Objectives: Stigma is believed to be one of the major barriers for the recovery process of persons with psychosis. Stigma-reducing program is believed to be able to enhance public knowledge and to improve treatment outcome as well as to alleviate discrimination and stigma. The current study therefore aimed at examining the level of public stigma of psychosis and its relationship with public attitudes towards patients with psychosis. The relationship of public’s stigma level, previous contact of persons with psychosis and the social distance scores on vignette will be studied. Method: Seventy-seven subjects were recruited from public health talks on psychosis organized by the Jockey Club Early Psychosis Project (JECP).Public stigma towards psychosis would be tested by two scales: the validated tool The Public Stigma Scale (Chan et al., 2009; Mak et al., 2012) and The Social Distance Scales (Chung, Chen & Liu2001). Other assessments included subjects’ previous contact with patients of psychosis and their history of working in the medical field. Results: The mean age of the subjects was 43.51 years (SD= 13.295); 23(32.5%) were male and 52 were female. In all, 15 (19.5%) had the history of working in medical field and 62(80.5%) worked in non-medical field; 49(63.6%) had pervious contact with the patients with psychosis while 28 (36.4%) did not have such experience. In our study, no correlation was found between overall stigma and number of contacts. Also, no correlation was found between overall stigma with gender and occupation. And we found that The Public Stigma and social distance were correlated. Subjects who had lower scores in the public stigma scale were related with less rejecting attitudes towards patient with psychosis. Conclusion: In this study, we found that pervious contact did not have significant correlation with the stigma and attitude. Gender and history of working in medical field difference also did not have significant correction with stigma and attitudes. Further studies are recommended to explore more effective strategies in stigma-reducing programme. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Thesis (M. Soc. Sc.)--University of Hong Kong, 2008. / Includes bibliographical references (p.70-80).

Thèse--Université de Paris. / "Bibliographie": 1 p.

No description available.

Lack of eye contact is one of the key clinical observations in schizophrenia. Sixteen schizophrenic patients and sixteen control subjects participated in our study of eye gazing. Frequencies of eye contact of both groups were measured in a role-play test which is closer to a natural environment. Autistic traits of both groups were measured using the Autism Quotient Questionnaire. We hypothesized that patients’ frequencies of eye contact were fewer than control subjects. We anticipated that patient group would score high in AQ. Furthermore, we examined the relationship between frequency of eye contact and cognitive functioning and symptomatology. Lastly, the study also examined the relationship between frequency of eye contact and autistic traits. Result showed that patients’ eye contact were significantly fewer than control group. Patients’ overall cognitive functioning was not as good as control group. In addition, schizophrenic patients scored significantly higher than control group in the Autism Quotient Questionnaire; autistic traits were found in schizophrenia patients. There was no relationship between frequency of eye contact and cognitive functioning. Nonetheless, negative correlation was found between frequency of eye contact and Digital symbol. More eye contact was associated with lower Digital symbol score. No relationship was found between frequency of eye contact and Autism quotient. Lastly, a trend correlation was found between frequency of eye contact and PANSS negative score; more eye contact was associated with higher PANSS negative score. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Background: In recent years, the study of emotion in psychosis has been neglected, and it would seem from the literature that emotion is not related to the formation or prediction of psychosis. Because emotions are the subjective experience of patients, they are not easily quantified. However, the latest fMRI research has shown that emotion and brain function are related and that understanding emotion is valuable for understanding patients’ cognitive function and its potential relationship with psychosis. Emotion regulation can be divided into two different categories based on when in the sequence of emotion regulation they appear. Cognitive reappraisal is antecedent-focused, and suppression is response-focused. I hypothesize that cognitive reappraisal can decrease maladaptive thought and emotions. In contrast, expressive suppression can reduce the appearance of emotion but not inner emotion. Furthermore, inhibiting a preference may not stop maladaptive emotions from arising over a long period of time. Methods: Two groups were recruited in study: a clinical group of patients with psychosis and a nonclinical group of healthy adolescents with no record of mental illness. Twenty-four psychotic patients were recruited from Early Assessment Services for Young People (EASY) in Queen Mary Hospital, and 30 nonclinical participants were recruited from nongovernmental organizations and schools. The participants ranged from 17 to 34 years old and were native Cantonese speakers living in Hong Kong. They completed a variety of measures of emotion regulation, depression, and anxiety. Results: The clinical and nonclinical groups were similar on several dimensions, including their demographic information and pattern of strategy usage. A higher percentage used both emotion-regulation strategies to cope with maladaptive emotion, and fewer used a single strategy. However, the two groups had significantly different outcomes from using expressive suppression as their major emotion regulation pattern. The clinical group was more likely to have higher depressive symptoms (moderate to severe levels on the Beck Depression Inventory). Conclusion: It is valuable to assess emotion-regulation strategies in order to evaluate patients’ habitual coping strategy. Cognitive reappraisal seems to allow participants to retain their cognitive function when maladaptive emotions are not fully occupying their cognitive resources. In contrast, when maladaptive emotion reaches a very high level, it cannot be contained through cognitive reappraisal. Habitual use of expressive suppression affects cognitive functioning and depletes resources that could be used for other regulation attempts. Unsuccessfully regulated maladaptive emotions could be a risk factor that occupies the cognitive functioning of psychotic patients. In order to solidify this hypothesis, further longitudinal research on psychotic patients’ emotional history is needed. More research is needed to understand the relationship between maladaptive emotions, cognitive function, and psychosis. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Background: Group-based life coaching intervention is new in mental health service to promote early functional recovery. This study explored the experience of a 10-week group-based life coaching intervention for patients with schizophrenia from the users’ perspective. Method: A qualitative methodology was used based on individual interviews. Four participates referred by the coach were successfully engaged. The materials were taped and transcribed. Result: Seven categories forming four main themes were identified: the usefulness of the coaching intervention; characteristic of goals, subjective feeling during and after the coaching intervention; and perceived changes afterward. Conclusion: Participants were satisfied with the experience through the coaching intervention. They adopted the tactics acquired to cope with the life events and clinical symptoms such as positive and negative psychotic symptoms. Successful attainment of desirable career was their common goals which were facilitated by the sense of achievement continuously encountered during the intervention. Positive changes in both personal and interpersonal level were recorded and thus increased the courage to pursue their ultimate careers. Peer support in group-based intervention enhanced the perseverance towards the pathway to goal attainment. Dependence on the coaches after intervention was observed which was contradictory to one of the aims of life coaching. This study examined the possibility of the implementation of this newly developed intervention in mental healthcare setting in addition to the currently available psychological interventions. Further research directions to improve the utility and explore the domain of recovery are suggested. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Background: For early psychosis patients, the first few years were critical period for determining long-term illness outcome. The first experience of admission had significant bearing on the perception of subsequent psychiatric treatment received. From this perspective, it was important to be aware of how patients suffered and how they coped in order to regain their sense of self of insight and treatment adherence and trust with nurses’ rapport and their therapeutic relationship. In this regard, a qualitative study was done with an aim to (i) explore the admission experiences and beliefs participants held upon admission and after discharged within two months. (ii) any influences on their perceptions of experience during and after admission which might impact on therapeutic relationship and treatment attitude Method: Eight ICD-10 first-episode psychosis (FEP) patients aged between 18 and 55 years who admitted to psychiatric inpatient unit for the management of their FEP were recruited. Two face-to-face in-depth interviews were conducted for each participant. First interview was conducted within 2 weeks of admission, while second interview was conducted during psychiatric outpatient follow-up appointment within two months after discharged from hospital. All interviews were audiotaped and transcribed. Thematic analysis was employed to derive common themes regarding patients’ experience and perception on psychiatric hospitalization for their FEP. Results: Thematic analysis revealed six main themes regarding patients’ subjective experience and perception on the illness and hospitalization. These were uncontrollable sense of self, supportive relationship with family members, unpleasant admission procedure, and feeling out of control during hospitalization, perceived benefits of admission, and perceived adverse impacts of admission. Conclusion: Our findings indicated that ideas about what constitute admission perception needed to take into account of patient’s views and experience in order to emphasize therapeutic optimism rather than pessimism, and to inform treatment contexts and the views of nursing staff. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Introduction: This study explored the subjective experience of relapse of psychosis from the patients’ perspective and the meanings they attach to the relapse, their prevention and their perception of risk of relapse. Method: A qualitative methodology was used based on a semi-structure interview. Audio tapes were transcribed verbatim and two researchers participated in a content analysis that identified five major themes: meaning of relapse, perceived risk of relapse in the future, views on antipsychotic medication, subjective risk and protective factors of relapse and the cost of having psychosis. Results: Patients’ view of relapse was similar to those held by psychiatrists, however, patients had a broader definition of the criteria of relapse, extending from family support to medication discontinuation. Their major concerns were the side effects and the independence of antipsychotic medication. Conclusion: Ideas about what constitutes relapse need to take into account the patients’ views and experiences in order to further improve and develop relevant intervention of relapse prevention in early psychosis. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Objectives Severe mental illness is a debilitating condition affecting a wide range of functioning of an individual. Identification of signs and symptoms is part of clinical assessment which aids case formulation, making diagnosis, determine treatment planning and outcome. How the symptoms are documented in case record undoubtedly affect the decision and communication among mental health professionals, treatment protocol, potential outcome and prognosis. This is the first study in Hong Kong mental health service to overview the symptom dimensions documented by clinicians in case records. Currently, there is no clinical practice guideline to guide clinicians on symptom documentation. This study attempts to explore the symptom dimensions as documented in the first interview records of people with first episode psychosis in EASY clinic in a local hospital. The result will serve as preliminary reference material or the development of an appropriate documentation guideline or audit in future. Method A retrospective review of case records was conducted to evaluate the symptom documentation by clinicians. All first interview notes of patients suffering from schizophrenia spectrum disorder who attended the EASY clinic in 2012 were included.90 case records were identified. The symptoms characteristics were recorded into a template and categorized with reference to the domains of psychopathology in DSM-5, SAPS and SANS. A total of 29 items of symptom characteristics and related clinical features were identified and measured with descriptive statistics. Results All symptom characteristics and clinical features were reported in percentage. It was found that majority of interview notes(62%)had documented a range of 22-26items out of 29 items(76-90%) of symptom characteristics and clinical features observed from case records. Clinicians had demonstrated high proficiency in documenting a comprehensive range of psychiatric symptoms. Conclusion This paper aims to increase the awareness of clinicians on continuous evaluation of current practice on symptom documentation; to identify good practice or area for improvement; and initiate the development of standardized documentation guideline to guide future symptom documentation practice for betterment of quality patient care and service planning for people with first episode psychosis. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine