A Preliminary Test of the Interpersonal Psychological Theory of Suicidal Behavior in Young People With a First Episode of Psychosis.

OBJECTIVES: The interpersonal-psychological theory (IPT) of suicidal behavior suggests that an individual who does not feel they belong and believes they are a burden combined with the capability to attempt suicide is more likely to attempt suicide. The study aimed to investigate this hypothesis in the context of psychosis. METHOD: Young people with a first episode of psychosis (N = 45) who considered suicide, attempted suicide, and had no history of suicide or attempt were compared on self-report measures of suicidal desire, capability for suicide, and substance use. RESULTS: No significant differences were found between groups in terms of suicidal desire or capability. All participants perceived they were a burden, did not feel they belonged, and had the capability for suicide. Poisoning (n = 22) was the most frequently reported method of a suicide attempt. Of those who had attempted suicide, 50% (n = 7) reported that it had been related to a psychotic episode. Of the participants, 30 reported previous suicidal ideation mainly to completely end or stop the distress they were experiencing. Levels of depression were significantly different between groups; moderate levels of depression were reported in the suicidal ideation and attempt groups. CONCLUSION: The concepts of IPT appear to resonate with the experience of psychosis, regardless of suicidality. Specific features of psychosis and their influence on suicidality are worth further exploration.

The Meriden Family Programme: lessons learned over 10 years.

BACKGROUND: Psychoeducational family approaches are effective in improving the quality of life for both those with mental health problems and their families, but implementation of these approaches within health services has been limited. The Meriden Family Programme has provided training and support for over 3,900 therapists and 242 trainers in Behavioural Family Therapy (BFT) to encourage widespread delivery of effective services for families with a member who has psychosis or other serious mental health problems. AIMS: This article synthesises healthcare professionals' and carers' views on the implementation of family work and ways of increasing family involvement in services. METHODS: During the Meriden Programme's 10th anniversary year, three Masterclass groups (n = 27) were conducted with healthcare professionals and carers involved with the programme over the past 10 years. RESULTS: A collaborative approach between management, commissioners, BFT trainers, therapists, carers and service users encourages and ensures the delivery of family work. The most effective types of support, methods of training and organisational factors in supporting family work implementation are illustrated. CONCLUSIONS: Best practices in implementing family work are identified to support and better inform those responsible for providing family work within their services.

Alzheimer's disease treatment: assessing caregiver preferences for mode of treatment delivery.

INTRODUCTION: Management of patients with Alzheimer's Disease (AD) can exert a substantial burden upon caregivers. As new modes of treatment administration are developed, it is important to assess caregiver satisfaction and preference in a standardized manner. This study describes the development of the Alzheimer's Disease Caregiver Preference Questionnaire (ADCPQ) to assess AD caregivers' satisfaction with and preference for patch or capsule treatments in AD patients. METHODS: Twenty-five published articles (1987-2002) were reviewed to identify potential ADCPQ domains. Three caregiver focus groups (n=24) were conducted to develop a first draft of the questionnaire. After evaluating the acceptance of ADCPQ to caregivers through in-depth interviews (n=10), its psychometric properties were assessed using data from 986 patients enrolled in a multicenter, randomized, double-blind, four-arm, placebo- and active-controlled, 24-week trial. RESULTS: Focus groups indicated that caregivers expressed dissatisfaction with current AD treatment routines including limitations related to: efficacy, administration schedule, number of pills, adherence to treatment, side effects, and taking pills. In-depth interviews with caregivers found the ADCPQ to be comprehensible with an acceptable layout. The resultant ADCPQ comprises three modules: A) baseline, 11 items assessing treatment expectations; B) week 8, 33 items on satisfaction and preferences with treatment options; C) week 24, 10 items assessing overall opinions of treatment options. Missing data per item was low (

The impact of spina bifida on caregivers.

INTRODUCTION: Neural tube defects (NTDs) are the second most common birth defects. Spina bifida (SB) and anencephaly make up approximately 90% of total NTDs. Given the number of infants born with an NTD each year, anyone who provides unpaid care for the child (especially caregivers) is affected. This literature review explores the humanistic burden on caregivers of people with SB, specifically myelomeningocele. METHODS: A search using PubMed, PsycINFO, and Embase was performed to find studies from 1976 to 2010. Interpretative phenomenological analysis was performed on qualitative data and relevant extracts from the data were collated to form master themes. RESULTS: A total of 168 abstracts met the inclusion and exclusion criteria. Of these, 25 articles related to caregivers of individuals with SB. Four master themes emerged: initial diagnosis, living with an individual with SB, social support, and coping. Different aspects of caregivers' lives were found to be affected by caring for a child with SB, including activities of daily living, work impact, time consumption, parental responsibilities, confidence, feelings and emotions, mental health, stress, social impact, psychological adjustment, and relationships. CONCLUSION: NTDs, such as SB, present a multitude of issues to caregivers. Issues that affect caregivers of individuals with SB must be addressed in order to reduce the considerable burden that SB places on the caregiver. Continued and enhanced support from health services and patient advocacy groups is needed. For example, providing additional information, support, and empathy can help parents prepare themselves for dealing with the needs of a child with SB over their lifetime.

Results of a thematic analysis to explore the experiences of patients with schizophrenia taking antipsychotic medication.

BACKGROUND: Approximately 50% of patients with schizophrenia do not adhere to their antipsychotic medication regimens, partly because of their concerns about medication. OBJECTIVE: The aim of this study was to investigate the experiences of patients with schizophrenia during treatment with antipsychotic medication. METHODS: As part of the SWAM (Satisfaction With Antipsychotic Medication) Scale (registered to Diana Rofail, Cheshire, United Kingdom) validation study, a convenience sample of patients with schizophrenia responded to an open-ended question regarding their treatment experiences with antipsychotic medication. Thematic analysis was performed. Each item was studied repeatedly, and relevant extracts from the data set were collated to form themes. Themes were then checked against each other and against the original data set to ensure that they were coherent, consistent, and distinctive. The process was predominantly inductive and data driven. RESULTS: A convenience sample of 80 participants (35 women and 45 men), aged 35 to 44 years, reported their treatment experiences with antipsychotic medication. Nine themes were identified: (1) symptoms of illness; (2) importance and helpfulness of medication; (3) adverse events and negative impact; (4) desire to stop medication; (5) knowledge and insight into the need for medication and its potential adverse effects; (6) feelings of being used as experimental subjects; (7) environment; (8) reservations about health care professionals; and (9) support from others. CONCLUSION: These patients with schizophrenia reported a range of experiences during their treatment with antipsychotic medication.