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AbstractDespite extensive research, interdependent problems such as severe mental illness and homelessness cause extreme disparities and health inequity. Handling complexity in careseeker–caregiver networks remains challenging. The local public health services in a Dutch city were enriched with a specialized team. An ethnographic policy evaluation was conducted to identify the essentials of an effective approach. We use the narrative of a homeless man who experiences psychoses for an in-depth analysis of the team's functionality. The narrative data shows the challenges of caregiver networks and underlines the need to integrate care. It demonstrates how normal behavior, personal skills, and a socio-ecological system strategy merge into collaborative networks with the ability to diversify care and keep focus on recovery. This paper demonstrates the failure of the linear handicap model and the costs of overspecialized care systems. Building on socio-ecological recovery literature, it provides insight how care networks successfully can foster recovery.

Intro -- GOEDE GGZ! NIEUWE CONCEPTEN, AANGEPASTE TAAL EN BETERE ORGANISATIE -- INHOUD -- TEN GELEIDE -- I ANDERE INSTEEK, NIEUWE ROLVERDELING,HERONTWERP, ALTERNATIEVE BEKOSTIGING -- 1 WAT IS DAT EIGENLIJK, GOEDE GGZ? -- 2 WAT IS PSYCHISCHE GEZONDHEID? -- 2.1 Het platonische gezondheidsideaal -- 2.2 Overbehandeling en overspannen gezondheidsideaal -- 2.3 Een nieuw model: positieve gezondheid -- 3 WAT ZIJN PSYCHISCHE KLACHTEN(NIET)? -- 3.1 De vijftien basisprincipes -- 3.2 Is positieve gezondheid 'antipsychiatrie'? -- 3.3 Psychische klachten als neuro-algoritmen -- 3.4 Voorbeelden van reductionistische verwarring -- 3.5 Ultra-high risk: toekomstbeeld of luchtkasteel? -- 4 DE MODERNE CONTEXT VAN PSYCHISCHE KLACHTEN -- 4.1 Sick care versus health care -- 4.2 De marktwerking -- 4.3 Regelzucht en gevolgen voor de patiënt -- 4.4 Multideskundige eCommunity's als antwoord op vastgelopenhyperbureaucratie -- 5 PSYCHISCHE KLACHTEN ZIJN MEERDEREDINGEN TEGELIJK -- 5.1 Een pluralistische benadering -- 5.2 Klacht of spirituele ervaring? -- 5.3 Context -- 5.4 Syndromen -- 5.5 Functies -- 6 WAT BETEKENT 'HULP NODIG HEBBEN' VOOR PSYCHISCHE KLACHTEN? -- 6.1 Psychische klachten als signaal voor verandering -- 6.2 Psychische klachten als uiting van kwetsbaarheid enzorgbehoefte -- 6.3 Psychische klachten als begin van een proces -- 7 WAT IS EVIDENCE-BASED BEHANDELEN VAN PSYCHISCHE KLACHTEN? -- 7.1 Richtlijnen in de ggz -- 7.2 Het placebo-effect als eigen kracht -- 7.3 Het placebo-effect als stoorzender in de moderne'breintherapie' -- 7.4 Alternatief: maak het ritueel in de ggz weer helend -- 8 VAN ZORGPADEN EN RICHTLIJNENNAAR KLINISCH REDENEREN EN EENWEBWINKEL VAN DE ZORG -- 8.1 De evidence-based geneeskunde -- 8.2 Lineair versus fasegericht behandelen -- 9 WAT IS EEN HULPVERLENER? NAAR EEN MULTIDESKUNDIG PERSPECTIEF -- 9.1 De continuïteit van ervaring

Auditory hallucination, or hearing voices, is generally associated with psychopathology. In psychiatry it is inter‐preted as a symptom of an illness, with no connection to the individual's life history. Voice hallucinations in childhood occur in a variety of contexts and have variable long‐term outcomes. Little is known about the course of the experience. In this study, 80 children and youngsters hearing voices were interviewed on four occasions over a period of three years about the content of the voices and their overall experience of voices, focusing on the determinants for a promising outcome in the pathways through care. The results indicate that the need for care in the context of the experience of voices is associated not only with high levels of problem behaviour and associated negative symptoms of psychosis, but also, independently, with an appraisal of the voices in terms of anxiety, depression, dissociation and frequency of occurrence. In 60 per cent of the participants the voices disappeared during the three‐year research period. The relationship between the disappearance of voices and the course of mental health treatment is, however, ambiguous.

AbstractMeta-analyses suggest that clinical psychopathology is preceded by dimensional behavioral and cognitive phenotypes such as psychotic experiences, executive functioning, working memory and affective dysregulation that are determined by the interplay between genetic and nongenetic factors contributing to the severity of psychopathology. The liability to mental ill health can be psychometrically measured using experimental paradigms that assess neurocognitive processes such as salience attribution, sensitivity to social defeat and reward sensitivity. Here, we describe the TwinssCan, a longitudinal general population twin cohort, which comprises 1202 individuals (796 adolescent/young adult twins, 43 siblings and 363 parents) at baseline. The TwinssCan is part of the European Network of National Networks studying Gene-Environment Interactions in Schizophrenia project and recruited from the East Flanders Prospective Twin Survey. The main objective of this project is to understand psychopathology by evaluating the contribution of genetic and nongenetic factors on subclinical expressions of dimensional phenotypes at a young age before the onset of disorder and their association with neurocognitive processes, such as salience attribution, sensitivity to social defeat and reward sensitivity.

Abstract
Purpose
To explore gender differences of the associations between childhood adversity (CA) subtypes and psychiatric symptoms in the general population.

Methods
Data of 791 participants were retrieved from a general population twin cohort. The Symptom Checklist-90 Revised (SCL-90) and the Childhood Trauma Questionnaire were used to assess overall psychopathology with nine symptom domains scores and total CA with exposure to five CA subtypes, respectively. The associations between CA and psychopathology were analyzed in men and women separately and were subsequently compared.

Results
Total CA was associated with total SCL-90 and all symptom domains without significant gender differences. However, the analyses of CA subtypes showed that the association between emotional abuse and total SCL-90 was stronger in women compared to men [χ2(1) = 4.10, P = 0.043]. Sexual abuse was significantly associated with total SCL-90 in women, but emotional neglect and physical neglect were associated with total SCL-90 in men. Exploratory analyses of CA subtypes and SCL-90 subdomains confirmed the pattern of gender-specific associations. In women, emotional abuse was associated with all symptom domains, and sexual abuse was associated with all except phobic anxiety and interpersonal sensitivity. In men, emotional neglect was associated with depression, and physical neglect was associated with phobic anxiety, anxiety, interpersonal sensitivity, obsessive–compulsive, paranoid ideation, and hostility subdomains.

Conclusion
CA is a trans-syndromal risk factor regardless of gender. However, differential associations between CA subtypes and symptom manifestation might exist. Abuse might be particularly associated with psychopathology in women, whereas neglect might be associated with psychopathology in men.