Schizophrenia in college students in Korea: a qualitative perspective

PURPOSE: The objective of this study was to identify the salient themes that characterize the life experiences of college students with schizophrenia. METHODS: Twenty-one schizophrenia patients enrolled in college underwent in-depth interviews employing semistructured questionnaires. The content of the interviews was analyzed for recurring themes and categories of experience. FINDINGS: Analyses revealed 25 themes and six categories of experience. Subjects reported the experiences of school life (23.6%), interactions with family (22.2%), interactions with friends (21.9%), a mental illness (20.5%), everyday life (6.1%), and social role performance (5.7%). CONCLUSIONS: This study supports the need for treatment options that meet the students' actual life experiences focusing on developmental characteristics and needs.     

Smooth Pursuit Eye Movement Dysfunction as a Biological Marker for Prediction of Disease Courses of Schizophrenia: A Preliminary Report

Abstract: We investigated the relationship between a smooth pursuit eye movement (SPEM) dysfunction and long-term disease courses of schizophrenia. Many schizophrenic patients without the SPEM dysfunction tended to show an acute onset of illness, undulating courses and relatively good outcomes. On the other hand, patients with cogwheel-like SPEM dysfunction tended to show a chronic onset, simple courses, relatively severe outcomes and negative symptoms.     

The epidemiology of onset and course of schizophrenia

Traditionally the heterogeneity of schizophrenia was dealt with by subdividing the syndrome into different subtypes. However, due to lacking standards, the result was an immense variety of subtypes partly based on cross-sectional assessments, partly taken the whole course between onset, resp. first admission and outcome after many years into account. Some solutions were based on symptomatology only, other also relied on social characteristics as the ability to fulfil different roles in family and the world of employment. So it is not surprising that the number of subtypes ranges from two up to more than 70. As one possible solution Carpenter and Kirkpatrick (1988) suggest that attempts to subdivide the schizophrenic syndrome should concentrate on few significant parts of the course thought of to represent specific disease processes. Based on two epidemiological studies finding about the onset, middle course and late course of schizophrenia are presented. In three quarter of the cases the onset of the first psychotic episode in schizophrenia is preceded by a prodromal phase with a mean length of about five years. The earliest signs of the disorder are depressive and negative symptoms. Early depressive symptoms predict higher overall symptom scores in the first illness episode and lower scores for affective flattening in the medium-term course. There is no decrease in the number of patients with acute symptomatology over fifteen years after first hospital admission, rather there is a tendency of an increase. With respect to social abilities we found a significant increase of disability over time. But the change already takes place during the first five years. Approx. 60% of those falling ill with schizophrenia become chronic and approx. 25% will recover during the first five to six years. Received: 10 April 2000 / Accepted: 25 April 2000     

E-learning courses in epilepsy--concept, evaluation, and experience with the e-learning course "genetics of epilepsies"

PURPOSE: To evaluate the efficacy of the e-learning course "Genetics of Epilepsies" and to assess the experiences of the participants and e-moderators with this new approach. METHODS: Prospective, controlled study with waiting group (control group, n = 18) and e-learning group (n = 20). The control group got the same reference literature list as the e-learning group. Both groups were assessed twice: The e-learning group before and after the course; the control group was assessed at the same times. Primary outcome measure: increase in knowledge about genetics of epilepsies using questionnaires based on items formulated by experts (internal consistency, Cronbach's alpha = 0.86). Main hypothesis: greater increase of knowledge in the e-learning group compared to control group. Secondary outcome measures: assessment of the educational course and learning environment by participants and by tutors/e-moderators. RESULTS: Significant time x group interaction and group effect (ANOVA, each p < 0.01) with regard to knowledge. At baseline, the groups did not differ with respect to knowledge about genetics of epilepsy. In contrast to the control group, the increase of knowledge in the e-learning group was highly significant (p < 0.001). The majority of the participants of the e-learning course was content with their personal learning process (75% agree, 15% strongly agree). Most of them reported a gain in competence in the treatment and counseling of people with epilepsy (38.9% agree, 50% strongly agree). All participants would recommend this course to others and all but one participant are interested in other e-learning courses. CONCLUSION: The study indicates e-learning courses are an appropriate tool to improve knowledge of physicians in genetics of epilepsy.     

Medicating for ADD/ADHD: Personal and Social Issues

Twenty college students from a private Midwestern university were interviewed about their past and present experiences with taking medication for Attention Deficit Disorder. Analysis of respondent interviews suggested the following themes that were discussed and analyzed: recruitment of the young, little personal stigma, societal issues, side effects and abuse. Social and personal factors associated with taking medication for ADD were explored and compared with prior studies on anti-depressant medication. Practice implications were presented.     

The developmental course of executive functioning in schizophrenia

Executive dysfunction is a core feature of schizophrenia, but our understanding of the developmental course of this neuropsychological domain in the disease remains largely unexplored. A review of the research evidence points to a number of persistent debates about the course of executive functioning and its relation to illness course. A better understanding of the neurocognitive trajectories of executive functioning in schizophrenia could help identify the risk and modifying factors that influence the onset, severity and course of disease, and the chance to re-direct or re-shape that course and improve outcomes. To accomplish this requires assessment of the diverse and integrated nature of those abilities, and the changes over time in those abilities requires multiple instruments and techniques in order to improve the research methods and understanding of an important area of impairment in schizophrenia.     

An introductory clinical core course in psychiatric management: an innovative lifespan course blending all nurse practitioner majors

TOPIC: The prevalence of anxiety, depression, substance abuse, and suicidal ideation is significant in primary care settings across the country. Nonpsychiatric nurse practitioners must be able to recognize symptoms of common psychiatric disorders, know how to treat less complex mental illnesses, and know when to refer to psychiatric mental health nurse practitioners (PMHNPs). PURPOSE: This article describes the course content, assignments, and teaching strategies used in a clinical core course in the nurse practitioner (NP) curriculum that is required for all NP majors at the University of Texas at Arlington. Psychiatric Management for Advanced Practice provides the foundation for later PMHNP major specific clinical courses. SOURCES: Development of the course content was based on NONPF Domains and Competencies for the NP, input from graduate NP faculty using a modified Delphi approach, NP student feedback, review of curriculum from other schools, and review of the literature on depression, suicide, anxiety, and substance abuse disorders in primary care settings. CONCLUSIONS: Since 1999, students from the eight different NP programs at the University of Texas at Arlington have been required to take this course. Student, faculty, and graduate feedback about this course have been consistently positive. Many NP students comment on feeling much more comfortable assessing for depression, suicide, and substance use.     

Effectiveness of a college-level self-management course on successful behavior change

Studies have shown that college-level self-management (SM) courses, which typically require students to complete an individual project as part of the course, can be an effective method for promoting successful self-change (i.e., targeted behavioral change). However, only a handful of studies have focused on and investigated the intensity of the SM component required for successfully changing a target behavior. The purpose of this study was to (a) examine the effectiveness of a SM course in improving a target behavior within a college setting, (b) determine the level of SM course intensity necessary for successful behavioral change, and (c) identify the characteristics of successful self-managers in terms of strategy use. A total of 84 college students were enrolled in a high-intensity SM course, low-intensity SM course, or non-SM course (i.e., control group). Self-report questionnaires were administered at the beginning and end of the courses. Results showed that only the high-intensity SM course was effective for successful behavioral change and helped increase certain psychosocial characteristics (e.g., internal locus of control, expectancy of success). Overall, successful self-managers used significantly more SM strategies than participants who were unable to meet their behavioral goals. Implications and limitations are also discussed.     

不同病程颞叶癫痫术后疗效及相关性分析

目的探讨不同病程颞叶癫痫患者术后疗效有无差异及手术疗效与病程有无相关关系。方法回顾性分析2002年1月-2011年1月在泸州医学院附属成都三六三医院神经外科接受手术治疗的颞叶癫痫患者183例,根据Engel分级评估分析不同病程患者术后疗效有无差异以及手术疗效与病程有无相关关系。结果早期手术治疗组术后无癫痫发作率占78．9％;中期手术治疗组术后无癫痫发作率占67．9％;晚期手术治疗组术后无癫痫发作率占58．6％。早期手术治疗组术后无癫痫发作率高于中期手术治疗组和晚期手术组,疗效差异有统计学意义（P〈0．05）;颞叶癫痫病程与术后疗效存在负相关关系（r=-0．213,P=0．002）,即病程越长,疗效越差。结论早期手术干预可能更加有利于控制癫痫发作,提高患者生存质量。