Insight in Schizophrenia. Its Relationship to Acute Psychopathology

McEvoy, Joseph P.; Apperson, L. Joy; Appelbaum, Paul S.; Ortlip, Priscilla; Brecosky, Joyce; Hammill, Kathleen; Geller, Jeffrey L.; Roth, Loren H.

doi:10.1097/00005053-198901000-00007

Cited by 477 publications

(270 citation statements)

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“…Current function was assessed by the Global Assessment of Functioning (GAF) (19). The Insight and Treatment Attitudes questionnaire (ITAQ) (20) was used to assess insight to mental illness. Interviewers at each site participated in an intensive two-day training session in reliable administration of the interview.…”

Section: Methodsmentioning

confidence: 99%

Patients' Perception of Possible Child Custody or Visitation Loss for Nonadherence to Psychiatric Treatment

Busch¹,

Redlich²

2007

Psychiatric Services

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Objective-This study explored whether parents treated in public mental health settings perceived that they might lose child custody or visitation if they were not adherent to treatment.Methods-Interview data were gathered from 1,011 adult outpatients from five community mental health centers located in five states in different U.S. regions.Results-Among parents with children younger than 16 (N=187), 19% perceived in the past six months that they might lose child custody or visitation if they were not adherent to treatment. Twothirds of the identified sources of this perception were family, themselves, or individuals outside the treatment, welfare, or legal systems.Conclusions-These preliminary data indicate that the perception of possible loss of child custody or visitation for nonadherence to treatment is not uncommon among patients treated in these public mental health settings and that "informal" sources are often the perceived source. Further study regarding the effects of this perception on patient and family outcomes is needed.

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Section: Methodsmentioning

confidence: 99%

Patients' Perception of Possible Child Custody or Visitation Loss for Nonadherence to Psychiatric Treatment

Busch¹,

Redlich²

2007

Psychiatric Services

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“…The anchored version of the Brief Psychiatric Rating Scale (BPRS) was used to assess current psychiatric symptoms (Moerner, Mannuzza, & Kane, 1988). The Insight and Treatment Attitudes Questionnaire (ITAQ) was used to measure awareness of mental health problems and acknowledgment of need for treatment in the past, at the current time, and in the future (McEvoy, Apperson, Appelbaum, & Ortlip, 1989). Additional clinical variables included diagnosis as obtained from the participant's medical record.…”

Section: Methodsmentioning

confidence: 99%

Effectively implementing psychiatric advance directives to promote self-determination of treatment among people with mental illness.

Elbogen¹,

Swanson²,

Swartz³

et al. 2007

Psychology, Public Policy, and Law

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Statutes on psychiatric advance directives (PADs) allow competent individuals to document instructions for future mental health treatment in the event of an incapacitating crisis. PADs are aimed at promoting a stronger sense of patient self-determination, considered a central tenet of psychosocial rehabilitation and recovery; however, it is unknown what factors (if any) lead psychiatric patients with PADs to experience this benefit long term. The current study involves examination of 1 year effects on perceived treatment self-determination among 125 people with mental disorders who completed PADs via a 1-on-1 facilitated PAD intervention. Descriptive analyses showed participants documented medically relevant information that would assist doctors in a crisis and participants reported a high level of satisfaction with the facilitated PAD intervention. Multivariate analyses demonstrated that increased sense of autonomy at 1 year was predicted by race, understanding PADs, and verbal memory. Results provide useful guidance for administrators and clinicians, suggesting that PADs show promise in helping empower people with mental illness, especially African-American clients. Further, findings indicate that optimal implementation of PADs will be achieved when facilitated intervention assists people with mental illness to better understand what PADs are and to remember they have a PAD at the time they are experiencing a psychiatric crisis. Legislation aiming to promote advance care planning and treatment self-determination among people with mental illness has proliferated in recent years. In the United States, laws defining psychiatric advance directives (PADs) have been passed in 25 states, allowing competent persons to document advance instructions for their future mental health treatment or to designate a health care agent to make decisions for them, in the event of an incapacitating psychiatric crisis (Appelbaum, 2004;Srebnik & La Fond, 1999;. In addition to recognizing the potential benefits of PADs, many states are beginning to recognize legal obligations under the federal Patient Self-Determination Act of 1991, which includes informing all hospital patients that they have a right to prepare advance directives and-with certain caveats-that clinicians are obliged to follow these directives (Hoge, 1994). As such, federal law helps ensure that people with mental illness, in whatever state they live, can use medical advance directives to specify mental health treatment preferences or to assign proxy decision makers for mental health decisions.If followed by treatment providers, PADs can help patients gain better access to the types of treatment that work best for them, especially during times when they are most in need of care but least able to speak for themselves (Backlar, McFarland, Swanson, & Mahler, 2001;Joshi, 2003;Vuckovich, 2003). Further, the very exercise of preparing a PAD and discussing it with a mental health professional may enhance therapeutic alliance and improve treatment engagement (Atkinson &...

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“…When consent was obtained, patients were administered the Insight to Treatment Questionnaire, an instrument developed to measure patients' insight; the questionnaire was used here-with modified scoring-to ascertain patients' attitudes toward their illness and need for treatment (26,27). The 19-item version of the Brief Psychiatric Rating Scale (BPRS) was also administered at that time by psychiatrists connected with this study (28).…”

Section: Methodsmentioning

confidence: 99%

Prospective study of patients' refusal of antipsychotic medication under a physician discretion review procedure

Kasper

Hoge²,

Feucht‐Haviar³

et al. 1997

AJP

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Insight in Schizophrenia. Its Relationship to Acute Psychopathology

Cited by 477 publications

References 0 publications

Patients' Perception of Possible Child Custody or Visitation Loss for Nonadherence to Psychiatric Treatment

Patients' Perception of Possible Child Custody or Visitation Loss for Nonadherence to Psychiatric Treatment

Effectively implementing psychiatric advance directives to promote self-determination of treatment among people with mental illness.

Prospective study of patients' refusal of antipsychotic medication under a physician discretion review procedure

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