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Sample records for acute paranoid psychosis

  1. Manganese and acute paranoid psychosis: a case report

    Egger Jos I

    2011-04-01

    Full Text Available Abstract Introduction Manganese regulates many enzymes and is essential for normal development and body function. Chronic manganese intoxication has an insidious and progressive course and usually starts with complaints of headache, fatigue, sleep disturbances, irritability and emotional instability. Later, several organ systems may be affected and, due to neurotoxicity, an atypical parkinsonian syndrome may emerge. With regard to neuropsychiatry, an array of symptoms may develop up to 30 years after intoxication, of which gait and speech abnormalities, cognitive and motor slowing, mood changes and hallucinations are the most common. Psychotic phenomena are rarely reported. Case presentation We describe the case of a 49-year-old Caucasian man working as a welder who was referred to our facility for evaluation of acute paranoid psychotic behavior. Our patient's medical history made no mention of any somatic complaints or psychiatric symptoms, and he had been involved in a professional career as a metalworker. On magnetic resonance imaging scanning of his brain, a bilateral hyperdensity of the globus pallidus, suggestive for manganese intoxication, was found. His manganese serum level was 52 to 97 nmol/L (range: 7 to 20 nmol/L. A diagnosis of organic psychotic disorder due to manganese overexposure was made. His psychotic symptoms disappeared within two weeks of treatment with low-dose risperidone. At three months later, serum manganese was decreased to slightly elevated levels and the magnetic resonance imaging T1 signal intensity was reduced. No signs of Parkinsonism were found and a definite diagnosis of manganese-induced apathy syndrome was made. Conclusion Although neuropsychiatric and neurological symptoms caused by (chronic manganese exposure have been reported frequently in the past, in the present day the disorder is rarely diagnosed. In this report we stress that manganese intoxication can still occur, in our case in a confined

  2. Acute paranoid psychosis as sole clinical presentation of hepatic artery thrombosis after living donor liver transplantation

    Obed Aiman

    2010-02-01

    Full Text Available Abstract Background Hepatic artery thrombosis is a devastating complication after orthotopic liver transplantation often requiring revascularization or re-transplantation. It is associated with considerably increased morbidity and mortality. Acute cognitive dysfunction such as delirium or acute psychosis may occur after major surgery and may be associated with the advent of surgical complications. Case presentation Here we describe a case of hepatic artery thrombosis after living-donor liver transplantation which was not preceded by signs of liver failure but rather by an episode of acute psychosis. After re-transplantation the patient recovered without sequelae. Conclusion This case highlights the need to remain cautious when psychiatric disorders occur in patients after liver transplantation. The diagnostic procedures should not be restricted to medical or neurological causes of psychosis alone but should also focus vascular complications related to orthotopic liver transplantation.

  3. Acute paranoid psychosis as sole clinical presentation of hepatic artery thrombosis after living donor liver transplantation

    Obed Aiman; Ramadori Giuliano; Meier Volker; Goralczyk Armin D; Lorf Thomas

    2010-01-01

    Abstract Background Hepatic artery thrombosis is a devastating complication after orthotopic liver transplantation often requiring revascularization or re-transplantation. It is associated with considerably increased morbidity and mortality. Acute cognitive dysfunction such as delirium or acute psychosis may occur after major surgery and may be associated with the advent of surgical complications. Case presentation Here we describe a case of hepatic artery thrombosis after living-donor liver ...

  4. Carbamazepine for acute psychosis with eeg abnormalities

    Ivković Maja; Damjanović Aleksandar; Marinković Dragan; Paunović Vladimir R.

    2004-01-01

    Aim. To investigate the efficacy of carbamazepine as adjuvant drug therapy in acute paranoid psychosis with associated EEG abnormalities, compared to sole antipsychotic treatment. Methods. Eleven medication-naive patients diagnosed with acute paranoid psychosis with associated EEG abnormalities were divided into two treatment groups: sole fluphenazine group, with flexible dosing of 5-10 mg/day (n=6), and carbamazepine group (n=5) with the addition of carbamazepine (600 mg/day) to fluphenazine...

  5. Carbamazepine for acute psychosis with eeg abnormalities

    Ivković Maja

    2004-01-01

    Full Text Available Aim. To investigate the efficacy of carbamazepine as adjuvant drug therapy in acute paranoid psychosis with associated EEG abnormalities, compared to sole antipsychotic treatment. Methods. Eleven medication-naive patients diagnosed with acute paranoid psychosis with associated EEG abnormalities were divided into two treatment groups: sole fluphenazine group, with flexible dosing of 5-10 mg/day (n=6, and carbamazepine group (n=5 with the addition of carbamazepine (600 mg/day to fluphenazine treatment. Clinical Global Impression (CGI, Brief Psychiatric Rating Scale (BPRS, Scale for the Assessment of Negative Symptoms (SANS, and EEG were assessed on the baseline and after 6 weeks of treatment. Paired and two-tailed t-tests were used for statistical significance. Results. All the patients showed significant improvement of mental state after 6 weeks of treatment with no significant differences in CGI, BPRS, and total SANS scores in relation to the therapy with carbamazepine. Nevertheless, after 6 weeks of the treatment, EEG findings were significantly better in carbamazepine group, in relation to the findings from the onset of the treatment, as well as in comparison to sole fluphenazine group. Conclusion. Although carbamazepine stabilized abnormal brain electrical activities it seemed that the associated EEG abnormalities were not significant for acute psychosis observed. These preliminary results suggested that there was no convincing evidence that carbamazepine was efficient as the augmentation of antipsychotic treatment for patients with both acute paranoid psychosis and EEG abnormalities.

  6. RECURRENT SEASONAL ACUTE PSYCHOSIS

    Agarwal, Vivek

    1999-01-01

    Acute psychoses have been reported to occur more frequently in summer. This is a report of seasonal recurrence of acute psychosis in a patient. This case report emphasizes towards the biological etiology of acute psychoses.

  7. Social defeat predicts paranoid appraisals in people at high risk for psychosis

    Valmaggia, Lucia R; Day, Fern; Garety, Philippa; Freeman, Daniel; Antley, Angus; Slater, Mel; Swapp, David; Myin-Germeys, Inez; McGuire, Philip

    2015-01-01

    BACKGROUND: The experience of social defeat may increase the risk of developing psychotic symptoms and psychotic disorders. We studied the relationship between social defeat and paranoid appraisal in people at high risk for psychosis in an experimental social environment created using Virtual Reality (VR).METHOD: We recruited UHR (N=64) participants and healthy volunteers (N=43). Regression analysis was used to investigate which baseline measures predicted paranoid appraisals during the VR ex...

  8. Psychosis with paranoid delusions after a therapeutic dose of mefloquine: a case report

    Browning Joseph

    2006-08-01

    Full Text Available Abstract Background Convenient once-a-week dosing has made mefloquine a popular choice as malaria prophylaxis for travel to countries with chloroquine-resistant malaria. However, the increased use of mefloquine over the past decade has resulted in reports of rare, but severe, neuropsychiatric adverse reactions, such as anxiety, depression, hallucinations and psychosis. A direct causality between mefloquine and severe reactions among travelers has been partly confounded by factors associated with foreign travel and, in the case of therapeutic doses of mefloquine, the central nervous system manifestations of Plasmodium infection itself. The present case provides a unique natural history of mefloquine-induced neuropsychiatric toxicity and revisits its dose-dependent nature. Case presentation This report describes an acute exacerbation of neuropsychiatric symptoms after an unwarranted therapeutic dose (1250 mg of mefloquine in a 37-year-old male previously on a once-a-week prophylactic regimen. Neuropsychiatric symptoms began as dizziness and insomnia of several days duration, which was followed by one week of escalating anxiety and subtle alterations in behaviour. The patient's anxiety culminated into a panic episode with profound sympathetic activation. One week later, he was hospitalized after developing frank psychosis with psychomotor agitation and paranoid delusions. His psychosis remitted with low-dose quetiapine. Conclusion This report suggests that an overt mefloquine-induced psychosis can be preceded by a prodromal phase of moderate symptoms such as dizziness, insomnia, and generalized anxiety. It is important that physicians advise patients taking mefloquine prophylaxis and their relatives to recognize such symptoms, especially when they are accompanied by abrupt, but subtle, changes in behaviour. Patients with a history of psychiatric illness, however minor, may be at increased risk for a mefloquine-induced neuropsychiatric toxicity

  9. Acute Psychosis: A Presentation of Cyanocobalamin Deficiency Megaloblastic Anemia

    A. K. TRIPATHI; Verma, S P; Himanshu, D.

    2010-01-01

    Cyanocobalamin deficiency is not rare in India. Patients present with megaloblastic anemia, pancytopenia and sometimes neuropsychiatric manifestations. Subacute combined degeneration of the cord, peripheral neuropathy, dementia, psychotic depression and paranoid schizophrenia are well reported. We are reporting a case of cyanocobalamine deficiency anemia who presented with acute psychosis which readily reversed on cyanocobalamin replacement.

  10. Acute psychosis induced by isotretinoin

    Rajagopal, Sundararajan

    2014-01-01

    Isotretinoin is used for the treatment of severe acne. Psychiatric side-effects, particularly depression, have been well-documented. This dramatic case report is about a young male patient who developed acute psychosis within a few days of starting isotretinoin. Due to his persecutory delusions, the patient, who was an Indian engineer working in Germany, decided to immediately return to India fearing for his life in Germany. Careful history taking established the cause of the psychosis. Isotr...

  11. Levofloxacin-induced acute psychosis

    Moorthy, Nagaraja; Raghavendra, N.; Venkatarathnamma, P. N.

    2008-01-01

    A wide range of drugs can cause mental status changes. Fluoroquinolones are one among them and are underrecognised.The CNS side effects of levofloxacin like headache, dizziness, restlessness, tremor, insomnia, hallucinations, convulsions, anxiety and depression are well documented. We report a rare case of middle aged diabetic male admitted to hospital with multiple infections who developed acute psychosis following levofloxacin administration.

  12. Manganese and acute paranoid psychosis: A case report

    W.M.A. Verhoeven (Wim); J.I.M. Egger (Jos); H.J. Kuijpers (Harold)

    2011-01-01

    textabstractIntroduction: Manganese regulates many enzymes and is essential for normal development and body function. Chronic manganese intoxication has an insidious and progressive course and usually starts with complaints of headache, fatigue, sleep disturbances, irritability and emotional instabi

  13. Manganese and acute paranoid psychosis: a case report

    Verhoeven, W.M.A.; Egger, J.I.M.; Kuijpers, H.J.H.

    2011-01-01

    Introduction Manganese regulates many enzymes and is essential for normal development and body function. Chronic manganese intoxication has an insidious and progressive course and usually starts with complaints of headache, fatigue, sleep disturbances, irritability and emotional instability. Later,

  14. Acute psychosis induced by topiramate

    Rajnish Raj; Raj Kumar

    2014-01-01

    Topiramate (TPM) is a new potent antiepileptic drug (AED) used as add-on therapy for generalized and partial seizures that are resistant to the other AEDs; or as a mood stabilizer, and for reducing weight gain associated with olanzapine and clozapine in patients with bipolar disorder or schizophrenia. However, there is a higher risk of psychosis with TPM in patients with a past history of psychiatric disorder. This case report highlights emergence of psychosis that was related to TPM which re...

  15. URINARY INCONTINENCE IN ACUTE PSYCHOSIS

    Choudhury, S.; Augustine, M.

    1993-01-01

    SUMMARY A prospective two year study of consecutive admissions (n=984) to a psychiatry ward revealed that the incidence of temporary urinary incontinence in psychiatric patients without delirium or dementia was 1.63% (n=l6). When compared with controls (n=64) the incontinent patients were more often psychotic, gave a history of childhood enuresis and a past history of temporary incontinence during psychosis. Compared with psychotic controls (n=26), incontinent patients (n=16) had been exposed...

  16. Patient satisfaction after acute admission for psychosis.

    Bø, Beate; Ottesen, Øyvind H; Gjestad, Rolf; Jørgensen, Hugo A; Kroken, Rune A; Løberg, Else-Marie; Johnsen, Erik

    2016-07-01

    Background Measuring patient satisfaction in mental health care potentially provides valuable information, but studies in acutely admitted psychosis patients are scarce. Aims The aims were to assess satisfaction among patients acutely admitted with psychosis, to compare satisfaction in voluntarily versus involuntarily admitted patients, and to assess the influence of symptom load and insight. Methods The UKU Consumer Satisfaction Rating Scale (UKU-ConSat) was used. A total of 104 patients completed the UKU-ConSat at discharge/follow-up (between 6-11 weeks after admittance if not discharged earlier) (mean duration of stay 4 weeks), thus corresponding to the end of the acute treatment phase. Results A total of 88.4% had total scores above zero (satisfied). Only three of the eight single items were statistically significantly different among patients admitted voluntarily versus involuntarily, and only the information item score remained significantly different in adjusted analyses. Insight level at admittance, and an increasing level of insight during the acute phase were positively associated with patient satisfaction, whereas levels and changes in positive and negative psychosis symptoms were indirectly related to satisfaction via this process of insight. Conclusions The vast majority of the acutely admitted patients were satisfied with treatment. There were few differences between the involuntarily and voluntarily admitted patient groups, except that the involuntary care group was clearly less satisfied with the information provided. Poor insight had a major negative impact on treatment satisfaction in psychosis. The provision of sufficient and adequate information is an important target for mental health care service improvement. PMID:26750532

  17. ACUTE NON-ORGANIC PSYCHOSIS-OUTCOME AFTER 10 YEARS

    Gupta, L.N.; Bhardwaj, Pramod

    2000-01-01

    62 out of 68 acute psychosis patients who were initially recruited from the Bikaner Centre in 1982 for the Indian Council of Medical Research (ICMR) study on "phenomenology and natural history of acute psychosis" were assessed after completion of 10 years in 1992-93 on SCAAPS and PSE with the objective of studying the long term course and outcome of acute psychosis. The results show that 35 (56.45%) patients of acute brief episode of psychosis never had any psychotic illness during the course...

  18. Acute psychosis: A neuropsychiatric dilemma

    Daniel Saldanha

    2013-01-01

    Full Text Available The acute onset of psychotic symptoms in elderly can be the presenting clinical feature for various Central Nervous System as well as other systemic illnesses. The diagnosis and treatment of such presentation require a cautious medical work up and high level of suspicion even if the patient is not showing any cardinal symptoms for organic pathology.

  19. Acute psychosis: A neuropsychiatric dilemma

    Daniel Saldanha; Preethi Menon; Bhushan Chaudari; Bhattacharya, L.; Sameer Guliani

    2013-01-01

    The acute onset of psychotic symptoms in elderly can be the presenting clinical feature for various Central Nervous System as well as other systemic illnesses. The diagnosis and treatment of such presentation require a cautious medical work up and high level of suspicion even if the patient is not showing any cardinal symptoms for organic pathology.

  20. Levetiracetam-induced acute psychosis in a child

    Syed Ahmed Zaki; Saurabh Gupta

    2014-01-01

    Levetiracetam is well-tolerated and commonly used as a broad spectrum antiepileptic in both partial and generalized seizures. Few cases of levetiracetam-induced psychosis in children are reported in the literature. The present case of levetiracetam-induced acute psychosis highlights the adverse effect of this drug and also emphasizes the need for close monitoring of children on levetiracetam.

  1. Acute Psychosis after Recent Isoniazid Initiation

    Arya, Sidharth; Sukhija, Gagandeep; Singh, Harpreet

    2015-01-01

    Isoniazid as part of Directly Observed Treatment-Short course (DOTS) regimen is universally used. Although, associated psychosis in certain cases is documented earlier, type of symptoms and onset of symptoms remains highly variable. We describe a case of 54-year-old female on anti-tubercular therapy with onset of psychosis within three days of Isoniazid initiation characterised by agitation, loosening of association, echolalia with spontaneous remission after drug stoppage. This case highligh...

  2. A Case of Acute Psychosis in an Adolescent Male

    Ghufran Babar

    2014-01-01

    Full Text Available Primary hyperparathyroidism (PHPT is a disorder of calcium homeostasis. We report the case of a 17-year-old adolescent male, who presented with an acute psychosis coinciding with severe hypercalcemia and markedly elevated intact parathyroid hormone (iPTH level and low vitamin D level. A Sestamibi scan showed a positive signal inferior to the left lobe of the thyroid gland. He had only a partial response to the initial medical and psychiatric management. The enlarged parathyroid gland was resected surgically and postoperatively serum calcium and iPTH levels normalized. The histopathology was compatible with a benign adenoma. Patient’s acute psychotic symptoms resolved gradually after surgery; however he remained under psychiatric care for the behavioral issues for about 6 months after surgery. While psychosis is a rare clinical manifestation of hypercalcemia secondary to PHPT in pediatric population, it should be considered as a clinical clue in an otherwise asymptomatic pediatric patient.

  3. A Case of Acute Psychosis in an Adolescent Male

    Ghufran Babar; Ramin Alemzadeh

    2014-01-01

    Primary hyperparathyroidism (PHPT) is a disorder of calcium homeostasis. We report the case of a 17-year-old adolescent male, who presented with an acute psychosis coinciding with severe hypercalcemia and markedly elevated intact parathyroid hormone (iPTH) level and low vitamin D level. A Sestamibi scan showed a positive signal inferior to the left lobe of the thyroid gland. He had only a partial response to the initial medical and psychiatric management. The enlarged parathyroid gland was re...

  4. Homicide and Associated Steroid Acute Psychosis: A Case Report

    G. Airagnes; C. Rouge-Maillart; J.-B. Garre; Gohier, B

    2011-01-01

    We report the case of an old man treated with methylprednisolone for chronic lymphoid leukemia. After two months of treatment, he declared an acute steroid psychosis and beat his wife to death. Steroids were stopped and the psychotic symptoms subsided, but his condition declined very quickly. The clinical course was complicated by a major depressive disorder with suicidal ideas, due to the steroid stoppage, the leukemia progressed, and by a sudden onset of a fatal pulmonary embolism. This cli...

  5. Psychosis

    ... prevents alcohol-induced psychosis. References American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, Va: American Psychiatric Publishing. 2013. ...

  6. Homicide and Associated Steroid Acute Psychosis: A Case Report

    G. Airagnes

    2011-01-01

    Full Text Available We report the case of an old man treated with methylprednisolone for chronic lymphoid leukemia. After two months of treatment, he declared an acute steroid psychosis and beat his wife to death. Steroids were stopped and the psychotic symptoms subsided, but his condition declined very quickly. The clinical course was complicated by a major depressive disorder with suicidal ideas, due to the steroid stoppage, the leukemia progressed, and by a sudden onset of a fatal pulmonary embolism. This clinical case highlights the importance of early detection of steroid psychosis and proposes, should treatment not be stopped, a strategy of dose reduction combined with a mood stabilizer or antipsychotic treatment. In addition have been revised the risks of the adverse psychiatric effects of steroids.

  7. Acute Psychosis and Type 2 Diabetes Mellitus:Should Screening Guidelines Be Revised?

    Bauer, Leah K.; Wulsin, Lawson R.; Guadagno, Gina

    2011-01-01

    Although psychosis increases the risk for developing type 2 diabetes, the temporal relationship between the onset of psychosis and the onset of diabetes has not been studied. We present 6 cases of acute psychosis, which led to the new diagnosis of type 2 diabetes during inpatient psychiatric admission within days to weeks of the psychotic episode. The implications of these findings and the efficacy of current diabetes screening guidelines are discussed.

  8. Meta-Analysis of Anti-Toxoplasma gondii IgM Antibodies in Acute Psychosis

    Monroe, Joel M.; Buckley, Peter F.; Miller, Brian J.

    2014-01-01

    Introduction: A number of different infections are associated with acute psychosis. However, relationships between infections and acute psychosis in patients with schizophrenia have not been extensively explored. Exposure to Toxoplasma gondii is a replicated risk factor for schizophrenia. Previous studies have focused on T. gondii IgG antibodies, which are a marker of lifetime exposure, whereas IgM antibodies are a marker of acute/recent exposure, persistent infection, or reinfection. We perf...

  9. Psychosis

    ... a special mission or even that you are God. Causes We are still learning about how and why psychosis develops, but several factors are likely involved. We do know that teenagers and young adults are at increased risk of experiencing an ...

  10. Acute Psychosis as Major Clinical Presentation of Legionnaires’ Disease

    Ricardo Coentre

    2016-01-01

    Full Text Available We report a case of a 61-year-old woman who presented with acute psychosis as a major manifestation of Legionnaires’ disease in the absence of other neuropsychiatric symptoms. Clinical history revealed dry cough and nausea. Observation showed fever and auscultation crackles in the lower lobe of the right lung. Laboratory testing demonstrated elevated C-reactive protein and lung chest radiograph showed patchy peribronchial and right lower lobe consolidation. Soon after admission, she started producing purulent sputum. Epidemiological data suggested Legionella pneumophila as possible cause of the clinical picture that was confirmed by urinary antigen detection and polymerase chain reaction of the sputum. She was treated with levofloxacin 750 mg/day for 10 days with complete remission of pulmonary and psychiatric symptoms. She has not had further psychotic symptoms.

  11. [Categorical and dimensional diagnostic approach to acute psychosis in view of operational diagnostic criteria].

    Sakamoto, Kaoru

    2011-01-01

    "Acute psychosis" is the tentative diagnosis made for the patients presenting acute onset of delusion, hallucination, confusion and emotional instability. "Acute psychosis" was focused in view of operational diagnostic criteria, ie, DSM-IV-TR and ICD-10. The diagnostic categories in the DSM-IV-TR corresponding to "acute psychosis" were brief psychotic disorder, schizophreniform disorder, schizo-affective disorder and mood disorder with psychotic features. Although brief psychotic disorder is representative of "acute psychosis" in the DSM-TR, it lacks in clinical usefulness, because its diagnostic criteria, based on no historical background, lack clinical validity in terms of symptom definition and duration (1 month>). On the other hand, in the ICD-10, a diagnostic category of acute transient psychotic disorder was based on the traditional "acute psychosis" concept that has been bred in the European Psychiatry. Among the acute transient psychotic disorders, acute polymorphic psychotic disorder is the diagnostic category made according to traditional concept of "bouffées délirantes" and cycloid psychosis. It is a clinically useful diagnostic category, because it could predict favorable episode outcome, if a person with fairly good premorbid social adaptation presents acute onset of polymorphic psychotic symptoms. One of the most prominent points of the revision of DSM-IV-TR to DSM-5 is the adoption of dimensional approach evaluation (diagnosis) in a disorder-crossing fashion. In addition to insomnia, depressive mood and anxiety, symptomatic domain such as acute onset, bipolarity, polymorphism of psychotic symptoms, and furthermore such domain as premorbid social adaptation, life event and episode outcome should be evaluated in the course of treatment, contributing to the clinical practice of the patients with acute psychosis. PMID:22352007

  12. A case of acute psychosis due to vitamin b12 deficiency

    Sayın, Selim; Arslan, Erol; Demirbaş, Şeref; ESER, Mithat; Kenan SAĞLAM

    2014-01-01

    Patients with vitamin B12 deficiency may present with hematologic, neuropsychiatric and cardiovascular symptoms. A clinical Picture of acute psychosis can be seen in rare cases and if not corrected, vitamin B12 deficiency can lead to permanent demage. Acute psychosis and symptoms of anemia with sixty-year-old male patient was evaluated and found that vitamin B12 deficiency due to the terminal ileitis. The patient was healed without permanent damage with replacement therapy.The diagnosis and t...

  13. A case of ciprofloxacin-induced acute polymorphic psychosis with a distinct deficit of the executive functions

    Grimm, Dr. Oliver; Alm, Dr. Barbara

    2005-01-01

    We present the case of a 45-year-old female patient who developed an acute polymorphic psychosis after treatment with the antibiotic ciprofloxacin. The patient showed a distinct neuropsychological deficit of the executive function. Comparing the psychopharmacological features of ketamine and ciprofloxacine we hypothesize that ciprofloxacine leads to psychosis similar to a ketamine induced psychosis. Our case report is unique not only because fluorquinolone induced psychosis has a very low ...

  14. Acute psychosis in children: do not miss immune-mediated causes.

    AlHakeem, Afnan S; Mekki, Mohamed S; AlShahwan, Saad M; Tabarki, Brahim M

    2016-07-01

    New-onset psychosis in children represents a complex presenting symptom. Psychosis can be attributable to a combination of factors and etiologies, and all possible causes must be systematically examined. There is growing evidence that a proportion of psychosis/ psychiatric manifestations in children may be immunemediated, and physicians should consider this etiology in each presentation of first-episode psychosis. Immunemediated encephalopathies/encephalitis are increasingly being recognized in children with antibodies to N-methyl-D-aspartate receptor, Leucine-rich gliomainactivated 1 or other central nervous system antigens such as Contactin-associated protein-like 2, glutamic acid decarboxylase, alpha-amino-3-hydroxy-5-methyl-4isoxazolepropionic acid or Gamma-aminobutyric acid B. In this study, we describe 3 cases of immune-mediated encephalopathy/encephalitis with prominent psychiatric symptoms at presentation, and suggest a practical diagnostic and treatment approach for children with acute psychosis of an immune-mediated cause. PMID:27356658

  15. [Language regression to the mother tongue in polyglot patients with acute psychosis].

    Heinemann, F; Assion, H J

    1996-07-01

    Three bilingual patients with schizophrenia are presented, who spoke almost exclusively in their native language during acute episodes of psychosis. Normal use of the foreign language, German, was again possible after remission of the acute symptoms. This phenomenon of regression is similar to speech disorders in patients with aphasia and is discussed with reference to recent biological findings. PMID:8927199

  16. Acute Psychosis Associated with Subcortical Stroke: Comparison between Basal Ganglia and Mid-Brain Lesions

    Aaron McMurtray; Ben Tseng; Natalie Diaz; Julia Chung; Bijal Mehta; Erin Saito

    2014-01-01

    Acute onset of psychosis in an older or elderly individual without history of previous psychiatric disorders should prompt a thorough workup for neurologic causes of psychiatric symptoms. This report compares and contrasts clinical features of new onset of psychotic symptoms between two patients, one with an acute basal ganglia hemorrhagic stroke and another with an acute mid-brain ischemic stroke. Delusions and hallucinations due to basal ganglia lesions are theorized to develop as a result ...

  17. Being in a process of transition to psychosis, as narrated by adults with psychotic illnesses acutely admitted to hospital

    Sebergsen, K; Norberg, A; Talseth, A-G

    2014-01-01

    Accessible summary Early intervention to prevent and reduce new episodes of psychosis involves patients, relatives and mental health personnel recognizing the early signs of psychosis. Twelve participants with psychotic illnesses narrated how they experienced becoming psychotic before they were admitted to acute psychiatric wards. The results of this study demonstrate that participants and their close others who sensed, understood and articulated experienced changes as signs of psychosis esta...

  18. Fronto-limbic novelty processing in acute psychosis: disrupted relationship with memory performance and potential implications for delusions

    Björn H Schott

    2015-06-01

    Full Text Available Recent concepts have highlighted the role of the hippocampus and adjacent medial temporal lobe (MTL in positive symptoms like delusions in schizophrenia. In healthy individuals, the MTL is critically involved in the detection and encoding of novel information. Here, we aimed to investigate whether dysfunctional novelty processing by the MTL might constitute a potential neural mechanism contributing to the pathophysiology of delusions, using functional magnetic resonance imaging (fMRI in 16 unmedicated patients with paranoid schizophrenia and 20 age-matched healthy controls. All patients experienced positive symptoms at time of participation. Participants performed a visual target detection task with complex scene stimuli in which novel and familiar rare stimuli were presented randomly intermixed with a standard and a target picture. Presentation of novel relative to familiar images was associated with hippocampal activation in both patients and healthy controls, but only healthy controls showed a positive relationship between novelty-related hippocampal activation and recognition memory performance after 24 hours. Patients, but not controls, showed a robust neural response in the orbitofrontal cortex (OFC during presentation of novel stimuli. Functional connectivity analysis in the patients further revealed a novelty-related increase of functional connectivity of both the hippocampus and the OFC with the rostral anterior cingulate cortex (rACC and the ventral striatum. Notably, delusions correlated positively with the difference of the functional connectivity of the hippocampus versus the OFC with the rACC. Taken together, our results suggest that alterations of fronto-limbic novelty processing may contribute to the pathophysiology of delusions in patients with acute psychosis.

  19. Paranoid personality disorder

    ... Names Personality disorder - paranoid References American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. ...

  20. Short-Term Diagnostic Stability of Acute Psychosis: Data from a Tertiary Care Psychiatric Center in South India

    Narayanaswamy, Janardhanan C.; Virupaksha Harave Shanmugam; Dhanya Raveendranathan; Biju Viswanath; Kesavan Muralidharan

    2012-01-01

    Context: Studies on acute psychosis in patients from India report good outcome. A small proportion of these patients may suffer relapses or other develop major psychiatric disorders later. Aim: The aim of this study was to examine the diagnostic stability of acute psychosis in patients from India. Materials and Methods: The records of patients who presented with the first episode of acute and transient psychotic disorder (n=57) over 1 year (2004) were analyzed, and the follow-up data at the e...

  1. Diagnostic Validity of the Eppendorf Schizophrenia Inventory (ESI): A Self-Report Screen for Ultrahigh Risk and Acute Psychosis

    Niessen, Maurice A. J.; Dingemans, Peter M. A. J.; van de Fliert, Reinaud; Becker, Hiske E.; Nieman, Dorien H.; Linszen, Don

    2010-01-01

    Providers of mental health services need tools to screen for acute psychosis and ultrahigh risk (UHR) for transition to psychosis in help-seeking individuals. In this study, the Eppendorf Schizophrenia Inventory (ESI) was examined as a screening tool and for its ability to correctly predict diagnostic group membership (e.g., help seeking, mild…

  2. Diagnostic Validity of the Eppendorf Schizophrenia Inventory (ESI): A Self-Report Screen for Ultrahigh Risk and Acute Psychosis

    M.A.J. Niessen; P.M.A.J. Dingemans; R. van de Fliert; H.E. Becker; D.H. Nieman; D. Linszen

    2010-01-01

    Providers of mental health services need tools to screen for acute psychosis and ultrahigh risk (UHR) for transition to psychosis in help-seeking individuals. In this study, the Eppendorf Schizophrenia Inventory (ESI) was examined as a screening tool and for its ability to correctly predict diagnost

  3. Acute psychosis as an initial manifestation of hypothyroidism: a case report

    Ueno, Shinichi; Tsuboi, Satoko; Fujimaki, Motoki; Eguchi, Hiroto; Machida, Yutaka; Hattori, Nobutaka; Miwa, Hideto

    2015-01-01

    Introduction Hypothyroidism is one of the most important causes of treatable dementia, and psychosis occasionally associated with it is known as myxedema madness. We report a case of a 90-year-old patient who developed myxedema madness acutely without overt clinical symptoms and signs suggestive of hypothyroidism. Case presentation A 90-year-old Japanese man, a general practitioner, was admitted to our emergency room because of acute-onset lethargy, delusions, and hallucinations. He had been ...

  4. Levetiracetam induced acute reversible psychosis in a patient with uncontrolled seizures

    Nithin Kumar; H S Swaroop; Ananya Chakraborty; Suhas Chandran

    2014-01-01

    Levetiracetam (LEV) is a relatively newer antiepileptic drug with novel mechanism of action. It was introduced to the market in the year 2000. Pre-marketing clinical trials of the drug reported good tolerability with a wide safety margin. On post-marketing updates, there are few reports of psychosis after treatment with the drug. Here, we report a case of 52-year-old epileptic man who developed acute, reversible psychosis within 3 days of initiation of treatment. The drug was prescribed at a ...

  5. Markers of thrombogenesis are activated in unmedicated patients with acute psychosis: a matched case control study

    Hosák Ladislav

    2011-01-01

    Full Text Available Abstract Background Antipsychotic treatment has been repeatedly found to be associated with an increased risk for venous thromboembolism in schizophrenia. The extent to which the propensity for venous thromboembolism is linked to antipsychotic medication alone or psychosis itself is unclear. The objective of this study was to determine whether markers of thrombogenesis are increased in psychotic patients who have not yet been treated with antipsychotic medication. Methods We investigated the plasma levels of markers indicating activation of coagulation (D-dimers and Factor VIII and platelets (soluble P-selectin, sP-selectin in an antipsychotic-naive group of fourteen men and eleven women with acute psychosis (age 29.1 ± 8.3 years, body mass index 23.6 ± 4.7, and twenty-five healthy volunteers were matched for age, gender and body mass index. Results D-dimers (median 0.38 versus 0.19 mg/l, mean 1.12 ± 2.38 versus 0.28 ± 0.3 mg/l; P = 0.003 and sP-selectin (median 204.1 versus 112.4 ng/ml, mean 209.9 ± 124 versus 124.1 ± 32; P = 0.0005 plasma levels were significantly increased in the group of patients with acute psychosis as compared with healthy volunteers. We found a trend (median 148% versus 110%, mean 160 ± 72.5 versus 123 ± 62.5; P = 0.062 of increased plasma levels of factor VIII in psychotic patients as compared with healthy volunteers. Conclusions The results suggest that at least a part of venous thromboembolic events in patients with acute psychosis may be induced by pathogenic mechanisms related to psychosis rather than by antipsychotic treatment. Finding an exact cause for venous thromboembolism in psychotic patients is necessary for its effective treatment and prevention.

  6. Duration of Untreated Psychosis Is Associated with More Negative Schizophrenia Symptoms after Acute Treatment for First-Episode Psychosis

    Grano, Niklas; Lindsberg, Jenni; Karjalainen, Marjaana; Gronroos, Peter; Blomberg, Ari-Pekka

    2010-01-01

    Evidence of association between duration of untreated psychosis (DUP) and negative symptoms of schizophrenia in first-episode psychosis (FEP) patients is inconsistent in the recent literature. In the present study, DUP, schizophrenia symptoms, duration of medication, and diagnosis were obtained from hospital archives in a sample of FEP patients.…

  7. Voriconazole-induced psychosis in a case of acute myeloid leukemia with febrile neutropenia

    Hemendra Singh; Nalini Kilara; Vyjayanthi Subramaniyan; Murali Thyloth

    2015-01-01

    Voriconazole-induced psychosis is a rare side effect. It is important that clinicians are made aware of voriconazole-induced potential psychosis. We report a case of voriconazole-induced psychosis that responded to haloperidol.

  8. Voriconazole-induced psychosis in a case of acute myeloid leukemia with febrile neutropenia

    Hemendra Singh

    2015-01-01

    Full Text Available Voriconazole-induced psychosis is a rare side effect. It is important that clinicians are made aware of voriconazole-induced potential psychosis. We report a case of voriconazole-induced psychosis that responded to haloperidol.

  9. Treatment of Acute Excited Psychosis with Intramuscular Haloperidol

    Finnegan, Paul; Buckingham, Robert

    1980-01-01

    Haloperidol (Haldol) is useful in the management of acutely psychotic patients who present with excited behavior which threatens their safety and the safety of others. The use of haloperidol allows rapid control of psychotic behavior with minimal risk of hypotension and avoidance of the excessive sedation associated with other antipsychotics. This article summarizes the rationale, indications, goals and treatment techniques of rapid treatment with intramuscular haloperidol. Major side effects...

  10. Acute and transient psychosis in old age and the subsequent risk of dementia: a nationwide register-based study

    Kørner, Alex; Lopez, Ana Garcia; Lauritzen, Lise;

    2009-01-01

    AIM: Using the unique Danish psychiatric and somatic health registers, we investigated the rate of subsequent dementia in patients with late-onset acute and transient psychosis. METHODS: By linkage of the psychiatric and the somatic nationwide registers of all patients with in- or outpatient...... hospital contact in Denmark, we included all patients with a first ever contact during the period 1 January 1994 to 31 December 2001 with one of the main index diagnoses: late-onset acute and transient psychosis or osteoarthritis. Data on the general population were also included. The first diagnosis of...... between a subsequent diagnosis of dementia and the index diagnosis, age and calendar time. Overall, the rate ratio for developing dementia in late-onset acute and transient psychosis compared to osteoarthritis patients was 10.86 (95% confidence intervals, 8.42 and 14.00, respectively), however, the...

  11. HYSTERICAL PSYCHOSIS

    Kuruvilla, K.; N Sitalakshmi

    1982-01-01

    SUMMARY Clinical features of 88 patients diagnosed as having hysterical psychosis are analysed and compared with those of an equal number of catatoaic schizophrenics and conversion reaction. Hysterical psychosis is characterised by acute onset. often following the occurence of an emotionally disturbing event, absence of any characteristic thought disturbance, and emotio.ial volatility. Prognosis is good. Even though physical methods of treatment like drugs and E.G.T. had to be used in many pa...

  12. Acute Psychosis Associated with Subcortical Stroke: Comparison between Basal Ganglia and Mid-Brain Lesions

    Aaron McMurtray

    2014-01-01

    Full Text Available Acute onset of psychosis in an older or elderly individual without history of previous psychiatric disorders should prompt a thorough workup for neurologic causes of psychiatric symptoms. This report compares and contrasts clinical features of new onset of psychotic symptoms between two patients, one with an acute basal ganglia hemorrhagic stroke and another with an acute mid-brain ischemic stroke. Delusions and hallucinations due to basal ganglia lesions are theorized to develop as a result of frontal lobe dysfunction causing impairment of reality checking pathways in the brain, while visual hallucinations due to mid-brain lesions are theorized to develop due to dysregulation of inhibitory control of the ponto-geniculate-occipital system. Psychotic symptoms occurring due to stroke demonstrate varied clinical characteristics that depend on the location of the stroke within the brain. Treatment with antipsychotic medications may provide symptomatic relief.

  13. Anti-N-methyl-D-aspartate receptor encephalitis presenting with acute psychosis in a preteenage girl: a case report

    Maggina Paraskevi

    2012-07-01

    Full Text Available Abstract Introduction Anti-N-methyl-D-aspartate receptor (anti-NMDAR encephalitis is a rare, newly defined autoimmune clinical entity that presents with atypical clinical manifestations. Most patients with anti-N-methyl-D-aspartate receptor encephalitis develop a progressive illness from psychosis into a state of unresponsiveness, with catatonic features often associated with abnormal movements and autonomic instability. This is the first report of anti-N-methyl-D-aspartate receptor encephalitis in a Greek pediatric hospital. Case presentation An 11-year-old Greek girl presented with clinical manifestations of acute psychosis. The differential diagnosis included viral encephalitis. The presence of a tumor usually an ovarian teratoma, a common clinical finding in many patients, was excluded. Early diagnosis and prompt immunotherapy resulted in full recovery up to one year after the initial diagnosis. Conclusion Acute psychosis is a rare psychiatric presentation in children, diagnosed only after possible organic syndromes that mimic acute psychosis are excluded, including anti-N-methyl-D-aspartate receptor receptor encephalitis. Pediatricians, neurologists and psychiatrists should consider this rare clinical syndrome, in order to make an early diagnosis and instigate appropriate treatment to maximize neurological recovery.

  14. Does amantadine induce acute psychosis? A case report and literature review

    Xu, Wei-juan; Wei, Ning; Xu, Yi; Hu, Shao-hua

    2016-01-01

    Background Over-the-counter cold medicines, which contain amantadine, are widely used in the People’s Republic of China. Clinicians are familiar with the psychosis caused by long-term treatment with amantadine, especially in elderly patients; however, early-onset psychotic complications among healthy young individuals have rarely been reported. Case presentation This article reports the case of a 28-year-old patient who presented with hallucination–delusion syndrome soon after treatment with cold medicine containing amantadine hydrochloride and acetaminophen. The symptoms resolved completely after a 2-week course of paliperidone treatment. Conclusion Clinicians should be sensitive to the acute psychotic complications induced by an interaction between amantadine and acetaminophen. PMID:27103808

  15. Spinocerebellar ataxia-10 with paranoid schizophrenia

    Bhavesh Trikamji

    2015-01-01

    Full Text Available Spino-cerebellar ataxia type 10 (SCA10 is an autosomal dominant disorder that is characterized by cerebellar ataxia, seizures and nystagmus with a fragmented pursuit. Schizophrenia has been reported with SCAs 1 and 2 yet in SCA 10, psychiatric manifestations are uncommon. We report a Hispanic family involving a father and his four children with SCA10 genetic mutation. Two of his children, a 20-year-old female and a 23-year-old male, presented with gradually progressive spino-cerebellar ataxia and paranoid schizophrenia. Neurological examination revealed ocular dysmetria, dysdiadokinesia, impaired finger-to-nose exam, gait ataxia and hyperreflexia in both the cases. Additionally, they had a history of psychosis with destructive behavior, depression and paranoid delusions with auditory hallucinations. Serology and CSF studies were unremarkable and MRI brain revealed cerebellar volume loss. Ultimately, a test for ATAXIN-10 mutation was positive thus confirming the diagnosis of SCA10 in father and his four children. We now endeavor to investigate the association between schizophrenia and SCA10.

  16. Attributional style in fist episode of schizophrenia and schizophrenia spectrum disorders with and without paranoid ideation.

    Zaytseva, Yulia; Burova, Vitalina; Garakh, Zanna; Gurovich, Isaac Ya

    2013-09-01

    In the present study we evaluated attributional style which refers to how individuals explain the causes for positive and negative events in their lives in patients with first episode of schizophrenia with and without paranoid ideation. 43 patients with first episode of psychosis and 37 matched normal controls completed Ambiguous Intentions Hostility Questionnaire (AIHQ) (Combs et al. 2007). Between group comparison of AIHQ scores showed a notable tendency to show aggressive response in overall patients group. We obtained significant elevation of hostility and blame biases scores in intentional and accidental situations in patients with paranoid ideation while the patients with non-paranoid ideation showed greater hostility and blame biases only in accidental situations as compared to controls. Correlations with positive and negative symptoms were obtained. Our findings suggest that patients with first episode of psychosis exhibit difficulties of the attribution biases which are interconnected with symptoms and thus indicate a trait-deficit of attributional style. PMID:23995202

  17. The serum level of C-reactive protein (CRP) is associated with cognitive performance in acute phase psychosis

    Johnsen, Erik; Fathian, Farivar; Kroken, Rune A.; Vidar M Steen; Jørgensen, Hugo A; Gjestad, Rolf; Løberg, Else-Marie

    2016-01-01

    Background Inflammatory processes have been implicated in the etiology of schizophrenia and related psychoses, in which cognitive deficits represent core symptoms. The aim of the present study was to investigate possible associations between the level of the inflammation marker C-reactive protein (CRP) and cognitive performance in patients through the acute phase of psychosis. Methods A total of 124 patients were assessed at admittance to hospital and 62 patients were retested at discharge or...

  18. Cognitive changes in patients with acute phase psychosis - Effects of illicit drug use

    Helle, Siri; Gjestad, Rolf; Johnsen, Erik; Kroken, Rune; Jørgensen, Hugo A; Løberg, Else-Marie

    2014-01-01

    Illicit drug use may influence cognition in non-affective psychosis. Previous studies have shown better cognition in psychosis with illicit drug use as compared to psychosis only. Possibly, illicit drug using patients have more transient drug-related cognitive deficits. Thus, the aim of the present study was to examine cognitive change the first weeks after admission to a psychiatric emergency ward, expecting more cognitive improvement at follow-up in the illicit drug group as compared to psy...

  19. Amphetamine-induced psychosis - a separate diagnostic entity or primary psychosis triggered in the vulnerable?

    Bramness Jørgen G; Gundersen Øystein; Guterstam Joar; Rognli Eline; Konstenius Maija; Løberg Else-Marie; Medhus Sigrid; Tanum Lars; Franck Johan

    2012-01-01

    Abstract Use of amphetamine and methamphetamine is widespread in the general population and common among patients with psychiatric disorders. Amphetamines may induce symptoms of psychosis very similar to those of acute schizophrenia spectrum psychosis. This has been an argument for using amphetamine-induced psychosis as a model for primary psychotic disorders. To distinguish the two types of psychosis on the basis of acute symptoms is difficult. However, acute psychosis induced by amphetamine...

  20. Amphetamine-induced psychosis - a separate diagnostic entity or primary psychosis triggered in the vulnerable?

    Jørgen G. Bramness; Gundersen, Øystein H.; Guterstam, Joar; Rognli, Eline B.; Konstenius, Maija; Løberg, Else-Marie; Medhus, Sigrid; Tanum, Lars; Franck, Johan

    2012-01-01

    Use of amphetamine and methamphetamine is widespread in the general population and common among patients with psychiatric disorders. Amphetamines may induce symptoms of psychosis very similar to those of acute schizophrenia spectrum psychosis. This has been an argument for using amphetamine-induced psychosis as a model for primary psychotic disorders. To distinguish the two types of psychosis on the basis of acute symptoms is difficult. However, acute psychosis induced by amphetamines seems t...

  1. Exploring psychotic symptoms: a comparison of motor related neuronal activation during and after acute psychosis

    Sheridan Rains Luke

    2012-08-01

    Full Text Available Abstract Background Delusions and hallucinations are classic positive symptoms of schizophrenia. A contemporary cognitive theory called the ‘forward output model’ suggests that the misattribution of self-generated actions may underlie some of these types of symptoms, such as delusions of control – the experience of self-generated action being controlled by an external agency. In order to examine the validity of this suggestion, we performed a longitudinal functional magnetic resonance imaging (fMRI study examining neuronal activation associated with motor movement during acute psychosis. Methods We studied brain activation using fMRI during a motor task in 11 patients with schizophrenia and 9 healthy controls. The patient group was tested at two time points separated by 6–8 weeks. Results At initial testing, the patient group had a mean Positive and Negative Syndrome Scale score of 56.3, and showed significantly increased activation within the left inferior parietal lobe (IPL compared to controls. Patients reported significantly decreased positive symptoms at 6–8 week followup and IPL activation had returned to normal. Our results demonstrate that first-rank positive symptoms are associated with hyperactivation in the secondary somatosensory cortex (IPL. Conclusions These findings lend further credence to the theory that a dysfunction in the sensory feedback system located in the IPL, and which is thought to underlie our sense of agency, may contribute to the aetiology of delusions of control.

  2. Does amantadine induce acute psychosis? A case report and literature review

    Xu WJ

    2016-04-01

    Full Text Available Wei-juan Xu,1,2 Ning Wei,1,2 Yi Xu,1,2 Shao-hua Hu1,2 1Department of Psychiatry, The First Affiliated Hospital of Zhejiang University School of Medicine, 2The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Hangzhou, People’s Republic of China Background: Over-the-counter cold medicines, which contain amantadine, are widely used in the People’s Republic of China. Clinicians are familiar with the psychosis caused by long-term treatment with amantadine, especially in elderly patients; however, early-onset psychotic complications among healthy young individuals have rarely been reported. Case presentation: This article reports the case of a 28-year-old patient who presented with hallucination–delusion syndrome soon after treatment with cold medicine containing amantadine hydrochloride and acetaminophen. The symptoms resolved completely after a 2-week course of paliperidone treatment. Conclusion: Clinicians should be sensitive to the acute psychotic complications induced by an interaction between amantadine and acetaminophen. Keywords: amantadine, acetaminophen, side effects

  3. Paranoid Ideation and Violence: Meta-analysis of Individual Subject Data of 7 Population Surveys

    Coid, Jeremy W.; Ullrich, Simone; Bebbington, Paul; Fazel, Seena; Keers, Robert

    2016-01-01

    There is controversy whether associations between psychosis and violence are due to coexisting substance misuse and factors increasing risk in nonpsychotic persons. Recent studies in clinical samples have implicated independent effects of paranoid delusions. Research findings suggest that individual psychotic-like-experiences on the psychosis continuum in the general population are associated with violence; it remains unclear whether this association is due to psychiatric comorbidity. We pooled data from 7 UK general population surveys (n = 23 444) and conducted a meta-analysis of individual subject data. Further meta-analyses were performed to identify heterogeneity. Main exposure variables: 5 psychotic-like-experiences and a categorical measure of psychosis. Comorbidity was established through standardized self-report instruments. Information was collected on violence, severity, victims. Paranoid ideation was associated with violence (AOR 2.26, 95% CI 1.75–2.91), severity and frequency, even when controlling for effects of other psychotic-like-experiences. Associations were not explained by comorbid conditions, including substance dependence. Psychotic disorder was associated with violence and injury to the perpetrator but associations were explained by paranoid ideation. Individual associations between hypomania, thought insertion, hallucinations, and violence were nonsignificant after adjustments, and significantly associated only when comorbid with antisocial personality disorder. Strange experiences were only associated with intimate partner violence. Paranoid ideation on a psychosis-continuum in the general population was associated with violence. All other associations were explained by comorbidity. Further investigation should determine whether paranoid ideation among persons in the community require preventive interventions, similar to those presenting to mental health services. Nevertheless, risks are considerably increased for psychotic

  4. Two cases of "cannabis acute psychosis" following the administration of oral cannabis.

    Pin Marie; Buclin Thierry; Appenzeller Monique; Rothuizen Laura E; Augsburger Marc; Ménétrey Annick; Favrat Bernard; Mangin Patrice; Giroud Christian

    2005-01-01

    Abstract Background Cannabis is the most commonly used illegal drug and its therapeutic aspects have a growing interest. Short-term psychotic reactions have been described but not clearly with synthetic oral THC, especially in occasional users. Case presentations We report two cases of healthy subjects who were occasional but regular cannabis users without psychiatric history who developed transient psychotic symptoms (depersonalization, paranoid feelings and derealisation) following oral ad...

  5. Two cases of "cannabis acute psychosis" following the administration of oral cannabis

    Pin Marie

    2005-04-01

    Full Text Available Abstract Background Cannabis is the most commonly used illegal drug and its therapeutic aspects have a growing interest. Short-term psychotic reactions have been described but not clearly with synthetic oral THC, especially in occasional users. Case presentations We report two cases of healthy subjects who were occasional but regular cannabis users without psychiatric history who developed transient psychotic symptoms (depersonalization, paranoid feelings and derealisation following oral administration of cannabis. In contrast to most other case reports where circumstances and blood concentrations are unknown, the two cases reported here happened under experimental conditions with all subjects negative for cannabis, opiates, amphetamines, cocaine, benzodiazepines and alcohol, and therefore the ingested dose, the time-events of effects on behavior and performance as well as the cannabinoid blood levels were documented. Conclusion While the oral route of administration achieves only limited blood concentrations, significant psychotic reactions may occur.

  6. An emerging problem in clinical practice: how to approach acute psychosis

    Sofia Markoula

    2011-12-01

    Full Text Available Limbic encephalitis (LE is rare, presents with memory impairment, seizures and behavioral disorder. We present a 44-year-old female with an agitation-depressive disorder associated with delusions and hallucinations, admitted to our hospital with the diagnosis of psychosis. A computed tomography (CT scan of the brain and lumbar puncture on admission were normal. Because of clinical deterioration and addition of seizures in the clinical picture, further workup with serum and repeat cerebrospinal fluid studies, magnetic resonance imaging (MRI, and electroencephalogram disclosed a lesion in the left medial temporal lobe consistent with LE. The patient was treated symptomatically with antidepressive, antipsychotic and anticonvulsant drugs. Aggressive diagnostic tests for the presence of an occult cancer were negative. An 8-year follow up has not revealed a tumor to support a paraneoplasmatic origin of LE. This case, initially diagnosed and treated as psychosis, is a case of non-paraneoplasmatic, non-infective LE, probably caused by an autoimmune mechanism.

  7. A Rare Case of Mayer-Rokitansky-Kuster-Hauser Syndrome Presenting with Acute Psychosis.

    Nath, Kamal; Boro, Bhanita; Naskar, Subrata

    2016-04-01

    The psychiatric co-morbidities in female population with mullerian agenesis is an area with limited research. This is probably due to the fact that when those patients are diagnosed not much attention or information is given for long term psychiatric follow-up. Owing to their inability to bear children, these subjects often become socially harassed. Thus these constant stressors may lead to development of psychopathology in future. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a congenital abnormality with absence of uterus, cervix and vagina, but normal secondary sexual characteristics and external genitalia and occurs in every 1 out of 4000-10,000 females. There is also limited literature on the probable common chromosomal aetiology for both psychosis and MRKH patients. We, present here a case of MRKH syndrome, whose initial presentation was psychosis only. In this respect, we also highlight the much neglected need of appropriate psychiatric screening and provision of psychiatric care in this population. PMID:27190929

  8. A woman with recurrent acute confusion: a case of cycloid psychosis.

    Bhaskara, S M

    1998-01-01

    A woman 46 years old presented with recurrent, brief, sudden-onset episodes of confusion, aimless motor overactivity and lability of mood, from which she recovered completely. She was admitted on each occasion to a medical unit with a provisional diagnosis of organic mental disorder and thoroughly examined. No organic etiology was identified. This patient meets the criteria for cycloid psychosis. The implications for diagnosis, investigations and management are discussed.

  9. Markers of thrombogenesis are activated in unmedicated patients with acute psychosis: a matched case control study

    Hosák Ladislav; Bažant Jan; Vališ Martin; Andrýs Ctirad; Malý Radovan; Masopust Jiří

    2011-01-01

    Abstract Background Antipsychotic treatment has been repeatedly found to be associated with an increased risk for venous thromboembolism in schizophrenia. The extent to which the propensity for venous thromboembolism is linked to antipsychotic medication alone or psychosis itself is unclear. The objective of this study was to determine whether markers of thrombogenesis are increased in psychotic patients who have not yet been treated with antipsychotic medication. Methods We investigated the ...

  10. Acute Onset of Psychosis in a Patient with a Left Temporal Lobe Arachnoid Cyst

    Alexander Mironov; Sabu John; Jonathan Auerbach; Ghassan Jamaleddine

    2014-01-01

    Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. A 38-year-old Haitian American female with no past psychiatric history presented with rapid onset of psychosis. Workup for medical etiology proved to be within normal limits, with the exception of a left temporal lobe arachnoid cyst. The purpose of this paper is to add to a number of existing case reports that suggest a relationship between such lesions and psychiatric illness.

  11. An emerging problem in clinical practice: how to approach acute psychosis

    Sofia Markoula; Dimitrios Chatzistefanidis; Spyridon Konitsiotis; Kyritsis, Athanassios P.

    2011-01-01

    Limbic encephalitis (LE) is rare, presents with memory impairment, seizures and behavioral disorder. We present a 44-year-old female with an agitation-depressive disorder associated with delusions and hallucinations, admitted to our hospital with the diagnosis of psychosis. A computed tomography (CT) scan of the brain and lumbar puncture on admission were normal. Because of clinical deterioration and addition of seizures in the clinical picture, further workup with serum and repeat cerebrospi...

  12. Acute Onset of Psychosis in a Patient with a Left Temporal Lobe Arachnoid Cyst

    Alexander Mironov

    2014-01-01

    Full Text Available Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. A 38-year-old Haitian American female with no past psychiatric history presented with rapid onset of psychosis. Workup for medical etiology proved to be within normal limits, with the exception of a left temporal lobe arachnoid cyst. The purpose of this paper is to add to a number of existing case reports that suggest a relationship between such lesions and psychiatric illness.

  13. The clock-drawing test as a possible indicator of acute psychosis.

    Tene, Oren; Sigler, Mayanit; Shiloh, Roni; Weizman, Abraham; Aizenberg, Dov

    2016-05-01

    The clock-drawing test (CDT) is used widely to evaluate cognitive disorders, but its role in the assessment of psychotic disorders has not been studied. We sought to examine whether the CDT plays a role as an indicator of psychosis and to establish its sensitivity to clinical improvement of psychosis. The CDT was administered twice to 53 hospitalized patients without dementia but with psychosis: once at admission and again before discharge. The CDT scores were calculated in a random order by two independent senior psychiatrists who were blinded to the patients' status (admission or discharge). The inter-rater reliability was high (0.89 at admission, 0.85 at discharge, Ppsychosis was assessed by the Positive and Negative Syndrome Scale (PANSS). Patients had significantly lower CDT scores at admission than at discharge (2.87±1.39 vs. 3.91±1.08, respectively, Ppsychosis severity, as reflected by the PANSS-positive symptom subscale at admission (R=-0.279, P<0.05). Our findings suggest that the CDT may aid in the assessment of psychotic states and in their clinical monitoring. PMID:26752620

  14. Does amantadine induce acute psychosis? A case report and literature review

    Xu WJ; Wei N; Xu Y; Hu SH

    2016-01-01

    Wei-juan Xu,1,2 Ning Wei,1,2 Yi Xu,1,2 Shao-hua Hu1,2 1Department of Psychiatry, The First Affiliated Hospital of Zhejiang University School of Medicine, 2The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Hangzhou, People’s Republic of China Background: Over-the-counter cold medicines, which contain amantadine, are widely used in the People’s Republic of China. Clinicians are familiar with the psychosis caused by long-term treatment with ...

  15. A study of epilepsy-related psychosis

    Roy A; Rajesh S; Iby N; Jose J; Sarma G

    2003-01-01

    The association of epilepsy and psychosis is studied. Among the 500 patients of epilepsy evaluated, there were 12 patients, 8 males and 4 females with epilepsy-related psychosis. Their average age was 38 years. The interval between the age of onset of epilepsy and psychotic features was 9 years. Complex partial seizures were present in 7 patients and primary generalized tonic-clonic seizure was present in 1 patient. Four patients had post-ictal psychosis, 7 had acute interictal psychosis and ...

  16. Acute psychosis due to non-paraneoplastic anti-NMDA-receptor encephalitis in a teenage girl: Case report.

    Kramina, Sandra; Kevere, Laura; Bezborodovs, Nikita; Purvina, Santa; Rozentals, Guntis; Strautmanis, Jurgis; Viksna, Zane

    2015-12-01

    Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a disease occurring when antibodies produced by the body's own immune system attack NMDA-type glutamate receptors in the brain. Most anti-NMDAR encephalitis cases are associated with paraneoplastic syndrome. We analyze the case of a 15-year-old girl who was hospitalized in a child psychiatry clinic in Riga, Latvia, with de novo acute polymorphic psychotic disorder gradually progressing to a catatonic state. The patient received antipsychotic and electroconvulsive therapy with no beneficial effect. The council of doctors discussed differential diagnoses of schizophrenia-induced catatonia and the autoimmune limbic encephalitis-induced catatonic condition. When the diagnosis of anti-NMDAR autoimmune encephalitis was finally confirmed by repeated immunological assays (specific immunoglobulin [Ig] G and IgM in her blood serum and cerebrospinal fluid), and a paraneoplastic process was ruled out, she was started on immunomodulating therapy (methylprednisolone, Ig, plasmapheresis, rituximab), which changed the course of her disease. On immunomodulating treatment, her physical and mental health have gradually improved to almost complete reconvalescence. Psychiatrists should consider anti-NMDAR encephalitis as a differential diagnosis in first-episode psychosis patients presenting with disorientation, disturbed consciousness, pronounced cognitive deficits, movement disorder, dysautonomia, or rapid deterioration, and test for specific IgG NR1 autoantibodies, even if there are no specific findings on routine neuroimaging, electroencephalography (EEG), or cerebrospinal fluid tests. PMID:26663628

  17. Amphetamine-induced psychosis - a separate diagnostic entity or primary psychosis triggered in the vulnerable?

    Bramness Jørgen G

    2012-12-01

    Full Text Available Abstract Use of amphetamine and methamphetamine is widespread in the general population and common among patients with psychiatric disorders. Amphetamines may induce symptoms of psychosis very similar to those of acute schizophrenia spectrum psychosis. This has been an argument for using amphetamine-induced psychosis as a model for primary psychotic disorders. To distinguish the two types of psychosis on the basis of acute symptoms is difficult. However, acute psychosis induced by amphetamines seems to have a faster recovery and appears to resolve more completely compared to schizophrenic psychosis. The increased vulnerability for acute amphetamine induced psychosis seen among those with schizophrenia, schizotypal personality and, to a certain degree other psychiatric disorders, is also shared by non-psychiatric individuals who previously have experienced amphetamine-induced psychosis. Schizophrenia spectrum disorder and amphetamine-induced psychosis are further linked together by the finding of several susceptibility genes common to both conditions. These genes probably lower the threshold for becoming psychotic and increase the risk for a poorer clinical course of the disease. The complex relationship between amphetamine use and psychosis has received much attention but is still not adequately explored. Our paper reviews the literature in this field and proposes a stress-vulnerability model for understanding the relationship between amphetamine use and psychosis.

  18. Rubinstein-taybi syndrome with psychosis.

    Nayak, Raghavendra B; Lakshmappa, Ambika; Patil, Nanasaheb M; Chate, Sameeran S; Somashekar, Lohit

    2012-04-01

    Rubinstein-Taybi syndrome (RTS) is a rare genetic disorder with characteristic physical anomalies. It is characterized by mental retardation, postnatal growth deficiency, microcephaly, specific facial characteristics, broad thumbs, and big toes. Behavioral problems are common with RTS; they include mental retardation, impulsivity, distractibility, instability of mood, stereotypes, poor coordination, atypical depression, and mania. To date, there is lack of literature on the presence of schizophrenia or non-affective psychosis with RTS. Here, we describe two cases where there is co-morbid psychosis with RTS. One case is diagnosed as paranoid schizophrenia and the other as psychosis possibly schizophrenia. Genetic analysis was not done due to unavailability. The possible etiological factors for the association of psychosis with RTS are discussed. Factors such as regulators of RNA polymerase II and hypoxia-inducible factor 1 alpha (HIF1A) may be some common etiological factors for the association of schizophrenia or non-affective psychosis and RTS. Schizophrenia / non-affective psychosis can be a comorbid psychiatric condition with RTS. PMID:23162199

  19. Rubinstein-Taybi syndrome with psychosis

    Raghavendra B Nayak

    2012-01-01

    Full Text Available Rubinstein-Taybi syndrome (RTS is a rare genetic disorder with characteristic physical anomalies. It is characterized by mental retardation, postnatal growth deficiency, microcephaly, specific facial characteristics, broad thumbs, and big toes. Behavioral problems are common with RTS; they include mental retardation, impulsivity, distractibility, instability of mood, stereotypes, poor coordination, atypical depression, and mania. To date, there is lack of literature on the presence of schizophrenia or non-affective psychosis with RTS. Here, we describe two cases where there is co-morbid psychosis with RTS. One case is diagnosed as paranoid schizophrenia and the other as psychosis possibly schizophrenia. Genetic analysis was not done due to unavailability. The possible etiological factors for the association of psychosis with RTS are discussed. Factors such as regulators of RNA polymerase II and hypoxia-inducible factor 1 alpha (HIF1A may be some common etiological factors for the association of schizophrenia or non-affective psychosis and RTS. Schizophrenia / non-affective psychosis can be a comorbid psychiatric condition with RTS.

  20. Abnormal plasma levels of serine, methionine, and taurine in transient acute polymorphic psychosis

    D. Fekkes (Durk)

    1994-01-01

    textabstractThe present study explored the usefulness of plasma amino acid concentrations in discriminating a subgroup of patients with transient acute polymorphic psychoses characterized by psychosensory symptoms (APP+ patients). Levels of amino acids in the plasma of APP+ patients were compared wi

  1. Acute psychosis followed by fever: Malignant neuroleptic syndrome or viral encephalitis?

    Stojanović Zvezdana

    2014-01-01

    Full Text Available Introduction. Neuroleptic malignant syndrome is rare, but potentially fatal idiosyncratic reaction to antipsychotic medications. It is sometimes difficult to diagnose some clinical cases as neuroleptic malignant syndrome and differentiate it from the acute viral encephalitis. Case report. We reported a patient diagnosed with acute psychotic reaction which appeared for the first time. The treatment started with typical antipsychotic, which led to febrility. The clinical presentation of the patient was characterised by the signs and symptoms that might have indicated the neuroleptic malignant syndrome as well as central nervous system viral disease. In order to make a detailed diagnosis additional procedures were performed: electroencephalogram, magnetic resonance imaging of the head, lumbar puncture and a serological test of the cerebrospinal fluid. Considering that after the tests viral encephalitis was ruled out and the diagnosis of neuroleptic malignant syndrome made, antipsychotic therapy was immediately stopped. The patient was initially treated with symptomatic therapy and after that with atypical antipsychotic and electroconvulsive therapy, which led to complete recovery. Conclusion. We present the difficulties of early diagnosis at the first episode of acute psychotic disorder associated with acute febrile condition. Concerning the differential diagnosis it is necessary to consider both neuroleptic malignant syndrome and viral encephalitis, i.e. it is necessary to make the neuroradiological diagnosis and conduct cerebrospinal fluid analysis and blood test. In neuroleptic malignant syndrome treatment a combined use of electroconvulsive therapy and low doses of atypical antipsychotic are confirmed to be successful.

  2. Cognitive Restructuring and Graded Behavioural Exposure for Delusional Appraisals of Auditory Hallucinations and Comorbid Anxiety in Paranoid Schizophrenia

    Pawel D. Mankiewicz

    2014-01-01

    Full Text Available The prevalence of diagnostic comorbidity between psychosis and anxiety disorders has been found to be considerable. Cognitive models of psychosis suggest that anxiety does not arise directly from positive symptoms of schizophrenia but rather from an individual interpretation of such experiences. In the United Kingdom, cognitive-behavioural therapy for psychosis (CBTp has been recommended within clinical guidelines as a psychological treatment of choice for those diagnosed with schizophrenia. However, despite empirical evidence supporting CBTp, the treatment provision remains infrequent and not routinely available. This case describes a successful implementation of CBTp. Sixteen sessions were delivered to a 40-year-old male with diagnoses of paranoid schizophrenia and comorbid anxiety, focusing primarily on cognitive restructuring of paranoid appraisals of auditory hallucinations and behavioural experiments employed progressively via graded exposure to anxiety-inducing stimuli. Standardised measurements, behavioural frequency sampling, and subjective data indicated a considerable reduction in both paranoia and anxiety. Also, the client’s psychosocial functioning improved substantially. This report indicates that the treatment may help those with experiences of psychosis and comorbid anxiety reach a significant improvement in their quality of life and offers an encouraging and innovative perspective on direct engagement with the content of paranoia and voices at the onset of therapy.

  3. Making sense of first episode psychosis.

    Billings, J

    2005-01-01

    This paper addresses whether the concept of illness perceptions, which has been developed in the arena of chronic physical illness, can be applied to an acute mental illness such as first episode psychosis. Literature related to first episode psychosis and illness perceptions is reviewed and the potential benefits and problems of using the illness perceptions framework when trying to understand how people make sense of a first episode of psychosis are discussed. Finally, areas warranting expl...

  4. Postpartum Psychosis

    ... with PSI Learn More Pregnancy & Postpartum Mental Health Depression During Pregnancy & Postpartum Anxiety During Pregnancy & Postpartum Pregnancy or Postpartum Obsessive Symptoms Postpartum Post-Traumatic Stress Disorder Bipolar Mood Disorders Postpartum Psychosis Tools for ...

  5. Steroid-induced acute psychosis in a child with asthma: report of one case.

    Lee, K M; Lin, Y Z; Huang, F Y

    2001-01-01

    A 5-year-old girl was admitted due to severe asthmatic attack. She was treated with methylprednisolone (40 mg i.v. q6h), aminophylline (loading with 5 mg/kg and maintained with 0.6 mg/kg/hr i.v. drip), nebulized terbutaline sulphate (5 mg q6h), oral procaterol 12.5 micrograms bid, along with oxygen therapy. Acute psychotic reaction with visual hallucination, delusion, panic reaction and myoclonic movement of hands developed on day 3 of admission. The patient had no previous history of psychiatric problems. The theophylline level was 9.89 micrograms/ml at the moment of psychotic reaction. After the dose of methylprednisolone was reduced from 40 mg to 20 mg i.v. q6h and shifted to other anti-asthma treatment by procaterol metered dose inhaler via spacer, the psychotic reaction disappeared a few hours later. The psychotic reaction was thought to be due to steroid therapy since no other causes could explain the psychotic reaction. PMID:11431864

  6. Psychoanalytic approach to psychosis : structure, logic, clinical, ethical

    Sakellariou, Dimitris Petros

    2011-01-01

    For Freud and Lacan psychosis is not a deficiency. Nowadays, Schreber’s text still remains an unequalled paradigmatic treatise. For Freud, paranoid delirium is an attempt at recovery, and for Lacan it is an attempt to analyze severe logic. The thorny question of psychotic transference still remains. Freud does not believe that a psychotic patient is capable of analytical transference. Lacan thinks that at the beginning, the transference is likely to provoke a trigged of, furthermore the psych...

  7. Psychosis and enuresis during disulfiram therapy

    Sherif, P.A.; Murthy, K. Krishna

    2006-01-01

    Disulfiram is the drug that is commonly prescribed for the treatment of alcohol dependence syndrome, and transient functional psychosis has been reported as one of its side-effects. Enuresis is another rare adverse effect reported. This report discusses a case of acute psychosis and enuresis in a patient on disulfiram who had ingested alcohol.

  8. Do emotions drive psychosis?

    João G. Ribeiro

    2012-12-01

    Full Text Available Introduction: How important is the emotional life of persons who manifest psychotic symptoms? Aims: The aim of this paper is to review evidence on a causal role for emotions in psychotic processes. Methods: Selective review of literature on affective symptoms in psychoses, on emotions in the production of psychotic symptoms and on dopaminergic models of psychosis. Results: Affective symptoms are relevant across psychoses. Persons with schizophrenia have high levels of emotional reactivity and the intensification of negative affects not only is associated with but also precedes the intensification of psychotic symptoms, which is evidence that negative emotions drive the course of psychotic symptoms. Negative self‑representations are central in psychotic processes and can be the link between negative emotions and psychosis. Evidence favours the notion that persecutory delusions are consistent with negative affects and self‑representations, while grandiose delusions are consistent with a defensive amplification of positive affects and self‑representations. Shame has been proposed as the core emotional experience of psychosis, one in which the self becomes vulnerable to the external world, which is consistent with persecutory experiences. Assaults on the self, under the form of hostility in the family environment and society, are strong predictors of relapse and development of schizophrenia. Assaults on the self which induce social defeat are also strong stimulants of mesolimbic dopaminergic pathways, whose hyperactivity is associated with acute psychotic episodes and the experience of “aberrant salience”, put forward as a dopaminergic model of psychosis. Conclusions: The “defeat of the self” emerges as a central link that binds the experience of negative emotions to the expression of psychotic symptoms and its psychological and neurobiological correlates. The hypothesis gains support that the emotions related to that defeat control

  9. Do emotions drive psychosis?

    João Guilherme Ribeiro

    2013-11-01

    Full Text Available Introduction: How important is the emotional life of persons who manifest psychotic symptoms? Aims: The aim of this paper is to review evidence on a causal role for emotions in psychotic processes. Methods: Selective review of literature on affective symptoms in psychoses, on emotions in the production of psychotic symptoms and on dopaminergic models of psychosis. Results: Affective symptoms are relevant across psychoses. Persons with schizophrenia have high levels of emotional reactivity and the intensification of negative affects not only is associated with but also precedes the intensification of psychotic symptoms, which is evidence that negative emotions drive the course of psychotic symptoms. Negative self‑representations are central in psychotic processes and can be the link between negative emotions and psychosis. Evidence favours the notion that persecutory delusions are consistent with negative affects and self‑representations, while grandiose delusions are consistent with a defensive amplification of positive affects and self‑representations. Shame has been proposed as the core emotional experience of psychosis, one in which the self becomes vulnerable to the external world, which is consistent with persecutory experiences. Assaults on the self, under the form of hostility in the family environment and society, are strong predictors of relapse and development of schizophrenia. Assaults on the self which induce social defeat are also strong stimulants of mesolimbic dopaminergic pathways, whose hyperactivity is associated with acute psychotic episodes and the experience of “aberrant salience”, put forward as a dopaminergic model of psychosis. Conclusions: The “defeat of the self” emerges as a central link that binds the experience of negative emotions to the expression of psychotic symptoms and its psychological and neurobiological correlates. The hypothesis gains support that the emotions related to that defeat control

  10. Anti-N-methyl-D-aspartate receptor encephalitis presenting with acute psychosis in a preteenage girl: a case report

    Maggina Paraskevi; Mavrikou Mersini; Karagianni Stavroula; Skevaki Chrysanthi L; Triantafyllidou Antigoni; Voudris Constantinos; Katsarou Eustathia; Stamogiannou Lela; Mastroyianni Sotiria

    2012-01-01

    Abstract Introduction Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare, newly defined autoimmune clinical entity that presents with atypical clinical manifestations. Most patients with anti-N-methyl-D-aspartate receptor encephalitis develop a progressive illness from psychosis into a state of unresponsiveness, with catatonic features often associated with abnormal movements and autonomic instability. This is the first report of anti-N-methyl-D-aspartate receptor encephal...

  11. Postpartum Psychosis

    Özgür Erdem

    2014-03-01

    Full Text Available Postpartum psychosis is the one of the most severe psychiatric disorder that can be seen during postpartum period. It can be seen between 0.1-0.2 % ratios at postpartum period. It is generally seen in the first two weeks after delivery but in almost 80% of the cases can also be seen until the end of the first month. Risk increases for those who have a positive family history of psychiatric disorder. It is seen more often in primipars, young and those who have psychological disorder history before delivery. Abrupt decrease of serum concentrations of estrogen and progesterone after delivery is suggested in its etiology. Early symptoms of postpartum psychosis may be insomnia and fatigue. The patient may give harm to her baby or herself if develops psychotic features including delusions or hallucinations. Suicidal ideas and suicide attempts may be more prominent than they occur in postpartum depression. It should be treated immediately and effectively due to suicide or homicide risks. If it can not be treated with antipsychotic drugs then electroconvulsive therapy (EKT can be an alternative treatment option. Ninety-five percent of the treated patients with postpartum psychosis recover usually in 2-3 months period. Health workers practicing in first step can play important roles in detection and early management of patients with postpartum psychosis.

  12. Acute psychosis in the course of treatment of acute adrenal crisis with hydrocortisone in the patient with secondary adrenal insufficiency – a case study.

    Jan Brykalski

    2015-08-01

    The case focuses attention on the risk of psychosis connected with the treatment of the adrenal crisis with high doses of Hydrocortisone. Because of the risk of psychiatric complications, the patients treated with high doses of corticosteroids, require an evaluation of risk factors for mental disturbances, and safety precautions in cooperation of endocrinologist and psychiatrist.

  13. First Episode Psychosis

    ... late teens to midtwenties. Psychosis can be a symptom of a mental illness or a physical condition. Psychosis can be caused by some medications, alcohol or drug abuse. Three out of 100 people will experience psychosis ...

  14. GENDER, PSYCHOSIS AND PSYCHOTROPIC DRUGS: DIFFERENCES AND SIMILARITIES

    Groleger, Urban; Novak-Grubič, Virginija

    2010-01-01

    Acute psychosis is diagnosed by clearly defined operational criteria embedded into international classification systems. Many studies have tried to determine the role of gender in psychosis but mainly in terms of epidemiology and course of illness, most often schizophrenia. There are however also important gender-specific differences in clinical symptoms of acute psychosis. No guidelines or treatment recommendations suggest gender as an important factor in the choice of antipsychotic treat...

  15. Psychosis associated with methimazole-induced hypothyroidism: a case report

    Priscila C. F. Lazaro

    2013-06-01

    Full Text Available INTRODUCTION: Thyroid dysfunction has often been associated with several psychiatric manifestations. Previous case reports/series suggest the possible role played by acute alteration of thyroid status in the onset of psychotic symptoms. METHODS: Case report and literature review. RESULTS: A 45-year-old woman with no psychiatric antecedents was brought to the ER with a full-blown psychotic episode, marked by paranoid delusions, which developed gradually over two months. She had been treated elsewhere for hyperthyroidism for five years with methimazole 40 mg/d, with poor compliance. One month before the beginning of the psychotic symptoms, methimazole was raised to 60 mg/d and she started taking it correctly. Five months earlier she had TSH: 0.074 uUI/ml and free T4: 1.3 ng/dl. At admission we found a diffuse thyroid goiter, TSH: 70.9 uUI/ml and free T4: 0.03 ng/dl. Brain CT was normal. We hospitalized her with the diagnosis of a psychosis secondary to hypothyroidism, suspended methimazole, and gave her levothyroxine (up to 75 µg/d and risperidone (2 mg/d. The patient had a quick remission and was discharged after 15 days. Within one month she had TSH: 0.7 uUI/ml and was completely recovered psychiatrically. She has been well since then, with risperidone in the first 8 months, and without it for 10 months now. CONCLUSION: This case report is a reminder of the necessity of checking thyroid status as part of clinical assessment of psychoses. It also supports the hypothesis that antithyroid drugs may have severe psychiatric consequences, especially when they lead to an acute change of thyroid status.

  16. A study of epilepsy-related psychosis

    Roy A

    2003-07-01

    Full Text Available The association of epilepsy and psychosis is studied. Among the 500 patients of epilepsy evaluated, there were 12 patients, 8 males and 4 females with epilepsy-related psychosis. Their average age was 38 years. The interval between the age of onset of epilepsy and psychotic features was 9 years. Complex partial seizures were present in 7 patients and primary generalized tonic-clonic seizure was present in 1 patient. Four patients had post-ictal psychosis, 7 had acute interictal psychosis and 1 patient had chronic psychosis. The inter-ictal and chronic psychoses were schizophreniform whereas the post-ictal psychoses were not. EEG showed a temporal focus in 7 patients with complex partial seizures and an extra-temporal focus was identified in 4 out of the other 5 patients. Imaging (CT scan/MRI revealed abnormalities in 10 patients. This study attempts to define the characteristics of psychoses occurring in epileptics.

  17. Acute psychosis in the course of treatment of acute adrenal crisis with hydrocortisone in the patient with secondary adrenal insufficiency – a case study.

    Jan Brykalski; Lucyna Papierska; Maria Załuska

    2015-01-01

    Objectives Presentation of the risk of psychosis induced by the treatment of adrenal crisis with high doses of hydrocortisone. Methods A case analysis in the context of the literature Results There are reported psychoses in the patients with adrenal hypofunction and hyperfunction. Psychoses following implementation of substitution with small doses of corticosteroids due to adrenal insufficiency were also observed. The hypereactivity of the glucocorticoid receptor is suppose...

  18. Relationships between paranoid thinking, self-esteem and the menstrual cycle.

    Brock, Rosalind; Rowse, Georgina; Slade, Pauline

    2016-04-01

    This study aimed to investigate whether paranoid experiences and levels of self-esteem fluctuate over the menstrual cycle and whether levels of self-esteem are lower when perceived persecution is felt to be deserved. Measures of anxiety, depression, persecution, deservedness and self-esteem were completed on-line by 278 women over their menstrual cycle. Responses were compared at the paramenstrual (3 days before and after menses onset) and mid-cycle phase. At the paramenstrual phase persecution, negative self-esteem, anxiety and depression were higher and positive self-esteem was lower than at mid-cycle. A greater proportion of women experienced persecution as deserved at the paramenstrual phase. This was associated with higher depression and negative self-esteem scores. Increased levels of deservedness significantly strengthened the relationship between persecution and negative, but not positive, self-esteem. These findings suggest that the paramenstrual phase is a time of vulnerability to increased paranoid experiences, an increased likelihood that feelings of persecution will feel deserved and lowered self-esteem. The findings support the view that interpersonal sensitivities may be key to menstrual cycle symptoms and have an impact on relationships. Further, the study illustrated that ideas developed for psychosis could make a valuable contribution to understanding and managing this aspect of menstruation-related distress. PMID:26260035

  19. Perceived ethnic discrimination and persecutory paranoia in individuals at ultra-high risk for psychosis.

    Shaikh, Madiha; Ellett, Lyn; Dutt, Anirban; Day, Fern; Laing, Jennifer; Kroll, Jasmine; Petrella, Sabrina; McGuire, Philip; Valmaggia, Lucia R

    2016-07-30

    Despite a consensus that psychosocial adversity plays a role in the onset of psychosis, the nature of this role in relation to persecutory paranoia remains unclear. This study examined the complex relationship between perceived ethnic discrimination and paranoid ideation in individuals at Ultra High Risk (UHR) for psychosis using a virtual reality paradigm to objectively measure paranoia. Data from 64 UHR participants and 43 healthy volunteers were analysed to investigate the relationship between perceived ethnic discrimination and persecutory ideation in a virtual reality environment. Perceived ethnic discrimination was higher in young adults at UHR in comparison to healthy controls. A positive correlation was observed between perceived ethnic discrimination and paranoid persecutory ideation in the whole sample. Perceived ethnic discrimination was not a significant predictor of paranoid persecutory ideation in the VR environment. Elevated levels of perceived ethnic discrimination are present in individuals at UHR and are consistent with current biopsychosocial models in which psychosocial adversity plays a key role in the development of psychosis and attenuated symptomatology. PMID:27232552

  20. A controlled Nordic multicentre study of zuclopenthixol acetate in oil solution, haloperidol and zuclopenthixol in the treatment of acute psychosis.

    Baastrup, P C; Alhfors, U G; Bjerkenstedt, L; Dencker, S J; Fensbo, C; Gravem, A; Pedersen, V; Elgen, K; Brekke, B; Fredslund-Andersen, K

    1993-01-01

    Zuclopenthixol acetate--a new injectable formulation with a duration of action of 2-3 days--was compared with conventional intramuscular and oral formulations of haloperidol and zuclopenthixol in the initial treatment of acutely disturbed, psychotic patients. The patients were stratified into 3 diagnostic categories: acute psychoses (48 patients), mania (22 patients), and exacerbation of chronic psychoses (73 patients). The patients were rated on the Brief Psychiatric Rating Scale (BPRS), the Bech-Rafaelsen Mania Rating Scale (BRMAS) (only manic patients) and globally on the Clinical Global Impression (CGI). The study was an open, randomized multicentre trial with a 6-day treatment period. The zuclopenthixol acetate patients received 1-4 doses, the haloperidol patients 1-26 and the zuclopenthixol patients 1-22 doses. The assessments on the CGI showed that all 3 treatments caused a clear reduction of the severity of illness scores in all 3 diagnostic categories, with no differences between treatments. The ratings of the acute and chronic psychotic patients on the BPRS also showed significant reductions in scores with no differences between treatments. All 3 treatments caused a rapid remission of symptoms on the BRMAS. Haloperidol induced hypokinesia in significantly more patients than zuclopenthixol acetate after 24 h. Later there were no significant differences between treatments. Zuclopenthixol acetate fulfils many desires for an amended neuroleptic formulation for the initial treatment of acutely disturbed psychotic patients. PMID:8093824

  1. Acute psychosis with a favorable outcome as a complication of central pontine/extrapontine myelinolysis in a middle aged man

    Gupta, Rishab; Balhara, Yatan Pal Singh; Sagar, Rajesh

    2012-01-01

    Central pontine myelinolysis is a demyelinating condition affecting the pons characterized by an acute progressive quadriplegia, dysarthria, dysphagia, and alterations of consciousness. Pathologic features include prominent demyelination in the central pons with sparing of axons and neurons. This condition is usually associated with systemic disorders such as hyponatremia, chronic alcoholism, liver failure, severe burns, malignant neoplasms, hemorrhagic pancreatitis, hemodialysis, and sepsis....

  2. Psychosis: Atypical Limbic Epilepsy versus Limbic Hyperexcitability with Onset at Puberty?

    Sharp, Frank R.; Hendren, Robert L.

    2007-01-01

    Phencyclidine (PCP), Ketamine (Special K) and MK-801 are non-competitive NMDA antagonists that produce acute psychosis in humans. The psychosis produced by these psychomimetic drugs is indistinguishable from schizophrenia and includes both positive and negative symptoms. This drug-induced psychosis occurs after puberty in humans. This brief review argues that this psychosis is an atypical form of limbic epilepsy based upon MK-801 induced spike-and-wave activity in rats and based upon increase...

  3. Isoniazid-induced psychosis in a patient on DOTS therapy

    Imran Masood; Sanjay Bhat; Aadil Beigh; Veena Gupta

    2011-01-01

    Acute psychosis induced by INH, especially when given as part of the DOTS regimen, has a variable presentation, and should always be kept in mind in the differential diagnosis. The diagnosis becomes especially challenging when the patient has tubercular meningitis or some other neurological disease. Here we present a case report of a patient who after 2 days of INH therapy under the DOTS regimen developed acute psychosis that resolved only after discontinuation of the drug.

  4. Isoniazid-induced psychosis in a patient on DOTS therapy

    Imran Masood

    2011-01-01

    Full Text Available Acute psychosis induced by INH, especially when given as part of the DOTS regimen, has a variable presentation, and should always be kept in mind in the differential diagnosis. The diagnosis becomes especially challenging when the patient has tubercular meningitis or some other neurological disease. Here we present a case report of a patient who after 2 days of INH therapy under the DOTS regimen developed acute psychosis that resolved only after discontinuation of the drug.

  5. PET findings in patients with chronic paranoid schizophrenia

    The regional cerebral blood flow (rCBF) of chronic schizophrenic patients with auditory hallucinations and paranoid delusions and normal controls was compared. The subjects were 5 male chronic inpatients (average age of 41.4 yrs, BPRS 29.3±15.0). Normal controls (6 males) were matched for age and sex. rCBF was determined by PET, based on the consecutive inhalation of 15O-CO2. rCBF in the paranoid schizophrenics was significantly higher than that in normal controls in the temporal lobe and cerebellum (p<0.05). rCBF in paranoid schizophrenia showed a tendency to be higher in the frontal lobe, parietal lobe, caudate nucleus, parahippocampus and putamen, but not in the thalamus. (author)

  6. Catha edulis chewing effects on treatment of paranoid schizophrenic patients

    Kotb El-Sayed, Mohamed-I; Amin, Hatem-K

    2015-01-01

    Background The current study’s aim is to evaluate the possible interaction effects of khat chewing on treatment of paranoid schizophrenic patients. Patients and methods In the study group, 42 male subjects suffered from paranoid schizophrenia and were classified according to their khat chewing habits into two subgroups: either khat-chewer subgroup (SKc; n=21; r=11, h=10) or non-khat-chewer subgroup (SNKc; n=21, r=11, h=10). Each subgroup was further subdivided according to type of treatment i...

  7. Patients with Paranoid Symptoms: Considerations for the Optometrist

    Mark Bampton, MS

    2013-05-01

    Full Text Available Pathological paranoia involves a pervasive style of thinking and relating to others that is unyielding to reason and is independent of transient influences. Paranoia associated with drug abuse, neurodegenerative disease, and mental health issues will be discussed and care strategies explored. Optometrists will undoubtedly encounter patients with varying degrees and forms of paranoid symptoms. In order to provide the best possible vision care for these patients, it is essential that the optometrist be well prepared for the tension and resistance that is likely to occur during the exam. This paper will focus on patients who exhibit problematic paranoid symptoms and the relevant considerations for optometry.

  8. "Honeymoon psychosis" in Japanese tourists to Hawaii.

    Langen, D; Streltzer, J; Kai, M

    1997-01-01

    Although Japanese tourists in Hawaii are infrequently treated for acute psychiatric emergencies, we observed several cases among Japanese honeymooners. To investigate this phenomenon, we retrospectively and prospectively collected such cases of honeymooners. Sixteen cases of acute psychiatric disturbance in Japanese honeymooners in Hawaii are described. This phenomenon occurs more frequently than in other Japanese tourists or non-Japanese honeymooners. The tradition of arranged marriage and other cultural factors may be associated with the potential for "honeymoon psychosis." PMID:9277018

  9. Efficacy of olanzapine in the treatment of patients with acute psychosis%奥氮平治疗急性期精神病患者的疗效观察

    弓剑

    2015-01-01

    Objective:To investigate the efficacy of olanzapine in the treatment of acute psychotic patients.Methods:39 acute psychosis patients were selected.They were treated with olanzapine.According to the PANSS scale,we evaluated the therapeutic effect,and we recorded the adverse reactions.Results:Compared with before the treatment,the PANSS scores of the patients were significantly decreased.There were in 4 cases of lethargy,3 cases of insomnia,1 cases of myotonia,tremor in 1 cases,10 cases of weight gain,4 cases of tachycardia,3 cases of dry mouth and nausea in 4 cases.Conclusion:Olanzapine as the drug therapy in patients with acute psychosis has significant effect.%目的:探讨奥氮平治疗急性期精神病患者的疗效。方法:收治急性期精神病患者39例,给予奥氮平治疗,根据PANSS量表评定治疗效果,记录不良反映。结果:与治疗前相比,患者PANSS量表评分明显降低。出现嗜睡4例、失眠3例、肌强直1例、震颤1例、体重增加10例、心动过速4例、口干3例和恶心4例。结论:奥氮平作为急性期精神病患者的治疗药物,有非常明显的效果。

  10. Psychosis associated with methimazole-induced hypothyroidism: a case report

    Priscila C. F. Lazaro; Julia C. Loureiro; BANZATO, CLAUDIO E.M.

    2013-01-01

    INTRODUCTION: Thyroid dysfunction has often been associated with several psychiatric manifestations. Previous case reports/series suggest the possible role played by acute alteration of thyroid status in the onset of psychotic symptoms. METHODS: Case report and literature review. RESULTS: A 45-year-old woman with no psychiatric antecedents was brought to the ER with a full-blown psychotic episode, marked by paranoid delusions, which developed gradually over two months. She had been treated el...

  11. Dealing with feeling: Specific emotion regulation skills predict responses to stress in psychosis.

    Lincoln, Tania M; Hartmann, Maike; Köther, Ulf; Moritz, Steffen

    2015-08-15

    Elevated negative affect is an established link between minor stressors and psychotic symptoms. Less clear is why people with psychosis fail to regulate distressing emotions effectively. This study tests whether subjective, psychophysiological and symptomatic responses to stress can be predicted by specific emotion regulation (ER) difficulties. Participants with psychotic disorders (n=35) and healthy controls (n=28) were assessed for ER-skills at baseline. They were then exposed to a noise versus no stressor on different days, during which self-reported stress responses, state paranoia and skin conductance levels (SCL) were assessed. Participants with psychosis showed a stronger increase in self-reported stress and SCL in response to the stressor than healthy controls. Stronger increases in self-reported stress were predicted by a reduced ability to be aware of and tolerate distressing emotions, whereas increases in SCL were predicted by a reduced ability to be aware of, tolerate, accept and modify them. Although paranoid symptoms were not significantly affected by the stressors, individual variation in paranoid responses was also predicted by a reduced ability to be aware of and tolerate emotions. Differences in stress responses in the samples were no longer significant after controlling for ER skills. Thus, interventions that improve ER-skills could reduce stress-sensitivity in psychosis. PMID:26001960

  12. BDNF-Deficient Mice Show Reduced Psychosis-Related Behaviors Following Chronic Methamphetamine

    Manning, Elizabeth E.; Halberstadt, Adam L.; van den Buuse, Maarten

    2015-01-01

    Background: One of the most devastating consequences of methamphetamine abuse is increased risk of psychosis. Brain-derived neurotrophic factor has been implicated in both psychosis and neuronal responses to methamphetamine. We therefore examined persistent psychosis-like behavioral effects of methamphetamine in brain-derived neurotrophic factor heterozygous mice. Methods: Mice were chronically treated with methamphetamine from 6 to 9 weeks of age, and locomotor hyperactivity to an acute D-am...

  13. Psychosis in mycoplasma infection.

    Moor, S.; Skrine, H.

    1989-01-01

    This report describes a patient with psychosis due to a Mycoplasma pneumoniae infection. Although he received specific treatment for this infection, the diagnosis was only confirmed after clinical recovery. The neuropsychiatric complications of mycoplasma infection are discussed.

  14. Apparent hallucinations in monkeys during around-the-clock amphetamine for seven to fourteen days. Possible relevance to amphetamine psychosis.

    Nielsen, E B; Lyon, M; Ellison, G

    1983-04-01

    Schizophrenia-like symptoms have been experimentally produced in humans by a single, large dose of amphetamine or by relatively low level, but continuous administration of the drug. In animal studies of the psychotomimetic properties of amphetamine, high doses and, in particular, repeated daily-injection drug schedules have often been used. However, amphetamine psychosis is not always a prominent effect of repeated intake drug schedules in humans and available clinical evidence suggests that psychosis develops more readily when the drug is taken in a continuous fashion over longer periods. The state produced by single large doses of amphetamine, although clearly abnormal, has been said to bear less resemblance to schizophrenia than the delayed paranoid symptoms developing after longer periods of continuous intake. In the present experiments we have studied the behavioral effects of 7 to 14 days of continuous administration of amphetamine to monkeys (Cercopithecus aethiops) using subcutaneously implanted silicone capsules releasing approximately .7 to 1.5 mg/kg/day of d-amphetamine base. Around-the-clock TV monitoring of the animals revealed a general biphasic sequence of drug effects, although considerable individual variation occurred: a) an "acute" phase dominated by stereotyped movements and/or prolonged staring, lasting for 2 to 5 days; b) a "late" phase peaking during days 5 to 10 after capsule implantation and characterized by highly individual, but striking sequences of: (1) Attack or sudden threat reactions directed at invisible objects; (2) rapid orienting and flight behavior without apparent cause; (3) sudden startle reactions; (4) prolonged vocalization; (5) visual tracking of invisible objects, sometimes involving coordinated patterns of "eating behavior" and (6) prolonged and rapid grooming directed at various parts of the body. These behaviors might be termed "hallucinatory" since no eliciting stimuli could be determined for their occurrence. Motor

  15. Psychosis and cannabis

    Heinz Häfner

    2005-01-01

    Alcohol and cannabis misuse is currently the most frequent co-morbidity disorder of schizophrenia. The following four issues will be dealt with: 1) the neurobiological basis of the psychosis-inducing, pathogenic effects of THC, the agent contained in cannabis products. 2) Can cannabis use - and for comparison alcohol abuse - prematurely trigger or even cause schizophrenia? 3) Are persons genetically liable to schizophrenia, psychosis-prone individuals or young persons before completion of bra...

  16. Can bupropion unmask psychosis

    Grover, Sandeep; Das, Partha Pratim

    2009-01-01

    Bupropion is an antidepressant, which has recently been promoted for the treatment of bipolar depression, because of its lower potency to induced switch. However, due to its dopamine enhancing effect, it has been reported to induce psychosis and perceptual changes. Most of the literature, which is available in relation to development of psychosis while receiving bupropion, has been with the use of immediate release formulation. Some of the case report which have reported development of psycho...

  17. Parkinson’s Psychosis

    Zahodne, Laura B.; Fernandez, Hubert H.

    2010-01-01

    Psychosis is a leading reason for nursing home placement of patients with Parkinson’s disease (PD). It may also be the single greatest stressor for caregivers of PD patients, it is generally persistent, and its presence markedly increases the risk of mortality. For these reasons, it is essential to recognize and appropriately treat psychosis in PD. Treatment of psychotic symptoms should be initiated after potential medical and environmental causes of delirium (eg, infection) have been elimina...

  18. Migraine madness: recurrent psychosis after migraine.

    Fuller, G N; Marshall, A.; Flint, J.; Lewis, S; Wise, R J

    1993-01-01

    A 69 year old man with longstanding migraine with aura had four episodes of psychosis lasting 7-28 days during a 17 year period. During attacks he had formed visual hallucination and delusions, including reduplicative paramnesia. His mother was similarly affected. His EEG showed symmetrical frontal delta waves. The time course and EEG changes are similar to acute confusional migraine. The reduplicative paramnesia suggests a focal non-dominant hemisphere dysfunction.

  19. The relationship of reactive psychosis and ICD-10 acute and transient psychotic disorders: evidence from a case register-based comparison

    Castagnini, Augusto; Bertelsen, Aksel; Munk-Jørgensen, Povl;

    2006-01-01

    relationship between the concept of reactive psychosis (RP), equivalent to the ICD-8 298 category of 'other psychoses', and ATPD. SAMPLING AND METHOD: Since January 1, 1994, ICD-10 has replaced ICD-8 as official classification in Denmark. Patients given an ICD-8 298 diagnosis on their last admission in 1992...... accounted for 8.7% of those with non-organic psychotic and affective disorders in 1994-1995. Thirty-eight per cent of patients with an ICD-8 298 diagnosis were readmitted during the years 1994-1995. Schizophrenia and related disorders (F2) and affective disorders (F3) accounted for three quarters of ICD-10......-1993 were identified from the Danish Psychiatric Central Register, and the ICD-8 diagnoses assigned were compared with their ICD-10 diagnoses when readmitted in 1994-1995. RESULTS: Diagnosis of RP was recorded in 19.2% of patients with functional psychoses in 1992-1993, whereas ATPD overall prevalence...

  20. Homicide during postictal psychosis

    Stephan Eisenschenk

    2014-01-01

    Full Text Available Postictal psychosis is characterized by a fluctuating combination of thought disorder, auditory and visual hallucinations, delusions, paranoia, affective change, and aggression including violent behavior. We present a case of homicide following a cluster of seizures. The patient's history and postictal behavior were his consistent with postictal psychosis. Contributing factors resulting in homicide may have included increased seizure frequency associated with a change in his AED regimen seizure frequency. The AED change to levetiracetam may also have increased impulsiveness with diminished mood regulation following discontinuation of carbamazepine. There is evidence that he had a cluster of seizures immediately prior to the murder which may have resulted in the postictal disinhibition of frontal lobe inhibitory systems. This homicide and other violent behaviors associated with postictal psychosis may be avoided with earlier recognition and treatment.

  1. Early detection of psychosis

    Larsen, Tor Ketil; Melle, Ingrid; Auestad, B.;

    2011-01-01

    , depressive and cognitive factors and for global assessment of functioning for social functioning at 5-year follow-up. The ED group also had more contacts with friends. Regression analysis did not find that these differences could be explained by confounders. Conclusions Early treatment had positive effects......Background During the last decades we have seen a new focus on early treatment of psychosis. Several reviews have shown that duration of untreated psychosis (DUP) is correlated to better outcome. However, it is still unknown whether early treatment will lead to a better long-term outcome. This...... study reports the effects of reducing DUP on 5-year course and outcome. Method During 1997–2000 a total of 281 consecutive patients aged >17 years with first episode non-affective psychosis were recruited, of which 192 participated in the 5-year follow-up. A comprehensive early detection (ED) programme...

  2. 1-123 iodoamphetamine SPECT findings in paranoid schizophrenia

    To find out if frontal metabolic and cerebral blood flow differ between normal subjects and patients with paranoid schizophrenia (PAR), the authors have examined regional synaptic amine metabolism. Using [I- 123]iodoamphetamine (IMP), the authors compared 85 subjects (61 PAR patients and 24 normal subjects) with single-head single-photon emission CT (SPECT). Virtually automatic analysis assigned relative tracer uptake to the frontal, anterior temporoparietal (TP), and posterior TP regions. Consistent with the visual inspection of two clinicians familiar with SPECT IMP images, this objective method yielded T-tests that showed higher relative frontal lobe ratios in normal subjects than in PAR patients (P =.03)

  3. The Effects of Cognitive--Behavioral Therapy on Trait Anger and Paranoid Ideation

    Gonzalez-Prendes, A. Antonio; Jozefowicz-Simbeni, Debra M. Hernandez

    2009-01-01

    Objective: This study evaluates a cognitive-behavioral anger treatment approach to reduce anger and paranoid ideation on men (n = 32) in treatment for anger problems and compares levels of paranoid ideation with a sample of men ( n = 27) who sought mental health treatment for non-anger issues. Method: A pre- and posttest design is used to evaluate…

  4. BIOMETRIC INDICES OF CONSTITUTIONAL RISKS FOR DEVELOPMENT OF PARANOID SCHIZOPHRENIA IN MALE PATIENTS

    Lebedeva Е.A; Zaichenko A.A.

    2009-01-01

    Aim: the current study examines features and correlations of particular psychodynamic, dermatoglyphic characteristics and body constitution of men with paranoid schizophrenia. Study groups: 25 men having the "paranoid schizophrenia" (F20.0), 27 men having no mental diseases. Methods: psychodiagnostic tests (Hand test, the Big Five Inventory (BFI)), anthropometry; dactyloscopy. Results: there were statistically significant differences in such personality factors as: extroversion and ...

  5. First-episode psychosis

    Simonsen, Erik

    2011-01-01

    . Patients with first-episode psychosis had significantly high NEO-PI-R scores for neuroticism and agreeableness, and lower scores for conscientiousness and extroversion. The median time for remission in the total sample was three months. Female gender and better premorbid functioning were predictive of less...

  6. Introduction to "Early psychosis

    McGorry, Patrick; Nordentoft, Merete; Simonsen, Erik

    2005-01-01

    warrants careful analysis. The Third International Early Psychosis Conference proved to be a watershed and was the largest and most vibrant meeting to that point. This preface aims to set the scene for a selection of contributions, derived from the array of new evidence reported in Copenhagen, and recently...

  7. Severe Psychosis, Drug Dependence, and Hepatitis C Related to Slamming Mephedrone

    Helen Dolengevich-Segal

    2016-01-01

    Full Text Available Background. Synthetic cathinones (SCs, also known as “bath salts,” are β-ketone amphetamine compounds derived from cathinone, a psychoactive substance found in Catha edulis. Mephedrone is the most representative SC. Slamming is the term used for the intravenous injection of these substances in the context of chemsex parties, in order to enhance sex experiences. Using IV mephedrone may lead to diverse medical and psychiatric complications like psychosis, aggressive behavior, and suicide ideation. Case. We report the case of a 25-year-old man admitted into a psychiatric unit, presenting with psychotic symptoms after slamming mephedrone almost every weekend for the last 4 months. He presents paranoid delusions, intense anxiety, and visual and kinesthetic hallucinations. He also shows intense craving, compulsive drug use, general malaise, and weakness. After four weeks of admission and antipsychotic treatment, delusions completely disappear. The patient is reinfected with hepatitis C. Discussion. Psychiatric and medical conditions related to chemsex and slamming have been reported in several European cities, but not in Spain. Psychotic symptoms have been associated with mephedrone and other SCs’ consumption, with the IV route being prone to produce more severe symptomatology and addictive conducts. In the case we report, paranoid psychosis, addiction, and medical complications are described.

  8. Severe Psychosis, Drug Dependence, and Hepatitis C Related to Slamming Mephedrone.

    Dolengevich-Segal, Helen; Rodríguez-Salgado, Beatriz; Gómez-Arnau, Jorge; Sánchez-Mateos, Daniel

    2016-01-01

    Background. Synthetic cathinones (SCs), also known as "bath salts," are β-ketone amphetamine compounds derived from cathinone, a psychoactive substance found in Catha edulis. Mephedrone is the most representative SC. Slamming is the term used for the intravenous injection of these substances in the context of chemsex parties, in order to enhance sex experiences. Using IV mephedrone may lead to diverse medical and psychiatric complications like psychosis, aggressive behavior, and suicide ideation. Case. We report the case of a 25-year-old man admitted into a psychiatric unit, presenting with psychotic symptoms after slamming mephedrone almost every weekend for the last 4 months. He presents paranoid delusions, intense anxiety, and visual and kinesthetic hallucinations. He also shows intense craving, compulsive drug use, general malaise, and weakness. After four weeks of admission and antipsychotic treatment, delusions completely disappear. The patient is reinfected with hepatitis C. Discussion. Psychiatric and medical conditions related to chemsex and slamming have been reported in several European cities, but not in Spain. Psychotic symptoms have been associated with mephedrone and other SCs' consumption, with the IV route being prone to produce more severe symptomatology and addictive conducts. In the case we report, paranoid psychosis, addiction, and medical complications are described. PMID:27247820

  9. Association of Huntington's disease and schizophrenia-like psychosis in a Huntington's disease pedigree

    Guimarães João

    2006-02-01

    Full Text Available Abstract Background Huntington's disease (HD is a dominantly inherited, neurodegenerative disorder due to expansion of a polymorphic trinucleotide repeat in the short arm of chromosome 4. Clinical manifestations consist of a triad of choreic movements, cognitive decline and psychiatric syndromes starting in the fourth to fifth decade. Psychiatric manifestations vary and may precede motor and cognitive changes. Personality changes and depression occur most commonly. Paranoid schizophrenia-like symptoms occur in 6% to 25% of cases. Case report We describe a 55 year-old woman with an 8 yearlong history of behavioural changes, multi-thematic delusions and auditory hallucinations. History and mental state examination were suggestive of paranoid schizophrenia. Neurological examination revealed discrete, involuntary movements affecting her arms and trunk. Genotyping detected an expanded allele (43 trinucleotide repeats. A three-generation-long family history of chorea and schizophrenia-like psychosis was found. Conclusion HD-families have been reported in which schizophrenia-like syndromes emerged in all or most HD-affected members long before they developed extra-pyramidal or cognitive changes. This has been attributed to more than mere coincidence. We hypothesise that in these families the HD gene is transmitted along with a low load of small-effect "psychosis genes" which, in the presence of the severe cognitive changes of HD, manifest as a schizophrenia-like phenotype. Further research is needed in order to clarify the links between genetic loading and the emergence of psychotic symptoms in Huntington's disease.

  10. Trauma, posttraumatic stress disorder and psychosis: etiopathogenic and nosological implications

    Álvaro Frías Ibáñez

    2014-03-01

    Full Text Available Background and Objectives: The relationship between trauma, post-traumatic stress disorder (PTSD, and psychosis has promoted heterogeneous research lines, in both etiopathogenic and nosological areas. The main aim of this review is to provide a systematic framework that encompasses this theoretical gap in the literature. Methods: A literature research was carried out through PubMed and PsycINFO between 1980 and May 2013. One hundred and thirteen articles were recruited. A first part of this review describes the role of trauma in the development of psychosis. The second part focuses on research about PTSD and psychosis. Results: Longitudinal and cross-sectional studies with clinical and community samples confirm that childhood trauma (CT is a vulnerability factor for schizophrenia and psychotic-like symptoms in adulthood. More empirical research is needed in order to assess the role of trauma as precipitant of acute psychosis. There is also preliminary evidence with cross-sectional samples that suggests that PTSD and psychosis are a risk factor for each other, with studies about post-psychotic PTSD (PP-PTSD being outstanding. Finally, results from different comparative research studies postulate a subtype of PTSD with psychotic features (PTSD-SP. Conclusions: The role of trauma in psychosis is more conclusive as predispositional rather than as trigger factor. Nosological status of acute psychoses remains a focus of controversy unresolved. The association between PTSD and psychosis is complex, requiring more prospective research in order to determine causal relationships between these pathologies. Also, research in nosological status of PTSD-SP must encourage more comparative studies not limited to neurobiological variables.

  11. Multivariate analyses of CT findings in typical schizophrenia and atypical psychosis

    In order to investigate the brain morphological differences between typical schizophrenia and atypical psychosis, the brain CTs of 41 patients with typical schizophrenia, 27 patients with atypical psychosis (ATP), and 20 controls were examined. The schizophrenics had larger values for 9 CT indices, i.e., interhemispheric fissure (IHF) index, VBR, 2 lateral ventricles (L-V) and 3rd venricle (III-V) indices, and 4 sylvian fissure (SF) indices, while the values of ATP patients for 3 SF indices were greater than for the controls. Moreover, the schizophrenics had greater III-V and L-V indices than the ATP patients. The correlation matrix of CT indices indicates that the III-V index correlated well with the other CT indices, whereas the VBR, IHF and right SF indices did not. Therefore, it was speculated that there might be 3 subgroups, each of which has a main focus of alteration in the above-mentioned regions. Therefore, all the cases were divided by means of a cluster analysis into 5 groups. Group I, which contained mainly normal controls, and Group II, which consisted mainly of atypical psychosis patients, had no abnormal CT findings. Group III, which comprised mainly ATP pateints and paranoid type schizophrenics, had right SF enlargement. Group IV, which showed significant IHF enlargement, and the residue group, which had larger VBR and significant left SF enlargement, consisted mostly of schizophrenics. Thus, our results suggest that the classification by CT data corresponds on the whole to our clinical diagnosis, according to which schizophrenic psychosis is divided into typical schizophrenia and atypical psychosis, and that each of the two psychosis groups may be further classified into distinct subgroups. (author)

  12. Temporal lobe lesions and psychosis in multiple sclerosis

    Yadav, R; Zigmond, A S

    2010-01-01

    Lesions in the temporal lobe are associated with psychiatric manifestations in multiple sclerosis. The authors describe this case of a young man with multiple sclerosis who presented with first-episode psychosis and had acute lesions in the temporal lobe. He was successfully treated with olanzapine and β-interferon.

  13. Exploratory Factor Analysis of SCL90-R Symptoms Relevant to Psychosis

    Javad Amini

    2011-10-01

    Full Text Available "nObjective: Inconsistent results have been reported regarding the symptom dimensions relevant to psychosis in symptoms check list revised (SCL90-R, i.e., "psychoticism" and "paranoid ideation". Therefore, some studies have suggested different factor structures for questions of these two dimensions, and proposed two newly defined dimensions of "schizotypal signs" and "schizophrenia nuclear symptoms". We conducted an exploratory factor analysis on the items of these two dimensions in a general population sample in Iran. "nMethod: A total of 2158 subjects residing in Southern Tehran (capital of Iran were interviewed using the psychoticism and paranoid ideation questions in SCL90-R to assess severity of these symptom dimensions. Factor analysis was done through SAS 9.1.3 PROC FACTOR using Promax rotation (power=3 on the matrix of "polychoric correlations among variables" as the input data. "nResults: Two factors were retained by the proportion criterion. Considering loadings >= 0.5 as minimum criteria for factor loadings, 7 out of 10 questions  from psychoticism ,and 3 out of 6 questions from paranoid ideation were retained, and others were eliminated. The factor labels proposed by the questionnaire suited the extracted factors and were retained. Internal consistency for each of the dimensions was acceptable (Cronbach's alpha 0.7 and 0.74 for paranoid ideation and psychoticism respectively. Composite scores showed a half-normal distribution for both dimensions which is predictable for instruments that detect psychotic symptoms. "nConclusion: Results were in contrast with similar studies, and questioned them by suggesting a different factor structure obtained from a statistically large population. The population in a developing nation (Iran in this study and the socio-cultural differences in developed settings are the potential sources for discrepancies between this analysis and previous reports.

  14. Cycloid psychosis: Perris criteria revisited

    Yadav Devender

    2010-01-01

    Full Text Available Cases presenting with recurrent confusion, alteration of psychomotor activity, and brief psychosis with good inter-episode recovery have many differing etiologies. Only rarely does one diagnose such cases as cycloid psychosis. Even among budding psychiatrists, there seems to be a lack of awareness of this unique disorder. This may be because the present international diagnostic classification systems, ICD10 and DSM IV, do not recognize it as a separate entity. A high index of suspicion is required to diagnose cycloid psychosis. Awareness and recognizing such cases would be helpful clinically as cycloid psychosis entails a distinct prognosis and may require a specific treatment.

  15. Clinical Analysis of Olanzapine in the Treatment of Patients with Acute Psychosis%奥氮平治疗急性期精神病患者的疗效分析

    刘从敏; 姚静; 雷兴旺; 吴林林

    2014-01-01

    Objective Research and Analysis treatment ef ect on the patients of acute psychosis with olanzapine.Methods 120 patients were selected for the stage of acute phase treatment in our hospital from June 2012 to January 2014,they were divided into two groups according to the dif erent treatment options. 60 cases in the control group were with treatment of clozapine of the clinical period, and the observation group, 60 cases, with olanzapine. Therapeutic ef ects of two groups were compared before and after treatment, and to evaluate the BPRS,PANSS,TESS scores.Results After treatment,the ef ective rate of observation group was 76.7%, and 66.7%in the control group.The dif erences between the two groups had the statistical significance(P0.05).Conclusion Olanzapine can significantly improve the patient's psychiatric symptoms in patients with acute psychosis, and no significant adverse reactions, which has good security, and is worthy of at ention and widely promoted.%目的:研究分析对急性期精神病患者采用奥氮平治疗的效果。方法本研究于2012年6月~2014年1月开展,入选研究的对象均为该阶段在本院接受治疗的急性期精神病患者,共120例,根据患者治疗期间接受的不同治疗方案,将其分为两组,对照组60例,临床期间采用氯氮平治疗,观察组60例,临床期间采用奥氮平治疗,比较两组患者的治疗效果,并评估其治疗前后的BPRS评分、PANSS评分、TESS评分水平情况。结果经临床治疗,观察组患者的临床有效率为76.7%,对照组为66.7%,组间比较差异明显,具有统计学意义,P<0.05;治疗后两组患者的BPRS评分均有明显降低,与治疗前比较差异明显,P<0.05,且观察组患者的评分水平低于对照组,组间比较差异具有统计学意义,P<0.05;治疗后两组患者的 PANSS评分均有明显下降,与治疗前比较,P<0.05,且观察组患者的下降水平优于对照组,P<0

  16. Brain dysfunction in psychosis

    The present investigation focused on the questions whether previously reported functional brain abnormalities in schizophrenia could be related to the clinical state of the patient (i.e. the degree of psychosis) at time of study, and whether similar findings in patients with schizophrenia, could be made in patients with cycloid psychosis. To this effect, patients were investigated with regional cerebral blood flow measurements and clinical rating on repeated occasions during their most extreme fluctuations during a psychotic episode, i.e. while they were in an exacerbated state and during clinical remission. A subgroup of schizophrenic patients were investigated before and after neuroleptic treatment and during mental activation with a word fluency test. The schizophrenic group has a normal mean hemispheric blood flow irrespective of clinical state and treatment. During exacerbation a highly significant positive correlation was seen between the frontal-occipital (F/O) ratio and the degree of psychosis, suggesting that the more psychotic the patients was, the higher was the ratio. During remission, the F/O ratio decreased. Schizophrenic patients did not activate their prefrontal cortex during exacerbation, but showed a normal frontal response to the word fluency test during remission. The regional cerebral blood flow of the cycloid patients differed clearly from that of the schizophrenic patients. During exacerbation they had elevated mean hemispheric flow levels, and a decreased F/O ration, while rCBF was normal during remission. The findings suggest that variability in the degree of psychosis can be an important factor underlying the heterogeneity of rCBF findings in schizophrenia. (au)

  17. SEXUALITY AND PSYCHOSIS

    Škodlar, Borut; Žunter Nagy, Marija

    2009-01-01

    Sexuality and sexual disorders of patients with psychoses are frequently neglected and under-investigated. The main purpose of the present study is to discuss the subjective experience of sexuality in patients with psychosis within the general psychodynamic and phenomenological understandings of psychotic states. The authors, both psychotherapists, dealing with patients with psychoses, reflected experiences from their clinical work with the help of the conceptual frameworks of psychodynami...

  18. Early psychosis symptoms

    Objective: To determine the prodromal symptoms of schizophrenia in the pathways to help-seeking. Study Design: A cross-sectional study. Place and Duration of Study: The Department of Psychiatry, the Aga Khan University, Karachi, from 2008 to 2009. Methodology: A total of 93 patients were interviewed in the pathways to care of schizophrenia. The diagnosis was based on ICD-10 criteria. The pathways to care were assessed through a semi-structured questionnaire. The onset, course and symptoms of psychosis were assessed through Interview for Retrospective Assessment at Age at Onset of Psychosis (IROAS). Results: Fifty five (59%) participants were male while 41% (n=38%) were female. Using IROAS, 108 symptoms were identified as concerning behaviour. Alternatively, 60 (55%) concerning behaviours were reported in the open-ended inquiry of the reasons for help seeking as assessed by the pathways to care questionnaire with a statistically significant difference between most symptoms category. The difference was most pronounced (p < 0.001) for depressed mood (66%), worries (65%), tension (63%), withdrawal/mistrust (54%) and loss of self-confidence (53%). Thought withdrawal (22%) and passivity (15%) were elicited only through structured interview (IROAS). When symptoms were categorized together, about 83% of the subjects presented with affective and non-specific prodromal symptoms. Roughly, 10% of the subjects presented with positive symptoms and 3% presented with the negative symptoms of psychosis. The non-specific, affective symptoms appear to predominate the prodromal phase of the illness. Conclusion: Prodromal symptoms of schizophrenia include non-specific, affective symptoms. Attention needs to be paid on identifying the prodromal symptoms and change in social functioning in order to identify those who are at risk of long term psychosis. (author)

  19. Contemporary Perspectives on Lacanian Theories of Psychosis

    Jonathan Douglas Redmond

    2013-06-01

    Full Text Available Abstract:In contemporary Lacanian psychoanalysis, Verhaeghe’s theory of actualpathology / psychopathology in psychosis and the Millerian idea of ordinary psychosis provide diverging conceptual approaches to psychosis. In this paper, the two approaches to psychosis are examined with a particular emphasis on mild psychosis and compensatory mechanisms. Despite the shared focus on similar clinical phenomena, particularly body disturbances, these two theories provide different explanations of psychosis. Verhaeghe’s theory of psychosis is a synthesis of Lacanian theory, Freud’s idea of actual neurosis and psychoanalytic attachment concepts. Moreover, these ideas are situated in the schizophrenia / paranoia dichotomy an important heuristic device utilised in clinical practice with psychosis. In contrast, the Millerian field of ordinary psychosis aims to broaden the idea of psychosis by reviving the idea of mild psychosis and the different forms of stabilisation possible in psychosis. Clinicians adapting the idea of ordinary psychosis aim to rethink pivotal Lacanian concepts - untriggered psychosis and stabilisation - beyond the scope of the schizophrenia / paranoia dichotomy. Although the idea of ordinary psychosis requires further development, it promise greater utility than Verhaeghe’s model, as it provides a broader and more nuanced approach to the complex vicissitudes of triggering and restitution in psychosis.

  20. 无抽搐电休克治疗急性期重性精神病的疗效%Clinical Effect of Modified Electric Convulsive Therapy on Acute Psychosis

    杨丽蓉

    2015-01-01

    Objective:To explore the clinical effect of modified electric convulsive therapy( MECT) on acute psychosis.Methods:60 patients with acute psychosis, who were in our hospital from December, 2013 to January,2014,were divided into drug treatment group( n=30) and MECT treatment group( n=30) in accordance with the admission time.brief psychiatric rating scale( BPRS) ,the Clinical Global Im-pression-Severty of Illness( CGI-SI) and Treatment Emergent Symptom Scale( TESS) were used to eval-uate the curative effect and side effects before the treatment and 1st,2nd,3rd and 4th week after the treat-ment.Results:The total efficiency of the MECT treatment group was 96.67% ,which was significantly higher than that of drug treatment group(46.67%) (P <0.01).There was no significant change in BPRS between two groups before the treatment.BPRS in MECT treatment group was significantly lower than that in the drug treatment group after 1 week (t=3.04,P<0.05),2 week(t=2.75,P<0.05),3 week (t=4.24,P<0.01)and 4 week treatment(t=3.89,P<0.01).The difference in CGI-SI score was no statistical significant between the two groups before and 1 week after the treatment.CGI-SI in MECT treatment group were significantly lower than those in the drug treatment group after 2 week ( t=9.91,P<0.01),3 week (t=6.79,P<0.01)and 4 week treatment(t=6.40,P<0.01).Significant lower incidences of adverse reactions to the drug were observed in the patients in MECT treatment group compared with drug treatment group at 1 week(t=2.40,P<0.05),2week(t=3.35,P<0.05),3week (t=4.15,P<0.01) and 4 week (t=5.53,P <0.01) after the treatment.Conclusion:The effect of MECT is superior to the conventional drug treatment and the side effect of MECT is lower than that of conventional drug treatment,MECT is a safe and effective treatment method for acute psychosis.%目的:探讨无抽搐电休克治疗( MECT)急性期重性精神病的临床疗效。方法:选取2013年12月-2014年1月在攀枝花市第三人民医院6个

  1. Influence of individual psychological support on the severity of psychopathological symptoms in patients with paranoid schizophrenia

    Bogumiła Witkowska

    2015-01-01

    Aim of the study The aim of the study was to investigate the relationship between psychological therapeutic interactions and the severity of psychopathological symptoms in patients diagnosed with paranoid schizophrenia during their hospitalisation. Subject or material and methods The study involved 60 patients hospitalised for paranoid schizophrenia. They were divided into two groups of 30. The first group consisted of patients actively using psychological assistance and...

  2. Catha edulis chewing effects on treatment of paranoid schizophrenic patients

    Kotb, Mohamed

    2015-01-01

    Mohamed-I Kotb El-Sayed, Hatem-K Amin Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Helwan University, Ain Helwan, Helwan, Cairo, Egypt Background: The current study’s aim is to evaluate the possible interaction effects of khat chewing on treatment of paranoid schizophrenic patients.Patients and methods: In the study group, 42 male subjects suffered from paranoid schizophrenia and were classified according to their khat chewing habits into two subgr...

  3. Catha edulis chewing effects on treatment of paranoid schizophrenic patients

    Kotb El-Sayed MI; Amin HK

    2015-01-01

    Mohamed-I Kotb El-Sayed, Hatem-K Amin Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Helwan University, Ain Helwan, Helwan, Cairo, Egypt Background: The current study’s aim is to evaluate the possible interaction effects of khat chewing on treatment of paranoid schizophrenic patients.Patients and methods: In the study group, 42 male subjects suffered from paranoid schizophrenia and were classified according to their khat chewing habits into two subgroups: ei...

  4. Assessing and Treating the Patient with Acute Psychotic Disorders.

    Jensen, Lisa; Clough, Rebecca

    2016-06-01

    Patients with acute psychosis often present to emergency departments. Management of acute agitation and psychosis can be a challenge for the staff. Medical stabilization, appropriate assessment, and diagnosis are important. Verbal de-escalation and other psychosocial interventions are helpful in creating a safe and therapeutic environment. Psychiatric and emergency room nurses are poised to treat patients presenting with acute psychosis and must be knowledgeable of evidence-based approaches to treat these complex disorders. PMID:27229275

  5. Prevalence of serum N-methyl-D-aspartate receptor autoantibodies in refractory psychosis

    Beck*, Katherine Emma; Lally, John Alexander; Shergill, Sukhwinder S.; Bloomfield, Michael A.P.; MacCabe, James Hunter; Gaughran, Fiona Patricia; Howes, Oliver

    2015-01-01

    N-methyl-d-aspartate receptor (NMDA-R) autoantibodies have been reported in people with acute psychosis. We hypothesised that their presence may be implicated in the aetiology of treatment-refractory psychosis. We sought to ascertain the point prevalence of NMDA-R antibody positivity in patients referred to services for treatment-refractory psychosis. We found that 3 (7.0%) of 43 individuals had low positive NMDA-R antibody titres. This suggests that NMDA-R autoantibodies are unlikely to acco...

  6. Obstetric Characteristics and Management of Patients with Postpartum Psychosis in a Tertiary Hospital Setting

    Shehu, C. E.; Yunusa, M. A.

    2015-01-01

    Background. Postpartum psychosis is the most severe and uncommon form of postnatal affective illness. It constitutes a medical emergency. Acute management emphasizes hospitalization to ensure safety, antipsychotic medication adherence, and treatment of the underlying disorder. Objective. The aim of the study was to determine the obstetric characteristics and management of patients with postpartum psychosis in a tertiary centre in North-Western Nigeria. Methodology. This was a 10-year retrospe...

  7. Psychosis and cannabis

    Heinz Häfner

    2005-01-01

    Full Text Available Alcohol and cannabis misuse is currently the most frequent co-morbidity disorder of schizophrenia. The following four issues will be dealt with: 1 the neurobiological basis of the psychosis-inducing, pathogenic effects of THC, the agent contained in cannabis products. 2 Can cannabis use - and for comparison alcohol abuse - prematurely trigger or even cause schizophrenia? 3 Are persons genetically liable to schizophrenia, psychosis-prone individuals or young persons before completion of brain development at an increased risk? 4 What consequences does cannabis use have on the symptomatology and further course of schizophrenia? Results from recent literature and the ABC Schizophrenia Study show that the risk for cannabis use in schizophrenia is about twice the size in healthy controls. In most cases cannabis use starts before first admission, in a third of cases before schizophrenia onset. There is an increased affinity to misuse already at the prodromal stage. Cannabis can prematurely trigger schizophrenia onset - on average eight years earlier than in non-use - and cause the illness partly in interaction with predisposing factors. Cannabis use in the course of schizophrenia increases positive symptoms and reduces affective flattening, thus leading to dysfunctional coping in some cases.

  8. Subjective experience of emotions and emotional empathy in paranoid schizophrenia.

    Lehmann, Anja; Bahçesular, Katja; Brockmann, Eva-Maria; Biederbick, Sarah-Elisabeth; Dziobek, Isabel; Gallinat, Jürgen; Montag, Christiane

    2014-12-30

    Unlike the cognitive dimensions, alterations of the affective components of empathy in schizophrenia are less well understood. This study explored cognitive and affective dimensions of empathy in the context of the subjective experience of aspects of emotion processing, including emotion regulation, emotional contagion, and interpersonal distress, in individuals with schizophrenia and healthy controls. In addition, the predictive value of these parameters on psychosocial function was investigated. Fifty-five patients with paranoid schizophrenia and 55 healthy controls were investigated using the Multifaceted Empathy Test and Interpersonal Reactivity Index, as well as the Subjective Experience of Emotions and Emotional Contagion Scales. Individuals with schizophrenia showed impairments of cognitive empathy, but maintained emotional empathy. They reported significantly more negative emotional contagion, overwhelming emotions, lack of emotions, and symbolization of emotions by imagination, but less self-control of emotional expression than healthy persons. Besides cognitive empathy, the experience of a higher extent of overwhelming emotions and of less interpersonal distress predicted psychosocial function in patients. People with schizophrenia and healthy controls showed diverging patterns of how cognitive and emotional empathy related to the subjective aspects of emotion processing. It can be assumed that variables of emotion processing are important moderators of empathic abilities in schizophrenia. PMID:25288043

  9. Paranoid Thoughts in Adolescents with Social Anxiety Disorder.

    Pisano, S; Catone, G; Pascotto, A; Iuliano, R; Tiano, C; Milone, A; Masi, G; Gritti, A

    2016-10-01

    Recently, social anxiety disorder (SAD) and paranoia have been demonstrated to be closely related. However, data were primarily drawn from adult community samples or patients with schizophrenia. The present study used a cross-sectional design to evaluate a sample of adolescents with SAD (n = 30, mean age 15.3 ± 0.9 years) compared with an age- and sex-matched group of healthy controls (n = 26, mean age 15.9 ± 1.6 years). The SAD group displayed more frequent and intense paranoid thoughts than the control group (t = 4.16, p anxiety disorders, although adjusting for depression slightly reduced the extent and significance of the prediction. A lack of awareness about the association between SAD and paranoia may lead to incorrect diagnoses (e.g. misdiagnosis of psychotic disorders), or it may negatively influence the (psycho)therapeutic process and patient outcomes. PMID:26658937

  10. [Coincidence of transsexuality and psychosis].

    Mayer, C; Kapfhammer, H P

    1995-03-01

    We report the case of a 32-year-old male transsexual patient with unipolar mania. Since the onset of his affective psychosis, alternating states of male and female identification were observed. The patient himself behaved as a woman only in manic phases. Possible relations between transsexuality and affective psychosis are discussed, together with a short review of the literature, especially psychodynamic theories on the genesis of transsexuality. PMID:7753248

  11. Acute Administration of MK-801 in an Animal Model of Psychosis in Rats Interferes with Cognitively Demanding Forms of Behavioral Flexibility on a Rotating Arena

    Jan eSvoboda

    2015-04-01

    Full Text Available Patients with schizophrenia often manifest deficits in behavioral flexibility. Non-competitive NMDA receptor antagonists such as MK-801 induce schizophrenia-like symptoms in rodents, including cognitive functions. Despite work exploring flexibility has been done employing behavioral paradigms with simple stimuli, much less is known about what kinds of flexibility are affected in an MK-801 model of schizophrenia-like behavior in the spatial domain. We used a rotating arena-based apparatus (Carousel requiring rats to avoid an unmarked sector defined in either the reference frame of the rotating arena (arena frame task, AF or the stationary room (room frame task, RF. We investigated behavioral flexibility in four conditions involving different cognitive loads. Each condition encompassed an initial (five sessions and a test phase (five sessions in which some aspects of the task were changed to test flexibility in which rats were given saline, 0.05 mg/kg or 0.1 mg/kg MK-801 thirty minutes prior to a session. In the first condition, rats acquired avoidance in RF with clockwise rotation of the arena while in the test phase the arena rotated counterclockwise. In the second condition, rats initially acquired avoidance in RF with the sector on the north and then it was reversed to south (spatial reversal. In the third and fourth conditions, rats initially performed an AF (RF, respectively task, followed by an RF (AF, respectively task, testing the ability of cognitive set-shifting. We found no effect of MK-801 either on simple motor adjustment after reversal of arena rotation or on spatial reversal within the RF. In contrast, administration of MK-801 at a dose of 0.1 mg/kg interfered with set-shifting in both conditions. Furthermore, we observed MK-801 0.1 mg/kg elevated locomotion in all cases. These data suggest that blockade of NMDA receptors by acute system administration of MK-801 preferentially affects set-shifting in the cognitive domain rather

  12. Brave new worlds--review and update on virtual reality assessment and treatment in psychosis.

    Veling, Wim; Moritz, Steffen; van der Gaag, Mark

    2014-11-01

    In recent years, virtual reality (VR) research on psychotic disorders has been initiated. Several studies showed that VR can elicit paranoid thoughts about virtual characters (avatars), both in patients with psychotic disorders and healthy individuals. Real life symptoms and VR experiences were correlated, lending further support to its validity. Neurocognitive deficits and difficulties in social behavior were found in schizophrenia patients, not only in abstract tasks but also using naturalistic virtual environments that are more relevant to daily life, such as a city or encounters with avatars. VR treatments are conceivable for most dimensions of psychotic disorders. There is a small but expanding literature on interventions for delusions, hallucinations, neurocognition, social cognition, and social skills; preliminary results are promising. VR applications for assessment and treatment of psychotic disorders are in their infancy, but appear to have a great potential for increasing our understanding of psychosis and expanding the therapeutic toolbox. PMID:25193975

  13. Mania and Psychosis Associated with St. John's Wort and Ginseng

    Joshi, Kaustubh G.; Faubion, Matthew D.

    2005-01-01

    The use of complimentary/alternative medicine has become popular as evidenced by grocery store aisles and “infomercials” devoted to herbal products. These products are often misconstrued as safe because of their natural origin. With an increase in the consumption of these products, physicians need to be aware of their potential adverse effects. There are several popular over-the-counter herbal products that can affect one's behavior, especially resulting in acute mania and/or psychosis. This ...

  14. Ziconotide-induced psychosis: a case report.

    Phan, Stephanie V; Waldfogel, Julie M

    2015-01-01

    Ziconotide is used intrathecally in the management of severe chronic pain that contains a warning against neuropsychiatric adverse events. The definition of psychiatric events is broad and management strategies are vague. This case report describes a 49-year-old female who was admitted to the acute psychiatric unit to address auditory hallucinations and paranoid ideation persisting for 3 weeks. Approximately 3 months ago, an intrathecal pump with ziconotide was implanted to treat pain. Upon hospital admission, the pump was infusing at a rate of 4.9 mcg/24 hours. Because the drug could not be immediately discontinued, risperidone 0.5 mg nightly was initiated and subsequently, the pump was drained of ziconotide, rinsed, and refilled with normal saline. The patient reported no hallucinations or apparent delusions several hours later and was eventually discharged with resolution of psychotic symptoms and continuation of risperidone for 10 days. Despite the identification of neuropsychiatric effects, limited information is available to characterize the presentation and guide specific management aside from recommendations to discontinue the infusion and possible use of psychotropic medications or necessity for hospitalization. This case report characterizes one presentation of hallucinations and paranoia associated with ziconotide intrathecal infusion. Clinicians should be aware of the management strategies to mediate these adverse effects, including expected time to adverse effect resolution, removal of ziconotide from the pump, and role for short-term use of antipsychotics. PMID:25459190

  15. Neurocognitive dysfunction in first-episode psychosis

    Rund, Bjørn Rishovd; Melle, Ingrid; Friis, Svein;

    2004-01-01

    The authors examined the relationship of neurocognitive function with duration of untreated psychosis, premorbid illness factors, and clinical symptoms to determine whether long duration of untreated psychosis independently compromises cognitive function....

  16. Early detection of first-episode psychosis

    Larsen, Tor K; Melle, Ingrid; Auestad, Bjørn;

    2006-01-01

    Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven.......Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven....

  17. Caregiver psychoeducation for first-episode psychosis.

    McWilliams, Stephen

    2010-01-01

    International best-practice guidelines for the management of first-episode psychosis have recommended the provision of psychoeducation for multifamily groups. While there is ample evidence of their efficacy in multiepisode psychosis, there is a paucity of evidence supporting this approach specifically for first-episode psychosis. We sought to determine whether a six-week caregiver psychoeducation programme geared specifically at first-episode psychosis improves caregiver knowledge and attitudes.

  18. Psychosis as Harbinger of Phenytoin Toxicity

    Borasi, Manish; Verma, R. Pravin; Gupta, Sumit Kumar

    2015-01-01

    Psychosis with phenytoin use has earlier been reported only in the context of Vitamin B12 or folic acid deficiency. We report a rare case of phenytoin toxicity manifesting as psychosis in the absence of Vitamin deficiency. The importance of recognition of psychosis as a harbinger of phenytoin toxicity and implications for management are discussed. PMID:26862279

  19. Paranoid Adipsia-induced Severe Hypernatremia and Uremia treated with Hemodialysis

    Choi, Jae-Hyun; Lee, Hee Seung; Kim, Sun Moon; Kim, Hye-Young; Kwon, Soon Kil

    2013-01-01

    We describe a patient with severe hypernatremia and uremia caused by paranoid adipsia who was treated successfully with hydration and hemodialysis. A previously healthy 40-year-old woman developed the paranoid idea that her water was poisoned, so she refused to drink any water. On admission, her blood urea nitrogen was 208mg/dL, creatinine 4.90mg/dL, serum osmolality 452mOsm/L, serum sodium 172mEq/L, urine specific gravity ≥1.030, urine osmolality 698mOsm/L, and urine sodium/potassium/chlorid...

  20. BIOMETRIC INDICES OF CONSTITUTIONAL RISKS FOR DEVELOPMENT OF PARANOID SCHIZOPHRENIA IN MALE PATIENTS

    Lebedeva Е.A

    2009-09-01

    Full Text Available Aim: the current study examines features and correlations of particular psychodynamic, dermatoglyphic characteristics and body constitution of men with paranoid schizophrenia. Study groups: 25 men having the "paranoid schizophrenia" (F20.0, 27 men having no mental diseases. Methods: psychodiagnostic tests (Hand test, the Big Five Inventory (BFI, anthropometry; dactyloscopy. Results: there were statistically significant differences in such personality factors as: extroversion and openness among two groups. Significantly smaller sizes of the chest and thigh circumferences were found in men with paranoid schizophrenia. The schizophrenic group exhibited higher frequency of "ulnar loop" and "double loop" finger pattern occurrence. Our study found a number of somato-psychic, dermato-psychic and dermato-somatic correlations, as well as correlations between personality factors and age. Conclusion: the examination of personality features correlated with markers of dermatoglyphic and body constitution helped to identify the predictors of risks for developing paranoid schizophrenia. This makes it possible the identification of at-risk groups with their monitoring and focusing on preventive programs

  1. Self psychology as a shift away from the paranoid strain in classical analytic theory.

    Terman, David M

    2014-12-01

    Classical psychoanalytic theory has a paranoid strain. There is, in effect, an "evil other"--the id--within each individual that must be tamed in development and confronted and worked through as resistance in treatment. This last has historically endgendered an adversarial relationship between patient and analyst. This paranoid strain came from a paranoid element in Freud's personality that affected his worldview, his relationships, and his theory. Self psychology offers a different view of development and conflict. It stresses the child's need for responsiveness from and admiration of caretakers in order to develop a well-functioning self. Though severe behavioral and character problems may result from faults in the process of self-construction, the essential need is not instinctual discharge but connection. Hence the long-assumed opposition between individual needs and social institutions or between patient and analyst is no longer inevitable or universal. Rather, an understanding of the primary need for connection creates both a different interpretive stance and a more cooperative ambience. These changes in theory and technique are traced to Kohut's personal struggles to emancipate himself from his paranoid mother. PMID:25339303

  2. Mania and Psychosis Associated with St. John's Wort and Ginseng.

    Joshi, Kaustubh G; Faubion, Matthew D

    2005-09-01

    The use of complimentary/alternative medicine has become popular as evidenced by grocery store aisles and "infomercials" devoted to herbal products. These products are often misconstrued as safe because of their natural origin. With an increase in the consumption of these products, physicians need to be aware of their potential adverse effects. There are several popular over-the-counter herbal products that can affect one's behavior, especially resulting in acute mania and/or psychosis. This article provides an overview of existing literature regarding the increased use of herbal agents, reviews several case reports describing a potential association between herbal products (St. John's Wort and ginseng) and the development of mania and psychosis, and discusses the limitations in determining the frequency of serious adverse effects due to herbal products. PMID:21120109

  3. Anatomía de una confusión: error diagnóstico de patología paranoide en víctimas de mobbing Anatomia de uma confusão: erro diagnóstico de patologia paranoide em vítimas de mobbing Anatomy of a misunderstanding: wrong diagnosis of paranoid pathology in victims of mobbing

    Ángel Martínez-Hernáez; Leticia Medeiros-Ferreira

    2010-01-01

    CONTEXTO: Diversas investigaciones subrayan el alto riesgo de error diagnóstico de trastorno delirante y trastorno paranoide de la personalidad entre víctimas de mobbing o acoso psicológico en el trabajo (APT). OBJETIVO: Analizar hasta qué punto los síntomas asociados con el mobbing son confundidos con criterios de dos nosologías del espectro paranoide (trastorno delirante y trastorno paranoide de la personalidad). MÉTODOS: Se realiza una revisión bibliográfica desde 1990 hasta Junio de 2009 ...

  4. Diagnostic pitfalls in a young Romanian ranger with an acute psychotic episode

    Nagy, Előd Ernő; Rácz, Attila; Urbán, Edit; Terhes, Gabriella; Berki, Timea; Horváth, Emőke; Georgescu, Anca M; Zaharia-Kézdi, Iringó E

    2016-01-01

    The identification and distinction of the pathological conditions underlying acute psychosis are often challenging. We present the case of a 35-year-old ranger who had no history of acute or chronic infectious disease or any previous neuropsychiatric symptoms. He arrived at the Psychiatry Clinic and was admitted as an emergency case, displaying bizarre behavior, hallucinations, paranoid ideation, and delusional faults. These symptoms had first appeared 7 days earlier. An objective examination revealed abnormalities of behavior, anxiety, visual hallucinations, choreiform, and tic-like facial movements. After the administration of neuroleptic and antidepressant treatment, he showed an initial improvement, but on day 10 entered into a severe catatonic state with signs of meningeal irritation and was transferred to the intensive care unit. An electroencephalogram showed diffuse irritative changes, raising the possibility of encephalitis. Taking into consideration the overt occupational risk, Borrelia antibody tests were prescribed and highly positive immunoglobulin (Ig)M and IgG titers were obtained from serum, along with IgG and antibody index positivity in cerebrospinal fluid. In parallel, anti-N-methyl-D-aspartate receptor antibodies and a whole battery of other autoimmune encephalitis markers showed negative. A complex program of treatment was applied, including antibiotics, beginning with ceftazidime and ciprofloxacin – for suspected aspiration bronchopneumonia – and thereafter with ceftriaxone. A gradual improvement was noticed and the treatment continued at the Infectious Disease Clinic. Finally, the patient was discharged with a doxycycline, antidepressant, and anxiolytic maintenance treatment. On his first and second control (days 44 and 122 from the disease onset), the patient was stable with no major complaints, Borrelia seropositivity was confirmed both for IgM and IgG while the cerebrospinal fluid also showed reactivity for IgG on immunoblot. On the

  5. Lifestyle Intervention for Diabetes and Weight Management in Psychosis

    2015-01-08

    Type 2 Diabetes Mellitus; Schizophrenia; Schizoaffective Disorder; Schizophreniform Disorder; Bipolar I Disorder; Major Depression With Psychotic Features; Substance-induced Psychosis; Psychosis Not Otherwise Specified

  6. An unusual presentation of brief recurrent psychosis: a case report

    Krishnamurthy CN

    2012-12-01

    Full Text Available Background: Although the term "zycloiden psychosen" was first used by Karl Kleist in 1926 to group together disorders, which had presented with sudden onset, brief episodic course, polymorphous psychotic symptoms and good inter-episode recovery, its origin can be traced back to 1880s. Despite its existence in the community, for so long, the diagnosis of cycloid psychosis is only seldom made, making it a unique disorder. Hence, there seems to be lack of awareness of this rare entity even among the psychiatrists.Case description: A middle-aged woman with abrupt onset of recurrent brief episodes of psychotic symptoms, and complete inter-episode recovery, was admitted with history of alleged consumption of poison in a state of confusion. During psychotic episodes, motility disturbances were predominant. The current episode lasted for about two weeks.Discussion: This case doesn't satisfy the criteria for schizophrenia or affective illness. Although ICD-10 describes 'acute polymorphic psychotic disorder' (F23.0, F23.1 it requires the presence of typical schizophrenic symptoms for its diagnosis and is usually not recurrent. The closest this case resembles is cycloid psychosis, meeting three of four Perris criteria.Conclusion: The diagnosis of such unusual cases of psychosis predicts the prognosis and helps in assessment and management of future episodes.

  7. [Young person's first-episode psychosis].

    Mäki, Pirjo; Veijola, Juha

    2012-01-01

    Young person's first-episode psychosis may signify the onset of schizophrenia, psychotic depression or bipolar disorder. It can also be a brief condition resulting in full recovery. The psychosis may be caused by drugs. First-episode psychosis is usually preceded by a long period of nonspecific symptoms. Provision of close and active follow-up is important in the prodromal phase. Treatment of first-episode psychosis is individual. Usually it involves medication, individual discussions, psychotherapy or music therapy as well as family meetings. The therapy helps the young person become independent. PMID:22312825

  8. [Prison psychosis and dissociative disorders].

    al Chaabani, S; Bataille, M

    2002-12-01

    Through a few clinical case histories stemming from their daily activities at the psychiatric section of the Lantin Prison, the authors propose to revisit the classic concept of Prison psychosis. They broaden its limits to include other psychotic and dissociative phenomena common to the jail population. This requires a strict differential diagnosis, allowing to eliminate some similar pathologies; nevertheless, some difficulties and imperfections persist. The development of the psychosis, the input from the jail architecture and milieu, the predisposing as well as facilitating factors linked to the personality of the inmate, and triggering phenomena are discussed. Finally, the comorbidity between these psychotic/dissociative phenomena and the borderline & histrionic personality disorders is envisaged. PMID:12632838

  9. A Personality Disorders: Schizotypal, Schizoid and Paranoid Personality Disorders in Childhood and Adolescence

    Esterberg, Michelle L.; Goulding, Sandra M.; Walker, Elaine F.

    2010-01-01

    Cluster A personality disorders (PD), including schizotypal personality disorder (SPD), paranoid personality disorder (PPD), and schizoid PD, are marked by odd and eccentric behaviors, and are grouped together because of common patterns in symptomatology as well as shared genetic and environmental risk factors. The DSM-IV-TR describes personality disorders as representing stable and enduring patterns of maladaptive traits, and much of what is understood about Cluster A personality disorders i...

  10. Schizotypal, Schizoid and Paranoid Characteristics in the Biological Parents of Social Anhedonics

    Cohen, Alex S.; Emmerson, Lindsay C.; Mann, Monica C.; Forbes, Courtney B.; Blanchard, Jack J.

    2010-01-01

    Mounting evidence suggests that social anhedonia may be a marker of genetic liability for schizophrenia-spectrum pathology. To examine this hypothesis, we conducted a study of severity of schizotypal, schizoid and paranoid pathology (i.e., Cluster A personality disorders) in the biological parents of individuals with high levels of social anhedonia and healthy controls. Eighty-six individuals with social anhedonia, 89 healthy controls and their biological parents were recruited from a large c...

  11. Sykepleiekompetanse -en kvalitativ studie om sykepleieres erfaringer i behandling av pasienter med diagnosen paranoid schizofreni

    Bakland, Maria

    2014-01-01

    Background and purpose: Today's political guidelines show increased investment in mental health care. Many people with mental illness, who have lost their employability, report that they feel they have not been treated for their mental health problem. As a nurse working with the patient with a diagnosis of paranoid schizophrenia , one is mostly dependent on using oneself as an instrument. It is therefore important to be aware of one's own skills, and the ways in which competence will affect t...

  12. First-Episode of Synthetic Cannabinoid-Induced Psychosis in a Young Adult, Successfully Managed with Hospitalization and Risperidone

    Lorenzo, Aileen; Li, Kevin J.; Young, Jonathan; Pinnaka, Subhash; Lapidus, Kyle A. B.

    2016-01-01

    Synthetic cannabinoids- (SCs-) induced psychosis is a growing public health concern. It leads to significant impairment, including emotional distress, difficulty communicating, and other debilitating symptoms. In this case report, we discuss a patient with no previous history of psychotic symptoms, presenting with first-episode psychosis in the context of progressive, acutely worsening, disorganized, psychotic thoughts and behaviors following prolonged use of SCs. We also discuss relevant literature on SCs-induced psychosis, highlighting its prevalence, presentation, diagnosis, and recommended management. It is important to diagnose and treat SCs-induced psychosis as early and efficiently as possible, in order to alleviate symptoms while limiting functional impairment and emotional distress to the patient. PMID:27429822

  13. The relationship of childhood bullying and paranoid thinking in a clinical population: the role of mediators

    Chaudhry, Khadija

    2012-01-01

    A wealth of research evidence has been accumulating over the last two decades, highlighting the association of childhood trauma and psychosis. The literature review evaluates empirical evidence and builds upon the previous literature reviews in this area. In addition, the literature review examines the theoretical bases and the underlying psychological factors that contribute to the relationship between childhood trauma and psychosis. It concluded that despite a large body of literature on th...

  14. Apathy in first episode psychosis patients

    Evensen, Julie; Røssberg, Jan Ivar; Barder, Helene;

    2012-01-01

    Apathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10 years after the first psychotic episode remain unexplored.......Apathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10 years after the first psychotic episode remain unexplored....

  15. ACUTE NON-ORGANIC PSYCHOTIC STATE IN INDIA: SYMPTOMATOLOGY

    Verma, Vijoy K.; Malhotra, Savita; Jiloha, Ram C.

    1992-01-01

    Patients with acute onset, non-organic psychotic states are frequently reported from India and certain other developing countries. This paper relates to an investigation of such cases in terms of their clinical history and their symptomatology examining the extent to which these are similar /dissimilar to schizophrenia and affective psychosis. 109 cases of acute psychosis fulfilling specified screening criteria were assessed on the Schedule for Clinical Assessment Acute Psychotic States (SCAA...

  16. ADD psychosis as a separate entity.

    Bellak, L

    1985-01-01

    "Attention deficit disorder (ADD) psychosis" merits delineation as a separate entity. It constitutes the end result of the effects of a certain particular neurological deficit (ADD) on personality organization. It is my belief that about 10 percent of psychoses currently diagnosed most often schizophrenic and sometimes affective psychosis must best be considered a separate organic psychosis, i.e., an ADD psychosis. This ADD psychosis, then, is not merely a subgroup of schizophrenia, as I once thought. It merits a separate designation because its etiology, pathogenesis, and life history are different from those of the schizophrenic syndrome. The family histories are also different, as are the psychological findings. The treatment response is so different that it merits urgent consideration. Prognosis, both short range and long range, also seems different from those of the other psychoses. PMID:4081648

  17. What is a psychosis and where is it located?

    Saugstad, Letten F

    2008-06-01

    pruning of excitatory synapses. Silent spots are the result of insufficient fill-in mechanisms following a breakdown of circuitry. They may affect the SMA in the case of very late puberty. An acute reduction in excitation and concomitantly a marked increase in silent spots might lead to an acute psychosis. A frontal preference is likely, given that a reduction might occur anywhere in the cortex, but particularly in the areas maturing latest. The varying localisations probably explain the difficulty in accepting schizophrenia as a disease entity. The multifactorial inheritance of the dichotomy implies that the genetics are not fate, a psychotic development might be prevented given enough epigenetic factors: brain food (omega 3). Might the present dietary adversity, with its lack of brain food, be responsible for a rising incidence in psychosis? A psychosis is an understandable and preventable dysfunction of the brain, and its mechanisms are known. Primarily a disorder of reduced excitation in an attenuated CNS, this explains why all the neuroleptics are convulsants, raising excitation, in contrast to all antidepressives, which are anti-epileptic. PMID:18516523

  18. Human Laboratory Studies on Cannabinoids and Psychosis.

    Sherif, Mohamed; Radhakrishnan, Rajiv; D'Souza, Deepak Cyril; Ranganathan, Mohini

    2016-04-01

    Some of the most compelling evidence supporting an association between cannabinoid agonists and psychosis comes from controlled laboratory studies in humans. Randomized, double-blind, placebo-controlled, crossover laboratory studies demonstrate that cannabinoid agonists, including phytocannabinoids and synthetic cannabinoids, produce a wide range of positive, negative, and cognitive symptoms and psychophysiologic deficits in healthy human subjects that resemble the phenomenology of schizophrenia. These effects are time locked to drug administration, are dose related, and are transient and rarely necessitate intervention. The magnitude of effects is similar to the effects of ketamine but qualitatively distinct from other psychotomimetic drugs, including ketamine, amphetamine, and salvinorin A. Cannabinoid agonists have also been shown to transiently exacerbate symptoms in individuals with schizophrenia in laboratory studies. Patients with schizophrenia are more vulnerable than healthy control subjects to the acute behavioral and cognitive effects of cannabinoid agonists and experience transient exacerbation of symptoms despite treatment with antipsychotic medications. Furthermore, laboratory studies have failed to demonstrate any "beneficial" effects of cannabinoid agonists in individuals with schizophrenia-challenging the cannabis self-medication hypothesis. Emerging evidence suggests that polymorphisms of several genes related to dopamine metabolism (e.g., COMT, DAT1, and AKT1) may moderate the effects of cannabinoid agonists in laboratory studies. Cannabinoid agonists induce dopamine release, although the magnitude of release does not appear to be commensurate to the magnitude and spectrum of their acute psychotomimetic effects. Interactions between the endocannabinoid, gamma-aminobutyric acid, and glutamate systems and their individual and interactive effects on neural oscillations provide a plausible mechanism underlying the psychotomimetic effects of

  19. [Current peculiarities of alcoholic psychosis].

    Aleksin, D S; Egorov, A Iu

    2011-01-01

    The follow-up study of alcoholic psychoses in male patients admitted to a clinical department of a psychiatric hospital in 2005-2007 was carried out. Patients with alcoholic psychoses made up from 15 to 30% of all patients. The number of psychosis had seasonal variations with the elevations in spring and autumn, peaks in January, lune and October. Alcoholic delirium morbidity made up from 69 to 82% of the total number of alcoholic psychoses, alcoholic hallucinosis varied from 14 to 27%. Other forms were presented by single cases. In alcoholic delirium hallucinations had brighter, sated character. The most specific were visual hallucinations in the form of zoohallucinations, hallucinations of an oral cavity ("sensation of threads, hair etc"). The most often observable characters were "extraneous people, animal, demons". In alcoholic hallucinosis, verbal contrast hallucinations, making comment hallucinations, visual illusions were most frequent. The family history of mental disorders and alcoholism was noted in 30% of patients with alcoholic psychosis. The probability of occurrence of alcoholic psychoses depended on the quality of consumed drinks. The presence of a cranial-brain injury in the anamnesis considerably aggravated the disease forecast and increased the risk of seizure syndrome. PMID:22611692

  20. Long term functioning in early onset psychosis: Two years prospective follow-up study

    Taha Ghada RA

    2011-07-01

    Full Text Available Abstract Background There were few studies on the outcome of schizophrenia in developing countries. Whether the outcome is similar to or different from developed world is still a point for research. The main aim of the current study was to know if patients with early onset non affective psychosis can behave and function properly after few years from start of the illness or not. Other aims included investigation of possible predictors and associated factors with remission and outcome. Method The study prospectively investigated a group of 56 patients with onset of psychosis during childhood or adolescence. Diagnosis made according to DSM-IV criteria and included; schizophrenia, psychotic disorder not otherwise specified and acute psychosis. Severity of psychosis was measured by PANSS. Measures of the outcome included; remission criteria of Andreasen et al 2005, the children's global assessment scale and educational level. Results Analysis of data was done for only 37 patients. Thirty patients diagnosed as schizophrenia and 7 with Psychotic disorder not otherwise specified. Mean duration of follow up was 38.4 +/- 16.9 months. At the end of the study, 6 patients (16.2% had one episode, 23(62.1% had multiple episodes and 8 (21.6% continuous course. Nineteen patients (51.4% achieved full remission, and only 11(29.7% achieved their average educational level for their age. Twenty seven percent of the sample had good outcome and 24.3% had poor outcome. Factors associated with non remission and poor outcome included gradual onset, low IQ, poor premorbid adjustment, negative symptoms at onset of the illness and poor adherence to drugs. Moreover, there was tendency of negative symptoms at illness start to predict poor outcome. Conclusion Some patients with early onset non affective psychosis can behave and function properly after few years from the start of the illness. Although remission is a difficult target in childhood psychosis, it is still achievable.

  1. Cognitive Restructuring and Graded Behavioural Exposure for Delusional Appraisals of Auditory Hallucinations and Comorbid Anxiety in Paranoid Schizophrenia

    Pawel D. Mankiewicz; Colin Turner

    2014-01-01

    The prevalence of diagnostic comorbidity between psychosis and anxiety disorders has been found to be considerable. Cognitive models of psychosis suggest that anxiety does not arise directly from positive symptoms of schizophrenia but rather from an individual interpretation of such experiences. In the United Kingdom, cognitive-behavioural therapy for psychosis (CBTp) has been recommended within clinical guidelines as a psychological treatment of choice for those diagnosed with schizophrenia....

  2. ACUTE PSYCHOTIC DISORDER AND HYPOGLYCEMIA

    Singh, S.K.; Agrawal, J.K.; Srivastava, A.S.; Bhardwaj, V.K.; Bose, B. Sarat

    1994-01-01

    A variable array of neuroglycopenic symptoms are frequently encountered in the hypoglycemic stage, but acute psychotic disorders are quite rare. A fifty five year old female presented with an acute psychosis following oral sulfonylurea induced hypoglycemia without preceding features of adrenomedullary stimulation. This case report suggests that an acute and transient psychotic disorder may be an important neuroglycopenic feature and its early recognition protects the patient from severe hypog...

  3. Predictors of recovery in first episode psychosis

    Austin, Stephen; Mors, Ole; Secher, Rikke Gry;

    2013-01-01

    Recovery, the optimal goal in treatment, is the attainment of both symptomatic and functional remission over a sustained period of time. Identification of factors that promote recovery can help develop interventions that facilitate good outcomes for people with first episode psychosis.......Recovery, the optimal goal in treatment, is the attainment of both symptomatic and functional remission over a sustained period of time. Identification of factors that promote recovery can help develop interventions that facilitate good outcomes for people with first episode psychosis....

  4. Cognitive Behavioral Therapy in Prodromal Psychosis

    Addington, Jean; Marshall, Catherine; French, Paul

    2012-01-01

    There is a strong impetus in the psychosis research field to develop interventions that aim to prevent the onset of psychotic disorders. Over the past 15 years there has been a tremendous development in the work aimed at understanding the pre-psychotic period. More recently there has been a focus on developing and testing treatments both pharmacological and psychological that could potentially prevent or delay the onset of psychosis. One of the psychological treatments that has received the m...

  5. NON-BEHAVIORAL MODELS OF PSYCHOSIS

    Parle Milind; Kadian Renu; Kaura Sushila

    2013-01-01

    Animal models have become indispensible tools for discovering new medicines and in the analysis of multitude of causes, bio-markers and pathophysiological changes, which bring about symptoms characteristics of a specific disorder. One of the biggest challenges in discovering medicines for psychosis is to find an appropriate animal model of this illness possessing fair face validity, construct validity, and predictive validity. We had explained in detail behavioral models of psychosis in our p...

  6. Thirty Days without a Bite: Wernicke’s Encephalopathy in a Patient with Paranoid Schizophrenia

    Langlois, Mélanie; Doré, Marie-Claire; Laforce, Robert

    2016-01-01

    Wernicke’s Encephalopathy (WE) is a preventable neurologic condition characterized by altered mental status, ophthalmoplegia, and ataxia. Although historically associated with alcoholism, a few authors have described WE in patients with non-alcohol related psychiatric disorders. We report herein the case of a 36-year-old young man with paranoid schizophrenia who was brought to hospital for confusion and difficulties with his vision. His roommate said he had gone about thirty days without eating ‘…because he was on a slimming cure’. History and physical examination suggested WE as a result of isolation and poor diet leading to nutritional deficiency. This was confirmed by brain magnetic resonance imaging showing classic thalamic, mammillary bodies and brainstem lesions. Of note, his cognitive profile was far more heterogeneous than what had classically been described in the literature and involved both cortical and subcortical pathology, generating memory but also significant executive deficits. Intravenous treatment with thiamine was given and our patient showed mild improvements in visual acuity and nystagmus. However, persistent cognitive and physical disabilities consistent with Korsakoff syndrome remained, and he now lives in a supervised home. This case illustrates the tragic consequences of nutritional deficiencies in a patient with paranoid schizophrenia. The threshold to suspect WE in schizophrenic patients should be lowered and in doubt prophylactic parenteral thiamine should be administered. PMID:27088109

  7. Anatomía de una confusión: error diagnóstico de patología paranoide en víctimas de mobbing Anatomia de uma confusão: erro diagnóstico de patologia paranoide em vítimas de mobbing Anatomy of a misunderstanding: wrong diagnosis of paranoid pathology in victims of mobbing

    Ángel Martínez-Hernáez

    2010-01-01

    Full Text Available CONTEXTO: Diversas investigaciones subrayan el alto riesgo de error diagnóstico de trastorno delirante y trastorno paranoide de la personalidad entre víctimas de mobbing o acoso psicológico en el trabajo (APT. OBJETIVO: Analizar hasta qué punto los síntomas asociados con el mobbing son confundidos con criterios de dos nosologías del espectro paranoide (trastorno delirante y trastorno paranoide de la personalidad. MÉTODOS: Se realiza una revisión bibliográfica desde 1990 hasta Junio de 2009 en PubMed y SciELO. RESULTADOS: La identificación de síntomas del espectro paranoide en las víctimas de mobbing no resulta consistente con la literatura que, en cambio, indica una fuerte presencia de síntomas del espectro del estrés postraumático (hasta el 92%, aunque no se cumpla el criterio A1 de esta nosología. Se apuntan algunas causas del error diagnóstico, tales como la tendencia a confundir hipervigilancia (criterio D4 del trastorno por estrés postraumático en el DSM-IV-TR con ideación paranoide, la existencia de un perfil defensivo en las víctimas de APT y la falta de reconocimiento por parte de los clínicos del impacto estresante y traumatizante del mobbing. CONCLUSIÓN: Se requieren investigaciones longitudinales y mixtas (cualitativos/cuantitativos para establecer criterios robustos de diagnóstico diferencial entre las manifestaciones clínicas asociadas al mobbing y los síntomas paranoides.CONTEXTO: Diversos estudos evidenciam o alto risco de erro diagnóstico de transtorno delirante e transtorno da personalidade paranoide entre as vítimas de mobbing ou assédio psicológico no trabalho (APT. OBJETIVO: Analisar a associação dos sintomas atribuídos ao mobbing com os critérios de duas nosologias do grupo paranoide (transtorno delirante e transtorno da personalidade paranoide. MÉTODOS: Realiza-se uma revisão bibliográfica de 1990 a junho de 2009 em PubMed e SciELO. RESULTADOS: A identificação de sintomas paranoides em

  8. Psychosis

    ... what is taking place, or who one is (delusions). See or hear things that are not there ( ... False beliefs that are not based in reality (delusions), especially unfounded fear or suspicion Hearing, seeing, or ...

  9. Are Specific Early-Life Adversities Associated With Specific Symptoms of Psychosis?: A Patient Study Considering Just World Beliefs as a Mediator.

    Wickham, Sophie; Bentall, Richard

    2016-08-01

    Epidemiological studies have suggested that there may be associations between specific adversities and specific psychotic symptoms. There is also evidence that beliefs about justice may play a role in paranoid symptoms. In this study, we determined whether these associations could be replicated in a patient sample and whether beliefs about a just world played a specific role in the relationship between adversity and paranoia. We examined associations between childhood trauma, belief in justice, and paranoia and hallucinatory experiences in 144 individuals: 72 individuals with a diagnosis of schizophrenia spectrum disorders and 72 comparison controls. There was a dose-response relationship between cumulative trauma and psychosis. When controlling for comorbidity between symptoms, childhood sexual abuse predicted hallucinatory experiences, and experiences of childhood emotional neglect predicted paranoia. The relationship between neglect and paranoia was mediated by a perception of personal injustice. The findings replicate in a patient sample previous observations from epidemiological research. PMID:27065105

  10. Insight dimensions and cognitive function in psychosis: a longitudinal study

    Peralta Victor

    2006-05-01

    Full Text Available Abstract Background It has been reported that lack of insight is significantly associated with cognitive disturbance in schizophrenia. This study examines the longitudinal relationships between insight dimensions and cognitive performance in psychosis. Methods Participants were 75 consecutively admitted inpatients with schizophrenia, affective disorder with psychotic symptoms or schizoaffective disorder. Assessments were conducted at two time points during the study: at the time of hospital discharge after an acute psychotic episode and at a follow-up time that occurred more than 6 months after discharge. A multidimensional approach of insight was chosen and three instruments for its assessment were used: the Scale to Assess Unawareness of Mental Disorder (SUMD, three items concerning insight on the Assessment and Documentation in Psychopathology (AMDP system and the Insight and Treatment Attitudes Questionnaire. The neuropsychological battery included a wide range of tests that assessed global cognitive function, attention, memory, and executive functions. Results After conducting adequate statistical correction to avoid Type I bias, insight dimensions and cognitive performance were not found to be significantly associated at cross-sectional and longitudinal assessments. In addition, baseline cognitive performance did not explain changes in insight dimensions at follow-up. Similar results were found in the subset of patients with schizophrenia (n = 37. The possibility of a Type II error might have increased due to sample attrition at follow-up. Conclusion These results suggest that lack of insight dimensions and cognitive functioning may be unrelated phenomena in psychosis.

  11. Paranoid, moi?

    Pedersen, Peter Ole; Løhmann Stephensen, Jan

    2010-01-01

    bordering on activism. This is sought combined with the ability to entertain the audience through elements of fiction and comic relief while attempting an analysis of a current and often controversial subject. Michael Moore’s productions are the most successful examples of this filmmaking strategy and two...

  12. Paranoid, moi?

    Pedersen, Peter Ole; Stephensen, Jan Løhmann

    2013-01-01

    The authors research the ways in which surveillance discourse and studies on surveillance phenomena manifest itself in mainstream documentary filmmaking. The subject of this critical case study is David Bond’s Erasing David (2010), a hybrid documentary which aesthetics and conceptual roots...

  13. Reducing the duration of untreated first-episode psychosis

    Melle, Ingrid; Larsen, Tor K; Haahr, Ulrik; Friis, Svein; Johannessen, Jan Olav; Opjordsmoen, Stein; Simonsen, Erik; Rund, Bjørn Rishovd; Vaglum, Per; McGlashan, Thomas

    2004-01-01

    Most studies on first-episode psychosis show an association between a long duration of untreated psychosis (DUP) and poorer short-term outcome, but the mechanisms of this relationship are poorly understood....

  14. Too paranoid to see progress: Social psychology is probably liberal, but it doesn't believe in progress.

    Winegard, Bo; Winegard, Benjamin; Geary, David C

    2015-01-01

    We agree with Duarte et al. that bias in social psychology is a serious problem that researchers should confront. However, we are skeptical that most social psychologists adhere to a liberal progress narrative. We suggest, instead, that most social psychologists are paranoid egalitarian meliorists (PEMs). We explain the term and suggest possible remedies to bias in social psychology. PMID:26785792

  15. Emotion Recognition and Psychosis-Proneness: Neural and Behavioral Perspectives

    Germine, Laura Thi

    2012-01-01

    Schizophrenia is associated with deficits in social cognition and emotion processing, but it is not known how these deficits relate to other domains of neurocognition and whether they might contribute to psychosis development. The current dissertation approaches this question by looking at the relationship between psychosis proneness and face emotion recognition ability, a core domain of social-emotional processing. Psychosis proneness was inferred by the presence of psychosis-like character...

  16. Psychosis and violence: stories, fears, and reality.

    Taylor, Pamela J

    2008-10-01

    Individuals with psychosis are often feared. In fact, they are themselves likely to be victims of violence; however, the main aim of this review is to provide an overview of the evidence on relations between psychosis and violence to others. The terms psychosis and violence were used in a literature search limited to the Cochrane Library and PubMed, a manual search of 8 journals, and a follow-up of additional references in the articles found. The overview draws on new empirical data and major reviews. Almost all sound epidemiologic data on psychosis and violence dates from 1990. There is consistency on a small but significant relation between schizophrenia and violent acts. Since then there has also been movement toward understanding the nature of associations and progress on strategies for managing individuals who have psychosis and are violent. Public fears about individuals with psychotic illnesses are largely unfounded, although there would be benefit in greater attention to the safety of those in their close social circle. The task for the next 10 years must be the development and application of knowledge to improve specific treatments-that is, interventions that go beyond holding and caring to bring about substantial change. PMID:18940033

  17. Secondary association of PDLIM5 with paranoid schizophrenia in Emirati patients.

    Moselhy, Hamdy; Eapen, Valsamma; Akawi, Nadia A; Younis, Ali; Salih, Badr; Othman, Aws R; Yousef, Said; Clarke, Raymond A; Ali, Bassam R

    2015-09-01

    Schizophrenia is a clinically and genetically heterogeneous disorder of unknown etiology. PDLIM5 variants have been linked to schizophrenia and other related neuropsychiatric disorders and upregulated in the brain of schizophrenia patients suggesting a possible pathogenic role in disease progression. The aim of this study is to examine the potential association of schizophrenia in Emirati patients with previously reported variants in PDLIM5, PICK1, NRG3 or DISC1 genes. Consequently, we found a secondary association between PDLIM5 variants and the paranoid subtype of schizophrenia in Emirati Arabs suggesting that PDLIM5 may represent a determinate/marker for schizophrenia subtype specification. However, no associations were found with variants in PICK1, NRG3 or DISC1 genes. PMID:26925374

  18. Secondary association of PDLIM5 with paranoid schizophrenia in Emirati patients

    Hamdy Moselhy

    2015-09-01

    Full Text Available Schizophrenia is a clinically and genetically heterogeneous disorder of unknown etiology. PDLIM5 variants have been linked to schizophrenia and other related neuropsychiatric disorders and upregulated in the brain of schizophrenia patients suggesting a possible pathogenic role in disease progression. The aim of this study is to examine the potential association of schizophrenia in Emirati patients with previously reported variants in PDLIM5, PICK1, NRG3 or DISC1 genes. Consequently, we found a secondary association between PDLIM5 variants and the paranoid subtype of schizophrenia in Emirati Arabs suggesting that PDLIM5 may represent a determinate/marker for schizophrenia subtype specification. However, no associations were found with variants in PICK1, NRG3 or DISC1 genes.

  19. First Aid Recommendations for Psychosis: Using the Delphi Method to Gain Consensus Between Mental Health Consumers, Carers, and Clinicians

    Langlands, Robyn L.; Jorm, Anthony F.; Kelly, Claire M.; Kitchener, Betty A.

    2008-01-01

    Background: Members of the general public often lack the knowledge and skills to intervene effectively to help someone who may be developing a psychotic illness before appropriate professional help is received. Methods: We used the Delphi method to determine recommendations on first aid for psychosis. An international panel of 157 mental health consumers, carers, and clinicians completed a 146-item questionnaire about how a member of the public could help someone who may be experiencing psychosis. The panel members rated each questionnaire item according to whether they believed the statement should be included in the first aid recommendations. The results were analyzed by comparing consensus rates across the 3 groups. Three rounds of ratings were required to consolidate consensus levels. Results: Eighty-nine items were endorsed by ≥80% of panel members from all 3 groups as essential or important for psychosis first aid. These items were grouped under the following 9 headings: how to know if someone is experiencing psychosis; how to approach someone who may be experiencing psychosis; how to be supportive; how to deal with delusions and hallucinations; how to deal with communication difficulties; whether to encourage the person to seek professional help; what to do if the person does not want help; what to do in a crisis situation when the person has become acutely unwell; what to do if the person becomes aggressive. Conclusions: These recommendations will improve the provision of first aid to individuals who are developing a psychotic disorder by informing the content of training courses. PMID:17768307

  20. Catha edulis chewing effects on treatment of paranoid schizophrenic patients

    Kotb El-Sayed MI

    2015-04-01

    Full Text Available Mohamed-I Kotb El-Sayed, Hatem-K Amin Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Helwan University, Ain Helwan, Helwan, Cairo, Egypt Background: The current study’s aim is to evaluate the possible interaction effects of khat chewing on treatment of paranoid schizophrenic patients.Patients and methods: In the study group, 42 male subjects suffered from paranoid schizophrenia and were classified according to their khat chewing habits into two subgroups: either khat-chewer subgroup (SKc; n=21; r=11, h=10 or non-khat-chewer subgroup (SNKc; n=21, r=11, h=10. Each subgroup was further subdivided according to type of treatment into r (risperidone and h (haloperidol. Healthy male subjects (37 were subdivided into healthy khat-chewer as positive controls (HKc, n=17 and healthy non-khat-chewer as negative controls (HNKc, n=20. Plasma dopamine, 3,4-dihydroxyphenylacetic acid (DOPAC, homovanillic acid, 5-hydroxytryptamine (serotonin, 5-hydroxyindoleacetic acid, epinephrine, and norepinephrine were estimated.Results: ANOVA and post hoc analysis showed that dopamine was illustrating significant elevation in all khat chewing groups. DOPAC was illustrating significant decrease in all khat chewing groups with an interesting outcome showing significant increase in DOPAC in SNKcr group due to risperidone effect. Homovanillic acid, serotonin, hydroxyindoleacetic acid, and norepinephrine were illustrating significant elevations in all khat chewing groups. Epinephrine was illustrating significant elevation in all chewers than non-chewers groups. Unexpected significant decrease in epinephrine in the SNKcr group indicated that risperidone drug is decreasing epinephrine through indirect mechanism involving calcium.Conclusion: Khat chewing in schizophrenic patients is contraindicated because it aggravates the disease symptoms, attenuates all used treatment medications, and deteriorates all biochemical markers of the patients. Keywords

  1. A study of theory of mind in paranoid schizophrenia: A theory or many theories?

    PeterB.Scherzer

    2012-11-01

    Full Text Available Social cognitive psychologists (Frith, 1992; Hardy-Baylé et al, 2003 sought to explain the social problems and clarify the clinical picture of schizophrenia by proposing a model that relates many of the symptoms to a problem of metarepresentation i.e. theory of mind (ToM. Given the differences in clinical samples and results between studies, and considering the wide range of what is considered to constitute ToM, the question is, is there a core function, or is ToM multifaceted with dissociable facets? If there are dissociable dimensions or facets which are affected in patients with paranoid schizophrenia? To answer these questions, a group of 21 individuals diagnosed with paranoid schizophrenia and 29 non-clinical control subjects, were tested on a battery of five different measures of theory of mind. The results confirmed that there was little difference in specificity of three of the tests in distinguishing between the clinical and non-clinical group, but there were important differences in the shared variance between the tests. Further analyses hint at two dimensions although a single factor with the same variance and the same contributing weights in both groups could explain the results. The deficits related to the attribution of cognitive and affective states to others inferred from available verbal and non-verbal information. Further analyses revealed incorrect attributions of mental states including the attribution of threatening intentions to others non-interpretative responses and incomplete answers, depending on the test of theory of mind.

  2. Acute psychotic disorders induced by topiramate: report of two cases Episódio psicótico agudo induzido por topiramato: relato de dois casos

    Florindo Stella

    2002-06-01

    Full Text Available We report on two epileptic patients who developed acute psychosis after the use of topiramate (TPM. One patient exhibited severe psychomotor agitation, heteroaggressiveness, auditory and visual hallucinations as well as severe paranoid and mystic delusions. The other patient had psychomotor agitation, depersonalization, derealization, severe anxiety and deluded that he was losing his memory. Both patients had to be taken to the casualty room. After interruption of TPM in one patient and reduction of dose in the other, a full remission of the psychotic symptoms was obtained without the need of antipsychotic drugs. Clinicians should be aware of the possibility of development of acute psychotic symptoms in patients undergoing TPM treatment.Relatamos dois pacientes epilépticos que manifestaram quadro psicótico agudo induzido por topiramato (TPM. Um paciente apresentou agitação psicomotora grave, heteroagressividade, alucinações auditivas e visuais, e delírios de conteúdo paranóide e místico. O outro paciente apresentou agitação psicomotora, despersonalização, desrealização, ansiedade intensa e delírio de que estava perdendo a memória. Ambos os pacientes foram conduzidos ao serviço de emergência e, após a interrupção do TPM em um deles e redução da droga em outro, houve remissão total dos sintomas psicóticos sem necessidade de medicação antipsicótica. Alertamos os clínicos para o risco de surgimento de sintomas psicóticos em pacientes em uso do TPM.

  3. WELLFOCUS PPT: Modifying positive psychotherapy for psychosis.

    Riches, Simon; Schrank, Beate; Rashid, Tayyab; Slade, Mike

    2016-03-01

    Positive psychotherapy (PPT) is an established psychological intervention initially validated with people experiencing symptoms of depression. PPT is a positive psychology intervention, an academic discipline that has developed somewhat separately from psychotherapy and focuses on amplifying well-being rather than ameliorating deficit. The processes targeted in PPT (e.g., strengths, forgiveness, gratitude, savoring) are not emphasized in traditional psychotherapy approaches to psychosis. The goal in modifying PPT is to develop a new clinical approach to helping people experiencing psychosis. An evidence-based theoretical framework was therefore used to modify 14-session standard PPT into a manualized intervention, called WELLFOCUS PPT, which aims to improve well-being for people with psychosis. Informed by a systematic review and qualitative research, modification was undertaken in 4 stages: qualitative study, expert consultation, manualization, and stake-holder review. The resulting WELLFOCUS PPT is a theory-based 11-session manualized group therapy. PMID:25961372

  4. Does "ICU psychosis" really exist?

    Justic, M

    2000-06-01

    In summary, ICU psychosis does not develop in all patients. Instead, many patients are at risk for hypoactive, hyperactive, or mixed hypoactive and hyperactive delirium. Prevention of delirium should always be foremost, including recognition of patients at high risk, minimal use of causative medications, and treatment of physiological conditions that are often unrelated to a patient's admitting diagnosis. When prevention fails, early diagnosis and treatment can make a marked difference in patients' outcomes. The potential adverse outcomes of delirium are well documented. These include increased mortality; increased length of stay; reduced level of functioning in the elderly, which often leads to placement in a nursing home; and stress response syndrome after hospitalization. The value of nursing in preventing delirium is evident when nurses apply their knowledge of potential causes and develop strategies to avoid these causes in their patients. Nurses provide early detection and coordinate with other members of the healthcare team to initiate a plan of care that includes prompt treatment of delirium to reduce the signs and symptoms, duration, and potential adverse sequelae of this disorder. Nursing interventions are designed to enhance patients' cognitive status, sense of security, safety, and comfort. Nurses are instrumental in providing appropriate choices, doses, and administration of medications and in recognizing side effects. Use of medications ordered to treat delirium is often left to nurses' discretion because the orders specify that the drugs should be given as needed. Finally, nurses are the ones who recognize the need for additional assistance via psychiatric consultations or for more intensive observation and management of patients to ensure quality care. PMID:11876211

  5. Childhood and later life stressors and psychosis

    Leslie J. Roper

    2015-12-01

    Full Text Available The etiology of psychosis consists of a complex integration of several risk factors including genetic vulnerability, adverse life events and trauma, and substance use. This review discusses the current theories of the genesis of psychosis, with an emphasis on the importance of Adverse Childhood Experiences (ACEs and later life events. ACEs in particular have a profound impact on an individual’s health later in life; and specifically, those who have experienced ACEs are at an increased risk for psychosis. In addition, stressful life events later in life may be relevant for onset and relapse of psychotic episodes. Associations between types of life adversity and specific symptomatology of a psychotic episode have also been suggested. A multi-factorial approach is suggested for linking genetic and environmental contributors to the onset of psychosis. This approach may have an advantage over a purely bio-medical model by focusing less on disability and more on underlying contributors that may be responsive to intervention.

  6. Personality disorders in first-episode psychosis

    Simonsen, Erik; Haahr, Ulrik; Mortensen, Erik Lykke; Friis, Svein; Johannessen, Jan Olav; Larsen, Tor K.; Melle, Ingrid; Opjordsmoen, Stein; Rund, Bjørn Rishovd; McGlashan, Thomas; Vaglum, Per

    2008-01-01

    The aim of the study was to determine the prevalence of personality disorders in the early course of first-episode psychosis and their likely presence in the premorbid period. Fifty-five patients were enrolled at baseline and premorbid function was evaluated by the Premorbid Adjustment Scale. Thi...

  7. WELLFOCUS PPT: modifying positive psychotherapy for psychosis

    Riches, Simon James; Schrank, Beate; Rashid, Tayyab; Slade, Mike Dominic

    2016-01-01

    Positive psychotherapy (PPT) is an established psychological intervention initially validated with people experiencing symptoms of depression. PPT is a positive psychology intervention, an academic discipline which has developed somewhat separately from psychotherapy and focuses on amplifying wellbeing rather than ameliorating deficit. The processes targeted in PPT (e.g. strengths, forgiveness, gratitude, savouring) are not emphasised in traditional psychotherapy approaches to psychosis. The ...

  8. NON-BEHAVIORAL MODELS OF PSYCHOSIS

    Parle Milind

    2013-08-01

    Full Text Available Animal models have become indispensible tools for discovering new medicines and in the analysis of multitude of causes, bio-markers and pathophysiological changes, which bring about symptoms characteristics of a specific disorder. One of the biggest challenges in discovering medicines for psychosis is to find an appropriate animal model of this illness possessing fair face validity, construct validity, and predictive validity. We had explained in detail behavioral models of psychosis in our previous article. In the present review article, the authors have described various non-behavioral models such as pharmacological models (administering specific chemicals, genetic models (through genetic manipulation, lesion models (lesion of selected brain parts and neuro-developmental models employed for screening anti-psychotic agents. All these animal models imitate schizophrenic defects in some manner. Traditionally, pharmacological models (drug/chemical-induced psychosis were the most widely used. These models involve the manipulation of dopaminergic, glutamatergic, serotonergic, or GABA-ergic systems. In Lesion models, selected area of an animal's brain is damaged, to induce psychosis-like symptoms. Genetic factors also play a prominent role in many psychiatric disorders and numerous putative candidate genes have been identified. Neurodevelopmental models are based on the fact that schizophrenia can be caused due to prenatal exposure to certain viruses. The animals usually employed for the development of these models include rats, mice, and primates. The specific animal models developed within these frameworks are described in this review article.

  9. Validation of the Excited Component of the Positive and Negative Syndrome Scale (PANSS-EC in a naturalistic sample of 278 patients with acute psychosis and agitation in a psychiatric emergency room

    San Luis

    2011-03-01

    Full Text Available Abstract Background Despite the wide use of the Excited Component of the Positive and Negative Syndrome Scale (PANSS-EC in a clinical setting to assess agitated patients, a validation study to evaluate its psychometric properties was missing. Methods Data from the observational NATURA study were used. This research describes trends in the use of treatments in patients with acute psychotic episodes and agitation seen in emergency departments. Exploratory principal component factor analysis was performed. Spearman's correlation and regression analyses (linear regression model as well as equipercentile linking of Clinical Global Impression of Severity (CGI-S, Agitation and Calmness Evaluation Scale (ACES and PANSS-EC items were conducted to examine the scale's diagnostic validity. Furthermore, reliability (Cronbach's alpha and responsiveness were evaluated. Results Factor analysis resulted in one factor being retained according to eigenvalue ≥1. At admission, the PANSS-EC and CGI-S were found to be linearly related, with an average increase of 3.4 points (p Conclusions The factorial analyses confirm the unifactorial structure of the PANSS-EC subscale. The PANSS-EC showed a strong linear correlation with rating scales such as CGI-S and ACES. PANSS-EC has also shown an excellent capacity to detect real changes in agitated patients.

  10. Mentaliseringsbasert psykoterapi - En mulig tilnærming til behandling av pasienter med unnvikende og paranoide personlighetsforstyrrelser?

    Mannsåker, Ingeborg; Sørensen, Kristine Bjørkaas; Zamfirova, Biliana

    2011-01-01

    The present thesis explores whether mentalization-based psychotherapy (MBT), on theoretical grounds, may be applicable in the treatment of patients with avoidant and paranoid personality disorders. We describe the development of mentalization and the principles of MBT. Characteristics of the two diagnostic groups in question are presented and compared with borderline personality disorder, for which the effectiveness of MBT has been empirically documented. We discuss whether pat...

  11. Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning.

    Bebbington, Paul

    2015-04-25

    This paper reviews a revolution in our understanding of psychosis over the last 20 years. To a major extent, this has resulted from a process of cross-fertilization between psychosocial epidemiology and cognitive behavior therapy for psychosis (CBT-p). This encouraged complementary strategies for the acquisition and analysis of data. These include the use of a range of dependent variables related to psychosis, and the exploitation of data from cross-sectional and longitudinal epidemiological surveys, virtual reality experiments, experience sampling methodology, and treatment trials. The key element is to investigate social and psychological measures in relation to each other. This research has confirmed the role of the external social world in the development and persistence of psychotic disorder. In addition, several psychological drivers of psychotic experiences have been identified. There is now persuasive evidence that the influence of social factors in psychosis is significantly mediated by non-psychotic symptoms, particularly mood symptoms and other attributes of affect such as insomnia. Psychotic symptoms are also driven by reasoning biases such as jumping to conclusions and belief inflexibility, though little is known about social influences on such biases. It is now clear that there are many routes to psychosis and that it takes many forms. Treatment of all kinds should take account of this: the dependence of CBT-p on a detailed initial formulation in terms of psychological processes and social influences is an example of the required flexibility. Individual mediators are now being targeted in specific forms of CBT-p, with good effect. This in turn corroborates the hypothesized role of non-psychotic symptoms in mediation, and attests to the power of the approaches described. PMID:26120255

  12. A case of Hashimoto`s encephalopathy presenting with seizures and psychosis

    Min-Joo Lee

    2012-03-01

    Full Text Available Hashimoto’s encephalopathy (HE is a rare, poorly understood, autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. Here, we report a case of a 14-year-old girl with HE and briefly review the literature. The patient presented with acute mental changes and seizures, but no evidence of infectious encephalitis. In the acute stage, the seizures did not respond to conventional antiepileptic drugs, including valproic acid, phenytoin, and topiramate. The clinical course was complicated by the development of acute psychosis, including bipolar mood, insomnia, agitation, and hallucinations. The diagnosis of HE was supported by positive results for antithyroperoxidase and antithyroglobulin antibodies. Treatment with methylprednisolone was effective; her psychosis improved and the number of seizures decreased. HE is a serious but curable, condition, which might be underdiagnosed if not suspected. Anti-thyroid antibodies must be measured for the diagnosis. HE should be considered in patients with diverse neuropsychiatric manifestations.

  13. Childhood trauma and psychosis - what is the evidence?

    Schäfer, Ingo; Fisher, Helen L.

    2011-01-01

    In the last decade, a substantial number of population-based studies have suggested that childhood trauma is a risk factor for psychosis. In several studies, the effects held after adjusting for a wide range of potentially confounding variables, including genetic liability for psychosis. Less is known about the mechanisms underlying the association between childhood trauma and psychosis. Possible pathways include relationships between negative perceptions of the self, negative affect, and psy...

  14. Incentive motivation in first-episode psychosis: A behavioural study

    Blackwell Andrew D; Corlett Philip R; Clark Luke; Murray Graham K; Cools Roshan; Jones Peter B; Robbins Trevor W; Poustka Luise

    2008-01-01

    Abstract Background: It has been proposed that there are abnormalities in incentive motivational processing in psychosis, possibly secondary to subcortical dopamine abnormalities, but few empirical studies have addressed this issue. Methods: We studied incentive motivation in 18 first-episode psychosis patients from the Cambridge early psychosis service CAMEO and 19 control participants using the Cued Reinforcement Reaction Time Task, which measures motivationally driven behaviour. We also ga...

  15. Postpartum psychosis and the association with sociodemographic and obstetric factors

    Nager, Anna

    2009-01-01

    Objective To examine the association between postpartum psychosis and the sociodemographic factors age, education, marital status and year of delivery (study 1). To examine the association between neighbourhood socioeconomic characteristics and postpartum psychosis (study 2). To examine the association between postpartum psychosis and obstetric factors (study 3). To examine the association between non-puerperal readmission and years of follow-up among women with postpartum p...

  16. Effects of early trauma on metacognitive functioning in psychosis

    Scherer-Dickson, Nicole

    2010-01-01

    Background: Empirical evidence suggests a relationship between early trauma and psychosis. However, the underlying mechanisms for this relationship remain unclear. Research into metacognitive functioning in psychosis indicates higher levels of metacognitive dysfunctional beliefs within this patient group. The potential effects of early trauma on metacognitive functioning in psychosis has to date been scarcely researched. Reflective functioning (RF) is believed to be affected by early trauma a...

  17. Treatment of Psychosis and Dementia in Parkinson’s Disease

    Goldman, Jennifer G.; Holden, Samantha

    2014-01-01

    Parkinson’s disease (PD) has been increasingly recognized as having a multitude of non-motor symptoms including psychosis, cognitive impairment and dementia, mood disturbances, fatigue, apathy, and sleep disorders. Psychosis and dementia, in particular, greatly affect quality of life for both patients and caregivers and are associated with poor outcomes. Safe and effective treatment options for psychosis and dementia in PD are much needed. Antipsychotics with dopamine-blocking properties can ...

  18. Pathways from Cannabis to Psychosis: A Review of the Evidence

    Burns, Jonathan K.

    2013-01-01

    The nature of the relationship between cannabis use and psychosis is complex and remains unclear. Researchers and clinicians remain divided regarding key issues such as whether or not cannabis is an independent cause of psychosis and schizophrenia. This paper reviews the field in detail, examining questions of causality, the neurobiological basis for such causality and for differential inter-individual risk, the clinical and cognitive features of psychosis in cannabis users, and patterns of c...

  19. Reinforcement and Reversal Learning in First-Episode Psychosis

    Murray, G. K.; Cheng, F.; Clark, L.; Barnett, J.H.; Blackwell, A. D.; Fletcher, P.C.; Robbins, T. W.; Bullmore, E. T.; Jones, P B

    2008-01-01

    Background: Abnormalities in reinforcement learning and reversal learning have been reported in psychosis, possibly secondary to subcortical dopamine abnormalities. Methods: We studied simple discrimination (SD) learning and reversal learning in a sample of 119 first-episode psychosis patients from the Cambridge early psychosis service (CAMEO) and 107 control participants. We used data on reinforcement learning and reversal learning extracted from the Cambridge Neuropsychological Test Automat...

  20. A Long Term Effects of a New Onset Psychosis after DBS Treated with Quetiapine in a Patient with Parkinson's Disease

    Piccoli, Sara; Perini, Giulia; Pizzighello, Silvia; Vestri, Alec; Ferri, Giovanni; Toffanin, Tommaso; Follador, Halima; Martinuzzi, Andrea

    2015-01-01

    Deep Brain Stimulation represents a therapeutic option for PD patients. In this paper, we present and discuss a case of acute delirium and psychosis manifesting after DBS in a 58-years-old man affected by Parkinson's Disease. We highlight the importance of an exhaustive psychiatric evaluation in candidates for DBS and we underline the severity and non-reversibility of some adverse events associated with the implantation, suggesting the use of Quetiapine in the management of these effects. Acu...

  1. The use of videoconferencing with patients with psychosis: a review of the literature

    Kobak Kenneth A

    2011-04-01

    Full Text Available Abstract Videoconferencing has become an increasingly viable tool in psychiatry, with a growing body of literature on its use with a range of patient populations. A number of factors make it particularly well suited for patients with psychosis. For example, patients living in remote or underserved areas can be seen by a specialist without need for travel. However, the hallmark symptoms of psychotic disorders might lead one to question the feasibility of videoconferencing with these patients. For example, does videoconferencing exacerbate delusions, such as paranoia or delusions of reference? Are acutely psychotic patients willing to be interviewed remotely by videoconferencing? To address these and other issues, we conducted an extensive review of Medline, PsychINFO, and the Telemedicine Information Exchange databases for literature on videoconferencing and psychosis. Findings generally indicated that assessment and treatment via videoconferencing is equivalent to in person and is tolerated and well accepted. There is little evidence that patients with psychosis have difficulty with videoconferencing or experience any exacerbation of symptoms; in fact, there is some evidence to suggest that the distance afforded can be a positive factor. The results of two large clinical trials support the reliability and effectiveness of centralized remote assessment of patients with schizophrenia.

  2. [Wernicke encephalopathy and Korsakoff's psychosis: clinical-pathophysiological correlation, diagnostics and treatment].

    Sivolap, Iu P; Damulin, I V

    2013-01-01

    Wernicke's encephalopathy and Korsakoff's psychosis are severe unfavorable forms of alcoholic brain damage with poor prognosis. Thiamine deficiency represents a common cause of both diseases. In many cases, Korsakoff's psychosis develops in the outcome of Wernicke's encephalopathy, which, along with the general etiology, lets talk about a single disease - Wernicke-Korsakoff syndrome, acute (usually reversible) stage of which is Wernicke's encephalopathy and a chronic one (often irreversible) is Korsakoff psychosis. The dramatic paradox of Wernicke's encephalopathy is that in most cases it is difficult to detect, but early diagnosed cases are quite easy to cure. Unrecognized and therefore go untreated Wernicke's encephalopathy is a serious threat to the health and lives of patients, worsens the processes of brain aging and increases the risk of Alzheimer's disease in later life. The basic approach to the treatment of Wernicke-Korsakoff syndrome is long-term parenteral administration of thiamine, often in high doses. As an adjuvant means of therapy memantine is considered. PMID:23887463

  3. [Psychosis and grammatical reality. Preliminary to an axiomatic system].

    Schmidt, P

    1981-05-01

    This paper is elaborated in the same order of those who developpe the idea that, Psychosis is pleaded as an alibi of a totalitarian reality (Psychosis alibi). So it may allow to disengage the evolution of the Psychiatry outside of the anti-psychiatry ideologies. The main subject of this work, is to analyse the gap between the Reality which includes the psychosis as a part of herself (Psychosis as disease). On the second hand the Reality of the psychosis from the psycho-pathologic point of view (delirium, hallucinations, autism, etc...). Considering the importance of the formal grammatical functions in the linguistic matter to site the reference to the reality according to the rules of the communication and the oral expression; so we propose a grammatical analysis. Two parts are distinguishable in this work. The first part concerns a review of languages proposed in different psychiatric "theorization" established previously about mental disorder. So it could be considered that the psychosis is the one who "speaks" the psychiatry. The second part concerns an abstract of the "semiotiques" studies by which we can tackle the psychosis with a scientific language: The Psychiatric "speaking" the psychosis not the opposite. This way of analyse allows to realize the modifications in the part of both protagonists in the game. By the same way, it authorizes to introduce the psychiatry from the axiomatic point of view, allowing a self-contained definition as a branch of the medicine, and disengaging his subject: The psychosis; as a syntactic subject. PMID:7305183

  4. Gray matter volumetric abnormalities associated with the onset of psychosis

    Wi Hoon eJung

    2012-12-01

    Full Text Available Patients with psychosis display structural brain abnormalities in multiple brain regions. The disorder is characterized by a putative prodromal period called ultra-high-risk (UHR status, which precedes the onset of full-blown psychotic symptoms. Recent studies on psychosis have focused on this period. Neuroimaging studies of UHR individuals for psychosis have revealed that the structural brain changes observed during the established phases of the disorder are already evident prior to the onset of the illness. Moreover, certain brain regions show extremely dynamic changes during the transition to psychosis. These neurobiological features may be used as prognostic and predictive biomarkers for psychosis. With advances in neuroimaging techniques, neuroimaging studies focusing on gray matter abnormalities provide new insights into the pathophysiology of psychosis, as well as new treatment strategies. Some of these novel approaches involve antioxidants administration, because it is suggested that this treatment may delay the progression of UHR to a full-blown psychosis and prevent progressive structural changes. The present review includes an update on the most recent developments in early intervention strategies for psychosis and potential therapeutic treatments for schizophrenia. First, we provide the basic knowledge of the brain regions associated with structural abnormalities in individuals at UHR. Next, we discuss the feasibility on the use of magnetic resonance imaging (MRI-biomarkers in clinical practice. Then, we describe potential etiopathological mechanisms underlying structural brain abnormalities in prodromal psychosis. Finally, we discuss the potentials and limitations related to neuroimaging studies in individuals at UHR.

  5. Pathways from cannabis to psychosis: a review of the evidence

    Jonathan K Burns

    2013-10-01

    Full Text Available The nature of the relationship between cannabis use and psychosis is complex and remains unclear. Researchers and clinicians remain divided regarding key issues such as whether or not cannabis is an independent cause of psychosis and schizophrenia. This paper reviews the field in detail, examining questions of causality, the neurobiological basis for such causality and for differential inter-individual risk, the clinical and cognitive features of psychosis in cannabis users, and patterns of course and outcome of psychosis in the context of cannabis use. The author proposes two major pathways from cannabis to psychosis based on a differentiation between early-initiated lifelong cannabis use and a scenario where vulnerable individuals without a lifelong pattern of use consume cannabis over a relatively brief period of time just prior to psychosis onset. Additional key factors determining the clinical and neurobiological manifestation of psychosis as well as course and outcome in cannabis users include: underlying genetic and developmental vulnerability to schizophrenia-spectrum disorders; and whether or not cannabis use ceases or continues after the onset of psychosis. Finally, methodological guidelines are presented for future research aimed at both elucidating the pathways that lead from cannabis to psychosis and clarifying the long-term outcome of the disorder in those who have a history of using cannabis.

  6. Cognitive Behavioral Therapy in Prodromal Psychosis

    Addington, Jean; Marshall, Catherine; French, Paul

    2014-01-01

    There is a strong impetus in the psychosis research field to develop interventions that aim to prevent the onset of psychotic disorders. Over the past 15 years there has been a tremendous development in the work aimed at understanding the pre-psychotic period. More recently there has been a focus on developing and testing treatments both pharmacological and psychological that could potentially prevent or delay the onset of psychosis. One of the psychological treatments that has received the most attention is cognitive behavioral therapy (CBT). Relatively few trials have been completed and this paper reviews the existing trials. Implications of these trials for the treatment of this early phase as well as for designing future studies are discussed. PMID:22239588

  7. Psychosis in Patients with Systemic Lupus Erythematosus

    Raghavendra B Nayak

    2012-01-01

    Full Text Available Neuropsychiatric manifestations in systemic lupus erythematosus (SLE are common; however, psychosis per se is bit uncommon. They may be cognitive deficit, lupus headache, psychoses, seizures, peripheral neuropathy, and cerebrovascular events. Psychiatric symptoms in SLE can be functionally independent psychiatric disorders. It can be due to drugs (steroids used for SLE or secondary to SLE because of its brain involvement, which is termed as neuropsychiatric systemic lupus erythematosus (NPSLE. No single clinical, laboratory, neuropsychological, and imaging test can be used to differentiate NPSLE from non-NPSLE patients with similar neuropsychiatric manifestations. Presently we are discussing about three cases of SLE with psychosis and which had different clinical presentation. The present reports also depict the approach to case differential diagnosis and management of the same.

  8. Gone to Pot - A Review of the Association between Cannabis and Psychosis

    Rajiv eRadhakrishnan

    2014-05-01

    Full Text Available Cannabis is the most commonly used illicit drug worldwide, with approximately 5 million daily users worldwide. Emerging evidence supports a number of associations between cannabis and psychosis/psychotic disorders, including schizophrenia. These associations based on case-studies, surveys, epidemiological studies, and experimental studies indicate that cannabinoids can produce acute, transient effects; acute, persistent effects as well as delayed, persistent effects that recapitulate the psychopathology and psychophysiology seen in psychotic illness such as schizophrenia. Acute exposure to both cannabis and synthetic cannabinoids (Spice/ K2 can produce a full range of transient psychotomimetic symptoms, cognitive deficits, and psychophysiological abnormalities that bear a striking resemblance to symptoms of schizophrenia. In individuals with an established psychotic disorder, cannabinoids can exacerbate symptoms, trigger relapse, and have negative consequences on the course of the illness. Several factors appear to moderate these associations, including family history, genetic factors, history of childhood abuse, and the age at onset of cannabis use. Exposure to cannabinoids in adolescence confers a higher risk for psychosis outcomes in later life and the risk is dose-related. Individuals with polymorphisms of COMT and AKT1 genes may be at increased risk for psychotic disorders in association with cannabinoids, as are individuals with a family history of psychotic disorders or a history of childhood trauma. The relationship between cannabis and schizophrenia fulfills many but not all of the standard criteria for causality, including temporality, biological gradient, biological plausibility, experimental evidence, consistency, and coherence. At the present time, the evidence indicates that cannabis may be a component cause in the emergence of psychosis, and warrants serious consideration from the point of view of public health policy.

  9. [Adolescent psychosis, can neuroscience improve prediction?].

    Holzer, L; Halfon, O; Jaugey, L

    2008-04-01

    Developments in the field of neuroscience have created a high level of interest in the subject of adolescent psychosis, particularly in relation to prediction and prevention. As the medical practice of adolescent psychosis and its treatment is characterised by a heterogeneity which is both symptomatic and evolutive, the somewhat poor prognosis of chronic development justifies the research performed: apparent indicators of schizophrenic disorders on the one hand and specific endophenotypes on the other are becoming increasingly important. The significant progresses made on the human genome show that the genetic predetermination in current psychiatric pathologies is complex and subject to moderating effects and there is therefore significant potential for nature-nurture interactions (between the environment and the genes). The road to be followed in researching the phenotypic expression of a psychosis gene is long and winding and is susceptible to many external influences at various levels with different effects. Neurobiological, neurophysiological, neuropsychological and neuroanatomical studies help to identify endophenotypes, which allow researchers to create identifying "markers" along this winding road. The endophenotypes could make it possible to redefine the nosological categories and enhance understanding of the physiopathology of schizophrenia. In a predictive approach, large-scale retrospective and prospective studies make it possible to identify risk factors, which are compatible with the neurodevelopmental hypothesis of schizophrenia. However, the predictive value of such markers or risk indicators is not yet sufficiently developed to offer a reliable early-detection method or possible schizophrenia prevention measures. Nonetheless, new developments show promise against the background of a possible future nosographic revolution, based on a paradigm shift. It is perhaps on the basis of homogeneous endophenotypes in particular that we will be able to

  10. Obsessive compulsive disorder masquerading as psychosis

    Dhanya Raveendranathan

    2012-01-01

    Full Text Available Obsessive compulsive disorder (OCD is commonly regarded as a disorder with good insight. However, it has now been recognized that insight varies in these patients. Pathological beliefs seem to lie on a continuum of insight, with full insight at one end and delusion at the other. This can indeed pose a considerable challenge, especially in a scenario where the phenomenon is difficult to discern. We report a case of OCD, which was initially diagnosed as psychosis.

  11. COMORBID ANXIETY IN PATIENTS WITH PSYCHOSIS

    Dernovšek, Mojca Zvezdana; Šprah, Lilijana

    2009-01-01

    A diagnosis of psychosis has tended to discount the considerable degree of emotional disorder associated with it, in a manner that may also inform psychological treatment options. Depression and anxiety are often associated with schizophrenia. Up to 40% of people have clinical levels of depression and anxiety symptoms could occur in 60% of patients with chronic psychotic disorder. Among emotional problems depression and depressive symptoms are well recognised and treated with success, whereas...

  12. Psychosis in children: diagnosis and treatment

    Courvoisie, Helen; Labellarte, Michael J.; Riddle, Mark A.

    2001-01-01

    The diagnosis of childhood psychosis raises a host of unresolved problems, despite the Diagnostic and Statistical Manual Of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) giving identical symptoms and definitions for children, adolescents, and adults. The fantasy lives of children, and issues of developing language and cognition (including retardation), all impair diagnostic accuracy, particularly when differentiating between childhood-onset schizophrenia (COS) (≤12 years), bipolar ...

  13. Biomarkers of suicide risk in psychosis

    Carlborg, Andreas

    2009-01-01

    Suicide and attempted suicide are major health problems. Approximately 1400 people die from suicide every year in Sweden and ten times more attempt suicide. Patients with schizophrenia spectrum psychosis have an increased risk of suicide and suicide rates have been suggested to be as high as 10%. Important risk factors include a prior suicide attempt and depressive disorder. Low concentrations of monoamine metabolites in cerebrospinal fluid (CSF) have been related to suicida...

  14. Williams syndrome and psychosis: a case report

    Salgado, Henrique; Martins-Correia, Luís

    2014-01-01

    Introduction Mental comorbidities, such as phobia, obsessive compulsive symptoms and anxiety disorders, are common in Williams syndrome. However, psychotic symptoms are rare in these patients. We report a case of psychosis in a patient with Williams syndrome. Case presentation A 23-year-old Caucasian woman with Williams syndrome arrived at the emergency room with persecutory delusions, auditory and verbal hallucinations, soliloquies and psychomotor agitation. These symptoms were consistently ...

  15. PSYCHOSIS NOT OTHERWISE SPECIFIED - CHANGE OF DIAGNOSIS AT FIVE YEAR FOLLOW -UP

    Sivakumar, V.; Chandrasekaran, R.

    1993-01-01

    SUMMARY A five-year follow-up study of 38 patients with ‘psychosis not otherwise specified’ revealed that diagnostic change occurred in 34.2% of the patients. 15.8% of the patients developed schizophrenia and 18.4% developed affective disorders. The initial diagnosis was retained in 65.8% of the patients. The onset of the illness was acute in patients from rural background and this is statistically significant. 42% of the patients presented only catatonic signs, of which nearly 70% showed ful...

  16. Psychosis during peginterferon-alpha2a and ribavirin therapy: case report

    Lucas C. Quarantini

    2006-12-01

    Full Text Available Pegylated Interferon-alpha, combined with ribavirin, gives high sustained virological response in patients with hepatitis C virus, an important public health problem and one of the most frequent chronic infectious diseases worldwide. Though it has therapeutic benefits, treatment with IFN-alpha may be complicated by various side effects, especially symptoms of major depression and acute mania. Psychosis is a rare side effect, and its management usually includes discontinuation of IFN-alpha. We report a case of psychotic disorder that occurred during therapy with pegylated Interferon-alpha given associated with ribavirin. After good response to psychiatric treatment, it became possible to finish the anti-viral therapy.

  17. The key to reducing duration of untreated first psychosis

    Joa, Inge; Johannessen, Jan Olav; Auestad, Bjørn; Friis, Svein; McGlashan, Thomas; Melle, Ingrid; Opjordsmoen, Stein; Simonsen, Erik; Vaglum, Per; Larsen, Tor K

    2008-01-01

    The TIPS early intervention program reduced the duration of untreated psychosis (DUP) in first-episode schizophrenia from 16 to 5 weeks in a health care sector using a combination of easy access detection teams (DTs) and a massive information campaign (IC) about the signs and symptoms of psychosi...

  18. Treatment delay and response rate in first episode psychosis

    Wunderink, A; Nienhuis, FJ; Sytema, S; Wiersma, D

    2006-01-01

    Objective: There is no consistent evidence of long duration of untreated psychosis (DUP) predicting long time to response (TTR) in first psychosis. This Study aims to investigate the predictors of DUP and TTR in a first episode patient population. Method: An epidemiologically representative sample o

  19. Economic aspects of peer support groups for psychosis

    Stant, A.D.; Castelein, S.; Bruggeman, R.; van Busschbach, J.T.; Knegtering, H.; Wiersma, D.

    2011-01-01

    Peer support groups are rarely available for patients with psychosis, despite potential clinical and economic advantages of such groups. In this study, 106 patients with psychosis were randomly allocated to minimally guided peer support in addition to care as usual (CAU), or CAU only. No relevant di

  20. Intrinsic motivation and amotivation in first episode and prolonged psychosis.

    Luther, Lauren; Lysaker, Paul H; Firmin, Ruth L; Breier, Alan; Vohs, Jenifer L

    2015-12-01

    The deleterious functional implications of motivation deficits in psychosis have generated interest in examining dimensions of the construct. However, there remains a paucity of data regarding whether dimensions of motivation differ over the course of psychosis. Therefore, this study examined two motivation dimensions, trait-like intrinsic motivation, and the negative symptom of amotivation, and tested the impact of illness phase on the 1) levels of these dimensions and 2) relationship between these dimensions. Participants with first episode psychosis (FEP; n=40) and prolonged psychosis (n=66) completed clinician-rated measures of intrinsic motivation and amotivation. Analyses revealed that when controlling for group differences in gender and education, the FEP group had significantly more intrinsic motivation and lower amotivation than the prolonged psychosis group. Moreover, intrinsic motivation was negatively correlated with amotivation in both FEP and prolonged psychosis, but the magnitude of the relationship did not statistically differ between groups. These findings suggest that motivation deficits are more severe later in the course of psychosis and that low intrinsic motivation may be partially independent of amotivation in both first episode and prolonged psychosis. Clinically, these results highlight the importance of targeting motivation in early intervention services. PMID:26386901

  1. Premorbid adjustment in first-episode non-affective psychosis

    Larsen, Tor K; Friis, Svein; Haahr, Ulrik;

    2004-01-01

    Knowledge about premorbid development in psychosis can shed light upon theories about aetiology and schizophrenic heterogeneity, and form a basis for early detection initiatives.......Knowledge about premorbid development in psychosis can shed light upon theories about aetiology and schizophrenic heterogeneity, and form a basis for early detection initiatives....

  2. Prevalence of autoimmune thyroid dysfunction in postpartum psychosis

    Bergink, Veerle; Kushner, Steven A.; Pop, Victor; Kuijpens, Hans; Lambregtse-van den Berg, Mijke P.; Drexhage, Roos C.; Wiersinga, Wilmar; Nolen, Willem A.; Drexhage, Hemmo A.

    2011-01-01

    Background Postpartum psychosis is a life-threatening psychiatric emergency, which often occurs without significant premorbid symptoms. Although many studies have postulated an involvement of the immune and endocrine systems in the onset of postpartum psychosis, the specific aetiological factors hav

  3. Citrin deficiency: A treatable cause of acute psychosis in adults

    Sunita Bijarnia-Mahay

    2015-01-01

    Full Text Available Citrin deficiency is an autosomal recessive genetic disorder caused by a defect in the mitochondrial aspartate/glutamate antiporter, citrin. The disorder manifests either as neonatal intra-hepatic cholestasis or occurs in adulthood with recurrent hyperammonemia and neuropsychiatric disturbances. It has a high prevalence in the East Asian population, but is actually pan-ethnic. We report the case of a 26-year-old male patient presenting with episodes of abnormal neuro-psychiatric behavior associated with hyperammonemia, who was diagnosed to be having citrin deficiency. Sequencing of the SLC25A13 gene revealed two novel mutations, a single base pair deletion, c. 650delT (p.Phe217SerfsFNx0133 in exon 7, and a missense mutation, c. 869T>C (p.Ile290Thr in exon 9. Confirmation of the diagnosis allowed establishment of the appropriate management. The latter is an essential pre-requisite for obtaining a good prognosis as well as for family counseling.

  4. Cavernous Angioma of the Corpus Callosum Presenting with Acute Psychosis

    Giacomo Pavesi; Francesco Causin; Alberto Feletti

    2014-01-01

    Psychiatric symptoms may occasionally be related to anatomic alterations of brain structures. Particularly, corpus callosum lesions seem to play a role in the change of patients’ behavior. We present a case of a sudden psychotic attack presumably due to a hemorrhagic cavernous angioma of the corpus callosum, which was surgically removed with complete resolution of symptoms. Although a developmental defect like agenesis or lipoma is present in the majority of these cases, a growing lesion of t...

  5. Cavernous Angioma of the Corpus Callosum Presenting with Acute Psychosis

    Giacomo Pavesi

    2014-01-01

    Full Text Available Psychiatric symptoms may occasionally be related to anatomic alterations of brain structures. Particularly, corpus callosum lesions seem to play a role in the change of patients’ behavior. We present a case of a sudden psychotic attack presumably due to a hemorrhagic cavernous angioma of the corpus callosum, which was surgically removed with complete resolution of symptoms. Although a developmental defect like agenesis or lipoma is present in the majority of these cases, a growing lesion of the corpus callosum can rarely be the primary cause. Since it is potentially possible to cure these patients, clinicians should be aware of this association.

  6. 10 year course of IQ in first-episode psychosis

    Barder, Helene Eidsmo; Sundet, Kjetil; Rund, Bjørn Rishovd;

    2015-01-01

    are largely uninvestigated, but may identify subgroups with different intellectual trajectories. Eighty-nine first-episode psychosis patients were investigated on IQ at baseline and at 10-years follow-up. Total time in psychosis was defined as two separate variables; Duration of psychosis before start...... of treatment (i.e. duration of untreated psychosis: DUP), and duration of psychosis after start of treatment (DAT). The sample was divided in three equal groups based on DUP and DAT, respectively. To investigate if diagnosis could separate IQ-trajectories beyond that of psychotic duration, two...... diagnostic categories were defined: core versus non-core SSDs. No significant change in IQ was found for the total sample. Intellectual course was not related to DUP or stringency of diagnostic category. However, a subgroup with long DAT demonstrated a significant intellectual decline, mainly associated with...

  7. Anti-NMDA Receptor Encephalitis Presenting as an Acute Psychotic Episode in a Young Woman: An Underdiagnosed yet Treatable Disorder

    Shikma Keller; Pablo Roitman; Tamir Ben-Hur; Omer Bonne; Amit Lotan

    2014-01-01

    Anti-NMDA receptor (NMDAR) encephalitis is a recently identified autoimmune disorder with prominent psychiatric symptoms. Patients usually present with acute behavioral change, psychosis, catatonic symptoms, memory deficits, seizures, dyskinesias, and autonomic instability. In female patients an ovarian teratoma is often identified. We describe a 32-year-old woman who presented with acute psychosis. Shortly after admission, she developed generalized seizures and deteriorated into a catatonic ...

  8. Pengaruh Kepatuhan Pengobatan dan Koping Keluarga terhadap Pencegahan Kekambuhan Penderita Skozofrenia Paranoid di Rumah Sakit Jiwa Daerah Provinsi Sumatera Utara Tahun 2014

    Manik, Chinta Bangun

    2015-01-01

    Schizophrenia paranoid is a chronic psychotic disorder which has a relapse. The data from the Medical Research of the Mental Hospital of North Sumatera stated that 65.8% of schizophrenia paranoid patients who were treated in 2013 had a relapse so that they had to be sent again to the hospital. The high rate of relapse is probably related to the medical compliance and family coping. The objective of the research was to analyze the influence of medical compliance and family coping on the preven...

  9. SNP8NRG433E1006 NEUREGULIN-1 GENETIC VARIATION IN BATAKS ETHNIC WITH SCHIZOPHRENIA PARANOID AND HEALTHY CONTROL

    Elmeida Effendy

    2014-05-01

    Full Text Available The neuregulin 1 (NRG1 gene which influences the development of white matter connectivity has been associated with schizophrenia. It influences neuronal migration, synaptogenesis, gliogenesis, neuron-glia communication, myelination, and neurotransmission in the brain and others. NRG1 is located in 8p13, and it is frequently replicated in schizphrenia. SNP8NRG433E1006 gene NRG1 is one of core at risk haplotype of schizphrenia. This study looked forward differences SNP8NRG433E1006 neuregulin 1 between Bataks ethnic with schizophrenia paranoid and Bataks ethnic healthy control. Methods: Batak ethnic with schizophrenia paranoid were recruited and interviewed with semi-structured MINI ICD-X to establish the diagnosis. All the eligible subjects were requested their permission for blood sampling. Healthy Batak ethnic were also recruited by mathcing the age and gender. The blood samples went through DNA isolation, Nested PCR, and DNA sequencing. Results: Ninety three subjects were recruited, but only 74 blood samples were succesfully sequenced. We found three types of polymorphisms, i.e. G/A allele at base pair (bp 76, G/T allele at bp 112, and deletion at bp 110 in Batak ethnic with schizophrenia. There were two kind sequences at bp 113-116 in Batak ethnics, and Batak ethnics with ATCG were at higher risk for having schizophrenia. This study support that NRG1 is a schizophrenia-susceptibility gene.

  10. Demographic features and premorbid personality disorder traits in relation to age of onset and sex in paranoid schizophrenia.

    Skokou, Maria; Gourzis, Philippos

    2014-03-30

    Personality disorders in the premorbid period of schizophrenia and particularly in relation to age of onset and sex, seem to be a rather under-researched area. In the present study, 88 patients with paranoid schizophrenia were examined, regarding demographic characteristics and premorbid personality disorder traits, in order to investigate for differences in the premorbid period of the disease, in relation to age of onset and sex. Age cutoff points were set at personality disorder traits were retrospectively assessed by using the Structured Clinical Interview for DSM-IV-Patient Edition for Axis II disorders (SCID-II). Comparisons were performed by applying the two-tailed Wilcoxon rank-sum and the χ(2) statistical tests. Young onset patients were characterized by significantly higher proportion of urban birth, single status, more avoidant premorbid personality disorder traits, and less passive-aggressive premorbid personality disorder traits, than late onset counterparts. Differences were more prominently shown in men. Earlier age of onset seems to be associated to increased social inhibition and worse psychosocial adaptation in the premorbid period of paranoid schizophrenia. PMID:24495576