Mental health aspects of paranormal and psi related experiences

This thesis aimed to investigate if paranormal beliefs and experiences represent signs of psychological ill-health or if they are neutral regarding psychological health. A further aim was to validate subjective paranormal experiences. The first part of the thesis compares two models for the construct schizotypy, a quasi-dimensional model and a fully dimensional model in the context of psychological health. The former views paranormal beliefs and experiences as pathological whereas the fully dimensional model is unbiased regarding health. Individuals were grouped according to their scores on a multi-dimensional schizotypy measure, the Oxford-Liverpool Inventory of Feelings and Experiences Scale (Mason, Claridge & Jackson, 1995). The schizotypy groups were compared regarding two mental health-related measures, the Sense of Coherence Scale (Antonovsky, 1991) and the Eysenck Personality Inventory (Bederoff-Petersson, Jägtoft & Åström, 1971) Neuroticism sub-scale, and a measure of paranormal beliefs and experiences, the Australian Sheep-Goat Scale (Thalbourne & Delin, 1993). The results support the fully dimensional schizotypy model. Noteworthy, a group of people with a high level of paranormal beliefs and experiences also reported a high level of sense of coherence in conjunction with low neuroticism, which signifies psychological health rather than ill-health. The second part of the thesis was designed to validate subjective paranormal experiences in the laboratory, where a Ganzfeld paradigm was used to induce psi. The psi Ganzfeld result was non-significant. Individual differences between successful and unsuccessful participants were investigated to explore the association between psi success and psychological health. The results of this thesis show that the relationships between the subjective reports of health-related sense of coherence, neuroticism, and subjective reports of strong paranormal beliefs and experiences are complex. It seems more likely that strong paranormal beliefs and experiences together with an inability to experience pleasure or cognitive disorganisation are related to perceived ill-health rather than strong paranormal beliefs and experiences on their own. The results support the notion of healthy schizotypy and the conclusion that paranormal beliefs and experiences should be viewed as neutral regarding mental health

Study protocol design and evaluation of a hospital-based multi-professional educational intervention: Person-Centred Psychosis Care (PCPC)

Abstract Background While patient involvement in mental health care is repeatedly stressed in policy documents, there are actually few studies that evaluate person-centred care interventions within psychiatric services. We present here the design and planned evaluation of an educational intervention for inpatient staff involved in the care of persons with schizophrenia and similar psychoses. Methods/design The care intervention will be assessed using a non-randomised trial with a before and after approach. The intervention involves an educational and experimental learning phase for hospital staff, followed by an implementation phase. The intervention is multi-professional; psychiatrists, psychiatric nurses, psychiatric carers, social workers, occupational therapists, and a medical secretary will be engaged in a participatory approach where they practice how to create a partnership and explore recovery-related goals together with patients. Patient-related outcomes include empowerment and satisfaction with care. Ward-level outcomes include daily ward burden, length of inpatient stay, and number of days with involuntary care. In addition, qualitative methods will be applied to capture patient, next-of-kin, and staff perspectives. Discussion The care intervention is expected to contribute to the improvement of inpatient care for persons with severe and complex mental health issues. Trial registration The trial was retrospectively registered at ClinicalTrials.gov June 9, 2017, identifier: NCT03182283

A lowered threshold to partnerships: a mixed methods process evaluation of participants’ experiences of a person-centred eHealth intervention

Abstract Background In order to understand pathways of complex interventions, the Medical Research Council has suggested that process evaluations should be conducted alongside randomised controlled trials (RCTs). This paper presents a mixed methods process evaluation of a complex, person-centred eHealth intervention for persons on sick leave with common mental disorders. Aim The aim of the study was to explore participants’ experiences of a person-centred eHealth intervention and illuminate meaningful activities and processes. Methods Participants were recruited from the intervention arm of an RCT (n = 102). Questionnaires on perceived meaningfulness of the overall intervention and intervention activities were sent to participants on two occasions, after 3 and 6 months, and semi-structured interviews were conducted with a purposeful sample of 15 participants in the intervention group. Questionnaire data were analysed using descriptive statistics, and interview data were analysed using qualitative content analysis. The quantitative and qualitative data strands were integrated at interpretation. Results At both follow-ups, a majority of participants reported that the intervention was fully or partly meaningful and that the most meaningful activity was the phone calls with health care professionals working in the intervention. In the qualitative analysis, three categories describing participants’ experiences of the intervention were formed: Acknowledgment in a disconcerting situation, Finding ways forward and Unmet expectations. A synthesis of quantitative and qualitative findings resulted in the overarching theme of meaningfulness as constituted by a lowered threshold to partnerships: support within reach, when needed. Conclusion Experiences of meaningfulness of the intervention were constituted by a lowered threshold to forming care partnerships, in which support was within reach, when needed. If the content of the intervention was not in accordance with individuals’ needs or expectations, access alone did not suffice to constitute meaningfulness. Trial registration ClinicalTrials.gov; NCT03404583; 19/01/2018

Cerebrospinal fluid concentration of complement component 4A is increased in first episode schizophrenia.

Postsynaptic density is reduced in schizophrenia, and risk variants increasing complement component 4A (C4A) gene expression are linked to excessive synapse elimination. In two independent cohorts, we show that cerebrospinal fluid (CSF) C4A concentration is elevated in patients with first-episode psychosis (FEP) who develop schizophrenia (FEP-SCZ: median 0.41 fmol/ul [CI = 0.34-0.45], FEP-non-SCZ: median 0.29 fmol/ul [CI = 0.22-0.35], healthy controls: median 0.28 [CI = 0.24-0.33]). We show that the CSF elevation of C4A in FEP-SCZ exceeds what can be expected from genetic risk variance in the C4 locus, and in patient-derived cellular models we identify a mechanism dependent on the disease-associated cytokines interleukin (IL)-1beta and IL-6 to selectively increase neuronal C4A mRNA expression. In patient-derived CSF, we confirm that IL-1beta correlates with C4A controlled for genetically predicted C4A RNA expression (r = 0.39; CI: 0.01-0.68). These results suggest a role of C4A in early schizophrenia pathophysiology