Impact of Patients’ Motivation and Scheme of Positive and Negative Symptoms among Patients with Psychotic Disorders (original) (raw)
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JPMA. The Journal of the Pakistan Medical Association, 2019
OBJECTIVE To investigate the patterns of positive, negative and general psychopathology symptoms on the Positive and Negative Syndrome Scale among a variety of schizophrenia patients. METHODS The cross-sectional study was conducted at the Institute of Behavioural Sciences, Dow University of Health Sciences, Karachi, in 2016-17, and comprised schizophrenia patients aged 18-52 years registered with the institute regardless of gender, socioeconomic class, marital status and severity of the diseases. The Positive and Negative Syndrome Scale was administered after one month of psychotropic medication. SPSS 21 was used for data analysis. RESULTS :Of the 104 patients, 62(59.6%) were males; 42(40.4%) were single; 45(43.3%) were married; 17(16.3%) were divorced/separated; 31(29.8%), belonged to low social class; 35(33.7%) to middle; and 38(36.5%) to upper class. Patients' scores were significantly different between in door and out-door patients (p<0.05); between patients who had come ...
Psychological Medicine, 1994
SynopsisThe problem of a possible lack of motivation to perform cognitive tasks, which is often encountered in psychotic patients, has been approached from the perspective of the ‘energetics’ of cognition (Hockey et al. 1986) and from the broader clinical context of psychosis as an ‘amotivational syndrome’ and its related negative symptoms.The presence of motivational deficits was investigated in a group of psychotic in-patients (N = 73, and 40 had schizophrenia) compared with a control group of non-psychotic psychiatric in-patients (N = 23). The motivational deficit was operationalized in terms of Sanders's (1983) cognitive–energetic model as a large effect of ‘time-on-task’ during a simple, monotonous reaction test. Significantly more psychotic patients than control patients showed evidence of this type of motivational deficit. The deficit appeared to be related with negative but not with positive symptoms of psychosis. Furthermore, the deficit was shown to be related to the c...
Clinical Psychology & Psychotherapy, 2016
The present study assessed motivation for engaging in treatment as rated by clinicians (n = 57) and patients with severe mental illness (SMI, n = 294) using measures based on three different motivation theories. Questionnaires were derived from self-determination theory, the transtheoretical model and the integral model of treatment motivation. It was investigated to which extent clinicians of patients with SMI were able to estimate their patient's perspective on motivation for engaging in treatment, to which extent they agreed on the patient's motivation and which factors were associated with estimation and agreement on treatment motivation. It was found that clinicians were poorly to moderately capable of estimating their patient's type of motivation and readiness for change. Further, agreement on the level of motivation between patients and clinicians was moderate. These findings were consistent across diagnostic groups (psychotic and personality disorders). A higher quality therapeutic relationship was generally associated with higher clinician-rated motivation. The patient's ethnicity and socially desirable responding were factors that differentiated between scales of different motivation theories. It is concluded that patients with SMI and their clinicians have different perceptions on the patient's motivation for engaging in psychiatric treatment, regardless of the theoretical framework that is used to measure motivation. The findings imply that a negotiated approach is needed where both perceptions of clinicians and patients on motivation for treatment are considered to ensure effective mental health interventions.
ABSTRACTBackgroundPharmacological treatment is usually the first line of treatment for schizophrenia, but more strategies are needed to augment this treatment to promote better outcomes. It is known that adherence to pharmacological treatment in schizophrenia patients can be increased by working with their insight into their disorder. In literature, many programs have been found to increase mental help-seeking and reducing symptom severity but most are from the Western cultures and/or are conducted with people attending any institution (i.e., a university or an in-patient care unit) and with specific age ranges (i.e., young adults or older adults). However, in the noninstitutionalized population of different age groups of Pakistan, there is a need to find ways (alongside medication) that promote attitude toward mental help-seeking and reduce symptom severity. Therefore, the current pilot study was designed to investigate the impact of a psychoeducation program on increasing patients...
Social Psychiatry and Psychiatric Epidemiology, 2010
Purpose Previous research has shown a link between 11 treatment satisfaction and global psychopathology in dif-12 ferent groups of psychiatric patients. However, neither the 13 relationship between treatment satisfaction and the sub-14 syndromes of global psychopathology nor their temporal 15 ordering have been explored. 16 Methods Participants admitted involuntarily to psychiat-17 ric wards in the UK and diagnosed with psychotic disorders 18 (N = 232) were included. Treatment satisfaction and psy-19 chopathological sub-syndromes (i.e., manic excitement, 20 anxiety-depression, negative symptoms, positive symp-21 toms) were measured within 1 week and at 1 month after 22 admission. 23 Results Repeated measures ANOVAs showed that higher 24 treatment satisfaction is associated with lower scores on the 25 manic excitement, anxiety-depression and positive symp-26 tom sub-syndromes, while no significant association was 27 found for negative symptoms. However, cross-lagged panel 28 analyses showed that treatment satisfaction predicted 29 change only in positive symptoms while none of the paths 30 from the relevant sub-syndromes to treatment satisfaction 31 was significant. 32 Conclusion Treatment satisfaction can be regarded as 33 an antecedent of changes in positive symptoms only. These results underline the importance of examining psychopathological sub-syndromes separately as they may relate differentially to other important correlates of psychoses.
Factors associated with psychotic relapse in patients with schizophrenia in a Pakistani cohort
International journal of mental health nursing, 2016
Despite a large body of research evaluating factors associated with the relapse of psychosis in schizophrenia, no studies in Pakistan have been undertaken to date to identify any such factors, including specific cultural factors pertinent to Pakistan. Semistructured interviews and psychometric measures were undertaken with 60 patients diagnosed with schizophrenia (49 male and 11 female) and their caregivers at four psychiatric hospitals in the Peshawar region in Pakistan. Factors significantly associated with psychotic relapse included treatment non-adherence, comorbid active psychiatric illnesses, poor social support, and high expressed emotion in living environments (P < 0.05). The attribution of symptoms to social and cultural values (97%) and a poor knowledge of psychosis by family members (88%) was also prevalent. In addition to many well-documented factors associated with psychotic relapse, beliefs in social and cultural myths and values were found to be an important, and p...
The Positive and Negative Symptoms Questionnaire: a self-report scale in schizophrenia
Comprehensive Psychiatry, 2005
The assessment of various symptoms in schizophrenia has received much interest, although few studies have compared evaluations by clinicians to those of their patients. Self-report tools may improve service delivery, data collection, and possibly also treatment adherence. We constructed the Positive and Negative Symptoms Questionnaire (PNS-Q), a self-report measure, after items from the Scale for Assessment of Positive Symptoms (SAPS) and the Scale for Assessment of Negative Symptoms (SANS). The PNS-Q contained 68 items and was administered to 61 schizophrenic inpatients. We examined its psychometric properties and utility as a self-report tool in schizophrenia. The PNS-Q exhibited high internal consistency for both its positive and negative subscales. External validity with the SAPS and SANS was low. The positive symptoms subscale correlated significantly with the SAPS (r = .341, P b .01), whereas the negative symptoms subscale did not correlate at all with the SANS (r = À0.086, P N .1). The correlation between patients' insight and scores of the PNS-Q was mixed. A partial correlation analysis failed to confirm a relationship between the rating of the patients' level of insight (measured by the Amador Scale to Assess Unawareness of Mental Disorders [SUMD]) and the disparity between the PNS-Q and the SAPS and SANS. However, the PNS-Q correlated highly with McEvoy's Vignettes, a measure of self-perception of symptoms. The results of this study are discussed in light of current research and methodologic issues. The PNS-Q reflects schizophrenics' self-perception, an important, yet neglected, aspect of schizophrenia. Using this new measure, we believe that clinicians and researchers will be able to gain insight to the inner world of these patients and improve their condition, as well as enhance patients' involvement in treatment planning. D