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Trinucleotide repeats have been associated with schizophrenia, but the evidence, based on cross-sectional clinical information, is equivocal.
To examine the relationship between genomic CAG/CTG repeat size and premorbid development in schizophrenia.
Early development and premorbid functioning of 22 patients with DSM-IV diagnosis of schizophrenia were assessed by parental interviews. Repeat expansion detection (RED) technique was used to measure genomic CAG/CTG repeat size, and PCR for CAG repeat size at the ERDA-1 and CTG 18.1 loci.
There was an inverse association between CAG/CTG size and perinatal complications. Patients with speech and motor developmental delay had larger repeats. The results were not due to expansion in the ERDA-1 and CTG 18.1 genes.
CAG/CTG repeat expansion is associated with speech and motor developmental delay in schizophrenia. We propose that the developmental model may be useful for research into the genetics of schizophrenia.
Despite the critical role families play in the care and recovery journeys of people who experience enduring mental distress, they are often excluded by the mental health services in the care and decision-making process. International trends in mental health services emphasise promoting a partnership approach between service users, families and practitioners within an ethos of recovery.
This paper evaluated the acceptability of and initial outcomes from a clinician and peer co-led family information programme.
A sequential design was used involving a pre-post survey to assess changes in knowledge, confidence, advocacy, recovery and hope following programme participation and interviews with programme participants. Participants were recruited from mental health services running the information programme. In all, 86 participants completed both pre- and post-surveys, and 15 individuals consented to interviews.
Survey findings indicated a statistically significant change in family members’ knowledge about mental health issues, recovery attitudes, sense of hope and confidence. In addition, the interviews suggested that the programme had a number of other positive outcomes for family members, including increased communication with members of the mental health team and increased awareness of communication patterns within the family unit. Family members valued the opportunity to share their experiences in a ‘safe’ place, learn from each other and provide mutual support.
The evaluation highlights the importance of developing information programmes in collaboration with family members as well as the strength of a programme that is jointly facilitated by a family member and clinician.
Letting ℳ denote the space of finite measures on ℕ, and μλ ∊ ℳ denote the Poisson distribution with parameter λ, the function W : [0, 1]2 → ℳ given by W(x, y) = μc log x log y is called the PAG graphon with density c. It is known that this is the limit, in the multigraph homomorphism sense, of the dense preferential attachment graph (PAG) model with edge density c. This graphon can then in turn be used to generate the so-called W-random graphs in a natural way, and similar constructions also work in the slightly more general context of the so-called PAGκ models. The aim of this paper is to compare these dense PAGκ models with the W-random graph models obtained from the corresponding graphons. Motivated by the multigraph limit theory, we investigate the expected jumble-norm distance of the two models in terms of the number of vertices n. We present a coupling for which the expectation can be bounded from above by O(log3/2n · n−1/2), and provide a universal lower bound that is coupling-independent, but without the logarithmic term.
Leading sociologists who live and work in East Asia examine their region's most dangerous and explosive social problems, and some of their most stunning success stories, from the viewpoint of Civil Sphere Theory. This new and increasingly influential sociological understanding of democracy aims to describe and explain the moral codes and institutional foundations of democratic solidarity, as it manifests itself within a distinct social sphere. Part of a multi-volume project, this collection includes cases from Japan, mainland China, Hong Kong, Taiwan, and South Korea, bringing together efforts by sociologists based in East Asian academic institutions. Through an extraordinary blend of sophisticated social theory and path-breaking empirical research, The Civil Sphere in East Asia aims to advance civil sphere theory by globalizing and regionalizing it at the same time.
Involuntary admission can be traumatic and is associated with negative attitudes that persist after the episode of illness has abated.
We aimed to prospectively assess satisfaction with care at the points of involuntary admission and symptomatic recovery, and identify their sociodemographic, clinical and service experience predictors.
Levels of satisfaction with care, and clinical and sociodemographic variables were obtained from a representative cohort of 263 patients at the point of involuntary admission and from 155 of these patients 3 months after termination of the involuntary admission. Data were analysed with multiple linear regression modelling.
Higher baseline awareness of illness (B = 0.19, P < 0.001) and older age (B = 0.05, P = 0.001) were associated with more satisfaction with care at baseline and follow-up. Transition to greater satisfaction with care was associated with improvements in awareness of illness (B = 0.13, P < 0.001) and in symptoms (B = 0.05, P = 0.02), as well as older age (B = 0.04, P = 0.01). Objective coercive experiences were not associated with variation in satisfaction with care.
There is wide variation in satisfaction with coercive care. Greater satisfaction with care is positively associated with clinical variables such as increased awareness of illness.
A theoretical model of individuals' experiences before, during and after involuntary admission has not yet been established.
To develop an understanding of individuals' experiences over the course of the involuntary admission process.
Fifty individuals were recruited through purposive and theoretical sampling and interviewed 3 months after their involuntary admission. Analyses were conducted using a Straussian grounded theory approach.
The ‘theory of preserving control’ (ToPC) emerged from individuals' accounts of how they adapted to the experience of involuntary admission. The ToPC explains how individuals manage to reclaim control over their emotional, personal and social lives and consists of three categories: ‘losing control’, ‘regaining control’ and ‘maintaining control’, and a number of related subcategories.
Involuntary admission triggers a multifaceted process of control preservation. Clinicians need to develop therapeutic approaches that enable individuals to regain and maintain control over the course of their involuntary admission.
We present 12-month follow-up results for a randomised controlled trial of prolonged exposure and eye movement desensitisation and reprocessing (EMDR) therapy in 85 (78.8%) participants with psychotic disorder and comorbid post-traumatic stress disorder (PTSD). Positive effects on clinician-rated PTSD, self-rated PTSD, depression, paranoid-referential thinking and remission from schizophrenia were maintained up to 12-month follow-up. Negative post-traumatic cognitions declined in prolonged exposure and were stable in EMDR. A significant decline in social functioning was found, whereas reductions in interference of PTSD symptoms with social functioning were maintained. These results support that current PTSD guidelines apply to individuals with psychosis.
Declaration of interest
M.v.d.G. and D.v.d.B. receive income for published books on psychotic disorders and for the training of postdoctoral professionals in the treatment of psychotic disorders. A.d.J. receives income for published books on EMDR therapy and for the training of postdoctoral professionals in this method. A.v.M. receives income for published book chapters on PTSD and for the training of postdoctoral professionals in prolonged exposure. C.d.R. receives income for the training of postdoctoral professionals in EMDR therapy.
This study presents secondary analyses of a recently published trial in which post-traumatic stress disorder (PTSD) patients with psychosis (n = 108) underwent 8 sessions of trauma-focused treatment, either prolonged exposure (PE) or eye movement desensitisation and reprocessing (EMDR) therapy. 24.1% fulfilled the criteria for the dissociative subtype, a newly introduced PTSD subtype in DSM-5. Treatment outcome was compared for patients with and without the dissociative subtype of PTSD. Patients with the dissociative subtype of PTSD showed large reductions in clinician-administered PTSD scale (CAPS) score, comparable with patients without the dissociative subtype of PTSD. It is concluded that even in a population with severe mental illness, patients with the dissociative subtype of PTSD do benefit from trauma-focused treatments without a pre-phase of emotion regulation skill training and should not be excluded from these treatments.
be a unramified finite extension of
be an irreducible mod
two-dimensional representation of the absolute Galois group of
. The aim of this article is the explicit computation of the Kisin variety parameterizing the Breuil–Kisin modules associated to certain families of potentially Barsotti–Tate deformations of
. We prove that this variety is a finite union of products of
. Moreover, it appears as an explicit closed connected subvariety of
. We define a stratification of the Kisin variety by locally closed subschemes and explain how the Kisin variety equipped with its stratification may help in determining the ring of Barsotti–Tate deformations of
Post-traumatic stress disorder (PTSD) is highly prevalent in patients with a psychotic disorder. Because a PTSD diagnosis is often missed in patients with psychosis in routine care, a valid screening instrument could be helpful.
To determine the validity of the Trauma Screening Questionnaire (TSQ) as a screening tool for PTSD among individuals with psychotic disorders.
Among 2608 patients with a psychotic disorder, the rate of trauma exposure was determined and the TSQ was administered to screen for PTSD. PTSD status was verified in 455 patients using the Clinician-Administered PTSD Scale (trial registration: ISRCTN 79584912).
Trauma exposure was reported by 78.2% of the 2608 patients. PTSD prevalence was estimated at 16% (95% CI 14.6–17.4%) compared with 0.5% reported in the patients' clinical charts. A TSQ cut-off score of six predicted PTSD with 78.8% sensitivity, 75.6% specificity, 44.5% correct positives and 93.6% correct negatives.
The TSQ seems to be a valid screening tool for PTSD in patients with a psychotic disorder.