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The role of shame in people with a diagnosis of schizophrenia
- Authors:
- KEEN Nadine, et al
- Journal article citation:
- British Journal of Clinical Psychology, 56(2), 2017, pp.115-129.
- Publisher:
- Wiley
Objectives: To examine the role of shame and its relationship to depression in schizophrenia. It was predicted that individuals with a diagnosis of schizophrenia would exhibit higher levels of shame due to the stigma associated with their diagnosis, independently of depression levels, compared with psychiatric and medical control groups. Design: Cross-sectional design with three groups: individuals with a diagnosis of (1) schizophrenia, (2) depression, and (3) rheumatoid arthritis. Methods: Sixty individuals participated in the study (20 per group). Groups were compared on questionnaires assessing external shame, trait shame and guilt, and depression. Results: The pattern of group differences depended on the type of shame measure used. Both the schizophrenia and depression groups exhibited higher levels of external shame, or seeing others as shaming, than the medical group. For individuals with schizophrenia, seeing others as shaming was associated with higher levels of depression, a relationship not found in either control group. They also showed lower levels of trait guilt and shame (at trend level), compared with both control groups. No difference was found between the groups on depression, suggesting that the observed differences were not attributable to differences in levels of depression. Conclusions: The findings highlight the importance of shame in schizophrenia, especially the link between seeing other people as shaming and depression, which was unique to this group. These results suggest that stigma associated with a diagnosis of mental illness, and schizophrenia in particular, has negative emotional consequences that may impede recovery, and should be addressed by psychological and social interventions. (Publisher abstract)
A traumatic life brought to book
- Author:
- SALE Anabel Unity
- Journal article citation:
- Community Care, 25.9.08, 2008, pp.28-29.
- Publisher:
- Reed Business Information
Social worker Philip Hill's life story was so extraordinary that his psychiatrist urged him to complete his autobiography. The book details his story from being taken into care, being misdiagnosed as having learning disabilities as a child and experiencing two breakdowns and paranoid schizophrenia, to becoming a social worker. In this article Philip talks to the author about his experiences.
Predictors of later schizophrenia and affective psychosis among attendees at a child psychiatry department
- Authors:
- CANNON Mary, et al
- Journal article citation:
- British Journal of Psychiatry, 178, May 2001, pp.420-426.
- Publisher:
- Cambridge University Press
Schizophrenia has been linked with psychological problems in childhood but there is little information on precursors of affective psychosis. Childhood item sheets, which give standardised information on signs and symptoms of mental illness in the year preceding assessment are completed for all attendees at the children's department of the Maudsley and Bethlem Royal Hospital. The authors examined item sheet data on individuals with an adult diagnosis of schizophrenia or affective psychosis and a comparison group with no adult mental illness. Finds that abnormal suspiciousness or sensitivity and relationship difficulties with peers are associated with later schizophrenia. In contrast, affective psychosis is associated with childhood hysterical symptoms and disturbances in eating. Concludes that childhood psychological precursors for schizophrenia and affective psychosis differ and do not simply reflect non-specific psychiatric disturbance in adolescence.
Rates of mental disorder in people convicted of homicide
- Authors:
- SHAW Jenny, et al
- Journal article citation:
- British Journal of Psychiatry, 188(2), February 2006, pp.143-147.
- Publisher:
- Cambridge University Press
This study aimed to estimate the rate of mental disorder in people convicted of homicide; to examine the relationship between definitions, verdict and outcome in court. A national clinical survey of people convicted of homicide (n=1594) in England and Wales (1996–1999). Rates of mental disorder were estimated based on: lifetime diagnosis, mental illness at the time of the offence, contact with psychiatric services, diminished responsibility verdict and hospital disposal. Of the 1594,545 (34%) had a mental disorder: most had not attended psychiatric services; 85 (5%) had schizophrenia (lifetime); 164 (10%) had symptoms of mental illness at the time of the offence; 149 (9%) received a diminished responsibility verdict and 111 (7%) a hospital disposal – both were associated with severe mental illness and symptoms of psychosis. The findings suggest an association between schizophrenia and conviction for homicide. Most perpetrators with a history of mental disorder were not acutely ill or under mental healthcare at the time of the offence. Some perpetrators receive prison sentences despite having severe mental illness.
Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study
- Authors:
- ZAMMIT Stanley, et al
- Journal article citation:
- British Medical Journal, 23.11.02, 2002, pp.1199-1201.
- Publisher:
- British Medical Association
An association between use of cannabis in adolescence and subsequent risk of schizophrenia was previously reported in a follow up of Swedish conscripts. Arguments were raised that this association may be due to use of drugs other than cannabis and that personality traits may have confounded results. Cannabis use is associated with an increased risk of developing schizophrenia, consistent with a causal relation. This association is not explained by use of other psychoactive drugs or personality traits relating to social integration.
Understanding psychosis and schizophrenia
- Editor:
- COOKE Anne
- Publisher:
- British Psychological Society
- Publication year:
- 2014
- Pagination:
- 175
- Place of publication:
- Leicester
An overview of the current state of knowledge about why some people hear voices, experience paranoia or have other experiences seen as psychosis or sometimes thought of as schizophrenia. The report also describes what can help, concluding that psychosis can be understood and treated in the same way as other psychological problems such as anxiety or shyness. It suggests that hearing voices or feeling paranoid are common experiences which can often be a reaction to trauma, abuse or deprivation. Calling them symptoms of mental illness, psychosis or schizophrenia is only one way of thinking about them, with advantages and disadvantages. There is no clear dividing line between ‘psychosis’ and other thoughts, feelings and beliefs, and while some people find it useful to think of themselves as having an illness others prefer to think of their problems as, for example, an aspect of their personality which sometimes gets them into trouble but which they would not want to be without. Psychological therapies – talking treatments such as Cognitive Behaviour Therapy – are very helpful for many people, although most people are currently unable to access it. Many people find that ‘antipsychotic’ medication helps to make the experiences less frequent, intense or distressing. However, there is no evidence that it corrects an underlying biological abnormality and recent evidence also suggests that it carries significant risks, particularly if taken long term. The report calls for services to change radically, and for increasing investment in prevention by taking measures to reduce abuse, deprivation and inequality. (Edited publisher abstract)
Report of the independent inquiry into the care and treatment of John Barrett
- Author:
- SOUTH WEST LONDON STRATEGIC HEALTH AUTHORITY
- Publisher:
- South West London Strategic Health Authority
- Publication year:
- 2006
- Pagination:
- 422p.
- Place of publication:
- London
The Inquiry report highlights some important systemic failures and is not only critical of the responsible Consultant, but also of Trust Management, of the Mental Health Review tribunal system, and some of the Home Office processes. The report makes recommendations on the need for changes to systemic processes and to the co-ordination of care of forensic patients. It is the responsibility of the Trust to ensure that mechanisms are in place to address these systemic failures, and that all the professionals involved in this Inquiry are supported, whilst important changes are implemented. John Barrett had been diagnosed with paranoid schizophrenia. Unfortunately, some patients with schizophrenia can be a risk to other people, although it should be stressed that this is a minority. Also only 10% of people committing homicides are mentally ill at the time. Psychiatrists recognise that such patients, although a critical few, need very careful management. The disciplines involved in their care and treatment have at heart the need to avoid such tragedies.
Psychosis and academic performance
- Author:
- KARLSSON Jon L.
- Journal article citation:
- British Journal of Psychiatry, 184(4), April 2004, pp.327-329.
- Publisher:
- Cambridge University Press
It has been suggested that psychosis genes might be associated with beneficial effects, explaining their high frequency in all human populations. The unusually complete demographic and scholastic records available in Iceland were used to locate academically accomplished individuals and assess the probability of previously identified patients with mental disorders and their relatives being among such groups. Close relatives of successful students showed increased risks of psychosis. Individuals who subsequently developed psychosis and relatives of people with psychosis excelled in school performance, particularly in mathematics. The study supports the hypothesis that stimulation associated with psychotic tendencies enhances performance in academic settings.
Thinking through delusions in Alzheimer’s disease
- Authors:
- SHANKS Michael F., VENNERI Annalena
- Journal article citation:
- British Journal of Psychiatry, 184(3), March 2004, pp.193-194.
- Publisher:
- Cambridge University Press
Delusions are common, disabling and persistent in the course of Alzheimer’s disease and are likely to relate to a range of specific cognitive failures with regional associations as much as to an interaction between neurological and psychosocial factors. It can be suggested that Alzheimer’s disease, far from being a diffuse degenerative disease in the course of which poorly differentiated psychotic symptoms emerge from global neurological causes, offers an opportunity to increase our understanding of higher cognitive functions including normal and abnormal belief formation. The investigation of delusions in this disease, compared with studies of the functional psychoses, has the advantage that a population is studied whose abnormal beliefs appear in a context often relatively free from overlapping psychopathological and treatment effects, perhaps in a form less integral with the individual psyche and against a background of normal cognitive development. Such studies of the breakdown in higher mental functions in the course of Alzheimer’s disease can clarify the fundamental mechanisms involved in delusional thinking and abnormal experience and inform qualitative comparisons with the phenomena seen in the schizophrenias and other delusional disorders. The ‘purer’ culture of individual symptoms in Alzheimer’s disease may, in the end, help provide the basis for a more truly scientific psychopathology.
Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study
- Authors:
- ARSENEAULT Louise, et al
- Journal article citation:
- British Medical Journal, 23.11.02, 2002, pp.1212-1213.
- Publisher:
- British Medical Association
Although most young people use cannabis in adolescence without harm, a vulnerable minority experience harmful outcomes. A tenth of the cannabis users by age 15 in our sample (3/29) developed schizophreniform disorder by age 26 compared with 3% of the remaining cohort (22/730). Our findings suggest that cannabis use among psychologically vulnerable adolescents should be strongly discouraged by parents, teachers, and health practitioners. Policy makers and law makers should concentrate on delaying onset of cannabis use.