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- Affectivity in schizophrenia: Its relations with functioning, quality of life, and social support satisfactionPublication . Pinho, Lara Guedes de; Pereira, Anabela Maria Sousa; Chaves, Claudia; Sequeira, Carlos; Sampaio, Francisco; Correia, Tânia Sofia Pereira; Gonçalves, Amadeu; Ferré-Grau, CarmeObjective: To evaluate the relationship between affectivity and sociodemographic and clinical characteristics, quality of life, functioning, and social support satisfaction in schizophrenia. Method: Cross‐sectional study of a sample of 282 schizophrenic patients. An interview was performed using a sociodemographic and clinical questionnaire and scales to evaluate positive and negative affect, quality of life, social support satisfaction, and functioning. Results: Participants' employment status, gender, whether they smoked, hospitalization in the last year, antidepressant medication and benzodiazepines, quality of life, functioning, and satisfaction with social support had relationships with positive or negative affect. Conclusion: This study provides further understanding of the factors related to affectivity in schizophrenia. More studies are needed to prove these relations and their effects on rehabilitation in people with schizophrenia.
- Assessing the efficacy and feasibility of providing metacognitive training for patients with schizophrenia by mental health nurses: a randomized controlled trialPublication . Pinho, Lara Guedes de; Sequeira, Carlos; Sampaio, Francisco; Rocha, Nuno; OZASLAN, ZEYNEP; Ferre‐Grau, CarmeAim: To evaluate the efficacy of metacognitive group training in reducing psychotic symptoms and improving cognitive insight and functions in people with schizophrenia.Design: Randomized controlled trial. It was carried out between July 2019-February 2020. Methods: Fifty-six patients with schizophrenia were enrolled and randomly as- signed to either a control group (N = 29) or a metacognitive training group (N = 27). Blinded assessments were made at baseline, 1-week post-treatment and at follow-up 3 months after treatment. The primary outcome measure was psychotic symptoms based on the Psychotic Symptom Rating Scales (PSYRATS). Secondary outcomes were assessed by the Beck Cognitive Insight Scale (BCIS), the Personal and Social Performance (PSP) scale and the World Health Organization Disability Assessment Schedule (WHODAS). Results: Completion at follow-up was high (92.86%). The intention-to-treat analy- ses demonstrated that patients in the metacognitive training group had significantly greater improvements of the Psychotic Symptom Rating Scales delusion score and total score and the Personal and Social Performance Scale, after 3 months, compared with the control group. The effect size was medium to large. The intention-to-treat analyses also demonstrated that patients in the metacognitive training group had significantly greater reductions of the Psychotic Symptom Rating Scales hallucination score and Beck Cognitive Insight Scale self-certainty score post-treatment, compared with the control group. The effect size was medium to large. Conclusion: The metacognitive training administered by psychiatric and mental health nurses was effective in ameliorating delusions and social functioning over time and it immediately reduced hallucinations post-treatment. Impact: Metacognitive training for treating psychosis in patients with schizophrenia is efficacious and administration is clinically feasible in the Portuguese context.
- A randomized controlled trial to evaluate the efficacy of metacognitive training for people with schizophrenia applied by mental health nurses: Study protocolPublication . Pinho, Lara Guedes de; Sequeira, Carlos; Sampaio, Francisco; Rocha, Nuno Barbosa; Ferre‐Grau, CarmeAim: To evaluate the efficacy of the Portuguese version of the metacognitive training (MCT) programme for schizophrenia and its effects on psychotic symptoms, insight into the disorder and functionality. Design: This is a randomized controlled trial that will be undertaken in six psychiatric institutions in Portugal. Methods: This study was approved in March 2019. The sample will consist of people with schizophrenia. The evaluation instruments will include sociodemographic and clinical questionnaires, the Psychotic Symptom Rating Scales, the Beck Cognitive Insight Scale, the World Health Disability Assessment Schedule, and the Personal and Social Performance Scale, applied to both groups at three different times. In the experimental group, the eight MCT modules will be applied over 4 weeks. Discussion: It is expected that at the end of the programme, the experimental group will have reduced severity of psychotic symptoms and improved insight into the disease and functionality. Impact: Schizophrenia is a severe mental disorder that, in most cases, leads to the deterioration of cognitive and social functioning as a result of psychotic symptoms. Metacognitive training for schizophrenia has been used in several countries, but its efficacy remains unclear. It is a type of programme that consists of changing the cognitive infrastructure of delusions.
- Cognitive insight in psychotic patients institutionalized and living in the community: an examination using the Beck Cognitive Insight ScalePublication . Pinho, Lara Guedes de; Sampaio, Francisco; Sequeira, Carlos; Martins, Teresa; Ferré-Grau, CarmeImproving cognitive insight can reduce delusions in patients with psychotic disorders. Although institutionalized patients usually have more severe delusions than outpatients, little is known about the differences in cognitive insight between these two groups. In this study, we evaluated the psychometric properties of the Beck Cognitive Insight Scale (BCIS) for a sample of Portuguese patients with psychotic disorders and compared the cognitive insight of institutionalized patients with patients living in the community. Participants in this study were 150 patients diagnosed with psychotic disorder (78 institutionalized patients and 72 outpatients). The tested model of the BCIS was a very good fit. Our study shows that patients living in the community showed higher levels of cognitive insight (total BCIS and self-reflectiveness) than institutionalized patients. Future studies assessing cognitive insight should take into account differences between the cognitive insights of institutionalized psychotic patients and psychotic patients living in the community.