Suchergebnisse

Purpose: Family interventions have been developed to support carers of people with mental illness, but not much is known about how such interventions can improve carers' physical health. This review aimed to identify and analyze existing family interventions that addressed the physical health of carers. Methods: A scoping review was conducted to identify peer-reviewed journal articles on family interventions with physical health components. A total of six articles were found and analyzed thematically to identify the family interventions, physical health components of the interventions, and associated physical health outcomes. Results: Synthesis of the findings from relevant articles showed that the development of physical health components in family interventions is emerging and at an early stage. However, most studies had physical health as a minor area focusing mainly on stress and sleep. Conclusions: Family interventions would be more holistic if consideration of physical health issues was addressed as a core module.

AbstractIn 2015, the Australian government committed to take an additional 12,000 refugees from Syria and Iraq prioritizing those considered most vulnerable including people with disability. The aim of this preliminary study was to understand, from multiple stakeholder perspectives, the experiences of settling in Australia for people with disability from Syrian and Iraqi refugee backgrounds living in Sydney. Interviews were conducted with nine family members of 11 people with disability from Iraqi and Syrian refugee backgrounds; eight Iraqi and Syrian community organization leaders; and seven community and health refugee service practitioners. Interviews were transcribed and analysed using the thematic analysis. Three themes were identified that contribute to understandings of disability based on the perceptions of the multiple stakeholders interviewed: Iraqi and Syrian perceptions of 'disability'; beliefs about who is 'responsible for' the disability; and comparisons between Iraqi/Syrian and Australian views, attitudes, and approaches to disability. Understandings of disability are shaped by fluid and dynamic factors, including culture. It is essential that services are offered to people with disability and their family members using a whole-of-person, culturally informed approach to community support.

BACKGROUND: Neuropsychological investigations can help untangle the aetiological and phenomenological heterogeneity of schizophrenia but have scarcely been employed in the context of treatment-resistant (TR) schizophrenia. No population-based study has examined neuropsychological function in the first-episode of TR psychosis. METHODS: We report baseline neuropsychological findings from a longitudinal, population-based study of first-episode psychosis, which followed up cases from index admission to 10 years. At the 10-year follow up patients were classified as treatment responsive or TR after reconstructing their entire case histories. Of 145 cases with neuropsychological data at baseline, 113 were classified as treatment responsive, and 32 as TR at the 10-year follow-up. RESULTS: Compared with 257 community controls, both case groups showed baseline deficits in three composite neuropsychological scores, derived from principal component analysis: verbal intelligence and fluency, visuospatial ability and executive function, and verbal memory and learning (p values⩽0.001). Compared with treatment responders, TR cases showed deficits in verbal intelligence and fluency, both in the extended psychosis sample (t = -2.32; p = 0.022) and in the schizophrenia diagnostic subgroup (t = -2.49; p = 0.017). Similar relative deficits in the TR cases emerged in sub-/sensitivity analyses excluding patients with delayed-onset treatment resistance (p values<0.01-0.001) and those born outside the UK (p values<0.05). CONCLUSIONS: Verbal intelligence and fluency are impaired in patients with TR psychosis compared with those who respond to treatment. This differential is already detectable - at a group level - at the first illness episode, supporting the conceptualisation of TR psychosis as a severe, pathogenically distinct variant, embedded in aberrant neurodevelopmental processes. ; The ÆSOP study has received funding support by the UK Medical Research Council (grant number G0500817) and the Department of Health via the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award to South London and Maudsley NHS Foundation Trust (SLaM) and the Institute of Psychiatry at King's College London. R.M.M. has received honoraria from Janssen, Astra-Zeneca, Lilly, BMS, and Roche. C.M. and R.M.M. have received funding support from the Wellcome Trust (grant no. HEALTH-F2-2009-241909) (Project EU-GEI) and the European Union (European Community's Seventh Framework Program; grant no. HEALTH-F2-2009-241 909; Project EU-GEI). C.M. has further received funding from the Wellcome Trust (grant number WT087417). We thank the Stanley Medical Research Institute for their support.