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Accents in second language speech have multiple perceptual consequences, including breakdown in communication and undesirable judgments about accented speakers. Whereas perceived accents are likely influenced by various acoustic variables, it is not clear which acoustic variables influence the perceived accents the most and whether such important predictors of accents change as learners’ proficiency develops. Here we report a study that has examined acoustic sources of foreign accent in second language Japanese produced by American learners at different instructional levels, including beginning and intermediate late learners and early bilinguals. We collected speech samples from these learners as well as a control group of native speakers and measured 27 segmental and prosodic variables. These acoustic variables were related to accent rating scores obtained from native listeners. Confirmatory analyses showed that 24 out of 27 variables tested were reliably associated with listeners’ accentedness judgements. Exploratory analyses showed that prosodic features were most predictive of beginning to intermediate late learners’ accents, whereas vowel features were most predictive of early bilinguals’ accents. These results shed light on issues related to the acoustic sources of foreign accent and the development of second language speech.
Methane (CH4) is a greenhouse gas (GHG) produced and released by eructation to the atmosphere in large volumes by ruminants. Enteric CH4 contributes significantly to global GHG emissions arising from animal agriculture. It has been contended that tropical grasses produce higher emissions of enteric CH4 than temperate grasses, when they are fed to ruminants. A number of experiments have been performed in respiration chambers and head-boxes to assess the enteric CH4 mitigation potential of foliage and pods of tropical plants, as well as nitrates (NO3−) and vegetable oils in practical rations for cattle. On the basis of individual determinations of enteric CH4 carried out in respiration chambers, the average CH4 yield for cattle fed low-quality tropical grasses (>70% ration DM) was 17.0 g CH4/kg DM intake. Results showed that when foliage and ground pods of tropical trees and shrubs were incorporated in cattle rations, methane yield (g CH4/kg DM intake) was decreased by 10% to 25%, depending on plant species and level of intake of the ration. Incorporation of nitrates and vegetable oils in the ration decreased enteric CH4 yield by ∼6% to ∼20%, respectively. Condensed tannins, saponins and starch contained in foliages, pods and seeds of tropical trees and shrubs, as well as nitrates and vegetable oils, can be fed to cattle to mitigate enteric CH4 emissions under smallholder conditions. Strategies for enteric CH4 mitigation in cattle grazing low-quality tropical forages can effectively increase productivity while decreasing enteric CH4 emissions in absolute terms and per unit of product (e.g. meat, milk), thus reducing the contribution of ruminants to GHG emissions and therefore to climate change.
Describe Attention Deficit Hyperactive Disorder's (ADHD) prevalence in Bipolar Disorders (BD) and relatives.
78 admissions for Bipolar Disorder (DSM-IV) in Impatient Psychiatric Unit, in Hospital Clínico Universitario of Valladolid (Spain). Only 36/78 patients participate in study. Demographic, social and clinical information were registered. ADHD symptomatology was evaluated from patient and descendant (Conners short version).
ADHD symptomatology suggestive in childhood/adolescence were detected in 13,9% (5/36). Conners score were negative (below 15) in all case.
ADHD symptomatology suggestive in their children were detected in 6,25% (n=3). Conner score were positive in 2,1%. Family psychiatry history in 72,2% (n=26), affective disorder in 60,52% (n=23). No family history with ADHD diagnosis. Only one case (2,8%) with symptomatology suggestive of ADHD in relatives.
The ADHD prevalence in our sample of BD and relatives weren’t higher than general population.
- Frontiers Between Attention Deficit Hyperactivity Disorder and Bipolar Disorder. Cathryn A. Galanter, MDa, Ellen Leibenluft, MD. Child Adolesc Psychiatric Clin N Am 17 (2008) 325-346.
- Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children.
Suicide is one of the most frequent causes of death. In 1993, Bleuler emphasized its importance in his “Suicidal behavior is the most serious symptom of schizophrenia”. Since then, various studies have confirmed importance of suicide in schizophrenia, and today it's clear that his research and knowledge is one of the great challenges of psychiatry.
- Establish clinical-socio-demographic profile and risk factors for psychotic people with autolytic behaviors.
- Determine frequency of suicides in psychotic disorders in our area of care.
Material and methods
Retrospective study(3 years evolution) that includes psychotic patients(diagnosed according DSM IV-TR) admitted to the HCU of Valladolid. With data provided by hospital medical records, analyzed socio-demographic variables and clinics. Study consists of two groups:group of cases(those patients who have suicidal behavior) and control group (those that haven't autolytic gesture during the study period). Statistical evaluation was performed with SPSS.
- The sample includes 191 patients:41(21%) have attempted suicide.
- Of them:73% are males;88% singles;51% have basic studies;61% we re unemployed;37% were 31-40 aged;54% started disease 21-30 aged and 63.5% are schizophrenic.
- Considering statistical study we find that suicidal patient profile is male(p = 0.039),diagnosed with schizophrenia(p = 0.033),with previous suicide attempts(p = 0.009)and lack of social support(p = 0.007).
- 21% of hospitalized psychotic patients have presented some autolytic attempt.
- Profile of suicidal psychotic patient is a male, single, 21-40 aged, primary education, unemployed, with a primary diagnosis of schizophrenia, particularly paranoid, with ten years evolution,without acceptable social support, number of revenues higher than non-suicidal psychotic and a personal history of previous autolytic attempts.
Present study shows the socio-demographic and clinical profile of patients with severe mental illness in Mancha Centro health area. Furthermore, it is a descriptive approach to the current state of clinical assistance in the area.
Socio-demographic and clinical variables were collected in a sample of 55 patients, 37 men and 18 women with severe mental illness, treated at the Mancha Centro Mental Health Centre. Using SPSS.15, analysis of qualitative and quantitative variables was made.
Average age was 39, 25 years +/− 8, 82; 72, 7% lived with their families and 85, 5% had the support of relatives. Main diagnosis were: psychotic disorder (81,2%) with high proportion of schizoaffective disorder; mood disorders (9,1%), personality disorders (5,5%) and OCD (3,6%). In the last two years, 25, 5% was admitted in a medium-stay psychiatric unit, 15% in a short- time stay psychiatric unit and, in the last six months, 4% came to emergency service. Patients with higher number of admissions and emergency consultations were those with schizophrenia and schizoaffective disorder. The average time of follow up was 10 years (+/− 6, 84), every 49, 45 days (+/− 19,1). 80% receive group therapy, 85,5% family intervention and 54,5% cognitive rehabilitation.
We found a profile of young man with significant family support, low number of admissions and emergency consultations. Results could be in relation to: geographical dispersion, emergency access difficulties and protective socio-cultural factors. Better knowledge about needs would allow a better assistance in the future.
UPD is a regional referral hospital psychiatric care unit, endowed with multidisciplinary equipment. It provides care to people with light/moderate/severe intellectual incapacity coexisting with mental disease and/or severe behavioral disorders. It offers attention to patients who need a protected therapeutical environment for correcting behavior disorders. It was opened in September 2008.
Description of:therapeutic goals, inclusion/exclusion criteria, admission protocol and psychotherapeutic/pharmacological interventions.
Analysis of inpatients's sociodemographic/clinical characteristics and preliminary assessment of therapy goals.
Retrospective study(13-month) of patients admitted to UPD of Leon Hospital from its inception to date. Data are collected from medical histories.
47 referrals have been received,5 of them have been rejected not to fulfill criteria. We’ve 16 patients on waiting list.32 incomes have been realized and 22 discharges have occurred.
19 of the incomes correspond to Mild,6 to Moderate,6 to Severe and 1 to Profound mental Retardation.
Regarding co-morbidity:22 patients presented serious behavioral disorder. From this group, 2 met criteria for autistic disorder, 5 had schizophrenia or unspecific psychotic disorders, 5 presented Personality Disorder and one ADHD.
10 patients did’nt present any important behavioral disturbance. From this group 2 were diagnosed with OCD,3 presented problems due to Alcohol and Substance-related Disorders,3 had Psychotic Disorders, one met criteria for Impulse Control Disorder and one presented Mood Disorder.
Before admission, 12 patients resided in specific handicappeds center, 5 intermittently at selected centers and in family, and 15 lived with family.
Psychotherapeutic intervention and treatment were useful in most cases. It was particularly helpful in treatment of behavioral disturbances. Now we must determine effectiveness in maintenance of improvement when they return to their community.
Alexithymia is a term to describe a state of deficiency in understanding, processing, or describing emotions. It expresses the cognitive-emotional state of vulnerable subjects who prone to suffer from psychosomatic illnesses. It’s characterized by difficulties in relationship and emptiness of feelings. It has been incriminated in genesis and maintenance of various psychosomatic pathologies, included psoriasis. Psychological stress is important in onset and exacerbation of psoriasis. We assume hypothesis that emotions that cannot be expressed through the appropriate symbolic language will be expressed through a symbolic somatic symptom.
A case study of psoriasis in a woman of 27 years without a previous psychiatric history. She was treated jointly by the service of psychiatry and dermatology. Methodology: We performed a detailed history in the course of the disease, summarizing vital changes and outstanding events of her lifetime in the different vital areas (family, work, school and sex life).
From the comprehensive revision of the ailments and pathobiography we can establish a clear relationship between physical-psychological symptoms.
Skin is an envelope that represents the boundary line between body-psyche. Skin and psyche interact in many ways. The skin reacts to feelings and perceptions. Psychosomatic patients feel extreme anxiety when they have to cope with separation and merger situations. They experience these situations as if they were to lose their physical limit. Broadly speaking, because of their alexithymia, they cannot process a painful emotion properly, and though they will express it through somatisation disorders and the development of diseases. In the case of our patient, the skin verbalizes her emotional silence.
A higher prevalence of toxic substances consumption is considered to be under schizophrenia states.These patients are also considered to have a higher possibility than general population of developing different disorders due to the use of substances being the risk above 3 regarding alcohol,5 for cannabis, 6 for opiates, and 13 for cocaine.Two hypotheses were used for explaining this comorbidity: for alleviating its symptomatology and the adverse effects of the antipsychotic treatment, and on the other hand, the use of toxic substances as causal and predisposing effect of psychotic episodes in patients with personal vulnerability.
Sociodemographic description of patients diagnosed as having psychotic disorders with abuse of toxic substances. Establishment of connections between the toxic substance consumption and development of his/her mental disorder.
Methodology: Open retrospective study of two years in which patients diagnosed as having schizophrenia admitted into the University Hospital in Valladolid, Spain: consumers/no consumers.Scales (SAPS, SANS).Hospital Reports(sociodemographic and clinical data).
Preliminary results show the prevalence of the schizophrenic patients with toxic abuse.Predominance of young males that had their first admissions into hospital at very early ages and a higher frequency of hospital readmissions. Likewise in this group positive symptomatology shows a higher predominance and a higher connection with affective disorders. These patients show a better premorbid adaptation, a higher frequency of violent and impulsive behaviours, treatment guidelines with higher doses and higher frequency of resistance to treatment.The order consumption of toxics is tobacco, alcohol, cannabis, cocaine, stimulants, and opiates.However it is not rare to find consumption of multiple drugs.
Antipsychotic treatment is known to be associated with secondary sexual dysfunction (SD). Recognition and treatment of this adverse effect has received growing attention. Until now, all antipsychotic agents were thought to potentially cause SD mediated by increased prolactin. Our aim was to observe whether aripiprazole modifies SD in patients with schizophrenia after 3 months of treatment.
Material and Methods:
Multicenter, observational, open-label, prospective, three-month study with single group of aripiprazole treated patients. Sexual activity was assessed using CGI-S and CGI-I for SD; SALSEX scale, validated for Spanish, 3 times after initiating study drug. Patient's clinical status was evaluated by CGI-S and CGI-I for psychotic disorders, and by BPRS Scale.
Result: 42 patients (70% men), 38 completed the study. Incidence of SD at 3 months was null for all patients studied. As period of treatment advanced, the Salsex score decreased, showing a mean overall reduction of –5 points (SD 3.6). Largest reduction was observed in subgroup of patients with SD in baseline visit, who exhibited a mean reduction of –6 points (SD 3.1).
Men with SD in baseline evaluation showed more marked improvement than women at 40 days of treatment (p=0.0447). However, recovery was similar for both groups at 90 days of treatment.
In schizophrenia, SD secondary studies to antipsychotics are important in establishing effectiveness of these agents in chronic treatment. After 3 months of aripiprazole treatment, no SD was observed in patients. Patients who presented SD at study initiation improved over course of 3 months treatment with aripiprazole.
Attention deficit hyperactivity disorder (ADHD) is a risk factor for drug. Prevalence rates between 15 and 30% had been previously found in this population.
To identify the real the prevalence of ADHD in alcoholics and to find/test/ evaluate? a new type of screening (ASRS) for the initial diagnosis of ADHD in alcoholics.
312 patients from an outpatient clinic for alcoholism were recruited during 1 year. All patients completed the ASRS: Adult Self-Report Scale. DSM IV criteria were used for other psychiatric diagnoses.
• 312 patients (66.3% (207) men) filled out the ASRS of which 13.5% (42) were positive.
• Alcohol consumption: 69% for more than 1 month, 17% less than a month and 14% with active consumption.
• 27.6% (86) had another psychiatric diagnosis from which 69% were ASRS positive. ASRS positive patients present a major risk of having another mental disorder. OR = 8.3 (4,1 - 17,1, c2 = 0,77, p = 0,001).
• Other drugs: 70.5% consume other drugs. 76% of them are ASRS positive. 27.6% consumed illegal substances, 47.6% of them being ASRS positive (c2 = 9.77, p = 0,002). ASRS positive patient have more average substance abuse (including tobacco): 1.02 DT: 0.87 versus 0.72, 7 DT: 0.04 (z -2.21, p.027).
• ASRS detected 13.5% of ADHD diagnosis in alcoholics.
• Patients with positive screening present more substance abuse and more risk of psychiatric comorbidity.
To examine the predictive diagnostic value of affective symptomatology in a first-episode psychosis (FEP) sample with 5 years’ follow-up.
Affective dimensions (depressive, manic, activation, dysphoric) were measured at baseline and 5 years in 112 FEP patients based on a factor structure analysis using the Young Mania Rating Scale and Hamilton Depression Rating Scale. Patients were classified as having a diagnosis of bipolar disorder at baseline (BDi), bipolar disorder at 5 years (BDf), or “other psychosis”. The ability of affective dimensions to discriminate between these diagnostic groups and to predict a bipolar disorder diagnosis was analysed.
Manic dimension score was higher in BDi vs. BDf, and both groups had higher manic and activation scores vs. “other psychosis”. Activation dimension predicted a bipolar diagnosis at 5 years (odds ratio = 1.383; 95% confidence interval, 1.205–1.587; P = 0.000), and showed high levels of sensitivity (86.2%), specificity (71.7%), positive (57.8%) and negative predictive value (90.5%). Absence of the manic dimension and presence of the depressive dimension were both significant predictors of an early misdiagnosis.
The activation dimension is a diagnostic predictor for bipolar disorder in FEP. The manic dimension contributes to a bipolar diagnosis and its absence can lead to early misdiagnosis.
The quality of the educational system of a country is not only an indicator of the levels of development and well made, but also to come. Not surprisingly, providing universal schooling is also capable of stimulating the development of children and youth, is a strategic objective of the first magnitude in the more advanced nations.
Our country is no stranger to this concern. It is for this reason that, in a recurrent way, the training of our young people, in particular, the problem of school failure are the subject of public debate.
School failure is considered now a major problem, especially in Spain (20-28%), where rates are above the European average and the OECD countries. The importance of this issue has led, in recent times, the emergence of numerous analyzes and various studies trying to determine the causes and to establish the true extent of the failure and dropout rates in our country.
This paper will describe possible factors for future preventive activities, influencing the increase in the rate of absenteeism / dropout: the appearance of breaking the educational link. Link or union that is fragmented by its components: the institution and the student.
The general model of cognitive impairment of schizophrenic patient may be summarized as follows:first difficulty interpreting signals from other(predominantly negative symptoms),and on the other an emotionally intense overinterpretation of these(predominantly positive symptomatology). These patients have greater difficulty in understanding the mental states of those around. So cognitive rehabilitation aims to build the capacity of relevant attribute mental states to others and solve specific problems and difficulties of daily life. The aim of the study is to evaluate the correlation between the ability of understanding of mental states and the ability to interpret expressions Machiavellian(manipulative purposes)
Cross-sectional data were analyzed from a study with a sample of 43 patients diagnosed with schizophrenia compared to normal controls matched for age, sex and educational level. As scale measuring instruments used Mach-IV, self-administered questionnaires and a comprehensive neuropsychological battery to assess performance and the PANSS, SAPS and SANS scales
The path analysis were used to evaluate the effects of neuropsychological functions, functional ability and level of functioning in real life. After evaluating the following functions:physical distinction-mental distinction-reality appearance, identification of intent gaze, identifying emotions, ability to deceive, ability to understand the jokes, ability to understand stories, the study showed how schizophrenic patients showed poor workability, deception or strategic thinking ability and a poor ability to “take the place of another”
Cognitive rehabilitation works to help construct representations of others and of oneself and use them flexibly to guide social behavior by encouraging the underlying social interactions involving human capacity to perceive the intentions and dispositions of the other mental functions. In short, an improvement in the therapeutic field biopsychosocial
The HDP care structures are intermediate in nature providing an active heatlth care, multidimensional, structured and intensive medical care, aimed at patients with severe and complex system of partial hospitalization in pathology, as well as those patients who do not require, at a given time, income to total time, but are not subject to appropriate outpatient therapeutic gains.
- To analyze the profile of psychotic patients admitted to HDP.
- To know the effectiveness of the intervention in HDP on psychotic patients.
Material and Methods
Prospective naturalistic study of psychotic patients (F2X.XX) entering HDP for 24 months. As main outcome variables use: PANSS score, GAF score and CASH for insight. These scales are passed on valuation and the day of discharge device.
We identified 81 patients that have been hospitalized after an acute event (67, 82.7%). From the initial sample, 22 cases were first psychotic episodes (27.2%), 46 males (56.8%) and 35 women (43.2%), Discharge statistically significant improvement in PANSS score (p objective <0.001) in the GAF score (p> o, o, o, 1) and in CASH to awareness of illness score (p <0,0,0,1).
Intervention in day Hospital on psychotic patients improves psychotic symptoms, functionality and insight.
Prescription Patterns Among Spanish Inpatients with Schizophrenia
R Oberguggenberger1,2, N Ruiz 1, M Ortega1, C Roset1, Y Rendal1, J Salva1, Lago E1, P Herbera1
1. Hospital Son Espases, Palma de Mallorca, Spain
2. Hospital Psiquiátrico. Palma de Mallorca, Spain
Polypharmacy in patients with schizophrenia is frequent in the short term and long term treatment. Prevalence of up to 50% of polypharmacy has been shown in some clinical settings. There is scare evidence of the prevalence of polypharmacy in inpatient settings.
The goal of this retrospective study is to assess the prescription patterns of patients with schizophrenia in a Spanish inpatient setting.
Records of all admissions between 2010 until 2012 in the adult ward of a public heatlh service in Palma de Mallorca will be analysed in this study.
The results will show current prescription patterns of patients with schizophrenia in a Spanish inpatient setting.
When we want to approach eating disorders in infancy and childhood we can not forget the importance of relations with the relational patterns figures. The bond with the primary attachment figure is critical to the physical and emotional development. The “be fed” is a task essential to life, through it, it helps the child regulate their states, differ feelings / emotions. … to food and environment are created and entrenched relational patterns exist when feeding problems is essential to evaluate the interactive situation and the representational world of the attachment figure. Only then can we understand the disorder and help participants to solve (R. Feldman, Karen M., 2004).
In this paper the study of possible empathic failures in the original development of attachment in relation to disordered eating behavior is presented. To do this, we have taken a sample of 10 patients with DSM-IV criteria for an eating disorder diagnosis and valued the relationship with the attachment figure reference.
Try, therefore, to analyze the basic elements that come into play around the feeding in the first year of life: the child with its biological characteristics and temperament and adult relationship leading figure, which is the one with food to the child and gives.
Publications and studies have shown that the existence of serious mental disorders in parents is a risk in the development of children and is more common the existence of mental illness in them than in the general pediatric population. This work aims to reflect in depth on the study of the influence of psychotic parents on child development through a review of a clinical study. We present the case of 14 years old adolescent who is being treated in a mental health center, whose parents suffers from a severe mental illness. We also defend the importance of a preventive approach or treatment that impinges on the child and family environment.
A way of community work, in coordination with the different teams (social services, educational services, etc.) allows more efficient and appropriate treatment, using various resources. When risk factors for developing mental health problems in childhood, family history and especially the existence of one or both parents of mentally pathology type schizophrenia or other psychoses are studied become important. It seems essential to address as a priority to the social group have called “high-risk group of psychosis’, and in particular to the” sons of patients diagnosed with psychosis”, both for its size and the severity and chronicity of psychopathology if developing means for early psychosocial care does not occur.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Schizophrenia and other psychotic disorders are associated with high rates of morbidity and mortality, caused by the use of specific treatments as well as health factors directly related to those processes. One of the high-frequency side effects in patients treated with classic and atypical antipsychotics is hyperprolactinemia. It causes alterations in neuroendocrine sphere (amenorrhea, galactorrhea, gynecomastia…), and other mid- and long-term effects (osteoporosis, cardiovascular risk increase and increased risk of developing cancers - specifically in breasts and endometrium).
Check hyperprolactinemia induction by maintained treatment with atypical antipsychotics.
A naturalistic prospective study was conducted following 75 patients on maintenance treatment with a single atypical antipsychotic during 24 months. Anthropometric and laboratory data were collected, along with the presence of different endocrine-metabolic during the 2-year study alterations.
Changes in prolactin levels were found in a large number of patients, with statistically significant differences between 0 (basal) and 24 months (Basal [M = 26.27; SD = 21], 2 years [M = 38.08, SD = 34.65]; t = −2.758; P = 0.013], with hyperprolactinemia increasing from 46.6% of patients at baseline to 65.5% at 2 years, mainly with paliperidone and risperidone long acting injection (statistically significant increase in both cases) (Fig. 1).
Paliperidone and risperidone long acting injectable induce increased prolactin levels in patients in long-term antipsychotic treatment.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The identification of new genetic variants underlying psychosis is crucial to improve its molecular diagnosis and to determine the disease etiology, which is necessary to develop new therapeutic targets.
To identify novel rare genetic variants associated to mental disorders, using whole exome sequencing (WES).
Two families with high prevalence of mental disease were genotyped using WES. The first family has 5 members affected, the mother with a bipolar disorder, three sons, two with schizophrenia and one with schizoaffective disorder, and a cousin with major depression and psychotic symptoms. The second family is constituted by 38 members affected by major mental diseases in three generations. Key affected members of each family were genotyped by WES. Shared rare variants, with allelic frequencies below 0.5% in general population, were identified among the affected members of the family. The segregation of those variants was confirmed by Sanger sequencing.
In family 1, thirty-seven genetic variants related to neurodevelopment were identified. Two of those variants in the genes TRIP12 and RNF25 segregated with psychosis. In family 2, seven rare genetic variants contained in genes related to neurodevelopment were identified. A mutation in the gene ARHGAP19 segregated with psychosis.
Three new genes have been found to be associated with psychosis. TRIP12 and RNF25 encode two E3-ubiquitin ligases which modulate the Wnt pathway, mutations in which lead to neurodevelopmental defects. ARHGAP19 encodes a GTPase which regulates the RhoA protein, involved in the regulation of the cytoskeleton.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
After several years of research to improve the action of antipsychotic medication and to reduce its side effects, we have realized the importance of an accurate intake of antipsychotic medication and because of it we started up a program in our Mental Health Rehabilitation Service. Therefore, we can affirm that outpatients behavior influence their intake medication and also the efficiency of the drug prescription. The main consequence of inadequate treatment compliance is an increase in relapses and hospital admission.
The aim of this program is to improve adherence to pharmacological treatment, to promote the quality of life for a better social integration, to know the use of prescribed medication, to know the health resources of the network to acquire the medication and to acquire skills for greater autonomy in the management and management of medication.
We analyzed a sample of 13 outpatient diagnosed with severe mental disorder that started up into our Program “Adherence to treatment” and their stabilization (less relapses and less admissions) in two years’ time.
One of the patients have completed the aims of the program and he is living on his own, nine of them continue the program without relapses or admissions, one dropped out the program because of relapse and an another one have also completed the program but he died because of somatic disease.
The experience of this program in group format is positive, since patients acquire skills, knowledge and strategies in their own treatment in line with the recovery model in psychosocial rehabilitation.
Disclosure of interest
The authors have not supplied their declaration of competing interest.