Explore the vast range of titles available.

\"In spite of improved access to psychosocial interventions, many people with psychosis continue to experience persistent problems which act as significant barriers to their recovery. This book investigates risk and problem behaviours in psychosis including staff and service factors that can impede the delivery of effective care. Working with Problematic Behaviour in Psychosis provides a new approach for assessment formulation and intervention with such problem behaviours in a team context. Of particular interest will be: an outline of the SAFE (Shared Assessment, Formulation and Education) approach an integrative model for understanding risk and problematic behaviour shared risk assessment and management processes the use of CBT in day-to-day interactions with clients a set of formulation driven strategies for managing problematic behaviours case studies and vignettes providing guidance and highlighting the benefits of the approach. This book will have particular appeal to professionals working in residential care for those with complex mental health problems as well as those working in intensive community based services. It is also an excellent resource for those training in psychological therapies for complex mental health problems, risk assessment and management\"--Provided by publisher.

Abstract Background Though olfactory deficits are well-documented in schizophrenia, fewer studies have examined olfactory performance profiles across the psychosis spectrum. The current study examined odor identification, discrimination, and detection threshold performance in first-episode psychosis (FEP) patients diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, major depression with psychotic features, and other psychotic conditions. Method FEP patients (n = 97) and healthy adults (n = 98) completed birhinal assessments of odor identification, discrimination, and detection threshold sensitivity for lyral and citralva. Participants also completed measures of anticipatory pleasure, anhedonia, and empathy. Differences in olfactory performances were assessed between FEP patients and controls and within FEP subgroups. Sex-stratified post hoc analyses were employed for a complete analysis of sex differences. Relationships between self-report measures and olfactory scores were also examined. Results Individuals with psychosis had poorer scores across all olfactory measures when compared to the control group. Within the psychosis cohort, patients with schizophrenia-associated psychosis had poorer odor identification, discrimination, and citralva detection threshold scores relative to controls. In schizophrenia patients, greater olfactory disturbance was associated with increased negative symptomatology, greater self-reported anhedonia, and lower self-reported anticipatory pleasure. Patients with mood-associated psychosis performed comparable to controls though men and women in this cohort showed differential olfactory profiles. Conclusions These findings indicate that olfactory deficits extend beyond measures of odor identification in FEP with greater deficits observed in schizophrenia-related subgroups of psychosis. Studies examining whether greater olfactory dysfunction confers greater risk for developing schizophrenia relative to other forms of psychosis are warranted.

Abstract That trauma can play a significant role in the onset and maintenance of voice-hearing is one of the most striking and important developments in the recent study of psychosis. Yet the finding that trauma increases the risk for hallucination and for psychosis is quite different from the claim that trauma is necessary for either to occur. Trauma is often but not always associated with voice-hearing in populations with psychosis; voice-hearing is sometimes associated with willful training and cultivation in nonclinical populations. This article uses ethnographic data among other data to explore the possibility of multiple pathways to voice-hearing for clinical and nonclinical individuals whose voices are not due to known etiological factors such as drugs, sensory deprivation, epilepsy, and so forth. We suggest that trauma sometimes plays a major role in hallucinations, sometimes a minor role, and sometimes no role at all. Our work also finds seemingly distinct phenomenological patterns for voice-hearing, which may reflect the different salience of trauma for those who hear voices.

Objectives: Cognitive dysfunction is a core symptom dimension that cuts across the psychoses. Recent findings support classification of patients along the cognitive dimension using cluster analysis; however, data-derived groupings may be highly determined by sampling characteristics and the measures used to derive the clusters, and so their interpretability must be established. We examined cognitive clusters in a cross-diagnostic sample of patients with psychosis and associations with clinical and functional outcomes. We then compared our findings to a previous report of cognitive clusters in a separate sample using a different cognitive battery. Methods: Participants with affective or non-affective psychosis (n=120) and healthy controls (n=31) were administered the MATRICS Consensus Cognitive Battery, and clinical and community functioning assessments. Cluster analyses were performed on cognitive variables, and clusters were compared on demographic, cognitive, and clinical measures. Results were compared to findings from our previous report. Results: A four-cluster solution provided a good fit to the data; profiles included a neuropsychologically normal cluster, a globally impaired cluster, and two clusters of mixed profiles. Cognitive burden was associated with symptom severity and poorer community functioning. The patterns of cognitive performance by cluster were highly consistent with our previous findings. Conclusions: We found evidence of four cognitive subgroups of patients with psychosis, with cognitive profiles that map closely to those produced in our previous work. Clusters were associated with clinical and community variables and a measure of premorbid functioning, suggesting that they reflect meaningful groupings: replicable, and related to clinical presentation and functional outcomes. (JINS, 2018, 24, 382–390)

Background People with severe mental illness (SMI) are two to three times more likely to be overweight and obese than the general population and this is associated with significant morbidity and premature mortality. Although lifestyle interventions can support people with SMI to lose weight, some are unable to make the necessary lifestyle changes or, despite making the changes, continue to gain weight. Objective To assess the feasibility and acceptability of delivering a full-scale trial evaluating whether liraglutide 3.0 mg, a once-daily injectable therapy, may be an effective treatment of overweight and obesity in people with schizophrenia, schizoaffective disorder and first-episode psychosis. Methods Design: a single-centre, double-blind, randomised, placebo-controlled trial. Setting: mental health facilities within Southern Health NHS Trust. Participants: 60 adults with schizophrenia, schizoaffective or first-episode psychosis prescribed antipsychotic medication will be recruited. Participants will be overweight or obese, defined by their baseline BMI which will be: • BMI ≥ 30 kg/m 2 or • BMI ≥ 27 kg/m 2 to < 30 kg/m 2 in the presence of at least one weight-related consequence. This is in concordance with the current EU licence for liraglutide (maximum dosage 3.0 mg). Intervention: participants will be allocated in a 1:1 ratio using a computer-based randomisation programme to either once-daily subcutaneously administered liraglutide or placebo, titrated to 3.0 mg daily, for 6 months. All participants will receive standardised written information about healthy eating and exercise at their randomisation visit. Outcomes: the main aim of the study is to gather data on recruitment, consent, retention and adherence. Qualitative interviews with a purposive sub-sample of participants and healthcare workers will provide data on intervention feasibility and acceptability. Secondary clinical outcome measurements will be assessed at 3 and 6 months and will include: weight, fasting plasma glucose, lipid profile, HbA 1c level; and the Brief Psychiatric Rating Scale. Discussion This study should provide evidence of the potential benefits of liraglutide (maximum dosage 3.0 mg daily) on body weight and metabolic variables in people with schizophrenia, schizoaffective disorder and first-episode psychosis. It will also address the feasibility and acceptability of the use of liraglutide in mental health settings. This will inform the design of a longer outcome study that will be needed to determine whether any weight loss can be maintained in the long term. Trial registration Universal Trial Number (UTN), ID: U1111-1203-0068 . Registered on on 2/10/2017. European Clinical Trials Database (EudraCT), ID: 2017-004064-35 . Registered on 3/10/2017.

In spite of improved access to psychosocial interventions, many people with psychosis continue to experience persistent problems which act as significant barriers to their recovery. This book investigates risk and problem behaviours in psychosis, including staff and service factors that can impede the delivery of effective care. Problematic and Risk Behaviours in Psychosis provides a new approach for assessment, formulation and intervention within such problem behaviours in a team context. Of particular interest will be: an outline of the SAFE (Shared Assessment, Formulation and Education) approach an integrative model for understanding risk and problematic behaviour shared risk assessment and management processes approaches to reducing team and carer barriers to effective care the use of CBT in day-to-day interactions with clients a set of formulation-driven strategies for managing problematic behaviours case studies and vignettes providing guidance and highlighting the benefits of the approach. This book will have particular appeal to professionals working in specialist community, hospital-based and residential services who often struggle to help those with the most complex mental health problems who are hardest to reach. It is also an excellent resource for those engaged in training in psychological therapies, risk assessment and management. Acknowledgements. Preface. Introduction. List of Abbreviations. Part I: The SAFE Approach; Theory, Models and Processes. Problematic Behaviour in Psychosis: A Barrier to Social Inclusion and Recovery. Definitions, Prevalence and Consequences. The SAFE Approach: An Overview. Improving Care Planning: The WHO ICIDH-2 Model and Service Level Formulation. Formulating the Person: Arriving at a Shared View. Shared Risk Assessment in Psychosis. Shared Risk Formulation. CARM: An Integrative Model for Understanding Problematic Behaviour in Psychosis. Working with Staff and Carer Beliefs in SAFE. Part II: Assessment. Assessing Problematic Behaviours Excesses in Psychosis: A Multidisciplinary Team Based Approach. Identifying Early Warning Signs of Risk. Assessing Behavioural Deficits. Part III: Interventions in SAFE. Working with Low Risk Behavioural Excesses. Working with High Risk Behaviours. Working with Behavioural Deficits. Part IV: Implementation Issues: Translating SAFE into Routine Clinical Practice. Translating SAFE into Care Plans. Applying SAFE and CARM in Specialist Settings. Implementing SAFE: The Dynamics of Change. Training, Supervision, Reflective Practice and Staff Support Groups. Appendices. References. Index. \"This book successfully illustrates how recent developments in cognitive therapy for psychosis, risk management and behavioural approaches can be integrated into a whole team treatment framework in services for people with complex and challenging mental health and behavioural needs. An excellent clinical resource for all professionals working with this client group.\" - Suzanne Jolley, Clinical Psychologist, King's College London, UK \"As a student with little clinical experience, I found the authors' approach engaging. They provide clear and concise definitions of every assessment and the use of therapy in the clinical field, which I found very helpful. They also provide an integrative approach, clearly showing the differences of assessments used in practice. The interesting thing is the use of illustrative examples: case studies which make the approach come to life...I found this book exceptional\" - Heather Brobbey, Journal of Mental Health , August 2011 \"The Shared Assessment, Formulation, and Education (SAFE) approach presented by Meaden and Hacker offers a system for providing comprehensive, cognitive-behavioral treatment for RPBs at all levels of the health care environment. Rather than present a brand new treatment, their book presents a much-needed system for implementing exisitng cogntive-behavioral interventions in settings that provide treatment to people with psychotic disorders.\" - Patrick L. Kerr, PsyCritiques, Volume 57, Issue 7, February 2012 Alan Meaden is a Consultant Specialist Clinical Psychologist for Birmingham and Solihull Mental Health Foundation Trust who specialises in working with those most affected by psychosis. He is an active researcher, most notably in the area of cognitive therapy for command hallucinations, and has other research interests in engagement and staff factors. David Hacker is a Principal Clinical Psychologist in Neuropsychology at University Hospital Birmingham Regional Neuroscience Centre. He is experienced in working clinically with psychosis, is an active researcher and a Cochrane reviewer. He has additional expertise in working with a range of forensic populations and has undertaken post-doctoral training in Neuropsychology, which is now his area of speciality.

Objectives. This study examined the prevalence and correlates of violent behavior by individuals with severe mental illness. Methods. Participants (N = 802) were adults with psychotic or major mood disorders receiving inpatient or outpatient services in public mental health systems in 4 states. Results. The 1-year prevalence of serious assaultive behavior was 13%. Three variables—past violent victimization, violence in the surrounding environment, and substance abuse—showed a cumulative association with risk of violent behavior. Conclusions. Violence among individuals with severe mental illness is related to multiple variables with compounded effects over the life span. Interventions to reduce the risk of violence need to be targeted to specific subgroups with different clusters of problems related to violent behavior.

Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated with the experience of psychosis. These impairments negatively impact functional outcome, contributing to the disabling nature of schizophrenia, bipolar disorder, and psychotic depression. The robust and reliable nature of cognitive deficits has led researchers to explore the timing and profile of impairments, as this may elucidate different neurodevelopmental patterns in individuals who experience psychosis. Here, we review the literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences, highlighting the dimensional nature of both psychosis and cognitive ability. We identify premorbid generalized cognitive impairment in schizophrenia that worsens throughout development, and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course. Research in affective psychosis is less clear, with mixed evidence regarding premorbid deficits, but a fairly reliable generalized deficit at first-episode, which appears to worsen into the chronic state. In general, cognitive impairments are most severe in schizophrenia, intermediate in bipolar disorder, and the least severe in psychotic depression. In all groups, cognitive deficits are associated with poorer functional outcome. Finally, while the generalized deficit is the clearest and most reliable signal, data suggests specific deficits in verbal memory across all groups, specific processing speed impairments in schizophrenia and executive functioning impairments in bipolar disorder. Cognitive deficits are a core feature of psychotic disorders that provide a window into understanding developmental course and risk for psychosis.

Abstract Many individuals with early psychosis experience impairments in social and occupational function. Identification of modifiable predictors of function such as cognitive performance has the potential to inform effective treatments. Our aim was to estimate the strength of the relationship between psychosocial function in early psychosis and different domains of cognitive and social cognitive performance. We conducted a systematic review and meta-analysis of peer-reviewed, cross-sectional, and longitudinal studies examining cognitive predictors of psychosocial function. Literature searches were conducted in PsycINFO, PubMed, and reference lists of relevant articles to identify studies for inclusion. Of the 2565 identified, 46 studies comprising 3767 participants met inclusion criteria. Separate meta-analyses were conducted for 9 cognitive domains. Pearson correlation values between cognitive variables and function were extracted. All cognitive domains were related to psychosocial function both cross-sectionally and longitudinally. Importantly, these associations remained significant even after the effects of symptom severity, duration of untreated psychosis, and length of illness were accounted for. Overall, general cognitive ability and social cognition were most strongly associated with both concurrent and long-term function. Associations demonstrated medium effect sizes. These findings suggest that treatments targeting cognitive deficits, in particular those focusing on social cognition, are likely to be important for improving functional outcomes in early psychosis.

Motor signs are critical features of psychosis that remain underutilized in clinical practice. These signs, including social motor behaviors, mechanistically relevant motor signs, and other motor abnormalities, have demonstrated potential as biomarkers for early detection and intervention. However, their application in clinical settings remains limited due to challenges such as cost, accessibility, and integration into clinical workflows. Recent advancements in related research fields, such as Human Movement Sciences and Affective Computing, offer promising solutions, enabling scalable and precise measurement of patients motor signs. In this editorial, we explore the spectrum of motor signs and highlight the evolving role of motor assessments in psychosis research. By examining traditional assessment methods alongside alternative and innovative tools, we underscore the potential of leveraging technology and methodology to bridge the gap between research and clinical application, ultimately advancing personalized care and improving outcomes.