Authors declare that there is no any financial support or relationships that may pose conflict of interest. Ethical statements: The study was approved by the Ethics Committee of the Bakırköy Mental Health and Neurological Diseases Hospital (01.09.2015, No. 487).
Patients with schizophrenia perform worse on neuropsychological tasks than controls. While most experts ascribe poor performance to neurocognitive impairment, an emerging literature is identifying important nonspecific mediators of neurocognitive test performance, some of which can be accounted for in trials (eg, motivation, effort, defeatist performance beliefs, stress, anxiety, physical inactivity). Other factors are harder, if not impossible, to control when patients are compared to non-clinical participants (eg, hospitalization, medication effects, distraction due to positive symptoms). Effect sizes of neurocognitive performance differences are usually not adjusted for these confounders, and the level of neurocognitive impairment due to schizophrenia is thus likely exaggerated. We suggest some ways for researchers to account for the effects of these mediators. Secondary influences that negatively affect neurocognitive performance should not be treated as mere noise. They give important insight into causal mechanisms and may inform more effective treatments that go beyond cognitive remediation.
Background: Because a great majority of the public knows about mental disorders primarily through printed or visual media, the attitudes exhibited in mass media might be predictive in stigmatizing individuals with mental disorders. Aim: The aim of this study was to retrospectively assess the articles in Turkish newspapers that mention individuals with mental disorders. Method: This study was designed to retrospectively investigate and analyze newspaper content in Turkey; the newspapers’ circulation information was collected by examining the websites of the four newspapers with above 1% of the total circulation. The News Evaluation Form was used to evaluate a sampling of articles that met the inclusion criteria of having appeared in the lifestyle and agenda pages of newspapers, and of using neutral or negative labeling keywords about psychiatric patients. Results: Almost all the articles reviewed were negative toward individuals with mental disorders. Three quarters of the reports were forensic, among which two thirds of the individuals with mental disorders were criminalized, and one third were victims of crime. In approximately half of the news reports, most images were related to the news and were not protected. Although not all the articles contain stigmatizing elements directed toward people with mental disorders, two thirds of the subjects’ images in the news were found to have stigmatizing elements. Conclusion: Media has an impact on attitudes toward people with mental disorders mostly negatively along with individual experiences and peer interactions.
Aim: To evaluate the efficacy of metacognitive group training in reducing psychotic symptoms and improving cognitive insight and functions in people with schizophrenia. Design: Randomized controlled trial. It was carried out between July 2019-February 2020. Methods: Fifty-six patients with schizophrenia were enrolled and randomly assigned to either a control group (N = 29) or a metacognitive training group (N = 27). Blinded assessments were made at baseline, 1-week post-treatment and at follow-up 3 months after treatment. The primary outcome measure was psychotic symptoms based on the Psychotic Symptom Rating Scales (PSYRATS). Secondary outcomes were assessed by the Beck Cognitive Insight Scale (BCIS), the Personal and Social Performance (PSP) scale and the World Health Organization Disability Assessment Schedule (WHODAS). Results: Completion at follow-up was high (92.86%). The intention-to-treat analyses demonstrated that patients in the metacognitive training group had significantly greater improvements of the Psychotic Symptom Rating Scales delusion score and total score and the Personal and Social Performance Scale, after 3 months, compared with the control group. The effect size was medium to large. The intention-to-treat analyses also demonstrated that patients in the metacognitive training group had significantly greater reductions of the Psychotic Symptom Rating Scales hallucination score and Beck Cognitive Insight Scale self-certainty score post-treatment, compared with the control group. The effect size was medium to large. Conclusion: The metacognitive training administered by psychiatric and mental health nurses was effective in ameliorating delusions and social functioning over time and it immediately reduced hallucinations post-treatment. Impact: Metacognitive training for treating psychosis in patients with schizophrenia is efficacious and administration is clinically feasible in the Portuguese context.
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