Book: Physical Health and Schizophrenia

Book Title:

Physical Health and Schizophrenia (Oxford Psychiatry Library Series).

Author(s): David J. Castle, Peter F. Buckley, and Fiona P. Gaughran.

Year: 2017.

Edition: First (1st), Illustrated Edition.

Publisher: Oxford University Press.

Type(s): Paperback and Kindle.

Synopsis:

In comparison to the general population, people with schizophrenia and related disorders have poorer physical health and increased mortality. Whilst it is recognized that serious mental illnesses such as schizophrenia carry a reduced life expectancy, it is often assumed that suicide is the main cause of this disparity. In actuality, suicide accounts for no more than a third of the early mortality associated with schizophrenia: the vast majority is due to cardiovascular factors

Physical Health and Schizophreniaoffers a user-friendly guide to the physical health problems associated with schizophrenia and a clear overview of strategies and interventions to tackle these issues. Spanning eight chapters this resource covers the essential topics in a practical and easy-to-read format to suit the needs of busy clinicians. It also includes an appendix designed specifically for patients and carers, with practical tips on how to be actively involved in monitoring and managing physical health problems.

Part of the Oxford Psychiatry Library series, Physical Health and Schizophrenia offers readers a fully up-to-date and valuable insight into this complex issue. With helpful key points at the start of each chapter and a clear layout, this is an essential resource for busy clinicians and researchers in any mental health field as well as those working in primary care.

Book: Schizophrenia and Psychiatric Comorbidities – Recognition Management

Book Title:

Schizophrenia and Psychiatric Comorbidities – Recognition Management (Oxford Psychiatry Library Series).

Author(s): David J. Castle, Peter F. Buckley, and Rachel Upthegrove.

Year: 2021.

Edition: First (1st).

Publisher: Oxford University Press.

Type(s): Paperback and Kindle.

Synopsis:

Psychiatric comorbidities such as depression, anxiety and substance use are extremely common amongst people with schizophrenia. They add to poor clinical outcomes and disability, yet are often not at the forefront of the minds of clinicians, who tend to concentrate on assessing and treating the core symptoms of schizophrenia, notably delusions and hallucinations. There is an imperative to assess every patient with schizophrenia for psychiatric comorbidities, as they might masquerade as core psychotic symptoms and also because they warrant treatment in their own right. This volume addresses these issues using a clinical lens informed by the current literature. Published as part of the Oxford Psychiatry Library series, the book serves as a concise and practical reference for busy clinicians.

Can We Identify Genetic Overlap & Novel Risk Loci for Attention-Deficit/Hyperactivity Disorder & Bipolar Disorder?

Research Paper Title

Identification of genetic overlap and novel risk loci for attention-deficit/hyperactivity disorder and bipolar disorder.

Background

Differential diagnosis between childhood onset attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) remains a challenge, mainly due to overlapping symptoms and high rates of comorbidity.

Despite this, genetic correlation reported for these disorders is low and non-significant.

Here the researchers aimed to better characterise the genetic architecture of these disorders utilising recent large genome-wide association studies (GWAS).

Methods

They analysed independent GWAS summary statistics for ADHD (19,099 cases and 34,194 controls) and BD (20,352 cases and 31,358 controls) applying the conditional/conjunctional false discovery rate (condFDR/conjFDR) statistical framework that increases the power to detect novel phenotype-specific and shared loci by leveraging the combined power of two GWAS.

Results

They observed cross-trait polygenic enrichment for ADHD conditioned on associations with BD, and vice versa.

Leveraging this enrichment, they identified 19 novel ADHD risk loci and 40 novel BD risk loci at condFDR <0.05.

Further, they identified five loci jointly associated with ADHD and BD (conjFDR < 0.05). Interestingly, these five loci show concordant directions of effect for ADHD and BD.

Conclusions

These results highlight a shared underlying genetic risk for ADHD and BD which may help to explain the high comorbidity rates and difficulties in differentiating between ADHD and BD in the clinic.

Improving our understanding of the underlying genetic architecture of these disorders may aid in the development of novel stratification tools to help reduce these diagnostic difficulties.

Reference

O’Connell, K.S., Shadrin, A., Bahrami, S., Smeland, O.B., Bettella, F., Frei, O., Krull, F., Askeland, R.B., Walters, G.B., Davíðsdóttir, K., Haraldsdóttir, G.S., Guðmundsson, Ó.Ó., Stefánsson, H., Fan, C.C., Steen, N.E., Reichborn-Kjennerud, T., Dale, A.M., Stefánsson, K., Djurovic, S. & Andreassen, O.A. (2019) Identification of genetic overlap and novel risk loci for attention-deficit/hyperactivity disorder and bipolar disorder. Molecular Psychiatry. doi: 10.1038/s41380-019-0613-z. [Epub ahead of print].

Specialist Mental Health Nurse Practitioner Candidate Roles & the Benefits these Roles can have in Reducing the Significant Morbidity & Mortality of Mental Health Consumers

Research Paper Title

Improving physical health outcomes for people with severe mental illness: A proof-of-concept study of nurse practitioner candidate practice.

Background

People with severe mental illness have significantly reduced life expectancy and higher risk of cardiovascular diseases than the general population.

There is a critical need for quality physical health care to improve consumers’ health outcomes.

There is minimal knowledge, however, on the impact of mental health nurse practitioner candidate (NPC) practices on consumers’ health outcomes.

The aim of this proof-of-concept study was to describe the impacts of NPC practices on the quality of physical healthcare provision and physical health outcomes (cardiovascular and cardiometabolic) of consumers in community mental health service settings.

Methods

Using a mixed methods design, quantitative data were collected for 12 months prior to (Period 1), and 12 months during (Period 2), the candidacy period.

Qualitative interviews were conducted with a purposive sample of n = 10 consumers to explore their perspectives on physical healthcare provision by the NPCs.

During the 12-month candidacy period, the number of metabolic monitoring assessments rose from n = 55 in Period 1 to n = 146 in Period 2 (P < 0.01, χ2 = 41.20).

Advanced practices provided by NPCs included taking an extensive holistic history and clinical examination, ordering diagnostic pathology, and clinical simulation of physical health medication prescription (under medical supervision).

Results

Analysis of consumer interviews resulted in two themes:

  • Positive and helpful NPC health care; and
  • Improvements in physical and mental health.

Conclusions

The findings add new knowledge on specialist mental health nurse practitioner candidate roles and demonstrate the benefits these roles can have in reducing the significant morbidity and mortality of mental health consumers.

Reference

Furness, T., Giandinoto, J.A., Wordie-Thompson, E., Woolley, S., Dempster, V. & Foster, K. (2019) Improving physical health outcomes for people with severe mental illness: A proof-of-concept study of nurse practitioner candidate practice. International Journal of Mental health Nursing. doi: 10.1111/inm.12680. [Epub ahead of print].

Providing a Starting Point for Discussions, Dialogue, and Further Study Regarding Mental Health Research for Indigenous Peoples around the World

Research Paper Title

The mental health of Indigenous peoples in Canada: A critical review of research.

Background

Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness.

Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples’ health internationally.

In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health.

This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada.

Methods

searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016.

Over two hundred papers are included in the review and coded according to research theme, population group, and geography.

Results

Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps.

Mental health research related to Indigenous peoples in Canada overemphasises suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples.

Conclusions

The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world.

Reference

Nelson, S.E. & Wilson, K. (2017) The mental health of Indigenous peoples in Canada: A critical review of research. Social Science & Medicine (1982). 176, pp.93-112. doi: 10.1016/j.socscimed.2017.01.021. Epub 2017 Jan 18.