Treatment of schizophrenia has as its ultimate goals, the functional recovery of the patients and improvement of their quality of life. While antipsychotic medication is the fundamental method for treating schizophrenia, it has certain limitations in terms of treating the illness beyond its positive symptoms. Therefore, psychosocial intervention should be used in tandem with pharmacological methods in treating schizophrenia. The efficacy of several modes of psychosocial intervention for improving outcomes in schizophrenia is well attested. Approximately 10 modes of psychosocial intervention have been recommended based on existing evidence, including family intervention, cognitive behavioral therapy, supported employment, early intervention services, lifestyle intervention for physical health enhancement, treatment of comorbid substance abuse, assertive community treatment, cognitive remediation, social skills training, and peer support. Ideally, these interventions are offered to patients in combination with one another. Over the last decade, increased emphasis has been placed on early detection and intervention, with particular focus on long-term recovery. Early intervention with comprehensive psychosocial interventions should be enacted promptly from the initial detection of schizophrenia.
Cognitive Therapy ; Community Mental Health Services ; Early Intervention (Education) ; Employment, Supported ; Humans ; Life Style ; Methods ; Quality of Life ; Rehabilitation ; Schizophrenia* ; Social Skills ; Substance-Related Disorders

BACKGROUND: Various occupational inpatient rehabilitation programs are established in Norway. This study aimed to assess change in cardiorespiratory fitness, pain, anxiety, depression, and quality of life in persons on long-term sick leave due to musculoskeletal-, mental or unspecific disorders after participation in multicomponent inpatient occupational rehabilitation. METHODS: Twenty-five women and five men (mean age 45.2 years, SD 6.7, range 30–57) volunteered to participate in the study. The participants attended either 8 or 17 full days of occupational multicomponent rehabilitation including physical exercise, cognitive behavioral therapy in the form of acceptance and commitment therapy (ACT), and development of a tailored plan for return to work. Cardiorespiratory fitness was assessed by the Åstrand/Ryhming cycle test at the start and end of rehabilitation program, and at one-year follow-up. Changes in somatic and mental health were measured by questionnaires up to 4 months after start of the program. RESULTS: Linear mixed models showed that the maximal oxygen uptake increased by 1.1 mL°kg-1°min− 1 during the rehabilitation program and by 3.7 mL°kg-1°min− 1 at one-year follow-up. There were minor improvements in somatic and mental health, and quality of life. CONCLUSIONS: This study indicates that occupational inpatient multicomponent rehabilitation including physical exercise and ACT may promote a long-term increase in physical exercise that is sufficient to induce a significant increase in cardiorespiratory fitness. TRIAL REGISTRATION: The current study is not registered, but is part of a larger trial registered at clinicaltrials.gov (No.: NCT01926574, registered 21. Aug 2013).
Acceptance and Commitment Therapy ; Anxiety ; Cognitive Therapy ; Depression ; Exercise ; Female ; Follow-Up Studies ; Humans ; Inpatients ; Male ; Mental Disorders ; Mental Health ; Musculoskeletal Diseases ; Norway ; Oxygen ; Quality of Life ; Rehabilitation ; Return to Work ; Sick Leave

Traditionally, clinicians and healthcare users alike use the term "recovery" to imply a return to a premorbid state. This form of clinical recovery is objective, measureable and is a clear health outcome. In the past decade, an alternative to clinical recovery, also known as personal recovery, has gained traction in mental health and has impacted numerous mental health systems. Originally, personal recovery was conceptualised as an individually unique ongoing process for individuals with serious mental illness that emphasises on growth and potential for recovery, but it has also been proposed to be a clinical outcome for mental health professionals. In this commentary, we discuss the differences in the 2 models of recovery and attempt to illustrate the concepts behind personal recovery so as to clarify its usage in people with serious mental illnesses.
Humans ; Mental Disorders ; rehabilitation ; Recovery of Function ; Resilience, Psychological

OBJECTIVES: There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. METHODS: We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. RESULTS: Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was ‘worries about being excluded from beneficiary of National Basic livelihood Protection Act’. CONCLUSIONS: Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.
Budgets ; Deinstitutionalization ; Electronic Mail ; Financial Support ; Government Programs ; Humans ; Korea ; Mental Disorders ; Mental Health ; Occupations ; Psychiatric Rehabilitation ; Public Health ; Rehabilitation ; Rehabilitation, Vocational ; Schizophrenia ; Telephone

PURPOSE: This study was done to develop an empowerment program for people with chronic mental illness and to analyze effects of the program on level of empowerment. METHODS: The research was conducted using a nonequivalent control group pretest-posttest design. Participants were 37 people with chronic mental illness (experimental group: 18, control group: 19). The empowerment program was provided for 8 weeks (15 sessions). Data were collected between July 21 and October 17, 2014. Data were analyzed using Chi-square, Fisher's exact test, Sapiro-wilk test, and Repeated measure ANOVA with SPSS/WIN 18.0. RESULTS: Quantitative results show that self-efficacy, interpersonal relationships, attitudes in the workplace, occupational performance capacity, and levels of empowered execute were significantly better in the experimental group compared to the control group. CONCLUSION: Study findings indicate that this empowerment program for persons with chronic mental illness is effective for improving self efficacy, interpersonal skills, attitudes in the workplace, occupational performance capacity, levels of empowered execute.
Adult ; Chronic Disease ; Female ; Humans ; Interpersonal Relations ; Male ; Mental Disorders/*psychology/rehabilitation ; Middle Aged ; *Power (Psychology) ; *Program Development ; *Program Evaluation ; Self Efficacy ; Surveys and Questionnaires ; Task Performance and Analysis ; Workplace

In patients with a language developmental delay, it is necessary to make a differential diagnosis for autism spectrum disorders (ASDs), specific language impairment, and mental retardation. It is important that pediatricians recognize the signs and symptoms of ASDs, as many patients with language developmental delays are ultimately diagnosed with ASDs. Pediatricians play an important role in the early recognition of ASDs, because they are usually the first point of contact for children with ASDs. A revision of the diagnostic criteria of ASDs was proposed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) that was released in May 2013. The autism spectrum describes a range of conditions classified as neurodevelopmental disorders in the fifth edition of the DSM. The new diagnostic criteria encompasses previous elements from the diagnosis of autistic disorder, Asperger disorder, childhood disintegrative disorder, and pervasive developmental disorder-not otherwise specified. An additional change to the DSM includes synthesizing the section on social and communication deficits into one domain. In ASD patients, the appropriate behavioral therapies and rehabilitation treatments significantly affect the prognosis. Therefore, this makes early diagnosis and treatment very important. In conclusion, pediatricians need to be able to recognize the signs and symptoms of ASDs and be attentive to them in order to make an early diagnosis and provide treatment.
Asperger Syndrome ; Autistic Disorder ; Child ; Autism Spectrum Disorder* ; Developmental Disabilities ; Diagnosis ; Diagnosis, Differential ; Diagnostic and Statistical Manual of Mental Disorders ; Early Diagnosis ; Genetics ; Humans ; Intellectual Disability ; Language Development ; Prognosis ; Rehabilitation

PURPOSE: This study was conducted in order to investigate changes in the physical, psychosocial and spiritual health of people with mental disorder in community participating in the Integrated Health Care Program (IHCP). METHODS: This study applied the non-equivalent control group pretest-posttest quasi-experimental design. The participants were 37 chronic psychiatric patients who had been clinically diagnosed with mental disorder and visiting a mental rehabilitation center located in S City (17 in the experimental group, and 20 in the control group). The experimental group participated in the IHCP consisting of 24 sessions for eight weeks. RESULTS: After the intervention, only the participants in the experimental group reported significant improvement in physical (body mass, triglyceride), psychosocial (mental symptoms, depression, self-esteem, ability of problem solving), and spiritual wellbeing when compared with those in the control group. CONCLUSION: These results indicate that IHCP is effective in improving the physical, psychosocial, and spiritual wellbeing of people with mental disorder. Therefore, IHCP developed in this study is considered a useful nursing intervention for raising the comprehensive health level of people with mental disorder in community.
Complementary Therapies ; Delivery of Health Care* ; Depression ; Health Status ; Humans ; Mental Disorders* ; Mind-Body Therapies ; Nursing ; Psychiatric Nursing ; Rehabilitation Centers ; Sensory Art Therapies

Therapeutic social environments contribute to the successful treatment and rehabilitation for patients with schizophrenia. However, social stigmata of psychiatric disorder in our society have kept away schizophrenic patients from their recovery and adaptation. Many persons have thought that psychiatric patients are more violent and criminal because of overwhelming prejudice on untreated or mistreated patients with schizophrenia. The purpose of this review is to propose the new and updated fundamentals of our knowledge on the relationship between schizophrenia and violence. In 1980s, many researchers have a belief that rates of criminal behavior vary independently on the rates of mental disorders. The following scientific studies on various population and meta-analyses of relevant data, overall violence rate have been higher in patients with schizophrenia and other psychotic disorders than in healthy controls. Even though schizophrenia and other psychotic disorders are associated with increased risk of homicide, the association has been not attributed to the psychopathology limited to schizophrenia. Most of all, co-occurrence of substance abuse has played an important role in increasing the possibility of violent behavior. The severe violent offending has been inclined to occur during the early period of psychotic episode before beginning the psychiatric treatment. Thus, most of the violent offending of schizophrenia patient can be prevented by prompt therapeutic interventions and treatments.
Christianity ; Criminals ; Homicide ; Humans ; Mental Disorders ; Prejudice ; Psychopathology ; Psychotic Disorders ; Rehabilitation ; Schizophrenia* ; Social Environment ; Social Stigma ; Substance-Related Disorders ; Violence*

Employment ; Employment, Supported ; methods ; Humans ; Mental Disorders ; epidemiology ; rehabilitation ; Prejudice ; Rehabilitation, Vocational ; methods ; Return to Work ; Singapore ; epidemiology ; Social Stigma ; Unemployment ; statistics & numerical data

Improving mental health and reducing the burden of mental illness are complementary strategies which, along with the treatment and rehabilitation of people with mental disorders, significantly improve population health and well-being. A Institute of Medicine report describes a range of interventions for mental disorders that included treatment and maintenance, reserving the term "prevention" for efforts that occur before onset of a diagnosable disorder. Mental health problems affect 10-20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability and their long lasting consequences, the mental health needs of children and adolescents are neglected. Early intervention can help reduce the significant impacts that children and adolescents with serious mental health problems may experience. Screening is the first step in early intervention, recognizing emotional and behavioral problems and providing help at an early stage. It is essential to implement early intervention in a sensitive and ethical manner to avoid any of the negative outcomes.
Adolescent* ; Child* ; Early Intervention (Education) ; Humans ; Institute of Medicine (U.S.) ; Mass Screening ; Mental Disorders ; Mental Health* ; Primary Prevention ; Rehabilitation ; Resin Cements