Background Non-adherence at psychiatric out-patients clinics has serious impact on clinical and economic outcomes. It is costly to both health care systems and the patients. This study aimed to examine the predictors of treatment adherence in a group of patients with first episode psychosis in Hong Kong. Methods Thirty five patients with psychosis underwent assessment for prospective memory, insight and social support at baseline. Clinical symptoms were also measured. Linear regression was used to identify predictors of treatment adherence at baseline. Actual medication adherence was assessed three months later and multiple linear regression models were used to identify predictors of non-adherence. Results The effects of independent variables age, gender, number of psychiatric hospitalization, and prospective memory were no statistically significant to treatment adherence. But educational level, insight and social support were showed positive correlation with treatment adherence. Conclusions The study demonstrates that treatment adherence is associated with level of education, insight and social support system. These factors are important to assess when trying to estimate the degree of medication adherence and its relationship to clinical presentation. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Subjective quality of life (QOL) has been measured as one of the important clinical outcomes of schizophrenia. Many studies on examining the relationship between subjective QOL and symptomatology as well as neurocognitive functions were reported. Consistent data have suggested that the severity of depressive symptoms contributed to poor subjective QOL of schizophrenia. However, reports on the relationship of subjective QOL with negative symptoms, neurocognitive functions, and duration of untreated psychosis were largely inconsistent. The current study on the examination of subjective QOL in schizophrenia, is to emphasize the importance of inner experiences of schizophrenia but do not treat them as Freedman (1974) called “average schizophrenic”, in order to find out a more effective intervention for improving subjective QOL of schizophrenia. The purpose of the present cross-sectional study was to replicate these previous studies on investigating factors related to subjective QOL of schizophrenia including, positive symptoms, negative symptoms, neurocognitive functions, as well as duration of untreated psychosis. Besides, as most previous studies focused on chronic schizophrenia, this study involved first episode remitted psychosis patients, and to test whether it was the same phenomenon between chronic schizophrenia and first episode remitted psychosis on subjective QOL. The study result can contribute to propose suitable treatment for improving QOL of persons with schizophrenia. In this study, 140 subjects with first episode remitted schizophrenia were examined. Significant associations between subjective QOL and psychopathology, neurocognitive functions were found; modest correlation of duration of untreated psychosis was also reported. Also, subjective QOL was associated with self-perception on the illness outlook in the first episode population. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Psychological distress aroused by stigma may lead to impairments in attentional functioning because it calls attention to the experience of stigma-related stress. Very few studies have actually considered whether stigma could disrupt attentional functioning by serving as distractors with emotional valence in the schizophrenia spectrum, given that there is a possible dysfunctional affective system in response to processing of emotional information. This research employed the paradigm of emotional Stroop task and attentional probe task to investigate how stigma impacts on the functioning of selective attention. The primary objective of this current study was to investigate how selective attention, as measured in terms of reaction time and accuracy, can be disturbed by stigma-related stimuli in schizophrenia patients. The secondary objective of this study was to test the assumption that schizophrenic patients with higher sensitivity towards stigmatization will demonstrate higher impairment of selective attention in relation to stigma-related stimuli, since they may display more intense negative emotions than patients with lower sensitivity. For emotional Stroop task, two categories of stimuli, including stigma-related words (emotional arousing to schizophrenic patients), furniture-related words (neutral stimuli) were shown in different colors and the subjects were instructed to name the color of words as fast and as accurate as possible. For attentional probe task, a stigma-related word was paired up with a furniture-related word in each trial. Participants had to respond as soon as they detect the dot in the position previously occupied by the words. Two groups of participants, healthy controls (N = 40) and patients with schizophrenia-related disorders (N = 40) were compared regarding their performances on emotional Stroop task and attentional probe task. The patients were further split into two groups; high-sensitivity towards stigma (N = 19) and low-sensitivity towards stigma(N = 18),for comparison on various variables, like level of symptoms, depression, medical adherence and awareness of mental disorders. Based on the group comparison of performance on emotional Stoop task, schizophrenic patients exhibited significant emotional interference with the presentations of stigma-related words when compared with the healthy controls. Although the group comparison of performance on attentional probe task did not provide a significant result, schizophrenic subjects obtained higher difference scores which indicated that they were in general displayed more attentional bias towards stigma-related stimuli as compared to furniture-related stimuli. Both emotional Stroop and attentional probe task results show that schizophrenia patients in high-sensitivity subgroup demonstrated the greatest effect of emotional interference with the presentations of stigma-related words. Level of emotional interference for stigma-related stimuli in schizophrenic patients was moderately correlated with the measure of positive symptoms severity, and patients in high-sensitivity group had a significantly higher mean depressive symptoms score than patients in low-sensitivity group. Such information might help to identify potential risk factors and lead to improved treatment and prevention strategies for psychotic patients. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Background: Researchers have addressed the extraordinarily high rate of unemployment in patients with psychotic disorders for many years, but few have focused on these patients’ subjective experience of employment in the recovery process. Method: A thematic analysis was performed by conducting six semistructured interviews with young patients diagnosed with psychotic disorders. Results: The interviewees agreed on the importance and benefits of employment in their recovery. Acceptance, financial support, and a meaningful life can be secured throughout the working process. However, the interviewees mentioned certain barriers to seeking and sustaining employment. Stigma and low motivation were common problems in searching for a job. Cognitive deficit, the side effects of medication, and interpersonal challenges in the workplace increased the difficulty of sustaining a job. Most of the interviewees participated in vocational rehabilitation programmes, and they expressed the belief that these programmes can help them enter the labour market at a certain level, but the programme design can be improved further to meet individual needs. Conclusion: Consistent with previous findings, the patients faced various difficulties in open employment. Employability training, psychoeducation at the corporate level, and self-efficacy development can be considered interventions for improving patients’ vocational outcomes. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

54 local secondary school teachers from two different secondary schools at same district were invited to participate in the study. A 67-item self-reported Chinese questionnaire was filled in by the 54 participants in order to test their knowledge about early psychosis, attitude towards students with early psychosis and also the school re-entry of young patients. It was found that there was no statistical significance correlation between the years of teaching experience of teachers and their attitude towards students with early psychosis and school re-entry of young patients. There was no significance gender difference in the attitude towards young patients and their school re-entry. Plus, a one-way ANOVA was used to further examined the significant difference across teachers had no religion, Christian teachers, Buddhist teachers and also Catholic teachers, F (3, 50) =4.628, p= .009, n^2=.042. Tukey’s post hoc procedure indicated that Christian teachers (M=95.7, SD=18.26) hold significance less negative attitude towards young patients than those who were Buddhist (M=92.6, SD=18.60), Catholic (M=80.25, SD=5.80) and those teachers who had no religion (M=74.71, SD=18.76). The feelings and attitude of participants towards psychosis was quite negative such as unpredictable (21%), violence and dangerous (16.7%), abnormal (13.6%), uncontrollable (14.2%) and madness (11.1%). Participants also were found that they were lack of enough basic knowledge on the average age of onset as most of them chose middle age is the age of onset of psychosis in Hong Kong. It was suggested that more structured mental health trainings session should be provided to educational professionals including teaching assistants. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

No description available.

No description available.

By re-examining the epistemological foundations upon which the ego-centric clinical construct of insight in psychosis rests, research conducted with the narratives of patients who participated in the clinical project, Psychosis and Culture: The Role of Spaces of Negotiation (Between Patients, Families, and Practitioners) During Consultation was aimed to explore and formulate a socio-centric model of insight construction more sensitive to patients' intersubjective and cultural milieus. Collected interviews---conducted with recently diagnosed psychotic patients using the Turning Point Interview (TPI) grid---were approached from a phenomenological and hermeneutical perspective in order to illustrate the processual manner in which patients' insight (into the cause and reason of illness) was the cognitive and epistemic derivative of dialogical relations with other persons set within a socio-cultural matrix. The results of this research indicate that the production of patients' insight in psychosis is an inherently intersubjective and dialogic phenomenon which, in the clinical context, occurs at two points of juncture: (1) a synchronic juncture where the patient is interpellated by the clinician and hence positioned as a speaking subject, and (2) a diachronic juncture where the patient, as a result of having been called into a speaking position, constructs and authors a narrative account of significant events related to his/her illness experience based on biographical memory. Insight was shown to consist of 3 stages: (1) Detection of alteration of lived experience, (2) Causal attribution, and (3) Global construction of meaning . Each stage was shown to form the intersubjective and dialogic basis for the production of a subjectively meaningful account of insight, using the lifeworid of the patients and the patients' entourage as subjective frames of reference.

Thesis (Ph.D.) -- University of Adelaide, Dept. of Psychiatry, 1974.

Thesis (Ph. D.)--University of Adelaide, Dept. of Clinical Nursing, 2005. / Title from t.p. of source document (viewed Apr. 2, 2007). "April 2005." Includes bibliographical references (leaves 208-221). Also available in print version.