| 1. |
- Alexiou, Eirini, et al.
(författare)
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A Survey of Psychiatric Healthcare Workers' Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden
- 2021
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to investigate the impact of the first wave of the COVID-19 pandemic on perceived working environment, including the possibility to recover, among psychiatric healthcare workers (PHCWs) in comparison with pre-pandemic measures. Method: A link to an anonymous, web-based COVID-19 related survey was sent via email to all PHCWs at a university hospital in Sweden (n = 1,618) in September 2020. The response rate was 38% (566 of 1,507 eligible participants). Working environment survey responses collected in 2019 were used as pre-pandemic comparators. Statistical analyses were performed to assess overall impact over time on work demands, support, motivation, and recovery, stratified by professional role, and considering variables such as access to personal protective equipment. Results: The percentage of individuals responding negatively to statements about working environment increased significantly for most items after the first wave. Similarly, the increase of five of the investigated factors indicated a more negative perception of recovery during the pandemic. Registered nurses reported a greater negative impact of the pandemic on perceived working conditions and ability to recover than other professional groups. PHCWs working with patients with COVID-19 (35%) who reported being worried about becoming infected (12%) or infecting others (17%), or lacking adequate personal protective equipment (22%) were more negatively impacted regarding work environment-related items than those who did not. Conclusions: PHCWs' working environment and possibility for recovery were impacted by the first wave of the COVID-19 pandemic, nurses being most affected. Although psychiatric services do not directly care for patients with severe COVID-19 infection, the results from this study suggests that mental health services should also prepare for future pandemics.
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| 2. |
- Alexiou, Eirini, et al.
(författare)
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Criminal recidivism of patients in Swedish forensic psychiatry: A register-based comparison study
- 2023
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 88
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to evaluate criminal outcomes of mentally disordered offenders in compulsory forensic psychiatric care during the year 2010 versus 2018. More specifically, we sought to identify the occurrence of new criminal sentences during ongoing treatment and possible factors associated with recidivistic criminality. Another aim was to map previous criminality, types of index crime, and whether there were any changes within this decade.Methods: Crime-, clinical, and treatment-related variables were collected from the Swedish National Forensic Psychiatric Register for all unique inpatients registered from January 1-December 31 in 2010 (N = 717) and 2018 (N = 757). The mean, frequency, percentage, and standard deviation were calculated per variable and stratified by study year and gender. Between-group comparisons were made using t-tests and Chi-square tests. Binary logistic regression was performed to determine whether variables expected to be associated with recidivism showed any relation to criminal recidivism for each study cohort.Results: Most patients were male and approximately one-quarter and one-half of the men, respectively, had a previous sentence for non-violent and violent crimes. The 2018 cohort showed significantly lower rates of sentences to forensic psychiatry with special court supervision although the numbers were low in both cohorts and for both men and women. Previous violent conviction was associated with criminal recidivism during treatment in 2010, while this was joined by index crime under the influence of alcohol/illicit drugs for the 2018 cohort.Conclusions: Overall, these results showed more similarities between the 2010 and 2018 cohorts then dissimilarities, while on the other hand some quite substantial differences were described between males versus females. The results of this study indicate that it may be possible to tailor forensic psychiatric treatment to gender as a proxy for other variables related to increased criminal recidivism in offenders sentenced to forensic psychiatric care.
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| 3. |
- Alexiou, Eirini, et al.
(författare)
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Sustainability of a person-centered ward atmosphere and possibility to provide person-centered forensic psychiatric care after facility relocation
- 2018
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Ingår i: Journal of Forensic and Legal Medicine. - : Elsevier BV. - 1752-928X. ; 56, s. 108-113
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This longitudinal study aims to assess the sustainability of staff perceptions of ward atmosphere and their possibility to provide person-centered forensic psychiatric care after relocation to new hospitals that aimed to provide supportive work conditions for the staff to be able to perform care of high quality. Methods: In this study we only present the result for the repeated measures, that is, only the individuals that performed both the questionnaires at baseline and at the three follow-ups. Data were collected prospectively between 2010 and 2016; before (baseline) and after relocation of the forensic psychiatric clinics to new buildings, i.e., after six months (follow-up 1), after one year (follow-up 2) and after two years (follow-up 3), respectively. Data were obtained by employing structured validated questionnaires. Results: The main findings of this study display an improvement in the staff assessment of a person-centered atmosphere from baseline to follow-up 3 in the domains of safety, everydayness and community where safety was evaluated the highest. No sustainable significant changes were found concerning staff's assessment of the support for them to provide person-centered care. Conclusion: The findings show sustainability of person-centered ward atmosphere in forensic psychiatric care according to staff's assessment after relocation from traditional health care facilities to evidence-based designed premises. In this study the increased staff perception of the possibility to provide person-centered care in the new facilities could not be revealed as sustainability over the two years of follow-up.
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| 4. |
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| 5. |
- Alexiou, Eirini, et al.
(författare)
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The impact of facility relocation on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care
- 2016
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Ingår i: Journal of Forensic and Legal Medicine. - : Elsevier BV. - 1752-928X. ; 42, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- In recent years, large groups of forensic psychiatric patients have been relocated into new medium-and maximum-security forensic psychiatric facilities in Sweden, where a psychosocial care approach is embedded. From this perspective and on the assumption that physical structures affect the therapeutic environment, a prospective longitudinal study was designed to investigate the impact of the facility relocation of three forensic psychiatric hospitals on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care. Participants were patients over 18 years of age sentenced to compulsory forensic psychiatric treatment. Data were obtained by validated questionnaires. Overall, 58 patients (78%) answered the questionnaires at baseline with a total of 25 patients (34%) completing follow-up 1 at six months and 11 patients (15%) completing follow-up 2, one year after relocation. Approximately two-thirds of the participants at all time-points were men and their age range varied from 18 to 69. The results of this study showed that poor physical environment features can have a severe impact on care quality and can reduce the possibilities for person-centered care. Furthermore, the study provides evidence that the patients' perceptions of person-centered care in forensic psychiatric clinics are highly susceptible to factors in the physical and psychosocial environment. Future work will explore the staff's perception of ward atmosphere and the possibilities to adapt a person-centered approach in forensic psychiatric care after facility relocation. (C) 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
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| 6. |
- Alexiou, Eirini, et al.
(författare)
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Worry perception and its association with work conditions among healthcare workers during the first wave of the COVID-19 pandemic: a web-based multimethod survey at a university hospital in Sweden.
- 2024
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Ingår i: BMJ open. - 2044-6055. ; 14:2
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we explored healthcare workers' (HCWs) worry perception and its association with their work situation during the first wave of the COVID-19 pandemic.A web-based multimethods survey including multiple choice and open-ended questions was used.The study was conducted at a university hospital in Sweden.All HCWs who were working during the first wave of the COVID-19 pandemic in March-June 2020 were eligible. HCWs (n=6484, response rate=41%) from 69 departments fulfilled the study inclusion criteria and responded to the survey. Of them, we analysed data from the 3532 participants who replied to the open-ended questions (54% of the respondents).Worry perception and its association with work conditions among HCWs.29% (n=1822) and 35% (n=2235) of the responding HCWs experienced a daily or more than daily strong worry of being infected or infecting others with SARS-CoV-2. This finding could be further confirmed and explored with themes from the qualitative results: 'ambiguity of feeling safe and secure', 'being obliged to adapt to a new reality' and 'into the unknown'. The themes consisted of 6 main categories and 15 subcategories. The findings revealed that the two main drivers of worry perceived by HCWs were lack of personal protective equipment and fear of bringing the virus home to their families and friends.Worries of getting infected are common among HCWs during crises such as the COVID-19 pandemic. Several factors are raised that plausibly could minimise the negative effects of worry among HCWs. Thus, effective preventive work plans should be created, promoted and communicated in order to minimise the effects of such crises and support HCWs. By focusing on effective communication and preparedness, including access to relevant protective equipment and providing general support to HCWs, the work environment and patient care could be sustained during a crisis such as the COVID-19 pandemic.
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| 7. |
- Angelaki, Maria, et al.
(författare)
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Frequency of sexual dysfunction in outpatients with severe mental illness in Greece
- 2023
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Ingår i: FRONTIERS IN PSYCHIATRY. - 1664-0640. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionPatients with psychosis can develop sexual dysfunction, which may be related to the disease itself, psychosocial factors, somatic comorbidities, and the use of psychotropic medication.ObjectiveWe aimed to investigate the type and frequency of sexual dysfunction in patients diagnosed with schizophrenia or bipolar disorder in order to assess the side effects of antipsychotics in sexual function.MethodsThis is a multicenter, cross-sectional study, involving patients diagnosed with schizophrenia (79.3%) or bipolar disorder (20.7%) treated in the Department of Psychiatry and Community Mental Health Centers from November 2018 to December 2019. Patients were enrolled in the study after signed informed consent. Demographic and clinical data were collected from patients through a semi-structured interview. The Antipsychotics and Sexual Functioning Questionnaire (ASFQ) was administered to assess sexual function.ResultsA total of 87 outpatients on antipsychotics were recruited in the study. The mean age was 43.6 years, while the mean duration of the disease was 16.9 years. Overall, only 9.1% of patients spontaneously reported sexual dysfunction. Patients treated with oral first-generation antipsychotics had more difficulties in achieving orgasm and decreased erection capacity. In contrast, patients treated with oral second-generation antipsychotics had decreased ejaculation capacity. Patients on antipsychotic combination therapy were associated with higher rates of sexual anhedonia.DiscussionThese results suggest that sexual dysfunction is a side effect of antipsychotic treatment, which was spontaneously rarely reported by patients. It seems essential to obtain a psychosexual clinical history before initiating antipsychotic treatment to evaluate following changes and adopt an individualized strategy to manage sexual dysfunction induced by antipsychotics.
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| 8. |
- Angelaki, M., et al.
(författare)
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Translation and Validation of the Greek Version of the Antipsychotics and Sexual Functioning Questionnaire (ASFQ)
- 2021
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Ingår i: Sexual Medicine. - : Oxford University Press (OUP). - 2050-1161. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Sexual dysfunction in patients with psychoses may be associated with the psychiatric illness itself (negative symptoms, such as apathy, and avolition), comorbid somatic health, psychosocial factors (stigmatization, discrimination), and the use of psychotropic drugs. In Greece, research into the study of antipsychoticinduced sexual dysfunction is not sufficient. Aim: This study was conducted to translate and validate the Greek version of the Antipsychotics and Sexual Functioning Questionnaire (ASFQ) in a sample of patients receiving antipsychotic treatment. Methods: A "forward-backward translation" method was applied. A pilot study was conducted with 15 outpatients with schizophrenia and bipolar disorder under antipsychotics treatment. Patients also completed the "Subjects' Response to Antipsychotics (SRA)" questionnaire in order to assess the validity of the ASFQ. The ASFQ and the SRA questionnaire were completed twice within 2 weeks. Main outcome measures: Reliability (internal consistency and test-retest) and validity were assessed. Results: The Greek translation of ASFQ was reliable, with excellent internal consistency (Cronbach's a = 0.90 formen and 0.95 for women in both measurements). In addition, the Spearman correlation coefficient was 1 (P<.001) in all Likert-type questions in both assessments. Finally, Spearman correlation coefficients between ASFQ and SRA were moderately positive to strongly positive (between 0.25 and 1) in both assessments, demonstrating moderate to high validity. Conclusions: The Greek version of the ASFQ has proved to be a reliable and valid clinical instrument, hence it can be used in further studies in the Greek population. Copyright (C) 2021 The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.
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| 9. |
- Fernqvist, Anja, 1975, et al.
(författare)
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Plasma neurofilament light chain protein is not increased in forensic psychiatric populations: a pilot study
- 2023
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Ingår i: Frontiers in Psychiatry. - 1664-0640. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionNeurofilament light chain protein (NfL) is a fluid biomarker of neural injury measurable in cerebrospinal fluid and blood. Patients with different neurodegenerative disorders and mild traumatic brain injury display elevated levels of NfL. However, so far, elevated levels of NfL have not been demonstrated in persons with psychiatric disorders. To our knowledge, the occurrence of NfL in the blood has not previously been studied in persons undergoing forensic psychiatric assessment or persons treated in forensic mental health services. Supposedly, these persons suffer from experiences and conditions with a higher risk of neural injury than other psychiatric patients. MethodsIn this pilot study, we investigated plasma levels of NfL in 20 persons undergoing forensic psychiatric assessment and 20 patients at a forensic psychiatric hospital. NfL values were compared with control groups of healthy individuals matched for age and sex. ResultsThe prevalence of increased NfL in both forensic groups was low and did not differ compared with the controls. However, some persons undergoing forensic psychiatric assessment showed slightly elevated values. DiscussionThe slightly elevated values were observed in the group investigated closer in time to the index crime, when elevated NfL levels could be expected to be more prevalent due to acute conditions from the time of the offense. This gives reason to look further into this group.
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| 10. |
- Innocenti, Alessio, et al.
(författare)
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A register-based comparison study of Swedish patients in forensic psychiatric care 2010 and 2018
- 2021
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 77
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study compared the characteristics of a population of Swedish patients in forensic psychiatric care in the year 2010 and 2018, with the goal of identifying similarities and differences in sociodemographic and clinical outcomes during the study period. Findings: Significant changes in patient characteristics and treatment aspects were found, although similarities between the years were more common. Schizophrenia, schizotypal and delusional disorders were the most predominant primary diagnoses characterizing forensic psychiatric patients. From 2010 to 2018 there was also a development in care conditions supporting a shift from inpatient to outpatient care and from first-generation antipsychotic/neuroleptic to second-generation antipsychotics/atypical antipsychotics. More liberty restrictive such as physical restraints and forcible medication diminished while less restrictive coercive measures increased. There was also a decrease in the length of stay in forensic psychiatric care among those treated 2018 compared to those treated 2010, something that emerged as particularly discernible among male patients. Conclusion: In conclusion, the results from this study illustrate the similarities among a Swedish forensic psychiatric population between the years of 2010 and 2018, while also reflecting some changes in patient characteristics and clinical practice during the study period.
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