Sex work is a major public health problem. It has many faces, but ill mental health of sex workers is primarily related to different forms of violence.
Exceptional experiences (EE) occur frequently within the populations of many countries and across various socio-cultural contexts. Although some EE show similarities with mental disorders, it would be a mistake to identify them in general as disorders. In fact, the vast number of individuals reporting EE includes subclinical and completely healthy subjects. We conducted a comparative empirical study of several characteristics of EE for two samples – one from ordinary population and the other from clients seeking advice. We found surprisingly similar phenomenological patterns of EE in both samples, but the frequency and intensity of EE for clients seeking advice significantly exceeded those for the ordinary population. Our results support the hypothesis of a continuous spectrum between mental health and mental disorder for the types of experiences analyzed.
Background. This study aimed to identify the course of unmet needs by patients with a first episode of schizophrenia and to determine associated variables.Method. We investigated baseline assessments in the European First Episode Schizophrenia Trial (EUFEST) and also follow-up interviews at 6 and 12 months. Latent class growth analysis was used to identify patient groups based on individual differences in the development of unmet needs. Multinomial logistic regression determined the predictors of group membership.Results. Four classes were identified. Three differed in their baseline levels of unmet needs whereas the fourth had a marked decrease in such needs. Main predictors of class membership were prognosis and depression at baseline, and the quality of life and psychosocial intervention at follow-up. Depression at follow-up did not vary among classes.Conclusions. We identified subtypes of patients with different courses of unmet needs. Prognosis of clinical improvement was a better predictor for the decline in unmet needs than was psychopathology. Needs concerning social relationships were particularly persistent in patients who remained high in their unmet needs and who lacked additional psychosocial treatment.
This article introduces the design, sampling, field procedures and instruments used in the ZInEP Epidemiology Survey. This survey is one of six ZInEP projects (Zürcher Impulsprogramm zur nachhaltigen Entwicklung der Psychiatrie, i.e. the "Zurich Program for Sustainable Development of Mental Health Services"). It parallels the longitudinal Zurich Study with a sample comparable in age and gender, and with similar methodology, including identical instruments. Thus, it is aimed at assessing the change of prevalence rates of common mental disorders and the use of professional help and psychiatric sevices. Moreover, the current survey widens the spectrum of topics by including sociopsychiatric questionnaires on stigma, stress related biological measures such as load and cortisol levels, electroencephalographic (EEG) and near-infrared spectroscopy (NIRS) examinations with various paradigms, and sociophysiological tests. The structure of the ZInEP Epidemiology Survey entails four subprojects: a short telephone screening using the SCL-27 (n of nearly 10,000), a comprehensive face-to-face interview based on the SPIKE (Structured Psychopathological Interview and Rating of the Social Consequences for Epidemiology: the main instrument of the Zurich Study) with a stratified sample (n = 1500), tests in the Center for Neurophysiology and Sociophysiology (n = 227), and a prospective study with up to three follow-up interviews and further measures (n = 157). In sum, the four subprojects of the ZInEP Epidemiology Survey deliver a large interdisciplinary database.
Results of this study imply that training in verbal learning should be included in supported employment programs. More generally, elaborated models are needed to explain interactions between cognitive functioning, supported employment, and employment outcomes and to enhance understanding of the interrelationships between cognitive functioning, employment outcomes, and any mediating and moderating variables.
Background: The aim of this research project, part of a program initiated by the Swiss Federal Council, was to trace the development of organized assisted suicide in Switzerland, starting from the very first case in 1985. Methods: Retrospective data on 3666 death records from Swiss institutes of forensic medicine for the years 1985 to 2014 were systematically compiled, read into a database, and for the most part quantitatively evaluated. Results: Alongside a marked increase in the overall number of assisted suicides since the turn of the century, the number of people traveling to Switzerland from other countries-predominantly Germany-for this purpose has risen steadily. The proportion of women was 60%, and the age at death ranged from 18 to 105 years (median 73). The largest diagnostic category was malignancy overall, neurological disease for those from other countries. The next largest category was age-related functional limitation, e.g., sensory impairment (loss of sight and hearing), the consequences of which were stated in writing as the reason for the wish to die. Following the Swiss Federal Court's promulgation of binding requirements in 2006, the documentation contained in the death records for the subsequent period up to 2014 is much more detailed, but still not uniform or even necessarily complete. Conclusion: The number of candidates for organized assisted suicide increased steadily during the study period, but no standard procedures were followed. The question therefore arises of whether further regulation or the introduction of a central registration office to maximize standardization and promote transparency would lead to improved quality assurance.
Background: Exceptional experiences (EE) are experiences that deviate from ordinary experiences, for example precognition, supernatural appearances, or déjà vues. In spite of the high frequency of EE in the general population, little is known about their effect on mental health and about the way people cope with EE. This study aimed to assess the quality and quantity of EE in persons from the Swiss general population, to identify the predictors of their help-seeking, and to determine how many of them approach the mental health system.Methods: An on-line survey was used to evaluate a quota sample of 1580 persons representing the Swiss general population with respect to gender, age, and level of education. Multinomial logistic regression was applied to integrate help-seeking, self-reported mental disorder, and other variables in a statistical model designed to identify predictors of help-seeking in persons with EE.Results: Almost all participants (91%) experienced at least one EE. Generally, help-seeking was more frequent when the EE were of negative valence. Help-seeking because of EE was less frequent in persons without a self-reported mental disorder (8.6%) than in persons with a disorder (35.1%) (OR = 5.7). Even when frequency and attributes of EE were controlled for, people without a disorder sought four times less often help because of EE than expected. Persons with a self-reported diagnosis of mental disorder preferred seeing a mental health professional. Multinomial regression revealed a preference for healers in women with less education, who described themselves as believing and also having had more impressive EE.Conclusion: Persons with EE who do not indicate a mental disorder less often sought help because of EE than persons who indicated a mental disorder. We attribute this imbalance to a high inhibition threshold to seek professional help. Moreover, especially less educated women did not approach the mental health care system as often as other persons with EE, but preferred seeing a healer.
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