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Poster #M255 INTERPERSONAL TRAUMA AND THE SOCIAL FUNCTIONING OF ADULTS WITH FIRST EPISODE PSYCHOSIS
S282
Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384
Poster #M253 VOCATIONAL RECOVERY IN FIRST EPISODE PSYCHOSIS: PRELIMINARY RESULTS FROM A LARGE RANDOMISED CONTROLLED TRIAL OF INDIVIDUAL PLACEMENT AND SUPPORT Eoin Killackey 1,2 , Henry Jackson 3 , Kelly Allott 1 , Susan Cotton 1 1 Centre for Youth Mental Health, The University of Melbourne; 2 Orygen Youth Health Research Centre; 3 School of Psychological Science, The University of Melbourne Background: Vocational recovery has been consistently shown to be a number-one priority of people with mental illness generally, and schizophrenia and first episode psychosis (FEP) specifically. Two previous randomised controlled trials (RCT) demonstrated the benefit of an employment intervention called Individual Placement and Support (IPS) for young people with FEP. The current study was conducted in order to examine not only the vocational benefits of such an approach, but to study a wide range of predictors and consequences of vocational recovery in FEP Methods: 146 young people with FEP were recruited to a RCT of IPS versus treatment as usual at the Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne. Those randomised to IPS received 6 months of vocational intervention with a specialist employment consultant. Follow up assessments occurred at 6, 12 and 18 months post baseline. The aims of this presentation will be to present the data pertaining to the vocational recovery at the 6 month time point of this study. Results: In terms of studying at the six month time point there was no difference between the two groups (χ2 (1)=2.08, p=0.149), nor of the number currently in paid work on the day of assessment at 6 months. (χ2 (1)=3.42, p=0.065). However, when employment over 6 months was compared there was a difference (χ2 (1)=5.74, p=0.017). Discussion: The preliminary results of this study indicate that IPS is effective at getting people into employment.
Poster #M254 DIFFERENTIAL EFFECTS OF ANTIPSYCHOTICS ON QUALITY OF LIFE AND FUNCTIONING IN CHINESE PATIENTS WITH FIRST-EPISODE PSYCHOSIS Edwin Lee 1 , Christy L.M. Hui 2 , Wing Chung Chang 3 , Sherry K.W. Chan 2 , Elaine Ching 3 , Eric Y.H. Chen 2 1 Department of Psychiatry, The University of Hong Kong; 2 The University of Hong Kong; 3 HKU Background: Meta-analysis of RCTs suggested that patients with second generation antipsychotic treatment have higher functioning and quality of life than those with first generation antipsychotic treatment. However, findings from CATIE and CUtLASS raised doubt about their difference in real clinical settings, especially in patients with first-episode psychosis. We compared the effects of antipsychotics on quality of life and functioning in Chinese patients with first-episode psychosis. Methods: A total of 285 patients were assessed with the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Udvalg for Kliniske Undersøgelser (UKU), the Social and Occupational Functioning Assessment Scale (SOFAS), the Role Functioning Scale (RFS) and the Medical Outcomes Study Short Form 12-Item Health Survey (SF-12) after stabilization of mental condition. Difference between individual antipsychotic medications was investigated using ANOVA and post-hoc analysis. Results: Significant differences were found between different antipsychotic medications in the mean of UKU neurological subscore, BARS total score, SOFAS score and SF-12 mental component summary score (MCS) score. Patients with haloperidol had higher mean UKU neurological subscore than patients with olanzapine or amisulpiride. Patients with risperidone had higher mean BARS total score than patients with olanzapine, amisulpiride or sulpiride. Patients with amisulpiride had higher mean MCS than patients with risperidone. Discussion: Antipsychotics have differential effects on quality of life and functioning in patients with first episode psychosis. Future prospective study is warranted to investigate if patients with first episode psychosis will benefit from specific type of antipsychotics more than the others.
Poster #M255 INTERPERSONAL TRAUMA AND THE SOCIAL FUNCTIONING OF ADULTS WITH FIRST EPISODE PSYCHOSIS Helen J. Stain 1,2 , Kolbjorn Bronnick 2 , Wenche ten Velden Hegelstad 2 , Inge Joa 2 , Jan Olav Johannessen 2 , Johannes Langeveld 2 , Lauren Mawn 3 , Tor Ketil Larsen 2 1 Durham University, United Kingdom; 2 Stavanger University Hospital, Norway; 3 Durham University, UK Background: Social functioning is an important treatment outcome for psychosis, and yet, we know little about its relationship to trauma despite high rates of trauma in people with psychosis. Trauma or maltreatment in childhood coincides with the period for a child’s development of relational understanding such as attachment to others and the reflective awareness of self and others. Childhood trauma is likely to disrupt the acquisition of interpersonal relatedness skills including the desire for affiliation and thus lead to impaired social functioning in adulthood. We hypothesized that childhood trauma would be a predictor of poor social functioning for adults with psychosis and that further trauma in adulthood would moderate this relationship. Methods: A first-episode psychosis sample from the TIPS2 study and aged 15–65 years (N=233) completed measures of social functioning (Lehman’s Quality of Life Interview and Strauss Carpenter Functioning Scale) and trauma (Brief Betrayal Trauma Survey), as well as clinical assessments. Results: Childhood trauma (any type) was associated with poorer premorbid functioning and was experienced by 61% of our sample. There were no associations with clinical symptoms. Interpersonal trauma was more common than non-interpersonal trauma in both childhood (36% vs 15.8%) and adulthood (36.8% vs 12.1%). Trauma in both childhood and adulthood was experienced by 14% of the sample. Interpersonal trauma in childhood was a significant predictor of social functioning satisfaction in adulthood, but this was not the case for interpersonal trauma in adulthood. However, 45% of adults who reported childhood interpersonal trauma also experienced adulthood interpersonal trauma. Discussion: As predicted, childhood trauma was associated with disruptions to social functioning, and this was evident in the premorbid phases of childhood, early adolescence and late adolescence as well as adulthood. By early adolescence, there was also evidence of poorer academic functioning for adults who had experienced childhood trauma. Our results emphasize the importance of early relationship experience such as interpersonal trauma, on the social functioning of adults with psychosis. We recommend extending our research by examining the impact of interpersonal childhood trauma on occupational functioning in psychosis.
Poster #M256 THE EFFECTS OF SELF-STIGMA CONTENT AND PROCESS ON SUBJECTIVE QUALITY OF LIFE IN PEOPLE WITH SCHIZOPHRENIA Kevin K.S. Chan 1 , Winnie W.S. Mak 2 The Hong Kong Institute of Education; 2 The Chinese University of Hong Kong
1
Background: People with schizophrenia may endorse and internalize public stigma directed against them and at times experience self-stigma. Having self-stigmatizing thoughts per se does not necessarily lead to chronic psychological distress. Only when such thinking occurs frequently and automatically as a mental habit does this generate constant mental chaos, which may have deleterious effects on the subjective quality of life of individuals. The mental process of self-stigma should be distinguished from the mental content, assessed independently, and not be assumed to be homogeneous across all people with schizophrenia. The present study aims empirically to test whether habitual self-stigma contributes to decreased subjective quality of life after controlling self-stigmatizing cognitive content. Methods: A community sample of 144 people with schizophrenia was recruited in Hong Kong. Subjective quality of life was measured with the Satisfaction With Life Scale (SWLS). Self-stigmatizing cognitive content was assessed with the Self-Stigma Scale-Short Form (SSS-S). We developed a self-reported measure of habitual self-stigma, that is, the Self-stigmatizing Thinking’s Automaticity and Repetition (STAR) scale. The STAR contains 15 items rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree) measuring the extent to which individuals experience frequent, automatic, and self-descriptive self-stigmatizing thinking.
Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384
Poster #M253 VOCATIONAL RECOVERY IN FIRST EPISODE PSYCHOSIS: PRELIMINARY RESULTS FROM A LARGE RANDOMISED CONTROLLED TRIAL OF INDIVIDUAL PLACEMENT AND SUPPORT Eoin Killackey 1,2 , Henry Jackson 3 , Kelly Allott 1 , Susan Cotton 1 1 Centre for Youth Mental Health, The University of Melbourne; 2 Orygen Youth Health Research Centre; 3 School of Psychological Science, The University of Melbourne Background: Vocational recovery has been consistently shown to be a number-one priority of people with mental illness generally, and schizophrenia and first episode psychosis (FEP) specifically. Two previous randomised controlled trials (RCT) demonstrated the benefit of an employment intervention called Individual Placement and Support (IPS) for young people with FEP. The current study was conducted in order to examine not only the vocational benefits of such an approach, but to study a wide range of predictors and consequences of vocational recovery in FEP Methods: 146 young people with FEP were recruited to a RCT of IPS versus treatment as usual at the Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne. Those randomised to IPS received 6 months of vocational intervention with a specialist employment consultant. Follow up assessments occurred at 6, 12 and 18 months post baseline. The aims of this presentation will be to present the data pertaining to the vocational recovery at the 6 month time point of this study. Results: In terms of studying at the six month time point there was no difference between the two groups (χ2 (1)=2.08, p=0.149), nor of the number currently in paid work on the day of assessment at 6 months. (χ2 (1)=3.42, p=0.065). However, when employment over 6 months was compared there was a difference (χ2 (1)=5.74, p=0.017). Discussion: The preliminary results of this study indicate that IPS is effective at getting people into employment.
Poster #M254 DIFFERENTIAL EFFECTS OF ANTIPSYCHOTICS ON QUALITY OF LIFE AND FUNCTIONING IN CHINESE PATIENTS WITH FIRST-EPISODE PSYCHOSIS Edwin Lee 1 , Christy L.M. Hui 2 , Wing Chung Chang 3 , Sherry K.W. Chan 2 , Elaine Ching 3 , Eric Y.H. Chen 2 1 Department of Psychiatry, The University of Hong Kong; 2 The University of Hong Kong; 3 HKU Background: Meta-analysis of RCTs suggested that patients with second generation antipsychotic treatment have higher functioning and quality of life than those with first generation antipsychotic treatment. However, findings from CATIE and CUtLASS raised doubt about their difference in real clinical settings, especially in patients with first-episode psychosis. We compared the effects of antipsychotics on quality of life and functioning in Chinese patients with first-episode psychosis. Methods: A total of 285 patients were assessed with the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Udvalg for Kliniske Undersøgelser (UKU), the Social and Occupational Functioning Assessment Scale (SOFAS), the Role Functioning Scale (RFS) and the Medical Outcomes Study Short Form 12-Item Health Survey (SF-12) after stabilization of mental condition. Difference between individual antipsychotic medications was investigated using ANOVA and post-hoc analysis. Results: Significant differences were found between different antipsychotic medications in the mean of UKU neurological subscore, BARS total score, SOFAS score and SF-12 mental component summary score (MCS) score. Patients with haloperidol had higher mean UKU neurological subscore than patients with olanzapine or amisulpiride. Patients with risperidone had higher mean BARS total score than patients with olanzapine, amisulpiride or sulpiride. Patients with amisulpiride had higher mean MCS than patients with risperidone. Discussion: Antipsychotics have differential effects on quality of life and functioning in patients with first episode psychosis. Future prospective study is warranted to investigate if patients with first episode psychosis will benefit from specific type of antipsychotics more than the others.
Poster #M255 INTERPERSONAL TRAUMA AND THE SOCIAL FUNCTIONING OF ADULTS WITH FIRST EPISODE PSYCHOSIS Helen J. Stain 1,2 , Kolbjorn Bronnick 2 , Wenche ten Velden Hegelstad 2 , Inge Joa 2 , Jan Olav Johannessen 2 , Johannes Langeveld 2 , Lauren Mawn 3 , Tor Ketil Larsen 2 1 Durham University, United Kingdom; 2 Stavanger University Hospital, Norway; 3 Durham University, UK Background: Social functioning is an important treatment outcome for psychosis, and yet, we know little about its relationship to trauma despite high rates of trauma in people with psychosis. Trauma or maltreatment in childhood coincides with the period for a child’s development of relational understanding such as attachment to others and the reflective awareness of self and others. Childhood trauma is likely to disrupt the acquisition of interpersonal relatedness skills including the desire for affiliation and thus lead to impaired social functioning in adulthood. We hypothesized that childhood trauma would be a predictor of poor social functioning for adults with psychosis and that further trauma in adulthood would moderate this relationship. Methods: A first-episode psychosis sample from the TIPS2 study and aged 15–65 years (N=233) completed measures of social functioning (Lehman’s Quality of Life Interview and Strauss Carpenter Functioning Scale) and trauma (Brief Betrayal Trauma Survey), as well as clinical assessments. Results: Childhood trauma (any type) was associated with poorer premorbid functioning and was experienced by 61% of our sample. There were no associations with clinical symptoms. Interpersonal trauma was more common than non-interpersonal trauma in both childhood (36% vs 15.8%) and adulthood (36.8% vs 12.1%). Trauma in both childhood and adulthood was experienced by 14% of the sample. Interpersonal trauma in childhood was a significant predictor of social functioning satisfaction in adulthood, but this was not the case for interpersonal trauma in adulthood. However, 45% of adults who reported childhood interpersonal trauma also experienced adulthood interpersonal trauma. Discussion: As predicted, childhood trauma was associated with disruptions to social functioning, and this was evident in the premorbid phases of childhood, early adolescence and late adolescence as well as adulthood. By early adolescence, there was also evidence of poorer academic functioning for adults who had experienced childhood trauma. Our results emphasize the importance of early relationship experience such as interpersonal trauma, on the social functioning of adults with psychosis. We recommend extending our research by examining the impact of interpersonal childhood trauma on occupational functioning in psychosis.
Poster #M256 THE EFFECTS OF SELF-STIGMA CONTENT AND PROCESS ON SUBJECTIVE QUALITY OF LIFE IN PEOPLE WITH SCHIZOPHRENIA Kevin K.S. Chan 1 , Winnie W.S. Mak 2 The Hong Kong Institute of Education; 2 The Chinese University of Hong Kong
1
Background: People with schizophrenia may endorse and internalize public stigma directed against them and at times experience self-stigma. Having self-stigmatizing thoughts per se does not necessarily lead to chronic psychological distress. Only when such thinking occurs frequently and automatically as a mental habit does this generate constant mental chaos, which may have deleterious effects on the subjective quality of life of individuals. The mental process of self-stigma should be distinguished from the mental content, assessed independently, and not be assumed to be homogeneous across all people with schizophrenia. The present study aims empirically to test whether habitual self-stigma contributes to decreased subjective quality of life after controlling self-stigmatizing cognitive content. Methods: A community sample of 144 people with schizophrenia was recruited in Hong Kong. Subjective quality of life was measured with the Satisfaction With Life Scale (SWLS). Self-stigmatizing cognitive content was assessed with the Self-Stigma Scale-Short Form (SSS-S). We developed a self-reported measure of habitual self-stigma, that is, the Self-stigmatizing Thinking’s Automaticity and Repetition (STAR) scale. The STAR contains 15 items rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree) measuring the extent to which individuals experience frequent, automatic, and self-descriptive self-stigmatizing thinking.