Background: The effectiveness of family-based psychosocial interventions (FPIs) in schizophrenia, particularly regarding dose-response patterns and caregiver-patient dynamics, remains insufficiently understood. This study examined how varying levels of real-world FPI exposure relate to social functioning in adults diagnosed with schizophrenia. Methods: A retrospective cohort of 812 Chinese adults diagnosed with schizophrenia treated at a psychiatric hospital was analyzed. Participants were categorized by documented FPI exposure from none to high (>= 5 sessions). The primary outcome was change in social functioning measured by the Personal and Social Performance Scale (PSP). Secondary outcomes included caregiver burden and patient-caregiver associations. Multivariable regression models adjusted for demographic and clinical covariates. Results: Higher FPI exposure was associated with greater PSP improvement (p < 0.001). In adjusted models, greater FPI intensity remained associated with improved functioning (beta = 0.28, p < 0.001) and reduced caregiver burden (beta = -0.28, p < 0.001). Lower caregiver burden at follow-up was also associated with better patient functioning (beta = -0.25, p < 0.001). High-exposure participants were more likely to achieve clinically meaningful improvement (aOR = 2.11, 95% CI: 1.41-3.16). Conclusion: Greater FPI exposure was associated with clinically meaningful functional gains, suggesting a potential threshold effect. Findings should be interpreted cautiously given the observational design but support sustained family involvement in routine care.
BackgroundWhy do individuals experiencing homelessness with psychotic disorders often remain unhoused despite available resources? This study examined how metacognitive capacities relate to ongoing homelessness of adults with psychotic disorders.MethodsTen participants from Montreal shelters completed narrative interviews scored on self-reflectivity, understanding others, decentration, and mastery. Quantitative analyses linked higher decentration to future-projection ability and greater mastery to viewing substance use as problematic.ResultsThematic analysis revealed: Profile A (Prospective Functioning), engaged in concrete, goal-directed future planning and had insight into their illness; Profile B (Substance-Aware Functioning) showed awareness into how substance use maintains homelessness and impedes stable housing efforts; and Profile C (Globally Impaired Functioning), exhibited pervasive metacognitive deficits coupled with marked impulsivity and low agency.DiscussionStronger decentration and mastery appear to support goal-directed thinking and obstacle recognition, potentially aiding exit from homelessness. Tailored metacognitive interventions may enhance recovery, warranting larger, longitudinal studies.
BackgroundThis study sought to understand the shared experiences of families impacted by postpartum psychosis.MethodsFour couples were interviewed and shared how they have made sense of this traumatic experience together over time. Data was analysed using Dialogical Narrative Analysis. Interpretation of the findings is limited by the small sample size.ResultsAmongst this small group of white-British, heterosexual couples, increased empathy seems to develop towards others experiencing mental health difficulties following lived experience of postpartum psychosis. Some evidence of increased feelings of closeness and strength within relationships was found, but this was not consistent across the whole sample.DiscussionThese findings suggest potential value in implementing couple-based interventions within perinatal mental health services.
BackgroundParanoia is common in the general population, but little is known about individual paranoid experiences in the workplace. We present the findings from the first study examining individual experiences of paranoia at work.MethodsA cross-sectional, survey design was used in which a general population sample completed two novel scales: the Paranoia at Work Scale (PAWS; a measure of workplace paranoia), and Personal Experiences of Paranoia in the Workplace Scale (PEPS-W; a measure of individual accounts of workplace paranoia), as well as trait paranoia, stress, general belonging and workplace emotional climate measures.ResultsParanoia was relatively common in the workplace, reported by 18% of participants, which was found to be preoccupying, impacted on wellbeing, and largely inflicted by someone of superior occupational status. These experiences were associated with higher trait paranoia, workplace paranoia and stress, and lower levels of general belonging and workgroup emotional climate.DiscussionThese findings demonstrate for the first time the commonality of paranoia at work. The PAWS and the PEPS-W provide an exciting opportunity to better understand the prediction and prevention of workplace paranoia.
