Ignacio Garcia-Cabeza1*, Ferreira Victor1, Epifanio Maria M2, Enrique de Portugal1
1Service of Psychiatry, Gregorio Maranon University Hospital, Complutense University of Madrid, Spain
2Martin de Vargas Health Center, Spain
The authors review the complex relationship between insight, adherence and symptoms with the functioning of the patient with diagnose of psychosis, either directly or as intermediary factors of each other.
Insight has been proposed to act through symptoms or psychodynamic factors. But in turn, adherence and insight are related in a bidirectional way and the first is one of the best predictors of outcomes in psychosis. Similarly symptoms, especially negative ones, are associated with a worse evolution of the disease.
The authors suggest that insight plays a role in the functioning of the patient, producing both a direct effect and also as a mediator by the improvement of adherence.
It is proposed that insight becomes a key therapeutic target in combined programs in order to favor better outcomes in the evolution of psychosis.DOI: 10.29245/2578-2959/2018/6.1172 View / Download Pdf
Christi A. Patten1*, James A. Levine2, Pamela S. Sinicrope1, Ioannis T. Pavlidis3
1Department of Psychology and Psychiatry, Mayo Clinic, Rochester, Minnesota, USA
2Foundation Ipsen, Paris, France; and Case Western Reserve University, Ohio, USA
3Department of Computer Science, University of Houston, Houston, Texas, USA
Smokers have an increased risk of depressive symptoms and depressive disorders. Smokers reporting higher levels of depressive symptoms prior to cessation treatment have greater difficulty quitting smoking. However, few interventions have targeted depressed smokers, a tobacco use disparity group. There is preliminary evidence to support the use of supervised, vigorous intensity exercise interventions to help smokers with depression quit. This Mini-Review addresses the potential role of exercise interventions for this population. We cover: (1) tobacco cessation treatments that have targeted depressed smokers, (2) efficacy of supervised exercise interventions for depression and smoking cessation, (3) results from a pilot study of supervised, vigorous intensity exercise for depressed women delivered in a community setting, and (4) future directions including technologies to scale up delivery of exercise interventions and exercise maintenance strategies. Future studies are needed that broaden the characteristics of participants in trials to include racially diverse men and women with a range of depressive symptoms. Positioning exercise delivery within community settings enhances the possible reach of interventions to a more diverse population of smokers. Delivery of exercise coaching through robotic and other digital technologies could also increase intervention scalability and open new avenues to explore methods and strategies to promote exercise adherence/maintenance.DOI: 10.29245/2578-2959/2018/6.1171 View / Download Pdf