Summary- The paper by Panayiotopoulos et al., (2013) has examined the burden experienced by the family members caring for the schizophrenic patients and also determined the factors affecting the family burden. For the collection of the data, the Involvement Evaluation questionnaire has been used. The participants were the caregivers residing in the urban or the rural areas of the district of Nicosia.
The dependant factors used for the analysis were tension, supervision, Encouragement and worry. The independent factors used were age, marital, status, gender, income, number of people residing in the same house, degree of relationship between the relative and the caregiver, age of the relative, and gender of the relative. The statistical significant data that was found was that the male relatives with schizophrenia more supervision than the female patients.
Evaluation and analysis- The results obtained from this paper did not necessarily match with the previous other papers related to this. Apart from the dimensions tension, supervision and financial cost, the results related to the other dimensions were not related other dimensions did not have statistical significant data. Another limitation is the low sample size that can lead to low response bias.
Summary- The paper by Harangozo et al., (2014), aimed to investigate the stigma experienced by the people suffering from Schizophrenia, while using the health care services. A cross sectional study was performed with 777 participants using face -to face- interview with the participants (62 % male and 38 % female). Health care issues, behavior of the health care staffs, personal privacy, safety and security, pregnancy and child birth were analyzed. Discrimination was measured by using the Discrimination and the Stigma scale (DISC). As per the results, 17 % of the participants reported of discrimination and 38 % of the participants reported of disrespect displayed by the mental health staffs.
Analysis and evaluation- One of the weakness of this study is that that participants did not consist of any health care members whose opinions could be tallied with the statements given by the people suffering from Schizophrenia. This can cause response bias owing to the predetermined notions adopted by the patients with mental health illness. One of the advantageous sides of this paper is that that the 36 item questionnaire consisted of a wide range of domains that can give a clear picture of the stigmatization taking place in health care services. Furthermore, the results obtained from this study tallied with some of the previous studies, related to discrimination faced by the schizophrenia patients.
The paper by Eranti et al., (2013), aimed to investigate the differences in gender in the age of onset of schizophrenia .The study methods selected for this is a systemic literature search, meta-analysis and meta-regression. 46 studies were considered with 29213 males and 19401 females. A pooled estimate was obtained by the random- effects model of the gender differences of about 1.07 years at the initial admission for schizophrenia, with the male members showing an early onset. This gender differences in age was almost similar between the developing and the developed countries. A greater gender differences can be found in age at the onset by using the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria than by using International Classification of Diseases (ICD) criteria. However, the gender differences were found to be significantly smaller that that was thought previously.
Analysis and evaluation- Some of the limitations of this study is that it did not consider the gender differences in late onset or the childhood onset of schizophrenia. Some of the roles of the important confounder were also not studied and only peer reviewed journals have been taken in to consideration that might have influenced the results. Another important point that should be mentioned is that this difference in gender at age is not only specific for schizophrenia and also for other psychotic diseases. It seems that there is a need for larger studies to examine the differences.
The aim of the study conducted by Cerit et al., (2012), is to understand and explore the predictors of the functioning like social support, demographic and the clinical variables, self perceived stigma in the patients with remissions of bipolar disorder. Eighty patients with BD, complete remission were chosen for the study. Bipolar disorder functioning questionnaire, young mania rating scale, Beck Depression Inventory, Students t test, schedule for the assessment of the three components of the insight were used. As per the results, the three most important predictors of functioning were found to be internalized stigmatization and social support.
Analysis and evaluation
One of the limitation of this study is the moderate sample size and the cross sectional design. Instead, longitudinal studies with large cross sectional design would have been appropriate. Furthermore it was also necessary to consider the limitations of the self perceived scales, that could have been used in this study. The result of this study solely reflects the predictors in the remission period and is subjected to remission. Stigma played a core role in predicting the functioning in the patients with BD, and complies with the result of many studies.
The paper by Rasic et al., (2013), aimed to calculate the risk associated with the mental disorders in the offsprings of the parents suffering from mental disorders and also determination of the risks extending beyond the disease present in parents. 3 studies with 386 children of parents having SMI and 318 control offspring were taken in to consideration. Metaanalysis of the relative rates of mental disorders in the off springs of the parents having bipolar disorder, schizophrenia or depression were considered. As per the results children having parents with SMI have more chance (32 % probability) of developing SMI in future than the control group. The high risk children had a considerably greater rate of the ailment present in the parent. Children with parents having schizophrenia also showed an increased risk of mood disorders. Children having parents suffering from bipolar disorder showed an increased chance of schizophrenia.
Analysis and evaluation
The limitations of this study are the heterogeneity of the studies and the problems related to the methodology. The age of the off springs selected was uneven with scarce data for the adult conditions especially among the parents with depressive disorders. Hence, some questions like whether, the chance of Schizophrenia is increased among the children of the parents suffering from depression remains open.
Theory of mind (ToM) dysfunction is common in a number of psychiatric disorders. autism and schizophrenia and can play a crucial role in the functioning of life. This paper aimed to investigate that ToM abilities are disrupted in bipolar disorders as well. A metaanalysis involving thirty four studies comparing 1214 patients with BP and 1097 healthy patients were included in the study. As per the results ToM performance was significantly disrupted in participants with BP. The impairment was noticed across several kinds of tasks involving the cognitive, affective, visual and the verbal domains. ToM was found to be more intense or severe at the time of acute episodes.
Analysis and evaluation
The strength of this study is that no studies have been conducted before this to analyze the ToM in bipolar disorders before. However some of the limitations are that a number of ToM tasks have different difficulty levels that play a role in the group differences. Again many studies did not include neuro-cognitive assessment battery or any control task for measuring the ToM. Again only general cognitive functions were recorded and not the executive functions.
References
Bora, E., Bartholomeusz, C., & Pantelis, C. (2016). Meta-analysis of Theory of Mind (ToM) impairment in bipolar disorder. Psychological medicine, 46(2), 253-264.
Cerit, C., Filizer, A., Tural, Ü., & Tufan, A. E. (2012). Stigma: a core factor on predicting functionality in bipolar disorder. Comprehensive Psychiatry, 53(5), 484-489
Eranti, S. V., MacCabe, J. H., Bundy, H., & Murray, R. M. (2013). Gender difference in age at onset of schizophrenia: a meta-analysis. Psychological Medicine, 43(1), 155-167.
Harangozo, J., Reneses, B., Brohan, E., Sebes, J., Csukly, G., Lopez-Ibor, J. J., … & Thornicroft, G. (2014). Stigma and discrimination against people with schizophrenia related to medical services. International Journal of Social Psychiatry, 60(4), 359-366. https://doi.org/10.1177/0020764013490263
Panayiotopoulos, C., Pavlakis, A., & Apostolou, M. (2013). Family burden of schizophrenic patients and the welfare system; the case of Cyprus. International journal of mental health systems, 7(1), 13. https://doi.org/10.1186/1752-4458-7-13
Rasic, D., Hajek, T., Alda, M., & Uher, R. (2013). Risk of mental illness in offspring of parents with schizophrenia, bipolar disorder, and major depressive disorder: a meta-analysis of family high-risk studies. Schizophrenia bulletin, 40(1), 28-38.
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