Book chapters will be unavailable on Saturday 24th August between 8am-12pm BST. This is for essential maintenance which will provide improved performance going forwards. Please accept our apologies for any inconvenience caused.
To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Psychiatric rehabilitation (PR) can improve functioning in people with severe mental illness (SMI), but outcomes are still suboptimal. Cognitive impairments have severe implications for functioning and might reduce the effects of PR. It has been demonstrated that performance in cognitive tests can be improved by cognitive remediation (CR). However, there is no consistent evidence that CR as a stand-alone intervention leads to improvements in real-life functioning. The present study investigated whether a combination of PR and CR enhances the effect of a stand-alone PR or CR intervention on separate domains of functioning.
A meta-analysis of randomized controlled trials of PR combined with CR in people with SMI was conducted, reporting on functioning outcomes. A multivariate meta-regression analysis was carried out to evaluate moderator effects.
The meta-analysis included 23 studies with 1819 patients. Enhancing PR with CR had significant beneficial effects on vocational outcomes (e.g. employment rate: SMD = 0.41), and social skills (SMD = 0.24). No significant effects were found on relationships and outcomes of community functioning. Effects on vocational outcomes were moderated by years of education, intensity of the intervention, type of CR approach and integration of treatment goals for PR and CR. Type of PR was no significant moderator.
Augmenting PR by adding cognitive training can improve vocational and social functioning in patients with SMI more than a stand-alone PR intervention. First indications exist that a synergetic mechanism also works the other way around, with beneficial effects of the combined intervention compared with a stand-alone CR intervention.
No study has so far explored differences in discrimination reported by
people with major depressive disorder (MDD) across countries and
To (a) compare reported discrimination across different countries, and
(b) explore the relative weight of individual and contextual factors in
explaining levels of reported discrimination in people with MDD.
Cross-sectional multisite international survey (34 countries worldwide)
of 1082 people with MDD. Experienced and anticipated discrimination were
assessed by the Discrimination and Stigma Scale (DISC). Countries were
classified according to their rating on the Human Development Index
(HDI). Multilevel negative binomial and Poisson models were used.
People living in ‘very high HDI’ countries reported higher discrimination
than those in ‘medium/low HDI’ countries. Variation in reported
discrimination across countries was only partially explained by
individual-level variables. The contribution of country-level variables
was significant for anticipated discrimination only.
Contextual factors play an important role in anticipated discrimination.
Country-specific interventions should be implemented to prevent
discrimination towards people with MDD.
Email your librarian or administrator to recommend adding this to your organisation's collection.