White noise speech illusions: A trait-dependent risk marker for psychotic disorder?

Introduction: White noise speech illusions index liability for psychotic disorder in case-control comparisons. In the current study, we examined i) the rate of white noise speech illusions in siblings of patients with psychotic disorder and ii) to what degree this rate would be contingent on exposure to known environmental risk factors (childhood adversity and recent life events) and level of known endophenotypic dimensions of psychotic disorder [psychotic experiences assessed with the Community Assessment of Psychic Experiences (CAPE) scale and cognitive ability]. Methods: The white noise task was used as an experimental paradigm to elicit and measure speech illusions in 1,014 patients with psychotic disorders, 1,157 siblings, and 1,507 healthy participants. We examined associations between speech illusions and increasing familial risk (control -> sibling -> patient), modeled as both a linear and a categorical effect, and associations between speech illusions and level of childhood adversities and life events as well as with CAPE scores and cognitive ability scores. Results: While a positive association was found between white noise speech illusions across hypothesized increasing levels of familial risk (controls -> siblings -> patients) [odds ratio (OR) linear 1.11, 95% confidence interval (CI) 1.02-1.21, p = 0.019], there was no evidence for a categorical association with sibling status (OR 0.93, 95% CI 0.79-1.09, p = 0.360). The association between speech illusions and linear familial risk was greater if scores on the CAPE positive scale were higher (p interaction = 0.003; ORlow CAPE positive scale 0.96, 95% CI 0.85-1.07; ORhigh CAPE positive scale 1.26, 95% CI 1.09-1.46); cognitive ability was lower (p interaction < 0.001; ORhigh cognitive ability 0.94, 95% CI 0.84-1.05; ORlow cognitive ability 1.43, 95% CI 1.23-1.68); and exposure to childhood adversity was higher (p interaction < 0.001; ORlow adversity 0.92, 95% CI 0.82-1.04; ORhigh adversity 1.31, 95% CI 1.13-1.52). A similar, although less marked, pattern was seen for categorical patient-control and sibling-control comparisons. Exposure to recent life events did not modify the association between white noise and familial risk (p interaction = 0.232). Conclusion: The association between white noise speech illusions and familial risk is contingent on additional evidence of endophenotypic expression and of exposure to childhood adversity. Therefore, speech illusions may represent a trait-dependent risk marker

What is related to the well-being of the siblings of patients with schizophrenia: An evaluation within the Lazarus and Folkman's Transactional Stress and Coping Model

Background: Schizophrenia is a chronic mental illness that strongly affects not only the patients with schizophrenia, but also their families and close relatives. So far, family research on patients with schizophrenia has mainly focused on parents, but has neglected siblings. Aim: This study aims to evaluate the well-being of 103 siblings of patients with schizophrenia within the Lazarus and Folkman's Transactional Coping and Stress Model. Materials: A Sociodemographic Information Form, Subjective Well-being Scale, Zarit Caregiver Burden Scale, Multidimensional Perceived Social Support Scale, Ways of Coping Scale and Shortened Perceived Parental Rearing Styles Form were administered to the siblings of patients with schizophrenia. Results: The results of this study revealed that well-being was associated with perceived mother overprotection, perceived social support, problem-focused coping and indirect coping. Social support moderated the relationship between burden and well-being as a buffering factor. Conclusion: Therefore, siblings of patients with schizophrenia should be given access to social support and their problem-focused coping strategies should be strengthened. Besides, parents should be supported to provide suitable care for the siblings of patients with schizophrenia

Antistigma Efforts in Turkey The Turkish Program Against Stigmatization and Discrimination Because of Schizophrenia as a Part of the World Psychiatric Association Global Program

This paper examines the Turkish program against stigmatization and discrimination because of schizophrenia as a part of the World Psychiatric Association (WPA) Global Program. The WPA program attempts to alleviate the problems caused by stigmitization and discrimination, such as social isolation, homelessness, and decreased quality of life, by disproving myths and misunderstandings related to schizophrenia. The article specifically addresses the role of teachers and students, general practitioners, media and journalists, and nongovernmental organizations in building an antistigmatization program in Turkey

Lessons Learned from Experiencing Mavi At Cafe (Blue Horse Cafe) 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 Cafe 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 Cafe. 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 Cafe draw attention to certain points and these points can serve as a guide, especially for establishing the working methods of Community Mental Health Centers

Development and validation of the Subjective Recovery Assessment Scale for patients with schizophrenia

OBJECTIVE Studies investigating the recovery from schizophrenia revealed two concepts of recovery; one is clinical recovery, and the other is personal or subjective recovery. Both states of recovery require specific assessment tools and therapeutic approaches. While current measures of clinical recovery can be used upon consensus all over the world, measures of subjective recovery which are based on cultural and individual values are yet to be investigated. The aim of this study was to develop and validate the Subjective Recovery Assessment Scale (SubRAS) for patients with schizophrenia. METHODS The SubRAS consisting of 17-item was prepared using related literature with focus group interviews. Internal consistency reliability was assessed by Cronbach’s alpha coefficients, and test–retest reliability was assessed. Exploratory factor analyses and correlations with Global Assessment of Functioning (GAF), The Heinrichs-Carpenter Quality of Life Scale (QLS), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression – Severity (CGI-S) were used to examine the factor-based validity and construct validity of the SubRAS. RESULTS The participants consisted of 127 patients with schizophrenia (n = 110) and schizoaffective disorder (n = 17), with 63.6% being male and a mean age of 41.2 years. Cronbach’s alpha coefficient of the scale was calculated as 0.98 while item-total score correlation coefficients were measured between 0.83 and 0.94. Test–retest reliability (r = .98) was very satisfactory. As for construct validity, a one-factor solution was obtained that could explain 83.0% of the variance. The scale showed a high correlation with the GAF (r = .82), the QLS (r = .76), PANSS (r = −.74), and CGI-S (r = −.74). CONCLUSIONS SubRAS is a valid and reliable instrument that can be utilized for patients with schizophrenia to assess their subjective recovery states. It is a culture-sensitive self-assessment instrument and easy to use for Turkish patients with schizophrenia

The distinction between unipolar and bipolar depression: A cognitive theory perspective

Background: There is very limited data about the cognitive structure of bipolar depression when compared to unipolar depression. The aim of the study was to look into the differences between unipolar and bipolar depressed patients regarding their cognitive structure in view of Beck's cognitive theory. Methods: In this study, 70 bipolar patients during a depressive episode, 189 unipolar depressed patients and 120 healthy subjects were recruited. The participants were interviewed by using a structured clinical diagnostic scale. To evaluate the cognitive structure differences, the Automatic Thoughts Questionnaire (ATQ) and the Dysfunctional Attitude Scale (DAS) were used. Results: We found that on the mean ATQ total score, the unipolar depressed patients scored significantly higher (92.9 +/- 22.7) than both the bipolar depressed patients (73.2 +/- 24.7) and the healthy subjects (47.1 +/- 19.6), even after controlling for all confounding factors, e.g. gender, marital status, depressive symptom severity (F = 157.872, p < 0.001). The bipolar depressed patients also scored significantly higher on the mean ATQ total score than the healthy controls. On the mean DAS total score, and on the mean score of its subscale of need for approval, the bipolar depressed patients scored (152.8 +/- 21.2 and 48.2 +/- 7.4, respectively) significantly higher than both the unipolar depressed patients (160.9 +/- 29.0 and 51.9 +/- 9.7, respectively) and the healthy subjects (127.9 +/- 32.8 and 40.2 +/- 12.2, respectively), even after controlling for any confounding factor (F = 45.803 [p < 0.001] and F = 43.206 [p < 0.001], respectively). On the mean score of the perfectionistic attitude subscale of the DAS, the depressed groups scored significantly higher than the healthy subjects, but they did not seem to separate from each other (F = 41.599, p < 0.001). Conclusions: These results may help enhance the understanding of the potentially unique psychotherapeutic targets and the underlying cognitive theory of bipolar depression. (C) 2013 Elsevier Inc. All rights reserved