WorldWideScience

Sample records for psychotic illness opcrit

  1. Humor e psicose em esquizofrenia: explorando fronteiras diagnósticas com o Inventário de Critérios Operacionais para Doenças Psicóticas (OPCRIT e o caso John Nash Ánimo y psicosis en esquizofrenia: explorando fronteras diagnósticas con el Inventario de Criterios Operacionales para Enfermedades Psicóticas (OPCRIT y el caso John Nash Mood and psychosis in schizophrenia: exploring diagnostic frontiers with the Operational Criteria Checklist for Psychotic Illness (OPCRIT and John Nash case

    Directory of Open Access Journals (Sweden)

    Cristiane Damacarena Martins

    2004-08-01

    ósticas actuales.BACKGROUNDS: A diagnostic simulation exercise was carried out using John Nash's case (the 1994 Mathematics Nobel Prize winner and described as suffering from schizophrenia to introduce the Operational Criteria Checklist for Psychotic Illness (OPCRIT and discuss the uncertain boundaries between some of the diagnostic categories presented by the instrument, as well as the use of dimensional diagnosis in psychiatry. METHODS: Data were obtained from John Nash's biography (written by Sylvia Nasar and from the movie A Beautiful Mind. The authors discussed the symptoms shown in both the biography and the movie and then entered data into the OPCRIT program. Because consensus was not reached in some items, two additional simulations were carried out. In these, three items were modified, in order to investigate the effects of these changes on diagnosis: thoughts racing (31st item, increased sociability (53rd item, and relationship psychotic/affective symptoms (52nd item. RESULTS: The diagnoses provided by two of the simulations were schizophrenia (DSM-IV and undifferentiated schizophrenia (ICD-10. Other results included schizoaffective disorder/bipolar type (DSM-IV and schizoaffective disorder/manic type (ICD-10. It is important to emphasize that the 52nd item (relationship psychotic/affective symptoms was the only one with an effect on diagnosis when altered (schizophrenia vs. schizoaffective disorder. DISCUSSION: The boundaries between schizophrenia and schizoaffective disorder are not clear and explain the frequent difficulty faced by psychiatrists in establishing diagnosis. CONCLUSIONS: This exercise revealed the importance of a detailed assessment of the course of illness for a correct diagnosis, emphasizing the relationship between psychotic and affective symptoms. We emphasize the importance of dimensional diagnosis and the need for further studies in order to validate the diagnostic categories currently used.

  2. Yoruba world view and the nature of psychotic illness.

    Science.gov (United States)

    Olugbile, O; Zachariah, M P; Kuyinu, A; Coker, A; Ojo, O; Isichei, B

    2009-05-01

    The Yoruba are an ethnic group in southern Nigeria. It is said that their world view centers around a continuous battle between forces of good and evil. Adverse events such as illness are due to the malevolence of enemies, using metaphysical means. Remedy often involves corrective metaphysical intervention, either exclusively or in addition to other methods, such as 'western Medicine'. This 'rule' is said to fit mental illness more than any other type of illness, although there is a lack of empirical data on the subject. This study is aimed at identifying elements of a Yoruba world view, and factors relevant to the perception and treatment of psychotic illness. 500 Yorubas in Lagos were randomly sampled (with a questionnaire), and 100 'home video' films were analyzed. Data were analyzed for: elements of world view; elements that pertain to illness in general; elements that pertain to psychotic illness; how such illness is to be treated. The world view has a significant influence on perception of psychotic illness. It is necessary to understand a people's world view in order to understand (and influence) attitudes towards psychotic illness in themselves and other people.

  3. Anomalies of subjective experience in schizophrenia and psychotic bipolar illness

    DEFF Research Database (Denmark)

    Parnas, J; Handest, P; Saebye, D

    2003-01-01

    OBJECTIVE: Contemporary psychopathology, as a result of behaviourally dominated epistemological stance, downplays anomalies of the patient's subjectivity. This neglect has probably deleterious consequences for research in the causes and the boundaries of the schizophrenia spectrum conditions....... The purpose of this study is to explore frequency of qualitative, not-yet-psychotic, anomalies of subjective experience in patients with residual schizophrenia and psychotic bipolar illness in remission. METHOD: The patients were examined with the Danish version of the Bonn Scale for the Assessment of Basic...... differential diagnosis and therefore potentially useful in the preonset detection of the schizophrenia spectrum illness....

  4. Comorbidities and psychotic illness. Part 1: Philosophy and clinical consequences.

    Science.gov (United States)

    Agius, Mark; Aquilina, Francesca Falzon

    2014-11-01

    This article aims at addressing the implications of defining 'comorbidity' within the field of psychiatry. We have looked at the standard definition of comorbidity and then discussed whether this definition can be applied to comorbidities in psychiatry. While comorbidities in physical illness are clearly the coexistence of two independent illnesses, Comorbidities in Mental illness are the result of the polygenic nature of mental illnesses, especially in psychotic illness whether schizophrenia or bipolar disorder. As a consequence, often the comorbidities of psychiatric illness are caused by two conditions which have in common the presence of particular single nucleotide polymorphisms (snps), which regulate the metabolism of neurotransmitters or the presence of neurotrophic factors . Thus inevitably, many such comorbidities are inextricably linked. We discuss the consequences of this form of comorbidity for the description, classification, and risk profile of mental illness.

  5. Schizoaffective Disorder in an acute psychiatric unit: Profile of users and agreement with Operational Criteria (OPCRIT

    Directory of Open Access Journals (Sweden)

    Ryola Singh

    2016-05-01

    Full Text Available Background: Schizoaffective Disorder is a controversial and poorly understood diagnosis. Experts disagree on whether it is a discrete disorder; whether it is on a spectrum between Bipolar Disorder and Schizophrenia or whether it even exists. Lack of individual research attention given to this disorder, changing diagnostic criteria and hence poor diagnostic stability have all contributed to the dearth of knowledge surrounding Schizoaffective Disorder. Objectives: To describe the profile of mental health care users (MHCUs diagnosed with Schizoaffective Disorder and determine the degree of agreement between the clinicians’ diagnosis and Operational Criteria (OPCRIT. Method: All MHCUs at Helen Joseph Hospital psychiatric unit with Schizoaffective Disorder between 01 January 2004 and 31 December 2010 were included. The demographic, clinical and treatment profiles as well as data required for OPCRIT were extracted from hospital records and discharge summaries. Results: Most MHCUs with Schizoaffective Disorder were female (68.89%, with a mean age of illness onset of 25 years (SD ± 7.11, had a family history of mood disorders (76.92% and displayed impaired functioning. Majority (80% were treated with at least one antipsychotic and one mood stabiliser. No agreement was found between the clinicians’ diagnosis and OPCRIT. Conclusion: While the profile of MHCUs with Schizoaffective Disorder in this study is similar to other studies, the lack of agreement between the clinicians’ and OPCRIT diagnoses calls for further research using larger population samples and a dimensional approach to diagnoses in order to improve understanding and management of Schizoaffective Disorder.

  6. Homicide of Strangers by People with a Psychotic Illness

    Science.gov (United States)

    Nielssen, Olav; Bourget, Dominique; Laajasalo, Taina; Liem, Marieke; Labelle, Alain; Häkkänen-Nyholm, Helina; Koenraadt, Frans; Large, Matthew M.

    2011-01-01

    Background: The homicide of strangers by people with psychosis, referred to here as “stranger homicides,” are rare and tragic events that generate adverse publicity for mental health services and have resulted in significant changes in mental health policy and law. Aim: To estimate the incidence of stranger homicides, using data from previously published studies, and to compare the characteristics of psychotic offenders who killed strangers with the characteristics of those who killed a close relative. Method: Meta-analysis of the population-based studies of homicide by persons suffering from a psychosis in which the number of subjects who killed strangers was also reported. Characteristics of stranger homicide and family homicide offenders were examined in a multicenter case–control study of homicide during psychotic illness in four high-income countries. Results: A pooled estimate of 1 stranger homicide per 14.3 million people per year (95% confidence interval, 1 in 18.9 million to 1 in 11.5 million people per year) was calculated by meta-analysis of 7 studies. The characteristics of the 42 stranger homicide offenders from New South Wales [NSW], Quebec and Eastern Ontario, Finland, and the Netherlands were identified. Twenty seven (64%) of these had never previously received treatment with antipsychotic medication. The stranger homicide offenders were more likely to be homeless, have exhibited antisocial conduct, and had fewer negative symptoms than those who killed family members. The victims of stranger homicide were mostly adult males and the homicides rarely occurred in the victim’s home or workplace. Conclusions: Stranger homicide in psychosis is extremely rare and is even rarer for a patient who has received treatment with antipsychotic medication. A lack of distinguishing characteristics of stranger homicide offenders and an extremely low base rate of stranger-homicide suggests that risk assessment of patients known to have a psychotic illness will

  7. A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness

    DEFF Research Database (Denmark)

    Petersen, Lone; Jeppesen, Pia; Thorup, Anne

    2005-01-01

    To evaluate the effects of integrated treatment for patients with a first episode of psychotic illness.......To evaluate the effects of integrated treatment for patients with a first episode of psychotic illness....

  8. Positive life change and remission of non-psychotic mental illness - A competing outcomes approach

    NARCIS (Netherlands)

    Neeleman, J; Oldehinkel, AJ; Ormel, J

    Background: Episode duration in non-psychotic mental illness is associated with personal characteristics of patients, like age or personality. Part of these links may be mediated by life change, a predictor of episode duration in its own right. Methods: In 170 primary care patients who suffered 4171

  9. Individualized prediction of illness course at the first psychotic episode: a support vector machine MRI study.

    LENUS (Irish Health Repository)

    Mourao-Miranda, J

    2012-05-01

    To date, magnetic resonance imaging (MRI) has made little impact on the diagnosis and monitoring of psychoses in individual patients. In this study, we used a support vector machine (SVM) whole-brain classification approach to predict future illness course at the individual level from MRI data obtained at the first psychotic episode.

  10. Yoruba World View and the nature of Psychotic Illness | Olugbile ...

    African Journals Online (AJOL)

    , A Kuyinu, A Coker, O Ojo, B Isichei. Abstract. Objective: The Yoruba are an ethnic group in southern Nigeria. It is said that their world view centers around a continuous battle between forces of good and evil. Adverse events such as illness are ...

  11. Internalized stigma of mental illness and depressive and psychotic symptoms in homeless veterans over 6 months.

    Science.gov (United States)

    Boyd, Jennifer E; Hayward, H'Sien; Bassett, Elena D; Hoff, Rani

    2016-06-30

    We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery. Published by Elsevier Ireland Ltd.

  12. Visual integration dysfunction in schizophrenia arises by the first psychotic episode and worsens with illness duration

    OpenAIRE

    Keane, Brian P.; Paterno, Danielle; Kastner, Sabine; Silverstein, Steven M.

    2016-01-01

    Visual integration dysfunction characterizes schizophrenia, but prior studies have not yet established whether the problem arises by the first psychotic episode or worsens with illness duration. To investigate the issue, we compared chronic schizophrenia patients (SZs), first episode psychosis patients (FEs), and well-matched healthy controls on a brief but sensitive psychophysical task in which subjects attempted to locate an integrated shape embedded in noise. Task difficulty depended on th...

  13. Vitamin D deficiency and psychotic features in mentally ill adolescents: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Gracious Barbara L

    2012-05-01

    Full Text Available Abstract Background Vitamin D deficiency is a re-emerging epidemic, especially in minority populations. Vitamin D is crucial not only for bone health but for proper brain development and functioning. Low levels of vitamin D are associated with depression, seasonal affective disorder, and schizophrenia in adults, but little is known about vitamin D and mental health in the pediatric population. Methods One hundred four adolescents presenting for acute mental health treatment over a 16-month period were assessed for vitamin D status and the relationship of 25-OH vitamin D levels to severity of illness, defined by presence of psychotic features. Results Vitamin D deficiency (25-OH D levels Conclusions Vitamin D deficiency and insufficiency are both highly prevalent in adolescents with severe mental illness. The preliminary associations between vitamin D deficiency and presence of psychotic features warrant further investigation as to whether vitamin D deficiency is a mediator of illness severity, result of illness severity, or both. Higher prevalence of vitamin D deficiency but no greater risk of psychosis in African Americans, if confirmed, may have special implications for health disparity and treatment outcome research.

  14. Young women's experiences of psychotic illness: a systematic review of qualitative research.

    Science.gov (United States)

    Chernomas, Wanda M; Rieger, Kendra L; Karpa, Jane V; Clarke, Diana E; Marchinko, Shelley; Demczuk, Lisa

    2017-03-01

    The relationship between young adulthood, women and psychosis was the focus for this systematic review. Age and gender are factors that can influence responses to illness. Research indicates that there are differences in how young men and women are affected biologically and psychosocially, including the presentation of a constellation of symptoms, response to anti-psychotic medications and how they assess their life circumstances. Yet in literature that examines experiences of young people with psychosis, the specific needs of young women are usually not presented separately. To better understand and address young adult women's healthcare and social service needs, a synthesis of evidence addressing the relationship between young adulthood, women and psychosis is needed. The aim of this systematic review was to synthesize the best available evidence on the experiences of young adult women (aged 18-35 years) living with a psychotic illness in the community. Specifically, the review question was:What are the experiences of young adult women living with a psychotic illness? Participants were young women between 18 and 35 years of age who were living with a psychotic illness in the community. The phenomenon of interest was the experiences of living with a psychotic illness of women aged 18-35 years in the community. Experiences were defined broadly as and inclusive of perceptions and experiences with health and social systems. The context for this review was the community setting. The current review included studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, feminist research and the qualitative component of mixed methods studies. A three-step search strategy was used to locate both published and unpublished studies. The search was limited to studies published from 1995 to the search date of May 13, 2015. Two reviewers independently appraised the nine included studies

  15. Visual integration dysfunction in schizophrenia arises by the first psychotic episode and worsens with illness duration.

    Science.gov (United States)

    Keane, Brian P; Paterno, Danielle; Kastner, Sabine; Silverstein, Steven M

    2016-05-01

    Visual integration dysfunction characterizes schizophrenia, but prior studies have not yet established whether the problem arises by the first psychotic episode or worsens with illness duration. To investigate the issue, we compared chronic schizophrenia patients (SZs), first episode psychosis patients (FEs), and well-matched healthy controls on a brief but sensitive psychophysical task in which subjects attempted to locate an integrated shape embedded in noise. Task difficulty depended on the number of noise elements co-presented with the shape. For half of the experiment, the entire display was scaled down in size to produce a high spatial frequency (HSF) condition, which has been shown to worsen patient integration deficits. Catch trials-in which the circular target appeared without noise-were also added so as to confirm that subjects were paying adequate attention. We found that controls integrated contours under noisier conditions than FEs, who, in turn, integrated better than SZs. These differences, which were at times large in magnitude (d = 1.7), clearly emerged only for HSF displays. Catch trial accuracy was above 95% for each group and could not explain the foregoing differences. Prolonged illness duration predicted poorer HSF integration across patients, but age had little effect on controls, indicating that the former factor was driving the effect in patients. Taken together, a brief psychophysical task efficiently demonstrates large visual integration impairments in schizophrenia. The deficit arises by the first psychotic episode, worsens with illness duration, and may serve as a biomarker of illness progression. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  16. The health informatics cohort enhancement project (HICE: using routinely collected primary care data to identify people with a lifetime diagnosis of psychotic disorder

    Directory of Open Access Journals (Sweden)

    Economou Alexis

    2012-02-01

    Full Text Available Abstract Background We have previously demonstrated that routinely collected primary care data can be used to identify potential participants for trials in depression [1]. Here we demonstrate how patients with psychotic disorders can be identified from primary care records for potential inclusion in a cohort study. We discuss the strengths and limitations of this approach; assess its potential value and report challenges encountered. Methods We designed an algorithm with which we searched for patients with a lifetime diagnosis of psychotic disorders within the Secure Anonymised Information Linkage (SAIL database of routinely collected health data. The algorithm was validated against the "gold standard" of a well established operational criteria checklist for psychotic and affective illness (OPCRIT. Case notes of 100 patients from a community mental health team (CMHT in Swansea were studied of whom 80 had matched GP records. Results The algorithm had favourable test characteristics, with a very good ability to detect patients with psychotic disorders (sensitivity > 0.7 and an excellent ability not to falsely identify patients with psychotic disorders (specificity > 0.9. Conclusions With certain limitations our algorithm can be used to search the general practice data and reliably identify patients with psychotic disorders. This may be useful in identifying candidates for potential inclusion in cohort studies.

  17. Impact of childhood adversities on the short-term course of illness in psychotic spectrum disorders.

    Science.gov (United States)

    Schalinski, Inga; Fischer, Yolanda; Rockstroh, Brigitte

    2015-08-30

    Accumulating evidence indicates an impact of childhood adversities on the severity and course of mental disorders, whereas this impact on psychotic disorders remains to be specified. Effects of childhood adversities on comorbidity, on symptom severity of the Positive and Negative Syndrome Scale and global functioning across four months (upon admission, 1 and 4 months after initial assessment), as well as the course of illness (measured by the remission rate, number of re-hospitalizations and dropout rate) were evaluated in 62 inpatients with psychotic spectrum disorders. Adverse experiences (of at least 1 type) were reported by 73% of patients. Patients with higher overall level of childhood adversities (n=33) exhibited more co-morbid disorders, especially alcohol/substance abuse and dependency, and higher dropout rates than patients with a lower levels of adverse experiences (n=29), together with higher levels of positive symptoms and symptoms of excitement and disorganization. Emotional and physical neglect were particularly related to symptom severity. Results suggest that psychological stress in childhood affects the symptom severity and, additionally, a more unfavorable course of disorder in patients diagnosed with psychoses. This impact calls for its consideration in diagnostic assessment and psychiatric care. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  18. Depot-medication compliance for patients with psychotic disorders: The importance of illness insight and treatment motivation

    NARCIS (Netherlands)

    E.L. Noordraven (Ernst); A.I. Wierdsma (André); P. Blanken (Peter); A.F.T. Bloemendaal (Anthony F. T.); C.L. Mulder (Niels)

    2016-01-01

    textabstractBackground: Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are

  19. Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation.

    Science.gov (United States)

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony Ft; Mulder, Cornelis L

    2016-01-01

    Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication. Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models. Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation. Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed.

  20. Confirmatory Factor Analysis and Differential Relationships of the Two Subdomains of Negative Symptoms in Chronically Ill Psychotic Patients

    Science.gov (United States)

    Stiekema, Annemarie P. M.; Liemburg, Edith J.; van der Meer, Lisette; Castelein, Stynke; Stewart, Roy; van Weeghel, Jaap; Aleman, André; Bruggeman, Richard

    2016-01-01

    Research suggests a two factor structure for negative symptoms in patients with psychotic disorders: social amotivation (SA) and expressive deficits (ED). Applying this two-factor structure in clinical settings may provide valuable information with regard to outcomes and to target treatments. We aimed to investigate 1) whether the factor structure is also supported in chronically ill patients with a psychotic disorder and 2) what the relationship is between these factors and functioning (overall functioning and living situation), depressive symptoms and quality of life. 1157 Patients with a psychotic disorder and a duration of illness of 5 years or more were included in the analysis (data selected from the Pharmacotherapy Monitoring Outcome Survey; PHAMOUS). A confirmatory factor analysis was performed using items of the Positive and Negative Syndrome Scale that were previously identified to reflect negative symptoms (N1-4, N6, G5, G7, G13, G16). Subsequently, regression analysis was performed on outcomes. The results confirmed the distinction between SA (N2, N4, G16) and ED (N1, N3, N6, G5, G7, G13) in chronically ill patients. Both factors were related to worse overall functioning as measured with the Health of the Nation Outcome Scales, ED was uniquely associated with residential living status. Higher scores for SA were associated with more depressive symptoms and worse quality of life. Thus, SA is most strongly related to level of social-emotional functioning, while ED are more related to living situation and thereby are indicative of level of everyday functioning. This subdivision may be useful for research purposes and be a valuable additional tool in clinical practice and treatment development. PMID:26895203

  1. Confirmatory Factor Analysis and Differential Relationships of the Two Subdomains of Negative Symptoms in Chronically Ill Psychotic Patients.

    Directory of Open Access Journals (Sweden)

    Annemarie P M Stiekema

    Full Text Available Research suggests a two factor structure for negative symptoms in patients with psychotic disorders: social amotivation (SA and expressive deficits (ED. Applying this two-factor structure in clinical settings may provide valuable information with regard to outcomes and to target treatments. We aimed to investigate 1 whether the factor structure is also supported in chronically ill patients with a psychotic disorder and 2 what the relationship is between these factors and functioning (overall functioning and living situation, depressive symptoms and quality of life. 1157 Patients with a psychotic disorder and a duration of illness of 5 years or more were included in the analysis (data selected from the Pharmacotherapy Monitoring Outcome Survey; PHAMOUS. A confirmatory factor analysis was performed using items of the Positive and Negative Syndrome Scale that were previously identified to reflect negative symptoms (N1-4, N6, G5, G7, G13, G16. Subsequently, regression analysis was performed on outcomes. The results confirmed the distinction between SA (N2, N4, G16 and ED (N1, N3, N6, G5, G7, G13 in chronically ill patients. Both factors were related to worse overall functioning as measured with the Health of the Nation Outcome Scales, ED was uniquely associated with residential living status. Higher scores for SA were associated with more depressive symptoms and worse quality of life. Thus, SA is most strongly related to level of social-emotional functioning, while ED are more related to living situation and thereby are indicative of level of everyday functioning. This subdivision may be useful for research purposes and be a valuable additional tool in clinical practice and treatment development.

  2. Maternally derived microduplications at 15q11-q13: implication of imprinted genes in psychotic illness

    NARCIS (Netherlands)

    Ingason, A.; Kirov, G.; Giegling, I.; Hansen, T.; Isles, A.R.; Jakobsen, K.D.; Kristinsson, K.T.; Roux, L. le; Gustafsson, O.; Craddock, N.; Moller, H.J.; McQuillin, A.; Muglia, P.; Cichon, S.; Rietschel, M.; Ophoff, R.A.; Djurovic, S.; Andreassen, O.A.; Pietilainen, O.P.H.; Peltonen, L.; Dempster, E.; Collier, D.A.; St Clair, D.; Rasmussen, H.B.; Glenthoj, B.Y.; Kiemeney, L.A.L.M.; Franke, B.; Tosato, S.; Bonetto, C.; Saemundsen, E.; Hreidarsson, S.J.; Nothen, Markus; Gurling, H.; O'Donovan, M.C.; Owen, M.J.; Sigurdsson, E.; Petursson, H.; Stefansson, H.; Rujescu, D.; Stefansson, K.; Werge, T.

    2011-01-01

    OBJECTIVE: Rare copy number variants have been implicated in different neurodevelopmental disorders, with the same copy number variants often increasing risk of more than one of these phenotypes. In a discovery sample of 22 schizophrenia patients with an early onset of illness (10-15 years of age),

  3. Recovery from psychotic illness : a 15-and 25-year international follow-up study

    NARCIS (Netherlands)

    Harrison, G; Hopper, K; Craig, T; Laska, E; Siegel, C; Wanderling, J; Dube, KC; Ganev, K; Giel, R; An der Heiden, W; Holmberg, SK; Janca, A; Lee, PWH; Leon, CA; Malhotra, S; Marsella, AJ; Nakane, Y; Sartorius, N; Shen, Y; Skoda, C; Thara, R; Tsirkin, SJ; Varma, VK; Walsh, D; Wiersma, D

    Background Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia. Aims To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the

  4. Maternally Derived Microduplications at 15q11-q13: Implication of Imprinted Genes in Psychotic Illness

    DEFF Research Database (Denmark)

    Ingason, Andrés; Kirov, George; Giegling, Ina

    2011-01-01

    or schizoaffective disorder and 41,370 comparison subjects without known psychiatric illness for copy number variants at 15q11-q13 and determined the parental origin of duplications using methylation-sensitive Southern hybridization analysis. Results: Duplications were found in four case patients and five comparison...

  5. Molecular genetic models related to schizophrenia and psychotic illness: heuristics and challenges.

    Science.gov (United States)

    O'Tuathaigh, Colm M P; Desbonnet, Lieve; Moran, Paula M; Kirby, Brian P; Waddington, John L

    2011-01-01

    Schizophrenia is a heritable disorder that may involve several common genes of small effect and/or rare copy number variation, with phenotypic heterogeneity across patients. Furthermore, any boundaries vis-à-vis other psychotic disorders are far from clear. Consequently, identification of informative animal models for this disorder, which typically relate to pharmacological and putative pathophysiological processes of uncertain validity, faces considerable challenges. In juxtaposition, the majority of mutant models for schizophrenia relate to the functional roles of a diverse set of genes associated with risk for the disorder or with such putative pathophysiological processes. This chapter seeks to outline the evidence from phenotypic studies in mutant models related to schizophrenia. These have commonly assessed the degree to which mutation of a schizophrenia-related gene is associated with the expression of several aspects of the schizophrenia phenotype or more circumscribed, schizophrenia-related endophenotypes; typically, they place specific emphasis on positive and negative symptoms and cognitive deficits, and extend to structural and other pathological features. We first consider the primary technological approaches to the generation of such mutants, to include their relative merits and demerits, and then highlight the diverse phenotypic approaches that have been developed for their assessment. The chapter then considers the application of mutant phenotypes to study pathobiological and pharmacological mechanisms thought to be relevant for schizophrenia, particularly in terms of dopaminergic and glutamatergic dysfunction, and to an increasing range of candidate susceptibility genes and copy number variants. Finally, we discuss several pertinent issues and challenges within the field which relate to both phenotypic evaluation and a growing appreciation of the functional genomics of schizophrenia and the involvement of gene × environment interactions.

  6. Ethical and methodological issues in qualitative studies involving people with severe and persistent mental illness such as schizophrenia and other psychotic conditions: a critical review.

    Science.gov (United States)

    Carlsson, Ing-Marie; Blomqvist, Marjut; Jormfeldt, Henrika

    2017-01-01

    Undertaking research studies in the field of mental health is essential in mental health nursing. Qualitative research methodologies enable human experiences to become visible and recognize the importance of lived experiences. This paper argues that involving people with schizophrenia in research is critical to promote their health and well-being. The quality of qualitative research needs scrutinizing according to methodological issues such as trustworthiness and ethical standards that are a fundamental part of qualitative research and nursing curricula. The aim of this study was to critically review recent qualitative studies involving people with severe and persistent mental illness such as schizophrenia and other psychotic conditions, regarding descriptions of ethical and methodological issues in data collection and analysis. A search for relevant papers was conducted in three electronic databases, in December 2016. Fifteen qualitative interview studies were included and reviewed regarding methodological issues related to ethics, and data collection and analysis. The results revealed insufficient descriptions of methodology regarding ethical considerations and issues related to recruitment and sampling in qualitative interview studies with individuals with severe mental illness, putting trustworthiness at risk despite detailed descriptions of data analysis. Knowledge from the perspective of individuals with their own experience of mental illness is essential. Issues regarding sampling and trustworthiness in qualitative studies involving people with severe mental illness are vital to counteract the stigmatization of mental illness.

  7. Personality and psychotic disorders

    NARCIS (Netherlands)

    Boyette, L.L.N.J.

    2014-01-01

    The subject of the current thesis is the contribution of normal personality traits as conceptualized by the Five-Factor Model of personality (FFM) to the manifestation of illness in patients with psychotic disorders. These studies were part of the Dutch national Genetic Risk and Outcome of Psychosis

  8. Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting on illness onset, risk, and severity--implications for diagnosis and ultra-high risk research.

    Science.gov (United States)

    Wigman, Johanna T W; van Nierop, Martine; Vollebergh, Wilma A M; Lieb, Roselind; Beesdo-Baum, Katja; Wittchen, Hans-Ullrich; van Os, Jim

    2012-03-01

    It is commonly assumed that there are clear lines of demarcation between anxiety and depressive disorders on the one hand and psychosis on the other. Recent evidence, however, suggests that this principle may be in need of updating. Depressive and/or anxiety disorders, with no previous history of psychotic disorder, were examined for the presence of psychotic symptoms in a representative community sample of adolescents and young adults (Early Developmental Stages of Psychopathology study; n = 3021). Associations and consequences of psychotic symptomatology in the course of these disorders were examined in terms of demographic distribution, illness severity, onset of service use, and risk factors. Around 27% of those with disorders of anxiety and depression displayed one or more psychotic symptoms, vs 14% in those without these disorders (OR 2.23, 95% CI 1.89-2.66, P illness course (P symptoms (P illness behavior (P illness (P disorders of anxiety and depression is common and a functionally and etiologically highly relevant feature, reinforcing the view that psychopathology is represented by a network or overlapping and reciprocally impacting dimensional liabilities.

  9. Severity of Illness and Adaptive Functioning Predict Quality of Care of Children Among Parents with Psychotic Disorders : A Confirmatory Factor Analysis

    NARCIS (Netherlands)

    Campbell, L.; Hanlon, M.--C.; Cherrie, G.; Harvey, C.; Stain, H. J.; Cohen, M.; van Ravenzwaaij, D.; Brown, S. D.

    2018-01-01

    OBJECTIVE: Parenthood is central to the personal and social identity of many people. For individuals with psychotic disorders, parenthood is often associated with formidable challenges. We aimed to identify predictors of adequate parenting among parents with psychotic disorders. METHODS: Data

  10. A comparative study of the economic and social functioning of Vietnamese-Australians with low English proficiency living with psychotic illness.

    Science.gov (United States)

    Stolk, Yvonne; Sevar, Katherine; Tran, Nga; Mancuso, Serafino G; Chopra, Prem; Castle, David

    2015-06-01

    Because national surveys of people living with psychotic disorders tend to exclude people with low English proficiency (LEP), little is known of their economic and social functioning. Culturally influenced explanatory models may result in delayed presentation and poorer functioning. The study aimed to compare the functioning of LEP Vietnamese-Australian and Australian-born patients with psychosis and to investigate the Vietnamese-Australians' pathways to care. In all, 19 LEP Vietnamese-Australians, previously excluded from the Australian Survey of High Impact Psychosis (SHIP), were matched with 15 Australian-born controls, and interviewed by a Vietnamese bilingual mental health professional using the SHIP Interview Schedule. The Vietnamese-Australian patients were significantly more likely to live with family, rate spirituality as important and participate in community rehabilitation programs. Their work, social and independent functioning, was better than the controls. The groups did not differ in mental health services received and satisfaction with services. Although half of Vietnamese-Australians attributed mental illness to supernatural, among other causes, none had consulted traditional healers. Despite LEP, Vietnamese-Australians with psychosis showed comparable or better functioning than Australian-born patients. Further investigation is recommended into LEP patients' clinical and social recovery and the role of language communities' support networks. © The Author(s) 2014.

  11. Physical health behaviours and health locus of control in people with schizophrenia-spectrum disorder and bipolar disorder: a cross-sectional comparative study with people with non-psychotic mental illness.

    Science.gov (United States)

    Buhagiar, Kurt; Parsonage, Liam; Osborn, David P J

    2011-06-24

    People with mental illness experience high levels of morbidity and mortality from physical disease compared to the general population. Our primary aim was to compare how people with severe mental illness (SMI; i.e. schizophrenia-spectrum disorders and bipolar disorder) and non-psychotic mental illness perceive their: (i) global physical health, (ii) barriers to improving physical health, (iii) physical health with respect to important aspects of life and (iv) motivation to change modifiable high-risk behaviours associated with coronary heart disease. A secondary aim was to determine health locus of control in these two groups of participants. People with SMI and non-psychotic mental illness were recruited from an out-patient adult mental health service in London. Cross-sectional comparison between the two groups was conducted by means of a self-completed questionnaire. A total of 146 people participated in the study, 52 with SMI and 94 with non-psychotic mental illness. There was no statistical difference between the two groups with respect to the perception of global physical health. However, physical health was considered to be a less important priority in life by people with SMI (OR 0.5, 95% CI 0.2-0.9, p = 0.029). There was no difference between the two groups in their desire to change high risk behaviours. People with SMI are more likely to have a health locus of control determined by powerful others (p locus of control may provide a theoretical focus for clinical intervention in order to promote a much needed behavioural change in this marginalised group of people.

  12. Psychotic depression, posttraumatic stress disorder, and engagement in cognitive-behavioral therapy within an outpatient sample of adults with serious mental illness.

    Science.gov (United States)

    Gottlieb, Jennifer D; Mueser, Kim T; Rosenberg, Stanley D; Xie, Haiyi; Wolfe, Rosemarie S

    2011-01-01

    Depression with psychotic features afflicts a substantial number of people and has been characterized by significantly greater impairment, higher levels of dysfunctional beliefs, and poorer response to psychopharmacologic and psychosocial interventions than nonpsychotic depression. Those with psychotic depression also experience a host of co-occurring disorders, including posttraumatic stress disorder (PTSD), which is not surprising given the established relationships between trauma exposure and increased rates of psychosis and between PTSD and major depression. To date, there has been very limited research on the psychosocial treatment of psychotic depression; and even less is known about those who also suffer from PTSD. The purpose of this study was to better understand the rates and clinical correlates of psychotic depression in those with PTSD. Clinical and symptom characteristics of 20 individuals with psychotic depression and 46 with nonpsychotic depression, all with PTSD, were compared before receiving cognitive-behavioral therapy for PTSD treatment or treatment as usual. Patients with psychotic depression exhibited significantly higher levels of depression and anxiety, a weaker perceived therapeutic alliance with their case managers, more exposure to traumatic events, and more negative beliefs related to their traumatic experiences, as well as increased levels of maladaptive cognitions about themselves and the world, compared with participants without psychosis. Implications for cognitive-behavioral therapy treatment aimed at dysfunctional thinking for this population are discussed. © 2011 Elsevier Inc. All rights reserved.

  13. [Psychotic parricide. Prevention].

    Science.gov (United States)

    Cornic, F; Olié, J-P

    2006-01-01

    Parricide is a rare event. In France, statistics indicate that it accounts for 2 to 3% of all homicides. It also represents an appreciable part (up to 30%) of homicides committed by psychotic subjects. Many studies suggest a strong positive correlation between criminality and characterized mental illness. The correlation is better when there is a diagnosis of schizophrenia, an alcohol or drugs consumption and a past personal history of violence. Parricide is a crime mainly committed by males. The most frequent form of parricide is patricide committed by sons. However, considering only psychotic parricides, the number of mothers killed seems is equal or higher to the number of fathers killed. The typical profile of an adult committing parricide could be described as follows: a young single unemployed male, living with his victim, suffering from schizophrenia with comorbidity of alcohol or drug abuse and consumption, who stops his medication, and having a past history of medicolegal behaviours. The parricide act can be divided into three stages; first, the contention of the emergence of parricide ideas; second, the violence and brutality of the act; third, following a transient appeasement suicidal thoughts or attempts are frequently observed. Preventing parricides and homicides committed by psychotic subjects is a great challenge. Only a few studies aim to a better understanding of the underlying motivations of such criminals. According to theses studies, we can point out several warning signals. Psychiatrist should particularly increase their vigilance to persecutive delusions, history of a long lasting illness with history of violence during acute stages, threats against family or friends, suicidal thoughts, failures of help requests and attempt to escape.

  14. Post-psychotic depression in schizophrenia.

    Science.gov (United States)

    Chintalapudi, M; Kulhara, P; Avasthi, A

    1993-01-01

    Post-psychotic depression (PPD) is defined as the development of depression during the phase of remission of schizophrenia. Two groups of DSM-III-R schizophrenics, one with PPD and the other without PPD (30 subjects in each group) were compared. Significantly more patients in PPD group belonged to nuclear families, had longer duration of psychotic phase of the illness, were hospitalised more frequently and had more sadness and anxiety-somatisation during florid illness phase. The PPD group also had more past history of depression. Although PPD patients had better premorbid personal-social adjustment in comparison with non-PPD group, they perceived themselves to be lacking in social support and had experienced more stressful life events. For patients in the PPD group, stepwise multiple regression analysis revealed age of onset, sadness during florid psychotic state, premorbid adjustment, social support and life events as significant determinants of severity of depression in the post-psychotic phase.

  15. Motives for offending among violent and psychotic men.

    Science.gov (United States)

    Taylor, P J

    1985-11-01

    Two hundred and three male remanded prisoners were interviewed with respect to their current offence, mental state, and social and psychiatric histories. All but nine of the sub-group of 121 psychotic men showed active symptoms at the time of committing a criminal offence; 20% of the actively ill psychotics were directly driven to offend by their psychotic symptoms, and a further 26% probably so. If some of the indirect consequences of the psychosis were taken into account, 82% of their offences were probably attributable to the illness. Among the normal and neurotic men, none claimed psychotic motives for offending, but motives suggesting high emotional arousal such as panic or retaliation triggered the greatest violence. Within the psychotic group, those driven to offend by their delusions were most likely to have been seriously violent, and psychotic symptoms probably accounted directly for most of the very violent behaviour.

  16. Measuring psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; Meyers, B S; Flint, A J

    Psychotic depression (PD) is a highly debilitating condition, which needs intensive monitoring. However, there is no established rating scale for evaluating the severity of PD. The aim of this analysis was to assess the psychometric properties of established depression rating scales and a number...... of new composite rating scales, covering both depressive and psychotic symptoms, in relation to PD....

  17. Measuring psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, S D; Meyers, B S; Flint, A J

    2014-01-01

    OBJECTIVE: Psychotic depression (PD) is a highly debilitating condition, which needs intensive monitoring. However, there is no established rating scale for evaluating the severity of PD. The aim of this analysis was to assess the psychometric properties of established depression rating scales...... and a number of new composite rating scales, covering both depressive and psychotic symptoms, in relation to PD. METHOD: The psychometric properties of the rating scales were evaluated based on data from the Study of Pharmacotherapy of Psychotic Depression. RESULTS: A rating scale consisting of the 6-item......'s correlation coefficient between change in HAMD-BPRS11 and Clinical Global Impression - Improvement (CGI-I) scores = -0.74--0.78) and unidimensionality (Loevinger's coefficient of homogeneity = 0.41) in the evaluation of PD. The HAM-D6 fulfilled the same criteria, whereas the full 17-item Hamilton Depression...

  18. Diagnostic agreement of schizophrenia spectrum disorders among chronic patients with functional psychoses

    DEFF Research Database (Denmark)

    Jakobsen, K D; Frederiksen, J N; Parnas, J

    2006-01-01

    of 100 individuals (35 women and 65 men) were randomly sampled and assessed using the Operational Criteria Checklist for Psychotic Illness and Affective Illness (OPCRIT). Based on the OPCRIT diagnoses the subjects suffering from schizophrenia and schizophrenia spectrum disorders according to seven...... function previous to the onset of illness. Similarly high pairwise CR were observed for schizophrenia spectrum disorders across all diagnostic systems. CONCLUSIONS: This study demonstrates that diagnostic agreement is higher among chronic patients than that observed in subjects with a recent onset...... serious epistemological consequences, thus underlining the conventional nature of the present schizophrenia diagnoses and the need for biologically founded diagnostic criteria....

  19. Brief psychotic disorder

    Science.gov (United States)

    ... as the cause of the symptoms. Treatment By definition, psychotic symptoms go away on their own in ... severely disrupt your life and possibly lead to violence and suicide. ... by: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by ...

  20. Psychotic experiences and religiosity

    DEFF Research Database (Denmark)

    Kovess-Masfety, V; Saha, S; Lim, C C W

    2018-01-01

    OBJECTIVES: Religiosity is often associated with better health outcomes. The aim of the study was to examine associations between psychotic experiences (PEs) and religiosity in a large, cross-national sample. METHODS: A total of 25 542 adult respondents across 18 countries from the WHO World Ment...

  1. Relationship between cognition, clinical and cognitive insight in psychotic disorders : A review and meta-analysis

    NARCIS (Netherlands)

    Nair, Akshay; Palmer, Emma Claire; Aleman, Andre; David, Anthony S.

    The neurocognitive theory of insight posits that poor insight in psychotic illnesses is related to cognitive deficits in cognitive self-appraisal mechanisms. In this paper we perform a comprehensive meta-analysis examining relationships between clinical insight and neurocognition in psychotic

  2. Reliability of clinical ICD-10 diagnoses among electroconvulsive therapy patients with chronic affective disorders

    DEFF Research Database (Denmark)

    Jakobsen, Klaus Damgaard; Hansen, Thomas Folkmann; Dam, Henrik

    2008-01-01

    investigated. A standardized schema for basic anamnesis and the Operational Criteria Checklist for Psychotic and Affective Illness (OPCRIT) were used. The sensitivity, specificity, positive and negative predictive values of clinical affective disorder ICD-10 diagnoses and the formal agreement between clinical...

  3. Brief psychotic disorder in a middle aged Nigerian following the ...

    African Journals Online (AJOL)

    This case report illustrates the sudden onset, brief course and remission of a psychotic illness in a middle-aged Nigerian starting soon after she heard about the terrorist attacks in America. Vulnerability factors including personality traits and other concurrent life events were identified in the patients. Common mental disorder ...

  4. Hot and cold executive functions in youth with psychotic symptoms.

    Science.gov (United States)

    MacKenzie, L E; Patterson, V C; Zwicker, A; Drobinin, V; Fisher, H L; Abidi, S; Greve, A N; Bagnell, A; Propper, L; Alda, M; Pavlova, B; Uher, R

    2017-12-01

    Psychotic symptoms are common in children and adolescents and may be early manifestations of liability to severe mental illness (SMI), including schizophrenia. SMI and psychotic symptoms are associated with impairment in executive functions. However, previous studies have not differentiated between 'cold' and 'hot' executive functions. We hypothesized that the propensity for psychotic symptoms is specifically associated with impairment in 'hot' executive functions, such as decision-making in the context of uncertain rewards and losses. In a cohort of 156 youth (mean age 12.5, range 7-24 years) enriched for familial risk of SMI, we measured cold and hot executive functions with the spatial working memory (SWM) task (total errors) and the Cambridge Gambling Task (decision-making), respectively. We assessed psychotic symptoms using the semi-structured Kiddie Schedule for Affective Disorders and Schizophrenia interview, Structured Interview for Prodromal Syndromes, Funny Feelings, and Schizophrenia Proneness Instrument - Child and Youth version. In total 69 (44.23%) youth reported psychotic symptoms on one or more assessments. Cold executive functioning, indexed with SWM errors, was not significantly related to psychotic symptoms [odds ratio (OR) 1.36, 95% confidence interval (CI) 0.85-2.17, p = 0.204). Poor hot executive functioning, indexed as decision-making score, was associated with psychotic symptoms after adjustment for age, sex and familial clustering (OR 2.37, 95% CI 1.25-4.50, p = 0.008). The association between worse hot executive functions and psychotic symptoms remained significant in sensitivity analyses controlling for general cognitive ability and cold executive functions. Impaired hot executive functions may be an indicator of risk and a target for pre-emptive early interventions in youth.

  5. Evaluation of primary health workers training program to provide psychoeducation to family caregivers of persons with psychotic disorder

    OpenAIRE

    Marchira, Carla Raymondalexas; Puspitasari, Warih Andan; Rochmawati, Ida; Mulyani, Siti

    2016-01-01

    ABTRACT Many persons suffering psychotic illnesses, such as schizophrenia, are largely untreated in low income countries. In these settings, most persons with severe mental illness live with their families. Thus, families play a particular critical role in determining whether a person with a psychotic illness will receive treatment and what the quality of treatment. Psychoeducation has proven to be extremely effective in helping families develop the knowledge and skills which is necessar...

  6. Implicit learning in psychotic patients

    NARCIS (Netherlands)

    Schmand, B.; Kop, W. J.; Kuipers, T.; Bosveld, J.

    1992-01-01

    Implicit verbal learning of psychotic patients (n = 59) and non-psychotic control patients (n = 20) was studied using stem completion and association tasks in lexical and semantic priming paradigms. Performance on these tasks was contrasted with explicit memory on Rey's verbal learning test.

  7. Oxytocin and Social Cognition in Affective and Psychotic Disorders

    Science.gov (United States)

    Perez-Rodriguez, M. Mercedes; Mahon, Katie; Russo, Manuela; Ungar, Allison K.; Burdick, Katherine E.

    2014-01-01

    Impairments in social cognition are now recognized as core illness features in psychotic and affective disorders. Despite the significant disability caused by social cognitive abnormalities, treatments for this symptom dimension are lacking. Here, we describe the evidence demonstrating abnormalities in social cognition in schizophrenia, major depressive disorder, and bipolar disorder, as well as the neurobiology of social cognition including the role of oxytocin. We then review clinical trials of oxytocin administration in psychotic and affective disorders and the impact of this agent on social cognition. To date, several studies have demonstrated that oxytocin may improve social cognition in schizophrenia; too few studies have been conducted in affective disorders to determine the effect of oxytocin on social cognition in these disorders. Future work is needed to clarify which aspects of social cognition may be improved with oxytocin treatment in psychotic and affective disorders. PMID:25153535

  8. Psychotic Depression and Suicidal Behavior.

    Science.gov (United States)

    Fredriksen, Kristin J; Schoeyen, Helle K; Johannessen, Jan O; Walby, Fredrik A; Davidson, Larry; Schaufel, Margrethe A

    2017-01-01

    This study investigated how severely depressed individuals experienced the relationship between psychotic symptoms and suicidal ideation and behavior. Semi-structured qualitative interviews were conducted with a purposive sample of nine inpatients from a psychiatric university hospital between September 2012 and May 2013 fulfilling diagnostic criteria for a psychotic depressive episode as part of a unipolar or bipolar disorder. Analysis was conducted using systematic text condensation. Participants experienced (1) being directed to perform impulsive potentially fatal actions, (2) feeling hounded to death, (3) becoming trapped in an inescapable darkness, and (4) being left bereft of mental control. They described how impulsivity directed by delusions and hallucinations resulted in unpredictable actions with only moments from decision to conduct. Suicide was seen as an escape not only from life problems but also from psychotic experiences and intense anxiety. Participants reported being in a chaotic state, unable to think rationally or anticipate the consequences of their actions. Their ability to identify and communicate psychotic symptoms and suicidal ideation and behavior was compromised, leaving them to struggle alone with these terrifying experiences. Suicide risk assessments based on verbal reports from individuals with psychotic depression may not always be valid due to potential impulsivity and underreporting of suicidal ideation. It may be important for clinicians to explore the delusional content of such patients' experiences to assess the possibility of suicide as a result of shame, guilt, remorse, or altruistic intentions to save others from harm.

  9. Psychotic versus non-psychotic firesetters : Similarities and differences in characteristics

    NARCIS (Netherlands)

    Dalhuisen, Lydia; Koenraadt, Frans; Liem, Marieke

    2015-01-01

    Firesetters with psychotic disorders constitute a distinct and important offender group. However, little is known about how psychotic firesetters differ from non-psychotic firesetters. More knowledge is required in order to treat this particular population effectively. Psychotic (n = 30) and

  10. [Swan Song: The Advent of the Psychotic Nucleus].

    Science.gov (United States)

    Zúñiga, Fernando Muñoz

    2012-09-01

    Different forms of artistic expression, such as literature and cinema, constitute an inexhaustible source for the study of mental illness. The use of psychodynamic models may contribute to a better understanding of the spectrum between personality disorders and the psychosis spectrum, thus enriching the phenomenological approach in the psychiatric clinical practice. To examine from psychodynamic standpoints the main character of the American film Black Swan, and the nature of her psychotic symptoms. Reviewing of sources and relevant theoretical currents. Analysis shows the usefulness of a psychodynamically- oriented dimensional model for understanding the so-called psychotic breaks as well as the applicability of psychoanalytic psychosis theories in general psychiatric practice, as they may provide a more flexible clinical approach, closer to the patient's subjective experience. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  11. The treatment of psychotic depression

    DEFF Research Database (Denmark)

    Leadholm, Anne Katrine K; Rothschild, Anthony J; Nolen, Willem A

    2013-01-01

    Psychotic depression (PD) is a prevalent, severe, under-diagnosed and often inadequately treated mental disorder, which has received disproportionally little attention by clinicians, researchers and the pharmaceutical industry. Consequently, the evidence base for optimal clinical practice regardi...... PD is limited. The aim of this study was to investigate the degree of consensus among international treatment guidelines on PD and to determine whether a potential lack of consensus would be reflected in the clinical practice of Danish psychiatrists....

  12. Risperidone in psychotic combat-related posttraumatic stress disorder: an open trial.

    Science.gov (United States)

    Kozarić-Kovacić, Dragica; Pivac, Nela; Mück-Seler, Dorotea; Rothbaum, Barbara Olasov

    2005-07-01

    Psychotic symptoms that frequently occur in combat-related posttraumatic stress disorder (PTSD) complicate its pharmacotherapy. We hypothesized that war veterans with psychotic PTSD, resistant to prior antidepressant treatment, would respond well to 6 weeks of treatment with the atypical antipsychotic risperidone, given as a monotherapy. Twenty-six male war veterans with psychotic PTSD (DSM-IV) completed the 6-week inpatient treatment with risperidone (2-4 mg/day) during the period from November 1999 through December 2002. The primary outcome measure was change from baseline to endpoint (6 weeks) in Positive and Negative Syndrome Scale (PANSS) total and subscale scores. Secondary outcome measures were changes in PTSD Interview (PTSD-I) and Clinical Global Impressions-Severity of Illness scale (CGI-S) total and subscale scores. Clinical improvement was assessed by CGI-S, CGI-Improvement scale, and Patient Global Impression of Improvement scale, while adverse events were recorded by Drug-Induced Extrapyramidal Symptoms Scale. Treatment with risperidone for either 3 or 6 weeks in an open trial significantly reduced total and subscales scores on the PANSS and on the PTSD-I and CGI-S when compared to baseline scores in patients with psychotic PTSD. Our preliminary data from the open trial indicate that risperidone decreased most of the psychotic and PTSD symptoms. Psychotic PTSD patients, unresponsive to antidepressant treatment, improved significantly after treatment for either 3 or 6 weeks with risperidone.

  13. Investigating the safety and efficacy of naltrexone for anti-psychotic induced weight gain in severe mental illness: study protocol of a double-blind, randomized, placebo-controlled trial.

    Science.gov (United States)

    Tek, Cenk; Guloksuz, Sinan; Srihari, Vinod H; Reutenauer, Erin L

    2013-06-27

    Obesity is a growing health problem leading to high rates of mortality and morbidity in patients with severe mental illness (SMI). The increased rate of obesity is largely attributed to antipsychotic use. The effect of antipsychotic medications on H1 and 5HT2 receptors has been associated with weight gain, but there is also a substantial amount of evidence showing that D2 receptor blockade may be responsible for weight gain by interacting with the dopamine-opioid system. Unfortunately, current available medications for weight loss have limited efficacy in this population. Naltrexone, an opioid receptor antagonist, may be a promising agent to reduce antipsychotic induced weight gain by decreasing food cravings. We aim to investigate the safety and efficacy of two doses of naltrexone (25 mg & 50 mg) versus placebo for weight and health risk reduction in overweight and obese individuals (BMI ≥ 28) with SMI, who gained weight while being treated with antipsychotics. One hundred and forty four patients will be recruited throughout the greater New Haven area. The participants will be randomized to naltrexone 25 mg/day, naltrexone 50 mg/day, or placebo in a 1:1:1 ratio. Participants will be on the study medication for 52 weeks, and assessed weekly for the first 4 weeks and bi-weekly thereafter. The primary outcome measurements are weight reduction and percentage achieving clinically significant weight loss (5% of total body weight). Waist circumference, body mass index, serum lipid profile, fasting glucose, and glycosylated hemoglobin are the secondary outcome measures. The effect of naltrexone on other outcome measurements such as schizophrenia symptoms, depression, dietary consumption, quality of life, cognitive functioning, physical activity, metabolism/inflammation markers, serum leptin, ghrelin, peptide YY, adinopectin, high sensitivity CRP, interleukin 6, interleukin-1B, interleukin-18, and tumor necrosis factor alpha (TNF-α) will be evaluated. The data will be

  14. Are screening instruments valid for psychotic-like experiences? A validation study of screening questions for psychotic-like experiences using in-depth clinical interview.

    LENUS (Irish Health Repository)

    Kelleher, Ian

    2011-03-01

    Individuals who report psychotic-like experiences are at increased risk of future clinical psychotic disorder. They constitute a unique "high-risk" group for studying the developmental trajectory to schizophrenia and related illnesses. Previous research has used screening instruments to identify this high-risk group, but the validity of these instruments has not yet been established. We administered a screening questionnaire with 7 items designed to assess psychotic-like experiences to 334 adolescents aged 11-13 years. Detailed clinical interviews were subsequently carried out with a sample of these adolescents. We calculated sensitivity and specificity and positive predictive value (PPV) and negative predictive value (NPV) for each screening question for the specific symptom it enquired about and also in relation to any psychotic-like experience. The predictive power varied substantially between items, with the question on auditory hallucinations ("Have you ever heard voices or sounds that no one else can hear?") providing the best predictive power. For interview-verified auditory hallucinations specifically, this question had a PPV of 71.4% and an NPV of 90.4%. When assessed for its predictive power for any psychotic-like experience (including, but not limited to, auditory hallucinations), it provided a PPV of 100% and an NPV of 88.4%. Two further questions-relating to visual hallucinations and paranoid thoughts-also demonstrated good predictive power for psychotic-like experiences. Our results suggest that it may be possible to screen the general adolescent population for psychotic-like experiences with a high degree of accuracy using a short self-report questionnaire.

  15. Are screening instruments valid for psychotic-like experiences? A validation study of screening questions for psychotic-like experiences using in-depth clinical interview.

    LENUS (Irish Health Repository)

    Kelleher, Ian

    2012-02-01

    Individuals who report psychotic-like experiences are at increased risk of future clinical psychotic disorder. They constitute a unique "high-risk" group for studying the developmental trajectory to schizophrenia and related illnesses. Previous research has used screening instruments to identify this high-risk group, but the validity of these instruments has not yet been established. We administered a screening questionnaire with 7 items designed to assess psychotic-like experiences to 334 adolescents aged 11-13 years. Detailed clinical interviews were subsequently carried out with a sample of these adolescents. We calculated sensitivity and specificity and positive predictive value (PPV) and negative predictive value (NPV) for each screening question for the specific symptom it enquired about and also in relation to any psychotic-like experience. The predictive power varied substantially between items, with the question on auditory hallucinations ("Have you ever heard voices or sounds that no one else can hear?") providing the best predictive power. For interview-verified auditory hallucinations specifically, this question had a PPV of 71.4% and an NPV of 90.4%. When assessed for its predictive power for any psychotic-like experience (including, but not limited to, auditory hallucinations), it provided a PPV of 100% and an NPV of 88.4%. Two further questions-relating to visual hallucinations and paranoid thoughts-also demonstrated good predictive power for psychotic-like experiences. Our results suggest that it may be possible to screen the general adolescent population for psychotic-like experiences with a high degree of accuracy using a short self-report questionnaire.

  16. COMPARATIVE STUDY OF OLANZAPINE AND QUETIAPINE IN PSYCHOTIC DISORDERS

    Directory of Open Access Journals (Sweden)

    Bithorai Basumatary

    2018-01-01

    Full Text Available BACKGROUND Psychotic disorders are a group of chronic debilitating psychiatric illness characterised by loss in touch with reality and disorders of thought, behaviour, appearance and speech. The second generation atypical antipsychotic olanzapine has been reported to be the commonly prescribed antipsychotic. However, olanzapine can cause adverse effects like weight gain, hyperglycaemia, diabetes, dyslipidaemia and metabolic syndrome. Quetiapine, another second generation antipsychotic has good efficacy and has become well established in the treatment of schizophrenia and manic episodes. There are reports on adverse effects of hyperglycaemia and diabetes with quetiapine, but these are comparatively lesser than olanzapine. The aim of the study is to compare the efficacy of olanzapine and quetiapine in patients with psychotic disorders. MATERIALS AND METHODS It was an unicentric, open label, prospective and comparative clinical study. Subjects (n=80 who were diagnosed with psychotic disorder were randomly assigned to receive olanzapine (group 1 or quetiapine (group 2. The efficacy of the two drugs was assessed on the basis Brief Psychiatric Rating Scale (BPRS scores at baseline, 1 week and 6 weeks. UKU scale (Udvalg Kliniske Undersogelser and laboratory investigations were used to assess the safety profile. RESULTS The two study groups had comparable sociodemographic profile. Both the groups showed significant reduction in psychotic symptoms as compared from baseline to 1 week and 6 weeks (p<0.001. The intergroup comparison of the efficacy of the two groups did not show any statistically significant results. There was statistically insignificant differences in the occurrence of adverse effects in both the groups. Sedation (50% in both the groups was the most common adverse effect in both the groups. The use of concomitant medications was comparable in both the groups. Benzodiazepines (56.3% in the olanzapine group and 51.9% in the quetiapine group

  17. Evidence that the presence of psychosis in non-psychotic disorder is environment-dependent and mediated by severity of non-psychotic psychopathology.

    Science.gov (United States)

    Guloksuz, S; van Nierop, M; Lieb, R; van Winkel, R; Wittchen, H-U; van Os, J

    2015-08-01

    Evidence suggests that in affective, non-psychotic disorders: (i) environmental exposures increase risk of subthreshold psychotic experiences (PEs) and strengthen connectivity between domains of affective and subthreshold psychotic psychopathology; and (ii) PEs are a marker of illness severity. In 3021 adolescents from the Early Developmental Stages of Psychopathology cohort, we tested whether the association between PEs and presence of DSM-IV mood disorder (MD)/obsessive-compulsive disorder (OCD) would be moderated by risk factors for psychosis (cannabis use, childhood trauma and urbanicity), using the interaction contrast ratio (ICR) method. Furthermore, we analysed whether the interaction between environment and PEs was mediated by non-psychotic psychopathology. The association between PEs and MD/OCD was moderated by urbanicity (ICR = 2.46, p = 0.005), cannabis use (ICR = 3.76, p = 0.010) and, suggestively, trauma (ICR = 1.91, p = 0.063). Exposure to more than one environmental risk factor increased the likelihood of co-expression of PEs in a dose-response fashion. Moderating effects of environmental exposures were largely mediated by the severity of general non-psychotic psychopathology (percentage explained 56-68%, all p psychopathology. The findings are compatible with a relational model of psychopathology in which more severe clinical states are the result of environment-induced disturbances spreading through a psychopathology network.

  18. LIVING WITH THE PSYCHOTIC IN THE FAMILIAR POINT OF VIEW

    Directory of Open Access Journals (Sweden)

    Cíntia Nasi

    2006-12-01

    Full Text Available ABSTRACT: A lot of people live situations of mental sickness, from psychotic character, that can cause suffering both for the sick and his family. We believe that try this situation means to live with limitations and wearings in the familiar everyday, what makes difficult the living with the psychotic person. Considering these aspects, this research has the purpose of knowing the familiar perception about his living with a psychotic bearer person. It is about a qualitative, explorative and descriptive study, developed in a northwest city of Rio Grande do Sul state, called Ijuí. The people of the investigation are composed of five psychotic’s parents, which frequent the socioterapy group in Gloria district. The information collection happened trough open interviews, recorded and wrote out at all. The analysis of the obtained data followed MINAYO’s (2002 methodological proposition. By the contained information in the stud’s social actor’s declarations, emerged three thematic with a similar nucleus of thoughts. On first thematic, we discussed about the difficulties faced by the familiars in the living with the psychotic in the moment he has the acute symptoms. On the second thematic, we talked about the medical question as bring a therapeutic element that helps the mental sick to keep stable., becoming better the familiars life. The third thematic shows the family conception about mental sickness. With this research we concluded that the living with a mental sick person is taxing for the familiar and, sometimes, there are difficulties to understand the symptoms showed by the sick person. Besides that, the family considers the medication one of the most important possibilities of intervention in the psychotic’s therapy, what is reinforced by the health team that leads with these people. KEY WORDS: Family; Mental Illness; Nursing.

  19. Sun Exposure and Psychotic Experiences

    Directory of Open Access Journals (Sweden)

    Izabela Pilecka

    2017-06-01

    Full Text Available ObjectiveSun exposure is considered the single most important source of vitamin D. Vitamin D deficiency has been suggested to play a role in the etiology of psychotic disorders. The aim of the present study was to evaluate the association between sun exposure and psychotic experiences (PEs in a general population sample of Swedish women.MethodsThe study population included participants from The Swedish Women’s Lifestyle and Health cohort study. The 20-item community assessment of psychic experiences (CAPEs was administered between ages 30 and 50 to establish PEs. Sun exposure as measured by (1 sunbathing holidays and (2 history of sunburn was measured between ages 10 and 39. The association between sun exposure and PEs was evaluated by quantile regression models.Results34,297 women were included in the analysis. Women who reported no sunbathing holidays and 2 or more weeks of sunbathing holidays scored higher on the CAPE scale than women exposed to 1 week of sunbathing holidays across the entire distribution, when adjusting for age and education. Similarly, compared with women who reported a history of one sunburn, the women with none or two or more sunburns showed higher scores on the CAPE scale.ConclusionThe results of the present study suggest that, in a population-based cohort of middle aged women, both low and high sun exposure is associated with increased level of positive PEs.

  20. Major depressive disorder with psychotic features may lead to misdiagnosis of dementia: a case report and review of the literature.

    Science.gov (United States)

    Wagner, Gerhardt S; McClintock, Shawn M; Rosenquist, Peter B; McCall, W Vaughn; Kahn, David A

    2011-11-01

    Major depressive disorder (MDD) with psychotic features is relatively frequent in patients with greater depressive symptom severity and is associated with a poorer course of illness and greater functional impairment than MDD without psychotic features. Multiple studies have found that patients with psychotic mood disorders demonstrate significantly poorer cognitive performance in a variety of areas than those with nonpsychotic mood disorders. The Mini Mental State Examination (MMSE) and the Dementia Rating Scale, Second Edition (DRS-2) are widely used to measure cognitive functions in research on MDD with psychotic features. Established total raw score cut-offs of 24 on the MMSE and 137 on the DRS-2 in published manuals suggest possible global cognitive impairment and dementia, respectively. Limited research is available on these suggested cut-offs for patients with MDD with psychotic features. We document the therapeutic benefit of electroconvulsive therapy (ECT), which is usually associated with short-term cognitive impairment, in a 68-year-old woman with psychotic depression whose MMSE and DRS-2 scores initially suggested possible global cognitive impairment and dementia. Over the course of four ECT treatments, the patient's MMSE scores progressively increased. After the second ECT treatment, the patient no longer met criteria for global cognitive impairment. With each treatment, depression severity, measured by the 24-item Hamilton Rating Scale for Depression, improved sequentially. Thus, the suggested cut-off scores for the MMSE and the DRS-2 in patients with MDD with psychotic features may in some cases produce false-positive indications of dementia.

  1. Anomalies of subjective experience in schizophrenia and psychotic bipolar illness

    DEFF Research Database (Denmark)

    Parnas, J; Handest, P; Saebye, D

    2003-01-01

    OBJECTIVE: Contemporary psychopathology, as a result of behaviourally dominated epistemological stance, downplays anomalies of the patient's subjectivity. This neglect has probably deleterious consequences for research in the causes and the boundaries of the schizophrenia spectrum conditions. The...

  2. Clothiapine for acute psychotic illness: a meta-analysis

    African Journals Online (AJOL)

    QuickSilver

    piperazinyl)dibenzo[b,f][1,4]thiazepine, is a dibenzothiazepine ... Six databases were searched, reference lists were inspected and relevant industry and authors contacted. .... als using clotiapine but most were case series, and therefore.

  3. Anomalies of subjective experience in schizophrenia and psychotic bipolar illness

    DEFF Research Database (Denmark)

    Parnas, Josef

    2003-01-01

    Symptoms (BSABS). Anomalies of experience were condensed into rational scales with good internal consistencies. RESULTS: Diagnosis of schizophrenia was associated with elevated scores on the scales measuring perplexity (loss of immediate meaning), disorders of perception, disorders of self......-awareness, and marginally so, disorders of cognition. CONCLUSION: These findings, in conjunction with those from other, methodologically similar studies, suggest that certain anomalies of subjective experience aggregate significantly in schizophrenia. These experiential anomalies appear to be relevant for early...

  4. Psychopharmacological treatment of psychotic mania and psychotic bipolar depression compared to non-psychotic mania and non-psychotic bipolar depression.

    Science.gov (United States)

    Bjørklund, Louise B; Horsdal, Henriette T; Mors, Ole; Gasse, Christiane; Østergaard, Søren D

    2017-09-01

    An evidence base for the treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of treatments between these subtypes. This study aimed to investigate whether the psychopharmacological treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice. We conducted a register-based study assessing the psychopharmacological treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The psychopharmacological treatment within 3 months following the time of diagnosis was considered. Potential differences in psychopharmacological treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ 2 test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder. A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, Pbipolar depression. The aOR for treatment with the combination of an antipsychotic and an anticonvulsant was 1.60 (95% CI: 1.06-2.43, Pbipolar psychotic depression. It would be of interest to conduct studies evaluating whether antipsychotics represent the superior pharmacological treatment for psychotic mania and psychotic bipolar depression. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. [Trauma and psychosis--part 1. On the association of early childhood maltreatment in clinical populations with psychotic disorders].

    Science.gov (United States)

    Kapfhammer, Hans-Peter

    2012-01-01

    A comprehensive literature stresses a high percentage of severe childhood maltreatment in the history of many psychotically ill patients treated in mental health services. Early childhood abuse seems to be associated among other things with a more severe clinical state, a more chronic course of illness and a more unfavourable psychosocial adaptation. In order not to jump to unwarranted causal conclusions, several conceptual und methodological problems have to be clarified before. From a conceptual perspective psychotic disorders diagnosed according to conventional criteria define only a minor subgroup within a much broader psychosis continuum in general population. Early childhood abuse has to be differentiated according to type, severity, timing, and context. The rates of early childhood abuse are high in general population. The methods of measurement of psychotic symptoms on the one side, of early trauma on the other side have to be critically evaluated. There is an empirically well founded association of childhood maltreatment and psychological and psychosomatic morbidity during adult years in general. In order to establish a potential conditional link also to psychotic disorders, clinical populations have to be compared to adequate control groups at least. A systematic literature search shows a very small number of studies including control groups at all. These studies underline that early childhood abuse may be significantly associated to the risk of psychosis indeed. The conditional role of early childhood abuse, however, has to be investigated only within a multifactorial biopsychosocial model of psychotic illness.

  6. Insight in psychotic disorder: relation with psychopathology and frontal lobe function.

    Science.gov (United States)

    Kumar, Atmesh; Sharma, Pranjal; Das, Shyamanta; Nath, Kamal; Talukdar, Uddip; Bhagabati, Dipesh

    2014-01-01

    Through conceptualising poor insight in psychotic disorders as a form of anosognosia, frontal lobe dysfunction is often ascribed a vital role in its pathogenesis. The objective of this study was to compare the relation of insight in patients with psychotic illness to that of psychopathology and frontal lobe function. Forty patients with psychotic disorder were selected from those attending the Department of Psychiatry in a tertiary care teaching hospital. The evaluation of insight was carried out using the Schedule for Assessment of Insight (SAI), that of frontal lobe function by the Frontal Assessment Battery (FAB) and psychopathology by the Brief Psychiatric Rating Scale (BPRS). The correlation coefficients were determined. A negative correlation between SAI and BPRS scores means that the BPRS score is opposite to SAI scores. When the SAI total score was compared with the FAB total score, the correlation coefficient demonstrated a positive correlation. Better insight predicted lesser psychopathology and also that poor insight would exist with greater psychopathology. Better insight predicted a higher functional status of frontal lobes and prefrontal cortex in particular. Insight deficits in schizophrenia and other psychotic illnesses are multidimensional. Integration of different aetiological factors like biological, psychopathological, environmental ones and others are necessary for a better understanding of insight in psychosis. Copyright © 2013 S. Karger AG, Basel.

  7. Feasibility and Efficacy of Prolonged Exposure for PTSD among Individuals with a Psychotic Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Anouk L. Grubaugh

    2017-06-01

    Full Text Available Objective: Few empirical studies have examined the feasibility of trauma-focused treatment among individuals with schizophrenia. This lack of research is important given the substantial overlap of trauma exposure and subsequent PTSD with psychotic spectrum disorders, and the potential for PTSD to complicate the course and prognosis of schizophrenia and other variants of severe mental illness.Method: As part of a larger study, 14 veterans with a psychotic spectrum disorder were enrolled to receive prolonged exposure (PE for PTSD within a single arm open trial study design. Patient reactions and responses to PE were examined using feasibility indices such as attrition, survey reactions, and treatment expectancy; pre and post-changes in PTSD severity and diagnostic status; and thematic interviews conducted post-intervention.Results: Quantitative and qualitative data indicate that implementation of PE is feasible, subjectively well-tolerated, and may result in clinically significant reductions in PTSD symptoms in patients with psychotic spectrum disorders.Conclusion: Consistent with treatment outcome data in clinical populations with a broader range of severe mental illnesses, the current results support the use of PTSD exposure-based interventions, such as PE, for individuals with psychotic spectrum disorders.

  8. Measuring treatment response in psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, Søren D; Meyers, Barnett S; Flint, Alastair J

    2014-01-01

    ). The response to the two regimens was compared using both a mixed effects model and effect size statistics on the total scores of three rating scales: the 17-item Hamilton Depression Rating Scale (HAM-D17), its 6-item melancholia subscale (HAM-D6), and the 11-item PDAS consisting of the HAM-D6 plus five items......BACKGROUND: There is no established psychometric instrument dedicated to the measurement of severity in psychotic depression (PD). The aim of this study was to investigate whether a new composite rating scale, the Psychotic Depression Assessment Scale (PDAS), covering both the psychotic...... and the depressive domains of PD, could detect differences in effect between two psychopharmacological treatment regimens. METHODS: We reanalyzed the data from the Study of Pharmacotherapy of Psychotic Depression (STOP-PD), which compared the effect of Olanzapine+Sertraline (n=129) versus Olanzapine+Placebo (n=130...

  9. A Dementia Case Presenting with Psychotic Symptoms

    Directory of Open Access Journals (Sweden)

    Osman Ozdemir

    2013-06-01

    Full Text Available Dementia is a progressive clinical syndrome in which affected areas of brain function may be affected, such as memory, language, abstract thinking, problem solving and attention. Psychotic symptoms include auditory and visual hallucinations and delusions, which usually occur in the dementia. In this paper, a dementia case presenting with psychotic symptoms is presented. [Cukurova Med J 2013; 38(3.000: 482-486

  10. Shared Psychotic Disorder (Folie à Deux in Turkey

    Directory of Open Access Journals (Sweden)

    Buket Cinemre

    2009-09-01

    Full Text Available Shared psychotic disorder or folie à deux is a rare and relatively unknown syndrome. Large case series are needed to find out and clarify the etiological factors and the phenomenology of shared psychotic disorder by comparing the cases from different society and cultures. In this study, we reviewed all reported cases of shared psychotic disorder that had been published or presented in Turkey since 1962. To reach this aim, we have searched Pubmed/Medline, ScienceDirect, Google Scholar, Ulakbim Turkish Medical Index, Turkish Psychiatric Index databases for published records originating from Turkey. We have also manually searched poster abstract books of congresses held in Turkey between 1962 and 2009. All cases eligible for inclusion into this study have been evaluated one by one and grouped as primary or secondary cases. The features of these cases were investigated for a number of variables including age, sex, educational level, occupation, the presence of shared delusion and hallucinations, diagnosis, management, onset of illness, family history, IQ, social isolation, the nature of the relationship and classification system used for diagnosis. The results have showed that the syndrome is more frequently observed among women, within same family members and between sisters. Social isolation was the most common risk factor in these patients and most patients shared hallucinations with their partners along with their delusions. Several secondary cases required antipsychotic drugs for the treatment of their symptoms. Though these features were inline with literature findings, the present findings from Turkish population were different from previous studies with regards to the presence of olfactory hallucinations, absence of grandiose delusions and the number of affected family members. The results mostly supported the challenges and discussions in western countries. To understand this most pathological form of interpersonal relationships

  11. Some Paths Towards Psychotic Alienation.

    Science.gov (United States)

    De Masi, Franco

    2017-12-01

    In this paper I use the term alienation to describe the mind's detachment from psychic reality and its withdrawal into an alien world that leads to progressive dehumanization. In spite of this phenomenon having a psychodynamic nosography and descriptive models that effectively reveal it in detail, mental alienation is still mysterious and unsettling, especially when it manifests all of a sudden in clinical work. Alienating withdrawal into sensory fantasizing, which causes increasing loss of contact with human reality, is often preceded by a long period of time spent in a dissociated world that has gradually replaced psychic reality. However, prior to the human world being completely replaced by the alien world, both worlds coexisted for a considerable length of time in the patient's mind. My hypothesis is that the dissociation from psychic reality that underlies the future state of psychotic alienation occurs in psychic withdrawal that begins in infancy. This mental state is particularly obvious in small children who constantly live in a fantasy world.

  12. Dreams and fantasies in psychodynamic group psychotherapy of psychotic patients.

    Science.gov (United States)

    Restek-Petrović, Branka; Orešković-Krezler, Nataša; Grah, Majda; Mayer, Nina; Bogović, Anamarija; Mihanović, Mate

    2013-09-01

    Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness.

  13. The advantages of "Dance-group" for psychotic patients.

    Science.gov (United States)

    Tavormina, Romina; Tavormina, Maurilio Giuseppe Maria; Nemoianni, Eugenio

    2014-11-01

    Psychosocial rehabilitation and in particular group dances allow the recovery of lost or compromised ability of patients with mental illness, and they facilitate their reintegration into the social context. The dance group has enabled users of the Day Centre of the Unit of Mental Health Torre del Greco ASL NA 3 south to achieve the objectives of rehabilitation such as: taking care of themselves, of their bodies and their interests, improving self-esteem , the management of pathological emotions, socialization and integration, overcoming the psychotic closing and relational isolation. In particular, patients with schizophrenia, psychotic and mood disorders had a concrete benefit from such rehabilitation activities, facilitating interpersonal relationships, therapy compliance and significantly improved mood, quality of life, providing them with the rhythm and the security in their relationship with each other. The dance group and for some individuals, also psychotherapy and drug therapy, have facilitated social inclusion, improved the quality of life and cured their diseases. The work is carrying out in a group with patients, practitioners, family members, volunteers, social community workers, following the operating departmental protocols. Using the chorus group "Sing that you go" as an operational tool for psychosocial rehabilitation and therapeutic element we promote the psychological well-being and the enhancement of mood.

  14. Environmental adversities and psychotic symptoms: The impact of timing of trauma, abuse, and neglect.

    Science.gov (United States)

    Schalinski, Inga; Breinlinger, Susanne; Hirt, Vanessa; Teicher, Martin H; Odenwald, Michael; Rockstroh, Brigitte

    2017-11-13

    Trauma and adverse childhood experiences (ACE) occur more often in mental illness, including psychosis, than in the general population. Individuals with psychosis (cases) report a higher number and severity (dose) of adversities than healthy controls. While a dose-dependent increase of adversities has been related to more severe psychopathology, the role of type and timing is still insufficiently understood on the exacerbation of positive and negative psychotic symptoms. Moreover, dissociative symptoms were examined as potential mediator between adversities and severity of psychotic symptoms. Exposure to adversities were assessed by interviews in n=180 cases and n=70 controls. In cases, symptom severities were obtained for psychotic symptoms and dissociation. Conditioned random forest regression determined the importance of type and timing of ACE for positive and negative symptom severity, and mediator analyses evaluated the role of dissociative symptoms in the relationship between adversities and psychotic symptoms. Cases experienced substantially more abuse and neglect than controls. Adversities were related in a dose-dependent manner to psychotic disorder. An array of adversities was associated with more severe positive symptoms, while the conditioned random forest regression depicted neglect at age 10 as the most important predictor. Dissociative symptoms mediated the small relation of trauma load in childhood and positive symptoms. The role of trauma and ACE on psychotic symptoms can be specified by neglect during frontocortical development in the exacerbation of positive symptoms. The mediating role of dissociation is restricted to the relation of childhood trauma and positive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. 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

  16. Psychotic experiences and hyper-theory-of-mind in preadolescence

    DEFF Research Database (Denmark)

    Clemmensen, L; van Os, J; Drukker, M

    2016-01-01

    BACKGROUND: Knowledge on the risk mechanisms of psychotic experiences (PE) is still limited. The aim of this population-based study was to explore developmental markers of PE with a particular focus on the specificity of hyper-theory-of-mind (HyperToM) as correlate of PE as opposed to correlate...... psychiatric liability; parental mental illness during early child development; change in family composition; low family income; regulatory problems in infancy; onset of puberty; bullying; concurrent mental disorder; and HyperToM. When estimating the adjusted effects, only low family income, concurrent mental...... disorder, bullying and HyperToM remained significantly associated with PE. Further analyses of the specificity of these correlates with regard to outcome revealed that HyperToM was the only variable specifically associated with PE without concurrent mental disorder. Finally, HyperToM did not share any...

  17. Evaluation of primary health workers training program to provide psychoeducation to family caregivers of persons with psychotic disorder

    Directory of Open Access Journals (Sweden)

    Carla Raymondalexas Marchira

    2016-02-01

    Full Text Available ABTRACT Many persons suffering psychotic illnesses, such as schizophrenia, are largely untreated in low income countries. In these settings, most persons with severe mental illness live with their families. Thus, families play a particular critical role in determining whether a person with a psychotic illness will receive treatment and what the quality of treatment. Psychoeducation has proven to be extremely effective in helping families develop the knowledge and skills which is necessary to help their family members. Indonesia has a national policy to integrate the management of mental health problems into the primary health care system. However, in practice, such care does not implemented effectively. A preliminary study in primary health centers in two districts of Bantul and Gunung Kidul regency, Yogyakarta province, showed that there was very little or there is not any training for health care workers on diagnosis and treatment of psychotic disorder. This study was conducted to evaluate the effectiveness of the training program for health workers in three primary health centers in Yogyakarta, Indonesia, to provide psychoeducation to family caregivers for persons with psychotic disorder. A quasi-experimental study with the approach of one group pre and posttest design was performed in this study. Fortythree health workers in 3 primary health centers in Bantul and Gunung Kidul, Yogyakarta were trained every week for a month to provide psychoeducation to family caregivers who live with psychotic disorder patient. Result showed that the baseline score of knowledge of schizophrenia among health workers in 3 primary health centers in Bantul and Gunung Kidul before training were not significantly different (p=0.162. After the psychoeducation training program there were significantly different (p=0.003 of the score of knowledge of schizophrenia among health workers in 3 primary health care centers compared with before training. For conclusion, the

  18. Direct Cost of Treating Acute Psychotic Episodes in Nnewi, South ...

    African Journals Online (AJOL)

    Background: Major psychotic disorders such as the schizophrenias consume a high proportion of health budgets in developed countries. The economic implications of acute psychotic disorders in Nigeria have not been well documented. Aim: To estimate the direct cost of treating patients with acute psychotic episodes in a ...

  19. Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies.

    LENUS (Irish Health Repository)

    Kelleher, Ian

    2012-07-01

    Epidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.

  20. Mentally Disordered Non-Psychotic Criminal Offenders

    DEFF Research Database (Denmark)

    Gottlieb, Peter; Gabrielsen, Gorm; Kørner, Alex

    2013-01-01

    Background: By including §69 into the Danish Penal Code, it has since 1975 been possible to use psychiatric measures as legal sanctions for even non-psychotic offenders-if the measure is believed to be preventive of future crime. To be able to decide on the applicability of treatment measures...

  1. Psychotic experiences and aggression inoutpatients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Konstantinos Tsirigotis

    2013-12-01

    Full Text Available Objective: Some authors report that aggressive behaviour in schizophrenia is of heterogeneous sources, for example, aggression may be an impulsive action and even deliberate behaviour designed to intimidate others. Violence and aggressive behaviour may also be associated with psychotic experiences, such as delusions or hallucinations. The aim of this study was to explore the relationship between psychotic experiences and the intensiveness of hostility and aggression in patients with paranoid schizophrenia. Material and method: Seventy outpatients (35 men and 35 women with paranoid schizophrenia were examined. Relevant scales, subscales and indices of the Polish version of Minnesota Multiphasic Personality Inventory (MMPI were used. Results: The analysis of correlation and the factor analysis revealed a number of statistically significant correlations between the scores of the scales assessing psychotic experiences and those assessing the intensiveness of hostility and aggression. Conclusions: The results of this study confirm the presence of a number of relationships between psychotic experiences and felt hostility and aggression. Psychotic symptoms and indices of aggressiveness created five factors: “psychoticism,” “hostility,” “psychopathic aggression,” “poignancy,” “persecutory ideas.” Important for the felt hostility and aggressiveness in patients turned out to be experienced anxiety about their mental health because of the sense of the unreality of what is going on and because of the sense of alienation of their own thoughts. Another important factor turned out to be a sense of being wronged by life, misunderstood by others, and the belief that people have a grudge and try to harm. In contrast, characteristics, attitudes and behaviour which are the opposite of paranoid disorders, i.e. faith in people and optimistic attitude towards them, are an important factor for the inhibition of aggression.

  2. Khat use as risk factor for psychotic disorders: A cross-sectional and case-control study in Somalia

    Directory of Open Access Journals (Sweden)

    Elbert Thomas

    2005-02-01

    Full Text Available Abstract Background Little is known about the prevalence of khat-induced psychotic disorders in East African countries, where the chewing of khat leaves is common. Its main psycho-active component cathinone produces effects similar to those of amphetamine. We aimed to explore the prevalence of psychotic disorders among the general population and the association between khat use and psychotic symptoms. Methods In an epidemiological household assessment in the city of Hargeisa, North-West Somalia, trained local interviewers screened 4,854 randomly selected persons from among the general population for disability due to severe mental problems. The identified cases were interviewed based on a structured interview and compared to healthy matched controls. Psychotic symptoms were assessed using the items of the WHO Composite International Diagnostic Interview and quantified with the Positive and Negative Symptoms Scale. Statistical testing included Student's t-test and ANOVA. Results Local interviewers found that rates of severe disability due to mental disorders were 8.4% among males (above the age of 12 and differed according to war experiences (no war experience: 3.2%; civilian war survivors: 8.0%; ex-combatants: 15.9%. The clinical interview verified that in 83% of positive screening cases psychotic symptoms were the most prominent manifestations of psychiatric illness. On average, cases with psychotic symptoms had started to use khat earlier in life than matched controls and had been using khat 8.6 years before positive symptoms emerged. In most cases with psychotic symptoms, a pattern of binge use (> two 'bundles' per day preceded the onset of psychotic symptoms, in contrast to controls of the same age. We found significant correlations between variables of khat consumption and clinical scales (0.35 to 0.50; p Conclusion Evidence indicates a relationship between the consumption of khat and the onset of psychotic symptoms among the male

  3. Care provided by general practitioners to patients with psychotic disorders: a cohort study

    Directory of Open Access Journals (Sweden)

    Slooff Cees J

    2010-11-01

    Full Text Available Abstract Background Patients suffering from psychotic disorders have an increased risk of comorbid somatic diseases such as cardiovascular disorders and diabetes mellitus. Doctor-related factors, such as unfamiliarity with these patients, as well as patient-related factors, such as cognitive disturbance and negative symptoms, contribute to suboptimal health care for these patients. General practitioners (GPs could play a key role in diagnosing and treating this somatic comorbidity as in the Netherlands, almost all residents are registered at a general practice. This study aims to find out whether there are any differences between the levels of health care provided by GPs to patients with psychotic disorders, compared to other types of patients. Methods A cohort of patients with an ICPC code of psychosis and two matched control groups, one consisting of patients with other mental problems and the other one of patients without any mental problems, were followed over a period of 5 years. Results Patients with psychotic disorders (N = 734 contacted the GP practice more often than patients in the control groups. These patients, both adults (p = 0.051 and the elderly (p 65 years old (p = 0.007. With regard to chronic illnesses, elderly psychosis patients had fewer contacts related to cardiovascular diseases or chronic lung diseases. Conclusion Patients with psychotic disorders contact the GP practice more frequently than other types of patients. Adult psychosis patients with diabetes mellitus, cardiovascular diseases or chronic lung diseases receive the same amount of health care for these diseases as other primary care patients. The finding that older patients with psychotic disorders are diagnosed with cardiovascular diseases and obstructive lung diseases less frequently than other types of elderly patients requires further study.

  4. Care provided by general practitioners to patients with psychotic disorders: a cohort study.

    Science.gov (United States)

    Oud, Marian J T; Schuling, Jan; Groenier, Klaas H; Verhaak, Peter F M; Slooff, Cees J; Dekker, Janny H; Meyboom-de Jong, Betty

    2010-11-25

    Patients suffering from psychotic disorders have an increased risk of comorbid somatic diseases such as cardiovascular disorders and diabetes mellitus. Doctor-related factors, such as unfamiliarity with these patients, as well as patient-related factors, such as cognitive disturbance and negative symptoms, contribute to suboptimal health care for these patients.General practitioners (GPs) could play a key role in diagnosing and treating this somatic comorbidity as in the Netherlands, almost all residents are registered at a general practice. This study aims to find out whether there are any differences between the levels of health care provided by GPs to patients with psychotic disorders, compared to other types of patients. A cohort of patients with an ICPC code of psychosis and two matched control groups, one consisting of patients with other mental problems and the other one of patients without any mental problems, were followed over a period of 5 years. Patients with psychotic disorders (N = 734) contacted the GP practice more often than patients in the control groups. These patients, both adults (p = 0.051) and the elderly (p 65 years old (p = 0.007). With regard to chronic illnesses, elderly psychosis patients had fewer contacts related to cardiovascular diseases or chronic lung diseases. Patients with psychotic disorders contact the GP practice more frequently than other types of patients. Adult psychosis patients with diabetes mellitus, cardiovascular diseases or chronic lung diseases receive the same amount of health care for these diseases as other primary care patients. The finding that older patients with psychotic disorders are diagnosed with cardiovascular diseases and obstructive lung diseases less frequently than other types of elderly patients requires further study.

  5. Velo-cardio-facial syndrome and psychotic disorders: Implications for psychiatric genetics

    Energy Technology Data Exchange (ETDEWEB)

    Chow, W.C.; Bassett, A.S.; Weksberg, R. [Univ. of Toronto, Ontario (Canada)

    1994-06-15

    Psychiatric disorders have been reported in over 10% of patients with velo-cardio-facial syndrome (VCFS) in long-term follow-up. To further explore the behavioral and psychiatric findings associated with VCFS in adulthood, detailed clinical histories of two patients - one with VCFS who developed a psychotic illness, and one with schizophrenia who was found to have dysmorphological features associated with VCFS - are described in the current report. The observed overlap of physical and psychiatric symptoms in these two patients suggests that VCFS and psychotic disorders may share a pathogenetic mechanism. This could be consistent with a contiguous gene model for VCFS and psychosis, suggesting chromosome 22q11 as a possible candidate region for genetic studies of schizophrenia. 26 refs., 2 tabs.

  6. COMT genetic variation confers risk for psychotic and affective disorders: a case control study

    Directory of Open Access Journals (Sweden)

    Lencz Todd

    2005-10-01

    Full Text Available Abstract Background Variation in the COMT gene has been implicated in a number of psychiatric disorders, including psychotic, affective and anxiety disorders. The majority of these studies have focused on the functional Val108/158Met polymorphism and yielded conflicting results, with limited studies examining the relationship between other polymorphisms, or haplotypes, and psychiatric illness. We hypothesized that COMT variation may confer a general risk for psychiatric disorders and have genotyped four COMT variants (Val158Met, rs737865, rs165599, and a SNP in the P2 promoter [-278A/G; rs2097603] in 394 Caucasian cases and 467 controls. Cases included patients with schizophrenia (n = 196, schizoaffective disorder (n = 62, bipolar disorder (n = 82, major depression (n = 30, and patients diagnosed with either psychotic disorder NOS or depressive disorder NOS (n = 24. Results SNP rs2097603, the Val/Met variant and SNP rs165599 were significantly associated (p = 0.004; p = 0.05; p = 0.035 with a broad "all affected" diagnosis. Haplotype analysis revealed a potentially protective G-A-A-A haplotype haplotype (-278A/G; rs737865; Val108/158Met; rs165599, which was significantly underrepresented in this group (p = 0.0033 and contained the opposite alleles of the risk haplotype previously described by Shifman et al. Analysis of diagnostic subgroups within the "all affecteds group" showed an association of COMT in patients with psychotic disorders as well as in cases with affective illness although the associated variants differed. The protective haplotype remained significantly underrepresented in most of these subgroups. Conclusion Our results support the view that COMT variation provides a weak general predisposition to neuropsychiatric disease including psychotic and affective disorders.

  7. Epidemiological and clinical characterization following a first psychotic episode in major depressive disorder: comparisons with schizophrenia and bipolar I disorder in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS).

    Science.gov (United States)

    Owoeye, Olabisi; Kingston, Tara; Scully, Paul J; Baldwin, Patrizia; Browne, David; Kinsella, Anthony; Russell, Vincent; O'Callaghan, Eadbhard; Waddington, John L

    2013-07-01

    While recent research on psychotic illness has focussed on the nosological, clinical, and biological relationships between schizophrenia and bipolar disorder, little attention has been directed to the most common other psychotic diagnosis, major depressive disorder with psychotic features (MDDP). As this diagnostic category captures the confluence between dimensions of psychotic and affective psychopathology, it is of unappreciated heuristic potential to inform on the nature of psychotic illness. Therefore, the epidemiology and clinical characteristics of MDDP were compared with those of schizophrenia and bipolar disorder within the Cavan-Monaghan First Episode Psychosis Study (n = 370). Epidemiologically, the first psychotic episode of MDDP (n = 77) was uniformly distributed across the adult life span, while schizophrenia (n = 73) and bipolar disorder (n = 73) were primarily disorders of young adulthood; the incidence of MDDP, like bipolar disorder, did not differ between the sexes, while the incidence of schizophrenia was more common in males than in females. Clinically, MDDP was characterized by negative symptoms, executive dysfunction, neurological soft signs (NSS), premorbid intellectual function, premorbid adjustment, and quality of life similar to those for schizophrenia, while bipolar disorder was characterized by less prominent negative symptoms, executive dysfunction and NSS, and better quality of life. These findings suggest that what we currently categorize as MDDP may be more closely aligned with other psychotic diagnoses than has been considered previously. They indicate that differences in how psychosis is manifested vis-à-vis depression and mania may be quantitative rather than qualitative and occur within a dimensional space, rather than validating categorical distinctions.

  8. Epidemiological and clinical characterization following a first psychotic episode in major depressive disorder: Comparisons with Schizophrenia and Bipolar I Disorder in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS).

    LENUS (Irish Health Repository)

    Owoeye, Olabisi

    2013-05-28

    While recent research on psychotic illness has focussed on the nosological, clinical, and biological relationships between schizophrenia and bipolar disorder, little attention has been directed to the most common other psychotic diagnosis, major depressive disorder with psychotic features (MDDP). As this diagnostic category captures the confluence between dimensions of psychotic and affective psychopathology, it is of unappreciated heuristic potential to inform on the nature of psychotic illness. Therefore, the epidemiology and clinical characteristics of MDDP were compared with those of schizophrenia and bipolar disorder within the Cavan-Monaghan First Episode Psychosis Study (n = 370). Epidemiologically, the first psychotic episode of MDDP (n = 77) was uniformly distributed across the adult life span, while schizophrenia (n = 73) and bipolar disorder (n = 73) were primarily disorders of young adulthood; the incidence of MDDP, like bipolar disorder, did not differ between the sexes, while the incidence of schizophrenia was more common in males than in females. Clinically, MDDP was characterized by negative symptoms, executive dysfunction, neurological soft signs (NSS), premorbid intellectual function, premorbid adjustment, and quality of life similar to those for schizophrenia, while bipolar disorder was characterized by less prominent negative symptoms, executive dysfunction and NSS, and better quality of life. These findings suggest that what we currently categorize as MDDP may be more closely aligned with other psychotic diagnoses than has been considered previously. They indicate that differences in how psychosis is manifested vis-à-vis depression and mania may be quantitative rather than qualitative and occur within a dimensional space, rather than validating categorical distinctions.

  9. [Tunisian mothers' beliefs about their child's first psychotic episode].

    Science.gov (United States)

    Bourgou, S; Halayem, S; Bouden, A; Halayem, M B

    2012-12-01

    schizophreniform disorder. The duration of untreated psychosis (DUP) was 11.5 months. Longer duration of untreated psychosis was associated with male gender (P=0.008). A significant relationship was also found between long DUP and stigmatization of mental hospital and psychiatry (respectively P=0.04 and P=0.05). Most of the mothers did not think that their child initially suffered from a psychotic disorder. In 63.3%, the cause of the child's symptomatology was attributed to spirit possession. The others reasons for seeking psychiatric treatment were: behavioral disorder in 77.3%, inefficacity of traditional practices in 54.5%, and patient refusal (40.9%). Stigmatization of the Razi hospital, the unique psychiatric hospital in the country, and of psychiatry in general were evoked by mothers as the main obstacles in initiating psychiatric treatment in more than half of the cases (70%). Others obstacles were: fear of side effects of psychiatric treatment (50%), patient refusal (40.9%), inaccessibility to psychiatric services (31.8%) and fear of an addiction to psychotropic agents (31.8%). Thirty-six percent of mothers underlined the need to consult in the occurrence of school difficulties or any change in the child's behavior; 27% proposed educational and anti-stigmatizing campaigns about the signs of early psychosis through radio, newspapers, cinema, and TV media advertisements. Making teachers and educators sensitive to psychosis was proposed by 13.6% of mothers; 9.1% thought that diagnostic skills should be improved in general practitioners. Knowledge of attitudes of mothers towards the illness of their child prior to psychiatric treatment and towards the start of treatment is essential for the development of interventions for reducing duration of untreated psychosis. Copyright © 2012 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  10. Long-term follow-up of patients treated for psychotic symptoms that persist after stopping illicit drug use.

    Science.gov (United States)

    Deng, Xianhua; Huang, Zhibiao; Li, Xuewu; Li, Yi; Wang, Yi; Wu, Dongling; Gao, Beiling; Yang, Xi

    2012-10-01

    The long-term outcome of patients diagnosed with drug-induced psychotic disorders in China is unknown. Assess the course of illness and severity of psychiatric symptoms in patients previously admitted to a psychiatric hospital for treatment of psychotic symptoms that were induced by the use of illicit drugs. Patients with psychotic symptoms at the time of their first psychiatric admission who had used illicit drugs in the month prior to admission were followed up 13 to 108 months after admission. Patients and coresident family members were interviewed about post-discharge drug use and psychotic symptoms. The 258 identified patients were primarily young, unemployed males whose most common drug of abuse was methamphetamines and who had been abusing drugs for an average of 7 years at the time of admission. Among these patients 189 (73%) were located and reinterviewed; 168 (89%) had restarted illicit drug use and 25 (13%) had required rehospitalization over the follow-up period. In 114 patients (60%) the psychotic symptoms resolved in less than 1 month after stopping the drugs, in 56 (30%) the symptoms persisted for 1 to 6 months, and in 19 (10%) the symptoms persisted for longer than 6 months (in 8 of these the diagnosis had changed to schizophrenia). Compared to the other two groups, patients whose symptoms persisted more than 6 months were more likely to have a family history of mental illness, an earlier age of onset and a longer duration of drug abuse prior to the index admission; they were also more likely to have been re-hospitalized during the follow-up period and to have psychotic symptoms at the time of follow-up. Most patients with substance-induced psychotic disorders in our sample had a good long-term prognosis but those who started illegal drug use early, used drugs for prolonged periods, or had a family history of psychiatric illnesses were more likely to develop a chronic psychosis. Further prospective studies are needed to determine the relationship of

  11. Selective deficits in semantic verbal fluency in patients with a first affective episode with psychotic symptoms and a positive history of mania.

    LENUS (Irish Health Repository)

    Kravariti, Eugenia

    2009-05-01

    Neurocognitive dysfunction is likely to represent a trait characteristic of bipolar disorder, but the extent to which it comprises \\'core\\' deficits as opposed to those secondary to longstanding illness or intellectual decline is unclear. We investigated neuropsychological performance in an epidemiologically derived sample of patients with a first affective episode with psychotic symptoms and a positive history of mania, compared to community controls.

  12. Explanatory models and distress in primary caregivers of patients with acute psychotic presentations: A study from South India.

    Science.gov (United States)

    Joy, Deepa S; Manoranjitham, S D; Samuel, P; Jacob, K S

    2017-11-01

    Emotional distress among caregivers of people with mental illness is common, changes overtime and requires appropriate coping strategies to prevent long-term disability. Explanatory models, which underpin understanding of disease and illness, are crucial to coping. To study the association of explanatory models and distress among caregivers of people with acute psychotic illness. A total of 60 consecutive patients and their primary caregivers who presented to the Department of Psychiatry, Christian Medical College, Vellore, were recruited for the study. Positive and Negative Syndrome Scale (PANSS), Short Explanatory Model Interview (SEMI) and the General Health Questionnaire-12 (GHQ-12) were used to assess severity of psychosis, explanatory models of illness and emotional distress. Standard bivariate and multivariable statistics were employed. Majority of the caregivers simultaneously held multiple models of illness, which included medical and non-medical perspectives. The GHQ-12 score were significantly lower in people who held multiple explanatory models of illness when compared to the caregivers who believed single explanations. Explanatory models affect coping in caregivers of patients with acute psychotic presentations. There is a need to have a broad-based approach to recovery and care.

  13. Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC).

    Science.gov (United States)

    Das-Munshi, Jayati; Bécares, Laia; Boydell, Jane E; Dewey, Michael E; Morgan, Craig; Stansfeld, Stephen A; Prince, Martin J

    2012-10-01

    Aetiological mechanisms underlying ethnic density associations with psychosis remain unclear. To assess potential mechanisms underlying the observation that minority ethnic groups experience an increased risk of psychosis when living in neighbourhoods of lower own-group density. Multilevel analysis of nationally representative community-level data (from the Ethnic Minorities Psychiatric Illness Rates in the Community survey), which included the main minority ethnic groups living in England, and a White British group. Structured instruments assessed discrimination, chronic strains and social support. The Psychosis Screening Questionnaire ascertained psychotic experiences. For every ten percentage point reduction in own-group density, the relative odds of reporting psychotic experiences increased 1.07 times (95% CI 1.01-1.14, P = 0.03 (trend)) for the total minority ethnic sample. In general, people living in areas of lower own-group density experienced greater social adversity that was in turn associated with reporting psychotic experiences. People resident in neighbourhoods of higher own-group density experience 'buffering' effects from the social risk factors for psychosis.

  14. Canadian Schizophrenia Guidelines: Schizophrenia and Other Psychotic Disorders with Coexisting Substance Use Disorders.

    Science.gov (United States)

    Crockford, David; Addington, Donald

    2017-09-01

    Persons with schizophrenia and other psychotic disorders frequently have coexisting substance use disorders that require modifications to treatment approaches for best outcomes. The objectives of this review were to identify evidence-based practices best practices that improve outcomes for individuals with schizophrenia and substance used disorders. We reviewed guidelines that were published in the last 5 years and that included systematic reviews or meta-analyses. Most of our recommendations came from 2 publications from the National Institute for Health and Care Excellence (NICE): the 2011 guidance titled Coexisting Severe Mental Illness (Psychosis) and Substance Misuse: Assessment and Management in Healthcare Settings and the 2014 guidance titled Psychosis and Schizophrenia in Adults: Prevention and Management. We placed these recommendations into the Canadian context to create this guideline. Evidence supports the inclusion of individuals with coexisting substance use disorders in first-episode psychosis programs. The programs should integrate psychosis and substance use treatments, emphasizing ongoing monitoring of both substance use and patterns and symptoms. The best outcomes are achieved with combined use of antipsychotic medications and addiction-based psychosocial interventions. However, limited evidence is available to recommend using one antipsychotic medication over another or one psychosocial intervention over another for persons with schizophrenia and other psychotic disorders with coexisting substance use disorders. Treating persons who have schizophrenia and other psychotic disorders with coexisting substance use disorders can present clinical challenges, but modifications in practice can help engage and retain people in treatment, where significant improvements over time can be expected.

  15. Childhood maltreatment, adult attachment and psychotic symptomatology: a study in patients, siblings and controls.

    Science.gov (United States)

    van Dam, D S; Korver-Nieberg, N; Velthorst, E; Meijer, C J; de Haan, L

    2014-11-01

    The association between childhood maltreatment (ChM) and psychotic disorders is well established. However, there is an ongoing debate about which factors account for this relationship. One explanation is that the relationship between ChM and psychosis is mediated by adult attachment style. Therefore, in this study, we aimed to investigate whether adult attachment style mediates the relationship between ChM and positive and negative symptomatology. We investigated the relation between ChM and psychotic symptoms, taking into account levels of (insecure) attachment, in 131 patients with psychotic illness, 123 siblings and 72 controls. ChM was assessed with the Childhood Trauma Questionnaire (CTQ). Attachment dimensions of anxiety and avoidance were measured using the Psychosis Attachment Measure (PAM). In both patients and siblings, ChM predicted positive symptoms and this relationship was partly mediated by attachment style. This relationship was found to be stronger for siblings than for patients. ChM predicted negative symptoms in patients and siblings. In the patient sample, attachment style did not mediate the relationship between ChM and negative symptoms, whereas attachment style was found to be a mediator in the sibling sample. ChM was associated with positive and negative symptomatology in both patients and siblings. Particularly in siblings, the relationship between ChM and psychosis seems to be mediated by adult attachment style. Perhaps attachment style may play a more prominent role on a subclinical level.

  16. The Association of Salvia divinorum and Psychotic Disorders: A Review of the Literature and Case Series.

    Science.gov (United States)

    El-Khoury, Joseph; Sahakian, Nayiri

    2015-01-01

    The association of substance abuse and psychotic disorders is of interest to clinicians, academics, and lawmakers. Commonly abused substances, such as cannabis, cocaine, amphetamines, and alcohol, have all been associated with substance-induced psychosis. Hallucinogens can induce desired psychedelic effects and undesirable psychomimetic reactions. These are usually transient and resolve once the duration of action is over. Sometimes, these effects persist, causing distress and requiring intervention. This article focuses on the hallucinogenic substance Salvia divinorum, the use of which has been observed, particularly among youth worldwide. We present background information based on a review of the literature and on our own clinical encounters, as highlighted by two original case reports. We hypothesize that consumption of Salvia divinorum could be associated with the development of psychotic disorders. We propose that clinicians routinely inquire about the use of Salvia in patients with substance use disorders or psychotic illnesses. More research is required to assess any relationship between Salvia divinorum and psychosis. Additionally, we advocate increased public and medical awareness of this substance and other emerging drugs of abuse.

  17. Left-Handedness Among a Community Sample of Psychiatric Outpatients Suffering From Mood and Psychotic Disorders

    Directory of Open Access Journals (Sweden)

    Jadon R. Webb

    2013-10-01

    Full Text Available The human brain develops asymmetrically, such that certain cognitive processes arise predominantly from the left or right side. It has been proposed that variations in this laterality contribute to certain forms of mental illness, such as schizophrenia. A convenient measure of brain laterality is hand dominance, and prior work has found that patients with schizophrenia are more likely to be left-handed than the general population. This finding is not consistent, however, and fewer studies have directly compared handedness between psychiatric diagnoses. We assessed hand dominance in 107 patients presenting to an outpatient psychiatric clinic with diagnoses of a mood or psychotic disorder. The prevalence of left-handedness was 11% for mood disorders, which is similar to the rate in the general population. It was 40% in those with psychotic disorders (adjusted odds ratio = 7.9, p < .001. The prevalence of left-handedness was much higher in psychotic disorders compared with mood disorders in this community mental health sample.

  18. Attenuated positive psychotic symptoms and social anxiety: Along a psychotic continuum or different constructs?

    Science.gov (United States)

    Cooper, Shanna; Klugman, Joshua; Heimberg, Richard G; Anglin, Deidre M; Ellman, Lauren M

    2016-01-30

    Social anxiety commonly occurs across the course of schizophrenia, including in the premorbid and prodromal phases of psychotic disorders. Some have posited that social anxiety may exist on a continuum with paranoia; however, empirical data are lacking. The study aim was to determine whether attenuated positive psychotic symptoms are related to social anxiety. Young adults (N=1378) were administered the Prodromal Questionnaire (PQ), which measures attenuated positive psychotic symptoms (APPS), and the Social Phobia Scale (SPS), which measures a subset of social anxiety symptoms. Confirmatory factor analyses were conducted to address the extent to which social anxiety and APPS tap distinct dimensions. Confirmatory factor analyses support the existence of a separate social anxiety factor scale and four separate, though interrelated, APPS factor domains (unusual thought content, paranoia/suspiciousness, disorganized thinking, and perceptual abnormalities). Additionally, social anxiety was significantly, but not differently related to each APPS domain, although the magnitude was reduced between social anxiety and distressing APPS. The current study suggests that social anxiety and attenuated positive psychotic symptoms are separable constructs, but are significantly associated with each other. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Psychotic-Like Experiences at the Healthy End of the Psychosis Continuum

    Directory of Open Access Journals (Sweden)

    Lui Unterrassner

    2017-05-01

    Full Text Available There is increasing evidence pointing toward a continuous distribution of psychotic symptoms and accompanying factors between subclinical and clinical populations. However, for the construction of continuum models, a more detailed knowledge of different types of psychotic-like experiences (PLE and their associations with distress, functional impairment, and demographic variables is needed. We investigated PLE in a sample of healthy adults (N = 206 incorporating the recently developed revised Exceptional Experiences Questionnaire (PAGE-R. For the first time, the PAGE-R was cross validated with PLE, disorganized-, and negative-like symptoms [Schizotypal Personality Questionnaire (SPQ, Physical Anhedonia Scale (PAS]. We subjected the PAGE-R to exploratory factor analyses and examined the resulting subtypes of EE for specific associations with contextual factors, valence ratings, socio-demographic variables, and general psychological burden (Revised Symptom-Checklist-90. Correlational cross-validation suggested that the PAGE-R measures facets of PLE. Importantly, we (1 identified three types of exceptional experiences (EE: Odd beliefs, dissociative anomalous perceptions, and hallucinatory anomalous perceptions. Further, the results suggested that even in healthy individuals (2 PLE and EE are indicative of reduced functioning, as reflected by increased psychological burden and lower educational achievement. Moreover, (3 similar sex-differences might exist as in psychotic patients with women reporting more positive-like symptoms and EE but less disorganized-like symptoms than men. Importantly, (4 EE might be differentially implicated in psychological functioning. We suggest that the PAGE-R holds the potential to complement the current assessment of sub-clinical psychosis. However, whereas our results might point toward a continuity of psychotic symptoms with EE and normal experiences, they require replication in larger samples as well as equivalence

  20. Dopaminergic function in cannabis users and its relationship to cannabis-induced psychotic symptoms.

    Science.gov (United States)

    Bloomfield, Michael A P; Morgan, Celia J A; Egerton, Alice; Kapur, Shitij; Curran, H Valerie; Howes, Oliver D

    2014-03-15

    Cannabis is the most widely used illicit drug globally, and users are at increased risk of mental illnesses including psychotic disorders such as schizophrenia. Substance dependence and schizophrenia are both associated with dopaminergic dysfunction. It has been proposed, although never directly tested, that the link between cannabis use and schizophrenia is mediated by altered dopaminergic function. We compared dopamine synthesis capacity in 19 regular cannabis users who experienced psychotic-like symptoms when they consumed cannabis with 19 nonuser sex- and age-matched control subjects. Dopamine synthesis capacity (indexed as the influx rate constant [Formula: see text] ) was measured with positron emission tomography and 3,4-dihydroxy-6-[(18)F]-fluoro-l-phenylalanine ([(18)F]-DOPA). Cannabis users had reduced dopamine synthesis capacity in the striatum (effect size: .85; t36 = 2.54, p = .016) and its associative (effect size: .85; t36 = 2.54, p = .015) and limbic subdivisions (effect size: .74; t36 = 2.23, p = .032) compared with control subjects. The group difference in dopamine synthesis capacity in cannabis users compared with control subjects was driven by those users meeting cannabis abuse or dependence criteria. Dopamine synthesis capacity was negatively associated with higher levels of cannabis use (r = -.77, p < .001) and positively associated with age of onset of cannabis use (r = .51, p = .027) but was not associated with cannabis-induced psychotic-like symptoms (r = .32, p = .19). These findings indicate that chronic cannabis use is associated with reduced dopamine synthesis capacity and question the hypothesis that cannabis increases the risk of psychotic disorders by inducing the same dopaminergic alterations seen in schizophrenia. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  1. Schizophrenia spectrum and other psychotic disorders

    DEFF Research Database (Denmark)

    Pagsberg, Anne Katrine

    2013-01-01

    The DSM-5 list of diagnoses concerning schizophrenia spectrum and other psychotic disorders is expected to be revised and graduated from mild to severe. The proposed changes for the diagnosis of schizophrenia affect demands for characteristic symptoms, clarify relation to pervasive developmental...... diagnostic reliability and validity, but it is estimated to exclude about 2 % of patients currently diagnosed with DSM-IV schizophrenia from fulfilling criteria for DSM-5 schizophrenia. It might generate a problem for future young patients if the changes concerning demands on characteristic symptoms turn out...

  2. Psychotic experiences and social functioning: a longitudinal study.

    Science.gov (United States)

    Sullivan, Sarah; Lewis, Glyn; Wiles, Nicola; Thompson, Andrew; Evans, Jonathan

    2013-07-01

    Both adolescent psychotic experiences and poor social functioning precede psychotic disorder; however, whether poor social functioning is also a risk factor for rather than a consequence of adolescent psychotic experiences is not clear. We investigate this question as well as whether deterioration in social functioning confers the strongest risk of psychotic experiences and whether theory of mind ability mediates any association, in a large community sample. Measures of social functioning (peer problems and prosocial behaviour) at ages 7 and 11 and theory of mind ability and psychotic experiences at age 12 were collected in a large community sample (n = 3,592). The association between social functioning and psychotic experiences was examined using logistic regression models at each age and any additional impact of deterioration in social functioning between ages 7 and 11. The potential role of theory of mind as a mediator was also investigated. Peer problems at both ages were independently associated with psychotic experiences at age 12 (7 years OR 1.11 95 % CI 1.03, 1.20), (11 years OR 1.13 95 % CI 1.05, 1.22). Theory of mind ability did not mediate this association. The association was not restricted to those with deteriorating social functioning (interaction term; p = 0.49). Poor childhood social functioning precedes adolescent psychotic experiences. There was no evidence that those with deteriorating social functioning were at greatest risk.

  3. Hyper-Theory-of-Mind in Children with Psychotic Experiences

    NARCIS (Netherlands)

    Clemmensen, Lars; van Os, Jim; Skovgaard, Anne Mette; Vaever, Mette; Blijd-Hoogewys, Els M. A.; Bartels-Velthuis, Agna A.; Jeppesen, Pia

    2014-01-01

    Background: Alterations in Theory-of-Mind (ToM) are associated with psychotic disorder. In addition, studies in children have documented that alterations in ToM are associated with Psychotic Experiences (PE). Our aim was to examine associations between an exaggerated type of ToM (HyperToM) and PE in

  4. Psychotic symptoms among male adolescent detainees in The Netherlands

    NARCIS (Netherlands)

    Vreugdenhil, Coby; Vermeiren, Robert; Wouters, Luuk F. J. M.; Doreleijers, Theo A. H.; van den Brink, Wim

    2004-01-01

    This study investigated the prevalence of psychotic symptoms among incarcerated boys as well as the relationship between these symptoms and violent offending and criminal recidivism. The presence of psychotic symptoms was assessed in a representative sample of 204 incarcerated boys aged 12-18 using

  5. How psychotic-like are paranormal beliefs?

    Science.gov (United States)

    Cella, Matteo; Vellante, Marcello; Preti, Antonio

    2012-09-01

    Paranormal beliefs and Psychotic-like Experiences (PLE) are phenotypically similar and can occur in individuals with psychosis but also in the general population; however the relationship of these experiences for psychosis risk is largely unclear. This study investigates the association of PLE and paranormal beliefs with psychological distress. Five hundred and three young adults completed measures of paranormal beliefs (Beliefs in the Paranormal Scale), psychological distress (General Health Questionnaire), delusion (Peters et al. Delusions Inventory), and hallucination (Launay-Slade Hallucination Scale) proneness. The frequency and intensity of PLE was higher in believers in the paranormal compared to non-believers, however psychological distress levels were comparable. Regression findings confirmed that paranormal beliefs were predicted by delusion and hallucination-proneness but not psychological distress. The use of a cross-sectional design in a specific young adult population makes the findings exploratory and in need of replication with longitudinal studies. The predictive value of paranormal beliefs and experiences for psychosis may be limited; appraisal or the belief emotional salience rather than the belief per se may be more relevant risk factors to predict psychotic risk. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Knowledge and insight in relation to functional remission in patients with long-term psychotic disorders

    DEFF Research Database (Denmark)

    Alenius, Malin; Hammarlund-Udenaes, Margareta; Hartvig, Per

    2009-01-01

    : To investigate the knowledge and insight in relation to treatment response. METHODS: A naturalistic study was performed using patient interviews and information gathered from patient drug charts. Apart from the rating scales used for classification of treatment response (CANSEPT method), the SPKS knowledge......BACKGROUND: Patients with psychotic symptoms often respond poorly to treatment. Outcomes can be affected by biological, physiological and psychological factors according to the vulnerability-stress model. The patient's coping strategies and beliefs have been correlated with outcomes. OBJECTIVES...... of illness and drugs rating scale was utilized. RESULTS: In the group of patients in functional remission (FR; n = 38), 37% had insight into their illness as compared to 10% among those not in functional remission (non-FR; n = 78; P strategy for responding...

  7. Effect of video self-observations vs. observations of others on insight in psychotic disorders.

    Science.gov (United States)

    David, Anthony S; Chis Ster, Irina; Zavarei, Hooman

    2012-04-01

    Improving insight in patients with schizophrenia and related disorders is a worthwhile goal. Previous work has suggested that patients' insight may improve if they see videos of themselves taken when ill. Our aim was to test the hypothesis that schizophrenia patients improve their insight after viewing videos of themselves when unwell more so than after viewing an actor. Forty patients admitted with an acute psychotic disorder underwent a videotaped recording of a clinical interview. The patients were then randomized to viewing this or a "control" video of a same-sex actor displaying psychotic symptoms approximately 3 weeks later. Insight, psychopathology, and mood were assessed before and 24 to 48 hours after viewing the videos. All participants showed general improvement across all measures. There was a trend for scores on the Schedule for the Assessment of Insight to improve more in those who viewed themselves when ill, but there were no clear statistically significant differences between the "self" and "other" video groups. In conclusion, video self-confrontation seems to be a safe and potentially effective means of enhancing insight, but evidence for a specific effect is lacking.

  8. A multi-center, randomized controlled trial of a group psychological intervention for psychosis with comorbid cannabis dependence over the early course of illness.

    LENUS (Irish Health Repository)

    Madigan, Kevin

    2013-01-01

    Patients who experience the onset of psychotic illness with a comorbid diagnosis of cannabis dependence experience poor clinical outcomes. Few studies have identified interventions that reduce cannabis use and improve clinical outcome in this population.

  9. French version validation of the psychotic symptom rating scales (PSYRATS for outpatients with persistent psychotic symptoms

    Directory of Open Access Journals (Sweden)

    Favrod Jerome

    2012-09-01

    Full Text Available Abstract Background Most scales that assess the presence and severity of psychotic symptoms often measure a broad range of experiences and behaviours, something that restricts the detailed measurement of specific symptoms such as delusions or hallucinations. The Psychotic Symptom Rating Scales (PSYRATS is a clinical assessment tool that focuses on the detailed measurement of these core symptoms. The goal of this study was to examine the psychometric properties of the French version of the PSYRATS. Methods A sample of 103 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms over the previous three months was assessed using the PSYRATS. Seventy-five sample participants were also assessed with the Positive And Negative Syndrome Scale (PANSS. Results ICCs were superior to .90 for all items of the PSYRATS. Factor analysis replicated the factorial structure of the original version of the delusions scale. Similar to previous replications, the factor structure of the hallucinations scale was partially replicated. Convergent validity indicated that some specific PSYRATS items do not correlate with the PANSS delusions or hallucinations. The distress items of the PSYRATS are negatively correlated with the grandiosity scale of the PANSS. Conclusions The results of this study are limited by the relatively small sample size as well as the selection of participants with persistent symptoms. The French version of the PSYRATS partially replicates previously published results. Differences in factor structure of the hallucinations scale might be explained by greater variability of its elements. The future development of the scale should take into account the presence of grandiosity in order to better capture details of the psychotic experience.

  10. Mental Illness

    Science.gov (United States)

    ... the same time. For example, you may have depression and a substance use disorder. Complications Mental illness is a leading cause of disability. Untreated mental illness can cause severe emotional, behavioral and physical health problems. Complications sometimes linked to mental illness include: ...

  11. [Psychotic forms of atypical autism in children].

    Science.gov (United States)

    Simashkova, N V

    2006-01-01

    The aim of the study was to determine clinical borders of psychotic forms of atypical autism in children, its psychopathological and age-specific manifestations as well as nosological peculiarities and to specify its pathogenetic features. Eighty patients with childhood endogenous autism, Rett syndrome, fragile X syndrome, Down syndrome have been studied during 14 years. The study showed that psychoses similar by symptoms and course, which are characterized by attacks and regressive-catatonic disorders, may develop in the course of atypical autism. These psychoses develop on the background of dysontogenesis with consequent replacement of the following stages: autistic, regressive, catatonic, with returning to the autistic stage between attacks. Psychopathological similarity of these psychoses in different disorders correlated with EEG changes of the same type (appearance of the marked I-rhythm at the regressive stage of psychosis).

  12. Neuroanatomical Classification in a Population-Based Sample of Psychotic Major Depression and Bipolar I Disorder with 1 Year of Diagnostic Stability

    Directory of Open Access Journals (Sweden)

    Mauricio H. Serpa

    2014-01-01

    Full Text Available The presence of psychotic features in the course of a depressive disorder is known to increase the risk for bipolarity, but the early identification of such cases remains challenging in clinical practice. In the present study, we evaluated the diagnostic performance of a neuroanatomical pattern classification method in the discrimination between psychotic major depressive disorder (MDD, bipolar I disorder (BD-I, and healthy controls (HC using a homogenous sample of patients at an early course of their illness. Twenty-three cases of first-episode psychotic mania (BD-I and 19 individuals with a first episode of psychotic MDD whose diagnosis remained stable during 1 year of followup underwent 1.5 T MRI at baseline. A previously validated multivariate classifier based on support vector machine (SVM was employed and measures of diagnostic performance were obtained for the discrimination between each diagnostic group and subsamples of age- and gender-matched controls recruited in the same neighborhood of the patients. Based on T1-weighted images only, the SVM-classifier afforded poor discrimination in all 3 pairwise comparisons: BD-I versus HC; MDD versus HC; and BD-I versus MDD. Thus, at the population level and using structural MRI only, we failed to achieve good discrimination between BD-I, psychotic MDD, and HC in this proof of concept study.

  13. Severe Mental Illness, Somatic Delusions, and Attempted Mass Murder.

    Science.gov (United States)

    Sarteschi, Christine M

    2016-01-01

    A case of an attempted mass shooting at a large psychiatric hospital in the United States by a 30-year-old male with severe mental illness, somatic delusions, and exceptional access to healthcare professionals is reported. Six persons were shot, one died at the scene, and the shooter was then killed by the police. Data were gathered from court documents and media accounts. An analysis of the shooter's psychiatric history, his interactions with healthcare professionals, and communications prior to the shooting suggest a rare form of mass murder, a random attack by a documented psychotic and delusional individual suffering with somatic delusions. Despite his being psychotic, the killer planned the attack and made a direct threat 1 month prior to the shootings. This case highlights problems with the healthcare system, indicating that it might be ill equipped to appropriately deal with severe mental illness. © 2015 American Academy of Forensic Sciences.

  14. When acute-stage psychosis and substance use co-occur: differentiating substance-induced and primary psychotic disorders.

    Science.gov (United States)

    Caton, C L; Samet, S; Hasin, D S

    2000-09-01

    Substances such as alcohol, cocaine, amphetamine, and cannabis can produce psychotic reactions in individuals who are otherwise free of serious mental illness. However, persons with primary psychotic disorders, such as schizophrenia and bipolar disorder, who use these substances often present for treatment with signs and symptoms similar to those whose psychosis resulted from the use of drugs alone. While it is often difficult to distinguish substance-induced from primary psychoses, especially early in the course of treatment, this differential diagnosis has important implications for treatment planning. To help clinicians distinguish these two types of presentations, the authors first review the types of psychotic symptoms that can co-occur with substance use. They discuss the prevalence and patterns of substance use that have been found in patients with schizophrenia and other primary psychotic disorders and review the negative outcomes associated with substance use in this population. The prevalence of and types of symptoms and problems associated with psychotic symptoms that occur as a result of substance use alone are also reviewed. The authors describe assessment procedures for differentiating substance-induced and primary psychotic disorders. They stress the importance of accurately establishing the temporal relationship between the substance use and the onset and continuation of psychotic symptoms in making a differential diagnosis, as well as the importance of being familiar with the types of psychological symptoms that can occur with specific substances. The authors review the utility and limitations of a number of diagnostic instruments for assessing patients with co-occurring psychosis and substance use problems, including The Addiction Severity Index, The Michigan Alcohol Screening Test, and diagnostic interviews such as the Schedule for Affective Disorders and Schizophrenia and the Structured Clinical Interview for DSM. They then discuss the

  15. Early non-psychotic deviant behaviour as an endophenotypic ...

    African Journals Online (AJOL)

    Early non-psychotic deviant behaviour as an endophenotypic marker in ... probed into: social dysfunction, unprovoked aggression, extreme anxiety, ... Demographic data included: age, marital status, gender, and years of formal education.

  16. Childhood trauma and childhood urbanicity in relation to psychotic disorder

    NARCIS (Netherlands)

    Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Bruggeman, Richard; Cahn, Wiepke; de Haan, Lieuwe; Kahn, René; Meije, Carin; Myin-Germeys, Inez; van Os, Jim; Wiersma, Durk

    2015-01-01

    Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect of

  17. Childhood trauma and childhood urbanicity in relation to psychotic disorder

    NARCIS (Netherlands)

    Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Cahn, W

    2015-01-01

    BACKGROUND: Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect

  18. The Use of Electroconvulsive Therapy in Atypical Psychotic Presentations

    Science.gov (United States)

    Vasu, Devi

    2007-01-01

    Convulsive therapy and its progeny, electroconvulsive therapy (ECT), were originally used for the treatment of catatonic schizophrenia, and there is little doubt that ECT remains an effective intervention for the treatment of schizophrenia. However, current practice tends to favor the use of ECT in severe or treatment refractory affective disorders, and its use in schizophrenia and other nonaffective (atypical) psychotic disorders has become controversial. Case reports have suggested a role for ECT in two specific atypical psychotic disorders: Cotard's syndrome and cycloid psychosis. In this article, we review the atypical psychotic disorders and report a series of five case examples that signify the role of ECT in atypical psychotic presentations, particularly when the symptoms resemble those found in Cotard's syndrome and cycloid psychosis. PMID:20428309

  19. Psychotic symptoms in narcolepsy: phenomenology and a comparison with schizophrenia.

    NARCIS (Netherlands)

    Droogleever Fortuyn, H.A.; Lappenschaar, G.A.; Nienhuis, F.J.; Furer, J.W.; Hodiamont, P.P.G.; Rijnders, C.A.T.; Lammers, G.J.; Renier, W.O.; Buitelaar, J.K.; Overeem, S.

    2009-01-01

    OBJECTIVE: Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and

  20. Psychotic symptoms in narcolepsy : phenomenology and a comparison with schizophrenia

    NARCIS (Netherlands)

    Fortuyn, Hal A. Droogleever; Lappenschaar, G. A.; Nienhuis, Fokko J.; Furer, Joop W.; Hodiamont, Paul P.; Rijnders, Cees A.; Lammers, Gert Jan; Renier, Willy O.; Buitelaar, Jan K.; Overeem, Sebastlaan

    2009-01-01

    Objective: Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and

  1. Psychotic-like Experiences and Substance Use in College Students.

    Science.gov (United States)

    Fonseca-Pedrero, Eduardo; Ortuño-Sierra, Javier; Paino, Mercedes; Muñiz, José

    2016-03-02

    Psychotic disorders, as well as psychotic-like experiences and substance use, have been found to be associated. The main goal of the present study was to analyse the relationship between psychoticlike experiences and substance use in college students. The simple comprised a total of 660 participants (M = 20.3 years, SD = 2.6). The results showed that 96% of the sample reported some delusional experience, while 20.3% reported at least one positive psychotic-like experience. Some substance use was reported by 41.1% of the sample, differing in terms of gender. Substance users reported more psychoticlike experiences than non-users, especially in the positive dimension. Also, alcohol consumption predicted in most cases extreme scores on measures of delusional ideation and psychotic experiences. The association between these two variables showed a differentiated pattern, with a stronger relationship between substance use and cognitive-perceptual psychotic-like experiences. To some extent, these findings support the dimensional models of the psychosis phenotype and contribute a better understanding of the links between psychoticlike experiences and substance use in young adults. Future studies should further explore the role of different risk factors for psychotic disorders and include models of the gene-environment interaction.

  2. Are Psychotic Experiences Related to Poorer Reflective Reasoning?

    Directory of Open Access Journals (Sweden)

    Martin J. Mækelæ

    2018-02-01

    Full Text Available Background: Cognitive biases play an important role in the formation and maintenance of delusions. These biases are indicators of a weak reflective mind, or reduced engaging in reflective and deliberate reasoning. In three experiments, we tested whether a bias to accept non-sense statements as profound, treat metaphorical statements as literal, and suppress intuitive responses is related to psychotic-like experiences.Methods: We tested deliberate reasoning and psychotic-like experiences in the general population and in patients with a former psychotic episode. Deliberate reasoning was assessed with the bullshit receptivity scale, the ontological confabulation scale and the cognitive reflection test (CRT. We also measured algorithmic performance with the Berlin numeracy test and the wordsum test. Psychotic-like experiences were measured with the Community Assessment of Psychic Experience (CAPE-42 scale.Results: Psychotic-like experiences were positively correlated with a larger receptivity toward bullshit, more ontological confabulations, and also a lower score on the CRT but not with algorithmic task performance. In the patient group higher psychotic-like experiences significantly correlated with higher bullshit receptivity.Conclusion: Reduced deliberate reasoning may contribute to the formation of delusions, and be a general thinking bias largely independent of a person's general intelligence. Acceptance of bullshit may be facilitated the more positive symptoms a patient has, contributing to the maintenance of the delusions.

  3. Disability and service use among homeless people living with psychotic disorders.

    Science.gov (United States)

    Herrman, Helen; Evert, Helen; Harvey, Carol; Gureje, Oye; Pinzone, Tony; Gordon, Ian

    2004-01-01

    The prevalence of psychosis and needs for care among homeless people were studied in inner Melbourne. This was a two-stage nested study within the Australian National Survey of People Living with Psychotic Illness. A screen for psychosis was administered to a representative sample of men and women living in marginal housing in a mental health service catchment area. A selected subsample of 82 screen-positive respondents was interviewed using the Diagnostic Interview for Psychosis (DIP), a semistructured, standardized interview with three modules: (i) demography, functioning and quality of life; (ii) diagnosis; and (iii) service use. An unexpectedly high prevalence of people living with psychotic disorders (estimated lifetime prevalence 42%, 95% CI=37-47%) may reflect a concentration of vulnerable people in the shrinking marginal housing supply in the inner city areas. Disability in everyday, occupational and social functioning is greater for this subgroup than for other people living with psychosis in Australia. Most people were single and unemployed, and many reported social isolation and feeling unsafe. Substance use disorders were common. Most people were using health services, including specialist mental health services, but few were receiving rehabilitation, vocational or housing support. Despite high levels of contact with a well-organized, sectorized mental health service in an affluent country, this pocket of several hundred people had high levels of persisting disability and needs. The literature and local experience suggest that changing this situation is likely to require co-ordinated policy and practice between the health, welfare and housing sectors.

  4. Protective Factors for Psychotic Symptoms Among Poly-victimized Children.

    Science.gov (United States)

    Crush, Eloise; Arseneault, Louise; Jaffee, Sara R; Danese, Andrea; Fisher, Helen L

    2018-04-06

    Experiencing victimization in early life has been repeatedly shown to be associated with the emergence of psychotic symptoms in childhood. However, most victimized children do not develop psychotic symptoms and why this occurs is not fully understood. This study investigated which individual, family-level, and wider community characteristics were associated with an absence of psychotic symptoms among children at risk for psychosis by virtue of their exposure to multiple victimization experiences (poly-victimization). Participants were from the Environmental Risk Longitudinal Twin Study, a nationally representative cohort of 2232 UK-born twins. Exposure to maltreatment, bullying and domestic violence prior to age 12 was determined from interviews with mothers, children, and observations by research workers at ages 5, 7, 10, and 12. Children were interviewed about psychotic symptoms at age 12. Protective factors were measured at ages 5, 7, 10, and 12. Childhood poly-victimization was associated with age-12 psychotic symptoms (OR = 4.61, 95% CI 2.82-7.52), but the majority of poly-victimized children did not report symptoms (80.7%). Having a relatively high IQ, more positive atmosphere at home, and higher levels of neighborhood social cohesion were found to be protective against childhood psychotic symptoms among poly-victimized children and also in the whole sample. However, "protected" poly-victimized children displayed elevated levels of other mental health problems compared to nonvictimized children. Children's characteristics, family context, and the wider community were all found to protect children from developing early psychotic symptoms, even when they were victimized multiple times. These findings indicate targets for multilevel preventive interventions.

  5. Bipolar patients sing more in singapore: singing as a signal for mania in psychotic patients.

    Science.gov (United States)

    Lim, Leslie; Leow, Me Lye; Soh, Bee Leng; Chan, Yiong Huak; Parker, Gordon

    2013-10-01

    Singing in psychotic patients has received little attention in the psychiatric literature. In this preliminary study, we test the hypothesis that manic patients sing more than schizophrenic patients (SPs). Manic patients and SP inpatients and outpatients were interviewed using a semi-structured questionnaire which included questions on musical interests, and how much they felt like singing prior to their most recent admission to hospital. They were asked if they were willing to sing during the interview and responses were observed. Of the 69 manic patients and 68 SPs interviewed, manic patients were more likely to report singing than SPs (76% vs 24%) prior to their most recent admission to hospital. There was a trend for manic inpatients to be more willing to sing during the interview. Increased singing is suggested as a useful symptom and sign in patients suffering from a manic illness.

  6. Subclinical psychotic experiences and subsequent contact with mental health services.

    Science.gov (United States)

    Bhavsar, Vishal; Maccabe, James H; Hatch, Stephani L; Hotopf, Matthew; Boydell, Jane; McGuire, Philip

    2017-03-01

    Although psychotic experiences in people without diagnosed mental health problems are associated with mental health service use, few studies have assessed this prospectively or measured service use by real-world clinical data. To describe and investigate the association between psychotic experiences and later mental health service use, and to assess the role of symptoms of common mental health disorders in this association. We linked a representative survey of south-east London (SELCoH-1, n =1698) with health records from the local mental healthcare provider. Cox regression estimated the association of PEs with rate of mental health service use. After adjustments, psychotic experiences were associated with a 1.75-fold increase in the rate of subsequent mental health service use (hazard ratio (HR) 1.75, 95% CI 1.03-2.97) compared with those without PEs. Participants with PEs experienced longer care episodes compared with those without. Psychotic experiences in the general population are important predictors of public mental health need, aside from their relevance for psychoses. We found psychotic experiences to be associated with later mental health service use, after accounting for sociodemographic confounders and concurrent psychopathology. None. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license.

  7. Data Gathering Bias: Trait Vulnerability to Psychotic Symptoms?

    Directory of Open Access Journals (Sweden)

    Ana Catalan

    Full Text Available Jumping to conclusions (JTC is associated with psychotic disorder and psychotic symptoms. If JTC represents a trait, the rate should be (i increased in people with elevated levels of psychosis proneness such as individuals diagnosed with borderline personality disorder (BPD, and (ii show a degree of stability over time.The JTC rate was examined in 3 groups: patients with first episode psychosis (FEP, BPD patients and controls, using the Beads Task. PANSS, SIS-R and CAPE scales were used to assess positive psychotic symptoms. Four WAIS III subtests were used to assess IQ.A total of 61 FEP, 26 BPD and 150 controls were evaluated. 29 FEP were revaluated after one year. 44% of FEP (OR = 8.4, 95% CI: 3.9-17.9 displayed a JTC reasoning bias versus 19% of BPD (OR = 2.5, 95% CI: 0.8-7.8 and 9% of controls. JTC was not associated with level of psychotic symptoms or specifically delusionality across the different groups. Differences between FEP and controls were independent of sex, educational level, cannabis use and IQ. After one year, 47.8% of FEP with JTC at baseline again displayed JTC.JTC in part reflects trait vulnerability to develop disorders with expression of psychotic symptoms.

  8. Psychotic symptoms in narcolepsy: phenomenology and a comparison with schizophrenia.

    Science.gov (United States)

    Fortuyn, Hal A Droogleever; Lappenschaar, G A; Nienhuis, Fokko J; Furer, Joop W; Hodiamont, Paul P; Rijnders, Cees A; Lammers, Gert Jan; Renier, Willy O; Buitelaar, Jan K; Overeem, Sebastiaan

    2009-01-01

    Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and contrast these with schizophrenia patients and healthy controls. We also compared the prevalence of formal psychotic disorders between narcolepsy patients and controls. We used SCAN 2.1 interviews to compare psychotic symptoms between 60 patients with narcolepsy, 102 with schizophrenia and 120 matched population controls. In addition, qualitative data was collected to enable a detailed description of hypnagogic hallucinations in narcolepsy. There were clear differences in the pattern of hallucinatory experiences in narcolepsy vs. schizophrenia patients. Narcoleptics reported multisensory "holistic" hallucinations rather than the predominantly verbal-auditory sensory mode of schizophrenia patients. Psychotic symptoms such as delusions were not more frequent in narcolepsy compared to population controls. In addition, the prevalence of formal psychotic disorders was not increased in patients with narcolepsy. Almost half of narcoleptics reported moderate interference with functioning due to hypnagogic hallucinations, mostly due to related anxiety. Hypnagogic hallucinations in narcolepsy can be differentiated on a phenomenological basis from hallucinations in schizophrenia which is useful in differential diagnostic dilemmas.

  9. A study of acculturation in psychotic and non-psychotic immigrants living in Athens.

    Science.gov (United States)

    Gonidakis, F; Lembesi, E; Kontaxakis, V P; Havaki-Kontaxaki, B J; Ploumpidis, D; Madianos, M; Papadimitriou, G N

    2013-03-01

    Acculturation is the phenomenon that results when a group with one culture comes into continuous contact with a host culture. To investigate the correlation between acculturation and psychotic symptomatology in a group of immigrants suffering from psychosis and to explore differences in demographic factors related with the acculturation process between individuals with and without psychosis. Sixty-five patients and 317 non-psychotic immigrants were interviewed using the Immigrant Acculturation Scale (IAS) and a structured questionnaire for demographic data. The Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Global Assessment of Functioning (GAF) were also administered to all immigrants suffering from psychosis. Total IAS scores, as well as IAS everyday life scores, were positively correlated with GAF scores. IAS everyday life score in the patient group related with religion, marital status, gender and years in Greece, while in the non-psychosis group it was related with gender and years in Greece. IAS wishful orientation/nostos (the strong desire for one's homeland) related with religion in both groups. The IAS identity in the psychosis group did not show any significant relation with any of the variables, while in the non-patient group, it was related with marital status, gender and years in Greece. Age, duration of residence in Greece and higher adoption of Greek ethnic identity were the variables that differentiated the two groups of immigrants. Acculturation in immigrants suffering from psychosis could be seen as a process that does not correlate strongly with the severity of the symptomatology but is probably influenced by different set of factors.

  10. LIVING WITH THE PSYCHOTIC IN THE FAMILIAR POINT OF VIEW

    Directory of Open Access Journals (Sweden)

    Leila Mariza Hildebrandt

    2004-04-01

    Full Text Available A lot of people live situations of mental sickness, from psychotic character, that can cause sufferingboth for the sick and his family. We believe that try this situation means to live with limitations and wearings in thefamiliar everyday, what makes difficult the living with the psychotic person. Considering these aspects, thisresearch has the purpose of knowing the familiar perception about his living with a psychotic bearer person. It isabout a qualitative, explorative and descriptive study, developed in a northwest city of Rio Grande do Sul state,called Ijuí. The people of the investigation are composed of five psychotic’s parents, which frequent the socioterapygroup in Gloria district. The information collection happened trough open interviews, recorded and wrote out at all.The analysis of the obtained data followed MINAYO’s (2002 methodological proposition. By the containedinformation in the stud’s social actor’s declarations, emerged three thematic with a similar nucleus of thoughts. Onfirst thematic, we discussed about the difficulties faced by the familiars in the living with the psychotic in themoment he has the acute symptoms. On the second thematic, we talked about the medical question as bring atherapeutic element that helps the mental sick to keep stable., becoming better the familiars life. The third thematicshows the family conception about mental sickness. With this research we concluded that the living with a mentalsick person is taxing for the familiar and, sometimes, there are difficulties to understand the symptoms showed bythe sick person. Besides that, the family considers the medication one of the most important possibilities ofintervention in the psychotic’s therapy, what is reinforced by the health team that leads with these people.

  11. Psychotic disorder and educational achievement: a family-based analysis.

    Science.gov (United States)

    Frissen, Aleida; Lieverse, Ritsaert; Marcelis, Machteld; Drukker, Marjan; Delespaul, Philippe

    2015-10-01

    Early social and cognitive alterations in psychotic disorder, associated with familial liability and environmental exposures, may contribute to lower than expected educational achievement. The aims of the present study were to investigate (1) how differences in educational level between parents and their children vary across patients, their healthy siblings, and healthy controls (effect familial liability), and across two environmental risk factors for psychotic disorder: childhood trauma and childhood urban exposure (effect environment) and (2) to what degree the association between familial liability and educational differential was moderated by the environmental exposures. Patients with a diagnosis of non-affective psychotic disorder (n = 629), 552 non-psychotic siblings and 326 healthy controls from the Netherlands and Belgium were studied. Participants reported their highest level of education and that of their parents. Childhood trauma was assessed with the Dutch version of the Childhood Trauma Questionnaire-Short Form. Urban exposure, expressed as population density, was rated across five levels. Overall, participants had a higher level of education than their parents. This difference was significantly reduced in the patient group, and the healthy siblings displayed intergenerational differences that were in between those of controls and patients. Higher levels of childhood urban exposure were also associated with a smaller intergenerational educational differential. There was no evidence for differential sensitivity to childhood trauma and childhood urbanicity across the three groups. Intergenerational difference in educational achievements is decreased in patients with psychotic disorder and to a lesser extent in siblings of patients with psychotic disorder, and across higher levels of childhood urban exposure. More research is required to better understand the dynamics between early social and cognitive alterations in those at risk in relation to progress

  12. Epidemiology, course and outcome of acute polymorphic psychotic disorder: implications for ICD-11

    DEFF Research Database (Denmark)

    Castagnini, Augusto; Foldager, Leslie

    2014-01-01

    Background: The proposed revision of the ICD-10 category of ‘acute and transient psychotic disorders' (ATPDs), subsuming polymorphic, schizophrenic or predominantly delusional syndromes, would restrict their classification to acute polymorphic psychotic disorder, reminiscent of the clinical...

  13. Evaluation of a cognitive-behavioral program for chronically psychotic forensic inpatients.

    NARCIS (Netherlands)

    Hornsveld, R.H.J.; Nijman, H.L.I.

    2005-01-01

    The present study evaluated the progress of four groups of chronically psychotic patients in treatment at De Kijvelanden Forensic Psychiatric Hospital. The psychotic patients were offered a cognitive-behavioral program, including psycho education, grief processing, stress management, functional

  14. Hyper-Theory-of-Mind in Children with Psychotic Experiences

    DEFF Research Database (Denmark)

    Clemmensen, Lars; van Os, Jim; Skovgaard, Anne Mette

    2014-01-01

    BACKGROUND: Alterations in Theory-of-Mind (ToM) are associated with psychotic disorder. In addition, studies in children have documented that alterations in ToM are associated with Psychotic Experiences (PE). Our aim was to examine associations between an exaggerated type of ToM (HyperToM) and PE...... their theory of the minds of others in an incorrect or biased way. METHOD: Hypotheses were tested in two studies with two independent samples: (i) a general population sample of 1630 Danish children aged 11-12 years, (ii) a population-based sample of 259 Dutch children aged 12-13 years, pertaining to a case...

  15. Hyper-Theory-of-Mind in Children with Psychotic Experiences

    OpenAIRE

    Clemmensen, Lars; van Os, Jim; Skovgaard, Anne Mette; Vaever, Mette; Blijd-Hoogewys, Els M. A.; Bartels-Velthuis, Agna A.; Jeppesen, Pia

    2014-01-01

    Background: Alterations in Theory-of-Mind (ToM) are associated with psychotic disorder. In addition, studies in children have documented that alterations in ToM are associated with Psychotic Experiences (PE). Our aim was to examine associations between an exaggerated type of ToM (HyperToM) and PE in children. Children with this type of alteration in ToM infer mental states when none are obviously suggested, and predict behaviour on the basis of these erroneous beliefs. Individuals with HyperT...

  16. Risk factors for suicide among 34,671 patients with psychotic and non-psychotic severe depression

    DEFF Research Database (Denmark)

    Leadholm, Anne Katrine K; Rothschild, Anthony J; Nielsen, Jimmi

    2014-01-01

    BACKGROUND: Severe unipolar depression is associated with increased risk of suicide, but it remains unknown whether the same risk factors are present in the non-psychotic (non-PD) and psychotic (PD) subtypes respectively. Therefore, this study aimed to identify risk factors for suicide in non......-PD and PD separately, and to investigate if the presence of psychotic symptoms is an independent risk factor for suicide in severe depression. METHODS: This register-based, nationwide, historical prospective cohort study used logistic regression analyses to ascertain risk factors for suicide among all...... adults diagnosed with severe depression at Danish psychiatric hospitals between January 1, 1994 and December 31, 2010. The risk for suicide was expressed as adjusted odds ratios (AOR). RESULTS: A total of 34,671 individuals with severe depression (non-PD: n=26,106 and PD: n=12,101) were included...

  17. Assisted reproductive technology (ART) treatment in women with schizophrenia or related psychotic disorder

    DEFF Research Database (Denmark)

    Ebdrup, Ninna H; Assens, Maria; Hougaard, Charlotte O

    2014-01-01

    To determine the prevalence rate of women with a diagnosis of schizophrenia or related psychotic disorder in assisted reproductive technology (ART) treatment and to study these women's fertility treatment outcome in comparison to women with no psychotic disorders.......To determine the prevalence rate of women with a diagnosis of schizophrenia or related psychotic disorder in assisted reproductive technology (ART) treatment and to study these women's fertility treatment outcome in comparison to women with no psychotic disorders....

  18. Mild psychotic experiences among ethnic minority and majority adolescents and the role of ethnic density

    NARCIS (Netherlands)

    Eilbracht, Lizzy; Stevens, Gonneke W. J. M.; Wigman, J. T. W.; van Dorsselaer, S.; Vollebergh, Wilma A. M.

    Despite evidence of the increased risk of psychotic disorders among ethnic minority adults, little is known about the effect of ethnic minority status to mild psychotic experiences among adolescents. This study investigated mild psychotic experiences in ethnic minority and majority adolescents in a

  19. Prefrontal NAA and Glx Levels in Different Stages of Psychotic Disorders: a 3T 1H-MRS Study.

    Science.gov (United States)

    Liemburg, Edith; Sibeijn-Kuiper, Anita; Bais, Leonie; Pijnenborg, Gerdina; Knegtering, Henderikus; van der Velde, Jorien; Opmeer, Esther; de Vos, Annerieke; Dlabac-De Lange, Jozarni; Wunderink, Lex; Aleman, André

    2016-02-23

    H-Magnetic Resonance Spectroscopy ((1)H-MRS) can offer insights in various neuropathologies by measuring metabolite levels in the brain. In the current study we investigated the levels of glutamate + glutamine (Glx, neurotransmitter and precursor) and N-Acetyl Aspartate + glutamic acid (NAA + NAAG; neuronal viability) in the prefrontal cortex of patients with a psychotic disorder and people at Ultra High Risk (UHR) for psychosis. A (1)H-MRS spectrum was acquired in 31 patients with a recent onset psychotic disorder and 60 with a chronic state, 16 UHR patients and 36 healthy controls. Absolute metabolite levels were calculated using LCModel with a reference water peak. Groups were compared while taking into account age and partial volume effects. Moreover, we investigated associations with positive and negative symptoms, duration of illness, and antipsychotic treatment in patients. The most notable finding is that chronicity of schizophrenia was related to decreased levels of Glx and NAA. On the other hand, although on an exploratory note, UHR showed increased levels of prefrontal Glx and NAA levels with increasing age. Our results may indicate an initial Glx and NAA increase and subsequent decrease during illness progression that may be related to the neurotoxic effects of glutamate.

  20. Patterns and Determinants of Treatment Seeking among Previously Untreated Psychotic Patients in Aceh Province, Indonesia: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Marthoenis Marthoenis

    2016-01-01

    Full Text Available Immediate treatment of first-episode psychosis is essential in order to achieve a positive outcome. However, Indonesian psychiatric patients often delay accessing health services, the reason for which is not yet fully understood. The current study aimed to understand patterns of treatment seeking and to reveal determinants of the delay in accessing psychiatric care among first-time user psychotic patients. Qualitative interviews were conducted with sixteen family members who accompanied the patients to a psychiatric hospital. Many families expressed beliefs that mental illness appertains to village sickness and not hospital sickness; therefore, they usually take the patients to traditional or religious healers before taking them to a health professional. They also identified various factors that potentially delay accessing psychiatric treatment: low literacy and beliefs about the cause of the illness, stigmatisation, the role of extended family, financial problems, and long distance to the psychiatric hospital. On the other hand, the family mentioned various factors related to timely help seeking, including being a well-educated family, living closer to health facilities, previous experience of successful psychotic therapy, and having more positive symptoms of psychosis. The findings call for mental health awareness campaigns in the community.

  1. An exploratory study of the extent of social inclusion among people with psychosis and psychotic-related conditions.

    Science.gov (United States)

    Turner, Niall; Ferguson, Lisa; Hill, Michele; Nesbitt, Tara; O'Callaghan, Eadbhard; O'Mahony, Paul; Clarke, Mary

    2017-05-01

    Understanding social inclusion among at-risk populations will deepen our understanding of their specific needs. This study explored the level of social inclusion among people with psychotic-related conditions using a standardised interview. The Social Inclusion Interview Schedule was used in two research projects. People with psychosis participated in both studies and had been recruited as part of an Irish programme of research on psychotic conditions. Descriptive statistics were used to quantify participants' level of social exclusion. Data from 71 participants were available, 38 in one cohort and 33 in the other. The smaller cohort had a shorter mean duration of illness. Participants' mean age was 40. The majority lived in the community and were satisfied with their living arrangements. In each cohort, the same two areas of community integration emerged as problematic - having something productive to do and being close to someone in the community. There was a higher level of perceived stigma among the cohort with the longer duration of illness. While evidence of social inclusion was found among participants, there were areas of concern particularly with regard to integration into work and social connectedness.

  2. Cushing Disease Presenting as Primary Psychiatric Illness: A Case Report and Literature Review.

    Science.gov (United States)

    Rasmussen, Sean A; Rosebush, Patricia I; Smyth, Harley S; Mazurek, Michael F

    2015-11-01

    We report the case of a woman with long-standing refractory depression and psychotic features who was eventually diagnosed with Cushing disease. After surgical treatment of a pituitary adenoma, she experienced gradual psychiatric recovery and was eventually able to discontinue all psychotropic medication. We review the psychiatric components of Cushing disease, implications of psychiatric illnesses for the treatment and prognosis of Cushing disease, and potential pathophysiological mechanisms linking glucocorticoid excess to psychiatric illness.

  3. Clinical and psychometric validation of the psychotic depression assessment scale

    DEFF Research Database (Denmark)

    Østergaard, Søren D; Pedersen, Christina H; Uggerby, Peter

    2015-01-01

    BACKGROUND: Recent studies have indicated that the 11-item Psychotic Depression Assessment Scale (PDAS), consisting of the 6-item melancholia subscale (HAM-D6) of the Hamilton Depression Rating Scale and 5 psychosis items from the Brief Psychiatric Rating Scale (BPRS), is a valid measure for the ...

  4. Current and emerging somatic treatment strategies in psychotic major depression.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Gonopolski, Yehudit; Kotler, Moshe

    2006-01-01

    Psychotic major depressive disorder (MDD) is a mood disorder characterized by severe affective and neurovegetative symptoms together with the presence of delusions and/or hallucinations. It is a common disorder seen in a quarter of consecutively admitted depressed patients and is often associated with severe symptomatology, increased suicide risk, poor acute response to antidepressants and poor acute and long-term treatment outcome. It is possible that poor response in psychotic depression is caused by the fact that we have yet to identify the most efficacious treatment protocol for psychotic MDD. Multiple studies have shown that modifications in the treatment paradigm may increase treatment efficacy in psychotic MDD. It has been generally accepted that, during the acute treatment phase, antidepressant-antipsychotic drug combination therapy is more effective than either treatment alone, although this strategy has recently been challenged. The question of the optimal duration of pharmacotherapy in order to prevent relapse and improve long-term (i.e., 5-year) outcome is a focus of current investigation. This article will review currently recommended treatment strategies for the acute, continuation and maintenance phases of therapy. In particular, it will address the role of newer-generation antidepressants, the role of second-generation antipsychotics, the use of mood stabilizers and indications for electroconvulsive therapy. Other possible treatment strategies such as transcranial magnetic stimulation, vagus nerve stimulation, deep-brain stimulation and glucocorticoid receptor antagonists will be discussed. Current recommendations for the prevention of relapse and improvement of long-term outcome will be reviewed.

  5. Psychotic Symptomatology in a Juvenile Court Clinic Population

    Science.gov (United States)

    Lewis, Dorothy Otnow; And Others

    1973-01-01

    This report indicating an unexpectedly high incidence of psychotic symptomatology in a population of cases referred to the Juvenile Court Psychiatric Clinic of the Second District of Connecticut, manifests the necessity for juvenile court systems to be made aware of the possibility of psychosis in our delinquent populations. (CS)

  6. Cerebral correlates of psychotic syndromes in neurodegenerative diseases.

    Science.gov (United States)

    Jellinger, Kurt A

    2012-05-01

    Psychosis has been recognized as a common feature in neurodegenerative diseases and a core feature of dementia that worsens most clinical courses. It includes hallucinations, delusions including paranoia, aggressive behaviour, apathy and other psychotic phenomena that occur in a wide range of degenerative disorders including Alzheimer's disease, synucleinopathies (Parkinson's disease, dementia with Lewy bodies), Huntington's disease, frontotemporal degenerations, motoneuron and prion diseases. Many of these psychiatric manifestations may be early expressions of cognitive impairment, but often there is a dissociation between psychotic/behavioural symptoms and the rather linear decline in cognitive function, suggesting independent pathophysiological mechanisms. Strictly neuropathological explanations are likely to be insufficient to explain them, and a large group of heterogeneous factors (environmental, neurochemical changes, genetic factors, etc.) may influence their pathogenesis. Clinico-pathological evaluation of behavioural and psychotic symptoms (PS) in the setting of neurodegenerative and dementing disorders presents a significant challenge for modern neurosciences. Recognition and understanding of these manifestations may lead to the development of more effective preventive and therapeutic options that can serve to delay long-term progression of these devastating disorders and improve the patients' quality of life. A better understanding of the pathophysiology and distinctive pathological features underlying the development of PS in neurodegenerative diseases may provide important insights into psychotic processes in general. © 2011 The Author Journal of Cellular and Molecular Medicine © 2011 Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd.

  7. Creating a Supportive Environment : Peer Support Groups for Psychotic Disorders

    NARCIS (Netherlands)

    Castelein, Stynke; Bruggeman, Richard; Davidson, Larry; van der Gaag, Mark

    People with psychotic disorders frequently experience significant mental and social limitations that may result in persisting social isolation. Research has shown that a supportive social environment is crucial for the process of personal recovery. Peer support groups can provide an opportunity to

  8. Creating a Supportive Environment: Peer Support Groups for Psychotic Disorders

    NARCIS (Netherlands)

    Castelein, S.; Bruggeman, R.; Davidson, L.; van der Gaag, M.

    2015-01-01

    People with psychotic disorders frequently experience significant mental and social limitations that may result in persisting social isolation. Research has shown that a supportive social environment is crucial for the process of personal recovery. Peer support groups can provide an opportunity to

  9. Interpersonal sensitivity and persistent attenuated psychotic symptoms in adolescence.

    Science.gov (United States)

    Masillo, Alice; Brandizzi, M; Valmaggia, L R; Saba, R; Lo Cascio, N; Lindau, J F; Telesforo, L; Venturini, P; Montanaro, D; Di Pietro, D; D'Alema, M; Girardi, P; Fiori Nastro, P

    2018-03-01

    Interpersonal sensitivity defines feelings of inner-fragility in the presence of others due to the expectation of criticism or rejection. Interpersonal sensitivity was found to be related to attenuated positive psychotic symptom during the prodromal phase of psychosis. The aims of this study were to examine if high level of interpersonal sensitivity at baseline are associated with the persistence of attenuated positive psychotic symptoms and general psychopathology at 18-month follow-up. A sample of 85 help-seeking individuals (mean age = 16.6, SD = 5.05) referred an Italian early detection project, completed the interpersonal sensitivity measure and the structured interview for prodromal symptoms (SIPS) at baseline and were assessed at 18-month follow-up using the SIPS. Results showed that individuals with high level of interpersonal sensitivity at baseline reported high level of attenuated positive psychotic symptoms (i.e., unusual thought content) and general symptoms (i.e., depression, irritability and low tolerance to daily stress) at follow-up. This study suggests that being "hypersensitive" to interpersonal interactions is a psychological feature associated with attenuated positive psychotic symptoms and general symptoms, such as depression and irritability, at 18-month follow-up. Assessing and treating inner-self fragilities may be an important step of early detection program to avoid the persistence of subtle but very distressing long-terms symptoms.

  10. Psychotic disorder and its characteristics in sex chromosome aneuploidies

    Directory of Open Access Journals (Sweden)

    Annapia Verri

    2009-09-01

    Full Text Available Sex chromosome anomalies have been associated with psychoses. We report a patient with XYY chromosome anomaly who developed a paranoid psychosis. The second case deal with a 51-year-old woman affected by Turner Syndrome and Psychotic Disorder, with a prevalent somatic and sexual focus.

  11. The Development of Pronoun Usage in the Psychotic Child.

    Science.gov (United States)

    Silberg, Joyanna L.

    1978-01-01

    Twenty-three psychotic children, ranging in age from 5 to 16, were interviewed in half-hour play sessions designed to elicit statements using the pronouns "I,""you," and "he" to express the concepts of possession, action, and description. (Author/SBH)

  12. Pattern of Serum Electrolytes Changes among Non Psychotic ...

    African Journals Online (AJOL)

    Method: Serum electrolytes, Na+, K+, Ca2+, Mg2+, were measured in 30 depressed patients at the Neuropsychiatric Hospital Rumuigbo, Port Harcourt before therapy commenced and after four (4) weeks of amitriptyline. Thirty (30) known non psychotic disordered subjects matched for age and sex were used as control.

  13. A Psychotic Reaction in a Sex-Chromatin Negative Female ...

    African Journals Online (AJOL)

    Neuropsychiatric disorders found in association with Turner's syndrome (gonadal agenesis) are unusual. The case report describes a patient with Turner's syndrome who suffered an acute psychotic reaction. A brief review of the literature concerning this association is surveyed. S. Afr. Med. J., 47, 146 (1973) ...

  14. Correlates of Suicidality among Patients with Psychotic Depression

    Science.gov (United States)

    Schaffer, Ayal; Flint, Alastair J.; Smith, Eric; Rothschild, Anthony J.; Mulsant, Benoit H.; Szanto, Katalin; Peasley-Miklus, Catherine; Heo, Moonseong; Papademetriou, Eros; Meyers, Barnett S.

    2008-01-01

    The independent association of age and other factors with suicidality in patients with major depression with psychotic features was examined. Of the 183 study participants, 21% had a suicide attempt during the current episode. Male gender, Hispanic background, past suicide attempt, higher depression scores, and higher cognitive scores were each…

  15. [The Psychotic Thinking of Patrick Bateman].

    Science.gov (United States)

    Fernando, Muñoz

    2012-06-01

    Literature is an inexhaustible source of study regarding mental illness which allows the academic exercise, whether dynamic oriented or not, that may help to understand the patient's inner world in the psychiatric clinical practice. Freudian, Post-Freudian and analytical examination of the main character in the U.S.A. novel AMERICAN PSYCHO. Review of sources and relevant theoretical currents. Analysis highlights the official nosologic classification boundaries, for conditions where symptoms are scattered across the spectrum of personality disorders and psychosis spectrum; usefulness and applicability of psychoanalytic concepts in psychiatric practice are also pointed out, thus granting flexibility to the clinical approach in order to justify its use. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  16. Diarrheal Illness

    Centers for Disease Control (CDC) Podcasts

    2011-08-30

    Dr. Steve Monroe, director of CDC’s Division of High-Consequence Pathogens and Pathology, discusses diarrheal illness, its causes, and prevention.  Created: 8/30/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 8/31/2011.

  17. Trauma and psychotic experiences: transnational data from the World Mental Health Survey.

    Science.gov (United States)

    McGrath, John J; Saha, Sukanta; Lim, Carmen C W; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura H; Bromet, Evelyn J; Bruffaerts, Ronny; Caldas de Almeida, José M; Cardoso, Graça; de Girolamo, Giovanni; Fayyad, John; Florescu, Silvia; Gureje, Oye; Haro, Josep M; Kawakami, Norito; Koenen, Karestan C; Kovess-Masfety, Viviane; Lee, Sing; Lepine, Jean-Pierre; McLaughlin, Katie A; Medina-Mora, Maria E; Navarro-Mateu, Fernando; Ojagbemi, Akin; Posada-Villa, Jose; Sampson, Nancy; Scott, Kate M; Tachimori, Hisateru; Ten Have, Margreet; Kendler, Kenneth S; Kessler, Ronald C

    2017-12-01

    Background Traumatic events are associated with increased risk of psychotic experiences, but it is unclear whether this association is explained by mental disorders prior to psychotic experience onset. Aims To investigate the associations between traumatic events and subsequent psychotic experience onset after adjusting for post-traumatic stress disorder and other mental disorders. Method We assessed 29 traumatic event types and psychotic experiences from the World Mental Health surveys and examined the associations of traumatic events with subsequent psychotic experience onset with and without adjustments for mental disorders. Results Respondents with any traumatic events had three times the odds of other respondents of subsequently developing psychotic experiences (OR = 3.1, 95% CI 2.7-3.7), with variability in strength of association across traumatic event types. These associations persisted after adjustment for mental disorders. Conclusions Exposure to traumatic events predicts subsequent onset of psychotic experiences even after adjusting for comorbid mental disorders. © The Royal College of Psychiatrists 2017.

  18. Self-medication hypothesis in substance-abusing psychotic patients: Can it help some subjects?

    Directory of Open Access Journals (Sweden)

    Susanta Kumar Padhy

    2016-01-01

    Full Text Available Background and Objectives: The evidence for gself.medication hypothesish (SMH in patients with dual diagnosis psychosis has been conflicting, though largely not supported, recently. But, still can SMH be a beneficial one in some patients with dual diagnosis remains a question. Methods: The study was conducted at Drug De.addiction and Treatment Centre, Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, a Tertiary Care Hospital in India. This cross.sectional comparative study had psychotic patients with substance use disorder as cases and those without substance use disorder as controls. Demographic details, clinical information, and Brief Psychiatric Rating Scale (BPRS scores were ascertained for cases and controls. Cases were additionally administered modified Stated Reasons Scale and modified Perceived Effects Scale. Results: Case and controls were comparable on demographic details and duration of psychotic illness, but cases had significantly lower scores on BPRS. The reasons reported for substance abuse in cases were more often nonhedonistic than hedonistic. Perceived effects of major substances of abuse (alcohol, cannabis, and opioids were different. Alcohol use was associated with perceived decrease in loneliness and cannabis was associated with perceived increase in suspiciousness and delusions. Considerable match was found between reasons for taking the substances and the effects perceived. Interpretation and Conclusions: Incorporating reasons for taking substance and their perceived effects in the treatment regimen would certainly help a subset of such difficult.to.treat patients. India being a low.resource country with a scarcity of experts and specialized dual diagnosis clinics, these findings may have an important implication in the clinical practice.

  19. Foodborne Illness

    OpenAIRE

    He, Zhan; Liu, Xuan; Li, Renjie

    2008-01-01

    Foodborne illnesses are a significant public health challenge in the world. Preventing foodborne disease in meat processing is an essential point to insure food safety and quality. HACCP systems currently are used for food processor to identify food safety hazards and prevent food is contaminated. By the introducing HACCP system into China in 1990s, Chinese government and enterprises have took more attention to control and monitoring the flow of food to insure food quality in processors. Meat...

  20. Foodborne Illness

    Science.gov (United States)

    1983-02-01

    contaminate different dietary constituents. These toxins may be of biologic origin (microbial. plant, or animal toxins) or they may be inorganic or...food mine if similar illness has occurred concomitantly poisoning for planning specific therapy, for esti- in companions or family members. Seek to...gin 4 to 8 hours after ingestion of the toxin and speciated botulinum immunoglobulin of equine include severe retching, vomiting, diarrhea, and

  1. [What support of young presenting a first psychotic episode, when schooling is being challenged?

    Science.gov (United States)

    Vacheron, M-N; Veyrat-Masson, H; Wehbe, E

    2017-12-01

    functionally impaired because of evolving FEP although school is a key setting for promoting positive mental health, fostering resilience, detecting and responding to emerging mental ill health. So, people with psychotic illness have low levels of secondary school completion. School dropout has been defined as leaving education without obtaining a minimal credential, most often a higher secondary education diploma. In France, the school is compulsory up to the age of 16. Consequences are significant: among young people without a degree out of initial training for one to four years and present on the labour market, 47% are unemployed. School dropout depends on a number of factors, including grades, family and social environment and the relationship with the school, but also the emergence of psychiatric disorders. For first episode psychotic patients, age of onset, lack of family support, longer duration of psychosis, levels of premorbid global functioning and education, negative and cognitive symptoms, addictions, depressive comorbidities and stigma plays an important role in school dropout. However, young adults have historically received less treatment than expected considering prevalence of mental illness at that age. In the last few decades, early intervention programs for psychosis have been developed all around the world in order to promote rehabilitation and prevent long-term disabilities. Early intervention programs focus on the special needs of young people and their families and engage in some form of assertive community treatment, which attempts to treat patients in the community rather than using inpatient services. For early intervention in psychosis programs, the goal is to keep patients engaged with treatment, prevent them from further psychotic episodes and hospitalizations and promote rehabilitation. The additional services of an early intervention program include staff specialized in psychosis treatment, family/group/individual counseling sessions, assertive

  2. MENTAL ILLNESS IN THE VIEW OF PSYCHOTIC INDIVIDUALS: THEIR LINES AND GRAPHIC REPRESENTATIONS

    Directory of Open Access Journals (Sweden)

    Danieli Gasparini

    2013-02-01

    Full Text Available Objetivo: conhecer os significados da doença mental para indivíduos com enfermidades psicóticas, internados em um hospital geral. Metodologia: estudo descritivo com abordagem qualitativa. Constituíram a amostra cinco pessoas. Foi utilizada entrevista semi-estruturada e representação gráfica para obtenção das informações. Os dados foram submetidos à análise do conteúdo, do tipo temática. Resultados e Discussão: os pesquisados se reportaram à doença mental, como resultado de castigos divinos e da feitiçaria; realidade carregada de sofrimento e dificuldades; fruto de perdas sofridas e de vivências da infância; algo difícil de explicar, carregado de estigma, incompreensão, descrédito e desqualificação; presença de sintomas; limitadora para as atividades cotidianas e incapacitante para o trabalho. Conclusão: conclui-se que há necessidade de intervenções que ultrapassem a redução e controle de sintomas, dirigindo um olhar para as relações do doente mental com família, trabalho e comunidade.

  3. Prevalence of Mental Illness among Homeless People in Hong Kong.

    Directory of Open Access Journals (Sweden)

    Larina Chi-Lap Yim

    Full Text Available This study examined the prevalence and correlates of mental illness in homeless people in Hong Kong and explored the barriers preventing their access to health care. Ninety-seven Cantonese-speaking Chinese who were homeless during the study period were selected at random from the records of the three organisations serving the homeless population. The response rate was 69%. Seventeen subjects could not give valid consent due to their poor mental state, so their responses were excluded from the data analysis. A psychiatrist administered the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I and the Mini -Mental State Examination. Consensus diagnoses for subjects who could not complete the SCID-I were established by three independent psychiatrists.The point prevalence of mental illness was 56%. Seventy-one percent of the subjects had a lifetime history of mental illness, 30% had a mood disorder, 25% had an alcohol use disorder, 25% had a substance use disorder, 10% had a psychotic disorder, 10% had an anxiety disorder and 6% had dementia. Forty-one percent of the subjects with mental illness had undergone a previous psychiatric assessment. Only 13% of the subjects with mental illness were receiving psychiatric care at the time of interview. The prevalence of psychotic disorders, dementia and the rate of under treatment are hugely underestimated, as a significant proportion (18% of the subjects initially selected were too ill to give consent to join the study.The low treatment rate and the presence of this severely ill and unreached group of homeless people reflect the fact that the current mode of service delivery is failing to support the most severely ill homeless individuals.

  4. Prevalence of Mental Illness among Homeless People in Hong Kong

    Science.gov (United States)

    Chan, Wai Chi; Lam, Marco Ho-Bun; Lim, Vivian Wai-Man

    2015-01-01

    Metholodogy This study examined the prevalence and correlates of mental illness in homeless people in Hong Kong and explored the barriers preventing their access to health care. Ninety-seven Cantonese-speaking Chinese who were homeless during the study period were selected at random from the records of the three organisations serving the homeless population. The response rate was 69%. Seventeen subjects could not give valid consent due to their poor mental state, so their responses were excluded from the data analysis. A psychiatrist administered the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I) and the Mini -Mental State Examination. Consensus diagnoses for subjects who could not complete the SCID-I were established by three independent psychiatrists. Findings The point prevalence of mental illness was 56%. Seventy-one percent of the subjects had a lifetime history of mental illness, 30% had a mood disorder, 25% had an alcohol use disorder, 25% had a substance use disorder, 10% had a psychotic disorder, 10% had an anxiety disorder and 6% had dementia. Forty-one percent of the subjects with mental illness had undergone a previous psychiatric assessment. Only 13% of the subjects with mental illness were receiving psychiatric care at the time of interview. The prevalence of psychotic disorders, dementia and the rate of under treatment are hugely underestimated, as a significant proportion (18%) of the subjects initially selected were too ill to give consent to join the study. Conclusion The low treatment rate and the presence of this severely ill and unreached group of homeless people reflect the fact that the current mode of service delivery is failing to support the most severely ill homeless individuals. PMID:26484889

  5. An update on the epigenetics of psychotic diseases and autism.

    Science.gov (United States)

    Abdolmaleky, Hamid Mostafavi; Zhou, Jin-Rong; Thiagalingam, Sam

    2015-01-01

    The examination of potential roles of epigenetic alterations in the pathogenesis of psychotic diseases have become an essential alternative in recent years as genetic studies alone are yet to uncover major gene(s) for psychosis. Here, we describe the current state of knowledge from the gene-specific and genome-wide studies of postmortem brain and blood cells indicating that aberrant DNA methylation, histone modifications and dysregulation of micro-RNAs are linked to the pathogenesis of mental diseases. There is also strong evidence supporting that all classes of psychiatric drugs modulate diverse features of the epigenome. While comprehensive environmental and genetic/epigenetic studies are uncovering the origins, and the key genes/pathways affected in psychotic diseases, characterizing the epigenetic effects of psychiatric drugs may help to design novel therapies in psychiatry.

  6. Narratives About Mental Illnesses in China: The Voices of Generation Y.

    Science.gov (United States)

    Tang, Lu; Bie, Bijie

    2016-01-01

    This study explores the cultured understanding of mental health and mental illnesses among members of Generation Y in China through a narrative approach. Five prominent narratives are identified through the analysis of stories about mental illnesses collected through semistructured interviews with college students. These five narratives feature the tragic genius, the psychotic criminal, the fragile victim, the antisocial recluse, and the homosexual. These narratives are gendered, in that women are the primary protagonists in the narrative about the fragile victim, while men are featured prominently in the narratives about the tragic genius, the psychotic criminal, and the antisocial recluse. Our study demonstrates that these narratives are based on, and will further reinforce, highly cultural-specific stereotypes and biases about mental illnesses in China. Theoretical and practical implications of this study are discussed.

  7. Role of social media and the Internet in pathways to care for adolescents and young adults with psychotic disorders and non-psychotic mood disorders.

    Science.gov (United States)

    Birnbaum, Michael L; Rizvi, Asra F; Confino, Jamie; Correll, Christoph U; Kane, John M

    2017-08-01

    Although psychosis often occurs during adolescence, there has been little research on how the ubiquitously used Internet and social media could impact pathways to care. We examined how youth with psychotic spectrum disorders (PSD) versus non-psychotic mood disorders (NPMD) use online resources in the early illness stages. Social media use and pathways to care data were collected using a semi-structured interview from 80 youth (PSD = 40 and NPMD = 40) aged 12-21 years within 2 years of symptom onset. A total of 97.5% of participants (mean age = 18.3 years) regularly used social media, spending approximately 2.6 ± 2.5 h per day online. There were 22.4% of our sample (PSD = 19.4%, NPMD = 25.0%, P = 0.56) who reported waiting to reach out for help believing that symptoms would disappear. A total of 76.5% (PSD = 67.5%, NPMD = 85.0%, P = 0.06) noticed social media habit changes during symptom emergence. Thirty per cent reported discussing their symptoms on social media (PSD = 22.5%, NPMD = 37.5%, P = 0.14). NPMD patients sought information most on how to stop symptoms (40.0% vs. 13.5%, P = 0.01), while PSD youth were more commonly interested in what caused their symptoms (21.6% vs. 15.0%, P = 0.45). More PSD patients (42.9% vs. 25.0%, P = 0.10) would prefer to receive mental health information via the Internet. Altogether, 63.6% (PSD = 64.9%, NPMD = 62.5%, P = 0.83) were amenable to clinicians proactively approaching them via social media during symptom emergence. A total of 74.3% (PSD = 78.4%, NPMD = 70.0%, P = 0.40) liked the idea of obtaining help/advice from professionals via social media. The Internet and social media provide an unparalleled opportunity to supplement and potentially transform early intervention services, and acceptance of this approach appears to be high. © 2015 Wiley Publishing Asia Pty Ltd.

  8. Cerebral correlates of psychotic syndromes in neurodegenerative diseases

    OpenAIRE

    Jellinger, Kurt A

    2012-01-01

    Abstract Psychosis has been recognized as a common feature in neurodegenerative diseases and a core feature of dementia that worsens most clinical courses. It includes hallucinations, delusions including paranoia, aggressive behaviour, apathy and other psychotic phenomena that occur in a wide range of degenerative disorders including Alzheimer?s disease, synucleinopathies (Parkinson?s disease, dementia with Lewy bodies), Huntington?s disease, frontotemporal degenerations, motoneuron and prion...

  9. [Psychotic parricide: clinical and analytic study of 16 cases].

    Science.gov (United States)

    Dakhlaoui, Olfa; Khémiri, Omar; Gaha, Nesrine; Ridha, Rym; Haffani, Fakhreddine

    2009-12-01

    The parricide is defined as "murder of the father or the mother or any other legitimate ascendant." It represents 1 to 5% of all homicides and 20 to 30% of psychotic homicides. In Tunisia, few studies have focused on this issue. We propose in this work to describe the profile of psychotic parricide. We tried to identify risk factors in order to prevent this acting out. Our study is retrospective we observed 16 male patients diagnosed with schizophrenia hospitalized between June 1979 and March 2008 in the forensic psychiatry department at the psychiatric hospital in Tunis, discharged for no ground for prosecution following parricide. They accounted for 20.8% of psychotic homicides hospitalized during the same period (16/77) and approximately 30% of homicides committed by schizophrenic patients. We found as many as patricide as matricide. The main factors that have emerged through our study are an early age (28 years), being single (70%), the socio-cultural poverty, unemployment, paranoid delusions, hallucinations and recent treatment interruption. All these factors have been cited by many authors including Millaud et al, they also cited history of violence and violent behavior and alcohol or drug abuse. One important point is that some signs of this imminent gesture are often present but misunderstood, such a sense of situational impasse, a request for help, or reluctance during interview. It is essential to identify risk factors, even to actively seek some warning signs, which often are not spontaneously reported by the psychotic patient. Hospitalization under constraint in psychiatry should be the appropriate response if these dangerousness signals are noticed by the psychiatrist.

  10. Self-Amputation in Two Non-Psychotic Patients.

    Science.gov (United States)

    Rahmanian, Hamid; Petrou, Nikoletta A; Sarfraz, M Aamer

    2015-09-01

    Self-amputation, the extreme form of self-mutilation, is uncommon. The vast majority of cases are associated with psychosis, with a small number being assigned the controversial diagnosis of body identity integrity disorder. In this article, we report two cases of non-psychotic self-amputation and their similarities with a view to highlighting the risk factors and formulating an appropriate management plan.

  11. Acute Psychotic Symptoms due to Benzydamine Hydrochloride Abuse with Alcohol

    Directory of Open Access Journals (Sweden)

    Yahya Ayhan Acar

    2014-01-01

    Full Text Available Benzydamine hydrochloride is a locally acting nonsteroidal anti-inflammatory drug. Benzydamine hydrochloride overdose can cause stimulation of central nervous system, hallucinations, and psychosis. We presented a young man with psychotic symptoms due to benzydamine hydrochloride abuse. He received a total dose of 1000 mg benzydamine hydrochloride with alcohol for its hallucinative effects. Misuse of benzydamine hydrochloride must be considered in differential diagnosis of first-episode psychosis and physicians should consider possibility of abuse in prescribing.

  12. Promoting Personal Recovery in People with Persisting Psychotic Disorders: Development and Pilot Study of a Novel Digital Intervention.

    Science.gov (United States)

    Thomas, Neil; Farhall, John; Foley, Fiona; Leitan, Nuwan Dominic; Villagonzalo, Kristi-Ann; Ladd, Emma; Nunan, Cassy; Farnan, Sue; Frankish, Rosalie; Smark, Tara; Rossell, Susan L; Sterling, Leon; Murray, Greg; Castle, David Jonathon; Kyrios, Michael

    2016-01-01

    For people with persisting psychotic disorders, personal recovery has become an important target of mental health services worldwide. Strongly influenced by mental health service consumer perspectives, personal recovery refers to being able to live a satisfying and contributing life irrespective of ongoing symptoms and disability. Contact with peers with shared lived experience is often cited as facilitative of recovery. We aimed to develop and pilot a novel recovery-based digitally supported intervention for people with a psychotic illness. We developed a website to be used on a tablet computer by mental health workers to structure therapeutic discussions about personal recovery. Central to the site was a series of video interviews of people with lived experience of psychosis discussing how they had navigated issues within their own recovery based on the Connectedness-Hope-Identity-Meaning-Empowerment model of recovery. We examined the feasibility and acceptability of an 8-session low intensity intervention using this site in 10 participants with persisting psychotic disorders and conducted a proof-of-concept analysis of outcomes. All 10 participants completed the full course of sessions, and it was possible to integrate use of the website into nearly all sessions. Participant feedback confirmed that use of the website was a feasible and acceptable way of working. All participants stated that they would recommend the intervention to others. Post-intervention, personal recovery measured by the Questionnaire for the Process of Recovery had improved by an average standardized effect of d  = 0.46, 95% CI [0.07, 0.84], and 8 of the 10 participants reported that their mental health had improved since taking part in the intervention. In-session use of digital resources featuring peer accounts of recovery is feasible and acceptable and shows promising outcomes. A randomized controlled trial is the next step in evaluating the efficacy of this low intensity intervention

  13. Does specific psychopathology predict development of psychosis in ultra high-risk (UHR) patients?

    Science.gov (United States)

    Thompson, Andrew; Nelson, Barnaby; Bruxner, Annie; O'Connor, Karen; Mossaheb, Nilufar; Simmons, Magenta B; Yung, Alison

    2013-04-01

    Studies have attempted to identify additional risk factors within the group identified as 'ultra high risk' (UHR) for developing psychotic disorders in order to characterise those at highest risk. However, these studies have often neglected clinical symptom types as additional risk factors. We aimed to investigate the relationship between baseline clinical psychotic or psychotic-like symptoms and the subsequent transition to a psychotic disorder in a UHR sample. A retrospective 'case-control' methodology was used. We identified all individuals from a UHR clinic who had subsequently developed a psychotic disorder (cases) and compared these to a random sample of individuals from the clinic who did not become psychotic within the sampling time frame (controls). The sample consisted of 120 patients (60 cases, 60 controls). An audit tool was used to identify clinical symptoms reported at entry to the clinic (baseline) using the clinical file. Diagnosis at transition was assessed using the Operational Criteria for Psychotic Illness (OPCRIT) computer program. The relationship between transition to a psychotic disorder and baseline symptoms was explored using survival analysis. Presence of thought disorder, any delusions and elevated mood significantly predicted transition to a psychotic disorder. When other symptoms were adjusted for, only the presence of elevated mood significantly predicted subsequent transition (hazard ratio 2.69, p = 0.002). Thought disorder was a predictor of transition to a schizophrenia-like psychotic disorder (hazard ratio 3.69, p = 0.008). Few individual clinical symptoms appear to be predictive of transition to a psychotic disorder in the UHR group. Clinicians should be cautious about the use of clinical profile alone in such individuals when determining who is at highest risk.

  14. Adult onset Hallervorden-Spatz disease with psychotic symptoms.

    Science.gov (United States)

    del Valle-López, Pilar; Pérez-García, Rosa; Sanguino-Andrés, Rosa; González-Pablos, Emilio

    2011-01-01

    Hallervorden-Spatz disease is a rare neurological disorder characterized by pyramidal and extrapyramidal manifestations, dysarthria and dementia. Its onset is usually in childhood and most patients have a fatal outcome in few years. A high percentage of cases are hereditary with a recessive autosomal pattern. In the majority of the patients reported, a mutation of the gene that encodes the pantothenate kinase (PANK2) located in the 20p13-p12.3 chromosome that causes iron storage in the basal ganglia of the brain has been found. Its diagnosis is based on clinical symptoms as well as specific MRI imaging findings. The most common psychiatric features are cognitive impairment as well as depressive symptoms. There are few documented cases with psychotic disorders. We present the case of a patient with late onset Hallervorden-Spatz disease and psychotic symptoms that preceded the development of neurological manifestations. The pathophysiology and the treatment of psychotic symptomatology are presented and discussed. Key words: Psicosis, Hallervorden-Spatz, late onset, Basal ganglia.

  15. Psychotic disorders in DSM-5 and ICD-11.

    Science.gov (United States)

    Biedermann, Falko; Fleischhacker, W Wolfgang

    2016-08-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published by the American Psychiatric Association (APA) in 2013, and the Work Group on the Classification of Psychotic disorders (WGPD), installed by the World Health Organization (WHO), is expected to publish the new chapter about schizophrenia and other primary psychotic disorders in 2017. We reviewed the available literature to summarize the major changes, innovations, and developments of both manuals. If available and possible, we outline the theoretical background behind these changes. Due to the fact that the development of ICD-11 has not yet been completed, the details about ICD-11 are still proposals under ongoing revision. In this ongoing process, they may be revised and therefore have to be seen as proposals. DSM-5 has eliminated schizophrenia subtypes and replaced them with a dimensional approach based on symptom assessments. ICD-11 will most likely go in a similar direction, as both manuals are planned to be more harmonized, although some differences will remain in details and the conceptual orientation. Next to these modifications, ICD-11 will provide a transsectional diagnostic criterion for schizoaffective disorders and a reorganization of acute and transient psychotic and delusional disorders. In this manuscript, we will compare the 2 classification systems.

  16. [Analysis of the Structure of Acute Psychotic Disorder].

    Science.gov (United States)

    Gerardo, Téllez R; Ricardo, Sánchez P; Luis, Eduardo Jaramillo

    2012-03-01

    Schizophrenia is a clinically heterogeneous disorder. A multifactorial structure of this syndrome has been described in previous reports. The aim of this study was to evaluate what are the possible diagnostic categories in patients having acute psychotic symptoms, studying their clinical characteristics in a cross-sectional study. An instrument for measuring psychotic symptoms was created using previous scales (SANS, SAPS, BPRS, EMUN, Zung depression scale). Using as criteria statistical indexes and redundance of items, the initial instrument having 101 items has been reduced to 57 items. 232 patients with acute psychotic symptoms, in most cases schizophrenia, attending Clínica Nuestra Señora de la Paz in Bogotá and Hospital San Juan de Dios in Chía have been evaluated from April, 2008 to December, 2009. Multivariate statistical methods have been used for analyzing data. A six-factor structure has been found (Deficit, paranoid-aggressive, disorganized, depressive, bizarre delusions, hallucinations). Cluster analysis showed eight subtypes that can be described as: 1) bizarre delusions-hallucinations; 2) deterioration and disorganized behavior; 3) deterioration; 4) deterioration and paranoid-aggressive behavior; 5) bizarre delusions; 6) paranoia-anxiety- aggressiveness; 7) depressive symptoms and bizarre delusions; 8) paranoia and aggressiveness with depressive symptoms These subtypes allow a more exhaustive characterization that those included in standard classification schemes and should be validated in longitudinal studies. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  17. Fluvoxamine monotherapy for psychotic depression: the potential role of sigma-1 receptors

    Directory of Open Access Journals (Sweden)

    Hashimoto Kenji

    2009-12-01

    Full Text Available Abstract Background Psychotic depression is a clinical subtype of major depressive disorder. A number of clinical studies have demonstrated the efficacy of the combination of an antidepressant (for example, a tricyclic antidepressant or selective serotonin reuptake inhibitor (SSRI and an atypical antipsychotic or electroconvulsive therapy in treating psychotic depression. In some cases, the clinician or patient may prefer to avoid antipsychotic drugs altogether because of the risk of extrapyramidal side effects (EPS in patients with psychotic depression treated with these drugs. Methods We report five cases where fluvoxamine monotherapy was effective in the patients with psychotic depression. Results The scores on the Hamilton Depression (HAM-D scale and the Brief Psychiatric Rating Scale (BPRS in the five patients with psychotic depression were reduced after fluvoxamine monotherapy. Conclusion Doctors should consider fluvoxamine monotherapy as an alternative approach in treating psychotic depression because it avoids the risk of EPS from antipsychotic drugs.

  18. Evidence That the Impact of Childhood Trauma on IQ Is Substantial in Controls, Moderate in Siblings, and Absent in Patients With Psychotic Disorder

    Science.gov (United States)

    Marsman, Anne; van Dam, Daniela; Simons, Claudia J. P.

    2017-01-01

    Abstract Research suggests that childhood trauma is associated with cognitive alterations, but it is not known whether the cognitive alterations observed in patients with psychotic disorder, and their relatives, is trauma-related. Patients with a schizophrenia-spectrum diagnosis (n = 1119), siblings of patients (n = 1059) and healthy comparison subjects (HCS; n = 586) were interviewed 3 times over a period of 6 years. Repeated measures of IQ were analyzed as a function of childhood trauma and group, controlling for confounders. There were significant differences in the impact of childhood trauma on IQ across the 3 groups. Exposure in HCS was associated with a nearly 5-point reduction in IQ (−4.85; 95% confidence interval [CI]: −7.98 to −1.73, P = .002), a lesser reduction in siblings (−2.58; 95% CI: −4.69 to −0.46, P = .017) and no significant reduction in patients (−0.84; 95% CI: −2.78 to 1.10, P = .398). One-fourth of the sibling-control difference in IQ was reducible to childhood trauma, whereas for patients this was only 5%. Over the 6-year follow-up, those with trauma exposure showed significantly less learning effects with repeated cognitive assessments (b = 1.36, 95% CI: 0.80‒1.92, P < .001) than the nonexposed (b = 2.31, 95% CI: 1.92‒2.71, P < .001; P interaction = .001). Although childhood trauma impacts cognitive ability and learning in non-ill people at low and high genetic risk, its effect on the observed cognitive alterations in psychotic disorder may be minor. Twin and family studies on cognitive alterations in psychotic disorder need to take into account the differential impact of trauma on cognition across ill and non-ill, at risk groups. PMID:28177077

  19. Secondary psychotic features in refugees diagnosed with post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Nygaard, Mette Kathrine; Sonne, Charlotte Kærgaard; Carlsson, Jessica

    2017-01-01

    at Competence Centre for Transcultural Psychiatry (CTP) were examined, and all the PTSD patients were divided into two groups; one group with secondary psychotic features (PTSD-SP group) and one without (PTSD group). A categorisation and description of the secondary psychotic features was undertaken. RESULTS......-SP prevalence in a clinical refugee population with PTSD. The study points to the difficulties distinguishing psychotic features from flashbacks and the authors call for attention to psychotic features in PTSD patients in order to improve documentation and understanding of the disorder....

  20. [Use of methadone in the treatment of psychotic patients with heroin dependence].

    Science.gov (United States)

    Walby, F A; Borg, P; Eikeseth, P H; Neegaard, E; Kjerpeseth, K; Bruvik, S; Waal, H

    2000-01-20

    Comorbidity of psychosis and substance abuse has gained increased attention for some time. However, pharmacological treatment for opioid dependence among psychotic patients is seldom described. We present the treatment of four opioid dependent psychotic patients with methadone and antipsychotic medication. Three of the four patients had initially a period of increased psychotic symptoms, but all four patients have shown marked improvement following the introduction of methadone. Compliance with treatment has increased, they have had enduring non-psychotic periods and a markedly reduced use of illegal substances. The results should obviously be interpreted with caution, given the small number of subjects. Further research is therefore important.

  1. Paliperidone palmitate once-monthly reduces risk of relapse of psychotic, depressive, and manic symptoms and maintains functioning in a double-blind, randomized study of schizoaffective disorder.

    Science.gov (United States)

    Fu, Dong-Jing; Turkoz, Ibrahim; Simonson, R Bruce; Walling, David P; Schooler, Nina R; Lindenmayer, Jean-Pierre; Canuso, Carla M; Alphs, Larry

    2015-03-01

    Schizoaffective disorder is a complex illness for which optimal treatment is not well established. Results of the first controlled, relapse-prevention study of paliperidone palmitate once-monthly injectable (paliperidone monthly) in schizoaffective disorder are presented. The study was conducted between September 20, 2010, and October 22, 2013. Patients with schizoaffective disorder (confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders) experiencing acute exacerbation of psychotic and depressive/manic symptoms were stabilized with paliperidone monthly as monotherapy or as adjunctive therapy to mood stabilizers or antidepressants and randomly assigned (1:1) to paliperidone monthly or placebo in a 15-month, double-blind, relapse-prevention phase. Randomization was stratified by administration as monotherapy or adjunctive therapy and by study center. The primary endpoint was time to relapse. 334 patients were evaluated. Paliperidone monthly significantly delayed time to relapse for psychotic, depressive, and manic symptoms compared with placebo (P schizoaffective disorder (5.9%, 3.0%), headache (3.5%, 5.5%), and nasopharyngitis (3.5%, 5.5%). Incidence of any extrapyramidal-related adverse event was 7.1% for placebo and 8.5% for paliperidone monthly. Paliperidone monthly as monotherapy or adjunctive therapy significantly delayed psychotic, depressive, and/or manic relapses; reduced their risk; and better maintained functioning in patients with schizoaffective disorder. Results support the value of maintenance treatment with paliperidone monthly in schizoaffective disorder. ClinicalTrials.gov identifier: NCT01193153. © Copyright 2015 Physicians Postgraduate Press, Inc.

  2. The serotonin transporter 5-HTTPR polymorphism is associated with current and lifetime depression in persons with chronic psychotic disorders.

    Science.gov (United States)

    Contreras, J; Hare, L; Camarena, B; Glahn, D; Dassori, A; Medina, R; Contreras, S; Ramirez, M; Armas, R; Munoz, R; Mendoza, R; Raventos, H; Ontiveros, A; Nicolini, H; Palmer, R; Escamilla, M

    2009-02-01

    Variation in the serotonin transporter gene (SLC6A4) promoter region has been shown to influence depression in persons who have been exposed to a number of stressful life events. We evaluated whether genetic variation in 5-HTTLPR, influences current depression, lifetime history of depression and quantitative measures of depression in persons with chronic psychotic disorders. This is an association study of a genetic variant with quantitative and categorical definitions of depression conducted in the southwest US, Mexico and Costa Rica. We analyzed 260 subjects with a history of psychosis, from a sample of 129 families. We found that persons carrying at least one short allele had a statistically significant increased lifetime risk for depressive syndromes (P depression during the course of their illness.

  3. Environmental pollution and risk of psychotic disorders: A review of the science to date.

    Science.gov (United States)

    Attademo, Luigi; Bernardini, Francesco; Garinella, Raffaele; Compton, Michael T

    2017-03-01

    Environmental pollution is a global problem with diverse and substantial public health implications. Although many environmental (i.e., non-genetic) risk factors for schizophrenia and other psychotic disorders have been identified, there has been comparatively little research on pollution as a possible risk factor. This is despite the fact that gene-by-environment interactions and epigenetic mechanisms are now recognized as likely facets of the etiology of schizophrenia, and the fact that pollution could potentially mediate the association between urban birth/upbringing and elevated risk. We conducted a review of the literature to date in order to summarize and synthesize work in this area. We identified 13 research reports and 16 review articles. Based on the extant knowledge in this area and what is known about the pathophysiology of schizophrenia, it is feasible that exposure to xenobiotic heavy metals such as lead and cadmium, constituents of air pollution such as particulate matter and nitrogen and sulfur oxides, organic solvents, and other constituents of environmental pollution could be component causes. Further research-from the cellular to epidemiological levels-is clearly needed. If causation is proven, enhancements of policy intended to reduce human exposure to environmental pollution could reduce the burden of schizophrenia and possibly other mental illnesses. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Concordance of child self-reported psychotic experiences with interview- and observer-based psychotic experiences

    DEFF Research Database (Denmark)

    Gundersen, Steffie V; Goodman, Robert; Clemmensen, Lars

    2018-01-01

    the online PE-section of DAWBA and the following face-to-face interview and assessment of PE. The DAWBA-PE-section asks the child 10 questions covering auditory and visual hallucinations, delusional ideas and subjective thought disturbances ever in life; and attributions to sleep, fever, illness or drug....... The current study aimed to investigate the concurrent validity of DAWBA-based self-reported PE (PE-S) with regard to interview-based measures of PE (PE-I). METHODS: Participants were 1571 (47.8% male) children of age 11 to 12 years from the Copenhagen Child Cohort 2000 (CCC2000) with complete data from both...... intake. The interview-based assessment of PE was performed by trained professionals using 22 items from The Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (KSADS-PL). The two assessments were completed independently. RESULTS: The prevalence of PE...

  5. Differences in suicide and death ideation among veterans and nonveterans with serious mental illness.

    Science.gov (United States)

    Jahn, Danielle R; Muralidharan, Anjana; Drapalski, Amy L; Brown, Clayton H; Fang, Li Juan; Lucksted, Alicia

    2018-02-01

    Individuals with serious mental illness and veterans are two populations at elevated risk for suicide; however, research has not examined whether veterans with serious mental illness may be at higher suicide risk than nonveterans with serious mental illness. Additionally, overlapping risk factors for suicide in these populations may account for differences in suicide-related outcomes between these groups. Therefore, the aim of this study was to identify differences in death ideation and suicide ideation among veterans and nonveterans with serious mental illness. We also aimed to explore these effects after adjusting for potentially shared risk factors. We found that veterans with serious mental illness reported death ideation and suicide ideation more than twice as often as nonveterans with serious mental illness. After adjusting for demographic, psychiatric, and theory-driven risk factors, the effect of veteran status on death ideation remained significant, though the effect on suicide ideation was no longer significant. Depressive and psychotic symptoms were significant predictors of death ideation; depressive symptoms and hostility were significant predictors of suicide ideation. Clinicians should particularly monitor death ideation and suicide ideation in veterans with serious mental illness, as well as associated clinical risk factors such as depression, psychotic symptoms, and hostility. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  6. Mental Illness Statistics

    Science.gov (United States)

    ... News & Events About Us Home > Health Information Share Statistics Research shows that mental illnesses are common in ... of mental illnesses, such as suicide and disability. Statistics Top ı cs Mental Illness Any Anxiety Disorder ...

  7. Ethnic variations in psychotic disorders in the criminal justice system: A systematic review

    NARCIS (Netherlands)

    Denzel, A.D.; van Esch, A.Y.M.; Harte, J.M.; Scherder, E.J.A.

    2016-01-01

    Objective To explore the relationship between ethnicity, psychotic disorders and criminal behavior by investigating differences in prevalence rates of psychotic disorders between detainees from Black and minority ethnic (BME) groups and non-BME detainees. Method A systematic review of all empirical

  8. Semi-metric analysis of the functional brain network: Relationship with familial risk for psychotic disorder

    Directory of Open Access Journals (Sweden)

    Sanne Peeters

    2015-01-01

    Discussion: The results are suggestive of more dispersed network communication in patients with psychotic disorder, with some evidence for trait-based network alterations in high-schizotypy individuals. Dispersed communication may contribute to the clinical phenotype in psychotic disorder. In addition, higher SMP may contribute to neuro- and social cognition, independent of psychosis risk.

  9. The fragmented self : imbalance between intrinsic and extrinsic self-networks in psychotic disorders

    NARCIS (Netherlands)

    Ebisch, Sjoerd J. H.; Aleman, Andre

    Self-disturbances are among the core features of schizophrenia and related psychotic disorders. The basic structure of the self could depend on the balance between intrinsic and extrinsic self-processing. We discuss studies on self-related processing in psychotic disorders that provide converging

  10. Psychotic symptoms in refugees diagnosed with PTSD: a series of case reports

    DEFF Research Database (Denmark)

    Nørredam, Marie Louise; Ekstrøm, Morten; Jensen, Mette

    2011-01-01

    BACKGROUND: In our clinical work, we treat refugees who have been exposed to trauma and who subsequently develop psychotic symptoms. However, the literature does not address the relationship between refugees with depression, post-traumatic stress disorder (PTSD) and psychotic symptoms. Therefore...

  11. Psychotic symptoms in refugees diagnosed with PTSD: a series of case reports

    DEFF Research Database (Denmark)

    Norredam, Marie; Jensen, Mette; Ekstrøm, Morten

    2011-01-01

    In our clinical work, we treat refugees who have been exposed to trauma and who subsequently develop psychotic symptoms. However, the literature does not address the relationship between refugees with depression, post-traumatic stress disorder (PTSD) and psychotic symptoms. Therefore the aim...

  12. Brief Report: Major Depressive Disorder with Psychotic Features in Williams Syndrome--A Case Series

    Science.gov (United States)

    Valdes, Francisca; Keary, Christopher J.; Mullett, Jennifer E.; Palumbo, Michelle L.; Waxler, Jessica L.; Pober, Barbara R.; McDougle, Christopher J.

    2018-01-01

    Descriptions of individuals with Williams syndrome (WS) and co-morbid major depressive disorder (MDD) with psychotic features have not appeared in the literature. In addition to reviewing previous reports of psychotic symptoms in persons with WS, this paper introduces clinical histories and therapeutic management strategies for three previously…

  13. Psychotic reactions to daily life stress and dopamine function in people with severe hearing impairment

    NARCIS (Netherlands)

    Gevonden, M. J.; Myin-Germeys, I.; van den Brink, W.; van Os, J.; Selten, J. P.; Booij, J.

    2015-01-01

    Minor stresses measured in daily life have repeatedly been associated with increased momentary psychotic experiences, both in individuals with psychotic disorders and in persons who are genetically at an increased risk for these disorders. Severe hearing impairment (SHI) is an environmental risk

  14. Aberrant salience, self-concept clarity, and interview-rated psychotic-like experiences.

    Science.gov (United States)

    Cicero, David C; Docherty, Anna R; Becker, Theresa M; Martin, Elizabeth A; Kerns, John G

    2015-02-01

    Many social-cognitive models of psychotic-like symptoms posit a role for self-concept and aberrant salience. Previous work has shown that the interaction between aberrant salience and self-concept clarity is associated with self-reported psychotic-like experiences. In the current research with two structured interviews, the interaction between aberrant salience and self-concept clarity was found to be associated with interview-rated psychotic-like experiences. The interaction was associated with psychotic-like experiences composite scores, delusional ideation, grandiosity, and perceptual anomalies. In all cases, self-concept clarity was negatively associated with psychotic-like experiences at high levels of aberrant salience, but unassociated with psychotic-like experiences at low levels of aberrant salience. The interaction was specific to positive psychotic-like experiences and not present for negative or disorganized ratings. The interaction was not mediated by self-esteem levels. These results provide further evidence that aberrant salience and self-concept clarity play an important role in the generation of psychotic-like experiences.

  15. Obesity and psychotic disorders: uncovering common mechanisms through metabolomics

    Directory of Open Access Journals (Sweden)

    Matej Orešič

    2012-09-01

    Full Text Available Primary obesity and psychotic disorders are similar with respect to the associated changes in energy balance and co-morbidities, including metabolic syndrome. Such similarities do not necessarily demonstrate causal links, but instead suggest that specific causes of and metabolic disturbances associated with obesity play a pathogenic role in the development of co-morbid disorders, potentially even before obesity develops. Metabolomics – the systematic study of metabolites, which are small molecules generated by the process of metabolism – has been important in elucidating the pathways underlying obesity-associated co-morbidities. This review covers how recent metabolomic studies have advanced biomarker discovery and the elucidation of mechanisms underlying obesity and its co-morbidities, with a specific focus on metabolic syndrome and psychotic disorders. The importance of identifying metabolic markers of disease-associated intermediate phenotypes – traits modulated but not encoded by the DNA sequence – is emphasized. Such markers would be applicable as diagnostic tools in a personalized healthcare setting and might also open up novel therapeutic avenues.

  16. Using biological indices to classify schizophrenia and other psychotic patients.

    Science.gov (United States)

    Sponheim, S R; Iacono, W G; Thuras, P D; Beiser, M

    2001-07-01

    Although classification of mental disorders using more than clinical description would be desirable, there is scant evidence that available laboratory tests (i.e. biological indices) would provide more valid classifications than current diagnostic systems (e.g. DSM-IV). We used cluster analysis of four biological variables to classify 163 psychotic patients and 83 nonpsychiatric comparison subjects. Analyses revealed a three-cluster solution with the first cluster reflecting electrodermal deviance, the second cluster representing nondeviant biological function, and the third cluster reflecting increased nailfold plexus visibility and ocular motor dysfunction. To assess the construct validity of proband clusters we examined ocular motor performance in 156 first-degree relatives as a function of proband cluster membership. First-degree relatives of third cluster probands exhibited worse ocular motor performance than relatives of other cluster probands. Additionally, better classification sensitivity and specificity were obtained for the relatives when they were grouped by proband cluster than by proband DSM-IV diagnosis. When a single proband characteristic (i.e. eyetracking performance) was used to group relatives, classification sensitivity and specificity failed to significantly increase over grouping by proband DSM-IV diagnosis. Multivariate biologically defined clusters may offer an advantage over DSM-IV classification when examining nosology and etiology of psychotic disorders.

  17. Psychotic Experiences and Overhasty Inferences Are Related to Maladaptive Learning.

    Directory of Open Access Journals (Sweden)

    Heiner Stuke

    2017-01-01

    Full Text Available Theoretical accounts suggest that an alteration in the brain's learning mechanisms might lead to overhasty inferences, resulting in psychotic symptoms. Here, we sought to elucidate the suggested link between maladaptive learning and psychosis. Ninety-eight healthy individuals with varying degrees of delusional ideation and hallucinatory experiences performed a probabilistic reasoning task that allowed us to quantify overhasty inferences. Replicating previous results, we found a relationship between psychotic experiences and overhasty inferences during probabilistic reasoning. Computational modelling revealed that the behavioral data was best explained by a novel computational learning model that formalizes the adaptiveness of learning by a non-linear distortion of prediction error processing, where an increased non-linearity implies a growing resilience against learning from surprising and thus unreliable information (large prediction errors. Most importantly, a decreased adaptiveness of learning predicted delusional ideation and hallucinatory experiences. Our current findings provide a formal description of the computational mechanisms underlying overhasty inferences, thereby empirically substantiating theories that link psychosis to maladaptive learning.

  18. The Assessment of Comunication and Interaction Skills in Psychotic Patiens

    Directory of Open Access Journals (Sweden)

    Katayoun Khoushabi

    2002-10-01

    Full Text Available Objective: The main objective at study was to assess the communication and interaction of psychotic patient above age of 18 in 2000. Materials & Methods: The study sample consist of 80 psychotic patients (38 female and 42 male from Razi and Imam Hossein Hospital and Raad and Sina outpatient clinic, selected based on occupational therapist using the Assessment of Communication and Interaction Skills Questionnaire (ACIS. Statistical analyses of information have done by spearman coefficient correlation, Mann Whitney and Wilcoxon tests. Results: Spearman of correlation, mann-and wilcoxon Findings indicate: 1-The average grade of ACIS test in the group of schizophrenic patients were significantly lower than the group schizoaffective patients (P<0.00l. 2-The average of ACIS test in the group of inpatient was lower than the group of outpatient (p<0.00l. 3-No significant difference was found for the average grade of ACIS test in the group of male & female. Conclusion: The obtained results show the weakness of communication and interaction skills in schizophrenic patient and also inpatients. The obtained results of this investigation give useful information about the communication and interaction skill of patient to the occupational therapists but application of this instrument needs more studies.

  19. [Psychotic disorder induced by Fahr's syndrome: a case report].

    Science.gov (United States)

    El Hechmi, S; Bouhlel, S; Melki, W; El Hechmi, Z

    2014-06-01

    Fahr's syndrome is a rare disorder characterized by abnormal deposits of calcium in areas of the brain that control movement, including the basal ganglia and the cerebral cortex associated with many neurological and psychiatric abnormalities such as a rigid hypokinetic syndrome, mood disorders and cognitive impairment. Fahr's syndrome is secondary to some disorders, such as hypoparathyroidism. We report the case of a 56 year-old man, with a history of cataract, who was admitted to our psychiatric hospital for the first time in his life because of psychotic symptoms associated with irritability and aggressiveness. Since the age of 38 the patient had become nervous, 10 years later he developed tonic-clonic seizures. Two months ago, he began expressing delusions of persecution against his wife and sons and making fugues. According to his family during this period, he was agitated, aggressive, and suffered from insomnia and anorexia. The general and psychiatric examination showed an upright and bronzed patient with neglected hygiene. He was indifferent to his environment and expressed poor mimics and gestures. He was anxious, suspicious and not very talkative. He was conscious but his attention was slightly decreased. Moreover, he was not aware of his problems. The neurological examination showed extrapyramidal syndrome with postural tremor and cerebellar ataxia. A cranial computed tomography brain scan found bilateral, symmetric basal ganglia calcifications, in favour of Fahr's syndrome. Phosphocalcic investigations revealed low concentration of serum calcium at 1.01mmol/L (normal 2.15 to 2.57mmol/L) and hyperphosphoremia at 2.69mmol/L (normal 0.81 to 1.55mmol/L). He also had low concentrations of 25-OH vitamin as well as decreased urinary levels of phosphate and calcium. The blood level of parathyroid hormone was 0ng/L. The diagnosis of Fahr's syndrome, revealing a hypoparathyroidism was posed. He was supplemented with calcium and alpha cholecalciferol and treated

  20. Sibutramine-associated psychotic symptoms and zolpidem-induced complex behaviours: implications for patient safety.

    Science.gov (United States)

    Wiglusz, Mariusz S; Cubała, Wiesław Jerzy; Nowak, Paweł; Jakuszkowiak-Wojten, Katarzyna; Landowski, Jerzy; Krysta, Krzysztof

    2013-09-01

    Sibutramine is a weight loss agent recently withdrawn from the European market due to cardiovascular risk concerns. It was used for long-term obesity treatment. Zolpidem is a short acting hypnotic agent commonly used in the treatment of insomnia. A number of case reports describing psychotic reaction to sibutramine were reported in the literature. We present a case of a 61-year-old Caucasian woman who developed two psychotic episodes related to sibutramine treatment. The second psychotic episode was complicated with complex behaviours after zolpidem use due to insomnia. Sibutramine and zolpidem discontinuation resulted in rapid resolution of psychotic symptoms. This case suggests a possibility of incidence of psychotic symptoms and complex behaviour disturbances in patients prescribed sibutramine or other monoaminergic reuptake inhibitors.

  1. Hippocampal Volume Is Reduced in Schizophrenia and Schizoaffective Disorder But Not in Psychotic Bipolar I Disorder Demonstrated by Both Manual Tracing and Automated Parcellation (FreeSurfer)

    Science.gov (United States)

    Arnold, Sara J. M.; Ivleva, Elena I.; Gopal, Tejas A.; Reddy, Anil P.; Jeon-Slaughter, Haekyung; Sacco, Carolyn B.; Francis, Alan N.; Tandon, Neeraj; Bidesi, Anup S.; Witte, Bradley; Poudyal, Gaurav; Pearlson, Godfrey D.; Sweeney, John A.; Clementz, Brett A.; Keshavan, Matcheri S.; Tamminga, Carol A.

    2015-01-01

    This study examined hippocampal volume as a putative biomarker for psychotic illness in the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) psychosis sample, contrasting manual tracing and semiautomated (FreeSurfer) region-of-interest outcomes. The study sample (n = 596) included probands with schizophrenia (SZ, n = 71), schizoaffective disorder (SAD, n = 70), and psychotic bipolar I disorder (BDP, n = 86); their first-degree relatives (SZ-Rel, n = 74; SAD-Rel, n = 62; BDP-Rel, n = 88); and healthy controls (HC, n = 145). Hippocampal volumes were derived from 3Tesla T1-weighted MPRAGE images using manual tracing/3DSlicer3.6.3 and semiautomated parcellation/FreeSurfer5.1,64bit. Volumetric outcomes from both methodologies were contrasted in HC and probands and relatives across the 3 diagnoses, using mixed-effect regression models (SAS9.3 Proc MIXED); Pearson correlations between manual tracing and FreeSurfer outcomes were computed. SZ (P = .0007–.02) and SAD (P = .003–.14) had lower hippocampal volumes compared with HC, whereas BDP showed normal volumes bilaterally (P = .18–.55). All relative groups had hippocampal volumes not different from controls (P = .12–.97) and higher than those observed in probands (P = .003–.09), except for FreeSurfer measures in bipolar probands vs relatives (P = .64–.99). Outcomes from manual tracing and FreeSurfer showed direct, moderate to strong, correlations (r = .51–.73, P schizoaffective disorder, but not for psychotic bipolar I disorder, and may reflect a cumulative effect of divergent primary disease processes and/or lifetime medication use. Manual tracing and semiautomated parcellation regional volumetric approaches may provide useful outcomes for defining measurable biomarkers underlying severe mental illness. PMID:24557771

  2. Comorbidity of chronic somatic diseases in patients with psychotic disorders and their influence on 4-year outcomes of integrated care treatment (ACCESS II study).

    Science.gov (United States)

    Lambert, Martin; Ruppelt, Friederike; Siem, Anna-Katharina; Rohenkohl, Anja Christine; Kraft, Vivien; Luedecke, Daniel; Sengutta, Mary; Schröter, Romy; Daubmann, Anne; Correll, Christoph U; Gallinat, Jürgen; Karow, Anne; Wiedemann, Klaus; Schöttle, Daniel

    2018-03-01

    People with psychotic disorders fulfilling criteria of a severe and persistent mental illness (SPMI) display a high risk of somatic comorbidity (SC). ACCESS II is a prospective, long-term study examining the effectiveness of Integrated Care for people with psychotic disorders fulfilling SPMI criteria. Chronic comorbid somatic disorders were systematically assessed according to ICD-10-GM criteria. Patients treated for ≥4years in ACCESS were categorized as early psychosis (treatment: ≤2years) or non-early psychosis (treatment: >2years) patients. Of 187 patients treated in ACCESS for ≥4years (mean age=41.8years, males=44.4%), 145 (77.5%) had SC, (mean=2.1±2.1). Overall, 55 different diseases from 15 different ICD-10-GM disease areas were identified. Prevalence of ≥1 SC (p=0.09) and specific types of SC (p=0.08-1.00) did not differ between early and non-early psychosis patients, but non-early psychosis patients had a higher mean number of SC (2.3±2.2 vs. 1.3±1.3, p=0.002). SC patients had higher rates of comorbid mental disorders (93% vs. 81%, p=0.002), specifically posttraumatic stress disorder (23% vs. 7%, p=0.002), and suicide attempts (43% vs. 19%, p<0.001). At the 4-year endpoint, both patients with and without comorbidity displayed major improvements in psychopathology, severity of illness, functioning, quality of life and satisfaction with care. SC is frequent in patients with severe psychotic disorders, even in the early psychosis phase. The magnitude of the problem underlines the need for regular screening, comprehensive assessment, preventive pharmacotherapy, and targeted SC management. Copyright © 2017. Published by Elsevier B.V.

  3. Bullying Mediates Between Attention-Deficit/Hyperactivity Disorder in Childhood and Psychotic Experiences in Early Adolescence.

    Science.gov (United States)

    Hennig, Timo; Jaya, Edo S; Lincoln, Tania M

    2017-09-01

    Although a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) is known to be linked to psychotic experiences and psychotic disorders in later life, the developmental trajectories that could explain this association are unknown. Using a sample from the prospective population-based Avon Longitudinal Study of Parents and Children (ALSPAC) (N = 8247), we hypothesized that the previously reported association of ADHD combined subtype in childhood and psychotic experiences in early adolescence is mediated by traumatic events and by involvement in bullying. Moreover, we expected this mediation to be specific to ADHD and tested this by comparison with specific phobia. Children with ADHD combined subtype at age 7 were more often involved in bullying at age 10 (OR 3.635, 95% CI 1.973-6.697) and had more psychotic experiences at age 12 (OR 3.362, 95% CI 1.781-6.348). Moreover, children who were involved in bullying had more psychotic experiences (2.005, 95% CI 1.684-2.388). Bullying was a significant mediator between ADHD and psychotic experiences accounting for 41%-50% of the effect. Traumatic events from birth to age 11 were also significantly associated with ADHD combined subtype and psychotic experiences; however, there was no evidence of mediation. Specific phobia was significantly associated with psychotic experiences, but not with bullying. To conclude, bullying is a relevant translating mechanism from ADHD in childhood to psychotic experiences in early adolescence. Interventions that eliminate bullying in children with ADHD could potentially reduce the risk of having psychotic experiences in later life by up to 50%. Clinicians should thus screen for bullying in routine assessments of children with ADHD. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  4. Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies.

    LENUS (Irish Health Repository)

    Kelleher, I

    2012-09-01

    Psychotic symptoms occur more frequently in the general population than psychotic disorder and index risk for psychopathology. Multiple studies have reported on the prevalence of these symptoms using self-report questionnaires or clinical interviews but there is a lack of consensus about the prevalence of psychotic symptoms among children and adolescents.

  5. Causal Beliefs and Effects upon Mental Illness Identification Among Chinese Immigrant Relatives of Individuals with Psychosis.

    Science.gov (United States)

    Yang, Lawrence H; Wonpat-Borja, Ahtoy J

    2012-08-01

    Identifying factors that facilitate treatment for psychotic disorders among Chinese-immigrants is crucial due to delayed treatment use. Identifying causal beliefs held by relatives that might predict identification of 'mental illness' as opposed to other 'indigenous labels' may promote more effective mental health service use. We examine what effects beliefs of 'physical causes' and other non-biomedical causal beliefs ('general social causes', and 'indigenous Chinese beliefs' or culture-specific epistemologies of illness) might have on mental illness identification. Forty-nine relatives of Chinese-immigrant consumers with psychosis were sampled. Higher endorsement of 'physical causes' was associated with mental illness labeling. However among the non-biomedical causal beliefs, 'general social causes' demonstrated no relationship with mental illness identification, while endorsement of 'indigenous Chinese beliefs' showed a negative relationship. Effective treatment- and community-based psychoeducation, in addition to emphasizing biomedical models, might integrate indigenous Chinese epistemologies of illness to facilitate rapid identification of psychotic disorders and promote treatment use.

  6. Fear of acquired immunodeficiency syndrome and fear of other illness in suicide

    DEFF Research Database (Denmark)

    Aro, A R; Jallinoja, P T; Henriksson, M M

    1994-01-01

    Suicide victims with fear of acquired immunodeficiency syndrome (AIDS) or other somatic illness were compared for psychosocial and health-related characteristics, triggers and content of fear. Fear of AIDS cases (n = 28), 2% of the 1-year Finnish suicide population (n = 1397), were younger...... and fewer had serious somatic disease (32% vs 64%) compared with cases of fear of other somatic illness. Both groups had more depression, especially major depression (54% and 61% vs 26%), more psychotic disorders (50% and 32% vs 24%) and health care contacts during their final week (61% and 64% vs 36%) than...... other suicides. Suicidal fear of AIDS calls for evaluation of sexual and other risk behaviour, but fear of AIDS was largely generated by the extensive media coverage. Fear of other somatic illness was more diverse in origin and related to illness experiences. Suicidal fear of illness calls...

  7. [Relationship of insight with depression and suicidal ideation in psychotic disorders].

    Science.gov (United States)

    Patelaros, E; Zournatzis, E; Kontstantakopoulos, G

    2015-01-01

    The associations of insight into psychosis (i.e., awareness of illness) with clinical variables have been examined by a great number of studies. Most of these studies revealed that the level of insight is negatively correlated with psychotic symptoms but positively correlated with depression and suicidal ideation. The aim of this study was to test these findings in a Greek sample of patients. Forty-three outpatients (30 men and 13 women) with schizophrenia or delusional disorder being followed up at the Mental Health Centre of Kavala took part in the study. Patients with bipolar or schizoaffective disorder were excluded. Patients' mean age was 40.7 years and the mean duration of illness was 18.67 years. All participants were under treatment and clinically stable at the time of the study. We used the Positive and Negative Syndrome Scale (PANSS) for the assessment of positive and negative symptoms, the Schedule for the Assessment of Insight-Expanded (SAI-E) to assess the insight into psychosis, and the Montgomery-Asberg Depression Rating Scale (MADRS) for the evaluation of depression recording separately the score for item 10 as an estimate of suicidal ideation. All the scales used have been adapted to Greek population. We used Spearman rho coefficient to assess the strength of correlations between the scales because the distributions of some scores were not normal. In order to assess the predictive value of insight for depression and suicidal ideation, we used hierarchical linear regression analysis. Correlation coefficients between SAI-E and the clinical scales of psychopathology, depression and suicide ideation was statistically significant at the pregression analysis showed that our model of positive and negative psychopathology and insight explained 47.4% of the variance of depression and 32.2% of the variance of suicidal ideation. The predictive value of insight was critically important, because only after the introduction of the SAI-E score in the analysis our

  8. The cumulative load of depressive illness is associated with cognitive function in the remitted state of unipolar depressive disorder

    DEFF Research Database (Denmark)

    Hasselbalch, BJ; Knorr, U; Hasselbalch, S G

    2013-01-01

    OBJECTIVE: To investigate whether the cumulative number, duration and subtypes (severity and presence of psychotic features) of previous episodes of depression in patients with unipolar depressive disorder in a remitted state are associated with decreased global cognitive function. METHODS: Via...... with the Cambridge Cognitive Examination (CAMCOG), which provides a composite measure of global cognitive function. RESULTS: A total of 88 patients and 50 controls accepted our invitation to participate, fulfilled the selection criteria and were included in the study. The cumulative duration of depressive episodes...... episodes with psychotic features, respectively. CONCLUSION: Our findings suggest that cognitive dysfunction is associated with the cumulative duration of depressive episodes, and that, in particular, depressive episodes with psychotic features in the course of illness may be a significant predictor...

  9. Exposure to stressful life events during pregnancy predicts psychotic experiences via behaviour problems in childhood.

    Science.gov (United States)

    Betts, Kim S; Williams, Gail M; Najman, Jakob M; Scott, James; Alati, Rosa

    2014-12-01

    Exposure to stressful life events during pregnancy has been associated with later schizophrenia in offspring. We explore how prenatal stress and neurodevelopmental abnormalities in childhood associate to increase the risk of later psychotic experiences. Participants from the Mater University Study of Pregnancy (MUSP), an Australian based, pre-birth cohort study were examined for lifetime DSM-IV positive psychotic experiences at 21 years by a semi-structured interview (n = 2227). Structural equation modelling suggested psychotic experiences were best represented with a bifactor model including a general psychosis factor and two group factors. We tested for an association between prenatal stressful life events with the psychotic experiences, and examined for potential moderation and mediation by behaviour problems and cognitive ability in childhood. Prenatal stressful life events predicted psychotic experiences indirectly via behaviour problems at child age five years, and this relationship was not confounded by maternal stressful life events at child age five. We found no statistical evidence for an interaction between prenatal stressful life events and behaviour problems or cognitive ability. The measurable effect of prenatal stressful life events on later psychotic experiences in offspring manifested as behaviour problems by age 5. By identifying early abnormal behavioural development as an intermediary, this finding further confirms the role of prenatal stress to later psychotic disorders. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Borderline personality pathology in young people at ultra high risk of developing a psychotic disorder.

    Science.gov (United States)

    Ryan, Jaymee; Graham, Anne; Nelson, Barnaby; Yung, Alison

    2017-06-01

    The association between borderline personality disorder and the ultra high risk (UHR) for psychosis state is unclear. The following study aimed to investigate the type of attenuated psychotic symptoms and prevalence of borderline personality pathology in a sample of UHR young people. Additionally, the study aimed to explore whether borderline personality pathology influenced the transition rate to psychosis. Medical records from Orygen Youth Health between 2007 and 2009 were examined. There were 180 patients who met UHR criteria and were included for analysis. Most patients were females (62.8%) and age ranged from 15 to 24 years. A quarter (25.2%) of UHR patients endorsed items consistent with borderline personality pathology. UHR patients with borderline personality pathology experienced a range of attenuated psychotic symptoms and could not be statistically differentiated from UHR patients with less significant or without borderline personality pathology. Borderline personality pathology did not increase or decrease the risk of developing a psychotic disorder. The absence of depression was the only predictor of psychosis. Many UHR patients present with concurrent borderline personality features. The psychotic experiences reported by UHR patients with borderline personality features were not limited to paranoid ideation, supporting the idea that borderline personality disorder may include a wider range of psychotic symptoms than previously thought. It is further possible that the psychotic symptoms experienced in this group could also be indicative of an emerging psychotic disorder. © 2015 Wiley Publishing Asia Pty Ltd.

  11. Assessment of Sexual Fantasies in Psychiatric Inpatients With Mood and Psychotic Disorders and Comorbid Personality Disorder Traits.

    Science.gov (United States)

    Colón Vilar, Giancarlo; Concepción, Erika; Galynker, Igor; Tanis, Thachell; Ardalan, Firouz; Yaseen, Zimri; Cohen, Lisa J

    2016-02-01

    Sexuality is an important aspect of quality of life and sexual fantasies comprise a normal part of human sexuality. However, the nature of sexuality and sexual fantasies of patients with mental illness remains an understudied area. To investigate the nature and frequency of sexual fantasies in psychiatric patients, the present study compared the frequency of four types of sexual fantasies across four different mood and psychotic diagnoses and three personality disorder clusters. Study participants included 133 psychiatric inpatients recruited from an urban hospital. Sexual fantasies were compared across patients with schizophrenia, bipolar disorder, schizoaffective disorder, major depressive disorder and three nonclinical samples from the literature and then correlated with personality cluster scores. Subjects were administered the Structured Clinical Interview for DSM-IV for Axis I and for Axis II Disorders. Sexual fantasies were assessed by the Wilson Sexual Fantasies Questionnaire, which measures four types of sexual fantasies (exploratory, intimate, impersonal, and sadomasochistic). Within the entire sample, there were significant differences across sexual fantasy types, with subjects scoring highest on intimate sexual fantasies and then exploratory, impersonal, and sadomasochistic. There were no significant differences across mood and psychotic diagnostic groups for any of the sexual fantasy scales and the scores were within the normative range of nonclinical samples. Patients with high cluster B scores scored significantly higher on all four fantasy scales than those without. Patients with high cluster A scores scored lower on intimate fantasies, but there was no association between cluster C scores and sexual fantasies. The association between cluster B and sexual fantasies remained consistent across Structured Clinical Interview for DSM-IV for Axis I diagnoses (no interaction effect). Patients with severe mental illness report sexual fantasies that are

  12. Lifetime Autism Spectrum Features in a Patient with a Psychotic Mixed Episode Who Attempted Suicide

    Directory of Open Access Journals (Sweden)

    Marly Simoncini

    2014-01-01

    Full Text Available We present a case report of a young man who attempted suicide during a mixed episode with psychotic symptoms. The patient’s history revealed the lifetime presence of signs and features belonging to the autism spectrum realm that had been completely overlooked. We believe that this case is representative of an important and barely researched topic: what happens to children with nondiagnosed and nontreated subthreshold forms of autism when they grow old. The issue of early recognition of autism spectrum signs and symptoms is discussed, raising questions on the diagnostic boundaries between autism and childhood onset psychotic spectrums among patients who subsequently develop a full-blown psychotic disorder.

  13. Comorbid Diagnosis of Psychotic Disorders in Borderline Personality Disorder: Prevalence and Influence on Outcome

    Directory of Open Access Journals (Sweden)

    C. W. Slotema

    2018-03-01

    Full Text Available BackgroundA diagnosis of psychotic disorder is traditionally considered incompatible with borderline personality disorder (BPD, even though patients sometimes fulfill the diagnostic criteria for both disorders. How often this happens is barely known, as is the influence of comorbid psychotic disorders on the outcome of BPD. Since studies on isolated auditory verbal hallucinations in patients with BPD indicate that these perceptual symptoms have severe consequences and are associated with suicidal behavior and hospitalization, patients with comorbid psychotic disorders are unlikely to fare better.ObjectiveTo examine the point prevalence of psychotic disorders in patients with BPD, their association with the outcome of BPD, and their predictive value for outcome.MethodsIn a cross-sectional design, 84 female outpatients diagnosed with BPD were interviewed with the aid of the MINI-International Neuropsychiatric Interview to establish the point prevalence of comorbid psychotic and other comorbid disorders. After termination of their treatment at a specialized outpatient clinic, the type of referral was considered to be a “good” outcome when they were referred to their general practitioner or to basic psychiatric care for noncomplex patients, and a “poor” outcome when referred to a specialized psychiatric department or to a psychiatric district team for patients with severe psychiatric disorders.ResultsPsychotic disorders were present in 38% of the patients with BPD. With a prevalence of 20%, psychotic disorder not otherwise specified (NOS was the most common subtype; the least common types were schizophrenia (2%, substance-induced psychotic disorder (2%, and brief psychotic disorder (1%. Among six types of comorbid disorders, only psychotic disorders were associated with a poor outcome; they were also predictors for a poor outcome, along with comorbid mood disorders, eating disorders, and somatoform disorders, as well as the severity of BPD

  14. Usher syndrome with psychotic symptoms: two cases in the same family.

    Science.gov (United States)

    Wu, Chen-Ying; Chiu, Chih-Chiang

    2006-10-01

    Usher syndrome is a heterogeneous autosomal recessive disorder characterized by hearing and visual sensory impairment. Retinitis pigmentosa is essential for its diagnosis. There are only a few reports describing patients with Usher syndrome presenting with psychotic features and the etiology of its psychiatric manifestation is still unknown. Herein, the authors report variable congenital hearing impairment and progressive visual loss occurring in five of seven family members and two of them meeting the diagnostic criteria of Usher syndrome with psychotic features. Furthermore, the authors compare their psychiatric symptoms with other reports and the possible etiologies of psychotic symptoms are discussed.

  15. Associations between the Five-Factor Model personality traits and psychotic experiences in patients with psychotic disorders, their siblings and controls.

    Science.gov (United States)

    Boyette, Lindy-Lou; Korver-Nieberg, Nikie; Verweij, Kim; Meijer, Carin; Dingemans, Peter; Cahn, Wiepke; de Haan, Lieuwe

    2013-12-15

    Earlier studies indicated that personality characteristics contribute to symptomatic outcome in patients with psychotic disorders. The aim of the present study was to further explore this connection by examining the relationship between the Five-Factor Model (FFM) personality traits and a dimensional liability for psychosis. FFM traits according to the NEO-FFI and levels of subclinical psychotic symptoms according to the CAPE were assessed in 217 patients with psychotic disorders, 281 of their siblings and 176 healthy controls. Psychotic symptoms according to the PANSS were assessed in the patient group. Patients differed from siblings and controls on four of the five FFM traits, all but Openness. Siblings reported higher levels of Neuroticism than controls, but lower levels than patients. Particularly lower Agreeableness, and to a lesser degree, higher Neuroticism and lower Extraversion were associated with more severe symptoms in patients. Furthermore, higher Neuroticism and higher Openness were associated with higher levels of subclinical psychotic experiences in all three groups. Associations were strongest in patients. Our findings suggest that levels of Neuroticism increase with the level of familial risk for psychosis. Levels of Openness may reflect levels of impairment that distinguish clinical from subclinical symptomatology. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Psychotic experiences and hyper-theory-of-mind in preadolescence--a birth cohort study.

    Science.gov (United States)

    Clemmensen, L; van Os, J; Drukker, M; Munkholm, A; Rimvall, M K; Væver, M; Rask, C U; Bartels-Velthuis, A A; Skovgaard, A M; Jeppesen, P

    2016-01-01

    Knowledge on the risk mechanisms of psychotic experiences (PE) is still limited. The aim of this population-based study was to explore developmental markers of PE with a particular focus on the specificity of hyper-theory-of-mind (HyperToM) as correlate of PE as opposed to correlate of any mental disorder. We assessed 1630 children from the Copenhagen Child Cohort 2000 regarding PE and HyperToM at the follow-up at 11-12 years. Mental disorders were diagnosed by clinical ratings based on standardized parent-, teacher- and self-reported psychopathology. Logistic regression analyses were performed to test the correlates of PE and HyperToM, and the specificity of correlates of PE v. correlates of any Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) mental disorder. Univariate analyses showed the following correlates of PE: familial psychiatric liability; parental mental illness during early child development; change in family composition; low family income; regulatory problems in infancy; onset of puberty; bullying; concurrent mental disorder; and HyperToM. When estimating the adjusted effects, only low family income, concurrent mental disorder, bullying and HyperToM remained significantly associated with PE. Further analyses of the specificity of these correlates with regard to outcome revealed that HyperToM was the only variable specifically associated with PE without concurrent mental disorder. Finally, HyperToM did not share any of the investigated precursors with PE. HyperToM may have a specific role in the risk trajectories of PE, being specifically associated with PE in preadolescent children, independently of other family and child risk factors associated with PE and overall psychopathology at this age.

  17. Self-Reported Visual Perceptual Abnormalities Are Strongly Associated with Core Clinical Features in Psychotic Disorders

    Directory of Open Access Journals (Sweden)

    Brian P. Keane

    2018-03-01

    Full Text Available BackgroundPast studies using the Bonn Scale for the Assessment of Basic Symptoms (hereafter, Bonn Scale have shown that self-reported perceptual/cognitive disturbances reveal which persons have or will soon develop schizophrenia. Here, we focused specifically on the clinical value of self-reported visual perceptual abnormalities (VPAs since they are underexplored and have been associated with suicidal ideation, negative symptoms, and objective visual dysfunction.MethodUsing the 17 Bonn Scale vision items, we cross-sectionally investigated lifetime occurrence of VPAs in 21 first-episode psychosis and 22 chronic schizophrenia/schizoaffective disorder (SZ/SA patients. Relationships were probed between VPAs and illness duration, symptom severity, current functioning, premorbid functioning, diagnosis, and age of onset.ResultsIncreased VPAs were associated with: earlier age of onset; more delusions, hallucinations, bizarre behavior, and depressive symptoms; and worse premorbid social functioning, especially in the childhood and early adolescent phases. SZ/SA participants endorsed more VPAs as compared to those with schizophreniform or psychotic disorder-NOS, especially in the perception of color, bodies, faces, object movement, and double/reversed vision. The range of self-reported VPAs was strikingly similar between first-episode and chronic patients and did not depend on the type or amount of antipsychotic medication. As a comparative benchmark, lifetime occurrence of visual hallucinations did not depend on diagnosis and was linked only to poor premorbid social functioning.ConclusionA brief 17-item interview derived from the Bonn Scale is strongly associated with core clinical features in schizophrenia. VPAs hold promise for clarifying diagnosis, predicting outcome, and guiding neurocognitive investigations.

  18. Types of marital intimacy and prevalence of emotional illness.

    Science.gov (United States)

    Waring, E M; Patton, D; Neron, C A; Linker, W

    1986-11-01

    Epidemiological research has demonstrated that married individuals generally experience better emotional health than the single, divorced and widowed. The married populations in these studies were not evaluated on the basis of the quality of their marital relationships. Research on the interpersonal quality of marital relationships in the general married population has rarely been reported in the psychiatric literature. A sample of the general married population (n = 250 couples) completed a self-report questionnaire which measures the quality and the quantity of intimacy in marriage. Four types of marital patterns were operationally defined by total intimacy score, pattern of scale profile, and social desirability scores. The relative frequencies of these types of marriages are reported. The prevalence of symptoms of non-psychotic emotional illness in one or both spouses in the four categories of marriage is reported. Thirty-one percent (31%) of the couples report marriages with absent and/or deficient intimacy. Couples with "absent and/or deficient" marital intimacy had a significantly higher proportion of spouses with symptoms of non-psychotic emotional illness. This study suggests that previous research may have confounded the variables of marital status and marital quality in the study of psychiatric disorder. These studies may have under-estimated the positive effect of an "optimally" intimate relationship.

  19. Trends in rates of mental illness in homicide perpetrators.

    Science.gov (United States)

    Swinson, Nicola; Flynn, Sandra M; While, David; Roscoe, Alison; Kapur, Navneet; Appleby, Louis; Shaw, Jenny

    2011-06-01

    The rise in homicides by those with serious mental illness is of concern, although this increase may not be continuing. To examine rates of mental illness among homicide perpetrators. A national consecutive case series of homicide perpetrators in England and Wales from 1997 to 2006. Rates of mental disorder were based on data from psychiatric reports, contact with psychiatric services, diminished responsibility verdict and hospital disposal. Of the 5884 homicides notified to the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness between 1997 and 2006, the number of homicide perpetrators with schizophrenia increased at a rate of 4% per year, those with psychotic symptoms at the time of the offence increased by 6% per year. The number of verdicts of diminished responsibility decreased but no change was found in the number of perpetrators receiving a hospital order disposal. The likeliest explanation for the rise in homicide by people with psychosis is the misuse of drugs and/or alcohol, which our data show increased at a similar magnitude to homicides by those with psychotic symptoms. However, we are unable to demonstrate a causal association. Although the Poisson regression provides evidence of an upward trend in homicide by people with serious mental illness between 1997 and 2006, the number of homicides fell in the final 2 years of data collection, so these findings should be treated with caution. There appears to be a concomitant increase in drug misuse over the period, which may account for this rise in homicide. However, an increase in the number of people in contact with mental health services may suggest that access to mental health services is improving. Previous studies have used court verdicts such as diminished responsibility as a proxy measure of mental disorder. Our data indicate that this does not reflect accurately the prevalence of mental disorder in this population.

  20. Insight into mental illness and child maltreatment risk among mothers with major psychiatric disorders.

    Science.gov (United States)

    Mullick, M; Miller, L J; Jacobsen, T

    2001-04-01

    This study examined the relationship between insight into mental illness and current child maltreatment risk among mothers who had a major psychiatric disorder and who had lost custody of a child because of abuse, neglect, or having placed the child at risk of harm. Specifically, a measure of insight was examined in relation to systematically observed parenting behaviors known to be correlated with past child maltreatment and in relation to a comprehensive clinical determination of risk. Forty-four mothers who had a major psychiatric disorder were independently rated for their insight into their illness, the quality of mother-child interaction, and the overall clinical risk of maltreatment. Better insight into mental illness was associated with more sensitive mothering behavior and with lower assessed clinical risk of maltreatment. The association remained when mothers with current psychotic symptoms were excluded from the analyses. Better insight did not appear to be associated with past psychotic symptoms, maternal psychiatric diagnosis, or the mother's level of education. Insight into mental illness may function as a protective factor that influences the risk of child maltreatment in mothers with mental illness. Measures of insight could be usefully incorporated into comprehensive parenting assessments for mothers with psychiatric disorders.

  1. The use of electroconvulsive therapy in atypical psychotic presentations: a case review.

    Science.gov (United States)

    Montgomery, John H; Vasu, Devi

    2007-10-01

    Convulsive therapy and its progeny, electroconvulsive therapy (ECT), were originally used for the treatment of catatonic schizophrenia, and there is little doubt that ECT remains an effective intervention for the treatment of schizophrenia. However, current practice tends to favor the use of ECT in severe or treatment refractory affective disorders, and its use in schizophrenia and other nonaffective (atypical) psychotic disorders has become controversial.CASE REPORTS HAVE SUGGESTED A ROLE FOR ECT IN TWO SPECIFIC ATYPICAL PSYCHOTIC DISORDERS: Cotard's syndrome and cycloid psychosis. In this article, we review the atypical psychotic disorders and report a series of five case examples that signify the role of ECT in atypical psychotic presentations, particularly when the symptoms resemble those found in Cotard's syndrome and cycloid psychosis.

  2. Clozapine and obsessions in patients with recent-onset schizophrenia and other psychotic disorders

    NARCIS (Netherlands)

    de Haan, L.; Linszen, D. H.; Gorsira, R.

    1999-01-01

    BACKGROUND: The increase or emergence of obsessions was compared in young patients with recent-onset schizophrenia or other psychotic disorders taking clozapine and other antipsychotic drugs. METHOD: We conducted a retrospective cohort study. Subjects were 121 consecutively admitted patients

  3. Neurocognitive functioning before and after the first psychotic episode: does psychosis result in cognitive deterioration?

    NARCIS (Netherlands)

    Becker, H. E.; Nieman, D. H.; Wiltink, S.; Dingemans, P. M.; van de Fliert, J. R.; Velthorst, E.; de Haan, L.; van Amelsvoort, T. A.; Linszen, D. H.

    2010-01-01

    Cognitive impairment is considered to be a core characteristic of schizophrenia. The relationship between psychosis and cognitive deterioration, however, remains unclear. This longitudinal study investigated the neuropsychological functioning of patients before and after their first psychotic

  4. Understanding and improving treatment adherence in patients with psychotic disorders: Review and a proposed intervention

    NARCIS (Netherlands)

    Staring, A.B.P.; Mulder, C.L.; van der Gaag, M.; Selten, J.P.; Loonen, A.J.M.; Hengeveld, M.W.

    2006-01-01

    Abstract: Non-adherence to treatment of patients with psychotic disorders is related to higher rates of relapse, hospitalization, and suicide. Important predictors of non-adherence include poor social structure, cognitive deficits, negative medication attitude, side effects, depression, a

  5. Understanding and improving treatment adherence in patients with psychotic disorders: A review and a proposed intervention

    NARCIS (Netherlands)

    A.B.P. Staring (Anton); C.L. Mulder (Niels); M. van der Gaag (Mark); J.-P. Selten (Jean-Paul); A.J.M. Loonen (Anton); M.W. Hengeveld (Michiel)

    2006-01-01

    textabstractNon-adherence to treatment of patients with psychotic disorders is related to higher rates of relapse, hospitalization, and suicide. Important predictors of non-adherence include poor social structure, cognitive deficits, negative medication attitude, side effects, depression, a

  6. Cognitive deficits and levels of IQ in adolescent onset schizophrenia and other psychotic disorders

    DEFF Research Database (Denmark)

    Fagerlund, Birgitte; Pagsberg, A Katrine; Hemmingsen, Ralf

    2006-01-01

    of intelligence, executive functions, memory, attention and processing speed was global or specific. First-episode psychotic adolescents (N = 39) between the ages 11 and 17 years were included, 18 of whom were diagnosed with schizophrenia, and 21 with other non-organic, non-affective psychoses, using ICD-10...... of attention, executive functions, reaction time, and memory in the schizophrenic and psychotic adolescent groups. However, analyses of WISC-III factor profiles suggested that early onset schizophrenia patients may have more global IQ deficits than non-organic, non-affective psychoses when examined recently...... the profile and severity of cognitive impairments in first-episode early onset psychotic patients who received the schizophrenia diagnosis to those diagnosed with other non-organic, non-affective psychotic disorders. The secondary purpose was to examine whether the profile of cognitive deficits, in terms...

  7. Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people.

    NARCIS (Netherlands)

    Henquet, C.J.; Krabbendam, L.; Spauwen, P.H.M.; Kaplan, C.; Lieb, R.; Wittchen, H.U.; Os, J. van

    2005-01-01

    OBJECTIVE: To investigate the relation between cannabis use and psychotic symptoms in individuals with above average predisposition for psychosis who first used cannabis during adolescence. DESIGN: Analysis of prospective data from a population based sample. Assessment of substance use,

  8. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Your Wishes Visiting The ER Who Takes Care Of You In An Emergency? Checking Into ... Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be ...

  9. Hyper-theory-of-mind in children with Psychotic Experiences.

    Science.gov (United States)

    Clemmensen, Lars; van Os, Jim; Skovgaard, Anne Mette; Væver, Mette; Blijd-Hoogewys, Els M A; Bartels-Velthuis, Agna A; Jeppesen, Pia

    2014-01-01

    Alterations in Theory-of-Mind (ToM) are associated with psychotic disorder. In addition, studies in children have documented that alterations in ToM are associated with Psychotic Experiences (PE). Our aim was to examine associations between an exaggerated type of ToM (HyperToM) and PE in children. Children with this type of alteration in ToM infer mental states when none are obviously suggested, and predict behaviour on the basis of these erroneous beliefs. Individuals with HyperToM do not appear to have a conceptual deficit (i.e. lack of representational abilities), but rather they apply their theory of the minds of others in an incorrect or biased way. Hypotheses were tested in two studies with two independent samples: (i) a general population sample of 1630 Danish children aged 11-12 years, (ii) a population-based sample of 259 Dutch children aged 12-13 years, pertaining to a case-control sampling frame of children with auditory verbal hallucinations. Multinomial regression analyses were carried out to investigate the associations between PE and ToM and HyperToM respectively. Analyses were adjusted for gender and proxy measures of general intelligence. Low ToM score was significantly associated with PE in sample I (OR = 1.6 95%CI 1.1-2.3 χ2(4) = 12.42 p = 0.010), but not in sample II (OR = 0.9 95%CI 0.5-1.8 χ2(3) = 7.13 p = 0.816). HyperToM was significantly associated with PE both in sample I (OR = 1.8, 95%CI 1.2-2.7 χ2(3) = 10.11 p = 0.006) and II (OR = 4.6, 95%CI 1.3-16.2 χ2(2) = 7.56 p = 0.018). HyperToM was associated particularly with paranoid delusions in both sample I (OR = 2.0, 95%CI: 1.1-3.7% χ2(4) = 9.93 p = 0.021) and II (OR = 6.2 95%CI: 1.7-23.6% χ2(4) = 9.90 p = 0.044). Specific alterations in ToM may be associated with specific types of psychotic experiences. HyperToM may index risk for developing psychosis and paranoid delusions in particular.

  10. Hyper-theory-of-mind in children with Psychotic Experiences.

    Directory of Open Access Journals (Sweden)

    Lars Clemmensen

    Full Text Available Alterations in Theory-of-Mind (ToM are associated with psychotic disorder. In addition, studies in children have documented that alterations in ToM are associated with Psychotic Experiences (PE. Our aim was to examine associations between an exaggerated type of ToM (HyperToM and PE in children. Children with this type of alteration in ToM infer mental states when none are obviously suggested, and predict behaviour on the basis of these erroneous beliefs. Individuals with HyperToM do not appear to have a conceptual deficit (i.e. lack of representational abilities, but rather they apply their theory of the minds of others in an incorrect or biased way.Hypotheses were tested in two studies with two independent samples: (i a general population sample of 1630 Danish children aged 11-12 years, (ii a population-based sample of 259 Dutch children aged 12-13 years, pertaining to a case-control sampling frame of children with auditory verbal hallucinations. Multinomial regression analyses were carried out to investigate the associations between PE and ToM and HyperToM respectively. Analyses were adjusted for gender and proxy measures of general intelligence.Low ToM score was significantly associated with PE in sample I (OR = 1.6 95%CI 1.1-2.3 χ2(4 = 12.42 p = 0.010, but not in sample II (OR = 0.9 95%CI 0.5-1.8 χ2(3 = 7.13 p = 0.816. HyperToM was significantly associated with PE both in sample I (OR = 1.8, 95%CI 1.2-2.7 χ2(3 = 10.11 p = 0.006 and II (OR = 4.6, 95%CI 1.3-16.2 χ2(2 = 7.56 p = 0.018. HyperToM was associated particularly with paranoid delusions in both sample I (OR = 2.0, 95%CI: 1.1-3.7% χ2(4 = 9.93 p = 0.021 and II (OR = 6.2 95%CI: 1.7-23.6% χ2(4 = 9.90 p = 0.044.Specific alterations in ToM may be associated with specific types of psychotic experiences. HyperToM may index risk for developing psychosis and paranoid delusions in particular.

  11. Psychotic-spectrum symptoms, cumulative adversity exposure and substance use among high-risk girls.

    Science.gov (United States)

    Lansing, Amy E; Plante, Wendy Y; Fennema-Notestine, Christine; Golshan, Shahrokh; Beck, Audrey N

    2018-02-01

    Psychotic-spectrum symptoms are linked to trauma, substance/alcohol use (SAU), criminality/violence and poor functional outcomes, supporting the need for early detection in vulnerable populations. To better understand high-risk girls' mental health, we assessed: (1) psychotic-spectrum symptoms; (2) cumulative trauma, adversity and loss exposures (C-TALE) and adversity-indicators (symptoms, maladaptive coping, stressor-reactivity); and SAU risk-factors; and (3) relationships among psychotic-spectrum symptoms, adversity-indicators and SAU risk-factors. We administered the Structured Clinical Interviews for Psychotic Spectrum, and Trauma and Loss Spectrum to 158 adolescent delinquent girls. Girls' psychotic-spectrum profiles were similar to previously reported adult psychotic patients and characterized by typical symptoms (hallucinations/delusions, reported largely SAU-independent), interpersonal sensitivity, schizoid traits and paranoia (over-interpretation, anger over-reactivity, hypervigilance). Auditory/visual hallucinations (55.7%), delusions (92.4%), ideas of reference (96.8%) and adversity (90.0% ≥10/24 C-TALE-types) were common. Mean loss (4) and trauma (8) onset-age occurred before SAU-onset (12). Significant positive correlations were found among psychotic-spectrum symptoms, stressor-reactivity, C-TALE, adversity-indicators; and number of SAU-types; and a negative correlation occurred between psychotic-spectrum symptoms and earlier alcohol use onset. After controlling for number of SAU-types, stressor-reactivity and adversity-related numbing individually had the largest associations with total psychotic-spectrum symptoms (b = 2.6-4.3). Girls averaged more than 4 maladaptive coping strategies (e.g., 24.8% attempted suicide) in response to adversity, amplifying potential health-disparities. No racial/ethnic differences emerged on psychotic-spectrum symptoms. This symptom constellation during adolescence likely interferes with social and academic

  12. A longitudinal twin study of the association between childhood autistic traits and psychotic experiences in adolescence

    OpenAIRE

    Taylor, Mark J.; Robinson, Elise B.; Happ?, Francesca; Bolton, Patrick; Freeman, Daniel; Ronald, Angelica

    2015-01-01

    Background: This twin study investigated whether autistic traits during childhood were associated with adolescent psychotic experiences. Methods: Data were collected from a community sample of approximately 5000 twin pairs, which included 32 individuals with diagnosed autism spectrum conditions (ASC). Parents rated autistic traits in the twins at four points between ages 8–16 years. Positive, negative, and cognitive psychotic experiences were assessed at age 16 years using self- and parent-re...

  13. Default mode network connectivity as a function of familial and environmental risk for psychotic disorder.

    Science.gov (United States)

    Peeters, Sanne C T; van de Ven, Vincent; Gronenschild, Ed H B M; Patel, Ameera X; Habets, Petra; Goebel, Rainer; van Os, Jim; Marcelis, Machteld

    2015-01-01

    Research suggests that altered interregional connectivity in specific networks, such as the default mode network (DMN), is associated with cognitive and psychotic symptoms in schizophrenia. In addition, frontal and limbic connectivity alterations have been associated with trauma, drug use and urban upbringing, though these environmental exposures have never been examined in relation to DMN functional connectivity in psychotic disorder. Resting-state functional MRI scans were obtained from 73 patients with psychotic disorder, 83 non-psychotic siblings of patients with psychotic disorder and 72 healthy controls. Posterior cingulate cortex (PCC) seed-based correlation analysis was used to estimate functional connectivity within the DMN. DMN functional connectivity was examined in relation to group (familial risk), group × environmental exposure (to cannabis, developmental trauma and urbanicity) and symptomatology. There was a significant association between group and PCC connectivity with the inferior parietal lobule (IPL), the precuneus (PCu) and the medial prefrontal cortex (MPFC). Compared to controls, patients and siblings had increased PCC connectivity with the IPL, PCu and MPFC. In the IPL and PCu, the functional connectivity of siblings was intermediate to that of controls and patients. No significant associations were found between DMN connectivity and (subclinical) psychotic/cognitive symptoms. In addition, there were no significant interactions between group and environmental exposures in the model of PCC functional connectivity. Increased functional connectivity in individuals with (increased risk for) psychotic disorder may reflect trait-related network alterations. The within-network "connectivity at rest" intermediate phenotype was not associated with (subclinical) psychotic or cognitive symptoms. The association between familial risk and DMN connectivity was not conditional on environmental exposure.

  14. Genome-wide analysis of adolescent psychotic-like experiences shows genetic overlap with psychiatric disorders.

    Science.gov (United States)

    Pain, Oliver; Dudbridge, Frank; Cardno, Alastair G; Freeman, Daniel; Lu, Yi; Lundstrom, Sebastian; Lichtenstein, Paul; Ronald, Angelica

    2018-03-31

    This study aimed to test for overlap in genetic influences between psychotic-like experience traits shown by adolescents in the community, and clinically-recognized psychiatric disorders in adulthood, specifically schizophrenia, bipolar disorder, and major depression. The full spectra of psychotic-like experience domains, both in terms of their severity and type (positive, cognitive, and negative), were assessed using self- and parent-ratings in three European community samples aged 15-19 years (Final N incl. siblings = 6,297-10,098). A mega-genome-wide association study (mega-GWAS) for each psychotic-like experience domain was performed. Single nucleotide polymorphism (SNP)-heritability of each psychotic-like experience domain was estimated using genomic-relatedness-based restricted maximum-likelihood (GREML) and linkage disequilibrium- (LD-) score regression. Genetic overlap between specific psychotic-like experience domains and schizophrenia, bipolar disorder, and major depression was assessed using polygenic risk score (PRS) and LD-score regression. GREML returned SNP-heritability estimates of 3-9% for psychotic-like experience trait domains, with higher estimates for less skewed traits (Anhedonia, Cognitive Disorganization) than for more skewed traits (Paranoia and Hallucinations, Parent-rated Negative Symptoms). Mega-GWAS analysis identified one genome-wide significant association for Anhedonia within IDO2 but which did not replicate in an independent sample. PRS analysis revealed that the schizophrenia PRS significantly predicted all adolescent psychotic-like experience trait domains (Paranoia and Hallucinations only in non-zero scorers). The major depression PRS significantly predicted Anhedonia and Parent-rated Negative Symptoms in adolescence. Psychotic-like experiences during adolescence in the community show additive genetic effects and partly share genetic influences with clinically-recognized psychiatric disorders, specifically schizophrenia and

  15. Psychotic experiences and disability: Findings from the Collaborative Psychiatric Epidemiology Surveys.

    Science.gov (United States)

    Oh, Hans; Koyanagi, Ai; Kelleher, Ian; DeVylder, Jordan

    2018-03-01

    Psychotic experiences are associated with a number of poor clinical outcomes, including multimorbid psychopathology, suicidal behavior, and poor treatment response. We wished to investigate the relationship between psychotic experiences and disability, including the following domains: cognition, mobility, self-care, social interaction, role functioning, and days out of role. We used three nationally representative and racially/ethnically diverse samples of the general US adult population: the National Comorbidity Survey Replication (NCS-R), the National Latino and Asian American Survey (NLAAS), and the National Survey of American Life (NSAL). Multi-variable logistic regression analyses were used to assess the associations between lifetime psychotic experiences (visual and auditory hallucinatory experiences and delusional ideation; WHO Composite International Diagnostic Interview psychosis screen) and 30-day impairments in functioning across disability domains (using the WHO Disability Assessment Schedule II). In all three samples, models were adjusted for socio-demographics and co-occurring psychiatric disorders. In the NCS-R, models were also adjusted for chronic health conditions. Across all three studies, our adjusted models showed that people with disability had anywhere from about 1.5 to over 3 times the odds of reporting lifetime psychotic experiences, depending on the domain. This was true for each disability domain, except self-care in the NLAAS and in the NSAL. Psychotic experiences are markers of risk for disability across a wide range of domains. This may explain the elevated rates of service utilization among individuals who report psychotic experiences and supports the need to assess for and respond to psychotic experiences even in the absence of psychotic disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Psychotic Symptoms Associated with the use of Dopaminergic Drugs, in Patients with Cocaine Dependence or Abuse.

    Science.gov (United States)

    Roncero, Carlos; Abad, Alfonso C; Padilla-Mata, Antonio; Ros-Cucurull, Elena; Barral, Carmen; Casas, Miquel; Grau-López, Lara

    2017-01-01

    In the field of dual diagnosis, physicians are frequently presented with pharmacological questions. Questions about the risk of developing psychotic symptoms in cocaine users who need treatment with dopaminergic drugs could lead to an undertreatment. Review the presence of psychotic symptoms in patients with cocaine abuse/dependence, in treatment with dopaminergic drugs. Systematic PubMed searches were conducted including December 2014, using the keywords: "cocaine", dopaminergic drug ("disulfuram-methylphenidate-bupropion-bromocriptine-sibutramineapomorphine- caffeine") and ("psychosis-psychotic symptoms-delusional-paranoia"). Articles in English, Spanish, Portuguese, French, and Italian were included. Articles in which there was no history of cocaine abuse/dependence, absence of psychotic symptoms, systematic reviews, and animal studies, were excluded. 313 papers were reviewed. 7 articles fulfilled the inclusion-exclusion criteria. There is a clinical trial including 8 cocaine-dependent patients using disulfiram in which 3 of them presented psychotic symptoms and 6 case-reports: disulfuram (1), methylphenidate (1), disulfiram with methylphenidate (2), and bupropion (2), reporting psychotic symptoms, especially delusions of reference and persecutory ideation. Few cases have been described, which suggests that the appearance of these symptoms is infrequent. The synergy of dopaminergic effects or the dopaminergic sensitization in chronic consumption are the explanatory theories proposed by the authors. In these cases, a relationship was found between taking these drugs and the appearance of psychotic symptoms. Given the low number of studies found, further research is required. The risk of psychotic symptoms seems to be acceptable if we compare it with the benefits for the patients but a closer monitoring seems to be advisable.

  17. Functional limitations and quality of life in schizophrenia and other psychotic disorders

    OpenAIRE

    Viertiö, Satu

    2011-01-01

    There is substantial evidence of the decreased functional capacity, especially everyday functioning, of people with psychotic disorder in clinical settings, but little research about it in the general population. The aim of the present study was to provide information on the magnitude of functional capacity problems in persons with psychotic disorder compared with the general population. It estimated the prevalence and severity of limitations in vision, mobility, everyday functioning and qual...

  18. A TWIN STUDY OF SCHIZOAFFECTIVE-MANIA, SCHIZOAFFECTIVE-DEPRESSION AND OTHER PSYCHOTIC SYNDROMES

    OpenAIRE

    Cardno, Alastair G; Rijsdijk, Frühling V; West, Robert M; Gottesman, Irving I; Craddock, Nick; Murray, Robin M; McGuffin, Peter

    2011-01-01

    The nosological status of schizoaffective disorders remains controversial. Twin studies are potentially valuable for investigating relationships between schizoaffective-mania, schizoaffective-depression and other psychotic syndromes, but no such study has yet been reported. We ascertained 224 probandwise twin pairs (106 monozygotic, 118 same-sex dizygotic), where probands had psychotic or manic symptoms, from the Maudsley Twin Register in London (1948–1993). We investigated Research Diagnosti...

  19. Ethnic variations regarding clinical profiles and symptom representation in prisoners with psychotic disorders.

    Science.gov (United States)

    Denzel, A Dorina; Harte, Joke M; van den Bergh, Mattis; Scherder, Erik J A

    2018-01-01

    Black and minority ethnic (BME) groups are known to have higher prevalences of psychotic disorders and are over-represented in western penitentiaries and forensic psychiatric institutions. Research from regular mental healthcare settings suggests that they could show different and more severe psychotic symptoms. Aims To explore ethnic variations in severity of symptomatology of BME and non-BME detainees with psychotic disorders. In this study, 824 patients with psychotic disorders from seven different ethnic groups, imprisoned in a penitentiary psychiatric centre in the Netherlands, were compared on symptom severity and symptom representation using the BPRS-E clinical interview. Data were analysed by means of a multilevel analysis. BME patients with psychotic disorders are over-represented in forensic psychiatry, and symptom profiles of prisoners with psychotic disorders vary by ethnicity. Additionally, severity levels of overall psychopathology differ between ethnic groups: patients with an ethnic majority status show more severe levels of psychopathology compared with BME patients. There are differences in symptom severity and symptom profiles between BME patients and non-BME patients. Disregarding these differences could have an adverse effect on the outcome of the treatment. Possible explanations and clinical impact are discussed. Declaration of interest None.

  20. Determining the effectiveness of the third person interview in the level of insight psychotic patients.

    Science.gov (United States)

    Mehdizadeh, Mahsa; Rezaei, Omid; Dolatshahi, Behrouz

    2016-11-30

    The goal of this study was to determine the effectiveness of the third person interview in increasing the level of insight and cooperation in psychotic patients. We used a quasi-experimental posttest design with an alternative method group. A number of 40 individuals with a definite diagnosis of psychosis were selected using a simple random sampling, and were put randomly in an experimental group (third person interview) and an alternative control group (clinical interview). The results indicated that using the third person interview, the insight level of the psychotic patients increased in all dimensions of insight, except awareness of flat or blunted affect and awareness of unsociability. The results of the independent t-test samples showed no significant difference in cooperation between the two groups of psychotic patients. It seems that the ability to consider one's mental viewpoint from other's, is dependent on the relative ability of psychotic patients to represent other's mental states (theory of mind). But, psychotic patients have severe impairment in the ability to represent their own mental states, resulting in an impairment in the recognition of their mental disorder, psychotic symptoms, the need for therapy, and social consequences of their mental disorder. Copyright © 2016. Published by Elsevier Ireland Ltd.

  1. Mental health-related stigma and pathways to care for people at risk of psychotic disorders or experiencing first-episode psychosis: a systematic review.

    Science.gov (United States)

    Gronholm, P C; Thornicroft, G; Laurens, K R; Evans-Lacko, S

    2017-08-01

    Stigma associated with mental illness can delay or prevent help-seeking and service contact. Stigma-related influences on pathways to care in the early stages of psychotic disorders have not been systematically examined. This review systematically assessed findings from qualitative, quantitative and mixed-methods research studies on the relationship between stigma and pathways to care (i.e. processes associated with help-seeking and health service contact) among people experiencing first-episode psychosis or at clinically defined increased risk of developing psychotic disorder. Forty studies were identified through searches of electronic databases (CINAHL, EMBASE, Medline, PsycINFO, Sociological Abstracts) from 1996 to 2016, supplemented by reference searches and expert consultations. Data synthesis involved thematic analysis of qualitative findings, narrative synthesis of quantitative findings, and a meta-synthesis combining these results. The meta-synthesis identified six themes in relation to stigma on pathways to care among the target population: 'sense of difference', 'characterizing difference negatively', 'negative reactions (anticipated and experienced)', 'strategies', 'lack of knowledge and understanding', and 'service-related factors'. This synthesis constitutes a comprehensive overview of the current evidence regarding stigma and pathways to care at early stages of psychotic disorders, and illustrates the complex manner in which stigma-related processes can influence help-seeking and service contact among first-episode psychosis and at-risk groups. Our findings can serve as a foundation for future research in the area, and inform early intervention efforts and approaches to mitigate stigma-related concerns that currently influence recognition of early difficulties and contribute to delayed help-seeking and access to care.

  2. [Neuropsychological approach to elucidating delusion and psychotic symptoms].

    Science.gov (United States)

    Kato, Motoichiro

    2012-01-01

    Neuropsychological symptom-oriented approach is a critical method to elucidate delusion and psychotic symptoms in patients with focal brain damages and schizophrenia. In Capgras delusion (CD), the delusional misidentification of familiar people disguised as others, the patients with right amygdala damage and bilateral ventromedial prefrontal lesions have a deficient or reduced emotional valence of the person with intact configurational processes of the face. Reduplicative paramnesia (RP) is a specific phenomenon characterized by subjective certainty that a familiar place or person has been duplicated. Clinical evidences indicated that the patient with RP following right prefrontal damages showed the lack of emotional valence for the present hospital. This abnormal sense of familiarity triggered the deficits of the orientation of self to the outside world, that is, double orientation, resulting in the development of geographical reduplicative paramnesia. In line with the pathogenesis of CD and RP after brain damages, the delusion in schizophrenia may have a germ as developmental origins, which include the aberrant or salient perceptual experiences and abnormal sense of agency, and might be further aggravated by the impairment of causal reasoning process such as the jumping-to-conclusions bias.

  3. Predicting Psychotic-Like Experiences during Sensory Deprivation

    Science.gov (United States)

    Daniel, Christina; Mason, Oliver J.

    2015-01-01

    Aims. This study aimed to establish the contribution of hallucination proneness, anxiety, suggestibility, and fantasy proneness to psychotic-like experiences (PLEs) reported during brief sensory deprivation. Method. Twenty-four high and 22 low hallucination-prone participants reported on PLEs occurring during brief sensory deprivation and at baseline. State/trait anxiety, suggestibility, and fantasy proneness were also measured. Results. Both groups experienced a significant increase in PLEs in sensory deprivation. The high hallucination prone group reported more PLEs both at baseline and in sensory deprivation. They also scored significantly higher on measures of state/trait anxiety, suggestibility, and fantasy proneness, though these did not explain the effects of group or condition. Regression analysis found hallucination proneness to be the best predictor of the increase in PLEs, with state anxiety also being a significant predictor. Fantasy proneness and suggestibility were not significant predictors. Conclusion. This study suggests the increase in PLEs reported during sensory deprivation reflects a genuine aberration in perceptual experience, as opposed to increased tendency to make false reports due to suggestibility of fantasy proneness. The study provides further support for the use of sensory deprivation as a safe and effective nonpharmacological model of psychosis. PMID:25811027

  4. Predicting Psychotic-Like Experiences during Sensory Deprivation

    Directory of Open Access Journals (Sweden)

    Christina Daniel

    2015-01-01

    Full Text Available Aims. This study aimed to establish the contribution of hallucination proneness, anxiety, suggestibility, and fantasy proneness to psychotic-like experiences (PLEs reported during brief sensory deprivation. Method. Twenty-four high and 22 low hallucination-prone participants reported on PLEs occurring during brief sensory deprivation and at baseline. State/trait anxiety, suggestibility, and fantasy proneness were also measured. Results. Both groups experienced a significant increase in PLEs in sensory deprivation. The high hallucination prone group reported more PLEs both at baseline and in sensory deprivation. They also scored significantly higher on measures of state/trait anxiety, suggestibility, and fantasy proneness, though these did not explain the effects of group or condition. Regression analysis found hallucination proneness to be the best predictor of the increase in PLEs, with state anxiety also being a significant predictor. Fantasy proneness and suggestibility were not significant predictors. Conclusion. This study suggests the increase in PLEs reported during sensory deprivation reflects a genuine aberration in perceptual experience, as opposed to increased tendency to make false reports due to suggestibility of fantasy proneness. The study provides further support for the use of sensory deprivation as a safe and effective nonpharmacological model of psychosis.

  5. Associations between the Five-Factor Model personality traits and psychotic experiences in patients with psychotic disorders, their siblings and controls

    NARCIS (Netherlands)

    Boyette, Lindy-Lou; Korver-Nieberg, Nikie; Verweij, Kim; Meijer, Carin; Dingemans, Peter; Cahn, Wiepke; de Haan, Lieuwe; Kahn, René S.; van Os, Jim; Wiersma, Durk; Bruggeman, Richard; Ca Meijer, Carin; Myin-Germeys, Inez

    2013-01-01

    Earlier studies indicated that personality characteristics contribute to symptomatic outcome in patients with psychotic disorders. The aim of the present study was to further explore this connection by examining the relationship between the Five-Factor Model (FFM) personality traits and a

  6. Psychotic experiences and suicide attempt risk in common mental disorders and borderline personality disorder.

    Science.gov (United States)

    Kelleher, I; Ramsay, H; DeVylder, J

    2017-03-01

    Recent research has demonstrated a strong relationship between psychotic experiences and suicidal behaviour. No research to date, however, has investigated the role of borderline personality disorder (BPD) in this relationship, despite the fact that BPD is highly comorbid with common mental disorders and is associated with both recurrent suicidal behaviour and psychotic experiences. This paper examined the relationship between psychotic experiences and suicide attempts, including interrelationships with BPD and common mental disorders. We used the 2007 Adult Psychiatric Morbidity Study, a stratified, multistage probability sample of households in England, which recruited a nationally representative sample aged 16 years and older. Participants were assessed for common mental disorders, BPD (clinical and subclinical), suicidal behaviour, and psychotic experiences. Approximately 4% of the total sample (n = 323) reported psychotic experiences. Psychotic experiences were associated with increased odds of suicide attempts in individuals with BPD (OR = 2.23, 95% CI = 1.03-4.85), individuals with a common mental disorder (OR = 2.47, 95% CI = 1.37-4.43), individuals without a common mental disorder (OR = 3.99, 95% CI = 2.47-6.43), and individuals with neither a common mental disorder nor BPD (OR = 3.20, 95% CI = 1.71-5.98). Psychotic experiences are associated with high odds of suicidal behaviour in individuals with and without psychopathology. This relationship is not explained by clinical or subclinical BPD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Neurological Soft Signs In Psychoses A Comparison Between Schizophrenia & Other Psychotic Disorders

    Directory of Open Access Journals (Sweden)

    Shahsavand. E. Noroozian. M

    2002-07-01

    Full Text Available Schizophrenia is one of the most important and disabling mental disorders in the world. Males and females are equally affected. Diagnosis is a very difficult problem in this disorder. Because the diagnostic systems such as ICD-10 and DSM-IV are mainly subjective, they are not valid and reliable. Essentially, in the future, we will need to more objective criteria in psychiatry especially in diagnosis of schizophrenia. Neurological soft signs are an example of these objective criteria. In this study we evaluated the prevalence of neurological soft signs in schizophrenic patients and compared it with the prevalence of these signs in other psychotic patients (except mood disorders with psychotic features and normal subjects."nMethods: We compared the neurological soft signs (sensory motor integration, motor. Coordination, consequent complex motor acts, primary reflexes, and eye movements in 30 schizophrenic patients, 30 other psychotic patients (other than mood disorders with psychotic features and 30 normal subjects. Diagnosis of schizophrenia and also other psychoses were based on DSM-IN criteria. Normal subjects have been selected form the staff of Roozbeh hospital randomly."nResults: The difference between the means of motor coordination subscale of neurological soft signs in schizophrenia and other psychotic disorders (other than mood disorders with psychotic features were significant (P value < 0.04. There were no significant differences between the means of other subscales of neurological soft signs in two groups of patients."nConclusion: There are some disturbances of motor coordination subscale of neurological soft signs in patients with schizophrenia. It seems that, these disturbances are evidence of involvements of basal ganglia, motor cerebral cortex, and cerebellum. So it may be suggested that motor coordination as a marker can be used in differentiation between the schizophrenia and other psychotic disorders.

  8. Anti-social personality characteristics and psychotic symptoms: Two pathways associated with offending in schizophrenia.

    Science.gov (United States)

    Van Dongen, Josanne D M; Buck, Nicole M L; Barendregt, Marko; Van Beveren, Nico M; De Beurs, Edwin; Van Marle, Hjalmar J C

    2015-07-01

    Several research groups have shown that people with schizophrenia who offend do not form a homogenous group. A three-group model claimed by Hodgins proposes distinguishing between people who start offending before the onset of psychosis (early starters), after psychosis onset but at age 34 years or under (late starters) and after psychosis onset but at age 35 years or older (late first offenders). This study aimed to test the hypotheses (1) that the personality of early starters and non-psychotic offenders would be similar, but different from either late-starter group; (2) that the late-starter groups would be more likely to have positive psychotic symptoms than non-criminal patients with schizophrenia; and (3) that symptom types would differentiate the psychotic groups. A retrospective file study was conducted on cases of 97 early starters, 100 late starters and 26 late first offenders all drawn from the Netherlands Institute of Forensic Psychiatry and Psychology (NIFP) archives 1993-2008, 115 non-psychotic offenders from 2005-2008 NIFP archives and 129 patients with schizophrenia and no criminal history from one general service in Rotterdam. Early starters closely resembled the non-psychotic offenders in their premorbid anti-social personality characteristics. The two late-onset offending psychosis groups were more likely to have persecutory and/or grandiose delusions than non-offenders with psychosis, but so were the early starters. In a first study to compare subgroups of offenders with psychosis directly with non-psychotic offenders and non-offenders with psychosis, we found such additional support for a distinction between early and late starters with psychosis that different treatment strategies would seem indicated, focusing on personality and substance misuse for the former but psychotic symptoms for all. It remains to be seen whether the higher rate of alcohol misuse amongst late first offenders is a fundamental distinction or a function of age

  9. Neurocognitive profile in psychotic versus nonpsychotic individuals with 22q11.2 deletion syndrome.

    Science.gov (United States)

    Weinberger, Ronnie; Yi, James; Calkins, Monica; Guri, Yael; McDonald-McGinn, Donna M; Emanuel, Beverly S; Zackai, Elaine H; Ruparel, Kosha; Carmel, Miri; Michaelovsky, Elena; Weizman, Abraham; Gur, Ruben C; Gur, Raquel E; Gothelf, Doron

    2016-10-01

    The 22q11.2 deletion syndrome (22q11DS) is associated with increased rates of psychotic disorders and cognitive deficits, but large scale studies are needed to elucidate their interaction. The objective of this two-center study was to identify the neurocognitive phenotype of individuals with 22q11DS and psychotic disorders. We hypothesized that psychotic 22q11DS individuals compared to nonpsychotic deleted individuals would have more severe neurocognitive deficits, especially in executive function and social cognition. These deficits would be present when compared to IQ- matched individuals with Williams Syndrome (WS). Three groups were ascertained from the Tel Aviv and Philadelphia centers: 22q11DS individuals with a psychotic disorder (n=31), nonpsychotic 22q11DS (n=86) and typically-developing controls (TD, n=828). In Tel Aviv a group of individuals with WS (n=18) matched in IQ to the 22q11DS psychotic group was also included. The Penn Computerized Neurocognitive Battery (CNB) was used to assess a wide-range of cognitive functions and all patients underwent structured psychiatric evaluations. 22q11DS individuals performed poorly on all CNB domains compared to TD. Participants with 22q11DS and psychosis, compared to nonpsychotic 22q11DS, had more severe deficits in global neurocognitive performance (GNP), executive function, social cognition and episodic memory domains. The primary deficits were also significant when comparing the Tel Aviv 22q11DS psychotic group to IQ-matched individuals with WS. In conclusion, 22q11DS individuals with a psychotic disorder have specific neurocognitive deficits that are reliably identified cross nationality using the CNB. These cognitive dysfunctions should be further studied as potential endophenotypes of psychosis in 22q11DS and as targets for intervention. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

  10. Bullying victimization in adolescence and psychotic symptomatology in adulthood: evidence from a 35-year study.

    Science.gov (United States)

    Boden, J M; van Stockum, S; Horwood, L J; Fergusson, D M

    2016-04-01

    There has been considerable recent interest in possible causal linkages between exposure to bullying victimization and later psychotic symptomatology. Prior research in this area has had several limitations which make it difficult to ascertain causality, and to determine the extent to which these effects extend beyond adolescence. Data were obtained from the Christchurch Health and Development Study, a 35-year study of a longitudinal birth cohort. This investigation used generalized estimating equation modelling to estimate the associations between bullying victimization (ages 13-16 years) and psychotic symptoms (ages 18-35 years), before and after controlling for possible confounding factors, including: gender; childhood socio-economic status; child intelligence quotient; exposure to sexual abuse in childhood; anxious/withdrawn behaviour and attention problems (ages 7-9 years); and adolescent psychotic symptoms and paranoid ideation (ages 15-16 years). There was a significant (p bullying victimization in adolescence and psychotic symptomatology in adulthood. Successive models controlling for covariation reduced this association to statistical non-significance. After controlling for covariates, those with the highest level of bullying victimization had rates of psychotic symptoms that were 1.21 (95% confidence interval 0.73-1.99) times higher than those who were not victimized. The association between bullying victimization in adolescence and psychotic symptomatology in adulthood could be largely explained by childhood behavioural problems, and exposure to sexual abuse in childhood. The results suggest that bullying victimization was unlikely to have been a cause of adult psychotic symptoms, but bullying victimization remained a risk marker for these symptoms.

  11. Concurrent and Sustained Cumulative Effects of Adolescent Marijuana Use on Subclinical Psychotic Symptoms.

    Science.gov (United States)

    Bechtold, Jordan; Hipwell, Alison; Lewis, David A; Loeber, Rolf; Pardini, Dustin

    2016-08-01

    Adolescents who regularly use marijuana may be at heightened risk of developing subclinical and clinical psychotic symptoms. However, this association could be explained by reverse causation or other factors. To address these limitations, the current study examined whether adolescents who engage in regular marijuana use exhibit a systematic increase in subclinical psychotic symptoms that persists during periods of sustained abstinence. The sample comprised 1,009 boys who were recruited in 1st and 7th grades. Self-reported frequency of marijuana use, subclinical psychotic symptoms, and several time-varying confounds (e.g., other substance use, internalizing/externalizing problems) were recorded annually from age 13 to 18. Fixed-effects (within-individual change) models examined whether adolescents exhibited an increase in their subclinical psychotic symptoms as a function of their recent and/or cumulative history of regular marijuana use and whether these effects were sustained following abstinence. Models controlled for all time-stable factors (default) and several time-varying covariates as potential confounds. For each year adolescent boys engaged in regular marijuana use, their expected level of subsequent subclinical psychotic symptoms rose by 21% and their expected odds of experiencing subsequent subclinical paranoia or hallucinations rose by 133% and 92%, respectively. The effect of prior regular marijuana use on subsequent subclinical psychotic symptoms persisted even when adolescents stopped using marijuana for a year. These effects were after controlling for all time-stable and several time-varying confounds. No support was found for reverse causation. These results suggest that regular marijuana use may significantly increase the risk that an adolescent will experience persistent subclinical psychotic symptoms.

  12. The Role of Aberrant Salience and Self-Concept Clarity in Psychotic-Like Experiences

    Science.gov (United States)

    Cicero, David C.; Becker, Theresa M.; Martin, Elizabeth A.; Docherty, Anna R.; Kerns, John G.

    2013-01-01

    Most theories of psychotic-like experiences posit the involvement of social-cognitive mechanisms. The current research examined the relations between psychotic-like experiences and two social-cognitive mechanisms, high aberrant salience and low self-concept clarity. In particular, we examined whether aberrant salience, or the incorrect assignment of importance to neutral stimuli, and low self-concept clarity interacted to predict psychotic-like experiences. The current research included three large samples (n = 667, 724, 744) of participants and over-sampled for increased schizotypal personality traits. In all three studies, an interaction between aberrant salience and self-concept clarity was found such that participants with high aberrant salience and low self-concept clarity had the highest levels of psychotic-like experiences. In addition, aberrant salience and self-concept clarity interacted to predict a supplemental measure of delusions in Study 2. In Study 3, in contrast to low self-concept clarity, neuroticism did not interact with aberrant salience to predict psychotic-like experiences, suggesting that the relation between low self-concept clarity and psychosis may not be due to neuroticism. Additionally, aberrant salience and self-concept clarity did not interact to predict to other schizotypal personality disorder criteria, social anhedonia or trait paranoia, which suggests the interaction is specific to psychotic-like experiences. Overall, our results are consistent with several social-cognitive models of psychosis suggesting that aberrant salience and self-concept clarity might be important mechanisms in the occurrence of psychotic-like symptoms. PMID:22452775

  13. Transdiagnostic neural markers of emotion-cognition interaction in psychotic disorders.

    Science.gov (United States)

    Sabharwal, Amri; Szekely, Akos; Kotov, Roman; Mukherjee, Prerona; Leung, Hoi-Chung; Barch, Deanna M; Mohanty, Aprajita

    2016-10-01

    Deficits in working memory (WM) and emotion processing are prominent impairments in psychotic disorders, and have been linked to reduced quality of life and real-world functioning. Translation of knowledge regarding the neural circuitry implementing these deficits into improved diagnosis and targeted treatments has been slow, possibly because of categorical definitions of disorders. Using the dimensional Research Domain Criteria (RDoC) framework, we investigated the clinical and practical utility of transdiagnostic behavioral and neural measures of emotion-related WM disruption across psychotic disorders. Behavioral and functional MRI data were recorded while 53 participants with psychotic disorders and 29 participants with no history of psychosis performed a modified n-back task with fear and neutral distractors. Hierarchical regression analyses showed that psychotic symptoms entered after diagnosis accounted for unique variance in fear versus neutral accuracy and activation in the ventrolateral, dorsolateral, and dorsomedial prefrontal cortex, but diagnostic group entered after psychotic symptoms did not. These results remained even after controlling for negative symptoms, disorganized symptoms, and dysphoria. Finally, worse accuracy and greater prefrontal activity were associated with poorer social functioning and unemployment across diagnostic groups. Present results support the transdiagnostic nature of behavioral and neuroimaging measures of emotion-related WM disruption as they relate to psychotic symptoms, irrespective of diagnosis. They also provide support for the practical utility of these markers in explaining real-world functioning. Overall, these results elucidate key aspects of the RDoC construct of WM maintenance by clarifying its transdiagnostic importance and clinical utility in psychotic disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. Frames of mental illness in the Yoruba genre of Nigerian movies: implications for orthodox mental health care.

    Science.gov (United States)

    Atilola, Olayinka; Olayiwola, Funmilayo

    2013-06-01

    This study examines the modes of framing mental illness in the Yoruba genre of Nigerian movies. All Yoruba films on display in a convenient sample of movie rental shops in Ibadan (Nigeria) were sampled for content. Of the 103 films studied, 27 (26.2%) contained scenes depicting mental illness. Psychotic symptoms were the most commonly depicted, while effective treatments were mostly depicted as taking place in unorthodox settings. The most commonly depicted aetiology of mental illness was sorcery and enchantment by witches and wizards, as well as other supernatural forces. Scenes of mental illness are common in Nigerian movies and these depictions-though reflecting the popular explanatory models of Yoruba-speaking Nigerians about mental illness- may impede utilization of mental health care services and ongoing efforts to reduce psychiatry stigma in this region. Efforts to reduce stigma and improve service utilization should engage the film industry.

  15. Insight in Psychosis: An Indicator of Severity of Psychosis, an Explanatory Model of Illness, and a Coping Strategy

    Science.gov (United States)

    Jacob, K. S.

    2016-01-01

    Recent studies related to insight, explanatory models (EMs) of illness and their relationship to outcome of psychosis are reviewed. The traditional argument that insight predicts outcome in psychosis is not supported by recent longitudinal data, which has been analyzed using multivariable statistics that adjust for severity and quality of illness. While all cognition will have a neurobiological representation, if “insight” is related to the primary psychotic process, then insight cannot be seen as an independent predictor of outcome but a part of the progression of illness. The evidence suggests insight, like all EMs, is belief which interacts with the trajectory of the person's illness and the local culture to produce a unique understanding of the illness for the particular individual and his/her family. PMID:27335513

  16. A pilot study on community-based outpatient treatment for patients with chronic psychotic disorders in Somalia: Change in symptoms, functioning and co-morbid khat use

    Directory of Open Access Journals (Sweden)

    Odenwald Michael

    2012-07-01

    Full Text Available Abstract Background In Low and Middle Income Countries, mental health services are often poorly developed due to the lack of resources and trained personnel. In order to overcome these challenges, new ways of care have been suggested such as a focus on community-based services. In Somalia, the consumption of the natural stimulant khat is highly prevalent, aggravating mental illness. At the same time, mental health care is largely unavailable to the vast majority of the population. In a pilot project, we tested possibilities for effective measures in community-based out-patient mental health care. Methods Thirty-five male patients with chronic psychotic disorders and their carers were involved in a 10-months follow-up study. All of them abused khat. Seventeen outpatients experiencing acute psychotic episodes were recruited from the community and received an intensive six week home-based treatment package. Additionally eighteen patients with chronic psychotic disorders in remission were recruited either following hospital discharge or from the community. In a second phase of the study, both groups received community-based relapse prevention that differed in the degree of the family’s responsibility for the treatment. The treatment package was comprised of psycho-education, low-dose neuroleptic treatment, monthly home visits and counseling. The Brief Psychiatric Rating Scale (BPRS was applied three times. Additionally, we assessed functioning, khat use and other outcomes. Results Of the 35 patients enrolled in the study, 33 participated in the 10-month follow-up. Outpatients improved significantly in the first six weeks of treatment and did not differ from remitted patients at the start of the second treatment phase. In the preventive treatment phase, we find heterogeneous outcomes that diverge between symptom and functioning domains. With the exception of depressive symptoms, symptoms in all patients tended to worsen. The outpatient group had

  17. Five dramas of illness.

    Science.gov (United States)

    Frank, Arthur W

    2007-01-01

    First-person narratives of illness experience are dramatic: the narrator, who is also the sufferer, is caught in conflicts of forces that permit understanding more than control. Among the dramas of illness, five occur frequently in autobiographical accounts of illness. These dramas overlap and have varying emphases in different people's stories. They are the drama of genesis (what instigated the illness); the drama of emotion work (what emotional displays are required or prohibited); the drama of fear and loss; the drama of meaning; and finally, the drama of self. This five-drama framework can focus critical and clinical attention on which conflicting forces the ill person is working to reconcile, what makes that work difficult, and how conceiving of one's illness as a drama can be a source of meaning and value.

  18. Cognitive deficits and levels of IQ in adolescent onset schizophrenia and other psychotic disorders

    DEFF Research Database (Denmark)

    Fagerlund, Birgitte; Pagsberg, A Katrine; Hemmingsen, Ralf

    2006-01-01

    Cognitive deficits have been found to be prevalent in early onset schizophrenia. Whether these deficits also characterise other early onset psychotic disorders to a similar degree is unclear, as very few comparative studies have been done. The primary purpose of this study was to compare the prof......Cognitive deficits have been found to be prevalent in early onset schizophrenia. Whether these deficits also characterise other early onset psychotic disorders to a similar degree is unclear, as very few comparative studies have been done. The primary purpose of this study was to compare...... the profile and severity of cognitive impairments in first-episode early onset psychotic patients who received the schizophrenia diagnosis to those diagnosed with other non-organic, non-affective psychotic disorders. The secondary purpose was to examine whether the profile of cognitive deficits, in terms...... of intelligence, executive functions, memory, attention and processing speed was global or specific. First-episode psychotic adolescents (N = 39) between the ages 11 and 17 years were included, 18 of whom were diagnosed with schizophrenia, and 21 with other non-organic, non-affective psychoses, using ICD-10...

  19. Assessing Social Networks in Patients with Psychotic Disorders: A Systematic Review of Instruments.

    Science.gov (United States)

    Siette, Joyce; Gulea, Claudia; Priebe, Stefan

    2015-01-01

    Evidence suggests that social networks of patients with psychotic disorders influence symptoms, quality of life and treatment outcomes. It is therefore important to assess social networks for which appropriate and preferably established instruments should be used. To identify instruments assessing social networks in studies of patients with psychotic disorders and explore their properties. A systematic search of electronic databases was conducted to identify studies that used a measure of social networks in patients with psychotic disorders. Eight instruments were identified, all of which had been developed before 1991. They have been used in 65 studies (total N of patients = 8,522). They assess one or more aspects of social networks such as their size, structure, dimensionality and quality. Most instruments have various shortcomings, including questionable inter-rater and test-retest reliability. The assessment of social networks in patients with psychotic disorders is characterized by a variety of approaches which may reflect the complexity of the construct. Further research on social networks in patients with psychotic disorders would benefit from advanced and more precise instruments using comparable definitions of and timescales for social networks across studies.

  20. S248. RELATION BETWEEN CHILDHOOD TRAUMA AND PSYCHOTIC SYMPTOMS IN SCHIZOPHRENIA

    Science.gov (United States)

    Larnaout, Amine; Nefzi, Rahma; Aissa, Amina; Trabelsi, Rouaa; Hechmi, Zouhaier El

    2018-01-01

    Abstract Background There is renewed interest in the relationship between early childhood trauma and risk of psychosis in adulthood. Trauma and stressful events in childhood and adolescence are known to be more prevalent among individuals with schizophrenia and other psychotic disorders than in the general population. Furthermore, other findings support the role of childhood trauma as a socio-environmental risk factor for psychotic symptoms, and research on the potential etiological relationship between trauma/stressful events in childhood/adolescence and psychotic disorders is evolving. The aim of the current study was to examine relations among all items and domains of childhood trauma and schizophrenic symptoms in patients with schizophrenia. The relationship between types of trauma and their association with psychotic symptoms was analysed. Methods In this study, we collected data from 50 schizophrenic patients (39 males and 11 females). All patients met the DSM 5 criteria for schizophrenia. Psychotic symptoms were measured by the Positive and Negative Syndrome Scale (PANSS). Trauma and stressful events in childhood and adolescence were assessed using the Childhood Trauma Questionnaire (CTQ). Results We found significant correlations between emotional and sexual abuse, emotional neglect and denial scale in CTQ with positive symptoms of the PANSS (pagressive behaviours was also described in litterature. These results went along with the stress sensitization model where the HPA axis is over-active and excessively reactive to the subsequent environemental stressors causing positive symptoms of the disease.

  1. The use of olanzapine in Huntington disease accompanied by psychotic symptoms

    Directory of Open Access Journals (Sweden)

    Cafer Alhan

    2014-06-01

    Full Text Available Huntington's disease is an autosomal dominant neurodegenerative disease. The disease begins between the ages of 30-50, including motor symptoms, psychiatric symptoms and is characterized by progressive dementia. Common psychiatric disorders of Huntington’s disease include mood and anxiety disorders, behavior and personality changes. Psychosis is relatively rare. Here, a patient is present, who has Huntington’s disease, which is associated with psychotic symptoms. 61-year-old male patient who were followed for Huntington disease for 25 years was admitted for complaints of thinking of poisoning and refuse to eat something. Patient was started on olanzapine at dose of 5 mg/day. In follow up psychotic symptoms disappeared. Emerging psychotic symptoms in Huntington disease is created a need for antipsychotic treatment. Atypical antipsychotic agents should be preferred in the treatment and as in the case olanzapine may be used as a treatment option should be kept in mind to control both involuntary movements and psychotic symptoms in Huntington's disease with psychotic features. J Clin Exp Invest 2014; 5 (2: 326-328

  2. Structural and functional perspectives on classification and seriation in psychotic and normal children.

    Science.gov (United States)

    Breslow, L; Cowan, P A

    1984-02-01

    This study describes a strategy for examining cognitive functioning in psychotic and normal children without the usual confounding effects of marked differences in cognitive structure that occur when children of the same age are compared. Participants were 14 psychotic children, 12 males and 2 females, mean age 9-2, matched with normal children at preoperational and concrete operational stage levels on a set of Piagetian classification tasks. The mean age of the normal children was 6-4, replicating the usually found developmental delay in psychotic samples. Participants were then compared on both structural level and functional abilities on a set of tasks involving seriation of sticks; the higher-level children were also administered a seriation drawing task. Analysis of children's processes of seriating and seriation drawings indicated that over and above the structural retardation, psychotic children at all levels showed functional deficits, especially in the use of anticipatory imagery. The implications for general developmental theory are that progress in structural development is not sufficient for imaginal development, and that structural development of logical concepts is relatively independent of the development of imagery. It was suggested that "thought disorder" may not be a disordered structure of thinking or a retardation in psychotic populations but rather a mismatch between higher-level logical structures and lower-level functions.

  3. Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders.

    Science.gov (United States)

    McKetin, Rebecca; Baker, Amanda L; Dawe, Sharon; Voce, Alexandra; Lubman, Dan I

    2017-05-01

    We examined the lifetime experience of hallucinations and delusions associated with transient methamphetamine-related psychosis (MAP), persistent MAP and primary psychosis among a cohort of dependent methamphetamine users. Participants were classified as having (a) no current psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient MAP, n=85); (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent MAP, n=37), or (d) meeting DSM-IV criteria for lifetime schizophrenia or mania (primary psychosis, n=52). Current psychotic symptoms were classified as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content in the past month. Lifetime psychotic diagnoses and symptoms were assessed using the Composite International Diagnostic Interview. Transient MAP was associated with persecutory delusions and tactile hallucinations (compared to the no symptom group). Persistent MAP was additionally associated with delusions of reference, thought interference and complex auditory, visual, olfactory and tactile hallucinations, while primary psychosis was also associated with delusions of thought projection, erotomania and passivity. The presence of non-persecutory delusions and hallucinations across various modalities is a marker for persistent MAP or primary psychosis in people who use methamphetamine. Copyright © 2017. Published by Elsevier B.V.

  4. Plasma homovanillic acid and family history of psychotic disorders in bipolar I patients.

    Science.gov (United States)

    Zumárraga, Mercedes; Dávila, Ricardo; Basterreche, Nieves; Arrue, Aurora; Goienetxea, Biotza; González-Torres, Miguel Angel; Guimón, José

    2009-04-01

    It has been suggested that the family history of psychotic disorders is useful in defining homogeneous groups of bipolar patients. The plasma homovanillic acid (pHVA) concentrations have been related to the effect of antipsychotic treatment in psychotic patients. We have studied the influence of a positive family history of psychotic disorders both on the variation of pHVA levels and on the relation between pHVA concentrations and the clinical response to treatment. Clinical status and pHVA levels were assessed in 58 medication free patients before and after 4 weeks of treatment with olanzapine and lithium. Clinical improvement correlated positively with pHVA levels on the 28th day of treatment only in the patients having first degree relatives with psychotic disorders. The pHVA levels did not decrease after 28 days of treatment. Our results reinforce the idea that a positive family history of psychosis in psychotic bipolar disorders may constitute a good basis for sub-grouping these patients.

  5. Detection of early psychotic symptoms: Validation of the Spanish version of the "Symptom Onset in Schizophrenia (SOS) inventory".

    Science.gov (United States)

    Mezquida, Gisela; Cabrera, Bibiana; Martínez-Arán, Anabel; Vieta, Eduard; Bernardo, Miguel

    2018-03-01

    The period of subclinical signs that precedes the onset of psychosis is referred to as the prodrome or high-risk mental state. The "Symptom Onset in Schizophrenia (SOS) inventory" is an instrument to characterize and date the initial symptoms of a psychotic illness. The present study aims to provide reliability and validity data for clinical and research use of the Spanish version of the SOS. Thirty-six participants with a first-episode of psychosis meeting DSM-IV criteria for schizophrenia/schizoaffective/schizophreniform disorder were administered the translated SOS and other clinical assessments. The internal validity, intrarater and interrater reliability were studied. We found strong interrater reliability. To detect the presence/absence of prodromal symptoms, Kappa coefficients ranged between 0.8 and 0.7. Similarly, the raters obtained an excellent level of agreement regarding the onset of each symptom and the duration of symptoms until first treatment (intraclass correlation coefficients between 0.9 and 1.0). Cronbach's alpha was 0.9-1.0 for all the items. The interrater reliability and concurrent validity were also excellent in both cases. This study provides robust psychometric properties of the Spanish version of the SOS. The translated version is adequate in terms of good internal validity, intrarater and interrater reliability, and is as time-efficient as the original version. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Canadian Guidelines for the Pharmacological Treatment of Schizophrenia Spectrum and Other Psychotic Disorders in Children and Youth.

    Science.gov (United States)

    Abidi, Sabina; Mian, Irfan; Garcia-Ortega, Iliana; Lecomte, Tania; Raedler, Thomas; Jackson, Kevin; Jackson, Kim; Pringsheim, Tamara; Addington, Donald

    2017-09-01

    Schizophrenia spectrum and other psychotic disorders often have their onset in adolescence. The sequelae of these illnesses can negatively alter the trajectory of emotional, cognitive, and social development in children and youth if left untreated. Early and appropriate interventions can improve outcomes. This article aims to identify best practices in the pharmacotherapy management of children and youth with schizophrenia spectrum disorders. A systematic search was conducted for published guidelines for schizophrenia and schizophrenia spectrum disorders in children and youth (under age 18 years). Recommendations were drawn from the National Institute for Health and Care Excellence guidelines on psychosis and schizophrenia in children and youth (2013 and 2015 updates). Current guidelines were adopted using the ADAPTE process, which includes consensus ratings by a panel of experts. Recommendations identified covered a range of issues in the pharmacotherapy management of children and youth with schizophrenia spectrum disorders. Further work in this area is warranted as we continue to further understand their presentation in the developing brain. Canadian guidelines for the pharmacotherapy management of children and youth with schizophrenia spectrum disorders are essential to assist clinicians in treating this vulnerable population. Ongoing work in this area is recommended.

  7. Subthreshold psychotic symptom distress, self-stigma, and peer social support among college students with mental health concerns.

    Science.gov (United States)

    Denenny, Danielle; Thompson, Elizabeth; Pitts, Steven C; Dixon, Lisa B; Schiffman, Jason

    2015-06-01

    The primary aim of this study was to explore the potential moderating effect of social support on the relation between distress caused by psychosis risk symptoms and self-stigma among college students with mental health diagnoses. Participants were young adult college students who endorsed having a past or present mental health diagnosis (n = 63). Self-report data were examined from the Prodromal Questionnaire-Brief, a measure of subthreshold psychosis risk symptoms; the Self-Concurrence/Application subscale of the Self-Stigma of Mental Illness Scale, a measure of self-stigma; and the Friendships subscale of the Lubben Social Network Scale-Revised, a measure of social support from peers. There was a modest direct relation between distress associated with psychosis risk symptoms and self-stigma. There was a larger relation between distress from risk symptoms and self-stigma for those with low social support compared to those with mean and high social support. Although causality cannot be determined based on this study, a strong relation between symptom distress and stigma was found among those reporting low peer social support. Interventions that target both self-stigma and social support might be relevant for young adults with a history of mental health concerns who currently endorse subthreshold psychotic symptoms. (c) 2015 APA, all rights reserved).

  8. An epidemiological study on herbal product self-medication practice among psychotic outpatients from Serbia: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Gordana Nikolić

    2018-03-01

    Full Text Available Utilization of herbal products (HPs is a common practice in the traditional medicine of people from southeastern Serbia. In this study, we focused on the usage of HPs as a self-medication practice among patients diagnosed with a mental illness, by aiming to ascertain the usage prevalence, the identity of the main plant taxa utilized, their formulations and target symptoms. This was accomplished through a cross-sectional study of psychiatric outpatients, conducted in the Clinic for Mental Health Protection in Niš, and which included a questionnaire on HP utilization and a non-structured psychiatric interview. Typically, single, middle-aged males, with a secondary education degree, utilized Matricaria chamomilla and/or Melissa officinalis in a form of an infusion (tea for relieving anxiety and psychotic symptoms. In some cases, adverse effects were noted when HPs were used in combination with prescribed psychotropic medications. Our and previous results urge a thorough evaluation of possible benefits and/or harmful interactions of HP with standard medication in the treatment of psychiatric patients.

  9. Prevalence of psychotic and non-psychotic disorders in relatives of patients with a first episode psychosis.

    Science.gov (United States)

    Faridi, Kia; Pawliuk, Nicole; King, Suzanne; Joober, Ridha; Malla, Ashok K

    2009-10-01

    Family members of individuals with schizophrenia suffer from elevated rates of schizophrenia-spectrum disorders (SSD) and other forms of psychopathology. However, few studies have examined familial psychopathology in probands with a first episode of psychosis (FEP). We systematically evaluated family history in patients experiencing an affective or non-affective FEP. The Family Interview for Genetic Studies was used to obtain diagnostic information on all first- and second-degree relatives of probands admitted to a specialized FEP program. Probands were 94 previously untreated patients suffering from a first-episode of affective or schizophrenia spectrum psychosis, aged 14 to 30. The interview ascertained diagnoses of psychotic disorders, affective disorders, substance-use disorders (SUD), and schizophrenia-related personality disorders. One in five probands (19.1%) had a history of psychosis among their first-degree relatives, while 34.0% had any relative with psychosis. Fewer probands had a family history of SSD (7.4% with a first-degree history and 18.1% with a history among any relatives). Over half (53.2%) of probands had a first-degree relative with Major Depressive Disorder, and 38.3% had a first-degree relative with a SUD. Overall, 69.9% of probands had a first-degree relative with a mental disorder. The proportion of probands with a family history of any of these diagnoses did not vary by proband diagnosis (affective or SS Psychosis), though probands with co-morbid SUD were more likely to have a family history of substance abuse. Diverse psychopathology is commonly present in families of FEP patients and may imply a generalized vulnerability to psychiatric disorders to be greater in such families compared to specific vulnerability to SS or affective psychosis. These findings may also have implications for provision of care for the probands.

  10. Impact of Different Childhood Adversities on 1-Year Outcomes of Psychotic Disorder in the Genetics and Psychosis Study

    Science.gov (United States)

    Trotta, Antonella; Murray, Robin M.; David, Anthony S.; Kolliakou, Anna; O’Connor, Jennifer; Di Forti, Marta; Dazzan, Paola; Mondelli, Valeria; Morgan, Craig; Fisher, Helen L.

    2016-01-01

    While the role of childhood adversity in increasing the risk of psychosis has been extensively investigated, it is not clear what the impact of early adverse experiences is on the outcomes of psychotic disorders. Therefore, we investigated associations between childhood adversity and 1-year outcomes in 285 first-presentation psychosis patients. Exposure to childhood adversity prior to 17 years of age was assessed using the Childhood Experience of Care and Abuse Questionnaire. Data on illness course, symptom remission, length of psychiatric hospitalization, compliance with medication, employment, and relationship status were extracted from clinical records for the year following first contact with mental health services for psychosis. Seventy-one percent of patients reported exposure to at least 1 type of childhood adversity (physical abuse, sexual abuse, parental separation, parental death, disrupted family arrangements, or being taken into care). No robust associations were found between childhood adversity and illness course or remission. However, childhood physical abuse was associated with almost 3-fold increased odds of not being in a relationship at 1-year follow-up compared to patients who did not report such adverse experiences. There was also evidence of a significant association between parental separation in childhood and longer admissions to psychiatric wards during 1-year follow-up and 2-fold increased odds of noncompliance with medication compared to those not separated from their parents. Therefore, our findings suggest that there may be some specificity in the impact of childhood adversity on service use and social functioning among psychosis patients over the first year following presentation to mental health services. PMID:26373540

  11. The effects of crisis plans for patients with psychotic and bipolar disorders: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Roosenschoon BJ

    2009-07-01

    Full Text Available Abstract Background Crises and (involuntary admissions have a strong impact on patients and their caregivers. In some countries, including the Netherlands, the number of crises and (involuntary admissions have increased in the last years. There is also a lack of effective interventions to prevent their occurrence. Previous research has shown that a form of psychiatric advance statement – joint crisis plan – may prevent involuntary admissions, but another study showed no significant results for another form. The question remains which form of psychiatric advance statement may help to prevent crisis situations. This study examines the effects of two other psychiatric advance statements. The first is created by the patient with help from a patient's advocate (Patient Advocate Crisis Plan: PACP and the second with the help of a clinician only (Clinician facilitated Crisis Plan: CCP. We investigate whether patients with a PACP or CCP show fewer emergency visits and (involuntary admissions as compared to patients without a psychiatric advance statement. Furthermore, this study seeks to identify possible mechanisms responsible for the effects of a PACP or a CCP. Methods/Design This study is a randomised controlled trial with two intervention groups and one control condition. Both interventions consist of a crisis plan, facilitated through the patient's advocate or the clinician respectively. Outpatients with psychotic or bipolar disorders, who experienced at least one psychiatric crisis during the previous two years, are randomly allocated to one of the three groups. Primary outcomes are the number of emergency (after hour visits, (involuntary admissions and the length of stay in hospital. Secondary outcomes include psychosocial functioning and treatment satisfaction. The possible mediator variables of the effects of the crisis plans are investigated by assessing the patient's involvement in the creation of the crisis plan, working alliance

  12. Prediction of the period of psychotic episode in individual schizophrenics by simulation-data construction approach.

    Science.gov (United States)

    Huang, Chun-Jung; Wang, Hsiao-Fan; Chiu, Hsien-Jane; Lan, Tsuo-Hung; Hu, Tsung-Ming; Loh, El-Wui

    2010-10-01

    Although schizophrenia can be treated, most patients still experience inevitable psychotic episodes from time to time. Precautious actions can be taken if the next onset can be predicted. However, sufficient information is always lacking in the clinical scenario. A possible solution is to use the virtual data generated from limited of original data. Data construction method (DCM) has been shown to generate the virtual felt earthquake data effectively and used in the prediction of further events. Here we investigated the performance of DCM in deriving the membership functions and discrete-event simulations (DES) in predicting the period embracing the initiation and termination time-points of the next psychotic episode of 35 individual schizophrenic patients. The results showed that 21 subjects had a success of simulations (RSS) ≥70%. Further analysis demonstrated that the co-morbidity of coronary heart diseases (CHD), risks of CHD, and the frequency of previous psychotic episodes increased the RSS.

  13. Platform for systems medicine research and diagnostic applications in psychotic disorders-The METSY project

    DEFF Research Database (Denmark)

    Frank, Elisabeth; Maier, Dieter; Pajula, Juha

    2018-01-01

    with detailed metabolic characterisation and multi-variate network analysis is essential in order to identify how lipid dysregulation may contribute to psychotic disorders. A decision support system, integrating clinical, neuropsychological and neuroimaging data, was also developed in order to aid clinical......Psychotic disorders are associated with metabolic abnormalities including alterations in glucose and lipid metabolism. A major challenge in the treatment of psychosis is to identify patients with vulnerable metabolic profiles who may be at risk of developing cardiometabolic co...... these endocannabinoid abnormalities relate to metabolic changes in psychosis. Here we review recent research in the field of metabolic co-morbidities in psychotic disorders as well as the methods to study them and potential links to the endocannabinoid system. We also describe the bioinformatics platforms developed...

  14. Complex Diagnostic and Treatment Issues in Psychotic Symptoms Associated with Narcolepsy

    Science.gov (United States)

    Ivanenko, Anna

    2009-01-01

    Narcolepsy is an uncommon chronic, neurological disorder characterized by abnormal manifestations of rapid eye movement sleep and perturbations in the sleep-wake cycle. Accurate diagnosis of psychotic symptoms in a person with narcolepsy could be difficult due to side effects of stimulant treatment (e.g., hallucinations) as well as primary symptoms of narcolepsy (e.g., sleep paralysis and hypnagogic and/or hypnapompic hallucinations). Pertinent articles from peer-reviewed journals were identified to help understand the complex phenomenology of psychotic symptoms in patients with narcolepsy. In this ensuing review and discussion, we present an overview of narcolepsy and outline diagnostic and management approaches for psychotic symptoms in patients with narcolepsy. PMID:19724760

  15. Heat-Related Illnesses

    Science.gov (United States)

    ... Share this! EmergencyCareForYou » Emergency 101 » Heat-Related Illnesses Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at ... about heat cramps and heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the ...

  16. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Share this! EmergencyCareForYou » Emergency 101 » Heat-Related Illnesses Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at ... about heat cramps and heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the ...

  17. Foodborne Germs and Illnesses

    Science.gov (United States)

    ... Español (Spanish) Recommend on Facebook Tweet Share Compartir What Causes Food Poisoning? Many different disease-causing germs can contaminate ... email address: Enter Email Address What’s this? Submit What's this? Submit Button ... of Foodborne Illness in the U.S. Food Safety is a CDC Winnable Battle Foodborne Illness ...

  18. The Association between Sleep Problems and Psychotic Symptoms in the General Population: A Global Perspective.

    Science.gov (United States)

    Koyanagi, Ai; Stickley, Andrew

    2015-12-01

    To assess the prevalence of sleep problems and their association with psychotic symptoms using a global database. Community-based cross-sectional study. Data were analyzed from the World Health Organization's World Health Survey (WHS), a population-based survey conducted in 70 countries between 2002 and 2004. 261,547 individuals aged ≥ 18 years from 56 countries. N/A. The presence of psychotic symptoms in the past 12 months was established using 4 questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Sleep problems referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression was used to estimate the associations. The overall prevalence of sleep problems was 7.6% and ranged from 1.6% (China) to 18.6% (Morocco). Sleep problems were associated with significantly higher odds for at least one psychotic symptom in the vast majority of countries. In the pooled sample, after adjusting for demographic factors, alcohol consumption, smoking, and chronic medical conditions, having sleep problems resulted in an odds ratio (OR) for at least one psychotic symptom of 2.41 (95% confidence interval [CI] 2.18-2.65). This OR was 1.59 (1.40-1.81) when further adjusted for anxiety and depression. A strong association between sleep problems and psychotic symptoms was observed globally. These results have clinical implications and serve as a basis for future studies to elucidate the causal association between psychotic symptoms and sleep problems. © 2015 Associated Professional Sleep Societies, LLC.

  19. Psychotic Symptoms in Attention-Deficit/Hyperactivity Disorder: An Analysis of the MTA Database.

    Science.gov (United States)

    Vitiello, Benedetto; Perez Algorta, Guillermo; Arnold, L Eugene; Howard, Andrea L; Stehli, Annamarie; Molina, Brooke S G

    2017-04-01

    To assess the prevalence of psychotic symptoms among youths (14-25 years of age) with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) combined type. Participants in the Multimodal Treatment Study of Children with ADHD (MTA) and a local normative comparison group (LNCG) were systematically assessed 6, 8, 10, 12, 14, and 16 years after the original enrollment at a mean age of 8.5 years. Trained research assistants administered a psychosis screener, and positive screens were referred to study clinicians to confirm or exclude psychosis. Possible associations between screening positive and alcohol or substance use were assessed. Data were available from 509 MTA participants (88% of original MTA sample; mean age 25.1 years) and 276 LNCG participants (96% of original sample; mean age 24.6 years) at year 16. Twenty-six MTA participants (5%; 95% CI 3-7) and 11 LNCG participants (4%; 95% CI 2-6) screened positive for at least 1 psychotic symptom (p = .60). Most psychotic symptoms were transient. The prevalence of clinician-confirmed psychotic symptoms was 1.1% (95% CI 0.2-2.1) in the MTA group and 0.7% (0-1.7) in the LNCG (p = .72). Greater cannabis use was reported by those who screened positive (p ADHD increased the risk for psychotic symptoms. In the ADHD and normative comparison groups, more frequent cannabis use was associated with a greater likelihood of experiencing psychotic symptoms, thus supporting the recommendation that youth should not use cannabis. Published by Elsevier Inc.

  20. Are genetic risk factors for psychosis also associated with dimension-specific psychotic experiences in adolescence?

    Directory of Open Access Journals (Sweden)

    Dominika Sieradzka

    Full Text Available Psychosis has been hypothesised to be a continuously distributed quantitative phenotype and disorders such as schizophrenia and bipolar disorder represent its extreme manifestations. Evidence suggests that common genetic variants play an important role in liability to both schizophrenia and bipolar disorder. Here we tested the hypothesis that these common variants would also influence psychotic experiences measured dimensionally in adolescents in the general population. Our aim was to test whether schizophrenia and bipolar disorder polygenic risk scores (PRS, as well as specific single nucleotide polymorphisms (SNPs previously identified as risk variants for schizophrenia, were associated with adolescent dimension-specific psychotic experiences. Self-reported Paranoia, Hallucinations, Cognitive Disorganisation, Grandiosity, Anhedonia, and Parent-rated Negative Symptoms, as measured by the Specific Psychotic Experiences Questionnaire (SPEQ, were assessed in a community sample of 2,152 16-year-olds. Polygenic risk scores were calculated using estimates of the log of odds ratios from the Psychiatric Genomics Consortium GWAS stage-1 mega-analysis of schizophrenia and bipolar disorder. The polygenic risk analyses yielded no significant associations between schizophrenia and bipolar disorder PRS and the SPEQ measures. The analyses on the 28 individual SNPs previously associated with schizophrenia found that two SNPs in TCF4 returned a significant association with the SPEQ Paranoia dimension, rs17512836 (p-value = 2.57×10⁻⁴ and rs9960767 (p-value = 6.23×10⁻⁴. Replication in an independent sample of 16-year-olds (N = 3,427 assessed using the Psychotic-Like Symptoms Questionnaire (PLIKS-Q, a composite measure of multiple positive psychotic experiences, failed to yield significant results. Future research with PRS derived from larger samples, as well as larger adolescent validation samples, would improve the predictive power to test

  1. AKT1 moderation of cannabis-induced cognitive alterations in psychotic disorder.

    Science.gov (United States)

    van Winkel, Ruud; van Beveren, Nico J M; Simons, Claudia

    2011-11-01

    Genetic variation in AKT1 may be associated with sensitivity to the psychotomimetic effects of cannabis as well as with increased risk for psychotic disorder following cannabis use. Investigation of the effect of this interaction on relevant intermediate phenotypes for psychosis, such as cognition, may help to clarify the underlying mechanism. Thus, verbal memory (visually presented Word Learning Task), sustained attention (Continuous Performance Test, CPT), AKT1 rs2494732 genotype, and cannabis use were examined in a large cohort of patients with psychotic disorder. No evidence was found for AKT1 × cannabis interaction on verbal memory. Cannabis use preceding onset of psychotic disorder did interact significantly with AKT1 rs2494732 genotype to affect CPT reaction time (β=8.0, SE 3.9, p=0.037) and CPT accuracy (β=-1.2, SE 0.4, p=0.003). Cannabis-using patients with the a priori vulnerability C/C genotype were slower and less accurate on the CPT, whereas cannabis-using patients with the T/T genotype had similar or better performance than non-using patients with psychotic disorder. The interaction was also apparent in patients with psychotic disorder who had not used cannabis in the 12 months preceding assessment, but was absent in the unaffected siblings of these patients and in healthy controls. In conclusion, cannabis use before onset of psychosis may have long-lasting effects on measures of sustained attention, even in the absence of current use, contingent on AKT1 rs2494732 genotype. The results suggest that long-term changes in cognition may mediate the risk-increasing effect of the AKT1 × cannabis interaction on psychotic disorder.

  2. 'Earning and learning' in those with psychotic disorders: the second Australian national survey of psychosis.

    Science.gov (United States)

    Waghorn, Geoffrey; Saha, Sukanta; Harvey, Carol; Morgan, Vera A; Waterreus, Anna; Bush, Robert; Castle, David; Galletly, Cherrie; Stain, Helen J; Neil, Amanda L; McGorry, Patrick; McGrath, John J

    2012-08-01

    Participation in mainstream education and employment facilitates both the recovery and the social inclusion of people with psychotic disorders. As part of the second Australian survey of psychosis, we assessed labour force activity and participation in formal education among working age adults with psychotic disorders. Data were drawn from a large national community prevalence survey of adults with psychotic disorders. Known as the Survey of High Impact Psychosis (SHIP), it was conducted in seven Australian catchment areas during March to December 2010. Current and past year labour force activity, current employment, past year participation in formal education and vocational training, and key clinical and demographic characteristics were examined in a sample of 1825 participants. Only 22.4% of people with psychotic disorders were found to be employed (either full-time or part-time) in the month prior to the survey. In the previous 12 months, 32.7% were employed at some time. Of those in competitive employment, the majority worked part-time (63.9%), while a quarter worked 38 or more hours per week (23.4%). In terms of educational attainment, 18.4% reported difficulties with reading or writing, while 31.9% completed high school, which represents 12 years of formal education. The proportion currently employed has remained stable at 22% since the last national survey in 1997. Policy makers and service providers could do more to ensure people with psychotic disorders obtain access to more effective forms of assistance with respect to both their continuing education and employment. More effective vocational and educational interventions for people with psychotic disorders appear to be urgently needed.

  3. Neural markers of emotional face perception across psychotic disorders and general population.

    Science.gov (United States)

    Sabharwal, Amri; Kotov, Roman; Szekely, Akos; Leung, Hoi-Chung; Barch, Deanna M; Mohanty, Aprajita

    2017-07-01

    There is considerable variation in negative and positive symptoms of psychosis, global functioning, and emotional face perception (EFP), not only in schizophrenia but also in other psychotic disorders and healthy individuals. However, EFP impairment and its association with worse symptoms and global functioning have been examined largely in the domain of schizophrenia. The present study adopted a dimensional approach to examine the association of behavioral and neural measures of EFP with symptoms of psychosis and global functioning across individuals with schizophrenia spectrum (SZ; N = 28) and other psychotic (OP; N = 29) disorders, and never-psychotic participants (NP; N = 21). Behavioral and functional MRI data were recorded as participants matched emotional expressions of faces and geometrical shapes. Lower accuracy and increased activity in early visual regions, hippocampus, and amygdala during emotion versus shape matching were associated with higher negative, but not positive, symptoms and lower global functioning, across all participants. This association remained even after controlling for group-related (SZ, OP, and NP) variance, dysphoria, and antipsychotic medication status, except in amygdala. Furthermore, negative symptoms mediated the relationship between behavioral and brain EFP measures and global functioning. This study provides some of the first evidence supporting the specific relationship of EFP measures with negative symptoms and global functioning across psychotic and never-psychotic samples, and transdiagnostically across different psychotic disorders. Present findings help bridge the gap between basic EFP-related neuroscience research and clinical research in psychosis, and highlight EFP as a potential symptom-specific marker that tracks global functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. No Evidence of Association between Childhood Urban Environment and Cortical Thinning in Psychotic Disorder.

    Science.gov (United States)

    Frissen, Aleida; van Os, Jim; Habets, Petra; Gronenschild, Ed; Marcelis, Machteld

    2017-01-01

    The alterations in cortical morphology, such as cortical thinning, observed in psychotic disorder, may be the outcome of interacting genetic and environmental effects. It has been suggested that urban upbringing may represent a proxy environmental effect impacting cortical thickness (CT). Therefore, the current study examined whether the association between group as a proxy genetic variable (patients with psychotic disorder [high genetic risk], healthy siblings of patients [intermediate risk] and healthy control subjects [average risk]) and CT was conditional on different levels of the childhood urban environment and whether this was sex-dependent. T1-weighted MRI scans were acquired from 89 patients with a psychotic disorder, 95 non-psychotic siblings of patients with psychotic disorder and 87 healthy control subjects. Freesurfer software was used to measure CT. Developmental urban exposure was classified as low, medium, and high, reflecting the population density and the number of moves between birth and the 15th birthday, using data from the Dutch Central Bureau of Statistics and the equivalent database in Belgium. Multilevel regression analyses were used to examine the association between group, sex, and urban upbringing (as well as their interactions) and cortical CT as the dependent variable. CT was significantly smaller in the patient group compared to the controls (B = -0.043, p <0.001), but not in the siblings compared to the controls (B = -0.013, p = 0.31). There was no main effect of developmental urbanicity on CT (B = 0.001, p = 0.91). Neither the three-way group × urbanicity × sex interaction (χ2 = 3.73, p = 0.16), nor the two-way group × urbanicity interaction was significant (χ2 = 0.51, p = 0.77). The negative association between (familial risk for) psychotic disorder and CT was not moderated by developmental urbanicity, suggesting that reduced CT is not the outcome of familial sensitivity to the proxy environmental factor 'urban upbringing'.

  5. No Evidence of Association between Childhood Urban Environment and Cortical Thinning in Psychotic Disorder.

    Directory of Open Access Journals (Sweden)

    Aleida Frissen

    Full Text Available The alterations in cortical morphology, such as cortical thinning, observed in psychotic disorder, may be the outcome of interacting genetic and environmental effects. It has been suggested that urban upbringing may represent a proxy environmental effect impacting cortical thickness (CT. Therefore, the current study examined whether the association between group as a proxy genetic variable (patients with psychotic disorder [high genetic risk], healthy siblings of patients [intermediate risk] and healthy control subjects [average risk] and CT was conditional on different levels of the childhood urban environment and whether this was sex-dependent.T1-weighted MRI scans were acquired from 89 patients with a psychotic disorder, 95 non-psychotic siblings of patients with psychotic disorder and 87 healthy control subjects. Freesurfer software was used to measure CT. Developmental urban exposure was classified as low, medium, and high, reflecting the population density and the number of moves between birth and the 15th birthday, using data from the Dutch Central Bureau of Statistics and the equivalent database in Belgium. Multilevel regression analyses were used to examine the association between group, sex, and urban upbringing (as well as their interactions and cortical CT as the dependent variable.CT was significantly smaller in the patient group compared to the controls (B = -0.043, p <0.001, but not in the siblings compared to the controls (B = -0.013, p = 0.31. There was no main effect of developmental urbanicity on CT (B = 0.001, p = 0.91. Neither the three-way group × urbanicity × sex interaction (χ2 = 3.73, p = 0.16, nor the two-way group × urbanicity interaction was significant (χ2 = 0.51, p = 0.77.The negative association between (familial risk for psychotic disorder and CT was not moderated by developmental urbanicity, suggesting that reduced CT is not the outcome of familial sensitivity to the proxy environmental factor 'urban

  6. Psychosomatic regularities of psychotic disorders of women in involution (pathogenesis, clinics, psychodynamic psychotherapy

    Directory of Open Access Journals (Sweden)

    М. М. Pustovoyt

    2017-08-01

    Full Text Available The problem of psychotic disorders with onset in the age of involution from broader perspective, guided by modern multidimensional paradigm, was never discussed before. Involutional psychosis is considered as a constellation of the biological changes that are irrefutable in this age period. Certain personality traits and coping strategies can be predisposing to psychotic response, as well as typical features of the “life curve” and external stressors that can run a psychotic reaction. The paper presents the result of our study. This study pays much attention to study of premorbid personality, with emphasis on characteristic features, peculiarities of the emotional reaction and motivation-behavioral area, which completely coincided with characteristics of the narcissistic personality disorder listed in DSM-V (2013. Aim: To explore the psychosomatic pathogenetic connections inherent involutionary psychosis, given pathogenic and pathoplastic impact of premorbid personality structure their syndromic form and dynamics, determine their place on the psychosomatic continuum and develop adequate and pathogenetic justified method of therapy. Methods. Data obtained by the clinical method were confirmed by the results of experimental psychological and neuropsychological researches. Results. Clinical characteristics of psychotic disorders in the patient population showed in the structure of psychosis the existence of two oppositely directed continuums: affective (depressive and delusional. This allows to allocate four main clinical forms of psychosis and their tendency to unite in two clusters that differed each other by the features, and also by their response to therapy and, therefore, by the prognosis. Conclusions: The psychodynamic approach to understanding the involutional psychosis, that was introduced by the author, got natural development in the proposed method of treatment that included complex medication and psychotherapy. The schemes of

  7. Structural magnetic resonance imaging in patients with first-episode schizophrenia, psychotic and severe non-psychotic depression and healthy controls. Results of the schizophrenia and affective psychoses (SAP) project.

    Science.gov (United States)

    Salokangas, R K R; Cannon, T; Van Erp, T; Ilonen, T; Taiminen, T; Karlsson, H; Lauerma, H; Leinonen, K M; Wallenius, E; Kaljonen, A; Syvälahti, E; Vilkman, H; Alanen, A; Hietala, J

    2002-09-01

    Structural brain abnormalities are prevalent in patients with schizophrenia and affective disorders. To study how regional brain volumes and their ratios differ between patients with schizophrenia, psychotic depression, severe non-psychotic depression and healthy controls. Magnetic resonance imaging scans of the brain on first-episode patients and on healthy controls. Patients with schizophrenia had a smaller left frontal grey matter volume than the other three groups. Patients with psychotic depression had larger ventricular and posterior sulcal cerebrospinal fluid (CSF) volumes than controls. Patients with depression had larger white matter volumes than the other patients. Left frontal lobe, especially its grey matter volume, seems to be specifically reduced in first-episode schizophrenia. Enlarged cerebral ventricles and sulcal CSF volumes are prevalent in psychotic depression. Preserved or expanded white matter is typical of non-psychotic depression.

  8. Intermediate phenotype analysis of patients, unaffected siblings, and healthy controls identifies VMAT2 as a candidate gene for psychotic disorder and neurocognition

    NARCIS (Netherlands)

    Simons, C.J.; van Winkel, R.; Bruggeman, R.; Cahn, W.; de Haan, L.; Kahn, R.S.; Krabbendam, L.; Linzen, D.; Myin-Germeys, I.; van Os, J; Wiersma, D.

    2013-01-01

    Psychotic disorders are associated with neurocognitive alterations that aggregate in unaffected family members, suggesting that genetic vulnerability to psychotic disorder impacts neurocognition. The aim of the present study was to investigate whether selected schizophrenia candidate single

  9. Treatment of unipolar psychotic depression : a randomized, double-blind study comparing imipramine, venlafaxine, and venlafaxine plus quetiapine

    NARCIS (Netherlands)

    Wijkstra, J.; Burger, H.; van den Broek, W. W.; Birkenhager, T. K.; Janzing, J. G. E.; Boks, M. P. M.; Bruijn, J. A.; van der Loos, M. L. M.; Breteler, L. M. T.; Ramaekers, G. M. G. I.; Verkes, R. J.; Nolen, W. A.

    Objective: It remains unclear whether unipolar psychotic depression should be treated with an antidepressant and an antipsychotic or with an antidepressant alone. Method: In a multi-center RCT, 122 patients (18-65 years) with DSM-IV-TR psychotic major depression and HAM-D-17 >= 18 were randomized to

  10. Treatment of unipolar psychotic depression: a randomized, double-blind study comparing imipramine, venlafaxine, and venlafaxine plus quetiapine.

    NARCIS (Netherlands)

    Wijkstra, J.; Burger, H.; Broek, W.W. van den; Birkenhäger, T.K.; Janzing, J.G.E.; Boks, M.P.; Bruijn, J.A.; Loos, M.L. van der; Breteler, L.M.; Ramaekers, G.M.; Verkes, R.J.; Nolen, W.A.

    2010-01-01

    OBJECTIVE: It remains unclear whether unipolar psychotic depression should be treated with an antidepressant and an antipsychotic or with an antidepressant alone. METHOD: In a multi-center RCT, 122 patients (18-65 years) with DSM-IV-TR psychotic major depression and HAM-D-17 > or = 18 were

  11. Stability and development of psychotic symptoms and the use of antipsychotic medication - long-term follow-up

    DEFF Research Database (Denmark)

    Gotfredsen, D R; Wils, R S; Hjorthøj, C

    2017-01-01

    BACKGROUND: Few studies have evaluated the development in the use of antipsychotic medication and psychotic symptoms in patients with first-episode psychosis on a long-term basis. Our objective was to investigate how psychotic symptoms and the use of antipsychotic medication changed over a 10-yea...

  12. An Open Trial of a New Acceptance-Based Behavioral Treatment for Major Depression with Psychotic Features

    Science.gov (United States)

    Gaudiano, Brandon A.; Nowlan, Kathryn; Brown, Lily A.; Epstein-Lubow, Gary; Miller, Ivan W.

    2013-01-01

    Research suggests that cognitive and behavioral therapies produce significant benefits over medications alone in the treatment of severe, nonpsychotic major depression or primary psychotic disorders such as schizophrenia. However, previous research has not demonstrated the efficacy of psychotherapy for major depression with psychotic features. In…

  13. Increased psychophysiological parameters of attention in non-psychotic individuals with auditory verbal hallucinations

    DEFF Research Database (Denmark)

    van Lutterveld, Remko; Oranje, Bob; Abramovic, Lucija

    2010-01-01

    with an auditory oddball paradigm in 18 non-psychotic individuals with AVH and 18 controls. RESULTS: P300 amplitude was increased in the AVH group as compared to controls, reflecting superior effortful attention. A trend in the same direction was found for processing negativity. No significant differences were...... found for mismatch negativity. CONCLUSION: Contrary to our expectations, non-psychotic individuals with AVH show increased rather than decreased psychophysiological measures of effortful attention compared to healthy controls, refuting a pivotal role of decreased effortful attention...

  14. Excess mortality of acute and transient psychotic disorders: comparison with bipolar affective disorder and schizophrenia

    DEFF Research Database (Denmark)

    Castagnini, Augusto; Foldager, Leslie; Bertelsen, Aksel

    2013-01-01

    Objective: To investigate mortality and causes of death of short-lived psychotic disorders, by carrying out a comparison with bipolar disorder and schizophrenia. Method: Record linkage study to the official register of causes of death of all cases aged 15–64 years who were listed for the first time...... in the Danish Psychiatric Register between 1995 and 2008 with an ICD-10 diagnosis of ‘acute and transient psychotic disorders’ (ATPDs; n = 4157), bipolar disorder (n = 3200) and schizophrenia (n = 4576). Results: A total of 232 patients (5.6%) with ATPDs, 172 (5.4%) with bipolar disorder and 233 (5...

  15. The neuroanatomy of psychotic diathesis: a meta-analytic review.

    Science.gov (United States)

    Palaniyappan, Lena; Balain, Vijender; Liddle, Peter F

    2012-10-01

    Several studies have found widespread structural changes affecting the grey matter at various stages of schizophrenia (the prodrome, first-episode, and the chronic stage). It is unclear which of these neuroanatomical changes are associated with a predisposition or vulnerability to develop schizophrenia rather than the appearance of the clinical features of the illness. 16 voxel-based morphometry (VBM) analyses involving 733 genetically high-risk relatives (HRR) of patients with schizophrenia, 563 healthy controls and 474 patients were meta-analysed using the Signed Differential Mapping (SDM) technique. Two meta-analyses were conducted, with one comparing HRR group with healthy controls and the other comparing HRR group with the patients. A significant grey matter reduction in the lentiform nucleus, amygdala/parahippocampal gyrus and medial prefrontal cortex was seen in association with the genetic diathesis. Grey matter reduction in bilateral insula, inferior frontal gyrus, superior temporal gyrus and the anterior cingulate was seen in association with the disease expression. The neuroanatomical changes associated with the genetic diathesis to develop schizophrenia appear to be different from those that contribute to the clinical expression of the illness. Grey matter abnormalities in multimodal brain regions that have a supervisory function are likely to be central to the expression of the clinical symptoms of schizophrenia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... exhaustion symptoms include cool, moist, pale or flushed skin; headache; dizziness; weakness; feeling exhausted; heavy sweating; nausea; ... stage of heat illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; ...

  17. Heat Related Illnesses

    National Research Council Canada - National Science Library

    Carter, R; Cheuvront, S. N; Sawka, M. N

    2006-01-01

    .... The risk of serious heat illness can be markedly reduced by implementing a variety of countermeasures, including becoming acclimated to the heat, managing heat stress exposure, and maintaining hydration...

  18. Obesity and Mental Illness

    Centers for Disease Control (CDC) Podcasts

    People with serious mental illness who are overweight or obese can benefit from taking part in a fitness program called InSHAPE where they receive help with fitness, weight loss, and even grocery shopping on a budget.

  19. Caregivers and Serious Illness

    Science.gov (United States)

    ... toll on you. You may experience distress, anxiety, depression, exhaustion, and worsening of your own physical and emotional well-being. As a result of these types of stress, your health can suffer. FAMILIES AND SERIOUS ILLNESS You are ...

  20. Cholera Illness and Symptoms

    Science.gov (United States)

    ... Share Compartir Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae and is spread by ingestion of contaminated food or water. The infection is often mild or without symptoms, ...

  1. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or ... the elderly are most at risk, but anyone can be affected. Here you will find information about ...

  2. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... ICE” in Your Cell Phone Prepare for Disasters Communication With Your Family And Your Doctor About Your ... Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be ...

  3. Neutrophils in critical illness.

    Science.gov (United States)

    McDonald, Braedon

    2018-03-01

    During critical illness, dramatic alterations in neutrophil biology are observed including abnormalities of granulopoeisis and lifespan, cell trafficking and antimicrobial effector functions. As a result, neutrophils transition from powerful antimicrobial protectors into dangerous mediators of tissue injury and organ dysfunction. In this article, the role of neutrophils in the pathogenesis of critical illness (sepsis, trauma, burns and others) will be explored, including pathological changes to neutrophil function during critical illness and the utility of monitoring aspects of the neutrophil phenotype as biomarkers for diagnosis and prognostication. Lastly, we review findings from clinical trials of therapies that target the harmful effects of neutrophils, providing a bench-to-bedside perspective on neutrophils in critical illness.

  4. Mass Psychogenic Illness

    Science.gov (United States)

    ... Outbreaks of mass psychogenic illness show us how stress affects us. Think of how stage fright can cause nausea, shortness of breath, headache, dizziness, a racing heart, a stomachache, or diarrhea. ...

  5. No duty owed to the relatives of a victim of a person with mental illness.

    Science.gov (United States)

    Scott, Russ

    2015-08-01

    To review the case of an acutely psychotic person who was discharged into the care of a friend whom he killed later the same day, and to consider the reasoning of the High Court in the subsequent negligence action of the victim's relatives. By a narrow interpretation, the High Court found that the exercise of the powers and duties in relation to the involuntary detention of a mentally ill person as prescribed by the Mental Health Act were inconsistent with a common law duty of care to another person or the relatives of another person. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  6. [Relationship between subclinical psychotic symptoms and cognitive performance in the general population].

    Science.gov (United States)

    Martín-Santiago, Oscar; Suazo, Vanessa; Rodríguez-Lorenzana, Alberto; Ruiz de Azúa, Sonia; Valcárcel, César; Díez, Álvaro; Grau, Adriana; Domínguez, Cristina; Gallardo, Ricardo; Molina, Vicente

    2016-01-01

    Subclinical psychotic symptoms are associated to negative life outcomes in the general population, but their relationship with cognitive performance is still not well understood. Assessing the relationship between performance in cognitive domains and subclinical psychotic symptoms in the general population may also help understand the handicap attributed to clinical psychosis, in which these alterations are present. Subclinical and cognitive assessments were obtained in 203 participants from the general population by means of the Community Assessment of Psychic Experiences, the Brief Assessment of Cognition in Schizophrenia, the Wechsler Adults Intelligence Scale and the Wisconsin Card Sorting Test. The positive and negative subclinical symptoms and their relationship with age and cognition were examined, followed by assessing the influence of subclinical depression scores on the possible relationships between those subclinical psychotic symptoms and cognitive deficits. Inverse relationships were found between frequency in the Community Assessment of Psychic Experiences positive dimension and motor speed, and frequency and distress in the Community Assessment of Psychic Experiences negative dimension and motor speed. A direct relationship was also found between distress scores of the positive dimension and executive functions. Both positive and negative subclinical symptoms were related to depression scores. Psychotic symptoms, similar to those in the clinical population, may be associated with cognitive deficits in the general population. Copyright © 2015 SEP y SEPB. Published by Elsevier España. All rights reserved.

  7. Impact on the psychotic vulnerability of the therapeutic approachin the Prison Psychiatric Hospital in Seville (Spain).

    Science.gov (United States)

    Massé-García, P; Lamas-Bosque, F J; Massé-Palomo, A

    2017-06-01

    to analyze changes in psychotic vulnerability following the implementation of a program of prison psychiatric treatment, recidivism after the release and various descriptive variables of criminological interest. review of a sample consisting of 50 patients diagnosed with schizophrenia admitted to the Prison Psychiatric Hospital of Seville. there was a statistically significant reduction of psychotic vulnerability according to an assessment using the Frankfurt psychopathological inventory (FBF-3), after conducting a complete psychiatric, psychological, social and rehabilitation approach in the prison environment. The core symptoms relating to complex perception and language also decreased significantly. The reduction is particularly noticeable in the number of patients categorized as medium-high and high severity. Recidivism in the follow-up of release of patients in the study sample is low (6%) and there were no cases of serious felony or grievous bodily harm. Recidivism, when it occurs, is not immediate. Although there is some criminal versatility, it is limited. The most frequent victims are parents with a previous relationship with the patient. Most of the patients in the sample, and all recidivists, have comorbid substance abuse (dual diagnosis). we need more comprehensive studies to establish causal relationships between the decrease in psychotic vulnerability and an integrated psychiatric, psychological, social and rehabilitation approach in prisons; or to attribute the low rate of recidivism to the decline of psychotic vulnerability.

  8. Ethnicity, social disadvantage and psychotic-like experiences in a healthy population based sample.

    Science.gov (United States)

    Morgan, C; Fisher, H; Hutchinson, G; Kirkbride, J; Craig, T K; Morgan, K; Dazzan, P; Boydell, J; Doody, G A; Jones, P B; Murray, R M; Leff, J; Fearon, P

    2009-03-01

    We sought to investigate the prevalence and social correlates of psychotic-like experiences in a general population sample of Black and White British subjects. Data were collected from randomly selected community control subjects, recruited as part of the AESOP study, a three-centre population based study of first-episode psychosis. The proportion of subjects reporting one or more psychotic-like experience was 19% (n = 72/372). These were more common in Black Caribbean (OR 2.08) and Black African subjects (OR 4.59), compared with White British. In addition, a number of indicators of childhood and adult disadvantage were associated with psychotic-like experiences. When these variables were simultaneously entered into a regression model, Black African ethnicity, concentrated adult disadvantage, and separation from parents retained a significant effect. The higher prevalence of psychotic-like experiences in the Black Caribbean, but not Black African, group was explained by high levels of social disadvantage over the life course.

  9. How do General Practitioners experience providing care for their psychotic patients?

    Directory of Open Access Journals (Sweden)

    Slooff Cees J

    2007-06-01

    Full Text Available Abstract Background In primary care, GPs usually provide care for patients with chronic diseases according to professional guidelines. However, such guidelines are not available in the Netherlands for patients with recurring psychoses. It seems that the specific difficulties that GPs experience in providing care for these patients hinder the development and implementation of such guidelines. This study aims to explore the chances and problems GPs meet when providing care for patients susceptible for recurring psychoses, including schizophrenia and related disorders, bipolar disorder, and psychotic depression. Methods A qualitative study of focus group discussions with practising GPs in both town and rural areas. Transcripts from three focus groups with 19 GPs were analysed with the computer program 'Kwalitan'. Theoretical saturation was achieved after these three groups. Results Analysis showed that eight categories of factors influenced the GPs' care for psychotic patients: patient presentation (acute vs. chronic phase, emotional impact, expertise, professional attitude, patient related factors, patient's family, practice organization, and collaboration with psychiatric specialists. Conclusion Current primary care for psychotic patients depends very much on personal characteristics of the GP and the quality of local collaboration with the Mental Health Service. A quantitative study among GPs using a questionnaire based on the eight categories mentioned above would determine the extent of the problems and limitations experienced with this type of care. From the results of this quantitative study, new realistic guidelines could be developed to improve the quality of care for psychotic patients.

  10. Subclinical psychotic experiences and bipolar spectrum features in depression : association with outcome of psychotherapy

    NARCIS (Netherlands)

    Wigman, J. T. W.; van Os, J.; Abidi, L.; Huibers, M. J. H.; Roelofs, J.; Arntz, A.; Kelleher, I.; Peeters, F. P. M. L.

    Background Subthreshold psychotic and bipolar experiences are common in major depressive disorder (MDD). However, it is unknown if effectiveness of psychotherapy is altered in depressed patients who display such features compared with those without. The current paper aimed to investigate the impact

  11. The association between social anhedonia, withdrawal and psychotic experiences in general and high-risk populations.

    Science.gov (United States)

    Velthorst, Eva; Meijer, Carin

    2012-07-01

    Social anhedonia (SA) and withdrawal are clinically relevant phenomena in schizophrenia. To examine the nature of the overlap between SA, withdrawal and positive symptoms, we investigated whether the co-occurrence of these phenotypes is more prominent in siblings of patients with a psychotic disorder compared to healthy controls, and if this association is independent of the amount of distress caused by psychotic experiences (PEs). Data were derived from 646 unaffected siblings and 326 healthy controls who were included in the Dutch Genetic Risk and Outcome in Psychosis (GROUP) study. PEs were assessed with the Community Assessment of Psychic Experiences and the Structured Interview for Schizotypy-Revised was used to examine social anhedonia and withdrawal. Our results show relatively small but significant cross-sectional associations between SA, withdrawal and PEs in unaffected siblings and none in the control group, irrespective of the level of distress caused by PEs. The findings of the present study suggest that the overlap between SA, withdrawal and psychotic symptoms often reported in schizophrenia patients, may at least partly reflect a shared genetic vulnerability, instead of merely being either a state marker of - or reaction to - acute psychotic symptoms. Copyright © 2012. Published by Elsevier B.V.

  12. Symptomatological features of patients with and without Ecstasy use during their first psychotic episode.

    Science.gov (United States)

    Rugani, Fabio; Bacciardi, Silvia; Rovai, Luca; Pacini, Matteo; Maremmani, Angelo Giovanni Icro; Deltito, Joseph; Dell'osso, Liliana; Maremmani, Icro

    2012-07-01

    Ecstasy use is generally chosen by adolescents and young adults for its entactogenic properties (the production of feelings of empathy, love, and emotional closeness to others.) Despite this desired and frequently realized outcome, Ecstasy use has often resulted in the genesis of psychotic symptoms and aggressive behaviors, particularly after chronic and/or intensive use. To explore the negative consequences of Ecstasy use and to examine the aggressive nature oftentimes seen in many Ecstasy users we employed a case-control study model. We compared, by means of validated psychometric tests, the psychopathological symptoms (BPRS), the aggressiveness (OAS) and the social adjustment (DSM-GAF) of psychotic patients with (n = 23) and without (n = 46) recent user of Ecstasy, during their first psychotic episode and hospitalization. All 23 Ecstasy users were Ecstasy users only. Almost all of the psychotic symptoms were of similar severity in both groups. Blunted affect was milder in users than in non-users, whereas hostility and aggressive behavior was significantly more severe in users than in non-users. psychosis with a high level of aggressiveness and violence constitutes an important 'side-effect' that surely runs counter to the expected entactogenic action of Ecstasy. At a patient psycho-educational level, this study suggests that the use of Ecstasy may be counterproductive with respect to user expectations.

  13. Psychotic experiences and hyper-theory-of-mind in preadolescence - a birth cohort study

    NARCIS (Netherlands)

    Clemmensen, L.; van Os, J.; Drukker, M.; Munkholm, A.; Rimvall, M. K.; Vaever, M.; Rask, C. U.; Bartels-Velthuis, A. A.; Skovgaard, A. M.; Jeppesen, P.

    Background. Knowledge on the risk mechanisms of psychotic experiences (PE) is still limited. The aim of this population-based study was to explore developmental markers of PE with a particular focus on the specificity of hyper-theory-of-mind (HyperToM) as correlate of PE as opposed to correlate of

  14. Mentally disordered non-psychotic criminal offenders--treatment instead of punishment

    DEFF Research Database (Denmark)

    Gottlieb, Peter; Gabrielsen, Gorm; Kørner, Ejnar Alex

    2013-01-01

    By including §69 into the Danish Penal Code, it has since 1975 been possible to use psychiatric measures as legal sanctions for even non-psychotic offenders-if the measure is believed to be preventive of future crime. To be able to decide on the applicability of treatment measures as sanctions...

  15. Understanding and improving treatment adherence in patients with psychotic disorders : A review and a proposed intervention

    NARCIS (Netherlands)

    Staring, Anton B.P.; van der Gaag, Mark; Selten, Jean-Paul; Loonen, Anton J.M.; Hengeveld, Michiel W.; Mulder, Cornelis L.

    2006-01-01

    Non-adherence to treatment of patients with psychotic disorders is related to higher rates of relapse, hospitalization, and suicide. Important predictors of non-adherence include poor social structure, cognitive deficits, negative medication attitude, side effects, depression, a sealing-over

  16. A Predictive Coding Account of Psychotic Symptoms in Autism Spectrum Disorder

    Science.gov (United States)

    van Schalkwyk, Gerrit I.; Volkmar, Fred R.; Corlett, Philip R.

    2017-01-01

    The co-occurrence of psychotic and autism spectrum disorder (ASD) symptoms represents an important clinical challenge. Here we consider this problem in the context of a computational psychiatry approach that has been applied to both conditions--predictive coding. Some symptoms of schizophrenia have been explained in terms of a failure of top-down…

  17. The relation of vitamin D, metabolic risk and negative symptom severity in people with psychotic disorders

    NARCIS (Netherlands)

    Bruins, J.; Jörg, F.; van den Heuvel, E.R.; Bartels-Velthuis, A.A.; Corpeleijn, E.; Muskiet, F.A.J.; Pijnenborg, G.H.M.; Bruggeman, R.

    2018-01-01

    People with psychotic disorders have an increased metabolic risk and their mean life expectancy is reduced with circa 28 years (Olfson et al., 2015).Predictors of this increased metabolic risk are genetic predisposition (Liu et al., 2013), lifestyle factors such as unhealthy diet, physical

  18. AKT1 Moderation of Cannabis-Induced Cognitive Alterations in Psychotic Disorder

    NARCIS (Netherlands)

    van Winkel, R.; van Beveren, N.J.; Simons, C.; Kahn, R.S.; Linszen, D.H.; van Os, J.; Wiersma, D.; Bruggeman, R.; Cahn, W.; de Haan, L.; Krabbendam, L.; Myin-Germeys, I.

    2011-01-01

    Genetic variation in AKT1 may be associated with sensitivity to the psychotomimetic effects of cannabis as well as with increased risk for psychotic disorder following cannabis use. Investigation of the effect of this interaction on relevant intermediate phenotypes for psychosis, such as cognition,

  19. AKT1 moderation of cannabis-induced cognitive alterations in psychotic disorder

    NARCIS (Netherlands)

    van Winkel, Ruud; van Beveren, Nico J. M.; Simons, Claudia; Kahn, René S.; Linszen, Don H.; van Os, Jim; Wiersma, Durk; Bruggeman, Richard; Cahn, Wiepke; de Haan, Lieuwe; Krabbendam, Lydia; Myin-Germeys, Inez

    2011-01-01

    Genetic variation in AKT1 may be associated with sensitivity to the psychotomimetic effects of cannabis as well as with increased risk for psychotic disorder following cannabis use. Investigation of the effect of this interaction on relevant intermediate phenotypes for psychosis, such as cognition,

  20. Brain germinoma presenting as a first psychotic episode in an adolescent male

    OpenAIRE

    2010-01-01

    Brain germinoma presenting as a first psychotic episode in an adolescent male phone: +34-93-2275477 (Undurraga, Juan) (Undurraga, Juan) Department of Psychiatry, Institute of Neuroscience, Hospital Clinic de Barcelona - Servicio de Psiquiatria (Escalera 9, Planta 6), Calle Villarroel, 170 - 08036 - Barcelona - SPAIN (Undurraga, Juan) Department of Child and Adolescent Psychology and Psychiatry, Institute of Neuroscience, Hospital Clinic de Barcelona - Barc...

  1. Social Cognitive Impairments and Psychotic Symptoms: What is the Nature of Their Association?

    NARCIS (Netherlands)

    Fett, A.J.; Maat, A.; Kahn, R.S.; Linszen, D.H.; van Os, J.; Wiersma, D.; Bruggeman, R.; Cahn, W.; de Haan, L.; Krabbendam, L.; Myin-Germeys, I.

    2013-01-01

    Social cognitive deficits are associated with psychotic symptoms, but the nature of this association remains unknown. This study uses a genetically sensitive cross-trait cross-sibling design to investigate the nature of the overlap between both phenotypes. A sample of 1032 patients, 1017 of their

  2. Cannabis use and childhood trauma interact additively to increase the risk of psychotic symptoms in adolescence.

    LENUS (Irish Health Repository)

    Harley, M

    2010-10-01

    Adolescent cannabis use has been shown in many studies to increase the risk of later psychosis. Childhood trauma is associated with both substance misuse and risk for psychosis. In this study our aim was to investigate whether there is a significant interaction between cannabis use and childhood trauma in increasing the risk for experiencing psychotic symptoms during adolescence.

  3. Impact on the psychotic vulnerability of the therapeutic approachin the Prison Psychiatric Hospital in Seville (Spain

    Directory of Open Access Journals (Sweden)

    P. Massé-García

    Full Text Available Objectives: to analyze changes in psychotic vulnerability following the implementation of a program of prison psychiatric treatment, recidivism after the release and various descriptive variables of criminological interest. Materials and methods: review of a sample consisting of 50 patients diagnosed with schizophrenia admitted to the Prison Psychiatric Hospital of Seville. Results: there was a statistically significant reduction of psychotic vulnerability according to an assessment using the Frankfurt psychopathological inventory (FBF-3, after conducting a complete psychiatric, psychological, social and rehabilitation approach in the prison environment. The core symptoms relating to complex perception and language also decreased significantly. The reduction is particularly noticeable in the number of patients categorized as medium-high and high severity. Recidivism in the follow-up of release of patients in the study sample is low (6% and there were no cases of serious felony or grievous bodily harm. Recidivism, when it occurs, is not immediate. Although there is some criminal versatility, it is limited. The most frequent victims are parents with a previous relationship with the patient. Most of the patients in the sample, and all recidivists, have comorbid substance abuse (dual diagnosis. Discussion: we need more comprehensive studies to establish causal relationships between the decrease in psychotic vulnerability and an integrated psychiatric, psychological, social and rehabilitation approach in prisons; or to attribute the low rate of recidivism to the decline of psychotic vulnerability.

  4. A Network Approach to Environmental Impact in Psychotic Disorder : Brief Theoretical Framework

    NARCIS (Netherlands)

    Isvoranu, A.M.; Borsboom, D.; van Os, J.; Guloksuz, S.

    2016-01-01

    The spectrum of psychotic disorder represents a multifactorial and heterogeneous condition and is thought to result from a complex interplay between genetic and environmental factors. In the current paper, we analyze this interplay using network analysis, which has been recently proposed as a novel

  5. Integrative psychotherapy model for treatment of Depressive Recurrent disorder without psychotic symptoms effectiveness.

    Directory of Open Access Journals (Sweden)

    Joaquín F. Márquez Pérez

    2010-10-01

    Full Text Available The investigation shows the results of the application of an integrative psychotherapy model in the treatment of Depressive Recurrent disorder without psychotic symptoms. The use of a design of a qualitative Investigation - Action was necessary for finding the psychological mechanism that explain different levels of effectiveness.

  6. The association between psychotic experiences and disability : Results from the WHO World Mental Health Surveys

    NARCIS (Netherlands)

    Navarro-Mateu, F.; Alonso, J.; Lim, C. C. W.; Saha, S.; Aguilar-Gaxiola, S.; Al-Hamzawi, A.; Andrade, L. H.; Bromet, E. J.; Bruffaerts, R.; Chatterji, S.; Degenhardt, L.; de Girolamo, G.; de Jonge, P.; Fayyad, J.; Florescu, S.; Gureje, O.; Haro, J. M.; Hu, C.; Karam, E. G.; Kovess-Masfety, V.; Lee, S.; Medina-Mora, M. E.; Ojagbemi, A.; Pennell, B. -E.; Piazza, M.; Posada-Villa, J.; Scott, K. M.; Stagnaro, J. C.; Xavier, M.; Kendler, K. S.; Kessler, R. C.; McGrath, J. J.

    Objective: While psychotic experiences (PEs) are known to be associated with a range of mental and general medical disorders, little is known about the association between PEs and measures of disability. We aimed to investigate this question using the World Mental Health surveys. Method: Lifetime

  7. Ethnic density of neighborhoods and incidence of psychotic disorders among immigrants

    NARCIS (Netherlands)

    Veling, Wim; Susser, Ezra; van Os, Jim; Mackenbach, Johan P; Selten, Jean-Paul; Hoek, Hans W

    OBJECTIVE: A high incidence of psychotic disorders has been reported in immigrant ethnic groups in Western Europe. Some studies suggest that ethnic density may influence the incidence of schizophrenia. The authors investigated whether this increased incidence among immigrants depends on the ethnic

  8. The interplay between environmental factors and DNA methylation in psychotic disorders : Environmental orchestration of the epigenome

    NARCIS (Netherlands)

    Houtepen, LC

    2016-01-01

    Introduction: Environmental exposures during early- life increase the risk of developing a psychotic disorder, but it remains unclear how early life events can have such persistent later life consequences. DNA methylation is the addition of a methyl group to a DNA base and is part of a group of

  9. Validity of 'post-traumatic stress disorder with secondary psychotic features': a review of the evidence

    NARCIS (Netherlands)

    Braakman, M. H.; Kortmann, F. A. M.; van den Brink, W.

    2009-01-01

    OBJECTIVE: To review the evidence from empirical studies regarding the validity of 'post-traumatic stress disorder with secondary psychotic features' (PTSD-SP) as a separate diagnostic entity. METHOD: The authors performed a review tracing publications between 1980 and January 2008. RESULTS:

  10. Aspects of Piaget's cognitive developmental psychology and neurobiology of psychotic disorders - an integrative model.

    Science.gov (United States)

    Gebhardt, Stefan; Grant, Phillip; von Georgi, Richard; Huber, Martin T

    2008-09-01

    Psychological, neurobiological and neurodevelopmental approaches have frequently been used to provide pathogenic concepts on psychotic disorders. However, aspects of cognitive developmental psychology have hardly been considered in current models. Using a hypothesis-generating approach an integration of these concepts was conducted. According to Piaget (1896-1980), assimilation and accommodation as forms of maintenance and modification of cognitive schemata represent fundamental processes of the brain. In general, based on the perceived input stimuli, cognitive schemata are developed resulting in a conception of the world, the realistic validity and the actuality of which is still being controlled and modified by cognitive adjustment processes. In psychotic disorders, however, a disproportion of environmental demands and the ability to activate required neuronal adaptation processes occurs. We therefore hypothesize a failure of the adjustment of real and requested output patterns. As a consequence autonomous cognitive schemata are generated, which fail to adjust with reality resulting in psychotic symptomatology. Neurobiological, especially neuromodulatory and neuroplastic processes play a central role in these perceptive and cognitive processes. In conclusion, integration of cognitive developmental psychology into the existing pathogenic concepts of psychotic disorders leads to interesting insights into basic disease mechanisms and also guides future research in the cognitive neuroscience of such disorders.

  11. Psychotic Experiences and Neuropsychological Functioning in a Population-based Sample.

    Science.gov (United States)

    Mollon, Josephine; David, Anthony S; Morgan, Craig; Frissa, Souci; Glahn, David; Pilecka, Izabela; Hatch, Stephani L; Hotopf, Matthew; Reichenberg, Abraham

    2016-02-01

    Psychotic experiences in early life are associated with neuropsychological impairment and the risk for later psychiatric disorders. Psychotic experiences are also prevalent in adults, but neuropsychological investigations spanning adulthood are limited, and confounding factors have not been examined rigorously. To characterize neuropsychological functioning in adults with psychotic experiences while adjusting for important sociodemographic characteristics and familial factors and investigating the effect of age. The South East London Community Health (SELCoH) study is a population-based household survey of physical and mental health in individuals 16 years or older conducted from June 1, 2008, to December 31, 2010, in 2 London boroughs. The study included 1698 participants from 1075 households. Data were analyzed from May 6, 2014, to April 22, 2015. Psychotic experiences measured using the Psychosis Screening Questionnaire. Neuropsychological functioning measured using tests assessing verbal knowledge (Wechsler Test of Adult Reading), working memory (Spatial Delayed Response Task), memory (Visual Object Learning Task), and processing speed (digit symbol coding task). A composite IQ score of general cognitive ability was calculated. A total of 1677 participants with a mean (SD) age of 40 (17) years were included in the analysis. Compared with the group without psychotic experiences, the 171 (9.7%) adults with psychotic experiences did not show a statistically significant impairment on mean (SD) measures of IQ (95.25 [16.58] vs 100.45 [14.77]; Cohen d, -0.22; P = .06) or processing speed (40.63 [13.06] vs 42.17 [13.79]; Cohen d, -0.03; P = .73) but were impaired on measures of verbal knowledge (31.36 [15.78] vs 38.83 [12.64]; Cohen d, -0.37; P = .003), working memory (20.97 [4.12] vs 22.51 [3.26]; Cohen d, -0.34; P = .005), and memory (43.80 [8.45] vs 46.53 [7.06]; Cohen d, -0.28; P = .01). Only participants 50 years and older with psychotic

  12. The association between childhood autistic traits and adolescent psychotic experiences is explained by general neuropsychiatric problems.

    Science.gov (United States)

    Cederlöf, Martin; Pettersson, Erik; Sariaslan, Amir; Larsson, Henrik; Östberg, Per; Kelleher, Ian; Långström, Niklas; Gumpert, Clara Hellner; Lundström, Sebastian; Lichtenstein, Paul

    2016-03-01

    Studies suggest associations between childhood autistic traits and adolescent psychotic experiences. However, recent research suggests that a general neuropsychiatric problems factor predicts adverse outcomes better than specific diagnostic entities. To examine if the alleged association between autistic traits and psychotic experiences could rather be explained by a general neuropsychiatric problems factor comprising symptoms of ADHD, tic disorder, developmental coordination disorder, and learning disorder, we conducted a prospective cohort study based on the Child and Adolescent Twin Study in Sweden. In addition, we examined the genetic and environmental influences on the associations. A total of 9,282 twins with data on childhood autistic traits and other neuropsychiatric problems, and follow-up data on psychotic experiences at ages 15 and/or 18 years were included. First, psychotic experiences were regressed on autistic traits and second, the general neuropsychiatric problems factor was added to the model. Auditory hallucinations were analyzed separately from the other psychotic experiences. Finally, twin analyses were employed to disentangle genetic from environmental influences in the observed associations. Replicating prior research, significant associations were found between autistic traits in childhood and auditory hallucinations at ages 15 and 18. However, after controlling for the general neuropsychiatric problems factor, the associations between autistic traits and auditory hallucinations disappeared, whereas the association between the general neuropsychiatric problems factor and auditory hallucinations persisted after controlling for autistic traits. Twin analyses revealed that the association between the general neuropsychiatric problems factor and auditory hallucinations was driven by shared genetic influences. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  13. Neighbourhood level social deprivation and the risk of psychotic disorders: a systematic review.

    Science.gov (United States)

    O'Donoghue, Brian; Roche, Eric; Lane, Abbie

    2016-07-01

    The incidence of psychotic disorders varies according to the geographical area, and it has been investigated whether neighbourhood level factors may be associated with this variation. The aim of this systematic review is to collate and appraise the literature on the association between social deprivation and the incidence or risk for psychotic disorders. A systematic review was conducted, and studies were included if they were in English, provided a measure of social deprivation for more than one geographically defined area and examined either the correlation, rate ratio or risk of psychotic disorder. A defined search strategy was undertaken with Medline, CINAHL Plus and PsychInfo databases. A total of 409 studies were identified in the search, of which 28 fulfilled the inclusion criteria. Of these, four examined the association between social deprivation at the time of birth, three examined the putative prodrome of psychosis or those at ultra-high risk (UHR) for psychosis, and 23 examined the time at presentation with a first episode of psychosis (FEP) (one study examined two time points and one study included both UHR and FEP). Three of the studies that examined the level of social deprivation at birth found an association with a higher risk for psychotic disorders and increased social deprivation. Seventeen of the 23 studies found that there was a higher risk or rate of psychotic disorders in more deprived neighbourhoods at the time of presentation; however, adjusting for individual factors tended to weaken this association. Limited research has been conducted in the putative prodromal stage and has resulted in conflicting findings. Research conducted to date has not definitively identified whether the association is a result of social causation or social drift; however, the findings do have significant implications for service provision, such as the location and access of services.

  14. Cumulative Effects of Neighborhood Social Adversity and Personal Crime Victimization on Adolescent Psychotic Experiences.

    Science.gov (United States)

    Newbury, Joanne; Arseneault, Louise; Caspi, Avshalom; Moffitt, Terrie E; Odgers, Candice L; Fisher, Helen L

    2018-02-15

    Little is known about the impact of urbanicity, adverse neighborhood conditions and violent crime victimization on the emergence of adolescent psychotic experiences. Participants were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of 2232 British twins who were interviewed about adolescent psychotic experiences at age 18. Urbanicity, neighborhood characteristics, and personal victimization by violent crime were measured during childhood and adolescence via geocoded census data, surveys of over 5000 immediate neighbors of the E-Risk participants, and interviews with participants themselves. Adolescents raised in urban vs rural neighborhoods were significantly more likely to have psychotic experiences (OR = 1.67, 95% CI = 1.21-2.30, P = .002). This association remained significant after considering potential confounders including family socioeconomic status, family psychiatric history, and adolescent substance problems (OR = 1.43, 95% CI = 1.01-2.03, P = .042), but became nonsignificant after considering adverse social conditions in urban neighborhoods such as low social cohesion and high neighborhood disorder (OR = 1.35, 95% CI = 0.94-1.92, P = .102). The combined association of adverse neighborhood social conditions and personal crime victimization with adolescent psychotic experiences (adjusted OR = 4.86, 95% CI = 3.28-7.20, P < .001) was substantially greater than for either exposure alone, highlighting a potential interaction between neighborhood conditions and crime victimization (interaction contrast ratio = 1.81, 95% CI = -0.03 to 3.65) that was significant at the P = .054 level. Cumulative effects of adverse neighborhood social conditions and personal victimization by violent crime during upbringing partly explain why adolescents in urban settings are more likely to report psychotic experiences. Early intervention efforts for psychosis could be targeted towards victimized youth living in urban and socially

  15. Risperidone, quetiapine, and olanzapine adjunctive treatments in major depression with psychotic features: a comparative study

    Directory of Open Access Journals (Sweden)

    Gabriel A

    2013-04-01

    Full Text Available A Gabriel Departments of Psychiatry and Community Health Sciences, University of Calgary, Calgary, AB, Canada Objectives: The purpose of this study was to compare the effectiveness of novel antipsychotics in the treatment of psychotic depression. Method: Consecutive patients who were admitted (n = 51 with a confirmed diagnosis of major depression with psychotic features (delusions or hallucinations or both participated in this open-label, naturalistic study. All patients were treated with selective serotonin reuptake inhibitors (SSRIs and serotonin–norepinephrine reuptake inhibitors (SNRIs (citalopram or venlafaxine extended release [XR], and atypical antipsychotic agents were added, as tolerated, during the first week of initiating the citalopram or venlafaxine. There were patients (n = 16 who received risperidone, who received quetiapine (n = 20, and who received olanzapine (n = 15, as an adjunctive treatment to either citalopram or venlafaxine for at least 8 weeks. Outcome measures included the Clinical Global Impression-Severity subscale (CGI-S, as the primary outcome measure, as well as the Hamilton Rating Scale for Depression-21 item (HAM-D21 and the Brief Psychiatric Rating Scale (BPRS. Tolerance to treatments and weight changes were monitored over the period of the trial. Results: All patients completed the trial with no drop outs. At 8 weeks, there was a statistically significant (P 0.01 in the olanzapine group. Conclusion: Quetiapine, risperidone, and olanzapine, given as adjunctive treatment with SSRIS or SNRIs can significantly and equally improve depressive and psychotic symptoms, in the short-term treatment of major depression with psychotic features. The author recommends that large controlled trials be conducted to examine the differences in long-term efficacy and tolerance between the atypical antipsychotic agents, in the treatment of major depression with or without psychotic features. Keywords: depression, novels

  16. Khat use, PTSD and psychotic symptoms among Somali refugees in Nairobi - a pilot study

    Directory of Open Access Journals (Sweden)

    Marina eWidmann

    2014-06-01

    Full Text Available In East-African and Arab countries, khat leaves are traditionally chewed in social settings. They contain the amphetamine-like alkaloid cathinone. Especially among Somali refugees khat use has been associated with psychiatric symptoms. We assessed khat use patterns and psychiatric symptoms among male Somali refugees living in a disadvantaged urban settlement area in Kenya, a large group that has not yet received scientific attention. We wanted to explore consume patterns and study the associations between khat use, traumatic experiences and psychotic symptoms.Using privileged access sampling we recruited 33 healthy male khat chewers and 15 comparable non-chewers. Based on extensive preparatory work, we assessed khat use, khat dependence according to DSM-IV, traumatic experiences, Posttraumatic Stress Disorder and psychotic symptoms using standardized diagnostic instruments that had been adapted to the Somali language and culture.Hazardous use patterns like chewing for more than 24 hours without interruption were frequently reported. All khat users fulfilled the DSM-IV-criteria for dependence and eighty-five percent reported functional khat-use, i.e. that khat helps them to forget painful experiences. We found that the studied group was heavily burdened by traumatic events and posttraumatic symptoms. Khat users had experienced more traumatic events and had more often PTSD than non-users. Most khat users experience khat-related psychotic symptoms and in a quarter of them we found true psychotic symptoms. In contrast, among control group members no psychotic symptoms could be detected.We found first evidence for the existence and high prevalence of severely hazardous use patterns, comorbid psychiatric symptoms and khat use as a self-medication of trauma-consequences among male Somali refugees in urban Kenyan refugee settlements. There is a high burden by psychopathology and adequate community-based interventions urgently need to be developed.

  17. Cumulative Effects of Neighborhood Social Adversity and Personal Crime Victimization on Adolescent Psychotic Experiences

    Science.gov (United States)

    Newbury, Joanne; Arseneault, Louise; Caspi, Avshalom; Moffitt, Terrie E; Odgers, Candice L

    2018-01-01

    Abstract Background: Little is known about the impact of urbanicity, adverse neighborhood conditions and violent crime victimization on the emergence of adolescent psychotic experiences. Methods: Participants were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of 2232 British twins who were interviewed about adolescent psychotic experiences at age 18. Urbanicity, neighborhood characteristics, and personal victimization by violent crime were measured during childhood and adolescence via geocoded census data, surveys of over 5000 immediate neighbors of the E-Risk participants, and interviews with participants themselves. Results: Adolescents raised in urban vs rural neighborhoods were significantly more likely to have psychotic experiences (OR = 1.67, 95% CI = 1.21–2.30, P = .002). This association remained significant after considering potential confounders including family socioeconomic status, family psychiatric history, and adolescent substance problems (OR = 1.43, 95% CI = 1.01–2.03, P = .042), but became nonsignificant after considering adverse social conditions in urban neighborhoods such as low social cohesion and high neighborhood disorder (OR = 1.35, 95% CI = 0.94–1.92, P = .102). The combined association of adverse neighborhood social conditions and personal crime victimization with adolescent psychotic experiences (adjusted OR = 4.86, 95% CI = 3.28–7.20, P crime victimization (interaction contrast ratio = 1.81, 95% CI = −0.03 to 3.65) that was significant at the P = .054 level. Conclusions: Cumulative effects of adverse neighborhood social conditions and personal victimization by violent crime during upbringing partly explain why adolescents in urban settings are more likely to report psychotic experiences. Early intervention efforts for psychosis could be targeted towards victimized youth living in urban and socially adverse neighborhoods. PMID:28535284

  18. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Fikreyesus, Mahlet; Soboka, Matiwos; Feyissa, Garumma Tolu

    2016-10-20

    Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH). Data were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS) to assess compliance to medication and abnormal involuntary movement scale (AIMS) to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value value higher when compared to those who have never experienced medication side effects (aOR = 1.83, 95 % CI = 1.01, 3.31). The high prevalence of relapse among patients with psychotic disorder needs special attention. Clinicians need to pay attention to medication side effects the patient faces. Intervening noncompliance to medication and appropriately managing medication side effects may help in preventing psychotic relapse that may result because of non-compliance. The provision of counseling, psycho education, psycho social support may help patients in improving compliance to medication and reducing psychotic relapse. Developing and strengthening community based rehabilitation services should be emphasized as part of mental healthcare services.

  19. Why Are Children in Urban Neighborhoods at Increased Risk for Psychotic Symptoms? Findings From a UK Longitudinal Cohort Study.

    Science.gov (United States)

    Newbury, Joanne; Arseneault, Louise; Caspi, Avshalom; Moffitt, Terrie E; Odgers, Candice L; Fisher, Helen L

    2016-11-01

    Urban upbringing is associated with a 2-fold adulthood psychosis risk, and this association replicates for childhood psychotic symptoms. No study has investigated whether specific features of urban neighborhoods increase children's risk for psychotic symptoms, despite these early psychotic phenomena elevating risk for schizophrenia and other psychiatric disorders in adulthood. Analyses were conducted on over 2000 children from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of UK-born twins. Neighborhood-level characteristics were assessed for each family via: a geodemographic discriminator indexing neighborhood-level deprivation, postal surveys of over 5000 residents living alongside the children, and in-home interviews with the children's mothers. Children were interviewed about psychotic symptoms at age 12. Analyses were adjusted for important family-level confounders including socioeconomic status (SES), psychiatric history, and maternal psychosis. Urban residency at age-5 (OR = 1.80, 95% CI = 1.16-2.77) and age-12 (OR = 1.76, 95% CI = 1.15-2.69) were both significantly associated with childhood psychotic symptoms, but not with age-12 anxiety, depression, or antisocial behavior. The association was not attributable to family SES, family psychiatric history, or maternal psychosis, each implicated in childhood mental health. Low social cohesion, together with crime victimization in the neighborhood explained nearly a quarter of the association between urbanicity and childhood psychotic symptoms after considering family-level confounders. Low social cohesion and crime victimization in the neighborhood partly explain why children in cities have an elevated risk of developing psychotic symptoms. Greater understanding of the mechanisms leading from neighborhood-level exposures to psychotic symptoms could help target interventions for emerging childhood psychotic symptoms. © The Author 2016. Published by Oxford University

  20. The illness/non-illness model: hypnotherapy for physically ill patients.

    Science.gov (United States)

    Navon, Shaul

    2014-07-01

    This article proposes a focused, novel sub-set of the cognitive behavioral therapy approach to hypnotherapy for physically ill patients, based upon the illness/non-illness psychotherapeutic model for physically ill patients. The model is based on three logical rules used in differentiating illness from non-illness: duality, contradiction, and complementarity. The article discusses the use of hypnotic interventions to help physically ill and/or disabled patients distinguish between illness and non-illness in their psychotherapeutic themes and attitudes. Two case studies illustrate that patients in this special population group can be taught to learn the language of change and to use this language to overcome difficult situations. The model suggests a new clinical mode of treatment in which individuals who are physically ill and/or disabled are helped in coping with actual motifs and thoughts related to non-illness or non-disability.

  1. Men and women with psychosis and the impact of illness-duration on sex-differences: The second Australian national survey of psychosis.

    Science.gov (United States)

    Hanlon, Mary-Claire; Campbell, Linda E; Single, Natalie; Coleman, Clare; Morgan, Vera A; Cotton, Susan M; Stain, Helen J; Castle, David J

    2017-10-01

    We aimed to examine and compare sex-differences in people receiving treatment for psychotic illnesses in community settings, based on long or short duration of illness; expecting association between longer illness-duration and worse outcomes in women and men. Clinical, demographic and service-use data from the Survey of High Impact Psychosis were analysed by sex and duration of illness (≤5 years; ≥6 years), using independent t-tests, chi-square tests, one-way ANOVA, and Cramer's V. Of the 1825 participants, 47% had schizophrenia, 17.5% bipolar and 16.1% schizo-affective disorders. More women than men had undertaken post-school education, maintained relationships, and been living in their own homes. Women with a shorter-illness-duration showed social functioning equivalent to non-ill women in the general population. Men tended to have an early illness onset, show premorbid dysfunction, be single, show severe disability, and to use illicit substances. Men with a longer-illness-duration were very socially disadvantaged and isolated, often experiencing homelessness and substance use. Men with a short-illness-duration were most likely to be in paid employment, but two-thirds earned less than $AUD500 per fortnight. Men with longer-illness-duration showed most disability, socially and globally. Interventions should be guided by diagnosis, but also by a person's sex and duration of illness. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Treating body, treating mind: The experiences of people with psychotic disorders and their general practitioners - Findings from the Australian National Survey of High Impact Psychosis.

    Science.gov (United States)

    Waterreus, Anna; Morgan, Vera A

    2017-09-01

    To describe from the perspective of people living with psychotic illness their use of general practitioner services over a 12-month period and the experiences, attitudes and challenges general practitioners face providing health care to this population. A two-phase design was used. Phase 1, screening for psychosis, occurred in public specialised mental health services and non-government organisations within seven catchment sites across Australia. In Phase 2, 1825 people who were screened positive for psychosis were randomly selected for interview which included questions about frequency and reason for general practitioner contact in the 12 months prior to interview. General practitioners (1473) of consenting participants were also surveyed. Almost all (90.3%) survey participants had consulted a general practitioner in the 12-month period, on average 8.9 times, and 28.8% of attenders had consulted 12 times or more. The majority (83.5%) attended one general practitioner practice. Most (77.6%) general practitioners wanted to be involved in the mental health care of their patient. Although 69.1% said the management of their patient was not problematic for their practice, one in five general practitioners reported issues related to patient non-compliance with treatment and non-attendance at scheduled appointments; time constraints; and lack of feedback from treating mental health services. People with psychotic disorders consult general practitioners, some very frequently. Most Australian general practitioners believe they have a responsibility to review the physical and mental health of their patients. Improved communication between general practitioners and mental health services, and easier access to mental health support, may help general practitioners manage the complex mental, physical and social problems of their patients.

  3. Estimating the number of adults with severe and persistent mental illness who have complex, multi-agency needs.

    Science.gov (United States)

    Whiteford, Harvey; Buckingham, Bill; Harris, Meredith; Diminic, Sandra; Stockings, Emily; Degenhardt, Louisa

    2017-08-01

    A population health approach to mental health service planning requires estimates that align interventions with the needs of people with mental illness. The primary objective was to estimate the number of people in Australia living with severe and persistent mental illness who have complex, multi-agency needs. The secondary objective was to describe the possible service needs of individuals with severe mental illness. We disaggregated the estimated 12-month prevalence of adults with severe mental illness into needs-based sub-groups, using multiple data sources. Possible service needs of 1825 adults with psychotic disorders and 334 adults with severe past-year affective and/or anxiety disorders were described using data from the 2010 Survey of High Impact Psychosis and 2007 National Survey of Mental Health and Wellbeing, respectively. Using best available data, we estimated that 3.3% of adults experience a severe mental illness each year, of whom one-third (1.1% of adults) experience a persistent mental illness that requires ongoing services to address residual disability. Among those with severe and persistent mental illness, one-third of adults (0.4% or 59,000 adults in 2015) have complex needs requiring multi-agency support to maximise their health, housing, social participation and personal functioning. Survey of High Impact Psychosis data indicated that among adults with psychotic disorders, use of accommodation (40%), non-government (30%) services and receipt of income support (85%) services were common, as were possible needs for support with socialising, personal care and employment. National Survey of Mental Health and Wellbeing data indicated that among individuals with severe affective and anxiety disorders, receipt of income support (37%) was common (information on accommodation and non-government support services was not available), as were possible needs for financial management and employment support. Agreed indicators of complex, multi-agency needs

  4. On being Credibly Ill

    DEFF Research Database (Denmark)

    Mik-Meyer, Nanna

    2011-01-01

    unexplained symptoms. The study is conducted in Denmark using qualitative interviews with welfare officers and clients. The paper's focus is on how issues of gender and class intersect in the negotiation of illness among welfare officers and clients. The particular client group in question consists...... of individuals that are defined by their lack of a bio-medical diagnosis. Their ‘lack’ of identity accentuates how gender and class become central in the categorisation practices, constructing the ill person as either bio-medically sick or as a person who may be suffering but only from diffuse psychological...

  5. Diagnosis and treatment delays among elderly breast cancer patients with pre-existing mental illness.

    Science.gov (United States)

    Iglay, Kristy; Santorelli, Melissa L; Hirshfield, Kim M; Williams, Jill M; Rhoads, George G; Lin, Yong; Demissie, Kitaw

    2017-11-01

    This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis. Patients were classified as having no mental illness, anxiety, depression, anxiety and depression, or severe mental illness (bipolar disorder, schizophrenia, and other psychotic disorder). Multivariable binomial regression was used to assess the association between mental illness and delays of ≥60 and ≥90 days after adjustment for confounders. Patients with comorbid anxiety and depression had an increased risk for diagnosis delay of ≥90 days from symptom recognition (RR 1.11; 95% CI 1.00, 1.23), and those with severe mental illness had an increased risk for initial treatment delay of ≥60 days from diagnosis (RR 1.36; 95% CI 1.06, 1.74). Patients with any mental illness experienced an increased risk for adjuvant chemotherapy delay of ≥90 days from last operation (RR 1.13; 95% CI 1.01, 1.26) and each category of mental illness, except depression, showed a non-significant trend for this association. Breast cancer patients with mental illness should be closely managed by a cross-functional care team, including a psychiatrist, a primary care physician, and an oncologist, to ensure adequate care is received within an appropriate timeframe.

  6. Study about Illness: Through the Narrative of "Illness Image"

    OpenAIRE

    岩城, 晶子

    2013-01-01

    In this research, the meaning of the illness was studied from the perpective of Image. From listening to the narrative about two types of Illness Image, i.e., "my illness" and "A's illness, " we found that there was a characteristic that the Illness Image was similar to the real image. In addition, there were several differences between 2 images, which indicated that distance between the narrator and these images had an influence. From the syudy of two cases, it was indicated that Illness Ima...

  7. Chronic Pain Among Homeless Persons with Mental Illness.

    Science.gov (United States)

    Vogel, Marc; Frank, Anastasia; Choi, Fiona; Strehlau, Verena; Nikoo, Nooshin; Nikoo, Mohammadali; Hwang, Stephen W; Somers, Julian; Krausz, Michael R; Schütz, Christian G

    2017-12-01

    Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking. We assessed chronic pain among homeless persons with mental illness in the At Home/Chez Soi study. Cross-sectional data from a randomized controlled trial on homelessness and mental health. Data collected between 2009 and 2013 in three Canadian cities. One thousand two hundred eighty-seven homeless persons with mental illness. Data on chronic pain and utilization of prescribed and nonprescribed interventions was assessed using a chronic pain screening instrument. Mental illness was diagnosed with the Mini-International Neuropsychiatric Interview. Forty-three percent reported moderate to severe chronic pain, interfering with general daily activities (80%), sleep (78%), and social interactions (61%). Multivariate analysis indicated that increasing age and diagnoses of major depressive disorder, mood disorder with psychotic features, panic disorder, and post-traumatic stress disorder (PTSD) were independent predictors of chronic pain. Chronic pain was further associated with increased suicidality. Among participants reporting chronic pain, 64% had sought medical treatment and 56% treated pain with prescribed drugs, while 38% used illicit drugs for pain relief. Chronic pain is very common among homeless persons with mental illness and affects activities of daily living. Clinicians treating this population should be aware of the common connections between chronic pain, depression, panic disorder, PTSD, and substance use. While the data indicate the contribution of chronic pain to complex treatment needs, they also indicate a clear treatment gap. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  8. Care for patients with severe mental illness: the general practitioner's role perspective

    Directory of Open Access Journals (Sweden)

    Groenier Klaas H

    2009-05-01

    Full Text Available Abstract Background Patients with severe mental illness (SMI experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. Methods A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. Results 186 general practitioners distributed over urban areas (49%, urbanised rural areas (38% and rural areas (15% of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices. GPs also saw their role as giving support and information to the patient's family. However, they felt a need for recognition of their competencies when working with mental health care specialists. Conclusion GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.

  9. Care for patients with severe mental illness: the general practitioner's role perspective.

    Science.gov (United States)

    Oud, Marian J T; Schuling, Jan; Slooff, Cees J; Groenier, Klaas H; Dekker, Janny H; Meyboom-de Jong, Betty

    2009-05-06

    Patients with severe mental illness (SMI) experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. 186 general practitioners distributed over urban areas (49%), urbanised rural areas (38%) and rural areas (15%) of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices.GPs also saw their role as giving support and information to the patient's family.However, they felt a need for recognition of their competencies when working with mental health care specialists. GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.

  10. Illness management and recovery

    DEFF Research Database (Denmark)

    Dalum, Helle Stentoft; Waldemar, Anna Kristine; Korsbek, Lisa

    2018-01-01

    OBJECTIVE: Illness Management and Recovery (IMR) is a psychosocial intervention with a recovery-oriented approach. The program has been evaluated in different settings; however evidence for the effects of IMR is still deficient. The aim of this trial was to investigate the benefits and harms...

  11. Chronic Illness & Mental Health

    Science.gov (United States)

    ... increased risk of cardiovascular disease, diabetes, stroke, and Alzheimer’s disease, for example. Research also suggests that people with depression are at higher risk for osteoporosis relative to others. The reasons are not yet clear. One factor with some of these illnesses is that many ...

  12. Conceptualizing Health and Illness

    Czech Academy of Sciences Publication Activity Database

    Kouba, Petr

    2008-01-01

    Roč. 39, č. 1 (2008), s. 59-80 ISSN 0047-2662 R&D Projects: GA AV ČR(CZ) IAA900090603; GA ČR(CZ) GP401/07/P293 Institutional research plan: CEZ:AV0Z90090514 Keywords : health * illness * existence * finitude Subject RIV: AA - Philosophy ; Religion

  13. Foodborne Illness Retrospective

    Centers for Disease Control (CDC) Podcasts

    2015-05-07

    Dr. Paul Mead and Dr. Peter Drotman discuss the historic October 1999 article, Food-related Illness and Death in the United States.  Created: 5/7/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/7/2015.

  14. [A multidiscipline clinical and biological approach to the study of psychotic types of autistic spectrum disorders in children].

    Science.gov (United States)

    Simashkova, N V; Iakupova, L P; Kliushnik, T P; Koval'-Zaĭtsev, A A

    2013-01-01

    The current problem of heterogeneity of psychotic types of autistic spectrum disorders (ASD) is reviewed. The authors present results of a multidiscipline psychopathological, pathopsychological, neurophysiological and immunological examination of 87 patients, aged from 3 to 14 years, with psychotic types of ASD: childhood psychosis (CP) and atypical childhood psychosis (ACP). Significant differences in clinical presentations of CP and ACP that were correlated with pathopsychological, neurophysiological and immunological disorders were found. These findings support different nosological entities of these types of ASD.

  15. [A case of shared psychotic disorder (folie à deux) with original aspects associated with cross-cultural elements].

    Science.gov (United States)

    Cuoco, Valentina; Colletti, Chiara; Anastasia, Annalisa; Weisz, Filippo; Bersani, Giuseppe

    2015-01-01

    Shared psychotic disorder (folie à deux) is a rare condition characterized by the transmission of delusional aspects from a patient (the "dominant partner") to another (the "submissive partner") linked to the first by a close relationship. We report the case of two Moroccan sisters who have experienced a combined delusional episode diagnosed as shared psychotic disorder. In these circumstances, assessment of symptoms from a cross-cultural perspective is a key factor for proper diagnostic evaluation.

  16. Neurosyphilis with psychotic symptoms and Parkinsonism in a young girl

    Directory of Open Access Journals (Sweden)

    Yin L

    2015-02-01

    Full Text Available Li Yin,* Shoukang Zou,* Yi Huang Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, People’s Republic of China *These authors contributed equally to this work Abstract: A 15-year-old girl with neurosyphilis was misdiagnosed as having viral encephalitis with psychotic symptoms and Parkinsonism. We found that she was experiencing visual hallucinations, persecutory delusions, flattening of affect, poorness of thought, tremors, four-limb rigidity, and restlessness, and she was unable to communicate with others. The Venereal Disease Research Laboratory serum test and further lumbar puncture enabled us to diagnose her with neurosyphilis. After antibiotic treatment, her psychotic symptoms and Parkinsonism were relieved. From this case, we believe that it is important to keep organic psychosis in mind during the diagnostic workup, and we argue that routine syphilis screening is necessary in psychiatry clinical practice. Keywords: syphilis, encephalitis, organic psychosis

  17. Antipsychotic medication and remission of psychotic symptoms 10 years after a first-episode psychosis

    DEFF Research Database (Denmark)

    Wils, Regitze Sølling; Gotfredsen, Ditte Resendal; Hjorthøj, Carsten

    2017-01-01

    medication for a period of time. This study investigated the long-term outcome and characteristics of patients in remission of psychotic symptoms with no use of antipsychotic medication at the 10-year follow-up. METHODS: The study was a cohort study including 496 patients diagnosed with schizophrenia...... spectrum disorders (ICD 10: F20 and F22-29). Patients were included in the Danish OPUS Trial and followed up 10years after inclusion, where patient data was collected on socio-demographic factors, psychopathology, level of functioning and medication. FINDINGS: 61% of the patients from the original cohort...... attended the 10-year follow up and 30% of these had remission of psychotic symptoms at the time of the 10-year follow up with no current use of antipsychotic medication. This outcome was associated with female gender, high GAF-F score, participation in the labour market and absence of substance abuse...

  18. HPA-axis hyperactivity and mortality in psychotic depressive disorder: preliminary findings.

    Science.gov (United States)

    Coryell, William; Fiedorowicz, Jess; Zimmerman, Mark; Young, Elizabeth

    2008-06-01

    The excess mortality associated with depressive disorders has been most often attributed to risks for suicide but diverse findings indicate that depressive disorders also increase risks for cardiovascular (CV) mortality. Among the possible mediators is the hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity that characterizes many cases of relatively severe depressive disorder and severity is characteristic of psychotic depressive disorder. The following describes a 17-year mortality follow-up of 54 patients with Research Diagnostic Criteria (RDC) psychotic major depression or schizoaffective, mainly affective, depression. All had baseline assessments that included a 1mg dexamethasone suppression test with post-dexamethasone samples at 8 a.m., 4 p.m. and 11 p.m. Regression analyses showed that both greater age and higher maximum post-dexamethasone cortisol concentrations predicted deaths due to CV causes (t=4.01, pdepressive disorder to CV mortality.

  19. [Correction of acute psychotic states in schizophrenia by rispolept solution per os].

    Science.gov (United States)

    Panteleeva, G P; Korenev, A N; Barkhatova, A N

    2004-01-01

    To stop acute psychotic states during the first episode or relapses of schizophrenia, 37 patients were treated with rispolept solution per os during 2 weeks. A procedure of a fast transition to optimal daily doses of the drug after 1 day of treatment (searching period) with a following stabilization of mean daily doses (5.02-5.7 mg) at the stage of 14 day treatment course was used. Positive therapeutic effect by PANSS total score reduction, along with minor side-effects, were found in 91.9% patients. Stopping effect of rispolept on acute psychotic states, emerging from day 1 of the treatment, and general antipsychotic and therapeutic action, beginning from day 2-3 and increasing to day 14, were stated out. Efficacy of the drug in syndromes differing by psychopathological structure is emphasized.

  20. Differences in social cognition between male prisoners with antisocial personality or psychotic disorder

    Directory of Open Access Journals (Sweden)

    Matias Salvador Bertone

    2017-07-01

    Full Text Available The objective of this work is to discriminate between different neurocognitive circuits involved in empathy, one of them linked to emotional processing and the other associated with cognitive function. This is evaluated through the use of neuropsychological tools (Hinting Task, Reading the Mind in the Eyes Test and Cambridge Mind Reading Test empathic cognition and empathic emotion. In this study, 57 male prisoners were divided into three groups: psychotic patients (20, antisocial patients (17, and a control group (20. Patients with psychosis were found to have significantly lower scores than the antisocial and control groups in a social reasoning test, but using tests of emotional recognition, we found that both psychotic patients and antisocial subjects scored significantly lower than the control group.

  1. Brain structure in schizophrenia vs. psychotic bipolar I disorder: A VBM study.

    Science.gov (United States)

    Nenadic, Igor; Maitra, Raka; Langbein, Kerstin; Dietzek, Maren; Lorenz, Carsten; Smesny, Stefan; Reichenbach, Jürgen R; Sauer, Heinrich; Gaser, Christian

    2015-07-01

    While schizophrenia and bipolar disorder have been assumed to share phenotypic and genotypic features, there is also evidence for overlapping brain structural correlates, although it is unclear whether these relate to shared psychotic features. In this study, we used voxel-based morphometry (VBM8) in 34 schizophrenia patients, 17 euthymic bipolar I disorder patients (with a history of psychotic symptoms), and 34 healthy controls. Our results indicate that compared to healthy controls schizophrenia patients show grey matter deficits (pright dorsolateral prefrontal, as well as bilaterally in ventrolateral prefrontal and insular cortical areas, thalamus (bilaterally), left superior temporal cortex, and minor medial parietal and parietooccipital areas. Comparing schizophrenia vs. bipolar I patients (pleft dorsolateral prefrontal cortex, and left cerebellum. Compared to healthy controls, the deficits in bipolar I patients only reached significance at prights reserved.

  2. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis.

    Science.gov (United States)

    Vancampfort, Davy; Stubbs, Brendon; Mitchell, Alex J; De Hert, Marc; Wampers, Martien; Ward, Philip B; Rosenbaum, Simon; Correll, Christoph U

    2015-10-01

    Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N = 198; n = 52,678). Relative risk meta-analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta-analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z = -3.6, p = 0.0003, r(2)  = 0.19). People treated with all individual antipsychotic medications had a significantly (ppeople with severe mental illness had a significantly increased risk for MetS (RR = 1.58; 95% CI: 1.35-1.86; p<0.001) and all its components, except for hypertension (p = 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and multidisciplinary management of medical and behavioral conditions is needed in these patients. Risks of individual antipsychotics should be considered when making treatment choices. © 2015 World Psychiatric Association.

  3. Birthdates of patients affected by mental illness and solar activity: A study from Italy

    Science.gov (United States)

    Ventriglio, Antonio; Borelli, Albacenzina; Bellomo, Antonello; Lepore, Alberto

    2011-04-01

    PurposeThis epidemiologic study tested an hypothesized association between the year of birth of persons with major mental illnesses and solar activity over the past century. MethodsWe collected data on diagnoses and birthdates of psychiatric patients born between 1926 and 1975 (N = 1954) in south Italy for comparison to yearly solar activity as registered by the International Observatories. ResultsWe found a strong inverse correlation between high solar activity (HSA) and incidence of schizophrenia and bipolar disorder in a 20-year period whereas the incidence of non-affective/non-psychotic disorders was moderately associated with HSA in the same period. ConclusionsInterpretation of the observed correlations between HSA during years of birth and the incidence of mental illnesses remains unclear, but the findings encourage further study.

  4. Platform for systems medicine research and diagnostic applications in psychotic disorders-The METSY project.

    Science.gov (United States)

    Frank, Elisabeth; Maier, Dieter; Pajula, Juha; Suvitaival, Tommi; Borgan, Faith; Butz-Ostendorf, Markus; Fischer, Alexander; Hietala, Jarmo; Howes, Oliver; Hyötyläinen, Tuulia; Janssen, Joost; Laurikainen, Heikki; Moreno, Carmen; Suvisaari, Jaana; Van Gils, Mark; Orešič, Matej

    2018-04-01

    Psychotic disorders are associated with metabolic abnormalities including alterations in glucose and lipid metabolism. A major challenge in the treatment of psychosis is to identify patients with vulnerable metabolic profiles who may be at risk of developing cardiometabolic co-morbidities. It is established that both central and peripheral metabolic organs use lipids to control energy balance and regulate peripheral insulin sensitivity. The endocannabinoid system, implicated in the regulation of glucose and lipid metabolism, has been shown to be dysregulated in psychosis. It is currently unclear how these endocannabinoid abnormalities relate to metabolic changes in psychosis. Here we review recent research in the field of metabolic co-morbidities in psychotic disorders as well as the methods to study them and potential links to the endocannabinoid system. We also describe the bioinformatics platforms developed in the EU project METSY for the investigations of the biological etiology in patients at risk of psychosis and in first episode psychosis patients. The METSY project was established with the aim to identify and evaluate multi-modal peripheral and neuroimaging markers that may be able to predict the onset and prognosis of psychiatric and metabolic symptoms in patients at risk of developing psychosis and first episode psychosis patients. Given the intrinsic complexity and widespread role of lipid metabolism, a systems biology approach which combines molecular, structural and functional neuroimaging methods with detailed metabolic characterisation and multi-variate network analysis is essential in order to identify how lipid dysregulation may contribute to psychotic disorders. A decision support system, integrating clinical, neuropsychological and neuroimaging data, was also developed in order to aid clinical decision making in psychosis. Knowledge of common and specific mechanisms may aid the etiopathogenic understanding of psychotic and metabolic disorders

  5. Imagination in human social cognition, autism, and psychotic-affective conditions.

    Science.gov (United States)

    Crespi, Bernard; Leach, Emma; Dinsdale, Natalie; Mokkonen, Mikael; Hurd, Peter

    2016-05-01

    Complex human social cognition has evolved in concert with risks for psychiatric disorders. Recently, autism and psychotic-affective conditions (mainly schizophrenia, bipolar disorder, and depression) have been posited as psychological 'opposites' with regard to social-cognitive phenotypes. Imagination, considered as 'forming new ideas, mental images, or concepts', represents a central facet of human social evolution and cognition. Previous studies have documented reduced imagination in autism, and increased imagination in association with psychotic-affective conditions, yet these sets of findings have yet to be considered together, or evaluated in the context of the diametric model. We first review studies of the components, manifestations, and neural correlates of imagination in autism and psychotic-affective conditions. Next, we use data on dimensional autism in healthy populations to test the hypotheses that: (1) imagination represents the facet of autism that best accounts for its strongly male-biased sex ratio, and (2) higher genetic risk of schizophrenia is associated with higher imagination, in accordance with the predictions of the diametric model. The first hypothesis was supported by a systematic review and meta-analysis showing that Imagination exhibits the strongest male bias of all Autism Quotient (AQ) subscales, in non-clinical populations. The second hypothesis was supported, for males, by associations between schizophrenia genetic risk scores, derived from a set of single-nucleotide polymorphisms, and the AQ Imagination subscale. Considered together, these findings indicate that imagination, especially social imagination as embodied in the default mode human brain network, mediates risk and diametric dimensional phenotypes of autism and psychotic-affective conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Incidence of psychotic disorders among first-generation immigrants and refugees in Ontario.

    Science.gov (United States)

    Anderson, Kelly K; Cheng, Joyce; Susser, Ezra; McKenzie, Kwame J; Kurdyak, Paul

    2015-06-16

    Evidence suggests that migrant groups have an increased risk of psychotic disorders and that the level of risk varies by country of origin and host country. Canadian evidence is lacking on the incidence of psychotic disorders among migrants. We sought to examine the incidence of schizophrenia and schizoaffective disorders in first-generation immigrants and refugees in the province of Ontario, relative to the general population. We constructed a retrospective cohort that included people aged 14-40 years residing in Ontario as of Apr. 1, 1999. Population-based administrative data from physician billings and hospital admissions were linked to data from Citizenship and Immigration Canada. We used Poisson regression models to calculate age- and sex-adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for immigrant and refugee groups over a 10-year period. In our cohort (n = 4,284,694), we found higher rates of psychotic disorders among immigrants from the Caribbean and Bermuda (IRR 1.60, 95% CI 1.29-1.98). Lower rates were found among immigrants from northern Europe (IRR 0.50, 95% CI 0.28-0.91), southern Europe (IRR 0.60, 95% CI 0.41-0.90) and East Asia (IRR 0.56, 95% CI 0.41-0.78). Refugee status was an independent predictor of risk among all migrants (IRR 1.27, 95% CI 1.04-1.56), and higher rates were found specifically for refugees from East Africa (IRR 1.95, 95% CI 1.44-2.65) and South Asia (IRR 1.51, 95% CI 1.08-2.12). The differential pattern of risk across ethnic subgroups in Ontario suggests that psychosocial and cultural factors associated with migration may contribute to the risk of psychotic disorders. Some groups may be more at risk, whereas others are protected. © 2015 Canadian Medical Association or its licensors.

  7. Psychotic-like symptomatology and reward responsivity in chronic ketamine and cannabis users

    OpenAIRE

    Joye, A. M.

    2015-01-01

    This thesis assesses psychotic-like symptomatology and reward responsivity in chronic users of two illicit drugs, cannabis and ketamine. As use of these drugs is steadily increasing, with cannabis being the most widely used drug worldwide (following alcohol, caffeine and tobacco) and the recent proliferation of ketamine misuse in parts of Asia, Europe and the United States, it is important to examine the effects of their habitual use. While research has linked cannabis use to sub-clinical psy...

  8. Exposure to conflict and disaster: A national survey on the prevalence of psychotic experiences in Sri Lanka.

    Science.gov (United States)

    Keraite, Arune; Sumathipala, Athula; Siriwardhana, Chesmal; Morgan, Craig; Reininghaus, Ulrich

    2016-03-01

    Recent research conducted in high-income countries suggests psychotic experiences are common in the general population, but evidence from low- and middle-income countries (LMIC) remains limited. Sri Lanka is a LMIC affected by three decades of civil conflict and, in 2004, a devastating tsunami. This study aimed to investigate the prevalence of psychotic experiences in a general population sample in Sri Lanka and associations with conflict- and tsunami-related trauma. This is a first National Mental Health Survey conducted in Sri Lanka. A cross-sectional, multi-stage, cluster sampling design was used to estimate the prevalence of psychotic symptoms. Data on socio-demographic characteristics, conflict- and tsunami-related trauma, and psychotic experiences were collected using culturally validated measures in a sample of 5927 participants. The weighted prevalence of psychotic symptoms was 9.7%. Exposure to one or more conflict-related events (adj. OR 1.79, 95% CI 1.40-2.31, pconflict (adj. OR, 1.83, 95% CI 1.42-2.37, pconflicts and natural disasters may be important socio-environmental factors in the development of psychotic experiences. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Diagnostic specificity of poor premorbid adjustment: comparison of schizophrenia, schizoaffective disorder, and mood disorder with psychotic features.

    Science.gov (United States)

    Tarbox, Sarah I; Brown, Leslie H; Haas, Gretchen L

    2012-10-01

    Individuals with schizophrenia have significant deficits in premorbid social and academic adjustment compared to individuals with non-psychotic diagnoses. However, it is unclear how severity and developmental trajectory of premorbid maladjustment compare across psychotic disorders. This study examined the association between premorbid functioning (in childhood, early adolescence, and late adolescence) and psychotic disorder diagnosis in a first-episode sample of 105 individuals: schizophrenia (n=68), schizoaffective disorder (n=22), and mood disorder with psychotic features (n=15). Social and academic maladjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. Worse social functioning in late adolescence was associated with higher odds of schizophrenia compared to odds of either schizoaffective disorder or mood disorder with psychotic features, independently of child and early adolescent maladjustment. Greater social dysfunction in childhood was associated with higher odds of schizoaffective disorder compared to odds of schizophrenia. Premorbid decline in academic adjustment was observed for all groups, but did not predict diagnosis at any stage of development. Results suggest that social functioning is disrupted in the premorbid phase of both schizophrenia and schizoaffective disorder, but remains fairly stable in mood disorders with psychotic features. Disparities in the onset and time course of social dysfunction suggest important developmental differences between schizophrenia and schizoaffective disorder. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Cannabis use during adolescent development: susceptibility to psychiatric illness

    Directory of Open Access Journals (Sweden)

    Benjamin eChadwick

    2013-10-01

    Full Text Available Cannabis use is increasingly pervasive among adolescents today, even more common than cigarette smoking. The evolving policy surrounding the legalization of cannabis reaffirms the need to understand the relationship between cannabis exposure early in life and psychiatric illnesses. Cannabis contains psychoactive components, notably Δ9-tetrahydrocannbinol (THC, that interfere with the brain’s endogenous endocannabinoid system, which is critically involved in both pre- and post-natal neurodevelopment. Consequently, THC and related compounds could potentially usurp normal adolescent neurodevelopment, shifting the brain’s developmental trajectory towards a disease-vulnerable state, predisposing early cannabis-users to motivational, affective and psychotic disorders. Numerous human studies, including prospective longitudinal studies, demonstrate that early cannabis use is associated with major depressive disorder and drug addiction. A strong association between schizophrenia and cannabis use is also apparent, especially when considering genetic factors that interact with this environmental exposure. These human studies set a foundation for carefully controlled animal studies which demonstrate similar patterns following early cannabinoid exposure. Given the vulnerable nature of adolescent neurodevelopment and the persistent changes that follow early cannabis exposure, the experimental findings outlined should be carefully considered by policymakers. In order to fully address the growing issues of psychiatric illnesses and to ensure a healthy future, measures should be taken to reduce cannabis use among teens.

  11. Widespread brain dysconnectivity associated with psychotic-like experiences in the general population

    Directory of Open Access Journals (Sweden)

    Joseph M. Orr

    2014-01-01

    Full Text Available It is becoming increasingly clear that psychosis occurs along a continuum. At the high end are formal psychotic disorders such as schizophrenia, and at the low-end are individuals who experience occasional psychotic symptoms, but are otherwise healthy (non-clinical psychosis, NCP. Schizophrenia has been shown to be marked by altered patterns of connectivity between brain regions, but it is not known if such dysconnectivity exists in NCP. In the current study we used functional magnetic resonance imaging (fMRI to compare resting-state functional connectivity in NCP individuals (n = 25 and healthy controls (n = 27 for four brain networks of interest (fronto-parietal, cingulo-opercular, default mode, and cerebellar networks. NCP individuals showed reduced connectivity compared to controls between regions of the default mode network and frontal regions, and between regions in all of the networks and the thalamus. NCP individuals showed greater connectivity compared to controls within regions of frontal control networks. Further, positive symptom scores in NCP individuals were positively correlated with connectivity between the cingulo-opercular network and the visual cortex, and were negatively correlated with connectivity between the cerebellar network and the posterior parietal cortex and dorsal premotor cortex. Connectivity was not correlated with positive symptom scores in controls. Taken together, these findings demonstrate that a spectrum of abnormal connectivity underlies the psychosis continuum, and that individuals with sub-clinical psychotic experiences represent a key population for understanding pathogenic processes.

  12. Symptom Profile and Severity in a Sample of Nigerians with Psychotic versus Nonpsychotic Major Depression

    Directory of Open Access Journals (Sweden)

    Increase Ibukun Adeosun

    2013-01-01

    Full Text Available The therapeutic strategies in managing patients with psychotic major depression (PMD differ from those with non-psychotic major depression (NMD, because of differences in clinical profile and outcome. However, there is underrecognition of psychotic symptoms in depressed patients. Previous studies in Western population suggest that certain symptom patterns, apart from psychosis which may be concealed, can facilitate the discrimination of PMD from NMD. These studies may have limited applicability to sub-Saharan Africa due to cross-cultural differences in the phenomenology of depression. This study compared the rates and severity of depressive symptoms in outpatients with PMD (n=129 and NMD (n=117 using the Structured Clinical Interview for Depression (SCID and Hamilton Depression Rating Scale (HAM-D. Patients with PMD had statistically significantly higher rates of suicidal ideation, suicidal attempt, psychomotor agitation, insomnia, and reduced appetite. Patients with NMD were more likely to manifest psychomotor retardation and somatic symptoms. PMD was associated with greater symptom severity. On logistic regression analysis, suicidal ideation, psychomotor disturbances, insomnia, and somatic symptoms were predictive of diagnostic status. The presence of these symptoms clusters may increase the suspicion of occult psychosis in patients with depression, thereby informing appropriate intervention strategies.

  13. Perfectionistic Self-Presentation and Suicide in a Young Woman with Major Depression and Psychotic Features

    Directory of Open Access Journals (Sweden)

    Sabrina Hassan

    2014-01-01

    Full Text Available A woman in her midtwenties with a history of major depressive disorder and a recent major depressive episode with mood-congruent psychotic features died by suicide. Two weeks before her death, she demonstrated exceptional elevations on the nondisplay of imperfection factor of Hewitt and Flett’s Perfectionistic Self-Presentation Scale. Perfectionism and especially perfectionistic self-presentation have been strongly associated with suicide across several populations, accounting for unique variance in suicidality beyond depression and hopelessness. Yet interpersonal facets of perfectionism are not recognized as clinical risk factors for suicide. There is also a paucity of research on perfectionism in relation to psychotic symptoms. This case account illustrates the role of perfectionistic self-presentation in suicides that occur seemingly without warning and, to our knowledge, this is the first examination of perfectionistic self-presentation and suicide in a case where psychotic features occurred. This study, though single case-based, draws attention to perfectionism and perfectionistic self-presentation and their potential roles in suicide, especially when accompanied by other risk factors. Future research in this area may elucidate the role of perfectionism in suicide, singularly and in the context of a comprehensive clinical risk assessment, demonstrating whether perfectionism confers information about suicide risk beyond known clinical risk factors.

  14. A systematic review on definitions and assessments of psychotic-like experiences.

    Science.gov (United States)

    Lee, Kit-Wai; Chan, Kit-Wa; Chang, Wing-Chung; Lee, Edwin Ho-Ming; Hui, Christy Lai-Ming; Chen, Eric Yu-Hai

    2016-02-01

    Psychotic-like experiences (PLEs) or subclinical psychotic experiences have received increased attention as some studies have suggested continuity between PLEs and psychotic disorders. However, epidemiological and correlational studies of PLEs showed mixed findings - it is observed that different studies use a wide variety of definitions of PLEs, as well as different assessment tools that are designed to capture such described experiences. The differences in definitions and assessment tools adopted could contribute to the discrepancy of findings. The current review aims to examine the definitions and assessment tools adopted in the studies of PLEs. Literature search was conducted between October 2013 and February 2014 using three search engines: Medline, Web of Science and PubMed. A total of 76 papers met the selection criteria and were included in the current review. It is found that the majority of papers reviewed defined PLEs quantitatively using assessment tools and do not have a specific phenomenological definition, whereas assessment tools adopted have a wide variety. Furthermore, phenomenological studies of PLEs were rare. The variations in definitions and assessment tools of PLEs might contribute to mixed findings in researches. Reaching to a consensus through the study of phenomenology of PLEs is essential to further advancement of the research in this area. © 2015 Wiley Publishing Asia Pty Ltd.

  15. The fragmented self: imbalance between intrinsic and extrinsic self-networks in psychotic disorders.

    Science.gov (United States)

    Ebisch, Sjoerd J H; Aleman, André

    2016-08-01

    Self-disturbances are among the core features of schizophrenia and related psychotic disorders. The basic structure of the self could depend on the balance between intrinsic and extrinsic self-processing. We discuss studies on self-related processing in psychotic disorders that provide converging evidence for disrupted communication between neural networks subserving the so-called intrinsic self and extrinsic self. This disruption might be mainly caused by impaired integrity of key brain hubs. The intrinsic self has been associated with cortical midline structures involved in self-referential processing, autobiographical memory, and emotional evaluation. Additionally, we highlight central aspects of the extrinsic self in its interaction with the environment using sensorimotor networks, including self-experience in sensation and actions. A deficient relationship between these self-aspects because of disrupted between-network interactions offers a framework to explain core clinical features of psychotic disorders. In particular, we show how relative isolation and reduced modularity of networks subserving intrinsic and extrinsic self-processing might trigger the emergence of hallucinations and delusions, and why patients with psychosis typically have difficulties with self-other relationships and do not recognise mental problems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Perfectionistic Self-Presentation and Suicide in a Young Woman with Major Depression and Psychotic Features

    Science.gov (United States)

    Flett, Gordon L.; Hewitt, Paul L.

    2014-01-01

    A woman in her midtwenties with a history of major depressive disorder and a recent major depressive episode with mood-congruent psychotic features died by suicide. Two weeks before her death, she demonstrated exceptional elevations on the nondisplay of imperfection factor of Hewitt and Flett's Perfectionistic Self-Presentation Scale. Perfectionism and especially perfectionistic self-presentation have been strongly associated with suicide across several populations, accounting for unique variance in suicidality beyond depression and hopelessness. Yet interpersonal facets of perfectionism are not recognized as clinical risk factors for suicide. There is also a paucity of research on perfectionism in relation to psychotic symptoms. This case account illustrates the role of perfectionistic self-presentation in suicides that occur seemingly without warning and, to our knowledge, this is the first examination of perfectionistic self-presentation and suicide in a case where psychotic features occurred. This study, though single case-based, draws attention to perfectionism and perfectionistic self-presentation and their potential roles in suicide, especially when accompanied by other risk factors. Future research in this area may elucidate the role of perfectionism in suicide, singularly and in the context of a comprehensive clinical risk assessment, demonstrating whether perfectionism confers information about suicide risk beyond known clinical risk factors. PMID:25328746

  17. Immigration and psychotic experiences in the United States: Another example of the epidemiological paradox?

    Science.gov (United States)

    Oh, Hans; Abe, Jennifer; Negi, Nalini; DeVylder, Jordan

    2015-10-30

    In Europe, it is widely established that immigration increases risk for psychotic disorder. However, research has yet to confirm this association in the United States, where immigrants paradoxically report better health status than their native-born counterparts. Further, few studies have examined this topic with respect to sub-threshold psychotic experiences, which are more common than psychotic disorders in the general population. This study analyzes the (1) National Comorbidity Survey-Replication, (2) the National Latino and Asian American Survey, and (3) the National Survey of American Life, in order to determine whether generation status had any impact on risk for lifetime and 12-month PE, and whether these associations vary across racial/ethnic groups, adjusting for demographic variables and socioeconomic status. We found an absence of an immigration effect on PE across various ethnic groups and across various geographic areas, and found that immigration is actually protective among Latinos, supporting the idea that the epidemiological paradox extends to the psychosis phenotype. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Stress Sensitivity and Psychotic Experiences in 39 Low- and Middle-Income Countries.

    Science.gov (United States)

    DeVylder, Jordan E; Koyanagi, Ai; Unick, Jay; Oh, Hans; Nam, Boyoung; Stickley, Andrew

    2016-11-01

    Stress has a central role in most theories of psychosis etiology, but the relation between stress and psychosis has rarely been examined in large population-level data sets, particularly in low- and middle-income countries. We used data from 39 countries in the World Health Survey (n = 176 934) to test the hypothesis that stress sensitivity would be associated with psychotic experiences, using logistic regression analyses. Respondents in low-income countries reported higher stress sensitivity (P countries. Greater stress sensitivity was associated with increased odds for psychotic experiences, even when adjusted for co-occurring anxiety and depressive symptoms: adjusted odds ratio (95% CI) = 1.17 (1.15-1.19) per unit increase in stress sensitivity (range 2-10). This association was consistent and significant across nearly every country studied, and translated into a difference in psychotic experience prevalence ranging from 6.4% among those with the lowest levels of stress sensitivity up to 22.2% among those with the highest levels. These findings highlight the generalizability of the association between psychosis and stress sensitivity in the largest and most globally representative community-level sample to date, and support the targeting of stress sensitivity as a potential component of individual- and population-level interventions for psychosis. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  19. [Association between the violence in the community and the aggressive behaviors of psychotics during their hospitalizations].

    Science.gov (United States)

    Rothärmel, M; Poirier, M-F; Levacon, G; Kazour, F; Bleher, S; Gastal, D; Lazareth, S; Lebain, P; Olari, M; Oukebdane, R; Rengade, C-E; Themines, J; Abbar, M; Dollfus, S; Gassiot, A; Haouzir, S; Januel, D; Millet, B; Olié, J-P; Stamatiadis, L; Terra, J-L; Bénichou, J; Campion, D; Guillin, O

    2017-10-01

    Violence is a common issue in psychiatry and has multiple determiners. The aim of this study is to assess the psychotic inpatients' violence in association with the violence of the neighborhood from which the patients are drawn and to estimate the impact of this environmental factor with regard to other factors. A prospective multicenter study was led in nine French cities. Eligible patients were psychotic involuntary patients hospitalized in the cities' psychiatric wards. During their treatments, any kind of aggressive behavior by the patients has been reported by the Overt Aggression Scale (OAS). From June 2010 to May 2011, 95 patients have been included. Seventy-nine per cent of the patients were violent during their hospitalizations. In a bivariate analysis, inpatient violence was significantly associated with different factors: male gender, patient violence history, substance abuse, manic or mixed disorder, the symptoms severity measured by the BPRS, the insight degree and the city crime rate. In a multivariate analysis, the only significant factors associated with the patients' violence were substance abuse, the symptoms severity and the crime rates from the different patients' cities. These results suggest that violence within the psychotic patients' neighborhood could represent a risk of violence during their treatments. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  20. Academic Performance in Children of Mothers With Schizophrenia and Other Severe Mental Illness, and Risk for Subsequent Development of Psychosis: A Population-Based Study.

    Science.gov (United States)

    Lin, Ashleigh; Di Prinzio, Patsy; Young, Deidra; Jacoby, Peter; Whitehouse, Andrew; Waters, Flavie; Jablensky, Assen; Morgan, Vera A

    2017-01-01

    We examined the academic performance at age 12 years of children of mothers diagnosed with schizophrenia or other severe mental illness using a large whole-population birth cohort born in Western Australia. We investigated the association between academic performance and the subsequent development of psychotic illness. The sample comprised 3169 children of mothers with severe mental illness (schizophrenia, bipolar disorder, unipolar major depression, delusional disorder or other psychoses; ICD-9 codes 295-298), and 88 353 children of comparison mothers without known psychiatric morbidity. Academic performance of children was indexed on a mandatory state-wide test of reading, spelling, writing and numeracy. A larger proportion of children (43.1%) of mothers with severe mental illness performed below the acceptable standard than the reference group (30.3%; children of mothers with no known severe mental illness). After adjusting for covariates, children of mothers with any severe mental illness were more likely than the reference group to perform below-benchmark on all domains except reading. For all children, poor spelling was associated with the later development of psychosis, but particularly for those at familial risk for severe mental illness (hazard ratio [HR] = 1.81; 95% CI for HR = 1.21, 2.72). Children of mothers with a severe mental illness are at increased risk for sub-standard academic achievement at age 12 years, placing these children at disadvantage for the transition to secondary school. For children with familial risk for severe mental illness, very poor spelling skills at age 12 years may be an indicator of risk for later psychotic disorder. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  1. Academic Performance in Children of Mothers With Schizophrenia and Other Severe Mental Illness, and Risk for Subsequent Development of Psychosis: A Population-Based Study

    Science.gov (United States)

    Lin, Ashleigh; Di Prinzio, Patsy; Young, Deidra; Jacoby, Peter; Whitehouse, Andrew; Waters, Flavie; Jablensky, Assen; Morgan, Vera A.

    2017-01-01

    Objective: We examined the academic performance at age 12 years of children of mothers diagnosed with schizophrenia or other severe mental illness using a large whole-population birth cohort born in Western Australia. We investigated the association between academic performance and the subsequent development of psychotic illness. Method: The sample comprised 3169 children of mothers with severe mental illness (schizophrenia, bipolar disorder, unipolar major depression, delusional disorder or other psychoses; ICD-9 codes 295–298), and 88 353 children of comparison mothers without known psychiatric morbidity. Academic performance of children was indexed on a mandatory state-wide test of reading, spelling, writing and numeracy. Results: A larger proportion of children (43.1%) of mothers with severe mental illness performed below the acceptable standard than the reference group (30.3%; children of mothers with no known severe mental illness). After adjusting for covariates, children of mothers with any severe mental illness were more likely than the reference group to perform below-benchmark on all domains except reading. For all children, poor spelling was associated with the later development of psychosis, but particularly for those at familial risk for severe mental illness (hazard ratio [HR] = 1.81; 95% CI for HR = 1.21, 2.72). Conclusions: Children of mothers with a severe mental illness are at increased risk for sub-standard academic achievement at age 12 years, placing these children at disadvantage for the transition to secondary school. For children with familial risk for severe mental illness, very poor spelling skills at age 12 years may be an indicator of risk for later psychotic disorder. PMID:27131155

  2. Type 2 diabetes mellitus in people with severe mental illness: inequalities by ethnicity and age. Cross-sectional analysis of 588 408 records from the UK.

    Science.gov (United States)

    Das-Munshi, J; Ashworth, M; Dewey, M E; Gaughran, F; Hull, S; Morgan, C; Nazroo, J; Petersen, I; Schofield, P; Stewart, R; Thornicroft, G; Prince, M J

    2017-07-01

    To investigate whether the association of severe mental illness with Type 2 diabetes varies by ethnicity and age. We conducted a cross-sectional analysis of data from an ethnically diverse sample of 588 408 individuals aged ≥18 years, registered to 98% of general practices (primary care) in London, UK. The outcome of interest was prevalent Type 2 diabetes. Relative to people without severe mental illness, the relative risk of Type 2 diabetes in people with severe mental illness was greatest in the youngest age groups. In the white British group the relative risks were 9.99 (95% CI 5.34, 18.69) in those aged 18-34 years, 2.89 (95% CI 2.43, 3.45) in those aged 35-54 years and 1.16 (95% CI 1.04, 1.30) in those aged ≥55 years, with similar trends across all ethnic minority groups. Additional adjustment for anti-psychotic prescriptions only marginally attenuated the associations. Assessment of estimated prevalence of Type 2 diabetes in severe mental illness by ethnicity (absolute measures of effect) indicated that the association between severe mental illness and Type 2 diabetes was more marked in ethnic minorities than in the white British group with severe mental illness, especially for Indian, Pakistani and Bangladeshi individuals with severe mental illness. The relative risk of Type 2 diabetes is elevated in younger populations. Most associations persisted despite adjustment for anti-psychotic prescriptions. Ethnic minority groups had a higher prevalence of Type 2 diabetes in the presence of severe mental illness. Future research and policy, particularly with respect to screening and clinical care for Type 2 diabetes in populations with severe mental illness, should take these findings into account. © 2016 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  3. HIGH-ALTITUDE ILLNESS

    Directory of Open Access Journals (Sweden)

    Dwitya Elvira

    2015-05-01

    Full Text Available AbstrakHigh-altitude illness (HAI merupakan sekumpulan gejala paru dan otak yang terjadi pada orang yang baru pertama kali mendaki ke ketinggian. HAI terdiri dari acute mountain sickness (AMS, high-altitude cerebral edema (HACE dan high-altitude pulmonary edema (HAPE. Tujuan tinjauan pustaka ini adalah agar dokter dan wisatawan memahami risiko, tanda, gejala, dan pengobatan high-altitude illness. Perhatian banyak diberikan terhadap penyakit ini seiring dengan meningkatnya popularitas olahraga ekstrim (mendaki gunung tinggi, ski dan snowboarding dan adanya kemudahan serta ketersediaan perjalanan sehingga jutaan orang dapat terpapar bahaya HAI. Di Pherice, Nepal (ketinggian 4343 m, 43% pendaki mengalami gejala AMS. Pada studi yang dilakukan pada tempat wisata di resort ski Colorado, Honigman menggambarkan kejadian AMS 22% pada ketinggian 1850 m sampai 2750 m, sementara Dean menunjukkan 42% memiliki gejala pada ketinggian 3000 m. Aklimatisasi merupakan salah satu tindakan pencegahan yang dapat dilakukan sebelum pendakian, selain beberapa pengobatan seperti asetazolamid, dexamethasone, phosopodiestrase inhibitor, dan ginko biloba.Kata kunci: high-altitude illness, acute mountain sickness, edema cerebral, pulmonary edema AbstractHigh-altitude illness (HAI is symptoms of lung and brain that occurs in people who first climb to altitude. HAI includes acute mountain sickness (AMS, high-altitude cerebral edema (HACE and high altitude pulmonary edema (HAPE. The objective of this review was to understand the risks, signs, symptoms, and treatment of high-altitude illness. The attention was given to this disease due to the rising popularity of extreme sports (high mountain climbing, skiing and snowboarding and the ease and availability of the current travelling, almost each year, millions of people could be exposed to the danger of HAI. In Pherice, Nepal (altitude 4343 m, 43% of climbers have symptoms of AMS. Furthermore, in a study conducted at sites in

  4. Emotional dysfunction in schizophrenia spectrum psychosis: the role of illness perceptions.

    Science.gov (United States)

    Watson, P W B; Garety, P A; Weinman, J; Dunn, G; Bebbington, P E; Fowler, D; Freeman, D; Kuipers, E

    2006-06-01

    Assessing illness perceptions has been useful in a range of medical disorders. This study of people with a recent relapse of their psychosis examines the relationship between illness perception, their emotional responses and their attitudes to medication. One hundred patients diagnosed with a non-affective psychotic disorder were assessed within 3 months of relapse. Measures included insight, self-reported illness perceptions, medication adherence, depression, self-esteem and anxiety. Illness perceptions about psychosis explained 46, 36 and 34% of the variance in depression, anxiety and self-esteem respectively. However, self-reported medication adherence was more strongly associated with a measure of insight. Negative illness perceptions in psychosis are clearly related to depression, anxiety and self-esteem. These in turn have been linked to symptom maintenance and recurrence. Clinical interventions that foster appraisals of recovery rather than of chronicity and severity may therefore improve emotional well-being in people with psychosis. It might be better to address adherence to medication through direct attempts at helping them understand their need for treatment.

  5. ILL. Annual report 1976

    International Nuclear Information System (INIS)

    In 1976 the three major functions of ILL continued to be generally satisfactorily performed (provision of neutron beams at the high flux reactor, development of advanced instrumentation, establishment of a forum). The implementation of the programme of measurements approved by the Scientific Council was again given absolute priority. This report gives a survey of the state of the experimental facilities at ILL and the scientific work carried out in 1976, and of the main technical and administrative activities of the Institute Chapters correspond to the various colleges (theory, fundamental and nuclear physics, excitations, structures liquid, gases and amorphous materials, impurities, structural biology and chemistry), reactor operation and instrument support services, computing services... A second volume of this report contains more detailed descriptions of the individual experiments

  6. High altitude illness

    Science.gov (United States)

    Hartman-Ksycińska, Anna; Kluz-Zawadzka, Jolanta; Lewandowski, Bogumił

    High-altitude illness is a result of prolonged high-altitude exposure of unacclimatized individuals. The illness is seen in the form of acute mountain sickness (AMS) which if not treated leads to potentially life-threatening high altitude pulmonary oedema and high-altitude cerebral oedema. Medical problems are caused by hypobaric hypoxia stimulating hypoxia-inducible factor (HIF) release. As a result, the central nervous system, circulation and respiratory system function impairment occurs. The most important factor in AMS treatment is acclimatization, withdrawing further ascent and rest or beginning to descent; oxygen supplementation, and pharmacological intervention, and, if available, a portable hyperbaric chamber. Because of the popularity of high-mountain sports and tourism better education of the population at risk is essential.

  7. Mental illness: psychiatry's phlogiston.

    Science.gov (United States)

    Szasz, T

    2001-10-01

    In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness.

  8. ILL. Annual report 1979. Annex

    International Nuclear Information System (INIS)

    1980-01-01

    This second volume, entitled 'Annex to the Annual Report' deals in more detail with the scientific work of the I.L.L. The scientific activity of theoreticians at the I.L.L. for 1979 is described. The experimental reports giving details on the experiments performed at the I.L.L. up to October 1, 1979 have been compiled. They are published here under their proposal number within the classification cheme in use at the I.L.L

  9. ILL Annual Report 1974

    International Nuclear Information System (INIS)

    1974-01-01

    This annual report provides a general view of the activities of the different sections of the ILL. In 1974, twenty-two different neutron spectrometers with different characteristics were available on a regular basis. Moreover, a number of special neutron sources were employed for on-line experiments. The major effort was devoted to an increase in experimental systems and to the development of new measurement techniques [fr

  10. Exercise Prevents Mental Illness

    Science.gov (United States)

    Purnomo, K. I.; Doewes, M.; Giri, M. K. W.; Setiawan, K. H.; Wibowo, I. P. A.

    2017-03-01

    Multiple current studies show that neuroinflammation may contribute to mental illness such as depression, anxiety, and mood disorder. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory marker like cytokine IL-6, TNF-α, and IL-1β. Pro-inflammatory cytokine in peripheral tissues can reach brain tissues and activate microglia and it causes neuroinflammation. Psychological stress may led peripheral and central inflammation. Activated microglia will produce pro-inflammatory cytokine, ROS, RNS, and tryptophan catabolizes. This neuroinflammation can promote metabolism changes of any neurotransmitter, such as serotonin, dopamine, and glutamate that will influence neurocircuit in the brain including basal ganglia and anterior cingulated cortex. It leads to mental illness. Exercise give contribution to reduce tissue inflammation. When muscle is contracting in an exercise, muscle will produce the secretion of cytokine like IL-6, IL-1ra, and IL-10. It will react as anti-inflammation and influence macrophage, T cell, monosit, protein Toll-Like Receptor (TLR), and then reduce neuroinflammation, characterised by the decrease of pro-inflammatory cytokine and prevent the activation of microglia in the brain. The objective of the present study is to review scientific articles in the literature related to the contribution of exercise to prevent and ease mental illness.

  11. The Stigma of Mental Illness

    Science.gov (United States)

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  12. War experiences and psychotic symptoms among former child soldiers in Northern Uganda: the mediating role of post-war hardships – the WAYS Study

    Science.gov (United States)

    Amone-P’Olak, Kennedy; Otim, Balaam Nyeko; Opio, George; Ovuga, Emilio; Meiser-Stedman, Richard

    2014-01-01

    Psychotic symptoms have been associated with post-traumatic stress disorder and war experiences. However, the relationships between types of war experiences, the onset and course of psychotic symptoms, and post-war hardships in child soldiers have not been investigated. This study assessed whether various types of war experiences contribute to psychotic symptoms differently and whether post-war hardships mediated the relationship between war experiences and later psychotic symptoms. In an ongoing longitudinal cohort study (the War-Affected Youths Survey), 539 (61% male) former child soldiers were assessed for psychotic symptoms, post-war hardships, and previous war experiences. Regression analyses were used to assess the contribution of different types of war experiences on psychotic symptoms and the mediating role of post-war hardships in the relations between previous war experiences and psychotic symptoms. The findings yielded ‘witnessing violence’, ‘deaths and bereavement’, ‘involvement in hostilities’, and ‘sexual abuse’ as types of war experiences that significantly and independently predict psychotic symptoms. Exposure to war experiences was related to psychotic symptoms through post-war hardships (β = .18, 95% confidence interval = [0.10, 0.25]) accounting for 50% of the variance in their relationship. The direct relation between previous war experiences and psychotic symptoms attenuated but remained significant (β = .18, 95% confidence interval = [0.12, 0.26]). Types of war experiences should be considered when evaluating risks for psychotic symptoms in the course of providing emergency humanitarian services in post-conflict settings. Interventions should consider post-war hardships as key determinants of psychotic symptoms among war-affected youths. PMID:24718435

  13. A comparison of Australian men with psychotic disorders remanded for criminal offences and a community group of psychotic men who have not offended.

    Science.gov (United States)

    White, Paul; Chant, David; Whiteford, Harvey

    2006-03-01

    People remanded into custody by the courts have a substantially higher rate of severe mental disorder than other prisoners and the general population. Knowledge of their prevalence, needs and characteristics and an analysis of pathways to care may be necessary to provide mental health care effectively and efficiently. Previous prison studies focusing on psychotic offenders have suffered from the use of instruments not validated in a forensic setting and lack of a relevant comparison group. The Diagnostic Interview for Psychosis (DP) is a composite semi-structured standardized interview schedule. It combines social and demographic descriptors with measures of functioning adapted from the World Health Organisation Disability Assessment Schedule (DAS). The remand centre surveyed had 466 cells and is the main remand and reception centre for males for the southern region of the state of Queensland, Australia. Of the 621 men screened, 65 answered yes to at least one question in the DP and were interviewed. Six hundred and twenty-one remandees were screened and of these 61 were interviewed as screened positive for psychotic disorder. Thirty-five per cent had been homeless for an average of 32 weeks during the previous year. Most had had little contact with families or close friends. Eighty-one per cent were receiving no treatment at the time of offence. Seventy-eight per cent were unemployed and in receipt of a pension. Eighty per cent were dependent on alcohol, cannabis or amphetamines. Statistical issues of power are detailed in the text. The simplistic 'prison, hospital or community treatment' debate is misleading. Instead, the development of flexible preventative, management and accommodation services for people with severe mental disorder who have committed offences is a priority.

  14. Attenuated psychotic and basic symptom characteristics in adolescents with ultra-high risk criteria for psychosis, other non-psychotic psychiatric disorders and early-onset psychosis.

    Science.gov (United States)

    Lo Cascio, Nella; Saba, Riccardo; Hauser, Marta; Vernal, Ditte Lammers; Al-Jadiri, Aseel; Borenstein, Yehonatan; Sheridan, Eva M; Kishimoto, Taishiro; Armando, Marco; Vicari, Stefano; Fiori Nastro, Paolo; Girardi, Paolo; Gebhardt, Eva; Kane, John M; Auther, Andrea; Carrión, Ricardo E; Cornblatt, Barbara A; Schimmelmann, Benno G; Schultze-Lutter, Frauke; Correll, Christoph U

    2016-10-01

    While attenuated psychotic symptoms (APS) and basic symptoms (BS) are the main current predictors of psychosis in adults, studies in adolescents are scarce. Thus, we (1) described the prevalence and severity of positive, negative, disorganization, general, and basic symptoms in adolescent patients at ultra-high risk for psychosis (UHR), with other non-psychotic psychiatric disorders (PC) and with early-onset psychosis (EOP); and (2) investigated BS criteria in relation to UHR criteria. Sixty-nine 12-18-year-old adolescents (15.3 ± 1.7 years, female = 58.0 %, UHR = 22, PC = 27, EOP = 20) were assessed with the structured interview for prodromal syndromes (SIPS) and the schizophrenia proneness instrument-child and youth version (SPI-CY). Despite similar current and past 12-month global functioning, both UHR and EOP had significantly higher SIPS total and subscale scores compared to PC, with moderate-large effect sizes. Expectedly, UHR had significantly lower SIPS positive symptom scores than EOP, but similar SIPS negative, disorganized, and general symptom scores. Compared to PC, both EOP and UHR had more severe basic thought and perception disturbances, and significantly more often met cognitive disturbances criteria (EOP = 50.0 %, UHR = 40.9 %, PC = 14.8 %). Compared to UHR, both EOP and PC significantly less often met cognitive-perceptive BS criteria (EOP = 35.0 %, UHR = 68.2 %, PC = 25.9 %). BS were significantly more prevalent in both EOP and UHR than PC, and UHR were similar to EOP in symptom domains. Given the uncertain outcome of adolescents at clinical high-risk of psychosis, future research is needed to determine whether the combined assessment of early subjective disturbances with observable APS can improve the accuracy of psychosis prediction.

  15. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Mahlet Fikreyesus

    2016-10-01

    Full Text Available Abstract Background Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH. Methods Data were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS to assess compliance to medication and abnormal involuntary movement scale (AIMS to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value <0.25 in the bivariate analyses were entered into multivariate logistic regression and variables with P-value < 0.05 in the final model were declared to be significantly associated with the outcome variable. Results The prevalence of relapse among patients with psychotic disorder was 24.6 % (n = 95. Of this, 25.4 and 22.4 % were males and females respectively. The odds of developing psychotic relapse among patients living with family was 72 % lower than that of patients living alone (aOR = 0.28, 95 % CI = 0.08, 0.93. The odds of developing psychotic relapse among patients compliant to medication was 69 % lower than that of patients who were not compliant to medications (aOR = 0.31, 95 % CI = 0.12, 0.80. The odds of developing psychotic relapse among patients having high score on social support score was 48 % lower than that of patients who were compliant to medications (aOR = 0.52, 95 % CI = 0.28, 0.95. The odds of developing psychotic relapse among patients reporting to have sought religious support was 45 % lower than that of patients who have not sought religious support (aOR = 0.55, 95 % CI = 0.31, 0.96. On the other hand, the odds of developing

  16. Gaius Caligula's mental illness.

    Science.gov (United States)

    Sidwell, Barbara

    2010-01-01

    The strange behavior of emperor Gaius has been the subject of debate for many historians. Some charge him with madness and attribute it to his illness in A.D. 37, whereas others believe it occurred later, or else had nothing to do with his sickness.We have no real evidence to reconstruct his mental state. Therefore speculations about madness are fruitless, as they can't be proven. Also, his madness belongs to a discourse which originates mainly from the senatorial narrative that sought to discredit him through any means possible. Thus, his acts should be seen from other angles, and the search for "mad Caligula" abandoned.

  17. Criminal victimization and psychotic experiences: cross-sectional associations in 35 low- and middle-income countries.

    Science.gov (United States)

    DeVylder, J E; Kelleher, I; Oh, H; Link, B G; Yang, L H; Koyanagi, A

    2018-04-22

    Criminal victimization has been associated with elevated risk for psychotic symptoms in the United Kingdom, but has not been studied in low- and middle-income countries (LMICs). Understanding whether crime exposure may play a role in the social etiology of psychosis could help guide prevention and intervention efforts. We tested the hypothesis that criminal victimization would be associated with elevated odds of psychotic experiences in 35 LMICs (N = 146 999) using cross-sectional data from the World Health Organization World Health Survey. Multivariable logistic regression analyses were used to test for associations between criminal victimization and psychotic experiences. Victimization was associated with greater odds of psychotic experiences, OR (95% CI) = 1.72 (1.50-1.98), and was significantly more strongly associated with psychotic experiences in non-urban, OR (95% CI) = 1.93 (1.60-2.33), compared to urban settings, OR (95% CI) = 1.48 (1.21-1.81). The association between victimization and psychosis did not change across countries with varying aggregated levels of criminal victimization. In the largest ever study of victimization and psychosis, the association between criminal victimization and psychosis appears to generalize across a range of LMICs and, therefore, across nations with a broad range of crime rates, degree of urban development, average per capita income, and racial/ethnic make-up. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Short-term course and outcome of acute and transient psychotic disorders: Differences from other types of psychosis with acute onset.

    Science.gov (United States)

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

    2016-02-01

    The category of 'acute and transient psychotic disorders' (ATPDs) appeared in the ICD-10 Classification of Mental and Behavioural Disorders (ICD-10), but its distinctive features remain uncertain. To examine the course and outcome of ATPDs, pointing out differences from other types of psychosis. A one-year follow-up investigation of patients enrolled at the former World Health Organization (WHO) Centre for Research and Training in Mental Health in Aarhus (Denmark) for the WHO collaborative study on acute psychoses. Of 91 patients aged 15-60 years presenting with acute psychosis, 47 (51.6%) were diagnosed with ATPD, and it occurred more commonly in females; yet, the other acute psychoses featured mainly mood disorders and affected equally both genders. After 1 year, the ATPD diagnosis did not change in 28 cases (59.6%); the remaining developed either affective psychoses (27.7%), or schizophrenia and schizoaffective disorder (12.8%). Nearly, all patients with unchanged diagnosis of ATPD enjoyed full recovery, while those with other types of acute psychosis had significantly higher rates of recurrence or incomplete remission. Duration of illness within 4 weeks and stressful events in the 3 months before symptom onset predicted 1-year favourable clinical outcome for acute psychoses. Although ATPDs fared better over the short-term than other acute psychoses, their diagnostic stability is relatively low. © The Author(s) 2015.

  19. Hospitalizations and economic analysis in psychotic patients with paliperidone palmitate long-acting injection.

    Science.gov (United States)

    Mesones-Peral, Jesús E; Gurillo-Muñoz, Pedro; Sánchez-Sicilia, Mari Paz; Miller, Adam; Griñant-Fernández, Alejandra

    Prevent hospitalizations in psychotic disorders is an important aim, so long-acting antipsychotic is a good option that can control better the correct adherence. Moreover, in the current economic context pharmacoeconomic studies are necessary. We estimate the effect in prevention of paliperidone palmitate long-acting injection (PP-LAI) and calculate the economic cost in the 12 months preceding the start of treatment with PP-LAI and 12 months later. Mirror image study of 71 outpatients diagnosed with psychotic disorders and treated with PP-LAI. In a first analysis, we measured along one year: number of hospitalizations/year, number of hospitalization in days, number of emergency assists/year and if there is antipsychotics associated to long-acting treatment. After this phase, we applied Fees Act of Valencia for economic analysis and estimate of the cost per hospitalization (€ 5,640.41) and hospital emergency (€ 187.61). After one year of treatment with PP-LAI (mean dose=130.65mg/month), we obtained greater numbers in assistance variables: total hospitalizations decrease, 78.8% (P=.009); shortening in hospitalization days, 89.4% (P=.009); abridgement of number of emergency assists, 79.1% (P=.002); decrease of rate of antipsychotics associated to long-acting treatment, 21% (P<.0001); increase in monotherapy, 53.8% (P<.0001). Therefore, after 12 months of treatment with PP-LAI we obtained a reduction in inpatient spending (savings of € 175,766.54) and increased spending on antipsychotics 32% (equivalent to € 151,126.92). PP-LAI can be an effective therapy for the treatment of patients with severe psychotic disorders: improves symptomatic stability and can prevent hospitalizations with cost-effective symptom control. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Counterfactual Reasoning in Non-psychotic First-Degree Relatives of People with Schizophrenia

    Directory of Open Access Journals (Sweden)

    Auria eAlbacete

    2016-05-01

    Full Text Available Counterfactual thinking (CFT is a type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Previous research has found this cognitive feature to be disrupted in schizophrenia. At the same time, the study of cognitive deficits in unaffected relatives of people with schizophrenia has significantly increased, supporting its potential endophenotypic role in this disorder. Using an exploratory approach, the current study examined CFT for the first time in a sample of non-psychotic first-degree relatives of schizophrenia patients (N=43, in comparison with schizophrenia patients (N=54 and healthy controls (N=44. A series of tests that assessed the causal order effect in CFT and the ability to generate counterfactual thoughts and counterfactually derive inferences using the Counterfactual Inference Test was completed. Associations with variables of basic and social cognition, levels of schizotypy and psychotic-like experiences in addition to clinical and sociodemographic characteristics were also explored. Findings showed that first-degree relatives generated a lower number of counterfactual thoughts than controls, and were more adept at counterfactually deriving inferences, specifically in the scenarios related to regret and to judgements of avoidance in an unusual situation. No other significant results were found. These preliminary findings suggest that non-psychotic first-degree relatives of schizophrenia patients show a subtle disruption of global counterfactual thinking compared with what is normally expected in the general population. Because of the potential impact of such deficits, new treatments targeting CFT improvement might be considered in future management strategies.

  1. Interplay between childhood physical abuse and familial risk in the onset of psychotic disorders.

    Science.gov (United States)

    Fisher, Helen L; McGuffin, Peter; Boydell, Jane; Fearon, Paul; Craig, Thomas K; Dazzan, Paola; Morgan, Kevin; Doody, Gillian A; Jones, Peter B; Leff, Julian; Murray, Robin M; Morgan, Craig

    2014-11-01

    Childhood abuse is considered one of the main environmental risk factors for the development of psychotic symptoms and disorders. However, this association could be due to genetic factors influencing exposure to such risky environments or increasing sensitivity to the detrimental impact of abuse. Therefore, using a large epidemiological case-control sample, we explored the interplay between a specific form of childhood abuse and family psychiatric history (a proxy for genetic risk) in the onset of psychosis. Data were available on 172 first presentation psychosis cases and 246 geographically matched controls from the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study. Information on childhood abuse was obtained retrospectively using the Childhood Experience of Care and Abuse Questionnaire and occurrence of psychotic and affective disorders in first degree relatives with the Family Interview for Genetic Studies. Parental psychosis was more common among psychosis cases than unaffected controls (adjusted OR = 5.96, 95% CI: 2.09-17.01, P = .001). Parental psychosis was also associated with physical abuse from mothers in both cases (OR = 3.64, 95% CI: 1.06-12.51, P = .040) and controls (OR = 10.93, 95% CI: 1.03-115.90, P = .047), indicative of a gene-environment correlation. Nevertheless, adjusting for parental psychosis did not measurably impact on the abuse-psychosis association (adjusted OR = 3.31, 95% CI: 1.22-8.95, P = .018). No interactions were found between familial liability and maternal physical abuse in determining psychosis caseness. This study found no evidence that familial risk accounts for associations between childhood physical abuse and psychotic disorder nor that it substantially increases the odds of psychosis among individuals reporting abuse. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

  2. Psychotic Experiences and Working Memory: A Population-Based Study Using Signal-Detection Analysis.

    Directory of Open Access Journals (Sweden)

    Rodolfo Rossi

    Full Text Available Psychotic Experiences (PEs during adolescence index increased risk for psychotic disorders and schizophrenia in adult life. Working memory (WM deficits are a core feature of these disorders. Our objective was to examine the relationship between PEs and WM in a general population sample of young people in a case control study. 4744 individuals of age 17-18 from Bristol and surrounding areas (UK were analyzed in a cross-sectional study nested within the Avon Longitudinal Study of Parents and Children (ALSPAC birth cohort study. The dependent variable was PEs, assessed using the semi-structured Psychosis-Like Symptom Interview (PLIKSi. The independent variable was performance on a computerized numerical n-back working memory task. Signal-Detection Theory indices, including standardized hits rate, false alarms rate, discriminability index (d' and response bias (c from 2-Back and 3-Back tasks were calculated. 3576 and 3527 individuals had complete data for 2-Back and 3-Back respectively. Suspected/definite PEs prevalence was 7.9% (N = 374. Strongest evidence of association was seen between PEs and false alarms on the 2-Back, (odds ratio (OR = 1.17 [95% confidence intervals (CI 1.01, 1.35] and 3-back (OR = 1.35 [1.18, 1.54] and with c (OR = 1.59 [1.09, 2.34], and lower d' (OR = 0.76 [0.65, 0.89], on the 3-Back. Adjustment for several potential confounders, including general IQ, drug exposure and different psycho-social factors, and subsequent multiple imputation of missing data did not materially alter the results. WM is impaired in young people with PEs in the general population. False alarms, rather than poor accuracy, are more closely related to PEs. Such impairment is consistent with different neuropsychological models of psychosis focusing on signal-to-noise discrimination, probabilistic reasoning and impaired reality monitoring as a basis of psychotic symptoms.

  3. The development of psychotic disorders in adolescence: a potential role for hormones.

    Science.gov (United States)

    Trotman, Hanan D; Holtzman, Carrie W; Ryan, Arthur T; Shapiro, Daniel I; MacDonald, Allison N; Goulding, Sandra M; Brasfield, Joy L; Walker, Elaine F

    2013-07-01

    This article is part of a Special Issue "Puberty and Adolescence". The notion that adolescence is characterized by dramatic changes in behavior, and often by emotional upheaval, is widespread and longstanding in popular western culture. In recent decades, this notion has gained increasing support from empirical research showing that the peri- and post-pubertal developmental stages are associated with a significant rise in the rate of psychiatric symptoms and syndromes. As a result, interest in adolescent development has burgeoned among researchers focused on the origins of schizophrenia and other psychotic disorders. Two factors have fueled this trend: 1) increasing evidence from longitudinal research that adolescence is the modal period for the emergence of "prodromal" manifestations, or precursors of psychotic symptoms, and 2) the rapidly accumulating scientific findings on brain structural and functional changes occurring during adolescence and young adulthood. Further, gonadal and adrenal hormones are beginning to play a more prominent role in conceptualizations of adolescent brain development, as well as in the origins of psychiatric symptoms during this period (Walker and Bollini, 2002; Walker et al., 2008). In this paper, we begin by providing an overview of the nature and course of psychotic disorders during adolescence/young adulthood. We then turn to the role of hormones in modulating normal brain development, and the potential role they might play in the abnormal brain changes that characterize youth at clinical high-risk (CHR) for psychosis. The activational and organizational effects of hormones are explored, with a focus on how hormone-induced changes might be linked with neuropathological processes in the emergence of psychosis. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Mind-body medicine for schizophrenia and psychotic disorders: a review of the evidence.

    Science.gov (United States)

    Helgason, Chanel; Sarris, Jerome

    2013-10-01

    Over half of psychiatric patients use some kind of Complementary and Alternative Medicine, with Mind-Body Medicine (MBM) being the most commonly used collective modality. To date however, to our knowledge, no overarching review exists examining MBM for psychotic disorders. Thus the purpose of this paper is to present the first review in this area. A MEDLINE search was conducted of articles written in English from 1946 up to January 15, 2011 using a range of MBM and psychotic disorder search terms. Human clinical trials and, where available, pertinent meta-analyses and reviews were included in this paper. Forty-two clinical studies and reviews of MBMs were located, revealing varying levels of evidence. All studies included used MBMs as an adjunctive therapy to usual care, including medication. Overall, supportive evidence was found for music therapy, meditation and mindfulness techniques. Some positive studies were found for yoga and breathing exercises, general relaxation training, and holistic multi-modality MBM interventions. Due to insufficient data, a conclusion cannot be reached for hypnosis, thermal or EMG biofeedback, dance or drama therapy, or art therapy. No clinical trials were found for guided imagery, autogenic training, journal writing, or ceremony practices. For many techniques, the quality of research was poor, with many studies having small samples, no randomization, and no adequate control. While the above techniques are likely to be safe and tolerable in this population based on current data, more research is required to decisively assess the validity of applying many MBMs in the mainstream treatment of psychotic disorders.

  5. Low vitamin D is associated with negative and depressive symptoms in psychotic disorders.

    Science.gov (United States)

    Nerhus, Mari; Berg, Akiah O; Kvitland, Levi R; Dieset, Ingrid; Hope, Sigrun; Dahl, Sandra R; Weibell, Melissa A; Romm, Kristin L; Faerden, Ann; Andreassen, Ole A; Melle, Ingrid

    2016-12-01

    There are indications that low S-25(OH)D is associated with increased disease severity in psychotic disorder. Our first aim was to investigate the relations between low S-25(OH)D and positive, negative and depressive symptoms. Our second aim was to explore if associations between S-25(OH)D and symptoms were influenced by levels of inflammatory markers. Participants (N=358) with a medical history of one or more psychotic episodes were recruited. Current symptomatology was assessed by The Structured Interview for the Positive and Negative Syndrome Scaleanalyzed by a five-factor model. The Calgary Depression Scale for Schizophrenia was used to assess depression and suicidal ideation. Blood samples were analyzed for S-25(OH)D, CRP, sTNF-R1, IL-Ra and OPG. We performed bivariate correlations and multiple regression models to evaluate the effect of S-25(OH)D on the outcomes. Low S-25(OH)D was significantly associated with negative symptoms (adjusted R 2 =0.113, F(6,357)=8.58, pD (rho=-0.13, p=0.02) and negative symptoms (rho=0.14, p=0.01), but did not act as a mediator. The correlations between S-25(OH)D and the inflammatory markers sTNF-R1, IL-Ra and OPG were not significant. There is a strong association between low S-25(OH)D and higher negative and depressive symptoms in psychotic disorders. Randomized controlled trials should be performed to investigate the effect of vitamin D supplementation as adjuvant treatment strategy in patients with prominent negative or depressive symptoms. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Treatment of cannabis use among people with psychotic or depressive disorders: a systematic review.

    Science.gov (United States)

    Baker, Amanda L; Hides, Leanne; Lubman, Dan I

    2010-03-01

    This article systematically reviews the evidence from randomized controlled trials (RCTs) for pharmacologic and psychological approaches to the treatment of cannabis use among individuals with psychotic or depressive disorders. A systematic literature search was conducted using the PubMed and PsychINFO databases from inception to December 2008. Individual searches in cannabis use (search terms: marijuana, cannabis, marijuana abuse, cannabis abuse, marijuana usage, cannabis usage), mental disorders (search terms: mood disorders, affective disorders, anxiety disorders, anxiety, depressive disorder, depression, psychotic disorders, psychosis, mental disorders), and pharmacotherapy (search terms: medication, drug therapy, pharmacotherapy, psychopharmacology, clinical trials, drug trial, treatment trial) were conducted and limited to humans, adolescents and adults. A search combining the individual cannabis use, mental disorder and pharmacotherapy searches produced 1,713 articles (PubMed = 1,398; PsychINFO = 315). Combining the cannabis use and mental disorder searches while limiting them to English articles and RCTs produced a total of 286 articles (PubMed = 228; PsychINFO = 58). From this literature, there were 7 RCTs conducted among mental health clients that reported cannabis use outcomes using pharmacologic or psychological interventions. While few RCTs have been conducted, there is evidence that pharmacologic and psychological interventions are effective for reducing cannabis use in the short-term among people with psychotic disorders or depression. Although it is difficult to make evidence-based treatment recommendations due to the paucity of research in this area, available studies indicate that effectively treating the mental health disorder with standard pharmacotherapy may be associated with a reduction in cannabis use and that longer or more intensive psychological interventions rather than brief interventions may be required, particularly among heavier

  7. A twin study of schizoaffective-mania, schizoaffective-depression, and other psychotic syndromes.

    Science.gov (United States)

    Cardno, Alastair G; Rijsdijk, Frühling V; West, Robert M; Gottesman, Irving I; Craddock, Nick; Murray, Robin M; McGuffin, Peter

    2012-03-01

    The nosological status of schizoaffective disorders remains controversial. Twin studies are potentially valuable for investigating relationships between schizoaffective-mania, schizoaffective-depression, and other psychotic syndromes, but no such study has yet been reported. We ascertained 224 probandwise twin pairs [106 monozygotic (MZ), 118 same-sex dizygotic (DZ)], where probands had psychotic or manic symptoms, from the Maudsley Twin Register in London (1948-1993). We investigated Research Diagnostic Criteria schizoaffective-mania, schizoaffective-depression, schizophrenia, mania and depressive psychosis primarily using a non-hierarchical classification, and additionally using hierarchical and data-derived classifications, and a classification featuring broad schizophrenic and manic syndromes without separate schizoaffective syndromes. We investigated inter-rater reliability and co-occurrence of syndromes within twin probands and twin pairs. The schizoaffective syndromes showed only moderate inter-rater reliability. There was general significant co-occurrence between syndromes within twin probands and MZ pairs, and a trend for schizoaffective-mania and mania to have the greatest co-occurrence. Schizoaffective syndromes in MZ probands were associated with relatively high risk of a psychotic syndrome occurring in their co-twins. The classification of broad schizophrenic and manic syndromes without separate schizoaffective syndromes showed improved inter-rater reliability, but high genetic and environmental correlations between the two broad syndromes. The results are consistent with regarding schizoaffective-mania as due to co-occurring elevated liability to schizophrenia, mania, and depression; and schizoaffective-depression as due to co-occurring elevated liability to schizophrenia and depression, but with less elevation of liability to mania. If in due course schizoaffective syndromes show satisfactory inter-rater reliability and some specific etiological

  8. A Network Approach to Psychosis: Pathways Between Childhood Trauma and Psychotic Symptoms.

    Science.gov (United States)

    Isvoranu, Adela-Maria; van Borkulo, Claudia D; Boyette, Lindy-Lou; Wigman, Johanna T W; Vinkers, Christiaan H; Borsboom, Denny

    2017-01-01

    Childhood trauma (CT) has been identified as a potential risk factor for the onset of psychotic disorders. However, to date, there is limited consensus with respect to which symptoms may ensue after exposure to trauma in early life, and whether specific pathways may account for these associations. The aim of the present study was to use the novel network approach to investigate how different types of traumatic childhood experiences relate to specific symptoms of psychotic disorders and to identify pathways that may be involved in the relationship between CT and psychosis. We used data of patients diagnosed with a psychotic disorder (n = 552) from the longitudinal observational study Genetic Risk and Outcome of Psychosis Project and included the 5 scales of the Childhood Trauma Questionnaire-Short Form and all original symptom dimensions of the Positive and Negative Syndrome Scale. Our results show that all 5 types of CT and positive and negative symptoms of psychosis are connected through symptoms of general psychopathology. These findings are in line with the theory of an affective pathway to psychosis after exposure to CT, with anxiety as a main connective component, but they also point to several additional connective paths between trauma and psychosis: eg, through poor impulse control (connecting abuse to grandiosity, excitement, and hostility) and motor retardation (connecting neglect to most negative symptoms). The results of the current study suggest that multiple paths may exist between trauma and psychosis and may also be useful in mapping potential transdiagnostic processes. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  9. ILL Annual report 97

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    In 1997 the reactor operated for the planned 225 days and more than 750 experiments were carried out. Among the experimental highlights are 2 contrasting examples of the new types of experiments now possible using the new high-intensity diffractometer D2O: stroboscopic measurements of kinetic processes and rapid texture measurements of structural materials. Some early results from the new high-resolution gamma spectrometer in the study of nuclear structure are also presented. Another new facility is just coming into service: the 2{pi} image-plate detector LADI, optimised for Laue measurements on biological crystals. The contrast between biological experiments and for example those on superconductivity or neutron {beta}-decay, illustrates very well the range of scientific questions addressed through the use of ILL`s neutron beams. 30 brief accounts of research work achieved during this year are given, they are classified under 9 topics: polymers and colloids, chemistry and structure, biology, materials science, liquids and glasses, magnetism, strongly correlated electron systems, quantum systems, nuclear and fundamental physics. The scheduled new developments are described and a list of the publications is also given

  10. Decompression illness - critical review

    Directory of Open Access Journals (Sweden)

    C S Mohanty

    2015-01-01

    Full Text Available Decompression illness is caused by intravascular or extravascular bubbles that are formed as a result of reduction in environmental pressure (decompression. The term covers both arterial gas embolism, in which alveolar gas or venous gas emboli (via cardiac shunts or via pulmonary vessels are introduced into the arterial circulation, and decompression sickness, which is caused by in-situ bubble formation from dissolved inert gas. Both syndromes can occur in divers, compressed air workers, aviators, and astronauts, but arterial gas embolism also arises from iatrogenic causes unrelated to decompression. Risk of decompression illness is affected by immersion, exercise, and heat or cold. Manifestations range from itching and minor pain to neurological symptoms, cardiac collapse, and death. First-aid treatment is 1 0 0 % oxygen and definitive treatment is recompression to increased pressure, breathing 1 0 0 % oxygen. Adjunctive treatment, including fluid administration and prophylaxis against venous thromboembolism in paralysed patients, is also recommended Treatment is, in most cases, effective although residual deficits can remain in serious cases, even after several recompressions.

  11. ILL Annual report 97

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    In 1997 the reactor operated for the planned 225 days and more than 750 experiments were carried out. Among the experimental highlights are 2 contrasting examples of the new types of experiments now possible using the new high-intensity diffractometer D2O: stroboscopic measurements of kinetic processes and rapid texture measurements of structural materials. Some early results from the new high-resolution gamma spectrometer in the study of nuclear structure are also presented. Another new facility is just coming into service: the 2{pi} image-plate detector LADI, optimised for Laue measurements on biological crystals. The contrast between biological experiments and for example those on superconductivity or neutron {beta}-decay, illustrates very well the range of scientific questions addressed through the use of ILL`s neutron beams. 30 brief accounts of research work achieved during this year are given, they are classified under 9 topics: polymers and colloids, chemistry and structure, biology, materials science, liquids and glasses, magnetism, strongly correlated electron systems, quantum systems, nuclear and fundamental physics. The scheduled new developments are described and a list of the publications is also given

  12. ILL. Annual report 1977

    International Nuclear Information System (INIS)

    In 1977 the three major functions of ILL continued to be performed (provision of neutron beams at the high flux reactor, development of advanced instrumentation, workshop organization). An integrated programme of improvement to the existing instruments and of new instrument construction, was carried out. A high priority was given to finishing instruments in the course of construction and both the ultra cold neutron source, PN5, and spin echo spectrometer, IN11, came into operation. No new instrument construction was started; even so, the completion of D18 (the interferometer) and IN12 (the cold three-axis machine) was delayed until 1978. Some advantage was taken of the delay to implement a new system of three-axis drive mechanics and interfacing electronics. This report gives a survey of the state of the experimental facilities at ILL and the scientific work carried out in 1977, and of the main technical and administrative activites of the Institute. Chapters correspond to the various colleges (theory, fundamental and nuclear physics, excitations, structures, liquid, gases and amorphous materials, impurities, structural biology and chemistry), reactor operation and instrument support services, computing services... A second volume of this report contains more detailed descriptions of the individual experiments [fr

  13. The role of social media networks in psychotic disorders: a case report.

    Science.gov (United States)

    Krishna, Nithin; Fischer, Bernard A; Miller, Moshe; Register-Brown, Kelly; Patchan, Kathleen; Hackman, Ann

    2013-01-01

    We report the case of a young man diagnosed with schizophrenia who presented with stalking behaviors that may have been caused by problematic use or participation in social media networks (SMN). We review the possible role of SMN in the formation of his romantic delusion and offer suggestions for clinicians around incorporation of SMN questions into assessments. It is imperative to identify populations at risk of SMN-related stalking behaviors to stratify mental health resources and interventions. Additional studies are needed to further clarify the role of SMN in psychotic disorders. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Behaviour of pharmaceuticals and psychotic drugs in conventional and advanced wastewater treatments

    International Nuclear Information System (INIS)

    Cortacans Torre, J. A.; Castillo Gonzalez, I. del; Hernandez Lehmann, A.; Hernandez Munoz, A.; Rodriguez Barrera, X.

    2009-01-01

    The occurrence of various pharmaceuticals and psychotic drugs in wastewater and their removal rates in a conventional wastewater treatment plant has been investigated. The psychoactive drugs are poorly removed in the biological step. However, most pharmaceuticals except of carbamazepine, are significantly biodegraded depending the removal degree on the type of compound and on the sludge retention time of the biological treatment. Also, the removal efficiency of conventional tertiary treatments and ultrafiltration and nano filtration membranes using two pilot plants was examined. the effects of retaining pharmaceuticals with ultrafiltration and nano filtration membranes do not greatly differ despite the difference in their pore size. (Author) 25 refs.

  15. Illness Identity in Adults with a Chronic Illness.

    Science.gov (United States)

    Oris, Leen; Luyckx, Koen; Rassart, Jessica; Goubert, Liesbet; Goossens, Eva; Apers, Silke; Arat, Seher; Vandenberghe, Joris; Westhovens, René; Moons, Philip

    2018-02-21

    The present study examines the concept of illness identity, the degree to which a chronic illness is integrated into one's identity, in adults with a chronic illness by validating a new self-report questionnaire, the Illness Identity Questionnaire (IIQ). Self-report questionnaires on illness identity, psychological, and physical functioning were assessed in two samples: adults with congenital heart disease (22-78 year old; n = 276) and with multisystem connective tissue disorders (systemic lupus erythematosus or systemic sclerosis; 17-81 year old; n = 241). The IIQ could differentiate four illness identity states (i.e., engulfment, rejection, acceptance, and enrichment) in both samples, based on exploratory and confirmatory factor analysis. All four subscales proved to be reliable. Rejection and engulfment were related to maladaptive psychological and physical functioning, whereas acceptance and enrichment were related to adaptive psychological and physical functioning. The present findings underscore the importance of the concept of illness identity. The IIQ, a self-report questionnaire, is introduced to measure four different illness identity states in adults with a chronic illness.

  16. Self-defining memories related to illness and their integration into the self in patients with schizophrenia.

    Science.gov (United States)

    Berna, Fabrice; Bennouna-Greene, Mehdi; Potheegadoo, Jevita; Verry, Paulina; Conway, Martin A; Danion, Jean-Marie

    2011-08-30

    Although schizophrenia alters the sense of personal identity, little is known about the impact of illness-related autobiographical events on patients' self-representation. We investigated self-defining memories (SDM) in 24 patients with schizophrenia and 24 controls to explore how illness-related SDM were integrated into the self at both the cognitive (how participants are able to give a meaning to past events: meaning making) and affective levels (how participants can re-experience past negative events as less negative: redemption and benefaction effects). We found that 26% of freely recalled SDM referred to their illness in patients. Further, while meaning making was impaired in patients for both illness-related and other SDM, illness-related SDM were characterized by a higher redemption and benefaction effects than other SDM. Our results highlight that despite a reduced ability to give a meaning to illness-related episodes, emotional processing seems to allow these events to become positively integrated into patients' life stories. This study provides new findings about the construction of the self in relation to psychotic episodes in patients with schizophrenia. We discuss clinical implications of our results that are helpful to guide cognitive interventions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Catatonic features noted in patients with post-partum mental illness.

    Science.gov (United States)

    Lai, Jiun-Yang; Huang, Tiao-Lai

    2004-04-01

    The purpose of the present study was to investigate the prevalence, distribution of psychiatric diagnoses, and treatment responses of patients with post-partum mental illness at an emergency unit at Chang Gung Memorial Hospital at Kaohsiung in Taiwan. During a 1 year period a total of 636 Taiwanese women received psychiatric consultation on their visits to the emergency room. Fifteen of these were noted to have post-partum mental illnesses. All subjects were followed up for a minimum of 3-6 months. The prevalence of patients with post-partum mental illness at an emergency unit at Chang Gung Memorial Hospital at Kaohsiung was 2.4% (15/636). The distribution of psychiatric diagnoses according to Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria included eight cases of major depressive disorders (53.3%), three cases of bipolar I disorder (20%), three cases of schizophrenia (20%), and one case of psychotic disorder due to a general medical condition (6.7%). Four subjects manifested catatonic features. Of these four, three had complete remission in catatonic symptoms after receiving intramuscular injection of lorazepam. The fourth subject died of multiple medical diseases. The treatment results suggest that most of the clinical presentations in patients with post-partum mental illness could be relieved by antipsychotics, mood stabilizers or antidepressants. In addition, it was found that intramuscular injection of lorazepam was also effective in patients with catatonic features and post-partum depression or psychosis.

  18. Stalkers and harassers of royalty: the role of mental illness and motivation.

    Science.gov (United States)

    James, D V; Mullen, P E; Pathé, M T; Meloy, J R; Preston, L F; Darnley, B; Farnham, F R

    2009-09-01

    Public figures are at increased risk of attracting unwanted attention in the form of intrusions, stalking and, occasionally, attack. Whereas the potential threat to the British Royal Family from terrorists and organized groups is clearly defined, there is a dearth of knowledge about that from individual harassers and stalkers. This paper reports findings from the first systematic study of this group. A retrospective study was conducted of a randomly selected stratified sample (n=275) of 8001 files compiled by the Metropolitan Police Service's Royalty Protection Unit over 15 years on inappropriate communications or approaches to members of the British Royal Family. Cases were split into behavioural types. Evidence of major mental illness was recorded from the files. Cases were classified according to a motivational typology. An analysis was undertaken of associations between motivation, type of behaviour and mental illness. Of the study sample, 83.6% were suffering from serious mental illness. Different forms of behaviour were associated with different patterns of symptomatology. Cases could be separated into eight motivational groups, which also showed significant differences in mental state. Marked differences in the intrusiveness of behaviour were found between motivational groups. The high prevalence of mental illness indicates the relevance of psychiatric intervention. This would serve the health interests of psychotic individuals and alleviate protection concerns without the necessity of attempting large numbers of individual risk predictions. The finding that some motivations are more likely to drive intrusive behaviours than others may help focus both health and protection interventions.

  19. Medication and physical activity and physical fitness in severe mental illness.

    Science.gov (United States)

    Perez-Cruzado, David; Cuesta-Vargas, Antonio; Vera-Garcia, Elisa; Mayoral-Cleries, Fermín

    2018-05-23

    Anti-psychotic medication has emerged as the primary medical treatment for people with severe mental illness, despite the great risks involved in the use of this medication. In addition, this population suffers from problems of obesity, sedentary lifestyle and poor physical fitness, which is aggravated by the use of this type of medication. The objective of this study is to explore the influence of the most commonly used antipsychotics in this population (Olanzapine and Risperidone) on physical activity and the physical fitness of people with severe mental illness. Sixty-two people between 26 and 61 years of age with severe mental illness were assessed. All participants were evaluated with a battery of 11 physical tests to assess their physical fitness and with the IPAQ-short version questionnaire to determine their level of physical activity. The doses of Risperidone and Olanzapine were also evaluated in all participants. Significant differences were found for physical activity, with higher levels reported in those patients with severe mental illness who did not take any of these medications. Regarding physical fitness, significant differences were only found for the consumption of Risperidone, with better physical fitness levels seen in patients who did not consume this medication; on the other hand, for the consumption of Olanzapine, differences were found in muscular strength, balance and aerobic condition with better values in non-Olanzapine consumers compared with Olanzapine consumers. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Illness appraisals and self-esteem as correlates of anxiety and affective comorbid disorders in schizophrenia.

    Science.gov (United States)

    Karatzias, Thanos; Gumley, Andrew; Power, Kevin; O'Grady, Margaret

    2007-01-01

    Comorbidity of anxiety and affective disorders in people with a diagnosis of schizophrenia is common. This study investigated the hypothesis that greater negative beliefs about illness and lower self-esteem will be significantly associated with the presence of anxiety or affective comorbidity in a sample of persons (n = 138) diagnosed with schizophrenia. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; the Positive and Negative Syndrome Scale; the Global Assessment of Functioning Scale; the Personal Beliefs about Illness Questionnaire; and the Rosenberg Self-Esteem Scale were all completed for each participant. Of the total sample, 62 (44.9%) had a comorbid anxiety or affective disorder. Logistic regression revealed that those with a comorbid anxiety or affective disorder had significantly lower levels of functioning (Global Assessment of Functioning), more negative appraisals of entrapment in psychosis (Personal Beliefs about Illness Questionnaire), and lower levels of self-esteem (Rosenberg Self-Esteem Scale). Although further research is required, the strong association between personal beliefs about self and illness and comorbidity suggests that negative beliefs about psychotic experiences and self-esteem may be linked to the development and maintenance of anxiety and affective comorbid conditions among people with a diagnosis of schizophrenia or the like.

  1. A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.

    Science.gov (United States)

    Tillman, Jane G

    2008-01-01

    Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach.

  2. Subjective Illness theory and coping

    Directory of Open Access Journals (Sweden)

    Gessmann H.-W.

    2015-03-01

    Full Text Available The article presents a view of a problem of subjective illness theory in context of coping behavior. The article compiles the results of the latest studies of coping; discloses the way subjective illness theory affects the illness coping and patient's health; presents the study of differences in coping behaviour of patients at risk of heart attack and oncology. The article is recommended for specialists, concerned with psychological reasons of pathogenic processes and coping strategies of patients.

  3. Impact of Adverse Childhood Experiences on Psychotic-Like Symptoms and Stress Reactivity in Daily Life in Nonclinical Young Adults.

    Directory of Open Access Journals (Sweden)

    Paula Cristóbal-Narváez

    Full Text Available There is increasing interest in elucidating the association of different childhood adversities with psychosis-spectrum symptoms as well as the mechanistic processes involved. This study used experience sampling methodology to examine (i associations of a range of childhood adversities with psychosis symptom domains in daily life; (ii whether associations of abuse and neglect with symptoms are consistent across self-report and interview methods of trauma assessment; and (iii the role of different adversities in moderating affective, psychotic-like, and paranoid reactivity to situational and social stressors.A total of 206 nonclinical young adults were administered self-report and interview measures to assess childhood abuse, neglect, bullying, losses, and general traumatic events. Participants received personal digital assistants that signaled them randomly eight times daily for one week to complete questionnaires about current experiences, including symptoms, affect, and stress.Self-reported and interview-based abuse and neglect were associated with psychotic-like and paranoid symptoms, whereas only self-reported neglect was associated with negative-like symptoms. Bullying was associated with psychotic-like symptoms. Losses and general traumatic events were not directly associated with any of the symptom domains. All the childhood adversities were associated with stress reactivity in daily life. Interpersonal adversities (abuse, neglect, bullying, and losses moderated psychotic-like and/or paranoid reactivity to situational and social stressors, whereas general traumatic events moderated psychotic-like reactivity to situational stress. Also, different interpersonal adversities exacerbated psychotic-like and/or paranoid symptoms in response to distinct social stressors.The present study provides a unique examination of how childhood adversities impact the expression of spectrum symptoms in the real world and lends support to the notion that

  4. A Chinese version of the Psychotic Symptom Rating Scales: psychometric properties in recent-onset and chronic psychosis.

    Science.gov (United States)

    Chien, Wai-Tong; Lee, Isabella Yuet-Ming; Wang, Li-Qun

    2017-01-01

    The purpose of this study was to test the reliability, validity, and factor structure of a Chinese version of the Psychotic Symptom Rating Scale (PSYRATS) in 198 and 202 adult patients with recent-onset and chronic psychosis, respectively. The PSYRATS has been translated into different language versions and has been validated for clinical and research use mainly in chronic psychotic patients but not in recent-onset psychosis patients or in Chinese populations. The psychometric analysis of the translated Chinese version included assessment of its content validity, semantic equivalence, interrater and test-retest reliability, reproducibility, sensitivity to changes in psychotic symptoms, internal consistency, concurrent validity (compared to a valid psychotic symptom scale), and factor structure. The Chinese version demonstrated very satisfactory content validity as rated by an expert panel, good semantic equivalence with the original version, and high interrater and test-retest (at 2-week interval) reliability. It also indicated very good reproducibility of and sensitivity to changes in psychotic symptoms in line with the symptom severity measured with the Positive and Negative Syndrome Scale (PANSS). The scale consisted of four factors for the hallucination subscale and two factors for the delusion subscale, explaining about 80% of the total variance of the construct, indicating satisfactory correlations between the hallucination and delusion factors themselves, between items, factors, subscales, and overall scale, and between factors and relevant item and subscale scores of the PANSS. The Chinese version of the PSYRATS is a reliable and valid instrument to measure symptom severity in Chinese psychotic patients complementary to other existing measures mainly in English language.

  5. Attributing illness to food

    DEFF Research Database (Denmark)

    Batz, M. B.; Doyle, M. P.; Morris, J. G.

    2005-01-01

    source responsible for illness. A wide variety of food attribution approaches and data are used around the world including the analysis of outbreak data, case-control studies, microbial subtyping and source tracking methods, and expert judgment, among others. The Food Safety Research Consortium sponsored......Identification and prioritization of effective food safety interventions require an understanding of the relationship between food and pathogen from farm to consumption. Critical to this cause is food attribution, the capacity to attribute cases of foodborne disease to the food vehicle or other...... the Food Attribution Data Workshop in October 2003 to discuss the virtues and limitations of these approaches and to identify future options for collecting food attribution data in the United States. We summarize workshop discussions and identify challenges that affect progress in this critical component...

  6. Effect of virtual reality exposure therapy on social participation in people with a psychotic disorder (VRETp) : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Pot-Kolder, Roos; Veling, Wim; Geraets, Chris; van der Gaag, Mark

    2016-01-01

    Background: Many patients with a psychotic disorder participate poorly in society. When psychotic disorders are in partial remission, feelings of paranoia, delusions of reference, social anxiety and self-stigmatization often remain at diminished severity and may lead to avoidance of places and

  7. TAILOR - tapered discontinuation versus maintenance therapy of antipsychotic medication in patients with newly diagnosed schizophrenia or persistent delusional disorder in remission of psychotic symptoms

    DEFF Research Database (Denmark)

    Stürup, Anne Emilie; Jensen, Heidi Dorthe; Dolmer, Signe

    2017-01-01

    , substance and alcohol use, sexual functioning and quality of life. The primary outcome will be remission of psychotic symptoms and no antipsychotic medication after 1 year. Secondary outcome measures will include: co-occurrence of remission of psychotic symptoms and 0-1-mg haloperidol equivalents...

  8. Perceived discrimination and psychotic experiences across multiple ethnic groups in the United States.

    Science.gov (United States)

    Oh, Hans; Yang, Lawrence H; Anglin, Deidre M; DeVylder, Jordan E

    2014-08-01

    The objective of this study was to examine the relationship between perceived discrimination and psychotic experiences (PE) using validated measures of discrimination and a racially/ethnically diverse population-level sample. Data were drawn from two population-level surveys (The National Latino and Asian American Survey and The National Survey of American Life), which were analyzed together using survey weights and stratification variables. The analytic sample (N=8990) consisted of Latino, Asian, African-American, and Afro-Caribbean adults living in the United States. Separate unadjusted and adjusted multivariable logistic regression models were used, first to examine the crude bivariate relationship between perceived discrimination and PE, and second to examine the relationship adjusting for demographic variables. Adjusted logistic regression models were also used to examine the relationships between perceived discrimination and specific sub-types of PE (auditory and visual hallucinatory experiences, and delusional ideation). When compared to individuals who did not report any discrimination, those who reported the highest levels of discrimination were significantly more likely to report both 12-month PE (Adjusted OR=4.590, pPerceived discrimination is associated with the increased probability of reporting psychotic experiences in a linear Fashion in the US general population. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis.

    LENUS (Irish Health Repository)

    Kelleher, I

    2011-01-01

    Recent research shows that psychotic symptoms, or psychotic-like experiences (PLEs), are reported not only by psychosis patients but also by healthy members of the general population. Healthy individuals who report these symptoms are considered to represent a non-clinical psychosis phenotype, and have been demonstrated to be at increased risk of schizophrenia-spectrum disorder. Converging research now shows that this non-clinical psychosis phenotype is familial, heritable and covaries with familial schizophrenia-spectrum disorder. A review of the research also shows that the non-clinical phenotype is associated extensively with schizophrenia-related risk factors, including social, environmental, substance use, obstetric, developmental, anatomical, motor, cognitive, linguistic, intellectual and psychopathological risk factors. The criterion and construct validity of the non-clinical psychosis phenotype with schizophrenia demonstrates that it is a valid population in which to study the aetiology of psychosis. Furthermore, it suggests shared genetic variation between the clinical and non-clinical phenotypes. Much remains to be learned about psychosis by broadening the scope of research to include the non-clinical psychosis phenotype.

  10. Alterations in theory of mind in patients with schizophrenia and non-psychotic relatives.

    Science.gov (United States)

    Janssen, I; Krabbendam, L; Jolles, J; van Os, Jim

    2003-08-01

    It has been proposed that alterations in theory of mind underlie specific symptoms of psychosis. The present study examined whether alterations in theory of mind reflect a trait that can be detected in non-psychotic relatives of patients with schizophrenia. Participants were 43 patients with schizophrenia or schizoaffective disorder, 41 first-degree non-psychotic relatives and 43 controls from the general population. Theory of mind was assessed using a hinting task and a false-belief task. There was a significant association between schizophrenia risk and failure on the hinting task (OR linear trend = 2.01, 95% CI: 1.22-3.31), with relatives having intermediate values between patients and controls. Adjustment for IQ and neuropsychological factors reduced the association by small amounts. The association between schizophrenia risk and failure on the false-belief tasks was not significant. Changes in theory of mind are associated with schizophrenia liability. General cognitive ability and neuropsychological measures seem to mediate only part of this association.

  11. Differential impairment of social cognition factors in bipolar disorder with and without psychotic features and schizophrenia.

    Science.gov (United States)

    Thaler, Nicholas S; Allen, Daniel N; Sutton, Griffin P; Vertinski, Mary; Ringdahl, Erik N

    2013-12-01

    While it is well-established that patients with schizophrenia and bipolar disorder exhibit deficits in social cognition, few studies have separately examined bipolar disorder with and without psychotic features. The current study addressed this gap by comparing patients with bipolar disorder with (BD+) and without (BD-) psychotic features, patients with schizophrenia (SZ), and healthy controls (NC) across social cognitive measures. Principal factor analysis on five social cognition tasks extracted a two-factor structure comprised of social/emotional processing and theory of mind. Factor scores were compared among the four groups. Results identified differential patterns of impairment between the BD+ and BD- group on the social/emotional processing factor while all clinical groups performed poorer than controls on the theory of mind factor. This provides evidence that a history of psychosis should be taken into account while evaluating social cognition in patients with bipolar disorder and also raises hypotheses about the relationship between social cognition and psychosis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Persistent psychotic symptoms after long-term heavy use of mephedrone: A two-case series.

    Science.gov (United States)

    Barrio, Pablo; Gaskell, Matthew; Goti, Javier; Vilardell, Sergi; Fàbregas, Josep Maria

    2016-06-15

    Mephedrone (4-methylmethcathinone) is a synthetic stimulant drug of the cathinone class. Similar effects to those of cocaine and ecstasy are reported by users, with a high addictive potential. Given its increasing rate of consumption in Europe, it is getting more and more attention from the addiction field. In spite of that, little is known about the long-term consequences of prolonged heavy use. The two following cases might depict some of them. Case 1 was a middle-age man who reported three years of intravenous use of mephedrone. He used to binge for several days in a row. Psychotic symptoms appeared after a few months, especially paranoid delusions. Sent to aftercare in a therapeutic community, delusions kept reappearing after prolonged abstinence. A good response to risperidone was observed. Case 2 was a young man who used mephedrone heavily for two years, always snorted. Upon admission to the therapeutic community, the patient reported auditory hallucinations that partially remitted with olanzapine. Both cases showed a good insight and no personality deterioration. Given its similarities to other substances that are known to induce psychotic symptoms, and the increasing consumption of mephedrone around Europe, similar cases are expected in the near future. Conventional antipsychotic treatment seems a reasonable pharmacological approach.

  13. Vitamin D status in psychotic disorder patients and healthy controls--The influence of ethnic background.

    Science.gov (United States)

    Nerhus, Mari; Berg, Akiah Ottesen; Dahl, Sandra Rinne; Holvik, Kristin; Gardsjord, Erlend Strand; Weibell, Melissa Authen; Bjella, Thomas Doug; Andreassen, Ole A; Melle, Ingrid

    2015-12-15

    Vitamin D deficiency is common among patients with psychotic disorders and could be due to unknown disease mechanisms or contingent factors. However most studies are performed in chronic patients and have often failed to address the influence of ethnicity on vitamin D levels in clinical samples. We investigated serum concentrations of 25-hydroxy vitamin D (S-25 OH D) in first episode patients compared to patients with multi episodes and healthy controls; with a specific focus on differences between visible ethnic minorities and participants from the majority population. A total of 284 participants were included in this cross-sectional study. First episode patients with a DSM-IV psychotic disorder were matched on age, gender and ethnicity to participants from a multi episode patient sample (1:1) and healthy controls (1:2). We did not find any differences between either patient groups or the healthy controls, but participants from visible ethnic minorities had significantly lower S-25 OH D than participants from the majority population. This implies that S-25 OH D should be routinely measured in persons from visible ethnic minorities since low levels are associated with higher levels of depressive symptoms. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Association Between Vitamin D Insufficiency and Metabolic Syndrome in Patients With Psychotic Disorders.

    Science.gov (United States)

    Yoo, Taeyoung; Choi, Wonsuk; Hong, Jin-Hee; Lee, Ju-Yeon; Kim, Jae-Min; Shin, Il-Seon; Yang, Soo Jin; Amminger, Paul; Berk, Michael; Yoon, Jin-Sang; Kim, Sung-Wan

    2018-04-01

    This study examined the association between vitamin D and metabolic syndrome in patients with psychotic disorders. The study enrolled 302 community-dwelling patients with psychotic disorders. Sociodemographic and clinical characteristics, including blood pressure, physical activity, and dietary habit were gathered. Laboratory examinations included vitamin D, lipid profile, fasting plasma glucose, HbA1c, liver function, and renal function. Vitamin D insufficiency was defined as vitamin D insufficiency were identified. Among the 302 participants, 236 patients (78.1%) had a vitamin D insufficiency and 97 (32.1%) had metabolic syndrome. Vitamin D insufficiency was significantly associated with the presence of metabolic syndrome (p=0.006) and hypertension (p=0.017). Significant increases in triglycerides and alanine transaminase were observed in the group with a vitamin D insufficiency (p=0.002 and 0.011, respectively). After adjusting for physical activity and dietary habit scores, vitamin D insufficiency remained significantly associated with metabolic syndrome and hypertension. Vitamin D insufficiency was associated with metabolic syndrome and was particularly associated with high blood pressure, although the nature, direction and implications of this association are unclear.

  15. Stability of cognition across wakefulness and dreams in psychotic major depression.

    Science.gov (United States)

    Cavallotti, Simone; Castelnovo, Anna; Ranieri, Rebecca; D'agostino, Armando

    2014-04-30

    Cognitive bizarreness has been shown to be equally elevated in the dream and waking mentation of acutely symptomatic inpatients diagnosed with affective and non-affective psychoses. Although some studies have reported on dream content in non-psychotic depression, no study has previously measured this formal aspect of cognition in patients hospitalized for Psychotic Major Depression (PMD). Sixty-five dreams and 154 waking fantasy reports were collected from 11 PMD inpatients and 11 age- and sex-matched healthy controls. All narrative reports were scored by judges blind to diagnosis in terms of formal aspects of cognition (Bizarreness). Dream content was also scored (Hall/Van de Castle scoring system). Unlike controls, PMD patients had similar levels of cognitive bizarreness in their dream and waking mentation. Dreams of PMD patients also differed from those of controls in terms of content variables. In particular, Happiness, Apprehension and Dynamism were found to differ between the two groups. Whereas dream content reflects a sharp discontinuity with the depressive state, cognitive bizarreness adequately measures the stability of cognition across dreams and wakefulness in PMD inpatients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Influence of depressive symptoms on distress related to positive psychotic-like experiences in women.

    Science.gov (United States)

    Brañas, Antía; Barrigón, María Luisa; Lahera, Guillermo; Canal-Rivero, Manuel; Ruiz-Veguilla, Miguel

    2017-12-01

    The Community Assessment of Psychic Experiences (CAPE) is an effective instrument for detection of the presence of psychotic symptoms and associated distress in the general population. However, little research has studied distress associated with positive psychotic-like experiences (PLEs). Our aim is to study PLE-related distress using the CAPE. In this study we analysed factors associated with differences in PLE-related distress in a sample of 200 non-clinical participants recruited by snowball sampling. Presence of PLEs and related psychological distress was measured using the CAPE questionnaire. The influence of age, gender, educational level and drug use was studied. In univariate analysis we found that gender and CAPE positive, depressive and negative scores, were associated with CAPE positive distress. Using multiple linear regression, we found that only the effect of gender, and the interaction between frequency of depression and gender, remained statistically significant. In our sample interaction between gender and depressive symptoms is a determining factor in distress associated with positive PLEs. The results of this study may be useful for the implementation of prevention programs. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Comparison of psychotic bipolar disorder, schizoaffective disorder, and schizophrenia: an international, multisite study.

    Science.gov (United States)

    Tondo, L; Vázquez, G H; Baethge, C; Baronessa, C; Bolzani, L; Koukopoulos, A; Mazzarini, L; Murru, A; Pacchiarotti, I; Pinna, M; Salvatore, P; Sani, G; Selle, V; Spalletta, G; Girardi, P; Tohen, M; Vieta, E; Baldessarini, R J

    2016-01-01

    Nosological distinctions among schizoaffective disorder (SA), bipolar I disorder with psychotic features (BDp), and schizophrenia (SZ) remain unresolved. We compared 2269 subjects with psychotic features in DSM-IV-TR diagnoses (1435 BDp, 463 SZ, 371 SA) from 8 collaborating international sites, by 12 sociodemographic and clinical measures, all between diagnostic pairs. In bivariate comparisons, SA was consistently intermediate between BDp and SZ for 11/12 features (except onset stressors), and SZ vs. BDp differed in all 12 factors. SA differed from both BDp and SZ in 9/12 factors: SA and BDp were similar in education and suicidal ideation or acts; SA and SZ were similar in education, onset stressors, and substance abuse. Meta-analytic comparisons of diagnostic pairs for 10 categorical factors indicated similar differences of SA from both SZ and BDp. Multivariate modeling indicated significantly independent differences between BDp and SZ (8 factors), SA vs. SZ (5), and BDp vs. SA (3). Measurement variance was similar for all diagnoses. SA was consistently intermediate between BDp and SZ. The three diagnostic groups ranked: BDp > SA > SZ related to lesser morbidity or disability. The findings are not consistent with a dyadic Kraepelinian categorization, although the considerable overlap among the three DSM-IV diagnostic groups indicates uncertain boundaries if they represent distinct disorders. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Illness perceptions among cancer survivors.

    Science.gov (United States)

    Zhang, Na; Fielding, Richard; Soong, Inda; Chan, Karen K K; Tsang, Janice; Lee, Victor; Lee, Conrad; Ng, Alice; Sze, Wing Kin; Tin, Pamela; Lam, Wendy Wing Tak

    2016-03-01

    The purpose of the study is to document in Hong Kong Chinese cancer survivors cross-sectional associations between illness perceptions, physical symptom distress and dispositional optimism. A consecutive sample of 1036 (response rate, 86.1%, mean age 55.18 years, 60% female) survivors of different cancers recruited within 6 months of completion of adjuvant therapy from Hong Kong public hospitals completed the Brief Illness Perception Questionnaire (B-IPQ), Chinese version of the Memorial Symptom Assessment Scale Short-Form (MSAS-SF), and the revised Chinese version of Life Orientation Test (C-LOT-R), respectively. Stepwise multiple regression analyses examined adjusted associations. IPQ seriousness, symptom identity, illness concern, and emotional impact scores varied by cancer type (p Stress-related, lifestyle, environment, psychological/personality, and health-related factors were most frequently attributed causes of cancer. After adjustment for sample differences, physical symptom distress was significantly associated with all illness perception dimensions (p differences by cancer type were eliminated by adjustment for sample characteristics. Illness perceptions did not differ by cancer type. Greater physical symptom distress and lower levels of optimism were associated with more negative illness perceptions. Understanding how cancer survivors make sense of cancer can clarify an important aspect of adaptation. This in turn can inform interventions to facilitate adjustment. Knowledge contributions include evidence of physical symptom distress correlating with most dimensions of illness perception. Optimism was also associated with cancer survivors' illness perceptions.

  19. Patterns of treatment seeking behavior for mental illnesses in Southwest Ethiopia: a hospital based study

    Directory of Open Access Journals (Sweden)

    Tesfaye Markos

    2011-08-01

    Full Text Available Abstract Background Early recognition of the signs and symptoms of mental health disorders is important because early intervention is critical to restoring the mental as well as the physical and the social health of an individual. This study sought to investigate patterns of treatment seeking behavior and associated factors for mental illness. Methods A quantitative, institution-based cross sectional study was conducted among 384 psychiatric patients at Jimma University Specialized Hospital (JUSH located in Jimma, Ethiopia from March to April 2010. Data was collected using a pretested WHO encounter format by trained psychiatric nurses. Data was analyzed using SPSS V.16. Result Major depression disorder 186 (48.4%, schizophrenia 55 (14.3% and other psychotic disorders 47 (12.2% were the most common diagnoses given to the respondents. The median duration of symptoms of mental illness before contact to modern mental health service was 52.1 weeks. The main sources of information for the help sought by the patients were found to be family 126 (32.8% and other patients 75 (19.5%. Over a third of the patients 135 (35.2%, came directly to JUSH. Half of the patients sought traditional treatment from either a religious healer 116 (30.2% or an herbalist 77 (20.1% before they came to the hospital. The most common explanations given for the cause of the mental illness were spiritual possession 198 (51.6% and evil eye 61 (15.9%, whereas 73 (19.0% of the respondents said they did not know the cause of mental illnesses. Nearly all of the respondents 379 (98.7% believed that mental illness can be cured with modern treatment. Individuals who presented with abdominal pain and headache were more likely to seek care earlier. Being in the age group 31-40 years had significant statistical association with delayed treatment seeking behavior. Conclusions There is significant delay in modern psychiatric treatment seeking in the majority of the cases. Traditional healers

  20. ILL Annual report 97

    International Nuclear Information System (INIS)

    1997-01-01

    In 1997 the reactor operated for the planned 225 days and more than 750 experiments were carried out. Among the experimental highlights are 2 contrasting examples of the new types of experiments now possible using the new high-intensity diffractometer D2O: stroboscopic measurements of kinetic processes and rapid texture measurements of structural materials. Some early results from the new high-resolution gamma spectrometer in the study of nuclear structure are also presented. Another new facility is just coming into service: the 2π image-plate detector LADI, optimised for Laue measurements on biological crystals. The contrast between biological experiments and for example those on superconductivity or neutron β-decay, illustrates very well the range of scientific questions addressed through the use of ILL's neutron beams. 30 brief accounts of research work achieved during this year are given, they are classified under 9 topics: polymers and colloids, chemistry and structure, biology, materials science, liquids and glasses, magnetism, strongly correlated electron systems, quantum systems, nuclear and fundamental physics. The scheduled new developments are described and a list of the publications is also given

  1. Qualitative analysis of interviews of future non-affective psychotic disorder patients and non-psychiatric controls: preliminary results

    Directory of Open Access Journals (Sweden)

    Katya Rubinstein

    2014-03-01

    Conclusions: The findings of this unique historical-prospective qualitative analysis of interviews performed before the onset of psychosis, confirmed previous findings of premorbid abnormality of future non-affective psychosis patients. Using qualitative analysis enabled obtaining a more in-depth understanding of the real-life experience of the premorbid period among patients with non-affective psychotic disorders.

  2. Self-perception but not peer reputation of bullying victimization is associated with non-clinical psychotic experiences in adolescents

    NARCIS (Netherlands)

    Gromann, P.M.; Goossens, F.A.; Olthof, T.; Pronk, J.; Krabbendam, L.

    2013-01-01

    Background Bullying victimization may be linked to psychosis but only self-report measures of victimization have been used so far. This study aimed (a) to investigate the differential associations of peer-nominated versus self-reported victim status with non-clinical psychotic experiences in a

  3. Small area-level variation in the incidence of psychotic disorders in an urban area in France: an ecological study.

    Science.gov (United States)

    Szoke, Andrei; Pignon, Baptiste; Baudin, Grégoire; Tortelli, Andrea; Richard, Jean-Romain; Leboyer, Marion; Schürhoff, Franck

    2016-07-01

    We sought to determine whether significant variation in the incidence of clinically relevant psychoses existed at an ecological level in an urban French setting, and to examine possible factors associated with this variation. We aimed to advance the literature by testing this hypothesis in a novel population setting and by comparing a variety of spatial models. We sought to identify all first episode cases of non-affective and affective psychotic disorders presenting in a defined urban catchment area over a 4 years period, over more than half a million person-years at-risk. Because data from geographic close neighbourhoods usually show spatial autocorrelation, we used for our analyses Bayesian modelling. We included small area neighbourhood measures of deprivation, migrants' density and social fragmentation as putative explanatory variables in the models. Incidence of broad psychotic disorders shows spatial patterning with the best fit for models that included both strong autocorrelation between neighbouring areas and weak autocorrelation between areas further apart. Affective psychotic disorders showed similar spatial patterning and were associated with the proportion of migrants/foreigners in the area (inverse correlation). In contrast, non-affective psychoses did not show spatial patterning. At ecological level, the variation in the number of cases and the factors that influence this variation are different for non-affective and affective psychotic disorders. Important differences in results-compared with previous studies in different settings-point to the importance of the context and the necessity of further studies to understand these differences.

  4. Medicinal cannabis (Bedrolite) substitution therapy in inpatients with a psychotic disorder and a comorbid cannabis use disorder: A case series

    NARCIS (Netherlands)

    Schipper, Regi; Dekker, Mathilde; de Haan, Lieuwe; van den Brink, Wim

    2017-01-01

    Cannabis use disorders are frequently comorbid in patients with a psychotic disorder and are associated with worse outcomes. To date there are no proven effective strategies to achieve cannabis abstinence in this population. An alternative for abstinence might be harm reduction, i.e. replacing the

  5. Third-person Diagnostic Interview on the Cognitive Insight Level of Psychotic Patients with an Insight at the Denial Level.

    Science.gov (United States)

    Mehdizadeh, Mahsa; Rezaei, Omid

    2016-01-01

    According to the previous findings, the third-person technique improved the clinical insight of psychotic patients, therefore the present study aims to examine the effect of a third-person interview compared to a first-person interview on the level of cognitive insight of psychotic patients with an insight at the denial level. In this study, using interviews and questionnaires, a total number of 44 patients of Razi Psychiatric Educational and Treatment Center with an insight at the denial level being assessed using diagnostic interviews were divided randomly into two groups. Then, the two groups of patients' cognitive insights were evaluated using Beck Cognitive Insight Scale. The findings indicated that in psychotic patients with an insight at the denial level, the third-person technique of interview compared to the first-person had little effect on the improvement of overall cognitive insight and its components, including self-reflection and self-assurance; however, this effect was not strong enough to make a significant difference between the two groups of patients. According to the study findings, we can conclude that the third-person interview compared to the first-person interview has no effect on the improvement of the cognitive insight of psychotic patients with an insight at the denial level. This finding is consistent with the previous studies indicating that although the theory of mind has some correlations with the clinical insight of patients, it has no effect on their cognitive insight.

  6. Theory of mind deficit in bipolar disorder: is it related to a previous history of psychotic symptoms?

    Science.gov (United States)

    Lahera, Guillermo; Montes, José Manuel; Benito, Adolfo; Valdivia, María; Medina, Elena; Mirapeix, Isabel; Sáiz-Ruiz, Jerónimo

    2008-12-15

    It has been hypothesized that a Theory of Mind (ToM) deficit could be a vulnerability marker for psychosis. Recent studies, however, have shown ToM deficits in affective relapses of bipolar disorder as well as in the euthymic phase. This study analyzes the relationship between ToM and a previous history of psychotic symptoms in bipolar disorder. ToM, sustained attention and executive functions were analyzed in 75 bipolar euthymic patients with three or more previous relapses (42 of them had a history of psychotic symptoms and 33 did not) and 48 healthy subjects. ToM was assessed with the Advanced Test by Happé. ToM performance was similar in bipolar patients with or without a history of psychotic symptoms, and in both cases it was significantly reduced as compared with the healthy control group. Similarly, both bipolar groups showed impaired sustained attention and executive functions. This general cognitive deficit partially explains the differences obtained in ToM. The ToM instrument used shows low sensitivity for assessing ToM in bipolar patients and it could partially reflect general cognitive functioning rather than a specific deficit in psychosis. ToM deficit is not a trait marker for psychosis, given that it is present in bipolar disorder regardless of a previous history of psychotic symptoms.

  7. Age at migration and future risk of psychotic disorders among immigrants in the Netherlands : a 7-year incidence study

    NARCIS (Netherlands)

    Veling, Wim; Hoek, Hans W; Selten, Jean-Paul; Susser, Ezra

    2011-01-01

    Objective: The purpose of this study was to examine whether the increased risk for developing a psychotic disorder among immigrants is related to their age at the time of migration. Method: In a 7-year first-contact incidence study, immigrants to the Netherlands and Dutch citizens, ages 15-54 years,

  8. The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder.

    LENUS (Irish Health Repository)

    Fisher, H L

    2010-12-01

    Childhood adversity has been associated with onset of psychosis in adulthood but these studies have used only general definitions of this environmental risk indicator. Therefore, we sought to explore the prevalence of more specific adverse childhood experiences amongst those with and without psychotic disorders using detailed assessments in a large epidemiological case-control sample (AESOP).

  9. [Young adult with psychotic disorders have problems relating to sexuality, intimacy and relationships. An explanatory study based on focus group].

    Science.gov (United States)

    de Jager, J; Wolters, H A; Pijnenborg, G H M

    2016-01-01

    Research has shown that young adults with psychotic disorders frequently have problems relating to sexuality, intimacy and relationships. Such problems are often neglected in clinical practice. To perform a study that explores, on the basis of focus groups, how issues such as sexuality, intimacy and relationships can be addressed as part of the treatment of adolescents suffering from a psychotic disorder. We created eight focus groups consisting of clients attending the department of psychotic disorders and caregivers who worked there. The meetings of each focus group were fully transcribed and analysed by means of Nvivo. Clients indicated they wanted to address the topics of sexuality, intimacy and relationships in a group setting. They expressed the wish to have mixed gender groups and decided that in the group discussions the main focus should be on the exchange of personal experiences. In our view, it is desirable that psychiatry should pay more attention to the subject of sexuality. By giving adolescents suffering from psychotic disorders the opportunity to discuss their experiences, problems and feelings of insecurity in a group setting and in a low-threshold environment, psychiatrists can greatly improve the quality of care that they provide for their patients.

  10. Sexual minority status and psychotic symptoms : findings from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS)

    NARCIS (Netherlands)

    Gevonden, M J; Selten, J P; Myin-Germeys, I; de Graaf, R; ten Have, M; van Dorsselaer, S; van Os, J; Veling, W

    BACKGROUND: Ethnic minority position is associated with increased risk for psychotic outcomes, which may be mediated by experiences of social exclusion, defeat and discrimination. Sexual minorities are subject to similar stressors. The aim of this study is to examine whether sexual minorities are at

  11. Sexual minority status and psychotic symptoms: findings from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS)

    NARCIS (Netherlands)

    Gevonden, M. J.; Selten, J. P.; Myin-Germeys, I.; de Graaf, R.; ten Have, M.; van Dorsselaer, S.; van Os, J.; Veling, W.

    2014-01-01

    Ethnic minority position is associated with increased risk for psychotic outcomes, which may be mediated by experiences of social exclusion, defeat and discrimination. Sexual minorities are subject to similar stressors. The aim of this study is to examine whether sexual minorities are at increased

  12. The relation between bullying and subclinical psychotic experiences and the influence of the bully climate of school classes

    NARCIS (Netherlands)

    Horrevorts, Esther M. B.; Monshouwer, Karin; Wigman, Johanna T. W.; Vollebergh, Wilma A. M.

    This study aims to examine the association between the bully climate of school classes and the prevalence of subclinical psychotic experiences among students who are involved in bullying (either as bully or as victim). Data were derived from the Dutch health behavior in school-aged children survey

  13. The relationship between personality traits and psychotic like experiences in a large non-clinical adolescent sample

    NARCIS (Netherlands)

    Wiltink, S.; Nelson, B.; Velthorst, E.; Wigman, J. T. W.; Lin, A.; Baksheev, G.; Cosgrave, E.; Ross, M.; Ryan, J.; Yung, A. R.

    Objective: The relationship between personality and psychosis is well established. It has been suggested that this relationship may be partly accounted for by higher levels of depression in individuals with certain personality traits. We explored whether the link between personality and psychotic

  14. The relation between bullying and subclinical psychotic experiences and the influence of the bully climate of school classes

    NARCIS (Netherlands)

    Horrevorts, Esther M B; Monshouwer, Karin; Wigman, Johanna T W; Vollebergh, Wilma A M

    2014-01-01

    This study aims to examine the association between the bully climate of school classes and the prevalence of subclinical psychotic experiences among students who are involved in bullying (either as bully or as victim). Data were derived from the Dutch health behavior in school-aged children survey

  15. Association study of GABA system genes polymorphisms with amphetamine-induced psychotic disorder in a Han Chinese population.

    Science.gov (United States)

    Zhang, Kai; Zhao, Yan; Wang, Qingzhong; Jiang, Haifeng; Du, Jiang; Yu, Shunying; Zhao, Min

    2016-05-27

    GABA system genes have been implicated in neurotrophy and neurogenesis, which play pivotal roles in an individual's variation in vulnerability to amphetamine addiction or amphetamine-induced psychosis (AIP). We hypothesized that common genetic variants in the GABA system genes may be associated with amphetamine-induced psychotic disorder. In our study, thirty-six single nucleotide polymorphisms (SNPs) within the GABA system genes were genotyped in 400 amphetamine-induced psychotic disorder patients and 400 amphetamine use disorders patients (AUP) (not including those categorized as psychosis) in the Han Chinese population. In this study, 51.88% of the Han Chinese amphetamine-type substance use disorder patients met the criteria of amphetamine-induced psychotic disorder, and 79.5% amphetamine-induced psychotic disorder patients had auditory hallucinations, while 46.5% had delusions of reference. The allele frequency of rs1129647 showed nominal association with AIP in the Han Chinese population (P=0.03). Compared with AUP group patients, T allele frequency of AIP group patients was significantly increased. The adjustment for age and gender factors in the AIP and AUP patients was executed using unconditional logistic regression under five inheritance models. The genotype frequency of rs1129647 showed nominal association with AIP in the log-additive model (P=0.04). The genotype frequency of rs2290733 showed nominal association with AIP in the recessive model (P=0.04). Compared with female AIP patients, male patients were more likely to have the CC genotype of rs17545383 (P=0.04). Moreover, we determined that more male patients carried the T allele of rs2290733 in the AIP group (P=0.004). Unfortunately, the significant differences did not survive Benjamini-Hochberg false discovery rate correction (adjusted P>0.05). No association between the SNPs of the GABA system genes and amphetamine-induced psychotic disorder risk was identified. No haplotype of the GABA system

  16. Youth blogging and serious illness.

    Science.gov (United States)

    Nesby, Linda; Salamonsen, Anita

    2016-03-01

    In recent years, a growing number of young people who experience illness tend to blog about it. In this paper, we question whether and how illness blogs illustrate the intercommunicative aspect of blogging by bringing forth both the literary concept of the implied reader and the sociological concepts of empowerment and agency in the analysis. We argue that young people blogging about serious illness demonstrate the inherent intercommunicative potential of blogging. We also argue that youth blogging about serious illness may represent a fruitful strategy for ill young people to create meaning, stay front-stage in youth communities and build self-esteem and confidence out of chaos. Furthermore, we argue that these blogs may contribute rather unique experience-based knowledge and reflections about existential issues to other young blog readers, who may otherwise not get access to this aspect of life. Youth blogging about serious illness thereby reflects a patient group so far not very visible and through the genre youth stand out as more competent when it comes to illness and healthcare issues than what is often presumed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Potential Benefits of Incorporating Peer-to-Peer Interactions Into Digital Interventions for Psychotic Disorders: A Systematic Review.

    Science.gov (United States)

    Biagianti, Bruno; Quraishi, Sophia H; Schlosser, Danielle A

    2018-04-01

    Peer-to-peer interactions and support groups mitigate experiences of social isolation and loneliness often reported by individuals with psychotic disorders. Online peer-to-peer communication can promote broader use of this form of social support. Peer-to-peer interactions occur naturally on social media platforms, but they can negatively affect mental health. Recent digital interventions for persons with psychotic disorders have harnessed the principles of social media to incorporate peer-to-peer communication. This review examined the feasibility, acceptability, and preliminary efficacy of recent digital interventions in order to identify strategies to maximize benefits of online peer-to-peer communication for persons with psychotic disorders. An electronic database search of PubMed, EMBASE, PsycINFO, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database was conducted in February 2017 and yielded a total of 1,015 results. Eight publications that reported data from six independent trials and five interventions were reviewed. The technology supporting peer-to-peer communication varied greatly across studies, from online forums to embedded social networking. When peer-to-peer interactions were moderated by facilitators, retention, engagement, acceptability, and efficacy were higher than for interventions with no facilitators. Individuals with psychotic disorders were actively engaged with moderated peer-to-peer communication and showed improvements in perceived social support. Studies involving service users in intervention design showed higher rates of acceptability. Individuals with psychotic disorders value and benefit from digital interventions that include moderated peer-to-peer interactions. Incorporating peer-to-peer communication into digital interventions for this population may increase compliance with other evidence-based therapies by producing more acceptable and engaging online environments.

  18. Peripheral blood microRNA and VEGFA mRNA changes following electroconvulsive therapy: implications for psychotic depression.

    Science.gov (United States)

    Kolshus, E; Ryan, K M; Blackshields, G; Smyth, P; Sheils, O; McLoughlin, D M

    2017-12-01

    MicroRNAs are short, non-coding molecules that regulate gene expression. Here, we investigate the role of microRNAs in depression and electroconvulsive therapy (ECT). We performed three studies: a deep sequencing discovery-phase study of miRNA changes in whole blood following ECT (n = 16), followed by a validation study in a separate cohort of patients pre-/post-ECT (n = 37) and matched healthy controls (n = 34). Changes in an experimentally validated gene target (VEGFA) were then analysed in patients pre-/post-ECT (n = 97) and in matched healthy controls (n = 53). In the discovery-phase study, we found no statistically significant differences in miRNA expression from baseline to end of treatment in the group as a whole, but post hoc analysis indicated a difference in patients with psychotic depression (n = 3). In a follow-up validation study, patients with psychotic depression (n = 7) had elevated baseline levels of miR-126-3p (t = 3.015, P = 0.006) and miR-106a-5p (t = 2.598, P = 0.025) compared to healthy controls. Following ECT, these differences disappeared. Baseline VEGFA levels were significantly higher in depressed patients compared to healthy controls (F(1,144) = 27.688, P = <0.001). Following ECT, there was a significant change in VEGFA levels in the psychotic group only (t = 2.915, P = 0.010). Molecular differences (miRNA and VEGFA) may exist between psychotic and non-psychotic depression treated with ECT. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Modelling the incidence and mortality of psychotic disorders: data from the second Australian national survey of psychosis.

    Science.gov (United States)

    Saha, Sukanta; Whiteford, Harvey; McGrath, John

    2014-04-01

    The aim of this study was to model estimates related to (a) the incidence of psychotic disorders and (b) the mortality associated with these disorders based on a large, population-based prevalence study. Data were drawn from the second national survey of adults with psychotic disorders conducted in seven Australian catchment areas during March to December 2010. To generate incidence rate estimates, we identified recent onset cases recruited as part of the prevalence study and then imputed population-based incidence rates using a set of conservative assumptions. Similarly, for mortality rates, we identified individuals who had died after being identified as 'screen-positive' for psychosis, but prior to full clinical assessment. Using a set of conservative assumptions, we then used these estimates to infer population-based mortality rates. Based on our models, we estimated that the incidence rate for psychotic disorders was 28 cases per 100,000 population. The rate estimates were significantly higher in males than females, with an overall male:female ratio of 1.57:1. Incidence rate estimates peaked in the youngest age group (18-24 years). The adjusted mortality rate estimated during the whole period of observation was 12.5 per 1000 persons, with a standardised mortality ratio of 5.5. Using treated prevalence data and observed deaths with appropriate algorithms, we were able to impute incidence and mortality rates for psychotic disorders consistent with the published literature. While the second national survey of psychotic disorders was not designed to identify mortality, our estimates provide a stark reminder of the increased mortality associated with these disorders.

  20. Disaster related heat illness

    International Nuclear Information System (INIS)

    Miyake, Yasufumi

    2012-01-01

    Explained and discussed are the outline of heat illness (HI), its raised risk and measures taken at the disaster of the Fukushima Nuclear Power Plant Accident (FNPPA; Mar. 2011). High temperature and humid environment induce HI through the fervescence and dehydration resulting in the intestinal ischemia/hypoxia and organ failure. Epidemiologic data of the heatstroke in Japan suggest its seemingly parallel incidence to seasonal hotness of the summer. HI is classified in either classical (non-exertional) or exertional heatstroke, both with severity of I (slight), II (slight symptom of the central nervous system (CNS); necessary for consultation) and III (most serious; having dysfunction of CNS, organ or coagulation). Therapy depends on the severity: I for the first aid on site, II necessary for carrying to hospital and III for hospitalization. Protection is possible by personal, neighbors' and managers' carefulness, and supply of sufficient water and minerals. Risk of HI was suddenly raised at taking measures to meet with the FNPPA. Japanese Association for Acute Medicine (JAAM) promptly organized JAAM-FNPPA Working Group to treat the emergent multiple incidents including the radiation exposure and HI as well. Exertional HI was mainly in labors wearing rather sealed closes to protect radiation to work for steps of the Accident, and which was similar to evacuees temporarily entering the evacuation area for visit to their own vacant houses. In the summer, classical HI was also a problem mainly in elderly living in the evacuation dwellings. Document of HI incidents and patients at FNPPA should be recorded for the reference to possible disaster in future. (T.T.)

  1. The association between psychotic experiences and disability: results from the WHO World Mental Health Surveys

    Science.gov (United States)

    Navarro-Mateu, Fernando; Alonso, Jordi; Lim, Carmen C. W.; Saha, Sukanta; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Andrade, Laura H.; Bromet, Evelyn J.; Bruffaerts, Ronny; Chatterji, Somnath; Degenhardt, Louisa; de Girolamo, Giovanni; de Jonge, Peter; Fayyad, John; Florescu, Silvia; Gureje, Oye; Haro, Josep M.; Hu, Chiyi; Karam, Elie G.; Kovess-Masfety, Viviane; Lee, Sing; Medina-Mora, Maria E.; Ojagbemi, Akin; Pennell, Beth-Ellen; Posada-Villa, Jose; Scott, Kate M.; Stagnaro, Juan Carlos; Kendler, Kenneth S.; Kessler, Ronald C.; McGrath, John J.

    2017-01-01

    Objective While psychotic experiences (PEs) are known to be associated with a range of mental and general medical disorders, little is known about the association between PEs and measures of disability. We aimed to investigate this question using the World Mental Health surveys. Method Lifetime occurrences of 6 types of PEs were assessed along with 21 mental disorders and 14 general medical conditions. Disability was assessed with a modified version of the WHO Disability Assessment Schedule. Descriptive statistics and logistic regression models were used to investigate the association between PEs and high disability scores (top quartile) with various adjustments. Results Respondents with PEs were more likely to have top quartile scores on global disability than respondents without PEs (19.1% vs. 7.5%; χ2 = 190.1, pmental or general medical disorders. PMID:28542726

  2. Possible curative role of the anti psychotic drug fluphenazine against post-irradiation injury in rats

    International Nuclear Information System (INIS)

    Hassan, S.H.M.; Abu-Ghadeer, A.R.M.; Osman, S.A.A.; Roushdy, H.M.

    1986-01-01

    In the present study, investigation of the possible curative role of the anti psychotic agent ''fluphenazine'' against post irradiation injury of certain sensitive biological targets has been studied in rats. Such investigation includes evaluation of the haematological levels, liver function as manifested by levels of relevant serum enzymes and kidney function as reflected by level of serum creatinine and rate of urine creatinine clearance. Data of the present study indicated that fractionated whole body gamma-irradiation resulted in haematological disorders, significant elevation in serum enzyme activities of both serum glutamic pyruvic transaminase (SGPT) and serum alkaline phosphatase (SALKPH.), significant decrease in serum cholinesterase (SCHE) activity and a significant increase in serum creatinine accompanied by a significant decrease in creatinine clearance. 4 figs., 4 tabs

  3. ADVANCES IN THE ASSESSMENT OF THE NEGATIVE SYMPTOMS OF THE PSYCHOTIC SYNDROME

    Directory of Open Access Journals (Sweden)

    Eduardo Fonseca-Pedrero

    2015-01-01

    Full Text Available The aim of this paper is to bring recent advances developed in the assessment of negative symptoms in psychotic spectrum disorders and related conditions to the professional psychologist. First, we briefly discuss the historical development of negative symptoms, their conceptualisation, and their impact on clinical practice and research. Second, the tools available for the assessment of negative symptoms are mentioned. The discussion focuses on the newly constructed tools and mentions their psychometric characteristics. Additionally, the measuring instruments for the assessment of negative symptoms as an expression of risk or vulnerability to psychosis are shown, within both the paradigm of high clinical risk and the psychometric paradigm. Third, and finally, we review and consider some conclusions, guidelines and possible future developments in this area of study.

  4. The association between psychotic experiences and disability: results from the WHO World Mental Health Surveys.

    Science.gov (United States)

    Navarro-Mateu, F; Alonso, J; Lim, C C W; Saha, S; Aguilar-Gaxiola, S; Al-Hamzawi, A; Andrade, L H; Bromet, E J; Bruffaerts, R; Chatterji, S; Degenhardt, L; de Girolamo, G; de Jonge, P; Fayyad, J; Florescu, S; Gureje, O; Haro, J M; Hu, C; Karam, E G; Kovess-Masfety, V; Lee, S; Medina-Mora, M E; Ojagbemi, A; Pennell, B-E; Piazza, M; Posada-Villa, J; Scott, K M; Stagnaro, J C; Xavier, M; Kendler, K S; Kessler, R C; McGrath, J J

    2017-07-01

    While psychotic experiences (PEs) are known to be associated with a range of mental and general medical disorders, little is known about the association between PEs and measures of disability. We aimed to investigate this question using the World Mental Health surveys. Lifetime occurrences of six types of PEs were assessed along with 21 mental disorders and 14 general medical conditions. Disability was assessed with a modified version of the WHO Disability Assessment Schedule. Descriptive statistics and logistic regression models were used to investigate the association between PEs and high disability scores (top quartile) with various adjustments. Respondents with PEs were more likely to have top quartile scores on global disability than respondents without PEs (19.1% vs. 7.5%; χ 2  = 190.1, P mental or general medical disorders. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Sexual Dysfunction and Hyperprolactinemia in Male Psychotic Inpatients: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Erik Johnsen

    2011-01-01

    Full Text Available Introduction. Sexual dysfunction (SD and hyperprolactinemia are frequently reported in patients with psychotic disorders and have the potential for severe complications but investigations in males are particularly scarce. The primary aims were to determine the prevalence of SD and hyperprolactinemia in male patients and to investigate whether associations exist between SD and prolactin levels. Methods. Cross-sectional data were obtained at discharge from the hospital or 6 weeks after admittance for patients acutely admitted for psychosis and treated with a second-generation antipsychotic drug. Results. Half the patients reported diminished sexual desire and more than a third reported erectile and ejaculatory dysfunctions with no differences among the drugs. More than half the sample was hyperprolactinemic. No association was found between prolactin levels and SD. Conclusion. High rates of SD and hyperprolactinemia were found in male patients and should be a treatment target. SD and hyperprolactinemia were not correlated.

  6. Mode of entry to an early intervention service for psychotic disorders: determinants and impact on outcome.

    Science.gov (United States)

    Pira, Shamira; Durr, Georges; Pawliuk, Nicole; Joober, Ridha; Malla, Ashok

    2013-11-01

    Specialized early intervention services for first-episode psychosis should treat a proportion of patients without using inpatient beds. This study compared such service users by their initial mode of treatment before entry-inpatient (N=157) or outpatient (N=102). On entry to a Montreal early intervention service, the groups were compared on baseline clinical and functional variables and on hospitalizations during two years of treatment. Initial presentation at an emergency service, shorter duration of untreated psychosis, lower functioning level, and aggressive and bizarre behavior were associated with the inpatient entry mode to early intervention services. During follow-up, individuals entering as inpatients spent more days hospitalized than those entering as outpatients, and their time to rehospitalization was shorter. Results suggest that entry into early intervention services via the hospital emergency department and presentation with behavioral and functional disturbances were more predictive than core psychotic symptoms of hospital inpatient status on referral to an early intervention service.

  7. Effect of ω-3 Polyunsaturated Fatty Acids in Young People at Ultrahigh Risk for Psychotic Disorders

    DEFF Research Database (Denmark)

    McGorry, Patrick D; Nelson, Barnaby; Markulev, Connie

    2017-01-01

    Rating Scale (MADRS) (range, 0-60), Young Mania Rating Scale (YMRS) (range, 0-44), Social and Occupational Functioning Assessment Scale (SOFAS) (range, 0-100), and the Global Functioning: Social and Role scale (range, 0-10). For SOFAS and Global Functioning: Social and Role scale, higher scores were...... better; for other measures, lower scores were better. Results: In this study of 304 adults at ultrahigh risk for psychotic disorders, 153 (50.3%) received ω-3 PUFAs and 151 (49.7%) received placebo. In all, 139 (45.7%) were male; mean (SD) age was 19.1 (4.6) years. The Kaplan-Meier-estimated 6-month...... outcome was transition to psychosis status at 6 months. The secondary outcomes were general levels of psychopathology and functioning, as assessed by the Brief Psychiatric Rating Scale (BPRS) (range, 24-168), Scale for the Assessment of Negative Symptoms (SANS) (range, 0-125), Montgomery-Åsberg Depression...

  8. Cost of illness and illness perceptions in patients with fibromyalgia.

    Science.gov (United States)

    Vervoort, Vera M; Vriezekolk, Johanna E; Olde Hartman, Tim C; Cats, Hans A; van Helmond, Toon; van der Laan, Willemijn H; Geenen, Rinie; van den Ende, Cornelia H

    2016-01-01

    The disease impact and economic burden of fibromyalgia (FM) are high for patients and society at large. Knowing potential determinants of economic costs may help in reducing this burden. Cognitive appraisals (perceptions) of the illness could affect costs. The present study estimated costs of illness in FM and examined the association between these costs and illness perceptions. Questionnaire data of FM severity (FIQ), illness perceptions (IPQ-R-FM), productivity losses (SF-HLQ) and health care use were collected in a cohort of patients with FM. Costs were calculated and dichotomised (median split). Univariate and hierarchic logistic regression models examined the unique association of each illness perception with 1) health care costs and 2) costs of productivity losses. Covariates were FM severity, comorbidity and other illness perceptions. 280 patients participated: 95% female, mean age 42 (SD=12) years. Annualised costs of FM per patient were €2944 for health care, and €5731 for productivity losses. In multivariate analyses, a higher disease impact (FIQ) and two of seven illness perceptions (IPQ-R-FM) were associated with high health care costs: 1) high scores on 'cyclical timeline' reflecting a fluctuating, unpredictable course and 2) low scores on 'emotional representations', thus not perceiving a connection between fibromyalgia and emotions. None of the variables was associated with productivity losses. Our study indicates that perceiving a fluctuating course and low emotional representation, which perhaps reflects somatic fixation, are associated with health care costs in FM. Future studies should examine whether targeting these illness perceptions results in reduction of costs.

  9. Parvovirus B19 and Other Illnesses

    Science.gov (United States)

    ... Cheek Rash Parvovirus B19 and Other Illnesses References Parvovirus B19 and Other Illnesses Recommend on Facebook Tweet Share ... disease is the most common illness caused by parvovirus B19 infection. Learn More Parvovirus B19 infection can cause ...

  10. Caring for a Seriously Ill Child

    Science.gov (United States)

    ... Search English Español Caring for a Seriously Ill Child KidsHealth / For Parents / Caring for a Seriously Ill ... helping hand. Explaining Long-Term Illness to a Child Honest communication is vital to helping a child ...

  11. Cannabis use in people with severe mental illness: The association with physical and mental health--a cohort study. A Pharmacotherapy Monitoring and Outcome Survey study.

    Science.gov (United States)

    Bruins, Jojanneke; Pijnenborg, Marieke G H M; Bartels-Velthuis, Agna A; Visser, Ellen; van den Heuvel, Edwin R; Bruggeman, Richard; Jörg, Frederike

    2016-04-01

    In the general population cannabis use is associated with better cardiometabolic outcomes. Patients with severe mental illness frequently use cannabis, but also present increased cardiometabolic risk factors. We explore the association between cannabis use and cardiometabolic risk factors in patients with severe mental illness. A total of 3169 patients with severe mental illness from a Dutch cohort were included in the study. The association of cannabis use with body mass index, waist circumference, blood pressure, cholesterol, triglycerides, glucose, glycated hemoglobin and Positive and Negative Syndrome Scale was examined with separate univariate AN(C)OVA. Changes in metabolic risk factors and Positive and Negative Syndrome Scale were examined after a follow-up interval of 9-24 months, for patients who continued, discontinued, started or were never using cannabis between the two assessments. Cannabis users at baseline had lower body mass index, smaller waist circumference, lower diastolic blood pressure, and more severe psychotic symptoms than non-users. Patients who discontinued their cannabis use after the first assessment had a greater increase in body mass index, waist circumference, diastolic blood pressure and triglyceride concentrations than other patients, and the severity of their psychotic symptoms had decreased more compared to continued users and non-users. Extra attention should be paid to the monitoring and treatment of metabolic parameters in patients who discontinue their cannabis use. © The Author(s) 2016.

  12. Emergence of psychotic content in psychotherapy: An exploratory qualitative analysis of content, process, and therapist variables in a single case study.

    Science.gov (United States)

    Leonhardt, Bethany L; Kukla, Marina; Belanger, Elizabeth; Chaudoin-Patzoldt, Kelly A; Buck, Kelly D; Minor, Kyle S; Vohs, Jenifer L; Hamm, Jay A; Lysaker, Paul H

    2018-03-01

    Emerging integrative metacognitive therapies for schizophrenia seek to promote subjective aspects of recovery. Beyond symptom remission, they are concerned with shared meaning-making and intersubjective processes. It is unclear, however, how such therapies should understand and respond to psychotic content that threatens meaning-making in therapeutic contexts. Accordingly, we sought to understand what factors precede and potentially trigger psychotic content within psychotherapy and what aids in resolution and return to meaning-making. Forty-eight transcripts from a single psychotherapy case were analyzed with thematic analysis. Passages of delusional or disorganized content were identified and themes present prior to the emergence and resolution of such material were identified and coded. Themes that preceded the emergence of psychotic content varied across early, middle, and late phases of therapy. Material related to the patient's experience of inadequacy and potential vulnerability, therapist setting boundaries within the therapeutic relationship and making challenges appeared to trigger psychotic content, especially early in treatment. Psychotic content may emerge in session following identifiable antecedents which change over phases of therapy. Attending to psychotic content by assuming a non-hierarchical stance and not dismissing psychotic content may aid in maintaining intersubjectivity and support patient's movements toward recovery in integrative metacognitive therapies.

  13. Emotional intelligence in non-psychotic first-degree relatives of people with schizophrenia.

    Science.gov (United States)

    Albacete, Auria; Bosque, Clara; Custal, Nuria; Crespo, José M; Gilabert, Ester; Albiach, Angela; Menchón, José M; Contreras, Fernando

    2016-08-01

    Subtle social cognitive deficits in unaffected relatives of schizophrenia patients have received increasing attention over the last few years, supporting their potential endophenotypic role for this disorder. The current study assessed non-psychotic first-degree relatives' performance on a multidimensional measure of emotional intelligence (EI): the Mayer-Salovey-Caruso Emotional Intelligence Test 2.0 (MSCEIT). Endorsed by the National Institute of Mental Health, the MSCEIT is a valid and reliable instrument for detecting emotion-processing deficits among schizophrenia patients and people high in schizotypy. Thirty-seven first-degree relatives, 37 schizophrenia outpatients and 37 healthy controls completed the MSCEIT, which comprises eight subscales aimed to assess the four branches of EI: Identifying, Facilitating, Understanding and Managing Emotions. Potential associations with cognitive function and schizotypy levels, measured with the Schizotypal Personality Questionnaire-Brief, were further evaluated. Relatives had significantly lower MSCEIT total scores than controls and also significantly lower scores on the Identifying emotions branch. Nevertheless, schizophrenia patients still had the poorest global EI performance. The strongest positive correlations were found in relatives and controls with measures of executive function, processing speed and general intelligence. A higher level of schizotypy correlated significantly with lower MSCEIT scores among controls, but not among relatives. Contrary to expectations in the general population, the current study observed subtle EI impairment in non-psychotic first-degree relatives of schizophrenia patients. These findings support the hypothesis that these EI deficiencies may be potential endophenotypes located between the clinical phenotype and the genetic predisposition for schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Social deprivation, inequality, and the neighborhood-level incidence of psychotic syndromes in East London.

    Science.gov (United States)

    Kirkbride, James B; Jones, Peter B; Ullrich, Simone; Coid, Jeremy W

    2014-01-01

    Although urban birth, upbringing, and living are associated with increased risk of nonaffective psychotic disorders, few studies have used appropriate multilevel techniques accounting for spatial dependency in risk to investigate social, economic, or physical determinants of psychosis incidence. We adopted Bayesian hierarchical modeling to investigate the sociospatial distribution of psychosis risk in East London for DSM-IV nonaffective and affective psychotic disorders, ascertained over a 2-year period in the East London first-episode psychosis study. We included individual and environmental data on 427 subjects experiencing first-episode psychosis to estimate the incidence of disorder across 56 neighborhoods, having standardized for age, sex, ethnicity, and socioeconomic status. A Bayesian model that included spatially structured neighborhood-level random effects identified substantial unexplained variation in nonaffective psychosis risk after controlling for individual-level factors. This variation was independently associated with greater levels of neighborhood income inequality (SD increase in inequality: Bayesian relative risks [RR]: 1.25; 95% CI: 1.04-1.49), absolute deprivation (RR: 1.28; 95% CI: 1.08-1.51) and population density (RR: 1.18; 95% CI: 1.00-1.41). Neighborhood ethnic composition effects were associated with incidence of nonaffective psychosis for people of black Caribbean and black African origin. No variation in the spatial distribution of the affective psychoses was identified, consistent with the possibility of differing etiological origins of affective and nonaffective psychoses. Our data suggest that both absolute and relative measures of neighborhood social composition are associated with the incidence of nonaffective psychosis. We suggest these associations are consistent with a role for social stressors in psychosis risk, particularly when people live in more unequal communities.

  15. Cannabis use and psychotic-like experiences trajectories during early adolescence: the coevolution and potential mediators.

    Science.gov (United States)

    Bourque, Josiane; Afzali, Mohammad H; O'Leary-Barrett, Maeve; Conrod, Patricia

    2017-12-01

    The authors sought to model the different trajectories of psychotic-like experiences (PLE) during adolescence and to examine whether the longitudinal relationship between cannabis use and PLE is mediated by changes in cognitive development and/or change in anxiety or depression symptoms. A total of 2,566 youths were assessed every year for 4-years (from 13- to 16-years of age) on clinical, substance use and cognitive development outcomes. Latent class growth models identified three trajectories of PLE: low decreasing (83.9%), high decreasing (7.9%), and moderate increasing class (8.2%). We conducted logistic regressions to investigate whether baseline levels and growth in cannabis use were associated with PLE trajectory membership. Then, we examined the effects of potential mediators (growth in cognition and anxiety/depression) on the relationship between growth in cannabis use and PLE trajectory. A steeper growth in cannabis use from 13- to 16-years was associated with a higher likelihood of being assigned to the moderate increasing trajectory of PLE [odds ratio, 2.59; 95% confidence interval (CI), 1.11-6.03], when controlling for cumulative cigarette use. Growth in depression symptoms, not anxiety or change in cognitive functioning, mediated the relationship between growth in cannabis use and the PLE moderate increasing group (indirect effect: 0.07; 95% CI, 0.03-0.11). Depression symptoms partially mediated the longitudinal link between cannabis use and PLE in adolescents, suggesting that there may be a preventative effect to be gained from targeting depression symptoms, in addition to attempting to prevent cannabis use in youth presenting increasing psychotic experiences. © 2017 Association for Child and Adolescent Mental Health.

  16. [PSYCHOTHERAPEUTIC INTERVENTIONS IN PATIENTS WITH AUTO-AGGRESSIVE BEHAVIOR DURING THE FIRST PSYCHOTIC EPISODE].

    Science.gov (United States)

    Mudrenko, I; Potapov, A; Sotnikov, D; Kolenko, O; Kmyta, A

    2017-09-01

    In this article the formation of psychopathological predictors auto-aggressive behavior in patients with a first psychotic episode were identified, which became "targets" in the framework of a comprehensive emergency suicide assistance to conduct the crisis psychotherapy. The work was done on the basis of the Sumy regional psychoneurologic dispensary, where 100 patients with a first psychotic episode were examined: 52 of them (core group) had suicidal symptoms and 48 (control group) had not. According to the test results of severity of auto-aggressive predictors (pre-suicidal syndrome) to clinicopsychopathological predictors of auto-aggressive behavior include: the narrowing of the cognitive function (p≤0,001), the avoidance of interpersonal contact (r≤0,001), the presence of affective (p≤0,001) and vegetative (p≤0,01) violations, the autoaggression of moderate severity (p≤0,001) and impulsivity (p≤0,001). Patients of the core group with the auto-aggressive behavior (n=58) completed a course of a crisis psychotherapy comprising the stages of crisis support, crisis intervention and increase the adaptation layer. After a psychotherapy course levels of aggression (6,45±0,41), auto-aggression (of 9,68±0,67), disorders in the affective sphere (18,58±0,66) and impulsivity (of 4,23±0,30) decreased, which was manifested in increasing tolerance to emotional stress factors, control over their emotions and reduce their affective valence (p≤0,001). The expansion of interpersonal interaction, the increase of patients social activity, the blood relationships establishment (of 9,23±0,40) was observed.

  17. Effects of childhood trauma on left inferior frontal gyrus function during response inhibition across psychotic disorders.

    Science.gov (United States)

    Quidé, Y; O'Reilly, N; Watkeys, O J; Carr, V J; Green, M J

    2018-07-01

    Childhood trauma is a risk factor for psychosis. Deficits in response inhibition are common to psychosis and trauma-exposed populations, and associated brain functions may be affected by trauma exposure in psychotic disorders. We aimed to identify the influence of trauma-exposure on brain activation and functional connectivity during a response inhibition task. We used functional magnetic resonance imaging to examine brain function within regions-of-interest [left and right inferior frontal gyrus (IFG), right dorsolateral prefrontal cortex, right supplementary motor area, right inferior parietal lobule and dorsal anterior cingulate cortex], during the performance of a Go/No-Go Flanker task, in 112 clinical cases with psychotic disorders and 53 healthy controls (HCs). Among the participants, 71 clinical cases and 21 HCs reported significant levels of childhood trauma exposure, while 41 clinical cases and 32 HCs did not. In the absence of effects on response inhibition performance, childhood trauma exposure was associated with increased activation in the left IFG, and increased connectivity between the left IFG seed region and the cerebellum and calcarine sulcus, in both cases and healthy individuals. There was no main effect of psychosis, and no trauma-by-psychosis interaction for any other region-of-interest. Within the clinical sample, the effects of trauma-exposure on the left IFG activation were mediated by symptom severity. Trauma-related increases in activation of the left IFG were not associated with performance differences, or dependent on clinical diagnostic status; increased IFG functionality may represent a compensatory (overactivation) mechanism required to exert adequate inhibitory control of the motor response.

  18. The phenomenology of the psychotic break and Huxley's trip: substance use and the onset of psychosis.

    Science.gov (United States)

    Nelson, Barnaby; Sass, Louis A

    2008-01-01

    While considerable research attention has been devoted to the causal relationship between substance use and psychosis, the phenomenology of the association between the two has largely been ignored. This is a significant shortcoming, because it blinds researchers to the possibility that there may be elements of the subjective experience of substance use and psychosis that contribute to their apparent relationship in empirical studies. The current paper examines the phenomenology of the onset of psychosis and the phenomenology of substance intoxication through consideration of two texts: Sass's account of the phenomenology of psychosis onset and Huxley's account of the experience of hallucinogenic intoxication. Sass's account of psychosis onset includes four components: Unreality, Fragmentation, Mere Being, and Apophany. The analysis reveals significant parallels - and also some differences - between this account and the phenomenology of substance intoxication. We discuss the implications of this for the causal relationship between psychosis and substance use and suggest several ways of understanding the overlapping phenomenologies. This includes the suggestion of a shared factor, perhaps best described as psychotic-like experience, which seems to involve a breakdown of the sign-referent relationship and relationship with the common-sense, practical world. However, in the onset of psychosis, this breakdown is primarily experienced as a sense of alienation from self and world, whereas in the hallucinogenic state a sense of mystical union and revelation seems predominant. Further research may extend this analysis by looking at experiences with other drugs, particularly cannabis, and by examining the phenomenology of psychotic disorder beyond the first episode. (c) 2008 S. Karger AG, Basel.

  19. Obstetric complications as risk factors for schizophrenia spectrum psychoses in offspring of mothers with psychotic disorder.

    Science.gov (United States)

    Suvisaari, Jaana M; Taxell-Lassas, Virpi; Pankakoski, Maiju; Haukka, Jari K; Lönnqvist, Jouko K; Häkkinen, Laura T

    2013-09-01

    Obstetric complications have predicted future development of schizophrenia in previous studies, but they are also more common in mothers with schizophrenia. The aims of this study were to compare the occurrence of obstetric complications in children of mothers with schizophrenia spectrum psychoses and control children, and to investigate whether obstetric complications predicted children's psychiatric morbidity. The Helsinki High-Risk (HR) Study monitors females born between 1916 and 1948 and treated for schizophrenia spectrum disorders in Helsinki psychiatric hospitals, their offspring born between 1941 and 1977, and controls. We examined information on obstetric complications and neonatal health of 271 HR and 242 control offspring. We compared the frequency of obstetric complications and neonatal health problems in the HR group vs controls and in HR children who later developed psychotic disorders vs healthy HR children. A Cox regression model was used to assess whether problems in pregnancy or delivery predicted psychiatric morbidity within the HR group. Few differences between HR and control offspring were found in obstetric complications. Within the HR group, infections (hazard rate ratio [HRR] 3.73, 95% CI 1.27-11.01), hypertension during pregnancy (HRR 4.10, 95% CI 1.15-14.58), and placental abnormalities (HRR 4.09, 95% CI 1.59-10.49) were associated with elevated risk of schizophrenia spectrum psychoses. Common medical problems during pregnancy were associated with increased risk of schizophrenia spectrum psychoses in offspring of mothers with schizophrenia spectrum psychoses. These results underline the role of the prenatal period in the development of schizophrenia and the importance of careful monitoring of pregnancies of mothers with psychotic disorder.

  20. Cardiometabolic risk factors in people with psychotic disorders: the second Australian national survey of psychosis.

    Science.gov (United States)

    Galletly, Cherrie A; Foley, Debra L; Waterreus, Anna; Watts, Gerald F; Castle, David J; McGrath, John J; Mackinnon, Andrew; Morgan, Vera A

    2012-08-01

    To determine the prevalence of cardiometabolic risk factors in Australian adults with a psychotic disorder. Data were collected during the interview phase of the second Australian survey of psychosis, a population-based survey of Australians aged 18 to 64 years with a psychotic disorder. Body mass index, waist circumference and blood pressure were measured. Participants were asked about diagnoses of relevant medical conditions, medications, smoking and physical activity. Fasting blood samples were analysed for glucose, high-density lipoprotein cholesterol, total cholesterol and triglycerides. The prevalence of metabolic syndrome was determined using the harmonized criteria developed by the International Diabetes Federation and other bodies. A total of 1087 men (60%) and 738 women (40%) participated. Their mean age was 38.36 (SD 11.16) years; 773 (42%) were aged 18-34 years and 1052 (58%) 35-64 years. Three-quarters were overweight or obese and 82% had abdominal obesity. Almost half were hypertensive. Two-thirds were current smokers and 81% had a lifetime history of smoking. Levels of physical activity were very low. About 30% reported a diagnosis of hypertension or high cholesterol, 20% knew they had diabetes or high blood sugar and 18% had cardiovascular disease. Half of those with self-reported hypertension were taking antihypertensive drugs, and about 40% with hypercholesterolemia or hyperglycaemia were receiving medication for these conditions. Seventy per cent (N = 1286) of participants provided fasting blood samples. Abnormal levels of high-density lipoprotein cholesterol and triglycerides were each found in almost half of participants and almost one-third had elevated fasting glucose. More than half of participants (54.8%) met criteria for metabolic syndrome. Australians living with psychosis have high rates of cardiometabolic risk factors. There are a number of obvious targets for prevention and treatment, including obesity (especially in women), smoking

  1. The expert consensus guideline series. Optimizing pharmacologic treatment of psychotic disorders. Introduction: methods, commentary, and summary.

    Science.gov (United States)

    Kane, John M; Leucht, Stefan; Carpenter, Daniel; Docherty, John P

    2003-01-01

    A growing number of atypical antipsychotics are available for clinicians to choose from in the treatment of psychotic disorders. However, a number of important questions concerning medication selection, dosing and dose equivalence, and the management of inadequate response, compliance problems, and relapse have not been adequately addressed by clinical trials. To aid clinical decision-making, a consensus survey of expert opinion on the pharmacologic treatment of psychotic disorders was undertaken to address questions not definitively answered in the research literature. Based on a literature review, a written survey was developed with 60 questions and 994 options. Approximately half of the options were scored using a modified version of the RAND 9-point scale for rating the appropriateness of medical decisions. For the other options, the experts were asked to write in answers (e.g., average doses) or check a box to indicate their preferred answer. The survey was sent to 50 national experts on the pharmacologic treatment of psychotic disorders, 47 (94%) of whom completed it. In analyzing the responses to items rated on the 9-point scale, consensus on each option was defined as a non random distribution of scores by chi-square "goodness-of-fit"test. We assigned a categorical rank (first line/preferred choice,second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating. Guideline tables indicating preferred treatment strategies were then developed for key clinical situations. The expert panel reached consensus on 88% of the options rated on the 9-point scale. The experts overwhelmingly endorsed the atypical antipsychotics for the treatment of psychotic disorders. Risperidone was the top choice for first-episode and multi-episode patients, with the other newer atypicals rated first line or high second line depending on the clinical situation. Clozapine and a long-acting injectable atypical

  2. Self-image and perception of mother and father in psychotic and borderline patients.

    Science.gov (United States)

    Armelius, K; Granberg

    2000-02-01

    Psychotic and borderline patients rated their self-image and their perception of their mother and father using the Structural Analysis of Social Behavior model (SASB). The borderline patients had more negative images of themselves and their parents, especially their fathers, than did the psychotic patients and the normal subjects, while the psychotic patients' ratings did not differ much from those of the normal subjects. The self-image was related to the images of both parents for borderline patients and normal subjects, while for the psychotic patients only the image of the mother was important for the self-image. In addition, the psychotic patients did not differentiate between the poles of control and autonomy in the introjected self-image. It was concluded that borderline patients are characterized by negative attachment, while psychotic patients are characterized by poor separation from the mother and poor differentiation between autonomy and control. The paper also discusses how this may influence the patients' relations to others. Psychotische und Borderline Patienten beurteilten ihr Selbstbild und ihre Wahrnehmung von Mutter und Vater mit Hilfe der strukturalen Analyse sozialen Verhaltens (SASB). Die Borderline Patienten hattten negativere Selbstbilder und Elternbilder (speziell Vaterbilder) als die psychotischen Patienten und gesunde Personen. Die Beurteilungen der psychotischen Patienten unterschieden sich dagegen nicht besonders von jenen Gesunder. Das Selbstbild stand in Beziehung zu beiden Elternbildern bei den Borderline Patienten und den Gesunden, während bei den psychotischen Patienten nur das Mutterbild für das Selbstbild bedeutsam war. Außerdem konnte bei den psychotischen Patienten nicht zwischen den Polen der Kontrolle und Autonomie bzgl. der introjizierten Selbstbilder differenziert werden. Aus den Ergebnissen wird gefolgert, dass Borderline Patienten durch eine negative Bindung charackterisiert sind, psychotische Patienten dagegen durch

  3. Substance use in adolescents with mental illness in Durban, South Africa.

    Science.gov (United States)

    Taukoor, Bhoodeo; Paruk, Saeeda; Karim, Enver; Burns, Jonathan K

    2017-05-01

    Comorbid substance use in adolescents with mental illness is often an indicator of poor treatment outcome. This study aims to determine the prevalence of, and associated risk factors for, substance use in adolescents with mental illness attending a mental health service. Data was collected from hospital records of 162 adolescents, using a structured data sheet, over a two-year period. Substance use was more significant in older adolescents and those with severe mental illness. Sixty-two (38.3%) adolescents used substances. Thirty-seven (38.1%) male adolescents reported substance use compared to 25 (38.5%) female adolescents. Alcohol was the most commonly used substance (n = 48; 29.6%), followed by cannabis (n = 32; 19.8%). There were significant direct associations between substance use and history of abuse or neglect, forensic history, educational setting, admission status, and the psychiatric diagnoses of schizophrenia, other psychotic disorders, and bipolar mood disorder. Inverse associations were found between substance use and adjustment disorders, attention deficit hyperactivity disorder, and intellectual disability. The results of this study indicate an urgent need for substance misuse programmes for at risk youth, and the introduction of dual diagnosis intervention programmes in this age group.

  4. Childhood abuse and neglect among women outpatients with chronic mental illness.

    Science.gov (United States)

    Muenzenmaier, K; Meyer, I; Struening, E; Ferber, J

    1993-07-01

    The purposes of the study were to determine the prevalence of childhood sexual abuse, physical abuse, and neglect among women outpatients with severe and persistent mental illness; to examine patterns of co-occurrence of the various types of abuse; and to explore the relationships between childhood abuse and adult psychiatric symptomatology. Childhood histories of abuse and data on clinical characteristics of 78 women enrolled in a New York State outpatient clinic were elicited in face-to-face interviews using a structured questionnaire. Sixty-five percent of the women reported histories of some type of abuse or neglect during childhood. Forty-five percent of the sample had been sexually abused, 51 percent had been physically abused, and 22 percent had experienced neglect. Seventy-four percent of the sexually abused women, 70 percent of the physically abused women, and 94 percent of the women who experienced neglect reported at least one additional form of abuse or neglect. Respondents who had been abused in childhood had higher levels of depressive and psychotic symptoms and higher rates of sexual victimization in adulthood than those who had not been abused. Women who experienced neglect as children had higher rates of homelessness in adulthood. Chronic mentally ill women seem to experience higher rates of abuse and more types of abuse than the general population. Clinicians should try to determine whether chronic mentally ill women have histories of abuse and to develop interventions to meet their special needs.

  5. An exploration of how psychotic-like symptoms are experienced, endorsed, and understood from the National Latino and Asian American Study and National Survey of American Life.

    Science.gov (United States)

    Earl, Tara R; Fortuna, Lisa Roxanne; Gao, Shan; Williams, David R; Neighbors, Harold; Takeuchi, David; Alegría, Margarita

    2015-01-01

    . To examine racial-ethnic differences in the endorsement and attribution of psychotic-like symptoms in a nationally representative sample of African-Americans, Asians, Caribbean Blacks, and Latinos living in the USA. Data were drawn from a total of 979 respondents who endorsed psychotic-like symptoms as part of the National Latino and Asian American Study (NLAAS) and the National Survey of American Life (NSAL). We use a mixed qualitative and quantitative analytical approach to examine sociodemographic and ethnic variations in the prevalence and attributions of hallucinations and other psychotic-like symptoms in the NLAAS and NSAL. The lifetime presence of psychotic-like symptoms was assessed using the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) psychotic symptom screener. We used logistic regression models to examine the probability of endorsing the four most frequently occurring thematic categories for psychotic-like experiences by race/ethnicity (n > 100). We used qualitative methods to explore common themes from participant responses to open ended questions on their attributions for psychotic-like symptoms. African-Americans were significantly less likely to endorse visual hallucinations compared to Caribbean Blacks (73.7% and 89.3%, p supernatural, ghosts/unidentified beings, death and dying, spirituality or religiosity, premonitions, familial and other. Respondents differed by race/ethnicity in the attributions given to psychotic like symptoms. Findings suggest that variations exist by race/ethnicity in both psychotic-like symptom endorsement and in self-reported attributions/understandings for these symptoms on a psychosis screening instrument. Ethnic/racial differences could result from culturally sanctioned beliefs and idioms of distress that deserve more attention in conducting culturally informed and responsive screening, assessment and treatment.

  6. Improving Communication About Serious Illness

    Science.gov (United States)

    2017-01-07

    Critical Illness; Chronic Disease; Terminal Care; Palliative Care; Communication; Advance Care Planning; Neoplasm Metastasis; Lung Neoplasms; Pulmonary Disease, Chronic Obstructive; Heart Failure; End Stage Liver Disease; Kidney Failure, Chronic

  7. Student Attitudes Toward Mental Illness

    Science.gov (United States)

    Hare-Mustin, Rachel T.; Garvine, Richard

    1974-01-01

    Inquiry into the initial attitudes toward mental illness of students taking an abnormal psychology class indicates students' concerns and preconceptions and provides a basis for shaping the course to respond to student needs. (JH)

  8. Living with Mentally Ill Parent

    Directory of Open Access Journals (Sweden)

    Kadriye Buldukoglu

    2011-12-01

    Full Text Available The present review seeks to identify and analyze qualitative studies that examined experiences of children whose parents have a mental illness. This study reported that children whose parents have a mental illness had some common experiences. These experiences may have negative effects on children’s coping skills, resilience to tough living conditions and ability to maintain their mental health. In spite of these negative conditions, some of these children have much more self-confidence, resilience and independence because of inner development and early maturation. Some effective intervention programs are needed to promote information to children and other family members about mental illness, coping behaviors. Availability of such psychiatric services and nation-wide programs with professionals to deal with these problems should be organized properly to increase quality of life of these children. Furthermore, qualitative researches that explore the experiences of children whose parents with mental illness should also be conducted in our country.

  9. Transfusion in critically ill children

    DEFF Research Database (Denmark)

    Secher, E L; Stensballe, J; Afshari, A

    2013-01-01

    Transfusion of blood products is a cornerstone in managing many critically ill children. Major improvements in blood product safety have not diminished the need for caution in transfusion practice. In this review, we aim to discuss the interplay between benefits and potential adverse effects...... of transfusion in critically ill children by including 65 papers, which were evaluated based on previously agreed selection criteria. Current practice on transfusing critically ill children is mainly founded on the basis of adult studies, common practices with cut-off values, and expert opinions, rather than...... evidence-based medicine. Paediatric patients have explicit physiological challenges and requirements to be addressed. Critically ill children often suffer from anaemia, have substantial iatrogenic blood loss with subsequent transfusions, and are at a higher risk of complications, often due to human errors...

  10. Risk Prediction Models in Psychiatry: Toward a New Frontier for the Prevention of Mental Illnesses.

    Science.gov (United States)

    Bernardini, Francesco; Attademo, Luigi; Cleary, Sean D; Luther, Charles; Shim, Ruth S; Quartesan, Roberto; Compton, Michael T

    2017-05-01

    We conducted a systematic, qualitative review of risk prediction models designed and tested for depression, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, and psychotic disorders. Our aim was to understand the current state of research on risk prediction models for these 5 disorders and thus future directions as our field moves toward embracing prediction and prevention. Systematic searches of the entire MEDLINE electronic database were conducted independently by 2 of the authors (from 1960 through 2013) in July 2014 using defined search criteria. Search terms included risk prediction, predictive model, or prediction model combined with depression, bipolar, manic depressive, generalized anxiety, posttraumatic, PTSD, schizophrenia, or psychosis. We identified 268 articles based on the search terms and 3 criteria: published in English, provided empirical data (as opposed to review articles), and presented results pertaining to developing or validating a risk prediction model in which the outcome was the diagnosis of 1 of the 5 aforementioned mental illnesses. We selected 43 original research reports as a final set of articles to be qualitatively reviewed. The 2 independent reviewers abstracted 3 types of data (sample characteristics, variables included in the model, and reported model statistics) and reached consensus regarding any discrepant abstracted information. Twelve reports described models developed for prediction of major depressive disorder, 1 for bipolar disorder, 2 for generalized anxiety disorder, 4 for posttraumatic stress disorder, and 24 for psychotic disorders. Most studies reported on sensitivity, specificity, positive predictive value, negative predictive value, and area under the (receiver operating characteristic) curve. Recent studies demonstrate the feasibility of developing risk prediction models for psychiatric disorders (especially psychotic disorders). The field must now advance by (1) conducting more large

  11. Parasitic Diseases and Psychiatric Illness

    OpenAIRE

    Weiss, Mitchell Gralnick

    1994-01-01

    Distinguishing parasitic diseases from other infections and tropical medical disorders based on microbiological classification is a matter of convenience. Organic brain syndromes are associated with both protozoan and helminthic infections; side-effects of drugs commonly used to treat parasitoses may impair mood and cause anxiety, agitation or psychosis. Emotional states may in turn affect the experience of medical illness. Psychiatrically significant features of medical illness are determine...

  12. Cost-of-illness studies.

    Science.gov (United States)

    Oderda, Gary M

    2003-01-01

    Cost-of-illness studies measure the overall economic impact of a disease on society. Such studies are important in setting public health priorities and for economic evaluation of new treatments. These studies should take the societal perspective and include both direct and indirect costs. Often indirect costs exceed direct costs. Comparison of cost-of-illness studies from different countries is difficult because of differences in population, currency, the way health care is provided, and other social and political factors.

  13. Client Perceptions of the Mental Health Engagement Network: A Secondary Analysis of an Intervention Using Smartphones and Desktop Devices for Individuals Experiencing Mood or Psychotic Disorders in Canada.

    Science.gov (United States)

    Forchuk, Cheryl; Donelle, Lorie; Ethridge, Paige; Warner, Laura

    2015-01-01

    The use of innovative technologies in mental health care has the potential to improve system efficiency, enhance quality of care, and increase patient engagement. The Mental Health Engagement Network (MHEN) project developed, delivered, and evaluated an interactive Web-based personal health record, the Lawson SMART Record (LSR), to assist mental health clients in managing their care and connecting with their care providers. This paper presents a secondary analysis of data collected in the MHEN project regarding clients' perceptions of technology and the use of these technologies in their care. We aimed to answer six questions: (1) What is the level of comfort with technology within a sample of individuals experiencing mood or psychotic disorders? (2) How easy to use and helpful are the MHEN technologies from the perspective of individuals experiencing a mental illness? (3) Are there differences in how helpful or useful individuals find the smartphone compared to the LSR? (4) Are there specific functions of MHEN technologies (eg, reminders for medications or appointments) that are more valued than others? (5) What are the other ways that individuals are using MHEN technologies in their daily lives? (6) How likely are individuals to be able to retain and maintain their smartphone? Mental health clients aged 18-80 (N=400) and diagnosed with a mood or psychotic disorder were provided with a smartphone (iPhone 4S) and participating care providers (n=52) were provided with a tablet (iPad) in order to access and engage with the LSR. A delayed implementation design with mixed methods was used. Survey and interview data were collected over the course of 18 months through semistructured interviews conducted by experienced research assistants every 6 months post-implementation of the intervention. Paired t tests were used to determine differences between 6 and 12-month data for perceptions of the MHEN technologies. A paired t test was used to examine whether differences

  14. Healthcare disparities in critical illness.

    Science.gov (United States)

    Soto, Graciela J; Martin, Greg S; Gong, Michelle Ng

    2013-12-01

    To summarize the current literature on racial and gender disparities in critical care and the mechanisms underlying these disparities in the course of acute critical illness. MEDLINE search on the published literature addressing racial, ethnic, or gender disparities in acute critical illness, such as sepsis, acute lung injury, pneumonia, venous thromboembolism, and cardiac arrest. Clinical studies that evaluated general critically ill patient populations in the United States as well as specific critical care conditions were reviewed with a focus on studies evaluating factors and contributors to health disparities. Study findings are presented according to their association with the prevalence, clinical presentation, management, and outcomes in acute critical illness. This review presents potential contributors for racial and gender disparities related to genetic susceptibility, comorbidities, preventive health services, socioeconomic factors, cultural differences, and access to care. The data are organized along the course of acute critical illness. The literature to date shows that disparities in critical care are most likely multifactorial involving individual, community, and hospital-level factors at several points in the continuum of acute critical illness. The data presented identify potential targets as interventions to reduce disparities in critical care and future avenues for research.

  15. Dependency in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Rumei Yang

    2016-03-01

    Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

  16. Prevalence of mental illness, intellectual disability, and developmental disability among homeless people in Nagoya, Japan: A case series study.

    Science.gov (United States)

    Nishio, Akihiro; Yamamoto, Mayumi; Ueki, Hirofumi; Watanabe, Takahiro; Matsuura, Kenshin; Tamura, Osamu; Uehara, Ryosuke; Shioiri, Toshiki

    2015-09-01

    While it has been reported that the prevalence of mental illness is higher in homeless people than in the national population, few studies have investigated the prevalence of intellectual and developmental disability among the homeless. In this study, we conducted a survey to comprehensively assess these mental problems among homeless people in Nagoya, Japan. The subjects were 18 homeless men. Mental illness was diagnosed with semi-structured interviews conducted by psychiatrists. We used the Wechsler Adult Intelligence Scale III to diagnose intellectual disability. Discrepancies between Wechsler Adult Intelligence Scale III subtest scores were used as criteria for developmental disability. Eleven of the 18 participants were diagnosed with mental illness: six with mood disorder, two with psychotic disorder, and six with alcohol problems. The mean IQ of all subjects was 83.4 ± 27.4. The 95% confidence interval (CI) was 96.2-69.1. Seven participants were found to have intellectual disability. Three men showed discrepancies of more than 10 between subtest scores, and all of them were diagnosed with a mental illness. We divided the participants into four groups: those with mental illness only; those with intellectual disability only; those with both problems; and those without diagnosis. The men with intellectual disability only were significantly younger and had been homeless since a younger age than the other groups. Participants diagnosed with a mental illness had been homeless for longer than those without mental health problems. Although the sample size was limited, this study revealed the high prevalence of mental illness and intellectual disability, 61% (95%CI, 35-83%) and 39% (95%CI, 17-64%), respectively, in homeless people in Nagoya, Japan. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  17. [Cultural aspects in depression masked by psychotic symptoms in Maghreb countries: three case reports].

    Science.gov (United States)

    Zouari, N; Aloulou, J; Siala, M; Ben Mahmoud, S; Zouari, L; Maalej, M

    2010-12-01

    In this study, we will describe three observations of depression "masked" by persecution delirium and/or hallucinations, to illustrate the role that the cultural factor could play in the expression and care of depression. In the first two observations, the persecutor was a group that was apparently difficult to circumscribe: the persecution appeared more important than the persecutor. In these two cases, persecution also had a depreciating role for the patient. In the third observation, the hallucinatory manifestations cast a slur on self-esteem and caused narcissistic injury. Analysis of the cultural context allows us to understand the depressive significance of such psychotic symptoms. In the traditional societies, depression is strongly related to the cultural context, it is often expressed by the fear of being punished or denied by the group, and a feeling of treason towards the community. The punishment can be direct or indirect, carried out by imaginary beings, "the djinn", or by any disease. According to Freud, the guilt is expressed by the fear of the vengeance of a dead man's spirit, which is then going to persecute the culprit. This persecution, which has a value of punishment, is based on the mechanism of the projection. In the same sense, Freud explained that the death, as a sequel of the disease, is the vengeance of the dead man's spirit in the living. In all religions, the impulses, the thoughts disapproved by the community, are attributed to Satan who etymologically means "the enemy" or "the opponent". This latter plays an important role in relieving fears, the sense of guilt and the disapproved thoughts. There is also involvement of the projection mechanism. So, guilt could be expressed by delirious ideas such as the conviction of being the victim of a demonic possession, to be under a spell or to be persecuted. Thus, taking the cultural context into account would allow us to fundamentally understand the depressive meaning of the delirious

  18. Psychodynamics in medically ill patients.

    Science.gov (United States)

    Nash, Sara Siris; Kent, Laura K; Muskin, Philip R

    2009-01-01

    This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment.

  19. Somali Refugees' Perceptions of Mental Illness.

    Science.gov (United States)

    Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

    2015-01-01

    Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

  20. Neuropsychological Impairments in Schizophrenia and Psychotic Bipolar Disorder: Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) Study

    Science.gov (United States)

    Hill, S. Kristian; Reilly, James L.; Keefe, Richard S.E.; Gold, James M.; Bishop, Jeffrey R.; Gershon, Elliot S.; Tamminga, Carol A.; Pearlson, Godfrey D.; Keshavan, Matcheri S.; Sweeney, John A.

    2017-01-01

    Objective Familial neuropsychological deficits are well established in schizophrenia but remain less well characterized in other psychotic disorders. This study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium 1) compares cognitive impairment in schizophrenia and bipolar disorder with psychosis, 2) tests a continuum model of cognitive dysfunction in psychotic disorders, 3) reports familiality of cognitive impairments across psychotic disorders, and 4) evaluates cognitive impairment among nonpsychotic relatives with and without cluster A personality traits. Method Participants included probands with schizophrenia (N=293), psychotic bipolar disorder (N=227), schizoaffective disorder (manic, N=110; depressed, N=55), their first-degree relatives (N=316, N=259, N=133, and N=64, respectively), and healthy comparison subjects (N=295). All participants completed the Brief Assessment of Cognition in Schizophrenia (BACS) neuropsychological battery. Results Cognitive impairments among psychotic probands, compared to healthy comparison subjects, were progressively greater from bipolar disorder (z=−0.77) to schizoaffective disorder (manic z=−1.08; depressed z=−1.25) to schizophrenia (z=−1.42). Profiles across subtests of the BACS were similar across disorders. Familiality of deficits was significant and comparable in schizophrenia and bipolar disorder. Of particular interest were similar levels of neuropsychological deficits in relatives with elevated cluster A personality traits across proband diagnoses. Nonpsychotic relatives of schizophrenia probands without these personality traits exhibited significant cognitive impairments, while relatives of bipolar probands did not. Conclusions Robust cognitive deficits are present and familial in schizophrenia and psychotic bipolar disorder. Severity of cognitive impairments across psychotic disorders was consistent with a continuum model, in which more prominent affective features and less