A first step toward cognitive remediation of voices: a case study.

Several studies have shown that source-monitoring errors are related to verbal hallucinations in schizophrenia. An exploratory pilot study has been carried out to investigate the possibility of training patients in how to avoid errors in source-monitoring. One patient with paranoid schizophrenia and persistent thought insertions was trained for 6 hours to use mnemonic techniques to compensate specific deficits in source-monitoring. Results show that the patient was able to improve his performance and maintain the acquired progress at a 1-month follow-up assessment. These preliminary results are interesting for developing a larger controlled study of cognitive remediation of source-monitoring deficits

Patients' Needs for Care in Public Mental Health: Unity and Diversity of Self-Assessed Needs for Care.

PURPOSE: Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients' needs are organized. This study investigates both general and specific dimensions of patients' needs for care. METHODS: Patients' needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients' perceptions. A patient-centered psychiatric practice facilitates empowerment as it is based on the patients' personal motivations, needs, and wants. Four seventy-one patients' profiles were analyzed through exploratory factor analysis. RESULTS: A four-factor bifactor model, including one general factor and three specific factors of needs, was most adequate. Specific factors were (a) "finances" and "administrative tasks"; (b) "transports," "public places," "self-care," "housework," and "food"; and (c) "family," "children," "intimate relationships," and "friendship." CONCLUSION: As revealed by the general factor, patients expressing urgent needs in some domains are also more susceptible to report urgent needs in several other domains. This general factor relates to high versus low utilizers of public mental healthcare. Patients also present specific needs in life domains, which are organized in three dimensions: management, functional disabilities, and familial and interpersonal relationships. These dimensions relate to the different types of existing social support described in the literature

Perceived coercion in psychiatric hospital admission: validation of the French-language version of the MacArthur Admission Experience Survey.

The MacArthur Admission Experience Survey (AES) is a widely used tool to evaluate the level of perceived coercion experienced at psychiatric hospital admission. The French-language AES was prepared using a translation/back-translation procedure. It consists of 16 items and 3 subscores (perceived coercion, negative pressures and voice). This study aimed to assess the psychometric properties of the French-language AES. 152 inpatients were evaluated. Reliability was estimated using internal consistency coefficients and a test-retest procedure. Internal validity was assessed using a two-parameter logistic item response model. Convergent validity was estimated using correlations between the AES scores and the Coercion Ladder (CL), the Coercion Experience Scale (CES) and the Global Assessment of Functioning (GAF) scale. Discriminatory power was evaluated by comparing the scores of patients undergoing voluntary or compulsory admission. The French-language AES showed good internal consistency and test-retest reliability. Internal validity of the three-factor model was excellent. Correlations between AES and CL, CES and GAF scores suggested good convergent validity. AES scores were significantly higher among patients subject to compulsory psychiatric hospital admission than among those admitted voluntarily. Overall, the French-language version of the AES demonstrated very good psychometric proprieties

Méta-analyse et efficacité des psychothérapies : Faits et fictions

In a political environment increasingly concerned with the problem of escalating health care costs, the issue of psychotherapy efficacy evaluation is still debated. Historically, this debate started after Eysenck (1952) published a famous article suggesting that average improvement from pre- to post-therapy has nothing to do with psychotherapy participation, but something that would tend to happen anyway ("spontaneous remission"). Wanting to prove that psychotherapy was effective (Glass, 2000), Smith and Glass (1977) published the first meta-analysis of the psychotherapy efficacy, combining the results of several controlled clinical trials, and found that psychotherapy was remarkably efficacious. Following a brief historical introduction, the objectives of this paper is to define the principles of meta-analysis, to discuss of epistemological contextualization of this methodological approach, and finally to examine the interest and limits of the application of this method in the field of evaluation of psychotherapy

13 - Programme intégratif IPT

Il y a plus de trente ans, Brenner, Roder et leur équipe proposèrent un programme intégratif pour les personnes souffrant de schizophrénie associant une intervention de remédiation cognitive avec un entraînement des compétences sociales : le programme IPT (ntegriertes Psychologisches Therapieprogramm ou Integrated Psychological Treatment, programme intégré de thérapie psychologique). L'IPT s’articule autour de deux pôles : le premier réunit des modules de remédiation cognitive (Différenciation cognitive et Perception sociale, Communication verbale), le second des modules d’entraînement des compétences sociales (Compétences sociales, Gestion des émotions et Résolution de problèmes interpersonnels). Aujourd'hui encore, plus de trente ans après son apparition, l'IPT reste un des seuls programmes intégratifs conçu comme un ensemble articulé de modules de remédiation cognitive et d’entraînement des compétences sociales pour les personnes soufrant de schizophrénie. L’IPT a évidemment évolué en fonction de l’avancée des données théoriques et pratiques et bénéficie de versions tout à fait révisées et actualisées.Traduit dans 13 langues différentes il est aussi probablement un des programmes de remédiation cognitive les mieux diffusés qui a a fait l'objet d'études d’évaluation qui montrent non seulement que les patients apprécient la formule mais qu'il est aussi un programme très bien validé sur le plan scientifique