Psychosocial rehabilitation (PSR) is at the core of psychiatric recovery. There is a paucity of evidence regarding how the needs and characteristics of patients guide clinical decisions to refer to PSR interventions. Here, we used explainable machine learning methods to determine how socio-demographic and clinical characteristics contribute to initial referrals to PSR interventions in patients with serious mental illness.

Data were extracted from the French network of rehabilitation centres, REHABase, collected between years 2016 and 2022 and analysed between February and September 2022. Participants presented with serious mental illnesses, including schizophrenia spectrum disorders, bipolar disorders, autism spectrum disorders, depressive disorders, anxiety disorders and personality disorders. Information from 37 socio-demographic and clinical variables was extracted at baseline and used as potential predictors. Several machine learning models were tested to predict initial referrals to four PSR interventions: cognitive behavioural therapy (CBT), cognitive remediation (CR), psychoeducation (PE) and vocational training (VT). Explanatory power of predictors was determined using the artificial intelligence-based SHAP (SHapley Additive exPlanations) method from the best performing algorithm.

Data from a total of 1146 patients were included (mean age, 33.2 years [range, 16–72 years]; 366 [39.2%] women). A random forest algorithm demonstrated the best predictive performance, with a moderate or average predictive accuracy [micro-averaged area under the receiver operating curve from ‘external’ cross-validation: 0.672]. SHAP dependence plots demonstrated insightful associations between socio-demographic and clinical predictors and referrals to PSR programmes. For instance, patients with psychotic disorders were more likely to be referred to PE and CR, while those with non-psychotic disorders were more likely to be referred to CBT and VT. Likewise, patients with social dysfunctions and lack of educational attainment were more likely to be referred to CR and VT, while those with better functioning and education were more likely to be referred to CBT and PE.

A combination of socio-demographic and clinical features was not sufficient to accurately predict initial referrals to four PSR programmes among a French network of rehabilitation centres. Referrals to PSR interventions may also involve service- and clinician-level factors. Considering socio-demographic and clinical predictors revealed disparities in referrals with respect to diagnoses, current clinical and psychological issues, functioning and education.

Given the negative social representation attributed to mental illness, it is urgent to reconfigure its representation, not as an individual problem, but also as a collective. Several solutions have been indicated to improve the skills and quality of life (QoL) of these individuals. Among these, psychosocial rehabilitation programs stand out to keep individuals inserted in society reaching a level of independent functioning.

This study aims to: - assess the level of QoL, social support, treatment adherence, mental health status and mental health literacy of Portuguese people with HIV integrated into a community intervention program “InPulsar - Giros na Rua” program [which aims to contribute to the improvement of the socio-sanitary conditions of people who use psychoactive substances and to their social and therapeutic referral, as well as promoting risk reduction by intervening in a public space]; - improve mental health literacy levels, adherence to therapeutic regimen and QoL in individuals with HIV, after 12 months of implementation of a psychosocial rehabilitation program [biweekly sessions].

We will perform a single-group pre-experimental study with pre- and post-intervention evaluation, supported by the participatory methodology in health.

This study has received ethical approval from the local IRB. Data collection will start in November 2021 and will be completed in November 2022.

Through a multidisciplinary approach, this study will allow the development of health interventions articulated with psychosocial interventions based on various educational and behavioural strategies, promoting literacy and adherence to the therapeutic regimen.

No significant relationships.

The increase of job satisfaction in mental health nurses, working in community mental facilities, helps them to become more efficient and understand the needs of individuals suffering from mental health problems.

To investigate sociodemographic and job characteristics, as well as the level of professional satisfaction of nurses working in psychosocial rehabilitation facilities of the psychiatric hospital of Athens, named Dafni.

220 nurses, working in the field of psychosocial rehabilitation completed (a) a sociodemographic questionnaire, (b) Spectοr’s Job Satisfaction Survey (JSS).

Nursing staff consists of mental health nurses (44.1%) and nursing assistants (55.9%) in the present study. 90% of the participants were female; while the 65% were married, the 19.5% had a university-level education and the 25% had administrative responsibilities. The 44.1% of our sample worked in hostels, 41.8% in nursing homes and 6.8% in Community Mental Health Centers. More specifically, moderate levels of total professional satisfaction were observed. Concerning the dimensions of satisfaction, low satisfaction rates were recorded in “salary”, “promotion” and in “privileges and benefits”. High satisfaction rates were recorded in “supervision by their superiors”, “cooperation between colleagues” and “the nature of their work”, while moderate satisfaction rates were reported in “communication” within facilities, as far as the explanation of tasks and objectives is concerned.

The results can be exploited by those with administrative and scientific responsibilities in the field of mental health in order to recognize nurses’ difficulties and solve their problems in psychosocial rehabilitation facilities.

An important aspect of rehabilitation programmes is assessment of their effectiveness, which is carried out mainly through clinical and psycho-pathological examinations, psychometric and psychological scales and questionnaires. The use of biological markers of the schizophrenic process to assess the effectiveness of rehabilitation assistance is of considerable interest.

To compare the clinical and socio-psychological characteristics of schizophrenia patients receiving psychosocial treatment in various forms of psychiatric care with the level of immune system activation reflecting the activity and severity of the pathological process in brain.

77 schizophrenia patients in remission of varying quality were examined, of which 52 patients (the 1st group) participated in a long-term comprehensive rehabilitation programme (3.7±2.5 years) in non-profit organization, and 25 patients (the 2nd group) received medical and rehabilitation assistance in the psychiatric day hospital (duration of treatment no more than 60 days). PANSS, HDRS, SAS-SR, SF-36, BRS scales were used. The activity of the pathological process was evaluated by the level of inflammatory markers.

Both patient groups showed a similar increase in the level of inflammatory and autoimmune markers compared to control (p<0,01). The 1st group compared to the 2nd one had a significantly higher level (p<0,05) of social functioning, stress resistance, awareness of the disease, motivation, comprehensiveness, as well as less the severity of psychopathological symptoms.

The results indicate the effectiveness of a long-term comprehensive rehabilitation programme to stabilize clinical remission, improve social functioning and the quality of life in schizophrenia patients, despite the active pathological process in brain.

The active development of psychosocial rehabilitation (PSR) has been taking place in Russia within latest two decades. In this regard, analysis of the accumulated experience and problems’ identification in the PSR field is relevant.

Conducting a sociological study in the Volga Federal District (VFD) to work out measures for further PSR system development.

Sociological, statistical, original semi-structured questionnaire on PSR application, including 26 questions.

63 institutions providing psychiatric care in 14 large regions of the VFD participated in the study. Achievements in the field of PSR include: introduction of new forms of rehabilitation care, modern psychosocial interventions; development of the volunteer sector and others. A number of systemic problems were also identified: more pronounced decrease in the availability of psychiatrists in VFD compared to the Russian Federation (RF) as a whole (in the VFD 0.76 psychiatrists per 10 thousand population in 2017 and 0.74 per 10 thousand population in 2018; in RF: 0.83 psychiatrists per 10 thousand population in 2017, 0.82 per 10 thousand in 2018); insufficient provision with psychotherapists, psychologists, social workers, which varies considerably in different territories (up to 10 times); insufficient use of non-profit organizations’ (NPOs) potential; lack of a unified system for assessing PSR effectiveness.

Measures for development of PSR were proposed: improving staffing levels and qualifications of employees, introducing psychosocial interventions with proven effectiveness; dissemination of successful experience of NPOs, development of methodological tools for assessing effectiveness of PSR, its standardization and others.

The Italian law 81/2014 has given a strong push to the design of therapeutic-rehabilitative paths for psychiatric patients who are offenders. This innovation requires a constant organizational effort on the part of mental health services to enforce the law. The rehabilitation team is represented by different professionals like psychiatrists, psychologists, nurses, psychiatric rehabilitation technicians, educators, social workers and others. They must be able to work in an integrated way among them and with private social sector.

It is in our interest to reach an agreement between different professionals working in the rehabilitation-forensic field about good practices.

We have prepared a survey to identify good practices in the field of psychosocial rehabilitation of the offender psychiatric patient, involving different professionals who have expertise.

This audit revealed, in everybody’s opinion, that these offending citizens have received a security measure capable of having greater control over their actions in a therapeutic-rehabilitative perspective but it is fundamental to educate them also to exercise their own safety for a social shared culture. Ensuring the safety of the offender during the therapeutic-rehabilitative path is as important as responding to a society’s need for social security.

Satisfying a society’s need for security, established by the Judge and the Law, all this cannot separated from the active exercise of security of the offending psychiatric patient towards himself, through psychoeducation. The safety towards others and towards oneself can constitute a good practice in the field of psychosocial rehabilitation.

No significant relationships.

Objective laws of emotional disorder formation, their frequency along with clinic and psychopathological structure have been poorly studied until now.3 groups of patients have been observed: 200 people with alcohol addiction, 180 people with opioid addiction, and 90 people with psychostimulant addiction.

All these have influenced our research which goal is to study patients’ emotional state at the stages of psychosocial rehabilitation.

Signs of psychological and physical addiction, specific personality disorders and decrease in social functioning level have been found for all of the observed patients. Psychodiagnostic research (performed according to Hamilton, Spielberger and Hanin, Buss-Durkee methods) has shown significant increase of depression and anxiety parameters, as well as aggression level for all the patients.

Psychosocial rehabilitation system has been formed and created according to the results of the research. It is built based on a stepwise multimodal principle, including social deprivation, individual and group psychotherapy, craft therapy with an outcome to self-organizing psychotherapeutic groups.

Emotional sphere state normalization occurred during the process of participation in the system. According to catamnesis data of 1 to 2 years, the developed system efficiency is: 72.00 % for patients with alcohol addiction, 64.00 % for patients with opioid addiction, 51.00 % for patients with psychostimulant addiction.

No significant relationships.

Few studies have explored whether high-anticholinergic load may hamper rehabilitation in persons with schizophrenia. We aim to explore the associations between anticholinergic load of psychotropic treatment and functioning or cognitive performances of persons with psychosis engaged in psychosocial rehabilitation.

The study was performed using data collected at baseline assessment in the REHABase cohort including persons referred to a French network of psychosocial rehabilitation centers. The composite-rating scale developed by Salahudeen et al. was used to rate the anticholinergic load of psychotropic drugs prescribed at baseline assessment. The associations between total anticholinergic load score (categorized as ‘low’ <3 v. ‘high’ ⩾3) and functioning or cognitive characteristics were explored using multivariate analyses.

Of the 1012 participants with schizophrenia spectrum disorders identified in the REHABase, half used at least two psychotropic drugs with anticholinergic activity and one out of three was prescribed at least one psychotropic drug with high-anticholinergic activity. High-anticholinergic load was significantly associated with lower stage of recovery [odds ratio (OR) = 1.70, 95% confidence interval (CI) 1.05–2.76, p = 0.03], poor mental well-being (OR = 1.55, 95% CI 1.02–2.33, p = 0.04) and poor self-rated medication adherence (OR = 2.14, 95% CI 1.29–3.53, p = 0.003). Regarding cognition, a high-anticholinergic score was associated with poorer delayed-episodic memory (OR = 1.69, 95% CI 1.01–2.85, p = 0.05) and at the trend level with faster completion time on the test exploring executive performance (OR = 0.67, 95% CI 0.43–1.04, p = 0.07).

The psychosocial rehabilitation plan of persons with psychosis should integrate optimization of psychotropic treatment in order to lessen the functional and cognitive impact of high-anticholinergic load.

Social cognition has been identified as a significant construct for schizophrenia research with relevance to diagnosis, assessment, treatment and functional outcome. However, social cognition has not been clearly understood in terms of its relationships with neurocognition and functional outcomes. The present study sought to examine the empirical independence of social cognition and neurocognition; to investigate the possible causal structure among social cognition, neurocognition and psychosocial functioning.

The sample consists of 130 individuals diagnosed with schizophrenia. All participants were recruited as they were admitted to four community-based psychosocial rehabilitation programs. Social cognition, neurocognition and psychosocial functioning were measured at baseline and 12 months. The empirical independence of social cognition and neurocognition was tested using confirmatory factor analysis (CFA) and the possible causal structure among social cognition, neurocognition and psychosocial functioning was investigated using latent difference score (LDS) analysis.

A two-factor model of social cognition and neurocognition fit the data very well, indicating the empirical independence of social cognition, whereas the longitudinal CFA results show that the empirical independence of neurocognition and social cognition is maintained over time. The results of the LDS analysis support a causal model that indicates that neurocognition underlies and is causally primary to social cognition, and that neurocognition and social cognition are causally primary to functional outcome.

Social cognition and neurocognition could have independent and distinct upward causal effects on functional outcome. It is also suggested that the approaches for remediation of neurocognition and social cognition might need to be distinct.

This study examined the magnitude of neurocognitive change during 1 year of community-based psychosocial intervention, whether neurocognitive change and functional change were linked, and how neurocognitive change combined with service intensity to facilitate functional change.

A total of 130 individuals diagnosed with schizophrenia were recruited upon admission to four community-based psychosocial rehabilitation programs. Subjects were assessed at baseline, 6 and 12 months on role functioning and symptom measures. Neurocognition was measured at baseline and 12 months. Service intensity was the number of days of treatment attendance during the study period. Latent mean difference tests and Latent Growth Curve Models (LCGMs) were used to examine the study hypotheses.

There was statistically and clinically significant functional improvement over 12 months. Neurocognition improved significantly over time. Seventy-six (58%) of the sample showed neurocognitive improvement and 54 (42%) did not. There was a significant rate of functional enhancement in the neurocognitive improver group. There was a non-significant rate of functional change in the neurocognitive non-improver group. Neurocognitive improvers showed functional improvement that was 350% greater than neurocognitive non-improvers. Service intensity did not vary between neurocognitive improvers and non-improvers but there was a strong interaction between neurocognitive improvement, service intensity and rate of functional improvement such that service intensity was strongly related to functional improvement for neurocognitive improvers but not for neurocognitive non-improvers. Medication usage and symptomatology did not confound these findings.

These findings suggest that neurocognitive improvement may be a foundation for functional change and treatment responsiveness during community-based psychosocial rehabilitation for individuals with schizophrenia.