Achieving a better knowledge on the causes and early course of psychoses: a profitable investment for the future?

Ruggeri, Mirella; Tansella, Michele

doi:10.1017/s1121189x00004693

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…Mental health services for people with a psychosis diagnosis illustrate the point. On the one hand, they benefit people experiencing psychosis, by providing treatments which alleviate symptoms and consequent distress and disability (Ruggeri & Tansella, 2007). In-patient admissions and home treatment teams offer a safety net for those no longer able to compensate for disturbance caused by their phenomenological experiences.…”

Section: Clinical Challengesmentioning

confidence: 99%

Recovery: an international perspective

Slade

Amering

Oades

2008

Epidemiol Psichiatr Soc

327

249

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SummaryAims– To review developments in recovery-focussed mental health services internationally.Methods– Two forms of ‘recovery’ which have been used in the literature are considered, and international examples of recovery-focussed initiatives reviews. A ‘litmus test’ for a recovery-focussed service is proposed.Results– ‘Clinical recovery’ has emerged from professional literature, focuses on sustained remission and restoration of functioning, is invariant across individuals, and has been used to establish rates of recovery. ‘Personal recovery’ has emerged from consumer narratives, focuses on living a satisfying, hopeful and contributing life even with limitations caused by the illness, varies across individuals, and the empirical evidence base relates to stages of change more than overall prevalence rates. Clinical and personal recovery are different. Two innovative, generalisable and empirically investigated examples are given of implementing a focus on personal recovery: the Collaborative Recovery Model in Australia, and Trialogues in German-speaking Europe. The role of medication is an indicator: services in which all service users are prescribed medication, in which the term ‘compliance’ is used, in which the reasoning bias is present of attributing improvement to medication and deterioration to the person, and in which contact with and discussion about the service user revolves around medication issues, are not personal recovery-focussed services.Conclusions– The term ‘Recovery’ has been used in different ways, so conceptual clarity is important. Developing a focus on personal recovery is more than a cosmetic change – it will entail fundamental shifts in the values of mental health services.Declaration of Interest: None.

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Section: Clinical Challengesmentioning

confidence: 99%

Recovery: an international perspective

Slade

Amering

Oades

2008

Epidemiol Psichiatr Soc

327

249

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“…Taken together these findings strongly suggest that basic visuomotor processes are affected in schizophrenia and that the CC is involved in the pathophysiology of the illness. Future fMRI studies should further investigate the role of the CC in regulating functional communication between the hemispheres in schizophrenia, particularly in subjects at the early phases of the illness, in order to better delineate the contribute of inter-hemispheric connectivity to the clinical course of the disease (Killackey et al, 2007;Ruggeri et al, 2007). 200513 controls (8 males) 51.6+12.9 alcoholics than in controls.…”

mentioning

confidence: 99%

Interhemispheric communication in schizophrenia

Marzi

Brambilla

2009

Epidemiol Psichiatr Soc

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The corpus callosum (CC) is the brain's largest white matter tract, mostly composed by both myelinated and unmyelinated fibres, connecting the two cerebral hemispheres. The CC can be divided into different sections: rostrum, genu, body, isthmus and splenium (Aboitiz et al., 1992). Myelinated fibres predominate in the midbody and the splenium while unmyelinated fibres are more numerous in the rostrum and the genu. The callosal fiber disposition approximately reflects brain topography: the anterior sections connect the frontal lobes, the median sections connect temporal and parietal regions, and the posterior sections link occipital areas (Pandya et al., 1971). This traditional picture, however, which has been obtained mainly through studies in non-human primates has been partly modified by modern diffusion tensor imaging studies in humans (Hofer & Frahm, 2006). The CC matures after birth through adolescence and into early adulthood and is involved in different cognitive processes such as sensory-motor integration, attention, language, arousal and memory. Its size has been shown to be associated with handedness, sex (i.e., greater splenium in females and greater genu in males, Dubb et al., 2003) and cerebral laterality (i.e., inverse correlation between callosal connectivity and brain lateralization in males; Luders et al., 2003), and age (Ota et al., 2006) Specifically, age-related callosal degeneration has been detected by a diffusion tensor imaging (DTI) study (Ota et al., 2006) in the sub-regions that connect areas which are thought to be vulnerable to normal aging: the genu, rostral body, and isthmus. This result replicated post mortem findings of callosal degeneration in rostral body, anterior midbody and isthmus (Aboitiz et al., 1996).

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“…La "cinghia di trasmissione" dei trattamenti più innovativi ed efficaci, dalla ricerca alla pratica di routine, quando funziona, funziona lentamente ed è influenzata da meccanismi complessi. In particolare, pare necessaria oggi una riflessione sia sul contesto in cui vengono forniti i trattamenti, sia sui contenuti dei trattamenti stessi, che coinvolga i modelli organizzativi dei servizi, la scelta degli specifici interventi, o dei pacchetti di interventi da attuarsi, il processo di formazione dei professionisti che operano nell'area della salute mentale e il metodo che deve essere utilizzato per realizzare questi obiettivi e per valutare la misura in cui sono stati raggiunti (Tansella & Thornicroft, 2001;Ruggeri & Tansella, 2007;Thornicroft & Tansella, 2008).…”

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“…Hence, it is crucial that policy makers and clinicians discuss both the delivery and the content of care on a regular basis when developing mental health care programmes. Other factors to always be carefully examined are overall organizational models, specific types of intervention or intervention packages selected, quantity and quality of mental health staff training, and most of all, the methods proposed for achieving these goals and assess their outcomes (Tansella & Thornicroft, 2001;Ruggeri & Tansella, 2007;Thornicroft & Tansella, 2008).…”

mentioning

confidence: 99%

Improving the treatment of schizophrenia in real world mental health services

Ruggeri¹,

Tansella²

2008

Epidemiol Psychiatr Sci

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Over the past decades, the therapeutic goal for schizophrenia has become more and more ambitious, shifting from that of controlling violent episodes to aim of ameliorating patients' symptoms, to the extent that individuals with schizophrenia can achieve a relative degree of social and relational remission. Indeed, thanks to more recent pharmacological and psychosocial forms of intervention, once pessimistic attitudes toward long-term schizophrenia outcomes are transforming gradually into guarded optimism. Evidence of the efficacy of various forms of treatment now make it possible for researchers and clinicians to consider both the remission of severe symptoms for long periods of time and good social functioning potential goals.

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Achieving a better knowledge on the causes and early course of psychoses: a profitable investment for the future?

Cited by 5 publications

References 25 publications

Recovery: an international perspective

Recovery: an international perspective

Interhemispheric communication in schizophrenia

Improving the treatment of schizophrenia in real world mental health services

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