Social Support and Religion: Mental Health Service Use and Treatment of Schizophrenia

The perceptions and religious beliefs held by family members, mental health and health care professionals, and the community may affect the treatment of individuals with schizophrenia. To better identify and understand the influence of families, professionals and community members on individual’s treatment for schizophrenia, this review paper examines: (1) the religious perceptions of families, professionals, and the public towards schizophrenia; (2) religious perceptions of the etiology of schizophrenia; (3) how others perceive religion as a coping mechanism; and (4) how religion influences treatment engagement and help-seeking behaviors. MEDLINE and PsycInfo databases were systematically searched from 1980 to 2010 using the terms schizophrenia, schizoaffective, schizophreniform, psychotic disorder not otherwise specified and religion, religiosity, spirituality, and faith. Forty-three (n = 43) original research studies met the inclusion criteria. This study found that religious beliefs influence the treatment of schizophrenia in the following ways: Religious themes were positively associated with coping, treatment engagement and help-seeking behavior. Evidence of religious underpinnings was found in perceptions of etiology. The findings also indicate that there is often both a preference among family members and caregivers to utilize religious-based professionals and caution toward mental health professionals. Researchers and professionals may find avenues for improving treatment through examining the interaction of religious and schizophrenia at the social support level

Genome-wide analyses as part of the international FTLD-TDP whole-genome sequencing consortium reveals novel disease risk factors and increases support for immune dysfunction in FTLD

Frontotemporal lobar degeneration with neuronal inclusions of the TAR DNA-binding protein 43 (FTLD-TDP) represents the most common pathological subtype of FTLD. We established the international FTLD-TDP whole genome sequencing consortium to thoroughly characterize the known genetic causes of FTLD-TDP and identify novel genetic risk factors. Through the study of 1,131 unrelated Caucasian patients, we estimated that C9orf72 repeat expansions and GRN loss-of-function mutations account for 25.5% and 13.9% of FTLD-TDP patients, respectively. Mutations in TBK1 (1.5%) and other known FTLD genes (1.4%) were rare, and the disease in 57.7% of FTLD-TDP patients was unexplained by the known FTLD genes. To unravel the contribution of common genetic factors to the FTLD-TDP etiology in these patients, we conducted a two-stage association study comprising the analysis of whole-genome sequencing data from 517 FTLD-TDP patients and 838 controls, followed by targeted genotyping of the most associated genomic loci in 119 additional FTLD-TDP patients and 1653 controls. We identified three genome-wide significant FTLD-TDP risk loci: one new locus at chromosome 7q36 within the DPP6 gene led by rs118113626 (pvalue=4.82e-08, OR=2.12), and two known loci: UNC13A, led by rs1297319 (pvalue=1.27e-08, OR=1.50) and HLA-DQA2 led by rs17219281 (pvalue=3.22e-08, OR=1.98). While HLA represents a locus previously implicated in clinical FTLD and related neurodegenerative disorders, the association signal in our study is independent from previously reported associations. Through inspection of our whole genome sequence data for genes with an excess of rare loss-of-function variants in FTLD-TDP patients (n≥3) as compared to controls (n=0), we further discovered a possible role for genes functioning within the TBK1-related immune pathway (e.g. DHX58, TRIM21, IRF7) in the genetic etiology of FTLD-TDP. Together, our study based on the largest cohort of unrelated FTLD-TDP patients assembled to date provides a comprehensive view of the genetic landscape of FTLD-TDP, nominates novel FTLD-TDP risk loci, and strongly implicates the immune pathway in FTLD-TDP pathogenesis

Conflicting Principles in Social Work Doctoral Programs: The Effects of Unspoken Power Dynamics

Doctoral students are guided by two distinct sets of principles - those of their profession and academe - that may conflict. The social work profession is built upon the collaborative principles of equity, diversity, social justice, anti-oppression, participation, respect for differences, and human dignity. In contrast, academe at the doctoral level promotes competition, productivity, research, publication, and the advancement of new knowledge and practice. When these frequently discordant tenets intersect in such areas as the supervisory relationship or the appointment of research and teaching assistants, the resulting unanticipated power dynamics can have a dramatic impact on students and faculty. Social work principles can be employed by faculty and students to identify and address these power dynamics, thus enriching the doctoral experience.Social Work, Graduate College o

Evidence-Based Family Psychoeducational Interventions for Children and Adolescents with Psychotic Disorders

Introduction: Family psychoeducational interventions have consistently been found to impact families positively and reduce relapse rates in individuals with psychotic disorders. Research finds that, for adults, family psychoeducational interventions are effective in preventing relapse and improving social and occupational functioning. Psychotic disorders are increasingly recognized as having early onset, yet limited psychoeducational evidence-based intervention services are available and no intervention has centered exclusively on youth with a psychotic disorders and their families. Method: This article reviews the evidence-based literature on family psychoeducational interventions for persons with a psychotic disorder, with a specific focus on the gaps, strengths, and limitations of family psychoeducational treatment for children and adolescents. This article incorporates current research in the proposed development of a family psychoeducational intervention exclusively for adolescents with a psychotic disorder and their parents. Results: A conceptual psychoeducational multiple family group intervention (PMFG) for adolescents with a psychotic disorder is presented. Conclusion: The impact of these disorders affects not only the diagnosed adolescents and their families, but places a significant burden on the health care system and society. This article adapts an evidence-based intervention to improve prognosis, social and peer functioning, and reduce relapse in children and adolescents throughout their life cycle

Deconstructing Mother Guilt: Single Mothers Can Effectively Raise an Emotionally Healthy and Well-Developed Male Child

Single mothers raising children on their own can be the result of a family breakdown, separation, divorce, or the result of a decision to have a baby without a partner. The family structure occurs in lower, middle, and upper class socioeconomic backgrounds and the number of children raised by single mothers has increased dramatically in recent years (Whitehead, 1993)

An Approach to Maximizing Treatment Adherence of Children and Adolescents with Psychotic Disorders and Major Mood Disorders

Introduction: Mental health research has consistently focused on high rates of treatment non-adherence, and how inpatient programs and health professionals can effectively confront this reality. The literature has centred almost exclusively on adult populations. Unfortunately, psychotic and major mood disorders are serious and persistent mental health problems that are increasingly recognized as having an early onset, affecting children and adolescents. Method: This article draws on a review of the literature and Habermas’s three domains of knowledge: technical, practical, and emancipatory. This article has incorporated current research, adherence theories, and the facilitation of the unique local expertise of health professionals to generate a framework. This framework is designed to teach health professionals working in child and adolescent psychiatric inpatient units how they and the larger unit can practice to enhance patient treatment adherence during and after admission. Results: A five-step approach to teach health professionals to enhance treatment adherence has been developed based on current research and educational theories and principles. Conclusion: Health professionals working in child and adolescent psychiatry can practice to enhance patient treatment adherence, and improve patient and family outcomes