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      Sailing Can Improve Quality of Life of People with Severe Mental Disorders: Results of a Cross Over Randomized Controlled Trial

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          Abstract

          The aim of this study was to evaluate the impact of a sailing rehabilitation program on the quality of life (QoL) in a sample of patients with severe mental disorders. The study adopted a randomized, crossover, waiting-list controlled design. The participants enrolled in the study were outpatients diagnosed with severe chronic mental disorders. The participants (N=40) exposed to rehabilitation with sailing took part in a series of supervised cruises near the gulf of Cagliari, South Sardinia, and showed a statistically significant improvement of their quality of life compared to the control group. This improvement was comparable to the improvement in psychopathologic status and social functioning as shown in a previous report of the same research project. The improvement was maintained at follow-up only during the trial and for a few months later: after 12 months, patients returned to their baseline values and their quality of life showed a worsening trend. This is the first study to show that rehabilitation with sailing may improve the quality of life of people with severe chronic mental disorders. In all likelihood, a program grounded on learning how to manage a sailing vessel - during which patients perform cruises that emphasize the exploration of the marine environment by sailing - might be interesting enough and capture the attention of the patients so as to favour greater effectiveness of standard rehabilitation protocols, but this should be specifically tested.

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          A scientific agenda for the concept of recovery as it applies to schizophrenia.

          Recovery is now a widely discussed concept in the field of research, treatment, and public policy regarding schizophrenia. As it has increasingly become a focus in mainstream psychiatry, however, it has also become clear both that the concept is often used in multiple ways, and that it lacks a strong scientific basis. In this review, we argue that such a scientific basis is necessary for the concept of recovery to have a significant long-term impact on the way that schizophrenia is understood and treated. The discussion focuses on key issues necessary to establish this scientific agenda, including: 1) differences in definitions of recovery and their implications for studying recovery processes and outcomes; 2) key research questions; 3) the implications of data from outcome studies for understanding what is possible for people diagnosed with schizophrenia; 4) factors that facilitate recovery processes and outcomes, and methods for studying these issues; and 5) recovery-oriented treatment, including issues raised by peer support. Additional conceptual issues that have not received sufficient attention in the literature are then noted, including the role of evidence-based practices in recovery-oriented care, recovery-oriented care for elderly people with schizophrenia, trauma treatment and trauma-informed care, and the role of hospitals in recovery-oriented treatment. Consideration of these issues may help to organize approaches to the study of recovery, and in doing so, improve the impact of recovery-based initiatives.
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            Recovery from mental illness as an emergent concept and practice in Australia and the UK.

            The language of recovery is now widely used in mental health policy, services, and research. Yet the term has disparate antecedents, and is used in a variety of ways. Some of the history of the use of the term recovery is surveyed, with particular attention to the new meaning of the term, especially as identified by service users, supported and taken up to various degrees by research and in the professional literature. Policy and practice in two countries--Australia and the United Kingdom--are examined to determine the manner and extent to which the concept of recovery is evident. In its new meaning, the concept of recovery has the potential to bring about profound and needed changes in mental health theory and practice. It is being taken up differently in different settings. It is clear that--at least in Australia and the United Kingdom--there are promising new recovery models and practices that support recovery, but the widespread use of recovery language is not enough to ensure that the core principles of the recovery model are implemented.
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              Physical Activity in Depressed Elderly. A Systematic Review

              Background: exercise may reduce depressive symptoms both in healthy aged populations and in old patients diagnosed with MDD, but few specific analysis were conducted on the efficacy of exercise as an adjunctive treatment with antidepressants, which may be probably more useful in clinical practice, considered the high prevalence of treatment resistant depression in late life, the low cost and safety of physical activity interventions. Objective: to establish the new findings on the effectiveness of exercise on depression in elderlies, with particular focus on the efficacy of the exercise as an adjunctive treatment with antidepressants drug therapy. Method: the search of significant articles was carried out in PubMed/Medline with the following key words: “exercise”, “physical activity”, “physical fitness”, “depressive disorder”, “depression”, “depressive symptoms”, “late life”, “old people”, and “elderly”. Results: 44 papers were retrieved by the search. Among the 10 included randomized controlled trials, treatment allocation was adequately conceived in 4 studies, intention-to-treat analysis was performed in 6 studies, but no study had a double-blinded assessment. We examined and discussed the results of all these trials. Conclusion: in the last 20 years, few progresses were done in showing the efficacy of exercise on depression, due in part to the persistent lack of high quality research, in part to clinical issues of management of depression in late life, in part to the difficult to establish the real effectiveness of exercise on depressive symptoms in elderlies. However, there are some promising findings on physical activity combined with antidepressants in treatment resistant late life depression.
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                Author and article information

                Journal
                Clin Pract Epidemiol Ment Health
                Clin Pract Epidemiol Ment Health
                CPEMH
                Clinical Practice and Epidemiology in Mental Health : CP & EMH
                Bentham Open
                1745-0179
                23 July 2014
                2014
                : 10
                : 80-86
                Affiliations
                [1 ]Centro di Psichiatria di Consulenza e Psicosomatica AUOC Cagliari and University of Cagliari, #CONI, Italian Olympic Committee – Sardinia
                [2 ]Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ)
                Author notes
                [* ]Address correspondence to this author at the Centro di Psichiatria di Consulenza e Psicosomatica AUOC Cagliari and University of Cagliari, Italy; Tel: +39 35 499994; Fax: +070 6093498; E-mail: mgcarta@ 123456tiscali.it
                Article
                CPEMH-10-80
                10.2174/1745017901410010080
                4150378
                8b99d24f-9e3f-4217-94ec-459928efec11
                © Carta et al.; Licensee Bentham Open.

                This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

                History
                : 5 May 2014
                : 12 June 2014
                : 12 June 2014
                Categories
                Article

                Neurology
                bipolar disorder,quality of life,rehabilitation,sailing,schizophrenia.
                Neurology
                bipolar disorder, quality of life, rehabilitation, sailing, schizophrenia.

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