Interpersonal distances, coping strategies and psychopathology in patients with depression and schizophrenia

AIM: To explore(1) intergroup differences in comfortable interpersonal distances(CIDs) and the use of coping strategies;(2) the association of these parameters with individual symptomatology; and(3) the interplay between CIDs and coping styles in patients with depression and schizophrenia. METHODS: The parameters of interest were assessed by means of standardized questionnaires: CID and Coping Inventory for Stressful Situations. Psychopathology was evaluated with the Beck Depression Inventory and Positive and Negative Syndromes Scale. ANOVA, Pearson's correlations and multiple regression analyses were used to examine relationships among the variables.RESULTS: Compared with controls, depressed patients were more distanced from family members, significant others and self-images, whereas patients with schizophrenia were less distanced from neutral and threatrelated stimuli. Distancing from self-images was mostly associated with depression severity in depressed patients, whereas distancing from hostile and threat-related stimuli with the severity of psychotic and affective symptoms in patients with schizophrenia. Both patient groups used more emotion-oriented than task-oriented and avoidance-oriented coping strategies. Self-distancing among patients with schizophrenia was positively associated with the use of the social diversion coping, implying social support seeking. CONCLUSION: Patients with depression and schizophrenia use different maladaptive emotion- regulation strategies to cope with their symptoms and related distress. Training in stress management might provide these patients with skills for more effective emotion regulation.

Changes in psychiatric nurse attitudes towards legal representation of inpatients at District Psychiatric Board hearings in Israel: a pilot study

Aims: To compare the initial attitudes of nurses and other professional groups in a psychiatric hospital towards the legal representation (LR) of involuntary admitted psychiatric patients before District Psychiatric Boards (DPB), and to assess how these attitudes changed after LR had become an everyday routine practice in the hospital. Background: LR of hospitalized psychiatric patients before DPB has been introduced into mental health system worldwide, including Israel. Attitudes of psychiatric staff towards LR and their changes over time are a very important –though unstudied issue. Methods: Thirty seven psychiatric nurses employed in the Tirat Carmel Mental Health Center, Israel and 30 other mental health professionals (comparison group) completed the Attitudes to Legal Representation Questionnaire before LR has been instituted in the Center (November 1, 2006) and one year later. Baseline differences between the groups were tested using one-way ANOVA, and prepost differences in the attitude scores were tested by paired t-tests. Results: Baseline psychiatric nurses attitudes towards LR were significantly more negative than those of the comparison group [F67,3 = 6.87, p 37 = 2.56, p = 0.015). Conclusion: Yearlong, routine exposure to the LR of involuntarily admitted psychiatric patients may attenuate negative nurse beliefs and attitudes towards LR of such patients at DPB hearings. The more positive attitudes may enhance the nurses’ ability to present information about patients without jeopardizing their human and civil rights, and help patients to attain a greater sense of control over their illness management and satisfaction with the services received.