Thèse de doctorat : Psychologie clinique : Rennes 2 : 2007. / Bibliogr. f. 296-299.

Thèse de doctorat : Psychopathologie et clinique psychanalytique : Rennes 2 : 2007.

Reproduction de : Thèse d'exercice : Médecine : Nancy 1 : 2006. / Titre provenant de l'écran-titre.

Background Early interventions (EI) for psychosis are predicted to have an effect in reducing suicidal attempts and self harms for first episode psychosis (FEP) patients. However there is little evidence to reveal that early intervention has a long term effect in reducing suicidal behaviors. Also, the longitudinal patterns of suicidal behavior of patients under EI and standard care (SC) programme were remained unclear. Therefore, this study was performed to explore the longitudinal pattern of suicidal behaviors for EI and SC patients. The long term effect of EI in reducing suicidal attempts and self harms and possible predictors for suicide were also explored and analysed. Method A secondary analysis was performed with data retrieved from medical data in different hospitals. The data are matched up for SC patients and EI patients based on their demographic information. Data related to suicidal behaviors are collected. Longitudinal patterns of suicidal behaviors were analysis with generalized linear model (GENLIN) and descriptive analysis. Univariate regression was also performed to investigate predictors for suicide. Results EI has a significant effect in reducing the total number of suicidal attempts (X^2=5.779, p=0.016) and deliberate self harm (X2=7.817, 0.005) over 10 years but no effect on suicidal attempts in the first three year when effect was expected. However, data indicated EI has an effect of reducing the number of complete suicide. Patients do not receive EI is a significant predictor for increase in the suicidal attempts and younger age is a predictor for latter deliberate self harm behaviors. Conclusion The result demonstrated that EI has a long term effect in reducing suicidal behavior rather only short term and non-lasting effect as suggested by other researches. However, EI treatment might have a short term negative effect on suicidal ideations as suggested by the increase of suicidal attempts in the second and third years. EI services do not only improve in symptoms and quality of life but a long term effects in reducing the number suicidal behaviors. Although, there is a possible negative effect on suicidal attempts, it might be beneficial if EI programme can be apply to all psychotic patients. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Background Patients infected with the human immunodeficiency virus (HIV), the causative agent of the acquired immunodeficiency syndrome (AIDS), have high rates of psychiatric morbidity. The effects of HIV on the Central Nervous System may lead to psychiatric morbidity even before the appearance of the full-blown AIDS syndrome. Sero-prevalence studies of patients with psychoses have found an estimated 5-20% to be HIV positive. However, sero-prevalence estimates vary from study to study due to the differences in sampling by geographic location, socio-economic class, race and ethnicity, and psychiatric-diagnostic composition. The Republic of South Africa has some of the highest prevalence rates in the world and research in this field is escalating rapidly. However research on HIV in patients with mental illness, particularly psychosis is very sparse. Aim of the study To determine the prevalence of HIV sero-positivity amongst patients admitted to Town Hill hospital presenting with first episode psychosis. Method All patients presenting to Town Hill hospital with first episode of psychotic symptoms were recruited to participate in the study. The treating doctor in collaboration with the multi-disciplinary team made the diagnosis of Psychosis. A total number of 63 patients participated in the study. Results. 23.8% of the patients tested positive for the human immunodeficiency virus. Conclusions. The prevalence of HIV sero-positivity is high amongst patients presenting with first episode psychosis. The HIV epidemic could have an important effect on the aetiology and clinical presentation of psychosis. Recommendations State mental health authorities should pursue the promotion of voluntary HIV testing programs, in patients presenting with first episode psychosis as soon as they are capable of giving informed consent. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2007.

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Background: Continuity of care and post-discharge follow-up visits can improve the quality of care and reduce the likelihood of relapse and re-hospitalization in patients with psychotic disorders. Purpose: This study aimed to analyze post-discharge follow-up interventions in patients with psychotic disorders, and to identify measurement instruments for intervention outcomes. Method: The literature review described here used a specific framework, where the follow-up interventions and the measurement instruments were analyzed systematically, to investigate fifteen studies identified through electronic databases such as Pubmed, Psychinfo, ProQuest, Cinahl, Medline, and Scopus. Results: The studies used interventions including psychoeducation, cognitive-behavioral therapy, cognitive behaviorally oriented service, optimal clinical management, relapse prevention plan, software suggested intervention, ambulatory outpatient care, community re-entry module, integrated treatment, and hospital-based community psychiatric service. Additionally these studies used thirty-eight measurement instruments to assess change in psychiatric patients or their relatives, based on psychological, social, and occupational factors as well as specific symptoms and symptom severity. The instruments also measured quality of life, insight, self-esteem, and cognitive function. Further, the studies examined therapeutic alliances and the experience of family members. The most commonly used instruments were the Global Assessment of Functioning and the Positive and Negative Syndrome Scale. Conclusion: The interventions reviewed here emphasize an individualized approach that targets education, illness management, coping strategies, social skills training and relapse prevention, and seeks to alter any harmful understanding of the illness. Although researchers can choose among numerous interventions, psychoeducation was the most appealing follow-up intervention for patients suffering from psychotic disorders. Importantly, evaluation instruments must be relevant to psychological symptoms, treatment, time and resources available, and what questions were being sought to answer. Approximately eleven of the thirty-eight instruments reviewed here showed weak or unclear reliability and validity. The most practical instrument for evaluating the outcome of an intervention for patients suffering from psychotic disorders wasthe Positive and Negative Syndrome Scale. / <p>ISBN 978-91-86739-70-6</p>

Typescript. / Thesis (Ph. D.)--University of Hawaii at Manoa, 1989. / Microfiche. / 2 v. leaves, bound ill 29 cm

Thèse (M.E.L.)--Université du Québec à Chicoutimi, 2002. / Document électronique également accessible en format PDF. CaQCU

Thesis (PhD) -- University of Western Sydney, Nepean, 1999. / "A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy" Bibliography : leaves 325-343. Electronic version is also available at.