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Schizophrenia-spectrum disorders: assessment, psychological processes and informal caregiver intervention

Barreto Carvalho, Castilho, P., Macedo, A., Pereira, A., Palmeira, L., Xavier, A., Marques, C., Pinto, A., Carreiras, da Motta, C., Pato, Cabral, J. Speaker

Clinical interview for Psychotic Disorders (CIPD): Presentation and Early findings The CIPD, in addition to diagnosis assessment, has a clinical valence aiming the evaluation of the psychosocial correlates of symptoms (clinician and patient-rated) and, therefore, it is useful throughout the therapeutic process. We will be presenting preliminary evidence of reliability with the established diagnosis and interrater reliability of the CIPD diagnosis and dimensional ratings (clinician rated): frequency, interference and severity. Suicide ideation in psychosis In this communication, the authors will explore the prevalence of suicide ideation (past and current) in a sample of people with psychosis. Associations with psychosocial and clinical variables will also be presented. Are people wired differently? Performance in social and neurocognitive tasks of patients with schizophrenia, relatives and controls This communication will explore existing differences regarding the performance in tasks assessing neurocognitive and social cognition variables between groups of patients with schizophrenia, first degree relatives and healthy controls. ANCORAGEM: Psychoeducational program for informal caregivers of people with schizophrenia ANCORAGEM is a 10-session psychoeducation program for family members/informal caregivers of patients with schizophrenia whose main objectives are to help caregivers to better understand and cope with the disease. It is based on Cognitive-Behavioral Therapy and the following topics are covered: definition and diagnosis of schizophrenia; origin of the pathology; symptoms and behaviors; treatment; positive and negative symptoms; coping strategies; and family role in the intervention. Results showed significant increased knowledge about schizophrenia and improvement regarding skills to deal with the difficulties of the caregiving process.

Author(s):
Chair/Discussant: Barreto Carvalho, C.1
Communication 1: Martins, M. J.2, Castilho, P.2, Macedo, A.2, Pereira, A. T.2, Palmeira,
L.2, Xavier, A.2, Marques, C.2, Pinto, A. M.2, Carreiras, D.2, & Barreto-Carvalho, C.1
Communication 2: Martins, M.J.2, Castilho, P.2, Macedo, A.2, Palmeira, L.2, Xavier, A.2,
Pereira, A. T.,2 & Barreto-Carvalho, C.1
Communication 3: da Motta, C.1, Barreto-Carvalho, C.1, Castilho, P.1, & Pato, M.3
Communication 4: Barreto Carvalho, C.1, Barreto Bulhões, M.4, da Motta, C.1, &
Cabral, J.1

Authors affiliations:
1University of Azores, Portugal
2University of Coimbra, Portugal
3SUNY Downstate Medical Center, College of Medicine, New York, USA
4Regional Secretariat for Social Solidarity
Abstracts

Clinical interview for Psychotic Disorders (CIPD): Presentation and Early findings
Martins, M. J., Castilho, P., Macedo, A., Pereira, A. T., Palmeira, L., Xavier, A., Pinto,
A. M., Carreiras, D., & Barreto-Carvalho, C.
The Clinical interview for Psychotic Disorders (CIPD) is a semi-structured clinical
interview that, in addition to diagnosis assessment, has a clinical valence aiming the
evaluation of the psychosocial correlates of symptoms (clinician and patient-rated). It is, therefore, useful throughout the therapeutic process (e.g., in identifying targets for
intervention, assessing change, evaluating the efficacy of psychosocial interventions).
This study main goals are: (1) assess the inter-rater reliability on diagnosis and symptoms (frequency, interference, severity) and the reliability with the previous established medical diagnosis; (2) explore the relationships between CIPD and other well-known instruments used to assess positive and negative symptoms (PANSS) and functionality (GAF and PSP); (3) analyze qualitative data from the CIPD in order to understand its adequacy and the feasibility of its administration in clinical settings. Preliminary results
(n = 30) showed higher levels of inter-rater reliability across symptom domains and the CIPD generated diagnosis corresponded to the previously established medical diagnosis most of the time. Implications of the present study and clinical applications of the CIPD will be discussed.

Suicide ideation in psychosis
Martins, M.J., Castilho, P., Macedo, A., Palmeira, L., Xavier, A., Pereira, A. T., &
Barreto-Carvalho, C.
Suicide risk is an important variable to consider both in assessment and throughout the therapeutic process in psychotic disorders. Up to 40% of the premature mortality in this population can be attributed to suicide and unnatural deaths. A meta-analysis estimated that 4.9% of schizophrenics commit suicide during their lifetime. Suicide risk in the context of psychosis will be evaluated with the SRS-P, a new 18-item scale computed from the patient and clinician-rated scores obtained in the CIPD. The scale comprises lifetime assessment of depressed mood, anhedonia and its current interference and severity, current and past feelings of hopelessness, suicidal ideation, ‘voices’ about suicide, and suicide-related behaviors. In this communication, authors will explore the prevalence of suicide ideation (past and current) in a sample of Portuguese patients with psychosis and characterize the associations between suicide risk, clinical and psychosocial variables.

Are people wired differently? Performance in social and neurocognitive tasks of patients with schizophrenia, relatives and controls
da Motta, C., Barreto-Carvalho, C., Castilho, P., & Pato, M.
Schizophrenia is a complex heritable brain disorder, entailing significant costs to
healthcare that presents severe social (e.g. family) and psychological consequences due to its nature and phenomenology. Research has consistently shown that patients present impairment in neurocognitive and social cognitive functioning, and between 20 to 60% of the functional outcome of schizophrenia can be explained by these variables rather than the disease’s symptoms. These impairments are thought to aggravate difficulties in several areas, including autonomous living, interpersonal relationships, community integration, employment, and leisure activities.
This investigation aims to provide an empirical contribute to the understanding of the
endophenotypic aspects involved in schizophrenia in the Portuguese Island Cohort, a
genetically homogenous population located in a geographical area that warrants stable
environmental conditions (S. Miguel Island, Azores). Data on the performance in
computerized tasks assessing neurocognitive and social cognition domains between of
patients diagnosed with schizophrenia, first-degree relatives and an equivalent healthy
control group of participants from will be presented. Preliminary results on the analysis
of variance of performance observed between groups across domains and its implications for new intervention targets and psychosocial approaches for families and patients will be discussed.

ANCORAGEM: Psychoeducational program for relatives and informal caregivers of patients with schizophrenia
Barreto Carvalho, C., Barreto Bulhões, M., da Motta, C., & Cabral, J.

Family members/informal caregivers are pivotal to the recovery of people diagnosed with schizophrenia. Thus, a growing interest in the development of psychosocial interventions that respond to the needs and difficulties felt by these caregivers has emerged in the
literature.
The ANCORAGEM is CBT-based psychoeducation program for relatives/informal
caregivers of patients with schizophrenia, aimed at educating and providing help about
schizophrenia, and developing more effective coping strategies for the participants.
Goals: The current work presents the development and application processes of the
ANCORAGEM, analyzing the program’s impact on the participants.
Method: Fifteen relatives of patients diagnosed with schizophrenia, between 30 and 66
years old, participated in the 10 sessions of ANCORAGEM, in the Azores, Portugal.
Participants were administered qualitative and quantitative measures to assess the
program’s impact.
Results: Results from this exploratory study indicate participants have increased their
knowledge about schizophrenia and improved their skills to cope with difficulties in
providing care to those patients. Discussion: Findings suggest the importance of investing in interventions aimed at caregivers to reduce their burden and improve specific caregiving skills for schizophrenia. It is possible that these interventions indirectly benefit patients with schizophrenia, which will be target of future studies within this research project.