MENTAL ILLNESSES – EVALUATION, TREATMENTS AND IMPLICATIONS Edited by Luciano L'Abate Mental Illnesses – Evaluation, Treatments and Implications Edited by Luciano L'Abate Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Gorana Scerbe Technical Editor Teodora Smiljanic Cover Designer InTech Design Team Image Copyright yurok.a, 2011. DepositPhotos First published December, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Mental Illnesses – Evaluation, Treatments and Implications, Edited by Luciano L'Abate p. cm. ISBN 978-953-307-645-4 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Introduction 1 Chapter 1 Understanding the Psychosocial Processes of Physical Activity for Individuals with Severe Mental Illness: A Meta-Ethnography 3 Andrew Soundy, Thomas Kingstone and Pete Coffee Chapter 2 Psychopathology and Quality of Life in Children of Mentally Ill Parents 21 Silke Wiegand-Grefe, Susanne Halverscheid, Franz Petermann and Angela Plass Part 2 Evaluation 35 Chapter 3 Applications of 3D Simulation in Mental Health: Utilities and New Developments 37 José A. Carmona Torres, Adolfo J. Cangas Díaz and Álvaro I. Langer Herrera Chapter 4 Temporal Stability of Repeated Assessments of Problematic Internet Use Among Adolescents: A Prospective Cohort Study 57 Lawrence T. Lam Chapter 5 The Youth Comprehensive Risk Assessment (YCRA) as a Treatment Guidance Tool for Adolescents with Behavioral and Developmental Challenges 65 Kenneth M. Coll, Brenda J. Freeman, John Butgereit, Patti Thobro and Robin Haas Chapter 6 The “ROC” Model: Psychiatric Evaluation, Stabilization and Restoration of Competency in a Jail Setting 75 Jerry L. Jennings and James D. Bell VI Contents Part 3 Treatments 89 Chapter 7 The Vitality of Fragmentation: Desublimation and the Symbolic Order 91 Geoffrey Thompson Chapter 8 Homelessness as an Incurable Condition? The Medicalization of the Homeless in the Swedish Special Housing Provision 105 Cecilia Hansen Löfstrand Chapter 9 The Role of Intentional Communities to Support Recovery from Mental Illness 127 Francesca Pernice-Duca, Wendy Case and Deborah Conrad-Garrisi Chapter 10 Adolescents with Mental Disorders: The Efficacy of a Multiprofessional Approach 141 Michela Gatta, Lara Dal Zotto, Lara Del Col, Francesca Bosisio, Giannino Melotti, Roberta Biolcati and Pier Antonio Battistella Chapter 11 “Mental Health Services are Different”: Economic and Policy Effects 171 Ruth F.G. Williams and D.P. Doessel Chapter 12 Mixing Oil and Water: Developing Integrated Treatment for People with the Co-Occurring Disorders of Mental Illness and Addiction 191 Andrew L. Cherry Chapter 13 Irrational Suffering – An Impact of Cognitive Behavioural Therapy on the Depression Level and the Perception of Pain in Cancer Patients 227 Ewa Wojtyna Chapter 14 Therapeutic Strategies in Schizophrenia 245 Jacqueline Conway Chapter 15 Ultrastructural Distinctions Between Treatment Responders and Non-Responders in Schizophrenia: Postmortem Studies of the Striatum 261 Rosalinda C. Roberts, Joy K. Roche, Shahza M. Somerville and Robert R. Conley Part 4 Pharmacotherapy 287 Chapter 16 Advances in the Pharmacotherapy of Bipolar Affective Disorder 289 Ashok Kumar Jainer, Rajkumar Kamatchi, Marek Marzanski and Bettahalasoor Somashekar Contents VII Chapter 17 Cognitive-Behavioural Therapy Combined with Antidepressants for Major Depressive Disorder 309 Narong Maneeton Chapter 18 Antidepressant Pharmacotherapy – Do the Benefits Outweigh the Risks? 331 Angela Getz, Fenglian Xu and Naweed Syed Part 5 Implications 355 Chapter 19 Primary Mental Healthcare and Integrated Services 357 Marie-Josée Fleury and Guy Grenier Chapter 20 Responding to the Challenge of Mental Health Recovery Policy 391 Lindsay G. Oades Chapter 21 Coping and Meaning in Everyday Life: Living with Mental Disabilities in Late-Modern Society 407 Bengt Eriksson and Jan Kåre Hummelvoll Chapter 22 Health Care Under the Influence: Substance Use Disorders in the Health Professions 427 Diane Kunyk and Charl Els Part 6 Conclusion 451 Chapter 23 The Future of Mental Health Care Toward an Integrative Paradigm 453 James Lake Preface The evaluation of mental illness requires a technical knowledge for the administration of routine tests and observations, as well as the professional expertise of how to interpret results from those tests and observations. In line with this introductory statement, Section I is dedicated to two chapters relating to observations of symptoms and syndromes in the etiology of mental illnesses. In Chapter 1, Andrew Soundy, Thomas Kingstone, and Pete Coffee indicate how physical activity can benefit individuals with severe mental illnesses through psychological, social and physical processes. Psychologically, patients can experience mood elevating effects, reduced anxiety, improved concentration, increased self- esteem, and reduced psychiatric symptoms like voices. Socially, co-patients in the physical activity environment can motivate, support and encourage social engagement, which can foster a sense of group belongingness (a shared social identity). Physically, patients can alleviate the significant negative side effects of anti- psychotic medication, such as weight gain. In Chapter 2, Silke Wiegand-Grefe, Susanne Halverscheid, Franz Petermann, and Angela Plass consider children of parents with mental illnesses as a high-risk population for the development of psychological disturbances, although the reported rates of affected children may vary between studies. Whether or not a child will develop a mental illness depends on risk factors as well as protective factors. Results from their study reveal an increased symptomatology being 3 to 7 times higher than in the general population, and a lower quality of life. Psychological disturbances of the children and their quality of life are associated with the parents’ subjectively experienced impairments by their mental illness. These results support the need for prevention and intervention programs for this special group of children. In Section II on evaluation (Chapter 3), José A. Carmona Torres, Adolfo J. Cangas Díaz, and Álvaro I. Langer Herrera focus on a review of the principal therapeutic developments in clinical psychology and psychiatry that relate to the application of new technologies in mental health. In particular, this chapter focuses on the usefulness of 3D simulation and virtual reality (VR) programs for the detection of various mental disorders and the improvement of current methods of treatment interventions. Over the past decade, several computer programs have been developed that have X Preface empirically demonstrated the usefulness of 3D simulation and VR as supportive tools for frequently used psychological treatments, especially, but not exclusively, phobias. In Chapter 4, in line with the many technological advances in dealing with mental illnesses, Lawrence T. Lam reports results from an original study on mental health assessments of Internet Addiction, the temporal stability of assessment as a criterion for the validity of a clinical diagnosis. Results of this study, however, did not seem to provide strong evidence for the temporal stability of assessment of problematic Internet usage in adolescents. In Chapter 5, Kenneth M. Coll, Brenda J. Freeman, John Butgereit, Patti Thobro, and Robin Haas present a complete youth risk assessment and treatment approach based on 20-plus years of research and collaboration with an award-winning child and an adolescent treatment facility recognized for its excellence. In this chapter, professionals will find not only a comprehensive, succinct, and useful assessment procedures, but also highly specific, research-based, and modularized intervention approaches. Furthermore, in Chapter 6, Jerry L. Jennings and James Diamond Bell argue that in times of budgetary crisis and shrinking public mental health resources, more and more people with serious and persistent mental illness and co-occurring disorders are ending up in the criminal justice system. There is a national need for alternative services that are both cost-effective and clinically effective. These authors describe components, outcomes, and advantages of an innovative forensic inpatient program that provides intensive psychiatric stabilization, forensic evaluations, and restoration of competency (ROC) services in a jail-based unit. Section III is devoted to psychological treatments, where at a more abstract level in Chapter 7, Goeffrey Thompson explores the phenomenon of fragmentation within the contexts of psychoanalysis, mental illness, art therapy, and art. He accomplishes this goal with respect to the concepts of wholeness, integration, maturation, and fragmentation, within the matrix of modernism and postmodernism. The relationships between sublimation, regression, creativity, pathology, and art therapy are examined and contrasted to fine art, art history, and aesthetics. In Chapter 8, Cecilia Hansen Löfstrand in Sweden argues that the prevailing model for counteracting homelessness has long since been – and to a great extent still is – the disciplining staircase model. Absolute sobriety is thought of as a necessary precondition for getting access to special-housing for the homeless. It also implies a view of homeless as incapable of independent living although regarded as able to become capable of independent living and (at least theoretically) getting access to an apartment of one’s own, by the means of discipline and self-regulation. Recently, new initiatives to combat homelessness have emerged. In Chapter 9, Francesca Pernice-Duca, Deborah Conrad-Garrisi, and Wendy Case support a community movement that, during the 1970’s, ushered a new era in the [...]... beginning (awareness raising) and during (engagement and practical facilitation) activity Other research implictly addresses this; for example, Raine et al., (2002) consider the engagement of exercise in community and illustrate the experience of inititating and maintaining activity It is clear, 4 Mental Illnesses – Evaluation, Treatments and Implications however, that barriers and facilitators to activity... themes generated from the first and second order interpretations along with the idiomatic interpretation and considered how the themes, ideas, metaphors and comments illustrated a process of activity from the onset This included two issues as discussed above: (1) 6 Mental Illnesses – Evaluation, Treatments and Implications increasing uptake/initial engagement in exercise, and (2) how to successfully maintain... certain environment, important of knowing the people and the facility Primary Role of HCPs Encouraging, motivating, educating and directing patients Distracting Support within sessions helps provide a distraction to experiences Listening – SMI user control content of conversation Reflective 12 Phase Post activity Mental Illnesses – Evaluation, Treatments and Implications Evolving autonomy express themselves... that can exist before the activity has begun and during the activity These challenges are illustrated by the barriers mentioned in section 4.2 and are clearly more significant in regard to the uptake of physical activity Barriers are generated by worry, caused by an unknown 14 Mental Illnesses – Evaluation, Treatments and Implications or uncertain experience, and then again during activity where perceptual... pp (209-215) 18 Mental Illnesses – Evaluation, Treatments and Implications Campbell, R., Pound, P., Pope, C., Britten, N., Pill, R., Morgan, M., Donovan, J (2003) Evaluating meta-ethnography: A synthesis of qualitative research on lay experiences of diabetes and diabetes care Social Science & Medicine, 56, pp (671684) Carless, D (2008) Narrative, identity and recovery from serious mental illness: A... Douglas and Carless (2010) because the study was a fictional tale; and, Soundy (2007) because it formed part of a PhD thesis and was not published Eight studies were selected to be used within the meta-ethnography and included: Carless (2007), Shiner et al (2008), Crone (2007), Fogarty and Happell (2005), Faulkner and Sparkes (1999), Carter-Morris and Faulkner (2003), Carless and Douglas (2004), and Crone... Sparkes, 1999) 4.2.2 Medication and symptom change Medication had an influence on all patients (Crone & Guy, 2008); it often influenced their level of drowsiness, motivation and could slow patients down, taking the ‘shine’ off their ability to undertake exercise or physical activity (Carter Morris & Faulkner, 2003) One of 8 Mental Illnesses – Evaluation, Treatments and Implications the biggest factors... maintaining activity 10 Mental Illnesses – Evaluation, Treatments and Implications 4.3.4 Social support Social support is central to the uptake and prolonged engagement in physical activity Before the physical activity has been initiated the social needs of patients have to be considered To ensure the most productive uptake of physical activity all staff are required to provide individualised and structured... initiation and maintenance among men with serious mental illness International Journal of Mental Health Promotion, 9, pp (17-27) Carless, D., Douglas, K (2004) A gold programme for people with severe and enduring mental health problems Journal of Mental Health Promotion, 3, pp (23-39) Carless, D., Douglas, K (2008a) Social support for and through exercise and sport in a sample of men with serious mental. .. viability and synaptic physiology Their findings are relevant in the context of recent developments in the fields of depression pathology research, underlying pharmacotherapy, and the potential for future drug discovery with better outcome and least side effects Section V is devoted to present implications that derive from both evaluations, treatments, and pharmacotherapies to deal with mental illnesses . MENTAL ILLNESSES – EVALUATION, TREATMENTS AND IMPLICATIONS Edited by Luciano L'Abate Mental Illnesses – Evaluation, Treatments and Implications Edited. the experience of inititating and maintaining activity. It is clear, Mental Illnesses – Evaluation, Treatments and Implications 4 however, that barriers and facilitators to activity are. orders@intechweb.org Mental Illnesses – Evaluation, Treatments and Implications, Edited by Luciano L'Abate p. cm. ISBN 978-953-307-645-4 free online editions of InTech Books and Journals