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Buenos Aires, Argentina

Latimer E.,University Institute of Mental Health
British Journal of Psychiatry | Year: 2010

Evidence to date indicates that the individual placement and support model of supported employment helps people with mental illness to obtain competitive jobs. The study by Howard et al (this issue) is the first unsuccessful trial of this model. Vocational workers had far fewer contacts with clients and employers than normal. Source

Van Elburg A.,University Institute of Mental Health | Treasure J.,Kings College London
Current Opinion in Psychiatry | Year: 2013

Purpose of review: To systematize new neurobiological findings on the cause and treatment of eating disorders. Recent findings: The conceptual framework of the cause of eating disorders has undergone great changes in the past decades. Recently, the National Institute of Mental Health proposed a new set of criteria for research purposes - the Research Domain Criteria (RDoC). We aim to structure this study as much as possible using these constructs across biological units of analysis, summarizing new findings. Brain imaging techniques have become sophisticated in identifying brain circuits related to illness behaviour and to fundamental traits such as reward and social processing. Genetic studies have moved from candidate gene studies onto genome-wide association studies; however, the field needs to cooperate to collect larger samples in order to benefit from this approach. Hormonal changes as the results of starvation or as underlying factors for behavioural changes still receive attention in both animal and human studies. Advances made in neuropsychology show problems in cognition (set shifting and central coherence) and in other RDoC domains. Some of these findings have been translated into treatment. Summary: New biological models are being developed which explain causal and maintaining factors. The RDoC construct may be used to systematize these findings. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

Piat M.,University Institute of Mental Health
Psychiatric rehabilitation journal | Year: 2012

With the use of a qualitative approach, this study focuses on service providers' experiences and perspectives on recovery-oriented reform. Nine focus groups were conducted with a sample of 68 service providers recruited from three Canadian sites. Three major themes were identified: 1) positive attitudes towards recovery-oriented reform; 2) skepticism towards recovery-oriented reform; and 3) challenges associated with implementing recovery-oriented practice. These challenges pertained to conceptual uncertainty and consistency around the meanings of recovery; application of recovery-oriented practice with certain populations and in certain contexts; bureaucratization of recovery-oriented tools; limited leadership support; and, societal stigma and social exclusion of persons with mental illnesses. The findings point towards challenges that might arise as system planners move ahead in their efforts toward implementing recovery within the mental health system. In this regard, we offer several recommendations for the planning of organizational and educational practices that support the implementation of recovery-oriented practice. Source

Lal S.,McGill University | Lal S.,University Institute of Mental Health | Adair C.E.,University of Calgary
Psychiatric Services | Year: 2014

Objective: The authors conducted a review of the literature on e-mental health, including its applications, strengths, limitations, and evidence base. Methods: The rapid review approach, an emerging type of knowledge synthesis, was used in response to a request for information from policy makers. MEDLINE was searched from 2005 to 2010 by using relevant terms. The search was supplemented with a general Internet search and a search focused on key authors. Results: A total of 115 documents were reviewed: 94% were peer-reviewed articles, and 51% described primary research. Most of the research (76%) originated in the United States, Australia, or the Netherlands. The review identified e-mental health applications addressing four areas of mental health service delivery: information provision; screening, assessment, and monitoring; intervention; and social support. Currently, applications are most frequently aimed at adults with depression or anxiety disorders. Some interventions have demonstrated effectiveness in early trials. Many believe that e-mental health has enormous potential to address the gap between the identified need for services and the limited capacity and resources to provide conventional treatment. Strengths of e-mental health initiatives noted in the literature include improved accessibility, reduced costs (although start-up and research and development costs are necessary), flexibility in terms of standardization and personalization, interactivity, and consumer engagement. Conclusions: E-mental health applications are proliferating and hold promise to expand access to care. Further discussion and research are needed on how to effectively incorporate e-mental health into service systems and to apply it to diverse populations. Source

Hovington C.L.,University Institute of Mental Health
Expert review of neurotherapeutics | Year: 2012

Negative symptoms have been a conundrum to researchers and clinicians alike since having first been identified by Bleuler and Kraepelin. The term 'negative symptoms' has been scrutinized with regards to what it encompasses. Negative symptomatology has been categorized into distinct subdomains, including primary symptoms, secondary symptoms, deficit syndrome and, more recently, persistent negative symptoms (PNS). Although there have been some theories put forward with regards to negative symptoms, there are still discordant findings regarding PNS. Thus, this article aimed to review the structural, functional and cognitive correlates of PNS in an attempt to better understand these specific negative symptoms in schizophrenia. According to the reviewed literature, deficit syndrome appears to have similar neurocognitive and structural deficits as PNS; however, some minor distinctions may suggest that PNS are a separate subtype of negative symptoms. White matter decrements in the frontal lobe and gray matter reductions in the temporal lobe may be related more specifically to PNS. Furthermore, unlike deficit syndrome, structural abnormalities in the frontal and temporal lobe also appear to be related to PNS in patients with first-episode schizophrenia. Cognitive domains, such as memory, are impaired and appear to be predominantly related to PNS. Hence, PNS do appear to have neuroimaging and neurocognitive correlates and warrant further research. Source

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