Motivation and Skills Support (MASS)
SchizophreniaSchizoaffective DisorderSocial impairment contributes to more severe symptoms, higher rates of hospitalization, and increased disability in persons with schizophrenia. In this study the investigators will develop a smartphone application and test its impact on improving real-world social functioning in persons with schizophrenia. Findings from this study will allow researchers and clinicians to better understand ways to improve social skills and social motivation, two common problems in the daily lives of persons with schizophrenia. The investigators hope this mobile phone-based support application will ultimately contribute to increased access to effective treatments for social functioning in this population.
Implementation of Family Involvement for Persons With Psychotic Disorders.
Psychotic DisordersThis study will develop and evaluate a complex intervention to implement guidelines on family involvement for patients with psychotic disorders (F20-29 in International Classification of Diseases ICD-10) in community mental health centres, by using a cluster randomised design. Fifteen Norwegian outpatient units participate in the study, and each of them constitutes a single cluster, except for two collaborating clinics who are considered one cluster. Of the fourteen clusters, half will receive implementation support and training immediately, whereas the other half will receive it one and a half year later. The study will assess both service level outcomes, by measuring fidelity scores, and selected outcomes for patients and relatives, by collecting questionnaires and data from central health registers and patient records. In addition, qualitative interviews will be performed with patients, relatives and health care personnel. The study will also include a cost-effectiveness analysis and a political economy analysis.
Virtual Reality Job Interview Training in Severe Mental Illness
SchizophreniaSchizoaffective Disorder2 moreThis is a randomized controlled trial to evaluate the community-based effectiveness of virtual reality job interview training (VR-JIT). Northwestern University is partnering with Thresholds Inc. to evaluate the effectiveness of VR-JIT at improving interviewing skills and access to employment. In addition, we will evaluate the cost effectiveness of VR-JIT and the process for implementing VR-JIT at Thresholds.
Engaging Patients With Mental Disorders From the ED in Outpatient Care
Mental DisorderThis study will compare the effectiveness of professional and peer care managers in improving linkage to and engagement in outpatient care after an emergency department (ED) discharge, as well as the mechanisms by which engagement occurs. The study will use a multi-site randomized trial study design across 8 EDs in South Carolina with telepsychiatry programs; each site will have one professional care manager (social worker or nurse) and one peer specialist care manager. Eligible subjects at each site will be randomized to a one-year treatment engagement intervention, the Coordination, Access, Referral and Evaluation (CARE) Program with either a peer or professional care manager, resulting in a total of 290 participants across sites. The CARE program will focus on shared decision-making between care managers and patients, and combines the traditional medical model of care management with a recovery-based approach.
Improving Neurocognitive Deficits and Function in Schizophrenia With Transcranial Magnetic Stimulation...
SchizophreniaSchizoaffective DisorderThe purpose of this study is to determine whether repetitive transcranial magnetic stimulation (rTMS) is effective in remediating cognitive deficits while also improving functionality in Veterans with schizophrenia.
Psychosocial Intervention to Reduce Self-stigma and Improve Quality of Life Among People With Mental...
SchizophreniaBipolar Disorder1 moreThe principal objective of this pilot trial is to evaluate the effectiveness of a psychosocial intervention to reduce self-stigma and improve treatment adherence and quality of life among people with a severe mental illness who attend to Community Mental Health Centers in Chile. The intervention is based on recovery and narrative therapy and considers 10 group sessions, mainly with patients, but also integrating relatives and professionals in some of the activities.
Person-Centered Psychosis Care: An Educational Intervention
Patient-Centered CarePsychiatry2 moreSchizophrenia is a major mental illness that presents in young adulthood and affects ~1% of the population. Impact on affected persons life is often major and life expectancy is reduced by ~20 years. Better and more effective care models are needed to increase health in these persons. Person-centered care have been suggested to be one way to increase efficiency in care delivery for patients with chronical and complex conditions. The impact of person-centered care on a inpatient psychosis care setting is now being tested. The purpose of this study is to test whether inpatient Person-centered psychosis care (PCPC) can increase patient empowerment improve patient satisfaction reduce the frequency of involuntary treatments reduce the duration of inpatient care and reduce overall ward burden A further purpose is to qualitatively explore which components in this complex intervention are experienced as facilitators or barriers to the achievement of good care, from both patient, next-of-kin and staff perspectives. Quantitative data is collected through questionnaires from patients (measuring empowerment, care satisfaction and perceived health) before and after an educational intervention for staff, along with ward level measures such as care burden, number of involuntary treatments and length of stay on ward. Qualitative interview is used to study experiences of patients, next-of-kin and staff.
Biomarkers of Conversion Risk and Treatment Response in Early-Stage Schizophrenia
Schizophrenia Spectrum and Other Psychotic DisordersSchizophrenia (SZ) is a highly debilitating neuropsychiatric disorder of young adulthood onset and a leading cause of disability worldwide. While treatments delivered at early stages of the disorder may be effective at reducing psychosis or altering the course of the disease, there are currently no biomarkers capable of identifying subjects in early stages of SZ who are likely to respond to treatment and would be good candidates for available proactive, symptomatic or future disease-modifying treatments; or those who would not respond and can be spared unnecessary medication exposure. The lack of these vitally important biomarkers provides a compelling rationale for the present multidisciplinary research project, which aims to develop and validate highly promising noninvasive and objective proton magnetic resonance spectroscopy (1H MRS)-based biomarkers for monitoring treatment response in early stages of SZ. In support of the viability of this overall objective is a large body of data, reported by the applicants and others, that show (a) that levels of glutamate (Glu) and - aminobutyric acid (GABA) - respectively, the major excitatory and inhibitory amino acid neurotransmitter systems - are abnormally elevated in medication-naïve and unmedicated first episode and chronic SZ patients; (b) that the effect of treatment with antipsychotic medications in these populations may be to lower or normalize brain levels of both Glu and GABA. To investigate the potential of these in vivo brain Glu and GABA abnormalities to serve as biomarkers of treatment response in early-stage SZ, the applicants propose to use 1H MRS to measure Glu and GABA levels in the largest cohort of medication-free SZ subjects to date, at baseline and following 4 weeks of antipsychotic treatment.
PRIME vs Usual Care for Clinical High Risk
Clinical High Risk Syndrome for PsychosisThe purpose of this study is to determine whether specialty care is superior to usual care in the treatment of patients at clinical high risk for psychosis.
RCT Examining the Effectiveness of Digital Picture Frame Use in Inpatient Setting
SchizophreniaPsychosis1 moreThis study will be a randomized controlled trial that investigates the effectiveness of digital picture frames (DPF) installed in inpatient rooms on long stay inpatient wards servicing schizophrenia clients at CAMH. The effects on client experience will consider the domains of self-concept, interactions with healthcare staff, perception of space, and implications for the recovery process. The comparison of inpatient client experience with DPFs versus a control group (Treatment as Usual - TAU), offers the opportunity to examine the effectiveness of this type of environmental adaptation. This trial builds upon earlier work that demonstrated the feasibility of DPFs in this context.