Investigating Trajectories of Social Recovery in Individuals with First Episode Psychosis:A Latent Class Growth Analysis

Background Social disability is a hallmark of severe mental illness yet individual differences and factors predicting outcome are largely unknown. Aim To explore trajectories and predictors of social recovery following a first episode of psychosis (FEP). Method A sample of 764 individuals with FEP were assessed on entry into early intervention in psychosis (EIP) services and followed up over 12 months. Social recovery profiles were examined using latent class growth analysis. Results Three types of social recovery profile were identified: Low Stable (66%), Moderate-Increasing (27%), and High-Decreasing (7%). Poor social recovery was predicted by male gender, ethnic minority status, younger age at onset of psychosis, increased negative symptoms, and poor premorbid adjustment. Conclusions Social disability is prevalent in FEP, although distinct recovery profiles are evident. Where social disability is present on entry into EIP services it can remain stable, highlighting a need for targeted intervention. Declaration of interest Non

From genes to folds: a review of cortical gyrification theory.

Cortical gyrification is not a random process. Instead, the folds that develop are synonymous with the functional organization of the cortex, and form patterns that are remarkably consistent across individuals and even some species. How this happens is not well understood. Although many developmental features and evolutionary adaptations have been proposed as the primary cause of gyrencephaly, it is not evident that gyrification is reducible in this way. In recent years, we have greatly increased our understanding of the multiple factors that influence cortical folding, from the action of genes in health and disease to evolutionary adaptations that characterize distinctions between gyrencephalic and lissencephalic cortices. Nonetheless it is unclear how these factors which influence events at a small-scale synthesize to form the consistent and biologically meaningful large-scale features of sulci and gyri. In this article, we review the empirical evidence which suggests that gyrification is the product of a generalized mechanism, namely the differential expansion of the cortex. By considering the implications of this model, we demonstrate that it is possible to link the fundamental biological components of the cortex to its large-scale pattern-specific morphology and functional organization.This work was funded by the Bernard Wolfe Health Neuroscience Fund and the Wellcome Trust.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s00429-014-0961-

Supporting Employment for Young Adults Living with Mental Health Conditions [English and Portuguese versions]

A Portuguese translation of this publication is available to download under Additional Files. Having a job as a youth or young adult is a predictor of long-term work success. Having a job has also been related to improved self-esteem, self-efficacy, and life satisfaction. However, there is a significant gap in work experience for many young adults living with mental health conditions. This tip sheet has information on 1) why work is especially important for young adults; 2) the impact of receiving disability benefits rather than employment early in life; 3) how to cultivate motivation toward employment goals; 4) ways to promote work experiences; 5) tips on helping young adults with mental health conditions get a job; 6) and resources to learn more

Onset and transition of and recovery from adverse development:study methodology

AIM: Early intervention programs for first-episode psychosis have led to the awareness that the period before onset of a first episode is important in light of early intervention. This has induced a focus on the so-called 'at risk mental state' (ARMS). Individuals with ARMS are at increased risk for later psychotic disorder, but also for other psychiatric disorders as well as poor psychosocial functioning. Thus, adequate detection and treatment of ARMS is essential. METHODS: Since 2018, screening for and treatment of ARMS is recommended standard care in the Netherlands. Implementation is still ongoing. We initiated a naturalistic long-term cohort study of ARMS individuals, the onset and transition of and recovery from adverse development (OnTheROAD) study, with the aim to monitor course and outcome of symptoms and psychosocial functioning over time, as well as patterns of comorbidity and associations with factors of risk and resilience. To this end, participants complete a broad battery of instruments at baseline and yearly follow-up assessments up to 3 years. Outcome is defined in terms of symptom severity level, functioning and quality of life. In particular, we aim to investigate the impact of negative symptoms as part of the ARMS concept. Results from this study can aid in refining the existing ARMS criteria, understanding the developmental course of ARMS and investigating the hypothesized pluripotentiality in outcome of ARMS. New knowledge may inform the further development of specialized early interventions. RESULTS AND CONCLUSIONS: In this article, we describe the rationale, outline and set-up of OnTheROAD

Psychology and the "At Risk Mental State"

Over the last decade there have been orchestrated efforts to detect and intervene during the earliest stages of psychotic illness. This article reviews some of the literature and highlights the current and future contributions of psychology to a rapidly expanding area of research and clinical practice

Implementing individual placement and support in Norway. From vocational rehabilitation to an employment scheme

We explore the implementation and development of individual placement and support (IPS) in Norway. IPS is an evidence-based practice for supporting people experiencing mental illness to obtain and maintain competitive employment. Implementation of IPS into routine practice has been challenged by different paradigms in vocational rehabilitation, health and welfare policies. Data were mainly collected through individual and joint interviews of IPS experts and key stakeholders involved in the implementation of IPS. Data were analysed using thematic analysis. Three themes were derived from the analysis, representing different phases in the implementation process: (1) seeking a way to meet unmet need in work and mental health practice, (2) gathering knowledge and national evidence, and (3) embedding IPS into routine practice. The study demonstrates how health and welfare policy gradually developed IPS from vocational rehabilitation to a mainstreamed welfare employment scheme. This development may secure the future of IPS in Norway. However, the implications for practice in the longer term are unknown. Our study provides insight into how implementation of an evidence-based practice both influences and is influenced by national policymaking