Papers by Stynke Castelein
European Psychiatry, Apr 1, 2021
Development and validation of a fidelity instrument for Cognitive Adaptation Training
Schizophrenia Research: Cognition, Mar 1, 2023
Cognitieve adaptatietraining als verpleegkundige interventie : Een clustergerandomiseerde studie
Tijdschrift voor neuropsychologie, 2021
Patient Preference and Adherence
Paliperidone palmitate is the only available long acting injectable (LAI) antipsychotic with a mo... more Paliperidone palmitate is the only available long acting injectable (LAI) antipsychotic with a monthly and three-monthly formulation. LAIs may help battle non-adherence. Studies about the experiences of switching from the monthly (PP1M) to the threemonthly formulation (PP3M) of paliperidone are scarce. Therefore, the aim of this study is to evaluate the perspectives of patients, relatives, and mental health professionals on PP3M compared with PP1M. Material and Methods: This was a multicenter, retrospective, non-interventional one-time questionnaire survey among patients with psychotic disorders who switched from PP1M to PP3M (n = 38), their relatives (n = 13) and mental health professionals (n = 38). General satisfaction and (un)desired effects were measured using the Medication Satisfaction Questionnaire (MSQ) and the Subjects' Reaction to Antipsychotics (SRA), respectively. Additional questionnaires assessed socio-demographic variables, preference, effectiveness, side-effects, and confidence in PP3M compared to PP1M. Results: Mean number of received PP3M injections was 4.2 (SD 2.5). The three study groups reported a high level of confidence in PP3M. High general satisfaction rates about PP3M among patients (69%) and mental health professionals (95%) were reported. The majority of patients, relatives, and mental health professionals reported similar or in some cases even greater effectiveness and similar or in some cases even less side-effects of PP3M compared to PP1M. Sixty-seven percent of the relatives reported less concerns about non-adherence after switching to PP3M. Conclusion: Most patients, relatives, and mental health professionals prefer PP3M over PP1M. The positive attitudes of all parties may facilitate the more frequent use of PP3M and potentially the clinical outcomes.
European Psychiatry
IntroductionConspiracy theories are popular during the COVID-19 pandemic. Conspiratorial thinking... more IntroductionConspiracy theories are popular during the COVID-19 pandemic. Conspiratorial thinking is characterised by the strong conviction that a certain situation that one sees as unjust is the result of a deliberate conspiracy of a group of people with bad intentions. Conspiratorial thinking appears to have many similarities with paranoid delusions.ObjectivesTo explore the nature, consequences, and social-psychological dimensions of conspiratorial thinking, and describe similarities and differences with paranoid delusions.MethodsCritically assessing relevant literature about conspiratorial thinking and paranoid delusions.ResultsConspiratorial thinking meets epistemic, existential, and social needs. It provides clarity in uncertain times and connection with an in-group of like-minded people. Both conspiratorial thinking and paranoid delusions involve an unjust, persistent, and sometimes bizarre conviction. Unlike conspiracy theorists, people with a paranoid delusion are almost alw...
Take-down policy If you believe that this document breaches copyright please contact us providing... more Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Schizophrenia Research, 2022
The specific phenotype of depression in recent onset schizophrenia spectrum disorders: A symptom ... more The specific phenotype of depression in recent onset schizophrenia spectrum disorders: A symptom profile and network comparison to recent onset major depressive disorder without psychotic features.
Herstel bevorderen bij mensen met ernstige psychische aandoeningen met behulp van resourcegroepen: Bevindingen uit de pilot Samen voor Herstel
Participatie en herstel van mensen met psychische aandoeningen en psychosociale beperkingen, 2021
Dit artikel beschrijft bevindingen uit de pilot Samen voor Herstel.1 In een specifieke wijk in de... more Dit artikel beschrijft bevindingen uit de pilot Samen voor Herstel.1 In een specifieke wijk in de stad Groningen namen ggz, verslavingszorg en het sociale wijkteam met behulp van de nieuwe resourcegroepenmethodiek het initiatief om tot een betere herstelondersteunende samenwerking te komen tussen cliënt, diens formele en informele netwerk, en binnen het formele netwerk. Met een kwantitatief en kwalitatief cohortonderzoek is in kaart gebracht hoe de deelnemers aan de pilot (cliënten) deze werkwijze hebben ervaren en wat de effecten waren op hun herstel en zorgtevredenheid.
Risk factors and oral health‐related quality of life: A case–control comparison between patients after a first‐episode psychosis and people from general population
Journal of Psychiatric and Mental Health Nursing, 2022
Accessible summaryWhat is known on the subject? Oral health consists of more than having good tee... more Accessible summaryWhat is known on the subject? Oral health consists of more than having good teeth; it is an important factor in general health and well‐being. Despite its importance, oral health care is still largely overlooked in mental health nursing. There is no research available about oral health risk factors and OHRQoL in patients diagnosed with a psychotic disorder with a psychotic disorder (first‐episode). What does this paper add to existing knowledge? This study provides insight into the severity of the problem. It demonstrates the differences in risk factors and OHRQoL between patients diagnosed with a psychotic disorder (first‐episode) and the general population. A negative impact on OHRQoL is more prevalent in patients diagnosed with a psychotic disorder (first‐episode) (14.8%) compared to the general population (1.8%). Patients diagnosed with a psychotic disorder (first‐episode) have a considerable increase in odds for low OHRQoL compared to the general population, a...
Journal of Mental Health, 2022
Background: Mental health recovery narratives are an active ingredient of recovery-oriented inter... more Background: Mental health recovery narratives are an active ingredient of recovery-oriented interventions such as peer support. Recovery narratives can create connection and hope, but there is limited evidence on the predictors of impact. Aims: The aim of this study was to identify characteristics of the narrator, narrative content and participant which predict the short-term impact of recovery narratives on participants. Method: Independent studies were conducted in an experimental (n ¼ 40) and a clinical setting (n ¼ 13). In both studies, participants with mental health problems received recorded recovery narratives and rated impact on hopefulness and connection. Predictive characteristics were identified using multi-level modelling. Results: The experimental study found that narratives portraying a narrator as living well with mental health problems that is intermediate between no and full recovery, generated higher self-rated levels of hopefulness. Participants from ethnic minority backgrounds had lower levels of connection with narrators compared to participants from a white background, potentially due to reduced visibility of a narrator's diversity characteristics. Conclusions: Narratives describing partial but not complete recovery and matching on ethnicity may lead to a higher impact. Having access to narratives portraying a range of narrator characteristics to maximise the possibility of a beneficial impact on connection and hopefulness.
[Impact of COVID-19 on patients from from FACT or autism teams]
Tijdschrift voor psychiatrie, 2021
BACKGROUND Most research focuses on the impact of COVID-19 for the general population. People wit... more BACKGROUND Most research focuses on the impact of COVID-19 for the general population. People with mental health problems may suffer even more from its consequences. AIM Measuring mental health, experiences with outpatient care and government measures of 105 people in mental health care in the Northern Netherlands during the first wave of COVID-19. METHOD Anonymous, online survey among people in care with autism- or FACT-teams in the Northern Netherlands between July-September 2020. RESULTS Few participants reported recent COVID-19-related symptoms (n=2); no participant had lab-confirmed COVID-19. Both positive (clear world, tranquility, few stimuli: 28%) and negative experiences (missing face-to-face contact with mental health care professionals: 22%) were reported. Although there was some fluctuation in happiness, the average happiness score did not change due to the first wave. Three-quarters were satisfied with their mental health care. Although in-person contact with mental hea...
[Decision aid for the treatment of psychotic illness: development of TReatment E-AssisT (TREAT)]
Tijdschrift voor psychiatrie, 2019
BACKGROUND Use of decision aids in mental health care is increasing and will also be introduced i... more BACKGROUND Use of decision aids in mental health care is increasing and will also be introduced in the Dutch mental healthcare system. We describe the context of this development and discuss how decision aids could facilitate evidence-based psychiatry. AIM: To describe the development of the decision aid TReatment E-Assist (TREAT) in the Dutch mental healthcare system that aims to optimize treatment of people with a psychotic illness. METHOD: We describe how the TREAT application works and discuss its potential contribution to the treatment of people with a psychotic illness. RESULTS: In a pilot study TREAT was judged as user friendly and useful. TREAT seemed to increase the integration of ROM-results in treatment and the advice offered new view points for practioners. CONCLUSION: TREAT is a novel application which combines routine outcome monitoring results with current treatment guidelines and standards of care in order to generate personalised treatment recommendations in the con...
Multiple Perspectives on Recovery-Oriented Mental Health Care for People with Severe Mental Illnesses in the Netherlands: A Mixed-Methods Study
Whereas people with severe mental illnesses (SMIs) traditionally received care in large psychiatr... more Whereas people with severe mental illnesses (SMIs) traditionally received care in large psychiatric institutions, recently there has been a paradigm shift towards recovery-oriented mental health care, which aims to increase the integration and participation of people with SMIs in society (Medeiros, McDaid, Knapp & the MHEEN Group, 2010). Although this has led to a significant decrease in hospital-based care, there is still a small group of people who need inpatient care for a longer period of time. These people have treatment-resistant positive symptoms, persistent negative symptoms, and impeding cognitive, social and functional impairments (Farkas, Rogers, & Thurer, 1987). They require high levels of support and ongoing treatment in a clinical setting, which mostly consists of pharmacotherapy, psychological therapy such as psycho-education and cognitive behavioral therapy, occupational and work-related daytime activities. Specifically for this population, the Active Recovery Triad ...
Erratum: Daling suïcidecijfer na eerste psychose : Een vergelijking met de situatie van twee decennia terug
Nederlands Tijdschrift voor Geneeskunde, 2016
Doel Meer dan 2 decennia geleden werd gerapporteerd dat maar liefst 11% van de patienten met een ... more Doel Meer dan 2 decennia geleden werd gerapporteerd dat maar liefst 11% van de patienten met een psychotische stoornis suicide pleegde in Noord-Nederland. Het primaire doel van de huidige studie was replicatie van deze bevindingen in hetzelfde geografische gebied. Het tweede doel was het onderzoeken van mogelijke predictoren van suicide. Opzet Retrospectief cohortonderzoek. Methode Met dossieronderzoek werd de huidige status onderzocht van alle patienten met een eerste psychose die in de periode 2000-2009 deelnamen aan de Psychosis Recent Onset Groningen-Survey (PROGR-S). PROGR-S is een diagnostisch protocol voor personen met een vermoedelijke eerste psychose. Met Kaplan-Meier-overlevingsanalyse werd het huidige suiciderisico bij patienten na een eerste psychose bepaald. Dit risico werd met een logrank-toets vergeleken met dat van patienten uit de periode 1973-1988. Ook werd de gestandaardiseerde mortaliteitsratio ten opzichte van de algemene bevolking vastgesteld. Met Cox-regressie...
Frontiers in Psychiatry, 2021
Background: Personal recovery (PR) is a subjective, multidimensional concept, and quantitative re... more Background: Personal recovery (PR) is a subjective, multidimensional concept, and quantitative research using PR as an outcome is rapidly increasing. This systematic review is intended to support the design of interventions that contribute to PR in psychotic disorders, by providing an overview of associated factors and their weighted importance to PR: clinical factors, social factors, and socio-demographic characteristics are included, and factors related to the concept of PR (organized into CHIME dimensions).Methods: A systematic literature search was conducted from inception to March 2020. Quantitative studies that had used a validated questionnaire assessing the concept of PR were included. Mean effect sizes for the relationship between PR-scale total scores and related factors were calculated using meta-analyses. Sources of heterogeneity were examined using meta-regression tests.Results: Forty-six studies, that used (a total of) eight PR measures, showed that in clinical factors...
IntroductionVarious studies have demonstrated that individuals with a psychotic disorder are at a... more IntroductionVarious studies have demonstrated that individuals with a psychotic disorder are at an increased risk of becoming a victim of crime. Little is known about gender differences in victimization types and in specific characteristics of victimization (e.g., perpetrator, location or disclosure). Knowledge on characteristics of victimization would provide clinicians with more insight which may be especially useful for tailoring interventions. The aim of this study is to examine gender differences in characteristics of violent and sexual victimization in patients with a psychotic disorder.MethodsInformation on violent (threats, physical abuse) and sexual victimization (harassment, assault) was assessed in 482 individuals with a psychotic disorder who received mental health care. Patients were recruited through a routine outcome monitoring study and a clinical trial.ResultsMen reported more threats with violence (20.7% vs. 10.5%, x2=7.68, p=0.01), whereas women reported more sexu...
JAMA Psychiatry, 2021
IMPORTANCE Although the importance of recovery-oriented care for people with severe mental illnes... more IMPORTANCE Although the importance of recovery-oriented care for people with severe mental illness (SMI) is widely acknowledged, essential elements such as personalization and involvement of significant others are not adequately implemented in practice. OBJECTIVE To determine whether using resource groups (RGs) within flexible assertive community treatment (FACT) has favorable effects on empowerment and recovery-related outcomes in people with SMI. DESIGN, SETTING, AND PARTICIPANTS This assessor-blind, multisite randomized clinical trial was conducted from September 1, 2017, to September 30, 2020, with follow-up at 9 and 18 months. A total of 158 participants aged 18 to 65 years meeting the criteria for SMI were randomly allocated to FACT plus RG vs FACT as usual (1:1) in 20 FACT teams throughout the Netherlands. Data were analyzed from September 1, 2020, to January 31, 2021. The study was prespecified in the trial protocol and data from the intent-to-treat population were analyzed. INTERVENTIONS In the FACT plus RG condition, patients chose members from their informal and formal networks to form an RG that meets quarterly to discuss self-formulated recovery goals. The RG was integrated into the multidisciplinary support provided by the FACT team. In the FACT as-usual condition, empowerment (defined as overcoming powerlessness and gaining control of one's life) and involvement of significant others was also part of the provided care, but without the structure of the RG. MAIN OUTCOMES AND MEASURES The primary outcome was self-reported empowerment, measured with the Netherlands Empowerment List. RESULTS A total of 158 participants with SMI (median age, 38 [median absolute deviation, 13] years; 93 men [58.9%]) were randomized to FACT plus RG (n = 80) or FACT as usual (n = 78) care. Intention-to-treat analyses showed that randomization to the RG condition was associated with a clinically significant increase in empowerment (Cohen d, 0.54; 95% CI, 0.21-0.86) and improved outcomes with small to medium effect sizes in terms of quality of life (Cohen d, 0.25; 95% CI, −0.07 to 0.56), personal recovery (Cohen d, 0.38; 95% CI, 0.06-0.69), quality of social contact (Cohen d, 0.24; 95% CI, −0.07 to 0.56), disability (Cohen d, 0.29; 95% CI, −0.03 to 0.60), general functioning (Cohen d, 0.30; 95% CI, −0.01 to 0.62), and social functioning (Cohen d, 0.28; 95% CI, −0.04 to 0.59). No differences between conditions were found regarding psychopathological symptoms, attachment, frequency of social contact, and employment. Compared with FACT as usual, participants who stayed with the assigned treatment in the RG condition were more satisfied with treatment at 9 (Cohen d = 0.45; t 135 = −2.62; P = .009) and 18 (Cohen d = 0.41; t 116 = −2.22; P = .02) months. CONCLUSIONS AND RELEVANCE These findings show that working with RGs improves empowerment and other mental health outcomes in people with SMI who receive community-based mental health services. This method of network-oriented care empowers people with SMI within their own environment.
Acta Neurobiologiae Experimentalis, 2021
Recent MRI studies have shown that abnormal functional connections in schizophrenia coexist with ... more Recent MRI studies have shown that abnormal functional connections in schizophrenia coexist with subtle changes in the structure of axons in the brain. However, there is a discrepancy in the literature concerning the relationship between white matter abnormalities and the occurrence of negative psychopathological symptoms. In the present study, we investigate the relationship between the altered white matter structure and specific psychopathology symptoms, i.e., subscales of Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptoms Scale (BNSS) in a sample of schizophrenia outpatients. For investigation on white matter abnormalities in schizophrenia, the diffusion tensor imaging analysis of between-group differences in main diffusion parameters by tract-based spatial statistics was conducted on schizophrenia outpatients and healthy controls. Hence, the correlation of PANSS and BNSS psychopathology subscales in the clinical group with fractional anisotropy was analyzed in the 17 selected cortical regions of interest. Presented between-group results revealed widespread loss of white matter integrity located across the brain in schizophrenia outpatients. Results on the white matter relationship with psychopathology revealed the negative correlation between fractional anisotropy in the left orbital prefrontal cortex, right Heschl's gyrus, bilateral precuneus and posterior cingulate cortex and the severity of asociality, as assessed with the BNSS. In conclusion, the presented study confirms the previous evidence on the widespread white matter abnormalities in schizophrenia outpatients and indicates the existence of the subtle but specific association between fractional anisotropy in the fronto-temporo-parietal regions with the asociality.
Schizophrenia Bulletin, 2020
Background Living well in spite of residual symptoms of mental illness is measured with the const... more Background Living well in spite of residual symptoms of mental illness is measured with the construct of personal recovery. The CHIME framework might be suitable to evaluate personal recovery measures and guide instrument choice. Methods Three validated measures were evaluated in Dutch patients with a psychotic disorder (N=52). We compared the Recovery Assessment Scale [RAS], the Mental Health Recovery Measure [MHRM] and the Netherlands Empowerment List [NEL]. The measures were assessed on six criteria: content validity (based on CHIME), convergent validity with a social support measure, internal consistency, floor and ceiling effects, item interpretability and ease of administration. Results The MHRM scored high on content validity with a balanced distribution of items covering the CHIME framework. The MHRM and NEL showed moderate convergent validity with social support. In all three measures internal consistency was moderate and floor and ceiling effects were absent. The NEL score...
International Journal of Methods in Psychiatric Research, 2020
A mindful yoga intervention for young women with major depressive disorder: Design and baseline s... more A mindful yoga intervention for young women with major depressive disorder: Design and baseline sample characteristics of a randomized controlled trial.
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Papers by Stynke Castelein