Early intervention for incipient insanity: early notions from the 19th century English literature.

AIM: Early intervention programmes in mental illnesses started to bloom in the 1990s, and many programmes have been established worldwide during the past twenty years. However, the concept of early intervention has emerged during the 19th century but it did not make much impact on practice. The aim of this review is to identify the difficulties appeared during that period of time which could provide insight into the modern development of early intervention initiatives. METHODS: A narrative review which focused on English literature about early intervention for insanity during the 19th century was undertaken. RESULTS: Clinicians during the 19th century recognized that treatment would be the most effective at the early stage of the mental illness and they had emphasized the importance of early intervention. However, because of a number of factors, such as the limited roles of asylums, lack of knowledge about mental disorder and the lack of effective treatment, the idea of early intervention did not make impact in clinical service during that period of time. CONCLUSION: During the past two hundred years, understanding towards mental illness has advanced and more effective treatments, such as the use of anti-psychotic medications, have been developed. Reflecting on the past experience and difficulties might shed light on the development of today early intervention in mental disorder.This is the author accepted manuscript. It is currently under an indefinite embargo pending publication by Wiley

Towards a global partnership model in interprofessional education for cross-sector problem-solving

Objectives A partnership model in interprofessional education (IPE) is important in promoting a sense of global citizenship while preparing students for cross-sector problem-solving. However, the literature remains scant in providing useful guidance for the development of an IPE programme co-implemented by external partners. In this pioneering study, we describe the processes of forging global partnerships in co-implementing IPE and evaluate the programme in light of the preliminary data available. Methods This study is generally quantitative. We collected data from a total of 747 health and social care students from four higher education institutions. We utilized a descriptive narrative format and a quantitative design to present our experiences of running IPE with external partners and performed independent t-tests and analysis of variance to examine pretest and posttest mean differences in students’ data. Results We identified factors in establishing a cross-institutional IPE programme. These factors include complementarity of expertise, mutual benefits, internet connectivity, interactivity of design, and time difference. We found significant pretest–posttest differences in students’ readiness for interprofessional learning (teamwork and collaboration, positive professional identity, roles, and responsibilities). We also found a significant decrease in students’ social interaction anxiety after the IPE simulation. Conclusions The narrative of our experiences described in this manuscript could be considered by higher education institutions seeking to forge meaningful external partnerships in their effort to establish interprofessional global health education

Managing treatment resistance in schizophrenia: a joint study in Hong Kong and Singapore

This study surveyed clinicians in psychiatry in Hong Kong and Singapore to understand their familiarity and prescribing practices in treatment-resistant schizophrenia (TRS) and clozapine-resistant schizophrenia (CRS).National Medical Research Council (NMRC)Published versionThis research was supported by the Singapore FY18 NHG-LKCMedicine Clinician-Scientist Preparatory Program (Reference code: CSPP-18001) and the Singapore Ministry of Health's National Medical Research Council under the Centre Grant Program (Grant No: NMRC/CG/M002/2017_IMH)

Eye movement consistency in global-local perceptual processing predicts schizotypy

Here we examined whether eye movement measures in global-local perceptual processing tasks, where abnormalities were typically found in individuals with schizophrenia, could be used to predict schizotypy through Eye Movement analysis with Hidden Markov Models (EMHMM). Using both multiple regression analysis and Gaussian process classifier to predict schizotypy, we found that in addition to longer response times in contour integration, a less consistent eye fixation to locate a stimulus and a more consistent subsequent fixation to start engaging local processing in the embedded figures task predicted high schizotypy. These effects may be related to reduced top-down attention control due to deficient global processing and enhanced local processing bias respectively. In addition, performance in embedded figures could further enhance classification accuracy when being used in conjunction with the above predictors, suggesting the multifactorial nature of the identification problem. These predictors may be important endophenotype markers for schizotypal personality

Rate and predictors of disengagement from a 2-year early intervention program for psychosis in Hong Kong

Objectives: This study aims to examine the prevalence and predictors of disengagement in a longitudinal cohort of first-episode psychosis (FEP) patients. Methods: Seven hundred FEP patients aged 15 to 25 enrolled into the Early Assessment Service for Young People with Psychosis (EASY) from 2001 to 2003 were recruited into the study. Data on sociodemographics, clinical characteristics, baseline symptoms and functioning and medication adherence were collected. Rate and predictors of service disengagement were the outcomes of interest. Predictors were examined using Cox proportional hazards model. Results: Ninety four patients (13%) were disengaged from the EASY program. Fewer negative symptoms at initial presentation, a diagnosis other than schizophrenia-spectrum disorder and poorer medication compliance in the first month of treatment were significant predictors of disengagement from service. Conclusions: Early intervention teams should pay attention to factors associated with disengagement, and monitor at risk patients closely to detect signs of non-adherence. © 2014 Elsevier B.V.link_to_subscribed_fulltex

Coupling physical exercise with dietary glucose supplement for treating cognitive impairment in schizophrenia: A theoretical model and future directions

Aims: Metabolic dysregulation may disrupt the complex neuroprotective mechanisms essential for brain health. Recent studies have pointed out the possible aetiological role of metabolic dysregulation in the onset of schizophrenia and the associated cognitive impairment. In this paper, we aimed to generate a theoretical model of how a combination of physical exercise and dietary glucose supplement may help to alleviate cognitive impairment in schizophrenia. Methods: Literature on metabolic dysregulation, especially insulin resistance, in relation to the onset of schizophrenia and the associated cognitive impairment is reviewed. The cognitive enhancement effects of physical exercise and dietary glucose supplement are then summarised. Finally, we propose a theoretical model based on the concerted effects of physical exercise and glucose supplement. Results: In general, the joint action of physical exercise and dietary glucose supplement could up-regulate glucose and insulin transport into the brain, as well as augmenting the release of insulin growth factor-1 and brain-derived neurotrophic factor. Physical exercise and glucose supplement could enhance energy supply and neuroplasticity in brain, subsequently leading to potential cognitive enhancement in schizophrenia. However, glucose supplement is not suitable for patients with abnormal metabolic profile. Conclusions: The combination of physical exercise and glucose supplement has potential therapeutic values in treating cognitive impairment in schizophrenia. Further research is necessary to investigate the optimal patterns of exercise and doses of glucose for treating cognitive impairment in schizophrenia. © 2013 Wiley Publishing Asia Pty Ltd.link_to_subscribed_fulltex