Adaptation and validation of the Columbia-Suicide Severity Rating Scale (C-SSRS) - screen version. / Polska adaptacja i walidacja wersji przesiewowej Skali Oceny Ryzyka Samobójstwa z Uniwersytetu Columbia (C-SSRS).

OBJECTIVES: To perform an adaptation and psychometric validation of the Polish version of the Columbia-Suicide Severity Rating Scale (C-SSRS) screen version in a clinical sample of patients admitted to the psychiatric hospital. METHODS: This was a single-center, observational and cross-sectional study. A total of 318 consecutive patients completed a set of questionnaires upon their admission to acute psychiatric units. The set comprised C-SSRS screener and the reference measures: the Suicidal Behaviors Questionnaire - Revised (SBQ-R), the Suicidal Ideation Attributes Scale (SIDAS), the Center of Epidemiological Studies Depression Scale - Revised (CESD-R), the Scale of Psychache, the Purpose in Life scale (PIL), and alcohol misuse screen test (CAGE). RESULTS: Cronbach's α of the C-SSRS was 0.89. Two latent components were identified in the factor analysis: (1) suicidal thoughts, intentions and plans, and (2) history of suicidal attempts. There were differences in the mean scores of all the utilized questionnaires (namely, SBQ-R, the Psychache scale, CAGE, SIDAS, PIL and CESD-R) between the C-SSRS risk groups (p=0.01). The C-SSRS risk group was associated with the category of the primary psychiatric diagnosis (p<0.001). CONCLUSIONS: The Polish version of the Columbia-Suicide Severity Rating Scale screener is a questionnaire with good psychometric features to assess the suicidal risk among psychiatric in-patients. It can be used for the purposes of a routine assessment of suicidal risk among hospitalized patients.

The prevalence of occupational burnout and its individual and situational predictors among addiction therapists.

This study assesses the prevalence and individual and organizational predictors of occupational burnout among addiction therapists. A total of 452 addiction therapists from a representative sample of 184 Polish alcohol treatment facilities (outpatient and inpatient) participated in the study (facility response rate = 42%). The Oldenburg Burnout Inventory was used to measure occupational burnout, and 15 subscales of the Copenhagen Psychosocial Questionnaire II were administered to assess psychosocial work conditions. In addition, the Coronavirus Anxiety Scale, the Hospital Anxiety and Depression Scale and the abbreviated six-item De Jong Gierveld Loneliness Scale measured other important dimensions of addiction therapists' psychosocial functioning. Logistic regression was used for the analysis of the data. Occupational burnout was noticeably prevalent in the study group: 62% of respondents experienced exhaustion and 50% experienced disengagement from work, both to at least a moderate degree. Situational (organizational) variables were the most important predictors, explaining much more of the variance in both dimensions of burnout than the individual factors, of which only depression was significantly related to higher levels of exhaustion. Coronavirus anxiety played a marginal role in explaining the severity of burnout. The current study is one of the first attempts to assess the level of occupational burnout among addiction therapists and to comprehensively investigate the factors contributing to it. The findings provide useful information for the development of interventions aimed at preventing or reducing burnout in this professional group.

Time perspective and self-stigma in schizophrenia.

BACKGROUND: Time perspective (TP) offers a new understanding of human personality, postulating that there are individual differences in how our mind assigns our experiences to different time categories. This concept may shed new light on the role of personality traits in shaping vulnerability to the internalized stigma. AIM: In this paper we propose a novel approach to clarifying the underpinning of self-stigma by empirically exploring its links with TP. METHOD: We conducted a cross-sectional study among 86 patients with ICD-10 diagnoses of paranoid schizophrenia to validate the predictive role of TP for self-stigma. We used the Zimbardo Time Perspective Inventory (ZTPI), Internalized Stigma of Mental Illness scale (ISMI) and Brief Psychiatric Rating Scale (BPRS). RESULTS: We found significant positive correlations of self-stigma with Past-Negative, Future-Negative and Present-Fatalistic TP categories and negative correlation with the Future-Positive category. The hierarchical regression analyses revealed that two TP categories and Deviation from the Balanced Time Perspective (DBTP) are significant predictors of self-stigma over and above sociodemographic and clinical control variables. Conclusion. The results of the study confirm the hypothesis that TP opens new possibilities to understand proneness or resistance to self-stigmatization, and this may provide a basis for novel approaches to anti-self-stigma interventions.

The relationship between occupational burnout and work ability among firefighters: exploring the mediating effects of insomnia, depressive symptoms, loneliness and alcohol misuse.

Purpose: Firefighting is a profession associated with a high risk of elevated levels of occupational stress and burnout. The aim of this cross-sectional study was to explore the mediating effects of insomnia, depressive symptoms, loneliness and alcohol misuse in the relationship between two dimensions of burnout (i.e., exhaustion and disengagement) and work ability among firefighters. Methods: A total of 460 firefighters from various regions of Poland completed a set of self-report questionnaires to assess constructs of interest. A mediation model was constructed to verify hypothesized paths, adjusted for socio-demographic and work-related background characteristics. Model parameters were estimated using a bootstrapping procedure, with sampling set at N = 1000. Results: The proposed model explained 44% of variance in work ability. Higher levels of both exhaustion and disengagement predicted worsened work ability. When mediators were controlled for, these effects remained statistically significant. Depressive symptoms and feelings of loneliness were found to be partial mediators of the association between exhaustion and work ability, and between disengagement and work ability. The mediating effects of insomnia and alcohol misuse were non-significant. Conclusions: Interventions aimed at counteracting the decrement in work ability among firefighters should target not only occupational burnout, but also depressive symptoms and a sense of loneliness as factors mediating its detrimental effects.

Associations of consequences of coronavirus pandemic with anxiety, depression and loneliness: moderating effects of internal resources.

The influence of personal internal resources (IRs) on coping with traumatic events is constantly researched. This study aimed to determine how the SARS-CoV-2 pandemic affected anxiety, depression, and loneliness in two groups at different levels of exposure (low and high) to the infection. We analysed the impact of IRs in the form of the level of hope and self-efficacy on mental reactions (anxiety and depression) and social well-being (loneliness). The study was conducted as an internet survey. Descriptive statistics, correlation analysis, and difference tests were used for preliminary analyses. Structural equation models (SEM) were used for multivariate data analysis. The SEM model revealed that people working in a profession with a higher risk of infection coped better in the pandemic. We observed a higher level of IRs in the higher exposure group, and the consequences were less pronounced. We concluded by stating that the level of hope and sense of self-efficacy could moderate the response in a pandemic situation and constitute protective factors against psychopathological symptoms.

How are various aspects of personal stigma related to secrecy about mental health problems among people diagnosed with psychotic disorders? A cross-sectional analysis.

OBJECTIVE: Service users commonly keep their mental illness secret in order to avoid rejection. However, this stigma-coping orientation is not necessarily effective and may lead to a number of negative psychological consequences. The purpose of the present study was to investigate the roles of various aspects of personal stigma in predicting secrecy about mental health problems among persons with psychosis. METHODS: A sample of 147 individuals diagnosed with psychotic disorders was recruited for the study. They were administered a set of questionnaires to gather data about sociodemographic and illness-related background characteristics, levels of social functioning, depressive symptoms, and overall psychopathology, elements of personal stigma (i.e., perceived stigma, experienced discrimination, self-stigma, and stigma-related stress), as well as the endorsement of secrecy as a way of coping with stigma. Hierarchical linear regression was utilized for data analysis. RESULTS: Personal stigma measures were entered into the regression equation as a block and explained as much as 29% of variance in the dependent variable over and above sociodemographic and clinical features. After accounting for all controls, higher perceived stigma (ß = 0.47, p < .01) and higher stigma stress (ß = 0.19, p < .05) were found to be independent predictors of secrecy, whereas experienced discrimination and self-stigma were not. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Perceived stigma and stigma stress appraisal should be considered as targets of interventions aiming to reduce the shame and fear of rejection associated with mental illness and to guide and support people's everyday decisions about coming out. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Depression and loneliness may predict work inefficiency among professionally active adults.

PURPOSE: Both depression and loneliness have been recognized as major public health issues, yet investigation into their role among young and middle-aged, professionally active persons is still required. The aim of the present study was to evaluate whether depression and loneliness may independently predict inefficiency at work among professionally active adults. METHODS: This is a cross-sectional study on a representative, nationwide sample. 1795 questionnaires were gathered from among professionally active adults from Poland from 1 to 31 July 2018 with a direct pen-and-paper interview. The sample was chosen by means of the stratified random method. The survey included a Patient Health Questionnaire (PHQ-9) to measure depression and questions, devised by the authors, relating to loneliness and inefficiency at work. Regression models were constructed with depression and loneliness as predictors of inefficiency at work, unadjusted and adjusted for selected sociodemographic, health- and work-related factors. RESULTS: In the unadjusted models, both depression and loneliness were independently associated with an increase of work inefficiency and absence from work, with effect sizes being higher for loneliness than for depression. After accounting for the control variables (i.e., sociodemographic, work- and health-related factors), the PHQ-9 score, but not the loneliness score, was associated with an increased probability of frequent thoughts about changing or leaving a job. CONCLUSION: Depression and loneliness independently predicted occupational functioning and differentially affect its various aspects. Counteracting depression and loneliness among employees should be regarded as a public health priority.

The self-disclosure of mental health problems: Its extent, predictors and consequences for people with psychotic disorders. / Ujawnianie problemów ze zdrowiem psychicznym: zakres, predyktory i konsekwencje dla osób z rozpoznaniem zaburzen psychotycznych.

OBJECTIVES: The analysis of the extent, sociodemographic and clinical predictors, and consequences of disclosing mental health problems for people with psychotic disorders. METHODS: 147 individuals with a diagnosis of psychotic disorder (ICD-10 categories F20-F29) were examined with questionnaires to assess the extent and consequences of their disclosing of mental health problems to others, as well as their social functioning, depressive symptoms, and the global severity of psychopathological symptoms. RESULTS: The majority of respondents talked openly about their mental health problems to their parents, spouses or life partners, as well as physicians and other non-psychiatric health care professionals, while a substantial minority (less than one-fifth) talked about these issues to casual acquaintances, neighbors, teachers and lecturers, co-workers, police officers and municipal guards, representatives of the court system, or public officials. Multiple regression analysis showed that the older the respondents were, the less willing they were to disclose their mental problems to others (ß = -0.34; p <0.05). In contrast, the longer they were ill, the more inclined they were to disclose their mental health issues (ß = 0.29; p <0.05). Disclosure of mental health problems had varying effects on the subjects' social relationships, with a significant proportion reporting no difference in the way they were treated by others, while others reported either deterioration or improvement in this area. CONCLUSIONS: The results of the study provide clinicians with practical guidance on supporting and assisting patients with psychotic disorders in the process of making informed decisions about "coming out".

Behind the screen of voluntary psychiatric hospital admissions: A qualitative exploration of treatment pressures and informal coercion in experiences of patients in Italy, Poland and the United Kingdom.

BACKGROUND: Despite the extensive research and intense debate on coercion in psychiatry we have seen in recent years, little is still known about formally voluntarily admitted patients, who experience high levels of perceived coercion during their admission to a psychiatric hospital. AIMS: The purpose of the present research was to explore forms of treatment pressure put on patients, not only by clinicians, but also by patients' relatives, during admission to psychiatric hospitals in Italy, Poland and the United Kingdom. METHODS: Data were obtained via in-depth, semi-structured interviews with patients (N = 108) diagnosed with various mental disorders (ICD-10: F20-F49) hospitalised in psychiatric inpatient wards. Maximum variation sampling was applied to ensure the inclusion of patients with different socio-demographic and clinical characteristics. The study applied a common methodology to secure comparability and consistency across participating countries. The qualitative data from each country were transcribed verbatim, coded and subjected to theoretical thematic analysis. RESULTS: The results of the analysis confirm that the legal classifications of involuntary and voluntary hospitalisation do not capture the fundamental distinctions between patients who are and are not coerced into treatment. Our findings show that the level of perceived coercion in voluntary patients ranges from 'persuasion' and 'interpersonal leverage' (categorised as treatment pressures) to 'threat', 'someone else's decisions' and 'violence' (categorised as informal coercion). CONCLUSION: We suggest that the term 'treatment pressures' be applied to techniques for convincing patients to follow a suggested course of treatment by offering advice and support in getting professional help, as well as using emotional arguments based on the personal relationship with the patient. In turn, we propose to reserve the term 'informal coercion' to describe practices for pressuring patients into treatment by threatening them, by making them believe that they have no choice, and by taking away their power to make autonomous decisions.

Disentangling the relationships between interpersonal competence, social network, social support and the experience of being stigmatized among people with psychotic disorders: A path modeling approach.

BACKGROUND: Deficits in social skills are common among people with psychosis and may contribute to the severity of the stigmatization they experience. The aim of the present research was to shed light on the mechanisms through which lack of interpersonal competence may lead to an increased exposure to stigma by investigating the mediating effects of social network and social support. METHODS: A sample of 207 patients diagnosed with psychotic disorders was recruited for the study. The pattern of relationships between interpersonal competence, social network, social support and experienced stigma was analyzed using path modeling. RESULTS: The level of interpersonal competence was found to be directly negatively related to the intensity of experienced stigma (ß = -0.20, SE = 0.08; P < 0.05) and directly positively related to the scope of social network (ß = 0.36, SE = 0.08, P < 0.01) and social support (ß = 0.36, SE = 0.08, P < 0.01). The analysis of mediation pathways between interpersonal competence and stigma experiences revealed significant indirect effect through social support (ßIND = -0.08, 95% CI: -0.16 to -0.02) and sequential effect through social network and social support (ßIND = -0.03, 95% CI: -0.06 to -0.01). The indirect pathway from interpersonal competence to stigma via social network alone turned out to be non-significant. CONCLUSIONS: The findings indicate that poor interpersonal competence may increase the extent of the stigma experienced by people with psychotic illness both directly and indirectly, with social support being the key mediator. Since interpersonal competence, social network and social support are potentially modifiable factors, they should be considered as possible targets of anti-stigma interventions.

Helpline provision during the first wave of the COVID-19 pandemic: experiences of the Mokotow Mental Health Center.

Purpose: The purpose of our study was to present the community helpline initiated by the Mokotow Mental Health Center (Mokotowskie Centrum Zdrowia Psychicznego - MCZP) during the first wave of the COVID-19 pandemic, and summarize its performance. Methods: The Mokotow Helpline (Mokotowska Linia Wsparcia - MLW) operated from March to July 2020, providing ad hoc interventions and short-term regular help by psychologists and a social worker. Results: 599 interventions were delivered to 262 people. Emergency support was given to 70.6% of callers and regular short-term support was provided to 29.4%. The highest number of people contacted the helpline in the first weeks of its operations, while from May 2020 onwards the frequency of calls systematically decreased. Women requested assistance twice as often as men. The most frequent reasons for contacting the line were the need for advice and support in connection with symptoms of mental illness occurring in a loved one (21.4%), request for medical services, e.g. appointment with a psychiatrist, prescription renewal or psychotherapy appointment (16.0%), anxiety (15.6%), reactive (adjustment) (13.0%) and depressive disorders (5.7%) and financial difficulties or loss of a job (5.7%). The most frequent interventions consisted of psychological support (73.8%), information or psychoeducation (16.9%), and also referring people to institutions that could provide the most appropriate form of help (8.1%). Conclusions: The helpline is an easily accessible and practical means of providing assistance to the population in critical situations such as the pandemic. The kind, duration and frequency of this form of help should be varied and adapted to the wide range of problems reported by callers.

Coronavirus anxiety as a predictor of burnout, depressive symptoms and insomnia among professionally active nurses: a preliminary report.

Purpose: A preliminary assessment of the direct association between coronavirus anxiety and burnout syndrome, depressive symptoms and insomnia among nurses in the context of selected work-related factors. Methods: This is a cross-sectional study. Fifty professionally active nurses were recruited from various psychiatric facilities and asked to fill out a set of questionnaires: the authors' survey on sociodemographic data, the Coronavirus Anxiety Scale (CAS), the Maslach Burnout Inventory - General Survey (MBI-GS), the revised version of the Center for Epidemiologic Studies Depression Scale (CESD-R), and the Athens Insomnia Scale (AIS). Linear regression models were constructed to predict the AIS, CESD-R and MBI-GS dimensions scores, with the CAS score as a predictor. The models were adjusted for sex, marital status, place of residence, length of service and working hours per week. Results: A rise in the CAS score was associated with rises in the CESD-R, MBI Exhaustion and MBI Cynicism scores. The effects were of similar size regardless of whether models were adjusted or unadjusted. Unadjusted and adjusted models predicting AIS total scores and MBI-Efficacy score were not fit to empirical data. In these models, the CAS score was not found to be significantly associated with the AIS and MBI-Efficacy scores. Conclusions: The severity of coronavirus anxiety contributed to the severity of depressive symptoms, cynicism and exhaustion among nurses. The ability to cope effectively with fear of being infected with SARS-CoV-2 may be crucial in preventing and mitigating other mental health sequelae.

Factors Predicting Response to the Recovery-Oriented Cognitive Behavioural Workshop for Persons Diagnosed with Schizophrenia.

A recovery-oriented, cognitive behavioural workshop for service users diagnosed with schizophrenia was developed, implemented and evaluated in a pilot study. Further analysis is required regarding factors which contribute to better treatment response, as this will provide useful information for workshop adaptation. Secondary multilevel model analyses were performed to determine whether workshop and booster session attendance, as well as sociodemographic variables such as gender, age, education, and duration of illness, predicted workshop responsiveness. Results showed that completers had lower responsiveness to the workshop in terms of confidence and hope, whereas those who attended an online booster session demonstrated better responsiveness as to psychosocial functioning. Longer duration of illness and older age generally predicted lower intervention responsiveness. In conclusion, adaptations utilising more booster sessions and accommodating older participants with longer duration of illness are required, as is further workshop evaluation in a randomised controlled study.

International classification of diseases/disorders diagnosis and International Classification of Functioning, Disability and Health activity/participation limitation among psychiatric patients: a cross-sectional and exploratory study.

To explore the relationships between international classification of diseases/disorders (ICD)-10 diagnoses and International Classification of Functioning, Disability and Health (ICF) disability dimensions - activity and participation restriction among mental health service users. Three hundred sixty patients from different health services diagnosed with diverse mental disorders (ICD-10) participated in the study. Functioning restrictions were evaluated by use of the Mini-ICF-APP. Selected sociodemographic and clinical variables were also analysed. The Mini-ICF-APP scores correlated positively with the clinical impression of disease severity and negatively with general functioning. As independent factors determining the Mini-ICF-APP score, regression analysis suggests diagnosis and severity of disorder but also contextual factors such as general functioning and active occupation. Percentage and percentile distributions of activity and participation restrictions in diagnostic sections and categories revealed noticeable variability regardless of diagnosis-related differences. The diagnosis determines them neither in an ambiguous nor an absolute manner. There is a need to further explore the covariability between clinical diagnosis and ICF activity and participation restriction, particularly in regard the rationalization of social welfare benefits.

The evaluation of the impact of anti-stigma training led by "experts by experience" on participants' attitudes towards persons with mental illness. / Ocena wplywu szkolen antystygmatyzacyjnych prowadzonych przez "ekspertów przez doswiadczenie" na postawy uczestników wobec osób chorujacych psychicznie.

OBJECTIVES: The purpose of this study was to evaluate the impact of anti-stigma training led by people who had previously experienced mental health crises (i.e., "experts by experience") on various aspects of participants' attitudes towards the people with mental illness. METHODS: The three-hour workshops were attended by 185 people; the training was held in 17 groups, with 3-19 people in each (11 on average). Almost half of the participants (45.4%) were employees of the mental health care system. The participants were asked to fill out a set of questionnaires immediately before and after the training, which evaluated the following aspects of their attitudes: social distance, stigmatizing attributions, beliefs about self-determination/ ability to attain important life goals by people with mental illness, and also beliefs about the social value of people with mental illness. The respondents were asked to complete the same set of questionnaires again online a month and six months after the training. The data were analyzed based on a piecewise latent trajectory model. RESULTS: Out of the 185 people who participated in the workshops, 115 (62.2%) filled out the questionnaires a month after, and 87 (47.0%) six months after the training. The analyses showed an improvement in all four measures of attitudes expressed directly after the training. In three out of the four examined aspects of attitudes (intensity of social distance, stigmatizing attributions and beliefs about self-determination of people with mental illness) the positive impact of the training continued after six months. CONCLUSIONS: The results provide preliminary empirical evidence that the structured antistigma intervention under evaluation, using the elements of education and interpersonal contact can be an effective tool for improving social attitudes towards people with mental illness.

Clozapine-induced myocarditis during co-administration of valproate: A case report. / Zapalenie miesnia sercowego indukowane klozapina w trakcie leczenia pochodnymi kwasu walproinowego: opis przypadku.

Clozapine, atypical antipsychotic drug, is widely used in patients with schizophrenia, for whom previous therapy was inadequate or not tolerated. Clozapine-induced myocarditis (CIM) is a relatively rare but potentially life-threatening complication of clozapine therapy; however, the underlying mechanism has not been so far well elucidated. Factors predisposing to CIM include a rapid dose titration, advanced age and co-administration of sodium valproate. In this paper, we present a case of a 22-year-old male patient with refractory schizophrenia who developed CIMduring low-dose clozapine treatment with co-administration of valproate and risperidone. On the basis of our case and literature review, we point out that during the first weeks of clozapine treatment patients should be actively, daily monitored for the presence of symptoms suggesting CIM. The low dose of clozapine and concurrent use of valproate are unique aspects of the report, adding new information to the discussion on safety of concomitant use of clozapine and valproate. Further investigation is required to better understand the role of co-administration of valproate and risperidone in the pathogenesis of CIM.

Development and Evaluation of a Recovery-Oriented Cognitive Behavioural Workshop for People Diagnosed with Schizophrenia.

BACKGROUND: There is a need to develop culturally adapted interventions that support the personal recovery and real-world functioning of people diagnosed with schizophrenia. AIMS: This study reports on the development and evaluation of a culturally adapted, recovery-oriented, cognitive behavioural workshop for service users with schizophrenia. METHOD: The feasibility and acceptability were assessed, as were changes over time in personal recovery and psychosocial functioning (primary outcomes) along with psychopathology and health-related behaviours (secondary outcomes), using multi-level modelling. It was also assessed whether personal recovery predicts psychosocial functioning. RESULTS: The workshop was feasible and was received favourably. Participants improved over time regarding confidence and hope, feeling less dominated by symptoms, psychosocial functioning, and psychopathology. Personal recovery predicted decreased psychosocial difficulties. CONCLUSIONS: The workshop is a promising intervention. It shows potential in terms of both improving personal recovery as well as real-life functioning of people diagnosed with schizophrenia. Further workshop evaluation in a randomized controlled study is required.

Hope and its dimensions in relation to clinical recovery: A cross-sectional study among people with psychotic disorders.

OBJECTIVE: Hope is a key component of personal recovery. There is limited evidence regarding the association of hope with the level of functioning in individuals with psychosis. It is also not clear which dimensions of hope are most strongly related to clinical recovery. Thus, this study aims to explore the relationships of hope and its dimensions with various indicators of clinical recovery such as overall psychopathology, depression and global functioning among people with psychotic disorders. METHOD: The Integrative Hope Scale (IHS; Schrank, Woppmann, Sibitz, & Lauber, 2011) was administered to 110 people with psychotic disorders. Multiple regression analysis was used to investigate the associations of the IHS total score and its four subscales (i.e., Trust and Confidence, Lack of Perspective, Positive Future Orientation, and Social Relations and Personal Value) with overall psychiatric symptoms, depression, and general functioning. RESULTS: A total level of Hope was not associated with overall psychopathology or global functioning; however, it showed a significant negative relationship with severity of depression. A stronger feeling of a Lack of Perspective turned out to be associated with more severe depression and a greater intensity of psychopathological symptoms. The relationships of the remaining dimensions of Hope with the indicators of clinical recovery were found to be nonsignificant. CONCLUSION AND IMPLICATIONS FOR PRACTICE: The findings suggest that combining Hope-enhancement strategies with interventions targeting symptoms may increase the effectiveness of rehabilitation programs for people with psychosis. They also point to the sense of a Lack of Perspective as the aspect of Hope most strongly related to clinical recovery. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Peer Rejection and Perceived Quality of Relations With Schoolmates Among Children With ADHD.

OBJECTIVE: The main aim of the current study was to investigate the links between ADHD diagnosis and the objective and subjective dimensions of social relationships among children from primary schools. METHOD: We used the data from 36 regular classrooms, consisting of 718 students, with each containing at least one child with an established clinical diagnosis of ADHD (38 children). RESULTS: For children with ADHD, the level of the perceived quality of social relations was lower than that of children without such a diagnosis. After controlling for sociometric status, the impact of ADHD on perceived status proved to be statistically nonsignificant but the indirect impact of ADHD on this status through sociometric status was statistically significant. CONCLUSION: Children diagnosed with ADHD are more often rejected by their peers and have a more pessimistic view of their social world. Moreover, ADHD diagnosis does not have a direct influence on the perceived quality of social relations otherwise than through sociometric status.

Investigating the roles of loneliness and clinician- and self-rated depressive symptoms in predicting the subjective quality of life among people with psychosis.

PURPOSE: To examine the roles of loneliness and clinician- and self-rated depressive symptoms as predictors of the subjective quality of life (QoL) in psychosis. METHODS: This cross-sectional study was conducted on a sample of 207 patients diagnosed with psychotic disorders. They were assessed with self-reported measures of QoL, loneliness and depression and with clinician-rated measures of depression and overall psychopathology. Multiple indicators multiple causes (MIMIC) modeling was used to analyze the data. RESULTS: Both loneliness and depression turned out to be independent predictors of impaired QoL. However, once loneliness was accounted for, the effect of depression on QoL was markedly reduced and the effect of loneliness proved to be visibly larger. Self-rated depression was found to be more strongly associated with QoL than clinician-rated depression. Each type of depression measure explained a unique amount of variance in QoL. Depression moderated the relationship between loneliness and QoL in such a way that the negative effect of loneliness on QoL weakened with the increasing intensity of depressive symptoms. CONCLUSIONS: Therapeutic programs aiming to enhance the QoL of people with psychotic disorders should incorporate interventions targeting both loneliness and depression and need to be tailored to the clinical status of patients. The emphasis on alleviating loneliness should be placed first of all in the case of those with low levels of depression, among whom the negative impact of loneliness on QoL is especially strong. Researchers should be aware that the method chosen for assessing depressive symptoms in models predicting QoL in psychosis matters.