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Sample records for acute paranoid psychosis

  1. Manganese and acute paranoid psychosis: a case report

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

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    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

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

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    Tripathi, A. K.; 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. PMID:21886392

  4. Bullying victimisation and paranoid ideation in people at ultra high risk for psychosis.

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    Valmaggia, L R; Day, F L; Kroll, J; Laing, J; Byrne, M; Fusar-Poli, P; McGuire, P

    2015-10-01

    Bullying victimisation has been suggested to contribute to paranoid ideation in general population samples and recent evidence found that individuals with an ultra high risk (UHR) for psychosis are twice as likely to have been bullied than controls. This study sought to examine whether a history of bullying would be associated with higher levels of paranoid ideation in individuals with an UHR and in healthy controls (HCs). The study included 64 UHR and 43 HC participants. Following the baseline assessment, participants entered a Virtual Reality (VR) London Underground train. Paranoid ideation was measured immediately after the end of the VR experience. Compared to HCs, UHR participants described higher levels of childhood bullying (OR 5.19, 95% CI=2.21-12.19, pbullying was associated with paranoid ideation during VR in both groups (χ(2)(1)=5.931, p=,021) but prolonged exposure to bullying was not associated with increased paranoid ideation. A history of bullying in childhood is particularly common in young adults at high risk for psychosis. However bullying is associated with paranoid ideation in later life, independent of clinical status, consistent with dimensional models of psychotic phenomena. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Predicting severity of paranoid schizophrenia

    OpenAIRE

    Kolesnichenko Elena Vladimirovna

    2015-01-01

    Clinical symptoms, course and outcomes of paranoid schizophrenia are polymorphic. 206 cases of paranoid schizophrenia were investigated. Clinical predictors were collected from hospital records and interviews. Quantitative assessment of the severity of schizophrenia as special indexes was used. Schizoid, epileptoid, psychasthenic and conformal accentuation of personality in the premorbid, early onset of psychosis, paranoid and hallucinatory-paranoid variants of onset predicted more expressed ...

  6. Manganese and acute paranoid psychosis: A case report

    NARCIS (Netherlands)

    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

  7. Manganese and acute paranoid psychosis: a case report

    NARCIS (Netherlands)

    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,

  8. 偏执性精神病27例诊疗体会%Experience in diagnosis and treatment of 27 cases of paranoid psychosis

    Institute of Scientific and Technical Information of China (English)

    刘丽娟

    2013-01-01

    目的:探讨偏执性精神病的临床诊疗效果。方法选择我院接诊的27例偏执性精神病患者,对其进行病因诊断和治疗,对所有患者治疗前后精神状况均进行评估。结论对于偏执性精神病患者,采取早发现,早治疗的原则;并给予心理解释及支持治疗,改变病态认知。%Objective To investigate the clinical effect of paranoid psychosis. Methods In our hospital admissions of 27 cases of paranoid psychosis patients, were in the diagnosis and treatment of the spirit, the situation before and after treatment in all patients were evaluated. Conclusions In patients with paranoid psychosis, take early discovery, early treatment principle;and to give psychological interpretation and supportive treatment, pathological cognitive change.

  9. World assumptions in psychosis: do paranoid patients believe in a just world?

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    Valiente, Carmen; Espinosa, Regina; Vázquez, Carmelo; Cantero, Dolores; Fuentenebro, Filiberto

    2010-11-01

    The aim of this study was to examine the contents of world views held by patients with current persecutory beliefs. We examined whether these beliefs in a just world (BJW) were associated with the severity of psychopathology of participants. Our results showed that, compared with a healthy control group, the current persecutory beliefs group had weaker beliefs in a just world related to themselves (BJW-P), but there were no differences between both groups in their beliefs in general justice in the world (BJW-G). Regression analyses showed that BJW, particularly weaker beliefs in personal justice, significantly associated with more severe symptoms of depression and paranoia as well as with lower scores of psychological well-being. Our results support the relevance of the BJW framework in exploring world views in patients with persecutory beliefs. We discuss the implications of these results for the research and treatment of paranoid ideation.

  10. Acute psychosis: A neuropsychiatric dilemma

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    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.

  11. Psychosis

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    ... Mental Health Conditions Early Psychosis and Psychosis Early Psychosis and Psychosis Overview Treatment Support Discuss Most people think of ... Staff and Coaches Symptoms Early warning signs before psychosis Early psychosis or FEP rarely comes suddenly. Usually, ...

  12. Recollected experiences of first hospitalisation for acute psychosis ...

    African Journals Online (AJOL)

    psychiatric hospital admission for acute psychosis of people diagnosed with schizophrenia. ..... having his basic needs met by others. Note that .... participants have strong emotional requirements of the nursing staff. The nurse-patient ...

  13. [Paranoid syndrome, paranoid reaction, paranoia].

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    Pavlovský, P

    2006-01-01

    The term paranoid is derived from the Greek word paranoia meaning nadnese. It does not only mean self-reference, but there are various personality features as they are hostility, a tendency towards aggressiveness, irritability, a lack of sense of humour, feelings of overestimation of one-self and a tendency towards accusations. These features may appear also within normal psychology and they becomeclinically important after thein increase of intensity and conspicuousness (los sof hearing, long-term abuse of alcohol and psychostimulants) and organic disorders of the brain may contribute to the development of paranoidity. A mechanism of projection is considered as a decivise factor from the point of view of dynamic psychiatry. Clinically unimportant sign sof paranoidity can be observed due to unusual situations. If a paranoid reaction becomes more serious, formation of a paranoid delusion should be taken to account. In our koncept the term paranoid and paranoidity should be used only as a psychopathological term.

  14. Clinical correlates of acute bipolar depressive episode with psychosis.

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    Caldieraro, Marco Antonio; Sylvia, Louisa G; Dufour, Steven; Walsh, Samantha; Janos, Jessica; Rabideau, Dustin J; Kamali, Masoud; McInnis, Melvin G; Bobo, William V; Friedman, Edward S; Gao, Keming; Tohen, Mauricio; Reilly-Harrington, Noreen A; Ketter, Terence A; Calabrese, Joseph R; McElroy, Susan L; Thase, Michael E; Shelton, Richard C; Bowden, Charles L; Kocsis, James H; Deckersbach, Thilo; Nierenberg, Andrew A

    2017-08-01

    Psychotic bipolar depressive episodes remain remarkably understudied despite being common and having a significant impact on bipolar disorder. The aim of this study is to identify the characteristics of depressed bipolar patients with current psychosis compared to those without psychosis. We used baseline data of a comparative effectiveness study of lithium and quetiapine for bipolar disorder (the Bipolar CHOICE study) to compare demographic, clinical, and functioning variables between those with and without psychotic symptoms. Of the 482 participants, 303 (62.9%) were eligible for the present study by meeting DSM-IV criteria for an acute bipolar depressive episode. Univariate analyses were conducted first, and then included in a model controlling for symptom severity. The sample was composed mostly of women (60.7%) and the mean age was 39.5±12.1 years. Psychosis was present in 10.6% (n=32) of the depressed patients. Psychotic patients had less education, lower income, and were more frequently single and unemployed. Psychosis was also associated with a more severe depressive episode, higher suicidality, more comorbid conditions and worse functioning. Most group differences disappeared when controlling for depression severity. Only outpatients were included and the presence of psychosis in previous episodes was not assessed. Psychosis during bipolar depressive episodes is present even in an outpatient sample. Psychotic, depressed patients have worse illness outcomes, but future research is necessary to confirm if these outcomes are only associated with the severity of the disorder or if some of them are independent of it. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Acute Psychosis as Main Manifestation of Central Pontine Myelinolysis

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    Mangala Gopal

    2017-01-01

    Full Text Available Central pontine myelinolysis (CPM is an acute demyelinating neurological disorder affecting primarily the central pons and is frequently associated with rapid correction of hyponatremia. Common clinical manifestations of CPM include spastic quadriparesis, dysarthria, pseudobulbar palsy, and encephalopathy of various degrees; however, coma, “locked-in” syndrome, or death can occur in most severe cases. Rarely, CPM presents with neuropsychiatric manifestations, such as personality changes, acute psychosis, paranoia, hallucinations, or catatonia, typically associated with additional injury to the brain, described as extrapontine myelinolysis (EPM. We present a patient with primarily neuropsychiatric manifestations of CPM, in the absence of focal neurologic deficits or radiographic extrapontine involvement. A 51-year-old female without significant medical history presented with dizziness, frequent falls, diarrhea, generalized weakness, and weight loss. Physical examination showed no focal neurological deficits. Laboratory data showed severe hyponatremia, which was corrected rather rapidly. Subsequently, the patient developed symptoms of an acute psychotic illness. Initial brain magnetic resonance imaging (MRI was unremarkable, although a repeat MRI two weeks later revealed changes compatible with CPM. This case demonstrates that acute psychosis might represent the main manifestation of CPM, especially in early stages of the disease, which should be taken into consideration when assessing patients with acute abnormalities of sodium metabolism.

  16. Acute Psychosis as Main Manifestation of Central Pontine Myelinolysis

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    Gopal, Mangala; Patel, Harsh

    2017-01-01

    Central pontine myelinolysis (CPM) is an acute demyelinating neurological disorder affecting primarily the central pons and is frequently associated with rapid correction of hyponatremia. Common clinical manifestations of CPM include spastic quadriparesis, dysarthria, pseudobulbar palsy, and encephalopathy of various degrees; however, coma, “locked-in” syndrome, or death can occur in most severe cases. Rarely, CPM presents with neuropsychiatric manifestations, such as personality changes, acute psychosis, paranoia, hallucinations, or catatonia, typically associated with additional injury to the brain, described as extrapontine myelinolysis (EPM). We present a patient with primarily neuropsychiatric manifestations of CPM, in the absence of focal neurologic deficits or radiographic extrapontine involvement. A 51-year-old female without significant medical history presented with dizziness, frequent falls, diarrhea, generalized weakness, and weight loss. Physical examination showed no focal neurological deficits. Laboratory data showed severe hyponatremia, which was corrected rather rapidly. Subsequently, the patient developed symptoms of an acute psychotic illness. Initial brain magnetic resonance imaging (MRI) was unremarkable, although a repeat MRI two weeks later revealed changes compatible with CPM. This case demonstrates that acute psychosis might represent the main manifestation of CPM, especially in early stages of the disease, which should be taken into consideration when assessing patients with acute abnormalities of sodium metabolism.

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

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    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.

  18. EEG screening for temporal lobe epilepsy in patients with acute psychosis.

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    Raybould, Jillian E; Alfers, Cory; Cho, Yong won; Wang, Hong; Shara, Nawar M; Epstein, Steven A; Motamedi, Gholam K

    2012-01-01

    Seizures may present with ictal or interictal psychosis mimicking primary psychiatric disorders. The authors reviewed EEG, brain-imaging, and clinical data of 240 patients presenting with acute psychotic episode to assess the diagnostic value of EEG in differentiating ictal psychosis from primary psychosis. Seven patients had interictal spikes, but there were no patients with ictal discharges. There were no significant associations between the tested variables except that taking neuroleptics/antidepressants was associated with abnormal EEG, and older age and taking anti-epileptic drugs were associated with abnormal CT scans. These findings do not support routine use of EEG in patients presenting with acute psychosis.

  19. Psychosis

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    Arciniegas, David B.

    2015-01-01

    Purpose of Review: Psychosis is a common and functionally disruptive symptom of many psychiatric, neurodevelopmental, neurologic, and medical conditions and an important target of evaluation and treatment in neurologic and psychiatric practice. The purpose of this review is to define psychosis, communicate recent changes to the classification of and criteria for primary psychotic disorders described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and summarize current evidence-based approaches to the evaluation and management of primary and secondary psychoses. Recent Findings: The DSM-5 classification of and criteria for primary psychotic disorders emphasize that these conditions occur along a spectrum, with schizoid (personality) disorder and schizophrenia defining its mild and severe ends, respectively. Psychosis is also identified as only one of several dimensions of neuropsychiatric disturbance in these disorders, with others encompassing abnormal psychomotor behaviors, negative symptoms, cognitive impairments, and emotional disturbances. This dimensional approach regards hallucinations and delusions as arising from neural systems subserving perception and information processing, thereby aligning the neurobiological framework used to describe and study such symptoms in primary psychotic disorders with those used to study psychosis associated with other neurologic conditions. Summary: This article provides practicing neurologists with updates on current approaches to the diagnosis, evaluation, and treatment of primary and secondary psychoses. PMID:26039850

  20. Varenicline precipitating psychosis in a patient with no previous psychiatric history: a case report of a Spanish patient who was later diagnosed with paranoid personality disorder.

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    Forcen, Fernando Espi; Martinez, Fernando Luis Espi; Moya, Amparo Martinez

    2012-01-01

    Varenicline is gaining popularity for the treatment of nicotine dependence. General treatment guidelines recommend monitoring for behavioral changes in patients with a mental illness. There are very few cases reported on patients developing psychiatric symptoms with no previous history. We are reporting the case of a Spanish patient who had developed a first-psychotic episode after he was started on varenicline. He was ultimately diagnosed with a paranoid personality disorder. Therefore, prior to starting a patient on varenicline, the clinician must identify possible paranoid and other cluster A personality traits. It is essential to monitor for new onset of psychotic symptoms during the treatment with this drug.

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

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    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.

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

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    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.

  3. Chloroquine psychosis: a chemical psychosis?

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    Mohan, D; Mohandas, E; Rajat, R

    1981-11-01

    Psychotic states are mimicked by the use of many drugs including amphetamines, cannabis, lysergic acid diethylamide, psilocybin, mescaline, isoniazid, and L-dopa. A paranoid psychotic picture in a clear sensorium is characteristic of amphetamine psychosis. In developing countries, malaria among other diseases is a frequent indicator of chloroquine administration. The present communication reports a series of chloroquine-induced psychosis in a clear sensorium simulating affective illness, such as mania, mixed affective states, or depression. The psychosis disappeared after cessation of the drug, combined with or without the use of low dosage phenothiazines in excited patients. From our cases, two types of presentation of chloroquine psychosis could be seen: (1) psychic with clear sensorium, mood changes, alteration in motor activity, delusions, and hallucinations; and (2) psycho-organic with clouded sensorium, disorientation, and fleeting hallucinations. The precise nature of the mechanism of the psychosis is not clear because of the limited number of reported cases.

  4. Acute intermittent porphyria: psychosis as the only clinical manifestation.

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    Ellencweig, Natalie; Schoenfeld, Nili; Zemishlany, Zvi

    2006-01-01

    Acute intermittent porphyria (AIP) is the most common of the four forms of neuroporphyria. AIP mimics a variety of disorders and thus poses a diagnostic quagmire. Abdominal pain occurs in 90-95% of the attacks. Some patients develop psychiatric symptoms such as psychosis similar to schizophrenia. The diagnostic difficulty may lead to under-diagnosis of patients who present with strictly psychiatric symptoms. This assumption is supported by a high prevalence of AIP in psychiatric hospitals. Therefore, we encourage a high index of suspicion for AIP in psychiatric patients in order to prevent false psychiatric diagnosis. In addition we discuss psychotropic drugs that may exacerbate acute attacks in undiagnosed patients. We report a case in which the diagnosis of AIP was clouded by the presence of only psychiatric symptoms. The clue for diagnosis was an anamnestic detail of the use of a porphyrogenic drug prior to the admission. The diagnosis of AIP was supported by excess of alpha aminolevulinic acid (ALA) and porphobilinogen (PBG) in urine concomitantly with a decrease in porphobilinogen deaminase (PBGD) activity in erythrocytes. The diagnosis was further strengthened by the fact that the patient's father was identified as an AIP carrier. However, in the absence of typical organic symptoms of porphyria, one cannot definitely rule out the presence of schizophrenia in this patient in addition to AIR

  5. Day/night changes in serum S100B protein concentrations in acute paranoid schizophrenia.

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    Morera-Fumero, Armando L; Díaz-Mesa, Estefanía; Abreu-Gonzalez, Pedro; Fernandez-Lopez, Lourdes; Cejas-Mendez, Maria Del Rosario

    2017-04-03

    There are day/night and seasonal changes in biological markers such as melatonin and cortisol. Controversial changes in serum S100B protein levels have been described in schizophrenia. We aim studying whether serum S100B levels present day/night variations in schizophrenia patients and whether S100B levels are related to psychopathology. Sixty-five paranoid schizophrenic inpatients participated in the study. Psychopathology was assessed with the Positive and Negative Syndrome Scale (PANSS) at admission and discharge. Blood was drawn at 12:00 (midday) and 00:00 (midnight) hours at admission and discharge. Sixty-five healthy subjects matched by age, gender and season acted as control group. At admission and discharge patients had significantly higher serum S100B concentrations at midday and midnight than healthy subjects. At admission, patients showed a day/night variation of S100B levels, with higher S100B levels at 12:00 than at 00:00h (143.7±26.3pg/ml vs. 96.9±16.6pg/ml). This day/night difference was not present in the control group. Midday and midnight S100B at admission decreased when compared to S100B at discharge (midday, 143.7±26.3 vs. 83.0±12, midnight 96.9±16.6 vs. 68.6±14.5). There was a positive correlation between the PANSS positive subscale and S100B concentrations at admission. This correlation was not present at discharge.

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

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    Schott, Björn H; Voss, Martin; Wagner, Benjamin; Wüstenberg, Torsten; Düzel, Emrah; Behr, Joachim

    2015-01-01

    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 h. 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 (VS). Notably, delusions correlated positively with the difference of the functional connectivity of the hippocampus vs. 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.

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

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    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.

  8. Paranoid personality disorder

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    Personality disorder - paranoid; PPD ... American Psychiatric Association. Paranoid personality disorder. Diagnostic and Statistical Manual of ental Disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:649-652. Blais MA, ...

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

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    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…

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

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

    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 dose of 500 mg per day. After 3 days of treatment, the patient developed visual hallucinations, mood swings, withdrawal and suspicious behavior. Delirium was ruled out as there was no fluctuation in his sensorium or focal neurological deficits. His lab investigations for electrolytes, renal function test, thyroid, liver function and other related tests levels were within normal limits. A diagnosis of LEV induced psychosis was reached based on clinical judgment and causality assessment.

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

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    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.

  12. [Clinico-psychopathologic varieties of the acute Kandinsky-Clerambault syndrome in schizophrenia].

    Science.gov (United States)

    Dikaia, V I

    1985-01-01

    Acute cases of the Kandinsky-Clerambault syndrome first manifested in adulthood were studied in schizophrenic patients. On the basis of the clinical mechanisms of the development of psychosis and the specific features of acute delirious disturbances in the structure of psychosis 3 clinical variants of the acute syndrome of psychic automatism were identified: developing according to the type of reaction in the structure of acute paranoid (the first variant), according to the regularities of endogenic paroxysm in the picture of acute sensory delirium (the second variant) and according to the mechanism of exacerbation of chronic delirium entering the structure of acute interpretative delirium (the third variant).

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

    Science.gov (United States)

    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.…

  14. Short-term diagnostic stability of acute psychosis: Data from a tertiary care psychiatric center in South India

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    Janardhanan C Narayanaswamy

    2012-01-01

    Full Text Available 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 end of 1 and 2 years were recorded. Results: The mean age of the sample was 30.72 years. The mean duration of illness episode was 18.15±17.10 days. The follow-up data were available for 77.2% (n=44 and 75.4% (n=43 of the sample at the end of first and second years. Relapse was recorded in 47.4 and 54.4% at the end of first and second years, respectively. Conclusion: The diagnosis changed into other disorders such as bipolar disorder, schizophrenia, and unspecified psychosis, while a majority retained the initial diagnosis of acute psychosis. The findings suggest that acute psychosis is a relatively stable condition. A small percentage of these patients may go on to develop schizophrenia or bipolar disorder.

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

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    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.

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

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    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.

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

    DEFF Research Database (Denmark)

    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 hosp...

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

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    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.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    diagnoses. The most frequently used ATPD subcategories were F23.3 'other acute delusional psychotic disorders', F23.0 'acute polymorphic psychotic disorder without symptoms of schizophrenia' and F23.9 'acute and transient psychotic disorder unspecified'. A significant majority were female and associated...... acute stress was recorded only in 5.3% of cases. CONCLUSIONS: ICD-8 298 register diagnosis of RP showed little empirical continuity to ATPD and conformed more to F23.3 acute delusional disorder among ATPD subtypes. Udgivelsesdato: 2007-null......BACKGROUND: ICD-10 introduced a new diagnostic category, F23 'acute and transient psychotic disorders' (ATPD), to embrace clinical concepts such as bouffée délirante, cycloid psychosis, psychogenic (reactive) psychosis and schizophreniform psychosis. The purpose of this study was to examine...

  20. Postpartum Psychosis

    Science.gov (United States)

    ... Mom Frequently Asked Questions Useful Links Media Postpartum Psychosis Psychosis Postpartum Psychosis is a rare illness, compared to ... Help in an Emergency PSI position paper - Perinatal Psychosis Related Tragedies Read and Download PSI Position Statement ...

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

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    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. Acute psychosis associated with dissociated sleep-wakefulness state after mirtazapine treatment.

    Science.gov (United States)

    Felthous, Alan R; Wenger, Philip J; Hoevet, Rod

    2010-04-01

    Tricyclic antidepressants decrease rapid eye movement (REM) sleep and may suppress sleep atonia. Reports indicate that these agents can induce visual hallucinations, sometimes characterized as hypnopompic or associated with a dissociated sleep-wakefulness state. In addition, disturbing dreams and confusional states were reported during clinical trials and in subsequent studies. To our knowledge, only two cases of nightmares associated with mirtazapine, a tetracyclic antidepressant, have been previously reported. We describe a 43-year-old Caucasian man with major depressive disorder who started mirtazapine 15 mg at bedtime because he had poor symptom control with other antidepressant drugs. Three days later, vivid dream activity was noted, evolving into realistic nightmares that the patient was not able to distinguish from reality on awakening. Acute paranoia was suspected, and haloperidol was started. The dream activity then ended, and within 3 days the patient was able to identify the dreams as unreality. Haloperidol was discontinued, but mirtazapine was continued, and the vivid dream activity persisted; however, reality testing when awake was intact. A short course of haloperidol restored the patient's reality testing, and mirtazapine was eventually replaced with bupropion. The unusual nocturnal activity resolved as a result. Clinicians should be aware of the possible transition from exceptionally vivid dreams to REM sleep behavior disorder and psychosis based on dream content as an adverse effect of mirtazapine.

  3. The open dialogue approach to acute psychosis: its poetics and micropolitics.

    Science.gov (United States)

    Seikkula, Jaakko; Olson, Mary E

    2003-01-01

    In Finland, a network-based, language approach to psychiatric care has emerged, called "Open Dialogue." It draws on Bakhtin's dialogical principles (Bakhtin, 1984) and is rooted in a Batesonian tradition. Two levels of analysis, the poetics and the micropolitics, are presented. The poetics include three principles: "tolerance of uncertainty," "dialogism," and "polyphony in social networks." A treatment meeting shows how these poetics operate to generate a therapeutic dialogue. The micropolitics are the larger institutional practices that support this way of working and are part of Finnish Need-Adapted Treatment. Recent research suggests that Open Dialogue has improved outcomes for young people in a variety of acute, severe psychiatric crises, such as psychosis, as compared to treatment-as-usual settings. In a nonrandomized, 2-year follow up of first-episode schizophrenia, hospitalization decreased to approximately 19 days; neuroleptic medication was needed in 35% of cases; 82% had no, or only mild, psychotic symptoms remaining; and only 23% were on disability allowance.

  4. Spinocerebellar ataxia-10 with paranoid schizophrenia.

    Science.gov (United States)

    Trikamji, Bhavesh; Singh, Parampreet; Mishra, Shrikant

    2015-01-01

    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.

  5. Spinocerebellar ataxia-10 with paranoid schizophrenia

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    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.

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

    Science.gov (United States)

    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.

  7. Paranoid personality disorder.

    Science.gov (United States)

    Triebwasser, Joseph; Chemerinski, Eran; Roussos, Panos; Siever, Larry J

    2013-12-01

    Paranoid personality disorder (PPD) is currently included in DSM-IV's "odd cluster" or "cluster A." In the present article, the authors review available information pertaining to the psychometric properties of PPD, as derived from the relevant literature and from databases of personality disorder study groups. There is comparatively little published evidence for the reliability and validity of PPD, and researchers by and large have tended not to study the disorder, either because of investigators' difficulty recruiting individuals with PPD into research studies, or (as seems more likely) because the trait-paranoia from which many psychiatric patients suffer has seemed better explained by other DSM-IV disorders on Axis I and/or Axis II than by PPD. Given the scant empirical evidence on PPD, it seems reasonable to remove it as an independent diagnosis from the next edition of DSM, and instead to encourage clinicians to code trait-paranoia using a dimensional approach.

  8. Different distribution patterns of lymphocytes and microglia in the hippocampus of patients with residual versus paranoid schizophrenia: further evidence for disease course-related immune alterations?

    Science.gov (United States)

    Busse, Stefan; Busse, Mandy; Schiltz, Kolja; Bielau, Hendrik; Gos, Tomasz; Brisch, Ralf; Mawrin, Christian; Schmitt, Andrea; Jordan, Wolfgang; Müller, Ulf J; Bernstein, Hans-Gert; Bogerts, Bernhard; Steiner, Johann

    2012-11-01

    Certain cytokines have been identified in the peripheral blood as trait markers of schizophrenia, while others are considered relapse-related state markers. Furthermore, data from peripheral blood, cerebrospinal fluid (CSF) and nuclear imaging studies suggest that (1) blood-brain barrier (BBB) dysfunction (e.g., immigration of lymphocytes into brain tissue and intrathecal antibody production) correlates with the development of negative symptoms, while (2) the brain's mononuclear phagocyte system (microglial cells) is activated during acute psychosis. Based on these neuroinflammatory hypotheses, we have quantified the numerical density of immunostained CD3+ T-lymphocytes, CD20+ B-lymphocytes, and HLA-DR+ microglial cells in the posterior hippocampus of 17 schizophrenia patients and 11 matched controls. Disease course-related immune alterations were considered by a separate analysis of residual (prevailing negative symptoms, n=7) and paranoid (prominent positive symptoms, n=10) schizophrenia cases. Higher densities of CD3+ and CD20+ lymphocytes were observed in residual versus paranoid schizophrenia (CD 3: left: P=0.047, right: P=0.038; CD20: left: P=0.020, right: P=0.010) and controls (CD3: left: P=0.057, right: P=0.069; CD20: left: P=0.008, right: P=0.006). In contrast, HLA-DR+ microglia were increased in paranoid schizophrenia versus residual schizophrenia (left: P=0.030, right: P=0.012). A similar trend emerged when this group was compared to controls (left: P=0.090, right: P=0.090). BBB impairment and infiltration of T cells and B cells may contribute to the pathophysiology of residual schizophrenia, while microglial activation seems to play a role in paranoid schizophrenia. The identification of diverse immune endophenotypes may facilitate the development of distinct anti-inflammatory schizophrenia therapies to normalize BBB function, (auto)antibody production or microglial activity.

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

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

    2016-07-01

    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

  10. Prolonged psychosis after Amanita muscaria ingestion.

    Science.gov (United States)

    Brvar, Miran; Mozina, Martin; Bunc, Matjaz

    2006-05-01

    Amanita muscaria has a bright red or orange cap covered with small white plaques. It contains the isoxazole derivatives ibotenic acid, muscimol and muscazone and other toxins such as muscarine. The duration of clinical manifestations after A. muscaria ingestion does not usually exceed 24 hours; we report on a 5-day paranoid psychosis after A. muscaria ingestion. A 48-year-old man, with no previous medical history, gathered and ate mushrooms he presumed to be A. caesarea. Half an hour later he started to vomit and fell asleep. He was found comatose having a seizure-like episode. On admission four hours after ingestion he was comatose, but the remaining physical and neurological examinations were unremarkable. Creatine kinase was 8.33 microkat/l. Other laboratory results and brain CT scan were normal. Toxicology analysis did not find any drugs in his blood or urine. The mycologist identified A. muscaria among the remaining mushrooms. The patient was given activated charcoal. Ten hours after ingestion, he awoke and was completely orientated; 18 hours after ingestion his condition deteriorated again and he became confused and uncooperative. Afterwards paranoid psychosis with visual and auditory hallucinations appeared and persisted for five days. On the sixth day all symptoms of psychosis gradually disappeared. One year later he is not undergoing any therapy and has no symptoms of psychiatric disease. We conclude that paranoid psychosis with visual and auditory hallucinations can appear 18 hours after ingestion of A. muscaria and can last for up to five days.

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

    Science.gov (United States)

    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.

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

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    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.

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

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    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.

  14. Psychosis in Parkinson's disease: diagnosis and treatment.

    Science.gov (United States)

    Doraiswamy, M; Martin, W; Metz, A; Deveaugh-Geiss, J

    1995-09-01

    1. This article reviews the prevalence, diagnosis, pathophysiology and management of psychosis in Parkinson's disease. 2. Psychosis in Parkinson's disease has been associated with all antiparkinsonian medications. The most common symptoms are vivid disturbing dreams, visual hallucinations and paranoid delusions. 3. The emergence of psychosis reduces the patient's functional capacity and increases caregiver burden. It also poses a therapeutic dilemma because effective treatment of psychotic symptoms may result in worsening of motor symptoms and vice versa. 4. Increased physician awareness is essential for proper diagnosis and management. Withdrawal of anticholinergic medications and amantadine followed by levodopa dose adjustment is effective in many patients. 5. Atypical neuroleptics, in low doses, may be successful when other measures have failed. However, these agents are not approved for treating Parkinsonian psychosis and must be considered as investigational therapies.

  15. Current Paranoid Thinking in Patients With Delusions: The Presence of Cognitive-Affective Biases

    Science.gov (United States)

    Freeman, Daniel

    2013-01-01

    Background: There has been renewed interest in the influence of affect on psychosis. Psychological research on persecutory delusions ascribes a prominent role to cognitive processes related to negative affect: anxiety leads to the anticipation of threat within paranoia; depressive negative ideas about the self create a sense of vulnerability in which paranoid thoughts flourish; and self-consciousness enhances feelings of the self as a target. The objective of this study was to examine such affective processes in relation to state paranoia in patients with delusions. Methods: 130 patients with delusions in the context of a nonaffective psychosis diagnosis (predominately schizophrenia) were assessed for contemporaneous levels of persecutory ideation on 5 visual analog scales. Measures were taken of anxiety, depression, threat anticipation, interpretation of ambiguity, self-focus, and negative ideas about the self. Results: Of the patients, 85% report paranoid thinking at testing. Symptoms of anxiety and depression were highly prevalent. Current paranoid thinking was associated with anxiety, depression, greater anticipation of threat events, negative interpretations of ambiguous events, a self-focused cognitive style, and negative ideas about the self. Conclusions: The study provides a clear demonstration that a range of emotion-related cognitive biases, each of which could plausibly maintain delusions, are associated with current paranoid thinking in patients with psychosis. We identified biases both in the contents of cognition and in the processing of information. Links between affect and psychosis are central to the understanding of schizophrenia. We conclude that treatment of emotional dysfunction should lead to reductions in current psychotic experiences. PMID:23223342

  16. Trastorno paranoide de la personalidad

    OpenAIRE

    Palencia de la Fuente, Natalia

    2015-01-01

    Se resumen las variantes, características, tratamientos, mitos y relatos históricos referentes al trastorno paranoide de la personalidad, mostrando sus semejanzas y diferencias con otros trastornos mentales y de personalidad. Se recopilan definiciones oficiales y aportaciones de autores diversos que aporten novedades, desmientan rumores y apoyen estudios o hipótesis

  17. [Neurophysiological Features of Perception of Emotional Stimuli in Health and in Patients with Paranoid Schizophrenia].

    Science.gov (United States)

    Arkhipov, A Yu; Strelets, V B

    2015-01-01

    Cognitive and emotional disorders, as far as is known, are the main syndromes of schizophrenia. Disorders of these functions are mainly determined by the clinical picture, as well as by psychophysiological correlates. The purpose of our study was to identify some psychophysiological factors which cause perceptual and emotional disturbances in patients with schizophrenia. These disorders of mental functions form the first rank (top) syndrome in patients with schizophrenia [1]. The studied patients had acute psychosis with a predominance of paranoid hallucinatory syndrome and did not receive antipsychotic therapy; i.e., the disturbances of sensory perception were most pronounced. The analysis of early component P100 and intermediate one N170 of event related potentials (ERPs) in the control group showed an increased level of excitation in response to emotionally threatening stimuli; the amplitude increased and the latency decreased in all leads. In contrast the analysis of components P100 and N170 in the group of patients with schizophrenia showed the increased latency and decreased amplitude. The obtained data provide evidence of pathological inhibition in the passive perception of emotionally significant stimuli.

  18. Anti-NMDA receptor encephalitis: a cause of acute psychosis and catatonia.

    Science.gov (United States)

    Ryan, Stephen A; Costello, Daniel J; Cassidy, Eugene M; Brown, Gemma; Harrington, Hugh J; Markx, Sander

    2013-03-01

    Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a newly described form of encephalitis associated with prominent psychiatric symptoms at onset. Recognition of the symptom complex is the key to diagnosis. Most patients with anti-NMDAR encephalitis develop a multistage illness that progresses from initial psychiatric symptoms to memory disturbance, seizures, dyskinesia, and catatonia. Psychiatric manifestations include anxiety, mania, social withdrawal, and psychosis (i.e., delusions, hallucinations, disorganized behavior). The disorder is more common in females (80%), in approximately half of whom it is associated with an underlying ovarian teratoma. Treatment involves immunosuppression, with steroids and intravenous immunoglobulin considered first line. The disorder is particularly relevant to psychiatrists, because most patients are initially seen by psychiatric services. Psychiatrists should consider anti-NMDAR encephalitis in patients presenting with psychosis as well as dyskinesia, seizures, and/or catatonia, especially if there is no history of a psychiatric disorder. We present the case of a 37-year-old woman who demonstrated many of the key clinical features of this potentially treatable disorder.

  19. Subjective emotional over-arousal to neutral social scenes in paranoid schizophrenia.

    Science.gov (United States)

    Haralanova, Evelina; Haralanov, Svetlozar; Beraldi, Anna; Möller, Hans-Jürgen; Hennig-Fast, Kristina

    2012-02-01

    From the clinical practice and some experimental studies, it is apparent that paranoid schizophrenia patients tend to assign emotional salience to neutral social stimuli. This aberrant cognitive bias has been conceptualized to result from increased emotional arousal, but direct empirical data are scarce. The aim of the present study was to quantify the subjective emotional arousal (SEA) evoked by emotionally non-salient (neutral) compared to emotionally salient (negative) social stimuli in schizophrenia patients and healthy controls. Thirty male inpatients with paranoid schizophrenia psychosis and 30 demographically matched healthy controls rated their level of SEA in response to neutral and negative social scenes from the International Affective Picture System and the Munich Affective Picture System. Schizophrenia patients compared to healthy controls had an increased overall SEA level. This relatively higher SEA was evoked only by the neutral but not by the negative social scenes. To our knowledge, the present study is the first designed to directly demonstrate subjective emotional over-arousal to neutral social scenes in paranoid schizophrenia. This finding might explain previous clinical and experimental data and could be viewed as the missing link between the primary neurobiological and secondary psychological mechanisms of paranoid psychotic-symptom formation. Furthermore, despite being very short and easy to perform, the task we used appeared to be sensitive enough to reveal emotional dysregulation, in terms of emotional disinhibition/hyperactivation in paranoid schizophrenia patients. Thus, it could have further research and clinical applications, including as a neurobehavioral probe for imaging studies.

  20. Virtual reality experiments linking social environment and psychosis: a pilot study.

    Science.gov (United States)

    Veling, Wim; Brinkman, Willem-Paul; Dorrestijn, Emily; van der Gaag, Mark

    2014-03-01

    Initial studies with healthy subjects and individuals with high risk for psychosis have suggested that virtual reality (VR) environments may be used to investigate social and psychological mechanisms of psychosis. One small study reported that VR can safely be used in individuals with current persecutory delusions. The present pilot study investigated the feasibility and potential negative side effects of exposure to different virtual social risk environments in patients with first episode psychosis and in healthy controls. Seventeen patients with first episode psychosis (FEP) and 24 healthy control subjects (HC) participated in four virtual experiments during which they walked for 3.5-4 minutes in a virtual café, looking for avatars with digits on their clothing. The level of paranoid thoughts, as well as psychological, physiological, and behavioral correlates of paranoid thoughts, were measured in different virtual social risk environments, manipulating two factors: population density and ethnicity of avatars. FEP and HC frequently had paranoid thoughts about avatars. Paranoia in the real world correlated strongly with paranoid thoughts about avatars in virtual environments (Spearman's ρ=0.67 and 0.54 in FEP and HC respectively, pvirtual environments with avatars of other ethnicity than in the own ethnicity condition. These results suggest that VR is an acceptable and sufficiently realistic method to use in patients with first episode psychosis. VR research may help to increase our understanding of the social and psychological mechanisms of psychosis and to develop new treatment applications.

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

    Science.gov (United States)

    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.

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

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    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.

  3. Psychopathological effects of psychostimulant substances and psychotic onset: the difficult process of differential diagnosis between substance-induced psychosis and acute primary psychosis

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    Emanuela Atzori

    2015-12-01

    Full Text Available Among the psychopathological effects induced by stimulants there can be a variety of psychotic-like experiences that can resolve in a matter of hours or within a few days without clinical treatment, or can instead constitute initial symptoms of a primary psychosis. The objective of this paper is to focalise on a series of psychodynamic aspects, detectable by the analysis of relational dynamics brought into play by the person who has used substances and suffers a psychotic crisis. These aspects can be used as criteria of differential diagnosis to integrate the first assessment of those psychopathological characteristics described in literature which distinguish a toxic psychosis from a primary psychosis. The diagnostic process is thus developed with the method of clinical observation and evaluation, for which the essential cognitive tool is formed by the sensibility of the therapist and their capacity to evaluate the quality of the patient’s mental reactions to the stimulus provoked by the development of the therapeutic relationship, including oniric activity. This paper proposes, on the basis of many years of research and clinical experience, diagnostic criteria also in dream analysis, as oniric images can reveal hidden thoughts and dynamics that could be pathological. The theoretical platform to which reference is made and presented in detail in this paper is known as “Human Birth Theory” (Teoria della nascita, formulated by Massimo Fagioli in 1971. The therapist involved in the therapeutic relationship can stimulate the internal mental world of the patient, proposing himself/herself as both a diagnostic and therapeutic instrument. The interpretation can give back to the patient their selfknowledge and the possibility to transform their unconscious relational methods through the therapeutic process, as documented in two case reports presented in this paper. The case reports, explained in a form of

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

    NARCIS (Netherlands)

    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

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

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    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.

  6. Rubinstein-Taybi syndrome with psychosis

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    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.

  7. Attributional biases, paranoia, and depression in early psychosis.

    Science.gov (United States)

    Langdon, Robyn; Still, Megan; Connors, Michael H; Ward, Philip B; Catts, Stanley V

    2013-11-01

    Attributional biases to externalize blame for negative events (externalizing bias) and to target other people for blame (personalizing bias) may constitute a vulnerability to psychosis. However, most research to date has only examined attributional biases in chronic patients. We examined attributional style, paranoia, and depression in early psychosis patients to assess the primacy of attributional biases in psychosis. A quasi-experimental design was adopted to compare the attributional style of patients and controls. Correlates of attributional style were also examined. Early psychosis patients and age- and gender-matched healthy controls completed the 'Internal, Personal and Situational Attributions Questionnaire'. Paranoid tendencies, suspiciousness, and depression were also assessed in both groups, while severity of current symptoms was assessed in patients. A high proportion of patients had persecutory delusions. These patients, however, did not differ from controls in externalizing or personalizing bias. Whereas suspiciousness and persecutory delusions in patients associated with externalizing bias, no bias measures associated with paranoid tendencies in either patients or controls. Counter to the pattern seen for endogenous depression, depression in patients was associated with an increased tendency to attribute events to self and a decreased tendency to attribute events to circumstances. These preliminary findings raise doubts about the primacy of attributional biases in psychosis. The novel findings with regard to depression warrant further investigation and suggest that young people, who develop depression after the onset of psychosis, may experience a need to re-establish a sense of personal control over life events that appear unpredictable. © 2013 The British Psychological Society.

  8. First Episode Psychosis

    Science.gov (United States)

    ... About Psychosis Treatment Share Fact Sheet: First Episode Psychosis Download PDF Download ePub Order a free hardcopy En Español Facts About Psychosis The word psychosis is used to describe conditions ...

  9. Childhood trauma, psychosis liability and social stress reactivity : a virtual reality study

    NARCIS (Netherlands)

    Veling, W.; Counotte, J.; Pot-Kolder, R.; van Os, J.; van der Gaag, M.

    2016-01-01

    Background. Childhood trauma is associated with higher risk for mental disorders, including psychosis. Heightened sensitivity to social stress may be a mechanism. This virtual reality study tested the effect of childhood trauma on level of paranoid ideations and distress in response to social stress

  10. Childhood trauma, psychosis liability and social stress reactivity : a virtual reality study

    NARCIS (Netherlands)

    Veling, W.; Counotte, J.; Pot-Kolder, R.; van Os, J.; van der Gaag, M.

    2016-01-01

    Background. Childhood trauma is associated with higher risk for mental disorders, including psychosis. Heightened sensitivity to social stress may be a mechanism. This virtual reality study tested the effect of childhood trauma on level of paranoid ideations and distress in response to social

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

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    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.

  12. Cognitive restructuring and graded behavioural exposure for delusional appraisals of auditory hallucinations and comorbid anxiety in paranoid schizophrenia.

    Science.gov (United States)

    Mankiewicz, Pawel D; Turner, Colin

    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. 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.

  13. Do emotions drive psychosis?

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    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

  14. Do emotions drive psychosis?

    Directory of Open Access Journals (Sweden)

    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

  15. Paranoid schizophrenia versus schizoaffective disorder: Neuropsychological aspects

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    Leposavić Ljubica

    2015-01-01

    Full Text Available Introduction. Neuropsychological aspects of paranoid schizophrenia have still not been examined enough. These disorders are usually not studied separately, but are included in the studies about schizophrenic patients with positive symptoms. Despite the fact that schizophrenia represents a heterogeneous group of mental disorders, usually it is not separated from schizoaffective disorder in neuropsychological researches. Objective. The essence of this research is to evaluate cognitive functioning of patients with paranoid schizophrenia and schizoaffective disorder by applying neuropsychological tests. Methods. The research included 91 subjects, right handed, from 30 to 53 years old, who were classified into three groups: inpatients with paranoid schizophrenia in remission (n=31, inpatients with schizoaffective disorder in remission (n=30 and healthy subjects (n=30. Results. Both groups of patients showed poorer achievements than healthy subjects in most of the applied tests. Patients with schizoaffective disorder showed global loss of intellectual efficiency, executive dysfunction and compromised visual-construction organization. Patients with paranoid schizophrenia expressed partial loss of intellectual efficiency with verbal IQ and executive functions preserved. Conclusion. In the remission phase, patients with paranoid schizophrenia expressed cognitive disorders in moderate degree, but when it comes to patients with schizoaffective disorder, more massive cognitive deficits were registered.

  16. What Is Psychosis?

    Science.gov (United States)

    ... The News Contact Us / Press Glossary What is Psychosis? The word psychosis is used to describe conditions that affect the ... called a psychotic episode. During a period of psychosis, a person’s thoughts and perceptions are disturbed and ...

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

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    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.

  18. Psychosis in Parkinson's disease

    OpenAIRE

    Thanvi, B; Lo, T.; Harsh, D

    2005-01-01

    Psychosis is common in Parkinson's disease (PD), particularly in its later stages. The symptoms range from comparatively minor illusions, vivid dreams, and occasional, non-disturbing visual hallucinations to frank psychosis. The pathogenesis of psychosis in PD is not fully known. Management of psychosis in PD requires a multidisciplinary approach. Some of the newer atypical antipsychotics are effective against psychosis with no significant worsening of PD. Psychosis in PD is associated with p...

  19. Psychosis in Parkinson's disease.

    Science.gov (United States)

    Thanvi, B R; Lo, T C N; Harsh, D P

    2005-10-01

    Psychosis is common in Parkinson's disease (PD), particularly in its later stages. The symptoms range from comparatively minor illusions, vivid dreams, and occasional, non-disturbing visual hallucinations to frank psychosis. The pathogenesis of psychosis in PD is not fully known. Management of psychosis in PD requires a multidisciplinary approach. Some of the newer atypical antipsychotics are effective against psychosis with no significant worsening of PD. Psychosis in PD is associated with poor quality of life for patients and the carers.

  20. A case of severe psychosis induced by novel recreational drugs [v1; ref status: indexed, http://f1000r.es/2o2

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    Filippo Dragogna

    2014-01-01

    Full Text Available Introduction:  The use of novel recreational drugs is becoming of public interest, especially after recent international alerts about their cardiovascular and neurological toxicity. Additionally, little is known about the psychiatric consequences of the long-term use of these compounds. Case presentation: We describe a case of severe psychotic episode likely induced by chronic use of a combination of new recreational drugs (methylenedioxypyrovalerone, mephedrone, butylone and alpha-pyrrolidinopentiophenone. The patient had no psychiatric history and showed poor response to conventional antipsychotic treatment (haloperidol. Conclusions: This case illustrates the potential negative effects of recreational drugs that cannot be limited to an acute psychotic episode but might determine a condition of prolonged paranoid psychosis. Although the use of these compounds is currently increasing, such molecules might often pass undetected in patients accessing the emergency room, leading to misdiagnosis (e.g. schizophrenic episode and lack of appropriate treatment.

  1. Comment on Differentiating Paranoid From Nonparanoid Schizophrenics

    Science.gov (United States)

    Calhoun, James F.

    1971-01-01

    Three methods of differentiating paranoid from nonparanoid schizophrenics were compared using 97 males from a Veterans Administration hospital. Official hospital diagnosis and behavior ratings were found to be significantly correlated, while self-report correlated with neither of the other two techniques. Implications for research are briefly…

  2. Paranoid atmospheres: Psychiatric knowledge and delusional realities

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    Schlimme Jann E

    2009-09-01

    Full Text Available Abstract In this paper I investigate the topic of paranoid atmospheres. This subject is especially of interest with respect to persons who are deluded, and also, I will demonstrate, sheds light upon the psychiatrist's "gaze" and knowledge of delusions. In my argument I will follow a path initially outlined by Karl Jaspers (1883-1969: modern psychiatric diagnosis of delusions is a diagnosis of form and not content. Jaspers' emphasis on the form of delusions enables psychiatrists to be self-critical about their professional knowledge and, consequently, prevent the development of dogmatic attitudes. In accord with Jaspers, my argument will focus on the basic structure of delusions and highlight the difference between delusional realities and non-delusional realities, a difference that follows from the possibility of self-criticism of one's own conscious and explicit convictions. I will demonstrate the importance of self-criticism with regard to paranoid atmospheres and also to psychiatric knowledge. In this manner, an understanding of delusions as lived experience will be developed, which argues that an escalation of the influence of delusional convictions, resulting in a profoundly paranoid atmosphere, is most problematic for the deluded person. To acknowledge this insight mirrors the need for a self-critique of psychiatric discourse, encourages an empathic and respectful relationship between professionals and deluded patients, and enables deluded persons to restrict their paranoid atmosphere. It is the main conclusion of my paper that a deluded person cannot do (with respect to his delusional convictions what a psychiatrist must do (with respect to his psychiatric knowledge and his own existential convictions in order to prevent a profoundly paranoid atmosphere in their relationship: be self-critical.

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

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    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.

  4. The cognitive and affective structure of paranoid delusions: a transdiagnostic investigation of patients with schizophrenia spectrum disorders and depression.

    Science.gov (United States)

    Bentall, Richard P; Rowse, Georgina; Shryane, Nick; Kinderman, Peter; Howard, Robert; Blackwood, Nigel; Moore, Rosie; Corcoran, Rhiannon

    2009-03-01

    Paranoid delusions are a common symptom of a range of psychotic disorders. A variety of psychological mechanisms have been implicated in their cause, including a tendency to jump to conclusions, an impairment in the ability to understand the mental states of other people (theory of mind), an abnormal anticipation of threat, and an abnormal explanatory style coupled with low self-esteem. To determine the structure of the relationships among psychological mechanisms contributing to paranoia in a transdiagnostic sample. Cross-sectional design, with relationships between predictor variables and paranoia examined by structural equation models with latent variables. Publicly funded psychiatric services in London and the North West of England. One hundred seventy-three patients with schizophrenia spectrum disorders, major depression, or late-onset schizophrenia-like psychosis, subdivided according to whether they were currently experiencing paranoid delusions. Sixty-four healthy control participants matched for appropriate demographic variables were included. Assessments of theory of mind, jumping to conclusions bias, and general intellectual functioning, with measures of threat anticipation, emotion, self-esteem, and explanatory style. The best fitting (chi(2)(96) = 131.69, P = .01; comparative fit index = 0.95; Tucker-Lewis Index = 0.96; root-mean-square error of approximation = 0.04) and most parsimonious model of the data indicated that paranoid delusions are associated with a combination of pessimistic thinking style (low self-esteem, pessimistic explanatory style, and negative emotion) and impaired cognitive performance (executive functioning, tendency to jump to conclusions, and ability to reason about the mental states of others). Pessimistic thinking correlated highly with paranoia even when controlling for cognitive performance (r = 0.65, P paranoia when controlling for pessimism (r = -0.34, P < .001). Both cognitive and emotion-related processes are involved in

  5. Variants of cognitive deficiency depending on the clinical characteristics of the disease in patients with paranoid schizophrenia

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    G. G. Lebedeva

    2015-01-01

    Full Text Available Pecific aspects of cognitive impairments in patients with paranoid schizophrenia depending on the clinical characteristics of the disease have been studied. One hundred and thirty patients were examined. A clinico-psychological, experimental psychological and statistical methods were used. Three main types of cognitive deficiency with paranoid schizophrenia, associated with the onset, disease duration, and severity of psychiatric symptomology : 1 long-term course of the disease accompanied by the average level of clinical symptomology associated with abnormal attention and visuospatial functions; 2 late onset of the disease and unexpressed clinical symptomology combined with memory impairments; 3 acute onset and early age combined with the absence of cognitive impairments.

  6. Acute variations of cytokine levels after antipsychotic treatment in drug-naïve subjects with a first-episode psychosis: A meta-analysis.

    Science.gov (United States)

    Capuzzi, Enrico; Bartoli, Francesco; Crocamo, Cristina; Clerici, Massimo; Carrà, Giuseppe

    2017-03-08

    Schizophrenia is likely to be associated with immunological abnormalities. However, antipsychotics may induce immunomodulatory effects, by influencing plasma cytokines. In order to distinguish these influences, we carried out a systematic review and meta-analysis exploring the acute effect of antipsychotics on candidate cytokines plasma levels (IL-1β, IL-2, IL-6, IL-17, IFN-γ, TNF-α) among drug-naïve subjects with first episode psychosis. We searched main Electronic Databases, identifying eight studies meeting our inclusion criteria. Pre and post-treatment plasma cytokines values were used to estimate standardized mean differences. Heterogeneity was estimated using the I(2) index. Heterogeneity-based sensitivity analyses were performed. IL-2 (p=0.023) and IL-6 (p=0.012) levels showed a significant decrease after four weeks of antipsychotic treatment. Relevant sensitivity analysis confirmed these findings. IL-1β had high between-study heterogeneity. However, leaving out one study, significant after treatment decrease was found. IL-6 and IL-2, and possibly IL-1β, could be considered state markers, decreasing after antipsychotic treatment, whilst TNF-α, IL-17, and IFN-γ might be considered trait markers. Options for novel treatments in FEP, involving cytokine-modulating agents, should be further studied.

  7. The Effect of State Anxiety on Paranoid Ideation and Jumping to Conclusions. An Experimental Investigation

    Science.gov (United States)

    Lincoln, Tania M.; Lange, Jennifer; Burau, Julia; Exner, Cornelia; Moritz, Steffen

    2010-01-01

    Theoretical models of persecutory delusions have emphasized the impact of reasoning biases and negative emotion at the early stages of symptom formation. However, the causal mechanisms remain unclear. This study tests the hypothesis that state anxiety will increase paranoid ideation and that this increase will be moderated by the level of individual vulnerability and mediated by the tendency to jump to conclusions. Healthy participants (n = 90) with varying levels of vulnerability (psychosis symptoms assessed by the Community Assessment of Psychic Experiences) were randomly assigned to either an anxiety or a nonanxiety condition. Anxiety was induced by pictures from the International Affective Picture System and by in sensu exposure to individual anxiety-provoking situations. During each condition, symptoms of paranoia were assessed by a state-adapted version of the Paranoia Checklist. Jumping to conclusions (JTC) was assessed using a modified version of the beads task. Overall, participants in the anxiety condition reported significantly more paranoid thoughts and showed more JTC than participants in the neutral condition. Participants with higher baseline vulnerability were more likely to show an increase in paranoia as reaction to the anxiety manipulation. Moreover, the association of anxiety and paranoia was mediated by the increased tendency to jump to conclusions in the beads task. The results are in line with a threat anticipation conceptualization of paranoia and provide evidence for an interaction of anxiety and reasoning biases in the development of paranoid beliefs. A combination of meta-cognitive training directed at reasoning biases and promoting emotion regulation skills might prove beneficial in preventing symptoms. PMID:19429844

  8. Paranoid delusional disorder follows social anxiety disorder in a long-term case series: evolutionary perspective.

    Science.gov (United States)

    Veras, André B; Souza, Thalita Gabínio E; Ricci, Thaysse Gomes; de Souza, Clayton Peixoto; Moryiama, Matheus César; Nardi, Antonio E; Malaspina, Dolores; Kahn, Jeffrey P

    2015-06-01

    Social anxiety disorder (SAD) patients may have self-referential ideas and share other cognitive processes with paranoid delusional disorder (PDD) patients. From an evolutionary perspective, SAD may derive from biologically instinctive social hierarchy ranking, thus causing an assumption of inferior social rank, and thus prompting concerns about mistreatment from those of perceived higher rank. This naturalistic longitudinal study followed four patients with initial SAD and later onset of PDD. These four patients show the same sequence of diagnosed SAD followed by diagnosed PDD, as is often retrospectively described by other PDD patients. Although antipsychotic medication improved psychotic symptoms in all patients, those who also had adjunctive serotonin-specific reuptake inhibitors for SAD had much more improvement in both psychosis and social functioning. From an evolutionary perspective, it can be conjectured that when conscious modulation of the SAD social rank instinct is diminished due to hypofrontality (common to many psychotic disorders), then unmodulated SAD can lead to paranoid delusional disorder, with prominent ideas of reference. Non-psychotic SAD may be prodromal or causal for PDD.

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

    Science.gov (United States)

    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.

  10. Flakka-Induced Prolonged Psychosis

    Directory of Open Access Journals (Sweden)

    Craig Crespi

    2016-01-01

    Full Text Available In South Florida, there has been a highly addictive new synthetic drug flooding the streets for people looking for a cheap high. Alpha-PVP, better known as Flakka, is an illegal substance that sells on the streets for as little as $5 a hit and delivers an instant high that can last from hours to days with lingering effects for weeks after it has been ingested. Although people use Flakka for its potential euphoric high, symptoms are known to easily escalate into frightening delusions, paranoid psychosis, extreme agitation, and a multitude of other altered mental states. According to the National Institute on Drug Abuse, Florida appears to be the nation’s hot spot for reports of Flakka. In this case report, a 17-year-old female with no prior psychiatric diagnosis presents to the hospital under a 72-hour involuntary placement for altered mental status with agitation and psychotic behaviors. After multiple days of symptomatic treatment with benzodiazepines and antipsychotics, the patient became coherent enough to give a history of a “friend” putting Flakka in her food at school as a joke. Although she continues to have residual symptoms including psychomotor agitation and slowing of cognition, she was alert, oriented, and able to be discharged home with proper follow-up.

  11. PARANOID INDIVIDUALS WITH SCHIZOPHRENIA SHOW GREATER SOCIAL COGNITIVE BIAS AND WORSE SOCIAL FUNCTIONING THAN NON-PARANOID INDIVIDUALS WITH SCHIZOPHRENIA.

    Science.gov (United States)

    Pinkham, Amy E; Harvey, Philip D; Penn, David L

    2016-03-01

    Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid individuals with schizophrenia differ in social cognition and functional outcomes. On measures assessing social cognitive bias, paranoid individuals endorsed more hostile and blaming attributions and identified more faces as untrustworthy; however, paranoid and non-paranoid individuals did not differ on emotion recognition and theory of mind tasks assessing social cognitive ability. Likewise, paranoid individuals showed greater impairments in real-world interpersonal relationships and social acceptability as compared to non-paranoid patients, but these differences did not extend to performance based tasks assessing functional capacity and social competence. These findings isolate specific social cognitive disparities between paranoid and non-paranoid subgroups and suggest that paranoia may exacerbate the social dysfunction that is commonly experienced by individuals with schizophrenia.

  12. Paranoid individuals with schizophrenia show greater social cognitive bias and worse social functioning than non-paranoid individuals with schizophrenia

    Directory of Open Access Journals (Sweden)

    Amy E. Pinkham

    2016-03-01

    Full Text Available Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid individuals with schizophrenia differ in social cognition and functional outcomes. On measures assessing social cognitive bias, paranoid individuals endorsed more hostile and blaming attributions and identified more faces as untrustworthy; however, paranoid and non-paranoid individuals did not differ on emotion recognition and theory of mind tasks assessing social cognitive ability. Likewise, paranoid individuals showed greater impairments in real-world interpersonal relationships and social acceptability as compared to non-paranoid patients, but these differences did not extend to performance based tasks assessing functional capacity and social competence. These findings isolate specific social cognitive disparities between paranoid and non-paranoid subgroups and suggest that paranoia may exacerbate the social dysfunction that is commonly experienced by individuals with schizophrenia.

  13. [Classification of long-term clinical course of 'atypical psychosis': a 20-year follow-up study at a medical school hospital].

    Science.gov (United States)

    Otsuka, Koichiro; Kato, Satoshi; Abe, Takaaki; Sugiyama, Hisashi; Watanabe, Yoshihiro; Kobayashi, Toshiyuki; Okajima, Yoshiro

    2002-01-01

    To study the long-term clinical course and outcomes of atypical psychosis, 8 patients diagnosed with atypical psychosis were observed for more than 12 years (mean, 20 years). Retrospective examination was performed, particularly with respect to clinical features at each episode. The overall course of each case was classified as one of the following three types: Type I--"Recurrent confused state" type. Patients frequently repeated acute transient confused or dream-like states in a similar way, sometimes and/or for part of the episode accompanied by a floating paranoid-hallucinatory state. Duration of psychotic episode was short, persisting for a few days to about one month. Type II--"Manic-depressive illness similar" type. After a long course of disease, the predominantly early middle-aged patients (30- to 40 years-old) demonstrated fewer original characteristic features of acute confused or dream-like states. Instead, manic or depressive episodes tended to predominate. Duration of psychotic episodes exceeded the duration of type I episodes, to a maximum of about 3 months. Type III--"Appearance of residual state" type. After several episodes characterized by transient confused state during middle age, residual states consisting of a slight depressive state, reduced spontaneity and flattening of emotions appear. These states become durable and the periodicity of the disease disappeared. We conclude that the core group of atypical psychosis patients presents with confused symptoms as a clinical feature of episodes, and with the recurrent confused state type representing the long-term clinical course. "Shift to manic-depressive illness similar" and "appearance of residual state" types were considered to be derived from the core group, according to the interplay of personality structure and viable dynamics.

  14. A Case of Very-late-onset Schizophrenia-like Psychosis

    OpenAIRE

    Son, Ji Hyun; Kee, Baik Seok

    2011-01-01

    This paper presents the case of a 67-year-old woman who visited the Psychiatry Department complaining of persecutory ideas and auditory hallucinations after a buccal cancer operation. On neuropsychological testing, she demonstrated paranoid psychosis and bizarre thoughts. Hospital admission was recommended for supportive care and treatment with antipsychotics. She was initially treated with olanzapine, but this medication had little effect and was replaced with amisulpride, which reduced the ...

  15. Theory of Mind differences in older patients with early-onset and late-onset paranoid schizophrenia.

    Science.gov (United States)

    Smeets-Janssen, M M J; Meesters, P D; Comijs, H C; Eikelenboom, P; Smit, J H; de Haan, L; Beekman, A T F; Stek, M L

    2013-11-01

    Theory of Mind (ToM) is considered an essential element of social cognition. In younger schizophrenia patients, ToM impairments have extensively been demonstrated. It is not clear whether similar impairments can be found in older schizophrenia patients and if these impairments differ between older patients with early-onset and late-onset schizophrenia. Theory of Mind abilities were assessed using the Hinting Task in 15 older patients (age 60 years and older) with early-onset paranoid schizophrenia, 15 older patients with late-onset paranoid schizophrenia and 30 healthy controls. ANCOVA was performed to test differences between groups. Analyses were adjusted for level of education. Effect sizes, partial eta squared (ε(2) ), were computed as an indication of the clinical relevance of the findings. Patients with early-onset schizophrenia scored significantly lower on the Hinting Task (mean 16.1; SD 4.3) compared with patients with late-onset schizophrenia (mean 18.6; SD 1.5) and with healthy controls (mean 19.0; SD 1.4). The effect size of this difference was large (ε(2)  = 0.2). These results suggest that ToM functioning may be a protective factor modulating the age at onset of psychosis. Further studies into the relationship between social cognition and onset age of psychosis are warranted. Copyright © 2013 John Wiley & Sons, Ltd.

  16. Psychosis following mycoplasma pneumonia.

    Science.gov (United States)

    Banerjee, Bonita; Petersen, Kyle

    2009-09-01

    Extrapulmonary manifestations of Mycoplasma pneumoniae are well described, including a subset of central nervous system (CNS)-associated syndromes. In pediatric populations, frequencies of CNS sequelae occur in 0.1% to 7% of patients. Neurologic illness associated with M. pneumoniae, such as meningitis, encephalitis, polyradiculitis, Guillain-Barre, and stroke have been reported; however, the incidence of M. pneumoniae-associated organic brain syndrome is rare. We present the case of a 20-year-old midshipman with acute psychosis following resolution of M. pneumoniae pneumonia and review 6 other adult cases found in the literature. M. pneumoniae remains one of the most common causes of respiratory illnesses in the military recruit setting and therefore should always be suspected as an organic cause of mental status changes in young persons such as recruits, cadets, and midshipmen particularly with antecedent respiratory illnesses.

  17. Esquizofrenia paranoide ou esquizotipia versus criatividade

    OpenAIRE

    Sequeira, Márcia

    2012-01-01

    A referência à relação entre psicopatologia e criatividade data da Grécia Antiga (1). No último século observou-se a exaustiva exploração da relação bipolaridade e criatividade, que ofuscou o estudo da relação da criatividade com a esquizofrenia, doença com um importante peso na sociedade atual. A esquizofrenia paranoide, pelo marcado predomínio da sintomatologia positiva, sem a deterioração cognitiva, que caracteriza os outros tipos de esquizofrenia (2); e a esquizotipia posit...

  18. Amygdala Hyperactivity at Rest in Paranoid Individuals With Schizophrenia.

    Science.gov (United States)

    Pinkham, Amy E; Liu, Peiying; Lu, Hanzhang; Kriegsman, Michael; Simpson, Claire; Tamminga, Carol

    2015-08-01

    The amygdala's role in threat perception suggests that increased activation of this region may be related to paranoid ideation. However, investigations of amygdala function in paranoid individuals with schizophrenia, compared with both healthy individuals and nonparanoid individuals with schizophrenia, have consistently reported reduced task-related activation. The reliance of blood-oxygen-level-dependent functional MRI on a contrast between events and baseline, and the inability to quantitatively measure this baseline, may account for these counterintuitive findings. The present study tested for differences in baseline levels of amygdala activity in paranoid and nonparanoid individuals with schizophrenia using arterial spin labeling perfusion MRI. Resting cerebral blood flow (CBF) and task-related activation of the amygdala were measured in 25 healthy individuals, 16 individuals with schizophrenia who were actively paranoid at the time of scanning, and 16 individuals with schizophrenia who were not paranoid. Analysis of relative CBF values extracted from the amygdala bilaterally revealed significantly increased activity in the left amygdala in paranoid patient volunteers compared with healthy comparison subjects and nonparanoid patient volunteers. Increased CBF was also evident in the right amygdala but did not reach the level of statistical significance. Paranoid volunteers also showed significantly decreased task-related activation of the amygdala compared with the two other groups. These findings suggest that amygdala hyperactivation may underlie paranoia in schizophrenia. Additionally, the reported differences between paranoid and nonparanoid patient volunteers emphasize the importance of considering symptom-based subgroups and baseline levels of activity in future investigations of neural activation in schizophrenia.

  19. Maintenance Electroconvulsive Therapy in a Patient with Treatment-Resistant Paranoid Schizophrenia and Comorbid Epilepsy

    Directory of Open Access Journals (Sweden)

    Beppe Micallef-Trigona

    2012-01-01

    Full Text Available The treatment of choice for acute schizophrenia is antipsychotic drug treatment and electroconvulsive therapy (ECT and should only be considered as an option for treatment-resistant schizophrenia, where treatment with clozapine has already proven ineffective or intolerable. The use of ECT as a maintenance treatment for patients with schizophrenia and comorbid epilepsy is uncommon as scant evidence exists to support this. We describe a patient with a serious case of paranoid schizophrenia and comorbid epilepsy who had not responded to typical and atypical antipsychotic medication, but responded remarkably to acute ECT and required maintenance ECT to sustain a positive therapeutic response.

  20. Maintenance electroconvulsive therapy in a patient with treatment-resistant paranoid schizophrenia and comorbid epilepsy.

    Science.gov (United States)

    Micallef-Trigona, Beppe; Spiteri, Joseph

    2012-01-01

    The treatment of choice for acute schizophrenia is antipsychotic drug treatment and electroconvulsive therapy (ECT) and should only be considered as an option for treatment-resistant schizophrenia, where treatment with clozapine has already proven ineffective or intolerable. The use of ECT as a maintenance treatment for patients with schizophrenia and comorbid epilepsy is uncommon as scant evidence exists to support this. We describe a patient with a serious case of paranoid schizophrenia and comorbid epilepsy who had not responded to typical and atypical antipsychotic medication, but responded remarkably to acute ECT and required maintenance ECT to sustain a positive therapeutic response.

  1. A case of acute psychosis in a patient following exposure to a single high dose of styrene.

    Science.gov (United States)

    Moon, Eunsoo; Suh, Hwagyu; Lee, Byung Dae; Park, Je Min; Lee, Young Min; Jeong, Hee Jeong

    2015-09-01

    We report a case of acute psychotic symptoms following exposure to a single high dose of styrene monomer. The 24-year-old male patient showed psychotic and cognitive symptoms immediately after exposure. His psychotic symptoms included auditory hallucinations and delusions of reference. Brain magnetic resonance imaging, electroencephalography, and laboratory examinations were performed to evaluate any other causes. The clinical, neuroimaging, and laboratory review in this case suggested that the suddenly developed psychotic symptoms that led to chronic deterioration were caused by the single exposure to styrene monomer. This is the first recent report in which acute psychotic symptoms developed from a single high dose of styrene suffocation compared with previous findings showing symptoms because of long-term low-dose exposure.

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

    Science.gov (United States)

    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.

  3. Aberrantly flattened responsivity to emotional pictures in paranoid schizophrenia.

    Science.gov (United States)

    Lee, Eun; Kim, Jae-Jin; Namkoong, Kee; An, Suk Kyoon; Seok, Jeong-Ho; Lee, Yu Jin; Kang, Jee In; Choi, Jae Hyuk; Hong, Taekyong; Jeon, Jong Hee; Lee, Hong Shick

    2006-08-30

    To investigate the nature of emotional experience in schizophrenia, we examined emotional responses to affective stimuli. Twenty-one outpatients with schizophrenia (9 paranoid, 12 nonparanoid) and 20 normal controls rated the arousal and valence that they experienced from the presentation of 60 pictures. Schizophrenia patients displayed less emotional responsivity to the positive stimuli and they displayed diverse responsivity to the negative stimuli, which depended upon arousal level. Further analysis, using schizophrenia subtype, indicated that nonparanoid patients reported increased negative responsivity and decreased positive responsivity, regardless of arousal level. However, paranoid schizophrenia patients showed enhanced self-reported experiences of emotion to the low arousing stimuli and diminished responsivity to the high arousing stimuli. This pattern was robust to the negative stimuli. These findings suggest that paranoid schizophrenia patients might suffer from aberrantly flattened responses to negative emotional stimuli, and that this may account for paranoid tendency and secondary social isolation in paranoid schizophrenia.

  4. Characteristics of trees drawn by patients with paranoid schizophrenia.

    Science.gov (United States)

    Inadomi, Hiroyuki; Tanaka, Goro; Ohta, Yasuyuki

    2003-08-01

    The objective of the present study was to investigate the relationship between schizophrenia subtype and morphological characteristics of trees drawn in the Baum test. Subjects comprised the following three groups: 20 patients diagnosed with paranoid schizophrenia according to International Classification of Diseases (10th revision; ICD-10) criteria; 26 patients with non-paranoid schizophrenia according to ICD-10 criteria; and 53 healthy individuals. Differences in psychiatric symptoms as assessed using the Brief Psychiatric Rating Scale (BPRS) score were compared between patients with paranoid and non-paranoid schizophrenia. In addition, differences in two morphological characteristics of trees, namely trunk-to-crown ratio and trunk end opening, were compared between the three groups. No differences in psychiatric symptoms were identified between patients with paranoid and non-paranoid schizophrenia. Conversely, mean +/- SD trunk-to-crown ratio was 13.1 +/- 8.0 for patients with non-paranoid schizophrenia, 8.8 +/- 4.6 for patients with paranoid schizophrenia, and 5.4 +/- 3.4 for healthy individuals. Significant differences were identified between all three groups. Furthermore, mean trunk end opening was 0.80 +/- 0.7 for patients with paranoid schizophrenia, 0.38 +/- 0.6 for patients with non-paranoid schizophrenia, and 0.06 +/- 0.3 for healthy individuals. Again, significant differences were apparent between all three groups. These findings suggest that morphological differences in trees drawn in the Baum test can be observed between the two schizophrenia subtypes in terms of not only psychopathological interpretation, but also gestalt formation, as assessed on the basis of trees with collapsed gestalt or with some degree of gestalt. This suggests the possibility of multiple disorders at a physiological level. The present study confirmed that the Baum test can quantitatively assess facets of schizophrenia that existing scales such as BPRS are unable to analyze

  5. Biosocial characteristics of patients with paranoid schizophrenia

    Directory of Open Access Journals (Sweden)

    Gergana K. Panayotova

    2016-04-01

    Full Text Available Schizophrenia is known as a complex disorder that combines both genetic and environmental factors. Different genes have been tested as candidates for association with schizophrenia and different environmental factors have been examined in many studies on epidemiology of schizophrenia. Specific environmental factors, such as nonspecific stress, mental and physical abuse, maternal diet during pregnancy, drug use, living in an urban setting, migration, seasonal effects on birth and exposure to infections, have been discussed as possible risk for schizophrenia. The present preliminary study is focused on the relations between biological and social characteristics of patients with paranoid schizophrenia with different cognitive levels, emotional and creative styles. Descriptive statistics, the Student's t-test and SPSS software, were used to analyse the relations mentioned. Differences between sexes and these concerning age of individuals (risk level of inheritance, ABO blood group distribution, triggering factors, aggressive behavior, single or multiple suicide attempts, levels of education and creative talents were indicated and discussed. The study identifies important trends and discuses essential biosocial relations in context of the knowledge for schizophrenia in Bulgaria. Future comparative investigations, including genetic markers and psychogenetic approaches, should be used in complex, in order to characterize the reasons for developing paranoid schizophrenia and the possible relations between biological, psychological and social factors better.

  6. Methamphetamine Psychosis: Epidemiology and Management

    Science.gov (United States)

    Glasner-Edwards, Suzette; Mooney, Larissa J.

    2016-01-01

    Psychotic symptoms and syndromes are frequently experienced among individuals who use methamphetamine, with recent estimates of up to approximately 40% of users affected. Though transient in a large proportion of users, acute symptoms can include agitation, violence, and delusions, and may require management in an inpatient psychiatric or other crisis intervention setting. In a subset of individuals, psychosis can recur and persist and may be difficult to distinguish from a primary psychotic disorder such as schizophrenia. Differential diagnosis of primary versus substance-induced psychotic disorders among methamphetamine users is challenging; nevertheless, with careful assessment of the temporal relationship of symptoms to methamphetamine use, aided by state-of-the art psychodiagnostic assessment instruments and use of objective indicators of recent substance use (i.e., urine toxicology assays), coupled with collateral clinical data gathered from the family or others close to the individual, diagnostic accuracy can be optimized and the individual can be appropriately matched to a plan of treatment. The pharmacological treatment of acute methamphetamine-induced psychosis may include the use of antipsychotic medications as well as benzodiazepines, although symptoms may resolve without pharmacological treatment if the user is able to achieve a period of abstinence from methamphetamine. Importantly, psychosocial treatment for methamphetamine dependence has a strong evidence base and is the optimal first-line treatment approach to reducing rates of psychosis among individuals who use methamphetamines. Prevention of methamphetamine relapse is the most direct means of preventing recurrence of psychotic symptoms and syndromes. Long-term management of individuals who present with recurrent and persistent psychosis, even in the absence of methamphetamine use, may include both behavioral treatment to prevent resumption of methamphetamine use and pharmacological treatment

  7. Methamphetamine psychosis: epidemiology and management.

    Science.gov (United States)

    Glasner-Edwards, Suzette; Mooney, Larissa J

    2014-12-01

    Psychotic symptoms and syndromes are frequently experienced among individuals who use methamphetamine, with recent estimates of up to approximately 40 % of users affected. Although transient in a large proportion of users, acute symptoms can include agitation, violence, and delusions, and may require management in an inpatient psychiatric or other crisis intervention setting. In a subset of individuals, psychosis can recur and persist and may be difficult to distinguish from a primary psychotic disorder such as schizophrenia. Differential diagnosis of primary vs. substance-induced psychotic disorders among methamphetamine users is challenging; nevertheless, with careful assessment of the temporal relationship of symptoms to methamphetamine use, aided by state-of-the art psychodiagnostic assessment instruments and use of objective indicators of recent substance use (i.e., urine toxicology assays), coupled with collateral clinical data gathered from the family or others close to the individual, diagnostic accuracy can be optimized and the individual can be appropriately matched to a plan of treatment. The pharmacological treatment of acute methamphetamine-induced psychosis may include the use of antipsychotic medications as well as benzodiazepines, although symptoms may resolve without pharmacological treatment if the user is able to achieve a period of abstinence from methamphetamine. Importantly, psychosocial treatment for methamphetamine dependence has a strong evidence base and is the optimal first-line treatment approach to reducing rates of psychosis among individuals who use methamphetamines. Prevention of methamphetamine relapse is the most direct means of preventing recurrence of psychotic symptoms and syndromes. Long-term management of individuals presenting with recurrent and persistent psychosis, even in the absence of methamphetamine use, may include both behavioral treatment to prevent resumption of methamphetamine use and pharmacological treatment

  8. Deficits in theory of mind and social anxiety as independent paths to paranoid features in schizophrenia.

    Science.gov (United States)

    Lysaker, Paul H; Salvatore, Giampaolo; Grant, Megan L A; Procacci, Michele; Olesek, Kyle L; Buck, Kelly D; Nicolò, Giuseppe; Dimaggio, Giancarlo

    2010-12-01

    Research suggests paranoia among persons with schizophrenia may be the result of a number of different psychological processes including deficits in theory of mind (ToM) and social anxiety. To test this hypothesis, this study sought to determine whether a group of highly paranoid persons with and without a ToM deficit could be detected and whether the group with paranoia and better ToM might have high levels of social anxiety. To explore this, a cluster analysis was performed on a group of 102 adults with schizophrenia spectrum disorders in a non-acute phase of illness on the basis of ratings of paranoid features using the Positive and Negative Syndrome Scale and levels of ToM deficit using a factor score which summarized four different ToM assessments. Four groups were produced: High Paranoia/Poor ToM (n = 14); Low Paranoia/Good ToM (n = 22); Low Paranoia/Low Middle ToM (n=29); and High Paranoia/High Middle ToM (n = 23). Groups were then compared on self report of social anxiety. As predicted, the group with levels of high paranoid features and relatively better ToM performance had significantly higher levels of social anxiety than all other groups.

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

    Science.gov (United States)

    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."

  10. CASE REPORT : GRAVE'S DISEASE PRESENTING AS PARANOID SCHIZOPHRENIA

    OpenAIRE

    Singh, S. K.; Hatwal, A.; Agarwal, J.K.; Bajpai, H.S.; Sharma, I

    1989-01-01

    SUMMARY The case of a 37 year old male is described who initially presented as paranoid schizophrenia unresponsive to anti-psychotic drug treatment and subsequently developed features of Grave's disease. Treatment with carbimazole alone improved his psychiatric symptoms.

  11. The safety, tolerability and efficacy of pimavanserin tartrate in the treatment of psychosis in Parkinson's disease.

    Science.gov (United States)

    Hermanowicz, Stefan; Hermanowicz, Neal

    2016-06-01

    Parkinson's disease psychosis (PDP) is a common and often very disturbing component of Parkinson's disease (PD). PDP consists of hallucinations that are mainly visual and delusions that are often of a paranoid nature. These symptoms can be the most troubling and disruptive of all the manifestations of Parkinson's disease. Current treatment methods include the reduction of anti-Parkinson's medications, a strategy that may worsen the motor problems the medications are prescribed to alleviate, and the introduction of selected antipsychotic medications that carry with them the potential for troubling side effects and serious consequences. Pimavanserin has been developed and studied in clinical trials to specifically address Parkinson's disease psychosis and has been submitted to the U.S. Food and Drug Administration for its approval for this purpose. If this is granted, we believe the evidence of Pimavanserin efficacy, safety and tolerability will position this medication as the first choice for treatment of Parkinson's disease psychosis.

  12. The neurology of psychosis.

    Science.gov (United States)

    Oyebode, Femi

    2008-01-01

    The neural basis of psychosis is yet to be fully elucidated. In this review the contribution of schizophrenia-like psychosis of epilepsy, delusional misidentification syndromes and psychotic phenomena, such as auditory and visual hallucinations, to our understanding of the neural basis of psychosis is examined. Schizophrenia-like psychosis of epilepsy is associated with seizures originating from the limbic structures. Reduced seizure frequency, left-sided electrical foci, and neurodevelopmental lesions manifesting as cortical dysgenesis are known to influence the likelihood of developing schizophrenia-like psychosis of epilepsy. The delusional misidentification syndromes are a group of rare psychiatric symptoms in which impairments of face recognition memory are present. These conditions appear also to be associated with organic lesions affecting limbic structures and also involving both the frontal and parietal lobes. There is evidence that right-sided lesions predominate in the aetiology of delusional misidentification syndromes. Thus, the common link between schizophrenia, schizophrenia-like psychosis of epilepsy and delusional misidentification syndromes appears to be involvement of limbic structures in their pathophysiology. Discrete psychotic phenomena such as visual and auditory hallucinations appear to arise from functional changes in the same cortical areas subserving the normal physiological functions of vision and audition but also involving limbic structures. In conclusion, the limbic structures appear to be central to the psychopathology of psychosis but with involvement of frontal and parietal structures. These inquiries are revealing as much about psychosis as they are about the nature of normal brain function.

  13. Theory of mind, insecure attachment and paranoia in adolescents with early psychosis and healthy controls.

    Science.gov (United States)

    Korver-Nieberg, Nikie; Fett, Anne-Kathrin J; Meijer, Carin J; Koeter, Maarten W J; Shergill, Sukhi S; de Haan, Lieuwe; Krabbendam, Lydia

    2013-08-01

    Impaired Theory of Mind (ToM) is found in adults with schizophrenia and is associated with paranoid symptoms. Insecure attachment is proposed to underlie impaired ToM as well as paranoia. Insight into associations between insecure attachment and impaired ToM skills may help clinicians and patients to understand interpersonal difficulties and use this knowledge to improve recovery. This study used a visual perspective-taking task to investigate whether cognitive ToM is already impaired in adolescents with early psychosis as compared to controls. Also investigated was whether perspective-taking and paranoia are associated with insecure (adult) attachment. Thirty-two adolescent patients with early psychosis and 78 healthy controls participated in this cross-sectional study design and completed the level 1 perspective-taking task, psychopathology assessments (CAPE, PANSS), paranoid thoughts (GPTS), attachment style (PAM) and the WASI vocabulary. Patients did not significantly differ in level-1 perspective-taking behaviour compared to healthy controls. No significant associations were found between perspective-taking, paranoia and attachment. Insecure attachment was significantly related to paranoid thoughts, after controlling for illness-related symptoms. No impairment of level-1 perspective-taking was found in adolescent patients with early psychosis compared to healthy controls. Results indicate that level-1 perspective-taking is not impaired during the early stages of psychotic illness. The association between paranoia and attachment support previous findings and provide further insight into the nature of psychotic symptoms. Understanding the role of attachment in paranoia may help patients and their care workers to gain insight into the reasons for the development or persistence of symptoms. Future research should compare early psychosis samples with more chronic samples to explore whether perspective-taking deteriorates during the course of the illness.

  14. Paranoid individuals with schizophrenia show greater social cognitive bias and worse social functioning than non-paranoid individuals with schizophrenia

    OpenAIRE

    Pinkham, Amy E.; Harvey, Philip D.; Penn, David L.

    2016-01-01

    Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid indiv...

  15. Paranoid individuals with schizophrenia show greater social cognitive bias and worse social functioning than non-paranoid individuals with schizophrenia

    OpenAIRE

    Pinkham, Amy E.; Harvey, Philip D.; Penn, David L.

    2016-01-01

    Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid indiv...

  16. 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

    Institute of Scientific and Technical Information of China (English)

    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。

  17. Canada: psychosis in the immigrant Caribbean population.

    Science.gov (United States)

    Seeman, Mary V

    2011-09-01

    Many reports from European countries suggest that acute episodes of psychosis are more frequent among immigrants from the Caribbean than among their non-immigrant peers. The aim of this selective review is to examine how the social correlates of migration to Canada interact with biological mechanisms to contribute to psychosis in the Caribbean population. PubMed and JSTOR social science databases (between 1966 and 2010) were searched using the following search terms: psychiatric genetics; dopamine pathways; Caribbean family structure and child rearing; cannabis and psychosis; obstetric complications and schizophrenia; social defeat; social capital; racial discrimination; urbanicity; immigration; assimilation; and immigration. This was followed by the cross-checking of references pertinent to Canada. There was no information about the prevalence of psychosis in Afro-Caribbean immigrant groups to Canada. There was a suggestion that the form the acute episode takes may differ, depending perhaps on the island of origin. Ethnicity and migration influence susceptibility and response to psychotic illness in a number of distinct and interacting ways depending both on the host country and the country of origin. Understanding the pathways can help to protect the health of immigrants.

  18. [Post-partum psychosis].

    Science.gov (United States)

    Gressier, Florence; Letranchant, Aurélie; Hardy, Patrick

    2015-02-01

    Postpartum psychosis occurs in 1-2/1000 childbearing women. It is commonly admitted that it belongs to bipolar disorder with psychotic features. A strong link between puerperal psychosis and bipolar disorder has been established. Symptoms include rapid mood fluctuations, confusion, delusions, hallucinations and bizarre behaviour. It can lead to devastating consequences. It is a psychiatric emergency that requires an urgent evaluation to exclude any organic cause. Therefore, early identification and appropriate treatment are critical. A quick and effective relief is necessary for maternal and child health and mother-infant relationship. Perinatal health professionals have to be accurate screening postpartum psychosis symptoms and have to educate patients and their family.

  19. Symptoms of psychosis in anorexia and bulimia nervosa.

    Science.gov (United States)

    Miotto, Paola; Pollini, Barbara; Restaneo, Antonietta; Favaretto, Gerardo; Sisti, Davide; Rocchi, Marco B L; Preti, Antonio

    2010-02-28

    Despite evidence from case series, the comorbidity of eating disorders with psychosis is less investigated than their comorbidity with anxiety and mood disorders. We investigated the occurrence of symptoms of psychosis in 112 female patients diagnosed with DSM-IV eating disorders (anorexia nervosa=61, bulimia nervosa=51) and 631 high school girls in the same health district as the patients: the items of the SCL-90R symptom dimensions "paranoid ideation" and "psychoticism" were specifically examined. No case of co-morbid schizophrenia was observed among patients. Compared with controls, the patients with anorexia nervosa were more likely to endorse the item "Never feeling close to another person"; the patients with bulimia nervosa were more likely to endorse the item "Feeling others are to blame for your troubles". Both groups of patients were more likely than controls to endorse the item "Idea that something is wrong with your mind". The students who were identified by the EAT and the BITE as being "at risk" for eating disorders were more likely to assign their body a causative role in their problems. Symptoms of psychosis can be observed in patients with eating disorders, but these could be better explained within the psychopathology of the disorders rather than by assuming a link with schizophrenia.

  20. Taxometric analyses of paranoid and schizoid personality disorders.

    Science.gov (United States)

    Ahmed, Anthony Olufemi; Green, Bradley Andrew; Buckley, Peter Francis; McFarland, Megan Elizabeth

    2012-03-30

    There remains debate about whether personality disorders (PDs) are better conceptualized as categorical, reflecting discontinuity from normal personality; or dimensional, existing on a continuum of severity with normal personality traits. Evidence suggests that most PDs are dimensional but there is a lack of consensus about the structure of Cluster A disorders. Taxometric methods are adaptable to investigating the taxonic status of psychiatric disorders. The current study investigated the latent structure of paranoid and schizoid PDs in an epidemiological sample (N=43,093) drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) using taxometric analyses. The current study used taxometric methods to analyze three indicators of paranoid PD - mistrust, resentment, and functional disturbance - and three indicators of schizoid PD - emotional detachment, social withdrawal, and functional disturbance - derived factor analytically. Overall, taxometrics supported a dimensional rather than taxonic structure for paranoid and schizoid PDs through examination of taxometric graphs and comparative curve fit indices. Dimensional models of paranoid and schizoid PDs better predicted social functioning, role-emotional, and mental health scales in the survey than categorical models. Evidence from the current study supports recent efforts to represent paranoid and schizoid PDs as well as other PDs along broad personality dimensions.

  1. Understanding the paranoid psychosis of James: Use of the repertory grid technique for case conceptualization.

    Science.gov (United States)

    García-Mieres, Helena; Ochoa, Susana; Salla, Marta; López-Carrilero, Raquel; Feixas, Guillem

    2016-09-22

    In this paper we illustrate the potential of the repertory grid technique as an instrument for case formulation and understanding of the personal perception and meanings of people with a diagnosis of psychotic disorders. For this purpose, the case of James is presented: A young man diagnosed with schizophrenia and personality disorder, with severe persecutory delusions and other positive symptoms that have not responded to antipsychotic medication, as well with depressive symptomatology. His case was selected because of the way his symptoms are reflected in his personal perception of self and others, including his main persecutory figure, in the different measures that result from the analysis of his repertory grid. Some key clinical hypotheses and possible targets for therapy are discussed.

  2. Paranoid symptoms and disorders among 100 Hmong refugees: a longitudinal study.

    Science.gov (United States)

    Westermeyer, J

    1989-07-01

    Paranoid disorder has been recognized as a special problem among migrants in general, and refugees in particular. Controversy exists about whether vulnerability to paranoia is a pre-emigration or postmigration phenomenon, and whether paranoia is caused by genetic or organic factors, victimization, or the stress of acculturation. Information is limited on the distribution of paranoid symptoms among refugees. The course of paranoid symptoms in refugees is unknown. Findings reveal that: most refugees have no or mild paranoid symptoms (suspiciousness or mistrust); a small number have severe symptoms (ideas of reference, paranoid delusions or paranoid hallucinations); paranoid symptoms (unlike depressive symptoms) tend to remain at about the same level over several years; and the prevalence and incidence of paranoid disorders among refugees are high compared with other groups.

  3. Early detection of psychosis

    DEFF Research Database (Denmark)

    Larsen, T. K.; Melle, I.; Auestad, B.

    2011-01-01

    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 1997â€"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...... with public information campaigns and low-threshold psychosis detection teams was established in one healthcare area (ED-area), but not in a comparable area (no-ED area). Both areas ran equivalent treatment programmes during the first 2 years and need-adapted treatment thereafter.Results At the start...

  4. Mindfulness for psychosis

    National Research Council Canada - National Science Library

    Chadwick, Paul

    2014-01-01

    Mindfulness treatments and research have burgeoned over the past decade. With psychosis, progress has been slow and likely held back by clinicians' belief that mindfulness may be harmful for this client group...

  5. PET findings in patients with chronic paranoid schizophrenia

    Energy Technology Data Exchange (ETDEWEB)

    Uesugi, Hideji [National Center of Neurology and Psychiatry, Kodaira, Tokyo (Japan). National Center Hospital for Mental, Nervous and Muscular Disorders; Toyoda, Junzo; Iio, Masaaki

    1995-07-01

    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 {sup 15}O-CO{sub 2}. 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. Paraphrenia: paranoid states of late life. I. European research.

    Science.gov (United States)

    Bridge, T P; Wyatt, R J

    1980-05-01

    American psychiatry has traditionally viewed late-life paranoid states either as rare or not part of the schizophrenic syndrome. European psychiatry has not subscribed to this view. The literature (chiefly European) is reviewed from the standpoints of history of the disorder, diagnostic reliability, pre-onset sensory loss, the multiple determinants of paranoia, and the response of paraphrenic patients to treatment with phenothiazines. The evidence leads to the conclusion that late-life paranoid states are not rare, and that the diagnosis "paraphrenia" has real clinical utility. Moreover, there seems to be a substantial relationship between schizophrenia and paraphrenia.

  7. Patients with Paranoid Symptoms: Considerations for the Optometrist

    Directory of Open Access Journals (Sweden)

    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. Environmental Social Stress, Paranoia and Psychosis Liability: A Virtual Reality Study.

    Science.gov (United States)

    Veling, Wim; Pot-Kolder, Roos; Counotte, Jacqueline; van Os, Jim; van der Gaag, Mark

    2016-11-01

    The impact of social environments on mental states is difficult to assess, limiting the understanding of which aspects of the social environment contribute to the onset of psychotic symptoms and how individual characteristics moderate this outcome. This study aimed to test sensitivity to environmental social stress as a mechanism of psychosis using Virtual Reality (VR) experiments. Fifty-five patients with recent onset psychotic disorder, 20 patients at ultra high risk for psychosis, 42 siblings of patients with psychosis, and 53 controls walked 5 times in a virtual bar with different levels of environmental social stress. Virtual social stressors were population density, ethnic density and hostility. Paranoia about virtual humans and subjective distress in response to virtual social stress exposures were measured with State Social Paranoia Scale (SSPS) and self-rated momentary subjective distress (SUD), respectively. Pre-existing (subclinical) symptoms were assessed with the Community Assessment of Psychic Experiences (CAPE), Green Paranoid Thoughts Scale (GPTS) and the Social Interaction Anxiety Scale (SIAS). Paranoia and subjective distress increased with degree of social stress in the environment. Psychosis liability and pre-existing symptoms, in particular negative affect, positively impacted the level of paranoia and distress in response to social stress. These results provide experimental evidence that heightened sensitivity to environmental social stress may play an important role in the onset and course of psychosis.

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

    Science.gov (United States)

    Beck, Katherine; Lally, John; Shergill, Sukhwinder S; Bloomfield, Michael A P; MacCabe, James H; Gaughran, Fiona; Howes, Oliver D

    2015-02-01

    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 account for a large proportion of treatment-refractory psychosis.

  10. Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood.

    Science.gov (United States)

    Bergink, Veerle; Rasgon, Natalie; Wisner, Katherine L

    2016-12-01

    Psychosis or mania after childbirth is a psychiatric emergency with risk for suicide and infanticide. The authors reviewed the epidemiologic and genetic research and physiological postpartum triggers (endocrine, immunological, circadian) of psychosis. They also summarized all systematic reviews and synthesized the sparse clinical studies to provide diagnostic recommendations, treatment options, and strategies for prevention. The incidence of first-lifetime onset postpartum psychosis/mania from population-based register studies of psychiatric admissions varies from 0.25 to 0.6 per 1,000 births. After an incipient episode, 20%-50% of women have isolated postpartum psychosis. The remaining women have episodes outside the perinatal period, usually within the bipolar spectrum. Presumably, the mechanism of onset is related to physiological changes after birth (e.g., hormonal, immunological, circadian), which precipitate disease in genetically vulnerable women. Some women have treatable causes and comorbidities, such as autoimmune thyroiditis or infections. N-methyl-d-aspartate-encephalitis or inborn errors of metabolism may present after birth with psychosis. Fewer than 30 publications have focused on the treatment of postpartum psychosis. The largest study (N=64) provided evidence that lithium is highly efficacious for both acute and maintenance treatment. Another report (N=34) described successful ECT treatment. Inpatient care is usually required to ensure safety, complete the diagnostic evaluation, and initiate treatment. The relapse risk after a subsequent pregnancy for women with isolated postpartum psychoses is 31% (95% CI=22-42). Strategies for prevention of postpartum psychosis include lithium prophylaxis immediately postpartum and proactive safety monitoring. Postpartum psychosis offers an intriguing model to explore etiologic contributions to the neurobiology of affective psychosis.

  11. Paranoid personality disorder in the United States: the role of race, illicit drug use, and income.

    Science.gov (United States)

    Raza, Gina T; DeMarce, Josephine M; Lash, Steven J; Parker, Jefferson D

    2014-01-01

    Differential rates of schizophrenia and paranoia symptoms have been found for Black and White individuals. Paranoid personality disorder shares symptoms with schizophrenia, yet has received minimal attention with regard to potential racial differences. In a sample consisting of 180 substance use disorder treatment-seeking individuals, the association between the diagnosis of paranoid personality disorder and the variables of race, cannabis use disorder, and income were examined. Results extended previous findings to paranoid personality disorder, supporting the hypothesis that Black individuals would be diagnosed with higher rates of paranoid personality disorder. Cannabis use disorder status and income did not predict paranoid personality disorder diagnoses.

  12. Momentary Assessment Research in Psychosis

    Science.gov (United States)

    Oorschot, Margreet; Kwapil, Thomas; Delespaul, Philippe; Myin-Germeys, Inez

    2009-01-01

    There is an expanding interest to study psychosis in the realm of daily life. The study of the person in the context of daily life may provide a powerful addition to more conventional and cross-sectional research strategies in the study of psychosis. This article first discusses the nature of experience sampling research in psychosis and…

  13. Paranoid Schizophrenia: Assessing the Validity of the Diagnostic Schemata.

    Science.gov (United States)

    Dobbs, James Mark

    This paper is concerned with changes which have been proposed in the major current diagnostic system regarding paranoid schizophrenia. It is noted that the proposed changes to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) would remove paranoia as a schizophrenic subtype and institute a spectrum description of…

  14. Paranoid Schizophrenia: Assessing the Validity of the Diagnostic Schemata.

    Science.gov (United States)

    Dobbs, James Mark

    This paper is concerned with changes which have been proposed in the major current diagnostic system regarding paranoid schizophrenia. It is noted that the proposed changes to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) would remove paranoia as a schizophrenic subtype and institute a spectrum description of…

  15. Posttraumatic growth in psychosis

    Directory of Open Access Journals (Sweden)

    Yael Mazor

    2016-12-01

    Full Text Available Objective: Recent research has shown high rates of exposure to trauma among people with serious mental illness (SMI. In addition studies suggest that psychosis and mental illness-related experiences can be extremely traumatic. While some individuals develop full blown PTSD related to these experiences, it has been noted that some may also experience posttraumatic growth (PTG. However, few studies have examined PTG as a possible outcome in people who have experienced psychosis. Method: To further understand the relationships between psychosis and PTG, 121 participants were recruited from community mental health rehabilitation centers and administered trauma and psychiatric questionnaires. Results: High levels of traumatic exposure were found in the sample. Regarding our main focus of study we observed that people who endured psychosis can experience PTG, and that PTG is mediated by meaning making and coping self-efficacy appraisal. Psychotic symptoms were found to be a major obstacle to meaning making, coping self-efficacy, and PTG, whereas negative symptoms were found to be significantly related to PTG when mediated by meaning making and coping self-efficacy. Conclusion: The current research provides preliminary evidence for potential role of meaning making and coping self-efficacy as mediators of PTG in the clinical, highly traumatized population of people with SMI who have experienced psychosis. This may have both research as well as clinical practice relevance for the field of psychiatric rehabilitation.

  16. Emotional, Cognitive and Behavioral Reactions to Paranoid Symptoms in Clinical and Nonclinical Populations.

    Science.gov (United States)

    Carvalho, Célia Barreto; da Motta, Carolina; Pinto-Gouveia, José; Peixoto, Ermelindo Manuel Bernardo

    Paranoia is a disruptive belief that can vary across a continuum, ranging from persecutory delusions presented in clinical settings to paranoid cognitions that are highly prevalent in the general population. The literature suggests that paranoid thoughts derive from the activation of a paranoid schema or information processing biases that can be sensitive to socially ambiguous stimuli and influence the processing of threatening situations. Four groups (schizophrenic participants in active psychotic phases, n=61; stable participants in remission, n=30; participants' relatives, n=32; and, healthy controls, n=64) were assessed with self-report questionnaires to determine how the reactions to paranoia of clinical patients differ from healthy individuals. Cognitive, emotional and behavioral dimensions of their reactions to these paranoid thoughts were examined. Paranoid individuals were present in all groups. Most participants referred to the rejection by others as an important trigger of paranoid ideations, while active psychotics were unable to identify triggering situations to their thoughts and reactions. This may be a determinant to the different reactions and the different degree of invalidation caused by paranoid thoughts observed across groups. Clinical and nonclinical expressions of paranoid ideations differ in terms of their cognitive, emotional and behavioral components. It is suggested that, in socially ambiguous situations, paranoid participants (presenting lower thresholds of paranoid schema activation) lose the opportunity to disconfirm their paranoid beliefs by resourcing to more maladaptive coping strategies. Consequently, by dwelling on these thoughts, the amount of time spent thinking about their condition and the disability related to the disease increases.

  17. Homicide during postictal psychosis

    Directory of Open Access Journals (Sweden)

    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.

  18. Are there differential deficits in facial emotion recognition between paranoid and non-paranoid schizophrenia? A signal detection analysis.

    Science.gov (United States)

    Huang, Charles Lung-Cheng; Hsiao, Sigmund; Hwu, Hai-Gwo; Howng, Shen-Long

    2013-10-30

    This study assessed facial emotion recognition abilities in subjects with paranoid and non-paranoid schizophrenia (NPS) using signal detection theory. We explore the differential deficits in facial emotion recognition in 44 paranoid patients with schizophrenia (PS) and 30 non-paranoid patients with schizophrenia (NPS), compared to 80 healthy controls. We used morphed faces with different intensities of emotion and computed the sensitivity index (d') of each emotion. The results showed that performance differed between the schizophrenia and healthy controls groups in the recognition of both negative and positive affects. The PS group performed worse than the healthy controls group but better than the NPS group in overall performance. Performance differed between the NPS and healthy controls groups in the recognition of all basic emotions and neutral faces; between the PS and healthy controls groups in the recognition of angry faces; and between the PS and NPS groups in the recognition of happiness, anger, sadness, disgust, and neutral affects. The facial emotion recognition impairment in schizophrenia may reflect a generalized deficit rather than a negative-emotion specific deficit. The PS group performed worse than the control group, but better than the NPS group in facial expression recognition, with differential deficits between PS and NPS patients.

  19. Neurocognition and Duration of Psychosis

    DEFF Research Database (Denmark)

    Rund, Bjørn Rishovd; Barder, Helene Eidsmo; Evensen, Julie

    2016-01-01

    A substantial proportion of schizophrenia-spectrum patients exhibit a cognitive impairment at illness onset. However, the long-term course of neurocognition and a possible neurotoxic effect of time spent in active psychosis, is a topic of controversy. Furthermore, it is of importance to find out...... what predicts the long-term course of neurocognition. Duration of untreated psychosis (DUP), accumulated time in psychosis the first year after start of treatment, relapse rates and symptoms are potential predictors of the long-term course. In this study, 261 first-episode psychosis patients were...... relationship between psychosis before (DUP) or after start of treatment and the composite score was found, providing no support for the neurotoxicity hypothesis, and indicating that psychosis before start of treatment has no significant impact on the course and outcome in psychosis. We found no association...

  20. Incomplete oedipism and chronic suicidality in psychotic depression with paranoid delusions related to eyes

    Directory of Open Access Journals (Sweden)

    Tatarelli Roberto

    2006-11-01

    Full Text Available Abstract Self-enucleation or oedipism is a term used to describe self-inflicted enucleation. It is a rare form of self-mutilation, found mainly in acutely psychotic patients. We propose the term incomplete oedipism to describe patients who deliberately and severely mutilate their eyes without proper enucleation. We report the case of a 32-year-old male patient with a five-year history of psychotic depression accompanied by paranoid delusions centered around his belief that his neighbors criticized him and stared at him. A central feature of his clinical picture was an eye injury that the patient had caused by pouring molten lead into his right eye during a period of deep hopelessness and suicidality when the patient could not resolve his anhedonia and social isolation. Pharmacotherapy and psychotherapy dramatically improved his disorder.

  1. Mitochondrial DNA sequence analysis of patients with 'atypical psychosis'.

    Science.gov (United States)

    Kazuno, An-A; Munakata, Kae; Mori, Kanako; Tanaka, Masashi; Nanko, Shinichiro; Kunugi, Hiroshi; Umekage, Tadashi; Tochigi, Mamoru; Kohda, Kazuhisa; Sasaki, Tsukasa; Akiyama, Tsuyoshi; Washizuka, Shinsuke; Kato, Nobumasa; Kato, Tadafumi

    2005-08-01

    Although classical psychopathological studies have shown the presence of an independent diagnostic category, 'atypical psychosis', most psychotic patients are currently classified into two major diagnostic categories, schizophrenia and bipolar disorder, by the Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria. 'Atypical psychosis' is characterized by acute confusion without systematic delusion, emotional instability, and psychomotor excitement or stupor. Such clinical features resemble those seen in organic mental syndrome, and differential diagnosis is often difficult. Because patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) sometimes show organic mental disorder, 'atypical psychosis' may be caused by mutations of mitochondrial DNA (mtDNA) in some patients. In the present study whole mtDNA was sequenced for seven patients with various psychotic disorders, who could be categorized as 'atypical psychosis'. None of them had known mtDNA mutations pathogenic for mitochondrial encephalopathy. Two of seven patients belonged to a subhaplogroup F1b1a with low frequency. These results did not support the hypothesis that clinical presentation of some patients with 'atypical psychosis' is a reflection of subclinical mitochondrial encephalopathy. However, the subhaplogroup F1b1a may be a good target for association study of 'atypical psychosis'.

  2. Introduction to "Early psychosis

    DEFF Research Database (Denmark)

    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...

  3. First-episode psychosis

    DEFF Research Database (Denmark)

    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...

  4. Attachment and psychosis

    NARCIS (Netherlands)

    Korver, N.

    2014-01-01

    The main goal of this thesis was to further our understanding of current psychosocial models by introducing attachment as a relevant developmental framework. Firstly, attachment theory provides a psychosocial model for a developmental pathway to psychosis. Secondly, after expression of psychotic sym

  5. Kallmann syndrome and paranoid schizophrenia: a rare combination

    Science.gov (United States)

    Verhoeven, Willem M A; Egger, Jos I M; Hovens, Johannes E; Hoefsloot, Lies

    2013-01-01

    Kallmann syndrome (KS) is a genetically heterogeneous and rare disorder characterised by the combination of hypothalamic hypogonadism and anosmia/hyposmia, a variable degree of intellectual disability and several somatic anomalies. In about one-third of the patients, mutations have been identified in at least seven different genes. Virtually no data are available about possible neuropsychiatric symptoms in KS. Here, a young adult male is described with a previous clinical diagnosis of KS and recent paranoid schizophrenia of which positive, but not negative symptoms, fully remitted upon treatment with antipsychotics. Neither genome-wide array analysis nor mutation analyses disclosed imbalances or mutations in any of presently known KS disease genes. This is the first report on a patient with KS and paranoid schizophrenia in whom extensive genetic analyses were performed. It is concluded that further studies are warranted in order to elucidate a possible increased risk for psychiatric symptoms in patients with KS. PMID:23329708

  6. Kallmann syndrome and paranoid schizophrenia: a rare combination.

    Science.gov (United States)

    Verhoeven, Willem M A; Egger, Jos I M; Hovens, Johannes E; Hoefsloot, Lies

    2013-01-17

    Kallmann syndrome (KS) is a genetically heterogeneous and rare disorder characterised by the combination of hypothalamic hypogonadism and anosmia/hyposmia, a variable degree of intellectual disability and several somatic anomalies. In about one-third of the patients, mutations have been identified in at least seven different genes. Virtually no data are available about possible neuropsychiatric symptoms in KS. Here, a young adult male is described with a previous clinical diagnosis of KS and recent paranoid schizophrenia of which positive, but not negative symptoms, fully remitted upon treatment with antipsychotics. Neither genome-wide array analysis nor mutation analyses disclosed imbalances or mutations in any of presently known KS disease genes. This is the first report on a patient with KS and paranoid schizophrenia in whom extensive genetic analyses were performed. It is concluded that further studies are warranted in order to elucidate a possible increased risk for psychiatric symptoms in patients with KS.

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

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    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.

  8. Early Identification of Psychosis: A Primer

    OpenAIRE

    Early Psychosis Initiative of British Columbia

    2000-01-01

    This document is an educational resource concerning the early identification of psychosis. Primary topics addressed include: an outline of the importance of early intervention; signs and symptoms of psychosis; and strategies for recognizing psychosis.  

  9. Virtual reality study of paranoid thinking in the general population.

    Science.gov (United States)

    Freeman, Daniel; Pugh, Katherine; Antley, Angus; Slater, Mel; Bebbington, Paul; Gittins, Matthew; Dunn, Graham; Kuipers, Elizabeth; Fowler, David; Garety, Philippa

    2008-04-01

    Judging whether we can trust other people is central to social interaction, despite being error-prone. A fear of others can be instilled by the contemporary political and social climate. Unfounded mistrust is called paranoia, and in severe forms is a central symptom of schizophrenia. To demonstrate that individuals without severe mental illness in the general population experience unfounded paranoid thoughts, and to determine factors predictive of paranoia using the first laboratory method of capturing the experience. Two hundred members of the general public were comprehensively assessed, and then entered a virtual reality train ride populated by neutral characters. Ordinal logistic regressions (controlling for age, gender, ethnicity, education, intellectual functioning, socio-economic status, train use, playing of computer games) were used to determine predictors of paranoia. The majority agreed that the characters were neutral, or even thought they were friendly. However, a substantial minority reported paranoid concerns. Paranoia was strongly predicted by anxiety, worry, perceptual anomalies and cognitive inflexibility. This is the most unambiguous demonstration of paranoid ideation in the general public so far. Paranoia can be understood in terms of cognitive factors. The use of virtual reality should lead to rapid advances in the understanding of paranoia.

  10. Facial emotion recognition in paranoid schizophrenia and autism spectrum disorder.

    Science.gov (United States)

    Sachse, Michael; Schlitt, Sabine; Hainz, Daniela; Ciaramidaro, Angela; Walter, Henrik; Poustka, Fritz; Bölte, Sven; Freitag, Christine M

    2014-11-01

    Schizophrenia (SZ) and autism spectrum disorder (ASD) share deficits in emotion processing. In order to identify convergent and divergent mechanisms, we investigated facial emotion recognition in SZ, high-functioning ASD (HFASD), and typically developed controls (TD). Different degrees of task difficulty and emotion complexity (face, eyes; basic emotions, complex emotions) were used. Two Benton tests were implemented in order to elicit potentially confounding visuo-perceptual functioning and facial processing. Nineteen participants with paranoid SZ, 22 with HFASD and 20 TD were included, aged between 14 and 33 years. Individuals with SZ were comparable to TD in all obtained emotion recognition measures, but showed reduced basic visuo-perceptual abilities. The HFASD group was impaired in the recognition of basic and complex emotions compared to both, SZ and TD. When facial identity recognition was adjusted for, group differences remained for the recognition of complex emotions only. Our results suggest that there is a SZ subgroup with predominantly paranoid symptoms that does not show problems in face processing and emotion recognition, but visuo-perceptual impairments. They also confirm the notion of a general facial and emotion recognition deficit in HFASD. No shared emotion recognition deficit was found for paranoid SZ and HFASD, emphasizing the differential cognitive underpinnings of both disorders.

  11. [The clinical peculiarities of psychogenically-induced exacerbations of paranoid schizophrenia].

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    Shmilovich, A A; Evdokimova, O S

    2008-01-01

    One hundred and twenty-eight patients diagnosed with paranoid schizophrenia were studied. A main group comprised 84 patients with psychogenically-induced paranoid psychoses. A control group consisted of 44 patients with spontaneous exacerbations of the disease. Psychogenically-induced exacerbations of paranoid schizophrenia differed by the clinical polymorphism, heterogeneity and atypism. Three types of psychogenically-induced relapses of paranoid schizophrenia were singled out: endoreactive, delusional with affective symptoms and delusional. Higher frequencies of suicidal tendencies (32.1%), absolute therapy resistance (25.0%), hospitalism (21.4%), non-compliance (46.4%) were observed in the main group of patients. These features predicted the poor outcome comparing to paranoid psychoses developed spontaneously. In conclusion, treatment of patients with paranoid schizophrenia with psychogenically-induced exacerbations demands the obligatory administration of psychotherapy. A combination of traditional neuroleptics with symptomatic pharmacotherapy of psychopathological presentations is the most efficient.

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

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    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.

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

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    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.

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

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    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.

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

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    Hayashi, Takuji; Watanabe, Toyonobu; Kitoh, Hiroshi; Sekine, Takeo (Aichi Medical Univ., Nagakute (Japan))

    1992-09-01

    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).

  16. Hypothesis: Grandiosity and Guilt Cause Paranoia; Paranoid Schizophrenia is a Psychotic Mood Disorder; a Review

    OpenAIRE

    Lake, Charles Raymond

    2007-01-01

    Delusional paranoia has been associated with severe mental illness for over a century. Kraepelin introduced a disorder called “paranoid depression,” but “paranoid” became linked to schizophrenia, not to mood disorders. Paranoid remains the most common subtype of schizophrenia, but some of these cases, as Kraepelin initially implied, may be unrecognized psychotic mood disorders, so the relationship of paranoid schizophrenia to psychotic bipolar disorder warrants reevaluation. To address whethe...

  17. Genetic associations between delusional disorder and paranoid schizophrenia: A novel etiologic approach.

    Science.gov (United States)

    Debnath, Monojit; Das, Sujit K; Bera, Nirmal K; Nayak, Chitta R; Chaudhuri, Tapas K

    2006-05-01

    Genetic associations between delusional disorder and paranoid schizophrenia are not well understood, although involvement of biological factors has been suspected. We investigated the incidence of human leukocyte antigen (HLA) class I alleles in patients with delusional disorder and paranoid schizophrenia, first, to explore a possible immunogenetic etiology of these paranoid disorders and, second, to determine whether they share similar etiologic mechanisms. We employed a nested case-control study design. Psychiatric reference data were available for 38,500 patients attending a hospital-based psychiatric outpatient department between 1998 and 2005. We enrolled 100 patients with delusional disorder and 50 patients with paranoid schizophrenia as the subject cases, using DSM-IV criteria. We considered equivalent numbers of healthy volunteers matched for age and ethnic background as control subjects. All subjects came from an India-born Bengali population. We applied the polymerase chain reaction-based molecular typing method to all patients and healthy subjects. The HLA-A*03 gene is significantly associated with delusional disorder as well as with paranoid schizophrenia. This HLA gene alone or in linkage disequilibrium with other HLA genes or other closely linked non-HLA genes may influence susceptibility to delusional disorder and paranoid schizophrenia. The study reveals important associations between HLA genes and paranoid disorders. Delusional disorder and paranoid schizophrenia may share similar etiologic mechanisms. This preliminary observation may help our understanding of the genetic basis of these paranoid disorders.

  18. SEXUALITY AND PSYCHOSIS

    OpenAIRE

    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...

  19. Psychosis following Tramadol Withdrawal

    OpenAIRE

    Rajabizadeh, Ghodratolah; Kheradmand, Ali; Nasirian, Mansoureh

    2009-01-01

    Background: Tramadol is a centrally acting opioid analgesic used to treat moderate to sever pain. It has more advantage and less opioid adverse effects than conventional opioid analgesia. Case Report: This article reports a patient with tramadol dependency that had psychosis after tramadol withdrawal. Conclusion: By the increase of tramadol usage for relief of chronic pain, tramadol abuse and dependency is increased. Some of tramadol withdrawal symptoms are not related to opioid, for example ...

  20. Introduction: Psychotherapy for Psychosis.

    Science.gov (United States)

    Garrett, Michael

    2016-01-01

    Beginning with Paul Federn--a contemporary of Sigmund Freud--every generation of psychotherapists for the past hundred years has included a small number of determined clinicians who have worked psychotherapeutically with psychotic patients, and written about their work. This special issue of the American Journal of Psychotherapy contains seven papers by clinicians in this generation who are using psychotherapy in the treatment of psychosis.

  1. Disturbances of visual information processing in early states of psychosis and experimental delta-9-tetrahydrocannabinol altered states of consciousness.

    Science.gov (United States)

    Koethe, Dagmar; Gerth, Christoph W; Neatby, Miriam A; Haensel, Anita; Thies, Martin; Schneider, Udo; Emrich, Hinderk M; Klosterkötter, Joachim; Schultze-Lutter, Frauke; Leweke, F Markus

    2006-12-01

    Recent data on alterations of the endogenous cannabinoid system in schizophrenia have raised the question of its functional role in this disease. The psychoactive compound of Cannabis sativa, delta-9-tetrahydrocannabinol (Delta9-THC), has been shown to induce psychotic symptoms, but it is unknown to what extend prodromal states of psychoses are reflected by these experimental approaches. This study compares four groups of subjects: antipsychotic-naïve patients suffering from acute paranoid schizophrenic or schizophreniform psychosis (SZ), patients in the prodromal state (IPS), healthy controls without any pharmacological intervention (HC) and a second group of healthy volunteers who were orally administered synthetic Delta9-THC (Dronabinol) (HC-THC). Neither SZ and IPS nor HC received the experimental drug. All subjects were assessed using the Brief Psychiatric Rating Scale (BPRS) and the Binocular Depth Inversion Illusion Test (BDII). The latter represents a sensitive measure of impaired visual information processing that manifests in various experimental and naturally occurring psychotic states. BDII values were well comparable in SZ, IPS and HC-THC, and all groups differed significantly to HC. The BPRS revealed no significant difference between HC-THC and IPS while both were significantly different from SZ and HC, respectively. Our results suggest that Delta9-THC-induced altered states of consciousness may serve as a useful tool for modeling psychotic disorders, particularly their prodromal states. Furthermore, they provide insight into the perceptual and psychopathological alterations induced by Delta9-THC, which is essential for the understanding of the pro-psychotic effects of herbal cannabis preparations with highly enriched Delta9-THC content.

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

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    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.

  3. The dreaming brain/mind, consciousness and psychosis.

    Science.gov (United States)

    Limosani, Ivan; D'Agostino, Armando; Manzone, Maria Laura; Scarone, Silvio

    2011-12-01

    Several independent lines of research in neurobiology seem to support the phenomenologically-grounded view of the dreaming brain/mind as a useful model for psychosis. Hallucinatory phenomena and thought disorders found in psychosis share several peculiarities with dreaming, where internally generated, vivid sensorimotor imagery along with often heightened and incongruous emotion are paired with a decrease in ego functions which ultimately leads to a severe impairment in reality testing. Contemporary conceptualizations of severe mental disorders view psychosis as one psychopathological dimension that may be found across several diagnostic categories. Some experimental data have shown cognitive bizarreness to be equally elevated in dreams and in the waking cognition of acutely psychotic subjects and in patients treated with pro-dopaminergic drugs, independent of the underlying disorder. Further studies into the neurofunctional underpinnings of both conditions will help to clarify the use and validity of this model.

  4. Psychosis and Transformation: A Phenomenological Inquiry

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    Nixon, Gary; Hagen, Brad; Peters, Tracey

    2010-01-01

    Conventional views towards psychosis typically portray psychosis as an illness of the brain with a generally poor prognosis, even if treated with antipsychotics. However, there is a growing body of literature which presents an alternative view of psychosis, whereby people are not only able to recover from psychosis, but can also experience…

  5. Contemporary Perspectives on Lacanian Theories of Psychosis

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    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.

  6. A comparative study of nature and types of hallucination across different kinds of psychosis

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    Dhrubajyoti Bhuyan

    2017-01-01

    Full Text Available Introduction: Hallucination is a fundamental psychiatric symptom often regarded as a hallmark of psychosis. It can be found in schizophrenia, other psychoses (including delusional disorder, acute and transient psychosis, post-partum psychosis, affective disorders, dementia, substance induced psychotic disorders, and delirium. Aims and objective: This study is a systematic attempt to study and compare the nature and types of hallucination across three different study groups, namely schizophrenia, mania, and other psychosis. Materials and methods: The study was conducted in a total of 90 randomly selected patients of schizophrenia, mania, and other psychotic disorders, i.e. 30 in each study group. The nature and types of hallucination were assessed by using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN. Results and observation: Hallucination was found in 66.67% cases of schizophrenia and 53.33% cases of other psychosis while in case of mania only 13.33% had hallucination. Hallucinations of schizophrenia were more prominent with frequency of hallucination being present every weeks. In majority of cases of schizophrenia (53.33% and other psychosis (33.33%, sound was more or less like real voices whereas special quality of sound (not much like real voices was found in majority of mania (ten per cent patients. Conclusion: In mania, auditory hallucination is comparatively rare as compared to schizophrenia or other psychosis. Hallucinations in schizophrenia were found to be more mood incongruent as compared to mania and other psychosis.

  7. ANANKASTIK PERSONALITY DISORDER IN SCHIZOPHRENIA PARANOID PATIENT: A CASE REPORT

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    Damarnegara ..

    2014-02-01

    Full Text Available Anankastik personality disorder is a health problem that can disturb the activities of person and can accompany a variety of other mental health problems. The patient in thiscase is a patient with an anankastik or obsessive compulsive personality disorder withthe axis I diagnoses is Paranoid Schizophrenia and was given haloperidol 2x5mg, buthave not done psychotherapy because the patient has not been cooperative. Theprognosis is dependent on patient compliance in taking medication and controls for thesetting of the dose, and the support of her family. 

  8. PREDICTORS FORMATION OF SOCIAL MALADJUSTMENT IN PATIENTS WITH PARANOID SCHIZOPHRENIA WITH CONCOMITANT SOMATIC-NEUROLOGICAL DISORDERS

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    Valeriy Semionovici PIDKORYTOV

    2017-05-01

    Full Text Available The investigation of the level of stress in patients with paranoid schizophrenia with concomitant somatic-neurological disorders and quality of life as predictors of the formation of their social exclusion. The influence of somatic-neurological pathology for paranoid schizophrenia at different levels of stress.

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

    Science.gov (United States)

    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…

  10. Parents with psychosis.

    Science.gov (United States)

    Craig, Thomas; Bromet, Evelyn J

    2004-01-01

    This study examined the prevalence of parenthood in a community-based sample of first-admission patients with DSM-IV diagnoses of Schizophrenia/Schizoaffective Disorder, Bipolar Disorder with psychotic features and Major Depressive Disorder with psychosis. A total of 130 (28.7%) of 453 patients were parents at the time of first admission. Women were twice as likely as men to be parents in all diagnostic groups. Patients with mood disorder with psychosis were twice as likely to be parents as those with Schizophrenia/Schizoaffective Disorder. Substance Use Disorder was a common comorbidity among fathers and to a somewhat lesser extent among mothers as well. At the time of admission, over three-quarters of mothers were living with their children, as were half or more of the fathers with mood disorder. Most continued to live with their children after discharge. Almost 40% of mothers with mood disorders were living as single parents both before and after admission. Almost three-quarters of the children were under 16 years of age. Over 40% of mothers in all diagnostic categories had at least one child under 5 years of age. About 20% of mothers in all 3 diagnoses experienced the onset of psychosis within 6 months of childbirth. Over half of these experienced psychotic symptoms related to the child or had neglected the child prior to admission. Our findings contrast with earlier studies from more chronic patient samples in documenting that first-admission patients with psychosis are generally intimately involved in their children's lives both before and after admission. Despite the fact that over three-quarters of these parents were still in treatment at 6-month follow-up, there was virtually no evidence that any form of educational or family-oriented treatment was offered to these parents. These results, coupled with earlier reports of highly disrupted family lives and serious adverse outcomes among the children of chronically ill parents, underscore the need for early

  11. Neuropsychological relationships in paranoid schizophrenia with and without delusional misidentification syndromes. A comparative study.

    Science.gov (United States)

    Lykouras, L; Typaldou, M; Mourtzouchou, P; Oulis, P; Koutsaftis, C; Dokianaki, F; Michalopoulou, P G; Havaki-Kontaxaki, M; Christodoulou, C

    2008-08-01

    Delusional misidentification syndromes (DMSs) and schizophrenia are strongly associated, since the former occur predominantly in the context of paranoid schizophrenia. However, the possible underlying neuropsychological relationships between DMSs and paranoid schizophrenia have not been thoroughly investigated. The aim of the present study was to investigate whether DMSs in paranoid schizophrenia are associated with a distinct neuropsychological substrate indicative of differential bilateral frontal and right hemisphere dysfunction. We compared two matched groups of paranoid schizophrenic patients with (N=22) and without (N=22) DMS(s) on a battery of neuropsychological tests assessing mainly frontal and right hemisphere functions. No statistically significant differences were detected between the two groups. Our findings are indicative of a bilateral frontal and right hemisphere dysfunction of equal severity in both DMS and non-DMS patients with paranoid schizophrenia.

  12. Paranoid personality masking an atypical case of frontotemporal dementia.

    Science.gov (United States)

    Iroka, Nneka; Jehangir, Waqas; Ii, Jay Littlefield; Pattan, Vishwanath; Yousif, Abdalla; Mishra, Arunesh K

    2015-05-01

    Frontotemporal dementia (FTD) is a debilitating disease that is well described in the "Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5)", and typically presents with memory impairment, progressive decline in cortical functioning, and behavioral changes. Age of onset is generally in the late fifties, and usually the first presentation involves a change in behavior and emotional blunting. Treatment of FTD involves management of any neurobehavioral symptoms while trials of atypical antipsychotics are ongoing but suggest some efficacy. We present a case of a patient who first presented with severe paranoid personality traits and frank persecutory delusions. This atypical presentation of our patient first led to her incorrect diagnosis of a psychotic disorder and paranoid personality disorder. As a result of this diagnosis, she was treated unsuccessfully. A subsequent magnetic resonance imaging (MRI) then showed atrophy of frontal and temporal lobes bilaterally (left more prominent than right) which confirmed the diagnosis of FTD. The importance of this case involves the atypical presentation of paranoia and delusions, and our patient's incorrect diagnosis based on her clinical presentation led to a trial of unsuccessful treatment. Only after performing an MRI, which showed atrophy, was the patient appropriately treated and deemed medically stable. This case report illustrates the importance of considering a rare presentation of frontotemporal lobe dementia with patients who are in the typical age range and present with paranoia and delusions.

  13. A review of postpartum psychosis.

    Science.gov (United States)

    Sit, Dorothy; Rothschild, Anthony J; Wisner, Katherine L

    2006-05-01

    The objective is to provide an overview of the clinical features, prognosis, differential diagnosis, evaluation, and treatment of postpartum psychosis. The authors searched Medline (1966-2005), PsycInfo (1974-2005), Toxnet, and PubMed databases using the key words postpartum psychosis, depression, bipolar disorder, schizophrenia, organic psychosis, pharmacotherapy, psychotherapy, and electroconvulsive therapy. A clinical case is used to facilitate the discussion. The onset of puerperal psychosis occurs in the first 1-4 weeks after childbirth. The data suggest that postpartum psychosis is an overt presentation of bipolar disorder that is timed to coincide with tremendous hormonal shifts after delivery. The patient develops frank psychosis, cognitive impairment, and grossly disorganized behavior that represent a complete change from previous functioning. These perturbations, in combination with lapsed insight into her illness and symptoms, can lead to devastating consequences in which the safety and well-being of the affected mother and her offspring are jeopardized. Therefore, careful and repeated assessment of the mothers' symptoms, safety, and functional capacity is imperative. Treatment is dictated by the underlying diagnosis, bipolar disorder, and guided by the symptom acuity, patient's response to past treatments, drug tolerability, and breastfeeding preference. The somatic therapies include antimanic agents, atypical antipsychotic medications, and ECT. Estrogen prophylaxis remains purely investigational. The rapid and accurate diagnosis of postpartum psychosis is essential to expedite appropriate treatment and to allow for quick, full recovery, prevention of future episodes, and reduction of risk to the mother and her children and family.

  14. Psychosis and cannabis

    Directory of Open Access Journals (Sweden)

    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.

  15. Sexuality and psychosis.

    Science.gov (United States)

    Skodlar, Borut; Nagy, Marija Zunter

    2009-09-01

    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 psychodynamic and phenomenological psychiatry. Willingness and need of patients to talk about sexuality, non-specificity of frequencies and variety of sexual disorders in psychotic patients, difficulties in establishment of a stable (sexual) identity and the question of homosexuality, absence of sexual activities with others and feelings of guilt and inadequacy, masturbation with its functions, impulsive sexual acts or lack of sexual self-control, erotic delusions and erotic transference were the main findings, dominating the sexual sphere of these patients. All these manifestations of sexuality in patients with psychosis can be seen - as exposed in discussion - as consequences of a basic self-disorder (phenomenological perspective) or of difficulties in regulating closeness and distance (psychodynamic perspective). Reasons of avoidance of treatment of sexuality by the therapists of psychotic patients are discussed as well. Implications for dealing with sexuality issues in psychotherapy of patients with psychoses were drawn from the above findings in the last part of the article.

  16. Externalized attributional bias in the Ultra High Risk (UHR) for psychosis population.

    Science.gov (United States)

    Thompson, Andrew; Papas, Alicia; Bartholomeusz, Cali; Nelson, Barnaby; Yung, Alison

    2013-04-30

    Specific externalizing attributional biases appear to be common in early psychosis. They may represent trait risk factors for the later development of a psychotic disorder, yet few studies have investigated this in clinical "at risk" populations. We aimed to investigate one particular bias, the Locus of Control of reinforcement (LOC) in a "Ultra High Risk" (UHR) for psychosis group. We recruited UHR individuals from an established at risk clinical service and a community control group. LOC was measured using the Adult Nowicki Strickland Internal External scale (ANSIE). Neuropsychological functioning, social functioning and psychopathology were assessed. We analyzed data from 30 controls and 30 UHR individuals. The UHR sample had a significantly more externalized LOC (control for events perceived to be external to the person) than controls. This difference remained statistically significant after adjusting for covariates (age, gender and IQ). More externalized LOC scores were negatively correlated with social and occupational functioning scores in the control group but not in the UHR group and positively correlated with negative symptoms and paranoid symptoms in the UHR group. These findings have implications for identifying potential psychological vulnerabilities for the development of psychosis and informing treatment approaches within the at risk group.

  17. Questions and Answers about Psychosis

    Science.gov (United States)

    ... Events News & Events Home Science News Events Multimedia Social Media Press Resources Newsletters NIMH News Feeds About Us ... episode may also experience depression, anxiety, sleep problems, social withdrawal, lack of motivation and difficulty functioning overall. Q: What causes psychosis? ...

  18. Actively Paranoid Patients with Schizophrenia Over Attribute Anger to Neutral Faces

    Science.gov (United States)

    Pinkham, Amy E.; Brensinger, Colleen; Kohler, Christian; Gur, Raquel E.; Gur, Ruben C.

    2010-01-01

    Previous investigations of the influence of paranoia on facial affect recognition in schizophrenia have been inconclusive as some studies demonstrate better performance for paranoid relative to non-paranoid patients and others show that paranoid patients display greater impairments. These studies have been limited by small sample sizes and inconsistencies in the criteria used to define groups. Here, we utilized an established emotion recognition task and a large sample to examine differential performance in emotion recognition ability between patients who were actively paranoid (AP) and those who were not actively paranoid (NAP). Accuracy and error patterns on the Penn Emotion Recognition test (ER40) were examined in 132 patients (64 NAP and 68 AP). Groups were defined based on the presence of paranoid ideation at the time of testing rather than diagnostic subtype. AP and NAP patients did not differ in overall task accuracy; however, an emotion by group interaction indicated that AP patients were significantly worse than NAP patients at correctly labeling neutral faces. A comparison of error patterns on neutral stimuli revealed that the groups differed only in misattributions of anger expressions, with AP patients being significantly more likely to misidentify a neutral expression as angry. The present findings suggest that paranoia is associated with a tendency to over attribute threat to ambiguous stimuli and also lend support to emerging hypotheses of amygdala hyperactivation as a potential neural mechanism for paranoid ideation. PMID:21112186

  19. Actively paranoid patients with schizophrenia over attribute anger to neutral faces.

    Science.gov (United States)

    Pinkham, Amy E; Brensinger, Colleen; Kohler, Christian; Gur, Raquel E; Gur, Ruben C

    2011-02-01

    Previous investigations of the influence of paranoia on facial affect recognition in schizophrenia have been inconclusive as some studies demonstrate better performance for paranoid relative to non-paranoid patients and others show that paranoid patients display greater impairments. These studies have been limited by small sample sizes and inconsistencies in the criteria used to define groups. Here, we utilized an established emotion recognition task and a large sample to examine differential performance in emotion recognition ability between patients who were actively paranoid (AP) and those who were not actively paranoid (NAP). Accuracy and error patterns on the Penn Emotion Recognition test (ER40) were examined in 132 patients (64 NAP and 68 AP). Groups were defined based on the presence of paranoid ideation at the time of testing rather than diagnostic subtype. AP and NAP patients did not differ in overall task accuracy; however, an emotion by group interaction indicated that AP patients were significantly worse than NAP patients at correctly labeling neutral faces. A comparison of error patterns on neutral stimuli revealed that the groups differed only in misattributions of anger expressions, with AP patients being significantly more likely to misidentify a neutral expression as angry. The present findings suggest that paranoia is associated with a tendency to over attribute threat to ambiguous stimuli and also lend support to emerging hypotheses of amygdala hyperactivation as a potential neural mechanism for paranoid ideation.

  20. Emotions, self-esteem, and paranoid episodes: an experience sampling study.

    Science.gov (United States)

    Thewissen, Viviane; Bentall, Richard P; Oorschot, Margreet; A Campo, Joost; van Lierop, Thom; van Os, Jim; Myin-Germeys, Inez

    2011-06-01

    OBJECTIVES. The evidence to date for a causal role of emotions in the generation of paranoid symptoms is scarce, mainly because of a lack of studies investigating the longitudinal association between emotional processes and paranoia. The primary aim of this study was to investigate whether momentary emotional experiences (anxiety, depression, anger/irritability) and self-esteem predicted the onset and duration of a paranoid episode. We also studied whether levels of emotional experiences and self-esteem were respectively higher and lower during a paranoid episode. DESIGN. A 1-week, prospective momentary assessment study. METHODS. Data were collected using the experience sampling method, a structured self-assessment diary technique. The sample consisted of 158 individuals who ranged across the paranoia continuum. Participants with a psychotic disorder were recruited from in-patient and out-patient mental health services. Participants without psychotic disorder were sampled from the general population. RESULTS. Specific aspects of emotional experience were implicated in the onset and persistence of paranoid episodes. Both an increase in anxiety and a decrease in self-esteem predicted the onset of paranoid episodes. Cross-sectionally, paranoid episodes were associated with high levels of all negative emotions and low level of self-esteem. Initial intensity of paranoia and depression was associated with longer, and anger/irritability with shorter duration of paranoid episodes. CONCLUSIONS. Paranoid delusionality is driven by negative emotions and reductions in self-esteem, rather than serving an immediate defensive function against these emotions and low self-esteem. Clinicians need to be aware of the central role of emotion-related processes and especially self-esteem in paranoid thinking.

  1. Neuroimaging Biomarkers for Psychosis

    Science.gov (United States)

    Hager, Brandon M.

    2015-01-01

    Background Biomarkers provide clinicians with a predictable model for the diagnosis, treatment and follow-up of medical ailments. Psychiatry has lagged behind other areas of medicine in the identification of biomarkers for clinical diagnosis and treatment. In this review, we investigated the current state of neuroimaging as it pertains to biomarkers for psychosis. Methods We reviewed systematic reviews and meta-analyses of the structural (sMRI), functional (fMRI), diffusion-tensor (DTI), Positron emission tomography (PET) and spectroscopy (MRS) studies of subjects at-risk or those with an established schizophrenic illness. Only articles reporting effect-sizes and confidence intervals were included in an assessment of robustness. Results Out of the identified meta-analyses and systematic reviews, 21 studies met the inclusion criteria for assessment. There were 13 sMRI, 4 PET, 3 MRS, and 1 DTI studies. The search terms included in the current review encompassed familial high risk (FHR), clinical high risk (CHR), First episode (FES), Chronic (CSZ), schizophrenia spectrum disorders (SSD), and healthy controls (HC). Conclusions Currently, few neuroimaging biomarkers can be considered ready for diagnostic use in patients with psychosis. At least in part, this may be related to the challenges inherent in the current symptom-based approach to classifying these disorders. While available studies suggest a possible value of imaging biomarkers for monitoring disease progression, more systematic research is needed. To date, the best value of imaging data in psychoses has been to shed light on questions of disease pathophysiology, especially through the characterization of endophenotypes. PMID:25883891

  2. CSF metabolic and proteomic profiles in patients prodromal for psychosis.

    Directory of Open Access Journals (Sweden)

    Jeffrey T-J Huang

    Full Text Available BACKGROUND: The initial prodromal state of psychosis (IPS is defined as an early disease stage prior to the onset of overt psychosis characterized by sub-threshold or more unspecific psychiatric symptoms. Little is known regarding the biochemical changes during this period. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the metabolic/proteomic profiles of cerebrospinal fluid (CSF of first-onset drug naïve paranoid schizophrenia patients (n = 54 and individuals presenting with initial prodromal symptoms (n = 24, alongside healthy volunteers (n = 70 using proton nuclear magnetic resonance ((1H-NMR spectroscopy and surface enhanced laser desorption ionization (SELDI mass spectrometry, respectively. Partial least square discriminant analysis (PLS-DA showed that 36%/29% of IPS patients displayed proteomic/metabolic profiles characteristic of first-onset, drug naïve schizophrenia, i.e., changes in levels of glucose and lactate as well as changes in a VGF-derived peptide (VGF23-62 and transthyretin protein concentrations. However, only 29% (n = 7 of the investigated IPS patients (who to date have been followed up for up to three years have so far received a diagnosis of schizophrenia. The presence of biochemical alterations in the IPS group did not correlate with the risk to develop schizophrenia. CONCLUSIONS/SIGNIFICANCE: Our results imply that schizophrenia-related biochemical disease processes can be traced in CSF of prodromal patients. However, the biochemical disturbances identified in IPS patients, at least when measured at a single time point, may not be sufficient to predict clinical outcome.

  3. Lorazepam-induced short-term remission of symptoms in a case of paranoid schizophrenia

    Directory of Open Access Journals (Sweden)

    Shubhangi R Parkar

    2011-01-01

    Full Text Available Conventionally, antipsychotics are used to treat schizophrenia due to predominant dopamine antagonist activity. The use of various types of Benzodiazepines (BZDs in the treatment of Schizophrenic symptoms like agitation and psychotic excitement in general and control of florid psychotic symptoms such as hallucinations and delusions in particular is well known. However, the use of BZDs, specifically in remission of paranoid schizophrenia, is not reported so far. Here, we are reporting a case of an elderly female patient with chronic paranoid schizophrenia showing short-term remission in paranoid symptoms with injectable lorazepam.

  4. Paranoid personality disorder and the schizophrenia spectrum-Where to draw the line?

    Science.gov (United States)

    Birkeland, Søren Fryd

    2013-08-01

    By means of a case vignette, this study explores the clinical intersection between paranoid personality disorder and other schizophrenia-spectrum illness. Even though the patient described had paramount signs of a paranoid personality disorder and was diagnosed as such, psychopathological symptoms extended considerably beyond the common concept and diagnostic criteria of the disorder. Management strategies included psychopharmacological and non-pharmacological interventions, yet psychosocial functioning permanently appeared defective. While there is a persistent need for an opportunity to distinguish the characteristic syndromal pattern of paranoid personality attributes, the case exemplifies the challenges associated with classifying some largely suspicious and distrustful eccentrics within the schizophrenia spectrum.

  5. Apparent motion perception in patients with paranoid schizophrenia.

    Science.gov (United States)

    Sanders, Lia Lira Olivier; de Millas, Walter; Heinz, Andreas; Kathmann, Norbert; Sterzer, Philipp

    2013-04-01

    Impaired perceptual inference has been suggested to be at the core of positive symptoms in schizophrenia. Apparent motion (AM) is a visual illusion in which perceptual inference gives rise to the experience of a single object moving back and forth when two spatially separated objects are flashed in alternation. Here, we investigated the strength of AM perception in patients with paranoid schizophrenia. Patients were less susceptible to the illusion as indicated by a lower probability of motion perception at the individual's optimal presentation frequency for AM. In addition, the probability of AM perception was inversely related to delusional conviction in the patient group. These results suggest that schizophrenia may be associated with a reduced susceptibility to visual phenomena that commonly rely on perceptual inference.

  6. Paranoid Thoughts in Adolescents with Social Anxiety Disorder.

    Science.gov (United States)

    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 paranoia may lead to incorrect diagnoses (e.g. misdiagnosis of psychotic disorders), or it may negatively influence the (psycho)therapeutic process and patient outcomes.

  7. 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

    Directory of Open Access Journals (Sweden)

    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

  8. Power spectrum scale invariance identifies prefrontal dysregulation in paranoid schizophrenia.

    Science.gov (United States)

    Radulescu, Anca R; Rubin, Denis; Strey, Helmut H; Mujica-Parodi, Lilianne R

    2012-07-01

    Theory and experimental evidence suggest that complex living systems function close to the boundary of chaos, with erroneous organization to an improper dynamical range (too stiff or chaotic) underlying system-wide dysregulation and disease. We hypothesized that erroneous organization might therefore also characterize paranoid schizophrenia, via optimization abnormalities in the prefrontal-limbic circuit regulating emotion. To test this, we acquired fMRI scans from 35 subjects (N = 9 patients with paranoid schizophrenia and N = 26 healthy controls), while they viewed affect-valent stimuli. To quantify dynamic regulation, we analyzed the power spectrum scale invariance (PSSI) of fMRI time-courses and computed the geometry of time-delay (Poincaré) maps, a measure of variability. Patients and controls showed distinct PSSI in two clusters (k(1) : Z = 4.3215, P = 0.00002 and k(2) : Z = 3.9441, P = 0.00008), localized to the orbitofrontal/medial prefrontal cortex (Brodmann Area 10), represented by β close to white noise in patients (β ≈ 0) and in the pink noise range in controls (β ≈ -1). Interpreting the meaning of PSSI differences, the Poincaré maps indicated less variability in patients than controls (Z = -1.9437, P = 0.05 for k(1) ; Z = -2.5099, P = 0.01 for k(2) ). That the dynamics identified Brodmann Area 10 is consistent with previous schizophrenia research, which implicates this area in deficits of working memory, executive functioning, emotional regulation and underlying biological abnormalities in synaptic (glutamatergic) transmission. Our results additionally cohere with a large body of work finding pink noise to be the normal range of central function at the synaptic, cellular, and small network levels, and suggest that patients show less supple responsivity of this region.

  9. Contemporary perspectives on Lacanian theories of psychosis

    Science.gov (United States)

    Redmond, Jonathan D.

    2013-01-01

    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 utilized 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 stabilization possible in psychosis. Clinicians adapting the idea of ordinary psychosis aim to rethink pivotal Lacanian concepts—“untriggered” psychosis and stabilization—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. PMID:23825465

  10. Neuroinflammation and Oxidative Stress in Psychosis and Psychosis Risk

    Directory of Open Access Journals (Sweden)

    Henry Barron

    2017-03-01

    Full Text Available Although our understanding of psychotic disorders has advanced substantially in the past few decades, very little has changed in the standard of care for these illnesses since the development of atypical anti-psychotics in the 1990s. Here, we integrate new insights into the pathophysiology with the increasing interest in early detection and prevention. First, we explore the role of N-methyl-d-aspartate receptors in a subpopulation of cortical parvalbumin-containing interneurons (PVIs. Postmortem and preclinical data has implicated these neurons in the positive and negative symptoms, as well as the cognitive dysfunction present in schizophrenia. These neurons also appear to be sensitive to inflammation and oxidative stress during the perinatal and peripubertal periods, which may be mediated in large part by aberrant synaptic pruning. After exploring some of the molecular mechanisms through which neuroinflammation and oxidative stress are thought to exert their effects, we highlight the progress that has been made in identifying psychosis prior to onset through the identification of individuals at clinical high risk for psychosis (CHR. By combining our understanding of psychosis pathogenesis with the increasing characterization of endophenotypes that precede frank psychosis, it may be possible to identify patients before they present with psychosis and intervene to reduce the burden of the disease to both patients and families.

  11. Neuroinflammation and Oxidative Stress in Psychosis and Psychosis Risk.

    Science.gov (United States)

    Barron, Henry; Hafizi, Sina; Andreazza, Ana C; Mizrahi, Romina

    2017-03-17

    Although our understanding of psychotic disorders has advanced substantially in the past few decades, very little has changed in the standard of care for these illnesses since the development of atypical anti-psychotics in the 1990s. Here, we integrate new insights into the pathophysiology with the increasing interest in early detection and prevention. First, we explore the role of N-methyl-d-aspartate receptors in a subpopulation of cortical parvalbumin-containing interneurons (PVIs). Postmortem and preclinical data has implicated these neurons in the positive and negative symptoms, as well as the cognitive dysfunction present in schizophrenia. These neurons also appear to be sensitive to inflammation and oxidative stress during the perinatal and peripubertal periods, which may be mediated in large part by aberrant synaptic pruning. After exploring some of the molecular mechanisms through which neuroinflammation and oxidative stress are thought to exert their effects, we highlight the progress that has been made in identifying psychosis prior to onset through the identification of individuals at clinical high risk for psychosis (CHR). By combining our understanding of psychosis pathogenesis with the increasing characterization of endophenotypes that precede frank psychosis, it may be possible to identify patients before they present with psychosis and intervene to reduce the burden of the disease to both patients and families.

  12. Neurocognitive dysfunction in first-episode psychosis

    DEFF Research Database (Denmark)

    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....

  13. Early detection of first-episode psychosis

    DEFF Research Database (Denmark)

    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....

  14. At the heart of an early psychosis centre: the core components of the 2014 Early Psychosis Prevention and Intervention Centre model for Australian communities.

    Science.gov (United States)

    Hughes, Frank; Stavely, Heather; Simpson, Raelene; Goldstone, Sherilyn; Pennell, Kerryn; McGorry, Patrick

    2014-06-01

    To describe the core components of the Early Psychosis Prevention and Intervention Centre service model as the template agreed with the Australian Federal Government for national upscaling. The Early Psychosis Prevention and Intervention Centre model of early intervention has two main goals: to reduce the period of time between the onset of psychosis and the commencement of treatment and to bring about symptomatic recovery and restore the normal developmental trajectory as early as possible. The Early Psychosis Prevention and Intervention Centre comprises three elements of service provision for young people experiencing a first episode of psychosis: (i) early detection; (ii) acute care during and immediately following a crisis; (iii) recovery-focused continuing care, featuring multimodal interventions to enable the young person to maintain or regain their social, academic and/or career trajectory during the critical first 2-5 years following the onset of a psychotic illness. It does this via a combination of 16 core components, which provide a flexible, comprehensive, integrated service that is able to respond quickly, appropriately and consistently to the individual needs of the young person and their family. Innovative service reforms, such as Early Psychosis Prevention and Intervention Centre, that recognise the value of early intervention are crucial to reducing the impact of serious mental illness on young people and their families and, ultimately, on our society. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  15. Overlapping clusters of gray matter deficits in paranoid schizophrenia and psychotic bipolar mania with family history.

    Science.gov (United States)

    Cui, Liqian; Li, Mingli; Deng, Wei; Guo, Wanjun; Ma, Xiaohong; Huang, Chaohua; Jiang, Lijun; Wang, Yingcheng; Collier, David A; Gong, Qiyong; Li, Tao

    2011-02-04

    The purpose of this study was to assess volumetric abnormalities of gray matter throughout the entire brain in patients with paranoid schizophrenia or with bipolar mania compared with control groups. We obtained weighted 3D T1 magnetic resonance images from 23 patients with paranoid schizophrenia, 24 patients with psychotic bipolar mania, and 36 healthy controls. Gray matter volume differences were assessed using optimized volumetric voxel-based morphometry (VBM). Both paranoid schizophrenia and bipolar mania group showed reduction of gray matter volume in the superior temporal gyrus (STG) (Brodmann Area, BA 22 areas), and the inferior parietal lobule, and enlargement of putamen, although different sides of the inferior parietal lobule and putamen were affected in the groups. Our findings showed the presence of overlapping clusters of gray matter deficits in paranoid-type schizophrenia and psychotic bipolar mania. The overlap in gray matter pathology between the two disorders may be attributed to risk factors common to both disorders.

  16. The impact of rumination on state paranoid ideation in a nonclinical sample.

    Science.gov (United States)

    Martinelli, Cristina; Cavanagh, Kate; Dudley, Robert E J

    2013-09-01

    Cognitive-behavioral models of paranoia have emphasized the potential role of perseverative thinking styles, such as rumination or worry, in the development, maintenance and exacerbation of paranoid beliefs. This study aimed to experimentally test the hypothesis that rumination may play a role in the maintenance or exacerbation of state paranoid ideation. Following a paranoia induction, 37 nonclinical participants were randomly assigned to either a rumination task or a distraction control condition. In accord with main hypothesis, rumination was associated with maintained levels of paranoia, whereas distraction was associated with a decrease in levels of paranoia. These findings suggest that perseverative thinking may play a role in the maintenance of paranoid ideas, which may have implications for our understanding of the maintenance of paranoia and persecutory delusions in the clinical population. Furthermore, the study used a novel experimental paradigm for inducing paranoia, which may prove valuable for future research aiming to elicit paranoid thoughts and feelings in vivo.

  17. Are Specific Early-Life Adversities Associated With Specific Symptoms of Psychosis?

    Science.gov (United States)

    Wickham, Sophie; Bentall, Richard

    2016-01-01

    Abstract 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

  18. Caregiver psychoeducation for first-episode psychosis.

    LENUS (Irish Health Repository)

    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.

  19. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia

    OpenAIRE

    Grover, Sandeep; Nehra, Ritu; Bhateja, Gaurav; Kulhara, Parmanand; Kumar, Suresh

    2011-01-01

    Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia ...

  20. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia

    OpenAIRE

    Grover, Sandeep; Nehra, Ritu; Bhateja, Gaurav; Kulhara, Parmanand; Kumar, Suresh

    2011-01-01

    Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia ...

  1. ALCOHOLIC HALLUCINOSIS AND PARANOID SCHIZOPHRENIA—A COMPARATIVE (CLINICAL AND FOLLOW UP) STUDY

    OpenAIRE

    Sampath, G.; Kumar, Y. Vikram; Channabasavanna, S.M.; Keshavan, M. S.

    1980-01-01

    SUMMARY In a Study Of 90 patients of Alcoholic Hallucinosis and 30 patients of Paranoid Schizophrenia, it was found that delusions, delusions of infidelity, third person and running commentary auditory hallucinations and insight were not different in the two groups. Delusions of grandeur, passivity, thought echo and thought broadcast were significantly more frequent in paranoid schizophrenic patients. Anxiety, visual iiafracinatians and hallucinations in more than one modality at the same tim...

  2. Alcohol abuse as the strongest risk factor for violent offending in patients with paranoid schizophrenia

    OpenAIRE

    Kudumija Slijepčević, Marija; Jukić, Vlado; Novalić, Darko; Žarković-Palijan, Tija; Milošević, Milan; Rosenzweig, Ivana

    2014-01-01

    Aim To determine predictive risk factors for violent offending in patients with paranoid schizophrenia in Croatia. Method The cross-sectional study including male in-patients with paranoid schizophrenia with (N = 104) and without (N = 102) history of physical violence and violent offending was conducted simultaneously in several hospitals in Croatia during one-year period (2010-2011). Data on their sociodemographic characteristics, duration of untreated illness phase (DUP), alcohol abuse, sui...

  3. Cycloserine induced psychosis with hepatic dysfunction

    Directory of Open Access Journals (Sweden)

    Vishal R Tandon

    2015-01-01

    Full Text Available With the increase in the cases of multidrug resistance tuberculosis, second line anti-tubercular drugs like the cycloserine are being prescribed frequently. Isoniazid and ethambutol are reported to cause psychosis like state; however, few reports of cycloserine induced psychosis are available. To the best of our knowledge, this is the first case of cycloserine induced psychosis with hepatic dysfunction.

  4. Recovery from Psychosis: A Phenomenological Inquiry

    Science.gov (United States)

    Nixon, Gary; Hagen, Brad; Peters, Tracey

    2010-01-01

    While mainstream psychiatry tends to view psychosis as an enduring and chronic condition, there is growing interest in the possibility of recovery from psychosis. A phenomenological research method was utilized in interviewing 17 individuals who all self-identified as being in recovery from psychosis. The research question was, "What was the lived…

  5. Delusional disorder as a partial psychosis.

    Science.gov (United States)

    Opjordsmoen, Stein

    2014-03-01

    In his textbook from 1838, Esquirol made the first comprehensive psychopathological description of paranoia, which he labeled partial psychosis. This was a condition with encapsulated, well organized, and persistent delusions. These are defended with a great deal of emotions and sharp argument. The individual appears quite convincing, especially because he or she otherwise behaves rationally. The intellectual capacity is used to achieve defined goals according to the delusional content. This condition is difficult to uncover because of dissimulation and adaptation. The frequency in the population is unknown, but the condition is rare in psychiatric treatment facilities, and usually only when the persons become litigious or criminal. In Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the condition is covered by the concept of delusional disorder, but that concept also comprises benign acute/subacute conditions as well as cases that turn out to have the diagnosis changed to schizophrenia.

  6. DSM-5: ATTENUATED PSYCHOSIS SYNDROME?

    Directory of Open Access Journals (Sweden)

    Eduardo Fonseca-Pedrero

    2013-09-01

    Full Text Available Psychotic syndrome includes several devastating mental disorders characterized by a rupture of higher mental functions. The signs and symptoms of psychosis begin in adolescence or early adulthood and usually begin gradually and progress over time. Attenuated psychosis syndrome is a new DSM-5 diagnostic proposal which deals with identifying people at high-risk mental state (ARMS/UHR which may be a predictor of conversion to psychosis. The potential benefit would be that if psychotic disorder is treated more effectively in its early stages, it could produce a lasting beneficial effect that probably could not be achieved with later intervention. This syndrome has generated intense discussion in specialized scientific and professional forums, crisscrossing arguments in favor and against its inclusion. HRMS is preferentially evaluated in the adolescent or young adult population. HRMS evolution is associated with a higher rate of transition toward nonaffective psychosis, although it can evolve toward other mental disorders, remain stable or remit over time. Empirical evidence shows that early intervention seems to have a certain beneficial effect, although for now the results are still insufficient and contradictory. The lack of specificity of symptoms in predicting psychosis, presence of certain limitations (e.g., stigmatization, results found in early interventions and lack of empirical evidence, have led to include the attenuated psychosis syndrome in the DSM-5 Appendix III. The main benefits and limitations of including this supposed category, possible lessons learned from this type of study and future lines of action are discussed in the light of these findings.

  7. Language Disorder In Schizophrenia Patient: A Case Study Of Five Schizophrenia Paranoid Patients In Simeulue District Hospital

    OpenAIRE

    Kurnia, Beby Febri

    2015-01-01

    Language disorder in schizophrenia patients is an acquired language disorder due to thought disorder. This analysis analyzed language disorder in schizophrenia paranoid patients in Simeulue District Hospital. The objective of this analysis were: (1) to find out the types of schizophrenic speech found in schizophrenia paranoid patients, (2) to find out the most dominant type of schizophrenia speech found in schizophrenia paranoid patients, and (3) to find out which patient has most severe lang...

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

    Science.gov (United States)

    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.

  9. [Oropharyngeal impalement in a case of paranoid hallucinatory schizophrenia].

    Science.gov (United States)

    Navarro-Crummenauer, Bianca; Urban, Reinhard

    2010-01-01

    Self-inflicted impalement is a rarity in forensic autopsies. The case of a 32-year-old man, who was found dead lying on a suburban street, is reported and compared with the relevant literature. A 5-cm-thick wooden stick with blood traces protruded from the oral cavity. At autopsy, it was found that the wooden post, which had a total length of 28 cm, filled the entire oral cavity with the pointed end being located at the entrance of the larynx with lacerations of the posterior wall of the pharynx. There were no signs of asphyxia or involvement of another party. As secondary findings, fresh hesitation cuts could be demonstrated on the right forearm. Death was assumed to have been caused by reflectory cardiac or respiratory arrest similar to bolus death. The police investigations showed that the man had suffered from paranoid hallucinatory schizophrenia for 12 years with 3 previous attempts to commit suicide and had been discharged from inpatient treatment in a psychiatric institution only 4 days before his death. The pattern of injuries is described and an attempt is made to reconstruct the course of events on the basis of the results of the police investigations and the psychiatric documentation. The rare case of self-inflicted fatal impalement is compared with other reports in the literature.

  10. Vocational functioning in schizotypal and paranoid personality disorders.

    Science.gov (United States)

    McGurk, Susan R; Mueser, Kim T; Mischel, Rebecca; Adams, Rebecca; Harvey, Philip D; McClure, Margaret M; Look, Amy E; Leung, Winnie W; Siever, Larry J

    2013-12-15

    Impaired vocational functioning is a hallmark of schizophrenia, but limited research has evaluated the relationships between work and schizophrenia-spectrum personality disorders, including schizotypal (SPD) and paranoid personality disorder (PPD). This study compared employment history and job characteristics of 174 individuals drawn from the community or clinic, based on four personality disorder groups: SPD Only, PPD Only, SPD+PPD, and No SPD or PPD. Symptoms and cognitive functioning were also assessed. Both PPD and/or SPD were associated with lower rates of current employment, and a history of having worked at less cognitively complex jobs than people without these disorders. Participants with PPD were less likely to have a history of competitive work for one year, whereas those with SPD tended to have worked at jobs involving lower levels of social contact, compared with those without these disorders. When the effects of symptoms and cognitive functioning were statistically controlled, PPD remained a significant predictor of work history, and SPD remained a significant predictor of social contact on the job. The findings suggest that impaired vocational functioning is an important characteristic of SPD and PPD.

  11. [Clinico-diagnostic evaluation of acute delirious syndromes in schizophrenia].

    Science.gov (United States)

    Panteleeva, G P

    1989-01-01

    Psychopathologic and nosologic issues of acute paranoid and Kandinsky-Clerambault syndromes are discussed on the background of clinical studies of 225 schizophrenic patients with these syndromes being initial manifestations. The data on the syndromes typology, clinical value and prognosis of acute delirious disorders are presented. These are shown to be not confined to progredient schizophrenia, including its paranoid form. Rather, they can manifest a course of the disease unspecific for schizophrenia, the so-called schizophrenic reactions and phasic states thus reflecting the course of latent schizophrenia. A differentiated approach to clinical and psychopathological analysis of acute delirious syndromes in schizophrenia is essential for adequate choice of medicosocial measures and epidemiologic investigations.

  12. Early intervention services in psychosis

    DEFF Research Database (Denmark)

    Csillag, Claudio; Nordentoft, Merete; Mizuno, Masafumi

    2016-01-01

    AIM: Early intervention (EI) in psychosis is a comprehensive and evidence-based approach aimed at detection and treatment of psychotic symptoms in their early stages. This paper presents core features and noteworthy aspects of the evidence basis and limitations of EI, the importance of programme...

  13. Parkinson’s disease psychosis

    Directory of Open Access Journals (Sweden)

    Jakel RJ

    2014-03-01

    Full Text Available Rebekah J Jakel,1,2 Mark Stacy31Department of Psychiatry, Duke University, Durham, NC, USA; 2Durham Veteran's Administration Medical Center, Durham, NC, USA; 3Department of Neurology, Duke University, Durham, NC, USAAbstract: Parkinson’s disease is a progressive neurodegenerative disease characterized by loss of nigral dopaminergic neurons associated with rigidity, resting tremor, bradykinesia, and postural instability. In addition to the above motor symptoms, nonmotor manifestations are increasingly recognized as part of Parkinson's disease pathology and contribute to overall symptom burden, morbidity, and mortality. Such nonmotor symptoms include autonomic dysfunction, impaired olfaction, gastrointestinal disturbances, and a variety of psychiatric symptoms including psychosis. Psychiatric symptoms may be inherent to the disease process itself, secondary to treatments aimed at restoring dopamine, or related to comorbid mental illness. Given that traditional medications used to treat psychosis are dopaminergic antagonists, pharmacologic treatment of these symptoms carries the risk of worsening the movement disorder, creating a challenge for providers. This review examines current literature regarding psychosis in the context of Parkinson’s disease including risk factors for psychosis, prognosis, and management of these challenging symptoms.Keywords: antipsychotics, delusions, hallucinations, non-motor symptoms, paranoia

  14. Virtual reality in the assessment and treatment of psychosis: a systematic review of its utility, acceptability and effectiveness.

    Science.gov (United States)

    Rus-Calafell, M; Garety, P; Sason, E; Craig, T J K; Valmaggia, L R

    2017-07-24

    Over the last two decades, there has been a rapid increase of studies testing the efficacy and acceptability of virtual reality in the assessment and treatment of mental health problems. This systematic review was carried out to investigate the use of virtual reality in the assessment and the treatment of psychosis. Web of Science, PsychInfo, EMBASE, Scopus, ProQuest and PubMed databases were searched, resulting in the identification of 638 articles potentially eligible for inclusion; of these, 50 studies were included in the review. The main fields of research in virtual reality and psychosis are: safety and acceptability of the technology; neurocognitive evaluation; functional capacity and performance evaluation; assessment of paranoid ideation and auditory hallucinations; and interventions. The studies reviewed indicate that virtual reality offers a valuable method of assessing the presence of symptoms in ecologically valid environments, with the potential to facilitate learning new emotional and behavioural responses. Virtual reality is a promising method to be used in the assessment of neurocognitive deficits and the study of relevant clinical symptoms. Furthermore, preliminary findings suggest that it can be applied to the delivery of cognitive rehabilitation, social skills training interventions and virtual reality-assisted therapies for psychosis. The potential benefits for enhancing treatment are highlighted. Recommendations for future research include demonstrating generalisability to real-life settings, examining potential negative effects, larger sample sizes and long-term follow-up studies. The present review has been registered in the PROSPERO register: CDR 4201507776.

  15. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia.

    Science.gov (United States)

    Grover, Sandeep; Nehra, Ritu; Bhateja, Gaurav; Kulhara, Parmanand; Kumar, Suresh

    2011-07-01

    Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia and 20 healthy controls. All three groups were matched on age, sex, and level of education. The two patient groups were also matched on duration of illness. In general, patients with delusional disorder performed worst than healthy controls and patients with paranoid schizophrenia performed in between the other two groups. Compared with healthy controls, both patients with delusional disorder and patients with paranoid schizophrenia were significantly impaired on different tests of attention and visual learning and memory. Compared with patients with paranoid schizophrenia, patients with delusional disorder had more impairment different tests of attention, visual learning and memory, verbal working memory, and executive functions. Patients with delusional disorder exhibit cognitive dysfunctions that are very similar to schizophrenia, but are more severe in intensity. The resemblance of cognitive profiles suggests that the two disorders may have similar etiological basis.

  16. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2011-01-01

    Full Text Available Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia and 20 healthy controls. All three groups were matched on age, sex, and level of education. The two patient groups were also matched on duration of illness. Results: In general, patients with delusional disorder performed worst than healthy controls and patients with paranoid schizophrenia performed in between the other two groups. Compared with healthy controls, both patients with delusional disorder and patients with paranoid schizophrenia were significantly impaired on different tests of attention and visual learning and memory. Compared with patients with paranoid schizophrenia, patients with delusional disorder had more impairment different tests of attention, visual learning and memory, verbal working memory, and executive functions. Conclusion: Patients with delusional disorder exhibit cognitive dysfunctions that are very similar to schizophrenia, but are more severe in intensity. The resemblance of cognitive profiles suggests that the two disorders may have similar etiological basis.

  17. Common variants in the TPH2 promoter confer susceptibility to paranoid schizophrenia.

    Science.gov (United States)

    Yi, Zhenghui; Zhang, Chen; Lu, Weihong; Song, Lisheng; Liu, Dentang; Xu, Yifeng; Fang, Yiru

    2012-07-01

    Serotonergic system-related genes may be good candidates in investigating the genetic basis of schizophrenia. Our previous study suggested that promoter region of tryptophan hydroxylase 2 gene (TPH2) may confer the susceptibility to paranoid schizophrenia. In this study, we investigated whether common variants within TPH2 promoter may predispose to paranoid schizophrenia in Han Chinese. A total of 509 patients who met DSM-IV criteria for paranoid schizophrenia and 510 matched healthy controls were recruited for this study. Five polymorphisms within TPH2 promoter region were tested. No statistically significant differences were found in allele or genotype frequencies between schizophrenic patients and healthy controls. The frequency of the rs4448731T-rs6582071A-rs7963803A-rs4570625T-rs11178997A haplotype was significantly higher in cases compared to the controls (P = 0.003; OR = 1.49; 95% CI, 1.15-1.95). Our results suggest that the common variants within TPH2 promoter are associated with paranoid schizophrenia in Han Chinese. Further studies in larger samples are warranted to elucidate the role of TPH2 in the etiology of paranoid schizophrenia.

  18. Right lateralized white matter abnormalities in first-episode, drug-naive paranoid schizophrenia.

    Science.gov (United States)

    Guo, Wenbin; Liu, Feng; Liu, Zhening; Gao, Keming; Xiao, Changqing; Chen, Huafu; Zhao, Jingping

    2012-11-30

    Numerous studies in first-episode schizophrenia suggest the involvement of white matter (WM) abnormalities in multiple regions underlying the pathogenesis of this condition. However, there has never been a neuroimaging study in patients with first-episode, drug-naive paranoid schizophrenia by using tract-based spatial statistics (TBSS) method. Here, we used diffusion tensor imaging (DTI) with TBSS method to investigate the brain WM integrity in patients with first-episode, drug-naive paranoid schizophrenia. Twenty patients with first-episode, drug-naive paranoid schizophrenia and 26 healthy subjects matched with age, gender, and education level were scanned with DTI. An automated TBSS approach was employed to analyze the data. Voxel-wise statistics revealed that patients with paranoid schizophrenia had decreased fractional anisotropy (FA) values in the right superior longitudinal fasciculus (SLF) II, the right fornix, the right internal capsule, and the right external capsule compared to healthy subjects. Patients did not have increased FA values in any brain regions compared to healthy subjects. There was no correlation between the FA values in any brain regions and patient demographics and the severity of illness. Our findings suggest right-sided alterations of WM integrity in the WM tracts of cortical and subcortical regions may play an important role in the pathogenesis of paranoid schizophrenia.

  19. The relationship between paranoia and aggression in psychosis: A systematic review.

    Science.gov (United States)

    Darrell-Berry, Hannah; Berry, Katherine; Bucci, Sandra

    2016-04-01

    Aggression in the context of schizophrenia has significant detrimental personal, clinical and societal implications. Whilst understanding the precise pathways to aggression in people with a diagnosis of schizophrenia is critical for risk management and treatment, these pathways remain unclear. A paranoid belief that others intend harm is one psychotic symptom that might contribute to aggressive behaviours. This is the first review to investigate the relationship between paranoia and aggression in psychosis. A systematic review of published literature pertinent to the relationship between paranoia and aggression was conducted. A search of online databases from inception to November 2014 was performed with keywords related to 'schizophrenia', 'paranoia' and 'aggression'. Fifteen studies, primarily cross-sectional in design (n=9), met eligibility criteria. Studies reviewed showed mixed support for an association between paranoia and aggression in both inpatients and community settings. However, when study quality was taken into account, more methodologically rigorous studies tended to show a positive association between factors. Mixed findings are most likely due to important methodological shortcomings, including heterogeneous samples and studies using a diverse range of aggression/violence measures. In light of methodological limitations of individual studies reviewed, further investigation of the relationship between paranoia and aggression in psychosis using robust methodology is needed before definitive clinical recommendations regarding the hypothesised relationship between paranoia and aggression can be made. This paper sets out key recommendations for future studies, including operationalizing the specific components of aggression and paranoia under investigation and methods to delineate important mediators in the paranoia and aggression relationship.

  20. Delusional Disorders—Are They Simply Paranoid Schizophrenia?

    Science.gov (United States)

    Marneros, Andreas; Pillmann, Frank; Wustmann, Tobias

    2012-01-01

    Objectives: This article tries to give an answer to the question of whether International Classification of Diseases (ICD-10) persistent delusional disorder (PDD) or Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) delusional disorder (DD) is simply paranoid schizophrenia (PS). Because ICD-10 PDD and DSM-IV DD are identical, we use DD as a synonym. Methods: A prospective and longitudinal study compared all inpatients with DD treated at the Halle-Wittenberg university hospital during a 14-year period with a previously investigated selected cohort of patients with PS. Sociodemographic data, symptomatology, course, and outcome parameters were examined using standardized instruments. The duration of the follow-up period in patients with DD was 10.8 years and for the PS patients 12.9 years. Results: Significant differences between DD and PS were found: DD patients are, in comparison to patients with PS, significantly older at onset. Less of their first-degree relatives have mental disorders. They less frequently come from a broken home situation. First-rank symptoms, relevant negative symptoms, and primary hallucinations did not occur in patients with DD. Patients with DD were less frequently hospitalized, and the duration of their hospitalization was shorter. Their outcome is much better regarding employment, early retirement due to the disorder, and psychopharmacological medication. They more often had stable heterosexual partnerships and were autarkic. They had lower scores in the Disability Assessment Scale and in Positive and Negative Syndrome Scale. The diagnosis of DD is very stable over time. Conclusions: The findings of this study support the assumption that DDs are a separate entity and only exceptionally can be a prodrome of schizophrenia. PMID:21078814

  1. Delusional disorders--are they simply paranoid schizophrenia?

    Science.gov (United States)

    Marneros, Andreas; Pillmann, Frank; Wustmann, Tobias

    2012-05-01

    This article tries to give an answer to the question of whether International Classification of Diseases (ICD-10) persistent delusional disorder (PDD) or Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) delusional disorder (DD) is simply paranoid schizophrenia (PS). Because ICD-10 PDD and DSM-IV DD are identical, we use DD as a synonym. A prospective and longitudinal study compared all inpatients with DD treated at the Halle-Wittenberg university hospital during a 14-year period with a previously investigated selected cohort of patients with PS. Sociodemographic data, symptomatology, course, and outcome parameters were examined using standardized instruments. The duration of the follow-up period in patients with DD was 10.8 years and for the PS patients 12.9 years. Significant differences between DD and PS were found: DD patients are, in comparison to patients with PS, significantly older at onset. Less of their first-degree relatives have mental disorders. They less frequently come from a broken home situation. First-rank symptoms, relevant negative symptoms, and primary hallucinations did not occur in patients with DD. Patients with DD were less frequently hospitalized, and the duration of their hospitalization was shorter. Their outcome is much better regarding employment, early retirement due to the disorder, and psychopharmacological medication. They more often had stable heterosexual partnerships and were autarkic. They had lower scores in the Disability Assessment Scale and in Positive and Negative Syndrome Scale. The diagnosis of DD is very stable over time. The findings of this study support the assumption that DDs are a separate entity and only exceptionally can be a prodrome of schizophrenia.

  2. [Anti-NMDA encephalitis in psychiatry; malignant catatonia, atypical psychosis and ECT].

    Science.gov (United States)

    Kanbayashi, Takashi; Tsutsui, Ko; Tanaka, Keiko; Omori, Yuki; Takaki, Manabu; Omokawa, Mayu; Mori, Akane; Kusanagi, Hiroaki; Nishino, Seiji; Shimizu, Tetsuo

    2014-01-01

    The symptoms of malignant (lethal) catatonia has been reported similar to initial symptoms of anti-NMDAR encephalitis. Subsequently, this autoimmune limbic encephalitis has been noticed in many psychiatrists. We have experienced several cases with malignant catatonia having anti-NMDAR antibody without clinical signs of encephalitis. Thereafter, we have also found anti-NMDAR antibody positive patients of young females with acute florid psychiatric symptoms without clinical signs of encephalitis. The features of these patients mirror-those of "Atypical psychosis" proposed by Mitsuda in Japan, a notion derived from "Cycloid psychosis" conceptualized by German psychiatrist, Leonhard. Both cycloid and atypical psychosis have coinciding features of acute onset, emotional disturbances, psychomotor disturbances, alternations of consciousness, high prevalence in women and oriented premorbid personality. Both malignant catatonia and atypical psychosis have been known to be effectively treated with modified electro convulsion therapy (m-ECT). Our 5 cases with anti-NMDAR antibody, m-ECT treatments were effective. Infectious encephalitis is contra indication of m-ECT, but this autoimmune encephalitis would be careful indication. Schizophrenia is a common, heterogeneous, and complex disorder with unknown etiology. There is established evidence of NMDAR hypofunction as a central component of the functional disconnectivity; this is one of the most accepted models for schizophrenia. Moreover, autoimmune mechanisms have been proposed to be involved, at least in subgroups of schizophrenia patients. Further research of anti-NMDAR antibody and encephalitis would be important clues for the investigation of schizophrenia, catatonia and atypical psychosis.

  3. A randomized prospective comparative study of efficacy of asenapine, iloperidone and zotepine in patients with psychosis

    Directory of Open Access Journals (Sweden)

    Nagesh H. N.

    2016-10-01

    Conclusions: In patients with acute psychosis and schizophrenia, iloperidone appears more effective and tolerated than the other two. Asenapine was effective but less tolerated and zotepine was less efficacious and produced poor response. Asenapine and zotepine have more dropouts and showed few uncommon extrapyramidal side effects. [Int J Basic Clin Pharmacol 2016; 5(5.000: 1898-1902

  4. An association study between polymorphisms in five genes in glutamate and GABA pathway and paranoid schizophrenia.

    Science.gov (United States)

    Zhang, Boyu; Yuan, Yanbo; Jia, Yanbin; Yu, Xin; Xu, Qi; Shen, Yucun; Shen, Yan

    2005-01-01

    Dysfunctions of glutamatergic and GABAergic neurotransmission are two important hypotheses for the pathogenesis of schizophrenia. Thus, genes in the pathway are candidates for schizophrenia susceptibility. Phosphate-activated glutaminase (GLS), glutamine synthetase (GLUL), glutamic acid decarboxylase (GAD), GABA transaminase (ABAT) and succinic semialdehyde dehydrogenase (ALDH5A1) are five primary enzymes in glutamate and GABA synthetic and degradative pathway. In order to investigate the possible involvement of these genes in the development of paranoid schizophrenia, we genotyped 80 paranoid schizophrenics from northern China and 108 matched controls by polymerase chain reaction (PCR) and restriction fragment length polymorphisms (RFLP) methods or directly sequencing of PCR product. Seven SNPs were found to be polymorphic in the population investigated. No significant differences in the genotype distributions or allele frequencies between patients and controls were found. Therefore, we conclude the polymorphisms studied in the five genes do not play major roles in pathogenesis of paranoid schizophrenia in the population investigated.

  5. The Experience of Delusion Content Psycholinguistic Analysis in Paranoid Schizophrenia Onset

    Directory of Open Access Journals (Sweden)

    Gorkovaia I.A.

    2017-06-01

    Full Text Available The article presents the experience of delusion content psycholinguistic analysis in paranoid schizophrenia onset. The 100 medical histories of men and women who have the diagnosis of paranoid schizophrenia (F20.0 have been studied. The patients have been divided into four groups according to their sex and age (adolescence and the first period of maturity, when the disease onset had been. To implement the delusion content psycholinguistic analysis at a lexical level of language the inductive content analysis has been used and to do this at a syntactical level of language the deductive content analysis has been used. The statistical manipulation variants of content analysis’s data and the ways of data graphic representation have been demonstrated. The conclusion that psycholinguistic analysis exposes the features of delusion content in the patients’ groups sorted out according their sex and age when paranoid schizophrenia onset had been have been done.

  6. The interaction of BDNF and NTRK2 gene increases the susceptibility of paranoid schizophrenia.

    Directory of Open Access Journals (Sweden)

    Zheng Lin

    Full Text Available The association between BDNF gene functional Val66Met polymorphism rs6265 and the schizophrenia is far from being consistent. In addition to the heterogeneous in schizophrenia per se leading to the inconsistent results, the interaction among multi-genes is probably playing the main role in the pathogenesis of schizophrenia, but not a single gene. Neurotrophic tyrosine kinase receptor 2 (NTRK2 is the high-affinity receptor of BDNF, and was reported to be associated with mood disorders, though no literature reported the association with schizophrenia. Thus, in the present study, total 402 patients with paranoid schizophrenia (the most common subtype of schizophrenia and matched 406 healthy controls were recruited to investigate the role of rs6265 in BDNF, three polymorphisms in NTRK2 gene (rs1387923, rs2769605 and rs1565445 and their interaction in the susceptibility to paranoid schizophrenia in a Chinese Han population. We did not observe significant differences in allele and genotype frequencies between patients and healthy controls for all four polymorphisms separately. The haplotype analysis also showed no association between haplotype of NTRK2 genes (rs1387923, rs2769605, and rs1565445 and paranoid schizophrenia. However, we found the association between the interaction of BDNF and NTRK2 with paranoid schizophrenia by using the MDR method followed by conventional statistical analysis. The best gene-gene interaction model was a three-locus model (BDNF rs6265, NTRK2 rs1387923 and NTRK2 rs2769605, in which one low-risk and three high-risk four-locus genotype combinations were identified. Our findings implied that single polymorphism of rs6265 rs1387923, rs2769605, and rs1565445 in BDNF and NTRK2 were not associated with the development of paranoid schizophrenia in a Han population, however, the interaction of BDNF and NTRK2 genes polymorphisms (BDNF-rs6265, NTRK2-rs1387923 and NTRK2-rs2769605 may be involved in the susceptibility to paranoid

  7. Paranoid schizophrenia is characterized by increased CB1 receptor binding in the dorsolateral prefrontal cortex.

    Science.gov (United States)

    Dalton, Victoria S; Long, Leonora E; Weickert, Cyndi Shannon; Zavitsanou, Katerina

    2011-07-01

    A number of studies suggest a dysregulation of the endogenous cannabinoid system in schizophrenia (SCZ). In the present study, we examined cannabinoid CB(1) receptor (CB(1)R) binding and mRNA expression in the dorsolateral prefrontal cortex (DLPFC) (Brodmann's area 46) of SCZ patients and controls, post-mortem. Receptor density was investigated using autoradiography with the CB(1)R ligand [(3)H] CP 55,940 and CB(1)R mRNA expression was measured using quantitative RT-PCR in a cohort of 16 patients with paranoid SCZ, 21 patients with non-paranoid SCZ and 37 controls matched for age, post-mortem interval and pH. All cases were obtained from the University of Sydney Tissue Resource Centre. Results were analyzed using one-way analysis of variance (ANOVA) and post hoc Bonferroni tests and with analysis of covariance (ANCOVA) to control for demographic factors that would potentially influence CB(1)R expression. There was a main effect of diagnosis on [(3)H] CP 55,940 binding quantified across all layers of the DLPFC (F(2,71) = 3.740, p = 0.029). Post hoc tests indicated that this main effect was due to patients with paranoid SCZ having 22% higher levels of CB(1)R binding compared with the control group. When ANCOVA was employed, this effect was strengthened (F(2,67) = 6.048, p = 0.004) with paranoid SCZ patients differing significantly from the control (p = 0.004) and from the non-paranoid group (p = 0.016). In contrast, no significant differences were observed in mRNA expression between the different disease subtypes and the control group. Our findings confirm the existence of a CB(1)R dysregulation in SCZ and underline the need for further investigation of the role of this receptor particularly in those diagnosed with paranoid SCZ.

  8. The interaction of BDNF and NTRK2 gene increases the susceptibility of paranoid schizophrenia.

    Science.gov (United States)

    Lin, Zheng; Su, Yousong; Zhang, Chengfang; Xing, Mengjuan; Ding, Wenhua; Liao, Liwei; Guan, Yangtai; Li, Zezhi; Cui, Donghong

    2013-01-01

    The association between BDNF gene functional Val66Met polymorphism rs6265 and the schizophrenia is far from being consistent. In addition to the heterogeneous in schizophrenia per se leading to the inconsistent results, the interaction among multi-genes is probably playing the main role in the pathogenesis of schizophrenia, but not a single gene. Neurotrophic tyrosine kinase receptor 2 (NTRK2) is the high-affinity receptor of BDNF, and was reported to be associated with mood disorders, though no literature reported the association with schizophrenia. Thus, in the present study, total 402 patients with paranoid schizophrenia (the most common subtype of schizophrenia) and matched 406 healthy controls were recruited to investigate the role of rs6265 in BDNF, three polymorphisms in NTRK2 gene (rs1387923, rs2769605 and rs1565445) and their interaction in the susceptibility to paranoid schizophrenia in a Chinese Han population. We did not observe significant differences in allele and genotype frequencies between patients and healthy controls for all four polymorphisms separately. The haplotype analysis also showed no association between haplotype of NTRK2 genes (rs1387923, rs2769605, and rs1565445) and paranoid schizophrenia. However, we found the association between the interaction of BDNF and NTRK2 with paranoid schizophrenia by using the MDR method followed by conventional statistical analysis. The best gene-gene interaction model was a three-locus model (BDNF rs6265, NTRK2 rs1387923 and NTRK2 rs2769605), in which one low-risk and three high-risk four-locus genotype combinations were identified. Our findings implied that single polymorphism of rs6265 rs1387923, rs2769605, and rs1565445 in BDNF and NTRK2 were not associated with the development of paranoid schizophrenia in a Han population, however, the interaction of BDNF and NTRK2 genes polymorphisms (BDNF-rs6265, NTRK2-rs1387923 and NTRK2-rs2769605) may be involved in the susceptibility to paranoid schizophrenia.

  9. Personality traits and psychotic symptoms in recent onset of psychosis patients.

    Science.gov (United States)

    Sevilla-Llewellyn-Jones, Julia; Cano-Domínguez, Pablo; de-Luis-Matilla, Antonia; Peñuelas-Calvo, Inmaculada; Espina-Eizaguirre, Alberto; Moreno-Kustner, Berta; Ochoa, Susana

    2017-04-01

    Personality in patients with psychosis, and particularly its relation to psychotic symptoms in recent onset of psychosis (ROP) patients, is understudied. The aims of this research were to study the relation between dimensional and categorical clinical personality traits and symptoms, as well as the effects that symptoms, sex and age have on clinically significant personality traits. Data for these analyses were obtained from 94 ROP patients. The Millon Clinical Multiaxial Inventory and the Positive and Negative Syndrome Scale were used to assess personality and symptoms. Correlational Analysis, Mann-Whitney test, and, finally, logistic regression were carried out. The negative dimension was higher in patients with schizoid traits. The excited dimension was lower for those with avoidant and depressive traits. The anxiety and depression dimension was higher for patients with dependent traits. The positive dimension was lower for patients with histrionic and higher for patients with compulsive traits. Logistic regression demonstrated that gender and the positive and negative dimensions explained 35.9% of the variance of the schizoid trait. The excited dimension explained 9.1% of the variance of avoidant trait. The anxiety and depression dimension and age explained 31.3% of the dependent trait. Gender explained 11.6% of the histrionic trait, 14.5% of the narcissistic trait and 11.6% of the paranoid trait. Finally gender and positive dimension explained 16.1% of the compulsive trait. The study highlights the importance of studying personality in patients with psychosis as it broadens understating of the patients themselves and the symptoms suffered. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Relational ethics: when mothers suffer from psychosis.

    Science.gov (United States)

    Seeman, M V

    2004-07-01

    The goal of this review is to aid clinicians with ethical issues arising in the treatment of women who suffer from psychosis. This paper is a synthesis of the recent literature in adult and child psychiatry, ethics, law, and child welfare pertaining to the topic of maternal psychosis. Topics include: family planning, the care of pregnant women with schizophrenia, postpartum psychosis, child custody, involuntary treatment, confidentiality issues, and service fragmentation. Appreciation of the particularized circumstances of issues arising in the treatment of mothers who suffer from psychosis serve the clinician better than the dispassionate application of a principle-driven ethic.

  12. [Clinical features of depression in the remission phase of paranoid schizophrenia].

    Science.gov (United States)

    Petrova, N N; Vishnevskaya, O A

    2013-01-01

    Phenomenological and pathogenetic features of depression developed in the remission phase of paranoid schizophrenia were studied in 75 patients (mean age 44.9±1.22 years). Depression was diagnosed in 58.7% patients. It has been shown that the psychopathological structure of depression was not homogenous and 63.6% cases were atypical. In 25% patients, depressive disorders were psychogenic. Depression concomitant with anxiety disorders was most common. Depression in the phase of remission developed most often in female patients older than 39 years and in male patients younger than 39 years. Cognitive function was not impaired in patients with depression in the remission phase of paranoid schizophrenia.

  13. Death, time, and psychosis.

    Science.gov (United States)

    Lombardi, Riccardo

    2013-08-01

    Working through the awareness of death and the consciousness of time, it is hypothesized, plays a decisive role in the analytic process and in the mental growth of psychotic analysands, as well as in the integration of the psychotic areas in healthier patients. Clinical material is presented from a psychotic woman treated analytically, four sessions a week, for twelve years. The patient suffered several acute relapses, during which the analytic work was not interrupted. Her fourth psychotic episode in the course of analysis, which involved a delusion about gray men and the theft of time, is explored in particular depth. This phase fostered the patient's recognition of the value of time, together with the acquisition of her own center of psychosensory integration, the basis of an ability to learn from experience.

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

    Science.gov (United States)

    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.

  15. Apathy in first episode psychosis patients

    DEFF Research Database (Denmark)

    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....

  16. President Bush's Pre-War Rhetoric on Iraq: Paranoid Style in Action

    Science.gov (United States)

    Nikolaev, Alexander G.; Porpora, Douglas V.

    2006-01-01

    The focus of this article is on the war rhetoric of the Bush administration as reflected in the speeches of President Bush. What was explored is how presidential speeches drew on a variety of rhetorical techniques, from role-taking and punctuation to the adoption of the paranoid style. The purpose of these techniques is to nullify voices of…

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

    Directory of Open Access Journals (Sweden)

    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

  18. The Prediction of Paranoid Behavior: Comparative Validities of Obvious vs. Subtle MMPI Paranoia (Pa) Items.

    Science.gov (United States)

    Hovanitz, Christine A.; And Others

    1983-01-01

    Investigated the relationship between the Minnesota Multiphasic Personality Inventory paranoia subtle, neutral, and obvious subscales and criteria presumed to reflect various paranoid characteristics in a sample of male college students (N=100). Results showed that both the obvious and subtle Pa Items predicted various criteria. (Author/JAC)

  19. FEATURES OF LIPID PEROXIDATION AND NEUROTROPHIC REGULATION IN PATIENTS SUFFERING FROM PARANOID SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    V.B. Vilyanov

    2008-09-01

    Full Text Available The article deals with the features of lipid peroxidation, activity of the antioxidative systems and level of brain-derived neurotrophic factor in patients with paranoid schizophrenia. Present study indicates associations between the studied parameters and type of progression, duration of disease and gender of patients.

  20. Association study of interleukin-4 polymorphisms with paranoid schizophrenia in the Polish population: a critical approach.

    Science.gov (United States)

    Fila-Danilow, Anna; Kucia, Krzysztof; Kowalczyk, Malgorzata; Owczarek, Aleksander; Paul-Samojedny, Monika; Borkowska, Paulina; Suchanek, Renata; Kowalski, Jan

    2012-08-01

    Changes in immunological system are one of dysfunctions reported in schizophrenia. Some changes based on an imbalance between Th1 and Th2 cytokines results from cytokine gene polymorphisms. Interleukin-4 gene (IL4) is considered as a potential candidate gene in schizophrenia association studies. The aim of the current case-control study was to examine whether the -590C/T (rs2243250) and -33C/T (rs2070874) IL4 gene polymorphisms are implicated in paranoid schizophrenia development in the Polish population. Genotyping of polymorphisms was performed by using PCR-RFLP technique. The genotypes and alleles distribution of both SNPs were analysed in patients (n = 182) and healthy individuals constituted the control group (n = 215). The connection between some clinical variables and studied polymorphisms has been examined as well. We did not revealed any association between the -590C/T and -33C/T polymorphisms and paranoid schizophrenia. In case of both SNPs the homozygous TT genotype was extremely rare. Both polymorphic sites of the IL4 gene were found to be in a very strong linkage disequilibrium. However we did not identify a haplotype predispose to paranoid schizophrenia. No associations were also observed between the clinical course and psychopathology of the disease and the genotypes of both analysed polymorphisms. Our results suggest that the polymorphisms -590C/T in IL4 gene promoter region and -33C/T in the 5'-UTR are not involved in the pathophysiology of paranoid schizophrenia in Polish residents.

  1. Jack the Giant Tamer: Poetry Writing in the Treatment of Paranoid Schizophrenia.

    Science.gov (United States)

    Silver, Constance

    1993-01-01

    Provides a brief case report on the use of poetry writing in the treatment of a patient with a diagnosis of paranoid schizophrenia. Notes that, after 23 sessions in which the patient said nothing, the patient brought a poem for the therapist to read at the 24 session. (SR)

  2. Behavioral Experiments in the Treatment of Paranoid Schizophrenia: A Single Case Study

    Science.gov (United States)

    Hagen, Roger; Nordahl, Hans M.

    2008-01-01

    Since the first description of cognitive therapy of paranoid delusions appeared in the literature, the empirical support for cognitive behavioral therapy in treating psychotic symptoms has been widely established. The aim of the present case study is to show how the behavioral experiment can be used as a powerful tool to change delusional thinking…

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

    Science.gov (United States)

    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.

  4. Psychosis and epilepsy in young people.

    Science.gov (United States)

    Lax Pericall, M T; Taylor, E

    2010-08-01

    The aim of this study was to describe the clinical characteristics of children and young people under 19 with both epilepsy and a psychotic state (schizophrenia-like psychotic episode, organic delusional disorder, or other brief psychotic episode). In total, the clinical case notes for 17 young people with these characteristics were identified retrospectively from three different sources. Compared with a group of young people with psychosis without epilepsy, children with epilepsy and psychosis more frequently had other neuropsychological problems like learning disability and autism. Both groups had a high rate of family histories of mental illness and social disability. Contrary to the findings in adults with psychosis and epilepsy, in this group of young people, psychosis was associated neither with temporal lobe epilepsy nor with mesial temporal sclerosis. The children with psychosis and epilepsy had a variety of seizure types and structural abnormalities.

  5. Hypothesis: grandiosity and guilt cause paranoia; paranoid schizophrenia is a psychotic mood disorder; a review.

    Science.gov (United States)

    Lake, Charles Raymond

    2008-11-01

    Delusional paranoia has been associated with severe mental illness for over a century. Kraepelin introduced a disorder called "paranoid depression," but "paranoid" became linked to schizophrenia, not to mood disorders. Paranoid remains the most common subtype of schizophrenia, but some of these cases, as Kraepelin initially implied, may be unrecognized psychotic mood disorders, so the relationship of paranoid schizophrenia to psychotic bipolar disorder warrants reevaluation. To address whether paranoia associates more with schizophrenia or mood disorders, a selected literature is reviewed and 11 cases are summarized. Comparative clinical and recent molecular genetic data find phenotypic and genotypic commonalities between patients diagnosed with schizophrenia and psychotic bipolar disorder lending support to the idea that paranoid schizophrenia could be the same disorder as psychotic bipolar disorder. A selected clinical literature finds no symptom, course, or characteristic traditionally considered diagnostic of schizophrenia that cannot be accounted for by psychotic bipolar disorder patients. For example, it is hypothesized here that 2 common mood-based symptoms, grandiosity and guilt, may underlie functional paranoia. Mania explains paranoia when there are grandiose delusions that one's possessions are so valuable that others will kill for them. Similarly, depression explains paranoia when delusional guilt convinces patients that they deserve punishment. In both cases, fear becomes the overwhelming emotion but patient and physician focus on the paranoia rather than on underlying mood symptoms can cause misdiagnoses. This study uses a clinical, case-based, hypothesis generation approach that warrants follow-up with a larger representative sample of psychotic patients followed prospectively to determine the degree to which the clinical course observed herein is typical of all such patients. Differential diagnoses, nomenclature, and treatment implications are

  6. Early psychosis workforce development: Core competencies for mental health professionals working in the early psychosis field.

    Science.gov (United States)

    Osman, Helen; Jorm, Anthony F; Killackey, Eoin; Francey, Shona; Mulcahy, Dianne

    2017-08-09

    The aim of this study was to identify the core competencies required of mental health professionals working in the early psychosis field, which could function as an evidence-based tool to support the early psychosis workforce and in turn assist early psychosis service implementation and strengthen early psychosis model fidelity. The Delphi method was used to establish expert consensus on the core competencies. In the first stage, a systematic literature search was conducted to generate competency items. In the second stage, a panel consisting of expert early psychosis clinicians from around the world was formed. Panel members then rated each of the competency items on how essential they are to the clinical practice of all early psychosis clinicians. In total, 1023 pieces of literature including textbooks, journal articles and grey literature were reviewed. A final 542 competency items were identified for inclusion in the questionnaire. A total of 63 early psychosis experts participated in 3 rating rounds. Of the 542 competency items, 242 were endorsed as the required core competencies. There were 29 competency items that were endorsed by 62 or more experts, and these may be considered the foundational competencies for early psychosis practice. The study generated a set of core competencies that provide a common language for early psychosis clinicians across professional disciplines and country of practice, and potentially are a useful professional resource to support early psychosis workforce development and service reform. © 2017 John Wiley & Sons Australia, Ltd.

  7. Psychosis: call a surgeon? A rare etiology of psychosis requiring resection

    Directory of Open Access Journals (Sweden)

    Kantha Medepalli

    2016-09-01

    Full Text Available Objective: Anti–N-methyl-d-aspartate receptor encephalitis is a rare but emerging cause of autoimmune encephalitis. Our objective is to present a case of this rare disease while highlighting the importance of an aggressive search for underlying malignancy as well as the common mischaracterization of primary psychiatric illness that occurs in these patients. Methods: A young Caucasian female with no known psychiatric history presented with acute onset of seizures and psychosis. Results: Magnetic resonance imaging abdomen and pelvis showed a 6-mm ovarian teratoma which was not visualized on initial computed tomographic scans. Pathology was consistent with a mature teratoma. Both serum and cerebrospinal fluid N-methyl-d-aspartate receptor antibodies were positive. Conclusion: An exhaustive search for underlying malignancy and specifically ovarian teratoma in young women should be completed in these patients. Diagnosis often is delayed given the prominent psychiatric manifestations and providers should be aware and strongly consider this in younger women with acute onset of neuropsychiatric symptoms.

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

    Science.gov (United States)

    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 paranoid schizophrenia.

  9. Variants of cognitive deficiency depending on the clinical characteristics of the disease in patients with paranoid schizophrenia

    OpenAIRE

    G. G. Lebedeva; E. R. Isaeva

    2015-01-01

    Pecific aspects of cognitive impairments in patients with paranoid schizophrenia depending on the clinical characteristics of the disease have been studied. One hundred and thirty patients were examined. A clinico-psychological, experimental psychological and statistical methods were used. Three main types of cognitive deficiency with paranoid schizophrenia, associated with the onset, disease duration, and severity of psychiatric symptomology : 1) long-term course of the disease accompanied b...

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Delirios paranoide-referenciales en la clínica de la depresión.

    Directory of Open Access Journals (Sweden)

    José María Redero San Román

    1994-01-01

    Full Text Available Un apoyo clínico: varios pacientes depresivos tratados en un Centro de Salud mental, presentan a lo largo de su evolución delirios autorreferenciales de matiz persecutorio. Son sujetos que parecen oscilar entre lo paranoide y lo depresivo. Paranoia y melancolía siempre en oposición, tanen la clínica psiquiátrica como en la psicoanalítica, son categorías puestas aquí en relación el apoyo de los textos freudianos y de la enseñanza de Jacques Lacan. El delirio autorreferencial parecería un puente de enlace entre ambos. Se analizan algunas relaciones entre el delirio autorreferencial y la culpabilidad en el depresivo y la oscilación depresivo-paranoide que aparece con una cierta vigencia en la clínica actual, posiblemente inducida por el uso de fármacos.

  12. [Specificity of spatial organization of evoked EEG rhythms in patients with paranoid schizophrenia].

    Science.gov (United States)

    Bochkarev, V K; Kirenskaya, A V; Solnceva, S V; Tkachenko, A A

    The study aimed at analyzing the spatial patterns of evoked event-related oscillations in patients with paranoid schizophrenia and their relationship with clinical symptoms of disease. Evoked delta, theta, alpha, beta, and gamma rhythms in response to target auditory stimulus in an oddball paradigm were studied in 21 schizophrenic patients and 22 healthy subjects. The independent spatial patterns were revealed within each of the frequency range using the principal component analysis. Each spatial pattern was characterized by the specificity of intra- and inter-hemispheric relations. The schizophrenic patients were characterized by a decrease in the evoked activity in the theta range with the most pronounced changes in the frontal-central areas of the right hemisphere and parietal-occipital areas bilaterally. Associations of the evoked rhythms with PANSS positive and negative symptoms were identified. The study demonstrated the high functional significance of evoked EEG rhythms changes for neurophysiological characteristics of patients with paranoid schizophrenia.

  13. [Impairment of attention and executive functions in patients with paranoid schizophrenia].

    Science.gov (United States)

    Tsygankov, B D; Khannanova, A N; Nekrasova, S V

    2013-01-01

    To study changes in attention and executive functions during psychopharmacotherapy in patients with paranoid schizophrenia, we have examined 120 patients with a first episode of paranoid schizophrenia treated with typical and atypical neuroleptics. Clinical and statistical analyses have revealed the heterogeneity within treatment groups that allowed to define two subgroups. These subgroups were characterized by a differed disease course (favorable or poor type). Before remission was achieved, the effect of atypical neuroleptics on cognitive performance was higher compared to typical neuroleptics. After remission, when doses of neuroleptics were decreased, a type of disease course played a main role. At 6 months after remission, attention and executive functions have improved in subgroups with favorable course of disease regardless of treatment.

  14. [Delusion and Gender in Paranoid Schizophrenia: Results of a Clinical Study].

    Science.gov (United States)

    Rössler, V; Richter, R; Walter, M H

    2016-11-01

    Aim: The aim of the present study was to investigate whether men and women differ in the frequency and phenomenology of delusions. Sample: Medical records of all patients who had been admitted to a psychiatric hospital in Germany between 2008 and 2011 for paranoid schizophrenia were analyzed. The sample consisted of 182 delusional inpatients (90 women, 92 men) with the diagnosis of a paranoid schizophrenia. Results: Men and women did not differ in the frequency of delusional themes. Analysis of delusional content, however, revealed considerable differences between them. Women with delusion of reference felt more often as being under constant surveillance compared to men. Men with delusion of reference showed a tendency to involve unspecified persons in their delusions and more often had the feeling of being talked about. Delusion of grandeur in women was more often built upon significant relationships with others.

  15. Methamphetamine psychosis, the efficacy of atypical antipsychotics

    Directory of Open Access Journals (Sweden)

    Amir Rezaei Ardani

    2014-12-01

    Full Text Available Worldwide growing methamphetamine abuse is one of the most serious health problems with several different consequences for victims, especially in developing countries. Chronic methamphetamine abuse is associated with several psychiatric problems in all countries which are faced to epidemic methamphetamine abuse. Methamphetamine-induced psychosis is a major medical challenge for clinical practitioner from both diagnostic and therapeutic viewpoints. Stimulant psychosis commonly occurs in people who abuse stimulants, but it also occurs in some patients taking therapeutic doses of stimulant drugs under medical supervision. The main characteristic of meth psychosis is the presence of prominent hallucinations and delusions. Other drugs, such as cocaine and marijuana, can trigger the onset of psychosis in someone who is already at increased risk because they have “vulnerability”.The current literature review attends to explain several aspects of MIP epidemiologically and clinically. Investigators proposed pharmacologically treatment based on recently published data.

  16. First-episode psychosis: An update

    African Journals Online (AJOL)

    cognitive symptoms, and it is postulated that there are specific .... effects.7 Psychological interventions alone (such as CBT) have also been shown to improve .... The controversy surrounding cannabis and psychosis seems to have been ...

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

    OpenAIRE

    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...

  18. Evidence for Distinguishable Treatment Costs among Paranoid Schizophrenia and Schizoaffective Disorder.

    Directory of Open Access Journals (Sweden)

    Dusan Hirjak

    Full Text Available Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000 individuals suffering from schizophrenia (SZ or schizoaffective disorder (SAD, a combination of psychotic and affective symptoms. Given the heterogeneous nature of these syndromes, one may assume that there is a difference in treatment costs among patients with paranoid SZ and SAD. However, the current the national system of cost accounting in psychiatry and psychosomatics in Germany assesses all schizophrenia spectrum disorders within one category.The study comprised a retrospective audit of data from 118 patients diagnosed with paranoid SZ (F20.0 and 71 patients with SAD (F25. We used the mean total costs as well as partial cost, i.e., mean costs for medication products, mean personal costs and mean infrastructure costs from each patient for the statistical analysis. We tested for differences in the four variables between SZ and SAD patients using ANCOVA and confirmed the results with bootstrapping.SAD patients had a longer duration of stay than patients with SZ (p = .02. Mean total costs were significantly higher for SAD patients (p = .023. Further, we found a significant difference in mean personnel costs (p = .02 between patients with SZ and SAD. However, we found no significant differences in mean pharmaceutical costs (p = .12 but a marginal difference of mean infrastructure costs (p = .05 between SZ and SAD. We found neither a common decrease of costs over time nor a differential decrease in SZ and SAD.We found evidence for a difference of case related costs of inpatient treatments for paranoid SZ and SAD. The differences in mean total costs seem to be primarily related to the mean personnel costs in patients with paranoid SZ and SAD rather than mean pharmaceutical costs, possibly due to higher personnel effort and infrastructure.

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

    OpenAIRE

    2015-01-01

    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 persecuti...

  20. Variants in TERT influencing telomere length are associated with paranoid schizophrenia risk.

    Science.gov (United States)

    Rao, Shuquan; Ye, Ning; Hu, Huiling; Shen, Yan; Xu, Qi

    2016-04-01

    Schizophrenia is one of the most severe psychiatric disorders, with a high heritability of up to 80%. Several studies have reported telomere dysfunction in schizophrenia, and common variants in the telomerase reverse transcriptase (TERT) gene. TERT is a key component of the telomerase complex that maintains telomere length by addition of telomere repeats to telomere ends, and has repeatedly shown association with mean lymphocyte telomere length (LTL). Thus, we hypothesized that TERT may be a novel susceptibility gene for schizophrenia. Using a Taqman protocol, we genotyped eight tag SNPs from the TERT locus in 1,072 patients with paranoid schizophrenia and 1,284 control subjects from a Chinese Han population. We also measured mean LTL in 98 cases and 109 controls using a quantitative PCR-based technique. Chi-square tests showed that two SNPs, rs2075786 (P = 0.0009, OR = 0.76, 95%CI = 0.65-0.90) and rs4975605 (P = 0.0026, OR = 0.73, 95%CI = 0.60-0.90), were associated with a protective effect, while rs10069690 was associated with risk of paranoid schizophrenia (P = 0.0044, OR = 1.23, 95%CI = 1.07-1.42). Additionally, the rs2736118-rs2075786 haplotype showed significant association with paranoid schizophrenia (P = 0.0013). Moreover, mean LTL correlated with rs2075786 genotypes was significantly shorter in the patient group than the control group. The present results suggest that the TERT gene may be a novel candidate involved in the development of paranoid schizophrenia.

  1. Assessment of white matter abnormalities in paranoid schizophrenia and bipolar mania patients.

    Science.gov (United States)

    Cui, Liqian; Chen, Zhuangfei; Deng, Wei; Huang, Xiaoqi; Li, Mingli; Ma, Xiaohong; Huang, Chaohua; Jiang, Lijun; Wang, Yingcheng; Wang, Qiang; Collier, David A; Gong, Qiyong; Li, Tao

    2011-12-30

    White matter abnormalities have been repeatedly reported in both schizophrenia and bipolar disorder (BD) in diffusion tensor imaging (DTI) studies, but the empirical evidence about the diagnostic specificity of white matter abnormalities in these disorders is still limited. This study sought to investigate the alterations in fractional anisotropy (FA) in white matter throughout the entire brain of patients from Chengdu, China with paranoid schizophrenia and bipolar mania. For this purpose, DTI was used to assess white matter integrity in patients with paranoid schizophrenia (n=25) and psychotic bipolar mania (n=18) who had been treated with standard pharmacotherapy for fewer than 5 days at the time of study, as well as in normal controls (n=30). The differences in FA were measured by use of voxel-based analysis. The results show that reduced FA was found in the left posterior corona radiata (PCR) in patients with psychotic bipolar mania and paranoid schizophrenia compared to the controls. Patients with psychotic bipolar mania also showed a significant reduction in FA in right posterior corona radiata and in right anterior thalamic radiation (ATR). A direct comparison between the two patient groups found no significant differences in any regions, and none of the findings were associated with illness duration. Correlation analysis indicated that FA values showed a significant negative correlation with positive symptom scores on the Positive and Negative Syndrome Scale in the left frontal-parietal lobe in the paranoid schizophrenia. It was concluded that common abnormalities in the left PCR might imply an overlap in white matter pathology in the two disorders and might be related to shared risk factors for the two disorders.

  2. Evidence for Distinguishable Treatment Costs among Paranoid Schizophrenia and Schizoaffective Disorder

    OpenAIRE

    Dusan Hirjak; Achim Hochlehnert; Philipp Arthur Thomann; Katharina Maria Kubera; Knut Schnell

    2016-01-01

    Background Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000 individuals suffering from schizophrenia (SZ) or schizoaffective disorder (SAD), a combination of psychotic and affective symptoms. Given the heterogeneous nature of these syndromes, one may assume that there is a difference in treatment costs among patients with paranoid SZ and SAD. However, the current the national system ...

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

    OpenAIRE

    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...

  4. Predictors of recovery in first episode psychosis

    DEFF Research Database (Denmark)

    Austin, Stephen F; 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....

  5. Detection of visual events along the apparent motion trace in patients with paranoid schizophrenia.

    Science.gov (United States)

    Sanders, Lia Lira Olivier; Muckli, Lars; de Millas, Walter; Lautenschlager, Marion; Heinz, Andreas; Kathmann, Norbert; Sterzer, Philipp

    2012-07-30

    Dysfunctional prediction in sensory processing has been suggested as a possible causal mechanism in the development of delusions in patients with schizophrenia. Previous studies in healthy subjects have shown that while the perception of apparent motion can mask visual events along the illusory motion trace, such motion masking is reduced when events are spatio-temporally compatible with the illusion, and, therefore, predictable. Here we tested the hypothesis that this specific detection advantage for predictable target stimuli on the apparent motion trace is reduced in patients with paranoid schizophrenia. Our data show that, although target detection along the illusory motion trace is generally impaired, both patients and healthy control participants detect predictable targets more often than unpredictable targets. Patients had a stronger motion masking effect when compared to controls. However, patients showed the same advantage in the detection of predictable targets as healthy control subjects. Our findings reveal stronger motion masking but intact prediction of visual events along the apparent motion trace in patients with paranoid schizophrenia and suggest that the sensory prediction mechanism underlying apparent motion is not impaired in paranoid schizophrenia.

  6. Association study between BDNF C-281A polymorphism and paranoid schizophrenia in Polish population.

    Science.gov (United States)

    Suchanek, Renata; Owczarek, Aleksander; Kowalski, Jan

    2012-01-01

    Brain-derived neurotrophic factor (BDNF) is one of the candidate genes for schizophrenia. Polymorphism C-281A (rs28383487) in BDNF gene leads to the reduction of promoter activity in the hippocampal neurons in vitro. To our knowledge, this is the first study to examine the influence of alleles and genotypes of BDNF C-281A polymorphism on development, as well as the clinical course (age of onset, suicidal behaviour and psychopathology) of paranoid schizophrenia. The psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) as subscale scores and also single-item scores. We have also performed the haplotype analysis with val66met BDNF polymorphism, which is known to be involved in the pathogenesis of schizophrenia. We have not found significant differences in the distribution of genotypes and alleles between schizophrenic patients and controls in both the overall analysis, as well as sex stratified. Also, we have not shown statistically significant differences between genotype groups and PANSS scale. However, an association between C-281A polymorphism and time of the first episode of paranoid schizophrenia was revealed. Genotype C/A had been connected with later age of onset of paranoid schizophrenia in men but not in women (p schizophrenia group compared to the controls.

  7. Prolactin and estradiol serum levels in unmedicated male paranoid schizophrenia patients.

    Science.gov (United States)

    Segal, Michael; Avital, Avi; Berstein, Severina; Derevenski, Andrei; Sandbank, Sergio; Weizman, Abraham

    2007-03-30

    There is evidence for the involvement of the endocrine system in schizophrenia. This involment was widely investigated in female patients. In the current study, we examined prolactin and estradiol serum levels in hospitalized unmedicated men with first-episode and recurrent schizophrenia and then tested possible correlation with various subtypes of the disease. In addition, the estradiol and prolactin levels were compared with a healthy control group. The serum samples were assessed the morning following admission in fifty-seven schizophrenia male patients. There was a significant difference in prolactin serum levels between the paranoid and "nonparanoid" schizophrenia subgroups. However, no significant differences were found in estradiol serum levels between schizophrenia subtypes or between the patients and their healthy counterparts. Finally, a significant and positive correlation was found between the prolactin and estradiol levels in the paranoid subgroup alone. Thus, it appears that low estradiol levels are associated with low prolactin levels, alleged hyperdopaminergic tone and psychotic breakdown in paranoid schizophrenia. The results of the present study further support our previous report of the association between prolactin serum levels and the schizophrenia cluster subtypes, indicating a different dopaminergic activity for the various forms of the disease.

  8. Gut feelings, deliberative thought, and paranoid ideation: a study of experiential and rational reasoning.

    Science.gov (United States)

    Freeman, Daniel; Evans, Nicole; Lister, Rachel

    2012-05-15

    Rapid intuitive hunches or gut feelings may be a compelling source of evidence for paranoid ideas. Conversely, a failure to apply effortful analytic thinking may contribute to the persistence of such thoughts. Our main aim was to examine for the first time the associations of persecutory thinking with experiential and rational thinking styles. Five hundred individuals recruited from the general population completed self-report assessments of current persecutory ideation, general reasoning styles and personality traits. Persecutory ideation was independently associated with greater use of experiential reasoning and less use of rational reasoning. The correlations were small. Persecutory ideation was also positively associated with neuroticism and negatively correlated with extraversion, agreeableness and conscientiousness. There was no evidence of an interaction between neuroticism and experiential reasoning in the prediction of paranoia, but high experiential reasoning in the context of low rational reasoning was particularly associated with persecutory ideation. Overall, the study provides rare evidence of self-reported general reasoning styles being associated with delusional ideation. Perceived reliance on intuition is associated with paranoid thinking, while perceived reliance on deliberation is associated with fewer such thoughts. The dual process theory of reasoning may provide a framework to contribute to the understanding of paranoid thinking.

  9. Predictors of subjective well-being in patients with paranoid symptoms: is insight necessarily advantageous?

    Science.gov (United States)

    Valiente, Carmen; Provencio, María; Espinosa, Regina; Chaves, Covadonga; Fuentenebro, Filiberto

    2011-09-30

    In schizophrenia, poor insight has been associated with negative outcome. In fact, some studies have found insight to be associated with greater treatment adherence and lower levels of symptomatology, as well as better psychosocial functioning. However, others have found that insight into illness is associated with an increase in depression, low self-esteem, and possibly higher risk of suicide. We investigated the relationship between insight and well-being in a sample of 40 people presenting paranoid symptoms and diagnosed with schizophrenia or other psychotic disorder. Independent-samples t-tests revealed that compared to a paranoid group with high insight, paranoid participants with low insight had more self-acceptance, higher sense of autonomy and personal growth, and greater orientation towards gratification. Moderation analyses showed that when experiential avoidance was high, insight into paranoia had a detrimental effect on self-acceptance. Overall, our results support the need to explore which psychological variables moderate insight in patients with persecutory beliefs. We discuss the implications of these results for the research of paranoia.

  10. Family Intervention in First-Episode Psychosis

    Directory of Open Access Journals (Sweden)

    Anvar Sadath

    2015-11-01

    Full Text Available Family interventions have produced benefits on clinical and family outcomes in long standing psychosis. However, little is known about the efficacy of such interventions in the early stages of psychosis. This article reviews published research over the last two decades on family intervention in first-episode psychosis. Electronic databases, such as PubMed, PsycINFO, and ScienceDirect, have been systematically searched. In addition, an exhaustive Internet search was also carried out using Google and Google Scholar to identify the potential studies that evaluated family interventions in first-episode psychosis. We have identified seven reports of five randomized controlled trials (RCTs and five non-randomized and uncontrolled studies of family intervention. Our review on 12 reports of family intervention studies has shown mixed effects on outcomes in first-episode psychosis. Most of the reports showed no added benefits or very short-term benefits on primary clinical or family outcome variables. There is a dearth of family intervention studies in first-episode psychosis. More RCTs are needed to reach reliable conclusions.

  11. Acute pancreatitis and acute renal failure complicating doxylamine succinate intoxication.

    Science.gov (United States)

    Lee, Yang Deok; Lee, Soo Teik

    2002-06-01

    Doxylamine succinate is an antihistaminic drugwith additional hypnotic, anticholinergic and local anesthetic effects first described in 1948. In Korea and many other countries, it is a common-over-the counter medication frequently involved in overdoses. Clinical symtomatology of doxylamine succinate overdose includes somnolence, coma, seizures, mydriasis, tachycardia, psychosis, and rhabdomyolysis. A serious complication may be rhabdomyolysis with subsequent impairment of renal function and acute renal failure. We report a case of acute renal failure and acute pancreatitis complicating a doxylamine succinate intoxication.

  12. Psychosis

    Science.gov (United States)

    ... NAMI to 741741 Find Help Living with a Mental Health Condition Family Members and Caregivers Teens and Young Adults Veterans & Active Duty Diverse Communities LGBTQ NAMI Programs Discussion Groups NAMI HelpLine Get Involved stigma free Learn how you can help replace stigma ...

  13. Psychosis

    Science.gov (United States)

    ... during withdrawal Brain diseases, such as Parkinson disease , Huntington disease Brain tumors or cysts Dementia (including Alzheimer disease ) ... 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 28. Review Date 2/21/2016 Updated by: Timothy Rogge, ...

  14. Relationship between menarche and psychosis onset in women with first episode of psychosis.

    Science.gov (United States)

    Rubio-Abadal, Elena; Usall, Judith; Barajas, Anna; Carlson, Janina; Iniesta, Raquel; Huerta-Ramos, Elena; Baños, Iris; Dolz, Montserrat; Sánchez, Bernardo; Ochoa, Susana

    2016-10-01

    The aim of this study was to explore the relationship between age at menarche and age at first episode of psychosis, as well as clinical severity and outcome, in a population of women with first-episode psychosis. Clinical and socio-demographical data, age at menarche and at first-episode psychosis, parental history of psychosis and cannabis-use habits were obtained from 42 subjects with a first episode of psychosis. Positive and Negative Syndrome Scale, Clinical Global Impression, Global Assessment Function, Disability Assessment Schedule, Wechsler Adult Intelligence Scale and Wechsler Intelligence Scale for Children, European Quality of Life, and Lewis and Murray Obstetric Complication Scales were administered. Statistical analysis was performed by means of zero-order correlations and Mann-Whitney U and Kruskal-Wallis tests using SPSS version 17.0. We found no significant correlation between age at menarche and age at first-episode psychosis, or with the clinical scores performed. We observed that subjects with earlier age at menarche had more parental history of psychosis. Our negative results do not support the theory of a possible protective role of oestrogen, which seems to be more complex than previously thought. We would suggest that further research is needed to investigate developmental influences of sex steroids on the onset of psychosis and potentially therapeutic benefits based upon oestrogen. © 2014 Wiley Publishing Asia Pty Ltd.

  15. Influence of Family and Childhood Memories in the Development and Manifestation of Paranoid Ideation.

    Science.gov (United States)

    Carvalho, Célia Barreto; da Motta, Carolina; Pinto-Gouveia, José; Peixoto, Ermelindo

    2016-09-01

    Several studies point out to the influence of social experiences on perceptions of the environment and others in cognitive functioning and different aspects of psychopathology. The current study aimed at studying the influence of the psychosocial risk factors in a mixed sample of participants from the general population and affected by paranoid schizophrenia. The extent to which the existence of negative life events and events that are threatening to the inner models of the self (i.e., history of maltreatment, physical, social or psychological abuse) or the memories of these traumatic events occurring during childhood are related to the existence of paranoid beliefs in adulthood was explored. Results suggested that memories of parental behaviours characterized by antipathy from both parental figures, submissiveness and bullying victimization were important predictors of paranoid ideation in adult life. This further emphasizes the need for understanding the family and social dynamics of people presenting paranoid ideations to the development of therapeutic interventions that can effectively reduce the invalidation caused by severe psychopathology, as is the case of schizophrenia. Copyright © 2015 John Wiley & Sons, Ltd. Memories of family dynamics characterized by behaviours of antipathy from both parental figures, submissiveness and bullying victimization are important predictors of paranoid ideation in adult life. The study highlights the importance of exploring subjective recalls of feelings and behaviours associated with early rearing experiences, peer relationships and themes related to social rank theory in the roots of internal models of relationship with the self and others in the general sample, patients diagnosed with schizophrenia and their first-degree relatives. Our findings indicate that schizophrenic patients in active phase differ regarding memories of threat and submission and are more likely to remember childhood experiences perceived as

  16. Reducing the duration of untreated first-episode psychosis

    DEFF Research Database (Denmark)

    Melle, Ingrid; Larsen, Tor K; Haahr, Ulrik

    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....

  17. Study Links Pot Use to Relapse in Psychosis Patients

    Science.gov (United States)

    ... html Study Links Pot Use to Relapse in Psychosis Patients But experts note effect is small, and ... boost the risk that people who struggle with psychosis will relapse. But critics said the effect seems ...

  18. Higher Death Rate Among Youth With First Episode Psychosis

    Science.gov (United States)

    ... Releases News Release Thursday, April 6, 2017 Higher death rate among youth with first episode psychosis NIH- ... experiencing first episode psychosis have a much higher death rate than previously thought. Researchers analyzed data on ...

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

    Science.gov (United States)

    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.

  20. The Epidemiologic Evidence Linking Autoimmune Diseases and Psychosis

    DEFF Research Database (Denmark)

    Benros, Michael E; Eaton, William W; Mortensen, Preben B

    2014-01-01

    This review summarizes the epidemiologic evidence linking autoimmune diseases and psychosis. The associations between autoimmune diseases and psychosis have been studied for more than a half century, but research has intensified within the last decades, since psychosis has been associated with ge...

  1. Use of carbamazepine in psychosis after neuroleptic malignant syndrome.

    Science.gov (United States)

    Peet, M; Collier, J

    1990-04-01

    A case is described of NMS during treatment with sulpiride. The subsequent psychosis resolved during treatment with carbamazepine. It is proposed that this patient may have suffered from a supersensitivity psychosis, and that resolution of her post-NMS psychosis could have been spontaneous.

  2. Current Understanding of Psychosis in Parkinson's Disease.

    Science.gov (United States)

    Ojo, Oluwadamilola O; Fernandez, Hubert H

    2016-10-01

    Psychosis in Parkinson's disease (PD) is one of the greatest determinants of nursing home placement and caregiver stress. Traditionally associated with medications with dopaminergic effect, it has now been linked to other medications and other stressors e.g. systemic illnesses. The development of hallucinations in a PD patient can herald the onset of dementia and usually predicts increased mortality risk. Medication reduction in PD psychosis usually reduces the symptoms; however, this comes at the cost of worsening motor function. If gradually decreasing the patient's medications does not resolve the psychosis, the treatment of choice is an atypical antipychotic. Though only clozapine has level A recommendation for this indication, other atypicals like quetiapine continue to get used for this purpose on account of the logistics involved with clozapine use. Cholinesterase inhibitors are also increasingly being used for PD psychosis on account of the association with dementia. The treatment of PD psychosis is an unmet need in PD management and search for suitable agents constitutes an active area of research in PD.

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

    Science.gov (United States)

    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.

  4. Disease biomarkers in cerebrospinal fluid of patients with first-onset psychosis.

    Directory of Open Access Journals (Sweden)

    Jeffrey T-J Huang

    2006-11-01

    Full Text Available BACKGROUND: Psychosis is a severe mental condition that is characterized by a loss of contact with reality and is typically associated with hallucinations and delusional beliefs. There are numerous psychiatric conditions that present with psychotic symptoms, most importantly schizophrenia, bipolar affective disorder, and some forms of severe depression referred to as psychotic depression. The pathological mechanisms resulting in psychotic symptoms are not understood, nor is it understood whether the various psychotic illnesses are the result of similar biochemical disturbances. The identification of biological markers (so-called biomarkers of psychosis is a fundamental step towards a better understanding of the pathogenesis of psychosis and holds the potential for more objective testing methods. METHODS AND FINDINGS: Surface-enhanced laser desorption ionization mass spectrometry was employed to profile proteins and peptides in a total of 179 cerebrospinal fluid samples (58 schizophrenia patients, 16 patients with depression, five patients with obsessive-compulsive disorder, ten patients with Alzheimer disease, and 90 controls. Our results show a highly significant differential distribution of samples from healthy volunteers away from drug-naïve patients with first-onset paranoid schizophrenia. The key alterations were the up-regulation of a 40-amino acid VGF-derived peptide, the down-regulation of transthyretin at approximately 4 kDa, and a peptide cluster at approximately 6,800-7,300 Da (which is likely to be influenced by the doubly charged ions of the transthyretin protein cluster. These schizophrenia-specific protein/peptide changes were replicated in an independent sample set. Both experiments achieved a specificity of 95% and a sensitivity of 80% or 88% in the initial study and in a subsequent validation study, respectively. CONCLUSIONS: Our results suggest that the application of modern proteomics techniques, particularly mass

  5. A control study of olanzapine vs.haloperidol in the treatment of acute symptoms in patients with amphetamine induced psychosis%奥氮平、氟哌啶醇治疗苯丙胺类兴奋剂所致精神障碍急性期症状的疗效观察

    Institute of Scientific and Technical Information of China (English)

    薛晓斌; 陈建平; 范强; 陈旭

    2016-01-01

    目的:比较分析奥氮平、氟哌啶醇对苯丙胺类兴奋剂所致精神障碍急性期精神病性症状的治疗效果。方法124例急性期苯丙胺所致精神障碍患者分为奥氮平组(奥氮平治疗,63例)和氟哌啶醇组(氟哌啶醇治疗,61例),治疗4周,于治疗前及治疗后第1、2、4周末采用简明精神病评定量表(BPRS)、临床总体印象-严重程度量表(CGI-SI)评价疗效,并记录治疗中的不良反应。结果奥氮平组见效时间早于氟哌啶醇组(P <0.05),两组有效率比较差异无统计学意义(P >0.05)。治疗后第1、2、4周末奥氮平组 BPRS 总分及各因子分均较治疗前下降(P <0.05);氟哌啶醇组治疗后第1周末激活性因子分较治疗前下降(P <0.05),治疗后第2周末除缺乏活力因子分外 BPRS 总分及各因子分均较治疗前下降(P <0.05),治疗后第4周末总分及各因子分均较治疗前下降(P <0.05)。组间比较发现,奥氮平组治疗后第1、2周末 BPRS 总分及焦虑抑郁、缺乏活力因子分均低于氟哌啶醇组(P <0.05);治疗后第4周末焦虑抑郁、缺乏活力及思维障碍因子分均低于氟哌啶醇组(P <0.05)。奥氮平组总不良反应发生率低于氟哌啶醇组(P <0.01)。结论奥氮平、氟哌啶醇治疗苯丙胺类兴奋剂所致精神障碍急性期症状疗效相当,但奥氮平起效相对快,且不良反应少。%Objective To compare the efficacy of olanzapine and haloperidol for treating acute symptoms in patients with amphetamine induced psychosis.Methods 124 patients with acute symptoms of amphetamine induced psychosis were divided into olanzapine group treated with olanzapine (n =63)and haloperidol group treated with haloperidol (n =61)for 4 weeks.All patients were assessed with Brief Psychiatric Rating Scale (BPRS)and Clinical Global Impressions Scale-Severity Item (CGI-SI),and the

  6. WELLFOCUS PPT: Modifying positive psychotherapy for psychosis.

    Science.gov (United States)

    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. (c) 2016 APA, all rights reserved).

  7. Attenuated psychosis syndrome: benefits of explicit recognition

    Science.gov (United States)

    SCHIFFMAN, Jason; CARPENTER, William T

    2015-01-01

    Summary Given the unique characteristics of people who meet criteria for attenuated psychosis syndrome (APS) and the growing literature on the clinical benefits of providing services to individuals who meet these criteria, the APS diagnosis serves an important, and previously missing, role in psychiatry. The promotion of the APS diagnosis should help reduce the over-diagnosis and over-treatment of individuals with prodromal psychotic conditions and it should also encourage expanded training about attenuated psychosis among clinicians who primarily provide services to youth (a primary group who are diagnosed with APS). Only some of the individuals with APS subsequently develop psychosis, but all have existing clinical needs – regardless of subsequent conversion. The formal recognition of APS in DSM-5 will facilitate the research needed to identify and meet those needs. PMID:25852257

  8. Heat shock protein 70 gene polymorphisms are associated with paranoid schizophrenia in the Polish population.

    Science.gov (United States)

    Kowalczyk, Malgorzata; Owczarek, Aleksander; Suchanek, Renata; Paul-Samojedny, Monika; Fila-Danilow, Anna; Borkowska, Paulina; Kucia, Krzysztof; Kowalski, Jan

    2014-03-01

    HSP70 genes have been considered as promising schizophrenia candidate genes based on their protective role in the central nervous system under stress conditions. In this study, we analyzed the potential implication of HSPA1A +190G/C, HSPA1B +1267A/G, and HSPA1L +2437T/C polymorphisms in the susceptibility to paranoid schizophrenia in a homogenous Caucasian Polish population. In addition, we investigated the association of the polymorphisms with the clinical variables of the disease. Two hundred and three patients with paranoid schizophrenia and 243 healthy controls were enrolled in the study. Polymorphisms of HSPA1A, -1B, and -1L genes were genotyped using the PCR-RFLP technique. Analyses were conducted in entire groups and in subgroups that were stratified according to gender. There were significant differences in the genotype and allele frequencies of HSPA1A polymorphism between the patients and controls. The +190CC genotype and +190C allele were over-represented in the patients and significantly increased the risk for developing schizophrenia (OR = 3.45 and OR = 1.61, respectively). Interestingly, such a risk was higher for females with the +190CC genotype than for males with the +190CC genotype (OR = 5.78 vs. OR = 2.76). We also identified the CGT haplotype as a risk haplotype for schizophrenia and demonstrated the effects of HSPA1A and HSPA1B genotypes on the psychopathology and age of onset. Our study provided the first evidence that the HSPA1A polymorphism may potentially increase the risk of developing paranoid schizophrenia. Further independent analyses in different populations to evaluate the role of gender are needed to replicate these results.

  9. Morphological and functional abnormalities of salience network in the early-stage of paranoid schizophrenia.

    Science.gov (United States)

    Pu, Weidan; Li, Li; Zhang, Huiran; Ouyang, Xuan; Liu, Haihong; Zhao, Jingping; Li, Lingjiang; Xue, Zhimin; Xu, Ke; Tang, Haibo; Shan, Baoci; Liu, Zhening; Wang, Fei

    2012-10-01

    A salience network (SN), mainly composed of the anterior insula (AI) and anterior cingulate cortex (ACC), has been suggested to play an important role in salience attribution which has been proposed as central to the pathology of paranoid schizophrenia. The role of this SN in the pathophysiology of paranoid schizophrenia, however, still remains unclear. In the present study, voxel-based morphometry and resting-state functional connectivity analyses were combined to identify morphological and functional abnormalities in the proposed SN in the early-stage of paranoid schizophrenia (ESPS). Voxel-based morphometry and resting-state functional connectivity analyses were applied to 90 ESPS patients and 90 age- and sex-matched healthy controls (HC). Correlation analyses were performed to examine the relationships between various clinical variables and both gray matter morphology and functional connectivity within the SN in ESPS. Compared to the HC group, the ESPS group showed significantly reduced gray matter volume (GMV) in both bilateral AI and ACC. Moreover, significantly reduced functional connectivity within the SN sub-networks was identified in the ESPS group. These convergent morphological and functional deficits in SN were significantly associated with hallucinations. Additionally, illness duration correlated with reduced GMV in the left AI in ESPS. In conclusion, these findings provide convergent evidence for the morphological and functional abnormalities of the SN in ESPS. Moreover, the association of illness duration with the reduced GMV in the left AI suggests that the SN and the AI, in particular, may manifest progressive morphological changes that are especially important in the emergence of ESPS.

  10. IFNGR2 genetic polymorphism associated with sex-specific paranoid schizophrenia risk.

    Science.gov (United States)

    Jemli, Achraf; Inoubli, Oumaima; Trifa, Fatma; Mechri, Anouar; Zaafrane, Ferid; Gaha, Lotfi; Jrad, Besma Bel Hadj

    2017-01-01

    Considering current scientific evidence about the significant role of chronic low grade inflammation in the physiopathology of schizophrenia, it has been hypothesized that changes in pro-inflammatory cytokines such as interferon gamma may have a significant role in the predisposition to schizophrenia. This study focuses on identifying whether the functional polymorphism of interferon gamma receptor 2 (IFNGR2) is a risk factor for the development of schizophrenia. This study was conducted by the RFLP-PCR on a Tunisian population composed of 225 patients with different sub-types of schizophrenia and 166 controls. The IFNGR2 (Q64R) polymorphism analysis showed higher frequencies of minor homozygous genotype (RR) and allele (R) in all patients compared to controls (21.8% vs 10.2%; p = .006, OR = 2.54) and (44% vs 34.9%; p = .01; OR = 1.46), respectively. This correlation was confirmed only for males. This study also noted a significant increase of the mutated homozygous (RR) genotype and (R) allele frequencies of IFNGR2 in paranoid schizophrenics compared to controls (31.4% vs 10.2%; p = .001; OR = 3.34 and 47.2% vs 34.9%; p = .009; OR = 1.66, respectively). This increase remains significant after using binary logistic regression to eliminate confounding factors such as age and sex. Additionally, carriers of RR genotype have significant lower scores on the Scale of Assessment of Positive (SAPS) and negative (SANS) symptoms comparatively to the carrier of the QQ + QR genotypes, suggesting that the R recessive allele carriers could have milder symptoms. The IFNGR2Q64R polymorphism is correlated with male sex and paranoid schizophrenia. It is suggested that a chronic neuroinflammation may predispose to the paranoid schizophrenia development in men.

  11. Social, familial and psychological risk factors for psychosis

    DEFF Research Database (Denmark)

    Shevlin, Mark; McElroy, Eoin; Christoffersen, Mogens Nygaard

    2016-01-01

    A broad range of biological, genetic, environmental, and psychological riskfactors for psychosis have been reported. However most research studies have tended to focus on one explanatory factor. The aim of this study wasto use data from a large Danish birth cohort to examine the associationsbetween...... psychosis and a broad range of familial (advanced paternal age, family dissolution, parental psychosis), environmental (urbanicity,deprivation) and psychological factors (childhood adversity). Findings indicated that all types of risk factors were significantly associated with psychosis. In conclusion......, large scale cohort studies using the Danish registry system is a powerful way of assessing the relative impact ofdifferent risk factors for psychosis....

  12. Heat shock protein 70 gene polymorphisms are associated with paranoid schizophrenia in the Polish population

    OpenAIRE

    2013-01-01

    HSP70 genes have been considered as promising schizophrenia candidate genes based on their protective role in the central nervous system under stress conditions. In this study, we analyzed the potential implication of HSPA1A +190G/C, HSPA1B +1267A/G, and HSPA1L +2437T/C polymorphisms in the susceptibility to paranoid schizophrenia in a homogenous Caucasian Polish population. In addition, we investigated the association of the polymorphisms with the clinical variables of the disease. Two hundr...

  13. Gender stereotypes for paranoid, antisocial, compulsive, dependent, and histrionic personality disorders.

    Science.gov (United States)

    Rienzi, B M; Scrams, D J

    1991-12-01

    To assess similarity between gender-role stereotypes and the personality disorder prototypes, university students (31 women and 13 men) were asked to assign gender to six descriptions of DSM-III--R personality disorders. Significant agreement was found in gender assignment for five of the six descriptions. Descriptions of the paranoid, antisocial, and compulsive personality disorders were viewed as male, and descriptions of the dependent and histrionic personality disorders were viewed as female. The description of schizoid personality disorder was not significantly gender-typed.

  14. Treatment outlines for paranoid, schizotypal and schizoid personality disorders. The Quality Assurance Project.

    Science.gov (United States)

    1990-09-01

    Treatment outlines for paranoid, schizotypal and schizoid personality disorders were developed by having nominated experts consider their own views in the light of the treatment literature and the responses of practising psychiatrists. In the detailed recommendations it is clear that while patients with all three disorders often present for treatment in a crisis and often see no issue other than the resolution of the crisis, patients with schizoid personality disorder can use long-term psychotherapy to develop and change to the extent of no longer being handicapped.

  15. History of religious delusions and psychosocial functioning among Mexican patients with paranoid schizophrenia.

    Science.gov (United States)

    Robles-García, Rebeca; López-Luna, Sonia; Páez, Francisco; Escamilla, Raúl; Camarena, Beatriz; Fresán, Ana

    2014-12-01

    The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.

  16. An investigation of the "jumping to conclusions" data-gathering bias and paranoid thoughts in Asperger syndrome.

    Science.gov (United States)

    Jänsch, Claire; Hare, Dougal Julian

    2014-01-01

    The existence of a data-gathering bias, in the form of jumping to conclusions, and links to paranoid ideation was investigated in Asperger syndrome (AS). People with AS (N = 30) were compared to a neurotypical control group (N = 30) on the Reading the Mind in the Eyes and the Beads tasks, with self-report measures of depression, general anxiety, social anxiety, self-consciousness and paranoid ideation. The AS group performed less well than the control group on the Reading the Mind in the Eyes Task with regard to accuracy but responded more quickly and tended to make decisions on the basis of less evidence on the Beads Task with 50 % demonstrating a clear 'jumping to conclusions bias', whereas none of the control group showed such a bias. Depression and general anxiety were associated with paranoid ideation but not data-gathering style, which was contrary to expectation.

  17. [Managing aggression and violence associated with psychosis].

    Science.gov (United States)

    Hallikainen, Tero; Repo-Tiihonen, Eila

    2015-01-01

    Risk for violence in psychosis is associated with the subject's history of early-onset antisocial behavior, substance abuse, suicidal ideation, lack of insight, and non-adherence to antipsychotic medication. These risk factors can be managed by effective treatment for psychosis, with the exception of predatory antisocial aggression. Generally, this group of patients is at considerable risk for untreated conditions. There is, however, no pharmacological treatment indicated solely for aggression. Physical violence can often be avoided by alertness and risk monitoring, and by attentive customer service skills. Safety at work is our shared responsibility.

  18. Association of the Met-196-Arg variation of human tumor necrosis factor receptor 2 (TNFR2) with paranoid schizophrenia.

    Science.gov (United States)

    Thabet, Sihem; Ben Nejma, Mouna; Zaafrane, Ferid; Gaha, Lotfi; Ben Salem, Kamel; Romdhane, Abdelaziz; Nour, Mohamed; Jrad, Besma Bel Hadj

    2011-03-01

    Research has provided strong evidence for oligodendrocyte and myelin-related genes dysfunction in schizophrenia. Several studies have suggested abnormalities in the expression of myelin-related genes including tumor necrosis factor receptor 2 (TNFR2) involved in the neurodegeneration and remyelination. In order to further assess the role of TNFR2 in schizophrenia, we examined a functional bi-allelic polymorphism associated with an impaired NF-KB signaling and cell survival. In the present case/control study, 220 patients with schizophrenia and 176 healthy controls were genotyped by RFLP-PCR for the T/G polymorphism at the position 676 in exon 6 of the TNFR2 gene. We found a trend towards over-representation of TNFR2 676G in the patients compared to the controls (p=0.19 and 0.09 respectively). Interestingly, when we evaluated the association between this genetic polymorphism and the clinical variables of schizophrenia, our findings indicated that the frequencies of the G/G genotype and the G allele were significantly higher in paranoid (p=0.014 and p=0.012 respectively) and adult-onset paranoid (p=0.004 and p=0.004 respectively) schizophrenia patient group compared to the controls. The potential association was confirmed by a logistic regression model only for development of the paranoid form of schizophrenia (p=0.022) indicating a substantially increased risk for paranoid schizophrenia with inheritance of the TNFR2(G) allele. In conclusion, this polymorphism in TNFR2 or a gene in proximity seems to be associated specifically with paranoid schizophrenia, at least in the Tunisian population. A replication of our findings in other and larger populations could be of particular importance to establish TNFR2 as one of the susceptibility genes of paranoid schizophrenia.

  19. PROP1 gene mutations in a 36-year-old female presenting with psychosis

    Directory of Open Access Journals (Sweden)

    Durgesh Prasad Chaudhary

    2017-03-01

    Full Text Available Combined pituitary hormonal deficiency (CPHD is a rare disease that results from mutations in genes coding for transcription factors that regulate the differentiation of pituitary cells. PROP1 gene mutations are one of the etiological diagnoses of congenital panhypopituitarism, however symptoms vary depending on phenotypic expression. We present a case of psychosis in a 36-year-old female with congenital panhypopituitarism who presented with paranoia, flat affect and ideas of reference without a delirious mental state, which resolved with hormone replacement and antipsychotics. Further evaluation revealed that she had a homozygous mutation of PROP1 gene. In summary, compliance with hormonal therapy for patients with hypopituitarism appears to be effective for the prevention and treatment of acute psychosis symptoms.

  20. Steroid-Induced Psychosis after EUS-Guided Celiac Plexus Blockade

    Science.gov (United States)

    Lewis, Jason J.

    2017-01-01

    A 46-year-old female with no previous personal or family psychiatric history underwent endoscopic ultrasound (EUS)-guided celiac plexus blockade (CPB) to treat pain related to cystic fibrosis transmembrane conductance regulator-associated chronic pancreatitis. She had excellent response to her first three CPBs using bupivacaine and triamcinolone. The patient’s subsequent CPBs were complicated by symptoms of racing thoughts, delusional thinking, and insomnia. She was diagnosed with acute psychosis secondary to triamcinolone. This is the first reported case of steroid-induced psychosis caused by EUS-guided CPB. Optimal treatment for steroid-induced psychiatric symptoms include dose reduction or discontinuation of steroids and administration of lithium, valproic acid, or atypical antipsychotics. PMID:28144616

  1. Flexible assertive community treatment (FACT) model in specialist psychosis teams: an evaluation.

    Science.gov (United States)

    Sood, Loopinder; Owen, Andy; Onyon, Richard; Sharma, Aarohi; Nigriello, Jessica; Markham, Dominic; Seabrook, Hannah

    2017-08-01

    Aims and method The impact of flexible assertive community treatment (FACT) has been observed in people previously supported by assertive community treatment (ACT) teams, but its effect on those previously with a community mental health team (CMHT) has not been studied in the UK. An observational study was conducted of 380 people from 3 CMHTs and 95 people from an ACT team, all with a history of psychosis, following service reconfiguration to 3 FACT teams. Results People previously with a CMHT required less time in hospital when the FACT model was introduced. A smaller reduction was observed in people coming from the ACT team. Both groups required less crisis resolution home treatment (CRHT) team input. Clinical implications FACT may be a better model than standard CMHT care for people with a history of psychosis, as a result of reduced need for acute (CRHT and in-patient) services.

  2. Disorders of working memory and selected cognitive processes inpatients treated for paranoid schizophrenia

    Directory of Open Access Journals (Sweden)

    Damian Giętkowski

    2012-03-01

    Full Text Available Already since the times of Baddeley and Hitch the dorsolateral part of the frontal lobe was regarded as the function‑ al centre of the working memory. Working memory disorders are, on the other hand, one of the basic and consoli‑ dated disorders in the course of paranoid schizophrenia. The concept of neurodevelopmental schizophrenia com‑ bines these elements and associates the illness with the changes occurring in the brain in the prenatal period. The efficiency of the working memory system, which acts as a buffer manipulating with the possessed and inflowing information, influences the quality of other cognitive processes, such as long‑term memory, short‑term memory, con‑ centration and thinking. A study was performed on two groups: one experimental consisting of 31 people suffering from paranoid schizophrenia and one control group of 31 healthy people. In both groups a replica of Wisconsin Card Sorting Task was used in order to measure the efficiency of the working memory and selected tests from WAIS‑R (PL: the Polish adaptation of Wechsler Adult Intelligence Scale to assess the functioning of concentration, memory and thinking. The results of the study showed that in the experimental group the efficiency of the working memory is very low and that the illness affects the performance of concentration, memory and thinking. Moreover the tests proved that the working memory disorder increases with time.

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

    Science.gov (United States)

    Scherzer, Peter; Leveillé, Edith; Achim, André; Boisseau, Emilie; Stip, Emmanuel

    2012-01-01

    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, one must ask if 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 ToM. 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 that incorrect attributions of mental states including the attribution of threatening intentions to others, non-interpretative responses and incomplete answers, depending on the test of ToM.

  4. [Role of psychoeducation in therapy of women with paranoid schizophrenia on the background of abdominal obesity].

    Science.gov (United States)

    Sinayko, V; Korovina, L

    2013-03-01

    Sufficient information of patients and their relatives about essence of disease, principles of medicamental therapy, is one of major factors influencing on adherence of patients to therapy. Application of psychoeducation programs allows to activate a patient in partnership with a doctor, that assists the increase of compliance. Research aim - to improve quality of remission and readaptation of patients with paranoid schizophrenia by realization of the psychoeducation programs. 45 women in age of 18-60 being on treatment in the Kharkiv regional clinical psychiatric hospital №3, with a diagnosis paranoid schizophrenia were examined. Psychoeducation lessons were conducted in closed groups for 7-8 persons, 2 times per a week, by duration every lesson for 45 minutes. The psychoeducation module consisted of informative block and forming of practical skills. Realization of psychoeducation lesson in this contingent showed the efficiency. Communicative activity became better for all patients as well as their adherence to therapy, that gave possibility promptly expose and warn development of side effects, improve quality and level of social adaptation of patients life.

  5. Relationship between genetic polymorphisms in the DRD5 gene and paranoid schizophrenia in northern Han Chinese.

    Science.gov (United States)

    Zhao, Y; Ding, M; Pang, H; Xu, X M; Wang, B J

    2014-03-12

    Dopamine (DA) has been implicated in the pathophysiol-ogy of several psychiatric disorders, including schizophrenia. Thus, genes related to the dopaminergic (DAergic) system are good candidate genes for schizophrenia. One of receptors of the DA receptor system is dopa-mine receptor 5 (DRD5). Single nucleotide polymorphisms (SNPs) in the regulatory regions of DRD5 gene may affect gene expression, influence biosynthesis of DA and underlie various neuropsychiatric disorders re-lated to DA dysfunction. The present study explored the association of SNPs within the DRD5 gene with paranoid schizophrenia in Han Chinese. A total of 176 patients with schizophrenia and 206 healthy controls were genotyped for four DRD5 SNPs (rs77434921, rs2076907, rs6283, and rs1800762). Significant group differences were observed in the allele and genotype frequencies of rs77434921 and rs1800762 and in the frequen-cies of GC haplotypes corresponding to rs77434921-rs1800762. Our find-ings suggest that common genetic variations of DRD5 are likely to con-tribute to genetic susceptibility to paranoid schizophrenia in Han Chinese. Further studies in larger samples are needed to replicate this association.

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

    Science.gov (United States)

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

    2014-09-25

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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

    Directory of Open Access Journals (Sweden)

    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

  9. Myelin, myelin-related disorders, and psychosis.

    Science.gov (United States)

    Mighdoll, Michelle I; Tao, Ran; Kleinman, Joel E; Hyde, Thomas M

    2015-01-01

    The neuropathological basis of schizophrenia and related psychoses remains elusive despite intensive scientific investigation. Symptoms of psychosis have been reported in a number of conditions where normal myelin development is interrupted. The nature, location, and timing of white matter pathology seem to be key factors in the development of psychosis, especially during the critical adolescent period of association area myelination. Numerous lines of evidence implicate myelin and oligodendrocyte function as critical processes that could affect neuronal connectivity, which has been implicated as a central abnormality in schizophrenia. Phenocopies of schizophrenia with a known pathological basis involving demyelination or dysmyelination may offer insights into the biology of schizophrenia itself. This article reviews the pathological changes in white matter of patients with schizophrenia, as well as demyelinating diseases associated with psychosis. In an attempt to understand the potential role of dysmyelination in schizophrenia, we outline the evidence from a number of both clinically-based and post-mortem studies that provide evidence that OMR genes are genetically associated with increased risk for schizophrenia. To further understand the implication of white matter dysfunction and dysmyelination in schizophrenia, we examine diffusion tensor imaging (DTI), which has shown volumetric and microstructural white matter differences in patients with schizophrenia. While classical clinical-neuropathological correlations have established that disruption in myelination can produce a high fidelity phenocopy of psychosis similar to schizophrenia, the role of dysmyelination in schizophrenia remains controversial.

  10. EMDR therapy for traumatized patients with psychosis

    NARCIS (Netherlands)

    B. van der Vleugel; D. van der Berg; P. de Bont; T. Staring; A. de Jongh

    2015-01-01

    EMDR is a valuable intervention in the treatment of various mental disorders, especially if symptoms are associated with negative life experiences. In this chapter, the authors describe possible interactions between trauma and psychosis and offer several methods for conceptualizing a case to facilit

  11. A Transdiagnostic Network Approach to Psychosis

    NARCIS (Netherlands)

    Wigman, Johanna T W; de Vos, Stijn; Wichers, Marieke; van Os, Jim; Bartels-Velthuis, Agna A

    2016-01-01

    Our ability to accurately predict development and outcome of early expression of psychosis is limited. To elucidate the mechanisms underlying psychopathology, a broader, transdiagnostic approach that acknowledges the complexity of mental illness is required. The upcoming network paradigm may be frui

  12. Depressive symptoms in first-episode psychosis

    DEFF Research Database (Denmark)

    Sönmez, Nasrettin; Røssberg, Jan Ivar; Evensen, Julie

    2016-01-01

    AIMS: The present study examined if any patient characteristics at baseline predicted depressive symptoms at 10 years and whether patients prone to depressive symptoms in the first year of treatment had a different prognosis in the following years. METHOD: A total of 299 first-episode psychosis...

  13. 38 CFR 3.384 - Psychosis.

    Science.gov (United States)

    2010-07-01

    ....384 Psychosis. For purposes of this part, the term “psychosis” means any of the following disorders listed in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, of the American Psychiatric Association (DSM-IV-TR): (a) Brief Psychotic Disorder; (b) Delusional Disorder; (c...

  14. Untangling pathways between childhood trauma and psychosis

    NARCIS (Netherlands)

    van Dam, D.S.

    2017-01-01

    The studies presented in this thesis aim to enhance our knowledge with regard to specific associations between types of trauma and the course of symptomatology and psychosocial functioning and to examine possible underlying mechanisms, by which childhood trauma influences the development of psychosi

  15. Mental health nursing and first episode psychosis

    NARCIS (Netherlands)

    Dusseldorp, L. van; Goossens, P.J.J.; Achterberg, T. van

    2011-01-01

    The purpose of this literature review is to identify mental health nursing's contribution to the care and treatment of patients with a first episode of psychosis; A systematic literature review was undertaken, with 27 articles selected for study. Five domains were identified: development of

  16. Sensorimotor Analysis of Early Onset Childhood Psychosis.

    Science.gov (United States)

    Ertel, David; Voyat, Gilbert

    1982-01-01

    Jean Piaget's theories about children's cognitive development are applied to the evaluation of childhood psychosis. Problems with the testing of such children are described, and results of a research project that used the Piaget-inspired Uzgiris and Hunt Ordinal Scales of Psychological Development to assess autistic children's cognitive processes…

  17. NON-BEHAVIORAL MODELS OF PSYCHOSIS

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  19. Time-lagged moment-to-moment interplay between negative affect and paranoia: new insights in the affective pathway to psychosis.

    Science.gov (United States)

    Kramer, Ingrid; Simons, Claudia J P; Wigman, Johanna T W; Collip, Dina; Jacobs, Nele; Derom, Catherine; Thiery, Evert; van Os, Jim; Myin-Germeys, Inez; Wichers, Marieke

    2014-03-01

    Evidence suggests that affect plays a role in the development of psychosis but the underlying mechanism requires further investigation. This study examines the moment-to-moment dynamics between negative affect (NA) and paranoia prospectively in daily life. A female general population sample (n = 515) participated in an experience sampling study. Time-lagged analyses between increases in momentary NA and subsequent momentary paranoia were examined. The impact of childhood adversity, stress sensitivity (impact of momentary stress on momentary NA), and depressive symptoms on these time-lagged associations, as well as associations with follow-up self-reported psychotic symptoms (Community Assessment of Psychic Experiences and the Symptom Checklist-90-Revised) were investigated. Moments of NA increase resulted in a significant increase in paranoia over 180 subsequent minutes. Both stress sensitivity and depressive symptoms impacted on the transfer of NA to paranoia. Stress sensitivity moderated the level of increase in paranoia during the initial NA increase, while depressive symptoms increased persistence of paranoid feelings from moment to moment. Momentary paranoia responses to NA increases were associated with follow-up psychotic symptoms. Examination of microlevel momentary experience may thus yield new insights into the mechanism underlying co-occurrence of altered mood states and psychosis. Knowledge of the underlying mechanism is required in order to determine source and place where remediation should occur.

  20. Time-Lagged Moment-to-Moment Interplay Between Negative Affect and Paranoia: New Insights in the Affective Pathway to Psychosis

    Science.gov (United States)

    Kramer, Ingrid

    2014-01-01

    Evidence suggests that affect plays a role in the development of psychosis but the underlying mechanism requires further investigation. This study examines the moment-to-moment dynamics between negative affect (NA) and paranoia prospectively in daily life. A female general population sample (n = 515) participated in an experience sampling study. Time-lagged analyses between increases in momentary NA and subsequent momentary paranoia were examined. The impact of childhood adversity, stress sensitivity (impact of momentary stress on momentary NA), and depressive symptoms on these time-lagged associations, as well as associations with follow-up self-reported psychotic symptoms (Community Assessment of Psychic Experiences and the Symptom Checklist-90-Revised) were investigated. Moments of NA increase resulted in a significant increase in paranoia over 180 subsequent minutes. Both stress sensitivity and depressive symptoms impacted on the transfer of NA to paranoia. Stress sensitivity moderated the level of increase in paranoia during the initial NA increase, while depressive symptoms increased persistence of paranoid feelings from moment to moment. Momentary paranoia responses to NA increases were associated with follow-up psychotic symptoms. Examination of microlevel momentary experience may thus yield new insights into the mechanism underlying co-occurrence of altered mood states and psychosis. Knowledge of the underlying mechanism is required in order to determine source and place where remediation should occur. PMID:23407984

  1. Paranoid, moi?

    DEFF Research Database (Denmark)

    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...

  2. Paranoid, moi?

    DEFF Research Database (Denmark)

    Pedersen, Peter Ole; Stephensen, Jan Løhmann

    2013-01-01

    are clearly embedded in the tradition of Michael Moore’s subjective, populist filmmaking. Pedersen and Stephenson’s critical analysis of Bond’s documentary follows issues of both the form and the problematic way in which surveillance was represented and conceptualized by the filmmaker. In order to articulate...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  5. Study of a possible role of the monoamine oxidase A (MAOA) gene in paranoid schizophrenia among a Chinese population.

    Science.gov (United States)

    Sun, Yuhui; Zhang, Jiexu; Yuan, Yanbo; Yu, Xin; Shen, Yan; Xu, Qi

    2012-01-01

    Monoamine oxidase A (MAOA) is the enzyme responsible for degradation of several monoamines, such as dopamine and serotonin that are considered as being two of the most important neurotransmitters involved in the pathophysiology of schizophrenia. To study a possible role of the MAOA gene in conferring susceptibility to schizophrenia, the present study genotyped the variable number of tandem repeat (VNTR) polymorphism and 41 SNPs across this gene among 555 unrelated patients with paranoid schizophrenia and 567 unrelated healthy controls. Quantitative real-time PCR analysis was employed to quantify expression of MAOA mRNA in 73 drug-free patients. While none of these genotyped DNA markers showed allelic association with paranoid schizophrenia, haplotypic association was found for the VNTR-rs6323, VNTR-rs1137070, and VNTR-rs6323-rs1137070 haplotypes in female subjects. Nevertheless, no significant change of the expression of MAOA mRNA was detected in either female or male patients with paranoid schizophrenia. Our study suggests that the interaction between genetic variants within the MAOA gene may contribute to an increased risk of paranoid schizophrenia, but the precise mechanism needs further investigation.

  6. Association study of interferon gamma (IFN-γ) +874T/A gene polymorphism in patients with paranoid schizophrenia.

    Science.gov (United States)

    Paul-Samojedny, Monika; Owczarek, Aleksander; Suchanek, Renata; Kowalczyk, Malgorzata; Fila-Danilow, Anna; Borkowska, Paulina; Kucia, Krzysztof; Kowalski, Jan

    2011-03-01

    Schizophrenia is a multifactorial disease with changes affecting the immune system. Dysregulation of the cytokine network in schizophrenia has been well documented. Such changes may occur due to disturbances in cytokine levels that are linked to polymorphisms of cytokine genes. However, research in the role of cytokine gene polymorphisms in schizophrenia has been surprisingly scanty. The aim of this study was to identify, in a case control study, whether polymorphism of IFN-γ gene is a risk factor for the development of paranoid schizophrenia. To the best of our knowledge, this is the first study that examines the association between the IFN-γ gene polymorphism and psychopathological symptoms in patients with paranoid schizophrenia. Polymorphism of IFN-γ (+874T/A, rs 62559044) in schizophrenic patients (n=179), as well as healthy individuals (n=196), both Polish residents, was genotyped using AS-PCR method. Of note, when analyzing the results, we took into consideration the gender of studied individuals. Surprisingly, a single-nucleotide polymorphism in the first intron of the IFN-γ gene was found to be associated with paranoid schizophrenia in males, but not in females. The presence of allele A at position +874 in the IFN-γ gene correlates with 1.66-fold higher risk of paranoid schizophrenia development in males. Differences in the genotypes may have an important role in determining the level of I gene transcription. Because other polymorphisms have been demonstrated to influence IFN-γ transcription, further analysis is necessary to clarify the role of this gene in the pathogenesis of paranoid schizophrenia.

  7. Attachment, Neurobiology, and Mentalizing along the Psychosis Continuum.

    OpenAIRE

    Martin Debbané; George Salaminios; Patrick Luyten; Deborah Badoud; Marco Armando; Alessandra Solida Tozzi; Peter Fonagy; Benjamin Brent

    2016-01-01

    In this review article, we outline the evidence linking attachment adversity to the psychosis, from the premorbid stages of the disorder to its clinical forms. To better understand the neurobiological mechanisms through which insecure attachment may contribute to psychosis, we identify at least five neurobiological pathways linking attachment to risk for developing psychosis. Besides its well documented influence on the hypothalamic-pituary-adrenal (HPA) axis, insecure attachment may also con...

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

    OpenAIRE

    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...

  9. Comparative analysis of psychological adaptation in patients with paranoid schizophrenia and shizotypal disorder

    Directory of Open Access Journals (Sweden)

    A. V. Stepanova

    2015-01-01

    Full Text Available The purpose of this research was the comparing of psychological adaptation characteristics (type of attitude to a disease, psychological defense mechanisms, special aspects of coping-strategy as exemplified by 2 groups of schizophrenia disorder patients: 1 schizotypal disorders (F-21 according to ICD-10; 2 paranoid schizophrenia (F-20 according to ICD-10. The authors arrived at the conclusion of the same nature if special aspects of psychological adaptation in the groups compared. At the same time, both groups compared showed imbalance of «the level of success» between individual characteristics constituting the module of psychological adaptation. This circumstance testifies to the fact that psychological adaptation in the patients with schizophrenic disorders should be evaluated on a case- bycase basis. In conclusion, the study revealed the necessity to take into consideration of these characteristics during rehabilitation of these patients.

  10. Sensitization, epileptic-like symptoms and local synchronization in patients with paranoid schizophrenia.

    Science.gov (United States)

    Bob, Petr; Palus, Milan; Susta, Marek; Glaslova, Katerina

    2010-02-01

    Recent findings indicate that changes in synchronization of neural activities underlying sensitization and kindling could be more comprehensively understood using nonlinear methods. With this aim we have examined local synchronization using novel measure of coarse-grained information rate (CIR) in 8 EEG signals recorded at different cortical areas in 44 patients with paranoid schizophrenia. The values of local synchronization that could reflect sensitization related changes in EEG activities of cortical sites were then related to psychometric measures of epileptic-like symptoms and positive and negative schizophrenia symptoms (PANSS). While no significant correlations between CIR and positive and negative symptoms have been found, statistically significant relationships described by Spearman correlation coefficients between CIR indices and results of LSCL-33 have been observed in 7 (of 8) EEG channels (r in the range from 0.307 to 0.374, pschizophrenia.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Lithium therapy in comorbid temporal lobe epilepsy and cycloid psychosis

    Science.gov (United States)

    Brown, Paul; Kashiviswanath, Sridhar; Huynh, Alison; Allha, Naveen; Piaggio, Ken; Sahoo, Saddichha; Gupta, Ankur

    2016-01-01

    The treatment of post-ictal psychosis has foundered on uncertainty in diagnosis of psychotic phenotypes, and equivocal efficacy of first and second generation antipsychotics. This article presents a case history of comorbid temporal lobe epilepsy and psychosis, suggests the applicability of the continental, cycloid psychosis diagnostic conceptualization to post-ictal psychoses, and demonstrates the efficacy of lithium in their treatment. Clinical studies of comorbidity of epilepsy and psychosis offer great potential as a basis for modelling brain–mind relationships, and neuropsychiatric nosology, pathophysiology and treatment. PMID:28031853

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Hyperthyroidism--cause of depression and psychosis: a case report

    National Research Council Canada - National Science Library

    Marian, G; Nica, E A; Ionescu, B E; Ghinea, D

    2009-01-01

    .... The link between psychosis and hyperthyroidism is poorly understood. Because of this association of psychiatric symptoms is important to exclude a somatic cause, when assessing a patient first...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Peter B. 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.

  18. Psychosis in Patients with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    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.

  19. The traumagenic neurodevelopmental model of psychosis revisited

    DEFF Research Database (Denmark)

    Read, John; Fosse, Roar; Moskowitz, Andrew

    2014-01-01

    Evidence that childhood adversities are risk factors for psychosis has accumulated rapidly. Research into the mechanisms underlying these relationships has focused, productively, on psychological processes, including cognition, attachment and dissociation. In 2001, the traumagenic......, with a range of methodologies, and provided both indirect support for and direct confirmation of the traumagenic neurodevelopmental model. Integrating our growing understanding of the biological sequelae of early adversity with our knowledge of the psychological processes linking early adversity to psychosis...... neurodevelopmental model sought to integrate biological and psychological research by highlighting the similarities between the structural and functional abnormalities in the brains of abused children and adults diagnosed with ‘schizophrenia’. No review of relevant literature has subsequently been published. The aim...

  20. Pathways to psychosis in cannabis abuse.

    Science.gov (United States)

    Shrivastava, Amresh; Johnston, Megan; Terpstra, Kristen; Bureau, Yves

    2015-04-01

    Cannabis has been implicated as a risk factor for the development of schizophrenia, but the exact biological mechanisms remain unclear. In this review, we attempt to understand the neurobiological pathways that link cannabis use to schizophrenia. This has been an area of great debate; despite similarities between cannabis users and schizophrenia patients, the evidence is not sufficient to establish cause-and-effect. There have been advances in the understanding of the mechanisms of cannabis dependence as well as the role of the cannabinoid system in the development of psychosis and schizophrenia. The neurobiological mechanisms associated with the development of psychosis and effects from cannabis use may be similar but remain elusive. In order to better understand these associations, this paper will show common neurobiological and neuroanatomical changes as well as common cognitive dysfunction in cannabis users and patients of schizophrenia. We conclude that epidemiologic evidence highlights potential causal links; however, neurobiological evidence for causality remains weak.

  1. Association Between Cannabis and Psychosis: Epidemiologic Evidence.

    Science.gov (United States)

    Gage, Suzanne H; Hickman, Matthew; Zammit, Stanley

    2016-04-01

    Associations between cannabis use and psychotic outcomes are consistently reported, but establishing causality from observational designs can be problematic. We review the evidence from longitudinal studies that have examined this relationship and discuss the epidemiologic evidence for and against interpreting the findings as causal. We also review the evidence identifying groups at particularly high risk of developing psychosis from using cannabis. Overall, evidence from epidemiologic studies provides strong enough evidence to warrant a public health message that cannabis use can increase the risk of psychotic disorders. However, further studies are required to determine the magnitude of this effect, to determine the effect of different strains of cannabis on risk, and to identify high-risk groups particularly susceptible to the effects of cannabis on psychosis. We also discuss complementary epidemiologic methods that can help address these questions. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. Transference and a New Relation in Psychosis

    Directory of Open Access Journals (Sweden)

    António Coimbra de Matos

    2014-10-01

    Full Text Available The author considers that the main problem in the comprehension of psychosis is the difficulty to reach the split unconscious. In the analytical treatment of psychotic patients he emphasizes the recommencement of suspended development in the new relatioship promoted by the dynamic process. The author also refers the breakdown of the feeling of power and the prevalence of "imagoico-imagetic" identification in this pathology, An extract of a patient's analysis with psychic encalves documents the exposed theory.

  3. Management of psychosis in Australian general practice.

    Science.gov (United States)

    Charles, Janice; Miller, Graeme; Ng, Anthea

    2006-03-01

    The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of consultations involving the management of psychoses. In this analysis we have included schizophrenia, affective disorders/bipolar, organic psychoses, and senile psychoses, with undefined psychosis and chronic brain syndrome grouped as 'other'. This synopsis provides a backdrop against which the theme articles in this issue of Australian Family Physician can be further considered.

  4. Diagnosing and managing psychosis in primary care.

    Science.gov (United States)

    Saunders, Kate; Brain, Susannah; Ebmeier, Klaus P

    2011-05-01

    Psychosis is broadly defined as the presence of delusions and hallucinations. It can be organic or functional. The former is secondary to an underlying medical condition, such as delirium or dementia, the latter to a psychiatric disorder, such as schizophrenia or bipolar disorder. The identification and treatment of psychosis is vital as it is associated with a 10% lifetime risk of suicide and significant social exclusion. Psychosis can be recognised by taking a thorough history, examining the patient's mental state and obtaining a collateral history. The history usually enables a distinction to be made between bipolar disorder, schizophrenia and other causes. Early symptoms often include low mood, declining educational or occupational functioning, poor motivation, changes in sleep, perceptual changes, suspiciousness and mistrust. The patient's appearance, e.g. unkempt or inappropriately attired, may reflect their predominant mental state. There may be signs of agitation, hostility or distractibility. Speech may be disorganised and difficult to follow or there may be evidence of decreased speech. Mood may be depressed or elated or change rapidly. Patients may describe abnormal thoughts and enquiry into thoughts of suicide should be routine. Disturbances of thought such as insertion or withdrawal may be present along with perceptual abnormalities i.e. illusions, hallucinations. Insight varies during the course of a psychotic illness but should be explored as it has implications for management. All patients presenting with first episode psychosis for which no organic cause can be found should be referred to the local early intervention service. In patients with a known diagnosis consider referral if there is: poor response or nonadherence to treatment; intolerable side effects; comorbid substance misuse; risk to self or others.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Gone to Pot – A Review of the Association between Cannabis and Psychosis

    Science.gov (United States)

    Radhakrishnan, Rajiv; Wilkinson, Samuel T.; D’Souza, Deepak Cyril

    2014-01-01

    Cannabis is the most commonly used illicit drug worldwide, with ~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; and delayed, persistent effects that recapitulate the psychopathology and psychophysiology seen in 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 this warrants serious consideration from the point of view of public health policy. PMID:24904437

  7. Neurolépticos en el tratamiento de la esquizofrenia paranoide del paciente hospitalizado Neuroleptic drugs for the treatment of paranoid squizophrenia in the hospitalizad patient

    Directory of Open Access Journals (Sweden)

    Ismary González Hernánde

    2008-12-01

    Full Text Available Se realizó un estudio de utilización de medicamentos: indicación-prescripción, con elementos de consumo y consecuencias prácticas en el Hospital Psiquiátrico de Santa Clara durante el año 2006. Se elaboró un formulario con datos como: edad, sexo, tiempo de evolución, neurolépticos usados, estadía hospitalaria y precio de los medicamentos por unidad. Se propuso describir el uso de neurolépticos en el manejo de la esquizofrenia paranoide del paciente hospitalizado, contrastar el número de neurolépticos utilizados según estadía hospitalaria y tiempo de evolución, así como los costos del tratamiento en estos pacientes. El análisis se realizó mediante pruebas paramétricas y no paramétricas, con un nivel de significación de 0,01 ó 0,05. Como resultados relevantes se observaron que los fármacos usados con mayor frecuencia fueron flufenacina y clorpromacina. La combinación más empleada resultó ser la flufenacina y clorpromacina. El grupo de pacientes con más de 63 días de estadía hospitalaria, mostró el más alto gasto promedio en medicamentos. Se concluyó que los neurolépticos más utilizados fueron la flufenacina, la clorpromacina y el levomepromacina. Existe asociación entre el número de neurolépticos utilizados y el tiempo de evolución de la enfermedad. La estadía hospitalaria constituye el indicador que más encareció la terapéutica del paciente esquizofrénico.A drug use evaluation study that considered prescription, consumption elements and practical consequences was carried out in the Psychiatric Hospital of Santa Clara city in Villa Clara province during 2006. A form to collect data such as age, sex, time of evolution, neuroleptic drugs used, stay at hospital and price of drug per unit was made. The objective was to describe the use of neuroleptic drugs in the management of paranoid squizophrenia of the hospitalized patient, to compare the number of neuroleptic drugs that was used according to stay at

  8. N,N-Dimethyltryptamine-Induced Psychosis.

    Science.gov (United States)

    Paterson, Neil E; Darby, W Connor; Sandhu, Preetpal S

    2015-01-01

    N,N-dimethyltryptamine (DMT) is a 5-hydroxytryptamine 2A and 1A receptor agonist that exhibits potent psychoactive properties in humans. Recreational use of this drug has increased precipitously and is likely to result in an increase in patients presenting with substance-induced psychoses. The present case provides an early example of substance-induced psychosis attributable to repeated use of DMT. A 42-year-old white man, with no significant past psychiatric history, was brought to the emergency department by the police and was found to exhibit disinhibited behavior, elevated affect, disorganized thought process, and delusions of reference. Laboratory studies revealed elevated creatinine kinase level indicative of rhabdomyolysis. The patient endorsed recent and repeated use of DMT, as well as long-term Cannabis (marijuana) use. Over the course of the next 3 weeks, the patient was successfully treated with quetiapine for psychosis, divalproex sodium (Depakote) for impulsivity, gabapentin for anxiety, and hydroxyzine for sleep, which resulted in the resolution of his symptoms and development of reasonable insight and judgment. Approximately 6 months after discharge, the patient remained treatment compliant, as well as drug and symptom free. This case report illustrates an important example of substance-induced psychosis that resolved with antipsychotic treatment in a 42-year-old white man with no past psychiatric history likely attributable to the use of DMT. Given the increasing use of this substance, the emergency department, primary care, and inpatient services are likely to see a significant increase in similar cases.

  9. Changing name: changing prospects for psychosis.

    Science.gov (United States)

    Kingdon, D; Taylor, L; Ma, K; Kinoshita, Y

    2013-12-01

    Names matter! Schizophrenia has negative associations which impede individual recovery and induce societal and self-stigmatization. Alternatives have been proposed and are worthy of debate; changes made in Japan have generally been considered successful. The group of 'schizophrenia and other psychoses' could be further differentiated based on the major social factors identified, i.e. drug misuse and the effects of severe childhood trauma. The use of appropriate International Classification of Diseases (ICD) coding and definitions could usefully differentiate these groups - the former is a drug-induced psychosis and the latter frequently presents as comorbid schizophrenia and borderline personality disorder (often attracting a diagnosis of schizoaffective disorder). The current established differentiation between early onset ('stress-sensitive' - 'Kraepelinian' schizophrenia) and later onset (DSM5 delusional disorder, i.e. with 'non-bizarreness' criterion removed) psychosis may also be worthy of further investigation to establish validity and reliability. Psychosocially descriptive terms have been found to be more acceptable to patients and perceived as less stigmatizing by others. Subgroups of psychosis with greater homogeneity would benefit research, clinical and therapeutic practice and public understanding, attitudes and behaviour.

  10. [Psychosis and the borders of madness].

    Science.gov (United States)

    Fontaine, Philippe

    2014-06-01

    The word "psychosis", designing a group of worse psychical pathologies, has been progressively substituted, since 1850, to the word "madness" in the psychiatric literature. Without any consensus on a precise etiology of all kinds of psychosis, there is a large convergence on a clinical diagnostic with one main symptom: the loss of a sens of reality. This loss is supposed to derive from an alteration of the body diagram of the subject. This alteration implies the non-separation between the subject and the word, and then, a blockage of any authentic communication with the Other. Being so blocked, the temporal perception impeaches the fulfilling of the subjectivity's usual goals. The loss of reality could also induce a delirium, which tries to rebuild another kind of relation with the world. The issue about psychosis brings us to that ultimate question, so what we need to root the psychical distortion in the ordinary perceptive life, because our life is frequently inhabited by dreams, phantasms, and moreover hallucinations. Therefore, we need to examine and to question the meaning and the legitimacy of the strict boarder currently established beetween reason and insanity.

  11. Gendering psychosis: the illness of Zelda Fitzgerald.

    Science.gov (United States)

    Seeman, Mary V

    2016-03-01

    Psychiatric textbooks tend to describe psychosis as it is experienced by men. The well-documented illness of Zelda Fitzgerald illustrates the feminine side of psychosis. The distinctive features of Zelda's illness--its specific precipitants, the timing of its onset, the discontinuities in its course, the pronounced mood swings, the preservation of intellect and of agency, the maintenance of human ties, the association of flare-ups with immune and hormonal changes, the responsiveness to treatment, the lifelong creativity and productivity--show the female side of psychotic illness, one that is rarely described in diagnostic manuals. This paper relies on Nancy Milford's biography of Zelda, as well as on several other biographical sources and, using Zelda's own words and the words of her husband and friends, allows entry into a feminine world of psychosis, not encountered in textbooks. The expression of psychotic illness varies from person to person, its exact shape depending on many factors, most of them still undetermined, but gender is a critically important core component of variance.

  12. Theory of mind in early psychosis.

    Science.gov (United States)

    Langdon, Robyn; Still, Megan; Connors, Michael H; Ward, Philip B; Catts, Stanley V

    2014-08-01

    A deficit in theory of mind--the ability to infer and reason about the mental states of others - might underpin the poor social functioning of patients with psychosis. Unfortunately, however, there is considerable variation in how such a deficit is assessed. The current study compared three classic tests of theory of mind in terms of their ability to detect impairment in patients in the early stages of psychosis. Twenty-three patients within 2 years of their first psychotic episode and 19 healthy controls received picture-sequencing, joke-appreciation and story-comprehension tests of theory of mind. Whereas the picture-sequencing and joke-appreciation tests successfully detected a selective theory-of-mind deficit in patients, the story-comprehension test did not. The findings suggest that tests that place minimal demands on language processing and involve indirect, rather than explicit, instructions to assess theory of mind might be best suited to detecting theory-of-mind impairment in early stages of psychosis. © 2013 Wiley Publishing Asia Pty Ltd.

  13. Management of psychosis in Parkinson's disease.

    Science.gov (United States)

    Wolters, E C; Berendse, H W

    2001-08-01

    Psychosis is quite common in Parkinson's disease (approximately 25% of patients) and therefore constitutes a serious public health problem. All patients suffering from idiopathic Parkinson's disease, and especially elderly and demented patients, are at risk of developing delusions or hallucinations. The most prominent psychotogenic factors are dopaminomimetic agents, which may induce dopamine hypersensitivity in the frontal and limbic dopamine projection regions, and consequently, either directly or indirectly, elicit psychotic signs and symptoms. A Parkinson's disease-related cholinergic deficit in combination with an age-related further loss of cholinergic integrity also plays a prominent role. Psychosis in Parkinson's disease patients appears to be a more important contributor to caregiver distress than motor parkinsonism. Psychosis therefore probably represents the single greatest risk factor for nursing home placement. Typical antipsychotic drugs, because of their selective dopamine receptor antagonistic effects, can reduce psychotic signs but at the cost of an increase in parkinsonism. As a consequence of a non-selective antagonism at both serotonergic and dopaminergic receptors, atypical antipsychotic drugs are associated with fewer extrapyramidal side-effects. On the other hand, hypersensitivity to these agents may induce delirium or a malignant neuroleptic syndrome. Atypical antipsychotic agents such as clozapine, quetiapine and olanzapine should therefore be started at very low doses that are increased gradually. Cholinomimetic therapy may prove to be helpful in the prevention and treatment of psychotic manifestations in Parkinson's disease patients, given the effects observed in patients suffering from dementia with Lewy bodies.

  14. Staff and service users' views on a 'Consent for Contact' research register within psychosis services: a qualitative study.

    Science.gov (United States)

    Papoulias, Constantina; Robotham, Dan; Drake, Gareth; Rose, Diana; Wykes, Til

    2014-12-24

    Recruitment to mental health research can be challenging. 'Consent for Contact' (C4C) is a novel framework which may expedite recruitment and contribute to equitable access to research. This paper discusses stakeholder perspectives on using a C4C model in services for people with psychosis. This is a cross sectional study investigating the views of service users and staff using qualitative methods. Eight focus groups were recruited: five with service users (n = 26) and three with clinicians (n = 17). Purposive sampling was applied in order to reflect the local population in terms of ethnicity, experience of psychiatric services and attitudes towards research. Staff and service users alike associated the principle of 'consent for contact' with greater service user autonomy and favourable conditions for research recruitment. Fears around coercion and inappropriate uses of clinical records were common and most marked in service users identifying as having a negative view to research participation. Staff working in inpatient services reported that consenting for future contact might contribute to paranoid ideation. All groups agreed that implementation should highlight safeguards and the opt-in nature of the register. Staff and service users responded positively to C4C. Clinicians explaining C4C to service users should allay anxieties around coercion, degree of commitment, and use of records. For some service users, researcher access to records is likely to be the most challenging aspect of the consultation.

  15. Mental models and language registers in the psychoanalysis of psychosis: an overview of a thirteen-year analysis.

    Science.gov (United States)

    Lombardi, Riccardo

    2003-08-01

    The author suggests that the use of mental models and language registers may help an analysis to proceed, especially in psychosis, when the patient has not yet developed a mental space that will allow him/her the functions of knowledge and containment of emotions. Models, according to Bion, are a primitive approach to abstraction and a manifestation of the analyst's reverie that enables him/her to transform sense data into alpha-elements. Ferrari, in a further development of Bion's theories, hypothesises a relationship between the transference and the internal level of body-mind communication, and proposes the use of language registers to sustain the psychoanalytic process. The author presents several clinical examples from a thirteen-year, four-session-a-week analysis of a psychotic analysand who was initially confused, paranoid and altogether unable to bring self-reflective thought to bear on her overwhelming emotions and had, by the end of the analysis, completely recovered from her psychotic symptoms. The clinical material shows how the technical tools of mental models and language registers helped in the construction of a mental space and spatio-temporal parameters, permitting the patient to tolerate overwhelming concrete emotions and finally to recognise and work through the emotions of an intense transference.

  16. Psychosis in parkinsonism: an unorthodox approach

    Directory of Open Access Journals (Sweden)

    Onofrj M

    2017-05-01

    Full Text Available Marco Onofrj,1,2 Danilo Carrozzino,3,4 Aurelio D’Amico,1,2 Roberta Di Giacomo,1,2 Stefano Delli Pizzi,1 Astrid Thomas,1,2 Valeria Onofrj,5 John-Paul Taylor,6 Laura Bonanni1,2 1Department of Neuroscience Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, 2CE.S.I. University Foundation, 3Department of Psychological, Health, and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy; 4Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark; 5Department of Bioimaging, University Cattolica del Sacro Cuore, Rome, Italy; 6Institute of Neuroscience, Campus for Ageing and Vitality Newcastle University Newcastle upon Tyne, Newcastle upon Tyne, UK Abstract: Psychosis in Parkinson’s disease (PD is currently considered as the occurrence of hallucinations and delusions. The historical meaning of the term psychosis was, however, broader, encompassing a disorganization of both consciousness and personality, including behavior abnormalities, such as impulsive overactivity and catatonia, in complete definitions by the International Classification of Diseases-10 (ICD-10 and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5. Our review is aimed at reminding that complex psychotic symptoms, including impulsive overactivity and somatoform disorders (the last being a recent controversial entity in PD, were carefully described in postencephalitic parkinsonism (PEP, many decades before dopaminergic treatment era, and are now described in other parkinsonisms than PD. Eminent neuropsychiatrists of the past century speculated that studying psychosis in PEP might highlight its mechanisms in other conditions. Yet, functional assessments were unavailable at the time. Therefore, the second part of our article reviews the studies of neural correlates of psychosis in parkinsonisms, by taking into account both theories on

  17. [Acute postpartum psychoses].

    Science.gov (United States)

    Tabbane, K; Charfi, F; Dellagi, L; Guizani, L; Boukadida, L

    1999-11-01

    The post-partum is a high risk period for the development of acute psychotic disorders. The frequence of post-partum psychoses is evaluated at 1 to 2 per 1,000 births. Post-partum psychosis include major affective disorders which is the most frequent diagnosis. The clinical pictures have specific characteristics: rapid change of symptomatology, liability of mood, and frequent confusional signs. The short-term prognosis is generally good but the risk of recurrence of the mental disorder, in or outside puerperal context, is high. At clinical, evolutive and genetic levels, the studies do not provide arguments for nosological autonomy of post-partum psychosis. At therapeutic level, the ECT is particularly efficient in this indication.

  18. Do paranoid delusions exist on a continuum with subclinical paranoia?:A multi-method taxometric study

    OpenAIRE

    Elahi, A.; Perez Algorta, G.; Varese, Filippo; McIntyre, J.C.; Bentall, R. P.

    2017-01-01

    Background: There is widespread interest in whether psychosis exists on a continuum with healthy functioning. Previous research has implied that paranoia, a common symptom of psychosis, exists on a continuum but this has not been investigated using samples including both patients and non-patients and up-to-date taxometric methods. Aim: To assess the latent structure of paranoia in a diverse sample using taxometric methods. Method: We obtained data from 2836 participants, including the general...

  19. Medical evaluation abnormalities in acute psychotic patients seen at the emergency department of Muhimbili national hospital in Dar es Salaam, Tanzania

    OpenAIRE

    S.G. Yusuf*; M.S. Runyon; V. Mwafongo; T.A. Reynolds

    2013-01-01

    Prior studies have shown varied rates of medical pathology in patients presenting to acute care settings with psychotic symptoms, and there is almost no literature from the sub-Saharan Africa region. We investigated the yield of physical examination and laboratory testing among patients presenting with acute psychosis to an urban ED in Dar es Salaam. Methods: This was a prospective observational study of patients presenting to the ED at Muhimbili National Hospital with acute psychosis. A s...

  20. Changes in Neuronal Oscillations Accompany the Loss of Hippocampal LTP that Occurs in an Animal Model of Psychosis

    Science.gov (United States)

    Kalweit, Alexander N.; Amanpour-Gharaei, Bezhad; Colitti-Klausnitzer, Jens; Manahan-Vaughan, Denise

    2017-01-01

    The first-episode of psychosis is followed by a transient time-window of ca. 60 days during which therapeutic interventions have a higher likelihood of being effective than interventions that are started with a greater latency. This suggests that, in the immediate time-period after first-episode psychosis, functional changes occur in the brain that render it increasingly resistant to intervention. The precise mechanistic nature of these changes is unclear, but at the cognitive level, sensory and hippocampus-based dysfunctions become increasingly manifest. In an animal model of first-episode psychosis that comprises acute treatment of rats with the irreversible N-methyl-D-aspartate receptor (NMDAR)-antagonist, MK801, acute but also chronic deficits in long-term potentiation (LTP) and spatial memory occur. Neuronal oscillations, especially in the form of information transfer through θ and γ frequency oscillations are an intrinsic component of normal information processing in the hippocampus. Changes in θ-γ coupling and power are known to accompany deficits in hippocampal plasticity. Here, we examined whether changes in δ, θ, α, β and γ oscillations, or θ-γ coupling accompany the chronic loss of LTP that is observed in the MK801-animal model of psychosis. One and 4 weeks after acute systemic treatment of adult rats with MK801, a potent loss of hippocampal in vivo LTP was evident compared to vehicle-treated controls. Overall, the typical pattern of θ-γ oscillations that are characteristic for the successful induction of LTP was altered. In particular, θ-power was lower and an uncoupling of θ-γ oscillations was evident in MK801-treated rats. The alterations in network oscillations that accompany LTP deficits in this animal model may comprise a mechanism through which disturbances in sensory information processing and hippocampal function occur in psychosis. These data suggest that the hippocampus is likely to comprise a very early locus of functional

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

    Science.gov (United States)

    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.

  2. The key to reducing duration of untreated first psychosis

    DEFF Research Database (Denmark)

    Joa, Inge; Johannessen, Jan Olav; Auestad, Bjørn

    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 psychosis...

  3. The Aberrant Salience Inventory: A New Measure of Psychosis Proneness

    Science.gov (United States)

    Cicero, David C.; Kerns, John G.; McCarthy, Denis M.

    2010-01-01

    Aberrant salience is the unusual or incorrect assignment of salience, significance, or importance to otherwise innocuous stimuli and has been hypothesized to be important for psychosis and psychotic disorders such as schizophrenia. Despite the importance of this concept in psychosis research, no questionnaire measures are available to assess…

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

    DEFF Research Database (Denmark)

    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....

  5. Premorbid multivariate prediction of adult psychosis-spectrum disorder

    DEFF Research Database (Denmark)

    Schiffman, Jason; Kline, Emily; Jameson, Nicole D.;

    2015-01-01

    Premorbid prediction of psychosis-spectrum disorders has implications for both understanding etiology and clinical identification. The current study used a longitudinal high-risk for psychosis design that included children of parents with schizophrenia as well as two groups of controls (children ...

  6. Prevalence of autoimmune thyroid dysfunction in postpartum psychosis

    NARCIS (Netherlands)

    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

  7. Economic aspects of peer support groups for psychosis

    NARCIS (Netherlands)

    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

  8. Behavioural activation therapy for adolescents 'at risk' for psychosis?

    Science.gov (United States)

    Welsh, Patrick; Kitchen, Charlotte E W; Ekers, David; Webster, Lisa; Tiffin, Paul A

    2016-04-01

    The following hypothesis explores the possibility of using behavioural activation therapy for adolescents with an at-risk mental state for psychosis. Support is drawn from psychosis-related survey and pilot data as well as a robust evidence base for adult depression. However, we acknowledge that extensive feasibility work is required before exploring this hypothesis further.

  9. Glucocorticosteroids Associated With a Decreased Risk of Psychosis

    NARCIS (Netherlands)

    Laan, Wijnand; Smeets, Hugo; de Wit, Niek J.; Kahn, Rene S.; Grobbee, Diederick E.; Burger, Huibert

    The hypothesis that chronic inflammation may play a role in psychosis receives increasing attention. In this study, we aim to investigate whether the use of steroidal anti-inflammatory drugs is associated with a decreased risk of psychosis. A longitudinal nested case-control study was performed

  10. Cannabis and Psychosis: a Critical Overview of the Relationship.

    Science.gov (United States)

    Ksir, Charles; Hart, Carl L

    2016-02-01

    Interest in the relationship between cannabis use and psychosis has increased dramatically in recent years, in part because of concerns related to the growing availability of cannabis and potential risks to health and human functioning. There now exists a plethora of scientific articles addressing this issue, but few provide a clear verdict about the causal nature of the cannabis-psychosis association. Here, we review recent research reports on cannabis and psychosis, giving particular attention to how each report provides evidence relating to two hypotheses: (1) cannabis as a contributing cause and (2) shared vulnerability. Two primary kinds of data are brought to bear on this issue: studies done with schizophrenic patients and studies of first-episode psychosis. Evidence reviewed here suggests that cannabis does not in itself cause a psychosis disorder. Rather, the evidence leads us to conclude that both early use and heavy use of cannabis are more likely in individuals with a vulnerability to psychosis. The role of early and heavy cannabis use as a prodromal sign merits further examination, along with a variety of other problem behaviors (e.g., early or heavy use of cigarettes or alcohol and poor school performance). Future research studies that focus exclusively on the cannabis-psychosis association will therefore be of little value in our quest to better understand psychosis and how and why it occurs.

  11. Risk of psychosis and internal migration: Results from the Bologna First Episode Psychosis study.

    Science.gov (United States)

    Tarricone, Ilaria; Boydell, Jane; Kokona, Arnisa; Triolo, Federico; Gamberini, Lisa; Sutti, Enrico; Marchetta, Michela; Menchetti, Marco; Di Forti, Marta; Murray, Robin M; Morgan, Craig; Berardi, Domenico

    2016-05-01

    Incidence of psychotic disorders is higher in many migrant groups; however little is known about internal migrants (IM). This study aims to describe the IR in natives (NA), IM and external migrants (EM). All patients aged 18-64years, with First Episode Psychosis (FEP), who made contact with the Bologna West psychiatric services, between 2002 and 2010, were included. 187 cases were included. Age and sex adjusted IR of psychosis per 100,000per year were: 12.6 for NA, 25.3 for IM and 21.4 for EM. The IRR was 1.93 (1.19-3.13, P=0.007) for IM and 1.79 (1.06-3.02, P=0.03) for EM compared to NA. Rates of psychosis were significantly elevated in IM as well as in EM. This result adds evidence as to the role of migration itself (versus ethnicity) on the risk of psychosis. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. 10 year course of IQ in first-episode psychosis

    DEFF Research Database (Denmark)

    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 a weaker...

  13. Post-partum transverse sinus thrombosis presenting as acute psychosis.

    Science.gov (United States)

    Dhasmana, Devesh Janardan; Brockington, Ian F; Roberts, Ann

    2010-08-01

    Whilst cerebral vascular disease and mental illness in the post-partum period are well recognised, their co-existence and the concept of organic psychoses in pregnancy, parturition and the puerperium remains poorly appreciated (Brockington 2006; Brockington Arch Women's Ment Health 10: 177-178, 2007a; Brockington Arch Women's Ment Health 10: 305-306, b). We report a woman who was referred to the Medical team on-call with a mixed presentation of euphoria, mutism and aggressive behaviour but ultimately demonstrated to have a transverse sinus thrombosis and recovered well with anti-coagulation. This serves an important reminder of the implications of a missed medical diagnosis in this high-risk and vulnerable group of patients.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. A Case of Acute Psychosis Following Energy Drink Consumption

    OpenAIRE

    G?RG?L?, Yasemin; TA?DELEN, ?znur; S?NMEZ, Mehmet B?lent; K?SE ?INAR, Rug?l

    2014-01-01

    Interest in energy drinks is increasing every day. Energy drink consumption is increasing proportionally. Users often utilize these drinks in order to enjoy, have fun and to increase performance and attention. However, consumption of the energy drinks sometimes may also cause adverse physical and psychological consequences. Unwanted physical results are in the more foreground, noticeable and visible but the data about psychological problems caused by energy drinks is accumulated over the year...

  17. A Case of Acute Psychosis Following Energy Drink Consumption.

    Science.gov (United States)

    Görgülü, Yasemin; Taşdelen, Öznur; Sönmez, Mehmet Bülent; Köse Çinar, Rugül

    2014-03-01

    Interest in energy drinks is increasing every day. Energy drink consumption is increasing proportionally. Users often utilize these drinks in order to enjoy, have fun and to increase performance and attention. However, consumption of the energy drinks sometimes may also cause adverse physical and psychological consequences. Unwanted physical results are in the more foreground, noticeable and visible but the data about psychological problems caused by energy drinks is accumulated over the years in the literature. In this case report, we describe the case of a young man with no psychiatric history who was hospitalized for psychotic symptoms following excessive consumption of energy drinks.

  18. An Investigation of the "Jumping to Conclusions" Data-Gathering Bias and Paranoid Thoughts in Asperger Syndrome

    Science.gov (United States)

    Jänsch, Claire; Hare, Dougal Julian

    2014-01-01

    The existence of a data-gathering bias, in the form of jumping to conclusions, and links to paranoid ideation was investigated in Asperger syndrome (AS). People with AS (N = 30) were compared to a neurotypical control group (N = 30) on the Reading the Mind in the Eyes and the Beads tasks, with self-report measures of depression, general anxiety,…

  19. Hubungan Dukungan Sosial Keluarga dengan Frekuensi Kekambuhan Pasien Skizofrenia Paranoid Di Poliklinik Rumah Sakit Jiwa Daerah Propsu Medan

    OpenAIRE

    Sebayang, Septian Mixrofa

    2011-01-01

    Social support is one source of stress management and influence a person's health condition. The purpose of this study is to find out the relationship between family social support with paranoid schizophrenia of patients relapse frequency in the Polyclinic Psychiatric Sumatera Utara Distric Hospital in Medan. This study design is a descriptive correlation. Purposive sampling were required 32 respondents. The result of the study shows that there is a significant correlation between f...

  20. Association of the IFN-γ (+874A/T) Genetic Polymorphism with Paranoid Schizophrenia in Tunisian Population.

    Science.gov (United States)

    Jemli, Achraf; Eshili, Awatef; Trifa, Fatma; Mechri, Anouar; Zaafrane, Ferid; Gaha, Lotfi; Juckel, George; Tensaout, Besma Bel Hadj Jrad

    2017-02-01

    Since growing evidence suggests a significant role of chronic low-grade inflammation in the physiopathology of schizophrenia, we have hypothesized that functional genetic variant of the IFN gamma (IFN-γ; +874A/T; rs2430561) gene may be involved in the predisposition to schizophrenia. This research is based on a case-control study which aims to identify whether polymorphism of the IFN-γ gene is a risk factor for the development of schizophrenia. The RFLP-PCR genotyping of the IFN-γ gene was conducted on a Tunisian population composed of 218 patients and 162 controls. The IFN-γ (+874A/T) polymorphism analysis showed higher frequencies of minor homozygous genotype (TT) and allele (T) in all patients compared with controls (11.5 vs. 4.9%; p = 0.03, OR = 2.64 and 30.7 vs. 24.1%, p = 0.04, OR = 1.4, respectively). This correlation was confirmed for male but not for female patients. Also, the T allele was significantly more common among patients with paranoid schizophrenia when compared with controls (25.8 vs. 4.9%, p = 0.0001; OR = 6.7). Using the binary regression analysis to eliminate confounding factors as age and sex, only this last association remained significant (p = 0.03; OR = 1.76, CI = 1.05-2.93). In conclusion, our results showed a significant association between +874A/T polymorphism of IFN-γ and paranoid schizophrenia, suggesting that this single nucleotide polymorphism (SNP) or another at proximity could predispose to paranoid schizophrenia. Since the minor allele of this polymorphism was correlated with an increased expression of their product, our study validates the hypothesis of excessive pro-inflammatory cytokine in the physiopathology of paranoid schizophrenia.

  1. Genetic variants in long non-coding RNA MIAT contribute to risk of paranoid schizophrenia in a Chinese Han population.

    Science.gov (United States)

    Rao, Shu-Quan; Hu, Hui-Ling; Ye, Ning; Shen, Yan; Xu, Qi

    2015-08-01

    The heritability of schizophrenia has been reported to be as high as ~80%, but the contribution of genetic variants identified to this heritability remains to be estimated. Long non-coding RNAs (LncRNAs) are involved in multiple processes critical to normal cellular function and dysfunction of lncRNA MIAT may contribute to the pathophysiology of schizophrenia. However, the genetic evidence of lncRNAs involved in schizophrenia has not been documented. Here, we conducted a two-stage association analysis on 8 tag SNPs that cover the whole MIAT locus in two independent Han Chinese schizophrenia case-control cohorts (discovery sample from Shanxi Province: 1093 patients with paranoid schizophrenia and 1180 control subjects; replication cohort from Jilin Province: 1255 cases and 1209 healthy controls). In discovery stage, significant genetic association with paranoid schizophrenia was observed for rs1894720 (χ(2)=74.20, P=7.1E-18), of which minor allele (T) had an OR of 1.70 (95% CI=1.50-1.91). This association was confirmed in the replication cohort (χ(2)=22.66, P=1.9E-06, OR=1.32, 95%CI 1.18-1.49). Besides, a weak genotypic association was detected for rs4274 (χ(2)=4.96, df=2, P=0.03); the AA carriers showed increased disease risk (OR=1.30, 95%CI=1.03-1.64). No significant association was found between any haplotype and paranoid schizophrenia. The present studies showed that lncRNA MIAT was a novel susceptibility gene for paranoid schizophrenia in the Chinese Han population. Considering that most lncRNAs locate in non-coding regions, our result may explain why most susceptibility loci for schizophrenia identified by genome wide association studies were out of coding regions.

  2. Genetic association between the dopamine D1-receptor gene and paranoid schizophrenia in a northern Han Chinese population

    Directory of Open Access Journals (Sweden)

    Yao J

    2014-04-01

    Full Text Available Jun Yao, Mei Ding, Jiaxin Xing, Jinfeng Xuan, Hao Pang, Yuqing Pan, Baojie WangInstitute of Forensic Medicine, China Medical University, Shenyang, People's Republic of ChinaObjective: Dysregulation of dopaminergic neurotransmission at the D1 receptor in the prefrontal cortex has been implicated in the pathogenesis of schizophrenia. Genetic polymorphisms of the dopamine D1-receptor gene have a plausible role in modulating the risk of schizophrenia. To determine the role of DRD1 genetic polymorphisms as a risk factor for schizophrenia, we undertook a case-control study to look for an association between the DRD1 gene and schizophrenia.Materials and methods: We genotyped eleven single-nucleotide polymorphisms within the DRD1 gene by deoxyribonucleic acid sequencing involving 173 paranoid schizophrenia patients and 213 unrelated healthy individuals. Statistical analysis was performed to identify the difference of genotype, allele, or haplotype distribution between cases and controls.Results: A significantly lower risk of paranoid schizophrenia was associated with the AG + GG genotype of rs5326 and the AG + GG genotype of rs4532 compared to the AA genotype and the AA genotype, respectively. Distribution of haplotypes was no different between controls and paranoid schizophrenia patients. In the males, the genotype distribution of rs5326 was statistically different between cases and controls. In the females, the genotype distribution of rs4532 was statistically different between cases and controls. However, the aforementioned statistical significances were lost after Bonferroni correction.Conclusion: It is unlikely that DRD1 accounts for a substantial proportion of the genetic risk for schizophrenia. As an important dopaminergic gene, DRD1 may contribute to schizophrenia by interacting with other genes, and further relevant studies are warranted.Keywords: dopamine D1 receptor, paranoid schizophrenic, single-nucleotide study, association, genetic

  3. Contributions of experimental psychiatry to research on the psychosis prodrome

    Directory of Open Access Journals (Sweden)

    Mitja eBodatsch

    2013-12-01

    Full Text Available In the recent decades, a paradigmatic change in psychosis research and treatment shifted attention towards the early and particularly the prodromal stages of illness. Despite substantial progress with regard to the neuronal underpinnings of psychosis development, the crucial biological mechanisms leading to manifest illness are yet insufficiently understood. Until today, one significant approach to elucidate the neurobiology of psychosis has been the modeling of psychotic symptoms by psychedelic substances in healthy individuals. These models bear the opportunity to evoke particular neuronal aberrations and the respective psychotic symptoms in a controlled experimental setting. In the present paper, we hypothesize that experimental psychiatry bears unique opportunities in elucidating the biological mechanisms of the prodromal stages of psychosis. Psychosis risk symptoms are attenuated, transient, and often only retrospectively reported. The respective neuronal aberrations are thought being dynamic. The correlation of unstable psychopathology with observed, e. g., neurophysiological disturbances is thus yet largely unclear. In modeling psychosis, the experimental setting allows not only for evoking particular symptoms, but for the concomitant assessment of psychopathology, neurophysiology, and neuropsychology. Herein, the glutamatergic model will be highlighted exemplarily, with special emphasis on its potential contribution to the elucidation of psychosis development. This model of psychosis appears as candidate for modeling the prodrome since it induces psychopathological, neurocognitive and neurofunctional changes that are comparable to clinical features of the prodrome.As exemplarily illustrated by the PCP/NMDA model of psychosis many aspects advocate that prodromal stages might be validly mimicked by psychedelic substances. In summary, experimental psychiatry bears the potential to further elucidate the biological mechanisms of the psychosis

  4. Topiramate-induced psychosis: the picture at 12 months.

    Science.gov (United States)

    Watkin, Anna; Alam, Faouzi; Javed, Qaiser

    2010-01-01

    A 19-year-old white British man, not previously known to psychiatric services, presented with acute onset of florid psychotic symptoms. His symptoms included auditory hallucinations, misidentification of family members, thought interference and delusions of control. His level of distress was high and did not respond to verbal or medical de-escalation; therefore, he required nursing in seclusion. It was noted that he recently had an increase of his anti-epileptic medication to 100 mg topiramate twice per day. Topiramate was thought to be the cause of his psychosis and, consequently, was changed to phenytoin. Since discontinuation of the topiramate, his psychotic symptoms settled within 4 days and he was discharged shortly afterwards. He was monitored by the Early Intervention services. At 15-months post-discharge, there was no recurrence of any symptoms despite not receiving antipsychotic medication. To our knowledge, this is the first report that describes the progress of a patient past the initial psychotic episode. Therefore, we believe this is an important finding to report.

  5. [PSYCHOEDUCATIONAL PROGRAM AS A WAY OF CORRECTING MOTIVATIONAL COMPONENTS IN PATIENTS WITH PARANOID SCHIZOPHRENIA WITH ABDOMINAL OBESITY].

    Science.gov (United States)

    Sinayko, V; Korovina, L

    2016-01-01

    The aim of the study was to investigate the influence of motivational and targeted psychoeducational programs designed for patients with paranoid schizophrenia with abdominal obesity. We observed 34 women aged 18-42 with continuous-flow type paranoid schizophrenia. All patients had a concomitant abdominal obesity, which developed secondarily after long-term administration of second generation antipsychotic medications (at least 1 year). Based on clinical-psychopathological and psychometric methods of assessment and on the analysis of Treatment Satisfaction Questionnaire we have developed modules for psychoeducational programs. Based on the results of the treatment we conclude that the application of psychoeducational programs is an effective component of complex treatment of patients with paranoid schizophrenia. Abdominal obesity should be regarded as an important and the main side effect of long-term therapy with atypical antipsychotic medications. It has a marked negative effect on subjective assessment of patients and decreases the level of their mental and social adaptation. This factor should be the basis for the formation of re-socialization and compliance-oriented actions.

  6. Women have later onset than men in schizophrenia--but only in its paranoid form. Results of the DSP project.

    Science.gov (United States)

    Salokangas, Raimo K R; Honkonen, Teija; Saarinen, Soile

    2003-10-01

    According to the literature, schizophrenia begins in men earlier than in women. It has been argued that the gender-bound age difference is due to the protective antidopaminergic effect of estrogens in women. However, the effect of gender on the age of onset may vary between different types of schizophrenias, and can also be modulated by marital status and by age at onset of illness. Comprehensive data were collected on 3306 DSM IIR schizophrenia patients, aged 15-64 years, who had been discharged from psychiatric hospitals in Finland in 1982, 1986 and 1990. The age of onset of illness (AOI) was defined by the age at the first admission (AFA). Male patients were admitted earlier than female patients, and a small second peak in women appeared at the age of 40-44. However, there were no gender differences in AFA within diagnostic subgroups, except in paranoid schizophrenia in which AFA was lower in men than in women even when marital status was taken into account. Within paranoid schizophrenia, this effect of gender was significant only in those of the patients whose AFA was higher than 30 years. It is suggested that there is no gender difference in AOI in early onset schizophrenia. In later onset, paranoid schizophrenia, the illness seems to manifest in women later than in men.

  7. Do Specific Early-Life Adversities Lead to Specific Symptoms of Psychosis? A Study from the 2007 The Adult Psychiatric Morbidity Survey

    Science.gov (United States)

    Bentall, Richard P.; Wickham, Sophie; Shevlin, Mark; Varese, Filippo

    2012-01-01

    Previous studies have reported associations between childhood adversities, eg, loss of a parent, being raised in institutional care, sexual and other kinds of abuse by adults and bullying by peers, and psychosis in adulthood. However, the mechanisms by which these adversities lead to psychotic experiences are poorly understood. From models of the psychological processes involved in positive symptoms, it was predicted that childhood sexual abuse would be specifically associated with auditory hallucinations in adulthood, and that disruption of early attachment relations and more chronic forms of victimization such as bullying would be specifically associated with paranoid ideation. We therefore examined the associations between sexual trauma, physical abuse, bullying, and being brought up in institutional or local authority care and reports of auditory hallucinations and paranoid beliefs in the 2007 Adult Psychiatric Morbidity Survey. All simple associations between childhood adversities and the two symptom types were significant. Childhood rape was associated only with hallucinations (OR 8.9, CI = 1.86–42.44) once co-occurring paranoia was controlled for. Being brought up in institutional care (OR = 11.08, CI = 3.26–37.62) was specifically associated with paranoia once comorbid hallucinations had been controlled for. For each symptom, dose-response relationships were observed between the number of childhood traumas and the risk of the symptom. The specific associations observed are consistent with current psychological theories about the origins of hallucinations and paranoia. Further research is required to study the psychological and biological mediators of these associations. PMID:22496540

  8. Intrinsic motivation as a mediator between metacognition deficits and impaired functioning in psychosis.

    Science.gov (United States)

    Luther, Lauren; Firmin, Ruth L; Vohs, Jenifer L; Buck, Kelly D; Rand, Kevin L; Lysaker, Paul H

    2016-09-01

    individuals with psychosis. The cross-sectional design of this study is a limitation, and additional longitudinal studies are needed to confirm the direction of the findings and rule out rival hypotheses. Generalization of the findings may be limited by the sample composition. It may be that different relationships exist between metacognition, intrinsic motivation, and functioning in those with early psychosis or among those in an acute phase or who decline treatment. © 2016 The British Psychological Society.

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

    Science.gov (United States)

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

    2010-12-01

    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 in particular stems from research with adult populations. Less in known about these disorders in children and adolescents, and controversy remains regarding diagnosis of personality disorders in general in youth. The current paper reviews the available research on Cluster A personality disorders in childhood and adolescence; specifically, we discuss differentiating between the three disorders and distinguishing them from other syndromes, measuring Cluster A disorders in youth, and the nature and course of these disorders throughout childhood and adolescence. We also present recent longitudinal data from a sample of adolescents diagnosed with Cluster A personality disorders from our research laboratory, and suggest directions for future research in this important but understudied area.

  10. Evidence from paranoid schizophrenia for more than one component of theory of mind

    Science.gov (United States)

    Scherzer, Peter; Achim, André; Léveillé, Edith; Boisseau, Emilie; Stip, Emmanuel

    2015-01-01

    We previously reported finding that performance was impaired on four out of five theory of mind (ToM) tests in a group of 21 individuals diagnosed with paranoid schizophrenia (pScz), relative to a non-clinical group of 29 individuals (Scherzer et al., 2012). Only the Reading the Mind in the Eyes Test did not distinguish between groups. A principal components analysis revealed that the results on the ToM battery could be explained by one general ToM factor with the possibility of a latent second factor. As well, the tests were not equally sensitive to the pathology. There was also overmentalization in some ToM tests and under-mentalisation in others. These results led us to postulate that there is more than one component to ToM. We hypothesized that correlations between the different EF measures and ToM tests would differ sufficiently within and between groups to support this hypothesis. We considered the relationship between the performance on eight EF tests and five ToM tests in the same diagnosed and non-clinical individuals as in the first study. The ToM tests shared few EF correlates and each had its own best EF predictor. These findings support the hypothesis of multiple ToM components. PMID:26579026

  11. Evidence from paranoid schizophrenia for more than one component of theory of mind.

    Science.gov (United States)

    Scherzer, Peter; Achim, André; Léveillé, Edith; Boisseau, Emilie; Stip, Emmanuel

    2015-01-01

    We previously reported finding that performance was impaired on four out of five theory of mind (ToM) tests in a group of 21 individuals diagnosed with paranoid schizophrenia (pScz), relative to a non-clinical group of 29 individuals (Scherzer et al., 2012). Only the Reading the Mind in the Eyes Test did not distinguish between groups. A principal components analysis revealed that the results on the ToM battery could be explained by one general ToM factor with the possibility of a latent second factor. As well, the tests were not equally sensitive to the pathology. There was also overmentalization in some ToM tests and under-mentalisation in others. These results led us to postulate that there is more than one component to ToM. We hypothesized that correlations between the different EF measures and ToM tests would differ sufficiently within and between groups to support this hypothesis. We considered the relationship between the performance on eight EF tests and five ToM tests in the same diagnosed and non-clinical individuals as in the first study. The ToM tests shared few EF correlates and each had its own best EF predictor. These findings support the hypothesis of multiple ToM components.

  12. [The Influence of Threatening Stimuli on the Component P200 in Patients with Paranoid Schizophrenia].

    Science.gov (United States)

    Strelets, V B; Arkhipov, A Yu

    2015-01-01

    We studied schizophrenic patients with the dominance of pseudohallucinations. As is well known, pseudohallucinations are the main syndrome of schizophrenia, the so-called first rank syndrome. Pseudohallucinations are defined as a disorder of sense (affective) perception. This disorder is mainly diagnosed from the clinical picture or by pathopsychologichal observations. We investigated the evoked potentials (EP) of brain after neutral and emotionally meaningful (threatening) visual stimuli in order to specify the neurophysiological disorders of affective perception in schizophrenic patients with severe paranoid-hallucinatory syndrome who did not receive neuroleptic therapy. The analysis of P200 component in healthy subjects showed an increase in the amplitude and shortening of the latency of this wave in response to thretaning stimuli, as compared to neutral stimuli. In the group of patients with schizophrenia, the analysis showed the same increase in the level of excitation in response to emotionally threatening stimuli. However, in schizophrenic patients there were also found certain areas where the amplitude and latency decreased or increased at the same time. The results show that patients with schizophrenia have the pathological effect of having parameters typical of the processes of both excitation and inhibition.

  13. Evidence from paranoid schizophrania for more than one component of theory of mind

    Directory of Open Access Journals (Sweden)

    Peter eScherzer

    2015-10-01

    Full Text Available We previously reported finding that performance was impaired on four out of five theory of mind (ToM tests in a group of 21 individuals diagnosed with paranoid schizophrenia (pScz, relative to a non-clinical group of 29 individuals (Scherzer, Léveillé, Achim, Scherzer, Boisseau, & Stip, 2012. Only the Reading the Mind in the Eyes Test (RMET did not distinguish between groups. A principal components analysis revealed that the results on the ToM battery could be explained by one general ToM factor with the possibility of a latent second factor. As well, the tests were not equally sensitive to the pathology. There was also overmentalization in some ToM tests and under-mentalisation in others. These results led us to postulate that there is more than one component to ToM. We hypothesized that correlations between the different EF measures and ToM tests would differ sufficiently within and between groups to support this hypothesis. We considered the relationship between the performance on eight EF tests and five ToM tests in the same diagnosed and non-clinical individuals as in the first study. The ToM test shared few EF correlates and each had its own best EF predictor.. These findings support the hypothesis of multiple ToM components

  14. Dissociative symptoms and interregional EEG cross-correlations in paranoid schizophrenia.

    Science.gov (United States)

    Bob, Petr; Susta, Marek; Glaslova, Katerina; Boutros, Nash N

    2010-05-15

    Recent findings indicate that binding and synchronization of distributed activities are crucial for the mechanism of consciousness, and there is increased evidence that disruptions in feature binding produce disintegration of consciousness in schizophrenia. These data suggest that the disrupted binding and disintegration of consciousness could be related to dissociation, which is historically linked to Bleuler's concept of splitting in schizophrenia. In the present study we aimed to investigate relations among electroencephalogram (EEG) activities of cortical sites and used psychometric measures of positive and negative schizophrenia symptoms (Positive and Negative Syndrome Scale) and the Dissociative Experiences Scale (DES) in 58 patients with paranoid schizophrenia. The results show statistically significant Spearman correlations of the DES with cross-correlation function in nine (of 16) EEG pairs. Positive symptoms display significant Spearman correlation with mean of cross-correlation function in only one EEG pair (F4-C4). Results of the Mann-Whitney test between patients with higher (DES > or = 30) and lower dissociation show statistically significant differences between the groups for cross-correlations in nine EEG pairs. The results of this study provide the first supportive evidence for a negative relationship between cross-correlation indices and symptoms of dissociation in schizophrenia.

  15. Different aspects of theory of mind in paranoid schizophrenia: evidence from a video-based assessment.

    Science.gov (United States)

    Montag, Christiane; Dziobek, Isabel; Richter, Inga S; Neuhaus, Kathrin; Lehmann, Anja; Sylla, Rudolf; Heekeren, Hauke R; Heinz, Andreas; Gallinat, Jürgen

    2011-04-30

    In schizophrenia, impairments of theory of mind (ToM) may be due to excessive ('overmentalizing') or defective ('undermentalizing') attribution of mental states. However, most ToM tests differentiate neither between 'overmentalizing' and 'undermentalizing' nor between cognitive and affective ToM in schizophrenia. This study aimed at differentiating these aspects of ToM in 80 patients diagnosed with paranoid schizophrenia and 80 matched healthy controls using the 'Movie for the Assessment of Social Cognition' (MASC). Outcome parameters comprised 1) error counts representing 'undermentalizing' or 'overmentalizing', 2) decoding of cognitive or emotional mental states and 3) non-social inferencing. Multivariate analysis of covariance (MANCOVA) showed significantly abnormal scores for two dimensions of 'undermentalizing' as well as for cognitive and emotional ToM that were not explained by global cognitive deficits. Scores for 'overmentalizing' did not differ between groups, when age, gender, non-social reasoning and memory were controlled. In schizophrenic patients, negative symptoms were associated with a lack of a mental state concept, while positive symptoms like delusions were associated with 'overmentalizing', supporting respective etiological concepts of delusions.

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

    Science.gov (United States)

    Esterberg, Michelle L.; Goulding, Sandra M.

    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 in particular stems from research with adult populations. Less in known about these disorders in children and adolescents, and controversy remains regarding diagnosis of personality disorders in general in youth. The current paper reviews the available research on Cluster A personality disorders in childhood and adolescence; specifically, we discuss differentiating between the three disorders and distinguishing them from other syndromes, measuring Cluster A disorders in youth, and the nature and course of these disorders throughout childhood and adolescence. We also present recent longitudinal data from a sample of adolescents diagnosed with Cluster A personality disorders from our research laboratory, and suggest directions for future research in this important but understudied area. PMID:21116455

  17. Schizotypal, schizoid and paranoid characteristics in the biological parents of social anhedonics.

    Science.gov (United States)

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

    2010-06-30

    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 community. Structured clinical interviews were conducted to obtain Cluster A diagnoses and symptom ratings for parents. The biological parents of socially anhedonic probands had elevated rates of Cluster A disorders (24%) compared with the parents of control probands (12%). Post hoc analyses revealed that these group differences were the result of elevated rates of diagnoses in the fathers of social anhedonic probands, but not the mothers. This finding was replicated when Cluster A symptoms were examined dimensionally. These findings are consistent with the hypothesis that social anhedonia is a promising indicator of the genetic vulnerability to schizophrenia-spectrum pathology. The unexpected findings of elevated pathology in fathers, but not mothers of socially anhedonic probands, require further exploration.

  18. Paranoid Secondary: Waterfilling in a Cognitive Interference Channel with Partial Information

    CERN Document Server

    Dash, Debashis

    2011-01-01

    We study a two-user cognitive channel, where the primary flow is sporadic, cannot be re-designed and operating below its link capacity. To study the impact of primary traffic uncertainty, we propose a block activity model that captures the random on-off periods of primary's transmissions. Each block in the model can be split into parallel Gaussian-mixture channels, such that each channel resembles a multiple user channel (MAC) from the point of view of the secondary user. The secondary senses the current state of the primary at the start of each block. We show that the optimal power transmitted depends on the sensed state and the optimal power profile is paranoid, i.e. either growing or decaying in power as a function of time. We show that such a scheme achieves capacity when there is no noise in the sensing. The optimal transmission for the secondary performs rate splitting and follows a layered water-filling power allocation for each parallel channel to achieve capacity. The secondary rate approaches a geni...

  19. [Wilson's disease associated with olfactory paranoid syndrome and idiopathic thrombocytopenic purpura].

    Science.gov (United States)

    Sagawa, Morihiko; Takao, Masaki; Nogawa, Shigeru; Mizuno, Masafumi; Murata, Mitsuru; Amano, Takahiro; Koto, Atsuo

    2003-10-01

    In this study we report an individual of Wilson's disease associated with olfactory paranoid syndrome and idiopathic thrombocytopenic purpura. The initial symptom of this female patient was olfactory paranoia at age 17. Although that psychiatric symptom was well controlled under pharmacological treatment for two years, she developed olfactory paranoia as well as sialorrhea, dysarthria and finger tremor at age 20. A year later rigidity was also present in the extremities. At age 23, idiopathic thrombocytopenic purpura was found based on hematological examinations. Because her extrapyramidal symptoms were progressive, she was referred to our department to evaluate her neurologic condition. She was diagnosed as having Wilson's disease based on (1) the presence of Kayser-Fleischer rings, (2) extrapyramidal signs, and (3) a decreased level of serum copper and ceruloplasmin. T2 and FLAIR images of brain MRI showed hyperintense lesions in the putamen, thalamus and pontine tegmentum. Diffusion-weighted images also showed hyperintense lesions in the thalamus and pontine tegmentum. The biopsy specimen of the liver revealed chronic hepatitis with copper accumulation. Since D-penicillamine treatment was initiated, she has shown no olfactory paranoia and exacerbation of ITP. Her gait disturbance has also improved. Olfactory paranoia and ITP are rare clinical complications of Wilson's disease. Further analysis may warrant consideration of the pathophysiological mechanism of the psychiatric, hematological and neuroradiological condition seen in Wilson's disease.

  20. Psychopharmacological treatment and course in paranoid personality disorder: a case series.

    Science.gov (United States)

    Birkeland, Søren F

    2013-09-01

    Little is known about the role of psychopharmacological treatment and course of illness in patients diagnosed with a paranoid personality disorder. This short communication provides a naturalistic study of a psychiatric hospital case series. Fifteen consecutive patients were retrospectively studied. The Clinical Global Impression was rated at first admission, at last psychiatric contact, and after a 6-week observation period with or without antipsychotic treatment. During psychiatric admissions, three patients improved markedly, eight showed only minor changes, and four worsened. In total, seven patients had been administered any antipsychotic medication. The median duration of treatment was 15 weeks (range 4 days-328 weeks). No major adverse effects were noted. Among patients with sixth-week observations available, four had received antipsychotics; they appeared to improve considerably compared with six patients who had not received antipsychotics. Although the findings should be interpreted with caution, they support the notion of the disorder being a relatively chronic condition, although antipsychotics appeared to be safe and possibly had an effect in the short term.

  1. Forgotten family members: the importance of siblings in early psychosis.

    Science.gov (United States)

    Bowman, Siann; Alvarez-Jimenez, Mario; Wade, Darryl; McGorry, Patrick; Howie, Linsey

    2014-08-01

    This paper reviews the evidence on the significance of sibling inclusion in family interventions and support during early psychosis. This narrative review presents the current research related to the importance of family work during early psychosis, the needs and developmental significance of siblings during adolescence and early adulthood, the protective effects of sibling relationships, and the characteristics of early psychosis relevant to the sibling experience. It will also review the evidence of the sibling experience in chronic physical illness and disability, as well as long-term psychotic illness. Despite the evidence that working with families is important during early psychosis, siblings have been largely ignored. Siblings are an important reciprocal relationship of long duration. They play an important role in development during adolescence and early adulthood. These relationships may be an underutilized protective factor due to their inherent benefits and social support. Developmental theories imply that early psychosis could negatively impact the sibling relationship and their quality of life, effecting personality development and health outcomes. The evidence shows that adolescent physical illness or disability has a significantly negative impact on the sibling's quality of life and increases the risk for the onset of mental health issues. Long-term psychotic illness also results in negative experiences for siblings. Current evidence shows that siblings in early psychosis experience psychological distress and changes in functional performance. Further research using standard measures is required to understand the impact early psychosis has on the sibling relationship and their quality of life. © 2013 Wiley Publishing Asia Pty Ltd.

  2. Theory of mind and social functioning in first episode psychosis.

    Science.gov (United States)

    Sullivan, Sarah; Herzig, Daniela; Mohr, Christine; Lewis, Glyn; Corcoran, Rhiannon; Drake, Richard; Evans, Jonathan

    2013-05-01

    There is evidence of associations between social functioning and theory of mind performance and between social functioning and negative symptoms in chronic psychosis. This study investigates these associations in those with first episode psychosis who are unaffected by factors related to long-term mental illness. Our first hypothesis states that there is an association between theory of mind and social functioning. The second hypothesis states that there is no association between symptoms of psychosis and social functioning. Fifty-two individuals with first episode psychosis were assessed for social functioning, theory of mind ability (using the Hinting test with verbal stimuli and the Visual Cartoon test with pictorial stimuli), and symptoms of psychosis. Multivariable logistic regression was used to examine associations. Social functioning and theory of mind were associated when measured by the Hinting test (OR 1.70, 95% CI 1.08, 2.66), but not with the Visual Cartoon test (ToM jokes OR 0.61, 95% CI 0.15, 2.53). There was no association between social functioning and symptoms (psychotic symptoms; OR 0.95, 95% CI 0.81, 1.12; selected negative symptoms; OR 1.33, 95% CI 0.78, 2.25). Theory of mind assessed by verbal stimuli is associated with social functioning in a population with first episode psychosis. These findings may be related to language disorders in psychosis.

  3. Retrospective study on structural neuroimaging in first-episode psychosis

    Directory of Open Access Journals (Sweden)

    Ricardo Coentre

    2016-05-01

    Full Text Available Background. No consensus between guidelines exists regarding neuroimaging in first-episode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT and magnetic resonance imaging (MRI in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18–48 years (mean age: 29.6 years, consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI and respective reports were analysed by an experienced consultant psychiatrist. Results. None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly and falx cerebri calcification. No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay and cannabis use were found between patients who had neuroimaging abnormalities versus those without. Discussion. This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age.

  4. Why psychosis is frequently associated with Parkinson’s disease?*

    Institute of Scientific and Technical Information of China (English)

    Jingmei Zhong; Kunhua Wu; Shaoyuan Wu; Ying Zhao; Hui Chen; Naiwei Zhao; Kunwen Zheng; Zhong Zhao; Wenli Chen; Bo Wang

    2013-01-01

    Psychosis is a common non-motor symptom of Parkinson’s disease whose pathogenesis remains poorly understood. Parkinson’s disease in conjunction with psychosis has been shown to induce injury to extracorticospinal tracts as wel as within some cortical areas. In this study, Parkinson’s disease patients with psychosis who did not receive antipsychotic treatment and those without psychosis underwent diffusion tensor imaging. Results revealed that in Parkinson’s disease patients with psychosis, damage to the left frontal lobe, bilateral occipital lobe, left cingulated gyrus, and left hippocampal white-matter fibers were greater than damage to the substantia nigra or the globus pal idus. Damage to white-matter fibers in the right frontal lobe and right cingulate gyrus were also more severe than in the globus pal idus, but not the substantia nigra. Damage to frontal lobe and cingulate gyrus white-matter fibers was more apparent than that to occipital or hippocampal fiber damage. Compared with Parkinson’s disease patients without psychosis, those with psychosis had significantly lower fractional anisotropy ratios of left frontal lobe, bilateral occipital lobe, left cingu-lated gyrus, and left hippocampus to ipsilateral substantia nigra or globus pal idus, indicating more severe damage to white-matter fibers. These results suggest that psychosis associated with Par-kinson’s disease is probably associated with an imbalance in the ratio of white-matter fibers be-tween brain regions associated with psychiatric symptoms (frontal lobe, occipital lobe, cingulate gyrus, and hippocampus) and those associated with the motor symptoms of Parkinson’s disease (the substantia nigra and globus pal idus). The relatively greater damage to white-matter fibers in psychiatric symptom-related brain regions than in extracorticospinal tracts might explain why psy-chosis often occurs in Parkinson’s disease patients.

  5. New Wine in Old Bottle: Late-Life Psychosis

    Science.gov (United States)

    Iglewicz, Alana; Meeks, Thomas W.; Jeste, Dilip V.

    2011-01-01

    Psychosis is common in late life and exacts enormous costs to society, affected individuals, and their caregivers. A multitude of etiologies for late-life psychosis exist, the two most prototypical being schizophrenia and psychosis of Alzheimer’s Disease (AD). As such, this review will focus on the non-affective, neuropsychiatric causes of chronic psychosis in the elderly, specifically schizophrenia, delusional disorder, and the psychosis of AD and other dementias. As evidenced in this review, the current research regarding the onset and course of late-life schizophrenia reflects a more favorable prognosis than that painted by the Kraepelinian notion of schizoprenia as “dementia praecox.” Antipsychotics are useful in controlling the symptoms of late-life schizophrenia, but their use among older adults warrants increased vigilance because of older adults’ increased proclivity to side effects. Psychosocial interventions can be effective, usually in conjunction with medication. Meanwhile, psychosis of AD occurs in nearly half of people with AD and is associated with increased hospitalizations, institutionalization, caregiver distress, and mortality. Despite the profound consequences of psychotic symptoms associated with dementias, the extant literature does not afford clinicians clear, consistent guidance on how to provide optimal treatment to specific patients. Second generation antipsychotics are usually the choice treatment for psychosis, but the black box warning regarding their associated 1–2% increased absolute risk in stroke and overall mortality in patients with dementia complicates their use. Using second generation antipsychotics in low doses for brief periods and discontinuing them when possible is the best clinical practice for dementia-related psychosis. Psychosocial interventions for the treatment of psychosis with AD appear promising in empirical research, but more rigorous study is needed. PMID:21536160

  6. Fetishistic transvestism in a patient with mental retardation and psychosis.

    Science.gov (United States)

    Velayudhan, Rajmohan; Khaleel, Asfia; Sankar, Nideesh; Kumar, Manoj; Kazhungil, Firoz; Raghuram, Thazhe Mangool

    2014-04-01

    Fetishistic transvestism is a disorder of sexual preference associated with fantasies and sexual urges to dress in opposite gender clothing as a means of arousal and as an adjunct to masturbation and coitus. The disorder has been reported in people with learning disabilities. The disorder has been reported in a young male with dull normal intelligence. Transvestism though has been described in schizophrenia and psychosis and fetishism has been described in the course of simple schizophrenia, there are no reports of fetishistic transvestism in a patient with mental retardation and psychosis. A case of fetishistic transvestism in a patient with mental retardation and psychosis with treatment and relevant review of literature is reported.

  7. Psychosis as a late manifestation of Sheehan's syndrome.

    Science.gov (United States)

    Reddy, Mukku Shiva Shanker; Nahar, Abhinav; Thippeswamy, Harish; Kumar, Chaturvedi Santosh

    2017-02-01

    Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum haemorrhage. It is one of the most common causes of hypopituitarism in underdeveloped or developing countries. Characteristic manifestations include failure to lactate or to resume menses, genital and axillary hair loss, asthenia and weakness, fine wrinkles around the eyes and lips, signs of premature aging, dry skin, hypopigmentation and other evidence of hypopituitarism. Uncommonly it can present with psychosis. There are only few case reports of psychoses in patients with Sheehan's syndrome. Our case report illustrates the relationship between psychosis and Sheehan's syndrome. The treatment challenges in managing Sheehan's syndrome and psychosis are discussed.

  8. Cannabis-induced psychosis associated with high potency "wax dabs".

    Science.gov (United States)

    Pierre, Joseph M; Gandal, Michael; Son, Maya

    2016-04-01

    With mounting evidence that the risk of cannabis-induced psychosis may be related to both dose and potency of tetrahydrocannbinol (THC), increasing reports of psychosis associated with cannabinoids containing greater amounts of THC are anticipated. We report two cases of emergent psychosis after using a concentrated THC extract known as cannabis "wax," "oil," or "dabs" raising serious concerns about its psychotic liability. Although "dabbing" with cannabis wax is becoming increasingly popular in the US for both recreational and "medicinal" intentions, our cases raise serious concerns about its psychotic liability and highlight the importance of understanding this risk by physicians recommending cannabinoids for purported medicinal purposes. Published by Elsevier B.V.

  9. Drug Abuse and Psychosis: New Insights into Drug-induced Psychosis

    Science.gov (United States)

    Ham, Suji; Kim, Tae Kyoo; Chung, Sooyoung

    2017-01-01

    Addictive drug use or prescribed medicine abuse can cause psychosis. Some representative symptoms frequently elicited by patients with psychosis are hallucination, anhedonia, and disrupted executive functions. These psychoses are categorized into three classifications of symptoms: positive, negative, and cognitive. The symptoms of DIP are not different from the symptoms of schizophrenia, and it is difficult to distinguish between them. Due to this ambiguity of distinction between the DIP and schizophrenia, the DIP animal model has been frequently used as the schizophrenia animal model. However, although the symptoms may be the same, its causes are clearly different in that DIP is acquired and schizophrenia is heritable. Therefore, in this review, we cover several DIP models such as of amphetamine, PCP/ketamine, scopolamine, and LSD, and then we also address three schizophrenia models through a genetic approach with a new perspective that distinguishes DIP from schizophrenia. PMID:28243163

  10. Neuropsychological Profiles in Individuals at Clinical High Risk for Psychosis: Relationship to Psychosis and Intelligence

    Science.gov (United States)

    Woodberry, Kristen A.; Seidman, Larry J.; Giuliano, Anthony J.; Verdi, Mary B.; Cook, William L.; McFarlane, William R.

    2010-01-01

    Background Characterizing neuropsychological (NP) functioning of individuals at clinical high risk (CHR) for psychosis may be useful for prediction of psychosis and understanding functional outcome. The degree to which NP impairments are associated with general cognitive ability and/or later emergence of full psychosis in CHR samples requires study with well-matched controls. Methods We assessed NP functioning across eight cognitive domains in a sample of 73 CHR youth, 13 of whom developed psychotic-level symptoms after baseline assessment, and 34 healthy comparison (HC) subjects. Groups were matched on age, sex, ethnicity, handedness, subject and parent grade attainment, and median family income, and were comparable on WRAT-3 Reading, an estimate of premorbid IQ. Profile analysis was used to examine group differences and the role of IQ in profile shape. Results The CHR sample demonstrated a significant difference in overall magnitude of NP impairment but only a small and nearly significant difference in profile shape, primarily due to a large impairment in olfactory identification. Individuals who subsequently developed psychotic-level symptoms demonstrated large impairments in verbal IQ, verbal memory and olfactory identification comparable in magnitude to first episode samples. Conclusions CHR status may be associated with moderate generalized cognitive impairments marked by some degree of selective impairment in olfaction and verbal memory. Impairments were greatest in those who later developed psychotic symptoms. Future study of olfaction in CHR samples may enhance early detection and specification of neurodevelopmental mechanisms of risk. PMID:20692125

  11. Psychotherapies in Acute and Transient Psychoses

    Directory of Open Access Journals (Sweden)

    Manuel González de Chávez

    2014-10-01

    Full Text Available From a comprehensive and global view -psychological, biological and social - acute and transient psychoses could be considered identity breakdowns with fragmentation of its structure, paranoid mechanism and cognitive regression. Psychotherapies favour evolution of psychotic identity through disorder awareness and knowledge of aspects of patients that make them more vulnerable to psychotic experiences. We underline the key role of group psychotherapy to improve therapeutic relationships and best use of patient’s coping strategies in the chronology of therapeutic interventions and recovery process of these patients.

  12. Aripiprazole-induced oculogyric crisis (acute dystonia

    Directory of Open Access Journals (Sweden)

    Jyotik T Bhachech

    2012-01-01

    Full Text Available Aripiprazole is the third generation atypical antipsychotic and a dopamine serotonin system stabilizer (DSS effective against positive and negative symptoms of schizophrenia. It has a low propensity for extrapyramidal side effects, causes minimal weight gain or sedation, produces no elevation in serum prolactin levels, and does not cause prolongation of QTc interval. This case report is of a patient suffering from schizophrenia (paranoid. The patient developed oculogyric crisis (acute dystonia with aripiprazole dose uptitration. Dystonic reaction resolved with promethazine administration. Naranjo′s causality assessment reveals probable association of aripiprazole with oculogyric crisis. A thorough workup and vigilance is required prior to initiation of aripiprazole in the case of schizophrenia.

  13. Functional polymorphism in the interleukin-6 and interleukin-10 genes in patients with paranoid schizophrenia--a case-control study.

    Science.gov (United States)

    Paul-Samojedny, Monika; Kowalczyk, Malgorzata; Suchanek, Renata; Owczarek, Aleksander; Fila-Danilow, Anna; Szczygiel, Aleksandra; Kowalski, Jan

    2010-09-01

    Schizophrenia is a multifactorial disease with changes in immunological system. Such changes are the result of cytokine-level disturbances connected with cytokine gene polymorphisms. However, research about cytokine gene polymorphisms in schizophrenia has been surprisingly limited and ambiguous. The aim of the study was to identify whether polymorphisms of interleukin (IL)-6 and IL-10 are risk factors for the development of paranoid schizophrenia in case-control study. IL-6 (-174G/C; rs 1800795) and IL-10 (-1082G/A; rs 1800896) promoter polymorphisms in patients with paranoid schizophrenia and healthy individuals were genotyped using polymerase chain reaction-restriction fragment length polymorphism method. Differences in IL-6 and IL-10 promoter haplotypes may play an important role in determining the transcription level for IL-6 and IL-10 genes in schizophrenic patients. The presence of allele C at position -174 of IL-6 promoter sequence may correlate with increasing risk of paranoid schizophrenia in the Polish population, but research on a broadened group of people is needed. The presence of allele G at position -1082 of IL-10 promoter sequence correlates with increasing risk of paranoid schizophrenia in the Polish population. The coexistence of genotype GG at position -1082 of IL-10 promoter sequence and genotype GC at position -174 of IL-6 promoter sequence correlates with increasing risk of paranoid schizophrenia in the Polish population.

  14. Psychosis and the control of lucid dreaming

    Directory of Open Access Journals (Sweden)

    Natália Bezerra Mota

    2016-03-01

    Full Text Available Dreaming and psychosis share important features, such as intrinsic senseperceptions independent of external stimulation, and a general lack of criticism that is associated with reduced frontal cerebral activity. Awareness of dreaming while a dream is happening defines lucid dreaming (LD, a state in which the prefrontal cortex is more active than during regular dreaming. For this reason, LD has been proposed to be potentially therapeutic for psychotic patients. According to this view, psychotic patients would be expected to report LD less frequently, and with lower control ability, than healthy subjects. Furthermore, psychotic patients able to experience LD should present milder psychiatric symptoms, in comparison with psychotic patients unable to experience LD. To test these hypotheses, we investigated LD features (occurrence, control abilities, frequency, and affective valence and psychiatric symptoms (measure by PANSS, BPRS and automated speech analysis in 45 subjects with psychotic symptoms (25 with Schizophrenia (S and 20 with Bipolar Disorder (B diagnosis versus 28 non-psychotic control (C subjects. Psychotic lucid dreamers reported control of their dreams more frequently (67% of S and 73% of B than non-psychotic lucid dreamers (only 23% of C; S > C with p=0. 0283, B > C with p=0.0150. Importantly, there was no clinical advantage for lucid dreamers among psychotic patients, even for the diagnostic question specifically related to lack of judgment and insight. Despite some limitations (e.g. transversal design, large variation of medications, these preliminary results support the notion that lucid dreaming is associated with psychosis, but falsify the hypotheses that we set out to test. A possible explanation is that psychosis enhances the experience of internal reality in detriment of external reality, and therefore lucid dreamers with psychotic symptoms would be more able to control their internal reality than non-psychotic lucid dreamers

  15. Psychosis and the Control of Lucid Dreaming.

    Science.gov (United States)

    Mota, Natália B; Resende, Adara; Mota-Rolim, Sérgio A; Copelli, Mauro; Ribeiro, Sidarta

    2016-01-01

    Dreaming and psychosis share important features, such as intrinsic sense perceptions independent of external stimulation, and a general lack of criticism that is associated with reduced frontal cerebral activity. Awareness of dreaming while a dream is happening defines lucid dreaming (LD), a state in which the prefrontal cortex is more active than during regular dreaming. For this reason, LD has been proposed to be potentially therapeutic for psychotic patients. According to this view, psychotic patients would be expected to report LD less frequently, and with lower control ability, than healthy subjects. Furthermore, psychotic patients able to experience LD should present milder psychiatric symptoms, in comparison with psychotic patients unable to experience LD. To test these hypotheses, we investigated LD features (occurrence, control abilities, frequency, and affective valence) and psychiatric symptoms (measure by PANSS, BPRS, and automated speech analysis) in 45 subjects with psychotic symptoms [25 with Schizophrenia (S) and 20 with Bipolar Disorder (B) diagnosis] versus 28 non-psychotic control (C) subjects. Psychotic lucid dreamers reported control of their dreams more frequently (67% of S and 73% of B) than non-psychotic lucid dreamers (only 23% of C; S > C with p = 0.0283, B > C with p = 0.0150). Importantly, there was no clinical advantage for lucid dreamers among psychotic patients, even for the diagnostic question specifically related to lack of judgment and insight. Despite some limitations (e.g., transversal design, large variation of medications), these preliminary results support the notion that LD is associated with psychosis, but falsify the hypotheses that we set out to test. A possible explanation is that psychosis enhances the experience of internal reality in detriment of external reality, and therefore lucid dreamers with psychotic symptoms would be more able to control their internal reality than non-psychotic lucid dreamers. Training dream

  16. Acceptance and Commitment Therapy for Inpatients with Psychosis (the REACH Study): Protocol for Treatment Development and Pilot Testing

    Science.gov (United States)

    Gaudiano, Brandon A.; Davis, Carter H.; Epstein-Lubow, Gary; Johnson, Jennifer E.; Mueser, Kim T.; Miller, Ivan W.

    2017-01-01

    Patients with schizophrenia-spectrum disorders frequently require treatment at inpatient hospitals during periods of acute illness for crisis management and stabilization. Acceptance and Commitment Therapy (ACT), a “third wave” cognitive-behavioral intervention that employs innovative mindfulness-based strategies, has shown initial efficacy in randomized controlled trials for improving acute and post-discharge outcomes in patients with psychosis when studied in acute-care psychiatric hospitals in the U.S. However, the intervention has not been widely adopted in its current form because of its use of an individual-only format and delivery by doctoral-level research therapists with extensive prior experience using ACT. The aim of the Researching the Effectiveness of Acceptance-based Coping during Hospitalization (REACH) Study is to adapt a promising acute-care psychosocial treatment for inpatients with psychosis, and to pilot test its effectiveness in a routine inpatient setting. More specifically, we describe our plans to: (a) further develop and refine the treatment and training protocols, (b) conduct an open trial and make further modifications based on the experience gained, and (c) conduct a pilot randomized controlled trial in preparation for a future fully-powered clinical trial testing the effectiveness of ACT. PMID:28475123

  17. Hashimoto's Encephalopathy Presenting with Acute Cognitive Dysfunction and Convulsion.

    Science.gov (United States)

    Kang, Woo-Hyuk; Na, Ju-Young; Kim, Meyung-Kug; Yoo, Bong-Goo

    2013-12-01

    Hashimoto's encephalopathy is an immune-mediated disorder characterized by acute or subacute encephalopathy related to increased anti-thyroid antibodies. Clinical manifestations of Hashimoto's encephalopathy may include stroke-like episodes, altered consciousness, psychosis, myoclonus, abnormal movements, seizures, and cognitive dysfunction. Acute cognitive dysfunction with convulsion as initial clinical manifestations of Hashimoto's encephalopathy is very rare. We report a 65-year-old man who developed acute onset of cognitive decline and convulsion due to Hashimoto's encephalopathy.

  18. [Clinical typology of organic psychosis in children and adolescents].

    Science.gov (United States)

    Makarov, I V

    2013-01-01

    Observation of a group of children and adolescents, aged 8-17 years, with organic psychosis are reviewed. Four main variants, including organic schizoid psychoses; organic affective psychoses; periodic organic psychoses and organic hallucinosis, are described.

  19. Efficacy and cost of micronutrient treatment of childhood psychosis

    Science.gov (United States)

    Rodway, Megan; Vance, Annette; Watters, Amany; Lee, Helen; Bos, Elske; Kaplan, Bonnie J

    2012-01-01

    Psychosis is difficult to treat effectively with conventional pharmaceuticals, many of which have adverse long-term health consequences. In contrast, there are promising reports from several research groups of micronutrient treatment (vitamins, minerals, amino acids and essential fatty acids) of mood, anxiety and psychosis symptoms using a complex formula that appears to be safe and tolerable. We review previous studies using this formula to treat mental symptoms, and present an 11-year-old boy with a 3-year history of mental illness whose parents chose to transition him from medication to micronutrients. Symptom severity was monitored in three clusters: anxiety, obsessive compulsive disorder and psychosis. Complete remission of psychosis occurred, and severity of anxiety and obsessional symptoms decreased significantly (pmicronutrient treatment was micronutrient treatment is warranted. PMID:23144350

  20. Are Australian men with psychosis spending more time homeless?

    Science.gov (United States)

    Holmes, Alex; Hodge, Mark; Bradley, Gail; Bluhm, Alan; Markulev, Natasha; North, Cameron; Innis, Andy

    2008-04-01

    The objective of this study was to determine if homeless men with psychosis using emergency accommodation services are spending more time homeless. A 12-month accommodation history was collected from all men with psychosis referred to mental health services using two emergency accommodation services in inner Melbourne over a 5-year period. Of the 241 men referred with psychosis, 200 (81%) were able to provide a full accommodation history. In 2001 the mean total days spent in crisis accommodation was 27.0 days and in 2005 the mean number of days was 60.9. Over the 5 years, increasing time was spent homeless in the 12 months prior to assessment, most commonly in emergency accommodations. Australian men with psychosis using emergency accommodation are spending an increasing amount of time homeless.

  1. Complete remission of epileptic psychosis after temporal lobectomy: case report

    Directory of Open Access Journals (Sweden)

    Marchetti Renato Luiz

    2001-01-01

    Full Text Available We report a case of a female patient with refractory complex partial seizures since 15 years of age, recurrent postictal psychotic episodes since 35 which evolved to a chronic refractory interictal psychosis and MRI with right mesial temporal sclerosis (MTS. After a comprehensive investigation (video-EEG intensive monitoring, interictal and ictal SPECT, and a neuropsychological evaluation including WADA test she was submitted to a right temporal lobectomy. Since then, she has been seizure-free with remission of psychosis, although with some persistence of personality traits (hiperreligiosity, viscosity which had been present before surgery. This case supports the idea that temporal lobectomy can be a safe and effective therapeutic measure for patients with MTS, refractory epilepsy and recurrent postictal epileptic psychosis or interictal epileptic psychosis with postictal exacerbation.

  2. Cycloid psychosis: an examination of the validity of the concept.

    Science.gov (United States)

    Peralta, Victor; Cuesta, Manuel J; Zandio, Maria

    2007-06-01

    The diagnosis of cycloid psychosis has a long tradition in European psychiatry. However, it has been poorly assimilated within the DSM IV and ICD-10 diagnostic systems. Leonhard set the basis for the current conceptualization of the disorder, and Perris and Brockington developed the first operational diagnostic criteria. However, the two conceptualizations of the disorder are not the same and differ across a number of meaningful variables. Cycloid psychosis is a useful concept in that it possesses both clinical and predictive validity. Despite the high prevalence of mood symptoms and syndromes, cycloid psychosis does not equal schizoaffective disorder. Although a substantial body of evidence suggests that cycloid psychosis differs meaningfully from typical schizophrenia, it is less clear whether it differs from major mood disorders or represents an independent nosological entity. The existence of putative subtypes is also likely, and the differentiation between affective and nonaffective subtypes has received some support.

  3. Depression and quality of life in first-episode psychosis.

    LENUS (Irish Health Repository)

    Renwick, Laoise

    2012-07-01

    Quality of life (QOL) has gained recognition as a valid measure of outcome in first-episode psychosis (FEP). This study aimed to determine the influence of specific groups of depressive symptoms on separate domains of subjectively appraised QOL.

  4. Cycloserine Induced Psychosis among Patient's on Second Line ...

    African Journals Online (AJOL)

    TNHJOURNALPH

    Cycloserine Induced Psychosis among Patient's on Second Line. Treatment for ... Department of Internal Medicine, 1Abubakar Tafawa Balewa University Teaching Hospital,. Bauchi .... delirium due to hepatic encephalopathy and decreased in ...

  5. Dynamic psychiatry and the treatment of anorexia psychosis.

    Science.gov (United States)

    Silver, Ann-Louise S; White, Janice

    2011-01-01

    Dynamic psychotherapy of psychosis works through gradually diminishing terror, replacing this with a clearer and shared understanding of the patient's life history, its traumas and its strengths. It is diametrically opposed to our current push for efficiency and an assumption of an underlying brain disorder that responds to our current medications. Over the course of a long treatment, this patient became a scholar of psychoanalytic contributions to understanding psychosis and is now a philosopher of this field, developing an understanding of anorexia psychosis. She draws on the writings of Freud, Bion, Lacan, and Julian Jaynes, placing the core of psychosis not in primary process but in a preceding, non-self phase of development. She relates this individual development to the history of human development.

  6. Striatal mitochondria in subjects with chronic undifferentiated vs. chronic paranoid schizophrenia.

    Science.gov (United States)

    Somerville, Shahza M; Conley, Robert R; Roberts, Rosalinda C

    2012-01-01

    Schizophrenia (SZ) is a heterogeneous disease with a spectrum of symptoms, risk factors, and etiology. Abnormalities in mitochondria, the energy-producing organelles of the cell, have been observed in mixed cohorts of subjects with SZ. The purpose of the present study was to determine if striatal mitochondria were differentially affected in two different DSM-IV subgroups of SZ. Postmortem striatal tissue was examined from normal controls (NC), chronic paranoid SZs (SZP), and chronic undifferentiated SZs (SZU). Tissue was processed for calbindin immunohistochemistry to identify striosomal compartments, prepared for electron microscopy and analyzed using stereological methods. In both caudate and putamen, the density of mitochondria in the neuropil was decreased in SZP compared to both NCs and SZU. In the putamen, both the SZP and the SZU subgroups had fewer mitochondria per synapse than did NCs. When examining patch matrix compartments, striatal compartments associated with different circuitry and function, only the matrix exhibited changes. In the caudate matrix, the SZP subgroup had fewer mitochondria in the neuropil than did the SZU and NCs. In the putamen matrix, the SZP had fewer mitochondria in the neuropil as compared to NCs, but not the SZU. The numbers of mitochondria per synapse in both the SZP and the SZU groups were similar to each other and fewer than that of NCs. A decrease in mitochondrial density in the neuropil distinguishes the SZP from the SZU subgroup, which could be associated with the symptoms of paranoia and/or could represent a protective mechanism against some of the symptoms that are less pronounced in this subtype than in the SZU subgroup such as cognitive and emotional deficits.

  7. Recent Neurobiological Insights into the Concept of Insight in Psychosis.

    Science.gov (United States)

    Mythri, Starlin Vijay; Sanjay, Y

    2016-01-01

    The concept of insight in psychosis has been an interesting area in clinical psychiatry for well over a century with a surge in research interest over the past 25 years. Moreover, the past 5 years have been particularly fruitful in deciphering its neurobiological underpinnings. This article presents the development of the concept of insight in psychosis and reviews the current neurobiological research findings in this area.

  8. Recent Neurobiological Insights into the Concept of Insight in Psychosis

    Science.gov (United States)

    Mythri, Starlin Vijay; Sanjay, Y

    2016-01-01

    The concept of insight in psychosis has been an interesting area in clinical psychiatry for well over a century with a surge in research interest over the past 25 years. Moreover, the past 5 years have been particularly fruitful in deciphering its neurobiological underpinnings. This article presents the development of the concept of insight in psychosis and reviews the current neurobiological research findings in this area. PMID:27335512

  9. Premorbid Personality and Insight in First-Episode Psychosis

    OpenAIRE

    Campos, Maria S.; Garcia-Jalon, Elena; Gilleen, James K.; David, Anthony S.; Peralta MD, Victor; Cuesta, Manuel J.

    2010-01-01

    Background: Insight in psychosis and schizophrenia is considered a complex biopsychosocial phenomenon. Premorbid personality is regarded by some authors as part of the substrate to many psychiatric phenomena, but it is not clear if this applies to insight. Aim: To examine longitudinal relationships between personality traits and insight dimensions in first-episode psychosis. Methods: One hundred consecutive antipsychotic-naïve first-episode nonaffective psychotic patients admitted to hospital...

  10. Personality disorders in first-episode psychosis

    DEFF Research Database (Denmark)

    Simonsen, Erik; Haahr, Ulrik; Mortensen, Erik Lykke

    2008-01-01

    or more personality disorders, while one-third of the patients did not fulfil the criteria for any personality disorder. The schizoid and the avoidant were the most frequent personality disorders and both were associated with social withdrawal during childhood and adolescence. The limitation of the study......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....... Thirty-three of these of the patients were assessed at two-year follow-up for comorbid personality disorders by the Structured Clinical Interview for DSM-IV Personality Disorders and by the self-report instrument Millon Clinical Multiaxial Inventory-II. Half of the patients met the criteria of two...

  11. Schizencephaly and Psychosis: A Rare Association

    Directory of Open Access Journals (Sweden)

    Matias Carvalho Aguiar Melo

    2013-01-01

    Full Text Available Schizencephaly is a rare malformation of the central nervous system defined as a gray matter-lined cleft filled with cerebrospinal fluid that extends from the pial surface to the ventricle. Few cases of association with psychosis were reported in the scientific literature. We present a case of a 46-year-old woman, admitted into a psychiatric hospital with crises of psychomotor agitation, disorganized and erotized behavior, persecutory and self-reference delusions, and auditory and visual hallucinations. She also reported seizures since her childhood. A head CT scan revealed a large subarachnoid space communication with the adjacent lateral ventricle in the topography of occipital, temporal, and parietal lobes to the right, suggestive of schizencephaly.

  12. Dissociative disorders: between neurosis and psychosis.

    Science.gov (United States)

    Devillé, C; Moeglin, C; Sentissi, O

    2014-01-01

    Dissociative disorders are a set of disorders defined by a disturbance affecting functions that are normally integrated with a prevalence of 2.4 percent in industrialised countries. These disorders are often poorly diagnosed or misdiagnosed because of sharing common clinical features with psychotic disorders, but requiring a very different trajectory of care. Repeated clinical situations in a crisis centre in Geneva provided us with a critical overview of current evidence of knowledge in clinical and etiopathological field about dissociative disorders. Because of their multiple expressions and the overlap with psychotic disorders, we focused on the clinical aspects using three different situations to better understand their specificity and to extend our thinking to the relevance of terms "neurosis" and "psychosis." Finally, we hope that this work might help physicians and psychiatrists to become more aware of this complex set of disorders while making a diagnosis.

  13. [The discourse of psychosis in contemporary philosophy].

    Science.gov (United States)

    Stompe, Thomas; Ritter, Kristina

    2009-01-01

    The preoccupation of philosophy with madness can be traced back till the Greek antiquity. For many philosophers like Descartes psychotic phenomena were symbols for the fragility of human mental powers, while others like Plato or Nietzsche saw madness as a way to escape the constraints of rationality. After 1960 three direction of contemporary philosophy dealt with the topics madness--schizophrenia--psychosis: Following Nietzsche and Bataille, Foucault as well as Deleuze and Guattari considered schizophrenia as the societal oppressed reverse of modern rationality, a notion which had a strong influence on the anti-psychiatric movement. Philosophical phenomenology primarily focussed on ontological problems of the psychotic existence. Finally Philosophy of Mind, the modern Anglo-American version of analytical philosophy, analyzed the logical coherence of psychotic inferences and experiences. Especially the insights of analytical philosophy may be important for a more sophisticated interpretation of psychopathological research as well as of the new findings of neuroscience.

  14. Dissociative Disorders: Between Neurosis and Psychosis

    Directory of Open Access Journals (Sweden)

    C. Devillé

    2014-01-01

    Full Text Available Dissociative disorders are a set of disorders defined by a disturbance affecting functions that are normally integrated with a prevalence of 2.4 percent in industrialised countries. These disorders are often poorly diagnosed or misdiagnosed because of sharing common clinical features with psychotic disorders, but requiring a very different trajectory of care. Repeated clinical situations in a crisis centre in Geneva provided us with a critical overview of current evidence of knowledge in clinical and etiopathological field about dissociative disorders. Because of their multiple expressions and the overlap with psychotic disorders, we focused on the clinical aspects using three different situations to better understand their specificity and to extend our thinking to the relevance of terms “neurosis” and “psychosis.” Finally, we hope that this work might help physicians and psychiatrists to become more aware of this complex set of disorders while making a diagnosis.

  15. Online social networking in people with psychosis: A systematic review.

    Science.gov (United States)

    Highton-Williamson, Elizabeth; Priebe, Stefan; Giacco, Domenico

    2015-02-01

    Online social networking might facilitate the establishment of social contacts for people with psychosis, who are often socially isolated by the symptoms and consequences of their disorder. We carried out a systematic review exploring available evidence on the use of online social networking in people with psychosis. The review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies examined the use of the online social networking by people with an a priori diagnosis of psychosis (inclusive of bipolar disorder). Data from included studies were extracted and narratively synthesised. A total of 11 studies, published between 2005 and 2013, reported data on online social networking in people with psychosis. People with psychosis seem to spend more time in chat rooms or playing online games than control groups. The use of other online tools, such as Facebook or communication through e-mail, is lower or the same than controls. Online social networking was used by patients with psychosis for establishing new relationships, maintaining relationships/reconnecting with people and online peer support. Online social networking, in the form of forums or online chats, could play a role in strategies aimed at enhancing social networks and reduce the risk of isolation in this population. © The Author(s) 2014.

  16. [Concomitant impact of organic pathology on the development of cognitive impairment in patients with attack-like paranoid schizophrenia].

    Science.gov (United States)

    Libin, L Ia; Tagil'tseva, A V; Lifanova, D E; Ganzenko, M A; Gritsevskaia, T M; Ivanov, M B

    2014-01-01

    The study included 47 patients (23 men, 24 women) with ICD-10 diagnosis of attack-like paranoid schizophrenia. Patients were divided into two groups: with- (25 patients) or without (22 patients) a concomitant organic disease. Memory, attention and thinking were assessed with psychometric tests. Inter- and intra-group differences were identified that indicated a considerable impact of a concomitant CNS organic pathology on the development of cognitive impairment in the schizophrenic process and active antipsychotic therapy. The data obtained can be used in the development of a differentiated approach to the treatment of patients with concomitant organic pathology.

  17. BDNF val66met polymorphism is associated with age at onset and intensity of symptoms of paranoid schizophrenia in a Polish population.

    Science.gov (United States)

    Suchanek, Renata; Owczarek, Aleksander; Paul-Samojedny, Monika; Kowalczyk, Małgorzata; Kucia, Krzysztof; Kowalski, Jan

    2013-01-01

    The brain-derived neurotrophic factor (BDNF) is one of the candidate genes for schizophrenia. There is evidence that val66met polymorphism may be involved in the pathophysiology of schizophrenia. The authors genotyped val66met (rs6265) polymorphism of the BDNF gene in 208 inpatients with paranoid schizophrenia and 254 control subjects in a Polish population. There was no association between val66met polymorphism and development of paranoid schizophrenia in either men or women. However, an association was found between this polymorphism and age at onset and psychopathology of paranoid schizophrenia. Men with the val/met genotype had an earlier age at onset, and the val/val genotype predisposed to more severe symptoms, particularly on the General Psychopathology Scale of the Positive and Negative Symptoms Scale (PANSS-G). The analysis of PANSS single items has shown that patients with the val/met genotype had higher scores on a hallucinatory behavior item than those with other genotypes.

  18. Medical evaluation abnormalities in acute psychotic patients seen at the emergency department of Muhimbili national hospital in Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    S.G. Yusuf*

    2013-12-01

    Conclusions: In our cohort, history and physical examination findings were not sufficient to rule out serious medical conditions among patients presenting with acute psychosis. The observed rate of laboratory abnormalities was higher than previously published rates from high-resource settings. Based on our findings, patients presenting with psychosis to an acute care facility in this region should be evaluated with physical examination and laboratory studies to rule out serious underlying medical pathology.

  19. Early traumatic experiences, perceived discrimination and conversion to psychosis in those at clinical high risk for psychosis.

    Science.gov (United States)

    Stowkowy, Jacqueline; Liu, Lu; Cadenhead, Kristin S; Cannon, Tyrone D; Cornblatt, Barbara A; McGlashan, Thomas H; Perkins, Diana O; Seidman, Larry J; Tsuang, Ming T; Walker, Elaine F; Woods, Scott W; Bearden, Carrie E; Mathalon, Daniel H; Addington, Jean

    2016-04-01

    There is evidence to suggest that both early traumatic experiences and perceived discrimination are associated with later onset of psychosis. Less is known about the impact these two factors may have on conversion to psychosis in those who are at clinical high risk (CHR) of developing psychosis. The purpose of this study was to determine if trauma and perceived discrimination were predictors of conversion to psychosis. The sample consisted of 764 individuals who were at CHR of developing psychosis and 280 healthy controls. All participants were assessed on past trauma, bullying and perceived discrimination. Individuals at CHR reported significantly more trauma, bullying and perceived discrimination than healthy controls. Only perceived discrimination was a predictor of later conversion to psychosis. Given that CHR individuals are reporting increased rates of trauma and perceived discrimination, these should be routinely assessed, with the possibility of offering interventions aimed at ameliorating the impact of past traumas as well as improving self-esteem and coping strategies in an attempt to reduce perceived discrimination.

  20. Conditioned blocking and schizophrenia: a replication and study of the role of symptoms, age, onset-age of psychosis and illness-duration.

    Science.gov (United States)

    Bender, S; Müller, B; Oades, R D; Sartory, G

    2001-04-15

    Measures of selective attention processing like latent inhibition (LI) and conditioned blocking (CB) are disturbed in some patients with schizophrenia. [LI is the delay in learning about the associations of a stimulus that has been associated with no event (versus de novo learning); CB is the delay in learning the associations of a stimulus-component when the other component has already started to acquire these associations.] We proposed: (1) to replicate the reported decreases of CB in patients without paranoid-hallucinatory symptoms; (2) to see if CB depends on the age of illness-onset and its duration, as reported for LI. We studied 101 young and old, acute and chronically ill patients with schizophrenia, of whom 62 learned a modified 'mouse-in-house' CB task, and compared them with 62 healthy controls matched for age, education and socio-economic background. CB was more evident in patients with a diagnosis of paranoid schizophrenia than other subtypes. An unusual persistence of high CB scores through testing was associated with productive symptoms (including positive thought disorder). Reduced CB related to the expression of (a) Schneider's first rank symptoms of ideas-of-reference and (b) to negative symptoms like poor rapport and poor attention. CB was less evident in the older patients and those with an earlier illness-onset. In contrast to the similar LI test of selective attention, CB is found in patients with paranoid schizophrenia and its expression is not related closely to illness duration. This implies that the two tests reflect the activity of different underlying processes. We suggest that reduced CB on initial test-trials in nonparanoid schizophrenia reflects the unusual persistence of controlled information processing strategies that would normally become automatic during conditioning. In contrast, continued CB during testing reflects an unusual persistence of automatic processing strategies.

  1. Psychosis in an adolescent with Wilson's disease: A case report and review of the literature.

    Science.gov (United States)

    Grover, Sandeep; Sarkar, Siddharth; Jhanda, Soumya; Chawla, Yogesh

    2014-10-01

    Neuropsychiatric manifestations are common in Wilson's disease and mainly include extrapyramidal and cerebellar symptoms. Presentations with psychotic symptoms have been described less frequently. In this report we present the case of a young boy with Wilson's disease who developed psychotic symptoms. A 12-year-old boy was diagnosed with Wilson's disease on the basis of the physical examination findings and low ceruloplasmin levels (8.1 mg/dl). After 2 weeks of being diagnosed with Wilson's disease, he developed an acute onset illness, characterized by delusion of persecution, fearfulness, hypervigilence and decreased sleep. These symptoms were not associated with any confusion, clouding of consciousness, hallucinations and affective symptoms. There was no past or family history of psychosis. One week after the onset of the symptoms he was prescribed tab penicillamine, initially 250 mg/day, which was increased to 500 mg/day after 3 days. After increase in the dose of penicillamine, his psychiatric symptoms worsened and led to hospitalization. A diagnosis of organic delusional disorder (F06.2) due to Wilson's disease was considered. Tab risperidone 1 mg/day was started, and the dose of penicillamine was reduced with which symptoms resolved. Whenever a young adolescent develops psychosis, especially of delusional type, the possibility of Wilson's disease must be considered.

  2. First aid guidelines for psychosis in Asian countries: A Delphi consensus study

    Directory of Open Access Journals (Sweden)

    Langlands Robyn L

    2008-02-01

    Full Text Available Abstract Background Guidelines for how a member of the public should give first aid to a person who is becoming psychotic have been developed for English-speaking countries. However, these guidelines may not be appropriate for use in other cultures. A study was therefore carried out to examine whether it was possible to achieve consensus on guidelines that could apply in a range of Asian countries. Methods A Delphi consensus study was carried out with a panel of 28 Asian mental health clinicians drawn from Cambodia, China, Hong Kong, Indonesia, Japan, Malaysia, Mongolia, South Korea, Sri Lanka, Taiwan, Thailand and Vietnam. The panel was given a 211 item questionnaire about possible first aid actions and asked to rate whether they thought these should be included in guidelines. Panel members were invited to propose additional items. Results After three Delphi rounds, there were 128 items that were rated as "essential" or "important" by 80% or more of the panel members. These items covered: recognition of psychosis, encouraging and assisting the person to seek help, how to interact with the person, responding to acute psychosis, responding to aggression, and what to do if the person refuses to get professional help. Conclusion Despite the diversity of the countries involved, there was consensus on a core set of first aid items that were considered as suitable for assisting a psychotic person. Future work is needed to develop guidelines for specific countries.

  3. Screening and Treatment for Depression, Dementia, and Psychosis with Parkinson Disease

    Science.gov (United States)

    ... AND TREATMENT FOR DEPRESSION, DEMENTIA, AND PSYCHOSIS WITH PARKINSON DISEASE Depression, dementia, and psychosis are common in people with Parkinson disease. These conditions can affect how people with Parkinson ...

  4. One-year effect of changing duration of untreated psychosis in a single catchment area

    DEFF Research Database (Denmark)

    Larsen, Tor K; Melle, Ingrid; Friis, Svein;

    2007-01-01

    There is highly replicated positive correlation between longer duration of untreated psychosis and poorer outcome.......There is highly replicated positive correlation between longer duration of untreated psychosis and poorer outcome....

  5. A Bayesian model of psychosis symptom trajectory in Alzheimer's disease.

    Science.gov (United States)

    Seltman, Howard J; Mitchell, Shaina; Sweet, Robert A

    2016-02-01

    Psychosis, like other neuropsychiatric symptoms of dementia, has many features that make predictive modeling of its onset difficult. For example, psychosis onset is associated with both the absolute degree of cognitive impairment and the rate of cognitive decline. Moreover, psychotic symptoms, while more likely than not to persist over time within individuals, may remit and recur. To facilitate predictive modeling of psychosis for personalized clinical decision making, including evaluating the role of risk genes in its onset, we have developed a novel Bayesian model of the dual trajectories of cognition and psychosis symptoms. Cognition was modeled as a four-parameter logistic curve with random effects for all four parameters and possible covariates for the rate and time of fall. Psychosis was modeled as a continuous-time hidden Markov model with a latent never-psychotic class and states for pre-psychotic, actively psychotic and remitted psychosis. Covariates can affect the probability of being in the never-psychotic class. Covariates and the level of cognition can affect the transition rates for the hidden Markov model. The model characteristics were confirmed using simulated data. Results from 434 AD patients show that a decline in cognition is associated with an increased rate of transition to the psychotic state. The model allows declining cognition as an input for psychosis prediction, while incorporating the full uncertainty of the interpolated cognition values. The techniques used can be used in future genetic studies of AD and are generalizable to the study of other neuropsychiatric symptoms in dementia. Copyright © 2015 John Wiley & Sons, Ltd.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. [The association of polymorphisms in SLC18A1, TPH1 and RELN genes with risk of paranoid schizophrenia].

    Science.gov (United States)

    Galaktionova, D Iu; Gareeva, A E; Khusnutdinova, E K; Nasedkina, T V

    2014-01-01

    We have developed a biochip for the analysis of polymorphisms in candidate genes for schizophrenia: DISC1, RELN, ZNF804A, PLXNA2, COMT, SLC18A41, CACNA1C, ANK3, TPH1, PLAA and SNAP-25. Using biochip the allele and genotype frequencies in 198 patients with schizophrenia and 192 healthy individuals have been obtained. For SLC18A1 polymorphism rs2270641 A>C, the frequencies of A allele (p = 0.007) and AA genotype (p = 0.002) were lower in patients compared with healthy individuals. A significant association was found between AA genotype (p = 0.036) of the TPH1 polymorphism rs1800532 C>A and schizophrenia. The C allele (p = 0.039) of the RELNpolymorphism rs7341475 C>T were lower in patients with schizophrenia compared with healthy individuals in a tatar population. Genotype AA of the TPH1 polymorphism rs1800532 C>A were more frequent in patients with schizophrenia compared with healthy individuals. Ithas been shown that the C allele (p = 0.0001) and GC (p = = 0.0001) genotype of the PLXNA2 polymorphism rs1327175 G>C are associated with the family history in patients with paranoid schizophrenia. The obtained data suggest that SLC18A1, TPH1 and RELN gene polymorphisms are associated with the risk of paranoid schizophrenia.

  8. TPH2 gene polymorphisms in the regulatory region are associated with paranoid schizophrenia in Northern Han Chinese.

    Science.gov (United States)

    Xu, X M; Ding, M; Pang, H; Wang, B J

    2014-03-12

    In the last years, serotonin (5-HT) has been related with the pathophysiology of several psychiatric disorders, including schizophrenia. Thus, genes related to the serotonergic (5-HTergic) system are good candidate genes for schizophrenia. The rate-limiting enzyme of 5-HT synthesis is tryptophan hydroxylase 2 (TPH2). Single nucleotide polymorphisms (SNPs) in the regulatory regions of TPH2 gene may affect gene expression and biosynthesis of 5-HT triggering to various neuropsychiatric disorders related to 5-HT dysfunction. The present study explored the association of SNPs within the TPH2 gene with paranoid schizophrenia in Han Chinese. A total of 164 patients with schizophrenia and 244 healthy controls were genotyped for six TPH2 SNPs (rs4570625, rs11178997, rs11178998, rs41317118, rs17110747, and rs41317114). Significant group differences were observed in the allele and genotype frequencies of rs4570625 and in the frequencies of GTA and TTA haplotypes corresponding to rs4570625-rs11178997-rs11178998. Our findings suggest that common genetic variations of TPH2 are likely to contribute to genetic susceptibility to paranoid schizophrenia in Han Chinese. Further studies in larger samples are needed to replicate this association.

  9. Ribosomal DNA transcription in the dorsal raphe nucleus is increased in residual but not in paranoid schizophrenia.

    Science.gov (United States)

    Krzyżanowska, Marta; Steiner, Johann; Brisch, Ralf; Mawrin, Christian; Busse, Stefan; Braun, Katharina; Jankowski, Zbigniew; Bernstein, Hans-Gert; Bogerts, Bernhard; Gos, Tomasz

    2015-03-01

    The central serotonergic system is implicated in the pathogenesis of schizophrenia, where the imbalance between dopamine, serotonin and glutamate plays a key pathophysiological role. The dorsal raphe nucleus (DRN) is the main source of serotonergic innervation of forebrain limbic structures disturbed in schizophrenia patients. The study was carried out on paraffin-embedded brains from 17 (8 paranoid and 9 residual) schizophrenia patients and 28 matched controls without mental disorders. The transcriptional activity of ribosomal DNA (rDNA) in DRN neurons was evaluated by the AgNOR silver-staining method. An increased rDNA transcriptional activity was found in schizophrenia patients in the cumulative analysis of all DRN subnuclei (t test, P = 0.02). Further subgroup analysis revealed that it was an effect specific for residual schizophrenia versus paranoid schizophrenia or control groups (ANOVA, P = 0.002). This effect was confounded neither by suicide nor by antipsychotic medication. Our findings suggest that increased activity of rDNA in DRN neurons is a distinct phenomenon in schizophrenia, particularly in residual patients. An activation of the rDNA transcription in DRN neurons may represent a compensatory mechanism to overcome the previously described prefrontal serotonergic hypofunction in this diagnostic subgroup.

  10. Paranoid symptoms and hallucinations among the older people in Western Europe.

    Science.gov (United States)

    Östling, Svante; Bäckman, Kristoffer; Waern, Margda; Marlow, Thomas; Braam, Arjan W; Fichter, Manfred; Lawlor, Brian A; Lobos, Antonio; Reischies, Friedel M; Copeland, John R M; Skoog, Ingmar

    2013-06-01

    It is not clear whether the prevalence of psychosis increases with age. We studied the age-specific prevalence of psychotic symptoms in older people in Western Europe. Older people without dementia (age 65-104 years, N = 8762) from the western part of Europe in the EURODEP concerted action took part in psychiatric examinations. In total, 2.4% of the men and 2.9% of the women had psychotic symptoms. Using a multilevel logistic regression model that included gender and age as a continuous variable, we found that a 5-year increase in age increased the prevalence of psychotic symptoms (odds ratio 1.2 95% confidence interval 1.06-1.3, p = 0.001). A second multilevel regression model showed that wishing to be dead, depressed mood, functional disability, not being married and cognitive impairment measured with Mini mental state examination were all associated with psychotic symptoms whereas gender was not. The prevalence of psychotic symptoms in non-demented older people increases with age, and these symptoms are associated with other psychopathology, social isolation and problems with daily living. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Childhood trauma and cognitive function in first-episode affective and non-affective psychosis.

    LENUS (Irish Health Repository)

    Aas, Monica

    2011-06-01

    A history of childhood trauma is reportedly more prevalent in people suffering from psychosis than in the general population. Childhood trauma has also been linked to cognitive abnormalities in adulthood, and cognitive abnormalities, in turn, are one of the key clinical features of psychosis. Therefore, this study investigated whether there was a relationship between childhood trauma and cognitive function in patients with first-episode psychosis. The potential impact of diagnosis (schizophrenia or affective psychosis) and gender on this association was also examined.

  12. Diagnostic and Prognostic Significance of DSM-5 Attenuated Psychosis Syndrome in Services for Individuals at Ultra High Risk for Psychosis.

    Science.gov (United States)

    Fusar-Poli, Paolo; De Micheli, Andrea; Cappucciati, Marco; Rutigliano, Grazia; Davies, Cathy; Ramella-Cravaro, Valentina; Oliver, Dominic; Bonoldi, Ilaria; Rocchetti, Matteo; Gavaghan, Lauren; Patel, Rashmi; McGuire, Philip

    2017-05-17

    The diagnostic and prognostic significance of the DSM-5-defined Attenuated Psychosis Syndrome (DSM-5-APS) in individuals undergoing an ultra high risk (UHR) clinical assessment for suspicion of psychosis risk is unknown. Prospective cohort study including all consecutive help-seeking individuals undergoing both a DSM-5-APS and a Comprehensive Assessment of At Risk Mental States (CAARMS 12/2006) assessment for psychosis risk at the Outreach and Support in South London (OASIS) UHR service (March 2013-April 2014). The diagnostic significance of DSM-5-APS was assessed with percent overall agreement, prevalence bias adjusted kappa, Bowker's test, Stuart-Maxwell test, residual analysis; the prognostic significance with Cox regression, Kaplan-Meier failure function, time-dependent area under the curve (AUC) and net benefits analysis. The impact of specific revisions of the DSM-5-APS was further tested. In 203 help-seeking individuals undergoing UHR assessment, the agreement between the DSM-5-APS and the CAARMS 12/2006 was only moderate (kappa 0.59). Among 142 nonpsychotic cases, those meeting DSM-5-APS criteria had a 5-fold probability (HR = 5.379) of developing psychosis compared to those not meeting DSM-5-APS criteria, with a 21-month cumulative risk of psychosis of 28.17% vs 6.49%, respectively. The DSM-5-APS prognostic accuracy was acceptable (AUC 0.76 at 24 months) and similar to the CAARMS 12/2006. The DSM-5-APS designation may be clinically useful to guide the provision of indicated interventions within a 7%-35% (2-year) range of psychosis risk. The removal of the criterion E or C of the DSM-5-APS may improve its prognostic performance and transdiagnostic value. The DSM-5-APS designation may be clinically useful in individuals accessing clinical services for psychosis prevention.

  13. Persistence of the extended psychosis phenotype in young people: Link between vulnerability and clinical need

    NARCIS (Netherlands)

    Wigman, J.T.W.

    2011-01-01

    Psychosis is one of the most severe psychiatric conditions, in terms of both individual and societal burden. The pathway from the earliest and mildest expressions of psychosis to clinical disorder is highly variable and heterogeneous. A better understanding of the psychosis phenotype and its

  14. Clinical presentation of Attenuated Psychosis Syndrome in children and adolescents : Is there an age effect?

    NARCIS (Netherlands)

    Ribolsi, Michele; Lin, Ashleigh; Wardenaar, Klaas J; Pontillo, Maria; Mazzone, Luigi; Vicari, Stefano; Armando, Marco

    2017-01-01

    There is limited research on clinical features related to age of presentation of the Attenuated Psychosis Syndrome in children and adolescents (CAD). Based on findings in CAD with psychosis, we hypothesized that an older age at presentation of Attenuated Psychosis Syndrome would be associated with l

  15. Persistence of the extended psychosis phenotype in young people: Link between vulnerability and clinical need

    NARCIS (Netherlands)

    Wigman, J.T.W.

    2011-01-01

    Psychosis is one of the most severe psychiatric conditions, in terms of both individual and societal burden. The pathway from the earliest and mildest expressions of psychosis to clinical disorder is highly variable and heterogeneous. A better understanding of the psychosis phenotype and its develop

  16. Predicting Prognosis of Psychosis in Huntington's Disease: Case Report and Review of Literature.

    Science.gov (United States)

    Kar, Sujita Kumar; Shahi, Mohit Kumar; Tripathi, Adarsh; Sharma, Praveen Kumar

    2017-01-01

    Huntington's disease (HD) is rare variant of progressive neurodegenerative disorder which follows an autosomal dominant pattern. Psychiatric comorbidities are not uncommon with HD. Mood disorder, cognitive disturbances, anxiety disorders, and psychosis are the psychiatric comorbidities reported with HD. We report here a case of HD, where psychosis developed during illness. Prognosis of psychosis in HD is emphasized in this report with review of literature.

  17. Persistence of the extended psychosis phenotype in young people: Link between vulnerability and clinical need

    NARCIS (Netherlands)

    Wigman, J.T.W.|info:eu-repo/dai/nl/304822353

    2011-01-01

    Psychosis is one of the most severe psychiatric conditions, in terms of both individual and societal burden. The pathway from the earliest and mildest expressions of psychosis to clinical disorder is highly variable and heterogeneous. A better understanding of the psychosis phenotype and its develop

  18. Social Dysfunction and Diet Outcomes in People with Psychosis

    Science.gov (United States)

    Mucheru, Doreen; Hanlon, Mary-Claire; Campbell, Linda E.; McEvoy, Mark; MacDonald-Wicks, Lesley

    2017-01-01

    This analysis aimed to examine the association of social dysfunction with food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption in people with psychosis from the Hunter New England (HNE) catchment site of the Survey of High Impact Psychosis (SHIP). Social dysfunction and dietary information were collected using standardised tools. Independent binary logistic regressions were used to examine the association between social dysfunction and food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption. Although social dysfunction did not have a statistically significant association with most diet variables, participants with obvious to severe social dysfunction were 0.872 (95% CI (0.778, 0.976)) less likely to eat breakfast than those with no social dysfunction p food insecurity, and intakes of fruits and vegetables below recommendations in people with psychosis. In light of this, a greater focus needs to be given to dietary behaviours and social dysfunction in lifestyle interventions delivered to people with psychosis. Well-designed observational research is also needed to further examine the relationship between social dysfunction and dietary behaviour in people with psychosis. PMID:28106815

  19. Psychosis in Parkinson's disease: identification, prevention and treatment.

    Science.gov (United States)

    Levin, Johannes; Hasan, Alkomiet; Höglinger, Günter U

    2016-01-01

    Psychosis in Parkinson's disease (PD) is a frequent condition affecting >20 % of all PD patients. It is characterized by vivid dreams, nightmares, illusions, delusions and mostly visual hallucinations. Typically psychosis occurs in the late stage of PD, affecting up to 70 % of the patients following a disease duration of 20 years or more, and can severely interfere with the care of the patients, especially if the patients develop delusions. Psychosis is the principal cause of admission to a nursing home for PD patients. Hence, preemptive identification of risk factors, and avoidance and elimination of triggers are most important measures against psychosis in PD patients. Secondarily, pharmaceutical measures are being undertaken successively, including simplification of medication regimes, discontinuation of non-essential CNS-active drugs, ordered reduction of antiparkinsonian drugs, addition of cholesterinase inhibitors in cognitively impaired patients, and finally addition of antipsychotic medication with limited parkinsonian side effects. As psychosis in PD is a frequent and important problem, we set out to write a state-of-the-art guideline for its identification and treatment.

  20. The epidemiologic evidence linking autoimmune diseases and psychosis.

    Science.gov (United States)

    Benros, Michael E; Eaton, William W; Mortensen, Preben B

    2014-02-15

    This review summarizes the epidemiologic evidence linking autoimmune diseases and psychosis. The associations between autoimmune diseases and psychosis have been studied for more than a half century, but research has intensified within the last decades, since psychosis has been associated with genetic markers of the immune system and with excess autoreactivity and other immune alterations. A range of psychiatric disorders, including psychosis, have been observed to occur more frequently in some autoimmune diseases, such as systemic lupus erythematosus and multiple sclerosis. Many autoimmune diseases involve multiple organs and general dysfunction of the immune system, which could affect the brain and induce psychiatric symptoms. Most studies have been cross-sectional, observing an increased prevalence of a broad number of autoimmune diseases in people with psychotic disorders. Furthermore, there is some evidence of associations of psychosis with a family history of autoimmune disorders and vice versa. Additionally, several autoimmune diseases, individually and in aggregate, have been identified as raising the risk for psychotic disorders in longitudinal studies. The associations have been suspected to be caused by inflammation or brain-reactive antibodies associated with the autoimmune diseases. However, the associations could also be caused by shared genetic factors or common etiologic components such as infections. Infections can induce the development of autoimmune diseases and autoantibodies, possibly affecting the brain. Autoimmune diseases and brain-reactive antibodies should be considered by clinicians in the treatment of individuals with psychotic symptoms, and even if the association is not causal, treatment would probably still improve quality of life and survival.

  1. Psychosis in Parkinson's Disease: Epidemiology, Pathophysiology, and Management.

    Science.gov (United States)

    Chang, Anna; Fox, Susan H

    2016-07-01

    Psychotic symptoms are common in Parkinson's disease (PD) and are associated with poorer quality of life and increased caregiver burden. PD psychosis is correlated with several factors, such as more advanced disease, cognitive impairment, depression, and sleep disorders. The underlying causes of psychosis in PD thus involve a complex interplay between exogenous (e.g., drugs, intercurrent illnesses) and endogenous (e.g., PD disease pathology) factors. Current theories of the pathophysiology of PD psychosis have come from several neuropathological and neuroimaging studies that implicate pathways involving visual processing and executive function, including temporo-limbic structures and neocortical gray matter with altered neurotransmitter functioning (e.g., dopamine, serotonin, and acetylcholine). Treatment of PD psychosis requires a step-wise process, including initial careful investigation of treatable triggering conditions and a comprehensive evaluation with adjustment of PD medications and/or initiation of specific antipsychotic therapies. Clozapine remains the only recommended drug for the treatment of PD psychosis; however, because of regular blood monitoring, quetiapine is usually first-line therapy, although less efficacious. Emerging studies have focused on agents involving other neurotransmitters, including the serotonin 5-HT2A receptor inverse agonist pimavanserin, cholinesterase inhibitors, and antidepressants and anxiolytics.

  2. The evolution of cognitive–behavioral therapy for psychosis

    Directory of Open Access Journals (Sweden)

    Mander H

    2015-02-01

    Full Text Available Helen Mander, David Kingdon Mental Health Group, University of Southampton, Southampton, Hampshire, England, UK Abstract: Cognitive therapy for psychosis has developed over the past 30 years from initial case studies, treatment manuals, pilot randomized controlled studies to fully powered and methodologically rigorous efficacy and, subsequently, effectiveness trials. Reviews and meta-analyses have confirmed the benefits of the interventions. Considered appraisal by government and professional organizations has now led to its inclusion in international treatment guidelines for schizophrenia. Patients consistently ask for access to psychotherapeutic interventions, and it is slowly becoming available in many European countries and other parts of the world, eg, US and the People’s Republic of China. However, it remains unacceptably difficult to access for the vast majority of people with psychosis who could benefit from it. Psychosis affects people in the prime of their lives and leads to major effects on their levels of distress, well-being, and functioning, and also results in major costs to society. Providing effective interventions at an early stage has the potential to reduce the high relapse rates that occur after recovery from first episode and the ensuing morbidity and premature mortality associated with psychosis. Keywords: psychosis, schizophrenia, psychotherapy, cognitive therapy, history

  3. Social Dysfunction and Diet Outcomes in People with Psychosis

    Directory of Open Access Journals (Sweden)

    Doreen Mucheru

    2017-01-01

    Full Text Available This analysis aimed to examine the association of social dysfunction with food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption in people with psychosis from the Hunter New England (HNE catchment site of the Survey of High Impact Psychosis (SHIP. Social dysfunction and dietary information were collected using standardised tools. Independent binary logistic regressions were used to examine the association between social dysfunction and food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption. Although social dysfunction did not have a statistically significant association with most diet variables, participants with obvious to severe social dysfunction were 0.872 (95% CI (0.778, 0.976 less likely to eat breakfast than those with no social dysfunction p < 0.05. Participants with social dysfunction were therefore, 13% less likely to have breakfast. This paper highlights high rates of social dysfunction, significant food insecurity, and intakes of fruits and vegetables below recommendations in people with psychosis. In light of this, a greater focus needs to be given to dietary behaviours and social dysfunction in lifestyle interventions delivered to people with psychosis. Well-designed observational research is also needed to further examine the relationship between social dysfunction and dietary behaviour in people with psychosis.

  4. Psychosis of epilepsy: a multifaceted neuropsychiatric disorder.

    Science.gov (United States)

    Kanner, Andres M; Rivas-Grajales, Ana Maria

    2016-06-01

    Psychosis of epilepsy (POE) is a term applied to a group of psychotic disorders with a distinct phenomenology in which potential etiopathogenic mechanisms are believed to be closely related to a seizure disorder. POE can present as interictal psychotic episodes, which may often differ semiologically from primary schizophrenic disorder. They may present as ictal or postictal psychotic episodes and may be the expression of an iatrogenic process to pharmacologic and/or surgical interventions.Epilepsy and POE have a complex and bidirectional relation, as not only are patients with epilepsy at greater risk of developing a psychotic disorder, but patients with a primary psychotic disorder are also at greater risk of developing epilepsy. The prevalence of POE is more than 7 times higher than the frequency of primary schizophreniform disorders in the general population. While POE has been associated with focal epilepsy of temporal and frontal lobe origin, its etiology and pathophysiology of POE have yet to be established.The treatment of all forms of POE, with the exception of ictal psychotic episodes, requires the use of antipsychotic drugs, preferably the atypical antipsychotic agents with a very low or negligible potential to lower the seizure threshold (eg, risperidone, apiprazole), starting at a low dose with stepwise increments.

  5. Epidemiology of psychosis in Parkinson's disease.

    Science.gov (United States)

    Fénelon, Gilles; Alves, Guido

    2010-02-15

    Psychotic symptoms are frequent and disabling in patients with Parkinson's disease (PD). Methodological issues in the epidemiology of PD associated psychosis (PDP) include differences in the symptoms assessed, the methods of assessment, and the selection of patients. Most studies are prospective clinic-based cross-sectional studies providing point prevalence rates in samples on dopaminergic treatment. Visual hallucinations are present in about one quarter to one third of the patients, auditory in up to 20%. Tactile/somatic, and olfactory hallucinations are usually not systematically sought. Minor phenomena such as sense of presence and visual illusions affect 17 to 72% of the patients, and delusions about 5%. Lifetime prevalence of visual hallucinations reaches approximately 50%. Prospective longitudinal cohort studies suggest that hallucinations persist and worsen in individual patients, and that their prevalence increases with time. A facilitating role of treatment on PDP is demonstrated at least for dopaminergic agonists, but there is no simple dose-effect relationship between dopaminergic treatment and the presence or severity of hallucinations. The main endogenous non-modifiable risk factor is cognitive impairment. Other associated factors include older age/longer duration of PD, disease severity, altered dream phenomena, daytime somnolence, and possibly depression and dysautonomia. PDP reduces quality of life in patients and increases caregiver distress, and is an independent risk factor for nursing home placement and development of dementia.

  6. The relationship of the Severe Personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders

    Directory of Open Access Journals (Sweden)

    Setareh Jani

    2016-12-01

    Full Text Available Introduction: Given the disruptive effects of personality disorders on personal and family life, it is essential to recognize their predisposing factors to understand them more accurately, and identify their preventive measures treatment facilitators. Therefore, the present study aimed to examine the relationship of severe personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders. Methods: The present descriptive-correlational study recruited patients with paranoid, borderline and schizotypal personality disorders presenting to psychiatry clinics in Ardabil using convenient sampling method. A total of 30 paranoid patients, 30 borderline patients and 20 schizotypal patients were selected by a psychiatrist through psychiatric examination, clinical interview and completing Millon Clinical Multiaxial Inventory (MCMI-III. The following instruments were used: MCMI- III and behavioral activation-inhibition system scale (BIS-BAS. The data were analyzed with Pearson’s correlation coefficient and stepwise regression. Results: BIS and BAS systems were both significant for predicting borderline and paranoid personality disorders, but only BIS was significant for predicting schizotypal personality disorder. Conclusion: These findings can help experts to have a better and more accurate understanding of personality disorders and use proper methods to predict the probability of these disorders and develop treatments.

  7. Altered attentional and perceptual processes as indexed by N170 during gaze perception in schizophrenia: Relationship with perceived threat and paranoid delusions.

    Science.gov (United States)

    Tso, Ivy F; Calwas, Anita M; Chun, Jinsoo; Mueller, Savanna A; Taylor, Stephan F; Deldin, Patricia J

    2015-08-01

    Using gaze information to orient attention and guide behavior is critical to social adaptation. Previous studies have suggested that abnormal gaze perception in schizophrenia (SCZ) may originate in abnormal early attentional and perceptual processes and may be related to paranoid symptoms. Using event-related brain potentials (ERPs), this study investigated altered early attentional and perceptual processes during gaze perception and their relationship to paranoid delusions in SCZ. Twenty-eight individuals with SCZ or schizoaffective disorder and 32 demographically matched healthy controls (HCs) completed a gaze-discrimination task with face stimuli varying in gaze direction (direct, averted), head orientation (forward, deviated), and emotion (neutral, fearful). ERPs were recorded during the task. Participants rated experienced threat from each face after the task. Participants with SCZ were as accurate as, though slower than, HCs on the task. Participants with SCZ displayed enlarged N170 responses over the left hemisphere to averted gaze presented in fearful relative to neutral faces, indicating a heightened encoding sensitivity to faces signaling external threat. This abnormality was correlated with increased perceived threat and paranoid delusions. Participants with SCZ also showed a reduction of N170 modulation by head orientation (normally increased amplitude to deviated faces relative to forward faces), suggesting less integration of contextual cues of head orientation in gaze perception. The psychophysiological deviations observed during gaze discrimination in SCZ underscore the role of early attentional and perceptual abnormalities in social information processing and paranoid symptoms of SCZ.

  8. CLINICAL RESEARCH ON ACUPUNCTURE TREATMENT OF DEPRESSIVE PSYCHOSIS

    Institute of Scientific and Technical Information of China (English)

    FU Wenbin

    2002-01-01

    Objective: To evaluate the therapeutic effect of acupuncture in the treatment of depressive psychosis.Methods: A total of 62 cases of depressive psychosis patients were randomly divided into treatment group (n=32) and control group (n=30). Acupoints used in treatment group were bilateral Hegu (LI 4), bilateral Taichong (LR 3), Baihui (GV 20) and Yintang (EX-HN 3). Patients of control group were asked to take Fluoxertine hydrochloride 20 mg/d.The therapeutic effect was assessed using Hamilton's depression (HAMD) scales. Results: After 8 weeks' treatment,in treatment and control groups, 4 and 3 cases were cured, 8 and 6 experienced marked improvement, 14 and 14 had improvement, 6 and 7 had no effect, with the effective rates being 81.25% and 76. 66% separately, and no significant difference was found between two groups in HAMD scales (P>0.05). Conclusion: Acupuncture therapy is an effective method for treatment of depressive psychosis.

  9. Patient satisfaction with treatment in first-episode psychosis

    DEFF Research Database (Denmark)

    Haahr, Ulrik; Simonsen, Erik; Røssberg, Jan Ivar

    2012-01-01

    Purpose: To examine first-episode psychotic patients' satisfaction with elements of a comprehensive 2-year treatment program. Subjects and method: The TIPS (Early Treatment and Intervention in Psychosis) project provided a 2-year treatment program consisting of milieu therapy (inpatient), individ......Purpose: To examine first-episode psychotic patients' satisfaction with elements of a comprehensive 2-year treatment program. Subjects and method: The TIPS (Early Treatment and Intervention in Psychosis) project provided a 2-year treatment program consisting of milieu therapy (inpatient...... in satisfaction for specific interventions. In this sample of first-episode psychosis patients, there was general satisfaction with treatments based on one-to-one relationships while multi-family group intervention was consistently valued less enthusiastically....

  10. Pathophysiology and treatment of psychosis in Parkinson's disease: a review.

    Science.gov (United States)

    Zahodne, Laura B; Fernandez, Hubert H

    2008-01-01

    Psychotic symptoms in Parkinson's disease (PD) are relatively common and, in addition to creating a disturbance in patients' daily lives, have consistently been shown to be associated with poor outcome. Our understanding of the pathophysiology of psychosis in PD has expanded dramatically over the past 15 years, from an initial interpretation of symptoms as dopaminergic drug adverse effects to the current view of a complex interplay of extrinsic and disease-related factors.PD psychosis has unique clinical features, namely that it arises within a context of a clear sensorium and retained insight, there is relative prominence of visual hallucinations and progression occurs over time. PD psychosis tends to emerge later in the disease course, and disease duration represents one risk factor for its development. The use of anti-PD medications (particularly dopamine receptor agonists) has been the most widely identified risk factor for PD psychosis. Other risk factors discussed in the literature include older age, disease severity, sleep disturbance, cognitive impairment, dementia and/or depression.Recent efforts have aimed to explore the complex pathophysiology of PD psychosis, which is now known to involve an interaction between extrinsic, drug-related and intrinsic, disease-related components. The most important extrinsic factor is use of dopaminergic medication, which plays a prominent role in PD psychosis. Intrinsic factors include visual processing deficits (e.g. lower visual acuity, colour and contrast recognition deficits, ocular pathology and functional brain abnormalities identified amongst hallucinating PD patients); sleep dysregulation (e.g. sleep fragmentation and altered dream phenomena); neurochemical (dopamine, serotonin, acetylcholine, etc.) and structural abnormalities involving site-specific Lewy body deposition; and genetics (e.g. apolipoprotein E epsilon4 allele and tau H1H1 genotype). Preliminary reports have also shown a potential relationship

  11. Fetishistic transvestism in a patient with mental retardation and psychosis

    Directory of Open Access Journals (Sweden)

    Rajmohan Velayudhan

    2014-01-01

    Full Text Available Fetishistic transvestism is a disorder of sexual preference associated with fantasies and sexual urges to dress in opposite gender clothing as a means of arousal and as an adjunct to masturbation and coitus. The disorder has been reported in people with learning disabilities. The disorder has been reported in a young male with dull normal intelligence. Transvestism though has been described in schizophrenia and psychosis and fetishism has been described in the course of simple schizophrenia, there are no reports of fetishistic transvestism in a patient with mental retardation and psychosis. A case of fetishistic transvestism in a patient with mental retardation and psychosis with treatment and relevant review of literature is reported.

  12. Cyberbullying in those at clinical high risk for psychosis.

    Science.gov (United States)

    Magaud, Emilie; Nyman, Karissa; Addington, Jean

    2013-11-01

    Several studies suggest an association between experiences of childhood trauma including bullying and the development of psychotic symptoms. The use of communications technology has created a new media for bullying called 'cyberbullying'. Research has demonstrated associations between traditional bullying and cyberbullying. Negative effects of cyberbullying appear similar in nature and severity to the reported effects of traditional bullying. Our aim was to examine the prevalence and correlates of cyberbullying in those at clinical high risk (CHR) for psychosis. Fifty young people at CHR for psychosis were administered the Childhood Trauma Questionnaire with added questions about cyberbullying. Cyberbullying was reported in 38% of the sample. Those who experienced cyberbullying also reported experiencing previous trauma. It is possible that cyberbullying may be a problem for those at CHR of psychosis, and due to the vulnerable nature of these young people may have longitudinal implications. © 2013 Wiley Publishing Asia Pty Ltd.

  13. Substance abuse in first-episode non-affective psychosis

    DEFF Research Database (Denmark)

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

    2006-01-01

    Abuse of alcohol and drugs is an important and clinically challenging aspect of first-episode psychosis. Only a few studies have been carried out on large-sized and reliably characterized samples. These are reviewed, and the results are compared with a sample of 300 first-episode psychosis patients...... recruited for the TIPS (Early Treatment and Identification of Psychosis) study from Norway and Denmark. Prevalence rates from the literature vary from 6% to 44% for drugs and 3% to 35% for alcohol. In our sample, 23% abused drugs and 15% abused alcohol during the last 6 months. When compared to non-abusers......, the drug-abusing group is characterized by the following: male gender, younger age, better premorbid social, poor premorbid academic functioning, and more contact with friends in the last year before onset. Alcohol abusers were the oldest group and they had the least contact with friends. A group...

  14. Service engagement in first episode psychosis: clinical and premorbid correlates.

    Science.gov (United States)

    Macbeth, Angus; Gumley, Andrew; Schwannauer, Matthias; Fisher, Rebecca

    2013-05-01

    Engagement can be understood as a multifactorial process, incorporating acceptance of treatment, therapeutic rapport, and collaboration in a shared goal of clinical and functional recovery. Difficulties in engagement with clinical services represent a risk factor for treatment discontinuation in first episode psychosis. The current study explored the associations between engagement, clinical, and preonset variables. We report the cross-sectional data on a Scottish sample with first episode psychosis, characterized in terms of psychotic symptoms, premorbid adjustment, duration of untreated psychosis, and clinician-rated engagement. Poorer clinician-rated engagement was associated with greater positive and negative symptoms, greater general psychopathology, and poorer premorbid social adjustment. In a regression analysis, only severity of negative symptoms predicted engagement. The study highlights the role of negative symptoms and impairments in social functioning as factors associated with poorer engagement with clinical services. The value of detailed assessment of social and premorbid functioning is highlighted.

  15. Cyberbullying in those at Clinical High Risk for psychosis

    Science.gov (United States)

    Magaud, Emilie; Nyman, Karissa; Addington, Jean

    2012-01-01

    Aim Several studies suggest an association between experiences of childhood trauma including bullying and the development of psychotic symptoms. The use of communications technology has created a new media for bullying called ‘cyberbullying’. Research has demonstrated associations between traditional bullying and cyberbullying. Negative effects of cyberbullying appear similar in nature and severity to the reported effects of traditional bullying. Our aim was to examine the prevalence and correlates of cyberbullying in those at clinical high risk (CHR) for psychosis. Methods Fifty young people at CHR for psychosis were administered the Childhood Trauma Questionnaire with added questions about cyberbullying. Results Cyberbullying was reported in 38% of the sample. Those who experienced cyberbullying also reported experiencing previous trauma. Conclusion It is possible that cyberbullying may be a problem for those at CHR of psychosis and due to the vulnerable nature of these young people, may have longitudinal implications. PMID:23343259

  16. [Glutamate receptors genes polymorphism and the risk of paranoid schizophrenia in Russians and tatars from the Republic of Bashkortostan].

    Science.gov (United States)

    Gareeva, A E; Khusnutdinova, E K

    2014-01-01

    Schizophrenia is a severe mental disorder that affects about 1% of the world population, leading to disability and social exclusion. Glutamatergic neurotransmission is a violation of one of the main hypotheses put forward to explain the neurobiological mechanisms of schizophrenia. Post mortem studies have found changes in the degree of affinity glutamate receptors, their transcription, and altered expression of their subunits in the prefrontal cortex, hippocampus, and thalamus in patients with schizophrenia. As a result of genetic studies of gene family encoding ionotropic AMPA and kainate glutamate receptors in schizophrenia, ambiguous results were received. The association of polymorphic variants of genes GRIA2 and GRIK2 with paranoid schizophrenia and response to therapy with haloperidol in Russian and Tatar of the Republic of Bashkortostan was conducted in the present study. DNA samples of 257 patients with paranoid schizophrenia and of 349 healthy controls of Russian and Tatar ethnic group living in the Republic of Bashkortostan were involved into the present study. In the result of the present study: (1) high risk genetic markers of paranoid schizophrenia (PSZ) were obtained: in Russians-GR4IA2*CCC (OR = 9.60) and in Tatars-GRIK2*ATG (OR = 3.5), GRIK2*TGG (OR = 3.12) (2) The following low risk genetic markers of PSZ were revealed: in Tatars-GRIA2*T/T (rs43025506) of GRIA2 gene (OR = 0.34); in Russians.- GRIA2*CCT (OR = 0.481). (3) Genetic markers of low haloperido! treatment efficacy in respect of negative and positive symptoms GRIK2*T/T (rs2227281) of GRIK2 gene and GRAL42*C/C in Russians, GRIK2*A/A (rs995640) of GRIK2 gene in Tatars. (4) Genetic markers of low haloperidol treatment efficacy in respect of positive symptoms GRL42*C/C in Russians. The results of the present study support the hypothesis of the involvement of glutamate receptor genes in schizophrenia pathway. Considerable inter-ethnic'diversity of genetic risk factors for this disease was

  17. Cortical and Striatal Reward Processing in Parkinson's Disease Psychosis.

    Science.gov (United States)

    Garofalo, Sara; Justicia, Azucena; Arrondo, Gonzalo; Ermakova, Anna O; Ramachandra, Pranathi; Tudor-Sfetea, Carina; Robbins, Trevor W; Barker, Roger A; Fletcher, Paul C; Murray, Graham K

    2017-01-01

    Psychotic symptoms frequently occur in Parkinson's disease (PD), but their pathophysiology is poorly understood. According to the National Institute of Health RDoc programme, the pathophysiological basis of neuropsychiatric symptoms may be better understood in terms of dysfunction of underlying domains of neurocognition in a trans-diagnostic fashion. Abnormal cortico-striatal reward processing has been proposed as a key domain contributing to the pathogenesis of psychotic symptoms in schizophrenia. This theory has received empirical support in the study of schizophrenia spectrum disorders and preclinical models of psychosis, but has not been tested in the psychosis associated with PD. We, therefore, investigated brain responses associated with reward expectation and prediction error signaling during reinforcement learning in PD-associated psychosis. An instrumental learning task with monetary gains and losses was conducted during an fMRI study in PD patients with (n = 12), or without (n = 17), a history of psychotic symptoms, along with a sample of healthy controls (n = 24). We conducted region of interest analyses in the ventral striatum (VS), ventromedial prefrontal and posterior cingulate cortices, and whole-brain analyses. There was reduced activation in PD patients with a history of psychosis, compared to those without, in the posterior cingulate cortex and the VS during reward anticipation (p < 0.05 small volume corrected). The results suggest that cortical and striatal abnormalities in reward processing, a putative pathophysiological mechanism of psychosis in schizophrenia, may also contribute to the pathogenesis of psychotic symptoms in PD. The finding of posterior cingulate dysfunction is in keeping with prior results highlighting cortical dysfunction in the pathogenesis of PD psychosis.

  18. Protocol for a multicentre study to assess feasibility, acceptability, effectiveness and direct costs of TRIumPH (Treatment and Recovery In PsycHosis): integrated care pathway for psychosis

    Science.gov (United States)

    Rathod, Shanaya; Garner, Christie; Griffiths, Alison; Dimitrov, Borislav D; Newman-Taylor, Katherine; Woodfine, Chris; Hansen, Lars; Tabraham, Paul; Ward, Karen; Asher, Carolyn; Phiri, Peter; Naeem, Farooq; North, Pippa; Munshi, Tariq; Kingdon, David

    2016-01-01

    Introduction Duration of untreated psychosis (time between the onset of symptoms and start of treatment) is considered the strongest predictor of symptom severity and outcome. Integrated care pathways that prescribe timeframes around access and interventions can potentially improve quality of care. Methods and analysis A multicentre mixed methods study to assess feasibility, acceptability, effectiveness and analysis of direct costs of an integrated care pathway for psychosis. A pragmatic, non-randomised, controlled trial design is used to compare the impact of Treatment and Recovery In PsycHosis (TRIumPH; Intervention) by comparison between NHS organisations that adopt TRIumPH and those that continue with care as usual (Control). Quantitative and qualitative methods will be used. We will use routinely collected quantitative data and study-specific questionnaires and focus groups to compare service user outcomes, satisfaction and adherence to intervention between sites that adopt TRIumPH versus sites that continue with usual care pathways. Setting 4 UK Mental health organisations. Two will implement TRIumPH whereas two will continue care as usual. Participants Staff, carers, individuals accepted to early intervention in psychosis teams in participating organisations for the study period. Intervention TRIumPH—Integrated Care Pathway for psychosis that has a holistic approach and prescribes time frames against interventions; developed using intelligence from data; co-produced with patients, carers, clinicians and other stakeholders. Outcomes Feasibility will be assessed through adherence to the process measures. Satisfaction and acceptability will be assessed using questionnaires and focus groups. Effectiveness will be assessed through data collection and evaluation of patient outcomes, including clinical, functional and recovery outcomes, physical health, acute care use. Outcome measures will be assessed at baseline, 12 and 24 months to measure whether there is

  19. Paranoia as an Antecedent and Consequence of Getting Ahead in Organizations: Time-Lagged Effects Between Paranoid Cognitions, Self-Monitoring, and Changes in Span of Control

    Directory of Open Access Journals (Sweden)

    Niels Van Quaquebeke

    2016-09-01

    Full Text Available A six-month, time-lagged online survey among 441 employees in diverse industries was conducted to investigate the role paranoia plays as an antecedent and as a consequence of advancement in organizations. The background of the study is the argument that it requires active social sense-making and behavioral adaptability to advance in organizations. The present paper thus explores the extent to which employees’ paranoid cognitions—representative of a heightened albeit suspicious sense-making and behavioral adaptability—link with their advancement in organizations (operationalized as changes in afforded span of control, both as an antecedent and an outcome. Following the strategy to illuminate the process by interaction analysis, both conditions (antecedent and outcome are examined in interaction with employees’ self-monitoring, which is considered representative of a heightened but healthy sense-making and behavioral adaptability. Results support the expected interference interaction between paranoid cognitions and self-monitoring in that each can to some degree compensate for the other in explaining employees’ organizational advancement. Reversely, changes in span of control also affected paranoid cognitions. In particular, low self-monitors, i.e. those low in adaptive sense-making, reacted with heightened paranoid cognitions when demoted. In effect, the present study is thus the first to empirically support that paranoid cognitions can be a consequence but also a prerequisite for getting ahead in organizations. Practical advice should, however, be suspended until it is better understood whether and under what circumstances paranoia may relate not only to personally getting ahead but also to an increased effectiveness for the benefit of the organization.

  20. Paranoia as an Antecedent and Consequence of Getting Ahead in Organizations: Time-Lagged Effects Between Paranoid Cognitions, Self-Monitoring, and Changes in Span of Control

    Science.gov (United States)

    Van Quaquebeke, Niels

    2016-01-01

    A 6-month, time-lagged online survey among 441 employees in diverse industries was conducted to investigate the role paranoia plays as an antecedent and as a consequence of advancement in organizations. The background of the study is the argument that it requires active social sense-making and behavioral adaptability to advance in organizations. The present paper thus explores the extent to which employees’ paranoid cognitions—representative of a heightened albeit suspicious sense-making and behavioral adaptability—link with their advancement in organizations (operationalized as changes in afforded span of control), both as an antecedent and an outcome. Following the strategy to illuminate the process by interaction analysis, both conditions (antecedent and outcome) are examined in interaction with employees’ self-monitoring, which is considered representative of a heightened but healthy sense-making and behavioral adaptability. Results support the expected interference interaction between paranoid cognitions and self-monitoring in that each can to some degree compensate for the other in explaining employees’ organizational advancement. Reversely, changes in span of control also affected paranoid cognitions. In particular, low self-monitors, i.e., those low in adaptive sense-making, reacted with heightened paranoid cognitions when demoted. In effect, the present study is thus the first to empirically support that paranoid cognitions can be a consequence but also a prerequisite for getting ahead in organizations. Practical advice should, however, be suspended until it is better understood whether and under what circumstances paranoia may relate not only to personally getting ahead but also to an increased effectiveness for the benefit of the organization. PMID:27713724

  1. Psychosis and the dynamics of the psychotherapy process

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Harder, Susanne

    2007-01-01

    The role of psychotherapy in the treatment of psychoses remains controversial but there is improving acceptance that an understanding of the dynamics of the psychological processes involved in treatment and in the disorder itself may be important. Psychosis is understood as a detachment of the 's......The role of psychotherapy in the treatment of psychoses remains controversial but there is improving acceptance that an understanding of the dynamics of the psychological processes involved in treatment and in the disorder itself may be important. Psychosis is understood as a detachment...

  2. Emotional experiences predict the conversion of individuals with Attenuated Psychosis Syndrome to psychosis: A six-month follow up study

    Directory of Open Access Journals (Sweden)

    Fa Zhan Chen

    2016-06-01

    Full Text Available The present study explored the conversion rate in individuals with Attenuated Psychosis Syndrome (APS and potential predictor for transition in China. Sixty-three participants were identified as APS were followed up six months later. The results showed that 17% of individuals with APS converted to psychosis. The converters exhibited poorer emotional experience and expression than the non-converters at baseline. A further binary logistic regression analysis showed that emotional experience could predict the transition (Wald = 4.18, p = 0.041, 95% CI = 1.04~6.82. The current study suggested an important role of emotional processing in the prediction of the development of full-blown psychosis.

  3. Can positive family factors be protective against the development of psychosis?

    Science.gov (United States)

    González-Pinto, Ana; Ruiz de Azúa, Sonia; Ibáñez, Berta; Otero-Cuesta, Soraya; Castro-Fornieles, Josefina; Graell-Berna, Montserrat; Ugarte, Amaia; Parellada, Mara; Moreno, Dolores; Soutullo, Cesar; Baeza, Inmaculada; Arango, Celso

    2011-03-30

    Genetic and environmental factors are both involved in the aetiology of psychotic disorders. The aim of this study was to assess if positive and negative environmental factors, together with psychotic family antecedents, are associated with the recent development of psychosis. We also investigated the interactions between family history of psychosis and positive and negative family environment. The sample comprised 110 children and adolescents, who had suffered a first psychotic episode and 98 healthy controls. All subjects were interviewed about their socioeconomic status, family history of psychosis and family environment (Family Environment Scale, FES). Early onset psychosis was significantly associated with a family history of psychosis. Family environment was perceived as more negative and less positive among patients than among controls. A negative family environment increased the risk of psychosis independently of the family history of psychosis. However, there was a significant protective effect of a positive family environment for persons with a family history of psychosis. This effect was not seen in subjects without a family history of psychosis. Therefore, our results support the importance of considering both family history of psychosis and family environment in the early stages of psychosis.

  4. The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability

    Science.gov (United States)

    Løberg, Else-Marie; Helle, Siri; Nygård, Merethe; Berle, Jan Øystein; Kroken, Rune A.; Johnsen, Erik

    2014-01-01

    There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings PMID:25477825

  5. The cannabis pathway to non-affective psychosis may reflect less neurobiological vulnerability

    Directory of Open Access Journals (Sweden)

    Else-Marie eLøberg

    2014-11-01

    Full Text Available There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability x cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics and neurological soft signs (NSS in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings.

  6. Disrupted Working Memory Circuitry in Adolescent Psychosis

    Directory of Open Access Journals (Sweden)

    Ariel Eckfeld

    2017-08-01

    Full Text Available Individuals with schizophrenia (SZ consistently show deficits in spatial working memory (WM and associated atypical patterns of neural activity within key WM regions, including the dorsolateral prefrontal cortex (dlPFC and parietal cortices. However, little research has focused on adolescent psychosis (AP and potential age-associated disruptions of WM circuitry that may occur in youth with this severe form of illness. Here we utilized each subject’s individual spatial WM capacity to investigate task-based neural dysfunction in 17 patients with AP (16.58 ± 2.60 years old as compared to 17 typically developing, demographically comparable adolescents (18.07 ± 3.26 years old. AP patients showed lower behavioral performance at higher WM loads and lower overall WM capacity compared to healthy controls. Whole-brain activation analyses revealed greater bilateral precentral and right postcentral activity in controls relative to AP patients, when controlling for individual WM capacity. Seed-based psychophysiological interaction (PPI analyses revealed significantly greater co-activation between the left dlPFC and left frontal pole in controls relative to AP patients. Significant group-by-age interactions were observed in both whole-brain and PPI analyses, with AP patients showing atypically greater neural activity and stronger coupling between WM task activated brain regions as a function of increasing age. Additionally, AP patients demonstrated positive relationships between right dlPFC neural activity and task performance, but unlike healthy controls, failed to show associations between neural activity and out-of-scanner neurocognitive performance. Collectively, these findings are consistent with atypical WM-related functioning and disrupted developmental processes in youth with AP.

  7. Attention in schizophrenia and in epileptic psychosis

    Directory of Open Access Journals (Sweden)

    I.C.J Kairalla

    2008-01-01

    Full Text Available The adaptive behavior of human beings is usually supported by rapid monitoring of outstanding events in the environment. Some investigators have suggested that a primary attention deficit might trigger symptoms of schizophrenia. In addition, researchers have long discussed the relationship between schizophrenia and the schizophrenia-like psychosis of epilepsy (SLPE. On the basis of these considerations, the objective of the present study was to investigate attention performance of patients with both disorders. Patient age was 18 to 60 years, and all patients had received formal schooling for at least four years. Patients were excluded if they had any systemic disease with neurologic or psychiatric comorbidity, or a history of brain surgery. The computer-assisted TAVIS-2R test was applied to all patients and to a control group to evaluate and discriminate between selective, alternating and sustained attention. The TAVIS-2R test is divided into three parts: one for selective attention (5 min, the second for alternating attention (5 min, and the third for the evaluation of vigilance or sustained attention (10 min. The same computer software was used for statistical analysis of reaction time, omission errors, and commission errors. The sample consisted of 36 patients with schizophrenia, 28 with interictal SLPE, and 47 healthy controls. The results of the selective attention tests for both patient groups were significantly lower than that for controls. The patients with schizophrenia and SLPE performed differently in the alternating and sustained attention tests: patients with SLPE had alternating attention deficits, whereas patients with schizophrenia showed deficits in sustained attention. These quantitative results confirmed the qualitative clinical observations for both patient groups, that is, that patients with schizophrenia had difficulties in focusing attention, whereas those with epilepsy showed perseveration in attention focus.

  8. A composição da experiência em Paranoid Park de Gus van Sant

    Directory of Open Access Journals (Sweden)

    Lucianno Gatti

    2009-07-01

    Full Text Available O artigo aborda a questão da composição da experiência a partir da forma narrativa do filme Paranoid Park> de Gus Van Sant. O significado da experiência com o desconhecido para o herói adolescente de Van Sant não é abordado do ponto de vista de um rito de passagem para a vida adulta, mas como uma forma específica de experiência nesta fase da vida. O modo como esta experiência é constituída é, por sua vez, indissociável do modo como ela é narrada. É esta correlação de experiência e narração que configura um modo peculiar de entrelaçar enredo e imagens que caracteriza o modo de filmar de Van Sant.

  9. [The Role of Neurotrophins and Neurexins Genes in the Risk of Paranoid Schizophrenia in Russians and Tatars].

    Science.gov (United States)

    Gareeva, A E; Traks, T; Koks, S; Khusnutdinova, E K

    2015-07-01

    Schizophrenia affects about 1% of the population. Its etiology is not fully understood. Environmental conditions certainly contribute to the development of schizophrenia, but the determining factor is genetic predisposition: the coefficient of heritability of schizophrenia is about 80%, which is typical for the most highly heritable multifactorial diseases. Polymorphic loci of genes of enzymes and receptors involved in the processes of neuroprotection and neurotrophia play significant role in the development of this disease. In this paper we investigated 48 polymorphic variants of genes of the neurotrophins and neurexins family (BDNF, NTRK2, NTRK3, NGF, NXPH1, and NRXN1) in Russian and Tatar cases and in a control group living in the Republic of Bashkortostan. The results of this study confirm the important role of neurotrophin and neurexin genes in paranoid schizophrenia development.

  10. Relationship between genetic polymorphisms in the HTR1A gene and paranoid schizophrenia in a northern Han Chinese population.

    Science.gov (United States)

    Zhou, Xue; Ding, Mei; Ding, Chunli; Yao, Jun; Pang, Hao; Xing, Jiaxin; Xuan, Jinfeng; Wang, Baojie

    2013-03-01

    The hypothesis for the etiology of schizophrenia involves various neurotransmitters, including 5-HT. Metabolic disorder of 5-HT is an important underlying neurobiochemical cause leading to the development of mental illness. Abnormality in the receptors involved in 5-HT synthesis and metabolism may affect the functioning of 5-HT in the central nervous system. There are seven types of 5-HT receptor families, with a total of 15 corresponding subtypes. HTR1A is the most abundantly expressed 5-HT receptor subtype in the mammalian brain. SNPs in HTR1A enhance or weaken the functioning of 5-HT by affecting HTR1A expression levels or ligand-binding activity, thereby placing HTR1A in an important role in the study of diseases of the nervous system. This study employed DNA sequencing to investigate HTR1A fragment lengths, including complete exons as well as 5' FR and 3' FR segments, for a total of 2,718 bp. Seven SNP loci (ss212928868, rs6295, rs6294, ss218178047, rs34118353, rs6449693, and rs878567) were found in 182 healthy volunteers and 161 patients. Among them, two SNP loci had not been reported in the National Center for Biotechnology Information (NCBI) database, promoter locus ss212928868 and exon locus ss218178047, which now have been approved by the NCBI database and assigned rs numbers, rs113195492 and rs112846276, respectively. ss212928868 and rs6294 were statistically different between control and paranoid schizophrenic women (P paranoid schizophrenic and control group women. Although such differences were lost after statistical correction, studies with larger sample sizes have not been conducted. Combined with the newly discovered loci, these findings can point out possible directions for future investigations in different populations.

  11. Persistent deficits in hippocampal synaptic plasticity accompany losses of hippocampus-dependent memory in a rodent model of psychosis

    Directory of Open Access Journals (Sweden)

    Valentina eWiescholleck

    2013-03-01

    Full Text Available Irreversible N-methyl-D-aspartate receptor (NMDAR antagonism is known to provoke symptoms of psychosis and schizophrenia in healthy humans. NMDAR hypofunction is believed to play a central role in the pathophysiology of both disorders and in an animal model of psychosis, that is based on irreversible antagonism of NMDARs, pronounced deficits in hippocampal synaptic plasticity have been reported shortly after antagonist treatment. Here, we examined the long-term consequences for long-term potentiation (LTP of a single acute treatment with an irreversible antagonist and investigated whether deficits are associated with memory impairments.The ability to express long-term potentiation (LTP at the perforant pathway – dentate gyrus synapse, as well as object recognition memory was assessed 1, 2, 3 and 4 weeks after a single -treatment of the antagonist, MK801. Here, LTP in freely behaving rats was significantly impaired at all time-points compared to control LTP before treatment. Object recognition memory was also significantly poorer in MK801-treated compared to vehicle-treated animals for several weeks after treatment. Histological analysis revealed no changes in brain tissue.Taken together, these data support that acute treatment with an irreversible NMDAR antagonist persistently impairs hippocampal functioning on behavioral, as well as synaptic levels. The long-term deficits in synaptic plasticity may underlie the cognitive impairments that are associated with schizophrenia-spectrum disorders.

  12. Neural correlates of insight in dreaming and psychosis

    NARCIS (Netherlands)

    Dresler, M.; Wehrle, R.; Spoormaker, V.I.; Steiger, A.; Holsboer, F.; Czisch, M.; Hobson, J.A.

    2015-01-01

    The idea that dreaming can serve as a model for psychosis has a long and honourable tradition, however it is notoriously speculative. Here we demonstrate that recent research on the phenomenon of lucid dreaming sheds new light on the debate. Lucid dreaming is a rare state of sleep in which the

  13. The treatment of behavioral disturbances and psychosis associated with dementia

    Directory of Open Access Journals (Sweden)

    Jeannie D. Lochhead

    2016-04-01

    Full Text Available Behavioral disturbances and psychosis associated with dementia are becoming an increasingly common cause of morbidity in patients with dementia. Approximately 70% of individuals with dementia will experience agitation, and 75% will experience symptoms of psychosis such as delusions or hallucinations. The goal of this article is to review the pharmacologic treatment options for behavioral disturbances and psychosis associated with dementia. A literature review was conducted on PubMed/Medline using key words of “dementia” and “interventions.” The results were filtered for meta-analysis, clinical trials, and systematic reviews. The results were then reviewed. At this time, the most evidence exists for the use of a second generation antipsychotics (SGAs, but consideration should be given to their collective boxed warning of morbidity/mortality. The evidence for second line treatments are limited. There is limited evidence to support the use of first generation antipsychotics (FGAs, antidepressants, anticonvulsants, cognitive enhancers, and analgesics. Additional randomized control trials are needed to guide clinical decision making regarding the behavioral disturbances and psychosis associated with dementia.

  14. Immune System Dysregulation in First-Onset Postpartum Psychosis

    NARCIS (Netherlands)

    Bergink, Veerle; Burgerhout, Karin M.; Weigelt, Karin; Pop, Victor J.; de Wit, Harm; Drexhage, Roos C.; Kushner, Steven A.; Drexhage, Hemmo A.

    2013-01-01

    Background: Accumulating evidence suggests that dysregulation of the immune system represents an important vulnerability factor for mood disorders. Postpartum psychosis (PP) is a severe mood disorder occurring within 4 weeks after delivery, a period of heightened immune responsiveness and an altered

  15. A case report of isotretinoin-induced manic psychosis

    Directory of Open Access Journals (Sweden)

    Jisha M Lucca

    2016-01-01

    Full Text Available Isotretinoin, an oral vitamin A derivative, used to treat severe treatment-resistant acne. Psychiatric side effects of isotretinoin particularly depression and suicidal thoughts have been well documented. We report a case of isotretinoin-induced manic psychosis in a young female without a family history and history of mental illness.

  16. Structural brain abnormalities in early onset first-episode psychosis

    DEFF Research Database (Denmark)

    Pagsberg, A K; Baaré, W F C; Raabjerg Christensen, A M;

    2007-01-01

    BACKGROUND: Brain morphometry in children and adolescents with first-episode psychosis offer a unique opportunity for pathogenetic investigations. METHODS: We compared high-resolution 3D T1-weighted magnetic resonance images of the brain in 29 patients (schizophrenia, schizotypal disorder, delusi...

  17. Using Digital Media Advertising in Early Psychosis Intervention.

    Science.gov (United States)

    Birnbaum, Michael L; Garrett, Chantel; Baumel, Amit; Scovel, Maria; Rizvi, Asra F; Muscat, Whitney; Kane, John M

    2017-07-17

    Identifying and engaging youth with early-stage psychotic disorders in order to facilitate timely treatment initiation remains a major public health challenge. Although advertisers routinely use the Internet to directly target consumers, limited efforts have focused on applying available technology to proactively encourage help-seeking in the mental health community. This study explores how one might take advantage of Google AdWords in order to reach prospective patients with early psychosis. A landing page was developed with the primary goal of encouraging help-seeking individuals in New York City to contact their local early psychosis intervention clinic. In order to provide the best opportunity to reach the intended audience, Google AdWords was utilized to link more than 2,000 selected search terms to strategically placed landing page advertisements. The campaign ran for 14 weeks between April 11 and July 18, 2016 and had a total budget of $1,427. The ads appeared 191,313 times and were clicked on 4,350 times, at a per-click cost of $.33. Many users took additional help-seeking steps, including obtaining psychosis-specific information/education (44%), completing a psychosis self-screener (15%), and contacting the local early treatment program (1%). Digital ads appear to be a reasonable and cost-effective method to reach individuals who are searching for behavioral health information online. More research is needed to better understand the many complex steps between online search inquiries and making first clinical contact.

  18. Do Profoundly Prelingually Deaf Patients with Psychosis Really Hear Voices?

    Science.gov (United States)

    Paijmans, R.; Cromwell, J.; Austen, S.

    2006-01-01

    The psychiatric literature has described profoundly prelingually deaf people with psychosis who report hearing voices. The present study proposes that such reports in fact reflect the beliefs of professionals in mental health and deafness and not the hallucinatory experience of psychotic deaf people. The study demonstrates that it is functionally…

  19. Ten year neurocognitive trajectories in first-episode psychosis

    DEFF Research Database (Denmark)

    Barder, Helene E; Sundet, Kjetil; Rund, Bjørn R

    2013-01-01

    Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitud......Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year...... longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory. Method: Forty-three FEP subjects (51% male, 28 ± 9 years...... of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that the majority of patients do not show significant change in cognitive performance during the first 10 years after being diagnosed....

  20. Neural correlates of insight in dreaming and psychosis

    NARCIS (Netherlands)

    Dresler, M.; Wehrle, R.; Spoormaker, V.I.; Steiger, A.; Holsboer, F.; Czisch, M.; Hobson, J.A.

    2015-01-01

    The idea that dreaming can serve as a model for psychosis has a long and honourable tradition, however it is notoriously speculative. Here we demonstrate that recent research on the phenomenon of lucid dreaming sheds new light on the debate. Lucid dreaming is a rare state of sleep in which the dream