Subjective quality of life in recent onset of psychosis patients and its association with sociodemographic variables, psychotic symptoms and clinical personality traits.

AIM: There is lack of research on the study of clinical personality traits in recent onset of psychosis (ROP) patients. The aims of this research were to study the relations among psychosocial, personality and clinical characteristics in ROP patients and also the effect that significant variables had on the different domains of Quality of Life (QoL). METHODS: Data for these analyses were obtained from 81 ROP patients. The Millon Clinical Multiaxial Inventory, the Positive and Negative Syndrome Scale and the World Health Organization Quality of Life Brief Scale were used to assess personality, symptoms and QoL. RESULTS: Correlations between the negative symptoms and the physical, psychological and social domains of QoL, and the disorganized symptoms and physical domain, were found. Furthermore, the physical, psychological and social relationship domains of QoL were lower in patients with schizoid traits and the psychological domain was lower in patients with depressive traits. In contrast, the psychological and social domains were higher in patients with histrionic traits, while the physical domain was higher for patients with narcissistic traits. Multiple linear regressions demonstrated that negative symptoms and narcissistic and depressive traits explained 16.9% of the physical domain. Narcissistic and depressive traits explained 15% of the psychological domain. Finally, the negative symptoms and histrionic traits explained 13.7% of the social domain. CONCLUSIONS: QoL seems to be better explained by negative psychotic symptoms and some clinical personality traits. Our results support the importance of integrated intervention approaches that consider personality.

La recuperación abordada desde el entorno próximo. A propósito de dos casos del Equipo De Apoyo Social Comunitario (EASC) / No disponible

Se exponen dos casos de una misma familia (padre e hija), con los que se interviene desde el EASC, dicha derivación surge desde el Servicio de Salud Mental (SSM) de referencia con distintos objetivos. La intervención y evolución de ambos usuarios en el recurso representan la importancia del abordaje en el entorno próximo haciendo posible la permanencia en el mismo. Para llevarlo a cabo se ha realizado un trabajo previo, individualizado con cada uno de ellos, promoviendo la autonomía y la adaptación a la vuelta al domicilio desde las respectivas Mini- residencias en las que permanecían. En un segundo momento, se trabaja sobre las condiciones de habitabilidad de la vivienda, de manera coordinada y con la participación activa de los usuarios. Igualmente ha sido precisa la tramitación de recursos de apoyo y la coordinación con el resto de recursos de atención, para garantizar la calidad de vida de ambos. En la actualidad se abordan los procesos de recuperación de manera individual en cada caso, requiriendo sesiones conjuntas con regularidad

We present two interventions by the EASC working with two members of the same family (father and daughter). Both patients were referred by the Mental Health Services of their community, with variable objectives. The intervention and improvement in evolution of both patients over time underlines the importance of community settings. Individualized approaches with father and daughter were implemented as a first step, promoting autonomy and a transition back home from the residential facilities where they were living. Habitability of the premises was then ensured, with the active participation of the clients. Support services and cooperation with other services was central to improving their overall quality of life. Nowadays, each case is individually approached although father-daughter joint sessions are frequently held in order to work on family relationships and cohabitation issues. In the daughter´s case the main objectives have been her inclusion in the psychosocial rehabilitation services of the community, an improvement in basic and instrumental activities of daily living, participation in vocational rehabilitation resources, focusing on personal strengths, promoting autonomy, and interventions aimed to enhance family functioning. Intervention with the father has focused on basic and instrumental activities of daily living, increasing in disease awareness and treatment adherence, autonomy in household setting, community integration, and as with her daughter, interventions aimed

Schizoid phenomena in substance abusers.

It is hypothesized that the spectrum of schizoid disorders, schizoid phenomena, and the underlying psychodynamics can often be found in the gamut of addictions and stand in the way of recovery. Features of schizoidness, the varieties of schizoid presentations, the etiology and pathogenesis of drug/alcohol abuse in the schizoid, and readily clinically apparent psychodynamic features are discussed. Schizoid phenomena can be dealt with effectively with an informed psychotherapy.

Paranoid-schizoid or symbiotic?

This critique of Mahler's derivation of a developmental stage of normal symbiosis from her work with psychotic children reveals some clear parallels with Klein's description of the paranoid-schizoid position. The defence mechanisms of splitting, and of projective and introjective identification are already operative in the symbiotic stage and imply some distinction between self and other in the unconscious. Both theorists described the same confusion between self and other, but they attributed different explanations to the phenomenon. Whereas Mahler described the experience of feeling at one with the other, Klein elucidated the unconscious psychic mechanisms which operate to create this experience. The separation-individuation process has been redefined as the developing awareness of a sense of self, as distinct from earlier unconscious processes.

Long-term outcome of major psychoses. II. Schizoaffective disorder compared with schizophrenia, affective disorders, and a surgical control group.

Eighty-five patients with both schizophrenic and affective features at the time of admission to the University of Iowa Psychiatric Hospital between 1934 and 1944 were selected for a 30- to 40-year outcome study. Comparison groups were 200 schizophrenic and 325 affective disorder patients, selected by the Feighner et at criteria, and 160 psychiatric symptom-free surgical patients. We assessed marital, residential, occupational, and psychiatric status to evaluate the outcome of these patients at the time of field follow-up. We used multivariate analysis of covariance to analyze the data by taking admission marital and occupational status into consideration. Patients with schizoaffective disorders had a significantly better outcome than those with schizophrenia, but a significantly poorer outcome than those with affective disorders and surgical conditions. Schizoaffective disorder fell somewhere in between the schizophrenia and mania group. Before final conclusions could be made about the nature of schizoaffective disorders, more research should be done.