Mediating effect of symptom severity on the relationship between aggression, impulsivity and quality of life outcomes among patients with schizophrenia and related psychoses

AimsAggression and impulsivity among individuals with schizophrenia have been associated with poor clinical outcomes including worsening of symptoms and substance abuse which have been linked to a lower quality of life (QoL). The current study aimed to look at the mediating effect of symptom severity on the relationship between aggression, impulsivity and QoL among outpatients with schizophrenia and related psychoses in a multi-ethnic Asian population.MethodsData (n = 397) were collected from outpatients seeking treatment at the Institute of Mental Health. The World Health Organization quality of life-BREF (WHOQOL-BREF) scale, the symptoms checklist-90 revised (SCL-90-R), Buss Perry aggression questionnaire (BPAQ), and the Barratt impulsiveness scales (BIS) were used to assess subjective well-being, symptom severity, aggression, and impulsivity, respectively. Mediation analysis was performed using the PROCESS macro to understand the mediating effect of symptom severity.ResultsMotor impulsivity (MI) was indirectly associated with both the physical and psychological health domains of QoL while self-control was indirectly associated with the physical, psychological, and environmental health QoL domains through increased symptom severity.ConclusionThe significant indirect effect of symptom severity in our study highlights one potential pathway through which impulsivity impacts the QoL of individuals with schizophrenia and related psychoses. Elucidating other factors besides symptom severity that have an indirect effect on the QoL of individuals provides alternative approaches for treatment through which better clinical outcomes can be achieved

Positive mental health among health professionals working at a psychiatric hospital.

BACKGROUND:Positive mental health (PMH) is a combination of emotional, psychological and social well-being that is necessary for an individual to be mentally healthy. The current study aims to examine the socio-demographic differences of PMH among mental health professionals and to explore the association between job satisfaction and total PMH. METHODS:Doctors, nurses and allied health staff (n = 462) completed the online survey which included the multidimensional 47-item PMH instrument as well as a single item job satisfaction question. Associations of PMH with job satisfaction were investigated via linear regression models. RESULTS:Significant differences in PMH total and domain specific scores were observed across socio-demographic characteristics. Age and ethnicity were significantly correlated with PMH total scores as well as various domain scores, while gender, marital and residency status and the staff's position were only significantly correlated with domain specific scores. Job satisfaction was also found to be a significantly associated with total PMH. CONCLUSION:The workplace is a key environment that affects the mental health and well-being of working adults. In order to promote and foster PMH, workplaces need to consider the importance of psychosocial well-being and the wellness of staff whilst providing an environment that supports and maintains overall health and work efficiency

Problematic drug use among outpatients with schizophrenia and related psychoses.

Problematic drug use is common among psychiatric patients and is linked with poorer course and outcomes of illness. The aim of this study is to assess the prevalence of problematic drug use, and to explore its sociodemographic correlates and associations with health behaviors and outcomes among outpatients with schizophrenia and related psychoses in Singapore. Data from 397 individuals who were aged 21-65 years and were seeking treatment for schizophrenia and related psychoses in the outpatient clinics of a tertiary psychiatric hospital were analyzed. The Drug Abuse Screening Test (DAST-10) was used to assess problematic drug use. Information on sociodemographics, smoking status, alcohol use, symptoms severity and quality of life were collected. Multivariable logistic regressions were conducted to explore correlates and associations of problematic drug use. The prevalence of problematic drug use was 5.8% ( = 23) in the sample, and 10.6% ( = 42) of the participants reported having problematic drug use and/or problematic alcohol use. More males than females reported having problematic drug use ( = 0.021), and also problematic drug and/or alcohol use ( = 0.004). Significant associations were observed between problematic drug use and smokers with nicotine dependence, and with physical health domain of quality of life. Individuals with greater symptom severity were approximately twice as likely to have problematic drug use and/or alcohol use. While the prevalence of problematic drug use in this sample population is relatively lower compared to other countries, there is a considerable number who might be at risk. Routine screening and close monitoring of drug use is recommended as part of psychiatric assessment, particularly among males and patients with nicotine dependence

Youth Positive Mental Health Concepts and Definitions: A Systematic Review and Qualitative Synthesis

Background: Research on youth positive mental health (PMH) lacks comprehensiveness. We reviewed literature to (i) identify and understand concepts related to youth PMH and (ii) to summarize their definitions under broad conceptual themes. Method: We conducted a systematic review using PRISMA methodology. The protocol was registered in PROSPERO database (ID:CRD42020203712). Pubmed, Embase, PsycINFO, and OpenGrey databases were searched for publications that examined, assessed, explained, or defined PMH concepts in youth populations. Methods included searching, independent screening and review using pre-determined inclusion and exclusion criteria, extraction, coding, and iterative thematic syntheses of literature. Results: Of 3427 unique records identified, 105 articles from 26 countries met review criteria. Qualitative analysis resulted in 22 broad themes of youth PMH. These included interpersonal relationships (interpersonal competence, school connectedness, etc.), positive emotions (feel and create pleasant emotions, gratitude, etc.), self-efficacy (strengths, human agency, etc.), life satisfaction (global assessment of one’s life), and personal growth (goal achievement, life aspirations, etc.). Five novel concepts related to youth PMH were identified. Conclusions: Our review summarized and operationalized multiple concepts of youth PMH for applications in research, evaluation, and public health improvement

A qualitative study on negative experiences of social media use and harm reduction strategies among youths in a multi-ethnic Asian society

PURPOSE: This study aimed to expand and inform the emerging body of research on the negative experiences of social media use among youths and how youths deal with them, in an Asian setting, using a qualitative approach. METHODS: Data were collected using 11 focus group discussions (FGDs) and 25 semi-structured interviews (SIs) among youths aged 15 to 24 years residing in Singapore who were recruited via purposive sampling. Data were analysed using thematic analysis. RESULTS: The salient negative effects mentioned by participants include the development of negative reactions and feelings from upward comparisons with others (e.g., others\u27 achievements and lifestyle), receiving hurtful comments, exposure to controversial content (e.g., political events and social movements), as well as the perpetuation of negative feelings, behaviours, and sentiments (e.g., rumination, unhealthy eating behaviour, and self-harm). Participants also described strategies which they have employed or deemed to be useful in mitigating the negative effects of social media use. These include filtering content and users, taking breaks from social media, cognitive reframing, and self-affirmation, where they identify and change stress-inducing patterns of thinking by setting realistic social, physical, and lifestyle expectations for themselves, and focusing on self-development. CONCLUSION: The current results highlight that while youths experience negative effects of social media use, they have high media literacy and have employed strategies that appear to mitigate the negative effects of social media use. The findings can inform various stakeholders involved in helping youths navigate the harms of social media use or provide directions for intervention studies aimed at reducing the harms of social media use

Psychotherapists’ perspective of the use of eHealth services to enhance positive mental health promotion

Objective Keyes’s two-continua model of mental health proposes that mental illness and positive mental health are two separate, correlated, unipolar dimensions. eHealth services have been used to deliver mental health care, though the focus remained largely on symptom reduction and management of negative aspects of mental health. The potential of eHealth services to promote positive mental well-being, however, has not been tapped sufficiently. The present study aims to explore psychotherapists’ perspective on the feasibility of eHealth services to enhance positive mental health promotion. Methods Seven focus group discussions were conducted among professionals ( n  = 38) who delivered psychotherapy to examine positive mental health in their practice. Responses related to the use of e-psychotherapy to promote mental well-being were extracted for use in a secondary analysis of data in this study. Thematic analysis of data via inductive approach was conducted to allow emergence of common themes. Results Three main themes related to psychotherapists’ perspective on the feasibility of eHealth intervention in enhancing positive mental health were identified: (1) use of eHealth to educate and improve positive mental health; (2) concerns on incorporating psychotherapy into online services; (3) other factors that affect uptake or effectiveness of eHealth intervention for positive mental health. Conclusions The study generally found support among psychotherapists for the feasibility of eHealth intervention in promoting positive mental health among clients. Potential difficulties in implementation and practicality concerns were discussed

Psychological status and quality of life among primary caregivers of individuals with mental illness: a hospital based study

Abstract Background This study aimed to explore the psychological status and quality of life among primary caregivers of individuals suffering from various mental illnesses including early psychosis, chronic schizophrenia, depressive disorders, anxiety disorders and dementia. Methods A total of 350 primary caregivers with relatives seeking treatment at a tertiary psychiatric hospital were recruited for this study. Socio-demographic data was obtained and the brief version of the World Health Organisation Quality of Life instrument was used to assess caregiver’s quality of life (QOL). Psychological status among primary caregivers was assessed using the General Anxiety Disorder - 7 item (GAD-7) and Patient Health Questionnaire - 9 item (PHQ-9) scales. Family Interview Schedule (FIS) was used to assess the impact of caregiving relating to social problems, interpersonal strain among family members, work related problems and financial difficulties as a result of their relative’s illness. The socio-demographic and clinical correlates of QOL, PHQ-9 and GAD-7 were examined using multiple linear and logistic regression analyses. Associations between QOL domains and psychological status was examined using multiple linear regression analyses. Results The mean age of the primary caregivers was 49.7 years (SD = 13.2), ranging from 21 to 82 years, with a preponderance of females (67.6%), aged 50–64 years old (45.7%). Majority were of Chinese ethnicity (57.5%), had secondary level education (43.1%), were married (65.2%), and employed (64.9%). 18.3% of primary caregivers had symptoms of depression (based on PHQ-9 cut-off point of 10 or greater) while 12.7% had symptoms of anxiety (based on GAD-7 cut-off point of 10 or greater). Multiple linear and logistic regression analyses revealed that primary caregivers aged between 35-49 years and 50–64 years, unemployed, living with others, providing care to those diagnosed with dementia and who had higher FIS scores were significantly more likely to report symptoms of depression whilst those who cared for their son/daughter were less likely to be associated with symptoms of depression. Primary caregivers who had lower education, were living with others, were single or divorced/separated, were unemployed and with higher FIS scores were associated with lower QOL domain scores. Those with symptoms of depression were significantly associated with low QOL across all four domains, whilst those with symptoms of anxiety were significantly associated with low QOL in the social relationships domain. Conclusion Psychological status of caregivers in the current study was associated with the various domains of QOL. In particular, caregivers’ symptoms of depression were significantly associated with lower QOL across all four domains of QOL whereas symptoms of anxiety were associated with lower scores in the social relationships domain. The study suggests a need to provide caregivers with social support and psycho-education to improve the QOL as well as aid in developing healthy coping strategies

Data_Sheet_1_Mediating effect of symptom severity on the relationship between aggression, impulsivity and quality of life outcomes among patients with schizophrenia and related psychoses.pdf

AimsAggression and impulsivity among individuals with schizophrenia have been associated with poor clinical outcomes including worsening of symptoms and substance abuse which have been linked to a lower quality of life (QoL). The current study aimed to look at the mediating effect of symptom severity on the relationship between aggression, impulsivity and QoL among outpatients with schizophrenia and related psychoses in a multi-ethnic Asian population.MethodsData (n = 397) were collected from outpatients seeking treatment at the Institute of Mental Health. The World Health Organization quality of life-BREF (WHOQOL-BREF) scale, the symptoms checklist-90 revised (SCL-90-R), Buss Perry aggression questionnaire (BPAQ), and the Barratt impulsiveness scales (BIS) were used to assess subjective well-being, symptom severity, aggression, and impulsivity, respectively. Mediation analysis was performed using the PROCESS macro to understand the mediating effect of symptom severity.ResultsMotor impulsivity (MI) was indirectly associated with both the physical and psychological health domains of QoL while self-control was indirectly associated with the physical, psychological, and environmental health QoL domains through increased symptom severity.ConclusionThe significant indirect effect of symptom severity in our study highlights one potential pathway through which impulsivity impacts the QoL of individuals with schizophrenia and related psychoses. Elucidating other factors besides symptom severity that have an indirect effect on the QoL of individuals provides alternative approaches for treatment through which better clinical outcomes can be achieved.</p

Socio-demographic correlates of PMH total and domain specific scores.

<p>Socio-demographic correlates of PMH total and domain specific scores.</p

The association of mental disorders with perceived social support, and the role of marital status : results from a national cross-sectional survey

Background: This study investigated whether (i) mental disorders were associated with perceived social support and its subcomponents, (ii) current marital status was related to perceived social support, and (iii) ‘Married’ status influenced the relationship between mental state and perceived social support. Methods: Data from a cross-sectional national survey comprising 6126 respondents were used. Lifetime diagnosis for five mental disorders was assessed with a structured questionnaire. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS) that provides Global and subscale scores for Significant Other, Family and Friends. Multiple linear regression analyses were conducted to address the research questions with MSPSS score as the dependent variable. Structural equation modeling (SEM) was performed to test mediation by marital status. Results: All mental disorders included in the study, except alcohol use disorder (AUD), were significantly and negatively associated with Global MSPSS scores. After controlling for sociodemographic factors and chronic physical illness, major depressive disorder (β = - 0.299, 95% CI: -0.484 – -0.113, p = 002) and having any of the five mental disorders (β = - 0.133, 95% CI: -0.254 – -0.012, p = 032) were negatively associated with support from Significant Other, while support from Family and Friends was lower among all disorders, except AUD. Being married was positively associated with perceived social support in people with and without mental disorders. Results of the SEM partially support mediation by mental state - perceived social support relationship by ‘Married’ status. Conclusion: Having mental disorders was associated with lower perceived social support. Being married has potential to influence this relationship.Ministry of Health (MOH)Temasek Foundation CLG LimitedPublished versionThe study was funded by the Ministry of Health Singapore and Temasek Foundation. Funding bodies provide general direction on study questionnaire and dissemination of results. Funders were not involved indata analysis