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Journal article Full text available online for free

La belle indifférence in conversion symptoms and hysteria: systematic review

Authors:
STONE Jon, et al
Journal article citation:
British Journal of Psychiatry, 188(3), March 2006, pp.204-209.
Publisher:
Royal College of Psychiatrists

La belle indifférence refers to an apparent lack of concern shown by some patients towards their symptoms. It is often regarded as typical of conversion symptoms/hysteria. This review aims to determine the frequency of la belle indifférence in studies of patients with conversion symptoms/hysteria and to determine whether it discriminates between conversion symptoms and symptoms attributable to organic disease. A systematic review of all studies published since 1965 that have reported rates of la belle indifférence in patients with conversion symptoms and/or patients with organic disease. A total of 11 studies were eligible for inclusion. The median frequency of la belle indifférence was 21% in 356 patients with conversion symptoms, and 29% in 157 patients with organic disease. The available evidence does not support the use of la belle indifférence to discriminate between conversion symptoms and symptoms of organic disease. The quality of the published studies is poor, with a lack of operational definitions and masked ratings. La belle indifférence should be abandoned as a clinical sign until both its definition and its utility have been clarified.

Journal article Full text available online for free

Does forming implementation intentions help people with mental health problems to achieve goals? A meta-analysis of experimental studies with clinical and analogue samples

Authors:
TOLI Agoro, WEBB Thomas L., HARDY Gillian E.
Journal article citation:
British Journal of Clinical Psychology, 55(1), 2016, pp.69-90.
Publisher:
Wiley-Blackwell

Objective: People struggle to act on the goals that they set themselves, and this gap between intention and action is likely to be exacerbated by mental health problems. Evidence suggests that forming specific if-then plans (or ‘implementation intentions’) can promote goal attainment and a number of studies have applied such techniques in clinical contexts. However, to date, the extent to which planning can help people with mental health problems has not been systematically examined. Method: This review used meta-analysis to investigate the effect of if-then planning on goal attainment among people with a DSM-IV/ICD-10 diagnosis (i.e., clinical samples) or scores above a relevant cut-off on clinical measures (i.e., analogue samples). In total, 29 experimental studies, from 18 records, met the inclusion criteria. Results: Excluding one outlying (very large) effect, forming implementation intentions had a large-sized effect on goal attainment. Implementation intentions proved effective across different mental health problems and goals, and in studies with different methodological approaches. Conclusions: Taken together, the findings suggest that forming implementation intentions can be a useful strategy for helping people with mental health problems to achieve various goals and might be usefully integrated into existing treatment approaches. However, further studies are needed addressing a wider range of mental health problems. (Edited publisher abstract)

Journal article

Social participation interventions for adults with mental health problems: a review and narrative synthesis

Authors:
NEWLIN Meredith, et al
Journal article citation:
Social Work Research, 39(3), 2015, pp.167-180.
Publisher:
Oxford University Press

People with mental health problems remain a highly socially excluded group despite international efforts to facilitate their inclusion. Enhancing their social participation is an important role for mental health social workers, but there is a lack of evidence-informed interventions to enable workers to achieve this goal. This article fills a gap in knowledge by systematically reviewing evidence of the effectiveness of interventions that aim to enhance the social participation of adults with mental health problems in their wider communities, outside of formal mental health services. A systematic review and modified narrative synthesis methodology was used. Sixteen articles reporting 14 unique interventions met the inclusion criteria, and findings across the studies were categorised by delivery mode and intervention strategy. Positive outcomes were found in asset-based approaches, social skills development, building trusting relationships between workers and service users, and resource finding to enhance community participation. However, only four studies were found to have a low overall risk of bias. The findings of this review suggest further evidence-informed interventions, and robust evaluations, are needed as current evidence is limited to inform mental health social work practice. (Edited publisher abstract)

Journal article Full text available online for free

Permanent supportive housing: assessing the evidence

Authors:
ROG Debra J., et al
Journal article citation:
Psychiatric Services, 65(3), 2014, pp.287-294.
Publisher:
American Psychiatric Association

Objectives: Permanent supportive housing provides safe, stable housing for people with mental and substance use disorders who are homeless or disabled. This article describes permanent supportive housing and reviews research. Methods: Authors reviewed individual studies and literature reviews from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. The authors chose from three levels of evidence (high, moderate, and low) on the basis of benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results: The level of evidence for permanent supportive housing was graded as moderate. Substantial literature, including seven randomized controlled trials, demonstrated that components of the model reduced homelessness, increased housing tenure, and decreased emergency room visits and hospitalization. Consumers consistently rated this model more positively than other housing models. Methodological flaws limited the ability to draw firm conclusions. Results were stronger for studies that compared permanent supportive housing with treatment as usual or no housing rather than with other models. Conclusions: The moderate level of evidence indicates that permanent supportive housing is promising, but research is needed to clarify the model and determine the most effective elements for various subpopulations. Policy makers should consider including permanent supportive housing as a covered service for individuals with mental and substance use disorders. An evaluation component is needed to continue building its evidence base. (Publisher abstract)

Journal article Full text available online for free

Supported employment: assessing the evidence

Authors:
MARSHALL Tina, et al
Journal article citation:
Psychiatric Services, 65(1), 2014, pp.16-23.
Publisher:
American Psychiatric Association

Objective: Supported employment is a direct service with multiple components designed to help adults with mental disorders or co-occurring mental and substance use disorders choose, acquire, and maintain competitive employment. This article describes supported employment and assesses the evidence base for this service. Methods: Authors reviewed meta-analyses, research reviews, and individual studies from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. Authors chose from three levels of evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence for service effectiveness. Results: The level of research evidence for supported employment was graded as high, based on 12 systematic reviews and 17 randomized controlled trials of the individual placement and support model. Supported employment consistently demonstrated positive outcomes for individuals with mental disorders, including higher rates of competitive employment, fewer days to the first competitive job, more hours and weeks worked, and higher wages. There was also strong evidence supporting the effectiveness of individual elements of the model. Conclusions: Substantial evidence demonstrates the effectiveness of supported employment. Policy makers should consider including it as a covered service. Future research is needed for subgroups such as young adults, older adults, people with primary substance use disorders, and those from various cultural, racial, and ethnic backgrounds. (Publisher abstract)

Journal article

Seriousness and lethality of attempted suicide: a systematic review

Authors:
LIOTTA Marco, MENTO Carmela, SETTINERIC Salvatore
Journal article citation:
Aggression and Violent Behavior, 21, 2015, pp.97-109.
Publisher:
Elsevier

The concepts of seriousness and lethality of suicide attempts are essential to the assessment of suicide risk and, therefore, to prevent suicidal behaviour. A review of the literature was conducted in order to identify the most important factors that increase the seriousness and potential lethality of attempted suicide. The factors identified were incorporated into four main categories: progression along the suicide continuum; age and gender; mental disorders and method of suicide. Although each category contains independent risk factors for the severity of the suicide attempt, their combination both within and, above all, between them, has emerged as the most important predictor of suicidal behaviour. (Publisher abstract)

Journal article

Determinants, self-management strategies and interventions for hope in people with mental disorders: systematic search and narrative review

Authors:
SCHRANK Beate, et al
Journal article citation:
Social Science and Medicine, 74(4), February 2012, pp.554-564.
Publisher:
Elsevier

Fifty-seven, mainly quantitative, studies investigating the determinants of hope were selected for review. As well as identifying a number of potential determinants the review reported a range of practical self-management strategies on a number of themes, identified by service users in five qualitative studies. Most of the eight controlled intervention studies reported positive effects on hope compared to treatment as usual but there was no evidence to support a specific intervention for increasing hope in participants with mental health problems. Further research on the causal influences on hope, and the need for theory based models to improve hope are called for.

Journal article

Biogenetic explanations and public acceptance of mental illness: systematic review of population studies

Authors:
ANGERMEYER Matthias C., et al
Journal article citation:
British Journal of Psychiatry, 199(5), November 2011, pp.367-372.
Publisher:
Royal College of Psychiatrists

It is widely believed that biological or genetic models of mental illness will increase tolerance towards people with mental illness by countering perceptions of responsibility and blame. This review examined this hypothesis among the general public; whether such attributions are related to lower perceptions of guilt and responsibility, to what extent notions of responsibility are associated with rejection of people who are mentally ill, and how prevalent notions of responsibility are among the general public with regard to different mental disorders. Thirty three representative population studies examining attitudes towards people with mental illness and beliefs about such disorders were included in a systematic analysis. Generally, biogenetic causal attributions were not associated with more tolerant attitudes and they were related to stronger rejection in most studies examining schizophrenia. No published study reported on associations of biogenetic causal attributions and perceived responsibility. The stereotype of self-responsibility was unrelated to rejection in most studies. Public images of mental disorder are generally dominated by the stereotypes of unpredictability and dangerousness; responsibility was less relevant. The authors conclude that biogenetic causal models are an inappropriate means of reducing rejection of people with mental illness.

Journal article

Mothers with mental health problems: a systematic review

Authors:
BLEGEN Nina E., HUMMELVOLL Jan K., SEVERINSSON Elisabeth
Journal article citation:
Nursing and Health Sciences, 12(4), December 2010, pp.519-528.
Publisher:
Wiley

Three major themes were examined in the 19 studies included in the review: the vulnerability of mothers with mental health problems, fears of not being considered a good enough mother, and concern that the children might develop mental health problems. The tendency to view the mothers in medical terms rather than as women with their own voices is identified as a barrier to providing help and support to mothers with mental health problems. The need for further research on lived experiences and existential concerns of the mothers is stressed.

Journal article

Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: a systematic review

Authors:
LI Zhuoyang, et al
Journal article citation:
Social Science and Medicine, 72(4), February 2011, pp.608-616.
Publisher:
Elsevier

Fourteen case-control and cohort studies were included in this systematic review and meta-analysis. Although relative risk for suicide was much higher for psychiatric disorders compared to socioeconomic factors, the population attributable risk for some socioeconomic factors and some psychiatric disorders were found to be of the same order of magnitude. The suggestion that public health policy on suicide prevention should focus on lower risk, but higher prevalence, socioeconomic factors is discussed.

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