Insight Into Illness and Defense Styles in Schizophrenia Although the psychological denial model argues that poor insight is a result of defense mechanisms, the direct relationship between the two remains unclear. This study aimed to examine the relationship between insight into illness and defense mechanisms while considering cognitive dysfunction in schizophrenia. A total of 38 patients with schizophrenia were evaluated for level of insight (Schedule for the Assessment of Insight), defense mechanisms (Defense Style Questionnaire), neurocognitive function (Brief Assessment of Cognition in Schizophrenia), and psychotic symptoms (Brief Psychiatric Rating Scale). Regarding level of insight, partial correlation analysis controlling neurocognitive and psychotic variables showed that “recognition of illness” was positively correlated with immature defense styles and negatively correlated with mature defense styles. Stepwise regression analyses revealed that “recognition of illness” was significantly predicted by immature defense styles. Our findings suggest that patients who tend to use immature defense styles are more likely to accept their own mental illness.

Interpersonal Problems Associated With Passive-Aggressive Personality Disorder With a controversial history, passive-aggressive personality disorder (PAPD) was eventually removed from the latest edition of the Diagnostic and Statistical Manual for Mental Disorders. Despite its demise from diagnostic nomenclature, clinicians continue to regard it as a clinically relevant construct, and some researchers argue for its resurrection. Toward this end, it is important to empirically demonstrate the relevance of the passive-aggressive personality construct, including demonstrating its association with impaired functioning. Consistent with contemporary emphasis on interpersonal functioning in personality pathology, the current study aims to explore interpersonal problems that are associated with PAPD in a large clinical sample. Before beginning treatment, 240 patients completed assessments of personality psychopathology and interpersonal functioning. Results showed that higher levels of PAPD were significantly associated with greater level of interpersonal distress, especially regarding interpersonal problems of a vindictive nature. The findings are consistent with clinical descriptions of the core conflictual relational issues of patients with PAPD and lend some support to further considering PAPD as a valid diagnostic construct.

Paranoid Ideation Without Psychosis Is Associated With Depression, Anxiety, and Suicide Attempts in General Population This study aimed to characterize the association between paranoid ideation without psychosis (PIP) and suicide attempts in a general population. A total of 12,532 adults were randomly selected as the study sample through one-person-per-household method. Subjects completed a face-to-face interview. Among 12,532 subjects, 471 (3.76%) met criteria for the PIP group. The PIP group was younger with more divorced/widowed/separated and lower income than the non-PIP group. The PIP group showed more than fivefold higher lifetime suicide attempt (LSA) rates and ninefold multiple attempt rates than the non-PIP group. Among PIP symptoms, “spouse was being unfaithful” showed the strongest association with LSA (adjusted odds ratio [AOR], 4.49; 95% confidence interval, 2.95–6.85). Major depressive disorder (MDD) in combination with PIP was associated with a higher risk of LSA (AOR, 15.39; 95% confidence interval, 9.63–24.59) compared with subjects without MDD or PIP. In conclusion, PIP, especially “doubting spouse,” was significantly associated with LSA. PIP in combination with comorbid MDD showed higher risk of LSA than subjects without PIP or MDD.

Further Exploration of Personal and Social Functioning: The Role of Interpersonal Violence, Service Engagement, and Social Network Social functioning (SF) has mainly been studied in major psychoses in relation to symptom severity, but other factors may interfere with the achievement of a functional remission. The aim of this study is to explore interpersonal violence (IV), service engagement (SE), and social network (SN), together with demographics, as predictors of SF in a sample of subjects with severe mental illness (SMI). Consecutive adult inpatients were evaluated using self-report and clinician-rated questionnaires. Findings suggest that IV, SE, SN, male sex, and illness duration explained 39.1% of SF variance in people affected by SMI. IV was the strongest predictor, followed by sex and duration of illness. Lifetime expression of violence is a stronger predictor than lifetime exposure to violence. Positive SE and SN were found to predict SF, whereas age was not associated. This study underlines the need of other non-symptom-related variables for the comprehension of SF in mental disorders.

Internet Addiction Among Lebanese Adolescents: The Role of Self-Esteem, Anger, Depression, Anxiety, Social Anxiety and Fear, Impulsivity, and Aggression—A Cross-Sectional Study The study objective was to evaluate the association between depression, anxiety, social anxiety and fear, impulsivity, and aggression and Internet addiction (IA) among Lebanese adolescents. This cross-sectional study, conducted between October 2017 and April 2018, enrolled 1103 young adolescents aged between 13 and 17 years. The Internet Addiction Test (IAT) was used to screen for IA. The results also showed that 56.4% of the participants were average Internet users (IAT score ≤49), 40.0% had occasional/frequent problems (IAT scores between 50 and 79), and 3.6% had significant problems (IAT scores ≥80) because of Internet use. The results of a stepwise regression showed that higher levels of aggression (β = 0.185), depression (Multiscore Depression Inventory for Children) (β = 0.219), impulsivity (β = 0.344), and social fear (β = 0.084) were associated with higher IA, whereas an increased number of siblings (β = −0.779) and a higher socioeconomic status (β = −1.707) were associated with lower IA. Uncontrolled use of the Internet can be associated with addiction and other psychological comorbidities.

Uncovering Demographic, Clinical, Triggering Factors Similarities Between Migraine and Irritable Bowel Syndrome: A Prospective Study The objective was to uncover demographical and clinical factors associated with migraine and irritable bowel syndrome (IBS) in a group of patients experiencing both painful disorders and to identify their triggering factors. A prospective study was performed between January 2016 and June 2017. Clinical characteristics and potential generating factors for both pathologies were then assessed using validated questionnaires. Our study showed that the percentage of patients diagnosed with migraine and having IBS was 34.3%. Compared with patients with migraine alone, patients having both diseases were identified with higher prevalence of concomitant chronic/psychiatric diseases, lower frequency of migraine attacks, and lower prevalence of throbbing/distressing/enervating pain and concentration difficulties than patients with migraine alone. Moreover, patients in this subgroup had moderate abdominal pain intensity, and constipation was the predominant stool type. Finally, some dietary and environmental factors seem to be significantly important triggering factors of migraine/IBS pain.

Developing Texting for Relapse Prevention: A Scalable mHealth Program for People With Schizophrenia and Schizoaffective Disorder Symptom relapse in people with schizophrenia and schizoaffective disorder is common and has a negative impact on the course of illness. Here, we describe the development of Texting for Relapse Prevention, a scalable, cost-effective text messaging relapse prevention program that queries patients' “early warning signs” daily. Results of development focus groups and content advisory teams with 25 patients and 19 providers suggest that patients were enthusiastic about the program and thought that receiving daily messages about their symptoms would help them feel supported. Providers also were positive about the idea but worried that the program might interfere with patient-provider communication if patients thought that the messages were coming from providers. Patients found the content positive and actionable. The program was improved to address this feedback. This iterative development process that included multiple stakeholders ensured that the program is feasible and acceptable to both patients and providers.

Assessment of School-Aged Children of Mothers With Idiopathic Generalized Epilepsy The aim is to examine the cognitive domains, behavioral domains, and electroencephalogram (EEG) findings in children of mothers with idiopathic generalized epilepsy who had been exposed to antiepileptic drugs (AEDs) in utero. Forty school-aged children born to 23 mothers with idiopathic generalized epilepsy were compared with 40 healthy children born to 34 healthy mothers. Stanford-Binet Intelligence Scale was applied to all children to assess their cognitive functions. Child Behavior Checklist was used to assess their behavioral characteristics. EEG was done for the epileptic mothers and their children. Children exposed to AEDs showed significantly lower scores in the verbal reasoning, visual reasoning, and global intelligence quotient (IQ). There was a significantly positive correlation between children's global IQ and maternal global IQ. Multiple regression analysis showed that in utero exposure to valproate and maternal IQ were the most independent factors affecting children's IQ. EEG findings of participating children were normal. Exposure to valproic acid during fetal life and maternal IQ represent confounding factors affecting the IQ of children with in utero exposure to AEDs.

The Association Between Child Abuse and Emotional and Behavioral Problems in Chinese School-Aged Boys With Attention Deficit Hyperactivity Disorder The aim of our study was to investigate the relationship between child abuse and emotional and behavioral problems in Chinese school-aged boys with attention deficit hyperactivity disorder (ADHD). Forty-eight school-aged boys with ADHD and 77 male healthy controls completed the final assessments that included the Child Behavior Checklist, the Barratt Impulsiveness Scale Version 11, the Screen for Child Anxiety Related Disorders, the Depression Self-Rating Scale for Children, and the Childhood Trauma Questionnaire, Short Form. Our findings showed that child abuse could associate with the behavioral problems in ADHD. Regression analysis further showed that child abuse (especially emotional abuse and physical abuse), adverse living conditions, and school anxiety significantly could be contributors to behavioral problems in boys with ADHD. Our study indicated that child abuse may be associated with the behavioral problems in Chinese school-aged boys with ADHD.

Mental Health Literacy Among Chinese Rural Residents: A Survey From Hubei Province in Central China on People's Perception of Mental Illnesses A survey was carried among 412 participants to examine mental health literacy in rural China. Two vignettes depicting schizophrenia and depression were presented, and participants were asked to reflect on their recognition and the beliefs about the causes, consequences, and the treatments of the conditions described. Results show that the recognition rates for schizophrenia and depression were 76.9% and 67.7%, respectively. Participants believed work stress, life stress, and encountered frustration were the most important reasons for mental illnesses. Participants believed that mental illnesses could cause many severe consequences to patients, such as emotional pain, bringing pain to the family, deterioration of interpersonal relationships, and destroying the individual's life. The participants were more likely to recommend nonmedical treatment for the patients in the two vignettes. Participants having a higher educational level were more likely to be aware of the consequences of the mental illnesses, and they also had a more positive attitude toward seeking professional help.