Lessons learned from experiencing Mavi At Café (Blue Horse Café) during Six years: A qualitative analysis of factors contributing to recovery from the perspective of Schizophrenia patients

Objective: In recent years, the recovery-oriented approaches (along with experiences and thoughts of patients and patient's relatives) have been taken into account for establishing mental health services and policies. This study aims to identify the factors contributing to recovery, as observed from the perspective of schizophrenia patients working at The Blue Horse Café which was founded by the Federation of Schizophrenia Associations. Method: The sample for the study consisted of 24 patients who worked at The Blue Horse Café. A phenomenological approach was used in the study, whereby interviews with patients were analyzed qualitatively. Results: Certain common factors, which were expressed as having contributed to recovery, were identified from the perspective of schizophrenia patients. These factors are: 1-The fact that the setting is informal and welcoming without being constrictive; 2-Predominance of the human element; 3-Hope and encouragement; 4-Being cared about; 5-Being able to reach someone when in need of support; 6-Friendly sharing; 7-Having a purpose, assuming responsibility, and being motivated; and 8-Giving meaning to life. Conclusion: The findings may serve as a stimulus since schizophrenia patients that contribute to recovery give mental health professionals the opportunity to question there need for a change in their professional roles. Additionally, schizophrenia patients that have experienced The Blue Horse Café draw attention to certain points and these points can serve as a guide, especially for establishing the working methods of Community Mental Health Centers

Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings

Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ. Patients showed medium to large deficits across all functions (ES range = –0.45 to –0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = –0.14 to –0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = –0.88 to –0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically significant, albeit reduced by half (ES range = –0.13 to –0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = –0.21 to –0.43, p < 0.01). Deficits in verbal knowledge, and working memory may specifically index familial, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders

Identifying an optimal treatment for schizophrenia: A 2-year randomized controlled trial comparing integrated care to a high-quality routine treatment

Objective. This study used repeated outcome measures over a 2-year period to compare the clinical and social benefits of routine schizophrenia treatment with those of evidence-based pharmacological and psychosocial treatment strategies. Method. One hundred patients who were diagnosed with schizophrenia according to DSM-IV criteria were randomly assigned to 24 months of either optimal case management (OCM) or routine case management (RCM). OCM involved minimally effective doses of antipsychotic medication with compliance training, an identical treatment programme with the addition of manual-based communication and problem solving training to help patients and caregivers manage stress, social skills training, supported employment, cognitive-behavioural strategies for residual psychotic and non-psychotic symptoms, as well as anger management and substance use counselling. RCM involved minimally effective doses of antipsychotic medication with compliance training, the monitoring of side effects, education about schizophrenia and its optimal treatment, detection of early warning signs and supportive psychotherapy to address practical problems. The symptoms, impairment, disability, unmet needs, quality of life of the patients were examined by blinded researchers every 6 months. Results. Statistically and clinically significant advantages were observed for OCM versus RCM on all measures. Most of these advantages increased throughout the 24-month period. Conclusions. This study helps demonstrate the importance of psychosocial interventions in the treatment of schizophrenia. Recent advances in evidence-based psychosocial strategies can be implemented into routine clinical practice with additional clinical and social benefits

The impact of antistigma education on the attitudes of general practitioners regarding schizophrenia

The aim of this study was to examine the views and attitudes of general practitioners (GP) with respect to schizophrenia, and the changes in their attitudes after antistigma education. A total of 106 GPs working in 71 health institutions were included in the study. A questionnaire of 16 items, focussing on doctors' views and attitudes towards schizophrenia, was applied. Questions were about the views and attitudes of doctors towards general myths related to schizophrenia. Doctors were asked to select one of two responses: 'I agree' or 'I disagree', for statements such as 'schizophrenic patients cannot work' and 'schizophrenic patients are aggressive and dangerous'. After completing the questionnaire, all the GPs were given a single session of antistigma education. The questionnaire was repeated 3 months after training meetings in a subsample of 54 GPs which represented the whole sample in terms of gender, age, and years in medical practice. The authors found statistically significant, positive changes on five items out of the 16 items in the post-test survey when compared to attitudes before training, including items about the treatability of schizophrenia, harmfulness and untrustworthiness of schizophrenic patients. The authors' findings suggest that one antistigma education session, supported by the distribution of related documents, can improve GPs attitudes towards schizophrenia

Effects of a Psychosocial Rehabilitation Program in Addition to Medication in Schizophrenic Patients: A Controlled Study

Objectives: The contemporary approach to psychiatric diseases is to refer the patient to community-based care instead of hospital-based care. In addition to medication, it has been found that day-hospital practices have positive results in schizophrenic patients. In this study, our purpose is to report the results of a psychosocial rehabilitation program at Bakirkoy Day Hospital for schizophrenic patients receiving medication, and to compare them with the results for schizophrenic patients receiving medication who were not in this program

Undescended testis:A roundtable discussion based on clinical scenarios – Part 1

Undescended testis (UDT, cryptorchidism) is the most common congenital anomaly of the genital tract. Despite its high incidence, the management of UDT varies between specialties (urology, pediatric surgery, pediatric urology, pediatric endocrinology). Therefore, as the European Association of Urology – Young Academic Urologists Pediatric Urology Working Group, we requested experts around the world to express their own personal approaches against various case scenarios of UDT in order to explore their individual reasoning. We intended to broaden the perspectives of our colleagues who deal with the treatment of this frequent genital malformation.</p