The impact of emotional faces on social motivation in schizophrenia.

Impairments in emotion recognition and psychosocial functioning are a robust phenomenon in schizophrenia and may affect motivational behavior, particularly during socio-emotional interactions. To characterize potential deficits and their interplay, we assessed social motivation covering various facets, such as implicit and explicit approach-avoidance tendencies to facial expressions, in 27 patients with schizophrenia (SZP) and 27 matched healthy controls (HC). Moreover, emotion recognition abilities as well as self-reported behavioral activation and inhibition were evaluated. Compared to HC, SZP exhibited less pronounced approach-avoidance ratings to happy and angry expressions along with prolonged reactions during automatic approach-avoidance. Although deficits in emotion recognition were replicated, these were not associated with alterations in social motivation. Together with additional connections between psychopathology and several approach-avoidance processes, these results identify motivational impairments in SZP and suggest a complex relationship between different aspects of social motivation. In the context of specialized interventions aimed at improving social cognitive abilities in SZP, the link between such dynamic measures, motivational profiles and functional outcomes warrants further investigations, which can provide important leverage points for treatment. Crucially, our findings present first insights into the assessment and identification of target features of social motivation.

[End of a psychiatric era? : Impact on the use of mechanical restraints after prohibition of psychiatric cage beds in a regional psychiatric department in Vienna, Austria]. / Ende einer Ära? : Auswirkungen des Verzichts auf den Einsatz psychiatrischer Intensivbetten in einer psychiatrischen Regionalabteilung Wiens ­ Erste Ergebnisse.

BACKGROUND: Since June 1st, 2014 the use of cage beds, a physical coercive measure in psychiatric wards, is forbidden by Austrian law. The 3rd Psychiatric Department at the Otto Wagner Hospital in Vienna carried out a pilot-study prior to the application of this law and compared 6 months with and 6 months without the use of cage beds in psychiatric acute treatment. The investigation focused on the use of mechanical restraints, especially of 4-point-restraints at admission time. METHODS: The study collected clinical and epidemiological data from the patients and analyzed interviews taken with patients and staff-members after the use of coercive measures. RESULTS: The prohibition of cage beds was associated with a relative increase of the use of 4-point-restraints. Time spent in 4-point-restraints is less than time spent in the cage beds. A trend could also be observed by a decrease of time spent in 4-point-restraints. Data from the interviews showed that there was no preference by patients of either kind of physical restraint. They strongly urged for more personal talks and non-physical and non-pharmacological therapies during admission. CONCLUSIONS: Team members required more human resources for the treatment of these acute psychiatric patients.