Background Despite the rising recognition of personal recovery, there is a lack of research on personal recovery in individuals with psychosis in Singapore. This study aims to evaluate the psychometric properties of the QPR-15 using the CHIME personal recovery framework and to examine its associations with clinical recovery factors. Methods Sixty-six stable outpatients were recruited and assessed at two time points approximately 2 weeks apart. Convergent validity was examined through Spearman correlations with scores on CHIME-related psychological factors: connectedness (Ryff subscale- positive relations with others), hope (Herth Hope Index- abbreviated), identity (Ryff subscale- self-acceptance, Internalized Stigma of Mental Illness- Brief), meaning (World Health Organization Quality of Life Assessment-Brief Form), empowerment (Empowerment Scale). Pearson’s correlation was used to examine the test-retest reliability, while Cronbach’s alpha was used to examine internal consistency. The initial factor structure was evaluated via principal component analysis, Velicer’s minimum average partial (MAP) criteria, parallel analysis, and a scree plot. Spearman correlations and hierarchical multiple linear regression (controlling for age and gender) were employed to examine the association of clinical (symptoms and functioning) and psychological factors with the QPR-15. Results The QPR-15 demonstrated convergent validity with all CHIME-related psychological factors (r s ranged from 0.472 to 0.687). Internal consistency was excellent (Cronbach’s alpha = 0.934), and test-retest reliability was adequate (r = 0.708). Initial factor structure evaluations revealed a one-factor model. Correlations of clinical factors with the QPR-15 were mostly low (r s ranged from − 0.105 to − 0.544) but significant, except for depressive symptoms (CDSS: r s = − 0.529 to − 0.544), while correlations were moderate for psychological factors. Clinical factors significantly explained 28.3–31.8% of the variance of the QPR-15. Adding psychological factors significantly increased the model variance at baseline (∆ adjusted R 2 = 0.369, F change < 0.001) and at time point 2 (∆ adjusted R 2 = 0.208, F change < 0.001). Conclusion Our results provide preliminary evidence that the QPR-15 has adequate psychometric properties in Singapore and encompasses the CHIME personal recovery framework. In addition, our results suggest that clinical recovery and personal recovery are not substitutes for each other but rather are complementary, thereby promoting a more holistic evaluation of recovery in people with psychosis. Implications are discussed. Electronic supplementary material The online version of this article (10.1186/s12888-019-2238-9) contains supplementary material, which is available to author...

Background: Improving Quality of Life (QoL) in Schizophrenia is an important treatment objective in the shift toward person-centered and recovery-oriented care. Health-Related Quality of Life (HRQoL) is a focused aspect of QoL that is directly impacted by healthcare intervention. This aim of the current study was to ascertain the clinical determinants of HRQoL in Schizophrenia and their collective contribution to HRQoL.Methods: 157 stable outpatients with schizophrenia were recruited for this study. Data collected included sociodemographic information and clinical characteristics. HRQoL was assessed on the RAND-36. Psychopathology was assessed on the Positive and Negative Syndrome Scale (PANSS) and functioning measured on the Global Assessment Scale (GAS).Findings: Multiple regression revealed that the Physical Health Component (PHC) of the RAND-36 was associated with positive symptoms (beta = −0.218, p = 0.005) and presence of psychiatric comorbidity (beta = −0.215, p = 0.003). The Mental Health Component (MHC) was associated with depressive (beta = −0.364, p < 0.001) and positive (beta = −0.175, p = 0.021,) symptoms. Symptoms, functioning, presence of psychiatric comorbidities, gender and age account for 20.3% of the total variance observed in HRQoL.Conclusion: Depressive and positive symptoms are key clinical determinants of HRQoL in people with schizophrenia. However, the medical model—looking solely at clinical determinants—could not account for a large proportion of variance in HRQoL. Hence, future research beyond the medical model is required to uncover the determinants of HRQoL in Schizophrenia. Identifying these factors will contribute toward developing a holistic and person-centered management plan for people with schizophrenia.

Traditionally, clinicians and healthcare users alike use the term “recovery” to imply a return to a premorbid state. This form of clinical recovery is objective, measureable and is a clear health outcome. In the past decade, an alternative to clinical recovery, also known as personal recovery, has gained traction in mental health and has impacted numerous mental health systems. Originally, personal recovery was conceptualised as an individually unique ongoing process for individuals with serious mental illness that emphasises on growth and potential for recovery, but it has also been proposed to be a clinical outcome for mental health professionals. In this commentary, we discuss the differences in the 2 models of recovery and attempt to illustrate the concepts behind personal recovery so as to clarify its usage in people with serious mental illnesses. Key words: Post-traumatic growth, Resilience, Stigma

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Purpose/Background: The differential influence of therapeutic alliance with different health care professionals on patients' medication adherence has never been examined.Methods/Procedures: Ninety-five stable outpatients (91 patients with schizophrenia and 4 patients with schizoaffective disorder) were recruited. Individual, clinical, and medication factors were assessed, along with drug attitude (10-item Drug Attitude Inventory). Comparison on these factors was made between outpatients who identified psychiatrists as the health care professional most involved in their care, as compared with other health care professionals.Findings/Results: Older age, longer duration of illness, presence of medical comorbidities, lower levels of internalized stigma, higher levels of insight, higher levels of functioning, lesser severity of depressive symptoms, and positive symptoms were found to be significantly associated with greater levels of drug attitude (small to moderate associations). Only therapeutic alliance had a large correlation with drug attitude (ρ = 0.503, P < 0.001). The therapeutic alliance scores between the 2 health care professionals groups are not significantly different. However, participants who have identified psychiatrists as the health care professional that contributed the most to their recovery reported a significantly more positive attitude (μ = 6.18, SD = 3.42) toward psychiatric medication as compared with the other health care professionals group (μ = 3.11, SD = 5.32, P = 0.004). Only 2 factors, the Revised Helping Alliance Questionnaire (β = 0.424, P < 0.001) and Personal and Social Performance scale (β = 0.272, P = 0.006), were statistically significant predictors of drug attitude.Implications/Conclusions: Therapeutic alliance is found to be the lead factor associated with drug attitude in patients with schizophrenia. Identifying psychiatrists as the health care professional most involved in the patients' recovery can greatly increase patients' drug attitudes. Maintaining individuals' functioning also contributes to drug attitude.

Pridopidine is currently in clinical development for Huntington’s disease (HD) and investigations to increase the understanding of its therapeutic benefit and mode of action are undergoing. In this study, we aim to investigate the efficacy and mechanism of action of pridopidine using the transgenic YAC128 mouse model of HD. Pridopidine was administered to animals starting at early (1.5 months of age) or late stages of disease (8 months of age). In the early treatment cohort, animals were divided into three groups receiving 0, 10, or 30 mg/kg of pridopidine for a period of 10.5 months. In the late cohort, animals were divided into two groups receiving either 0 mg/kg or an escalating dose of pridopidine (10 mg/kg in week 1, 20 mg/kg in week 2, and 30 mg/kg in weeks 3–8). Pridopidine treated animals were evaluated using a battery of behavioural tests. Our analysis reveals that chronic treatment with pridopidine improves motor coordination and depressive-like phenotypes in the YAC128 HD mice. Currently, neuropathological analysis by immunohistochemistry and structural MRI, and molecular assessments to investigate the mechanism of action of pridopidine are ongoing. At the same time, the observed antidepressant effect of pridopidine after chronic treatment in the YAC128 HD mice prompted us to question whether this effect would also be observed after acute treatment. For this, we are currently breeding a new cohort of mice to further evaluate the effect of acute treatment with pridopidine on anxiety- and depressive-like behavioural phenotypes in HD.