Symptoms and functioning: a content analysis of the PANSS under the ICF framework.

PURPOSE: The study aimed to compare the content of the Positive and Negative Syndrome Scale (PANSS) with that of the International Classification of Functioning, Disability, and Health (ICF) and to examine the extent to which PANSS items are represented in the ICF Core Sets (ICF-CS) for schizophrenia. METHODS: The 30 items of the PANSS were linked to the ICF using established rules by two health professionals experienced in applying the ICF conceptual framework. RESULTS: PANSS items were linked to 42 unique ICF categories, corresponding mainly to the Body functions component; categories b160 Thought functions and b152 Emotional functions from this component were the most frequently linked. Regarding the Activities and participation component, the second-level category d720 Complex interpersonal interactions was the most frequently linked to PANSS items. Overall, PANSS items covered 18% and 40% of the categories included, respectively, in the Comprehensive and Brief versions of the ICF-CSs for schizophrenia. No PANSS items were linked to categories from the Body structures or Environmental factors components. CONCLUSIONS: The PANSS broadly covers the content of the ICF, especially as regards mental and movement-related functions, although it also covers some aspects of interpersonal relationships.

Significaciones del malestar psíquico en espacios de apoyo mutuo y activismo: Una historia de vida / Meanings for mental distress in mutual support spaces and activism: A life story

Nuestra experiencia y el saber derivado de ella es habitualmente segregado de las prácticas para tratarnos en el ámbito de la salud mental. En este trabajo exploramos qué significados son construidos para la experiencia del malestar psíquico cuando participamos en espacios de apoyo mutuo y activismo. Realizamos una investigación cualitativa, de carácter exploratoria, dentro del marco de los Mad Studies (Estudios Locos) y la Survivor Research (Investigación guiada por sobrevivientes), utilizando como método la historia vida de una activista en salud mental. Analizamos la historia según recomendaciones de la Survivor Research y el análisis narrativo comprensivo. La participante entiende su malestar psíquico como un viaje hacia la recuperación, camino que cursa con esperanza y optimismo. Discutimos estos hallazgos y concluimos que se requiere más investigación para desafiar el modelo biomédico predominante y su hegemonía en la definición de nuestras experiencias de malestar psíquico y/o diversidad psicosocial. (AU)

In mental health our experience and the knowledge derived from it is usually omitted from the practices that are used to treat us. In this work, we explore what meanings are built for the experience of mental distress when we participate in mutual support spaces and activism. We carried out a qualitative and exploratory research following the Mad Studies and the Survivor Research framework. The life story of a mental health activist was used as a method. We considered the Survivor Research recommendations and the comprehensive narrative analysis for the analysis. The participant understands her mental distress as a journey to recovery in which she walks with hope and optimism. We discussed these findings and concluded that more research is required to challenge the prevailing biomedical model and its hegemony in defining our experiences of mental distress and /or psychosocial diversity. (AU)

Mapping mad maps and recovery tools developed by mental health service users and survivors of psychiatry: a scoping review.

BACKGROUND: Since 1997, several tools based on the experiences of users and survivors of psychiatry have been developed with the goal of promoting self-determination in recovery, empowerment and well-being. OBJECTIVES: The aims of this study were to identify these tools and their distinctive features, and to know how they were created, implemented and evaluated. METHOD: This work was conducted in accordance with a published Scoping Review protocol, following the Arksey and O'Malley approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Five search strategies were used, including contact with user and survivor networks, academic database searching (Cochrane, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PsycARTICLES, SCOPUS, PubMed and Web of Science), grey literature searching, Google Scholar searching and reference harvesting. We focused on tools, elaborated by users and survivors, and studies reporting the main applications of them. The searches were performed between 21 July and 22 September 2022. Two approaches were used to display the data: descriptive analysis and thematic analysis. RESULTS: Six tools and 35 studies were identified, most of them originating in the USA and UK. Thematic analysis identified six goals of the tools: improving wellness, navigating crisis, promoting recovery, promoting empowerment, facilitating mutual support and coping with oppression. Of the 35 studies identified, 34 corresponded to applications of the Wellness Recovery Action Plan (WRAP). All of them, but one, evaluated group workshops implementations. The most common objective was to evaluate symptom improvement. Only eight studies included users and survivors as part of the research team. CONCLUSIONS: Only the WRAP has been widely disseminated and investigated. Despite the tools were designed to be implemented by peers, it seems they have been usually implemented without them as trainers. Even when these tools are not aimed to promote clinical recovery, in practice the most disseminated recovery tool is being used in this way.

Qué significa la recuperación para las personas usuarias de servicios de salud mental en Catalunya / What recovery means for mental health services users in Catalonia

En este estudio exploramos el significado del concepto de recuperación desde la perspectiva de las personas usuarias de servicios de salud mental en Cataluña. Realizamos cinco grupos focales para recopilar los datos, y utilizamos la teoría fundamentada para el análisis. Identificamos on-ce temas o tópicos en torno a los cuales los participantes organizaron sus argumentos. La ma-nera como las personas entienden la recuperación está vinculada al marco conceptual del que derivan sus ideas: el modelo biomédico o el paradigma de la recuperación. Algunos de estos temas coinciden con el modelo CHIME, propio del marco internacional de las políticas públicas orientadas a la recuperación. Los tópicos o temas que se corresponden con supuestos del mode-lo biomédico generaron perspectivas en conflicto y contraargumentaciones. Participar en espa-cios de apoyo mutuo y activismo de salud mental parece favorecer la incorporación del marco conceptual del paradigma de la recuperación. (AU)

In this study we explored the meaning of the recovery concept from the perspective of users of mental health services in Catalonia. We conducted five focus groups to collect the data, and we used grounded theory for the analysis. We identify eleven themes or topics around which participants organized their arguments. How people understand recovery are linked to the conceptual framework from which their ideas are derived: the biomedical model or the recovery paradigm. Some of these issues coincided with the CHIME model of the international framework of recovery-oriented public policies. The topics or themes which correspond toas-sumptions of the biomedical model generated conflicting perspectives and counterarguments. Participating in spaces for mutual support and mental health activism seems to promote the incorporation of the conceptual framework of the recovery paradigm. (AU)

A Systematic Review of Executive Function and Information Processing Speed in Major Depression Disorder.

BACKGROUND: Major depression is a psychiatric disorder characterized neuropsychologically by poor performance in tasks of memory, attention, processing speed, and executive function. The aim of this systematic review was to examine the evidence regarding the neuropsychological profile of people with major depression and to determine which of two explanatory models-the processing speed hypothesis or the cognitive effort hypothesis-has most empirical support. METHODS: We searched three relevant databases and reviewed the reference lists of the articles retrieved. The results obtained with the Trail Making Test and the Stroop Color-Word Test were reviewed for 37 studies published between 1993 and 2020. RESULTS: The empirical evidence supports both hypotheses: cognitive effort and processing speed, suggesting that depression is not only characterized by psychomotor slowing but also involves a specific deficit in executive function. DISCUSSION: We discuss potentially relevant variables that should be considered in future research in order to improve knowledge about the neurocognitive profile of depression. The main limitation of this study derives from the considerable heterogeneity of participants with MD, which makes it difficult to compare and integrate the data.

Mapping mental health recovery tools developed by mental health service users and ex-users: protocol for a scoping review.

INTRODUCTION: Since the emergence in 1997 of the Wellness Recovery Action Plan, a number of other tools developed by users and/or ex-users of mental health services have been published and implemented. All these tools aim to promote self-determination in mental health recovery processes. A scoping review will be carried out in order to (1) identify existing tools, (2) describe their distinctive characteristics and (3) examine how they have been implemented and evaluated. METHODS AND ANALYSIS: The scoping review will be guided by the methodological framework proposed by Arksey and O'Malley and expanded by Levac et al. It will involve, primarily, a literature search of the following electronic databases: Cochrane database, Cumulative Index to Nursing and Allied Health Literature, PsycInfo, PsycArticles, Scopus, PubMed and Web of Science. In addition, the search process will consider grey literature databases. Users, ex-users and survivors organisations and networks will be contacted in order to identify any relevant material. The reference lists of the articles identified through the literature search will be inspected. Finally, hand searches of journals will be conducted in order to increase the confidence in the search. Two main approaches will be used to present the charted data: a descriptive analysis and a thematic analysis. The study will be performed between April and December 2020. The results will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. ETHICS AND DISSEMINATION: This study does not require ethical approval because the data used are from publicly available materials. The study results will be disseminated through an article submitted for publication to a scientific journal and presented at relevant conferences. The results will also be shared in future workshops and seminars as part of continuing education programmes for mental health professionals.

Employment Support Needs of People with Schizophrenia: A Scoping Study.

Purpose People with schizophrenia continue to encounter barriers to employment acquisition. The aim of this scoping study was to identify and synthesize existent evidence about the employment support needs of people diagnosed with schizophrenia. Methods Five relevant databases were used: CINAHL, Medline, PsycINFO, SCOPUS, and Web of Science. Additional material of potential interest was identified through the references of the retrieved articles. A manual search for publications from the 3 months immediately prior to the electronic search was carried out in specialized journals. Searches covered the period between 1945 and August 30, 2017 without language restrictions. Two approaches were used to display the data: descriptive analysis and thematic analysis. Results Twelve articles met the inclusion criteria, most of which discussed experiences of participation in individual placement and support programmes. Thematic analysis identified four support needs: developing skills, vocational intervention, support and encouragement, and a supportive work environment. Conclusions There is a paucity of literature examining and evaluating employment support needs from the perspectives of people with schizophrenia. Future research must look beyond individual factors affecting employment outcomes to consider societal attitudes, stigma and work-related legislation.

Trends in the Study of Motivation in Schizophrenia: A Bibliometric Analysis of Six Decades of Research (1956-2017).

Motivation in schizophrenia has been a key research aim for several decades. Motivation is a very complex process underlying negative symptoms that has been assessed and identified using very different instruments and terminologies. This study provides a comprehensive overview of the growing literature production and highlights an extensive set of variables to better understand the study of motivation. Electronic databases were searched in order to compile relevant studies of motivation in individuals with schizophrenia. The initial search identified 3,248 potentially interesting records, and of these, 161 articles published between 1956 and 2017 were finally included. Information such as year of publication, journal, country, and number of authors was codified. Variables related to sample characteristics, methodological aspects, and motivational terms were also extracted. The results revealed a significant growth trend in literature production, especially since the 2000s, with reward as the main term studied. In addition, questionnaires were identified as the preferred instrument to assess motivation in patients with schizophrenia. Other aspects such as country of publication, authors, journals of publication, and co-citation network analysis were also examined. The discussion offers recommendations for future research.

Employment outcomes for people with schizophrenia spectrum disorder: A meta-analysis of randomized controlled trials.

Access to employment plays a critical role in the recovery and functioning of people with schizophrenia. We have investigated the effectiveness of treatments to enhance employment outcomes for people with schizophrenia and evaluated the potential moderators of these outcomes. A literature search was conducted in CINAHL, Cochrane Databases, MEDLINE, ProQuest XML, PsycINFO, Scopus, and Web of Science. Grey literature databases, references lists of the retrieved articles and specialized journals in the field were also inspected. Job placement, job tenure and wages earned were tested. Risk ratios were extracted for job placement and standardized mean differences were calculated for job tenure and wages earned. Twenty-five randomized controlled trials published between 1986 and December 2015 were analyzed. Engaging in a vocational intervention increases the likelihood of obtaining a competitive job (risk ratio (RR) = 2.31, 95% confidence interval (CI): 1.85-2.88) and has a positive impact on hours worked in any job (standardized mean difference (SMD) = 0.42, 95% CI: 0.16-0.68). There was no evidence of intervention efficacy with regard to wages earned from competitive employment. Participation in rehabilitative vocational treatment is not sufficient to ensure work participation for people with schizophrenia. Comprehensive treatments are necessary to address functional deficits that hinder labor stability and job performance for people with schizophrenia. Int J Occup Med Environ Health 2017;30(3):345-366.

Los caminos del capital humano avanzado: discusiones desde las experiencias / The ways of advanced human capital: discussions from experiences

Esta investigación tuvo como objetivo conocer las significaciones de la experiencia de formación de tercer ciclo de personas chilenas que realizan postgrados en el extranjero, en el marco del Programa Formación de Capital Humano Avanzado del Gobierno de Chile. Como marco metodológico se utilizó una epistemología feminista de conocimiento situado y como técnica, las producciones narrativas, desde las que se analizaron las experiencias de siete estudiantes de universidades españolas, mayoritariamente beneficiarios de Becas Chile. Como principales hallazgos se observaron una valoración positiva de la experiencia de estudiar en el extranjero y, simultáneamente, percepciones divergentes de esta experiencia vinculadas a las trayectorias educativas previas y el nivel socioeconómico de los profesionales, aspectos que incidieron en las identificaciones con el concepto de Capital Humano Avanzado para Chile. Así también, para algunos participantes, el Capital Humano Avanzado se plantea como un concepto impuesto y no coincidente con las oportunidades reales en el país para el ejercicio profesional, mostrándose más escépticos respecto a las posibilidades de una adecuada inserción laboral en el retorno a Chile.

The present research aimed to know the significance of academic training experienced by postgraduate students who are pursuing their studies abroad under the context of a Training Program for Advanced Human Capital promoted by the Government of Chile. A feminist epistemology of situated knowledge was used as methodological framework, and narrative productions were used as technique of data collection. With this approach, the experiences of seven graduate students in Spanish universities, mostly of them beneficiaries of scholarships from Chile, were analyzed. The main findings were: the positive assessment of the experience of studying abroad, the divergent testimonies about these experiences, which based on previous educational trajectories and the socioeconomic level of the professional. These aspects influenced the identifications with the concept of Advanced Human Capital for Chile. Also, for some participants, the Advanced Human Capital is seen as an imposed concept which does not coincide with the real opportunities for the professional practice in the country. Therefore, the participants are sceptical about the possibilities of adequate job insertion in the return to Chile.

Revisión de eficacia y costo-efectividad del uso de medicamentos biológIcos en pacientes adultos con artritis reumatoide refractarios al uso de fármacos modificadores de la enfermedad / Review of efficacy and cost-effectiveness of the use of biological drugs in adult patients with rheumatoid arthritis refractory to the use of drugs modifying the disease

Objetivos: Describir y sintetizar la evidencia de eficacia y costo-efectividad del uso de agentes biológicos en pacientes adultos con AR refractarios a FARMEs. Las preguntas a contestar son: Cuál es la eficacia de los productos farmacéuticos biológicos en pacientes con artritis reumatoide que han respondido inadecuadamente o han fracasado a terapia previa con FARMEs, en relación al tratamiento habitual con FARMEs? Es costo-efectivo introducir biológicos en el tratamiento de pacientes adultos con AR refractarios a FARMEs, en relación al tratamiento habitual con FARMEs? Métodos: Ambas preguntas fueron abordadas aplicando la metodología de revisiones sistemáticas (RS), focalizando el análisis en medicamentos biológicos con registro sanitario en el país. En el caso de eficacia, se realizó una revisión de revisiones sistemáticas con búsqueda sensible en MEDLINE y The Cochrane Library. La estrategia de búsqueda consideró la intervención y el problema de salud. Se incluyeron todas las revisiones sistemáticas recientemente publicadas (enero 2013 al 29 de abril de 2014) que cumplieron los criterios de inclusión preestablecidos. La calidad se evaluó utilizando el instrumento Assesment of Multiple Sistematic Reviews (AMSTAR). Los resultados se agruparon por subgrupos de pacientes según si habían recibido o no medicación previa con FARMEs y además, por tipo de comparaciones. Conclusión: Independiente del tipo de resultado o outcome utilizado para determinar eficacia y las medidas de efecto utilizadas, la evidencia es consistente en concluir mayor eficacia de la terapia biológica al comparar con FARMEs en monoterapia. Esta superioridad es aún mayor cuando la terapia del biológico se combina con un FARME (entre ellos MTX) y se administra a pacientes que han fracasado previamente o han respondido inadecuadamente a terapia previa con FARME. El resultado de costo-efectividad basado en el ICER promedio de los 13 ICER que son relevantes al contexto chileno y que provienen de las 6 EE altamente transferibles, equivale a USD 73.588,06 por QALY ganada (dólares del 2013), con un rango que fluctúa entre USD 24.337 por QALY en Finlandia (usando TCZ) y USD 147.084 por QALY en Suecia (incluyendo ADA, ETAN e IFX). Se observó que a iguales condiciones, las estrategias de biológicos combinadas con FARMEs son más costo-efectivas. Sin embargo, al sugerir en Chile un umbral referencial de 1 PIB per-cápita por QALY ganada para considerar una intervención como costo-efectiva (aprox. USD 16.000 año 2013), se aprecia que la introducción de biológicos en AR resulta no costo-efectiva en el país, a los costos vigentes de estos medicamentos.