schizophrenia. However, in recent years some prominent nonreplications of the EE-relapse relationship have been published. To more fully address the question of the predictive validity of EE, we conducted a meta-analysis of all available EE and outcome studies in schizophrenia. We also examined the predictive validity of the EE construct for mood disorders and eating disorders. Methods An extensive literature search revealed 27 studies of the EE-outcome relationship in schizophrenia. Using meta-analytic procedures, we combined the findings of these investigations to provide an estimate of the effect size associated with the EE-relapse relationship. We also used meta-analysis to provide estimates of the effect sizes associated with EE for mood and eating disorders. Results The results confirmed that EE is a significant and robust predictor of relapse in schizophrenia. Additional analyses demonstrated that the EE-relapse relationship was strongest for patients with more chronic schizophrenic illness. Interestingly, although the EE construct is most closely associated with research in schizophrenia, the mean effect sizes for EE for both mood disorders and eating disorders were significantly higher than the mean effect size for schizophrenia. Conclusion These findings highlight the importance of EE in the understanding and prevention of relapse in a broad range of psychopathological conditions.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/203937/yoa6360.pdf

Expressed Emotion and Psychiatric Relapse: A Meta-analysis

The development of new CRISPR-Cas genome editing tools continues to drive major advances in the life sciences. Four classes of CRISPR-Cas-derived genome editing agents-nucleases, base editors, transposases/recombinases and prime editors-are currently available for modifying genomes in experimental systems. Some of these agents have also moved rapidly into the clinic. Each tool comes with its own capabilities and limitations, and major efforts have broadened their editing capabilities, expanded their targeting scope and improved editing specificity. We analyze key considerations when choosing genome editing agents and identify opportunities for future improvements and applications in basic research and therapeutics.

Genome editing with CRISPR–Cas nucleases, base editors, transposases and prime editors

Background Depressive and anxiety disorders are prevalent and cause substantial morbidity. While effective treatments exist, little is known about the quality of care for these disorders nationally. We estimated the rate of appropriate treatment among the US population with these disorders, and the effect of insurance, provider type, and individual characteristics on receipt of appropriate care. Methods Data are from a cross-sectional telephone survey conducted during 1997 and 1998 with a national sample. Respondents consisted of 1636 adults with a probable 12-month depressive or anxiety disorder as determined by brief diagnostic interview. Appropriate treatment was defined as present if the respondent had used medication or counseling that was consistent with treatment guidelines. Results During a 1-year period, 83% of adults with a probable depressive or anxiety disorder saw a health care provider (95% confidence interval [CI], 81%-85%) and 30% received some appropriate treatment (95% CI, 28%-33%). Most visited primary care providers only. Appropriate care was received by 19% in this group (95% CI, 16%-23%) and by 90% of individuals visiting mental health specialists (95% CI, 85%-94%). Appropriate treatment was less likely for men and those who were black, less educated, or younger than 30 or older than 59 years (range, 19-97 years). Insurance and income had no effect on receipt of appropriate care. Conclusions It is possible to evaluate mental health care quality on a national basis. Most adults with a probable depressive or anxiety disorder do not receive appropriate care for their disorder. While this holds across diverse groups, appropriate care is less common in certain demographic subgroups.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/481702/yoa20071.pdf

The Quality of Care for Depressive and Anxiety Disorders in the United States

Schizophrenic patients were recruited into a trial of a prophylactic behavioural intervention with families. Families with at least one high Expressed Emotion (EE) relative were randomly allocated to one of four intervention groups: Behavioural Intervention Enactive; Behavioural Intervention Symbolic; Education Only; Routine Treatment. Patients from low-EE families were randomly allocated to two groups: Education Only or Routine Treatment. Relapse rates over nine months after discharge were significantly lower for patients in the two Behavioural Intervention, compared with Education Only and Routine Treatment groups. There was little difference between the two low-EE groups. Patients returning to high-EE relatives showed significantly higher relapse rates than those returning to low-EE relatives, in groups not receiving active intervention. Changes from high to low EE occurred in the Behavioural Intervention groups, and similar although less extensive changes occurred in the Education Only and Routine Treatment groups. Changes in criticism and marked emotional over-involvement (EOI) occurred generally in high-EE groups but were larger in magnitude in the Enactive and Symbolic groups. Reduction of hostility only occurred in the Behavioural Intervention groups. These results give partial support for the causal role of EE in relapse. There were no significant differences between the groups with respect to contact with the psychiatric services or medication.

The community management of schizophrenia. A controlled trial of a behavioural intervention with families to reduce relapse.

The relapse and readmission rates of schizophrenic patients who participated in a controlled trial of a nine-month behavioural family intervention trial based on the EE status of their relatives are presented at two years. The patients who received the behavioural family intervention had lower rates of relapse and readmission than patients from high-EE homes who had received a short educational programme or routine treatment. The relapse rate of the behavioural family intervention group (33%) was the same as that of the low-EE group (33%), and significantly lower than that of the non-intervention high-EE group (59%).

Community management of schizophrenia. A two-year follow-up of a behavioural intervention with families

An instrument for assessing and evaluating what relatives know about schizophrenia was evaluated as both a pre- and a post-test for an educational programme. The Knowledge About Schizophrenia Interview (KASI) places emphasis on the functional value of the reported knowledge rather than on the recall of information; it is quick, easy to administer, can be rated reliably, and has face-validity for the relative. The educational programme increased scores from pre-test to a post-test one week after the programme. Relatives with high criticism ratings on the Camberwell Family Interview had lower scores at both tests. Relatives of less chronic patients showed lower scores at pre-test and acquired significantly more information from the programme, while relatives of more chronic patients were less influenced by the information sessions.

Assessing the functional value of relatives' knowledge about schizophrenia: a preliminary report.

Introduction Like Moliere's Monsieur Jourdain, who discovered to his delight that what he had been speaking for so many years was actually prose, we have become aware fairly recently that our familiar surroundings are â€ ̃¿ the environment'. This is not without significance; anthropology has shown that the attribution of a name can itself result in objective changes to real pheno.. mena. Attaching a label is thus the beginning of a process of identification and analysis, with a view to possible intervention. Such a process is most overdue in relation to the psychopatho logical effects of the environment on individuals, but the whole subject, which one might well regard as crucial to the sciences of the mind, has been so neglected that it lacks not only scientific data but even properly defined concepts. This is surprising, since European psychiatry at least acknowledges for most disorders a multifactorial origin which must surely include aspects of the environment; in the present state of knowledge, though, these aspects can be no more than roughly assessed. Correspondingly, few recom mendations with any true professional validity can yet be made by psychiatrists for environ mental action to promote mental health. The core of specific data is therefore small, but there is a vast borderland of information in related areas which needs examining before a psychiatry of the environment can properly begin. Little more can be done here than to sample the more important contributions; the present author has reviewed some aspects of the subject previously (Freeman, 1972, 1975), and there is an annotated bibliography by Esser and Deutsch (i@7@). Craik (ig73) states that the man-environment discipline has two con

Mental health and the environment.

Summary A sample of 190 patients, diagnosed as schizophrenic by the same psychiatrist, have been surveyed in an urban community and their clinical and social status assessed. Compared to the local population as a whole, a significantly greater proportion of the men had never married, and although the women had married at approximately the same rate as those in the general population, 25 per cent of them had been divorced by the time of the interview. Assessments of the subjects' clinical condition by the Present State Examination were analysed into four groups of syndromes. Only 27 patients showed schizophrenic or paranoid symptoms, whereas neurotic symptoms were not only prevalent but seemed to cause most of the reported personal problems. Twenty-eight patients were free of symptoms at the time of interview. The great majority of the sample (72 per cent) were being maintained on long-acting neuroleptics. These data will form the baseline to assess a monitoring system, designed to keep the local psychiatric services in touch with schizophrenic patients who might otherwise drop out of treatment.

Hugh Freeman

Papers

The community management of schizophrenia. A controlled trial of a behavioural intervention with families to reduce relapse.

Community management of schizophrenia. A two-year follow-up of a behavioural intervention with families

Assessing the functional value of relatives' knowledge about schizophrenia: a preliminary report.

Mental health and the environment.

Chronic Schizophrenic Patients in the Community