RESUMEN
Throughout the COVID-19 pandemic, and beyond for many businesses, employees have had to adapt to new ways of working due to disruptions in traditional practices. It is therefore crucial to understand the new challenges that employees are facing when it comes to taking care of their mental wellbeing at work. To that end, we distributed a survey to full-time UK employees (N = 451) to explore how supported they felt throughout the pandemic, and to identify whether there are any additional types of support they would like to receive. We also compared employees' intentions to seek help before versus during the COVID-19 pandemic, and assessed their current attitudes toward mental health. Based on direct employee feedback, our results show remote workers felt more supported throughout the pandemic compared to hybrid workers. We also found that employees who had previously experienced an episode of anxiety or depression were significantly more likely to want extra support at work compared to those who had not. Furthermore, employees were significantly more likely to seek help for their mental health during the pandemic compared to before. Interestingly, the largest increase in intentions to seek help during the pandemic compared to before was with digital health solutions. Finally, we found that the strategies managers have adopted to better support their employees, an employee's mental health history, and their attitude to mental health all contributed to significantly increasing the likelihood that an employee would disclose a mental health concern to their line manager. We provide recommendations that encourage organisations to make changes to better support their employees, and we highlight the importance of mental health awareness training for both managers and employees. This work is of particular interest to organisations who are looking to tailor their current employee wellbeing offer to a post-pandemic world.
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COVID-19 , Humanos , COVID-19/epidemiología , Pandemias , Empleo , Recursos Humanos , Reino Unido/epidemiologíaRESUMEN
PURPOSE: People living with psychotic illness disproportionately experience more comorbidities and have a markedly shorter life expectancy compared to the general population. This review evaluates the effectiveness of health behavior change interventions in improving health outcomes in this group. DESIGN AND METHODS: All studies included objective physical health measures or health behaviors as the main outcome measures and experimental design with baseline and follow-up quantitative data. Only studies of moderate and strong quality were included. Narrative synthesis was undertaken. FINDINGS: Included studies utilized a range of methodological designs and outcome measures. The majority reported significant intervention effect on most outcome measures. PRACTICE IMPLICATIONS: Health behavior change interventions can be effective in improving health outcomes in people with psychotic illness, with the potential benefit of improved psychiatric outcomes.
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Promoción de la Salud/métodos , Trastornos Psicóticos/terapia , Conductas Relacionadas con la Salud , Estado de Salud , Humanos , Servicios de Salud Mental/organización & administración , Trastornos Psicóticos/complicaciones , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
An inability to experience pleasure or a reduction in the ability to do so is a prominent feature of schizophrenia that is often included among the negative symptoms of the disorder. As a whole, dysfunction in the affective experience of pleasure in patients with schizophrenia is poorly understood and is mediated by a number of cognitive and emotional processes. Whilst there is evidence that patients with schizophrenia have an impaired ability to derive and experience pleasure from non-current tasks, there is some evidence that they report current pleasurable experiences similar to non-clinical control participants. Previous studies investigating anhedonia have a number of methodological shortcomings that fail to examine the impact of general symptomology on the ability to experience pleasure. This current study involved 55 adults meeting the criteria for a diagnosis of schizophrenia. We looked specifically at relationships between anhedonia and positive, negative and general symptomatology. The results support the notion that anhedonia may best be considered as a separate phenomenon from negative symptoms of schizophrenia and from related symptomatology. The implications of these findings are considered in relation to future treatment initiatives.
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Síntomas Afectivos/psicología , Anhedonia , Psicología del Esquizofrénico , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Síntomas , Adulto JovenRESUMEN
OBJECTIVE: This study identified predictors of psychosocial outcome in schizophrenia. METHOD: A mixed group of patients diagnosed with schizophrenia were assessed as part of a routine clinical evaluation. A linear regression analysis was conducted in order to examine the effect of duration of untreated illness, number of previous hospitalisations, history of psychotic episodes and age at illness onset on patients' functioning, as assessed with the Global Assessment of Functioning (GAF) scale. RESULTS: Number of previous psychotic episodes as well as duration of untreated illness were the strongest predictors of patients' levels of functioning amongst all main outcome measures. Older age at illness onset also predicted poorer functioning. Limitations. A principal limitation of our study is that our sample included predominantly Caucasian males; therefore, any extrapolation to other groups may remain speculative. CONCLUSIONS: Our preliminary results suggest that psychosocial outcome in schizophrenia may be affected by different factors. Longer history of psychotic episodes emerged as the most significant determinant of poorer outcome while longer duration of untreated illness and older age at illness onset were also associated with detrimental effects. Our findings may reflect the combined influences of neurodevelopmental abnormalities, exposure to psychotropic medication and psychosocial interventions as well as the vicissitudes of natural aging processes embedded in a chronic mental illness.
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Trastornos Psicóticos/complicaciones , Esquizofrenia/complicaciones , Psicología del Esquizofrénico , Adolescente , Adulto , Edad de Inicio , Hospitalización , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Pronóstico , Escalas de Valoración Psiquiátrica , Trastornos Psicóticos/epidemiología , Adulto JovenRESUMEN
To explore whether cognitive impairment and global functioning can predict the degree of insight into illness as well as whether insight is mediated by specific symptom dimensions of psychopathology in schizophrenia. A dimensional/cross sectional approach was used. A mixed group of clients (n = 36) were assessed as part of a routine clinical evaluation. The Wechsler Adult Intelligence Scale (WAIS) was used as a measure of intellectual performance, the Brief Symptom Inventory (BSI) was used as a measure of general psychopathology while the Global Assessment of Functioning (GAF) scale assessed clients' psychosocial functioning; insight was assessed with the Insight and Treatment Attitudes Questionnaire (ITAQ). The correlation matrix of all outcome variables was examined; confounding effects of illness duration were tested by partial correlation analyses. GAF correlated with insight (rho = 0.41, P = 0.01) and the interpersonal sensitivity dimension of BSI (rho = -0.38, P = 0.03. Insight correlated positively with the anxiety (rho = 0.38, P = 0.03) and psychoticism (rho = 0.36, P = 0.04) dimensions of BSI. Our results suggest that insight is part of the phenomenology in schizophrenia, not being determined by neurocognitive disturbances. Improved insight was associated with more frequent psychotic symptoms endorsement, higher levels of anxiety and less severe psychopathological symptoms and difficulties in psychosocial functioning; clients with more pronounced difficulties in their personal and social interactions exhibited worse psychosocial functioning and more severe psychopathological symptoms.
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Actitud Frente a la Salud , Cognición , Esquizofrenia/diagnóstico , Psicología del Esquizofrénico , Adulto , Estudios de Cohortes , Femenino , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Calidad de Vida , Índice de Severidad de la Enfermedad , Conducta SocialRESUMEN
BACKGROUND: Donepezil Hydrochloride (Aricept) is a selective anticholinesterase inhibitor developed for the treatment of Alzheimer's disease (AD). This study investigated the safety and efficacy of the drug to treat Down syndrome (DS) adults with mild to moderate AD. METHOD: This was a 24-week, double blind, placebo controlled, parallel-group trial. Patients were randomized to receive placebo or donepezil (5 mg per day during the first four weeks, and then 10 mg per day thereafter). Primary efficacy was measured using the Dementia Scale for Mentally Retarded Persons (DMR), and secondary efficacy was measured using the Severe Impairment Battery (SIB), Neuropsychiatric Inventory (NPI) and by the Adaptive Behavior Scale (ABS). RESULTS: A total of 30 DS patients with AD entered the study of which 27 were included in the subsequent data analysis. The donepezil group had non-statistically significant reduction in deterioration in DMR, SIB, and ABS mean scores relative to the placebo group. However NPI scores showed less improvement in the donepezil group when compared to the placebo group. Fifty percent of subjects in the donepezil group showed improvement in mean DMR scores at the end point compared to baseline, when compared to 31% on placebo. There were no life threatening adverse effects associated with treating adults with DS with donepezil. A number of side-effects did occur including diarrhoea, insomnia, fatigue, and nausea. CONCLUSION: Donepezil Hydrochloride administered once a day appears to be generally well tolerated and safe in DS adults who have AD. There is some possible efficacy in the treatment of symptoms of mild to moderate Alzheimer's disease in this population, although the sample size of this study was too small for statistical significance. It is recommended that donepezil, with the appropriate precautions, should be considered for the treatment of AD in adults with DS as deemed by a specialist.