Experience of Horticultural Group Therapy Among People With Chronic Schizophrenia
Chronic SchizophreniaTaiwan National Health Insurance Administration database shows that the number of people seeking medical treatment due to mental illness has reached 1.454 million in 2021. The annual growth rate of mental illness is between 3.3% to 6.6%. Fifty percent of mental illness patient has catastrophic illness certificate because of chronic schizophrenia (Ministry of Health and Welfare,2022). Auditory hallucinations, delusions, emotional disturbances, and disorder in behavior and the poor ability of speaking are common in patients with schizophrenia. These symptoms lead to reduce the cognitive and executive function, resulting severe impairment of eventual daily living functions and social interactions. Thus, the cost of hospitalization and medical fee is increased. It is worth considering the appropriateness of the model of care. According to researches, people with schizophrenia still strive to pursue a happy and satisfying life. However, statistics of satisfaction and happiness are still lower than people who are healthy (Palmer et al., 2014; Fervaha et al., 2016). The American Horticultural Therapy Association (AHTA) pointed out that horticultural therapy increases the well-being of participants through active or passive participation in plant-related activities. It also helps participants learn new skills or regain lost skills. Furthermore, psychiatric symptoms, recovery outcomes, life satisfaction, and the benefits of social function are significantly improved (Lu et al., 2021; Oh et al., 2018). Taiwanese scholars mention that combining horticultural activities and group psychotherapy improves the therapeutic results. It means that using of flowers and plants in gardening combines with the therapeutic advantages of group psychotherapy, mental illness patients can benefit more from it (Lin, 2016). This study aims to explore the experience of patients with chronic schizophrenia participating in horticultural group therapy. This research design adopts the purposive sampling in qualitative method from a psychiatric hospital in central Taiwan. It is expected that 10 participants will involve in 12 times of horticultural therapy, and recordings will be made in each group. After 12 times of the therapy, participants will be involved in semi-structured audio-recorded interviews. The collected data were analyzed step by step using the content analysis method. In addition, participants will finish the questionnaires of the "Mental Well-Being Scale"," Satisfaction With Life Scale ", " activity of daily living Scale ", Instrumental Activities of Daily Living Scale", and "Group Efficacy Observation Form" before and after the therapies. The data will be conducted with descriptive statistics, Pearson's correlation coefficient, Chi-square Test, Paired Sample t test by using SPSS 21.0 statistical software. This research hopes to understand the impact of horticultural treatments in people who suffer from chronic schizophrenia, and provides a reference to clinical teams.
Pharmacologic Treatment in Legal Offenders With Schizophrenia, a Prospective Observational Mirror...
SchizophreniaConsidering the vulnerability of patients with schizophrenia in forensic treatment, we have designed a prospective-observational trial. The purpose of our study, notably its focus on selecting the appropriate medication, developing clinical profiles, and determining the grounds of clinical judgment, is relevant for treating patients with schizophrenia.
Long-acting Antipsychotics for Mental Ill-Health in Pregnancy and Postpartum
SchizophreniaPsychosis6 moreThe goal of this observational study is to learn about how long-acting, injectable mental health medications are affected by the changes that take place in the body during pregnancy, and how much an unborn baby is exposed to. The investigators are also interested in the amount of these drugs that enters into breastmilk and taken by babies during breastfeeding. In addition to their regular clinic visits to receive long-acting mental health medicine injection, participants will be invited for up to four study visits between day 2 and 14 after the injection. This will happen only once during pregnancy, and once during the breastfeeding period to collect a few drops of blood on special filter paper card from the finger using safety lancet. A few drops of breastmilk will also be collected. Immediately after delivery, a few drops of blood will be collected from the mother, umbilical cord and the baby heel. The investigators will use these samples to determine the amount of the drug in the body during pregnancy and compare this to the amount during the breastfeeding period. Additionally, every month during the third trimester, and during the first 3 months postpartum, participants will complete a questionnaire (using the Liverpool University Neuroleptic Side Effect Scale) to document how they are feeling. Clinical improvement will be documented by the primary care provider using the Clinical Global Impressions Scale. Findings from this study are expected to help healthcare providers to understand these drugs better so that they can make informed decisions about if and how to use these drugs in women who become pregnant or are breastfeeding.
Multidisciplinary Design to Optimize Schizophrenia Treatment Based on Multi-omics Data and Systems...
SchizophreniaTreatment-resistant Schizophrenia5 moreSchizOMICS is a Phase IV, multicenter, dose-flexible, open-label, randomized controlled clinical trial to evaluate the efficacy and safety of aripiprazole versus paliperidone using multi-omics data in patients with a first psychotic episode. The trial will include a total of 244 patients, with two arms of treatment with paliperidone and aripiprazole (1:1). The main objectives of the study are: To compare the efficacy and safety of aripiprazole and paliperidone in the treatment of first episode psychosis (FEP) subjects in real-world clinical settings at 3 months. To elucidate whether non-responders after 3 months of adequate treatment may display different molecular signatures at baseline based on multi omics data and systems biology analysis. To uncover whether the appearance of side effects after 1 year of adequate treatment may be related to different molecular signatures based on multi-omics data and lifestyle phenotype using systems biology analysis.
Time,Self and Spontaneous Mental Activities in Patients With Psychotic Disorders
SchizophreniaBipolar DisorderThe main purpose of the study is to examine to which extent abnormalities in the dynamics of neural activities observed in patients with psychosis is related to difficulties at ordering simple visual stimuli and/or personal events.
National Pregnancy Registry for Atypical Antipsychotics
Use of Atypical Antipsychotics During PregnancySchizophrenia3 moreThe purpose of the National Pregnancy Registry for Atypical Antipsychotics is to determine the frequency of birth defects among infants exposed to atypical antipsychotics.
Add-on Aripiprazole on Cardiometabolic Profile in Treatment Resistant Schizophrenia: RCT
Difference in the Change in Cardiovascular Risk in Treatment Resistant SchizophreniaThe goal of this clinical trial participant population is to evaluate the effect of add on Aripiprazole in reducing the metabolic parameters in patients of TRS on Clozapine with metabolic syndrome. The cardiovascular risk would be measured by calculating the change in QRISK3(QRISK3 is an algorithm tool used to calculate cardiovascular risk. The software calculates the risk score using various parameters. It is a name not an abbreviation.) score and the metabolic parameters by change in Low density lipoprotein(LDL)/High-density lipoprotein(HDL) ratio, High sensitive C Reactive Protein (hs CRP), Insulin resistance (HOMA IR) and fasting plasma glucose level. The main question is to find out the change in cardiovascular risk score between the study groups in TRS on Clozapine with metabolic syndrome. It aims to answer the change in cardiovascular risk in terms of change in QRISK 3 score. Participants will be assessed for cardiovascular risk using QRISK 3 and entering the entering information like age, height, BMI, weight, Lipid profile, past history of angina, Chronic Kidney Disease (CKD), Migraine etc in the QRISK 3 algorithm. Subsequently they will be assessed using rating scales like Positive and negative symptom scale (PANSS) and Clinical Global Improvement (CGI) for positive and negative symptoms and clinical global improvement respectively. They will be randomized into 2 groups and one group will receive treatment as usual while the other group will receive Aripiprazole 10 mg/day along with treatment as usual. They will be reassessed at 3 time points like baseline, at 3 months and 6 months. Blood sample will be collected for hs CRP, lipid profile, Fasting Blood Sugar (FBS) at the baseline and after 6 months. Researchers will compare both the groups to see if augmentation with Aripiprazole will reduce the metabolic risk or not.
Predictors of Functional Remission in Discharged Patients With Schizophrenia After Long-term Drug...
SchizophreniaStudy objectives: Describe the characteristics of discharged patients with schizophrenia achieving functional remission after drug discontinuation. Establish a prediction model of patients with schizophrenia having good prognosis after drug discontinuation.
Critical Time Intervention-Peer Support
Psychotic DisordersSchizophrenia2 moreThere is increasing awareness of the importance of providing mental health services and support that promote a recovery-oriented and human rights-based approach. A mental health service system that is guided by a rehabilitation and recovery perspective places emphasis on treating the consequences of the illness rather than just the illness "per se", and on empowering people to regain control of their identity and life, and to have hope for the future. Within this philosophy, mental health policies in several countries advocate for the introduction of peer workers in mental health services, people with lived experience of mental health issues and recovery, who are employed to use their lived experience to support those who access mental health services. However, more effectiveness and implementation research is needed. Evidence also suggests that the period following hospital discharge is of high risk of treatment dropout for people with serious mental illness, thus interrupting their recovery process. Therefore, this vulnerable population may particularly benefit from more targeted interventions during this transitional period. The research project will conduct a randomized controlled trial to evaluate the effectiveness, feasibility and implementation of the Critical Time Intervention-Peer Support model, a recovery-oriented based model for people with serious mental illness discharged from inpatient psychiatric treatment facilities in Portugal. The randomized controlled trial (RCT) will be conducted in three psychiatric services in the Lisbon Metropolitan Area and their catchment areas. People with diagnoses of psychotic disorders discharged from inpatient psychiatric treatment facilities will be recruited and randomly divided into CTI-PS intervention or usual care. Those allocated to the intervention group will additionally receive CTI-PS rather than usual care alone over a 9-month period. Outcomes at baseline, 9- and 18-months will be analyzed by multilevel models, considering the observations clustered within sites. Longitudinal analyses will be used to examine trends over time of the outcomes of interest. The implementation of the CTI-PS model will introduce a novel approach to community mental health care that has not yet been tried in Portugal. This study aims to explore to what extent this intervention can be effective and implemented in countries with the characteristics of Portugal. Additionally, the proposed research aims to contribute to the global knowledge about peer interventions by investigating whether the CTI model maintains its effectiveness using peers.
Effectiveness of Motivation Skills Training (MST)
SchizophreniaSchizoaffective DisorderThis study will take place at four outpatient clinics serving adults with serious mental illness. Informed consent will be obtained from N=80 individuals with a Diagnostic and Statistical Manual of Mental Illnesses (DSM)-5 diagnosis of schizophrenia or schizoaffective disorder meeting inclusion/exclusion criteria to participate in a randomized controlled trial comparing Motivation Skills Training (MST) to a Healthy Behaviors Control (HBC) group. Eligible participants will receive a baseline assessment including sociodemographic and psychosocial assessments, measures of motivation, goal attainment, and quality of life, as well as measures of executive skills, community functioning, and psychiatric symptoms severity. Both MST and HBC will be implemented as once weekly group therapies. The treatment phase is approximately 12-14 weeks. MST will focus on motivation knowledge and self-regulation skills while HBC will focus on physical health and health-related skills.