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Sample records for psychotic symptoms including

  1. 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

  2. Correlates of psychotic symptoms among elderly outpatients.

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    Holroyd, S; Laurie, S

    1999-05-01

    Psychotic symptoms presenting in late life can offer a diagnostic challenge to the clinician. In this study, 140 geriatric outpatients were prospectively examined for psychotic symptoms and assessed on a number of demographic and clinical variables. Cognition was assessed using the Mini-Mental State Exam. Psychiatric diagnoses were made by DSM-III-R criteria. Twenty-seven per cent (N = 38) had psychotic symptoms, delusions being the most common type. Patients with psychosis were significantly more likely to have a previous history of psychosis, to have a lower MMSE and to live in a nursing home. Four diagnoses accounted for 79.5% of all psychotic patients. In order of frequency, these were dementia, major depression, delirium and organic psychosis (organic hallucinosis, organic delusional disorder). Psychotic patients were significantly more likely to have a diagnosis of dementia, delirium or organic psychosis than non-psychotics, but depression was significantly more likely to occur in patients without psychosis. Although psychotic symptoms occur in a variety of illnesses, elderly patients with psychosis should be carefully evaluated for these disorders.

  3. Etiological and Clinical Features of Childhood Psychotic Symptoms

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    Polanczyk, Guilherme; Moffitt, Terrie E.; Arseneault, Louise; Cannon, Mary; Ambler, Antony; Keefe, Richard S. E.; Houts, Renate; Odgers, Candice L.; Caspi, Avshalom

    2013-01-01

    Context It has been reported that childhood psychotic symptoms are common in the general population and may signal neurodevelopmental processes that lead to schizophrenia. However, it is not clear whether these symptoms are associated with the same extensive risk factors established for adult schizophrenia. Objective To examine the construct validity of children’s self-reported psychotic symptoms by testing whether these symptoms share the risk factors and clinical features of adult schizophrenia. Design Prospective, longitudinal cohort study of a nationally representative birth cohort in Great Britain. Participants A total of 2232 twelve-year-old children followed up since age 5 years (retention, 96%). Main Outcome Measure Children’s self-reported hallucinations and delusions. Results Children’s psychotic symptoms are familial and heritable and are associated with social risk factors (eg, urbanicity); cognitive impairments at age 5; home-rearing risk factors (eg, maternal expressed emotion); behavioral, emotional, and educational problems at age 5; and comorbid conditions, including self-harm. Conclusions The results provide a comprehensive picture of the construct validity of children’s self-reported psychotic symptoms. For researchers, the findings indicate that children who have psychotic symptoms can be recruited for neuroscience research to determine the pathogenesis of schizophrenia. For clinicians, the findings indicate that psychotic symptoms in childhood are often a marker of an impaired developmental process and should be actively assessed. PMID:20368509

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

    DEFF Research Database (Denmark)

    MacKenzie, L E; Patterson, V C; Zwicker, A

    2017-01-01

    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. METHODS: In a cohort of 156 youth (mean age 12......BACKGROUND: 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.......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...

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

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    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

    2017-06-07

    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.

  6. Psychotic Symptoms Associated with Left Caudate Infarction

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    Ying-Chih Cheng

    2015-09-01

    Full Text Available Psychotic symptoms following acquired brain lesion are relatively rare, and thus, the specific association linking such symptoms to the distinct brain structure remains unclear. The frontal–subcortical circuits are thought to modulate motor activity and human behavior, and have been reported to be associated with many neuropsychiatric symptoms. We herein report the case of a 77-year-old man without previous psychiatric disorder who developed a new onset of psychotic symptoms following left caudate infarction. The presented case supports the fact that psychosis might arise from alteration of the distinct brain structure. The functional impairment of the frontal–subcortical circuits may be a critical factor linking the pathogenesis of psychosis associated with acquired brain lesion.

  7. School Mobility during Childhood Predicts Psychotic Symptoms in Late Adolescence

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    Winsper, Catherine; Wolke, Dieter; Bryson, Alex; Thompson, Andrew; Singh, Swaran P.

    2016-01-01

    Background: Recently, school mobility was identified as a risk factor for psychotic symptoms in early adolescence. The extent to which this risk continues into late adolescence and the trajectories via which this risk manifests remain unexplored. Methods: Psychotic symptoms in 4,720 adolescents aged 18 were ascertained by trained psychologists…

  8. An integrated network model of psychotic symptoms.

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    Looijestijn, Jasper; Blom, Jan Dirk; Aleman, André; Hoek, Hans W; Goekoop, Rutger

    2015-12-01

    The full body of research on the nature of psychosis and its determinants indicates that a considerable number of factors are relevant to the development of hallucinations, delusions, and other positive symptoms, ranging from neurodevelopmental parameters and altered connectivity of brain regions to impaired cognitive functioning and social factors. We aimed to integrate these factors in a single mathematical model based on network theory. At the microscopic level this model explains positive symptoms of psychosis in terms of experiential equivalents of robust, high-frequency attractor states of neural networks. At the mesoscopic level it explains them in relation to global brain states, and at the macroscopic level in relation to social-network structures and dynamics. Due to the scale-free nature of biological networks, all three levels are governed by the same general laws, thereby allowing for an integrated model of biological, psychological, and social phenomena involved in the mediation of positive symptoms of psychosis. This integrated network model of psychotic symptoms (INMOPS) is described together with various possibilities for application in clinical practice.

  9. Psychotic symptoms in normal pressure hydrocephalus.

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    Chatziioannidis, S; Charatsidou, I; Nikolaidis, N; Garyfallos, G; Giouzepas, I

    2013-01-01

    Normal Pressure Hydrocephalus due to idiopathic aqueductal stenosis is a chronic abnormal accumulation of cerebrospinal fluid in the cerebral ventricles caused by an obstruction in the Sylvian aqueduct. This leads to a dilatation of the ventricular system and to subsequent damage of the adjacent parenchyma. Although NPH typically presents with the progressive 'triad' of cognitive impairment, gait disturbance and urinary incontinence, it has been described that it rarely manifests in the form of predominant psychotic symptoms. It has been suggested that thought and perceptual disorders could develop secondary to the damage caused by NPH. Although precise anatomical correlates have not yet been established, certain cerebral regions -primarily the frontal cortex, mesencephalic and diencephalic structures of the brain- have been implicated in the pathogenesis of hydrocephalic psychosis. Because frontal lobe lesions are traditionally known to facilitate one's inability to integrate and correct perceptual distortions in the face of contradictory evidence, frontal lobe dysfunction may be integral in delineating the etiology of delusions in NPH. We present the case of a 30-year-old female, admitted involuntarily to our acute psychiatric department because she exhibited aggressive behavior while being in an agitated state with delusions of persecution. Her neurological examination disclosed subtle bradykinesia. Neuropsychological batteries and intelligence testing revealed mild cognitive impairment and a CT scan showed considerable dilatation of the ventricular system due to idiopathic aqueductal stenosis. While a conservative approach was chosen for the treatment of NPH, our patient was initiated on 2nd generation antipsychotics showing marked improvement of her psychiatric symptomatology. The atypical presentation of hydrocephalus in the aforementioned case underlines the necessity to thoroughly investigate the possible presence of an underlying organic factor in those

  10. School mobility during childhood predicts psychotic symptoms in late adolescence

    OpenAIRE

    Winsper, Catherine; Wolke, Dieter; Bryson, Alex; Thompson, Andrew D.; Singh, Swaran P.

    2016-01-01

    Background: Recently, school mobility was identified as a risk factor for psychotic symptoms in early adolescence. The extent to which this risk continues into late adolescence, and the trajectories via which this risk manifests, remain unexplored.\\ud \\ud Methods: Psychotic symptoms in 4, 720 adolescents aged 18 were ascertained by trained psychologists using the Psychosis-Like Symptoms Interview. Mothers reported on sociodemographic factors (i.e., family adversity, ethnicity, urbanicity) fro...

  11. Methylomic analysis of monozygotic twins discordant for childhood psychotic symptoms

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    Fisher, Helen L; Murphy, Therese M; Arseneault, Louise; Caspi, Avshalom; Moffitt, Terrie E; Viana, Joana; Hannon, Eilis; Pidsley, Ruth; Burrage, Joe; Dempster, Emma L; Wong, Chloe C Y; Pariante, Carmine M; Mill, Jonathan

    2015-01-01

    Childhood psychotic symptoms are associated with increased rates of schizophrenia, other psychiatric disorders, and suicide attempts in adulthood; thus, elucidating early risk indicators is crucial to target prevention efforts. There is considerable discordance for psychotic symptoms between monozygotic twins, indicating that child-specific non-genetic factors must be involved. Epigenetic processes may constitute one of these factors and have not yet been investigated in relation to childhood psychotic symptoms. Therefore, this study explored whether differences in DNA methylation at age 10 were associated with monozygotic twin discordance for psychotic symptoms at age 12. The Environmental Risk (E-Risk) Longitudinal Twin Study cohort of 2,232 children (1,116 twin pairs) was assessed for age-12 psychotic symptoms and 24 monozygotic twin pairs discordant for symptoms were identified for methylomic comparison. Children provided buccal samples at ages 5 and 10. DNA was bisulfite modified and DNA methylation was quantified using the Infinium HumanMethylation450 array. Differentially methylated positions (DMPs) associated with psychotic symptoms were subsequently tested in post-mortem prefrontal cortex tissue from adult schizophrenia patients and age-matched controls. Site-specific DNA methylation differences were observed at age 10 between monozygotic twins discordant for age-12 psychotic symptoms. Similar DMPs were not found at age 5. The top-ranked psychosis-associated DMP (cg23933044), located in the promoter of the C5ORF42 gene, was also hypomethylated in post-mortem prefrontal cortex brain tissue from schizophrenia patients compared to unaffected controls. These data tentatively suggest that epigenetic variation in peripheral tissue is associated with childhood psychotic symptoms and may indicate susceptibility to schizophrenia and other mental health problems. PMID:26479702

  12. 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

  13. 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

  14. 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 contras

  15. 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...... Centre Gentofte in Copenhagen during 2009. RESULTS: Our cases were all characterized by having severe symptoms of depression and PTSD. Before treatment start they had a score on the Harvard Trauma Questionnaire between 2.9 and 3.8 (cut-off: 2.5), and a score on the Hopkins Symptom Checklist-25 between 2...... into the prevalence of psychotic symptoms among refugees with depression and PTSD, including the qualitative dimensions of the symptoms in order to optimize diagnosis and treatment among this group of psychiatric patients....

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

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    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.

  17. The comorbidity of psychotic symptoms and posttraumatic stress disorder: evidence for a specifier in DSM-5.

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    Bosson, Julia Vigna; Reuther, Erin T; Cohen, Alex S

    2011-10-01

    The comorbidity of posttraumatic stress disorder (PTSD) and psychotic symptoms is higher than what might be expected based on the prevalence of either disorder alone. Furthermore, the presence of psychotic symptoms is evident in PTSD patients who do not otherwise meet criteria for a psychotic spectrum disorder. The current paper discusses three existing hypotheses regarding the relation of PTSD and psychosis and presents a series of case studies that illustrates this phenomenon across a diverse group of patients and scenarios. Clinical implications in light of these case studies are offered, including the suggestion that the next edition of the Diagnostic and Statistical Manual of Mental Disorders includes a specifier of PTSD with psychotic features.

  18. Cannabis use predicts future psychotic symptoms, and vice versa

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    Ferdinand, R.F.; Sondeijker, F.; Ende, J. van den; Huizink, A.C.; Verhulst, F.C.

    2005-01-01

    Aims - To assess if cannabis use is a risk factor for future psychotic symptoms, and vice versa, in adolescents and young adults from the general population. Design Cohort study. Setting/participants - 'Zuid Holland' study, a 14-year follow-up study of 1580 initially 4-16-year-olds who were drawn ra

  19. [Psychotic symptoms in a case of locked-in syndrome].

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    Mutschler, J; Czell, D; Kaps, M; Manzl, G

    2006-12-01

    In this case report we describe a patient who suffered brainstem bleeding mainly in the pons and mesencephalon leading to locked-in syndrome. During rehabilitation she suffered psychotic symptoms of threatening character. Due to location of the lesion and the coincidental appearance of the bleeding, we diagnosed an organic psychosis. After treatment with the atypical neuroleptic drug Quetiapine, the symptoms decreased, facilitating the patient's rehabilitation course.

  20. An integrated network model of psychotic symptoms

    NARCIS (Netherlands)

    Looijestijn, Jasper; Blom, Jan Dirk; Aleman, Andre; Hoek, Hans W.; Goekoop, Rutger

    2015-01-01

    The full body of research on the nature of psychosis and its determinants indicates that a considerable number of factors are relevant to the development of hallucinations, delusions, and other positive symptoms, ranging from neurodevelopmental parameters and altered connectivity of brain regions to

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

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    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.

  2. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia

    OpenAIRE

    Leweke, F M; Piomelli, D; Pahlisch, F; Muhl, D; Gerth, C W; Hoyer, C.; Klosterkotter, J.; Hellmich, M.; Koethe, D

    2012-01-01

    Cannabidiol is a component of marijuana that does not activate cannabinoid receptors, but moderately inhibits the degradation of the endocannabinoid anandamide. We previously reported that an elevation of anandamide levels in cerebrospinal fluid inversely correlated to psychotic symptoms. Furthermore, enhanced anandamide signaling let to a lower transition rate from initial prodromal states into frank psychosis as well as postponed transition. In our translational approach, we performed a dou...

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

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    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.

  4. Why Are Children in Urban Neighborhoods at Increased Risk for Psychotic Symptoms? Findings From a UK Longitudinal Cohort Study

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    Newbury, Joanne; Arseneault, Louise; Caspi, Avshalom; Moffitt, Terrie E.; Odgers, Candice L.; Fisher, Helen L.

    2016-01-01

    Background: 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. Methods: 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. Results: 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. Conclusions: 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

  5. Misattributing the Source of Self-Generated Representations Related to Dissociative and Psychotic Symptoms

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    Chui-De eChiu

    2016-04-01

    Full Text Available Objective: An intertwined relationship has been found between dissociative and psychotic symptoms, as the two symptom clusters frequently co-occur, suggesting some shared risk factors. Using a source monitoring paradigm, previous studies have shown that patients with schizophrenia made more errors in source monitoring, suggesting that a weakened sense of individuality may be associated with psychotic symptoms. However, no studies have verified a relationship between sense of individuality and dissociation, and it is unclear whether an altered sense of individuality is a shared sociocognitive deficit underlying both dissociation and psychosis.Method: Data from 80 acute psychiatric patients with unspecified mental disorders were analyzed to test the hypothesis that an altered sense of individuality underlies dissociation and psychosis. Behavioral tasks, including tests of intelligence and source monitoring, as well as interview schedules and self-report measures of dissociative and psychotic symptoms, general psychopathology, and trauma history, were administered.Results: Significant correlations of medium effect sizes indicated an association between errors attributing the source of self-generated items and positive psychotic symptoms and the absorption and amnesia measures of dissociation. The associations with dissociative measures remained significant after the effects of intelligence, general psychopathology, and trauma history were excluded. Moreover, the relationships between source misattribution and dissociative measures remained marginally significant and significant after controlling for positive and negative psychotic symptoms, respectively.Limitations: Self-reported measures were collected from a small sample, and most of the participants were receiving medications when tested, which may have influenced their cognitive performance.Conclusions: A tendency to misidentify the source of self-generated items characterized both dissociation

  6. Psychotic aura symptoms in familial hemiplegic migraine type 2 (ATP1A2).

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    Barros, José; Mendes, Alexandre; Matos, Ilda; Pereira-Monteiro, José

    2012-10-01

    Neuropsychological symptoms are rare in familial hemiplegic migraine (FHM). There are no reports of psychotic symptoms in FHM type 2 (ATP1A2). We examined a family with a FHM phenotype due to a M731T mutation in ATP1A2. A 10-year follow-up allowed us to observe complex auras, including psychotic symptoms in two siblings. Male, 48 years old, with an aura that included complex illusions with a feeling of time travelling, coincident with other aura features. The aura was regarded as mystical by the patient. Female, 38 years old, with a complex migraine aura, during which she believed she had the ability to time travel and was being followed by lobbyists who wanted to steal this ability from her. FHM type 2 must be included in the list of differential diagnoses of acute psychosis in patients with a previous history of migraine aura.

  7. Multiple Cavernous Angiomas Associated With Psychotic Symptoms: A Case Report

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    Mohammad Sayadnasiri

    2016-09-01

    Full Text Available Introduction Multiple cerebral cavernous angiomas (CCA have genetic origin. They are uncommon entity and rarely occurring with psychiatric manifestations. Case Presentation A 28- year-old man presented with delusional disorder some months after diagnosis of CCA for which a neurosurgical intervention had been performed. According to clinical and neuroimaging findings, we discuss the possible correlation of CCA with psychotic symptoms of this patient. Conclusions Possibly, abnormal brain development secondary to a genetic abnormality or peri-natal insult predisposed patient to two different neuropsychiatric conditions.

  8. Functional Connectivity Anomalies in Adolescents with Psychotic Symptoms

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    O’Hanlon, Erik; Kraft, Dominik; Oertel-Knöchel, Viola; Clarke, Mary; Kelleher, Ian; Higgins, Niamh; Coughlan, Helen; Creegan, Daniel; Heneghan, Mark; Power, Emmet; Power, Lucy; Ryan, Jessica; Frodl, Thomas; Cannon, Mary

    2017-01-01

    Background Previous magnetic resonance imaging (MRI) research suggests that, prior to the onset of psychosis, high risk youths already exhibit brain abnormalities similar to those present in patients with schizophrenia. Objectives The goal of the present study was to describe the functional organization of endogenous activation in young adolescents who report auditory verbal hallucinations (AVH) in view of the “distributed network” hypothesis of psychosis. We recruited 20 young people aged 13–16 years who reported AVHs and 20 healthy controls matched for age, gender and handedness from local schools. Methods Each participant underwent a semi-structured clinical interview and a resting state (RS) neuroimaging protocol. We explored functional connectivity (FC) involving three different networks: 1) default mode network (DMN) 2) salience network (SN) and 3) central executive network (CEN). In line with previous findings on the role of the auditory cortex in AVHs as reported by young adolescents, we also investigated FC anomalies involving both the primary and secondary auditory cortices (A1 and A2, respectively). Further, we explored between-group inter-hemispheric FC differences (laterality) for both A1 and A2. Compared to the healthy control group, the AVH group exhibited FC differences in all three networks investigated. Moreover, FC anomalies were found in a neural network including both A1 and A2. The laterality analysis revealed no between-group, inter-hemispheric differences. Conclusions The present study suggests that young adolescents with subclinical psychotic symptoms exhibit functional connectivity anomalies directly and indirectly involving the DMN, SN, CEN and also a neural network including both primary and secondary auditory cortical regions. PMID:28125578

  9. Improvement of Psychotic Symptoms and the Role of Tissue Plasminogen Activator

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    Silvia Hoirisch-Clapauch

    2015-11-01

    Full Text Available Tissue plasminogen activator (tPA mediates a number of processes that are pivotal for synaptogenesis and remodeling of synapses, including proteolysis of the brain extracellular matrix, degradation of adhesion molecules, activation of neurotrophins, and activation of the N-methyl-d-aspartate receptor. Abnormalities in these processes have been consistently described in psychotic disorders. In this paper, we review the physiological roles of tPA, focusing on conditions characterized by low tPA activity, which are prevalent in schizophrenia. We then describe how tPA activity is influenced by lifestyle interventions and nutritional supplements that may ameliorate psychotic symptoms. Next, we analyze the role of tPA in the mechanism of action of hormones and medications effective in mitigating psychotic symptoms, such as pregnenolone, estrogen, oxytocin, dopamine D3 receptor antagonists, retinoic acid, valproic acid, cannabidiol, sodium nitroprusside, N-acetyl cysteine, and warfarin. We also review evidence that tPA participates in the mechanism by which electroconvulsive therapy and cigarette smoking may reduce psychotic symptoms.

  10. Childhood Trauma and Children's Emerging Psychotic Symptoms: A Genetically Sensitive Longitudinal Cohort Study

    National Research Council Canada - National Science Library

    Arseneault, Louise; Cannon, Mary; Fisher, Helen L; Polanczyk, Guilherme; Moffitt, Terrie E; Caspi, Avshalom

    2011-01-01

    Objective:Using longitudinal and prospective measures of trauma during childhood, the authors assessed the risk of developing psychotic symptoms associated with maltreatment, bullying, and accidents...

  11. Hippocampal volume correlates with attenuated negative psychotic symptoms irrespective of antidepressant medication

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    Raffaele Bernasconi

    2015-01-01

    Conclusion: Reduced GMV in the hippocampus and precuneus is associated with short-term antidepressant medication and more severe depressive symptoms. Hippocampal volume is further negatively correlated with attenuated negative psychotic symptoms. Longitudinal studies are needed to distinguish whether hippocampal volume deficits in the ARMS are related to attenuated negative psychotic symptoms or to antidepressant action.

  12. 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...

  13. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia.

    Science.gov (United States)

    Leweke, F M; Piomelli, D; Pahlisch, F; Muhl, D; Gerth, C W; Hoyer, C; Klosterkötter, J; Hellmich, M; Koethe, D

    2012-03-20

    Cannabidiol is a component of marijuana that does not activate cannabinoid receptors, but moderately inhibits the degradation of the endocannabinoid anandamide. We previously reported that an elevation of anandamide levels in cerebrospinal fluid inversely correlated to psychotic symptoms. Furthermore, enhanced anandamide signaling let to a lower transition rate from initial prodromal states into frank psychosis as well as postponed transition. In our translational approach, we performed a double-blind, randomized clinical trial of cannabidiol vs amisulpride, a potent antipsychotic, in acute schizophrenia to evaluate the clinical relevance of our initial findings. Either treatment was safe and led to significant clinical improvement, but cannabidiol displayed a markedly superior side-effect profile. Moreover, cannabidiol treatment was accompanied by a significant increase in serum anandamide levels, which was significantly associated with clinical improvement. The results suggest that inhibition of anandamide deactivation may contribute to the antipsychotic effects of cannabidiol potentially representing a completely new mechanism in the treatment of schizophrenia.

  14. Impact of Adverse Childhood Experiences on Psychotic-Like Symptoms and Stress Reactivity in Daily Life in Nonclinical Young Adults

    Science.gov (United States)

    Ballespí, Sergi; Mitjavila, Mercè; Myin-Germeys, Inez; Kwapil, Thomas R.; Barrantes-Vidal, Neus

    2016-01-01

    Background 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. Method 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. Results 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. Discussion The present study provides a unique examination of how childhood adversities impact the expression of spectrum symptoms in the real world and lends support

  15. Prevalence of Psychotic Symptoms and Their Risk Factors in Urban Tanzania

    Directory of Open Access Journals (Sweden)

    Rachel Jenkins

    2010-06-01

    Full Text Available This study aimed to determine the prevalence of psychotic symptoms in urban Tanzania and their relationship with demographic, socio-economic and social factors. A random sample of 899 adults aged 15–59 was surveyed. The main outcome measure was endorsement of one or more psychotic symptoms identified by the Psychosis Screening Questionnaire. 3.9% respondents reported one or more psychotic symptoms in the preceding year. Significantly higher rates of symptoms were found in those who had recently experienced two or more stressful life events, those with CMD and people who had used cannabis in the preceding year.

  16. 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.

  17. Symptoms at first contact for psychotic disorder : Comparison between native Dutch and ethnic minorities

    NARCIS (Netherlands)

    Veling, Wim; Selten, Jean-Paul; Mackenbach, Johan P.; Hoek, Hans W.

    The incidence of schizophrenia and other psychotic disorders is very high among several ethnic minority groups in the Netherlands, and is most increased for Moroccans. This study compared symptoms at first treatment contact for a psychotic disorder between 117 native Dutch and 165 ethnic minority

  18. Facial and prosodic emotion recognition deficits associate with specific clusters of psychotic symptoms in schizophrenia.

    Directory of Open Access Journals (Sweden)

    Huai-Hsuan Tseng

    Full Text Available BACKGROUND: Patients with schizophrenia perform significantly worse on emotion recognition tasks than healthy participants across several sensory modalities. Emotion recognition abilities are correlated with the severity of clinical symptoms, particularly negative symptoms. However, the relationships between specific deficits of emotion recognition across sensory modalities and the presentation of psychotic symptoms remain unclear. The current study aims to explore how emotion recognition ability across modalities and neurocognitive function correlate with clusters of psychotic symptoms in patients with schizophrenia. METHODS: 111 participants who met the DSM-IV diagnostic criteria for schizophrenia and 70 healthy participants performed on a dual-modality emotion recognition task, the Diagnostic Analysis of Nonverbal Accuracy 2-Taiwan version (DANVA-2-TW, and selected subscales of WAIS-III. Of all, 92 patients received neurocognitive evaluations, including CPT and WCST. These patients also received the PANSS for clinical evaluation of symptomatology. RESULTS: The emotion recognition ability of patients with schizophrenia was significantly worse than healthy participants in both facial and vocal modalities, particularly fearful emotion. An inverse correlation was noted between PANSS total score and recognition accuracy for happy emotion. The difficulty of happy emotion recognition and earlier age of onset, together with the perseveration error in WCST predicted total PANSS score. Furthermore, accuracy of happy emotion and the age of onset were the only two significant predictors of delusion/hallucination. All the associations with happy emotion recognition primarily concerned happy prosody. DISCUSSION: Deficits in emotional processing in specific categories, i.e. in happy emotion, together with deficit in executive function, may reflect dysfunction of brain systems underlying severity of psychotic symptoms, in particular the positive dimension.

  19. Insular Dysfunction Reflects Altered Between-Network Connectivity and Severity of Negative Symptoms in Schizophrenia during Psychotic Remission

    Science.gov (United States)

    Manoliu, Andrei; Riedl, Valentin; Doll, Anselm; Bäuml, Josef Georg; Mühlau, Mark; Schwerthöffer, Dirk; Scherr, Martin; Zimmer, Claus; Förstl, Hans; Bäuml, Josef; Wohlschläger, Afra M.; Koch, Kathrin; Sorg, Christian

    2013-01-01

    Schizophrenia is characterized by aberrant intrinsic functional connectivity (iFC) within and between intrinsic connectivity networks (ICNs), including the Default Mode- (DMN), Salience- (SN), and Central Executive Network (CEN). The anterior insula (AI) of the SN has been demonstrated to modulate DMN/CEN interactions. Recently, we found that the dependence of DMN/CEN interactions on SN’s right AI activity is altered in patients with schizophrenia in acute psychosis and related to psychotic symptoms, indicating a link between aberrant AI, DMN, CEN, and psychosis. However, since structural alterations of the insula are also present during psychotic remission and associated with negative symptoms, impaired AI interaction might be relevant even for psychotic remission and corresponding symptoms. Twelve patients with schizophrenia during psychotic remission (SR) and 12 healthy controls were assessed using resting-state fMRI and psychometric examination. High-model-order independent component analysis of fMRI data revealed ICNs including DMN, SN, and CEN. Scores of iFC within (intra-iFC) and between (inter-iFC) distinct subsystems of the DMN, SN, and CEN were calculated, compared between groups and correlated with the severity of symptoms. Intra-iFC was altered in patients’ SN, DMN, and CEN, including decreased intra-iFC in the left AI within the SN. Patients’ inter-iFC between SN and CEN was increased and correlated with the severity of negative symptoms. Furthermore, decreased intra-iFC of the left AI correlated with both severity of negative symptoms and increased inter-iFC between SN and CEN. Our result provides first evidence for a relationship between AI dysfunction and altered between-network interactions in schizophrenia during psychotic remission, which is related to the severity of negative symptoms. Together with our previous results, data suggest specific SN/DMN/CEN reorganization in schizophrenia with distinct insular pathways for distinct symptom

  20. 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.

  1. 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,

  2. 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, predispositi

  3. Basic symptoms and psychotic symptoms: their relationships in the at risk mental states, first episode and multi-episode schizophrenia.

    Science.gov (United States)

    Comparelli, Anna; De Carolis, Antonella; Emili, Emanuele; Rigucci, Silvia; Falcone, Ilaria; Corigliano, Valentina; Curto, Martina; Trovini, Giada; Dehning, Julia; Kotzalidis, Giorgio D; Girardi, Paolo

    2014-05-01

    In the field of the early psychosis two main approaches attempt to develop rating tools, one investigating the basic symptoms domain, and the other the attenuated psychotic symptoms. To explore the relationship between basic symptoms (BSs) and other symptom domains in different phases of the psychotic illness 32 at ultra-high risk (UHR), 49 first episode schizophrenia (FES), 42 multiple episode schizophrenia (MES), and 28 generalized anxiety disorder (GAD) patients were enrolled. Participants were assessed using the SIPS/SOPS and the FCQ scales. Analyses of covariance taking into account socio-demographic and clinical variables significantly different between groups were applied to compare FCQ and SOPS scores. Finally FCQ and SOPS principal component analysis was carried out in the schizophrenia spectrum group. SOPS scores were higher in the UHR, FES and MES groups compared to the GAD control group. Concordantly, FES and MES groups had a higher number of basic symptoms in comparison with the GAD group, whereas UHR did not differ from the control group. The largest number of correlations between BSs and psychotic symptoms was found in the GAD group. According to the principal component analysis (PCA) five factors were extracted, with the BSs loading on a unique factor. Our findings imply that the boundary between psychotic and non-psychotic conditions cannot be outlined on the basis of the presence/absence of basic and psychotic symptoms.

  4. Kynurenic acid and psychotic symptoms and personality traits in twins with psychiatric morbidity.

    Science.gov (United States)

    Kegel, Magdalena E; Johansson, Viktoria; Wetterberg, Lennart; Bhat, Maria; Schwieler, Lilly; Cannon, Tyrone D; Schuppe-Koistinen, Ina; Engberg, Göran; Landén, Mikael; Hultman, Christina M; Erhardt, Sophie

    2017-01-01

    Increased cytokines and kynurenic acid (KYNA) levels in cerebrospinal fluid (CSF) have been reported in patients with schizophrenia and bipolar disorder. The aim of the present study was to investigate cytokines and kynurenines in the CSF of twin pairs discordant for schizophrenia or bipolar disorder and to study these CSF markers in relation to psychotic symptoms and personality traits. CSF levels of tryptophan (TRP), KYNA, quinolinic acid (QUIN), interleukin (IL)-6, IL-8 and tumor necrosis factor-alpha (TNF-α) were analyzed in 23 twins with schizophrenia or bipolar disorder, and in their not affected co-twins. Ratings of psychotic symptoms and personality traits were made using the Scales for Assessment of Negative and Positive symptoms, the Structured Clinical Interview for DSM-IV - Axis II Disorders, and the Schizotypal Personality Questionnaire - Brief. A total score for psychotic symptoms and personality traits was constructed for analysis. CSF KYNA was associated with the score for psychotic symptom and personality traits. TNF-α and IL-8 were associated, and the intra-pair differences scores of TNF-α and IL-8 were highly correlated. Intraclass correlations indicated genetic influences on CSF KYNA, TRP, IL-8 and TNF-α. The association between KYNA and psychotic symptoms further supports a role of KYNA in psychotic disorders.

  5. Quality of life in patients with psychotic disorders: impact of symptoms, personality, and attachment.

    Science.gov (United States)

    Boyette, Lindy-Lou; Korver-Nieberg, Nikie; Meijer, Carin; de Haan, Lieuwe

    2014-01-01

    The aims of this study were to assess the relative contribution of symptoms and specific psychosocial factors to different domains of quality of life (QoL) in patients with psychotic disorders. Positive, negative, and depressive symptoms; Five-Factor Model personality traits; and attachment dimensions were assessed in 110 patients with nonaffective psychotic disorders. Hierarchical and stepwise regression analyses were conducted. Psychosocial factors were able to predict all domains of QoL, when symptom severity was controlled for. Furthermore, the physical QoL domain was best predicted by attachment, personality, and sex (R = 43.1%); the psychological QoL domain, by personality and depressive symptoms (R = 60.5%); the social domain, by personality and positive symptoms (R = 30.3%); and the environmental domain, by personality and negative symptoms (R = 27.9%). Our findings highlight the role that specific individual characteristics play in different aspects of QoL in patients with psychotic disorders.

  6. Functional Neuroimaging Predictors of Self-Reported Psychotic Symptoms in Adolescents.

    Science.gov (United States)

    Bourque, Josiane; Spechler, Philip A; Potvin, Stéphane; Whelan, Robert; Banaschewski, Tobias; Bokde, Arun L W; Bromberg, Uli; Büchel, Christian; Quinlan, Erin Burke; Desrivières, Sylvane; Flor, Herta; Frouin, Vincent; Gowland, Penny; Heinz, Andreas; Ittermann, Bernd; Martinot, Jean-Luc; Paillère-Martinot, Marie-Laure; McEwen, Sarah C; Nees, Frauke; Orfanos, Dimitri Papadopoulos; Paus, Tomáš; Poustka, Luise; Smolka, Michael N; Vetter, Nora C; Walter, Henrik; Schumann, Gunter; Garavan, Hugh; Conrod, Patricia J

    2017-06-01

    This study investigated the neural correlates of psychotic-like experiences in youths during tasks involving inhibitory control, reward anticipation, and emotion processing. A secondary aim was to test whether these neurofunctional correlates of risk were predictive of psychotic symptoms 2 years later. Functional imaging responses to three paradigms-the stop-signal, monetary incentive delay, and faces tasks-were collected in youths at age 14, as part of the IMAGEN study. At baseline, youths from London and Dublin sites were assessed on psychotic-like experiences, and those reporting significant experiences were compared with matched control subjects. Significant brain activity differences between the groups were used to predict, with cross-validation, the presence of psychotic symptoms in the context of mood fluctuation at age 16, assessed in the full sample. These prediction analyses were conducted with the London-Dublin subsample (N=246) and the full sample (N=1,196). Relative to control subjects, youths reporting psychotic-like experiences showed increased hippocampus/amygdala activity during processing of neutral faces and reduced dorsolateral prefrontal activity during failed inhibition. The most prominent regional difference for classifying 16-year-olds with mood fluctuation and psychotic symptoms relative to the control groups (those with mood fluctuations but no psychotic symptoms and those with no mood symptoms) was hyperactivation of the hippocampus/amygdala, when controlling for baseline psychotic-like experiences and cannabis use. The results stress the importance of the limbic network's increased response to neutral facial stimuli as a marker of the extended psychosis phenotype. These findings might help to guide early intervention strategies for at-risk youths.

  7. 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.

  8. Childhood Trauma and Children’s Emerging Psychotic Symptoms: A Genetically Sensitive Longitudinal Cohort Study

    Science.gov (United States)

    Arseneault, Louise; Cannon, Mary; Fisher, Helen L.; Polanczyk, Guilherme; Moffitt, Terrie E.; Caspi, Avshalom

    2012-01-01

    Objective Using longitudinal and prospective measures of trauma during childhood, the authors assessed the risk of developing psychotic symptoms associated with maltreatment, bullying, and accidents in a nationally representative U.K. cohort of young twins. Method Data were from the Environmental Risk Longitudinal Twin Study, which follows 2,232 twin children and their families. Mothers were interviewed during home visits when children were ages 5, 7, 10, and 12 on whether the children had experienced maltreatment by an adult, bullying by peers, or involvement in an accident. At age 12, children were asked about bullying experiences and psychotic symptoms. Children’s reports of psychotic symptoms were verified by clinicians. Results Children who experienced maltreatment by an adult (relative risk=3.16, 95% CI=1.92–5.19) or bullying by peers (relative risk=2.47, 95% CI=1.74–3.52) were more likely to report psychotic symptoms at age 12 than were children who did not experience such traumatic events. The higher risk for psychotic symptoms was observed whether these events occurred early in life or later in childhood. The risk associated with childhood trauma remained significant in analyses controlling for children’s gender, socioeconomic deprivation, and IQ; for children’s early symptoms of internalizing or externalizing problems; and for children’s genetic liability to developing psychosis. In contrast, the risk associated with accidents was small (relative risk=1.47, 95% CI=1.02–2.13) and inconsistent across ages. Conclusions Trauma characterized by intention to harm is associated with children’s reports of psychotic symptoms. Clinicians working with children who report early symptoms of psychosis should inquire about traumatic events such as maltreatment and bullying. PMID:20952460

  9. 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…

  10. Quality of life in patients with psychotic disorders: impact of symptoms, personality, and attachment

    NARCIS (Netherlands)

    Boyette, L.L.; Korver-Nieberg, N.; Meijer, C.; de Haan, L.

    2014-01-01

    The aims of this study were to assess the relative contribution of symptoms and specific psychosocial factors to different domains of quality of life (QoL) in patients with psychotic disorders. Positive, negative, and depressive symptoms; Five-Factor Model personality traits; and attachment dimensio

  11. Dissociative symptoms in patients with schizophrenia: relationships with childhood trauma and psychotic symptoms.

    Science.gov (United States)

    Schäfer, Ingo; Fisher, Helen L; Aderhold, Volkmar; Huber, Barbara; Hoffmann-Langer, Liv; Golks, Dietmar; Karow, Anne; Ross, Colin; Read, John; Harfst, Timo

    2012-05-01

    This study sought to examine the stability of dissociative symptoms in patients with schizophrenia spectrum disorders as well as relationships between psychotic symptoms, childhood trauma, and dissociation. One hundred forty-five patients with schizophrenia spectrum disorders (72% schizophrenia, 67% men) were examined at admission to inpatient treatment and 3 weeks later using the Positive and Negative Syndrome Scale, the Childhood Trauma Questionnaire, and the Dissociative Experiences Scale. Dissociative symptoms significantly decreased over time (mean, 19.2 vs 14.1; P dissociative symptoms at admission was the Positive and Negative Syndrome Scale positive subscale (F(inc)(3,64) = 3.66, P = .017), whereas childhood sexual abuse best predicted dissociation when patients were stabilized (F(inc)(10,80) = 2.00, P = .044). Dissociative symptoms in patients with schizophrenia spectrum disorders are related to childhood trauma. Dissociation seems to be state dependent in this diagnostic group. Moreover, diagnostic interviews, in addition to the Dissociative Experiences Scale, should be considered to avoid measurement artifacts. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Development of psychotic symptoms following ingestion of small quantities of alcohol

    Directory of Open Access Journals (Sweden)

    Lu DL

    2016-09-01

    Full Text Available Da-Li Lu,1 Xiao-Ling Lin2 1Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, People’s Republic of China; 2School of Nursing, Sun Yat-Sen University, Guangzhou, People’s Republic of China Abstract: Psychotic symptoms can occur in some clinical conditions related to alcohol, such as intoxication, withdrawal, and other alcohol-induced neuropsychiatric disorders. Here, we present a case report of a 24-year-old man, without a known psychiatric history, who developed brief psychotic symptoms following ingestion of small quantities of alcohol repeatedly. To our knowledge, no related previous literature regarding this has been reported. Keywords: Alcohol consumption, psychotic symptoms, behavioral change, minimal quantity, pathological intoxication, schizophrenia 

  13. 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 < .05) and were confirmed positive (p < .01). There was no evidence that 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.

  14. Atypical Antipsychotics in the Treatment of Depressive and Psychotic Symptoms in Patients with Chronic Schizophrenia: A Naturalistic Study

    Directory of Open Access Journals (Sweden)

    Marco Innamorati

    2013-01-01

    Full Text Available Objectives. The aim of this naturalistic study was to investigate whether treatment with clozapine and other atypical antipsychotics for at least 2 years was associated with a reduction in psychotic and depressive symptoms and an improvement in chronic schizophrenia patients’ awareness of their illness. Methods. Twenty-three adult outpatients (15 men and 8 women treated with clozapine and 23 patients (16 men and 7 women treated with other atypical antipsychotics were included in the study. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS, depressive symptoms were assessed with the Calgary Depression Scale for Schizophrenia (CDSS, and insight was assessed with the Scale to Assess Unawareness of Mental Disorder (SUMD. Results. The sample as a whole had a significant reduction in positive, negative, and general symptoms, whereas the reduction in depression was significant only for patients with CDSS scores of 5 and higher at the baseline. At the follow-up, patients treated with other atypical antipsychotics reported a greater reduction in depression than patients treated with clozapine, but not when limiting the analyses to those with clinically relevant depression. Conclusions. Atypical antipsychotics may be effective in reducing psychotic and depressive symptoms and in improving insight in patients with chronic schizophrenia, with no differences in the profiles of efficacy between compounds.

  15. 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.

  16. Shared Etiology of Psychotic Experiences and Depressive Symptoms in Adolescence: A Longitudinal Twin Study.

    Science.gov (United States)

    Zavos, Helena M S; Eley, Thalia C; McGuire, Philip; Plomin, Robert; Cardno, Alastair G; Freeman, Daniel; Ronald, Angelica

    2016-09-01

    Psychotic disorders and major depression, both typically adult-onset conditions, often co-occur. At younger ages psychotic experiences and depressive symptoms are often reported in the community. We used a genetically sensitive longitudinal design to investigate the relationship between psychotic experiences and depressive symptoms in adolescence. A representative community sample of twins from England and Wales was employed. Self-rated depressive symptoms, paranoia, hallucinations, cognitive disorganization, grandiosity, anhedonia, and parent-rated negative symptoms were collected when the twins were age 16 (N = 9618) and again on a representative subsample 9 months later (N = 2873). Direction and aetiology of associations were assessed using genetically informative cross-lagged models. Depressive symptoms were moderately correlated with paranoia, hallucinations, and cognitive disorganization. Lower correlations were observed between depression and anhedonia, and depression and parent-rated negative symptoms. Nonsignificant correlations were observed between depression and grandiosity. Largely the same genetic effects influenced depression and paranoia, depression and hallucinations, and depression and cognitive disorganization. Modest overlap in environmental influences also played a role in the associations. Significant bi-directional longitudinal associations were observed between depression and paranoia. Hallucinations and cognitive disorganization during adolescence were found to impact later depression, even after controlling for earlier levels of depression. Our study shows that psychotic experiences and depression, as traits in the community, have a high genetic overlap in mid-adolescence. Future research should test the prediction stemming from our longitudinal results, namely that reducing or ameliorating positive and cognitive psychotic experiences in adolescence would decrease later depressive symptoms. © The Author 2016. Published by Oxford

  17. Do trauma-focussed psychological interventions have an effect on psychotic symptoms? A systematic review and meta-analysis.

    Science.gov (United States)

    Brand, Rachel M; McEnery, Carla; Rossell, Susan; Bendall, Sarah; Thomas, Neil

    2017-08-24

    There is growing recognition of the relationship between trauma, posttraumatic stress disorder (PTSD) and psychosis. There may be overlaps in causal mechanisms involved in the development of PTSD and psychosis following traumatic or adverse events. Trauma-focussed treatments found to be effective in treating PTSD may therefore represent a new direction in the psychological treatment of psychosis. This systematic review examined the literature on trauma-focussed treatments conducted with people with schizophrenia spectrum or psychotic disorders to determine effects on psychotic symptoms. Secondary outcomes were symptoms of PTSD, depression and anxiety. Twenty-five studies were included in the review, with 12 being included in the meta-analysis. Trauma-focussed treatments had a small, significant effect (g=0.31, CI [0.55, 0.06]) on positive symptoms immediately post-treatment, but the significance and magnitude of this effect was not maintained at follow-up (g=0.18, CI [0.42, -0.06]). Trauma-focussed treatments also had a small effect on delusions at both post-treatment (g=0.37, CI [0.87, -0.12]) and follow-up (g=0.38, CI [0.67, 0.10]), but this only reached significance at follow-up. Effects on hallucinations and negative symptoms were small and non-significant. Effects on PTSD symptoms were also small (post-treatment g=0.21, CI [0.70, -0.27], follow up g=0.31, CI [0.62, 0.00]) and only met significance at follow-up. No significant effects were found on symptoms of depression and anxiety. Results show promising effects of trauma-focussed treatments for the positive symptoms of psychosis, however further studies developing and evaluating trauma-focussed treatments for trauma-related psychotic symptoms are needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Disrupted working memory circuitry and psychotic symptoms in 22q11.2 deletion syndrome

    Directory of Open Access Journals (Sweden)

    C.A. Montojo

    2014-01-01

    Full Text Available 22q11.2 deletion syndrome (22q11DS is a recurrent genetic mutation that is highly penetrant for psychosis. Behavioral research suggests that 22q11DS patients exhibit a characteristic neurocognitive phenotype that includes differential impairment in spatial working memory (WM. Notably, spatial WM has also been proposed as an endophenotype for idiopathic psychotic disorder, yet little is known about the neurobiological substrates of WM in 22q11DS. In order to investigate the neural systems engaged during spatial WM in 22q11DS patients, we collected functional magnetic resonance imaging (fMRI data while 41 participants (16 22q11DS patients, 25 demographically matched controls performed a spatial capacity WM task that included manipulations of delay length and load level. Relative to controls, 22q11DS patients showed reduced neural activation during task performance in the intraparietal sulcus (IPS and superior frontal sulcus (SFS. In addition, the typical increases in neural activity within spatial WM-relevant regions with greater memory load were not observed in 22q11DS. We further investigated whether neural dysfunction during WM was associated with behavioral WM performance, assessed via the University of Maryland letter–number sequencing (LNS task, and positive psychotic symptoms, assessed via the Structured Interview for Prodromal Syndromes (SIPS, in 22q11DS patients. WM load activity within IPS and SFS was positively correlated with LNS task performance; moreover, WM load activity within IPS was inversely correlated with the severity of unusual thought content and delusional ideas, indicating that decreased recruitment of working memory-associated neural circuitry is associated with more severe positive symptoms. These results suggest that 22q11DS patients show reduced neural recruitment of brain regions critical for spatial WM function, which may be related to characteristic behavioral manifestations of the disorder.

  19. 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.

  20. A Network Approach to Psychosis : Pathways Between Childhood Trauma and Psychotic Symptoms

    NARCIS (Netherlands)

    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. T

  1. Psychotic-like symptoms as a risk factor of violent recidivism in detained male adolescents

    NARCIS (Netherlands)

    Colins, O.F.; Vermeiren, R.R.; Noom, M.; Broekaert, E.

    2013-01-01

    The aim of this study was to prospectively examine whether psychotic-like symptoms (PLSs) are positively associated with violent recidivism and whether this relation is stronger when PLSs co-occur with substance use disorders (SUDs). Participants were 224 detained male adolescents from all youth det

  2. Psychotic Symptoms and Population Risk for Suicide Attempt A Prospective Cohort Study

    NARCIS (Netherlands)

    Kelleher, Ian; Corcoran, Paul; Keeley, Helen; Wigman, Johanna T. W.; Devlin, Nina; Ramsay, Hugh; Wasserman, Camilla; Carli, Vladimir; Sarchiapone, Marco; Hoven, Christina; Wasserman, Danuta; Cannon, Mary

    IMPORTANCE Up to 1 million persons die by suicide annually. However, a lack of risk markers makes suicide risk assessment one of the most difficult areas of clinical practice. OBJECTIVE To assess psychotic symptoms (attenuated or frank) as a clinical marker of risk for suicide attempt. DESIGN,

  3. Self-disorders in individuals with attenuated psychotic symptoms: Contribution of a dysfunction of autobiographical memory.

    Science.gov (United States)

    Berna, Fabrice; Göritz, Anja S; Schröder, Johanna; Martin, Brice; Cermolacce, Michel; Allé, Mélissa C; Danion, Jean-Marie; Cuervo-Lombard, Christine V; Moritz, Steffen

    2016-05-30

    Patients with schizophrenia and people with subclinical psychotic symptoms have difficulties getting a clear and stable representation of their self. The cognitive mechanisms involved in this reduced clarity of self-concept remain poorly understood. The present study examined whether an altered way of thinking or reasoning about one's past may account for the reduced clarity of self-concept in individuals with attenuated psychotic symptoms (APS). An online study comprising 667 participants examined the capacity to give a meaning to past events and to scrutinize autobiographical memory to better understand him/herself. Our results showed that in this sample, individuals with APS (n=49) have a lower clarity of self-concept and a higher tendency to scrutinize autobiographical memory than controls subjects (n=147). A mediation analysis performed on the full sample revealed that the relation between APS and clarity of self-concept was mediated by a tendency to scrutinize autobiographical memory. Our results suggest that the weakness of self-concept, which increases with the intensity of psychotic symptoms, may be related to an altered function of autobiographical memory, so that examining past events may fail to sustain a stable and clear representation of the self when psychotic symptoms increase.

  4. Anxiety Interacts With Expressed Emotion Criticism in the Prediction of Psychotic Symptom Exacerbation

    Science.gov (United States)

    Docherty, Nancy M.; St-Hilaire, Annie; Aakre, Jennifer M.; Seghers, James P.; McCleery, Amanda; Divilbiss, Marielle

    2011-01-01

    Psychotic symptoms are exacerbated by social stressors in schizophrenia and schizoaffective disorder patients as a group. More specifically, critical attitudes toward patients on the part of family members and others have been associated with a higher risk of relapse in the patients. Some patients appear to be especially vulnerable in this regard. One variable that could affect the degree of sensitivity to a social stressor such as criticism is the individual’s level of anxiety. The present longitudinal study assessed 27 relatively stable outpatients with schizophrenia or schizoaffective disorder and the single “most influential other” (MIO) person for each patient. As hypothesized, (1) patients with high critical MIOs showed increases in psychotic symptoms over time, compared with patients with low critical MIOs; (2) patients high in anxiety at the baseline assessment showed increases in psychotic symptoms at follow-up, compared with patients low in anxiety, and (3) patients with high levels of anxiety at baseline and high critical MIOs showed the greatest exacerbation of psychotic symptoms over time. Objectively measured levels of criticism were more predictive than patient-rated levels of criticism. PMID:19892819

  5. Psychotic Symptoms and Population Risk for Suicide Attempt A Prospective Cohort Study

    NARCIS (Netherlands)

    Kelleher, Ian; Corcoran, Paul; Keeley, Helen; Wigman, Johanna T. W.; Devlin, Nina; Ramsay, Hugh; Wasserman, Camilla; Carli, Vladimir; Sarchiapone, Marco; Hoven, Christina; Wasserman, Danuta; Cannon, Mary

    2013-01-01

    IMPORTANCE Up to 1 million persons die by suicide annually. However, a lack of risk markers makes suicide risk assessment one of the most difficult areas of clinical practice. OBJECTIVE To assess psychotic symptoms (attenuated or frank) as a clinical marker of risk for suicide attempt. DESIGN, SETTI

  6. 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.

  7. 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.

  8. Psychotic symptoms in young adults exposed to childhood trauma--a 20 year follow-up study.

    Science.gov (United States)

    Galletly, Cherrie; Van Hooff, Miranda; McFarlane, Alexander

    2011-04-01

    Childhood adversity has been shown to increase the risk of psychotic symptoms in adult life. However, there are no previous studies looking at the association between experiencing a natural disaster during childhood and the development of psychotic symptoms in young adulthood. Eight hundred and six bushfire-exposed children and 725 control children were evaluated following the 1983 South Australian bushfires. Five hundred and twenty nine (65.6%) of the bushfire group and 464 (64%) controls participated in a follow up study 20 years later. Childhood data on emotional and behavioural disorders and dysfunctional parenting was available. The adult assessment included the Australian National Health and Well-Being psychosis screen and detailed information about trauma, childhood adversity and alcohol and cannabis abuse. 5.6% of subjects responded positively to the psychosis screen and 2.6% responded positively to a further probe question. Psychotic symptoms were more common in subjects exposed to a greater number of traumas, and were associated with higher rates of childhood adversity, emotional and behavioural disturbance, dysfunctional parenting, and alcohol and cannabis abuse. Subjects exposed to bushfires as children did not have a greater risk of psychosis. Our results indicate that exposure to multiple traumas, rather than a single major trauma, increases the risk of later psychosis.

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

    OpenAIRE

    Moturi, Sricharan; 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 identi...

  10. Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study

    Science.gov (United States)

    Kuepper, Rebecca; Lieb, Roselind; Wittchen, Hans-Ulrich; Höfler, Michael; Henquet, Cécile

    2011-01-01

    Objective To determine whether use of cannabis in adolescence increases the risk for psychotic outcomes by affecting the incidence and persistence of subclinical expression of psychosis in the general population (that is, expression of psychosis below the level required for a clinical diagnosis). Design Analysis of data from a prospective population based cohort study in Germany (early developmental stages of psychopathology study). Setting Population based cohort study in Germany. Participants 1923 individuals from the general population, aged 14-24 at baseline. Main outcome measure Incidence and persistence of subthreshold psychotic symptoms after use of cannabis in adolescence. Cannabis use and psychotic symptoms were assessed at three time points (baseline, T2 (3.5 years), T3 (8.4 years)) over a 10 year follow-up period with the Munich version of the composite international diagnostic interview (M-CIDI). Results In individuals who had no reported lifetime psychotic symptoms and no reported lifetime cannabis use at baseline, incident cannabis use over the period from baseline to T2 increased the risk of later incident psychotic symptoms over the period from T2 to T3 (adjusted odds ratio 1.9, 95% confidence interval 1.1 to 3.1; P=0.021). Furthermore, continued use of cannabis increased the risk of persistent psychotic symptoms over the period from T2 to T3 (2.2, 1.2 to 4.2; P=0.016). The incidence rate of psychotic symptoms over the period from baseline to T2 was 31% (152) in exposed individuals versus 20% (284) in non-exposed individuals; over the period from T2 to T3 these rates were 14% (108) and 8% (49), respectively. Conclusion Cannabis use is a risk factor for the development of incident psychotic symptoms. Continued cannabis use might increase the risk for psychotic disorder by impacting on the persistence of symptoms. PMID:21363868

  11. A randomized-controlled trial of heart rate variability biofeedback for psychotic symptoms.

    Science.gov (United States)

    Clamor, Annika; Koenig, Julian; Thayer, Julian F; Lincoln, Tania M

    2016-12-01

    Arousal and the way it is coped with are relevant to the emergence of psychotic symptoms. Heart rate variability (HRV) stems from autonomic responses to environmental demands such as stress and is an index of physiological arousal, adaptability, and homeostatic reflexes forming autonomic balance. A randomized-controlled between-subjects trial that compared HRV-biofeedback (BF) to an active relaxation and to a waiting control condition was conducted in a sample with attenuated subclinical psychotic symptoms (N = 84). A 20-min intervention was preceded and followed by repeated assessments of stress responses. Change scores of the post-stress periods were analyzed using ANOVAs for HRV, subjective stress, perceived control, and state paranoia. As expected, BF participants showed greater improvements in perceived control than waiting controls (p = 0.006). However, no group differences occurred in HRV, paranoid symptoms or subjective stress. In exploratory analyses in a subset of participants who were breathing per protocol, the expected effects were found for total HRV and state paranoia. Thus, this trial of HRV-BF for people with attenuated psychotic symptoms indicates that the intervention may hold potential if conducted per protocol. To reach this, longer training might be inevitable. Future studies are needed to further elucidate efficacy and applicability of HRV-BF in clinical samples. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Anxiety Symptoms in Psychotic Disorders: Results from the Second Australian National Mental Health Survey.

    Science.gov (United States)

    Bosanac, Peter; Mancuso, Sam G; Castle, David J

    2016-01-01

    The prevalence of anxiety symptoms among Australians with psychotic disorders was examined as part of the Survey of High Impact Psychosis (SHIP). A two-phase design was used. Of 7,955 people who were screened positive for psychosis and eligible, there were 1,825 participants (18-34 years and 35-64 years) interviewed. Data were collected on symptomatology, substance use, cognitive ability, functioning, disability, physical health, mental health service utilization, medication use, education, employment and housing. Anxiety symptomatology was divided into generalized anxiety, panic, phobic, social anxiety and obsessive-compulsive symptoms. The most common ICD-10 diagnoses were schizophrenia or schizoaffective disorder (63.0%) and bipolar (mania) disorder (17.5%). Overall, 59.8% (n=1,092) of participants reported experiencing anxiety symptoms in the previous twelve months. Female gender was highly associated with all domains of anxiety. Smoking was significantly associated with all domains of anxiety, except generalized anxiety. The presence of any depressive symptoms in the previous twelve months was significantly associated with all anxiety symptoms. Medication side effects were associated with phobic and obsessive-compulsive symptoms. Social dysfunction was associated with social anxiety, and less so for obsessive-compulsive symptoms. Anxiety symptoms are common in people with psychotic disorders. Appropriate screening and treatment should be a clinical priority.

  13. 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

  14. Intranasal oxytocin reduces psychotic symptoms and improves Theory of Mind and social perception in schizophrenia.

    Science.gov (United States)

    Pedersen, Cort A; Gibson, Clare M; Rau, Shane W; Salimi, Kayvon; Smedley, Kelly L; Casey, Robin L; Leserman, Jane; Jarskog, L Fredrik; Penn, David L

    2011-10-01

    Oxytocin has numerous prosocial and antipsychotic-like effects in animals. Prosocial effects of acute intranasal oxytocin administration have also been reported in human subjects. We conducted a randomized, placebo-controlled trial testing the effects of twice daily intranasal oxytocin treatment for 14 days on psychotic symptoms and social cognition in patients with schizophrenia. PANSS scores declined significantly and several social cognition measures improved significantly or nearly significantly in oxytocin (N=11) but not placebo (N=9) recipients. Our results suggest that, in addition to reducing classic psychotic symptoms, oxytocin may diminish certain social cognition deficits that are not improved by current antipsychotic medications. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Psychopathological mechanisms linking childhood traumatic experiences to risk of psychotic symptoms: analysis of a large, representative population-based sample.

    Science.gov (United States)

    van Nierop, Martine; Lataster, Tineke; Smeets, Feikje; Gunther, Nicole; van Zelst, Catherine; de Graaf, Ron; ten Have, Margreet; van Dorsselaer, Saskia; Bak, Maarten; Myin-Germeys, Inez; Viechtbauer, Wolfgang; van Os, Jim; van Winkel, Ruud

    2014-03-01

    Different psychological models of trauma-induced psychosis have been postulated, often based on the observation of "specific" associations between particular types of childhood trauma (CT) and particular psychotic symptoms or the co-occurrence of delusions and hallucinations. However, the actual specificity of these associations remains to be tested. In 2 population-based studies with comparable methodology (Netherlands Mental Health Survey and Incidence Study-1 [NEMESIS-1] and NEMESIS-2, N = 13 722), trained interviewers assessed CT, psychotic symptoms, and other psychopathology. Specificity of associations was assessed with mixed-effects regression models with multiple outcomes, a statistical method suitable to examine specificity of associations in case of multiple correlated outcomes. Associations with CT were strong and significant across the entire range of psychotic symptoms, without evidence for specificity in the relationship between particular trauma variables and particular psychotic experiences (PEs). Abuse and neglect were both associated with PEs (OR abuse: 2.12, P effect size. Intention-to-harm experiences showed stronger associations with psychosis than CT without intent (χ(2) = 58.62, P childhood traumatic experiences to psychosis, most likely characterized by co-occurrence of hallucinations and delusions, indicating buildup of psychotic intensification, rather than specific psychotic symptoms in isolation. No evidence was found to support psychological theories regarding specific associations between particular types of CT and particular psychotic symptoms.

  16. Development of psychotic symptoms following ingestion of small quantities of alcohol

    OpenAIRE

    Lu DL; Lin XL

    2016-01-01

    Da-Li Lu,1 Xiao-Ling Lin2 1Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, People’s Republic of China; 2School of Nursing, Sun Yat-Sen University, Guangzhou, People’s Republic of China Abstract: Psychotic symptoms can occur in some clinical conditions related to alcohol, such as intoxication, withdrawal, and other alcohol-induced neuropsychiatric disorders. Here, we present a case report of a 24-year-old man, without a known psychiatric history, who developed ...

  17. Haemophilus influenzae Disease (Including Hib) Symptoms

    Science.gov (United States)

    ... Search The CDC Cancel Submit Search The CDC Haemophilus influenzae Disease (Including Hib) Note: Javascript is disabled or ... and Symptoms Recommend on Facebook Tweet Share Compartir Haemophilus influenzae , including Hib, disease causes different symptoms depending on ...

  18. 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.

  19. 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.

  20. Self-report of basic symptoms among psychotic and nonpsychotic subjects.

    Science.gov (United States)

    Ciani, N; Pezzarossa, B; Curini, A; Rubino, I A

    1999-10-01

    Basic symptoms, as defined and described by the Bonn Scale, were assessed by means of a new self-report inventory, the Rome Basic Disorders Scale. On all the subscales, psychiatric outpatients (n = 105; most frequent diagnoses: Schizophrenia, Anxiety Disorders, and Mood Disorders) scored significantly higher (p < .001) than nonclinical controls (n = 105). Psychiatric patients with at least one diagnosis on the psychotic sets of Foulds' hierarchical inventory (n = 45), compared with the rest of the psychiatric sample (n = 60), had significantly higher scores on nearly all subscales. Two groups of inpatients with Schizophrenia (n = 20) and Mood Disorders (n = 20) were tested on Day 2 and 9 of hospitalization in an emergency ward. Schizophrenic patients had significantly higher scores on most of the subscales, but only on Day 9; on Day 2 depressed and manic patients scored significantly higher on four subscales. Until now basic symptoms had not been studied during the intrapsychotic phase, mainly because of their transformation into first-rank symptoms; present findings suggest that basic symptoms are active also at the height of the psychotic breakdown and that they are more responsive to treatment in Depression and Mania than in Schizophrenia.

  1. Drug dependence and psychotic symptoms: a retrospective study of adolescents who abuse drugs at Al-Amal Hospital in Jeddah, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Osama Alibrahim

    2012-03-01

    Full Text Available Drug abuse is reported to be on the increase among young persons using illicit substances but little is known about the frequency with which they occur, the symptoms on presentation to health institutions, and the different substances abused. To establish this, we reviewed patient data collected at Al-Amal Hospital in Jeddah Kingdom of Saudi Arabia on young persons who are refered to the hospital for problems related to drug abuse. Data on 69 adolescent drug users were reviewed and analyzed using the Composite International Diagnostic Interview - Substance Abuse Model (CIDI-SAM to assess dependence on substances including amphetamines, cannabis, cocaine, and opioids. Furthermore, we assessed the adolescents’ data on history of delusions and hallucinations in the context of use of, or withdrawal from, these specific substances. Our analysis shows that 10 to 79.6% of users of amphetamines, cannabis, cocaine, and opiates met DSM-III-R dependence criteria for each specific substance. The prevalence of psychotic symptoms associated with each specific substance ranged from users with no diagnosis to users with severe dependence as follows: amphetamines (3-100%, cannabis (7- 60.0%, cocaine (5-70.7%, and opiates (4- 88%. The risk of psychotic symptoms increased for respondents who abused (OR=7.2 or had mild (OR=8.1, moderate (OR=20.0, or severe dependence (OR=14.0 on cocaine when compared to those who were users with no diagnosis. A similar pattern was evident in cannabis, opiate, and amphetamine users. In conclusion, most adolescent drug users in Saudi Arabia who are dependent on illicit substances experience psychotic symptoms in the context of use of, or withdrawal from, these substances. Psychotic symptoms increased with the severity of the disorders associated with use of all four substances. These findings underscore the importance of developing services to target this population; a population at risk of developing psychotic symptoms.

  2. Impact of psychotic symptoms on cognitive functioning in child and adolescent psychiatric inpatients with severe mood disorders.

    Science.gov (United States)

    McCarthy, James B; Weiss, Shira R; Segovich, Kristin T; Barbot, Baptiste

    2016-10-30

    Despite established differences in cognitive functioning of adults with mood disorder-related psychosis and those with non-affective psychotic disorders, there is limited evidence of the impact of psychotic symptoms on the cognitive functioning of children and adolescents with mood disorders. This study investigates IQ, working memory, and processing speed scores in 80 child and adolescent inpatients discharged from an intermediate care state psychiatric hospital, using a retrospective chart review. Associations between diagnosis based on DSM-IV criteria (7 with Major Depression- MDD; 43 with Bipolar Disorders-BD, and 30 with Mood Disorders Not Otherwise Specified-NOS), presence of current psychotic features, and cognitive functioning (WISC-IV IQ, Coding, Symbol Search, and Digit Span) were investigated using Multivariate Analyses of Variance. No differences were found in cognitive functioning between patients with MDD and BD, or between those with severe Mood Disorders (MDD or BD) and those with NOS, when controlling for age, gender, and presence of psychotic features. However, patients with severe mood disorders and psychotic features showed lower IQs and greater working memory deficits than those without psychotic features or NOS. Results are discussed in terms of treatment planning for children and adolescents at risk for developing psychotic symptoms and severe mood disorders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Salience attribution and its relationship to cannabis-induced psychotic symptoms.

    Science.gov (United States)

    Bloomfield, M A P; Mouchlianitis, E; Morgan, C J A; Freeman, T P; Curran, H V; Roiser, J P; Howes, O D

    2016-12-01

    Cannabis is a widely used drug associated with increased risk for psychosis. The dopamine hypothesis of psychosis postulates that altered salience processing leads to psychosis. We therefore tested the hypothesis that cannabis users exhibit aberrant salience and explored the relationship between aberrant salience and dopamine synthesis capacity. We tested 17 cannabis users and 17 age- and sex-matched non-user controls using the Salience Attribution Test, a probabilistic reward-learning task. Within users, cannabis-induced psychotic symptoms were measured with the Psychotomimetic States Inventory. Dopamine synthesis capacity, indexed as the influx rate constant K i cer , was measured in 10 users and six controls with 3,4-dihydroxy-6-[18F]fluoro-l-phenylalanine positron emission tomography. There was no significant difference in aberrant salience between the groups [F 1,32 = 1.12, p = 0.30 (implicit); F 1,32 = 1.09, p = 0.30 (explicit)]. Within users there was a significant positive relationship between cannabis-induced psychotic symptom severity and explicit aberrant salience scores (r = 0.61, p = 0.04) and there was a significant association between cannabis dependency/abuse status and high implicit aberrant salience scores (F 1,15 = 5.8, p = 0.03). Within controls, implicit aberrant salience was inversely correlated with whole striatal dopamine synthesis capacity (r = -0.91, p = 0.01), whereas this relationship was non-significant within users (difference between correlations: Z = -2.05, p = 0.04). Aberrant salience is positively associated with cannabis-induced psychotic symptom severity, but is not seen in cannabis users overall. This is consistent with the hypothesis that the link between cannabis use and psychosis involves alterations in salience processing. Longitudinal studies are needed to determine whether these cognitive abnormalities are pre-existing or caused by long-term cannabis use.

  4. The Intricate Relationship between Psychotic-Like Experiences and Associated Subclinical Symptoms in Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Lui Unterrassner

    2017-09-01

    Full Text Available The interplay between subclinical psychotic, negative, and affective symptoms has gained increased attention regarding the etiology of psychosis spectrum and other mental disorders. Importantly, research has tended to not differentiate between different subtypes of psychotic-like experiences (PLE although they may not have the same significance for mental health. In order to gain information on the subclinical interplay between specific PLE and other symptoms as well as the significance of PLE for mental health, we investigated their specific associations in 206 healthy individuals (20–60 years, 73 females using correlational and linear regression analyses. PLE were assessed with the Magical Ideation Questionnaire, the revised Exceptional Experiences Questionnaire, and subscales of the Schizotypal Personality Questionnaire (SPQ. The revised Symptom Checklist 90, the SPQ, and the Physical Anhedonia Scale were used to measure subclinical negative symptoms, affective symptoms, and other symptoms such as, emotional instability. As hypothesized, we found that (1 most affective symptoms and all other subclinical symptoms correlated positively with all PLE, whereas we found only partial associations between negative symptoms and PLE. Notably, (2 magical ideation and paranormal beliefs correlated negatively with physical anhedonia. In the regression analyses we found (3 similar patterns of specific positive associations between PLE and other subclinical symptoms: Suspiciousness was a specific predictor of negative-like symptoms, whereas ideas of reference, unusual perceptual experiences, and dissociative anomalous perceptions specifically predicted anxiety symptoms. Interestingly, (4 ideas of reference negatively predicted physical anhedonia. Similarly, paranormal beliefs were negatively associated with constricted affect. Moreover, odd beliefs were a negative predictor of depression, emotional instability, and unspecific symptoms. Our findings

  5. The Intricate Relationship between Psychotic-Like Experiences and Associated Subclinical Symptoms in Healthy Individuals.

    Science.gov (United States)

    Unterrassner, Lui; Wyss, Thomas A; Wotruba, Diana; Haker, Helene; Rössler, Wulf

    2017-01-01

    The interplay between subclinical psychotic, negative, and affective symptoms has gained increased attention regarding the etiology of psychosis spectrum and other mental disorders. Importantly, research has tended to not differentiate between different subtypes of psychotic-like experiences (PLE) although they may not have the same significance for mental health. In order to gain information on the subclinical interplay between specific PLE and other symptoms as well as the significance of PLE for mental health, we investigated their specific associations in 206 healthy individuals (20-60 years, 73 females) using correlational and linear regression analyses. PLE were assessed with the Magical Ideation Questionnaire, the revised Exceptional Experiences Questionnaire, and subscales of the Schizotypal Personality Questionnaire (SPQ). The revised Symptom Checklist 90, the SPQ, and the Physical Anhedonia Scale were used to measure subclinical negative symptoms, affective symptoms, and other symptoms such as, emotional instability. As hypothesized, we found that (1) most affective symptoms and all other subclinical symptoms correlated positively with all PLE, whereas we found only partial associations between negative symptoms and PLE. Notably, (2) magical ideation and paranormal beliefs correlated negatively with physical anhedonia. In the regression analyses we found (3) similar patterns of specific positive associations between PLE and other subclinical symptoms: Suspiciousness was a specific predictor of negative-like symptoms, whereas ideas of reference, unusual perceptual experiences, and dissociative anomalous perceptions specifically predicted anxiety symptoms. Interestingly, (4) ideas of reference negatively predicted physical anhedonia. Similarly, paranormal beliefs were negatively associated with constricted affect. Moreover, odd beliefs were a negative predictor of depression, emotional instability, and unspecific symptoms. Our findings indicated that

  6. Psychotic symptoms as a complication of electroconvulsive therapy - a case report.

    Science.gov (United States)

    Antosik-Wójcińska, Anna; Chojnacka, Magdalena; Święcicki, Łukasz

    2017-02-26

    We report a patient who experienced atypical symptoms in the course of electroconvulsive therapy (ECT). During ECT treatment patient experienced psychotic symptoms which should be differentiated with prolonged delirium and nonconvulsive status epilepticus. 46-year-old female was referred to hospital with a diagnosis of major depressive disorder with no psychotic features in the course of recurrent depression. Despite several changes of pharmacological treatment no improvement was achieved, therefore it was decided to initiate ECT. Physical and neurological examination revealed no deviations from the norm. The results of other tests (CT and EEG) were normal. 4 bilateral, bitemporal ECT procedures were performed. The course of each procedure was typical, the same doses of anesthetic medication and pulse dose was administered throughout all of the procedures. The duration of seizure was 32-40 s. Despite this mental symptoms observed during the course of the treatment differed from known to the authors from both their own experience and from literature. Delusions of reference, persecution, agitation, oneiric delusions and olfactory hallucinations which appeared after the 4th ECT session maintained for 14 days and resolved after treatment with olanzapine. To the best of our knowledge, this is the first report on delusions of reference and persecution, oneiric delusions and olfactory hallucinations associated with the course of ECT.

  7. 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

  8. The Effect of Changes in Cannabis Exposure on Psychotic Symptoms in Patients With Comorbid Cannabis Use Disorder

    DEFF Research Database (Denmark)

    Toftdahl, Nanna Gilliam; Nordentoft, Merete; Hjorthøj, Carsten

    2016-01-01

    OBJECTIVE: It remains unclear whether there is an association between severity of cannabis use and psychotic symptom severity over time. Shedding light on this under-researched matter could have clinical implications for this patient group. METHODS: This was a secondary analysis of a randomized......, parallel-group, superiority, assessor-blinded trial. We followed 60 patients with dually diagnosed psychosis and cannabis use disorders from the Danish CapOpus trial, which included assessments at baseline, post-treatment (6 months) and 10 months. Cannabis use was registered by self-report assisted...... and persistent cannabis use (severe use group) had significantly higher scores, as compared to those with minor use, on the positive symptom (17.0, 95% CI [4.7-19.2] vs. 12.7, 95% CI [10.4-15.0], respectively, adjusted p

  9. 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.

  10. Non-pharmacological treatment reducing not only behavioral symptoms, but also psychotic symptoms of older adults with dementia: a prospective cohort study in Taiwan.

    Science.gov (United States)

    Chen, Rue-Chuan; Liu, Chien-Liang; Lin, Ming-Hsien; Peng, Li-Ning; Chen, Liang-Yu; Liu, Li-Kuo; Chen, Liang-Kung

    2014-04-01

    The clinical effectiveness of non-pharmacological interventions on behavioral and psychological symptoms of dementia (BPSD) among older Chinese with dementia remains unclear, and the evidence supporting the benefits of a non-pharmacological approach on psychotic symptoms is scarce. A prospective cohort study including 104 older men with dementia living in two veterans homes in Taiwan was carried out in 2011. An organized program of music therapy, orientation training, art-cognitive activities and physical activities was carried out for the intervention group. All participants were evaluated for neuropsychiatric inventory (NPI), defined daily dose of psychotropic drug use, Barthel Index, Instrumental Activities of Daily Living, Mini-Mental State Examination, Geriatric Depression Scale, Tinetti balance score and Tinetti gait score. Overall, 104 residents were enrolled and 92 of them completed the study. The intervention group had a more significant reduction than the reference group in the overall NPI score (-2.36, P = 0.046), and in the subcategories of delusion (-0.9, P = 0.018), hallucination (-0.82, P = 0.004) and agitation (-0.91, P = 0.038). Multivariate analysis showed that the non-pharmacological intervention was associated with a favorable outcome in overall NPI score (OR 4.113, P = 0.013) and in the subcategories of hallucination (OR 14.309, P = 0.049) and agitation (OR 6.604, P = 0.037). Meanwhile, a higher baseline NPI score was also associated with a favorable outcome in overall NPI score, and in the subcategories of delusion, hallucination and agitation. Non-pharmacological interventions have a positive effect on behavioral and psychological symptoms of dementia, not only in outward symptoms like agitation, but also intrinsic psychotic symptoms like hallucination and delusion, and agitation in older Chinese men with dementia. © 2013 Japan Geriatrics Society.

  11. Etiopathogenic perspectives on chronic psycho traumatic and chronic psychotic symptoms: the hypothesis of a hyperdopaminergic endophenotype of PTSD.

    Science.gov (United States)

    Auxemery, Yann

    2012-11-01

    Post traumatic stress disorder (PTSD) is a complex and heterogeneous disorder, which specific symptoms are re-experiencing, increased arousal and avoidance of stimuli associated with the trauma. PTSD has much comorbidity like depression, substance abuse, somatic complaints, repeated dissociative phenomena and transitory or chronic psychotic reactions. PTSD can manifest itself in different clinical forms: some patients present higher symptoms in one domain as compared to another, probably because of abnormalities in different neurobiological systems. Hyposerotonergic and hypernoradrenergic PTSD endophenotypes have been previously identified and the purpose of this paper is to focus on the hypothesis of a hyperdopaminergic endophenotype. The current review discusses several entities: PTSD with psychotic features with or without depression, the comorbide use of psychoactive substances that increase psychotic symptoms and traumatic brain injuries as agents of psycho traumatic and psychotic features. For all of these nosographic entities, the dopaminergic neuromodulation may play a central role. The hypothesis of a hyperdopaminergic endophenotype of PTSD opens up new research and therapeutic perspectives. Although antipsychotics are frequently used for people with PTSD further studies are needed to develop a consensus on the guidelines for treating the psychotic forms of PTSD. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. An Investigation of Cannabis Use and Childhood Trauma in Relation to Psychotic Symptoms and Their Outcomes: a Population-Based Follow-up Study of Irish Adolescents

    OpenAIRE

    Harley, Michelle

    2013-01-01

    Background: Adolescent cannabis use has been shown to increase risk of later psychosis and childhood trauma is associated with both substance misuse and risk for psychosis. Psychotic symptoms in adolescents have been linked with later common mental disorders as well as psychotic outcomes, however personality disorders have not been investigated. There is limited information on rates of psychiatric disorder among adolescents and adults with psychotic symptoms in community samples, and no infor...

  13. Psychotic-like symptoms as a risk factor of violent recidivism in detained male adolescents.

    Science.gov (United States)

    Colins, Olivier F; Vermeiren, Robert R; Noom, Marc; Broekaert, Eric

    2013-06-01

    The aim of this study was to prospectively examine whether psychotic-like symptoms (PLSs) are positively associated with violent recidivism and whether this relation is stronger when PLSs co-occur with substance use disorders (SUDs). Participants were 224 detained male adolescents from all youth detention centers in Flanders. The Diagnostic Interview Schedule for Children was used to assess PLSs and the number of SUDs. Two to 4 years later, information on official recidivism was obtained. Although hallucinations were unrelated to violent recidivism, paranoid delusions (PDs) and threat/control override delusions (TCODs) were negatively related to violent recidivism. The relation between PLSs and violent recidivism did not become stronger in the presence of SUDs. Detained youths with PLSs do not have a higher risk for violent recidivism than detained youths without PLSs. In contrast, by identifying detained youths with PDs or TCODs, clinicians are likely to identify youths with a low risk for future violent crimes.

  14. Methamphetamine-induced disruption of frontostriatal reward learning signals: relation to psychotic symptoms.

    Science.gov (United States)

    Bernacer, Javier; Corlett, Philip R; Ramachandra, Pranathi; McFarlane, Brady; Turner, Danielle C; Clark, Luke; Robbins, Trevor W; Fletcher, Paul C; Murray, Graham K

    2013-11-01

    Frontostriatal circuitry is critical to learning processes, and its disruption may underlie maladaptive decision making and the generation of psychotic symptoms in schizophrenia. However, there is a paucity of evidence directly examining the role of modulatory neurotransmitters on frontostriatal function in humans. In order to probe the effects of modulation on frontostriatal circuitry during learning and to test whether disruptions in learning processes may be related to the pathogenesis of psychosis, the authors explored the brain representations of reward prediction error and incentive value, two key reinforcement learning parameters, before and after methamphetamine challenge. Healthy volunteers (N=18) underwent functional MRI (fMRI) scanning while performing a reward learning task on three occasions: after placebo, after methamphetamine infusion (0.3 mg/kg body weight), and after pretreatment with 400 mg of amisulpride and then methamphetamine infusion. Brain fMRI representations of learning signals, calculated using a reinforcement Q-learning algorithm, were compared across drug conditions. In the placebo condition, reward prediction error was coded in the ventral striatum bilaterally and incentive value in the ventromedial prefrontal cortex bilaterally. Reward prediction error and incentive value signals were disrupted by methamphetamine in the left nucleus accumbens and left ventromedial prefrontal cortex, respectively. Psychotic symptoms were significantly correlated with incentive value disruption in the ventromedial prefrontal and posterior cingulate cortex. Amisulpride pretreatment did not significantly alter methamphetamine-induced effects. The results demonstrate that methamphetamine impairs brain representations of computational parameters that underpin learning. They also demonstrate a significant link between psychosis and abnormal monoamine-regulated learning signals in the prefrontal and cingulate cortices.

  15. 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.

  16. Ethnic identity, racial discrimination and attenuated psychotic symptoms in an urban population of emerging adults.

    Science.gov (United States)

    Anglin, Deidre M; Lui, Florence; Espinosa, Adriana; Tikhonov, Aleksandr; Ellman, Lauren

    2016-01-28

    Studies suggest strong ethnic identity generally protects against negative mental health outcomes associated with racial discrimination. In light of evidence suggesting racial discrimination may enhance psychosis risk in racial and ethnic minority (REM) populations, the present study explored the relationship between ethnic identity and attenuated positive psychotic symptoms (APPS) and whether ethnic identity moderates the association between racial discrimination and these symptoms. A sample of 644 non-help-seeking REM emerging adults was administered self-report inventories for psychosis risk, experiences of discrimination and ethnic identity. Latent class analysis was applied to determine the nature and number of ethnic identity types in this population. The direct association between ethnic identity and APPS and the interaction between ethnic identity and racial discrimination on APPS were determined in linear regression analyses. Results indicated three ethnic identity classes (very low, moderate to high and very high). Ethnic identity was not directly related to APPS; however, it was related to APPS under racially discriminating conditions. Specifically, participants who experienced discrimination in the moderate to high or very high ethnic identity classes reported fewer symptoms than participants who experienced discrimination in the very low ethnic identity class. Strong ethnic group affiliation and connection may serve a protective function for psychosis risk in racially discriminating environments and contexts among REM young adults. The possible social benefits of strong ethnic identification among REM youth who face racial discrimination should be explored further in clinical high-risk studies. © 2016 John Wiley & Sons Australia, Ltd.

  17. Informal care for people with chronic psychotic symptoms: four case studies in a San community in South Africa.

    Science.gov (United States)

    den Hertog, Thijs N; Gilmoor, Andrew R

    2017-03-01

    Despite the internationally recognised importance of informal care, especially in settings with limited services, few studies focus on the informal care for people with mental health problems in low- and middle-income countries. Making informal care visible is important for understanding the challenges and identifying the needs to be addressed. This ethnographic case study explored the dynamics of informal care for people with chronic psychotic symptoms in a group of San living in poor socioeconomic circumstances in a township near Kimberley, Northern Cape, South Africa. Data were collected in 2013 and 2014 and included semi-structured interviews, informal conversations and observations. Using local terminology, four individuals with chronic psychotic symptoms were identified and selected during the research process. A total of 33 semi-structured interviews took place with their caregivers. Data were analysed using descriptive, interpretive and pattern coding to identify core themes and interrelations across the four cases. Results indicate that informal care is characterised by shared and fragmented care structures. Care was shared among family members from various households and unrelated community members. This allowed for an adaptive process that responded to local dynamics and the care recipients' needs. However, informal care was fragmented as it was generally uncoordinated, which increased the recipients' vulnerability as caregivers could redirect care-giving responsibility and withdraw care. Specific challenges for providing care were related to poverty and care resistance. To improve the living conditions of people suffering from psychosis-related mental health problems, community-based mental healthcare should broaden its scope and incorporate local strengths and challenges.

  18. Modeling psychotic and cognitive symptoms of affective disorders: Disrupted latent inhibition and reversal learning deficits in highly stress reactive mice.

    Science.gov (United States)

    Knapman, A; Heinzmann, J-M; Holsboer, F; Landgraf, R; Touma, C

    2010-09-01

    Increased stress reactivity has repeatedly been reported in patients suffering from psychiatric diseases including schizophrenia and major depression. These disorders also have other symptoms in common, such as cognitive deficits and psychotic-like behavior. We have therefore investigated if increased stress reactivity is associated with these phenotypic endpoints in an animal model of affective disorders. The stress reactivity mouse model used in this study consists of three CD-1-derived mouse lines, that have been selectively bred for high (HR), intermediate (IR) or low (LR) stress reactivity. Male mice from these three breeding lines were subjected to a reversal learning task and latent inhibition (Li) was assessed using a conditioned taste aversion paradigm. Furthermore, as the dopaminergic system is involved in both Li and reversal learning, the dopamine 1 receptor (D1R), dopamine 2 receptor (D2R) and dopamine transporter (DAT) mRNA expression levels were assessed in relevant brain areas of these animals. The results demonstrate that HR mice show perseveration in the reversal learning task and have disrupted Li. Furthermore, compared to LR mice, HR mice have decreased D2R mRNA levels in the ventral tegmental area, as well as decreased D1R mRNA levels in the cingulate cortex, and an increased expression of D2R mRNA in the nucleus accumbens. Taken together, these results demonstrate that the HR mice display cognitive deficits associated with psychotic-like behavior, similar to those observed in patients suffering from schizophrenia and major depression and could be utilized in the search for better treatment strategies for these symptoms of psychiatric disorders.

  19. The catatonia conundrum: evidence of psychomotor phenomena as a symptom dimension in psychotic disorders.

    Science.gov (United States)

    Ungvari, Gabor S; Caroff, Stanley N; Gerevich, Jozsef

    2010-03-01

    To provide a rational basis for reconceptualizing catatonia in Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), we briefly review historical sources, the psychopathology of catatonia, and the relevance of catatonic schizophrenia in contemporary practice and research. In contrast to Kahlbaum, Kraepelin and others (Jaspers, Kleist, and Schneider) recognized the prevalence of motor symptoms in diverse psychiatric disorders but concluded that the unique pattern and persistence of certain psychomotor phenomena defined a "catatonic" subtype of schizophrenia, based on intensive long-term studies. The enduring controversy and confusion that ensued underscores the fact that the main problem with catatonia is not just its place in Diagnostic and Statistical Manual of Mental Disorders but rather its lack of conceptual clarity. There still are no accepted principles on what makes a symptom catatonic and no consensus on which signs and symptoms constitute a catatonic syndrome. The resulting heterogeneity is reflected in treatment studies that show that stuporous catatonia in any acute disorder responds to benzodiazepines or electroconvulsive therapy, whereas catatonia in the context of chronic schizophrenia is phenomenologically different and less responsive to either modality. Although psychomotor phenomena are an intrinsic feature of acute and especially chronic schizophrenia, they are insufficiently recognized in practice and research but may have significant implications for treatment outcome and neurobiological studies. While devising a separate category of catatonia as a nonspecific syndrome has heuristic value, it may be equally if not more important to re-examine the psychopathological basis for defining psychomotor symptoms as catatonic and to re-establish psychomotor phenomena as a fundamental symptom dimension or criterion for both psychotic and mood disorders.

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

    Science.gov (United States)

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

    2017-04-01

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

  1. Lifetime presence of psychotic symptoms in bipolar disorder is associated with less favorable socio-demographic and certain clinical features.

    Science.gov (United States)

    Dell'Osso, Bernardo; Camuri, Giulia; Cremaschi, Laura; Dobrea, Cristina; Buoli, Massimiliano; Ketter, Terence A; Altamura, A Carlo

    2017-07-01

    The presence of psychotic symptoms in bipolar disorder (BD) is considered a feature of higher severity of illness and, in particular, of manic episodes in bipolar I disorder (BD I). However, the possibility to apply the "with psychotic features" specifier to major depressive episodes in either bipolar II disorder (BD II) or BD I highlights the need for additional research in this area. The present study assessed the lifetime presence of psychotic symptoms and related socio-demographic and clinical features in a large sample of BD patients (N=360), with (BDPs, N=207) and without a lifetime history of psychosis (BDNPs, N=153). An overall less favorable socio-demographic profile was observed in BDPs vs BDNPs. In terms of clinical variables, BDPs vs BDNPs had: earlier age at onset (27.7±10.5 vs 30.1±12.3years; p=0.02), higher rates of BD I diagnosis (95.7% vs 45.8%; psocio-demographic and certain clinical characteristics associated with the lifetime presence of psychotic symptoms in bipolar patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Continuum beliefs about psychotic symptoms are a valid, unidimensional construct: Construction and validation of a revised continuum beliefs questionnaire.

    Science.gov (United States)

    Schlier, Björn; Scheunemann, Jakob; Lincoln, Tania M

    2016-07-30

    Growing evidence supports a continuum model of psychosis, with mild psychotic symptoms being frequently experienced by the general population. Moreover, believing in the continuum model correlates with less stigmatization of schizophrenia. This study explores whether continuum beliefs are a valid construct and develops a continuum beliefs scale. First, expert-generated items were reduced to a candidate scale (study 1, n=95). One-dimensionality was tested using confirmatory factor analysis (study 2, n=363). Convergent validity was tested with a previous continuum beliefs scale, essentialist beliefs, and stigmatization (study 2), while self-reported psychotic experiences (i.e. frequency and conviction) served to test discriminant validity (study 3, n=229). A nine item questionnaire that assesses continuum beliefs about schizophrenia symptoms showed acceptable to good psychometric values, high correlations with a previous continuum beliefs scale and small correlations with essentialist beliefs, stereotypes, and desired social distance. No correlations with psychotic experiences were found. Thus, continuum beliefs can be considered a valid construct. The construed CBQ-R asks about symptoms rather than the abstract category "schizophrenia", which may increase understandability of the scale. Validation confirms previous studies and highlights the difference between continuum beliefs and personal psychotic experiences.

  3. "Attenuated psychotic symptoms syndrome" as a risk syndrome of psychosis, diagnosis in DSM-V: The debate.

    Science.gov (United States)

    Shrivastava, Amresh; McGorry, P D; Tsuang, Ming; Woods, Scott W; Cornblatt, Barbara A; Corcoran, Cheryl; Carpenter, William

    2011-01-01

    Schizophrenia is a common disorder, affecting approximately 1 out of every 100 people, with a typical onset during adolescence and early adulthood. The personal and societal costs of schizophrenia are extremely high. Prevention of schizophrenia, would offer substantial benefits to patients, their family members, and the community at large. The prodromal phase of schizophrenia has been recognized since the 19th century. At-risk individuals for psychosis and schizophrenia are the subjects who can provide information for intervention prior to development of frank psychosis. This approach is currently being investigated. The question remains, however, whether it can be a diagnostic category by itself. The proposal for including the risk syndrome is one of the recommendations by the working group on schizophrenia and psychotic disorders for the forthcoming DSM-V. There are differing views in academia regarding this proposal. Prior to becoming fully psychotic, a consistent literature demonstrates that patients generally had suffered from accelerating attenuated symptoms and distress. It is important that the prodromal phase be accurately recognized in order to accomplish the goal of prevention. We can then purposefully engage in early intervention aiming toward prevention. A recent strong resurgent interest in this area stems largely from two developments: First, the identification of the neurobiological deficit processes associated with the severity and chronicity of schizophrenia, and second, the development of reliable criteria for diagnosis. Although the general at-risk construct appears to offer great potential to advance both the treatment and research dealing with psychotic illnesses, it seems premature to many researchers to include the syndrome as an established entity in the text of the new DSM-V. It would be far more appropriate to include this proposed syndrome in the appendix and evaluate the many contemporary issues in future studies. The main issues

  4. Symptom severity scale of the DSM5 for schizophrenia, and other psychotic disorders: diagnostic validity and clinical feasibility.

    Science.gov (United States)

    Ritsner, Michael S; Mar, Maria; Arbitman, Marina; Grinshpoon, Alexander

    2013-06-30

    Innovations in DSM5 include dimensional diagnosis of schizophrenia (SZ) and other psychotic (OP) disorders using the symptom severity scale (SS-DSM5). We evaluated the psychometric properties and diagnostic validity of the SS-DSM5 scale using a cross-sectional design and an unselected convenience unselected sample of 314 inpatients and outpatients with SZ/OP and mood disorders who received standard care in routine clinical practice. The SS-DSM5 scale, the Clinical Global Impression-Severity scale (CGI-S), the Positive and Negative Syndrome Scale (PANSS), and the Bech-Rafaelsen Mania Scale (BRMS) were administered. Factor structure, reliability, internal consistency, convergent and diagnostic ability of the DSM5-SS were evaluated. Factor analysis indicated two latent factors underlying the SS-DSM5 (Psychotic and Deficit sub-scales). Cronbach's alpha was >0.70. Convergent validity of the SS-DSM5 was highly significant. Patients with SZ/PO disorders were correctly diagnosed (77.9%) using the SS-DSM5 scale (72% using PANSS). The agreement of the diagnostic decisions between the SS-DSM5 and PANSS was substantial for SZ/PO disorders (Kappa=0.75). Classifying participants with SZ/PO versus mood disorders using SS-DSM5 provided a sensitivity of 95%, and specificity of 34%. Thus, this study suggests that the SS-DSM5 has acceptable psychometric properties and that its use in clinical practice and research is feasible in clinical settings. The dimensional option for the diagnosis of schizophrenia and related disorders using SS-DSM5 is discussed.

  5. Multiple Sclerosis Presents with Psychotic Symptoms and Coexists with Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Muhammed Emin Özcan

    2014-01-01

    Full Text Available Multiple sclerosis (MS is a demyelinating disease of the central nervous system. Psychiatric symptoms are not infrequent during MS, yet onset of MS with psychosis is rarely encountered. A 27-year-old Caucasian male was admitted due to numbness in his right arm and difficulty in walking. His clinical and laboratorial exams lead to the MS diagnosis. Nine months earlier, he also developed psychotic disorder, not otherwise specified (PD-NOS. His sudden onset of PD-NOS, his rapid and complete response to antipsychotics, and a relatively short interval between psychiatric and neurological signs indicate a high likelihood that PD-NOS was a manifestation of underlying MS. He also suffers from hypertrophic obstructive cardiomyopathy (HOCM. The patient’s neurological complaints were recovered with methylprednisolone (1 g/day, i.v. given for five days. Glatiramer acetate (1 × 1 tb.s.c. was prescribed for consolidation and, after nine months of his admission, the patient fully recovered from neurological and psychiatric complaints. Interestingly, very recent studies indicate specific alpha-actinin antibodies in MS and alpha-actinin mutations cause HOCM. Thus, concurrence of MS with HOCM can be even a new syndrome, if further genetic studies prove.

  6. Psychotic symptoms are associated with physical health problems independently of a mental disorder diagnosis: results from the WHO World Health Survey.

    Science.gov (United States)

    Moreno, Carmen; Nuevo, Roberto; Chatterji, Somnath; Verdes, Emese; Arango, Celso; Ayuso-Mateos, José Luis

    2013-10-01

    This study explored whether physical health problems are related to psychotic symptoms independently of a mental disorder diagnosis. A total of 224,254 subjects recruited for the World Health Organization World Health Survey were subdivided into those with both a lifetime diagnosis of psychosis and at least one psychotic symptom in the 12 months prior to the evaluation, those with at least one psychotic symptom in the past 12 months but no lifetime diagnosis of psychosis, and those without psychotic symptoms in the past 12 months and without a lifetime diagnosis of psychosis. The three groups were compared for the presence of medical conditions, health problems, and access to health care. Medical conditions and health problems (angina, asthma, arthritis, tuberculosis, vision or hearing problems, mouth/teeth problems, alcohol consumption, smoking, and accidents), medication consumption, and hospital admissions (but not regular health care visits) were more frequent in individuals with psychotic symptoms but no psychosis diagnosis, compared to those with no symptoms and no diagnosis. The number of medical conditions increased with the number of psychotic symptoms. Given the sample analyzed, this trend seems to be independent from the socio-economic development of the country or the specific health care system.

  7. Early detection of psychotic disorders in adolescents: specificity of basic symptoms in psychiatric patient samples.

    Science.gov (United States)

    Resch, F; Koch, E; Möhler, E; Parzer, P; Brunner, R

    2002-01-01

    Based on the results of adult studies that have shown a subgroup of basic symptoms to have a predictive value for later schizophrenic disorder, a cross-sectional study on 36 schizophrenic and 75 nonschizophrenic adolescent psychiatric inpatients was performed to elucidate the specificity of prodromal signs in early age groups. The occurrence of any single basic symptom does not show schizophrenic specificity in adolescents, but the number of basic symptoms in the categories of the Bonn Scale for the Assessment of Basic Symptoms is increased in schizophrenic patients compared with subjects with other diagnoses. The interrelation between minus symptoms and cognitive symptoms exerts a higher amount of cognitive disturbances given a certain level of irritation in schizophrenic adolescents. With the help of odds ratios, the seven most discriminating cognitive items could be elucidated including perception, information processing and action tendency.

  8. Cognitive function in euthymic bipolar disorder (BP I) patients with a history of psychotic symptoms vs. schizophrenia.

    Science.gov (United States)

    Nenadic, Igor; Langbein, Kerstin; Dietzek, Maren; Forberg, Anne; Smesny, Stefan; Sauer, Heinrich

    2015-11-30

    Patients with bipolar disorder show cognitive deficits including executive function, which appear to be related to social functioning and outcome. However, subgroups within the spectrum as well as psychopathological features, current mood state/euthymia and disease stage might be confounding factors. We analysed data tests from the Wechsler Intelligence Scale (WIE), verbal fluency (COWA) and trail making tests (TMT-A and TMT-B) obtained in a selected subgroup of currently bipolar I disorder patients, who were currently euthymic and had a history of psychotic symptoms, and compared them to patients with schizophrenia (in remission) and healthy controls, all matched for age, gender, and handedness. Schizophrenia patients showed more severe cognitive impairment, including digit symbol and arithmetic tests, as well as TMT-B (compared to healthy controls), but bipolar patients had stronger impairment on the letter number sequencing test, an indicator of working memory and processing speed. There were no group effects on most verbal fluency tasks (except impairment of schizophrenia patients on one subscale of category fluency). Within the limitations of the study design, our results suggest that even in subgroups of presumably more severely impaired bipolar patients, some cognitive dimensions might achieve remission, possibly related to considerable state effects at testing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Schizophrenia-like psychotic symptoms in a patient with confirmed Huntington’s disease: A case report [Objawy psychotyczne sugerujące schizofrenię u pacjenta z potwierdzonym rozpoznaniem choroby Huntingtona – opis przypadku

    Directory of Open Access Journals (Sweden)

    Grabski, Bartosz

    2012-08-01

    Full Text Available Aim. The aim of this study is to discuss diagnostic and therapeutic challenges in a patient with a mutation in the gene responsible for the development of Huntington’s disease (HD who presented schizophrenia-like psychotic symptoms. Method. A case report. Results. A 35-year old man with genetically-confirmed HD who developed significant behavioural changes that occurred many years prior to the outbreak of choreic movements. There was a close temporal relationship between an onset of discrete involuntary movements and schizophrenia-like psychotic symptoms (delusions of persecution, reference and bodily change, as well as auditory pseudohallucinations of threatening and commanding voices. At admission (subsequently to a suicidal attempt he was ambivalent, ambitendent and – periodically – agitated. Pharmacotherapeutic regime of olanzapine (20 mg qd and amisulpride (400 mg qd led to a gradual improvement of the patient’s mental status. Conclusions. HD should always be included in the differential diagnosis of psychotic disorders. Patients with HD can exhibit various psychopathological symptoms (including psychotic ones prior to the outbreak of movement symptoms. Both neurologists and psychiatrists should take part in the therapeutic process. Atypical antipsychotics seem to be effective in the discussed group of patients (although the evidence body consists mainly of scarce, low-quality data.

  10. Distribution of response time, cortical, and cardiac correlates during emotional interference in persons with subclinical psychotic symptoms

    Directory of Open Access Journals (Sweden)

    Lisa Kathinka Barbara Holper

    2016-09-01

    Full Text Available A psychosis phenotype can be observed below the threshold of clinical detection. The study aimed to investigate whether subclinical psychotic symptoms are associated with deficits in controlling emotional interference, and whether cortical brain and cardiac correlates of these deficits can be detected using functional near-infrared spectroscopy (fNIRS. A data set derived from a community sample was obtained from the Zurich Program for Sustainable Development of Mental Health Services. 174 subjects (mean age 29.67 ± 6.41, 91 females were assigned to four groups ranging from low to high levels of subclinical psychotic symptoms (derived from the Symptom Checklist-90-R. Emotional interference was assessed using the emotional Stroop task comprising neutral, positive, and negative conditions. Statistical distributional methods based on delta plots (behavioral response time data and quantile analysis (fNIRS data were applied to evaluate the emotional interference effects.Results showed that both interference effects and disorder-specific (i.e., group-specific effects could be detected, based on behavioral response times, cortical hemodynamic signals (brain correlates, and heart rate variability (cardiac correlates. Subjects with high compared to low subclinical psychotic symptoms revealed significantly reduced amplitudes in dorsolateral prefrontal cortices (interference effect, p < 0.001 and middle temporal gyrus (disorder-specific group effect, p < 0.001, supported by behavioral and heart rate results. The present findings indicate that distributional analyses methods can support the detection of emotional interference effects in the emotional Stroop. The results suggested that subjects with high subclinical psychosis exhibit enhanced emotional interference effects. Based on these observations, subclinical psychosis may therefore prove to represent a valid extension of the clinical psychosis phenotype.

  11. Racial discrimination is associated with distressing subthreshold positive psychotic symptoms among US urban ethnic minority young adults.

    Science.gov (United States)

    Anglin, Deidre M; Lighty, Quenesha; Greenspoon, Michelle; Ellman, Lauren M

    2014-10-01

    Racial discrimination is related to depression, anxiety, and severe psychological distress, and evidence drawn from studies emanating from the United Kingdom and The Netherlands suggest racial discrimination is also related to clinical psychosis and subthreshold psychotic symptoms in racial and ethnic minority (REM) populations. The present study sought to determine the association between racial discrimination experiences and attenuated positive psychotic symptoms (APPS) in a United States (US) urban, predominantly immigrant and REM young adult population. A cohort of 650 young adults was administered a self-report inventory for psychosis risk [i.e., Prodromal Questionnaire (PQ)], and the Experiences of Discrimination Questionnaire. The PQ allowed the dimensional assessment of APPS, as well as the categorical assessment of a potentially "high risk" group (i.e., 8 or more APPS endorsed as distressing), the latter of which was based on previous validation studies using the structured interview for prodromal syndromes. The relations between self-reported racial discrimination and APPS, and racial discrimination and "high" distressing positive PQ endorsement were determined, while accounting for anxiety and depression symptoms. Racial discrimination was significantly associated with APPS and with significantly higher odds of endorsing eight or more distressing APPS, even after adjusting for anxiety and depression symptoms. The present study provides preliminary evidence that racial discrimination among US ethnic minorities may be associated with APPS, as well as potentially higher risk for psychosis.

  12. Hippocampal Temporal-Parietal Junction Interaction in the Production of Psychotic Symptoms: A Framework for Understanding the Schizophrenic Syndrome

    Directory of Open Access Journals (Sweden)

    Cynthia Gayle Wible

    2012-06-01

    Full Text Available A framework is described for understanding the schizophrenic syndrome at the brain systems level. It is hypothesized that over-activation of dynamic gesture and social perceptual processes in the temporal-parietal occipital junction (TPJ, posterior superior temporal sulcus (PSTS and surrounding regions produce the syndrome (including positive and negative symptoms, their prevalence, prodromal signs and cognitive deficits. Hippocampal system hyper-activity and atrophy have been consistently found in schizophrenia. Hippocampal activity is highly related to activity in the TPJ and may be a source of over-excitation of the TPJ and surrounding regions. Strong evidence for this comes from in-vivo recordings in humans during psychotic episodes. The TPJ and PSTS play a key role in the perception (and production of dynamic social, emotional and attentional gestures for the self and others (e.g., body/face/eye gestures, audiovisual speech, prosody. The single cell representation of dynamic gestures is multimodal (auditory, visual, tactile, matching the predominant hallucinatory categories in schizophrenia. Inherent in the single cell perceptual signal of dynamic gesture representations is a computation of intention, agency, and anticipation or expectancy (for the self and others. The neurons are also tuned or biased to detect threat related emotions. Abnormal over-activation in this system could produce the conscious hallucination of a voice (audiovisual speech, person or a touch. Over-activation could interfere with attentional/emotional gesture perception and production (negative symptoms. It could produce the unconscious feeling of being watched, followed or of a social situation unfolding along with accompanying perception of intent and agency inherent in those representations (delusions. Cognitive disturbances in attention, predictive social processing, agency, working memory, and a bias toward the perception of threat would also be predicted.

  13. TAILOR - tapered discontinuation versus maintenance therapy of antipsychotic medication in patients with newly diagnosed schizophrenia or persistent delusional disorder in remission of psychotic symptoms: study protocol for a randomized clinical trial.

    Science.gov (United States)

    Stürup, Anne Emilie; Jensen, Heidi Dorthe; Dolmer, Signe; Birk, Merete; Albert, Nikolai; Nielsen, Mai; Hjorthøj, Carsten; Eplov, Lene; Ebdrup, Bjørn H; Mors, Ole; Nordentoft, Merete

    2017-09-29

    The aim of the TAILOR trial is to investigate the effect of closely monitored tapering/discontinuation versus maintenance therapy with antipsychotic medication in patients with newly diagnosed schizophrenia or persistent delusional disorder and with minimum 3 months' remission of psychotic symptoms. Two hundred and fifty patients will be included from the psychiatric early intervention program, OPUS, in two regions in Denmark. Inclusion criteria are: ICD-10 diagnoses schizophrenia (F20, except F20.6) or persistent delusional disorder (F22), minimum 3 months' remission of psychotic symptoms and in treatment with antipsychotic medication (except clozapine). The patients will be randomized to maintenance therapy or tapering/discontinuation with antipsychotic medication in a 1-year intervention. The tapering/discontinuation group will be using a smartphone application to monitor early warning signs of psychotic relapse. Patients will be assessed at baseline, 1-, 2- and 5-year follow-up regarding psychotic and negative symptoms, side-effects of antipsychotic medication, social functioning, cognitive functioning, perceived health status, patient satisfaction, 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 of antipsychotic medication after 1-year intervention; antipsychotic dose; antipsychotic side effects; negative symptoms; social functioning; cognitive functioning; and patient satisfaction. Exploratory outcomes will include remission, clinical recovery, substance and alcohol use, sexual functioning, quality of life, self-beliefs of coping and user experience of support from health workers. Safety measures will include death, admissions to psychiatric hospital, severe self-harm and psychotic relapses. The TAILOR trial

  14. Race-based rejection sensitivity partially accounts for the relationship between racial discrimination and distressing attenuated positive psychotic symptoms.

    Science.gov (United States)

    Anglin, Deidre M; Greenspoon, Michelle; Lighty, Quenesha; Ellman, Lauren M

    2016-10-01

    Self-reported experiences of racial discrimination have been associated with a continuum of psychotic experiences in racial and ethnic minority populations; however, the underlying mechanisms of this relationship are not yet clear. Race-based rejection sensitivity (RS-race) has been associated with thought intrusions about being the target of racial discrimination; therefore, the present study aimed to determine whether RS-race accounts for the relationship between racial discrimination and psychotic-like experiences in racial and ethnic minority populations. A sample of 644 young adults from a US urban, predominantly immigrant, and racial and ethnic minority population was administered a self-report inventory of psychosis risk (i.e. Prodromal Questionnaire (PQ) ), providing a dimensional assessment of the total number of attenuated positive psychotic symptoms experienced as distressing (APPS-distress). Participants also completed the Experiences of Discrimination Questionnaire and the Rejection Sensitivity Questionnaire-Race. Hierarchical linear regression analyses revealed that RS-race and racial discrimination were both significantly related to higher levels of APPS-distress. Bootstrapping analyses of indirect effects indicated that RS-race partially accounted for the relationship between racial discrimination and APPS-distress. Although the cross-sectional nature of the data limits conclusions about causal inference, our findings do suggest that racial discrimination and RS-race may both be important for understanding risk for distress in the psychotic spectrum among racial and ethnic minority young adults. Some individuals who report racial discrimination may be more vulnerable to APPS-distress in part because they are anxiously anticipating being racially slighted, and this should be explored further in prospective clinical high-risk studies. © 2014 Wiley Publishing Asia Pty Ltd.

  15. The feasibility and validity of ambulatory self-report of psychotic symptoms using a smartphone software application

    Directory of Open Access Journals (Sweden)

    Palmier-Claus Jasper E

    2012-10-01

    Full Text Available Abstract Background Semi-structured interview scales for psychosis are the gold standard approach to assessing psychotic and other symptoms. However, such assessments have limitations such as recall bias, averaging, insensitivity to change and variable interrater reliability. Ambulant, real-time self-report assessment devices may hold advantages over interview measures, but it needs to be shown that the data thus collected are valid, and the collection method is acceptable, feasible and safe. We report on a monitoring system for the assessment of psychosis using smartphone technology. The primary aims were to: i assess validity through correlations of item responses with those on widely accepted interview assessments of psychosis, and ii examine compliance to the procedure in individuals with psychosis of varying severity. Methods A total of 44 participants (acute or remitted DSM-4 schizophrenia and related disorders, and prodromal completed 14 branching self-report items concerning key psychotic symptoms on a touch-screen mobile phone when prompted by an alarm at six pseudo-random times, each day, for one week. Face to face PANSS and CDS interviews were conducted before and after the assessment period blind to the ambulant data. Results Compliance as defined by completion of at least 33% of all possible data-points over seven days was 82%. In the 36 compliant participants, 5 items (delusions, hallucinations, suspiciousness, anxiety, hopelessness showed moderate to strong (rho 0.6-0.8 associations with corresponding items from interview rating scales. Four items showed no significant correlation with rating scales: each was an item based on observable behaviour. Ambulant ratings showed excellent test-retest reliability and sensitivity to change. Conclusions Ambulatory monitoring of symptoms several times daily using smartphone software applications represents a feasible and valid way of assessing psychotic phenomena for research and clinical

  16. Psychotic symptoms in anti-N-methyl-d-aspartate (NMDA) receptor encephalitis: A case report and challenges.

    Science.gov (United States)

    Sharma, Pawan; Sagar, Rajesh; Patra, Bichitrananda; Saini, Lokesh; Gulati, Sheffali; Chakrabarty, Biswaroop

    2016-08-01

    Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis, only recently first described, is an increasingly well-recognized inflammatory encephalitis that is seen in children and adults. An 11-year old girl admitted to the psychiatry ward with a presentation of acute psychosis was diagnosed with NMDA receptor encephalitis following neurology referral and was treated accordingly. This case highlights psychiatric manifestations in encephalitis and the need for the psychiatrist to have high index of suspicion when atypical symptoms (e.g., dyskinesia, seizure, fever etc.) present in acutely psychotic patients.

  17. Cognitive behavioral therapy in 22q11.2 microdeletion with psychotic symptoms: What do we learn from schizophrenia?

    Science.gov (United States)

    Demily, Caroline; Franck, Nicolas

    2016-11-01

    The 22q11.2 deletion syndrome (22q11.2DS) is one of the most common microdeletion syndromes, with a widely underestimated prevalence between 1 per 2000 and 1 per 6000. Since childhood, patients with 22q11.2DS are described as having difficulties to initiate and maintain peer relationships. This lack of social skills has been linked to attention deficits/hyperactivity disorder, anxiety and depression. A high incidence of psychosis and positive symptoms is observed in patients with 22q11.2DS and remains correlated with poor social functioning, anxiety and depressive symptoms. Because 22q11.2DS and schizophrenia share several major clinical features, 22q11.2DS is sometimes considered as a genetic model for schizophrenia. Surprisingly, almost no study suggests the use of cognitive and behavioral therapy (CBT) in this indication. We reviewed what should be learned from schizophrenia to develop specific intervention for 22q11.2DS. In our opinion, the first step of CBT approach in 22q11.2DS with psychotic symptoms is to identify precisely which tools can be used among the already available ones. Cognitive behavioral therapy (CBT) targets integrated disorders, i.e. reasoning biases and behavior disorders. In 22q11.2DS, CBT-targeted behavior disorders may take the form of social avoidance and withdrawal or, in the contrary, a more unusual disinhibition and aggressiveness. In our experience, other negative symptoms observed in 22q11.2DS, such as motivation deficit or anhedonia, may also be reduced by CBT. Controlled trials have been studying the benefits of CBT in schizophrenia and several meta-analyses proved its effectiveness. Therefore, it is legitimate to propose this tool in 22q11.2DS, considering symptoms similarities. Overall, CBT is the most effective psychosocial intervention on psychotic symptoms and remains a relevant complement to pharmacological treatments such as antipsychotics.

  18. 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).

  19. Cocaine-induced psychotic disorders: presentation, mechanism, and management.

    Science.gov (United States)

    Tang, Yilang; Martin, Nancy L; Cotes, Robert O

    2014-01-01

    Cocaine, the third mostly commonly used illicit drug in the United States, has a wide range of neuropsychiatric effects, including transient psychotic symptoms. When psychotic symptoms occur within a month of cocaine intoxication or withdrawal, the diagnosis is cocaine-induced psychotic disorder (CIPD). Current evidence suggests those with CIPD are likely to be male, have longer severity and duration of cocaine use, use intravenous cocaine, and have a lower body mass index. Differentiating CIPD from a primary psychotic disorder requires a detailed history of psychotic symptoms in relation to substance use and often a longitudinal assessment. Treatment includes providing a safe environment, managing agitation and psychosis, and addressing the underlying substance use disorder. This review begins with a clinical case and summarizes the literature on CIPD, including clinical presentation, differential diagnosis, mechanism and predictors of illness, and treatment.

  20. 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....

  1. 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....

  2. DSM-IV “criterion A” schizophrenia symptoms across ethnically different populations: evidence for differing psychotic symptom content or structural organization?

    Science.gov (United States)

    McLean, Duncan; Thara, Rangaswamy; John, Sujit; Barrett, Robert; Loa, Peter; McGrath, John; Mowry, Bryan

    2014-01-01

    There is significant variation in the expression of schizophrenia across ethnically different populations, and the optimal structural and diagnostic representation of schizophrenia is contested. We contrasted both lifetime frequencies of DSM-IV criterion A (the core symptom criterion of the internationally recognized DSM classification system) symptoms and types/content of delusions and hallucinations in transethnic schizophrenia populations from Australia (n=776), India (n=504) and Sarawak, Malaysia (n=259), to elucidate clinical heterogeneity. Differences in both criterion A symptom composition and symptom content were apparent. Indian individuals with schizophrenia reported negative symptoms more frequently than other sites, whereas individuals from Sarawak reported disorganized symptoms more frequently. Delusions of control and thought broadcast, insertion or withdrawal were less frequent in Sarawak than Australia. Curiously, a subgroup of 20 Indian individuals with schizophrenia reported no lifetime delusions or hallucinations. These findings potentially challenge the long-held view in psychiatry that schizophrenia is fundamentally similar across cultural groups, with differences in only the content of psychotic symptoms, but equivalence in structural form. PMID:24981830

  3. Two subdomains of negative symptoms in psychotic disorders : Established and confirmed in two large cohorts

    NARCIS (Netherlands)

    Liemburg, E.; Castelein, S.; Stewart, R.; van der Gaag, M.; Aleman, A.; Knegtering, H.

    2013-01-01

    Negative symptoms of schizophrenia are normally grouped into a single category. However, the diversity of such symptoms suggests that they are actually made up of more than one dimension. The DSM-V proposes two negative symptom domains, namely expressive deficits and avolition/asociality. We investi

  4. The effects of lifestyle interventions on (long-term) weight management, cardiometabolic risk and depressive symptoms in people with psychotic disorders : a meta-analysis

    NARCIS (Netherlands)

    Bruins, Jojanneke; Jörg, Frederike; Bruggeman, Richard; Slooff, C. J.; Corpeleijn, Eva; Pijnenborg, Marieke

    2014-01-01

    AIMS: The aim of this study was to estimate the effects of lifestyle interventions on bodyweight and other cardiometabolic risk factors in people with psychotic disorders. Additionally, the long-term effects on body weight and the effects on depressive symptoms were examined. MATERIAL AND METHODS: W

  5. Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders

    NARCIS (Netherlands)

    de Bont, P.A.J.M.; van den Berg, D.P.G.; van der Vleugel, B.M.; de Roos, C.; de Jongh, A.; van der Gaag, M.; van Minnen, A.M.

    2016-01-01

    Background. In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown Method. In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for

  6. Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: Effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders

    NARCIS (Netherlands)

    Bont, P.A.J.M. de; Berg, D.P.G. van den; Vleugel, B.M. van der; Roos, C.J.A.M. de; Jongh, A. de; Gaag, M. van der; Minnen, A. van

    2016-01-01

    Background: In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown Method: In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for

  7. 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.

  8. The effects of lifestyle interventions on (long-term) weight management, cardiometabolic risk and depressive symptoms in people with psychotic disorders : a meta-analysis

    NARCIS (Netherlands)

    Bruins, Jojanneke; Jörg, Frederike; Bruggeman, Richard; Slooff, C. J.; Corpeleijn, Eva; Pijnenborg, Marieke

    2014-01-01

    AIMS: The aim of this study was to estimate the effects of lifestyle interventions on bodyweight and other cardiometabolic risk factors in people with psychotic disorders. Additionally, the long-term effects on body weight and the effects on depressive symptoms were examined. MATERIAL AND METHODS:

  9. Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders

    NARCIS (Netherlands)

    de Bont, P.A.J.M.; van den Berg, D.P.G.; van der Vleugel, B.M.; de Roos, C.; de Jongh, A.; van der Gaag, M.; van Minnen, A.M.

    2016-01-01

    Background. In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown Method. In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for

  10. Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: Effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders

    NARCIS (Netherlands)

    Bont, P.A.J.M. de; Berg, D.P.G. van den; Vleugel, B.M. van der; Roos, C.J.A.M. de; Jongh, A. de; Gaag, M. van der; Minnen, A. van

    2016-01-01

    Background: In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown Method: In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for

  11. Common psychotic symptoms can be explained by the theory of ecological perception.

    Science.gov (United States)

    Golembiewski, Jan Alexander

    2012-01-01

    The symptoms of psychiatric illness are diverse, as are the causes of the conditions that cause them. Yet, regardless of the heterogeneity of cause and presentation, a great deal of symptoms can be explained by the failure of a single perceptual function--the reprocessing of ecological perception. It is a central tenet of the ecological theory of perception that we perceive opportunities to act. It has also been found that perception automatically causes actions and thoughts to occur unless this primary action pathway is inhibited. Inhibition allows perceptions to be reprocessed into more appropriate alternative actions and thoughts. Reprocessing of this kind takes place over the entire frontal lobe and it renders action optional. Choice about what action to take (if any) is the basis for the feeling of autonomy and ultimately for the sense-of-self. When thoughts and actions occur automatically (without choice) they appear to originate outside of the self, thereby providing prima facie evidence for some of the bizarre delusions that define schizophrenia such as delusional misidentification, delusions of control and Cotard's delusion. Automatic actions and thoughts are triggered by residual stimulation whenever reprocessing is insufficient to balance automatic excitatory cues (for whatever reason). These may not be noticed if they are neutral and therefore unimportant or where actions and thoughts have a positive bias and are desirable. Responses to negative stimulus, on the other hand, are always unwelcome, because the actions that are triggered will carry the negative bias. Automatic thoughts may include spontaneous positive feelings of love and joy, but automatic negative thoughts and visualisations are experienced as hallucinations. Not only do these feel like they emerge from elsewhere but they carry a negative bias (they are most commonly critical, rude and are irrationally paranoid). Automatic positive actions may include laughter and smiling and these are

  12. 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

    2017-06-08

    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.

  13. Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis

    Directory of Open Access Journals (Sweden)

    Haug Elisabeth

    2011-08-01

    Full Text Available Abstract Background Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. Method A total of 113 patients from the Thematically Organized Psychosis research study (TOP were included at first treatment. The Positive and Negative Syndrome Scale (PANSS was used to assess present symptoms. Premorbid adjustment was measured with the Premorbid Adjustment Scale (PAS and self-esteem by the Rosenberg Self-Esteem Scale (RSES. Results Premorbid social adjustment was significantly related to lower self-esteem and explained a significant proportion of the variance in self-esteem. Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression. Conclusion There are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, furthermore, that self-esteem is associated with the development of delusions and hallucinations.

  14. A pilot RCT of psychodynamic group art therapy for patients in acute psychotic episodes: feasibility, impact on symptoms and mentalising capacity.

    Science.gov (United States)

    Montag, Christiane; Haase, Laura; Seidel, Dorothea; Bayerl, Martin; Gallinat, Jürgen; Herrmann, Uwe; Dannecker, Karin

    2014-01-01

    This pilot study aimed to evaluate the feasibility of an assessor-blind, randomised controlled trial of psychodynamic art therapy for the treatment of patients with schizophrenia, and to generate preliminary data on the efficacy of this intervention during acute psychotic episodes. Fifty-eight inpatients with DSM-diagnoses of schizophrenia were randomised to either 12 twice-weekly sessions of psychodynamic group art therapy plus treatment as usual or to standard treatment alone. Primary outcome criteria were positive and negative psychotic and depressive symptoms as well as global assessment of functioning. Secondary outcomes were mentalising function, estimated with the Reading the mind in the eyes test and the Levels of emotional awareness scale, self-efficacy, locus of control, quality of life and satisfaction with care. Assessments were made at baseline, at post-treatment and at 12 weeks' follow-up. At 12 weeks, 55% of patients randomised to art therapy, and 66% of patients receiving treatment as usual were examined. In the per-protocol sample, art therapy was associated with a significantly greater mean reduction of positive symptoms and improved psychosocial functioning at post-treatment and follow-up, and with a greater mean reduction of negative symptoms at follow-up compared to standard treatment. The significant reduction of positive symptoms at post-treatment was maintained in an attempted intention-to-treat analysis. There were no group differences regarding depressive symptoms. Of secondary outcome parameters, patients in the art therapy group showed a significant improvement in levels of emotional awareness, and particularly in their ability to reflect about others' emotional mental states. This is one of the first randomised controlled trials on psychodynamic group art therapy for patients with acute psychotic episodes receiving hospital treatment. Results prove the feasibility of trials on art therapy during acute psychotic episodes and justify

  15. A pilot RCT of psychodynamic group art therapy for patients in acute psychotic episodes: feasibility, impact on symptoms and mentalising capacity.

    Directory of Open Access Journals (Sweden)

    Christiane Montag

    Full Text Available This pilot study aimed to evaluate the feasibility of an assessor-blind, randomised controlled trial of psychodynamic art therapy for the treatment of patients with schizophrenia, and to generate preliminary data on the efficacy of this intervention during acute psychotic episodes. Fifty-eight inpatients with DSM-diagnoses of schizophrenia were randomised to either 12 twice-weekly sessions of psychodynamic group art therapy plus treatment as usual or to standard treatment alone. Primary outcome criteria were positive and negative psychotic and depressive symptoms as well as global assessment of functioning. Secondary outcomes were mentalising function, estimated with the Reading the mind in the eyes test and the Levels of emotional awareness scale, self-efficacy, locus of control, quality of life and satisfaction with care. Assessments were made at baseline, at post-treatment and at 12 weeks' follow-up. At 12 weeks, 55% of patients randomised to art therapy, and 66% of patients receiving treatment as usual were examined. In the per-protocol sample, art therapy was associated with a significantly greater mean reduction of positive symptoms and improved psychosocial functioning at post-treatment and follow-up, and with a greater mean reduction of negative symptoms at follow-up compared to standard treatment. The significant reduction of positive symptoms at post-treatment was maintained in an attempted intention-to-treat analysis. There were no group differences regarding depressive symptoms. Of secondary outcome parameters, patients in the art therapy group showed a significant improvement in levels of emotional awareness, and particularly in their ability to reflect about others' emotional mental states. This is one of the first randomised controlled trials on psychodynamic group art therapy for patients with acute psychotic episodes receiving hospital treatment. Results prove the feasibility of trials on art therapy during acute psychotic

  16. WCST Performance in Schizophrenia and Severe Depression with Psychotic Features

    National Research Council Canada - National Science Library

    Rady, Ahmed; Elsheshai, Adel; Abou El Wafa, Heba; Elkholy, Osama

    2012-01-01

    .... Both share psychotic features and severe impairment in occupational functions. Severe psychomotor retardation, not uncommon in psychotic depression, may simulate negative symptoms of schizophrenia...

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

    Directory of Open Access Journals (Sweden)

    Sheridan Rains Luke

    2012-08-01

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

  18. Psychotic symptoms in patients undergoing coronary artery bypass grafting and heart valve operation

    NARCIS (Netherlands)

    Giltay, Erik J.; Huijskes, Raymond V. H. R.; Kho, King H.; Blansjaar, Ben A.; Rosseel, Peter M. J.

    Objective: Delirium on internal medicine and surgical wards of the general hospital is associated with several predisposing and precipitating factors as well as adverse outcomes. Whether psychosis, the symptom of delirium that may be recognized most promptly, is similarly associated with these

  19. Cortical thickness in individuals with non-clinical and clinical psychotic symptoms

    NARCIS (Netherlands)

    van Lutterveld, Remko; van den Heuvel, Martijn P.; Diederen, Kelly M. J.; de Weijer, Antoin D.; Begemann, Marieke J. H.; Brouwer, Rachel M.; Daalman, Kirstin; Blom, Jan Dirk; Kahn, Rene S.; Sommer, Iris E.

    2014-01-01

    Symptoms that are linked to psychosis are also experienced by individuals who are not in need of care. In the present study, cortical thickness was investigated in these individuals. Fifty individuals with non-clinical auditory verbal hallucinations (most of them also experienced other non-clinical

  20. Psychotic Disorders

    Science.gov (United States)

    Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch ... is not there. Schizophrenia is one type of psychotic disorder. People with bipolar disorder may also have ...

  1. Psychotic-affective symptoms and multiple system atrophy expand phenotypes of spinocerebellar ataxia type 2

    OpenAIRE

    Chen, Kai-Hsiang; Lin, Chin-Hsien; Wu, Ruey-Meei

    2012-01-01

    Spinocerebellar ataxia type 2 (SCA2) is a progressive neurodegenerative disorder, characterised by ataxic gait, slow saccades and peripheral neuropathy. Levodopa-responsive parkinsonism could be a clinical phenotype of SCA2, especially those of Chinese origin. In addition to these motor symptoms, SCA2 has been associated with depression and cognitive dysfunction, with only rare reports of psychosis. The authors report the presence of severe psychosis, major depression and multiple system atro...

  2. MAJOR DEPRESSIVE DISORDER WITHOUT PSYCHOTIC SYMPTOMS IN CHILDREN UNDER THE AGE OF 14 YEAR-OLD RAPE VICTIM.

    Directory of Open Access Journals (Sweden)

    Andika Metrisiawan

    2014-02-01

    Full Text Available Depression is a very large impact on the global disease that affects people worldwide.Lately, an estimated 350 million people suffering from depression. The World MentalHealth Survey in 17 countries stated that 1 in 20 people who reported experiencing adepressive episode in the last 1 year. Depressive disorders often appear early in life andcauses a decrease in a person's interest and often recurrent. For this reason it is said thatdepression is the leading cause of disability in relation to total annual loss due to disability.Therapy should be given a basic psychosocial support combined with antidepressantmedication or psychotherapy such as cognitive behavioral therapy, interpersonal psychotherapy or problem-solving treatment. This case report discusses the severe depression without psychotic symptoms in children under the age of 14 year-old rapevictim. In addition to the victim made an approach to the development of psychological 1 therapy is also given in the form of Psychotherapy and Pharmacotherapy ie 1 x 20 mgfluoxetine oral and Benzodiazepine 1 x 10 mg orally. 

  3. Oxytocin model of formation of psychotic symptoms and its implications for research on oxytocinergic pathway in schizophrenia

    Directory of Open Access Journals (Sweden)

    Holka-Pokorska, Justyna

    2014-02-01

    Full Text Available There are more and more data to support the dysregulation of the oxytocinergic pathway in schizophrenia. The development of the above branch of knowledge began to evolve alongside the mainstream of studies concerning gene polymorphisms for dopaminergic, glutamatergic and serotoninergic systems. Both experimental studies and clinical trials have demonstrated an antipsychotic effect of oxytocin. Starting with the pioneering neuroendocrinobehavioral experiment which demonstrated that oxytocin nasal spray increases the level of trust in healthy volunteers dozens of experiments were carried out confirming the modulatory role of oxytocin for the recognition of emotion, social memory, pro-social behaviours, collaborative behaviours and behaviours that require generosity and altruism. According to ,oxytocin model’ of development of psychotic symptoms – oxytocinergic system dysregulation may affect the incorrect attribution of meaning of emotional information from the environment. This can be manifested in the form of social cognition dysfunction and leads to abnormal social behaviour as withdrawal from social contact, isolation and formulation of paranoid delusions. From the clinical psychiatry point of view it became crucially need for research on selective oxytocin receptor agonists, as they may be used in the treatment of diseases which manifest in social withdrawal, lack of trust and the absence of affiliation behaviour as in schizophrenia.

  4. Plasma levels of brain derived-neurotrophic factor and catecholamine metabolites are increased during active phase of psychotic symptoms in CNS lupus: a case report.

    Science.gov (United States)

    Ikenouchi, Atsuko; Yoshimura, Reiji; Ikemura, Naomi; Utsunomiya, Kensuke; Mitoma, Masae; Nakamura, Jun

    2006-09-30

    In the present study, the authors reported a case of systemic lupus erythematosus (SLE) with central nervous system involvement (CNS lupus). The authors also longitudinally investigated plasma levels of brain-derived neurotrophic factor (BDNF) and catecholamine metabolites in the patient, and found that plasma levels of BDNF, 3-methoxy-4-hydroxyphenylglycol (MHPG), and homovanillic acid (HVA) were raised in accordance with the severity of psychotic symptoms in this case of CNS lupus. These results suggest that it is useful to measure plasma levels of BDNF and the catecholamine metabolites in order to predict the severity of psychotic symptoms in CNS lupus and to provide a differential diagnosis from that of steroid-induced psychosis.

  5. Neural correlates of aberrant emotional salience predict psychotic symptoms and global functioning in high-risk and first-episode psychosis

    OpenAIRE

    Modinos, Gemma; Tseng, Huai-Hsuan; Falkenberg, Irina; Samson, Carly; McGuire, Philip; Allen, Paul

    2015-01-01

    Neurobiological and behavioral findings suggest that psychosis is associated with corticolimbic hyperactivity during the processing of emotional salience. This has not been widely studied in the early stages of psychosis, and the impact of these abnormalities on psychotic symptoms and global functioning is unknown. We sought to address this issue in 18 patients with first-episode psychosis (FEP), 18 individuals at ultra high risk of psychosis (UHR) and 22 healthy controls (HCs). Corticolimbic...

  6. Direct association between orbitofrontal atrophy and the response of psychotic symptoms to olanzapine in schizophrenia.

    Science.gov (United States)

    Molina, Vicente; Sanz, Javier; Benito, Carlos; Palomo, Tomás

    2004-07-01

    The study of cerebral variables associated with response to neuroleptics holds interest from both theoretical and clinical points of view. To date, no studies have aimed to identify predictors of response to olanzapine based on cerebral measurements. Here, we used magnetic resonance to assess the relationship between volumes of the prefrontal (dorsolateral and orbitofrontal) and temporal (temporal lobe and hippocampus) cortical regions and ventricles and, on the other hand, the response to olanzapine in 16 schizophrenic patients. Data from 42 healthy controls were used to calculate volume residuals in the patients, defined as deviations from the expected values, given individual age and intracranial volume. Residuals thus represent the effect of illness on regional measurements. The association between clinical change and those residuals was calculated separately for the positive, negative and total scores from the Positive and Negative Syndrome Scale (PANSS). There was a significant direct association between the degree of orbitofrontal atrophy and the improvement of positive symptoms with olanzapine. No predictors were found for change in the negative dimension. A trend was found for patients with larger ventricles to show a greater global decrease in total PANSS scores. Neither age nor duration of illness explained a significant proportion of the symptom improvement. This result, together with others from the literature, supports the idea that atypical antipsychotics may offer some benefit to patients with significant regional atrophy, and this may have implications for the choice of antipsychotic in clinical practice.

  7. Cannabis Use Is Associated With Increased Psychotic Symptoms and Poorer Psychosocial Functioning in First-Episode Psychosis: A Report From the UK National EDEN Study.

    Science.gov (United States)

    Seddon, Jennifer L; Birchwood, Max; Copello, Alex; Everard, Linda; Jones, Peter B; Fowler, David; Amos, Tim; Freemantle, Nick; Sharma, Vimal; Marshall, Max; Singh, Swaran P

    2016-05-01

    The use of cannabis during the early stage of psychosis has been linked with increased psychotic symptoms. This study aimed to examine the use of cannabis in the 12 months following a first-episode of psychosis (FEP) and the link with symptomatic course and outcome over 1 year post psychosis onset. One thousand twenty-seven FEP patients were recruited upon inception to specialized early intervention services (EIS) for psychosis in the United Kingdom. Participants completed assessments at baseline, 6 and 12 months. The results indicate that the use of cannabis was significantly associated with increased severity of psychotic symptoms, mania, depression and poorer psychosocial functioning. Continued use of cannabis following the FEP was associated with poorer outcome at 1 year for Positive and Negative Syndrome Scale total score, negative psychotic symptoms, depression and psychosocial functioning, an effect not explained by age, gender, duration of untreated psychosis, age of psychosis onset, ethnicity or other substance use. This is the largest cohort study of FEP patients receiving care within EIS. Cannabis use, particularly "continued use," was associated with poorer symptomatic and functional outcome during the FEP. The results highlight the need for effective and early intervention for cannabis use in FEP. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  8. Antipsychotic medication and remission of psychotic symptoms 10years after a first-episode psychosis

    DEFF Research Database (Denmark)

    Wils, Regitze Sølling; Gotfredsen, Ditte Resendal; Hjorthøj, Carsten

    2017-01-01

    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...

  9. Relevance of Five-Factor Model personality traits for obsessive-compulsive symptoms in patients with psychotic disorders and their un-affected siblings.

    Science.gov (United States)

    Schirmbeck, Frederike; Boyette, Lindy-Lou; van der Valk, Renate; Meijer, Carin; Dingemans, Peter; Van, Rien; de Haan, Lieuwe; Kahn, René S; de Haan, Lieuwe; van Os, Jim; Wiersma, Durk; Bruggeman, Richard; Cahn, Wiepke; Meijer, Carin; Myin-Germeys, Inez

    2015-02-28

    High rates of obsessive-compulsive symptoms (OCS) in schizophrenia require pathogenic explanations. Personality traits may represent risk and resiliency factors for the development of mental disorders and their comorbidities. The aim of the present study was to explore the associations between Five-Factor Model (FFM) personality traits and the liability for OCS in patients with psychotic disorders and in their un-affected siblings. FFM traits, occurrence and severity of OCS and (subclinical) psychotic symptoms were assessed in 208 patients and in 281 siblings. Differences in FFM traits between participants with vs. without comorbid OCS were examined and the predictive value of FFM traits on group categorization was evaluated. Associations between FFM traits and OCS severity were investigated. Patients and siblings with OCS showed significantly higher Neuroticism compared to their counterparts without OCS. Neuroticism was positively associated with higher OCS severity and significantly predicted group assignment in both patients and in siblings. Patients with comorbid OCS presented with lower scores on Extraversion and Conscientiousness. Higher Neuroticism, and to a lesser degree lower Extraversion and Conscientiousness might add to the vulnerability of patients with a psychotic disorder to also develop OCS. Future prospective studies are needed to elucidate proposed personality-psychopathology interrelations and possible mediating factors.

  10. 20 CFR 220.114 - Evaluation of symptoms, including pain.

    Science.gov (United States)

    2010-04-01

    ... a determination as to the intensity, persistence, or functionally limiting effects of the claimant's... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Evaluation of symptoms, including pain. 220.114 Section 220.114 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE...

  11. A STUDY ON THE EFFICACY OF SIDHARTHAKADI YOGA IN THE MANAGEMENT OF MANIA WITHOUT PSYCHOTIC SYMPTOMS-AN UNCONTROLLED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    T.S. Manikandan

    2012-12-01

    Full Text Available Psychiatry in Ayurveda is called Bhootavidya. All mental disorders come under bhootavidya. Various types of treatment modalities are described in Ayurvedic classics for mental disorders. They include spiritual healing, psychotherapy and pharmacotherapy. Ayurvedic treatment is based on balancing of humors of body and mind. So, adverse effects are comparatively less.But, only a few of the formulations and treatment modalities are in practice today. There is much to be studied on. One among them is Sidharthakadi Yoga. The indication is in graha especially Asuragraha. Asuragraha has features like anger, hyperactivity, grandiosity and overconfidence. One of the disorders similar to this in modern psychiatry is mania. It is based on this view point, the present study was conducted. Sidharthakadi Yoga is prepared in two forms-as gutika for nasya and as tablet for intake. The study was conducted on 20 subjects. Nasya with Sidharthakadi Gutika was done for 7 days and tablets were given for intake for 30 days (3 tabs twice daily after the course of nasya. Assessment was done before nasya, after 7 days of nasya and after 30 days of tablet intake. The assessment was done with Young Mania Rating Scale. It was observed that Sidharthakadi Yoga has significant effect in the management of mania without psychotic symptoms.

  12. Acupuncture Alleviated the Nonmotor Symptoms of Parkinson’s Disease including Pain, Depression, and Autonomic Symptoms

    OpenAIRE

    Chifumi Iseki; Taiga Furuta; Masao Suzuki; Shingo Koyama; Keiji Suzuki; Tomoko Suzuki; Akiyo Kaneko; Tadamichi Mitsuma

    2014-01-01

    A woman started to feel intractable pain on her lower legs when she was 76. At the age of 78, she was diagnosed as having Parkinson’s disease (PD). The leg pain was suspected to be a symptom of PD after eliminating other causes. The patient also suffered from nonmotor symptoms, depression, anxiety, hot flashes, and paroxysmal sweating. Though the patient had received pharmacotherapy including levodopa for 5 years, she still suffered from the nonmotor symptoms and was referred to our departmen...

  13. Personality and psychotic symptoms as predictors of self-harm and attempted suicide.

    Science.gov (United States)

    Del Bello, Valentina; Verdolini, Norma; Pauselli, Luca; Attademo, Luigi; Bernardini, Francesco; Quartesan, Roberto; Moretti, Patrizia

    2015-09-01

    Nonfatal suicidal behaviours (NSB), including suicide ideation, suicide plan and suicide attempt, constitute a serious problem for public healthcare services. Suicide gesture (SG) which refers to self-injurious behaviour with no intent to die, differs from NSB in a variety of important ways. The aim of this study was to investigate demographic and clinical characteristics of NSB and SG to examine whether self-injurers with intent to die differ significantly from self injurers without such intent. All admissions for NSB and SG to the Psychiatric Inpatient Unit of University / General Hospital Santa Maria della Misericordia, Perugia, Umbria, Italy, from January 2015 to June 2015 were included in a medical record review. Basic descriptive statistics and distributional properties of all variables were first examined. Bivariate analyses were performed using Chi-square tests for group comparisons and t-test for independent samples used when appropriated. The study sample included 38 patients. Of these 23 had committed NSB (13.1%), 15 had commetted SG (8.5%). Number of married NSB was significantly higher than the number of married SG (p=0.08). We found a significant difference between NSB and SG related to the item of impulse control that was poorer in SG than NSB (p=0.010). BPRS items of hostility (p=0.082), suspiciousness (p=0.042) and excitement (p=0.02) were found to be significantly higher in SG than NSB. Borderline personality disorder (p=0.032) and Passive-Aggressive personality disorder (p=0,082) diagnosed by the means of the SCID-II, were more represented in SG than NSB (p=0.044). Schizoid personality disorder was significantly related to NSB (p=0.042). No others significant differences were found. NSB and SG are different for many psychopathological characteristics. These results confirm the importance of classifying individuals on the basis of the intent to die. Additional research is needed to understand and elucidate psychopatological and clinical

  14. Severe Psychotic Disorder as the Main Manifestation of Adrenal Insufficiency

    Science.gov (United States)

    Farah, Julia de Lima; Lauand, Carolina Villar; Chequi, Lucas; Fortunato, Enrico; Pasqualino, Felipe; Bignotto, Luis Henrique; Batista, Rafael Loch; Aprahamian, Ivan

    2015-01-01

    We describe a case of severe psychotic disorder as the only manifestation of primary adrenal insufficiency. A 63-year-old man presented with psychotic symptoms without any prior psychiatric history. During the clinical and laboratorial investigation, exams revealed a normovolemic hyponatremia. The patient showed no other clinical signs or symptoms compatible with adrenal insufficiency but displayed very high ACTH and low serum cortisol concentrations. Brain magnetic resonance imaging showed no significant changes, including the pituitary gland. The patient was initially treated with intravenous corticosteroids, resulting in rapid remission of the psychotic symptoms. The association between adrenal insufficiency and neuropsychiatric symptoms is rare but these symptoms can often be the first clinical presentation of the disease. PMID:25954562

  15. Severe Psychotic Disorder as the Main Manifestation of Adrenal Insufficiency

    Directory of Open Access Journals (Sweden)

    Julia de Lima Farah

    2015-01-01

    Full Text Available We describe a case of severe psychotic disorder as the only manifestation of primary adrenal insufficiency. A 63-year-old man presented with psychotic symptoms without any prior psychiatric history. During the clinical and laboratorial investigation, exams revealed a normovolemic hyponatremia. The patient showed no other clinical signs or symptoms compatible with adrenal insufficiency but displayed very high ACTH and low serum cortisol concentrations. Brain magnetic resonance imaging showed no significant changes, including the pituitary gland. The patient was initially treated with intravenous corticosteroids, resulting in rapid remission of the psychotic symptoms. The association between adrenal insufficiency and neuropsychiatric symptoms is rare but these symptoms can often be the first clinical presentation of the disease.

  16. 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

    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

  17. 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

  18. Cognitive behavioural therapy versus supportive therapy for persistent positive symptoms in psychotic disorders: The POSITIVE Study, a multicenter, prospective, single-blind, randomised controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Sartory Gudrun

    2010-12-01

    Full Text Available Abstract Background It has been demonstrated that cognitive behavioural therapy (CBT has a moderate effect on symptom reduction and on general well being of patients suffering from psychosis. However, questions regarding the specific efficacy of CBT, the treatment safety, the cost-effectiveness, and the moderators and mediators of treatment effects are still a major issue. The major objective of this trial is to investigate whether CBT is specifically efficacious in reducing positive symptoms when compared with non-specific supportive therapy (ST which does not implement CBT-techniques but provides comparable therapeutic attention. Methods/Design The POSITIVE study is a multicenter, prospective, single-blind, parallel group, randomised clinical trial, comparing CBT and ST with respect to the efficacy in reducing positive symptoms in psychotic disorders. CBT as well as ST consist of 20 sessions altogether, 165 participants receiving CBT and 165 participants receiving ST. Major methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, analysis by intention to treat, data management using remote data entry, measures of quality assurance (e.g. on-site monitoring with source data verification, regular query process, advanced statistical analysis, manualized treatment, checks of adherence and competence of therapists. Research relating the psychotherapy process with outcome, neurobiological research addressing basic questions of delusion formation using fMRI and neuropsychological assessment and treatment research investigating adaptations of CBT for adolescents is combined in this network. Problems of transfer into routine clinical care will be identified and addressed by a project focusing on cost efficiency. Discussion This clinical trial is part of efforts to intensify psychotherapy research in the field of psychosis in Germany, to contribute to the

  19. 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

  20. The 22Q11.2 Deletion in Children: High Rate of Autistic Disorders and Early Onset of Psychotic Symptoms

    Science.gov (United States)

    Vorstman, Jacob A. S.; Morcus, Monique E. J.; Duijff, Sasja N.; Klaassen, Petra W. J.; Heineman-de, Josien A.; Beemer, Frits A.; Swaab, Hanna; Kahn, Rene S.; van Engeland, Herman

    2006-01-01

    Objective: To examine psychopathology and influence of intelligence level on psychiatric symptoms in children with the 22q11.2 deletion syndrome (22q11DS). Method: Sixty patients, ages 9 through 18 years, were evaluated. Assessments followed standard protocols, including structured and semistructured interviews of parents, videotaped psychiatric…

  1. Should the space of basic personality traits be extended to include the disposition toward psychotic-like experiences?

    Directory of Open Access Journals (Sweden)

    Međedović Janko

    2014-01-01

    Full Text Available Previous research has shown that there is a latent disposition toward psychotic-like experiences in the general population, labeled schizotypy. However, there is a dispute over the conceptual status of schizotypy: does it represent merely psychosis proneness, or is it a broad and general personality trait? If a disposition should be regarded even as a candidate for a personality trait, its scores would probably be distributed normally in the population and it must show irreducibility in regard to the previously discovered personality traits. In this research, these questions are addressed, using the construct of Disintegration as an operationalization of schizotypy. The results show that although some modalities of Disintegration have skewed distributions in the student sample (N=345, 65% female, the global Disintegration scores have a normal distribution. Furthermore, Disintegration modalities constitute a latent component which is distinct from the personality traits that form HEXACO model of basic personality structure. Nevertheless, Disintegration shares some variance with the HEXACO traits, especially with the negative poles of Extraversion and Conscientiousness. The results suggest that a conceptual view of a schizotypy as a personality trait is at least plausible and they can be used as guidelines for future empirical studies of this problem. [Projekat Ministarstva nauke Republike Srbije, br. 47011

  2. Screening for psychotic experiences: social desirability biases in a non-clinical sample.

    Science.gov (United States)

    DeVylder, Jordan E; Hilimire, Matthew R

    2015-08-01

    Subthreshold psychotic experiences are common in the population and may be clinically significant. Reporting of psychotic experiences through self-report screens may be subject to threats to validity, including social desirability biases. This study examines the influence of social desirability on the reporting of psychotic experiences. College students (n = 686) completed a psychosis screen and the Marlowe-Crowne social desirability scale as part of a self-report survey battery. Associations between psychosis and social desirability were tested using logistic regression models. With the exception of auditory hallucinations, all other measures of psychotic experiences were subject to social desirability biases. Respondents who gave more socially desirable answers were less likely to report psychotic experiences. Respondent's tendency to underreport psychotic experiences should be accounted for when screening for these symptoms clinically. Findings also suggest that population figures based on self-report may underestimate the prevalence of subthreshold delusions but not hallucinations. © 2014 Wiley Publishing Asia Pty Ltd.

  3. PROBLEMATIC ISSUES OF DIAGNOSTICS AND THERAPY OF NON-PSYCHOTIC MENTAL DISORDERS IN FEMALE PATIENTS OF CLIMACTERIC AGE WITH HYSTERICAL SYMPTOM COMPLEX (LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Ye. V. Lukiyanova

    2013-01-01

    Full Text Available In the article, problematic questions of diagnostics and therapy of non-psychotic mental disorders (NPMD in female patients of climacteric age with hysterical symptom complex are considered. Efficacy of psychotherapy (PT in NPMD, hypnopsychotherapy in hysterical states: hysterical neurosis, neurasthenia and obsessive-compulsive neurosis is indicated. In treatment of NPMD, PT by creative selfexpression is successfully used. It is highlighted that PT forms conscious-critical attitude of patients toward themselves. Combination of PT with physiotherapy in hysterical conversional symptoms has been described. In hysterical manifestations neuroleptics are recommended, in neurotic depressions – antidepressants of mild action. In severe hysterical state, psychopharmacotherapy (PPhT with tranquilizers and neuroleptics is applied on long-term basis. Stable recovery in dissociative and hysterical disorders has been shown. In vegetovascular disorders in structure of climacteric syndrome (CS vinpocetine, in psychoemotional manifestations phenibut was administered. In therapy of hysterical neurosis, “minor neuroleptics”, hypnosuggestive therapy, social rehabilitation were applied. Effective group PT of psychogenically conditioned disorders in asthenicand anxiety-depressive symptoms is effective. Complex therapy of NPMD in hysterical and asthenic neurosis, obsessive-compulsive neurosis has been suggested. Organization of specialized preventive examinations for early revealing of persons with personality pathology is based. Efficacy of a number of medications in periand post-menopause – SSRIs and gabapentin, during menopause paroxetine, in depressions of non-psychotic level – pyrazidol, coaxil, in neurotic hypochondriasis sulpiride and quetiapine, diazepam, in climacteric vegetative and mental disorders hormone replacement therapy (HRT, hormonal therapy, PPhT and PT, in neurovegetative symptoms of CS – antidepressants, in psychovegetative syndromes

  4. Acupuncture Alleviated the Nonmotor Symptoms of Parkinson's Disease including Pain, Depression, and Autonomic Symptoms.

    Science.gov (United States)

    Iseki, Chifumi; Furuta, Taiga; Suzuki, Masao; Koyama, Shingo; Suzuki, Keiji; Suzuki, Tomoko; Kaneko, Akiyo; Mitsuma, Tadamichi

    2014-01-01

    A woman started to feel intractable pain on her lower legs when she was 76. At the age of 78, she was diagnosed as having Parkinson's disease (PD). The leg pain was suspected to be a symptom of PD after eliminating other causes. The patient also suffered from nonmotor symptoms, depression, anxiety, hot flashes, and paroxysmal sweating. Though the patient had received pharmacotherapy including levodopa for 5 years, she still suffered from the nonmotor symptoms and was referred to our department. We treated her with acupuncture based on the Chinese traditional medicine and electroacupuncture five times per week. After the 2-week treatment, the assessment for the symptoms was as follows; visual analogue scale (VAS) score of the leg pain was 16 mm (70 mm, before), Hamilton's rating scales for depression (HAM-D) score was 9 (18, before), timed 3 m Up and Go took 20 steps in 30 sec (24 steps in 38 sec, before), and the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part 1 score was 13 (21, before). Autonomic symptoms, hot flashes and paroxysmal sweating, were also alleviated. Acupuncture may be a good treatment modality for nonmotor symptoms in PD.

  5. Measuring psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; 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...

  6. 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.

  7. Decreases in perceived maternal criticism predict improvement in subthreshold psychotic symptoms in a randomized trial of family-focused therapy for individuals at clinical high risk for psychosis.

    Science.gov (United States)

    O'Brien, Mary P; Miklowitz, David J; Cannon, Tyrone D

    2015-12-01

    Perceived criticism (PC) is a measure of how much criticism from 1 family member "gets through" to another. PC ratings have been found to predict the course of psychotic disorders, but questions remain regarding whether psychosocial treatment can effectively decrease PC, and whether reductions in PC predict symptom improvement. In a sample of individuals at high risk for psychosis, we examined a) whether Family Focused Therapy for Clinical High-Risk (FFT-CHR), an 18-session intervention that consists of psychoeducation and training in communication and problem solving, brought about greater reductions in perceived maternal criticism, compared to a 3-session family psychoeducational intervention; and b) whether reductions in PC from baseline to 6-month reassessment predicted decreases in subthreshold positive symptoms of psychosis at 12-month follow-up. This study was conducted within a randomized controlled trial across 8 sites. The perceived criticism scale was completed by 90 families prior to treatment and by 41 families at 6-month reassessment. Evaluators, blind to treatment condition, rated subthreshold symptoms of psychosis at baseline, 6- and 12-month assessments. Perceived maternal criticism decreased from pre- to posttreatment for both treatment groups, and this change in criticism predicted decreases in subthreshold positive symptoms at 12-month follow-up. This study offers evidence that participation in structured family treatment is associated with improvement in perceptions of the family environment. Further, a brief measure of perceived criticism may be useful in predicting the future course of attenuated symptoms of psychosis for CHR youth.

  8. Evidence that environmental and genetic risks for psychotic disorder may operate by impacting on connections between core symptoms of perceptual alteration and delusional ideation.

    Science.gov (United States)

    Smeets, Feikje; Lataster, Tineke; Viechtbauer, Wolfgang; Delespaul, Philippe

    2015-05-01

    Relational models of psychopathology propose that symptoms are dynamically connected and hypothesize that genetic and environmental influences moderate the strength of these symptom connections. Previous findings suggest that the interplay between hallucinations and delusions may play a crucial role in the development of psychotic disorder. The current study examined whether the connection between hallucinations and delusions is impacted by proxy genetic and environmental risk factors. Hallucinations and delusions at baseline and at 3-year follow-up were assessed in a sample of 1054 healthy siblings and 918 parents of 1109 patients with psychosis, and in 589 healthy controls (no familial psychosis risk). Environmental factors assessed were cannabis use, childhood trauma, and urbanicity during childhood. Logistic regression analyses tested whether familial psychosis risk predicted increased risk of delusions, given presence of hallucinations. Moderating effects of environmental factors on the hallucination-delusion association were tested in a similar fashion, restricted to the control and sibling groups. The risk of delusions, given hallucinations, was associated with proxy genetic risk: 53% in parents, 47% in siblings, and 36% in controls. The hallucination-delusion association was stronger in those reporting cannabis use (risk difference: 32%) and childhood trauma (risk difference: 15%) although not all associations were statistically conclusive (respectively: p = .037; p = .054). A directionally similar but nonsignificant effect was found for urb anicity during childhood (risk difference: 14%, p =.357). The strength of the connection between delusions and hallucinations is associated with familial and environmental risks for psychotic disorder, suggesting that specific symptom connections in the early psychosis psychopathology network are informative of underlying mechanisms. © The Author 2014. Published by Oxford University Press on behalf of the Maryland

  9. Dietary intake of fish, omega-3, omega-6 polyunsaturated fatty acids and vitamin D and the prevalence of psychotic-like symptoms in a cohort of 33 000 women from the general population

    Directory of Open Access Journals (Sweden)

    Lewander Tommy

    2010-05-01

    Full Text Available Abstract Background Low intake of fish, polyunsaturated fatty acids (PUFA and vitamin D deficiency has been suggested to play a role in the development of schizophrenia. Our aim was to evaluate the association between the intake of different fish species, PUFA and vitamin D and the prevalence of psychotic-like symptoms in a population-based study among Swedish women. Methods Dietary intake was estimated using a food frequency questionnaire among 33 623 women aged 30-49 years at enrolment (1991/92. Information on psychotic-like symptoms was derived from a follow-up questionnaire in the years 2002/03. Participants were classified into three predefined levels: low, middle and high frequency of symptoms. The association between diet and psychotic-like symptoms was summarized in terms of relative risks (RR and corresponding 95% confidence intervals and was evaluated by energy-adjusted multinomial logistic regression. Results 18 411 women were classified as having a low level of psychotic-like symptoms, 14 395 as middle and 817 as having a high level. The risk of high level symptoms was 53% (95% CI, 30-69% lower among women who ate fish 3-4 times per week compared to women who never ate fish. The risk was also lower for women with a high intake of omega-3 and omega-6 PUFA compared to women with a lower intake of these fatty acids. The effect was most pronounced for omega-6 PUFAs. The RR comparing the highest to the lowest quartile of omega-6 PUFAs intake was 0.78 (95% CI, 0.64-0.97. The associations were J-shaped with the strongest reduced risk for an intermediate intake of fish or PUFA. For fatty fish (herring/mackerel, salmon-type fish, the strongest inverse association was found for an intermediate intake (RR: 0.81, 95% CI, 0.66-0.98, whereas a high intake of fatty fish was associated with an increased risk of psychotic-like symptoms (RR: 1.90, 95% CI, 1.34-2.70. Women in the highest compared with the lowest quartile of vitamin D consumption

  10. A young woman presenting with psychotic and mood symptoms from anti-N-methyl-D-aspartate receptor (NMDA-R) encephalitis: an emerging diagnosis.

    Science.gov (United States)

    Yuan, Neal; Glezer, Anna

    2013-01-01

    Anti-N-methyl-D-aspartate receptor (NMDA-R) encephalitis, first characterized in 2005, is a neurological disease with prominent psychiatric features that frequently involves the consultation of psychiatrists. Since its discovery, the rate of diagnosis of new cases has increased rapidly and several epidemiological studies now confirm that NMDA-R encephalitis may be as common as many other prominent infectious etiologies of encephalitis. We describe a case of a young woman presenting initially with psychotic and mood symptoms who was found to have anti-NMDA-R encephalitis. We further provide details of her treatment and prolonged recovery process after hospital discharge with a review of the literature and discussion of the epidemiology, symptomology, diagnosis, and management of both the neurologic and psychiatric manifestations of this condition. Last, we contextualize the importance of anti-NMDA-R encephalitis for psychiatrists, highlighting the role for psychiatrists in establishing the initial diagnosis as well as in providing ongoing psychiatric care.

  11. Comprehensive gene-based association study of a chromosome 20 linked region implicates novel risk loci for depressive symptoms in psychotic illness.

    Directory of Open Access Journals (Sweden)

    T Bernard Bigdeli

    Full Text Available BACKGROUND: Prior genomewide scans of schizophrenia support evidence of linkage to regions of chromosome 20. However, association analyses have yet to provide support for any etiologically relevant variants. METHODS: We analyzed 2988 LD-tagging single nucleotide polymorphisms (SNPs in 327 genes on chromosome 20, to test for association with schizophrenia in 270 Irish high-density families (ISHDSF, N = 270 families, 1408 subjects. These SNPs were genotyped using an Illumina iSelect genotyping array which employs the Infinium assay. Given a previous report of novel linkage with chromosome 20p using latent classes of psychotic illness in this sample, association analysis was also conducted for each of five factor-derived scores based on the Operational Criteria Checklist for Psychotic Illness (delusions, hallucinations, mania, depression, and negative symptoms. Tests of association were conducted using the PDTPHASE and QPDTPHASE packages of UNPHASED. Empirical estimates of gene-wise significance were obtained by adaptive permutation of a the smallest observed P-value and b the threshold-truncated product of P-values for each locus. RESULTS: While no single variant was significant after LD-corrected Bonferroni-correction, our gene-dropping analyses identified loci which exceeded empirical significance criteria for both gene-based tests. Namely, R3HDML and C20orf39 are significantly associated with depressive symptoms of schizophrenia (P(emp<2×10⁻⁵ based on the minimum P-value and truncated-product methods, respectively. CONCLUSIONS: Using a gene-based approach to family-based association, R3HDML and C20orf39 were found to be significantly associated with clinical dimensions of schizophrenia. These findings demonstrate the efficacy of gene-based analysis and support previous evidence that chromosome 20 may harbor schizophrenia susceptibility or modifier loci.

  12. [A case report of early-onset Alzheimer's disease with multiple psychotic symptoms, finally diagnosed as APPV717I mutation by genetic testing].

    Science.gov (United States)

    Ishimaru, Takashi; Ochi, Shinichiro; Matsumoto, Teruhisa; Yoshida, Taku; Abe, Masao; Toyota, Yasutaka; Fukuhara, Ryuji; Tanimukai, Satoshi; Ueno, Shu-ichi

    2013-01-01

    It is difficult to confirm a diagnosis of early-onset Alzheimer's disease (EOAD) because patients sometimes have non-specific cortical features, such as psychiatric symptoms, executive functional impairment, and pyramidal symptoms, along with typical symptoms, such as recent memory impairment and disorientation. We encountered a patient with multiple psychotic symptoms, finally diagnosed with EOAD on genetic testing. A right-handed sixty-year-old man, whose mother was suspected of having dementia, developed memory impairment at the age of fifty, disorientation at the age of fifty-six, and both visual hallucination and dressing apraxia at the age of fifty-nine. After admission to a psychiatric hospital for treatment, his symptoms disappeared with antipsychotic medication. However, his ADL were declining and so he was referred to our university hospital. He had frontal lobe symptoms, pyramidal signs, and extrapyramidal signs with severe dementia. Neuropsychological examinations were not possible because of sedation. On brain MRI, he showed diffuse atrophy of the cerebral cortex and hippocampus. HMPO-SPECT showed hypoperfusion of cerebral cortices diffusely. We decided to perform genetic testing because he had both family and alcohol abuse histories. He showed EOAD with V717I mutation of the amyloid precursor protein gene. After the discontinuation of antipsychotics, excessive sedation and extrapyramidal signs disappeared. A dose of 10 mg of donepezil was effective to improve motivation and activity, and his mini mental examination score was calculable after recovery. The case supports usefulness of applying genetic testing for Alzheimer's disease to patients with early onset dementia, even when they do not have a family history.

  13. Acute and long-term effectiveness of clozapine in treatment-resistant psychotic depression.

    Science.gov (United States)

    Ranjan, R; Meltzer, H Y

    1996-08-15

    The treatment of refractory major depression, including the psychotic subtype, is a therapeutic challenge. Three cases of resistant psychotic depression were treated with clozapine monotherapy, an atypical antipsychotic drug effective in treatment-resistant schizophrenia and mania. Both psychotic and mood symptoms responded well to clozapine monotherapy, although response was delayed in one case. Tardive dyskinesia improved markedly, and tardive dystonia improved moderately in one patient. No patient relapsed during a follow-up period of 4-6 years of clozapine treatment. Clozapine was well-tolerated with few side effects. These observations suggest controlled trials of clozapine in the treatment of psychotic depression that fails to respond to electroconvulsive therapy or typical neuroleptics plus tricyclic antidepressants are indicated. The same is true for the use of clozapine in maintenance treatment for psychotic depression in those cases in which typical neuroleptic drugs are required, in order to reduce the risk of tardive dyskinesia and dystonia.

  14. Long-lasting recovery of psychotic-like symptoms in isolation-reared rats after chronic but not acute treatment with the cannabinoid antagonist AM251.

    Science.gov (United States)

    Zamberletti, Erica; Viganò, Daniela; Guidali, Cinzia; Rubino, Tiziana; Parolaro, Daniela

    2012-03-01

    In this work we investigated the ability of AM251 to reverse schizophrenia-like symptoms produced by a neurodevelopmental animal model based on a social isolation procedure. First, we assessed the validity of our isolation-rearing protocol and, as expected, isolation-reared rats showed hyperlocomotion in a novel environment, cognitive impairment in the novel object recognition (NOR) test and a significant increase in the number of aggressive behaviours in the social interaction test compared to group-housed controls. This behavioural picture was associated with a reduction in CB₁ receptor/G protein coupling in specific brain areas as well as reduced c-Fos immunoreactivity in the prefrontal cortex and caudate putamen. In this model, chronic but not acute treatment with the CB₁ receptor antagonist AM251 counteracted isolation-induced cognitive impairment in the NOR test and aggressive behaviours in the social interaction test. This behavioural recovery was accompanied by the rescue of CB₁ receptor functionality and c-Fos levels in all brain regions altered in isolation-reared rats. Moreover, chronic AM251 also increased c-Fos immunoreactivity in the nucleus accumbens, as previously demonstrated for antipsychotic drugs. Interestingly, the behavioural recovery due to chronic AM251 administration persisted until 10 d after discontinuing the treatment, indicating a long-lasting effect of the cannabinoid antagonist on psychotic-like symptoms.

  15. Neural correlates of aberrant emotional salience predict psychotic symptoms and global functioning in high-risk and first-episode psychosis.

    Science.gov (United States)

    Modinos, Gemma; Tseng, Huai-Hsuan; Falkenberg, Irina; Samson, Carly; McGuire, Philip; Allen, Paul

    2015-10-01

    Neurobiological and behavioral findings suggest that psychosis is associated with corticolimbic hyperactivity during the processing of emotional salience. This has not been widely studied in the early stages of psychosis, and the impact of these abnormalities on psychotic symptoms and global functioning is unknown. We sought to address this issue in 18 patients with first-episode psychosis (FEP), 18 individuals at ultra high risk of psychosis (UHR) and 22 healthy controls (HCs). Corticolimbic response and subjective ratings to emotional and neutral scenes were measured using functional magnetic resonance imaging. The clinical and functional impact of corticolimbic abnormalities was assessed with regression analyses. The FEP and UHR groups reported increased subjective emotional arousal to neutral scenes compared with HCs. Across groups, emotional vs neutral scenes elicited activation in the dorsomedial prefrontal cortex, inferior frontal gyrus/anterior insula and amygdala. Although FEP and UHR participants showed reduced activation in these regions when viewing emotional scenes compared with controls, this was driven by increased activation to neutral scenes. Corticolimbic hyperactivity to neutral scenes predicted higher levels of positive symptoms and poorer levels of functioning. These results indicate that disruption of emotional brain systems may represent an important biological substrate for the pathophysiology of early psychosis and UHR states. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  16. Negative psychotic symptoms and impaired role functioning predict transition outcomes in the at-risk mental state: a latent class cluster analysis study.

    Science.gov (United States)

    Valmaggia, L R; Stahl, D; Yung, A R; Nelson, B; Fusar-Poli, P; McGorry, P D; McGuire, P K

    2013-11-01

    Many research groups have attempted to predict which individuals with an at-risk mental state (ARMS) for psychosis will later develop a psychotic disorder. However, it is difficult to predict the course and outcome based on individual symptoms scores. Data from 318 ARMS individuals from two specialized services for ARMS subjects were analysed using latent class cluster analysis (LCCA). The score on the Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to explore the number, size and symptom profiles of latent classes. LCCA produced four high-risk classes, censored after 2 years of follow-up: class 1 (mild) had the lowest transition risk (4.9%). Subjects in this group had the lowest scores on all the CAARMS items, they were younger, more likely to be students and had the highest Global Assessment of Functioning (GAF) score. Subjects in class 2 (moderate) had a transition risk of 10.9%, scored moderately on all CAARMS items and were more likely to be in employment. Those in class 3 (moderate-severe) had a transition risk of 11.4% and scored moderately severe on the CAARMS. Subjects in class 4 (severe) had the highest transition risk (41.2%), they scored highest on the CAARMS, had the lowest GAF score and were more likely to be unemployed. Overall, class 4 was best distinguished from the other classes on the alogia, avolition/apathy, anhedonia, social isolation and impaired role functioning. The different classes of symptoms were associated with significant differences in the risk of transition at 2 years of follow-up. Symptomatic clustering predicts prognosis better than individual symptoms.

  17. Self-Stigma and Its Relationship with Victimization, Psychotic Symptoms and Self-Esteem among People with Schizophrenia Spectrum Disorders

    NARCIS (Netherlands)

    Horsselenberg, Ellen M. A.; van Busschbach, Jooske T.; Aleman, Andre; Pijnenborg, Gerdine H.M.

    2016-01-01

    Objective Self-stigma is highly prevalent in schizophrenia and can be seen as an important factor leading to low self-esteem. It is however unclear how psychological factors and actual adverse events contribute to self-stigma. This study empirically examines how symptom severity and the experience o

  18. Self-Stigma and Its Relationship with Victimization, Psychotic Symptoms and Self-Esteem among People with Schizophrenia Spectrum Disorders

    NARCIS (Netherlands)

    Horsselenberg, Ellen M. A.; van Busschbach, Jooske T.; Aleman, Andre; Pijnenborg, Gerdine H.M.

    2016-01-01

    Objective Self-stigma is highly prevalent in schizophrenia and can be seen as an important factor leading to low self-esteem. It is however unclear how psychological factors and actual adverse events contribute to self-stigma. This study empirically examines how symptom severity and the experience o

  19. Altered white matter microstructure is associated with social cognition and psychotic symptoms in 22q11.2 microdeletion syndrome

    Directory of Open Access Journals (Sweden)

    Maria eJalbrzikowski

    2014-11-01

    Full Text Available 22q11.2 Microdeletion Syndrome (22q11DS is a highly penetrant genetic mutation associated with a significantly increased risk for psychosis. Aberrant neurodevelopment may lead to inappropriate neural circuit formation and cerebral dysconnectivity in 22q11DS, which may contribute to symptom development. Here we examined: 1 differences between 22q11DS participants and typically developing controls in diffusion tensor imaging (DTI measures within white matter tracts; 2 whether there is an altered age-related trajectory of white matter pathways in 22q11DS; and 3 relationships between DTI measures, social cognition task performance and positive symptoms of psychosis in 22q11DS and typically developing controls. Sixty-four direction diffusion weighted imaging data were acquired on 65 participants (36 22q11DS, 29 controls. We examined differences between 22q11DS vs. controls in measures of fractional anisotropy (FA, axial (AD and radial diffusivity (RD, using both a voxel-based and region of interest approach. Social cognition domains assessed were: Theory of Mind and emotion recognition. Positive symptoms were assessed using the Structured Interview for Prodromal Syndromes. Compared to typically developing controls, 22q11DS participants showed significantly lower AD and RD in multiple white matter tracts, with effects of greatest magnitude for AD in the superior longitudinal fasciculus. Additionally, 22q11DS participants failed to show typical age-associated changes in FA and RD in the left inferior longitudinal fasciculus. Higher AD in the left inferior fronto-occipital fasciculus and left uncinate fasciculus was associated with better social cognition in 22q11DS and controls. In contrast, greater severity of positive symptoms was associated with lower AD in bilateral regions of the inferior fronto-occipital fasciculus in 22q11DS. White matter microstructure in tracts relevant to social cognition is disrupted in 22q11DS, and may contribute to

  20. Oxytocin and social cognition in affective and psychotic disorders.

    Science.gov (United States)

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

    2015-02-01

    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. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

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

    DEFF Research Database (Denmark)

    Bjørklund, Louise B; Horsdal, Henriette T; Mors, Ole

    2017-01-01

    OBJECTIVES: 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. METHODS: 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...

  2. Psychological Mechanisms Mediating Effects Between Trauma and Psychotic Symptoms: The Role of Affect Regulation, Intrusive Trauma Memory, Beliefs, and Depression.

    Science.gov (United States)

    Hardy, Amy; Emsley, Richard; Freeman, Daniel; Bebbington, Paul; Garety, Philippa A; Kuipers, Elizabeth E; Dunn, Graham; Fowler, David

    2016-07-01

    Evidence suggests a causal role for trauma in psychosis, particularly for childhood victimization. However, the establishment of underlying trauma-related mechanisms would strengthen the causal argument. In a sample of people with relapsing psychosis (n = 228), we tested hypothesized mechanisms specifically related to impaired affect regulation, intrusive trauma memory, beliefs, and depression. The majority of participants (74.1%) reported victimization trauma, and a fifth (21.5%) met symptomatic criteria for Posttraumatic Stress Disorder. We found a specific link between childhood sexual abuse and auditory hallucinations (adjusted OR = 2.21, SE = 0.74, P = .018). This relationship was mediated by posttraumatic avoidance and numbing (OR = 1.48, SE = 0.19, P = .038) and hyperarousal (OR = 1.44, SE = 0.18, P = .045), but not intrusive trauma memory, negative beliefs or depression. In contrast, childhood emotional abuse was specifically associated with delusions, both persecutory (adjusted OR = 2.21, SE = 0.68, P = .009) and referential (adjusted OR = 2.43, SE = 0.74, P = .004). The link with persecutory delusions was mediated by negative-other beliefs (OR = 1.36, SE = 0.14, P = .024), but not posttraumatic stress symptoms, negative-self beliefs, or depression. There was no evidence of mediation for referential delusions. No relationships were identified between childhood physical abuse and psychosis. The findings underline the role of cognitive-affective processes in the relationship between trauma and symptoms, and the importance of assessing and treating victimization and its psychological consequences in people with psychosis.

  3. 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

    -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......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...... 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...

  4. Psychotic disorders in Prader-Willi syndrome.

    Science.gov (United States)

    Vogels, A; De Hert, M; Descheemaeker, M J; Govers, V; Devriendt, K; Legius, E; Prinzie, P; Fryns, J P

    2004-06-15

    The Prader-Willi syndrome (PWS) is a genetically determined developmental disorder caused by abnormalities of the proximal region of chromosome 15q11-13. In a previous study, we reported that psychotic episodes, occurring in 16% of persons with PWS, had an onset in adolescence, never occurred in persons with paternal deletion, and were exclusively associated with maternal uniparental disomy (UPD) or imprinting abnormalities (IM). In order to gain a better understanding of the psychopathology and to further refine the psychiatric diagnosis, we describe in more detail the psychopathological manifestations of six adults with a history of psychotic episodes. All these individuals had a detailed psychiatric examination, including the use of the operational criteria (OPCRIT) checklist. An identifiable subtype of psychotic disorder was associated with PWS. Characteristics include early age of onset, acute onset, polymorphous, and shifting symptomatology and a need for psychiatric hospitalization. The presence of precipitating stress factors and a prodromal phase with physiological symptoms was reported in all patients. Current diagnostic categories do not allow an unequivocal psychiatric diagnosis. Copyright 2004 Wiley-Liss, Inc.

  5. 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.

  6. [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.

  7. 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

  8. 20 CFR 416.929 - How we evaluate symptoms, including pain.

    Science.gov (United States)

    2010-04-01

    ... produce your pain or other symptoms does not involve a determination as to the intensity, persistence, or... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How we evaluate symptoms, including pain. 416.929 Section 416.929 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY...

  9. 20 CFR 404.1529 - How we evaluate symptoms, including pain.

    Science.gov (United States)

    2010-04-01

    ... symptoms does not involve a determination as to the intensity, persistence, or functionally limiting... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How we evaluate symptoms, including pain. 404.1529 Section 404.1529 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS...

  10. POST TRAUMATIC STRESS DISORDERS (PTSD WITH SEVERE DEPRESSION SYMPTOMS WITH ACUTE PSYCHOTIC IN PATIENT WITH HISTORY AS A PEDOPHILE VICTIMS AND DOMESTIC VIOLENCE IN 22 YEARS OLD MAN : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    I Ketut Agus Indra Adhiputra

    2014-02-01

    Full Text Available Post traumatic stress disorders (PTSD is a disorder that is fairly common in thecommunity. Every event in the life will have its own meaning in later, especially eventsthat occur in childhood. Data in the U.S. showed 60% men and 50% women have atraumatic experience, which develops into PTSD approximately 6.7% of the entirepopulation. While data from the Indonesian National Commission of Women, since 20072010there has been 91311 cases of sexual violence against women, as well as cases ofchild sexual abuse reported to reach 250 cases. Presenting symptoms can range fromanxiety disorders, depression, until psychotic. The severity of symptoms depends on eachself-defense mechanism thus the PTSD symptoms are very diverse.

  11. Genome-wide gene pathway analysis of psychotic illness symptom dimensions based on a new schizophrenia-specific model of the OPCRIT.

    Science.gov (United States)

    Docherty, Anna R; Bigdeli, T Bernard; Edwards, Alexis C; Bacanu, Silviu; Lee, Donghyung; Neale, Michael C; Wormley, Brandon K; Walsh, Dermot; O'Neill, F Anthony; Riley, Brien P; Kendler, Kenneth S; Fanous, Ayman H

    2015-05-01

    Empirically derived phenotypic measurements have the potential to enhance gene-finding efforts in schizophrenia. Previous research based on factor analyses of symptoms has typically included schizoaffective cases. Deriving factor loadings from analysis of only narrowly defined schizophrenia cases could yield more sensitive factor scores for gene pathway and gene ontology analyses. Using an Irish family sample, this study 1) factor analyzed clinician-rated Operational Criteria Checklist items in cases with schizophrenia only, 2) scored the full sample based on these factor loadings, and 3) implemented genome-wide association, gene-based, and gene-pathway analysis of these SCZ-based symptom factors (final N=507). Three factors emerged from the analysis of the schizophrenia cases: a manic, a depressive, and a positive symptom factor. In gene-based analyses of these factors, multiple genes had qschizophrenia.

  12. Acute manic and psychotic symptoms following subcutaneous leuprolide acetate in a male patient without prior psychiatric history: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Yuan-Hung Pong

    2014-03-01

    Full Text Available Leuprolide acetate is usually used in the treatment of advanced prostate cancer. The adverse events associated with administration of leuprolide acetate include fatigue, hot flashes, loss of libido, impotence, and depression. These side effects can be treated conservatively. Acute manic and psychiatric symptoms following leuprolide acetate injection are very rare. Few case reports have been published documenting these symptoms. Here, we describe the case of a 62-year-old male with metastatic prostate cancer, who developed acute manic and psychiatric symptoms 2 months after subcutaneous leuprolide acetate injection. These symptoms were relieved after administration of neuroleptic drugs, such as risperidone. Administration of leuprolide acetate was eventually stopped. The exact mechanism causing the manic and psychiatric adverse events is unclear. Some experts have theorized that estrogen withdrawal following leuprolide acetate therapy may induce psychiatric symptoms. Manic episodes may arise from a deficit in central serotonergic neurotransmission. Based on these hypotheses, risperidone, lithium, and some anticonvulsants, such as divalproex sodium and carbamazepine, have been used effectively in the treatment and prophylaxis of manic episodes. Although psychiatric adverse events are rare following administration of leuprolide acetate, clinicians should be aware of the possibility.

  13. Secondary psychotic features in refugees diagnosed with post-traumatic stress disorder: a retrospective cohort study.

    Science.gov (United States)

    Nygaard, Mette; Sonne, Charlotte; Carlsson, Jessica

    2017-01-05

    A substantial amount of refugees (10-30%) suffer from Post-Traumatic Stress Disorder (PTSD). In Denmark there are different facilities specialised in psychiatric treatment of trauma-affected refugees. A previously published case report from such a facility in Denmark shows that some patients suffer from secondary psychotic symptoms alongside their PTSD. The aim of this study was to illustrate the characteristics and estimate the prevalence of psychotic features in a clinical population of trauma-affected refugees with PTSD. Psychiatric records from 220 consecutive patients 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. One hundred eighty-one patients were diagnosed with PTSD among which psychotic symptoms were identified in 74 (40.9, 95% CI 33.7-48.1%). The majority of symptoms identified were auditory hallucinations (66.2%) and persecutory delusions (50.0%). There were significantly more patients diagnosed with enduring personality change after catastrophic experience in the PTSD-SP group than in the PTSD group (P = 0.009). Furthermore the PTSD-SP group included significantly more patients exposed to torture (P = 0.001) and imprisonment (P = 0.005). This study provides an estimation of PTSD-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.

  14. Urticaria and Prodromal Symptoms Including Erythema Marginatum in Danish Patients with Hereditary Angioedema.

    Science.gov (United States)

    Rasmussen, Eva R; de Freitas, Priscila Valente; Bygum, Anette

    2016-03-01

    Erythema marginatum is a characteristic skin rash seen in patients with hereditary angioedema (HAE); however, it can be confused with urticaria, leading to delay in correct diagnosis. The aim of this study was to clarify how often erythema marginatum is misinterpreted as urticaria, potentially leading physicians to refrain from testing for HAE. Few studies have been published on urticaria and prodromal symptoms in HAE, thus the incidence of these parameters were also investigated. A total of 87 patients affiliated to the national HAE Centre were included. Retrospective and prospective data on skin eruptions and prodromal symptoms were collected. Fifty-six percent of 87 patients had a positive history of erythema marginatum. Half of the patients had experienced erythema marginatum being misinterpreted as urticaria. The most prevalent other prodromal symptoms were other skin symptoms, malaise, psychological changes, fatigue and gastrointestinal symptoms. HAE patients with erythema marginatum have a longer diagnostic delay, presumably caused by misinterpretation of the rash as urticaria.

  15. Psychotic disorders induced by antiepileptic drugs in people with epilepsy.

    Science.gov (United States)

    Chen, Ziyi; Lusicic, Ana; O'Brien, Terence J; Velakoulis, Dennis; Adams, Sophia J; Kwan, Patrick

    2016-10-01

    Antiepileptic drug treatment can induce psychosis in some patients. However, there are no agreed definitions or diagnostic criteria for antiepileptic drug-induced psychotic disorder in the classification systems of either epileptology or psychiatry. In this study we investigated the clinical spectrum of antiepileptic drug-induced psychotic disorder in patients with epilepsy. The medical records of all patients with epilepsy who were diagnosed by a neuropsychiatrist as having a psychotic disorder at the Royal Melbourne Hospital from January 1993 to June 2015 were reviewed. Data were extracted regarding epilepsy and its treatment, psychotic symptoms profile and outcome. The diagnosis of epilepsy was established in accordance to the classification system of the International League Against Epilepsy while that of psychotic disorder was made according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition and the proposal on neuropsychiatric disorders in epilepsy. Patients with antiepileptic drug-induced psychotic disorder were compared to those with psychotic disorders unrelated to antiepileptic drugs assessed over the same period (non-antiepileptic drug induced psychotic disorder group). Univariate comparisons were performed and variables with a value of P psychosis after valproate withdrawal, 76.9% in the antiepileptic drug induced psychotic disorder group were female and the percentage of temporal lobe involvement was higher in the antiepileptic drug induced psychotic disorder group (69.2% versus 38.1%, P psychosis had antiepileptic drug-induced psychotic disorder. In these patients, female gender, temporal lobe involvement and current use of levetiracetam were significantly associated with antiepileptic drug induced psychotic disorder compared to other types of psychosis, while carbamazepine had a negative association. Disorganized behaviours and thinking were predominant in antiepileptic drug-induced psychotic disorder. Patients with

  16. Cannabis and Alcohol Abuse Among First Psychotic Episode Inpatients.

    Science.gov (United States)

    Katz, Gregory; Kunyvsky, Yehuda; Hornik-Lurie, Tzipi; Raskin, Sergey; Abramowitz, Moshe Z

    2016-01-01

    Psychoactive substance abuse, which includes abuse of alcohol and street drugs, is common among first-episode psychosis patients, but the prevalence of cannabis abuse is particularly high. However, there have been very few reported studies concerning the occurrence of psychoactive substance abuse among first-episode psychotic individuals using standard toxicological testing. We study the prevalence of cannabis and alcohol abuse among first-psychoticepisode inpatients as well as compare the demographic, diagnostic, and psychopathological profiles of substance abusers versus nonusers. Subjects were recruited from the Jerusalem Mental Health Center between 2012 and 2014. Ninety-one consecutively admitted psychiatric patients diagnosed using the DSM-IV criteria with a first psychotic episode due to schizophrenia, schizophreniform disorder, bipolar disorder, brief psychotic episode, and psychosis NOS disorder entered the study. The diagnoses of schizophrenia (all types), psychosis NOS disorder, brief psychotic episode, and schizophreniform disorder were categorized as "only psychosis" and those of bipolar disorder manic episode with psychotic features (congruent and incongruent) and severe depression with psychotic features were categorized as "predominantly affective symptoms." Urine tests for tetrahydrocannabinol (THC) were performed during the first 48 hours of admission, and likewise self-report questionnaires were administered. Alcohol abuse and dependence were diagnosed by self-report. Of the 91 subjects in the study, 49 (53.8%) did not abuse any illegal psychoactive substance. Twenty patients (22%) abused only cannabis; 14 (15.4%) abused cannabis and another psychoactive substance; 54 (59.3%) of the subjects reported no alcohol abuse; 33 (36.3%) reported occasional drinking (between two and ten times a month); and 4 (4.4%) reported continuous repeated drinking (more than ten times a month). There was no correlation between the demographic characteristics and the

  17. Urticaria and Prodromal Symptoms Including Erythema Marginatum in Danish Patients with Hereditary Angioedema

    DEFF Research Database (Denmark)

    Rasmussen, Eva R; Valente de Freitas, Priscila; Bygum, Anette

    2016-01-01

    Erythema marginatum is a characteristic skin rash seen in patients with hereditary angioedema (HAE); however, it can be confused with urticaria, leading to delay in correct diagnosis. The aim of this study was to clarify how often erythema marginatum is misinterpreted as urticaria, potentially...... leading physicians to refrain from testing for HAE. Few studies have been published on urticaria and prodromal symptoms in HAE, thus the incidence of these parameters were also investigated. A total of 87 patients affiliated to the national HAE Centre were included. Retrospective and prospective data...... on skin eruptions and prodromal symptoms were collected. Fifty-six percent of 87 patients had a positive history of erythema marginatum. Half of the patients had experienced erythema marginatum being misinterpreted as urticaria. The most prevalent other prodromal symptoms were other skin symptoms, malaise...

  18. Effects of psychotic symptoms on individual theory of mind a-bility%精神病性症状对个体心理理论能力的影响

    Institute of Scientific and Technical Information of China (English)

    罗克勇; 陈峰; 石建喜; 付华斌

    2015-01-01

    Objective To explore the effects of psychotic symptoms on individual theory of mind (TOM ) ability .Methods Ninety‐nine patients were divided into three groups according to types of disease ,ones with depression accompanied by psychotic symptoms were 31 ,ones with depression without 35 ,ones with non‐remission schizophrenia 33 ,selected 30 healthy adults were assigned to control group ,TOM abilities measured with story‐image method , mental symptoms with the Positive and Negative Syndrome Scale (PANSS) ,depressive symptoms with the Hamilton Depression Scale (HAMD) ,and IQs with Wechsler Adult Intelligence Scale (WAIS) .Results There were no significant differences in first‐class TOM task achievements among 4 groups (P> 0 .05) .There were significant differences in second‐class TOM task a‐chievements among depression with psychotic symptom ,depression without and control group (P 0 .05) .Conclusion Psychotic symptoms can be the main factors influencing individual theory of mind ability .%目的:探讨精神病性症状对个体心理理论能力的影响。方法将99例患者根据疾病类型分为3组,抑郁症伴精神病性症状组31例、抑郁症不伴精神病性症状组35例、精神分裂症未缓解组33例,另抽取30名健康者设为对照组,分别采用故事‐图片法测量心理理论能力,阳性与阴性症状量表评定精神症状,汉密顿抑郁量表评定抑郁症状,并测量智商。结果4组一级心理理论任务成绩比较差异无显著性(P>0.05)。在二级心理理论任务成绩上,抑郁症伴精神病性症状组与抑郁症不伴精神病性症状组、对照组比较差异有显著性(P<0.01),与精神分裂症未缓解组比较差异无显著性(P>0.05);精神分裂症未缓解组与抑郁症不伴精神病性症状组、对照组比较差异有显著性(P<0.01);而抑郁症不伴精神病性症状组与对照组比较差异无显著性(P>0.05)

  19. 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.

  20. 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.

  1. Nefazodone in psychotic unipolar and bipolar depression: a retrospective chart analysis and open prospective study on its efficacy and safety versus combined treatment with amitriptyline and haloperidol.

    Science.gov (United States)

    Grunze, Heinz; Marcuse, Alain; Schärer, Lars O; Born, Christoph; Walden, Jörg

    2002-01-01

    Although atypical antipsychotics are on the rise, traditional treatment of psychotic (or delusional) depression mostly includes the addition of classical antipsychotics to antidepressants. As there are only few data supporting this approach compared with antidepressant monotherapy, and almost no data comparing it with antidepressants of the latest generation, we conducted a retrospective chart analysis and a prospective, randomized open study on the efficacy and tolerability of nefazodone monotherapy versus combined treatment with amitriptyline and haloperidol in psychotic depression. The results suggest that the addition of classical antipsychotics should be reserved for those with very severe psychotic symptoms, but may not be needed in milder forms.

  2. Efficacy of Paroxetine plus Amisulpride for Depressive Episode Associated with Psychotic Symptoms%帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作的效果评价

    Institute of Scientific and Technical Information of China (English)

    杨薇; 陈怡兰; 陈雪; 张礼会

    2015-01-01

    目的:探讨帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作的的临床效果。方法:选择玉溪市第二人民医院就诊的伴精神病症状抑郁发作患者100例,随机分为观察组和对照组,每组50例。观察组采用帕罗西汀联合氨磺必利治疗,对照组单用帕罗西汀治疗,采用汉密尔顿抑郁量表( HAMD)减分率评定治疗后第1周、第2周、第4周、第8周的疗效;并使用症状量表( TESS)评定不良反应。结果:观察组有效率为90.0%,对照组有效率为64.0%,观察组有效率显著高于对照组( P<0.05);治疗前,两组HAMD评分差异无统计学意义(P>0.05),治疗后两组评分差异均有统计学意义(P<0.05),表明伴精神病症状的抑郁发作采用两种方法治疗均有良好疗效,两组第1周、2周、4周、8周比较差异均有统计学意义( P<0.05)。结论:帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作是一种更安全、有效的治疗方法,值得临床推广。%OBJECTIVE:To investigate the clinical efficacy of paroxetine plus amisulpride for depressive episodes associated with psychotic symptoms.METHODS: 140 patients with depressive episodes associated with psychotic symptoms were randomly assigned to either observation group or control group, of 50 cases each.The control group received paroxetine alone while the observation group received paroxetine plus amisulpride.The curative efficacy was evaluated at 1, 2, 4, and 8 weeks of treatment using Hamilton depression scale ( HAMD) and the adverse drug reactions were evaluated using the symptoms scale ( TESS) .RESULTS:The response rate in the observation group was significantly higher than in the control group ( 90.0% vs.64.0%; P 0.05 ) , however, after treatment, statistically significant differences were noted in HAMD scores for the two groups ( P<0.05 ) , indicating that both paroxetine alone and

  3. A systematic review including meta-analysis of work environment and depressive symptoms.

    Science.gov (United States)

    Theorell, Töres; Hammarström, Anne; Aronsson, Gunnar; Träskman Bendz, Lil; Grape, Tom; Hogstedt, Christer; Marteinsdottir, Ina; Skoog, Ingmar; Hall, Charlotte

    2015-08-01

    Depressive symptoms are potential outcomes of poorly functioning work environments. Such symptoms are frequent and cause considerable suffering for the employees as well as financial loss for the employers. Accordingly good prospective studies of psychosocial working conditions and depressive symptoms are valuable. Scientific reviews of such studies have pointed at methodological difficulties but still established a few job risk factors. Those reviews were published some years ago. There is need for an updated systematic review using the GRADE system. In addition, gender related questions have been insufficiently reviewed. Inclusion criteria for the studies published 1990 to June 2013: 1. European and English speaking countries. 2. Quantified results describing the relationship between exposure (psychosocial or physical/chemical) and outcome (standardized questionnaire assessment of depressive symptoms or interview-based clinical depression). 3. Prospective or comparable case-control design with at least 100 participants. 4. Assessments of exposure (working conditions) and outcome at baseline and outcome (depressive symptoms) once again after follow-up 1-5 years later. 5. Adjustment for age and adjustment or stratification for gender. Studies filling inclusion criteria were subjected to assessment of 1.) relevance and 2.) quality using predefined criteria. Systematic review of the evidence was made using the GRADE system. When applicable, meta-analysis of the magnitude of associations was made. Consistency of findings was examined for a number of possible confounders and publication bias was discussed. Fifty-nine articles of high or medium high scientific quality were included. Moderately strong evidence (grade three out of four) was found for job strain (high psychological demands and low decision latitude), low decision latitude and bullying having significant impact on development of depressive symptoms. Limited evidence (grade two) was shown for psychological

  4. Frontal fasciculi and psychotic symptoms in antipsychotic-naive patients with schizophrenia before and after 6 weeks of selective dopamine D2/3 receptor blockade

    DEFF Research Database (Denmark)

    Ebdrup, Bjørn H; Raghava, Jayachandra M; Nielsen, Mette Ødegaard;

    2016-01-01

    of fractional anisotropy (FA) using voxelwise tract-based spatial statistics (TBSS) and anatomic region of interest (ROI)-based analyses. Subsequently, patients underwent 6 weeks of antipsychotic monotherapy with amisulpride. We repeated the examinations after 6 weeks. RESULTS: We included 38 patients...... longitudinal fasciculus (z = -3.31, p= 0.001). At re-examination, all correlations between positive symptoms and frontal fasciculi had resolved. Fractional anisotropy in the ATR increased more in patients than in controls (z = -4.92, pamisulpride dose correlated positively with FA changes...... in the right CT (t= 2.52, p= 0.019). LIMITATIONS: Smoking and a previous diagnosis of substance abuse were potential confounders. Long-term effects of amisulpride on white matter were not evaluated. CONCLUSION: Antipsychotic-naive patients with schizophrenia displayed subtle deficits in white matter...

  5. Evidence that the urban environment specifically impacts on the psychotic but not the affective dimension of bipolar disorder

    NARCIS (Netherlands)

    Kaymaz, Nil; Krabbendam, Lydia; de Graaf, Ron; Nolen, Willem; ten Have, Margreet; van Os, Jim

    2006-01-01

    Objectives: High rates of psychotic disorders and psychotic symptoms have been found in urban environments but reports for bipolar affective illness have been inconsistent, possibly due to failure to stratify for comorbid psychotic symptoms. It was hypothesised, therefore, that any effect of urbanic

  6. Psychodiagnosis of personality structure: psychotic personality organization.

    Science.gov (United States)

    Acklin, M W

    1992-06-01

    Recent developments in Rorschach psychology, including nomothetic approaches focused on scores, ratios, and indices and idiographic approaches focused on content emerging from psychoanalytic theory, offer the Rorschach clinician a rich and potent interpretive methodology. This article examines the structural diagnosis of personality organization with a focus on psychotic personality structure. Rorschach approaches to the differential diagnosis of psychotic personality organization are presented. The Rorschach is viewed as indispensible in the differential diagnosis of personality organization, especially in the so-called "borderline" cases.

  7. 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.

  8. Rapid improvement of depression and psychotic symptoms in Huntington's disease: a retrospective chart review of seven patients treated with electroconvulsive therapy.

    Science.gov (United States)

    Cusin, Cristina; Franco, Felipe Boschini; Fernandez-Robles, Carlos; DuBois, Christina M; Welch, Charles A

    2013-01-01

    Many patients with Huntington's disease (HD) develop psychiatric symptoms such as depression and psychosis. For severe symptoms, electroconvulsive therapy (ECT) can be a valuable treatment. In this case series, we identified seven patients with HD who received ECT at Massachusetts General Hospital in the past 20 years. In all cases, ECT was well tolerated and produced improvement in psychiatric and behavioral symptoms. Our case series supports the hypothesis of a positive risk-benefit ratio for ECT in patients with HD and severe depression or psychosis. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Relevance of Five-Factor Model personality traits for obsessive-compulsive symptoms in patients with psychotic disorders and their un-affected siblings

    NARCIS (Netherlands)

    Schirmbeck, F.; Boyette, L.L.; van der Valk, R.; Meijer, C.; Dingemans, P.; Van, R.; de Haan, L.; Kahn, R.S.; van Os, J.; Wiersma, D.; Bruggeman, R.; Cahn, W.; Myin-Germeys, I.

    2015-01-01

    High rates of obsessive-compulsive symptoms (OCS) in schizophrenia require pathogenic explanations. Personality traits may represent risk and resiliency factors for the development of mental disorders and their comorbidities. The aim of the present study was to explore the associations between Five-

  10. Major depression with psychotic features

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000933.htm Major depression with psychotic features To use the sharing features on this page, please enable JavaScript. Major depression with psychotic features is a mental disorder in ...

  11. Ventral striatum gray matter density reduction in patients with schizophrenia and psychotic emotional dysregulation

    Directory of Open Access Journals (Sweden)

    Katharina Stegmayer

    2014-01-01

    Discussion: Decreased gray matter density in a large cluster including the right ventral striatum was associated with severe symptoms of emotional dysregulation in patients with schizophrenia. The ventral striatum is an important part of the limbic system, and was indicated to be involved in the generation of incentive salience and psychotic symptoms. Only patients with severe emotional dysregulation had decreased gray matter in several brain structures associated with emotion and reward processing compared to healthy controls. The results support the hypothesis that grouping patients according to specific clinical symptoms matched to the limbic system allows identifying patient subgroups with structural abnormalities in the limbic network.

  12. Frontal dopamine D(2/3) receptor binding in drug-naive first-episode schizophrenic patients correlates with positive psychotic symptoms and gender

    DEFF Research Database (Denmark)

    Glenthoj, Birte Y; Mackeprang, Torben; Svarer, Claus

    2006-01-01

    with single-photon emission computerized tomography (SPECT) using the D(2/3)-receptor ligand [123I]epidepride. RESULTS: In the hitherto largest study on extrastriatal D(2/3) receptors we detected a significant correlation between frontal D(2/3) BP values and positive schizophrenic symptoms in the larger group......; the patients, however, had significantly higher BP in the right compared to the left thalamus, whereas no significant hemispheric imbalances were observed in the healthy subjects. CONCLUSIONS: The present data are the first to confirm a significant correlation between frontal D(2/3) receptor BP values...

  13. Relationship between obsessive-compulsive and psychotic symptoms in schizophrenia patients%精神分裂症患者强迫与分裂症状的相关性研究

    Institute of Scientific and Technical Information of China (English)

    尹红蕾; 赵静波

    2010-01-01

    目的 分析精神分裂症患者强迫与分裂症状的相关性及其自知力特点.方法 采用强迫症状评定量表(Y-BOCS)、阳性症状与阴性症状量表(PANSS),对52例伴强迫症状的精神分裂症患者进行评定结果 Y-BOCS总体严重程度条目得分[(26.7±4.78)分]与PANSS总分[(86.9±13.4)分]之间无显著相关(r=0.191,P>0.05),Y-B0CS第11条自知力得分[(2.65±0.81)分]与PANSS总分[(86.9±13.4)分]呈显著正相关(r=0.416,P<0.01),Y-BOCS第11条自知力得分[(2.65±0.81)分]与Y-BOCS总体严重程度条目得分[(26.7±4.78)分]呈显著正相关(r=0.387,P<0.01).结论 精神分裂症患者的强迫症状与分裂症状无显著相关,强迫症状并非精神分裂症的固有症状;自知力与强迫及分裂症状均有相关,针对这类患者进行抗强迫及抗精神病治疗应均能有效改善自知力.%Objective To investigate the relatiouship between obsessive-compulsive symptoms and schizophreuia symptoms in schizo-obsessive patients, and to address the feature of insight. Methods Fifty-two cases of schizophrenia with obsessive-compulsive symptoms were assessed by Yale-Brown obsessive-compulsive scale( YBOCS) and positive and negative syndrome scale(PANSS). Results The Y-BOCS overall severity score(26.7 ±4.78)was not correlated with the PANSS total score(86.9 ± 13.4)( r=0. 191 , P>0.05), there was significant association between the insight score( 2.65 ±0.81 )and the PANSS total score( 86. 9 ± 13.4 ) ( r = 0. 416, P<0. 01 ),and the same between the insight score( 2.65 ± 0. 81 )and the Y-BOCS overall severity score(26.7 ±4.78 ) ( r = 0. 387, P < 0. 01 ). Conclusion Obsessive-compulsive symptoms and schizophrenia symptoms in schizo-obsessive patients are not correlated, obsessive-compulsive symptoms are not inherent symptoms of schizophrenia. As insight is correlated with both obsessive-compulsive symptoms and schizophrenia symptoms, anti-psychotic along with anti-compulsive treatment should

  14. Analyses of clinical features of unipolar and bipolar disorder patients with psychotic symptoms%伴精神病性症状单相与双相抑郁障碍临床特征分析

    Institute of Scientific and Technical Information of China (English)

    叶凯文; 张深山

    2014-01-01

    目的:探讨伴精神病性症状单相与双相抑郁障碍的临床特征,为临床诊断提供依据。方法将56例伴精神病性症状单相抑郁障碍患者设为单相组,53例伴精神病性症状双相抑郁障碍患者设为双相组。两组均予以艾司西酞普兰联合喹硫平治疗,双相组辅以碳酸锂治疗。采用自制一般资料调查表、汉密顿抑郁量表、阳性与阴性症状量表进行测评分析。结果双相组病程显著长于单相组( P<0.05或0.01),阳性精神病家族史及病前不良个性检出率显著高于单相组( P<0.05或0.01);治疗前妄想、被动体验、情感低落检出率显著低于单相组( P<0.05或0.01),自杀观念和自杀行为检出率显著高于单相组( P<0.05或0.01)。结论伴精神病性症状的双相抑郁障碍与单相抑郁障碍相比,具有病程较长、家族史阳性率较高、病前不良个性较多、伴精神病性症状时间较长等特点,自杀风险较高。%Objective To explore the clinical features of unipolar and bipolar disorder patients with psy-chotic symptoms (PS) in order to provide basis for clinical diagnosis .Methods Fifty-six unipolar disorder patients with PS were assigned to unipolar group and 53 bipolar ones to bipolar group .Both groups were treated with escitalopram and quetiapine ,bipolar group was plus lithium carbonate .Assessments were car-ried out with self-made general data questionnaire ,Hamilton Depression Scale (HAMD) and Positive and Negative Symptom Scale (PANSS) .Results Course was significantly longer (P<0 .05 or 0 .01) and de-tection rate of positive psychosis family history and premorbid unhealthy personality higher ( P<0 .05 or 0 .01) in bipolar than unipolar group ;detection rate of pretreatment delusion ,passive experience ,hypot-hymia was significantly lower (P<0 .05 or 0 .01) and that of suicidal ideation and behavior higher (P<0 .05 or 0 .01) in bipolar than

  15. A comparison of thought and perception disorders in borderline personality disorder and schizophrenia: psychotic experiences as a reaction to impaired social functioning.

    Science.gov (United States)

    Oliva, Francesco; Dalmotto, Marinella; Pirfo, Elvezio; Furlan, Pier Maria; Picci, Rocco Luigi

    2014-10-03

    Although previous studies suggest a high frequency of psychotic symptoms in DSM-IV Borderline Personality Disorder (BPD) there is currently no consensus on their prevalence and characteristics (type, frequency, duration, location etc.). Similarly, there are few papers addressing psychotic reactivity, the crucial aspect of BPD included in the ninth criterion for DSM-IV BPD, which remained unchanged in DSM-IV-TR and DSM-5. The purposes of the present study were to compare thought and perception disorders in patients with DSM-IV BPD and schizophrenia (SC), investigating their relationship with social functioning. Thought and perception disorders and social functioning over the previous two years were assessed by the Diagnostic Interview for Borderline Revised (DIB-R) and Personal and Social Performance scale (PSP) respectively in outpatients with DSM-IV BPD (n = 28) or DSM-IV SC (n = 28). Quasi-psychotic thought (i.e. transient, circumscribed and atypical psychotic experiences) was more frequent in BPD (BPD = 82.1%, SC = 50%, p = 0.024); whereas true psychotic thought (i.e. Schneiderian first-rank, prolonged, widespread and bizarre psychotic symptoms) was more frequent in SC (SC = 100%, BPD = 46.4%, p delusional paranoia (e.g. undue suspiciousness and ideas of references) was ubiquitous but was more severe in BPD than SC patients (U(54) = 203.5, p = 0.001). In the BPD group there was a strong negative correlation between personal and social functioning and non-delusional paranoia (τ(28) = 0.544, p = 0.002) and level of personal and social functioning was a significant predictor of the severity of non-delusional paranoia only in the BPD group (β = -0.16, t(23) = 2.90, p = 0.008). BPD patients reported less severe psychotic experiences with more frequent quasi-psychotic thought, less frequent true psychotic thought and more severe non-delusional paranoia than SC patients. Interpersonal functioning seems to

  16. [Therapeutic strategies in the first psychotic episode].

    Science.gov (United States)

    Douki, S; Taktak, M J; Ben Zineb, S; Cheour, M

    1999-11-01

    A first psychotic episode includes a wide range of disorders with different outcomes: schizophrenia, bipolar disorder, schizophreniform disorder, schizoaffective disorder, drug-induced psychosis, brief reactive psychosis, organic psychoses and delusional disorder. The course and outcome of a first psychotic episode is greatly dependent on its initial management. Major clinical, etiopathogenic and therapeutic advances have been achieved in this field and have allowed specific management strategies to be adopted. The primary task of therapists involved in the management of patients who have experienced a first episode of psychosis is promotion of recovery and prevention of secondary morbidity, relapse and persistent disability. The main guidelines of an early psychosis management are:--to keep in mind that early psychosis is not early schizophrenia. Thus, clinicians and therapists should avoid an early diagnosis of schizophrenia. Diagnosis in early psychosis can be highly unstable. A diagnosis of schizophrenia, with its implications of pessimism, relapse and disability, does not contribute anything positive in terms of guiding treatment. On the contrary, such a diagnosis may damage the patient and family by stigmatizing them and affecting the way they are viewed and managed by healthcare professionals.--To integrate biological, psychological and social interventions: effective medications is useful in reducing the risk of relapse, but is not a guarantee against it. Psychological and social interventions can greatly help promote recovery.--To tailor the various strategies to met the needs of an individual: as an example, it is important to formulate appropriate strategies for the different stages of the illness (prodromal phase, acute phase, early recovery phase and late recovery phase) because patients have different therapeutic needs at each stage.--In the acute treatment, not to concentrate on short-term goals in indicating antipsychotic treatment: prescribing

  17. [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.

  18. [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

  19. [Changes to Schizophrenia Spectrum and other psychotic disorders in DSM-5].

    Science.gov (United States)

    Schultze-Lutter, Frauke; Schimmelmann, Benno G

    2014-05-01

    This article provides an overview of the main changes in the chapter "Schizophrenia Spectrum and Other Psychotic Disorders" from DSM-IV-TR to DSM-5, which, once again, does not make allowance for potential characteristics of children and adolescents. Changes in the main text include abandoning the classical subtypes of Schizophrenia as well as of the special significance of Schneider's first-rank symptoms, resulting in the general requirement of two key features (one having to be a positive symptom) in the definition of Schizophrenia and the allowance for bizarre contents in Delusional Disorders. Further introduced are the diagnosis of a delusional obsessive-compulsive/body dysmorphic disorder exclusively as Obsessive-Compulsive Disorder, the specification of affective episodes in Schizoaffective Disorder, and the formulation of a distinct subchapter "Catatonia" for the assessment of catatonic features in the context of several disorders. In Section III (Emerging Measures and Models) there is a recommendation for a dimensional description of psychoses. A likely source of confusion lies in the double introduction of an "Attenuated Psychosis Syndrome." On the one hand, a vague description is provided among "Other Specified Schizophrenia Spectrum and Other Psychotic Disorders" in the main text; on the other hand, there is a precise definition in Section III as a "Condition for Further Study." There is some cause to worry that this vague introduction of the attenuated psychosis syndrome in the main text might indeed open the floodgates to an overdiagnosis of subthreshold psychotic symptoms and their early pharmacological treatment.

  20. 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.

  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. 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

  3. Association between genetic variation in the oxytocin receptor gene and emotional withdrawal, but not between oxytocin pathway genes and diagnosis in psychotic disorders.

    Directory of Open Access Journals (Sweden)

    Marit eHaram

    2015-01-01

    Full Text Available Social dysfunction is common in patients with psychotic disorders. Oxytocin is a neuropeptide with a central role in social behaviour. This study aims to explore the relationship between oxytocin pathway genes and symptoms related to social dysfunction in patients with psychotic disorders. We performed association analyses between four oxytocin pathway genes (OXT, OXTR, AVP, CD38 and four areas of social behaviour-related psychopathology as measured by Positive and Negative Syndrome Scale (PANSS. For this purpose, we used both a polygenic risk score (PGRS and single OXTR candidate SNPs previously reported in the literature (rs53576, rs237902, rs2254298. A total of 734 subjects with DSM-IV psychotic spectrum disorders and 420 healthy controls were included. Oxytocin pathway PGRSs were calculated based on the independent Psychiatric Genomics Consortium study sample. There was a significant association between symptom of Emotional Withdrawal and the previously reported OXTR risk allele A in rs53576. No significant associations between oxytocin pathway gene variants and a diagnosis of psychotic disorder were found. Our findings indicate that while oxytocin pathway genes do not appear to contribute to the susceptibility to psychotic disorders, variations in the OXTR gene might play a role in the development of impaired social behaviour.

  4. Brain Dysfunction as One Cause of CFS Symptoms Including Difficulty with Attention and Concentration

    Directory of Open Access Journals (Sweden)

    Benjamin H Natelson

    2013-05-01

    Full Text Available We have been able to reduce substantially patient pool heterogeneity by identifying phenotypic markers that allow the researcher to stratify chronic fatigue syndrome (CFS patients into subgroups. To date, we have shown that stratifying based on the presence or absence of co-morbid psychiatric diagnosis leads to a group with evidence of neurological dysfunction across a number of spheres. We have also found that stratifying based on the presence or absence of comorbid fibromyalgia leads to information that would not have been found on analyzing the entire, unstratified patient group. Objective evidence of orthostatic intolerance may be another important variable for stratification and may define a group with episodic cerebral hypoxia leading to symptoms. We hope that this review will encourage other researchers to collect data on discrete phenotypes in CFS to allow this work to continue more broadly. Finding subgroups of CFS suggests different underlying pathophysiological processes responsible for the symptoms seen. Understanding those processes is the first step toward developing discrete treatments for each.

  5. Does Operational Diagnosis of Schizophrenia Significantly Impact Intellectual Deficits in Psychotic Disorders?

    Science.gov (United States)

    Kitamura, H.; Shioiri, T.; Itoh, M.; Sato, Y.; Shichiri, K.; Someya, T.

    2007-01-01

    Background: Evidence suggests that, as a group, patients with schizophrenia have intellectual deficits that may precede the manifestation of psychotic symptoms; however, how successfully intelligence tests are able to discriminate schizophrenia from other psychotic disorders has yet to be investigated in detail. Methods: Using Wechsler Adult…

  6. REPEATED CONFUSIONAL STATES FOLLOWING DISCONTINUATION OF PROXETINE IN A 51-YEAR-OLD WOMEN SUFFERING FROM PSYCHOTIC DEPRESSION

    Directory of Open Access Journals (Sweden)

    Horst J. Koch

    2015-09-01

    Full Text Available A 51-year-old women suffering from depression with psychotic symptoms including a history of meningitis and epilepsy since childhood was treated with paroxetine, olanzapine and lamotrigine for years. In the periods she interrupted paroxetine administration, she developed each time a confusional state requiring intensive psychiatric care. She recovered in a few days after re-administration of paroxetine. Clinicians should be aware of severe withdrawal reactions after discontinuation of SSRI, particularly in patients with neurological history.

  7. Rating scales measuring the severity of psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, S D; Rothschild, A J; Flint, A J

    2015-01-01

    OBJECTIVE: Unipolar psychotic depression (PD) is a severe and debilitating syndrome, which requires intensive monitoring. The objective of this study was to provide an overview of the rating scales used to assess illness severity in PD. METHOD: Selective review of publications reporting results...... into the following categories: (i) rating scales predominantly covering depressive symptoms, (ii) rating scales predominantly covering psychotic symptoms, (iii) rating scales covering delusions, and (iv) rating scales covering PD. For the vast majority of the scales, the clinical and psychometric validity had...... not been tested empirically. The only exception from this general tendency was the 11-item Psychotic Depression Assessment Scale (PDAS), which was developed specifically to assess the severity of PD. CONCLUSION: In PD, the PDAS represents the only empirically derived rating scale for the measurement...

  8. A systematic review including meta-analysis of work environment and burnout symptoms.

    Science.gov (United States)

    Aronsson, Gunnar; Theorell, Töres; Grape, Tom; Hammarström, Anne; Hogstedt, Christer; Marteinsdottir, Ina; Skoog, Ingmar; Träskman-Bendz, Lil; Hall, Charlotte

    2017-03-16

    Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies - original as well as reviews - restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms. A wide range of work exposure factors was screened. Inclusion criteria were: 1) Study performed in Europe, North America, Australia and New Zealand 1990-2013. 2) Prospective or comparable case control design. 3) Assessments of exposure (work) and outcome at baseline and at least once again during follow up 1-5 years later. Twenty-five articles met the predefined relevance and quality criteria. The GRADE-system with its 4-grade evidence scale was used. Most of the 25 studies focused emotional exhaustion, fewer cynicism and still fewer personal accomplishment. Moderately strong evidence (grade 3) was concluded for the association between job control and reduced emotional exhaustion and between low workplace support and increased emotional exhaustion. Limited evidence (grade 2) was found for the associations between workplace justice, demands, high work load, low reward, low supervisor support, low co-worker support, job insecurity and change in emotional exhaustion. Cynicism was associated with most of these work factors. Reduced personal accomplishment was only associated with low reward. There were few prospective studies with sufficient quality on adverse chemical, biological and physical factors and burnout. While high levels of job support and workplace justice were protective for emotional exhaustion, high demands, low job control, high work load, low reward and job insecurity increased the risk for developing exhaustion. Our

  9. Dual cases of type 1 narcolepsy with schizophrenia and other psychotic disorders.

    Science.gov (United States)

    Canellas, Francesca; Lin, Ling; Julià, Maria Rosa; Clemente, Antonio; Vives-Bauza, Cristofol; Ollila, Hanna M; Hong, Seung Chul; Arboleya, Susana M; Einen, Mali A; Faraco, Juliette; Fernandez-Vina, Marcelo; Mignot, Emmanuel

    2014-09-15

    Cases of narcolepsy in association with psychotic features have been reported but never fully characterized. These patients present diagnostic and treatment challenges and may shed new light on immune associations in schizophrenia. Our case series was gathered at two narcolepsy specialty centers over a 9-year period. A questionnaire was created to improve diagnosis of schizophrenia or another psychotic disorder in patients with narcolepsy. Pathophysiological investigations included full HLA Class I and II typing, testing for known systemic and intracellular/synaptic neuronal antibodies, recently described neuronal surface antibodies, and immunocytochemistry on brain sections to detect new antigens. Ten cases were identified, one with schizoaffective disorder, one with delusional disorder, two with schizophreniform disorder, and 6 with schizophrenia. In all cases, narcolepsy manifested first in childhood or adolescence, followed by psychotic symptoms after a variable interval. These patients had auditory hallucinations, which was the most differentiating clinical feature in comparison to narcolepsy patients without psychosis. Narcolepsy therapy may have played a role in triggering psychotic symptoms but these did not reverse with changes in narcolepsy medications. Response to antipsychotic treatment was variable. Pathophysiological studies did not reveal any known autoantibodies or unusual brain immunostaining pattern. No strong HLA association outside of HLA DQB1*06:02 was found, although increased DRB3*03 and DPA1*02:01 was notable. Narcolepsy can occur in association with schizophrenia, with significant diagnostic and therapeutic challenges. Dual cases maybe under diagnosed, as onset is unusually early, often in childhood. Narcolepsy and psychosis may share an autoimmune pathology; thus, further investigations in larger samples are warranted. © 2014 American Academy of Sleep Medicine.

  10. 伴与不伴精神病性症状抑郁症患者临床特征及影响因素分析%Analysis of clinical features and its influencing factors of depression patients with and without psy-chotic symptoms

    Institute of Scientific and Technical Information of China (English)

    李秀英; 陈宏; 辛建

    2016-01-01

    influencing factors of depression pa⁃tients with and without psychotic symptoms. Methods According to the presence of psychotic symptoms, 374 patients with major depression were divided into psychotic major depression ( PMD group,79 case) and nonpsychotic major depression ( NMD group,268 case) . All patients completed social demographic question⁃naire ( including gender,age,marital status,educational level,family history,positive family history of psychi⁃atric disorder,disease onset age,frequency of attack,times of hospitalization,etc.) and Hamilton's depression scale (HAMD⁃24). Results Positive family history(PMD group 47/79,NMD group 104/268, P<0.01), psychiatric disorder positive family history(PMD group 19/79,NMD group 26/268, P<0.01) and times of hospitalization(PMD group(2.52±1.29),NMD group(1.39±1.31), P<0.01) in the PMD group were signifi⁃cantly higher than the NMD group.HAMD total scores(PMD total score(47.85±8.69),NMD total score (43.44±8.51), P<0.01),the factor score of anxiety/somatization(PMD group(11.40±3.28),NMD group (9.19±3.54), P<0.01) and cognitive impairment(PMD group(12.24±3.77),NMD group(9.45±3.68), P<0.01) in the PMD group were significantly higher than the NMD group.Disease onset age(PMD group(30.09 ±5.17),NMD group(35.95±9.06), P<0.01),the course of the disease(PMD group(1.58±0.76),NMD group(3.02±2.87), P<0.01),the factor score of day and night change(PMD group(0.76±0.46),NMD group(1.01±0.51), P<0.01) in PMD group were significantly lower than the NMD. Logistic regression anal⁃ysis showed the major depression with positive family history of mental disorders( β=3.278) ,attack in early age( β=-2.524),seriously cognitive dysfunction in patients( β=3.836) may indicate the psychotic symp⁃ toms( P<0.05).Conclusion PMD patients more positive family history,psychiatric disorder positive family history,likely to be hospitalization,severe symptoms and attack in early age compared with NMD. With posi⁃tive family history of mental

  11. Paranoid symptoms and hallucinations among the older people in Western Europe.

    Science.gov (United States)

    Östling, Svante; Bäckman, Kristoffer; Waern, Margda; Marlow, Thomas; Braam, Arjan W; Fichter, Manfred; Lawlor, Brian A; Lobos, Antonio; Reischies, Friedel M; Copeland, John R M; Skoog, Ingmar

    2013-06-01

    It is not clear whether the prevalence of psychosis increases with age. We studied the age-specific prevalence of psychotic symptoms in older people in Western Europe. Older people without dementia (age 65-104 years, N = 8762) from the western part of Europe in the EURODEP concerted action took part in psychiatric examinations. In total, 2.4% of the men and 2.9% of the women had psychotic symptoms. Using a multilevel logistic regression model that included gender and age as a continuous variable, we found that a 5-year increase in age increased the prevalence of psychotic symptoms (odds ratio 1.2 95% confidence interval 1.06-1.3, p = 0.001). A second multilevel regression model showed that wishing to be dead, depressed mood, functional disability, not being married and cognitive impairment measured with Mini mental state examination were all associated with psychotic symptoms whereas gender was not. The prevalence of psychotic symptoms in non-demented older people increases with age, and these symptoms are associated with other psychopathology, social isolation and problems with daily living. Copyright © 2012 John Wiley & Sons, Ltd.

  12. Measuring Empowerment Among People With Psychotic Disorders: A Comparison of Three Instruments

    NARCIS (Netherlands)

    Castelein, S.; Gaag, van der M.; Bruggeman, R.; Busschbach, J.T.; Wiersma, D.

    2008-01-01

    OBJECTIVE: This study compared three instruments that are used to measure empowerment of people with psychotic disorders. The study evaluated internal consistency, discriminant and convergent validity, sensitivity to symptom levels, and clinical usefulness. METHODS: Fifty patients in the Netherlands

  13. Measuring Empowerment Among People With Psychotic Disorders : A Comparison of Three Instruments

    NARCIS (Netherlands)

    Castelein, Stynke; van der Gaag, Mark; Bruggeman, Richard; van Busschbach, Jooske T.; Wiersma, Durk

    2008-01-01

    Objective: This study compared three instruments that are used to measure empowerment of people with psychotic disorders. The study evaluated internal consistency, discriminant and convergent validity, sensitivity to symptom levels, and clinical usefulness. Methods: Fifty patients in the Netherlands

  14. 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 regarding...

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

    DEFF Research Database (Denmark)

    Parnas, Josef; Handest, Peter; Saebye, D

    2003-01-01

    . 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...... 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...

  16. [Acute and transient psychotic disorder at the onset of schizophrenia].

    Science.gov (United States)

    Le Galudec, Mickaël; Sauder, Charlotte; Stephan, Florian; Robin, Gaëlle; Walter, Michel

    2014-01-01

    Although the mode of onset of schizophrenia can be acute, it is important to remember that the disorder rarely starts as a "clap of thunder in a quiet sky", and that it is more often gradual and insidious, with negative and affective symptoms. Acute and transient psychotic disorder, on the other hand, is a short delusional episode forming suddenly and lasting a few days, sometimes a few hours. Schizophrenic evolution forms only part of the possible evolutions. It is therefore necessary to disassociate acute and transient psychotic disorder from schizophrenic disorders, which gives a wrong representation of the onset of schizophrenia.

  17. [Structural therapy. Global therapeutic model of the psychotic child].

    Science.gov (United States)

    López, M I; León, N A

    1976-01-01

    The authors report the means to manage the psychotic child throughout the out patients consult approaching directly the modalities of interpersonal relationships between the child and his family. The therapeutic plan includes an educational and formative program designed especifically, taking into consideration the needs and potencialties of each child and acting psychotherapeutically through a modality of individual psycotherapy directed to estimulate the psychological functions which are responsible of the development of the mental autorepresentation (ego boundaries). The treatment program is an adaptation of the one utilized for the management of autistic children in an institution for psychotic children. The type of individual psychotherapy is a modification of Des Lauriers' therapy, developed by him for the management of schizophrenic adolescents and adapted by Ward in 1969 to be applied to the psychotic child in the mentioned institution. The authors present the application and obtained results with the use of this therapy in the treatment of a psychotic girl.

  18. 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.

  19. Delusional and psychotic disorders in juvenile myotonic dystrophy type-1.

    Science.gov (United States)

    Jacobs, Delphine; Willekens, Diane; de Die-Smulders, Christine; Frijns, Jean-Pierre; Steyaert, Jean

    2017-06-01

    We investigated the clinically derived hypothesis of a relatively high incidence of delusional and psychotic disorders in adolescents with juvenile Myotonic Dystrophy type-1 (DM1). Twenty-seven subjects of age 16-25 with juvenile DM1 and their parents were invited to have a clinical psychiatric interview, and to complete an ASEBA behavior checklist (YSR, ASR, CBCL, and ABCL). We diagnosed a Delusional Disorder in 19% of our patients and a Psychotic Disorder not otherwise specified in another 19%. These two groups of patients had a significantly worse level of clinically defined general functioning. It is clinically relevant to investigate in patients with juvenile DM the symptom of delusions and the presence of a delusional and psychotic disorder, and to consider the presence of juvenile DM in youngsters presenting with such a thought disorder. These disorders compromise the general functioning of the subjects and are often to some extent treatable. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  20. Omega-3 Supplementation for Psychotic Mania and Comorbid Anxiety in Children.

    Science.gov (United States)

    Vesco, Anthony T; Lehmann, Jennifer; Gracious, Barbara L; Arnold, L Eugene; Young, Andrea S; Fristad, Mary A

    2015-09-01

    Therapeutic benefits of omega-3 fatty acids (Ω3) for mood disorders, psychosis, and anxiety have been reported in the literature. The purpose of the present article is to provide a literature review of Ω3 supplementation for affective disorders and to illustrate the benefits of Ω3 with a case presentation of a young girl with a history of bipolar disorder-type 1 with psychotic features and generalized anxiety disorder. Reviewed literature includes treatment studies of the impact of Ω3 on child mood disorders supplemented by review of meta-analyses within the adult mood disorders literature. The subject of this case report participated in 11 in-depth diagnostic and functional assessments over 5 years as part of an unrelated study. Three years were presupplementation and 2 years were with supplementation with no other medication changes, thus making a naturalistic multiple-baseline single-subject experiment. Augmentation over a 2 year period was notable for clinically significant and sustained improvement in depressive, manic, and psychotic symptoms. Ω3 supplementation may be a safe, adjunct intervention for treating bipolar disorder in children and adolescents, even in the presence of psychotic and anxious features. The 2 year follow-up in this case offers hope of an accumulating and enduring benefit. Further research into mechanisms of Ω3 action and of combination treatment with other well-known interventions for mood disorders would be beneficial.

  1. Anti-NMDA-receptor antibody detected in encephalitis, schizophrenia, and narcolepsy with psychotic features

    Directory of Open Access Journals (Sweden)

    Tsutsui Ko

    2012-05-01

    Full Text Available Abstract Background Causative role of encephalitis in major psychotic features, dyskinesias (particularly orofacial, seizures, and autonomic and respiratory changes has been recently emphasized. These symptoms often occur in young females with ovarian teratomas and are frequently associated with serum and CSF autoantibodies to the NMDA receptor (NMDAR. Methods The study included a total of 61 patients from age 15 to 61 and was carried out between January 1, 2005, and Dec 31, 2010. The patients were divided into the following three clinical groups for comparison. Group A; Patients with typical clinical characteristics of anti-NMDAR encephalitis. Group B; Patients with narcolepsy with severe psychosis. Group C; Patients with schizophrenia or schizo-affective disorders. Results Ten out of 61 cases were anti-NMDAR antibody positive in typical encephalitis cases (group A: 3 of 5 cases and cases in a broader range of psychiatric disorders including narcolepsy (group B: 3 of 5 cases and schizophrenia (group C: 4 of 51 cases. Conclusion In addition to 3 typical cases, we found 7 cases with anti-NMDAR antibody associated with various psychotic and sleep symptoms, which lack any noticeable clinical signs of encephalitis (seizures and autonomic symptoms throughout the course of the disease episodes; this result suggest that further discussion on the nosology and pathophysiology of autoimmune-mediated atypical psychosis and sleep disorders is required.

  2. 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.

  3. A Bayesian model of psychosis symptom trajectory in Alzheimer's disease.

    Science.gov (United States)

    Seltman, Howard J; Mitchell, Shaina; Sweet, Robert A

    2016-02-01

    Psychosis, like other neuropsychiatric symptoms of dementia, has many features that make predictive modeling of its onset difficult. For example, psychosis onset is associated with both the absolute degree of cognitive impairment and the rate of cognitive decline. Moreover, psychotic symptoms, while more likely than not to persist over time within individuals, may remit and recur. To facilitate predictive modeling of psychosis for personalized clinical decision making, including evaluating the role of risk genes in its onset, we have developed a novel Bayesian model of the dual trajectories of cognition and psychosis symptoms. Cognition was modeled as a four-parameter logistic curve with random effects for all four parameters and possible covariates for the rate and time of fall. Psychosis was modeled as a continuous-time hidden Markov model with a latent never-psychotic class and states for pre-psychotic, actively psychotic and remitted psychosis. Covariates can affect the probability of being in the never-psychotic class. Covariates and the level of cognition can affect the transition rates for the hidden Markov model. The model characteristics were confirmed using simulated data. Results from 434 AD patients show that a decline in cognition is associated with an increased rate of transition to the psychotic state. The model allows declining cognition as an input for psychosis prediction, while incorporating the full uncertainty of the interpolated cognition values. The techniques used can be used in future genetic studies of AD and are generalizable to the study of other neuropsychiatric symptoms in dementia. Copyright © 2015 John Wiley & Sons, Ltd.

  4. Pregnenolone blocks cannabinoid-induced acute psychotic-like states in mice.

    Science.gov (United States)

    Busquets-Garcia, A; Soria-Gómez, E; Redon, B; Mackenbach, Y; Vallée, M; Chaouloff, F; Varilh, M; Ferreira, G; Piazza, P-V; Marsicano, G

    2017-02-21

    Cannabis-induced acute psychotic-like states (CIAPS) represent a growing health issue, but their underlying neurobiological mechanisms are poorly understood. The use of antipsychotics and benzodiazepines against CIAPS is limited by side effects and/or by their ability to tackle only certain aspects of psychosis. Thus, safer wide-spectrum treatments are currently needed. Although the blockade of cannabinoid type-1 receptor (CB1) had been suggested as a therapeutical means against CIAPS, the use of orthosteric CB1 receptor full antagonists is strongly limited by undesired side effects and low efficacy. The neurosteroid pregnenolone has been recently shown to act as a potent endogenous allosteric signal-specific inhibitor of CB1 receptors. Thus, we tested in mice the potential therapeutic use of pregnenolone against acute psychotic-like effects of Δ(9)-tetrahydrocannabinol (THC), the main psychoactive component of cannabis. We found that pregnenolone blocks a wide spectrum of THC-induced endophenotypes typically associated with psychotic-like states, including impairments in cognitive functions, somatosensory gating and social interaction. In order to capture THC-induced positive psychotic-like symptoms (e.g. perceptual delusions), we adapted a behavioral paradigm based on associations between different sensory modalities and selective devaluation, allowing the measurement of mental sensory representations in mice. Acting at hippocampal CB1 receptors, THC impaired the correct processing of mental sensory representations (reality testing) in an antipsychotic- and pregnenolone-sensitive manner. Overall, this work reveals that signal-specific inhibitors mimicking pregnenolone effects can be considered as promising new therapeutic tools to treat CIAPS.Molecular Psychiatry advance online publication, 21 February 2017; doi:10.1038/mp.2017.4.

  5. 阳性症状为主型精神分裂症和伴有精神病性症状双相障碍患者MMPI对照研究%A study on the difference of MMPI between schizophrenia with positive symptoms and bipolar disorder, current episode manic or depression with psychotic symptoms

    Institute of Scientific and Technical Information of China (English)

    钟舒明; 刘滔; 廖潇潇; 贾艳滨

    2014-01-01

    Objective To investigate the differences of personality characteristics between schizophrenia with positive symptoms and bipolar disorder, current episode manic or depression with psychotic symptoms by MMPI, which can provide clues to their differential diagnosis. Methods Twenty-four schizophrenia patients with positive symptoms and thirty-seven bipolar disorder patients, current episode manic or depression with psychotic symptoms were enrolled in this study. Subjects were tested personality with MMPI software, and then calculated the scores of ten clinical scales. All data analyses were performed using SPSS for Windows software, version 13.0, to find the differences between the two groups. Results The male schizophrenia with positive symptoms patients' social introversion(Si) score was significantly higher than female schizophrenia patients(t=2.186, P=0.040). There was no significant difference between the genders in bipolar disorder patients. No significant differences of the clinical scales were found between the two patient groups(P>0.05), however, the scores of psychopathic deviate, paranoia, schizophrenia and hypomania in schizophrenia patients with positive symptoms were higher than the T score of China norm, as well as the score of paranoia in bipolar disorder patients. Conclusions Personality characteristics changes exist in both schizophrenia with positive symptoms and bipolar disorder patients when compared with China norm, there is no significant difference between the two patient groups, social introversion in schizophrenia patients with positive symptoms may have gender differences.%目的:探讨阳性症状为主型精神分裂症和伴有精神病性症状的躁狂或抑郁的双相障碍患者的个性特征,为其鉴别诊断提供线索。方法采用MMPI测试软件,评估24例精神分裂症阳性症状为主型患者(精神分裂症组)和37例伴有精神病性症状的躁狂或抑郁的双相障碍患者(双相障碍组)人格

  6. Are psychotic experiences among detained juvenile offenders explained by trauma and substance use?

    Science.gov (United States)

    Colins, Olivier; Vermeiren, Robert; Vreugdenhil, Coby; Schuyten, Gilberte; Broekaert, Eric; Krabbendam, Anne

    2009-02-01

    High rates of psychotic experiences among detained adolescents have been reported. However, the significance of psychotic experiences in detained juveniles is still poorly understood. The current study, therefore, (1) examines whether psychotic experiences could be explained by substance use and/or traumatic experiences, and (2) investigates this objective without taking into account the frequently occurring paranoia-related symptoms that may not be psychosis-related in detained minors. Data were derived from 231 detained adolescents. By means of the Diagnostic Interview Schedule for Children, psychotic experiences, life-threatening events and substance use were assessed while the Child Traumatic Questionnaire was used for a history of abuse and neglect. In univariate logistic regression analyses, having psychotic experiences was positively associated with substance-related (e.g. past year intense marihuana use) and trauma-related (e.g. emotional abuse) variables. However, without taken paranoia-related experiences into account, different associations between psychotic experiences and substance-related and/or trauma-related variables were found. After building best fitting models, logistic regression analyses demonstrated a preponderance of trauma-related over substance-related variables in predicting the number of psychotic experiences (i.e. 0, 1-2, >2). These findings suggest that psychotic experiences in detained adolescents may be explained by trauma and substance use. In addition, paranoia-related experiences seemed to be particularly associated with emotional abuse.

  7. [Psychotic disorders: special aspects in general practice].

    Science.gov (United States)

    Kurmann, Julius

    2015-09-30

    In emergency situations the general practitioner is often the first professional contact psychotic patients have. The following article conveys basic knowledge about psychotic disorders and their clinical features typically seen in general practice.

  8. Relationship between Urinary N-Desmethyl-Acetamiprid and Typical Symptoms including Neurological Findings: A Prevalence Case-Control Study.

    Science.gov (United States)

    Marfo, Jemima Tiwaa; Fujioka, Kazutoshi; Ikenaka, Yoshinori; Nakayama, Shouta M M; Mizukawa, Hazuki; Aoyama, Yoshiko; Ishizuka, Mayumi; Taira, Kumiko

    2015-01-01

    Neonicotinoid insecticides are nicotinic acetylcholine receptor agonists used worldwide. Their environmental health effects including neurotoxicity are of concern. We previously determined a metabolite of acetamiprid, N-desmethyl-acetamiprid in the urine of a patient, who exhibited some typical symptoms including neurological findings. We sought to investigate the association between urinary N-desmethyl-acetamiprid and the symptoms by a prevalence case-control study. Spot urine samples were collected from 35 symptomatic patients of unknown origin and 50 non-symptomatic volunteers (non-symptomatic group, NSG, 4-87 year-old). Patients with recent memory loss, finger tremor, and more than five of six symptoms (headache, general fatigue, palpitation/chest pain, abdominal pain, muscle pain/weakness/spasm, and cough) were in the typical symptomatic group (TSG, n = 19, 5-69 year-old); the rest were in the atypical symptomatic group (ASG, n = 16, 5-78 year-old). N-desmethyl-acetamiprid and six neonicotinoids in the urine were quantified by liquid chromatography-tandem mass spectrometry. The detection of N-desmethyl-acetamiprid was the most frequent and highest in TSG (47.4%, 6.0 ppb (frequency, maximum)), followed by in ASG (12.5%, 4.4 ppb) and in NSG (6.0%, 2.2 ppb), however acetamiprid was not detected. Thiamethoxam was detected in TSG (31.6%, 1.4 ppb), in ASG (6.3%, 1.9 ppb), but not in NSG. Nitenpyram was detected in TSG (10.5%, 1.2 ppb), in ASG (6.3%, not quantified) and in NSG (2.0%, not quantified). Clothianidin was only detected in ASG (6.3%, not quantified), and in NSG (2.0%, 1.6 ppb). Thiacloprid was detected in ASG (6.3%, 0.1 ppb). The cases in TSG with detection of N-desmethyl-acetamiprid and thiamethoxam were aged 5 to 62 years and 13 to 62 years, respectively. Detection of N-desmethyl-acetamiprid was associated with increased prevalence of the symptoms (odds ratio: 14, 95% confidence interval: 3.5-57). Urinary N-desmethyl-acetamiprid can be used as a

  9. Relationship between Urinary N-Desmethyl-Acetamiprid and Typical Symptoms including Neurological Findings: A Prevalence Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Jemima Tiwaa Marfo

    Full Text Available Neonicotinoid insecticides are nicotinic acetylcholine receptor agonists used worldwide. Their environmental health effects including neurotoxicity are of concern. We previously determined a metabolite of acetamiprid, N-desmethyl-acetamiprid in the urine of a patient, who exhibited some typical symptoms including neurological findings. We sought to investigate the association between urinary N-desmethyl-acetamiprid and the symptoms by a prevalence case-control study. Spot urine samples were collected from 35 symptomatic patients of unknown origin and 50 non-symptomatic volunteers (non-symptomatic group, NSG, 4-87 year-old. Patients with recent memory loss, finger tremor, and more than five of six symptoms (headache, general fatigue, palpitation/chest pain, abdominal pain, muscle pain/weakness/spasm, and cough were in the typical symptomatic group (TSG, n = 19, 5-69 year-old; the rest were in the atypical symptomatic group (ASG, n = 16, 5-78 year-old. N-desmethyl-acetamiprid and six neonicotinoids in the urine were quantified by liquid chromatography-tandem mass spectrometry. The detection of N-desmethyl-acetamiprid was the most frequent and highest in TSG (47.4%, 6.0 ppb (frequency, maximum, followed by in ASG (12.5%, 4.4 ppb and in NSG (6.0%, 2.2 ppb, however acetamiprid was not detected. Thiamethoxam was detected in TSG (31.6%, 1.4 ppb, in ASG (6.3%, 1.9 ppb, but not in NSG. Nitenpyram was detected in TSG (10.5%, 1.2 ppb, in ASG (6.3%, not quantified and in NSG (2.0%, not quantified. Clothianidin was only detected in ASG (6.3%, not quantified, and in NSG (2.0%, 1.6 ppb. Thiacloprid was detected in ASG (6.3%, 0.1 ppb. The cases in TSG with detection of N-desmethyl-acetamiprid and thiamethoxam were aged 5 to 62 years and 13 to 62 years, respectively. Detection of N-desmethyl-acetamiprid was associated with increased prevalence of the symptoms (odds ratio: 14, 95% confidence interval: 3.5-57. Urinary N-desmethyl-acetamiprid can be used as a

  10. To Study the Clinical Effect of Sulpiride Combined Citalopram in the Treatment of Depression with Psychotic Symptoms%舒必利联合西酞普兰治疗伴精神病性症状抑郁症的临床效果研究

    Institute of Scientific and Technical Information of China (English)

    汪锦华

    2016-01-01

    目的::研究舒必利联合西酞普兰治疗伴精神病性症状抑郁症的临床效果。方法:将某院2013年6月~2015年6月收治的伴精神病性症状抑郁症患者76例,随机分为两组各38例,观察组采用舒必利联合西酞普兰进行治疗,对照组采用西酞普兰治疗,比较两组治疗前后 HAMD、HAMA评分变化和疗效。结果:观察组治疗后 HAMD、HAMA评分均低于对照组,差异均具有统计学意义(均P<0.05);观察组总有效率高于对照组,差异具有统计学意义(P<0.05)。结论:舒必利联合西酞普兰治疗伴精神病性症状抑郁症效果较单纯西酞普兰治疗更好,值得临床上推广。%Objective:To study the clinical effect of Sulpiride combined citalopram in the treatment with psychotic symptoms.Methods:A total of 76 patients of depression with psychotic symptoms received in a hospital from June 2013 to June 2015 were randomly divided into two groups,each of 38 cases.The observa-tion group were treated with Sulpiride combined citalopram,while the control group were treated with citalo-pram.Then compare the HAMD,HAMA score changes and the clinical effect.Results:After treatment,the HAMD,HAMA score of the observation group were lower than those of the control group,and the differ-ences were statistically significant(P<0.05).The total effective rate of the observation group were higher than that of the control group,and the difference was statistically significant (P<0.05).Conclusion:The clinical effect of sulpiride combined citalopram in the treatment of psychotic symptoms of depression is better than that of treating with only citalopram,which is worth of clinical promotion.

  11. 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.

  12. Can we combine symptom scales for collaborative research projects?

    LENUS (Irish Health Repository)

    Lyne, John P

    2012-02-01

    Collaborative research projects have the potential to answer important research questions, which may otherwise require huge resources, funding, and time to complete. There are several scales for measuring psychotic symptoms in schizophrenia and other psychotic disorders, with the Scale for Assessment of Positive Symptoms (SAPS), Scale for Assessment of Negative Symptoms (SANS), Positive and Negative Symptom Scale (PANSS), and the Brief Psychiatric Rating Scale (BPRS) being among the most commonly used. High quality research efforts have used these three scales in different projects, and in order to merge study efforts, some means of combining data from these scales may be necessary. We reviewed correlations in published studies for these three scales, finding them to be highly correlated, however on comparison of the three scales there were considerable clinical differences between them. The paper discusses potential methods for combining the scales in collaborative research, including use of the recently developed standardised remission criteria for schizophrenia.

  13. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction.

    Science.gov (United States)

    Gratzke, Christian; Bachmann, Alexander; Descazeaud, Aurelien; Drake, Marcus J; Madersbacher, Stephan; Mamoulakis, Charalampos; Oelke, Matthias; Tikkinen, Kari A O; Gravas, Stavros

    2015-06-01

    Lower urinary tract symptoms (LUTS) represent one of the most common clinical complaints in adult men and have multifactorial aetiology. To develop European Association of Urology (EAU) guidelines on the assessment of men with non-neurogenic LUTS. A structured literature search on the assessment of non-neurogenic male LUTS was conducted. Articles with the highest available level of evidence were selected. The Delphi technique consensus approach was used to develop the recommendations. As a routine part of the initial assessment of male LUTS, a medical history must be taken, a validated symptom score questionnaire with quality-of-life question(s) should be completed, a physical examination including digital rectal examination should be performed, urinalysis must be ordered, post-void residual urine (PVR) should be measured, and uroflowmetry may be performed. Micturition frequency-volume charts or bladder diaries should be used to assess male LUTS with a prominent storage component or nocturia. Prostate-specific antigen (PSA) should be measured only if a diagnosis of prostate cancer will change the management or if PSA can assist in decision-making for patients at risk of symptom progression and complications. Renal function must be assessed if renal impairment is suspected from the history and clinical examination, if the patient has hydronephrosis, or when considering surgical treatment for male LUTS. Uroflowmetry should be performed before any treatment. Imaging of the upper urinary tract in men with LUTS should be performed in patients with large PVR, haematuria, or a history of urolithiasis. Imaging of the prostate should be performed if this assists in choosing the appropriate drug and when considering surgical treatment. Urethrocystoscopy should only be performed in men with LUTS to exclude suspected bladder or urethral pathology and/or before minimally invasive/surgical therapies if the findings may change treatment. Pressure-flow studies should be performed

  14. 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.

  15. Oxytocin system dysfunction as a common mechanism underlying metabolic syndrome and psychiatric symptoms in schizophrenia and bipolar disorders.

    Science.gov (United States)

    Quintana, Daniel S; Dieset, Ingrid; Elvsåshagen, Torbjørn; Westlye, Lars T; Andreassen, Ole A

    2017-01-01

    There is growing interest in using intranasal oxytocin (OT) to treat social dysfunction in schizophrenia and bipolar disorders (i.e., psychotic disorders). While OT treatment results have been mixed, emerging evidence suggests that OT system dysfunction may also play a role in the etiology of metabolic syndrome (MetS), which appears in one-third of individuals with psychotic disorders and associated with increased mortality. Here we examine the evidence for a potential role of the OT system in the shared risk for MetS and psychotic disorders, and its prospects for ameliorating MetS. Using several studies to demonstrate the overlapping neurobiological profiles of metabolic risk factors and psychiatric symptoms, we show that OT system dysfunction may be one common mechanism underlying MetS and psychotic disorders. Given the critical need to better understand metabolic dysregulation in these disorders, future OT trials assessing behavioural and cognitive outcomes should additionally include metabolic risk factor parameters.

  16. Cognitive Performance and Long-Term Social Functioning in Psychotic Disorder : A Three-Year Follow-Up Study

    NARCIS (Netherlands)

    Simons, Claudia J P; Bartels-Velthuis, Agna A; Pijnenborg, Gerdina H M

    2016-01-01

    Objective Studies have linked cognitive functioning to everyday social functioning in psychotic disorders, but the nature of the relationships between cognition, social cognition, symptoms, and social functioning remains unestablished. Modelling the contributions of non-social and social cognitive a

  17. Efficacy of cognitive rehabilitation of attention, executive functions, and working memory in psychotic disorders: A systematic review.

    Science.gov (United States)

    Rodríguez-Blanco, Lucía; Lubrini, Genny; Vidal-Mariño, Carmen; Ríos-Lago, Marcos

    2017-07-01

    dies have postulated that it is the basis of the disease as evidenced by its independent and persistent quality and its relation to prognosis. Research on cognitive deficits in psychotic disorders has led to the development of intervention strategies for the cognitive rehabilitation of these patients. Attention, working memory, and executive functions are among the most widely affected functions and are closely related to the functionality of these patients. This work aims to study the effectiveness of cognitive rehabilitation targeting attention, executive functions, and working memory in people diagnosed with a psychotic disorder (mostly schizophrenia). An exhaustive search in PubMed and PsycINFO was conducted up to January 2016. All research papers that were included studied a therapeutic technique to improve one or more of the aforementioned functions in patients over age 16 years diagnosed with psychotic disorder. Studies with methodological diversity were included, which were afterwards organized by levels of evidence. Thirty-four papers were studied, from which we can conclude that cognitive rehabilitation of the aforementioned cognitive functions brings about improvements in cognition. As a result of the influence of cognitive rehabilitation on other variables such as social functioning and symptoms of the disease, the results are promising.

  18. 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

  19. Current Issues in the Classification of Psychotic Major Depression

    Science.gov (United States)

    Keller, Jennifer; Schatzberg, Alan F.; Maj, Mario

    2007-01-01

    Depression is one of the most common mental disorders worldwide. There are a number of depression subtypes, and there has been much debate about how to most accurately capture and organize the features and subtypes of major depression. We review the current state of categorizing unipolar major depression with psychotic features (psychotic major depression, PMD), including clinical, biological, and treatment aspects of the disorder. We then propose some improvements to the current unipolar major depression categorization system. Finally, we identify important issues in need of further research to help elucidate the subtype of unipolar PMD. PMID:17548842

  20. Psychotic experiences in the context of depression: The cumulative role of victimization.

    Science.gov (United States)

    Nam, Boyoung; Hilimire, Matthew; Schiffman, Jason; DeVylder, Jordan

    2016-11-01

    Previous studies have reported an association between depression and psychotic experiences, but little is known about what drives this co-occurrence. This study tests the hypothesis that exposure to trauma and bullying may strengthen the relation between depression and psychotic experiences. A total of 799 college students completed self-report questionnaires on psychotic experiences, depression, bullying, and sexual trauma. Hierarchical linear regression analyses were conducted to test the direct relationship between depression and psychotic experiences, as well as interactions. Approximately 20% of respondents reported a history of being bullied, and 7% reported exposure to childhood sexual trauma. There was a significant direct relationship between depression and psychotic experiences. The association between depression and psychotic experiences was significantly stronger among respondents who were victims of both bullying and sexual violence compared to those who experienced either exposure alone, or who were not exposed to either form of victimization. These findings suggest that cumulative exposure to trauma and victimization may contribute to the co-occurrence of depression and psychotic experiences. History of victimization should be assessed among individuals with depressive symptoms to improve treatment plans and outcomes.

  1. The opposite effects of fluvoxamine and sertraline in the treatment of psychotic major depression: a case report

    Directory of Open Access Journals (Sweden)

    Kitagaki Tetsuno

    2010-05-01

    Full Text Available Abstract Background Psychotic major 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 (ECT in treating psychotic major depression. In several studies, monotherapy of SSRIs such as fluvoxamine has been shown to be effective in the treatment of psychotic major depression. Methods We report on a 36-year-old Japanese woman in whom fluvoxamine (a SSRI with sigma-1 receptor agonist and sertraline (a SSRI with sigma-1 receptor antagonist showed the opposite effects on psychotic symptoms in the treatment of psychotic major depression. Results Symptoms of depression and psychosis in the patient who was non-respondent to antipsychotic drugs improved after fluvoxamine monotherapy. At 3 years later, a switch to sertraline from fluvoxamine dramatically worsened the psychotic symptoms in the patient. Then, a switch back to fluvoxamine from sertraline improved these symptoms 1 week after fluvoxamine treatment. Conclusion Doctors should consider the monotherapy of sigma-1 receptor agonist fluvoxamine as an alternative approach to treating psychotic major depression.

  2. Individual differences in psychotic effects of ketamine are predicted by brain function measured under placebo

    NARCIS (Netherlands)

    Honey, Garry D.; Corlett, Philip R.; Absalom, Anthony R.; Lee, Michael; Pomarol-Clotet, Edith; Murray, Graham K.; McKenna, Peter J.; Bullmore, Edward T.; Menon, David K.; Fletcher, Paul C.

    2008-01-01

    The symptoms of major psychotic illness are diverse and vary widely across individuals. Furthermore, the prepsychotic phase is indistinct, providing little indication of the precise pattern of symptoms that may subsequently emerge. Likewise, although in some individuals who have affected family memb

  3. Cut points on 0-10 numeric rating scales for symptoms included in the edmonton symptom assessment scale in cancer patients: A systematic review

    NARCIS (Netherlands)

    W.H. Oldenmenger (Wendy); P.J. de Raaf (Pleun); C. de Klerk (Cora); C.C.D. van der Rijt (Carin)

    2013-01-01

    textabstractContext: To improve the management of cancer-related symptoms, systematic screening is necessary, often performed by using 0-10 numeric rating scales. Cut points are used to determine if scores represent clinically relevant burden. Objectives: The aim of this systematic review was to exp

  4. 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...... schizophrenic or predominantly delusional symptoms. Acute polymorphic psychotic disorder was more common in females, while cases with acute schizophrenic features predominated in younger males and evolved more often into schizophrenia and related disorders. Conclusions: These findings suggest that acute....... Results: Although about half of ATPD patients tended to experience transition to another category over a mean follow-up period of 9.3 years, acute polymorphic psychotic disorder fared better in terms of cases with a single episode of psychosis and temporal stability than the subtypes featuring...

  5. Comorbidity of severe psychotic disorders with measures of substance use.

    Science.gov (United States)

    Hartz, Sarah M; Pato, Carlos N; Medeiros, Helena; Cavazos-Rehg, Patricia; Sobell, Janet L; Knowles, James A; Bierut, Laura J; Pato, Michele T

    2014-03-01

    Although early mortality in severe psychiatric illness is linked to smoking and alcohol, to our knowledge, no studies have comprehensively characterized substance use behavior in severe psychotic illness. In particular, recent assessments of substance use in individuals with mental illness are based on population surveys that do not include individuals with severe psychotic illness. To compare substance use in individuals with severe psychotic illness with substance use in the general population. We assessed comorbidity between substance use and severe psychotic disorders in the Genomic Psychiatry Cohort. The Genomic Psychiatry Cohort is a clinically assessed, multiethnic sample consisting of 9142 individuals with the diagnosis of schizophrenia, bipolar disorder with psychotic features, or schizoaffective disorder, and 10,195 population control individuals. Smoking (smoked >100 cigarettes in a lifetime), heavy alcohol use (>4 drinks/day), heavy marijuana use (>21 times of marijuana use/year), and recreational drug use. Relative to the general population, individuals with severe psychotic disorders have increased risks for smoking (odds ratio, 4.6; 95% CI, 4.3-4.9), heavy alcohol use (odds ratio, 4.0; 95% CI, 3.6-4.4), heavy marijuana use (odds ratio, 3.5; 95% CI, 3.2-3.7), and recreational drug use (odds ratio, 4.6; 95% CI, 4.3-5.0). All races/ethnicities (African American, Asian, European American, and Hispanic) and both sexes have greatly elevated risks for smoking and alcohol, marijuana, and drug use. Of specific concern, recent public health efforts that have successfully decreased smoking among individuals younger than age 30 years appear to have been ineffective among individuals with severe psychotic illness (interaction effect between age and severe mental illness on smoking initiation, P = 4.5 × 105). In the largest assessment of substance use among individuals with severe psychotic illness to date, we found the odds of smoking and alcohol and

  6. [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.

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

    DEFF Research Database (Denmark)

    Parnas, J; Handest, P; Saebye, D

    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....... 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......-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...

  8. A comparison study of early non-psychotic deviant behavior in Afrikaner and US patients with schizophrenia or schizoaffective disorder.

    Science.gov (United States)

    Sobin, Christina; Roos, J Louw; Pretorius, Herman; Lundy, Laura S; Karayiorgou, Maria

    2003-02-15

    In a previous study early non-psychotic deviant behaviors in US adult schizophrenic patients recruited for a large-scale genetic study were examined (Psychiatry Research, 101, 101). Early deviance characterized a distinct subgroup of patients at rates that were consistent with earlier reports. In addition, specific early non-psychotic deviant behaviors were meaningfully associated with later disease outcomes. In the present study, we examined the demographic, syndrome course, symptom and early deviant behavior history of 109 Afrikaner probands who met criteria for DSM schizophrenia or schizoaffective disorder, and compared them to 109 age- and gender-matched US probands. Consistent with past findings, 68% of Afrikaner probands, as compared to 67% of age- and gender-matched US probands, reported one or more forms of early non-psychotic deviance, including poor socialization, extreme fears/chronic sadness, and/or attention/learning impairment. The remaining 32 and 33% of probands, respectively, were without behavioral deviance until the onset of schizophrenia or schizoaffective disorder. The frequency and distribution of individual deviant behaviors were strikingly consistent between the samples. However, logistic regression analyses revealed different patterns of associations between the early deviant behaviors manifested and disease outcome. Afrikaner participants with early fears/chronic sadness were 3 times more likely to attempt suicide, while among US participants, this form of early deviance conferred 3.5 times more risk for later schizoaffective disorder, and 3 times greater likelihood of later sensory (tactile and/or olfactory) hallucinations. Afrikaner participants with attention/learning impairment were 2.5 times more likely to experience later auditory hallucinations, while US participants with these early difficulties were 3 times more likely to experience thought disorder. We concluded that early non-psychotic childhood deviance in this independently

  9. 西酞普兰联合舒必利在有精神病性症状抑郁症治疗中的临床价值分析%Citalopram combined with sulpiride in the analysis of the clinical value of psychotic symptoms in the treatment of depression

    Institute of Scientific and Technical Information of China (English)

    孙建

    2015-01-01

    目的:对西酞普兰联合舒必利在有精神病性症状抑郁症治疗中的临床价值进行分析和研究。方法选择2013年4月~2014年4月在本院住院治疗的有精神病性症状的抑郁症患者50例,随机分为对照组和实验组,各25例,对照组行西酞普兰治疗,实验组行西酞普兰联合舒必利治疗,观察两组患者的疗效。结果对照组患者经西酞普兰治疗后,总有效率为68%,明显低于实验组经西酞普兰联合舒必利治疗后的总有效率96%,对照组患者的汉密尔顿抑郁量表(HAMD)评分也明显优于实验组,两组间有效率的比较,差异具有统计学意义(P<0.05)。结论针对有精神病性症状的抑郁症患者行西酞普兰联合舒必利治疗,具有显著的疗效,值得各医院临床推广使用。%Objective Of citalopram in combination with sulpiride with psychotic symptoms of clinical value in the treatment of depression is analyzed and studied. Methods The data in April 2013-April 2014 in our hospital hospitalization with 50 patients with psychotic symptoms of depression, randomly divided into two groups, each 25 cases, the control line citalopram treatment, the experimental group lines of citalopram in combination with sulpiride treatment, to observe the efifcacy of two groups of patients. Results The patients with the control group after treatment with citalopram, the total effective rate was 68.00%, signiifcantly lower than the experimental group after treatment with citalopram combined sulpiride the total effective rate of 96.00%, the experimental group is obviously better than the control group patients with HAMD scores also, efifcient comparative differences between the two groups have statistical significance (P<0.05). Conclusion For patients with psychotic symptoms of depression citalopram combined therapy with sulpiride, has signiifcant curative effect, is worth the clinical promotion use.

  10. [Mania with psychotic feature induced by the use of pramipexole in Parkinson's disease: a case report].

    Science.gov (United States)

    Meriç, Ceren; Pirdoğan, Efruz; Günday Toker, Ömür; Tekin, Atilla; Bakım, Bahadır; Çelik, Selime

    2014-01-01

    Parkinson's disease, a neurodegenerative disorder characterized by movement abnormalities, is frequently complicated by psychiatric syndromes. Psychiatric symptoms may be the direct result of PD, its co-morbid pathologies, or occur as a side effect of its pharmacotherapy. Pramipexole, like other dopamine agonists for treating Parkinson's disease , has a tendency to induce psychotic and manic symptoms due to central dopaminergic stimulation. In this article, mania with psychotic feature induced by the use of dopamine agonists which is not observed frequently in the literature will be discussed.

  11. Associations of attention-deficit/hyperactivity and other childhood disorders with psychotic experiences and disorders in adolescence.

    Science.gov (United States)

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

    2016-09-13

    Prodromal symptoms of psychosis are associated with an increased risk of transition, functional impairment, poor mental health, and unfavorable developmental prospects. Existing interventions targeting the prodrome are non-satisfactory. It may thus be more promising to attempt to identify risk factors in the premorbid phase preceding the prodrome to increase the chances of successful preventive approaches. Here, we investigate whether childhood mental disorders in general and attention-deficit/hyperactivity disorder (ADHD) specifically indicate a risk for subsequent psychotic experiences and disorders. We used a sample from the prospective Avon Longitudinal Study of Parents and Children (N = 5528). When the participants were 7 years old, mental disorders were assigned according to the DSM-IV. In standardized interviews, psychotic experiences were assessed at age 12 and psychotic disorders at age 18. We examined the associations of each of the childhood mental disorders alone and in combination with psychotic experiences at age 12 and psychotic disorders at age 18 using logistic regression. Compared to participants without a disorder, participants with a mental disorder had a higher risk of psychotic experiences at age 12 (OR 1.70, 95 % CI 1.28-2.27) and of psychotic disorders at age 18 (OR 2.31, 95 % CI 1.03-5.15). Particularly, the ADHD combined subtype at age 7 was strongly associated with psychotic experiences at age 12 (OR 3.26, 95 % CI 1.74-6.10). As expected, childhood mental disorders are risk indicators of psychotic experiences and disorders. To improve prevention, health care professionals need to screen for psychotic experiences in children with non-psychotic disorders.

  12. Family Stressors as the Cause of Rehospitalization in Psychotic Disorders

    Directory of Open Access Journals (Sweden)

    Victoria Omranifard

    2008-09-01

    Full Text Available Objective: This study aimed to describe attributors of family stressors which cause rehospitalizations in patients with psychotic disorders.Materials and methods: In a cross sectional study (during 2006-7 203 randomly selected psychiatric readmitted patients with psychotic diagnosis and registered demographic and psychiatric clinical data were included. Family stressors as the possible cause of readmission were asked through a structured interview by the psychiatrist.Results: Family factors were reported as a cause in 132 (60.6% cases. Poor family support (n=88; 43.3% and family conflict (n=58; 28.6% were the two most prevalent family stressors, respectively. Bivariate analysis showed that admission due to family issues was different among men and women (79.1% vs. 38.7%, respectively p<0.001 and according to job situation (p<0.001, and literacy (p=0.036. According to logistic regression, gender (men was the only predictor of admission due to family issues (OR=5.989, CI=3.220-11.141, p<0.001.Conclusion: Family factors are prevalent causes of return to hospital in patients with psychotic disorders, and this is more prevalent in men. An approach to decrease the marital stressors is needed in patients with psychotic disorders. In this approach, increasing family support and decreasing family conflict are essential.

  13. Efficacy of electroconvulsive therapy in Fahr disease associated with bipolar psychotic disorder: a case report.

    Science.gov (United States)

    Casamassima, Francesco; Lattanzi, Lorenzo; Perlis, Roy H; Fratta, Sara; Litta, Antonella; Longobardi, Antonio; Stange, Jonathan P; Tatulli, Alessandro; Cassano, Giovanni B

    2009-09-01

    We report a case of a patient with Fahr disease affected by bipolar disorder type I with psychotic symptoms. The complex clinical picture, characterized by both neurological and psychiatric symptoms, proved to be partially or completely resistant to several pharmacological trials. On the contrary, a marked improvement of clinical picture occurred after a cycle of 10 sessions of electroconvulsive therapy, followed by a complete and sustained resolution of mood, cognitive, motor, and behavioral symptoms during the next 4 years.

  14. Psychotic-like experiences and their cognitive appraisal under short-term sensory deprivation

    Directory of Open Access Journals (Sweden)

    Christina eDaniel

    2014-08-01

    Full Text Available Aims: This study aimed to establish and compare the effects of brief sensory deprivation on individuals differing in trait hallucination proneness. Method: 18 participants selected for high hallucination-proneness were compared against 18 participants rating low on this trait. The presence of psychotic-like experiences, and participants’ cognitive appraisals of these, was evaluated in three different settings: at baseline, in a ‘secluded office’ environment, and in light-and-sound sensory deprivation.Results: Psychotic-like experiences were experienced significantly more often in sensory deprivation for both groups. In particular both experienced slight increases in perceptual distortions and anhedonia in seclusion, and these increased further during sensory deprivation. Highly hallucination prone individuals showed a significantly greater increase in perceptual distortions in sensory deprivation than did non-prone individuals suggesting a state-trait interaction. Their appraisals of these anomalous experiences were compared to both clinical and non-clinical individuals experiencing psychotic symptoms in everyday life.Conclusion: Short-term sensory deprivation is a potentially useful paradigm to model psychotic experiences, as it is a non-pharmacological tool for temporarily inducing psychotic-like states and is entirely safe at short duration. Experiences occur more frequently, though not exclusively, in those at putative risk of a psychotic disorder. The appraisals of anomalous experiences arising are largely consistent with previous observations of non-clinical individuals though importantly lacked the general positivity of the latter.

  15. Clinical Characteristics and Pharmacological Treatment of Psychotic Patients Attending the Mental Health Services of the Pediatric Hospital of Cienfuegos

    Directory of Open Access Journals (Sweden)

    Beatriz Sabina Roméu

    2016-06-01

    Full Text Available Background: the mental health services of the Pediatric Hospital of Cienfuegos receive all patients in the province that need to be hospitalized. Among them, children and adolescents functioning at the psychotic level are of great clinical and social importance. Objective: to describe the clinical characteristics and pharmacological treatment of psychotic patients treated in the mental health services. Methods: a case series study of 35 psychotic patients admitted to the mental health unit of the Pediatric Hospital of Cienfuegos was conducted between 2008 and 2012. Demographic variables, in addition to variables related to clinical data and pharmacotherapeutic aspects were analyzed. Results: sixty five point seven percent of patients were adolescents and 77.1% were of urban origin. The most common diagnoses were acute and transient psychotic disorder and schizophrenia. Sixty three percent had a family history of psychiatric disorder. Forty percent were treated with trifluoperazine and an equal percent took haloperidol. Psychotic symptoms were controlled in 58% of patients during the first weeks. Conclusion: white adolescent patients from urban areas with a family history of psychiatric illness predominated. They received regular psychiatric attention and experienced the symptoms for a short time before being treated. The most frequently prescribed medications were typical antipsychotic drugs, which caused adverse reactions in a third of the patients. In the first few weeks, psychotic symptoms were controlled in most patients, although half of them experienced a recurrence of symptoms, which evolved into conditions with worse prognosis.

  16. Developing Therapeutics for Schizophrenia and Other Psychotic Disorders

    Science.gov (United States)

    Marek, Gerard; Merchant, Kalpana

    2005-01-01

    Summary: Although the second-generation or atypical antipsychotic drugs have been breakthrough medicines for the treatment of schizophrenia and other psychotic conditions, cognitive dysfunction and to some extent negative symptoms of the disease continue to be the main cause of poor vocational status of the patients. Thus, the majority of investigational drug development efforts today target these unmet medical needs. This review postulates that the field of schizophrenia research has advanced sufficiently to develop biochemical hypotheses of the etiopathology of the disease and target the same for revolutionary disease modifying therapy. This postulate is based on recent studies that have begun to provide a testable etiopathology model that integrates interactions between genetic vulnerability factors, neurodevelopmental anomalies, and neurotransmitter systems. This review begins with a brief overview of the nosology and etiopathology of schizophrenia and related psychotic disorders to establish a context for subsequent detailed discussions on drug discovery and development for psychotic disorders. Particular emphasis is placed on recent advances in genetic association studies of schizophrenia and how this can be integrated with evidence supporting neurodevelopmental abnormalities associated with the disease to generate a testable model of the disease etiopathology. An in-depth review of the plethora of new targets and approaches targeting the unmet medical need in the treatment of schizophrenia exemplify the challenges and opportunities in this area. We end the review by offering an approach based on emerging genetic, clinical, and neurobiological studies to discover and validate novel drug targets that could be classified as disease modifying approaches. PMID:16489367

  17. 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.

  18. 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.

  19. [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.

  20. Subjective experiences in psychotic disorders: diagnostic value and clinical correlates.

    Science.gov (United States)

    Peralta, V; Cuesta, M J

    1998-01-01

    This study evaluated the prevalence and clinical correlates of abnormal subjective experiences across functional psychotic disorders. Patients were recruited from consecutive admissions with the following diagnoses; schizophrenia (n = 40), schizophreniform disorder (n = 40), schizoaffective disorder (n = 21), mood disorder (n = 18), brief reactive psychosis (n = 15), and atypical psychosis (n = 16). Subjective experiences were assessed using the Frankfurt Complaint Questionnaire (FCQ), and the clinical status was assessed with the Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS) and the Manual for the Assessment and Documentation of Psychopathology (AMDP). Neither the FCQ total score nor individual subjective experiences displayed significant differences across diagnoses. When the clinical predictors of subjective experiences were studied by multiple regression analyses, a different pattern resulted for individual psychotic disorders. In schizophrenic patients, subjective experiences were predicted by female gender, euphoria, lack of insight, greater illness severity, and more positive symptoms. The only predictors of subjective experiences in the schizophreniform disorder group were the negative symptoms. Within the affective disorders group, subjective experiences had no clinical predictors.

  1. Increased prevalence of self-reported psychotic illness predicted by crystal methamphetamine use: Evidence from a high-risk population.

    Science.gov (United States)

    Lappin, Julia M; Roxburgh, Amanda; Kaye, Sharlene; Chalmers, Jenny; Sara, Grant; Dobbins, Timothy; Burns, Lucinda; Farrell, Michael

    2016-12-01

    The potential of methamphetamine, and high-potency crystal methamphetamine in particular, to precipitate psychotic symptoms and psychotic illness is the subject of much speculation internationally. Established psychotic illness is disabling for individuals and costly to society. The aim of this study was to investigate whether use of crystal methamphetamine was associated with greater prevalence of self-reported psychotic illness, compared to use of other forms of methamphetamine. The sample comprised participants interviewed as part of an annual cross-sectional survey of Australian people who inject drugs. Comparisons were made between groups according to the nature of their methamphetamine use: crystal methamphetamine or other forms of methamphetamine. Self-reported diagnoses of psychotic illness and other mental health problems were compared between groups. Predictors of self-reported psychotic illness were examined using multivariable logistic regression analyses. Self-reported psychotic illness was highly prevalent among users of crystal methamphetamine (12.0%), and significantly more so than among users of other forms of methamphetamine (3.9%) (OR=3.36; CI: 1.03-10.97). Significant predictors of self-reported psychosis in the cohort were: use of crystal methamphetamine; dependent use; lack of education beyond high school; and younger age. Highly increased prevalence of self-reported psychotic illness is associated with use of high-potency crystal methamphetamine in people who inject drugs, particularly where there is dependent use. There is an urgent need to develop effective interventions for dependent crystal methamphetamine use; and a need to monitor for symptoms of psychotic illness in drug-using populations. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. First contact incidence of psychotic disorders among native Dutch and Moroccan immigrants in the Netherlands : Influence of diagnostic bias

    NARCIS (Netherlands)

    Zandi, T.; Havenaar, J. M.; Smits, M.; Limburg-Okken, A. G.; van Es, H.; Cahn, W.; Algra, A.; Kahn, R. S.; van den Brink, W.

    2010-01-01

    Background: Several studies have reported increased incidence rates of psychotic disorders among immigrant groups. Surprisingly, the cross-cultural validity of the diagnostic instruments that were used was never tested. Aims: To examine whether the incidence rates of psychotic disorders including sc

  3. Neurocysticercosis masquerading psychotic disorder: A case report

    Directory of Open Access Journals (Sweden)

    Rachita Sarangi

    2013-01-01

    Full Text Available Psychotic manifestations are uncommon in neurocysticercosis. This article describes a ten year girl presented with manic–psychotic manifestation for which she was under treatment with antipsychotics for eight months. Eventually she developed generalized tonic clonic seizure and CT scan of brain revealed small isodense right posterior parietal lesion of 5 mm size with perifocal edema. CECT revealed intense nodular post contrast enhancement. This highlights the possible misdiagnosis of a case of neurocysticercosis as an organic psychotic disorder so it should be considered as a differential diagnosis in patients with neurological as well as psychiatric manifestations in endemic area like India.

  4. Relationship between cardiovagal modulation and psychotic state in patients with paranoid schizophrenia.

    Science.gov (United States)

    Bär, Karl-Jürgen; Wernich, Kirsten; Boettger, Silke; Cordes, Joachim; Boettger, Michael Karl; Löffler, Stefan; Kornischka, Jürgen; Agelink, Marcus-Willi

    2008-01-15

    Disturbed autonomic nervous system (ANS) function in schizophrenia might contribute to increased cardiovascular mortality. We obtained heart rate variability indices from 40 unmedicated schizophrenic patients and 58 matched controls. Mainly we found that patients displaying stronger psychotic symptoms as assessed by the Brief Psychiatric Rating Scale exhibit more severe cardiac ANS disturbances compared with controls.

  5. Childhood abuse and neglect in relation to the presence and persistence of psychotic and depressive symptomatology

    NARCIS (Netherlands)

    van Dam, D. S.; van Nierop, M.; Viechtbauer, W.; Velthorst, E.; van Winkel, R.; Bruggeman, R.; Cahn, W.; de Haan, L.; Kahn, R. S.; Meijer, C. J.; Myin-Germeys, I.; van Os, J.; Wiersma, D.

    2015-01-01

    BACKGROUND: The association between childhood trauma and psychotic and depressive symptomatology is well established. However, less is known about the specificity and course of these symptoms in relation to childhood trauma. METHOD: In a large sample (n = 2765) of patients with psychosis (n = 1119),

  6. 无抽搐电休克对精神病症状的效果及治疗原理探讨%Modified Electric Convulsive Therapy treatment psychotic symptoms effect

    Institute of Scientific and Technical Information of China (English)

    杨开波

    2013-01-01

      目的探讨无抽搐电休克(Modified Electric Convulsive Therapy MECT)治疗精神病症状的效果及探讨MECT治疗原理。方法将我院2011年1月~2011年12月,在我院接受MECT治疗的86例精神病病人治疗前后的简明精神病量表(BPRS)资料进行分析。结果 MECT抑郁症的疗效最好(90.91%),其次为躁狂症(86.36%),精神分裂症(74.19%);总有效率为83.72%,尤其以敌对猜疑、激活性两因子减分显著;对不合作、兴奋、吵闹、敌对、妄想状态、拒食及木僵等症状的有较好的效果。结论 MECT治疗精神病有效;是控制精神科急、危、重、难症状的有效措施之一。MECT治疗原理,可能是影响神经元突触后膜受体的敏感性有关。%objective Modified Electric Convulsive Therapy (MECT) treatment and the effects of psychiatric symptoms related problem. Methods from 2011 years from January 2011 to December, accept MECT treatment in our hospital of 86 cases of mental ilness the patient's before treatment, after the brief psychiatric scale (BPRS) data were analyzed. Results the total effective rate was 83.72%, especialy with suspicion, activate the two hostile sexual deduction significant factor; To not cooperation, excited, noisy, hostile, state, and MuJiang delusion refusing foods such as the symptoms have better effect. Conclusion MECT treatment mental effective; Is the control psychiatric urgent, dangerous, heavy, one of the effective measures to symptoms.

  7. Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms.

    Science.gov (United States)

    Gibson, Lauren E; Alloy, Lauren B; Ellman, Lauren M

    2016-11-01

    Traumatic life events have been robustly associated with various psychosis outcomes, including increased risk of psychotic disorders, the prodrome of psychosis, and dimensional measures of psychotic symptoms, such as attenuated positive psychotic symptoms. However, trauma exposure has been linked to various mental disorders; therefore, the specificity of trauma exposure to psychosis remains unclear. This review focuses on two understudied areas of the trauma and psychosis literature: 1) the specificity between trauma and psychosis in relation to other disorders that often result post-trauma, and 2) proposed mechanisms that uniquely link trauma to psychosis. We begin by discussing the underlying connection between trauma exposure and the entire psychosis spectrum with a focus on the influence of trauma type and specific psychotic symptoms. We then consider how the principles of multifinality and equifinality can be useful in elucidating the trauma-psychosis relationship versus the trauma-other disorder relationship. Next, we discuss several cognitive and neurobiological mechanisms that might uniquely account for the association between trauma and psychosis, as well as the role of gender. Lastly, we review important methodological issues that complicate the research on trauma and psychosis, ending with clinical implications for the field. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Efficacy and safety of flexible dose fesoterodine in men and women with overactive bladder symptoms including nocturnal urinary urgency.

    Science.gov (United States)

    Weiss, Jeffrey P; Jumadilova, Zhanna; Johnson, Theodore M; Fitzgerald, Mary P; Carlsson, Martin; Martire, Diane L; Malhotra, Atul

    2013-04-01

    Awakening from sleep to urinate is the hallmark of nocturia, a condition that impacts several facets of health related quality of life and for which current therapy is suboptimal. Given the paucity of prospective data on antimuscarinics for the management of nocturia, we investigated the efficacy and safety of flexible dose fesoterodine for the treatment of nocturnal urgency in subjects with nocturia and overactive bladder. Subjects with 2 to 8 nocturnal urgency episodes per 24 hours began a 2-week, single-blind, placebo run-in followed by 1:1 randomization to 12 weeks of double-blind treatment with fesoterodine (4 mg daily for 4 weeks with an optional increase to 8 mg) or placebo using predefined criteria for nocturnal urgency episodes, nocturnal urine volume voided and total 24-hour urine volume voided. The primary end point was change from baseline to week 12 in the mean number of micturition related nocturnal urgency episodes per 24 hours. Overall 963 subjects were randomized from 2,990 screened, and 82% of subjects treated with fesoterodine and 84% of those treated with placebo completed the study. Significant improvements in the primary end point (-1.28 vs -1.07), in nocturnal micturitions per 24 hours (-1.02 vs -0.85) and in nocturnal frequency urgency sum (-4.01 vs -3.42) were observed with fesoterodine vs placebo (all p ≤0.01). Health related quality of life measures (overactive bladder questionnaire Symptom Bother -20.1 vs -16.5, sleep 22.3 vs 19.9 and other domains; all p fesoterodine. To our knowledge this is the first prospective study to assess antimuscarinic efficacy for reducing nocturnal urgency. Flexible dose fesoterodine significantly reduced nocturnal urgency episodes vs placebo in subjects with overactive bladder. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. 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

  10. Prognosis of patients with psychotic disorders due to psychoactive substances abuse%精神活性物质所致精神病性障碍患者预后的研究

    Institute of Scientific and Technical Information of China (English)

    邓先华; 黄志彪; 李学武; 李毅; 王轶; 吴冬凌; 高北陵

    2013-01-01

    目的:探讨精神活性物质所致精神病性障碍患者的预后. 方法:2012年1~3月应用一般资料调查表及阳性与阴性症状量表(PANSS)对2003年1月至2010年12月因精神活性物质所致精神病性障碍住院的189例患者进行随访. 结果:随访时复吸率为88.9%;随访前6个月内仍吸毒32例(16.9%).PANSS评估示42例(22.2%)随访时有不同程度精神病性症状,其中19例仍吸毒.根据PANSS评估将随访前6个月无吸毒的157例患者分为有精神病性症状组(23例)及无精神病性症状组(134例);与无精神病性症状组比较,有精神病性症状组初吸年龄小、吸毒年限长、家族精神病阳性率及再住院率高(P均<0.05). 结论:精神活性物质所致精神病性障碍患者多数预后较好,预后不良者可能与其初吸年龄、吸毒年限及家族精神病史有关.%Objective:To investigate the prognosis of patients with psychotic disorders due to psychoactive substance abuse.Method:January to March in 2012 the follow-up was preformed in 189 patients with psychotic disorders due to psychoactive substance abuse and were hospitalized during January 2003 to December 2010 by use general information questionnaire and positive and negative symptoms scale (PANSS).Results:The relapse rate was 88.9% when the follow-up,and there was still a drug use in 32 cases (16.9%) during the 6 months before the follow-up.42 cases (22.2%) still had psychotic symptoms in different degree by PANSS assessment,including 19 cases had still taking drugs.The 157 cases who without drug abuse in 6 months before the follow-up,were divided into the psychotic symptom group (23 cases) and non psychotic symptom group (134 cases) according to PANSS assessment.Compared with non psychotic symptom group,the age of the first time drug use was small,the number of year for drug use was longer,and the rate of family psychosis positive and rehospitalization in psychotic symptom group were higher

  11. Measuring treatment response in psychotic depression

    DEFF Research Database (Denmark)

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

    2014-01-01

    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......). 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...

  12. Perinatal complications in offspring of psychotic parents.

    Science.gov (United States)

    Mirdal, G M; Rosenthal, D; Wender, P H; Schulsinger, F

    1977-05-01

    The birth records of 78 subjects born to psychotic parents and 72 subjects born to normal parents were studied. No significant differences in the rates of pregnancy and birth complications (PBCs) were found between the offspring of psychotic parents and normal control parents. There were no differences between offspring born to psychotic mothers compared to psychotic fathers. Neither the onset of the parent's illness, nor the mother's age at delivery, nor the sex of the offspring seemed to influence the rate of PBCs. The offspring of chronic schizophrenic mothers and manic-depressive fathers had lower PBC rates than the offspring of parents of other diagnostic categories. The parents of these two groups, which were of a limited size, did not differ on any variable of significance, excepting the time of their first psychiatric hospital admission.

  13. The impact of a history of psychotic symptoms on cognitive function in euthymic bipolar patients: a comparison with schizophrenic patients and healthy controls O impacto da história de sintomas psicóticos na função cognitiva de doentes bipolares eutímicos: comparação com doentes esquizofrênicos e controles saudáveis

    Directory of Open Access Journals (Sweden)

    Sofia Brissos

    2011-12-01

    Full Text Available BACKGROUND: About two-thirds of patients with bipolar disorder (BD have a lifetime history of at least one psychotic symptom. Objective: To compare the neurocognitive performance of four groups: BD patients with and without a history of psychotic symptoms (BD HPS+ and BD HPS-, respectively; patients with schizophrenia (SZ; and healthy control (HC subjects. METHOD: In this cross-sectional study, 35 stabilized patients with SZ, 79 euthymic (44 HPS+ and 35 HPS- patients with BD, and 50 HC were administered a comprehensive battery of neuropsychological tests. RESULTS: There was worse neurocognitive functioning in both BD and SZ patients compared to HC. Overall, data from both groups of BD patients did not differ on sociodemographic, clinical, or neurocognitive variables. However, BD HPS+ patients had significantly more negative symptoms, as measured by the Positive and Negative Syndrome Scale (PANSS, and showed a trend toward worse performance on executive functions compared to BD HPS- patients. Moreover, both BD groups had better performance on all neurocognitive tests compared to SZ group. CONCLUSIONS: Neurocognitive dysfunction may be more marked in SZ than in BD, yet qualitatively similar. A history of past psychotic symptoms in BD was not associated with more severe cognitive impairment during euthymia. Therefore, BD with psychotic symptoms does not appear to be a distinct neurocognitive phenotype.INTRODUÇÃO: Cerca de dois terços dos pacientes com Transtorno Bipolar (TB apresentam sintomas psicóticos ao longo da vida. OBJETIVO: Comparar o desempenho neurocognitivo de quatro grupos: pacientes com TB, com e sem histórico de sintomas psicóticos (HPS+ ou HPS-, respectivamente; pacientes esquizofrénicos; e grupo controle (GC com indivíduos saudáveis. MÉTODOS: Estudo transversal no qual 35 pacientes com esquizofrenia (EZ, 79 pacientes com TB na fase eutímica (44 HPS+ e 35 HPS- e 50 GC foram submetidos a extensa avaliação neuropsicol

  14. A systematic review of instruments to measure depressive symptoms in patients with schizophrenia

    NARCIS (Netherlands)

    Lako, Irene M.; Bruggeman, R.; Knegtering, H.; Wiersma, D.; Schoevers, R. A.; Slooff, C. J.; Taxis, K.

    2012-01-01

    Background: Depressive symptoms require accurate recognition and monitoring in clinical practice of patients with schizophrenia. Depression instruments developed for use in depressed patients may not discriminate depressive symptoms from negative psychotic symptoms. Objective: We reviewed depression

  15. [Psychotic Disorder and Sheehan's Syndrome: Etiology or Comorbidity?: A Case Report].

    Science.gov (United States)

    Tıkır, Baise; Göka, Erol; Aydemir, Makbule Çiğdem; Gürkan, Şahin

    2015-01-01

    Sheehan's Syndrome -also called postpartum hypopituitarism- is a syndrome which characterized by lots of bleeding during or after delivery and necrosis of pituitary gland due to hypovolemic shock. It appears with not only agalactorrhea, amenorrhea, hypoythyroidism and hypoglycemia but also psychiatric disorders like psychosis. In this study, we reported a case presented with psychotic disorder and diagnosed as Sheehan's Syndrome at the same time. 44 year-old, female patient, married. She was admitted for withdrawal, irritability, insomnia, hearing voices -especially insult her- thoughts about that her husband was cheating on her and people would do evil. She was diagnosed as psychotic disorder and she was treated with olanzapine 20 mg/day. She had hypopituitarism symptoms so hormone tests and cranial MRI are done. Sheehan's syndrome was also diagnosed and prednisolone and tyroxine were added to the treatment. Her symptoms were disappeared one months later Olanzapine was stopped after 4 months and her treatment continued with prednisolone and tyroxine. Studies about etiology of psychotic symptoms refer to endocrine and autoimmune systems. In this study, we discussed a case that diagnosed as psychotic disorder and Sheehan's Syndrome -diagnosed 24 years later and etiological aspect with the follow-up period and treatment.

  16. Analysis Relative Factors of Stability Psychotic Symptoms in Bipolar Disorder MoCA and Cognitive Function Assessment in Patients With Type I%精神病性症状的稳定期双相障碍Ⅰ型患者认知功能MoCA评估及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    刘琳

    2015-01-01

    Objective To explore and analysis of stability of psychotic symptoms in patients with bipolar disorder type I related cause of impaired cognitive function. Methods Selected 60 cases with plateau bipolar type I psychiatric as observation group, and selected 50 normal cases as control group, selected and used the Montreal cognitive assessment scale MoCA all cognitive level into the research object, analyzed the reasons of patients with impaired cognitive function. Results Observation group the cognitive function in patients with evaluation scores were worse than normal control group, P<0.05, had difference statistically significance. Conclusion The depression score, mania rating and its cognitive situation of patients has certain relevance.%目的:探讨与分析精神病性症状的稳定期双相障碍I型患者认知功能受损的相关原因。方法将我院接受治疗的60例稳定期双相障碍I型精神病患者作为观察组,同时选取50例健康正常人作为对照组,选用蒙特利尔认知功能评估量表MoCA评定所有纳入研究对象的认知水平,分析患者认知功能受损原因。结果观察组患者各项认知功能评价成绩均差于正常对照组,P<0.05,差异具有统计学意义。结论患者的抑郁评分、狂躁评分与其认知功能情况存在一定的相关性。

  17. Positive Association Between Posterior Subgenual Cingulate and Pituitary Volumes in Psychotic Major Depression

    Directory of Open Access Journals (Sweden)

    Konstantina Vassilopoulou

    2015-03-01

    Full Text Available Posterior subgenual cingulate cortex has been consistently linked with the pathophysiology of major depression in both structural and functional brain imaging studies. Likewise, the hyperactivity of the hypothalamic-pituitary-adrenal axis in major depression is well established, especially in its psychotic subtype. Moreover, posterior subgenual cingulate cortex exerts an inhibitory effect on the hypothalamic-pituitary-adrenal axis. While studies show pituitary volume to be a valid marker of hypothalamic-pituitary-adrenal axis activity, none have investigated the volumetric relationships between posterior subgenual cingulate cortex and pituitary volume in subtypes of major depressive disorder, which was precisely the aim of our study. We hypothesized a differential volumetric relationship in psychotic depression. We assessed posterior subgenual cingulate and pituitary volume using Magnetic Resonance Imaging scanning and investigated their volumetric relationships in 39 patients with major depressive disorder (17 psychotic and 22 melancholic and 18 normal controls. We found strong positive correlations between both left and right posterior subgenual volumes and pituitary volume only in the psychotic depression group (left: rs=0.77, p<0.001, right: rs=0.67, p=0.003. These positive associations were confirmed by regression analyses controlling for patient’s age and type of medications. By contrast, no significant volumetric associations were detected in the groups of melancholic patients and normal controls. Our findings provide support to the hypothesis that posterior subgenual cingulate is differentially involved in the pathophysiology of psychotic symptoms in major depressive disorder.

  18. Altered functional connectivity links in neuroleptic-naïve and neuroleptic-treated patients with schizophrenia, and their relation to symptoms including volition

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    Weidan Pu

    2014-01-01

    Full Text Available In order to analyze functional connectivity in untreated and treated patients with schizophrenia, resting-state fMRI data were obtained for whole-brain functional connectivity analysis from 22 first-episode neuroleptic-naïve schizophrenia (NNS, 61 first-episode neuroleptic-treated schizophrenia (NTS patients, and 60 healthy controls (HC. Reductions were found in untreated and treated patients in the functional connectivity between the posterior cingulate gyrus and precuneus, and this was correlated with the reduction in volition from the Positive and Negative Symptoms Scale (PANSS, that is in the willful initiation, sustenance, and control of thoughts, behavior, movements, and speech, and with the general and negative symptoms. In addition in both patient groups interhemispheric functional connectivity was weaker between the orbitofrontal cortex, amygdala and temporal pole. These functional connectivity changes and the related symptoms were not treated by the neuroleptics. Differences between the patient groups were that there were more strong functional connectivity links in the NNS patients (including in hippocampal, frontal, and striatal circuits than in the NTS patients. These findings with a whole brain analysis in untreated and treated patients with schizophrenia provide evidence on some of the brain regions implicated in the volitional, other general, and negative symptoms, of schizophrenia that are not treated by neuroleptics so have implications for the development of other treatments; and provide evidence on some brain systems in which neuroleptics do alter the functional connectivity.

  19. 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

  20. The meaning of dreams in the psychotic state. Theoretical considerations and clinical applications.

    Science.gov (United States)

    Capozzi, P; de Masi, F

    2001-10-01

    The authors consider that the Freudian theory of dreams is not directly applicable to psychotic and borderline patients with their constantly varying states of mental integration. Because these patients' dreams lack associations, the usual psychoanalytic approach cannot be used to ascertain their meaning. After reviewing the literature on the specific quality of dreams in the psychotic state, the authors point out that such dreams have nothing to do with the metaphorical language of the dream work but instead express the concreteness of the hallucinatory construction. For this reason, a dream's meaning may fail to be understood by the patient even if it seems clear to an observer. Yet the analyst's reception of a 'psychotic dream' is a unique and essential source of valuable information on the manner of construction of the delusional system, allowing analytic work on the psychotic nucleus. In the authors' view, such dreams may help the analyst and the patient--while still lucid--to acquire insight, thus affording a stable foundation for emergence from psychosis. The paper includes some case histories, in one of which a psychotic female patient is enabled by work on dreams to reconstruct a psychotic episode and thereby to ward off an imminent fresh lapse into psychosis.

  1. Qualitative and quantitative EEG in psychotic children.

    Science.gov (United States)

    Itil, T M; Simeon, J; Coffin, C

    1976-05-01

    The EEGs of hospitalized psychotic boys were analyzed quantitatively by means of visual evaluation, analog frequency analysis, and digital computer period analysis and were compared with those of age- and sex-matched normals. Visual evaluation of the records demonstrated that psychotic children have significantly more beta activity as well as fewer alpha bursts than normal controls. EEG analog frequency analysis showed that psychotic children have a greater percentage of total voltage in the 3-5 cps and 13-33 cps bands, while they show less voltage in the 6-12 cps bands as compared with normal controls. Digital computer period analysis demonstrated more slow, less alpha, and more fast activity, as well as a greater average frequency and frequency deviation in both the primary wave and first derivative measurements in psychotic children than normals, while normals showed a trend towards higher amplitude and amplitude variability. The similarity of the EEG differences between psychotic and normal children to those differences observed between adult chronic schizophrenics and normals, as well as to those between children of "high risk" for becoming schizophrenic and controls, suggests that the above described findings are characteristic for the pathophysiology of schizophrenia.

  2. Psychotic and borderline psychotic adolescents: frequency of psychiatric illness and treatment in childhood in 100 consecutive cases.

    Science.gov (United States)

    Aarkrog, T

    1975-07-01

    The first results covering the assessment period phase of a systematic study of 50 borderline psychotic and 50 psychotic adolescents are described. These 100 adolescents comprised one-third of the total number of admissions to an adolescent department during the years from 1968 to 1975. There were 58 boys and 42 girls; 53 of the 100 cases had been psychiatrically ill in childhood with evident symptoms. In 22 cases, there was positive information supporting the fact that the patients had been healthy in childhood. The rest (25 cases) were classified under "unclarified picture", showing non specific symptoms. It is concluded that in this material more than half of the adolescents had shown some instability before puberty. The illnesses described in childhood are categorised as infantile borderline psychosis, borderline psychosis probable, and other psychiatric illnesses. A shift in diagnosis is often seen in the individual case, but the symptoms in childhood and in adolescence have many similarities. The necessary treatment in childhood has not been given in one-third of the cases. The possible reasons for this are discussed. In spite of much effort in some cases and because of resistance to therapy or the proposal of inadequate therapy in others, the therapeutic possibilities in childhood have not been fully realised. It is recommended that more emphasis be placed on the emotional development in the evaluation of the children. In the treatment, development of interpersonal relationships through individual, family and/or milieu therapy should be stressed. A follow-up of children with symptoms in childhood left untreated and a teamwork between child psychiatrist and adult psychiatrist with longitudinal studies is suggested.

  3. Clozapine Treatment and Cannabis Use in Adolescents with Psychotic Disorders – A Retrospective Cohort Chart Review

    Science.gov (United States)

    Tang, Sephora M.; Ansarian, Aylar; Courtney, Darren B.

    2017-01-01

    Objectives To examine the association between clozapine treatment and frequency of cannabis use in adolescents with co-occurring psychotic and cannabis use disorder in a retrospective cohort chart review. Method We conducted a retrospective cohort chart review of patients diagnosed with a psychotic disorder and concurrent cannabis use disorder admitted to a tertiary care youth inpatient unit from 2010–2012. Longitudinal exposure and outcome data was coded month-by-month. Frequency of cannabis use was measured using a 7-point ordinal scale. Severity of psychosis was measured on a 3-point ordinal scale. Mixed effects regression modeling was used to describe the relationship between exposure and outcome variables. Results Thirteen patients had exposure to clozapine and fourteen had no exposure to clozapine. Cannabis use decreased in patients treated with clozapine, compared to patients treated with other antipsychotics (OR 2.8; 95% CI 0.97–7.9). Compared to no medication, clozapine exposure was associated with significantly less cannabis use (OR 7.1; 95% CI 2.3–22.3). Relative to treatment with other antipsychotics, clozapine exposure was significantly associated with lower severity of psychotic symptoms (OR 3.7; 95% CI 1.2–11.8). Conclusions Clozapine may lead to decreased cannabis use and psychotic symptoms in adolescents with concurrent psychosis and substance use. Clinical trials are warranted. PMID:28331504

  4. Nightmares and psychotic decompensation: a case study.

    Science.gov (United States)

    Levin, R; Daly, R S

    1998-01-01

    There have been numerous reports in the literature on the descriptive similarities between a severe nightmare and an acute psychotic episode. Nightmares may be a prelude to psychotic decompensation, and it has been suggested that frequent lifelong nightmares may even be diagnostic of an underlying vulnerability to psychosis. In this report, we present a case study of a 40-year old female experiencing chronic paranoid schizophrenia, whose two witnessed psychotic relapses in the hospital were immediately preceded by intense and vivid nightmare attacks. Significantly, the content of these nocturnal dreams was thematically consistent with her waking hallucinations, suggesting a direct continuity between these experiences. We propose that further systematic study of the dreams and nightmares of individuals diagnosed with schizophrenia may be particularly useful in understanding their phenomenological experience.

  5. Replicated evidence of absence of association between serum S100B and (risk of psychotic disorder.

    Directory of Open Access Journals (Sweden)

    Christine van der Leeuw

    Full Text Available BACKGROUND: S100B is a potential marker of neurological and psychiatric illness. In schizophrenia, increased S100B levels, as well as associations with acute positive and persisting negative symptoms, have been reported. It remains unclear whether S100B elevation, which possibly reflects glial dysfunction, is the consequence of disease or compensatory processes, or whether it is an indicator of familial risk. METHODS: Serum samples were acquired from two large independent family samples (n = 348 and n = 254 in the Netherlands comprising patients with psychotic disorder (n = 140 and n = 82, non-psychotic siblings of patients with psychotic disorder (n = 125 and n = 94 and controls (n = 83 and n = 78. S100B was analyzed with a Liaison automated chemiluminescence system. Associations between familial risk of psychotic disorder and S100B were examined. RESULTS: Results showed that S100B levels in patients (P and siblings (S were not significantly different from controls (C (dataset 1: P vs. C: B = 0.004, 95% CI -0.005 to 0.013, p = 0.351; S vs. C: B = 0.000, 95% CI -0.009 to 0.008, p = 0.926; and dataset 2: P vs. C: B = 0.008, 95% CI -0.011 to 0.028, p = 0.410; S vs. C: B = 0.002, 95% CI -0.016 to 0.021, p = 0.797. In patients, negative symptoms were positively associated with S100B (B = 0.001, 95% CI 0.000 to 0.002, p = 0.005 in one of the datasets, however with failure of replication in the other. There was no significant association between S100B and positive symptoms or present use or type of antipsychotic medication. CONCLUSIONS: S100B is neither an intermediate phenotype, nor a trait marker for psychotic illness.

  6. [Neurological appraisal of children and adolescents with psychotic symptoms].

    Science.gov (United States)

    Tomás-Vila, Miguel

    2015-05-01

    Introduccion. Las manifestaciones psicoticas en la infancia no son infrecuentes; sin embargo, la bibliografia existente acerca de la valoracion neurologica de niños y adolescentes con cuadros psicoticos es muy escasa. Objetivo. Realizar una revision bibliografica no sistematica que permita responder a estas tres cuestiones: cuando debe llevarse a cabo una valoracion neurologica en un niño con rasgos psicoticos?, cuales son las condiciones medicas que pueden incluir un cuadro psicotico en su evolucion? y cual debe ser el procedimiento diagnostico? Desarrollo. Se revisan las enfermedades que pueden presentar sintomatologia psicotica al inicio o durante la evolucion, y se agrupan por patologias: errores congenitos del metabolismo, enfermedades geneticas, enfermedades autoinmunes e infecciosas, malformaciones del sistema nervioso central, epilepsia, patologia vascular, procesos reumatologicos, tumores cerebrales, y farmacos y sustancias psicoactivas. Se propone una pauta diagnostica en la que se valora la informacion obtenida a partir de la anamnesis y la exploracion y la aportacion de cada prueba diagnostica. Conclusiones. El numero de procesos que pueden manifestar sintomatologia psicotica a lo largo de su evolucion es muy elevado, y hay que considerar las claves que ofrecen la anamnesis y la exploracion. Esta revision puede ayudar a neuropediatras y otros especialistas a realizar una valoracion mas sistematizada de niños y adolescentes con cuadros psicoticos.

  7. Psychotic Symptoms, Anger, and Anxiety as Determinants of Agrresive Behavior

    NARCIS (Netherlands)

    A.F. Nederlof (Angela F.)

    2012-01-01

    textabstractAs an introduction on the topic of this dissertation, it might be interesting to look at some other cases of psychiatric patients that displayed clear-cut aggressive behavior towards other persons: Case 1. Twenty-nine-year-old man, who stabbed his mother’s fiancé in the chest with the in

  8. Psychotic Symptoms, Anger, and Anxiety as Determinants of Agrresive Behavior

    NARCIS (Netherlands)

    A.F. Nederlof (Angela F.)

    2012-01-01

    textabstractAs an introduction on the topic of this dissertation, it might be interesting to look at some other cases of psychiatric patients that displayed clear-cut aggressive behavior towards other persons: Case 1. Twenty-nine-year-old man, who stabbed his mother’s fiancé in the chest with the

  9. Psychotic symptoms in post traumatic stress disorder: a case ...

    African Journals Online (AJOL)

    QuickSilver

    2003-05-07

    May 7, 2003 ... Posttraumatic stress disorder (PTSD) is a psychiatric illness for- mally recognized with the .... addition, he received individual and group supportive psycho- therapy similar to .... is needed in this area to clarify which factors contribute to the development of ... Herman,J. Trauma & Recovery. Basic Books:New ...

  10. 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.

  11. 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.

  12. [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.

  13. Relationship between brain-derived neurotrophic factor gene C270T polymorphisms and the psychotic symptoms and cognitive functioning of patients with schizophrenia%脑源性神经营养因子C270T基因多态性与精神分裂症精神病理症状和认知功能的关系

    Institute of Scientific and Technical Information of China (English)

    翟金国; 赵靖平; 陈敏; 李君; 苏中华

    2012-01-01

    Background: Findings from previous studies linking brain-derived neurotrophic factor (BDNF) and schizophrenia are inconsistent and few studies have assessed the relationship between BDNF C270T gene polymorphisms and the clinical and cognitive symptoms of schizophrenia.Aim: Compare the prevalence of the BDNF C270T gene polymorphisms between patients with schizophrenia and controls and, in the patients, assess the relationship of genotypes to the severity of symptoms.Methods: BDNF C270T genotype and allele frequency were measured using Polymerase Chain Reaction methods in 224 drug-free patients with schizophrenia and 220 controls. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), and cognitive functioning was assessed using the Wisconsin Card Sorting Test (WCST) and the Trail Making Test (TMT). In the patient group, differences in severity of symptoms across the three genotypes (i.e., C/C, C/T,and T/T) of C270T were assessed using one-way analysis of variance.Results: The frequency of the T allele was much higher in patients than in controls(15.6% vs. 4.3%, χ2=31.47, p<0.001)and the C/T genotype was more common among patients than controls (27.7% vs. 7.7%, χ2=34.93, p<0.001). Compared to controls, patients performed poorly on all the cognitive tests, but there were no significant differences in the cognitive measures between patients with the three different genotypes. The total PANSS score, the PANSS negative symptoms subscale score, and the PANSS general psychopathology subscale score were not significantly different between the three groups of patients. However, the PANSS positive symptoms subscale score showed a small, statistically significant elevation in the severity of positive symptoms in the C/T genotype compared to the C/C genotype.Conclusion: We confirm previous findings about differences in the prevalence of the BDNF C270T gene polymorphisms in schizophrenia, but do not find strong evidence of a relationship

  14. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction.

    Science.gov (United States)

    Oelke, Matthias; Bachmann, Alexander; Descazeaud, Aurélien; Emberton, Mark; Gravas, Stavros; Michel, Martin C; N'dow, James; Nordling, Jørgen; de la Rosette, Jean J

    2013-07-01

    To present a summary of the 2013 version of the European Association of Urology guidelines on the treatment and follow-up of male lower urinary tract symptoms (LUTS). We conducted a literature search in computer databases for relevant articles published between 1966 and 31 October 2012. The Oxford classification system (2001) was used to determine the level of evidence for each article and to assign the grade of recommendation for each treatment modality. Men with mild symptoms are suitable for watchful waiting. All men with bothersome LUTS should be offered lifestyle advice prior to or concurrent with any treatment. Men with bothersome moderate-to-severe LUTS quickly benefit from α1-blockers. Men with enlarged prostates, especially those >40ml, profit from 5α-reductase inhibitors (5-ARIs) that slowly reduce LUTS and the probability of urinary retention or the need for surgery. Antimuscarinics might be considered for patients who have predominant bladder storage symptoms. The phosphodiesterase type 5 inhibitor tadalafil can quickly reduce LUTS to a similar extent as α1-blockers, and it also improves erectile dysfunction. Desmopressin can be used in men with nocturia due to nocturnal polyuria. Treatment with an α1-blocker and 5-ARI (in men with enlarged prostates) or antimuscarinics (with persistent storage symptoms) combines the positive effects of either drug class to achieve greater efficacy. Prostate surgery is indicated in men with absolute indications or drug treatment-resistant LUTS due to benign prostatic obstruction. Transurethral resection of the prostate (TURP) is the current standard operation for men with prostates 30-80ml, whereas open surgery or transurethral holmium laser enucleation is appropriate for men with prostates >80ml. Alternatives for monopolar TURP include bipolar TURP and transurethral incision of the prostate (for glands <30ml) and laser treatments. Transurethral microwave therapy and transurethral needle ablation are effective

  15. The global efficiency of the brain structural networks and its relationship with the psychotic symptoms in male paranoid schizophrenia%男性偏执型精神分裂症患者脑结构网络全局效率与精神症状相关性研究

    Institute of Scientific and Technical Information of China (English)

    陈建淮; 姚志剑; 秦姣龙; 阎锐; 汤浩; 花玲玲; 卢青

    2015-01-01

    Objective To explore the differences of the global efficiency of the brain structural networks between the male paranoid schizophrenia and male healthy and its relationship with the psychotic symptoms of the schizophrenia.Methods The diffusion tensor imaging data were obtained from 27 male paranoid schizophrenia patients and 28 male healthy controls.The whole cerebral cortex was parcellated into 90 regions by the anatomical label map.Tractography was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using fiber assignment by continuous tracking(FACT) algorithm.And then the brain structural binary networks were constructed using the complex network theory.The average global efficiency of the brain network and the global efficiency of the nodes of both groups were examined by two sample t-test and its relationship with the psychotic symptoms in the male paranoid schizophrenia was explored by the correlation analysis.Results Compared with control group,the average global efficiency of the brain network of the patients decreased significantly (7.87±0.56,8.17±0.56,P=0.005),and the global efficiency of the nodes in the brain network of the patient decreased significantly in the left superior frontal gyrus (orbital part) (P=0.00025),the left superior parietal gyrus (P=0.00011),the left cuneus (P=0.00012) and the left putamen (P=0.00032),all survived FDR correction.Significant negative correlation was found between the global efficiency of the left putamen and the total scores (r=-0.43,P=0.03),the positive scores (r=-0.41,P=0.03) and the cognitive scores (r=-0.40,P=0.04) of PANSS.Conclusion The decreased global efficiency of the left frontal,parietal and occipital lobes and the subcortical structures lead to the occurrence of schizophrenia.And the reduced efficiency of the subcortical structures is associated with the positive symptoms and the abnormal cognitive function of the patients.%目的 探讨男性偏执型

  16. Serum 25-hydroxyvitamin D3 and D2 and non-clinical psychotic experiences in childhood.

    Directory of Open Access Journals (Sweden)

    Anna-Maija Tolppanen

    Full Text Available Non-clinical psychotic experiences are common and distressing. It has been hypothesized that early life vitamin D deficiency may be a risk factor for psychosis-related outcomes, but it is not known if circulating concentrations of 25-hydroxyvitamin D (25(OHD during childhood are associated with psychosis-related outcomes or whether the two different forms of 25(OHD, (25(OHD(3 and 25(OHD(2, have similar associations with psychosis-related outcomes.We investigated the association between serum 25(OHD(3 and 25(OHD(2 concentrations and psychotic experiences in a prospective birth cohort study. Serum 25(OHD(3 and 25(OHD(2 concentrations were measured at mean age 9.8 years and psychotic experiences assessed at mean age 12.8 years by a psychologist (N = 3182.Higher 25(OHD(3 concentrations were associated with lower risk of definite psychotic experiences (adjusted odds ratio: OR (95% confidence interval: CI 0.85 (0.75-0.95. Higher concentrations of 25(OHD(2 were associated with higher risk of suspected and definite psychotic experiences (adjusted odds ratio: OR (95% confidence interval: CI 1.26 (1.11, 1.43. Higher 25(ODD(2 concentrations were also weakly associated with definite psychotic experiences (adjusted OR (95% CI 1.17 (0.96, 1.43, though with wide confidence intervals including the null value.Our findings of an inverse association of 25(OHD(3 with definite psychotic experiences is consistent with the hypothesis that vitamin D may protect against psychosis-related outcomes.

  17. Working memory capacity and psychotic-like experiences in a general population sample of adolescents and young adults

    Directory of Open Access Journals (Sweden)

    Tim eZiermans

    2013-12-01

    Full Text Available Working memory (WM impairment is a common feature in individuals with schizophrenia and high-risk for psychosis and a promising target for early intervention strategies. However, it is unclear to what extent WM impairment parallels specific behavioral symptoms along the psychosis continuum. To address this issue, the current study investigated the relation of WM capacity with psychotic-like experiences (PLEs in a large Swedish population sample (N = 1012 of adolescents and young adults (M = 24.4 years, range 12-35. WM was assessed with two online computer tasks: A task where participants had to identify and remember the location of an odd shape and a task of remembering and following instructions. PLE scores were derived from a translated symptom questionnaire (Community Assessment of Psychic Experiences; CAPE, which includes positive, negative and depressive symptom scales. Positive and negative symptom scales were further subdivided into symptom clusters based on factor analyses. The results showed that low WM capacity was modestly associated with increased reports of bizarre experiences and depressive symptoms, after controlling for age, gender, and global symptom scores. Interestingly, when analyses were repeated for separate age groups, low WM was exclusively associated with a higher frequency of bizarre experiences for young adults (20 - 27 years and with depressive symptoms for older adults (28 - 35 years. These findings suggest that specific PLEs can be indicative of reduced WM capacity in early adulthood, which in turn may reflect an increased risk for psychosis and a greater need for targeted intervention. In contrast, during adolescence individual differences in cognitive development may influence the strength of the relationships and thereby mask potential vulnerabilities for psychopathology.

  18. Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates.

    Science.gov (United States)

    Rajkumar, Ravi Philip

    2015-01-01

    Introduction. Depressive symptoms are common in schizophrenia and are associated with poorer functioning, lower quality of life, and an elevated risk of suicidal behaviour. There are few studies on the occurrence and correlates of these symptoms in acutely ill patients with schizophrenia. Method. 72 acutely ill patients with schizophrenia were assessed for depression using the Calgary Depression Scale for Schizophrenia (CDSS). A cut-off score of ≥6 on the CDSS was used to identify clinically significant depressive symptoms. The relationship between depression and illness variables, including psychotic symptom dimensions as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), was examined. Results. Eleven (15.3%) patients had clinically significant depressive symptoms. These patients scored higher on the positive and general psychopathology scales of the PANSS and had higher rates of suicidal behavior and poorer functioning. The severity of depressive symptoms was positively correlated with the PANSS positive subscale and negatively correlated with the PANSS negative subscale. Discussion. These findings confirm previous reports that depressive symptoms in active schizophrenia is related to the severity of positive psychotic symptoms and is a risk factor for suicidal behaviour in these patients.

  19. Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Ravi Philip Rajkumar

    2015-01-01

    Full Text Available Introduction. Depressive symptoms are common in schizophrenia and are associated with poorer functioning, lower quality of life, and an elevated risk of suicidal behaviour. There are few studies on the occurrence and correlates of these symptoms in acutely ill patients with schizophrenia. Method. 72 acutely ill patients with schizophrenia were assessed for depression using the Calgary Depression Scale for Schizophrenia (CDSS. A cut-off score of ≥6 on the CDSS was used to identify clinically significant depressive symptoms. The relationship between depression and illness variables, including psychotic symptom dimensions as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS, was examined. Results. Eleven (15.3% patients had clinically significant depressive symptoms. These patients scored higher on the positive and general psychopathology scales of the PANSS and had higher rates of suicidal behavior and poorer functioning. The severity of depressive symptoms was positively correlated with the PANSS positive subscale and negatively correlated with the PANSS negative subscale. Discussion. These findings confirm previous reports that depressive symptoms in active schizophrenia is related to the severity of positive psychotic symptoms and is a risk factor for suicidal behaviour in these patients.

  20. Measuring Empowerment Among People With Psychotic Disorders: A Comparison of Three Instruments

    OpenAIRE

    Castelein, S; Gaag, van der, V.; Bruggeman, R; van Busschbach, J.T.; Wiersma, D

    2008-01-01

    Objective: This study compared three instruments that are used to measure empowerment of people with psychotic disorders. The study evaluated internal consistency, discriminant and convergent validity, sensitivity to symptom levels, and clinical usefulness. Methods: Fifty patients in the Netherlands were administered the Empowerment Scale (ES), the Personal Empowerment Scale ( PES), and the Mental Health Confidence Scale (MHCS). Results: The MHCS had good internal consistency, whereas the lev...

  1. Genomic imprinting in the development and evolution of psychotic spectrum conditions.

    Science.gov (United States)

    Crespi, Bernard

    2008-11-01

    I review and evaluate genetic and genomic evidence salient to the hypothesis that the development and evolution of psychotic spectrum conditions have been mediated in part by alterations of imprinted genes expressed in the brain. Evidence from the genetics and genomics of schizophrenia, bipolar disorder, major depression, Prader-Willi syndrome, Klinefelter syndrome, and other neurogenetic conditions support the hypothesis that the etiologies of psychotic spectrum conditions commonly involve genetic and epigenetic imbalances in the effects of imprinted genes, with a bias towards increased relative effects from imprinted genes with maternal expression or other genes favouring maternal interests. By contrast, autistic spectrum conditions, including Kanner autism, Asperger syndrome, Rett syndrome, Turner syndrome, Angelman syndrome, and Beckwith-Wiedemann syndrome, commonly engender increased relative effects from paternally expressed imprinted genes, or reduced effects from genes favouring maternal interests. Imprinted-gene effects on the etiologies of autistic and psychotic spectrum conditions parallel the diametric effects of imprinted genes in placental and foetal development, in that psychotic spectrum conditions tend to be associated with undergrowth and relatively-slow brain development, whereas some autistic spectrum conditions involve brain and body overgrowth, especially in foetal development and early childhood. An important role for imprinted genes in the etiologies of psychotic and autistic spectrum conditions is consistent with neurodevelopmental models of these disorders, and with predictions from the conflict theory of genomic imprinting.

  2. 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.

  3. Widespread brain dysconnectivity associated with psychotic-like experiences in the general population.

    Science.gov (United States)

    Orr, Joseph M; Turner, Jessica A; Mittal, Vijay A

    2014-01-01

    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.

  4. 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.

  5. Trajectories of childhood internalizing and externalizing psychopathology and psychotic-like experiences in adolescence: A prospective population-based cohort study.

    Science.gov (United States)

    Lancefield, Kristin S; Raudino, Alessandra; Downs, Johnny M; Laurens, Kristin R

    2016-05-01

    Adolescent internalizing and externalizing psychopathology is strongly associated with adult psychiatric morbidity, including psychotic disorders. This study examined whether internalizing or externalizing trajectories (continuity/discontinuity of symptoms) from middle childhood were associated with adolescent psychotic-like experiences (PLEs). Prospective data were collected from a community sample of 553 children (mean age = 10.4 years; 50% male) and their primary caregivers. Participants completed questionnaire reports of internalizing and externalizing psychopathology and PLEs at baseline, and again approximately 2 years later. Logistic regression was used to examine the association of adolescent PLEs with four trajectories of internalizing and externalizing psychopathology (persistent, incident, remitting, and none), controlling for a range of potential confounders and sampling bias. Significant associations were identified between adolescent PLEs and the incident internalizing (adjusted odds ratio [adj. OR] = 2.96; 95% confidence interval [CI] = 1.60-5.49) and externalizing psychopathology (adj. OR = 2.14; 95% CI = 1.11-4.14) trajectories, as well as the persistent internalizing (adj. OR = 1.90; 95% CI = 1.13-3.18) and externalizing (adj. OR = 1.81, 95% CI = 1.02-3.19) trajectories. Children with remitting psychopathology trajectories were no more likely to present later PLEs than those who never experienced psychopathology. While for many individuals symptoms and illness remit during development without intervention, this study provides important insights regarding potential targets and timing for delivery of early intervention and prevention programs.

  6. Prevention of negative symptom psychopathologies in first-episode schizophrenia

    DEFF Research Database (Denmark)

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

    2008-01-01

    The duration of untreated psychosis (DUP)-the time from onset of psychotic symptoms to the start of adequate treatment--is consistently correlated with better course and outcome, but the mechanisms are poorly understood....

  7. Psychiatric symptoms and disorders in HIV infected mine workers in ...

    African Journals Online (AJOL)

    The dominating symptoms were those of cognitive deficits, and different psychotic ... for substance abuse showed that 9 of the patients had ongoing cannabis abuse and 10 had ..... patients had not developed psychological reactions to the HIV.

  8. Menopausal symptoms

    OpenAIRE

    Rymer, Janice; Morris, Edward P.

    2011-01-01

    In the UK, the median age for onset of menopausal symptoms is 45.5 to 47.5 years. Symptoms associated with the menopause include vasomotor symptoms, sleeplessness, mood changes, reduced energy levels, loss of libido, vaginal dryness, and urinary symptoms.Many symptoms, such as hot flushes, are temporary, but those resulting from reduced hormone levels, such as genital atrophy, may be permanent.

  9. 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...

  10. Psychological mechanisms of dopamine in psychotic symptoms of schizophrenia:Recent theoretical and empirical advances%多巴胺在精神分裂症阳性症状中的心理机制:新近理论和研究进展

    Institute of Scientific and Technical Information of China (English)

    束庆; 段直光; 胡刚; 李鸣

    2012-01-01

    Schizophrenia is one of the most severe neuropsychiatric disorders that exert a huge financial burden on individuals and societies. Its etiology is still unknown. Due to the influence of the dominant reductionist approach in this field, much research has been devoted to the studies of the genes, molecules and neuroreceptors and their possible contributions to the development of schizophrenia. Although schizophrenia is considered as a brain disorder, its diagnosis and evaluation of symptom improvement are all based on behavioral observations. Therefore, in order to gain a complete understanding of schizophrenia, we need a psychological theory rooted in basic neurobiology to explain various symptoms of schizophrenia. The present paper focuses on the delusions and hallucinations—two main positive symptoms of schizophrenia—and attempts to delineate the roles of dopamine in the etiology, pathophysiology, and psychopharmacological treatment of schizophrenia and further discuss how these symptoms arise from a psychological perspective. We present findings from our animal psychopharmacoiogy work using the conditioned avoidance response model in the framework of the motivational salience hypothesis proposed by Shitij Kapur. We elaborate on how this hypothesis explains changes at the molecular level (e.g. Dopamine) leading to the changes at the behavioral level (e.g. Psychosis). It is thought that hyperactivity of dopamine neurotransmission causes excess incentive learning (e.g., hyperactivity of associations of thoughts) and heightened motivational salience of stimuli (e.g., thoughts, actions, etc.), which generate many "erroneous" conclusions in the form of delusions or hallucinations. Antipsychotic drugs are supposed to correct the hyperdoperminergic state in which psychotic beliefs are generated by halting incentive learning or weakening aberrantly heightened salience of psychosis. From this paper, we hope that readers will have a better understanding of the roles of

  11. [Persistent psychotic disorder following bilateral mesencephalo-thalamic ischaemia: case report].

    Science.gov (United States)

    Predescu, A; Damsa, C; Riegert, M; Bumb, A; Pull, C

    2004-01-01

    A 38-year old male patient with no history of psychiatric illness developed a progressive psychotic disorder after bilateral (predominantly left) mesencephalo-thalamic cerebral ischaemia. The reason of the emergency hospitalization was the sudden onset of a confusional state, culminating in a fluctuating comatose status. The neurological examination found mild right hemiparesia, praxic disorders and reactive left mydriasis with paresia of the downward vertical stare, leading to the hospitalisation in the neurology department for suspicion of a cerebral vascular ischaemic accident. The psychiatric symptoms started with acoustic-verbal hallucinations, poorly structured paranoid delusions, progressively developed over two weeks, followed by behavioural disorders with psychomotor agitation and heteroaggressivity. The patient was transferred to the psychiatric department, because of the heteroaggressive risk and lack of morbid consciousness, in spite of recovering from the confusional status. An intensive psychiatric management was proposed, combining a psychotherapeutic approach with 4 mg of risperidone and adjustable doses of benzodiazepine according to the psychomotor agitation. During the next days, there was a net recovery of the behavioural disorders, in spite of the persistence of the ideas of persecution. All the neurological symptoms also decreased. An anomaly of the polygon of Willis was found on a cerebral arteriography (the posterior cerebral arteries had a foetal origin, dependent on carotidal axes and not on the vertebro-basilar system). The main emboligen risk factor was the presence of a permeable foramen ovale, discovered during a transoesophageal echography. The patient underwent a surgical correction of the permeable foramen ovale. The psychiatric hospitalization for three months was continued by ambulatory follow-up. The initial positive symptoms (delusions, acoustic-verbal hallucinations) progressively diminished while negative symptoms became

  12. 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.

  13. Anthrax: Symptoms

    Science.gov (United States)

    ... EID Journal Articles Anthrax-Related MMWRs Medscape Commentaries Symptoms Language: English Español (Spanish) Recommend on Facebook Tweet ... cause severe illness and even death. Cutaneous anthrax symptoms can include: A group of small blisters or ...

  14. Cognitive styles and psychotic experiences in a community sample.

    Directory of Open Access Journals (Sweden)

    Sarah Sullivan

    Full Text Available In clinical populations paranoid delusions are associated with making global, stable and external attributions for negative events. Paranoia is common in community samples but it is not known whether it is associated with a similar cognitive style. This study investigates the association between cognitive style and paranoia in a large community sample of young adults.2694 young adults (mean age 17.8, SD 4.6 from the ALSPAC cohort provided data on psychotic experiences and cognitive style. Psychotic experiences were assessed using a semi-structured interview and cognitive style was assessed using the Cognitive Styles Questionnaire-Short Form (CSQ-SF on the same occasion. Logistic regression was used to investigate associations between paranoia and CSQ-SF scores, both total and domain-related (global, stable, self, external. The role of concurrent self-reported depressive symptoms in the association was explored.Paranoia was associated with Total CSQ-SF scores (adjusted OR 1.69 95% CI 1.29, 2.22, as well as global (OR 1.56 95% CI 1.17, 2.08, stable (OR 1.56 95% CI 1.17, 2.08 and self (OR 1.37 95% CI 1.05, 1.79 domains, only Total score and global domain associations remained after additional adjustment for self-reported depression. There was no association between paranoia and external cognitive style (OR 1.10 95% CI 0.83, 1.47.Paranoid ideation in a community sample is associated with a global rather than an external cognitive style. An external cognitive style may be a characteristic of more severe paranoid beliefs. Further work is required to determine the role of depression in the association between cognitive style and paranoia.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  16. 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.

  17. 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; A.J.M. Loonen (Anne); 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 sealing-

  18. Neuromyelitis optica presenting with psychiatric symptoms and catatonia: a case report.

    Science.gov (United States)

    Alam, Abdulkader; Patel, Rachit; Locicero, Briana; Rivera, Nicole

    2015-01-01

    Neuromyelitis optica (NMO) is an aggressive disease characteristically affecting the spinal cord and optic nerves that has recently been differentiated from multiple sclerosis. We present a case of a 16-year-old Antiguan female previously diagnosed with NMO who presented with a 1-week history of confusion and agitation. She had symptoms of psychosis, including delusional thinking and auditory and visual hallucinations, and scored 11/23 on the Bush-Francis Catatonia Scale. This case demonstrates an NMO exacerbation that presented with psychotic symptoms and catatonia.

  19. Disease-related and psychosocial factors associated with depressive symptoms in patients with systemic sclerosis, including fear of progression and appearance self-esteem.

    Science.gov (United States)

    Kwakkenbos, Linda; van Lankveld, Wim G J M; Vonk, Madelon C; Becker, Eni S; van den Hoogen, Frank H J; van den Ende, Cornelia H M

    2012-03-01

    The prevalence of depressive symptoms is high in patients with systemic sclerosis (SSc, scleroderma). This study was conducted to determine which disease-related and psychosocial factors are associated with depressive symptoms, independent of sociodemographic factors. In total, 215 patients with SSc completed questionnaires on sociodemographics, physical functioning (HAQ-DI), pain (VAS), fatigue (CIS), psychosocial characteristics (CISS, ICQ, PRQ, ASE, FoP-Q-SF) and depressive symptoms (CES-D). Disease characteristics (disease duration, disease subtype, modified Rodnan Skin Score) were collected. Hierarchical linear regression analyses were conducted to assess associations with depressive symptoms. The mean CES-D score was 12.9 (SD=9.7) and the prevalence of patients scoring>= 16 and>=19 were 32.1% and 25.1%, respectively. The variance explained by sociodemographics and disease characteristics was negligible (R(2)≤.09). Fatigue and pain were independently associated with depressive symptoms (R(2) change=.35). After adding psychological factors (R(2) change=.21), satisfaction with social support, emotion-focused coping and helplessness were also significantly associated with depressive symptoms. Higher fear of progression was associated with more depressive symptoms (P≤.01), and appearance self-esteem showed a marginally significant association (P=.08). Depressive symptoms were common in the present sample of patients with SSc and were independently associated with pain, fatigue, social support, emotion-focused coping, helplessness and fear of progression. Results suggest that, in addition to assessment of disease characteristics, attention should be given also to psychosocial factors found to be associated with depressive symptoms. For the development and trialling of psychological interventions, fear of progression could be an important target. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. 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.

  1. Electroconvulsive Therapy Treatment in a Patient With Neurosyphilis and Psychotic Disorder: Case Report and Literature Review.

    Science.gov (United States)

    Pecenak, Jan; Janik, Peter; Vaseckova, Barbora; Trebulova, Kristina

    2015-12-01

    Syphilis is an infectious disease caused by Treponema pallidum that presents clinically in different ways. Over recent years, an upsurge of new cases of syphilis has been reported, often in combination with human immunodeficiency virus infection. The clinical picture is changing because of the widespread use of antibiotics, and psychiatric manifestations may be the main reason why patients seek medical help. In most cases, treatment with penicillin and psychotropic medication is effective. Electroconvulsive therapy (ECT) is rarely used for the psychiatric manifestations of neurosyphilis: we identified only 19 cases in the literature. We report here on a 40-year-old man newly diagnosed with neurosyphilis during hospitalization for a psychotic state with depression and also review the literature. He was treated with 2 courses of penicillin and several antipsychotics. The ECT was indicated because he failed to respond well to antipsychotic treatment and developed a high risk of dangerous behavior. A series of 8 sessions of ECT rapidly relieved the psychotic symptoms.

  2. 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.

  3. [Experimental Approach to Analysis of the Relationship between Food Environments and Lifestyle-Related Diseases, Including Cardiac Hypertrophy, Fatty Liver, and Fatigue Symptoms].

    Science.gov (United States)

    Horiuchi, Masahisa; Nakakuma, Miwa; Arimura, Emi; Ushikai, Miharu; Yoshida, Goichiro

    2015-01-01

    The food habit is involved in the onset and development of lifestyle-related diseases. In this review I would like to describe a historical case of vitamin B1 deficiency, as well as our case study of fatty acid metabolism abnormality due to carnitine deficiency. In history, the army and navy personnel in Japan at the end of the 19th century received food rations based on a high-carbohydrate diet including white rice, resulting in the onset of beriberi. An epidemiological study by Kenkan Takaki revealed the relationship between the onset of beriberi and rice intake. Then, Takaki was successful in preventing the onset of beriberi by changing the diet. However, the primary cause had yet to be elucidated. Finally, Christian Eijkman established an animal model of beriberi (chickens) showing peripheral neuropathy, and he identified the existence of an anti-beriberi substance, vitamin B1. This is an example of the successful control of a disease by integrating the results of epidemiological and experimental studies. In our study using a murine model of fatty acid metabolism abnormality caused by carnitine deficiency, cardiac abnormality and fatty liver developed depending on the amount of dietary fat. In addition, the mice showed disturbance of orexin neuron activity related to the sleep-arousal system, which is involved in fatigue symptoms under fasting condition, one of the states showing enhanced fatty acid metabolism. These findings suggest that fatty acid toxicity is enhanced when the mice are more dependent on fatty acid metabolism. Almost simultaneously, a human epidemiological study showed that narcolepsy, which is caused by orexin system abnormality, is associated with the polymorphism of the gene coding for carnitine palmitoyltransferase 1B, which is involved in carnitine metabolism. To understand the pathological mechanism of fatty acid toxicity, not only an experimental approach using animal models, but also an epidemiological approach is necessary. The

  4. Change in cannabis use, clinical symptoms and social functioning among patients with first-episode psychosis

    DEFF Research Database (Denmark)

    Clausen, L; Hjorthøj, C R; Thorup, Anne A.E.

    2014-01-01

    BACKGROUND: Several studies indicate that cannabis use among patients with psychotic disorders is associated with worse outcome, but only a few studies have controlled for baseline condition and medication. METHOD: At 5-year follow-up, interviews were carried out with 314 first-episode psychosis.......26, 95% CI 2.13-14.39, p = 0.01). Those who stopped using cannabis between entry and 5-year follow-up had a significantly lower level of psychotic symptoms at 5-year follow-up even after controlling for baseline level of psychotic symptoms and for insufficient antipsychotic medication (adjusted...... difference in psychotic dimension -1.04, 95% CI -1.77 to -0.31, p = 0.006). CONCLUSIONS: Continuous cannabis use was associated with higher levels of psychotic symptoms after 5 years, and this association was only partly explained by insufficient antipsychotic medication....

  5. Reversal of cerebral glucose hypometabolism on positron emission tomography with electroconvulsive therapy in an elderly patient with a psychotic episode.

    Science.gov (United States)

    Hassamal, Sameer; Jolles, Paul; Pandurangi, Ananda

    2016-11-01

    AB, a 74-year-old Caucasian woman, was admitted for acute onset of psychosis, anxiety, and cognitive impairment. Pharmacotherapy was unsuccessful and the patient was referred for electroconvulsive therapy (ECT). Pre-ECT, (18) F-fluorodeoxyglucose-positron emission tomography (PET)/computed tomography showed extensive frontal, parietal, and temporal cortical hypometabolism suggestive of a neurodegenerative disease. After eight ECT sessions, the psychotic and anxiety symptoms as well as the cognitive impairment resolved. The rapid improvement in symptoms was more suggestive of a psychotic episode rather than dementia. Two days after the ECT course, (18) F-fluorodeoxyglucose-PET/computed tomography showed improvements in cerebral cortical hypometabolism, especially in the left parietal cortex, left temporal/occipital cortex. and bifrontal regions. At a follow-up visit 2 months after the ECT course, the psychotic episode was still in remission, and (18) F-fluorodeoxyglucose-PET/computed tomography continued to show improved cerebral cortical hypometabolism in these areas. This case illustrated the effect of ECT in reversing cerebral glucose hypometabolism on PET. The improvement in cerebral glucose hypometabolism may represent the neurophysiological mechanism of ECT in the treatment of a psychotic episode. Improved cerebral glucose hypometabolism was present 2 months post-ECT, which suggests that ECT caused sustained functional neural changes. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

  6. Basic symptoms in schizophrenic and affective psychoses.

    Science.gov (United States)

    Ebel, H; Gross, G; Klosterkötter, J; Huber, G

    1989-01-01

    The study compares schizophrenic and affective psychoses with regard to basic symptoms. 30 patients in schizophrenic pre-, intra-, and postpsychotic basic stages and 30 patients in endogenous-depressive phases were examined according to the Bonn Scale for the Assessment of Basic Symptoms. The most important result is that certain cognitive basic symptoms and cenesthesias which are decisive for the development of florid productive-psychotic phenomena are found more frequently in the group of schizophrenias.

  7. Cultural and linguistic adaptability of the Rorschach Performance Assessment System as a measure of psychotic characteristics and severity of mental disturbance in Taiwan.

    Science.gov (United States)

    Su, Wen-So; Viglione, Donald J; Green, Elizabeth E; Tam, Wai-Cheong Carl; Su, Jian-An; Chang, Yi-Ting

    2015-12-01

    This study investigated the cultural and linguistic adaptability of the Rorschach Performance Assessment System (R-PAS), a new Rorschach administration, scoring, and interpretation system that minimizes psychometric weaknesses of the Comprehensive System (CS). This investigation addressed the validity of R-PAS measures of psychotic characteristics and psychopathology severity in Taiwan, including the incremental validity of the R-PAS relative to the CS variables measuring the same constructs. Ninety Taiwanese individuals (75 psychiatric patients and 15 nonpatients) were tested with standard R-PAS administration and scoring. Two non-Rorschach severity of disturbance measures and 2 psychosis measures served as independent criterion measures. The R-PAS measures were found to be valid in Taiwan in assessing psychotic symptoms and psychopathology severity, thus demonstrating cultural and linguistic adaptability. Moreover, hierarchical regression analyses demonstrated incremental validity for the R-PAS variables over their CS counterparts, providing support that the R-PAS revisions enhance the test psychometrically. These research findings also demonstrate the viability of the R-PAS as a Rorschach system that can be effectively employed outside the U.S. in a different language and culture.

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

    DEFF Research Database (Denmark)

    Parnas, J; Handest, P; Saebye, D

    2003-01-01

    . 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...

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

    DEFF Research Database (Denmark)

    Parnas, J; Handest, P; Saebye, D

    2003-01-01

    . 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...

  10. 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

  11. 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.

  12. Clinical correlates of thalamus volume deficits in anti-psychotic-naïve schizophrenia patients: A 3-Tesla MRI study.

    Science.gov (United States)

    Rao, Naren P; Kalmady, Sunil; Arasappa, Rashmi; Venkatasubramanian, Ganesan

    2010-07-01

    Thalamus, the sensory and motor gateway to the cortex, plays an important role in cognitive and perceptual disturbances in schizophrenia. Studies examining the volume of the thalamus in schizophrenia have reported conflicting findings due to the presence of potential confounding factors such as low-resolution imaging and anti-psychotics. The thalamus volume in anti-psychotic-naïve patients determined using high-resolution 3-Tesla magnetic resonance imaging (MRI) has not yet been examined. Using 3-Tesla MRI, this study for the first time examined anti-psychotic-naïve schizophrenia patients (n=18; M:F:11:7) in comparison with healthy controls (n=19;M:F:9:10) group-matched for age, sex, handedness, education, and socioeconomic status. The volume of the thalamus was measured using a three-dimensional, interactive, semi-automated analysis with good inter-rater and intra-rater reliability. Psychopathology was assessed using the Scale for Assessment of Negative Symptoms (SANS) and the Scale for Assessment of Positive Symptoms (SAPS). Right, left, and total thalamus volumes of patients were significantly smaller than those of controls after controlling for the potential confounding effect of intracranial volume. Thalamus volumes had significant positive correlation with positive symptoms score (SAPS) and significant negative correlation with negative symptoms score (SANS). Thalamus volume deficits in anti-psychotic-naïve schizophrenia patients support a neurodevelopmental pathogenesis. The contrasting correlation of thalamus volume deficits with psychopathology scores suggests that contrasting pruning aberrations underlie symptom genesis in schizophrenia.

  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. Trauma, shame and psychotic depression experienced by ex-POWs after release.

    Science.gov (United States)

    Urlić, Ivan; Strkalj-Ivezić, Sladana; John, Nada

    2009-09-01

    Modern societies are growing ever more sensitive to the various sources and many kinds of psychic traumas, resulting even in psychotic reactions or states of functioning. Especially the war captivity situation represents the prolonged basis for chronic severe psychic stress and traumatisation, that may become deleterious even for the core self of the person. Severely psychotraumatized war veterans, or ex-POWs in the aftermath of the war captivity situation, survivors of extreme forms of violence and humiliation, are very reluctant to recall traumas. This avoidant behaviour is many times one of the most prominent symptoms that should be recognised and confronted in order to start the retraumatising process of healing the previously unthinkable traumas. The authors believe that shameful feelings are at the very basis of the psychotraumatised persons' withdrawal, depression, suicidal attempts, and even psychotic answers. The main feature of the first phase of any therapeutic work with these patients is the mourning process that should be gradually unfolded. The clinical examples will illustrate therapeutic work with these patients. The authors will expose some basic psychodynamic approaches and concepts regarding shame. This difficult feeling will be put in relationship with the psychotic answers. In that frame of reference the concept of 'near psychosis' will be described.

  15. Psychological Interventions for Post-traumatic Stress Symptoms in Psychosis: A Systematic Review of Outcomes

    Science.gov (United States)

    Swan, Sarah; Keen, Nadine; Reynolds, Nicola; Onwumere, Juliana

    2017-01-01

    Individuals with severe mental health problems, such as psychosis, are consistently shown to have experienced high levels of past traumatic events. They are also at an increased risk of further traumatisation through victimization events such as crime and assault. The experience of psychosis itself and psychiatric hospitalization have also been recognized to be sufficiently traumatic to lead to the development of post-traumatic stress (PTS) symptoms. Rates of post-traumatic stress disorder (PTSD) are elevated in people with psychosis compared to the general population. The current guidance for the treatment of PTSD is informed by an evidence base predominately limited to populations without co-morbid psychiatric disorders. The systematic review therefore sought to present the current available literature on the use of psychological treatments targeting PTS symptoms in a population with a primary diagnosis of a psychotic disorder. The review aimed to investigate the effect of these interventions on PTS symptoms and also the effect on secondary domains such as psychotic symptoms, affect and functioning. Fifteen studies were identified reporting on cognitive behavior therapy, prolonged exposure, eye movement desensitisation and reprocessing and written emotional disclosure. The review provides preliminary support for the safe use of trauma-focused psychological interventions in groups of people with severe mental health problems. Overall, the interventions were found to be effective in reducing PTS symptoms. Results were mixed with regard to secondary effects on additional domains. Further research including studies employing sufficiently powered methodologically rigorous designs is indicated.

  16. Social disorganization of neighborhoods and incidence of psychotic disorders: a 7-year first-contact incidence study.

    Science.gov (United States)

    Veling, W; Susser, E; Selten, J-P; Hoek, H W

    2015-07-01

    Environmental factors such as urban birth and ethnic minority position have been related to risk for psychotic disorders. There is some evidence that not only individual, but also neighborhood characteristics influence this risk. The aim of this study was to investigate social disorganization of neighborhoods and incidence of psychotic disorders. The research was a 7-year first-contact incidence study of psychotic disorders in The Hague. Neighborhood characteristics included continuous, dichotomous and cumulative measures of socio-economic level, residential mobility, ethnic diversity, proportion of single person households, voter turnout, population density and crime level. Using multilevel Poisson regression analysis, incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of psychotic disorders were calculated for the indicators of neighborhood social disorganization. A total of 618 incident cases were identified. Neighborhood socio-economic level and residential mobility had the strongest association with incidence of psychotic disorders [individual-level adjusted Wald χ2 1 = 13.03 (p = 0.0003) and 5.51 (p = 0.02), respectively]. All but one (proportion of single person households) of the dichotomous neighborhood indicators were significantly associated with a higher IRR. The cumulative degree of neighborhood social disorganization was strongly and linearly associated with the incidence of psychotic disorders (trend test, Wald χ2 5 = 25.76, p = 0.0001). The IRR in neighborhoods with the highest degree of social disorganization was 1.95 (95% CI 1.38-2.75) compared with the lowest disorganization category. The findings suggest that the risk for developing a psychotic disorder is higher for people living in socially disorganized environments. Longitudinal studies are needed to investigate causality.

  17. Multiple Myeloma Symptoms

    Science.gov (United States)

    ... Treatment Center Finder Home » About Multiple Myeloma » Symptoms Multiple Myeloma Symptoms Multiple myeloma symptoms may vary by patient, ... to be managed or prevented. The most common multiple myeloma symptoms may include: Bone pain or bone fractures ...

  18. [Duration of untreated psychosis and cognitive deficits in a cohort of chronic psychotic patients].

    Science.gov (United States)

    Primavera, D; Carta, R; Lepori, T; Sanna, L; Carpiniello, B

    2013-01-01

    Outcome of psychotic disorders, particularly schizophrenia and related disorders, seems to be associated, among a number of other factors, to the latency of treatment of irst episode (duration of untreated psychosis, DUP); indeed, outcome seems to be worse in subjects with a longer DUP. However, few studies addressed the topic of long term outcome and DUP as regard to cognitive functioning, though the latter plays a crucial role in explaining a significant proportion of disability both in non-affective and affective psychoses. The study aims to analyze relationships between DUP and cognitive functioning in a sample of chronic psychotic patients. We considered a unselected sample constituted by 82 chronic outpatients, 49 males (59,8%) e 33 females (40,2%), age range 20-74 yrs (mean age 46,59; s.d. 10,68 yrs); these patients were affected by schizofrenia (n=41, 50%), Bipolar Disorder type I, with psychotic mood congruent or uncongruent features (n=18, 22%,) and Schizoaffettive Disorder (n=23, 28%) according to DSMIVTR, with diagnosis confirmed by means of SCID-I. Patients underwent WAIS-R in order to evaluate cognitive functioning. A longer DUP (more than 3 months between onset of first clinically evident psychotic symptoms and first antipsychotic treatment) was associated with significantly lower scores in 9 out of 11 subtests of WAIS, weighted total score, IQ-verbal score, IQ-performance score and IQ-total score. A significant relationship between a longer DUP and lower cognitive performances was confirmed among schizophrenic and schizoaffective patients, although limited to some subtests. The study provides new evidence for a positive association between longer DUP and worse neurocognitive functioning, even in the long term.

  19. First- and Third-Person Perspectives in Psychotic Disorders and Mood Disorders with Psychotic Features

    Directory of Open Access Journals (Sweden)

    Lucrezia Islam

    2011-01-01

    Full Text Available Lack of insight, very frequent in schizophrenia, can be considered a deficit in Theory of Mind (ToM performances, and is also found in other psychiatric disorders. In this study, we used the first- to third-person shift to examine subjects with psychotic and psychotic mood disorders. 92 patients were evaluated with SANS and SAPS scales and asked to talk about their delusions. They were asked to state whether they thought what they said was believable for them and for the interviewer. Two weeks later, 79 patients listened to a tape where their delusion was reenacted by two actors and were asked the same two questions. Some patients gained insight when using third-person perspective. These patients had lower SAPS scores, a lower score on SAPS item on delusions, and significant improvement in their SAPS delusion score at the second interview. Better insight was not related to a specific diagnostic group.

  20. 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.

  1. The quality of life among first-episode psychotic patients in the OPUS trial

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia

    2010-01-01

    BACKGROUND: From an 'objective' perspective, treatment of first-episode psychosis has improved in many ways with the development of specialised early and intensive team-based treatment like e.g. the 'OPUS' treatment. However, the patients' perspective is also important and was investigated in the...... extent and more strongly with the affective balance and level of self-esteem....... by Lancashire QoLP in a significantly different way from the standard treatment (ST). There were no significant differences in quality of life between the ST group and the OPUS group concerning the 9 life domains. Quality of life correlated with psychopathology (both psychotic and negative symptoms) to a minor...

  2. Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report

    OpenAIRE

    2012-01-01

    Abstract Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were “irritability, regressive behavior, apathy, crying and truancy” which lasted for a year. Premorbid personality was unrema...

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

    Science.gov (United States)

    Isvoranu, Adela-Maria; Borsboom, Denny; van Os, Jim; Guloksuz, Sinan

    2016-07-01

    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 psychometric framework for the study of mental disorders. Using general population data, we construct network models for the relation between 3 environmental risk factors (cannabis use, developmental trauma, and urban environment), dimensional measures of psychopathology (anxiety, depression, interpersonal sensitivity, obsessive-compulsive disorder, phobic anxiety, somatizations, and hostility), and a composite measure of psychosis expression. Results indicate the existence of specific paths between environmental factors and symptoms. These paths most often involve cannabis use. In addition, the analyses suggest that symptom networks are more strongly connected for people exposed to environmental risk factors, implying that environmental exposure may lead to less resilient symptom networks.

  4. Neurocysticercosis masquerading psychotic disorder:A case report

    Institute of Scientific and Technical Information of China (English)

    Rachita Sarangi; Surjeet Sahoo; Satyasunder Mohapatra

    2013-01-01

    Psychotic manifestations are uncommon in neurocysticercosis. This article describes a ten year girl presented with manic–psychotic manifestation for which she was under treatment with antipsychotics for eight months. Eventually she developed generalized tonic clonic seizure and CT scan of brain revealed small isodense right posterior parietal lesion of 5 mm size with perifocal edema. CECT revealed intense nodular post contrast enhancement. This highlights the possible misdiagnosis of a case of neurocysticercosis as an organic psychotic disorder so it should be considered as a differential diagnosis in patients with neurological as well as psychiatric manifestations in endemic area like India.

  5. Quality of life in patients with non-psychotic mental disorders, suffering from acute and chronic pancreatitis

    Directory of Open Access Journals (Sweden)

    Shevchenko Y.M.

    2015-03-01

    Full Text Available The aim of the study was to examine the quality of life and clinical features of non-psychotic mental disorders in patients with acute and chronic pancreatitis. Polymorphic mental disorders of different clinical content and severity in most cases not only comorbid diseases of the pancreas, but often are the first earliest clinical manifestations of the disease. The data on clinical and psychopathological features of non-psychotic mental disorders in patients with acute and chronic pancreatitis are given. The share of cardinal syndromes such as asthenic-neurotic and anxious-depressive was established and described. The study was conducted using the following methods: clinical psychiatric questionnaire of common type MOS Short Form-36 Health Survey (SF-36 and methods of mathematical processing. The sample included 131 patients with acute and chronic pancreatitis. Clinical variant of acute and chronic pancreatitis debut were the features of mental disorders and psychotic-pathologic structure of non-psychotic mental disorders. Various indicators of quality of life in acute and chronic pancreatitis in presence of psychotic disorders were revealed.

  6. Premorbid Negative Symptoms in First-Episode Psychosis

    Directory of Open Access Journals (Sweden)

    Manuel J. Cuesta

    2007-09-01

    Full Text Available Background and Objectives: Negative symptoms emerge in many patients with psychotic disorders long before the onset of the acute illness. These symptoms are often impossible to differentiate from certain Cluster A personality traits. Methods: The current study examines the extent to which premorbid negative symptoms are contributing factors to the development of primary and secondary negative symptomatology. Participants were 84 neuroleptic-naïve patients experiencing the occurrence of their first acute psychotic episode. Symptoms of psychopathology were assessed at two points: at admission and after remission of the acute episode. The Spanish version of the PANSS scale was administered. Premorbid personality assessment was considered as a proxy measure to evaluate each participant's negative symptomatology prior to the onset of the illness. Potential causes of secondary negative symptomatology, such as depression and extrapyramidal symptoms, were also examined. Results: 'Non-respondent' or 'residual' negative symptoms at discharge were significantly predicted by primary negative symptoms. To a lesser extent, disorganization and depressive symptoms at discharge and the Schizoid dimension of premorbid personality predicted residual negative symptoms. Conclusions: The severity of negative symptoms at the onset of the psychotic episode varied across patients. After controlling for 'respondent' and 'non-respondent' primary negative symptoms and other potential causes of negative symptoms, premorbid negative symptoms had a slight, but significant predictive relationship with residual negative symptoms.

  7. The concept of basic symptoms in schizophrenic and schizoaffective psychoses.

    Science.gov (United States)

    Huber, G; Gross, G

    1989-12-01

    This paper presents the psychiatric aspects of the concept of basic symptoms (BS), especially history, actual position and tendencies of development of the doctrine of BS, phenomenology and clinical picture of basic stages, the Bonn Scale for the assessment of dynamic and cognitive basic deficiencies (BSABS) and the importance of this concept for early diagnosis, therapy, prevention and rehabilitation. The patients experience and communicate the BS as deficiencies and are able to cope with, adapt and compensate for them. The BS were termed as basic symptoms because they represent the basis of the productive-psychotic symptomatology. Follow-up studies of cases with the suspicion diagnosis "prodrome of schizophrenia" based on BSABS rating, revealed that the subgroup passing over in schizophrenic psychoses after an average of 6.3 years showed significantly higher scores of cognitive BS at the time of index investigation. It now seems possible to impede increase of cognitive BS already present in prepsychotic prodromal states before reaching the threshold of transition into productive-psychotic symptomatology. Long-term development is more favorable if therapy commences as early as possible including the prepsychotic basic stages and also taking into consideration BS which were, until now, disregarded in DSM-III. Summarizing our findings of the last 30 years we suggest that the BS-concept may be an approach to overcome the dichotomy of negative and positive psychopathology in schizophrenia.

  8. 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

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

    NARCIS (Netherlands)

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

    2015-01-01

    BACKGROUND: 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

  10. EFFICACY OF COMMUNITY TREATMENTS FOR SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS: A LITERATURE REVIEW.

    Directory of Open Access Journals (Sweden)

    Julio eArmijo

    2013-10-01

    Full Text Available Background: In Chile, the clinical guidelines For the Treatment of People from First Episode of Schizophrenia aim to support individuals with schizophrenia to live independently, establishment occupational goals, and gain an adequate quality of life and social interaction. This requires the implementation of a treatment model that integrates psychosocial and pharmacological dimensions. Community intervention strategies ensure the achievement of these goals.Objectives: This study compiles and synthesizes available scientific evidence from the last 14 years on the effectiveness of community intervention strategies for schizophrenia and related psychotic disorders. Methodology: An electronic search was carried out using PUBMED, LILACS and Science-Direct as databases. Criteria of inclusion: i: randomized clinical trials, ii. Community-based interventions, iii. diagnosis of schizophrenia or related psychotic disorder (section F2 of ICD-10. Exclusion Criteria: i. treatments exclusively pharmacological, ii. Interventions carried out in inpatient settings, ii. bipolar affective disorder or substance-induced psychosis (greater than 50% of sample. Results: 66 articles were reviewed. Community strategies for integrated treatment from the first outbreak of schizophrenia significantly reduced negative and psychotic symptoms, days of hospitalization, and comorbidity with substance abuse and improved global functioning and adherence to treatment. In other stages, there were improved outcomes in negative and positive symptoms and general psychopathology. Psychoeducation for patients and families reduced the levels of self-stigma and domestic abuse, as well as improved knowledge of the disease and treatment adherence. Training focused on cognitive, social, and labor skills has been shown to improve yields in social functioning and employment status. Conclusions: Community-based intervention strategies are widely supported in the treatment of patients with

  11. Efficacy of Community Treatments for Schizophrenia and Other Psychotic Disorders: A Literature Review

    Science.gov (United States)

    Armijo, Julio; Méndez, Emmanuel; Morales, Ricardo; Schilling, Sara; Castro, Ariel; Alvarado, Rubén; Rojas, Graciela

    2013-01-01

    Background: In Chile, the clinical guidelines “for the treatment of people from first episode of schizophrenia” aim to support individuals with schizophrenia to live independently, establishment occupational goals, and gain an adequate quality of life and social interaction. This requires the implementation of a treatment model that integrates psychosocial and pharmacological dimensions. Community intervention strategies ensure the achievement of these goals. Objectives: This study compiles and synthesizes available scientific evidence from the last 14 years on the effectiveness of community intervention strategies for schizophrenia and related psychotic disorders. Methodology: An electronic search was carried out using PUBMED, LILACS, and Science Direct as databases. Criteria of inclusion: (i) randomized clinical trials, (ii) Community-based interventions, (iii) diagnosis of schizophrenia or related psychotic disorder (section F2 of ICD-10). Exclusion Criteria: (i) treatments exclusively pharmacological, (ii) interventions carried out in inpatient settings, (iii) bipolar affective disorder or substance-induced psychosis (greater than 50% of sample). Results: Sixty-six articles were reviewed. Community strategies for integrated treatment from the first outbreak of schizophrenia significantly reduced negative and psychotic symptoms, days of hospitalization, and comorbidity with substance abuse and improved global functioning and adherence to treatment. In other stages, there were improved outcomes in negative and positive symptoms and general psychopathology. Psychoeducation for patients and families reduced the levels of self-stigma and domestic abuse, as well as improved knowledge of the disease and treatment adherence. Training focused on cognitive, social, and labor skills has been shown to improve yields in social functioning and employment status. Conclusion: Community-based intervention strategies are widely supported in the treatment of patients with

  12. Increased Intrinsic Brain Activity in the Striatum Reflects Symptom Dimensions in Schizophrenia

    Science.gov (United States)

    Sorg, Christian; Manoliu, Andrei; Neufang, Susanne; Myers, Nicholas; Peters, Henning; Schwerthöffer, Dirk; Scherr, Martin; Mühlau, Mark; Zimmer, Claus; Drzezga, Alexander; Förstl, Hans; Bäuml, Josef; Eichele, Tom; Wohlschläger, Afra M.; Riedl, Valentin

    2013-01-01

    Striatal dysfunction is thought to be a fundamental element in schizophrenia. Striatal dopamine dysfunction impacts on reward processing and learning and is present even at rest. Here, we addressed the question whether and how spontaneous neuronal activity in the striatum is altered in schizophrenia. We therefore assessed intrinsic striatal activity and its relation with disorder states and symptom dimensions in patients with schizophrenia. We performed resting-state functional (rs-fMRI) and structural magnetic resonance imaging as well as psychometric assessment in 21 schizophrenic patients during psychosis. On average 9 months later, we acquired follow-up data during psychotic remission and with comparable levels of antipsychotic medication. Twenty-one age- and sex-matched healthy controls were included in the study. Independent component analysis of fMRI data yielded spatial maps and time-courses of coherent ongoing blood-oxygen-level-dependent signal fluctuations, which were used for group comparisons and correlation analyses with scores of the positive and negative syndrome scale. During psychosis, coherent intrinsic activity of the striatum was increased in the dorsal part and correlated with positive symptoms such as delusion and hallucination. In psychotic remission of the same patients, activity of the ventral striatum was increased and correlated with negative symptoms such as emotional withdrawal and blunted affect. Results were controlled for volumetric and medication effects. These data provide first evidence that in schizophrenia intrinsic activity is changed in the striatum and corresponds to disorder states and symptom dimensions. PMID:22241165

  13. Treating Depressive Symptoms in Psychosis: A Network Meta-Analysis on the Effects of Non-Verbal Therapies.

    Directory of Open Access Journals (Sweden)

    Laura A Steenhuis

    Full Text Available The aim of this study was to examine whether non-verbal therapies are effective in treating depressive symptoms in psychotic disorders.A systematic literature search was performed in PubMed, Psychinfo, Picarta, Embase and ISI Web of Science, up to January 2015. Randomized controlled trials (RCTs comparing a non-verbal intervention to a control condition in patients with psychotic disorders, whilst measuring depressive symptoms as a primary or secondary outcome, were included. The quality of studies was assessed using the 'Clinical Trials Assessment Measure for psychological treatments' (CTAM scale. Cohen's d was calculated as a measure of effect size. Using a Network Meta-analysis, both direct and indirect evidence was investigated.10 RCTs were included, of which three were of high quality according to the CTAM. The direct evidence demonstrated a significant effect on the reduction in depressive symptoms relative to treatment as usual (TAU, in favor of overall non-verbal therapy (ES: -0.66, 95% C.I. = -0.88, -0.44 and music therapy (ES: -0.59, 95% C.I. = -0.85, -0.33. Combining both direct and indirect evidence, yoga therapy (ES: -0.79, 95% C.I. = -1.24, -0.35 had a significant effect on depressive symptoms, and occupational therapy (ES: 1.81, 95% C.I. = 0.81, 2.81 was less effective, relative to TAU. Exercise therapy did not show a significant effect on depressive symptoms in comparison to TAU (ES: -0.02 95% C.I. = -0.67, 0.62. Due to inconsistency of study evidence, the indirect effects should be interpreted cautiously.Non-verbal therapies appear to be effective in reducing depressive symptomatology in psychotic disorders, in particular music therapy and yoga therapy.

  14. Exposure to environmental factors increases connectivity between symptom domains in the psychopathology network.

    Science.gov (United States)

    Guloksuz, Sinan; van Nierop, Martine; Bak, Maarten; de Graaf, Ron; Ten Have, Margreet; van Dorsselaer, Saskia; Gunther, Nicole; Lieb, Roselind; van Winkel, Ruud; Wittchen, Hans-Ulrich; van Os, Jim

    2016-07-08

    We investigated to what degree environmental exposure (childhood trauma, urbanicity, cannabis use, and discrimination) impacts symptom connectivity using both continuous and categorical measures of psychopathology. Outcomes were continuous symptom dimensions of self-reported psychopathology using the Self-report Symptom Checklist-90-R in 3021 participants from The Early Developmental Stages of the Psychopathology (EDSP) study and binary DSM-III-R categories of mental disorders and a binary measure of psychotic symptoms in 7076 participants from The Netherlands Mental Health Survey and Incidence Study (NEMESIS-1). For each symptom dimension in the EDSP and mental disorder in the NEMESIS-1 as the dependent variable, regression analyses were carried out including each of the remaining symptom dimensions/mental disorders and its interaction with cumulative environmental risk load (the sum score of environmental exposures) as independent variables. All symptom dimensions in the EDSP and related diagnostic categories in the NEMESIS-1 were strongly associated with each other, and environmental exposures increased the degree of symptom connectivity in the networks in both cohorts. Our findings showing strong connectivity across symptom dimensions and related binary diagnostic constructs in two independent population cohorts provide further evidence for the conceptualization of psychopathology as a contextually sensitive network of mutually interacting symptoms.

  15. 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; Correll, Christoph U; Kane, John M; Confino, Jamie

    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.

  16. Psychotic reactivity to daily life stress and the dopamine system: a study combining experience sampling and [18F]fallypride positron emission tomography.

    Science.gov (United States)

    Hernaus, Dennis; Collip, Dina; Lataster, Johan; Viechtbauer, Wolfgang; Myin, Erik; Ceccarini, Jenny; Van Laere, Koen; van Os, Jim; Myin-Germeys, Inez

    2015-02-01

    Stressful life events increase the risk for psychosis, and the subjective experience of stress related to daily life activities drives moment-to-moment variation in psychotic intensity. Positron emission tomography (PET) studies suggest that dopaminergic (DAergic) activity mediates the behavioral response to an experimental stressor. However, it is not known how alterations in this DAergic stress response relate to the subjective experience of stress in real life situations assessed in momentary assessment studies. This study combined [18F]fallypride PET with an Experience Sampling ambulatory assessment approach to examine the association between the prefrontal DAergic response to experimentally induced stress and real life psychotic reactivity to the subjective experience of stress in daily life. Healthy first-degree relatives of individuals with a psychotic disorder (N = 14) and healthy controls (N = 11) participated in (a) a psychosocial [18F]fallypride PET stress paradigm and (b) an experience sampling study, using a structured diary approach. Mixed multilevel random intercept models revealed that stress-induced [18F]fallypride displacement, indicative of DAergic activity, in ventromedial prefrontal cortex (VMPFC) was associated with psychotic reactivity to daily life stress in the entire sample. Lower levels of [18F]fallypride displacement to stress predicted increased psychotic reactivity to daily life stress. This study combined PET neuroimaging with real life behavioral assessments in the investigation of psychotic symptoms; we showed decreased [18F]fallypride displacement to stress in VMPFC to be associated with increased psychotic reactivity to daily life stress. The preliminary evidence in this study demonstrates that it is possible to acquire a grasp on how brain function is associated with contextualized experience, which has relevance for neuroimaging studies in general.

  17. Health management of older persons with chronically medicated psychotic disorders: the results of a survey in France.

    Science.gov (United States)

    Arbus, Christophe; Clement, Jean-Pierre; Bougerol, Thierry; Fremont, Patrick; Lancrenon, Sylvie; Camus, Vincent

    2012-03-01

    The medical care of elderly patients with psychotic disorders is a matter of major concern. The aim of the study was to investigate health conditions and treatment of elderly patients with psychotic disorders in France. The SAGE (Schizophrenia AGEd) study (observational, cross-sectional) was a survey conducted among 123 physicians in France, regarding prescriptions of antipsychotic drugs in elderly patients (≥60 years) suffering from psychotic disorders. The survey was based on a questionnaire addressing the mental and somatic health management of the patients. Data from 930 patients (mean age: 70.4 years) were collected. Most patients (58.5%) suffered from schizophrenia, 20.8% had delusional disorder and 20.6% hallucinatory chronic psychosis (very-late-onset schizophrenia-like psychosis). 70.8% of them were outpatients, while 29.2% were inpatients. The severity of psychotic symptoms was assessed in 97.8% of patients, but cognitive function was only evaluated in 41.6%. Some 46.5% of patients were treated with atypical antipsychotics alone, 36.2% with classical antipsychotics alone and 17.3% received a combination of both, atypical and classical antipsychotics; 36.3% patients were given antiparkinsonian medication, of whom only 17.8% as preventive treatment; 51.1% of patients had somatic comorbidities, particularly cardiovascular disorders (34.0%). Evaluation of renal and/or liver function to adjust the dose of treatment was done in only 32.1% of patients. Over the previous 12 months, almost half of the patients had had no ECG, glycemia or creatininemia investigated and HDL-cholesterol and triglycerides were available for less than one-third of them. Antipsychotic and antiparkinsonian drug prescriptions in French aged psychotic patients follow only partially the clinical guidelines and recommendations of consensus conferences. Moreover, cognitive, cardiac and metabolic aspects are not fully managed as expected.

  18. Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology.

    Science.gov (United States)

    Honings, Steven; Drukker, Marjan; van Nierop, Martine; van Winkel, Ruud; Wittchen, Hans-Ulrich; Lieb, Roselind; Ten Have, Margreet; de Graaf, Ron; van Dorsselaer, Saskia; van Os, Jim

    2016-11-30

    This study examines the longitudinal associations between psychotic experiences (PE) and incident suicidal ideation and behaviour in the general population, and to what degree the association may be confounded by non-psychotic psychopathology. Data from three prospective, general population cohorts were combined into one dataset (n=15,837) and analysed using logistic regression, controlling for continuous measures of depression, anxiety and mania symptoms. Analyses were conducted in the entire sample, and in subsamples stratified by presence or absence of mental disorders. The presence of PE at baseline increased the risk of incident suicidal ideation and behaviour. However, adjustment for dimensional measures of psychopathology reduced effect sizes, although PE remained significantly associated with suicide attempts. Further examination of the associations revealed that PE were only associated with suicide attempts in individuals with at least one mental disorder. Similarly, in individuals without mental disorders, the risk of suicidal ideation increased as PE co-occurred with more symptom domains. The results of this study confirm that individuals with PE are at increased risk of suicidal ideation and behaviour. However, these associations are not specific, but reflect the increased risk of suicidal ideation in individuals with subthreshold multidimensional psychopathology and suicide attempts in individuals with co-occurring mental disorders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Variations in incidence rates and age of onset of acute and transient psychotic disorders

    DEFF Research Database (Denmark)

    Castagnini, Augusto; Foldager, Leslie

    2013-01-01

    disorder (BD). Methods: We identified all subjects aged 15–64 years who were listed for the first time in the Danish Psychiatric Register with a diagnosis of ATPDs (n = 3,350), SZ (n = 4,576) and BD (n = 3,200) in 1995–2008. Incidence rates and rate ratios (IRR; 95 % confidence interval) by gender and age...... were calculated. Results: The incidence of ATPDs was 6.7 per 100,000 person-years, similarly high for both genders (IRR 1.0; 0.9–1.1). Among the ATPD subtypes, polymorphic psychotic disorder was more common in females (IRR 1.4; 1.2–1.6) as opposed to those featuring schizophrenic symptoms, which tended......Purpose: To determine incidence and age of onset of the ICD-10 category of ‘acute and transient psychotic disorders’ (ATPDs) characterised by subtypes with polymorphic, schizophrenic and predominantly delusional symptoms, pointing out differences from schizophrenia (SZ) and bipolar affective...

  20. [Is the diagnosis of schizophrenic illness possible in the initial prodromal phase to the first psychotic manifestation?].

    Science.gov (United States)

    Klosterkötter, J; Hellmich, M; Schultze-Lutter, F

    2000-04-01

    In the international research on schizophrenia, the early detection and intervention already in the initial prodromal phase prior to the first psychotic manifestation has become one of the main aims in recent years. Therefore, in the present study, the diagnostic efficiency of initial prodromal symptoms was examined prospectively for the first time ever. At index-examination, patients were examined with the 'Bonn Scale for the Assessment of Basic Symptoms--BSABS' and the ninth version of the 'Present State Examination--PSE 9'. At that time, none of the 160 patients had shown psychotic symptoms, but in 110 of the cases prodromal symptoms were found. At the reexamination that took place in average 9.6 years later, patients were explored with regard to a meantime transition to a first psychotic episode applying the same instruments as at index-examination. 79 of the 160 patients (49.38%) had developed a schizophrenic disorder according to DSM-IV-criteria in the catamnestic interval. In general, the 66 assessed prodromal symptoms exhibited a high sensitivity (.98), a high negative predictive power (.96) and a low percentage of false-negative predictions (1.3%), but lower values of specificity (.59) and positive predictive power (.70) as well as a higher percentage of false-positive predictions (20.6%). However, for a subset of mainly cognitive prodromal symptoms with a sensitivity sufficient for diagnostic criteria, high specificities (.85-.91) and positive predictive powers (.71-.91) as well as satisfactory percentages of false-positive predictions (7.5%-1.9%), and good classification rates (81.25%) were found. The results show that the applied conceptualization of prodromal symptoms that originates in the German psychopathological tradition is indeed useful for an early detection of psychoses. By assessing those prodromal symptoms, which were proven to be highly predictive, a diagnosis of schizophrenic disorders already seems possible in the initial prodrome. Thus in

  1. A case report of brief psychotic disorder with catalepsy associated with sequential life-threatening events in a patient with advanced cancer.

    Science.gov (United States)

    Ishida, Mayumi; Kawada, Satoshi; Onishi, Hideki

    2017-01-01

    Cancer is commonly perceived as life-threatening and universally stressful; however, brief psychotic disorder, which occurs in response to extremely stressful events, has not been reported. A 63-year-old woman, who was diagnosed as having pancreatic cancer with liver metastasis, became unresponsive with very little reaction to verbal contact after sequential life-threatening events, such as thrombosis of both pulmonary arteries and stenosis of the third portion of the duodenum, due to disease progression over 3 weeks beginning with oncological emergency hospital admission. Laboratory findings and electroencephalography were unremarkable. She maintained the position when the psycho-oncologist raised her hand (catalepsy). She had no medical history of psychiatric illness, or alcohol or drug abuse. From these findings, she was suspected of having a brief psychotic disorder with catalepsy and substupor, and 2.5 mg of haloperidol was administered. Her psychiatric symptoms disappeared in 4 days and the diagnosis of brief psychotic disorder was confirmed. Brief psychotic disorders can manifest in patients with cancer. Careful clinical assessment is needed to correctly diagnose patients with cancer who develop brief psychotic disorders and to identify those who will benefit from correct treatment.

  2. Psychotic experiences are linked to cannabis use in adolescents in the community because of common underlying environmental risk factors.

    Science.gov (United States)

    Shakoor, Sania; Zavos, Helena M S; McGuire, Philip; Cardno, Alastair G; Freeman, Daniel; Ronald, Angelica

    2015-06-30

    Cannabis users are more likely to have psychotic experiences (PEs). The degree to which these associations are driven by genetic or environmental influences in adolescence is unknown. This study estimated the genetic and environmental contributions to the relationship between cannabis use and PEs. Specific PEs were measured in a community-based twin sample (4830 16-year-old pairs) using self-reports and parent-reports. Adolescents reported on ever using cannabis. Multivariate liability threshold structural equation model-fitting was conducted. Cannabis use was significantly correlated with PEs. Modest heritability (37%), common environmental influences (55%) and unique environment (8%) were found for cannabis use. For PEs, modest heritability (27-54%), unique environmental influences (E=12-50%) and little common environmental influences (11-20%), with the exception of parent-rated Negative Symptoms (42%), were reported. Environmental influences explained all of the covariation between cannabis use and paranoia, cognitive disorganization and parent-rated negative symptoms (bivariate common environment=69-100%, bivariate unique environment=28-31%), whilst the relationship between cannabis use and hallucinations indicated familial influences. Cannabis use explains 2-5% of variance in positive, cognitive, and negative PEs. Cannabis use and psychotic experience co-occur due to environmental factors. Focus on specific environments may reveal why adolescent cannabis use and psychotic experiences tend to 'travel together'. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  3. Psychotic experiences are linked to cannabis use in adolescents in the community because of common underlying environmental risk factors

    Science.gov (United States)

    Shakoor, Sania; Zavos, Helena M.S.; McGuire, Philip; Cardno, Alastair G.; Freeman, Daniel; Ronald, Angelica

    2015-01-01

    Cannabis users are more likely to have psychotic experiences (PEs). The degree to which these associations are driven by genetic or environmental influences in adolescence is unknown. This study estimated the genetic and environmental contributions to the relationship between cannabis use and PEs. Specific PEs were measured in a community-based twin sample (4830 16-year-old pairs) using self-reports and parent-reports. Adolescents reported on ever using cannabis. Multivariate liability threshold structural equation model-fitting was conducted. Cannabis use was significantly correlated with PEs. Modest heritability (37%), common environmental influences (55%) and unique environment (8%) were found for cannabis use. For PEs, modest heritability (27–54%), unique environmental influences (E=12–50%) and little common environmental influences (11–20%), with the exception of parent-rated Negative Symptoms (42%), were reported. Environmental influences explained all of the covariation between cannabis use and paranoia, cognitive disorganization and parent-rated negative symptoms (bivariate common environment=69–100%, bivariate unique environment=28–31%), whilst the relationship between cannabis use and hallucinations indicated familial influences. Cannabis use explains 2–5% of variance in positive, cognitive, and negative PEs. Cannabis use and psychotic experience co-occur due to environmental factors. Focus on specific environments may reveal why adolescent cannabis use and psychotic experiences tend to ‘travel together’. PMID:25912376

  4. Psychotic experiences co-occur with sleep problems, negative affect and mental disorders in preadolescence

    DEFF Research Database (Denmark)

    Jeppesen, Pia; Clemmensen, Lars; Munkholm, Anja

    2014-01-01

    -reported mental health difficulties in absence of a diagnosis (31.4%). The risk of delusions increased with onset of puberty. The risk of PE increased with emotional and neurodevelopmental disorders, subthreshold depressive symptoms, sleep problems and lack of sleep, regardless of whether PE were expressed...... were examined by multivariable binomial regression analyses, adjusting for gender and onset of puberty. RESULTS: The weighted life time prevalence of PE at age 11-12 years was 10.9% (CI 9.1-12.7). The majority of children with PE (n = 172) either had a diagnosable DSM-IV-mental disorder (31.4%) or self......BACKGROUND: Knowledge on the significance of childhood psychotic symptoms and experiences (PE) is still limited. This study aimed to investigate the prevalence and clinical significance of PE in preadolescent children from the general population by use of in-depth psychopathological interviews...

  5. The clinical and cost effectiveness of group art therapy for people with non-psychotic mental health disorders: a systematic review and cost-effectiveness analysis.

    Science.gov (United States)

    Uttley, Lesley; Stevenson, Matt; Scope, Alison; Rawdin, Andrew; Sutton, Anthea

    2015-07-07

    The majority of mental health problems are non-psychotic (e.g., depression, anxiety, and phobias). For some people, art therapy may be a more acceptable alternative form of psychological therapy than standard forms of treatment, such as talking therapies. This study was part of a health technology assessment commissioned by the National Institute for Health Research, UK and aimed to systematically appraise the clinical and cost-effective evidence for art therapy for people with non-psychotic mental health disorders. Comprehensive literature searches for studies examining art therapy in populations with non-psychotic mental health disorders were performed in May 2013. A quantitative systematic review of clinical effectiveness and a systematic review of studies evaluating the cost-effectiveness of group art therapy were conducted. Eleven randomised controlled trials were included (533 patients). Meta-analysis was not possible due to clinical heterogeneity and insufficient comparable data on outcome measures across studies. The control groups varied between studies but included: no treatment/wait-list, attention placebo controls and psychological therapy comparators. Art therapy was associated with significant positive changes relative to the control group in mental health symptoms in 7 of the 11 studies. A de novo model was constructed and populated with data identified from the clinical review. Scenario analyses were conducted allowing comparisons of group art therapy with wait-list control and group art therapy with group verbal therapy. Group art-therapy appeared cost-effective compared with wait-list control with high certainty although generalisability to the target population was unclear; group verbal therapy appeared more cost-effective than art therapy but there was considerable uncertainty and a sizeable probability that art therapy was more cost effective. From the limited available evidence art therapy was associated with positive effects compared with

  6. Chinese translation and validation of the questionnaire on the process of recovery in schizophrenia and other psychotic disorders.

    Science.gov (United States)

    Chien, Wai Tong; Chan, Zenobia C Y

    2013-08-01

    Individuals recovering from schizophrenia and other psychotic disorders who have residual symptoms can achieve relatively normal work and social functioning in the community. This research aimed to test the psychometric properties of a Chinese version of the 22-item Questionnaire about the Process of Recovery. The translated Chinese QPR had satisfactory semantic equivalence with the original scale and high Cronbach alpha coefficients and test-retest stability at a 2-week interval. When tested in 300 outpatients with psychosis, the Chinese version was found to consist of three factors (Self-Empowerment, Rebuilding Life, and Effective Interpersonal Relationships) with satisfactory correlations with patients' quality of life, self-efficacy, and functioning. The Chinese version appears reliable and valid as a measure of psychotic patients' perceived levels of recovery. Copyright © 2013 Wiley Periodicals, Inc.

  7. Presentation and stability of noncognitive symptom patterns in patients with Alzheimer disease.

    Science.gov (United States)

    Haupt, M; Jänner, M; Ebeling, S; Stierstorfer, A; Kretschmar, C

    1998-12-01

    The purpose of this study was to investigate noncognitive symptoms in Alzheimer disease to identify symptom patterns and to study stability of such patterns prospectively. Furthermore, variables were examined that could be associated with certain types of symptom patterns or could be predictors of change of these patterns. Forty-eight patients with the clinical diagnosis of probable Alzheimer disease were included in this study and were assessed weekly over a 3-week period. Noncognitive symptoms were rated according to the Behavioral Abnormalities in Alzheimer's Disease Rating Scale and the Dementia Mood Assessment Scale and to a set of items that specifically assess misidentifications. By means of principal component factor analysis different noncognitive symptom patterns were obtained, yielding a four-factor solution. They mapped onto rational domains with respect to clinical experience: depression, apathy, psychotic symptoms/aggression, and misidentifications/agitation. Demographic and clinical variables were not associated with the factor solutions and did not predict change of the factor values. The results demonstrate that in Alzheimer disease there are distinct noncognitive symptom patterns that hold at least short-term prospective stability. None of the examined clinical variables, such as age at entry, the status of the patients (outpatient or inpatient), or dementia severity, exerted substantial influence on the noncognitive symptom patterns. Further investigations should concentrate on the pathological and prognostic correlates of noncognitive symptom patterns in Alzheimer disease.

  8. 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

    2017-07-05

    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.

  9. Cancer comortality patterns in schizophrenia and psychotic disorders: a new methodological approach for unique databases.

    Science.gov (United States)

    Ajdacic-Gross, Vladeta; Tschopp, Alois; Bopp, Matthias; Gutzwiller, Felix; Rössler, Wulf

    2014-03-01

    The aim of this study was to determine the pattern of cancer comortality in deaths registered with schizophrenia and psychotic disorders. It focused on the question of whether the proportions of different types of cancer diverge when they are co-registered with schizophrenia/psychotic disorders or with other causes of death in mortality statistics. We developed an analysis approach applicable to common mortality statistics data when no linkage with morbidity databases or other registers is possible. The analysis covered Swiss mortality data from a 39-year period (1969 - 2007) and was confined to the most frequent cancers. We applied a two-step case-control analysis with bootstrapping (1000 repetitions). The cases were defined by the cancer-schizophrenia registrations for each specific cancer, whereas the controls were matched from the remaining cases (matching criteria: sex, age, region, subperiod). Cancers with deviant standardized mortality ratios (SMRs) included stomach cancer (1.6; 2.2 after reweighting), lung cancer (0.8; 0.5 after reweighting) and breast cancer (1.6; 1.5 after reweighting). The comortality pattern of cancers in schizophrenia and psychotic disorders diverges from the pattern found in other co-registered causes of death. The relatively low frequency of lung cancers is particularly paradoxical in view of the smoking habits of schizophrenia patients.

  10. Is psychotic disorder associated with increased levels of craving for cannabis? An Experience Sampling study.

    Science.gov (United States)

    Kuepper, R; Oorschot, M; Myin-Germeys, I; Smits, M; van Os, J; Henquet, C

    2013-12-01

    Although cannabis use among individuals with psychotic disorder is considerable, little is known about patterns of use and factors contributing to continuation of use. Therefore, we investigated craving in relation to cannabis use in patients with psychotic disorder and healthy controls. The study included 58 patients with non-affective psychotic disorder and 63 healthy controls; all were frequent cannabis users. Craving was assessed with the Obsessive Compulsive Drug Use Scale (OCDUS) for cannabis, as well as in daily life using the Experience Sampling Method (ESM). Patients scored higher on the OCDUS (B = 1.18, P = 0.022), but did not differ from controls in ESM indices of craving (all P > 0.05). In daily life, ESM craving predicted cannabis use and this was stronger in controls (χ(2) = 4.5, P = 0.033; Bcontrols = 0.08, P craving was predicted by negative affect, paranoia, and hallucinations (Bnegativeaffect = 0.12, P = 0.009; Bparanoia = 0.13, P = 0.013; Bhallucinations = 0.13, P = 0.028), and followed by an increase in negative affect at non-cannabis-using moments (B = 0.03, P = 0.002). The temporal dynamics of craving as well as craving intensity in daily life appear to be similar in patients and controls. Further research is needed to elucidate the inconsistencies between cross-sectional and daily-life measures of craving in psychosis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. 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.

  12. Time series models of symptoms in schizophrenia.

    Science.gov (United States)

    Tschacher, Wolfgang; Kupper, Zeno

    2002-12-15

    The symptom courses of 84 schizophrenia patients (mean age: 24.4 years; mean previous admissions: 1.3; 64% males) of a community-based acute ward were examined to identify dynamic patterns of symptoms and to investigate the relation between these patterns and treatment outcome. The symptoms were monitored by systematic daily staff ratings using a scale composed of three factors: psychoticity, excitement, and withdrawal. Patients showed moderate to high symptomatic improvement documented by effect size measures. Each of the 84 symptom trajectories was analyzed by time series methods using vector autoregression (VAR) that models the day-to-day interrelations between symptom factors. Multiple and stepwise regression analyses were then performed on the basis of the VAR models. Two VAR parameters were found to be associated significantly with favorable outcome in this exploratory study: 'withdrawal preceding a reduction of psychoticity' as well as 'excitement preceding an increase of withdrawal'. The findings were interpreted as generating hypotheses about how patients cope with psychotic episodes.

  13. 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.

  14. The symbolic and concrete: Psychotic adolescents in psychoanalytic psychotherapy.

    Science.gov (United States)

    Pestalozzi, Julia

    2003-06-01

    Unique disturbances in symbolisation are characteristic of the pathology of schizophrenia. Drawing on the case vignette of a psychotic adolescent, the author discusses theoretical problems in the symbolisation process in general and then in psychosis, in particular the relation between 'concretism' as a thought disorder and other psychotic defences. The ability to symbolise on the one hand and to maintain sufficiently stable ego boundaries on the other hand are examined in their relation. The author's clinical experience supports her hypothesis that there is a close relationship between the impairment of the symbolisation process in the adolescent or adult psychotic patient and his/her inability to engage in symbolic play as a child. Special attention is paid to the role of early trauma and consequent pathology of object relations for disturbances of symbolic play in childhood. Regression to concrete thinking is understood as the chance of the psychotic patient to give some meaning to reality in an unreal, delusional world and as his/her last chance to communicate at all. Conclusions are drawn for psychoanalytic techniques in the treatment of patients who are deeply regressed in this respect. Special attention is given to the particular circumstances and challenges of adolescence and to providing psychoanalytic psychotherapy to adolescent psychotic patients.

  15. Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders.

    Science.gov (United States)

    Uttley, Lesley; Scope, Alison; Stevenson, Matt; Rawdin, Andrew; Taylor Buck, Elizabeth; Sutton, Anthea; Stevens, John; Kaltenthaler, Eva; Dent-Brown, Kim; Wood, Chris

    2015-03-01

    Mental health problems account for almost half of all ill health in people under 65 years. The majority are non-psychotic (e.g. depression, anxiety and phobias). For some people, art therapy may provide more profound and long-lasting healing than more standard forms of treatment, perhaps because it can provide an alternative means of expression and release from trauma. As yet, no formal evaluation of art therapy for non-psychotic mental health disorders has been conducted. This review aimed to evaluate evidence for the clinical effectiveness and cost-effectiveness of art therapy for non-psychotic mental health disorders. Comprehensive literature searches for studies examining art therapy in populations with non-psychotic mental health disorders were performed in major health-related and social science bibliographic databases including MEDLINE, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Allied and Complementary Medicine Database (AMED) and Applied Social Sciences Index and Abstracts (ASSIA) from inception up to May 2013. A quantitative systematic review of clinical effectiveness, a qualitative review to explore the acceptability, relative benefits and potential harms, and a cost-utility analysis of studies evaluating cost-effectiveness of art therapy were conducted. In the quantitative review, 15 randomised controlled trials (RCTs) were included (n = 777). Meta-analysis was not possible because of clinical heterogeneity and insufficient comparable data on outcome measures across studies. A narrative synthesis reports that art therapy was associated with significant positive changes relative to the control group in mental health symptoms in 10 out of the 15 studies. The control groups varied between studies but included wait-list/no treatment, attention placebo controls and psychological therapy comparators. Four studies reported improvement from baseline but no significant difference between groups

  16. Complementary treatment of psychotic and epileptic patients in malaysia.

    Science.gov (United States)

    Razali, Salleh Mohd; Yassin, Azhar Mohd

    2008-09-01

    The objective of this article is to describe and compare the use of traditional/complementary medicine (T/CM) among psychotic (schizophrenia and schizophreniform disorder) and epileptic Malay patients in peninsular Malaysia. There were 60 patients in each group. T/CM consultation was uniformly spread across all levels of education and social status. We could not find a single over-riding factor that influenced the decision to seek T/CM treatment because the decision to seek such treatment was complex and the majority of decisions were made by others. Fifty-three patients (44.2%), consisting of 37 (61.7%) psychotic and 16 (26.7%) epileptic patients had consulted Malay traditional healers (bomoh) and/or homeopathic practitioners in addition to modern treatment; of these, only three had consulted bomoh and homeopathic practitioners at the same time. The use of T/CM was significantly higher in psychotic than in epileptic Malay patients.

  17. The history of artistic creativity in psychotic patients.

    Science.gov (United States)

    Klavora, Vlasta Meden

    2008-06-01

    The article deals with the question of artistic creativity in psychotic patients, focussing particularly on why it occurs and how interest in it developed. One of the main motivations for carrying out this study was to explore the idea of the connection between genius and insanity, which was accepted by one of the most important pre-Freud psychiatrists of the 19th century, Cesare Lombroso. The article describes the history of the first exhibitions and collections of artistic creations of psychotic patients, of which the most important is the collection of Hans Prinzhorn. It also conveys the influence of Adolf Wölfli, psychotic patient, who was one of the most notable creators and influenced the concept of art brut at the beginning of the 20th century.

  18. Glucose-6 phosphate dehydrogenase deficiency and psychotic illness

    Directory of Open Access Journals (Sweden)

    Vijender Singh

    2012-01-01

    Full Text Available Mr. T, a 28-year-old unmarried male, a diagnosed case of Glucose-6 Phosphate Dehydrogenase (G6PD deficiency since childhood, presented with 13 years of psychotic illness and disturbed biological functions. He showed poor response to antipsychotics and mood stabilizers and had three prior admissions to Psychiatry. There was a family history of psychotic illness. The General Physical Examination and Systemic Examination were unremarkable. Mental Status Examination revealed increased psychomotor activity, pressure of speech, euphoric affect, prolixity, delusion of persecution, delusion of grandiosity, delusion of control, thought withdrawal and thought insertion, and second and third person auditory hallucinations, with impaired judgment and insight. A diagnosis of schizophrenia paranoid type, with a differential diagnosis of schizoaffective disorder manic subtype, was made. This case is being reported for its rarity and atypicality of clinical presentation, as well as a course of psychotic illness in the G6PD Deficiency state,with its implications on management.

  19. 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....

  20. 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 conce...

  1. 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.

  2. Gender Differences in the Clinical Characteristics of Psychotic Depression: Results from the CRESCEND Study.

    Science.gov (United States)

    Park, Seon-Cheol; Østergaard, Søren Dinesen; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Yim, Hyeon-Woo; Park, Yong Chon

    2015-12-31

    To test whether there are gender differences in the clinical characteristics of patients with psychotic depression (PD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, we tested for potential gender differences in clinical characteristics among 53 patients with PD. The Psychotic Depression Assessment Scale (PDAS) and other psychometric scales were used to evaluate various clinical features of the study subjects. Independent t-tests were performed for normally distributed variables, Mann-Whitney U-tests for non-normally distributed variables, and χ(2)tests for discrete variables. In addition, to exclude the effects of confounding variables, we carried out an analysis of covariance (ANCOVA) for the normally distributed variables and binary logistic regression analyses for discrete variables, after adjusting the effects of marital status. We identified more prevalent suicidal ideation (adjusted odds ratio [aOR]=10.316, p=0.036) and hallucinatory behavior (aOR=8.332, p=0.016), as well as more severe anxiety symptoms (degrees of freedom [df]=1, F=6.123, p=0.017), and poorer social and occupational functioning (df=1, F=6.265, p=0.016) in the male patients compared to the female patients. Our findings suggest that in South Korean patients with PD, suicidal ideation, hallucinatory behavior, and anxiety is more pronounced among males than females. This should be taken into consideration in clinical practice.

  3. Social outcome compared in psychotic and nonpsychotic bipolar I patients.

    Science.gov (United States)

    Rosen, L N; Rosenthal, N E; Dunner, D L; Fieve, R R

    1983-05-01

    Eighty-nine bipolar I patients were given a structured interview, the Schedule for Affective Disorders and Schizophrenia. Those who had experienced delusions or hallucinations at some time during the course of their illness were designated "psychotic," and those who had not were designated "nonpsychotic." The two groups were compared with regard to a number of outcome variables as well as age, age at first treatment, and duration of illness. The psychotic group had significantly poorer outcome in terms of social functioning. Although age, age at first treatment, and duration of illness distinguished between the two groups of patients, statistical analyses indicated that these variables did not account for differences in social outcome.

  4. Dissecting the catatonia phenotype in psychotic and mood disorders on the basis of familial-genetic factors.

    Science.gov (United States)

    Peralta, Victor; Fañanás, Lourdes; Martín-Reyes, Migdyrai; Cuesta, Manuel J

    2017-09-14

    This study examines the familial aggregation (familiality) of different phenotypic definitions of catatonia in a sample of multiplex families with psychotic and mood disorders. Participants were probands with a lifetime diagnosis of a DSM-IV functional psychotic disorder, their parents and at least one first-degree relative with a psychotic disorder. The study sample included 441 families comprising 2703 subjects, of whom 1094 were affected and 1609 unaffected. Familiality (h(2)) was estimated by linear mixed models using family membership as a random effect, with h(2) indicating the portion of phenotypic variance accounted for by family membership. Familiality estimates highly varied for individual catatonia signs (h(2)=0.17-0.65), principal component analysis-derived factors (h(2)=0.29-0.49), number of catatonia signs present (h(2)=0.03-0.43) and severity of the catatonia syndrome (h(2)=0.25-0.59). Phenotypes maximizing familiality estimates included individual signs (mutism and rigidity, both h(2)=0.65), presence of ≥5 catatonia signs (h(2)=0.43), a classical catatonia factor (h(2)=0.49), a DSM-IV catatonia syndrome at a severity level of moderate or higher (h(2)=0.59) and the diagnostic construct of psychosis with prominent catatonia features (h(2)=0.56). Familiality estimates of a DSM-IV catatonia syndrome did not significantly differ across the diagnostic categories of psychotic and mood disorders (h(2)=0.40-0.47). The way in which catatonia is defined has a strong impact on familiality estimates with some catatonia phenotypes exhibiting substantial familial aggregation, which may inform about the most adequate phenotypes for molecular studies. From a familial-genetic perspective, the catatonia phenotype in psychotic and mood disorders has a transdiagnostic character. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. 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.

    2015-01-01

    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

  6. 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

  7. Reasons for Cannabis Use and Effects of Cannabis Use as Reported by Patients with Psychotic Disorders

    NARCIS (Netherlands)

    N. Dekker; D.H. Linszen; L. de Haan

    2009-01-01

    Background: Cannabis is one of the most commonly used substances in patients with a psychotic disorder and is associated with a higher risk of psychotic relapses. Identifying reasons for cannabis use and subjective effects in patients with psychotic disorders can provide insight into the functions o

  8. Differences in compassion fatigue, symptoms of posttraumatic stress disorder and relationship satisfaction, including sexual desire and functioning, between male and female detectives who investigate sexual offenses against children: a pilot study.

    Science.gov (United States)

    Lane, Eric J; Lating, Jeffrey M; Lowry, Jenny L; Martino, Traci P

    2010-01-01

    Law enforcement detectives who work with traumatized individuals, especially children who were victims of sexual abuse or assault, are likely to experience job-related emotional distress. The purpose of this study was to examine the relations among compassion fatigue, probable PTSD symptoms, and personal relationship satisfaction, including communication and sexual satisfaction, in a sample of 47 male and female detectives. Responses to the administered questionnaires indicated a relation between compassion fatigue symptoms and probable PTSD symptoms. There also were compelling gender differences. For example, for male detectives, open communication with their spouse or significant other was negatively correlated with burnout, indicating the more open the communication, the lower the reported burnout. However for female detectives there was a negative correlation between open communication with spouse or significant other and compassion satisfaction, suggesting that more open communication was related to lower levels of satisfaction with their ability to be a professional caregiver Furthermore, although stepwise regression analysis indicated that years of service as a detective is independently associated with sexual desire, female detectives evidenced less sexual desire and more difficulty with sexual functioning than did male detectives. Implications of these preliminary findings are discussed and limitations addressed.

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

    NARCIS (Netherlands)

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

    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 r

  10. [Metacognition in psychotic disorders: from concepts to intervention].

    Science.gov (United States)

    de Jong, S; van Donkersgoed, R J M; Arends, J; Lysaker, P H; Wunderink, L; van der Gaag, M; Aleman, A; Pijnenborg, G H M

    2016-01-01

    Persons with a psychotic disorder commonly experience difficulties with what is considered to be metacognitive capacity. In this article we discuss several definitions of this concept, the measurement instruments involved and the clinical interventions that target this concept. To present a review of various frequently used definitions of metacognition and related concepts and to describe the measurement instruments involved and the treatment options available for improving the metacognitive capacity of persons with a psychotic disorder. We present an overview of several definitions of metacognition in psychotic disorders and we discuss frequently used measurement instruments and treatment options. The article focuses on recent developments in a model devised by Semerari et al. The measurement instrument involved (Metacognition Assessment Scale - A) is discussed in terms of it being an addition to existing methods. On the basis of the literature it appears that metacognition and related concepts are measurable constructs, although definitions and instruments vary considerably. The new conceptualisation of social information processing also leads to the development of a new form of psychotherapy that aims to help patients suffering from psychotic disorders to improve metacognitive capacity. There seems to be evidence that metacognitive abilities are a possible target for treatment, but further research is needed.

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

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; 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 ...

  12. Sustained Responding under Intermittent Reinforcement in Psychotic Children.

    Science.gov (United States)

    Deckner, C. William; And Others

    1982-01-01

    A procedure that classifies children according to capacity to sustain adaptive responding without consistent, extrinsic reinforcement was used to assess differences in tolerance for intermittent reinforcement among 21 psychotic children. The procedure was correlated with three prognostically important variables: intelligence measures, social…

  13. Association Between Psychotic Experiences and Subsequent Suicidal Thoughts and Behaviors

    DEFF Research Database (Denmark)

    Bromet, Evelyn J; Nock, Matthew K; Saha, Sukanta

    2017-01-01

    Importance: Community-based studies have linked psychotic experiences (PEs) with increased risks of suicidal thoughts and behaviors (STBs). However, it is not known if these associations vary across the life course or if mental disorders contribute to these associations. Objective: To examine the...

  14. 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.

  15. Nonschizophrenic psychotic disorders : The case of cycloid psychoses

    NARCIS (Netherlands)

    Tuinier, S; Kahn, RS; Verhoeven, WMA

    2004-01-01

    Background: Cycloid psychosis is a psychiatric disorder known for about 100 years. This disorder is at present partly and simplified represented in the ICD-10. Sampling and Methods: Over a period of 15 months, 139 consecutively acutely admitted psychotic patients were assessed, by means of different

  16. 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.

  17. 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

  18. How the Illness Management and Recovery Program Enhanced Recovery of Persons With Schizophrenia and Other Psychotic Disorders: A Qualitative Study.

    Science.gov (United States)

    van Langen, Wilma J M; Beentjes, Titus A A; van Gaal, Betsie G I; Nijhuis-van der Sanden, Maria W G; Goossens, Peter J J

    2016-10-01

    This study aims to describe how the Illness Management and Recovery program enhanced recovery of persons with schizophrenia and other psychotic disorders from their own perspective. Participants valued learning how to divide huge goals into attainable steps, how to recognize and prevent a relapse by managing symptoms, practicing skills, and talking openly about illness related experience. They learned from the exchange with peers and from the information in the IMR textbook. Nurses should have continuous attention and reinforcement for progress on goals, skills practice and exchange of peer information. A peer-support specialist can contribute to keep this focus.

  19. Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report

    Directory of Open Access Journals (Sweden)

    Tufan Ali

    2012-06-01

    Full Text Available Abstract Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were “irritability, regressive behavior, apathy, crying and truancy” which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg’s sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5 mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg’s sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3 months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6 months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features

  20. 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 in...... in criminal cases, the court will request a psychiatric report. They may furthermore ask a medical expert consultation board, the Danish Medico-Legal Council, for an opinion on the mental status of the defendant....

  1. Bright splenium of a psychotic mind

    Directory of Open Access Journals (Sweden)

    Shankar C Udaya

    2015-01-01

    Full Text Available A twenty-one-year old primigravida presented two weeks postpartum with new onset of behavioral alteration and irrelevant talking without fever, headache, or seizures. Magnetic resonance imaging (MRI of brain showed a lesion with diffusion restriction in splenium of corpus callosum. A possibility of postpartum psychosis was considered after ruling out various etiologies for splenium hyperintense lesion. Near complete resolution of symptoms was noted after initiation of antipsychotic medications. Literature has described multiple etiologies for lesions involving splenium of corpus callosum on brain imaging. We present this case as a unique clinical presentation of splenial pathology in the form of postpartum psychosis.

  2. Prodromal and autistic symptoms in schizotypal personality disorder and 22q11.2 deletion syndrome.

    Science.gov (United States)

    Esterberg, Michelle L; Ousley, Opal Y; Cubells, Joseph F; Walker, Elaine F

    2013-02-01

    Despite clear diagnostic distinctions, schizophrenia and autism share symptoms on several dimensions. Recent research has suggested the two disorders overlap in etiology, particularly with respect to inherited and noninherited genetic factors. Studying the relationship between psychotic-like and autistic-like symptoms in risk groups such as 22q11 deletion syndrome (22q11DS) and schizotypal personality disorder (SPD) has the potential to shed light on such etiologic factors; thus, the current study examined prodromal symptoms and autistic features in samples of 22q11DS and SPD subjects using standardized diagnostic measures, including the Structured Interview for Prodromal Symptoms (SIPS) and the Autism Diagnostic Inventory-Revised (ADI-R). Results showed that SPD subjects manifested significantly more severe childhood and current social as well as stereotypic autistic features, as well as more severe positive prodromal symptoms. The two groups did not differ on negative, disorganized, or general prodromal symptoms, but were distinguishable based on correlations between prodromal and autistic features; the relationships between childhood autistic features and current prodromal symptoms were stronger for the SPD group. The results suggest that childhood autistic features are less continuous with subsequent prodromal signs in 22q11DS patients relative to those with SPD, and the findings highlight the importance of studying the overlap in diagnostic phenomenology in groups at risk for developing psychosis and/or autism.

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

    OpenAIRE

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Shubhangi R Parkar

    2011-01-01

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

  5. [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.

  6. Perceived discrimination is associated with severity of positive and depression/anxiety symptoms in immigrants with psychosis: a cross-sectional study

    National Research Council Canada - National Science Library

    Berg, Akiah O; Melle, Ingrid; Rossberg, Jan Ivar; Romm, Kristin Lie; Larsson, Sara; Lagerberg, Trine V; Andreassen, Ole A; Hauff, Edvard

    2011-01-01

    Immigration status is a significant risk factor for psychotic disorders, and a number of studies have reported more severe positive and affective symptoms among immigrant and ethnic minority groups...

  7. Prevalence of item level negative symptoms in first episode psychosis diagnoses.

    LENUS (Irish Health Repository)

    Lyne, John

    2012-03-01

    The relevance of negative symptoms across the diagnostic spectrum of the psychoses remains uncertain. The purpose of this study was to report on prevalence of item and subscale level negative symptoms across the first episode psychosis (FEP) diagnostic spectrum in an epidemiological sample, and to ascertain whether items and subscales were more prevalent in a schizophrenia spectrum diagnoses group compared to an \\'all other psychotic diagnoses\\' group. We measured negative symptoms in 330 patients presenting with FEP using the Scale for Assessment of Negative Symptoms (SANS), and ascertained diagnosis using the Structured Clinical Interview for DSM IV. Prevalence of SANS items and subscales were tabulated across all psychotic diagnoses, and logistic regression analysis determined which items and subscales were predictive of schizophrenia spectrum diagnoses. SANS items were most prevalent in schizophrenia spectrum conditions but frequently presented in other FEP diagnoses, particularly substance induced psychotic disorder and Major Depressive Disorder. Brief psychotic disorder and bipolar disorders had low levels of negative symptoms. SANS items and subscales which significantly predicted schizophrenia spectrum diagnoses, were also frequently present in some of the other psychotic diagnoses. Conclusions: SANS items have high prevalence in FEP, and while commonest in schizophrenia spectrum conditions are not restricted to this diagnostic subgroup.

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

    Directory of Open Access Journals (Sweden)

    Nagy EE

    2016-05-01

    battery of other autoimmune encephalitis markers showed negative. A complex program of treatment was applied, including antibiotics, beginning with ceftazidime and ciprofloxacin – for suspected aspiration bronchopneumonia – and thereafter with ceftriaxone. A gradual improvement was noticed and the treatment continued at the Infectious Disease Clinic. Finally, the patient was discharged with a doxycycline, antidepressant, and anxiolytic maintenance treatment. On his first and second control (days 44 and 122 from the disease onset, the patient was stable with no major complaints, Borrelia seropositivity was confirmed both for IgM and IgG while the cerebrospinal fluid also showed reactivity for IgG on immunoblot. On the basis of the putative occupational risk, acute psychotic episode, and the success of antibiotic therapy, we registered this case as a late neuroborreliosis with atypical appearance.Keywords: Borrelia burgdorferi, neuroborreliosis, neuropsychiatric symptoms, encephalitis, anti-NMDAR

  9. Mismanagement of Wilson′s disease as psychotic disorder

    Directory of Open Access Journals (Sweden)

    Reza Bidaki

    2012-01-01

    Full Text Available Wilson′s disease (WD or hepatolenticular degeneration is an inherited neurodegenerative disorder of copper metabolism (autosomal recessive, chromosome13. Psychiatric disorders in WD include dementia, characterized by mental slowness, poor concentration, and memory impairment. Symptoms may progress rapidly, especially in younger patients, but are more often gradual in development with periods of remission and exacerbation. Delusional disorder and schizophrenia-like psychosis are rare forms of psychiatric presentation. In this report, the patient with WD presented by psychosis symptoms and treated mistaken as schizophrenia for almost ten years. Although he has treated with antipsychotics, he had periods of remissions and relapses and never was symptoms free. Since psychosis can be the manifestation of medical diseases such as WD, overall view of these patients is necessary and medical diseases should be considered as a differential diagnosis.

  10. Efficacy and safety of Quetiapine combined with Huperzine A in treatment of Alzheimer disease accompanied with obvious psychotic symptoms%喹硫平合并石杉碱甲治疗阿尔茨海默病伴明显精神病性症状的疗效和安全性

    Institute of Scientific and Technical Information of China (English)

    李红忠; 陈玲; 吴春喜

    2014-01-01

    Objective:To study the efficacy and safety of Quetiapine combined with Huperzine A in treatment of Alzheimer dis-ease. Methods:60 Alzheimer inpatients in our hospital who conform to the Chinese classification and Diagnostic criteria of mental dis-eases-3rd edition undergone the treatment of Quetiapine combined with Huperzine A for 12 weeks. Before and 2, 4 and 8 weeks after the treatment, the efficacy was evaluated by positive and negative symptom scale (PANSS), and the adverse reactions were evaluated by treatment emergent symptom scale (TESS). Before and 12 weeks after the treatment, cognitive functions was evaluated by Mini-mental state examination. Results: The PANSS score reduced significantly 8 weeks after the treatment, The MMSE score reduced sig-nificantly 12 weeks after the treatment and less adverse reactions occurred. Conclusions: Quetiapine combined with Huperzine A in the treatment of Alzheimer disease is a safe and effective treatment with less adverse reactions and more tolerability.%目的::探讨喹硫平合并石杉碱甲治疗阿尔茨海默病的疗效和安全性。方法:60例在我院住院治疗的阿尔茨海默病患者,符合中国精神障碍分类与诊断标准第3版诊断标准。患者接受为期12周的喹硫平合并石杉碱甲的治疗,在治疗前及治疗2、4、8周采用阳性与阴性症状量表(PANSS)评定疗效,采用治疗中出现的症状量表(TESS)评定不良反应。于治疗前及治疗12周采用简易智力状态量表(MMSE)评定认知功能。结果:治疗8周时 PANSS 评分显著降低,治疗12周 MMSE 评分显著降低,不良反应较少。结论:喹硫平合并石杉碱甲治疗阿尔茨海默病安全有效,不良反应少,耐受性较好。

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    -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. RESULTS: Low ToM score......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 HyperToM do not appear to have a conceptual deficit (i.e. lack of representational abilities), but rather they apply...

  12. Sleep spindle deficits in antipsychotic-naïve early course schizophrenia and in non-psychotic first-degree relatives

    Directory of Open Access Journals (Sweden)

    Dara S Manoach

    2014-10-01

    Full Text Available Introduction: Chronic medicated patients with schizophrenia have marked reductions in sleep spindle activity and a correlated deficit in sleep-dependent memory consolidation. Using archival data, we investigated whether antipsychotic-naïve early course patients with schizophrenia and young non-psychotic first-degree relatives of patients with schizophrenia also show reduced sleep spindle activity and whether spindle activity correlates with cognitive function and symptoms.Method: Sleep spindles during Stage 2 sleep were compared in antipsychotic-naïve adults newly diagnosed with psychosis, young non-psychotic first-degree relatives of schizophrenia patients and two samples of healthy controls matched to the patients and relatives. The relations of spindle parameters with cognitive measures and symptom ratings were examined.Results: Early course schizophrenia patients showed significantly reduced spindle activity relative to healthy controls and to early course patients with other psychotic disorders. Relatives of schizophrenia patients also showed reduced spindle activity compared with controls. Reduced spindle activity correlated with measures of executive function in early course patients, positive symptoms in schizophrenia and IQ estimates across groups.Conclusions: Like chronic medicated schizophrenia patients, antipsychotic-naïve early course schizophrenia patients and young non-psychotic relatives of individuals with schizophrenia have reduced sleep spindle activity. These findings indicate that the spindle deficit is not an antipsychotic side-effect or a general feature of psychosis. Instead, the spindle deficit may predate the onset of schizophrenia, persist throughout its course and be an endophenotype that contributes to cognitive dysfunction.

  13. Hallucinations in the psychotic state: Psychoanalysis and the neurosciences compared.

    Science.gov (United States)

    De Masi, Franco; Davalli, Cesare; Giustino, Gabriella; Pergami, Andrea

    2015-04-01

    In this contribution, which takes account of important findings in neuroscientific as well as psychoanalytic research, the authors explore the meaning of the deep-going distortions of psychic functioning occurring in hallucinatory phenomena. Neuroscientific studies have established that hallucinations distort the sense of reality owing to a complex alteration in the balance between top-down and bottom-up brain circuits. The present authors postulate that hallucinatory phenomena represent the outcome of a psychotic's distorted use of the mind over an extended period of time. In the hallucinatory state the psychotic part of the personality uses the mind to generate auto-induced sensations and to achieve a particular sort of regressive pleasure. In these cases, therefore, the mind is not used as an organ of knowledge or as an instrument for fostering relationships with others. The hallucinating psychotic decathects psychic (relational) reality and withdraws into a personal, bodily, and sensory space of his own. The opposing realities are not only external and internal but also psychic and sensory. Visual hallucinations could thus be said to originate from seeing with the 'eyes' of the mind, and auditory hallucinations from hearing with the mind's 'ears'. In these conditions, mental functioning is restricted, cutting out the more mature functions, which are thus no longer able to assign real meaning to the surrounding world and to the subject's psychic experience. The findings of the neurosciences facilitate understanding of how, in the psychotic hallucinatory process, the mind can modify the working of a somatic organ such as the brain.

  14. Multivariate analysis reveals genetic associations of the resting default mode network in psychotic bipolar disorder and schizophrenia.

    Science.gov (United States)

    Meda, Shashwath A; Ruaño, Gualberto; Windemuth, Andreas; O'Neil, Kasey; Berwise, Clifton; Dunn, Sabra M; Boccaccio, Leah E; Narayanan, Balaji; Kocherla, Mohan; Sprooten, Emma; Keshavan, Matcheri S; Tamminga, Carol A; Sweeney, John A; Clementz, Brett A; Calhoun, Vince D; Pearlson, Godfrey D

    2014-05-13

    The brain's default mode network (DMN) is highly heritable and is compromised in a variety of psychiatric disorders. However, genetic control over the DMN in schizophrenia (SZ) and psychotic bipolar disorder (PBP) is largely unknown. Study subjects (n = 1,305) underwent a resting-state functional MRI scan and were analyzed by a two-stage approach. The initial analysis used independent component analysis (ICA) in 324 healthy controls, 296 SZ probands, 300 PBP probands, 179 unaffected first-degree relatives of SZ probands (SZREL), and 206 unaffected first-degree relatives of PBP probands to identify DMNs and to test their biomarker and/or endophenotype status. A subset of controls and probands (n = 549) then was subjected to a parallel ICA (para-ICA) to identify imaging-genetic relationships. ICA identified three DMNs. Hypo-connectivity was observed in both patient groups in all DMNs. Similar patterns observed in SZREL were restricted to only one network. DMN connectivity also correlated with several symptom measures. Para-ICA identified five sub-DMNs that were significantly associated with five different genetic networks. Several top-ranking SNPs across these networks belonged to previously identified, well-known psychosis/mood disorder genes. Global enrichment analyses revealed processes including NMDA-related long-term potentiation, PKA, immune response signaling, axon guidance, and synaptogenesis that significantly influenced DMN modulation in psychoses. In summary, we observed both unique and shared impairments in functional connectivity across the SZ and PBP cohorts; these impairments were selectively familial only for SZREL. Genes regulating specific neurodevelopment/transmission processes primarily mediated DMN disconnectivity. The study thus identifies biological pathways related to a widely researched quantitative trait that might suggest novel, targeted drug treatments for these diseases.

  15. Continuação do antipsicótico em depressão psicótica Antipsychotic medication maintenance in depression with psychotic features

    Directory of Open Access Journals (Sweden)

    Ana Paula Werneck de Castro

    2004-01-01

    Full Text Available Pacientes com depressão psicótica apresentam maior índice de morbidade e mortalidade que pacientes com depressão não-psicótica. Apesar de freqüentemente ocorrerem recaída e recorrência na depressão psicótica, poucos estudos abordam a eficácia do tratamento de manutenção e continuação. O propósito deste estudo é avaliar a melhor forma de tratamento da depressão psicótica após remissão dos sintomas. Após um levantamento bibliográfico sistemático foram encontrados três estudos e apenas um deles preencheu os critérios preestabelecidos. Depressão psicótica é uma forma grave de transtorno de humor. O uso de antipsicótico durante as fases de manutenção e continuação é pouco estudado e não há resultados conclusivos. Dois casos são apresentados.Patients who have major depression with psychotic features have greater morbidity and mortality than patients with non-psychotic major depression. Despite the frequent relapse and recurrence in major depression with psychotic features, there are few studies of the efficacy and maintenance treatments. The purpose of this study is to determine the best way to treat psychotic depression after remission of symptoms. After a Systematic Bibliography review three studies were found and only one met all pre-established sets of criteria. Psychotic depression is a severe form of Mood Disorder and the use of antipsychotics during maintenance and continuation phase is poorly tested and there aren't conclusive results. Two cases are presented.

  16. Copy number variants in a sample of patients with psychotic disorders: is standard screening relevant for actual clinical practice?

    Science.gov (United States)

    Van de Kerkhof, Noortje WA; Feenstra, Ilse; van der Heijden, Frank MMA; de Leeuw, Nicole; Pfundt, Rolph; Stöber, Gerald; Egger, Jos IM; Verhoeven, Willem MA

    2012-01-01

    With the introduction of new genetic techniques such as genome-wide array comparative genomic hybridization, studies on the putative genetic etiology of schizophrenia have focused on the detection of copy number variants (CNVs), ie, microdeletions and/or microduplications, that are estimated to be present in up to 3% of patients with schizophrenia. In this study, out of a sample of 100 patients with psychotic disorders, 80 were investigated by array for the presence of CNVs. The assessment of the severity of psychiatric symptoms was performed using standardized instruments and ICD-10 was applied for diagnostic classification. In three patients, a submicroscopic CNV was demonstrated, one with a loss in 1q21.1 and two with a gain in 1p13.3 and 7q11.2, respectively. The association between these or other CNVs and schizophrenia or schizophrenia-like psychoses and their clinical implications still remain equivocal. While the CNV affected genes may enhance the vulnerability for psychiatric disorders via effects on neuronal architecture, these insights have not resulted in major changes in clinical practice as yet. Therefore, genome-wide array analysis should presently be restricted to those patients in whom psychotic symptoms are paired with other signs, particularly dysmorphisms and intellectual impairment. PMID:22848183

  17. Subcortical grey matter alterations in cocaine dependent individuals with substance-induced psychosis compared to non-psychotic cocaine users.

    Science.gov (United States)

    Willi, Taylor S; Lang, Donna J; Honer, William G; Smith, Geoff N; Thornton, Allen E; Panenka, William J; Procyshyn, Ric M; Vila-Rodriguez, Fidel; Su, Wayne; Vertinsky, A Talia; Leonova, Olga; Rauscher, Alexander; MacEwan, G William; Barr, Alasdair M

    2016-10-01

    After prolonged psychostimulant abuse, transient psychotic symptoms referred to as "substance-induced psychosis" (SIP) can develop - closely resembling symptoms observed in schizophrenia spectrum disorders. The comparability in psychotic presentation between SIP and schizophrenias suggests that similar underlying neural deficits may contribute to the expression of psychosis across these disorders. To date, neuroanatomical characterization of grey matter structural alterations in SIP has been limited to methamphetamine associated psychosis, with no studies controlling for potential neurotoxic effects of the psychostimulant that precipitates psychosis. To investigate grey matter subcortical alterations in SIP, a voxel-based analysis of magnetic resonance images (MRI) was performed between a group of 74 cocaine dependent nonpsychotic individuals and a group of 29 individuals with cocaine-associated psychosis. The cocaine-associated psychosis group had significantly smaller volumes of the thalamus and left hippocampus, controlling for age, total brain volume, current methamphetamine dependence, and current marijuana dependence. No differences were present in bilateral caudate structures. The findings of reduced thalamic and hippocampal volumes agree with previous reports in the schizophrenia literature, suggesting alterations of these structures are not specific to schizophrenia, but may be common to multiple forms of psychosis.

  18. Perceived relational evaluation as a predictor of self-esteem and mood in people with a psychotic disorder.

    Science.gov (United States)

    Norman, Ross M G; Windell, Deborah; Lynch, Jill; Manchanda, Rahul

    2012-05-01

    There is evidence that social support predicts self-esteem and related moods for people with psychotic disorders. However, there has been little investigation of relative importance of specific components of social support. Evidence from social psychology suggests that perceived relational evaluation (PRE) or the extent to which people see others as valuing them, is a particularly important determinant of self-esteem and mood. Our study compared the importance of PRE and other types of social support, in predicting self-esteem and depressive mood, anxiety, and anger-hostility in a sample of patients in an early intervention program for psychotic disorders. One hundred and two patients of the Prevention and Early Intervention Program for Psychoses in London, Ontario, completed measures of PRE, appraisal, tangible and general emotional social support, self-esteem, and mood. In addition, ratings of positive and negative symptoms were completed for all participants. In general, perceived relational value was the most important predictor of self-esteem and mood. These relations were not a result of confounding with positive or negative symptoms. PRE appears to be a particularly important aspect of social support in predicting self-esteem and mood states. Possible implications of these findings and future research directions are discussed.

  19. Sustaining remission of psychotic depression: rationale, design and methodology of STOP-PD ΙΙ

    Directory of Open Access Journals (Sweden)

    Flint Alastair J

    2013-01-01

    Full Text Available Abstract Background Psychotic depression (PD is a severe disabling disorder with considerable morbidity and mortality. Electroconvulsive therapy and pharmacotherapy are each efficacious in the treatment of PD. Expert guidelines recommend the combination of antidepressant and antipsychotic medications in the acute pharmacologic treatment of PD. However, little is known about the continuation treatment of PD. Of particular concern, it is not known whether antipsychotic medication needs to be continued once an episode of PD responds to pharmacotherapy. This issue has profound clinical importance. On the one hand, the unnecessary continuation of antipsychotic medication exposes a patient to adverse effects, such as weight gain and metabolic disturbance. On the other hand, premature discontinuation of antipsychotic medication has the potential risk of early relapse of a severe disorder. Methods/design The primary goal of this multicenter randomized placebo-controlled trial is to assess the risks and benefits of continuing antipsychotic medication in persons with PD once the episode of depression has responded to treatment with an antidepressant and an antipsychotic. Secondary goals are to examine age and genetic polymorphisms as predictors or moderators of treatment variability, potentially leading to more personalized treatment of PD. Individuals aged 18-85 years with unipolar psychotic depression receive up to 12 weeks of open-label treatment with sertraline and olanzapine. Participants who achieve remission of psychosis and remission/near-remission of depressive symptoms continue with 8 weeks of open-label treatment to ensure stability of remission. Participants with stability of remission are then randomized to 36 weeks of double-blind treatment with either sertraline and olanzapine or sertraline and placebo. Relapse is the primary outcome. Metabolic changes are a secondary outcome. Discussion This trial will provide clinicians with much

  20. Ventral anterior cingulate connectivity distinguished nonpsychotic bipolar illness from psychotic bipolar disorder and schizophrenia.

    Science.gov (United States)

    Anticevic, Alan; Savic, Aleksandar; Repovs, Grega; Yang, Genevieve; McKay, D Reese; Sprooten, Emma; Knowles, Emma E; Krystal, John H; Pearlson, Godfrey D; Glahn, David C

    2015-01-01

    Bipolar illness is a debilitating neuropsychiatric disorder associated with alterations in the ventral anterior cingulate cortex (vACC), a brain region thought to regulate emotional behavior. Although recent data-driven functional connectivity studies provide evidence consistent with this possibility, the role of vACC in bipolar illness and its pattern of whole brain connectivity remain unknown. Furthermore, no study has established whether vACC exhibits differential whole brain connectivity in bipolar patients with and without co-occurring psychosis and whether this pattern resembles that found in schizophrenia. We conducted a human resting-state functional connectivity investigation focused on the vACC seed in 73 remitted bipolar I disorder patients (33 with psychosis history), 56 demographically matched healthy comparison subjects, and 73 demographically matched patients with chronic schizophrenia. Psychosis history within the bipolar disorder group corresponded with significant between-group connectivity alterations along the dorsal medial prefrontal surface when using the vACC seed. Patients with psychosis history showed reduced connectivity (Cohen's d = -0.69), whereas those without psychosis history showed increased vACC coupling (Cohen's d = 0.8) relative to controls. The vACC connectivity observed in chronic schizophrenia patients was not significantly different from that seen in bipolar patients with psychosis history but was significantly reduced compared with that in bipolar patients without psychosis history. These robust findings reveal complex vACC connectivity alterations in bipolar illness, which suggest differences depending on co-occurrence of lifetime psychosis. The similarities in vACC connectivity patterns in schizophrenia and psychotic bipolar disorder patients may suggest the existence of common mechanisms underlying psychotic symptoms in the two disorders. © The Author 2014. Published by Oxford University Press on behalf of the Maryland

  1. Signs and symptoms of acute mania: a factor analysis

    Directory of Open Access Journals (Sweden)

    de Silva Varuni A

    2011-08-01

    Full Text Available Abstract Background The major diagnostic classifications consider mania as a uni-dimensional illness. Factor analytic studies of acute mania are fewer compared to schizophrenia and depression. Evidence from factor analysis suggests more categories or subtypes than what is included in the classification systems. Studies have found that these factors can predict differences in treatment response and prognosis. Methods The sample included 131 patients consecutively admitted to an acute psychiatry unit over a period of one year. It included 76 (58% males. The mean age was 44.05 years (SD = 15.6. Patients met International Classification of Diseases-10 (ICD-10 clinical diagnostic criteria for a manic episode. Patients with a diagnosis of mixed bipolar affective disorder were excluded. Participants were evaluated using the Young Mania Rating Scale (YMRS. Exploratory factor analysis (principal component analysis was carried out and factors with an eigenvalue > 1 were retained. The significance level for interpretation of factor loadings was 0.40. The unrotated component matrix identified five factors. Oblique rotation was then carried out to identify three factors which were clinically meaningful. Results Unrotated principal component analysis extracted five factors. These five factors explained 65.36% of the total variance. Oblique rotation extracted 3 factors. Factor 1 corresponding to 'irritable mania' had significant loadings of irritability, increased motor activity/energy and disruptive aggressive behaviour. Factor 2 corresponding to 'elated mania' had significant loadings of elevated mood, language abnormalities/thought disorder, increased sexual interest and poor insight. Factor 3 corresponding to 'psychotic mania' had significant loadings of abnormalities in thought content, appearance, poor sleep and speech abnormalities. Conclusions Our findings identified three clinically meaningful factors corresponding to 'elated mania', 'irritable mania

  2. 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.

  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. Mentalization-based treatment for psychosis: linking an attachment-based model to the psychotherapy for impaired mental state understanding in people with psychotic disorders.

    Science.gov (United States)

    Brent, Benjamin K; Holt, Daphne J; Keshavan, Matcheri S; Seidman, Larry J; Fonagy, Peter

    2014-01-01

    Disturbances of mentalization have been increasingly associated with the symptoms and functional impairment of people with psychotic disorders. it has been proposed that psychotherapy designed to foster self and other understanding, such as mentalization-based treatment (mBt), may play an important part in facilitating recovery from psychosis. Here, we present an attachment-based understanding of mentalization impairments. We then outline a neuropsychological model that links disruptions of mentalization associated with disturbances in the caregiving environment to the pathophysiology of psychosis in genetically at-risk individuals. this is followed by an illustration of some of the core mBt techniques for the rehabilitation of the capacity to mentalize as applied to the treatment of a patient with a psychotic disorder.

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

    National Research Council Canada - National Science Library

    Lake, Charles Raymond

    2008-01-01

    ... 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...

  6. Dysphagia in a psychotic patient: Diagnostic challenges and a systematic management approach.

    Science.gov (United States)

    Baheshree, Ramanaganga D; Jonas, Suganthan S

    2012-07-01

    Dysphagia can be due to a variety of causes in a psychotic patient. It could be a side-effect of anti-psychotic medication or the manifestation of a psychotic phenomenon or even due to a co-morbid medical cause. We report a case of dysphagia in a young lady with psychosis who had been recently started on anti-psychotic medication. We would specifically like to highlight the practical challenges regarding its diagnosis and report success with a systematic management approach.

  7. Systematic Recording of Behaviors and Skills of Retarded and Psychotic Children

    Science.gov (United States)

    Wing, Lorna; Gould, Judith

    1978-01-01

    The reliability of the Children's Handicaps, Behavior and Skills structured interview schedule, intended to elicit information concerning mentally retarded or psychotic children, was investigated. (Author/SBH)

  8. Sex differences in schizophrenia and other psychotic disorders: a 20-year longitudinal study of psychosis and recovery.

    Science.gov (United States)

    Grossman, Linda S; Harrow, Martin; Rosen, Cherise; Faull, Robert; Strauss, Gregory P

    2008-01-01

    This longitudinal study was designed to provide data on sex differences in the course of schizophrenia and other psychotic disorders. Ninety-seven participants (43 women and 54 men) were assessed during index hospitalization when they were in the acute phase of illness and then reassessed prospectively at 6 consecutive follow-ups over a 20-year period. Patients were evaluated by a series of standardized measures on many aspects of illness including the presence of psychosis, global outcome, and rate of recovery. When women were compared to men in this sample, the data demonstrated a lower percentage of psychotic activity for women over the course of illness (significant at the 7.5- and 20-year follow-ups), and a significant improvement in psychotic activity over 20 years for women (P < .05), but not for men. In addition, women showed significantly better global functioning (P < .05) at 3 of the 6 follow-ups (the 2-, 7.5-, and 10-year follow-ups). Significantly higher percentages (P < .05) of women were in recovery at 2 of the 6 follow-up years (the 2- and 10-year follow-ups). Cumulatively, 61% of the women with schizophrenia showed a period of recovery at some point during the 20-year period compared to 41% of the men. The sex difference patterns were similar for patients with schizophrenia and for those with other types of psychotic disorders. Sex differences in this sample were specifically not attributable to differences in age of onset or premorbid developmental achievements.

  9. Sudden psychotic episode probably due to meningoencephalitis and Chlamydia pneumoniae acute infection

    Directory of Open Access Journals (Sweden)

    Canas Nuno

    2005-09-01

    Full Text Available Abstract Background Since 9% to 20% of all cases of acute psychosis presenting to an Emergency Department (ED are due to a general medical condition, cautious medical workup should be mandatory in such patients. Differential diagnosis must consider conditions as diverse as renal failure or CNS infection. Acute Chlamydia pneumoniae infection usually causes a self-limited respiratory syndrome. Rarely, acute neurological complications occur, with acute meningoencephalitis most frequently reported. Diagnosis requires a high level of suspicion and is difficult to confirm. Case report We describe a 22 year-old female Caucasian who, three days after a mild pharingitis, developed an acute psychosis with exuberant symptoms interspersed with periods of lucidity, in a background of normal consciousness and orientation. Initial medical and imagiological workup were inconclusive. After 20 days of unsuccessful treatment with antipsychotics she developed a high fever and was re-evaluated medically. Lumbar puncture revealed an inflammatory cerebrospinal fluid. MRI showed irregular thickening and nodularity of the lateral ventricles' lining. An anti-Chlamydia pneumoniae IgM antibody titter of 85 IU/ml was detected. All symptoms cleared after treatment with antibiotics and corticosteroids. Conclusion This is, to our knowledge, the first reported case of acute CP-associated meningoencephalitis manifesting as an acute psychotic episode. It illustrates the principle that non-organic psychiatric syndromes must remain a diagnosis of exclusion in first-time acute psychosis.

  10. Recognizing Symptoms

    Science.gov (United States)

    ... bowel habits. Learn More About Pain in IBS Symptoms Won’t Stop Everyone suffers from bowel changes ... They can be constant or keep coming back. Symptoms Change Some or all of IBS symptoms can ...

  11. 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

  12. Race- and gender-related differences in clinical characteristics and quality of life among outpatients with psychotic disorders.

    Science.gov (United States)

    Nejtek, Vicki A; Allison, Nanette; Hilburn, Craig

    2012-09-01

    Historically, the literature suggests that African Americans with mental illness are diagnosed with psychotic disorders at a higher rate and receive higher doses of antipsychotic medications than other racial groups. However, few studies have compared clinical characteristics and quality of life among African-American (AA) and white men and women. Thus, research is needed to examine potential race and gender differences in clinical characteristics, prescribing practices, and quality of life. This exploratory, hypothesis-generating study examined current and past diagnoses, current pharmacotherapy, failed psychotropic medications, and quality of life among 23 AA and 31 white men and women receiving outpatient treatment for psychosis. Depression and psychotic depression were common complaints in the sample, yet only a third of the patients received antidepressants. We found that AA men received an antidepressant for depression symptoms less often, received higher antipsychotic doses, and rated their overall quality of life as poorer than any other group. White men and AA women had a history of more years of mental illness and had experienced 57% and 69% more psychotropic medication failures, respectively, than AA men or white women. Quality of life scores were significantly related to years of mental illness, number of past diagnoses, and number of failed medications. Our data suggest that clinicians could significantly enhance prognostic outcomes in outpatients with psychotic disorders by routinely re-evaluating depressive symptomatology and prescribing practices and considering adding psychosocial interventions to avert deterioration in quality of life. Further investigation of race and gender differences in quality of life and satisfaction as a function of diagnoses and treatment is warranted.

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

    DEFF Research Database (Denmark)

    Petersen, Lone Bente; 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....

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

    NARCIS (Netherlands)

    Ebisch, Sjoerd J. H.; Aleman, Andre

    2016-01-01

    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 ev

  15. 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.

  16. Psychotic experiences in the population : Association with functioning and mental distress

    NARCIS (Netherlands)

    Kelleher, Ian; Wigman, Johanna T. W.; Harley, Michelle; O'Hanlon, Erik; Coughlan, Helen; Rawdon, Caroline; Murphy, Jennifer; Power, Emmet; Higgins, Niamh M.; Cannon, Mary

    Psychotic experiences are far more common in the population than psychotic disorder. They are associated with a number of adverse outcomes but there has been little research on associations with functioning and distress. We wished to investigate functioning and distress in a community sample of

  17. 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.

    2014-01-01

    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 disord

  18. No evidence for attenuated stress-induced extrastriatal dopamine signaling in psychotic disorder

    NARCIS (Netherlands)

    Hernaus, D; Collip, D; Kasanova, Z; Winz, O; Heinzel, A; van Amelsvoort, T; Shali, S M; Booij, J; Rong, Y; Piel, M; Pruessner, J; Mottaghy, F M; Myin-Germeys, I

    2015-01-01

    Stress is an important risk factor in the etiology of psychotic disorder. Preclinical work has shown that stress primarily increases dopamine (DA) transmission in the frontal cortex. Given that DA-mediated hypofrontality is hypothesized to be a cardinal feature of psychotic disorder, stress-related

  19. The Prodromal Questionnaire : a case for IRT-based adaptive testing of psychotic experiences?

    NARCIS (Netherlands)

    van Bebber, Jan; Wigman, Johanna T W; Meijer, Rob R; Ising, Helga K; van den Berg, David; Rietdijk, Judith; Dragt, Sara; Klaassen, Rianne; Nieman, Dorien; de Jonge, Peter; Sytema, Sjoerd; Wichers, Marieke; Linszen, Don; van der Gaag, Mark; Wunderink, Lex

    2016-01-01

    Computerized adaptive tests (CATs) for positive and negative psychotic experiences were developed and tested in N = 5705 help-seeking, non-psychotic young individuals. Instead of presenting all items, CATs choose a varying number of different items during test administration depending on respondents

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

    NARCIS (Netherlands)

    Ebisch, Sjoerd J. H.; Aleman, Andre

    2016-01-01

    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 ev

  1. Early Therapeutic Alliance, Treatment Retention, and 12-Month Outcomes in a Healthy Lifestyles Intervention for People with Psychotic Disorders.

    Science.gov (United States)

    Andrews, Michelle; Baker, Amanda L; Halpin, Sean A; Lewin, Terry J; Richmond, Robyn; Kay-Lambkin, Frances J; Filia, Sacha L; Castle, David; Williams, Jill M; Clark, Vanessa; Callister, Robin

    2016-12-01

    Engaging and retaining individuals with psychotic disorders in psychosocial treatments is difficult. Early therapeutic alliance, treatment retention, and 12-month outcomes were examined in a subsample of smokers with a psychotic disorder (N = 178) participating in a healthy lifestyles study comparing a telephone versus face-to-face delivered intervention. Therapeutic alliance was assessed using the Agnew Relationship Measure; primary outcomes were treatment retention and changes in symptoms and health behaviors. Contrary to expectations, early alliance did not predict treatment retention. However, elements of both client- and therapist-rated alliance predicted some clinical outcomes (e.g., higher confidence in the therapeutic alliance at session 1 predicted improvements in 12-month depression). Some modest interactions between early alliance and intervention condition were also identified (e.g., clients initially with lower self-perceived initiative, or higher therapist-perceived bonding benefited preferentially from the telephone-delivered intervention), highlighting the need to further examine the interplay between therapeutic alliance and treatment modality.

  2. The association between duration of untreated psychosis in first psychotic episode patients and help seeking behaviors in Jogjakarta, Indonesia

    Science.gov (United States)

    Marchira, Carla R.; Supriyanto, Irwan; Subandi; Soewadi; Good, Byron J.

    2016-01-01

    ABSTRACT Help seeking is predictor of prognosis in the first episode of psychotic disorders. Caregivers play a key role in deciding from whom to seek help. In Indonesia, caregivers often seek help from alternative healers first and health professionals later, which is believed to result in delayed psychiatric treatment and risk for poor prognosis. This study measured the duration of untreated psychosis (DUP) in a sample of 100 persons being treated for a first episode of psychosis in Yogyakarta, Indonesia. We attempted to measure and determine associations among caregivers’ explanatory models, help seeking behaviors and DUP in this sample. The data were then statistically analyzed. The DUP for this population was very short. Most caregivers were parents or spouses (72 and 12%, respectively) and at the time of being interviewed described medical explanatory models for the psychotic symptoms (60%). A majority described having visited traditional/alternative healers prior to their visit to health professionals (67%). Despite this, the DUP was not significantly different for these two groups. Thus, first resort to traditional/alternative healers did not predict prolonged DUP. Further study with a larger sample is needed to better understand the relationship between care seeking, use of alternative healers and DUP in Indonesia. PMID:27226809

  3. 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.

  4. [Schizophrenia and other psychotic disorders in DSM-5: summary of the changes compared to DSM-IV].

    Science.gov (United States)

    Paulzen, M; Schneider, F

    2014-05-01

    With the introduction of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) numerous changes in the area of the schizophrenia spectrum and psychotic disorders have been implemented. Establishing a metastructure based on the characteristics of the spectrum of psychopathological disturbances should improve clarity. The classical subtypes of schizophrenia were eliminated and specific psychopathological dimensions for the assessment of disease severity were added. The special role of Schneiderian first rank symptoms was abandoned and a higher delineation towards schizoaffective disorders is made. The nosological status of catatonia is clarified and occurs together with a consistent use of catatonic disturbances over all chapters. The attenuated psychosis syndrome is added as a new condition for further study. The shared psychotic disorder in the sense of a folie à deux is no longer maintained. However, the initial goal to integrate more disorder-specific etiopathogenetic information into the reconceptualization could not be achieved. Contemporaneously to the development process of DSM-5 the National Institute of Mental Health (NIMH) carried out the research domain criteria project (RDoC) attempting to incorporate the current growth in knowledge of genetics, neurocognitive and cognitive sciences in future diagnostic systems. This article gives an overview of the changes that have been made within the revision process from DSM-IV to DSM-5.

  5. Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis

    OpenAIRE

    Haug Elisabeth; Hansen Charlotte; Rossberg Jan; Romm Kristin; Andreassen Ole A; Melle Ingrid

    2011-01-01

    Background Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. Method A total of 113 patients from the Thematically Organized Psychosis...

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

    Directory of Open Access Journals (Sweden)

    Emanuela Atzori

    2015-12-01

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

  7. 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.

  8. Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study

    Science.gov (United States)

    Landewé, R; Braun, J; Deodhar, A; Dougados, M; Maksymowych, W P; Mease, P J; Reveille, J D; Rudwaleit, M; van der Heijde, D; Stach, C; Hoepken, B; Fichtner, A; Coteur, G; de Longueville, M; Sieper, J

    2014-01-01

    Objectives To evaluate the efficacy and safety of certolizumab pegol (CZP) after 24 weeks in RAPID-axSpA (NCT01087762), an ongoing Phase 3 trial in patients with axial spondyloarthritis (axSpA), including patients with ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). Methods Patients with active axSpA were randomised 1:1:1 to placebo, CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg every 4 weeks (Q4W). In total 325 patients were randomised. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society 20) response at week 12. Secondary outcomes included change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) linear. Results Baseline disease activity was similar between AS and nr-axSpA. At week 12, ASAS20 response rates were significantly higher in CZP 200 mg Q2W and CZP 400 mg Q4W arms versus placebo (57.7 and 63.6 vs 38.3, p≤0.004). At week 24, combined CZP arms showed significant (p<0.001) differences in change from baseline versus placebo in BASFI (−2.28 vs −0.40), BASDAI (−3.05 vs −1.05), and BASMI (−0.52 vs −0.07). Improvements were observed as early as week 1. Similar improvements were reported with CZP versus placebo in both AS and nr-axSpA subpopulations. Adverse events were reported in 70.4% vs 62.6%, and serious adverse events in 4.7% vs 4.7% of All CZP versus placebo groups. No deaths or malignancies were reported. Conclusions CZP rapidly reduced the signs and symptoms of axSpA, with no new safety signals observed compared to the safety profile of CZP in RA. Similar improvements were observed across CZP dosing regimens, and in AS and nr-axSpA patients. PMID:24013647

  9. 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.

  10. Examining social competence, self-perception, quality of life, and internalizing and externalizing symptoms in adolescent females with and without autism spectrum disorder: a quantitative design including between-groups and correlational analyses.

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    Jamison, T Rene; Schuttler, Jessica Oeth

    2015-01-01

    Adolescent females with an autism spectrum disorder (ASD) are an understudied population, yet are also quite vulnerable, due to the increased complexities of social interaction and increased risk for internalizing symptoms in adolescence. Most research literature currently focuses on males with ASD, limiting our understanding of social experiences for females with ASD, and thus the potential to better inform supports and intervention to promote social-emotional functioning. This study examined similarities and differences in selected indicators of social-emotional health (social competence, self-perception, quality of life) and problematic behaviors such as externalizing and internalizing symptoms for adolescent females with and without ASD. This study employed a quantitative design utilizing correlational analysis as well as t test comparisons to examine selected indicators of social-emotional health and problematic symptoms using the Social Skills Improvement System (SSIS), Youth Quality of Life Instrument (YQOL), and the Self-Perceptions Profile for Adolescents (SPPA) for adolescent females with ASD in relation to their typically developing peers. Significant differences were found between females with and without ASD in terms of their self-ratings of social-emotional health and problematic behaviors. The no-ASD group rated themselves higher across all areas of social-emotional health. Findings also suggest strong relationships between these constructs, especially for females without ASD. Parent reports of autism symptoms and social-emotional health indicated that as symptoms of autism are more severe, so too was the impact on individuals' social competence. Adolescent females with ASD perceive themselves as having lower social competence, self-worth, and quality of life and higher levels of internalizing and externalizing symptoms as compared to their typically developing peers. Parent ratings indicate that higher levels of autism symptoms relate to lower

  11. Expressed and perceived criticism, family warmth, and symptoms in schizophrenia.

    Science.gov (United States)

    Medina-Pradas, Cristina; Navarro, J Blas; Pousa, Esther; Montero, M Isabel; Obiols, Jordi E

    2013-01-01

    Criticism directed by caregivers towards a family member with schizophrenia, both from the perspective of the patient and of the caregiver, predicts relapse, although both perspectives differ. This study aims to verify if the same applies to a Mediterranean sample, where criticism is not the main attitude of high expressed emotion families. The Camberwell Family Interview was applied to assess the family's perspective, and the Perceived Criticism and the Family Emotional Involvement and Criticism Scales were used to assess the patients' perspective, in 21 dyads. The association between both perspectives and psychotic symptoms was also examined. Results replicated those of previous studies in other countries, revealing that the perspectives on Criticism of patients and families do not match. The fact that family members also presented positive attitudes towards the patient did not cushion the patient's perceived criticism. Thus, it seems that families considered to be critical may not be perceived as such by the patients. Furthermore, only the warmth from the family's perspective correlated with the symptoms: positive affect proved to be more relevant than negative affect. Therefore, the patients' subjective assessments and family warmth should be included in clinical and research proposals.

  12. [Acute delusional disorder with dissociative symptoms--case report].

    Science.gov (United States)

    Małyszczak, Krzysztof; Pawłowski, Tomasz; Tersa, Kamila

    2006-01-01

    Delusions are amongst the main symptoms of schizophrenia. Delusional states may be caused by stress, somatic illness, or may be idiopathic, such as the persistent delusional disorder. Determination of a cause is usually difficult, but it is really important for the treatment. A case report of acute delusional disorder complicated by dissociative symptoms, suggesting an organic cause of the disorder is presented. Delirium caused by neuroleptic intoxication was an additional complication. Detailed informations gathered from relatives and psychological examinations made it possible to determine personality disorder as a ground, and stress as a precipitating factor of acute delusional disorder. Hospitalisation and psychological support helped in getting rid of the psychotic symptoms.

  13. A case study evaluating the use of clozapine in depression with psychotic features

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    Vieweg Ray

    2006-11-01

    Full Text Available Abstract The purpose of this case study was to use an evidence based medicine approach to work through an unusual way of treating a common problem. We looked at an example of an in-patient with severe refractory psychotic depression who had been resistant to treatment with a combination of antidepressant, antipsychotics, mood stabiliser, and concomitant ECT therapy. We then undertook a literature search for the use of clozapine in a patient with severe refractory depression. Although the resulting evidence was low level and thin, we felt on balance that a trial of clozapine was justified. We used a BPRS inventory to monitor her mood prior to commencing clozapine. Her mood and functional abilities were monitored as her clozapine was titrated upwards. Our patient showed a significant improvement in mood and functional abilities and a reduction in her BPRS score during this period. Her symptoms improved to the point where she was successfully discharged home on a combination of clozapine and an antidepressant. The improvement was sustained for a further two years. We thought this was an important case to highlight the limited evidence in using this successful form of treatment for a common clinical problem and that further research in this area was needed.

  14. Variations in incidence rates and age of onset of acute and transient psychotic disorders

    DEFF Research Database (Denmark)

    Castagnini, Augusto; Foldager, Leslie

    2013-01-01

    Purpose: To determine incidence and age of onset of the ICD-10 category of ‘acute and transient psychotic disorders’ (ATPDs) characterised by subtypes with polymorphic, schizophrenic and predominantly delusional symptoms, pointing out differences from schizophrenia (SZ) and bipolar affective...... to occur in younger males (IRR 1.4; 1.2–1.7). No significant gender difference was found for acute predominantly delusional disorder (IRR 1.0; 0.9–1.2), which had a later onset than any ATPD subtypes. SZ had an incidence twice as high in males (IRR 2.0; 1.9–2.2), and an earlier age of onset than ATPDs...... disorder (BD). Methods: We identified all subjects aged 15–64 years who were listed for the first time in the Danish Psychiatric Register with a diagnosis of ATPDs (n = 3,350), SZ (n = 4,576) and BD (n = 3,200) in 1995–2008. Incidence rates and rate ratios (IRR; 95 % confidence interval) by gender and age...

  15. Behavioural symptoms in patients with Alzheimer's disease and their association with cognitive impairment

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    Balañá Montse

    2010-09-01

    Full Text Available Abstract Background Behavioural and psychological symptoms of dementia (BPSD are non-cognitive symptoms commonly associated to Alzheimer's disease (AD. The characterization of the clinical profile of AD patients might help to better understand disease evolution and to improve diagnosis and treatment. Thus, the aim of the present study is to describe the clinical profile of AD patients, and to correlate the presence of BPSD with the severity of the disease. Methods A cross-sectional, observational and multicenter study was conducted at 115 centres in Spain. Patients suffering from AD with higher and lower BPSD scores (ADAS-Noncog score 26-50 and ≤25, respectively were included. Demographic and clinical data were collected, and dementia severity was assessed by the Mini Mental State Examination (MMSE [mild 27-21, moderate 20-11, severe ≤10]. The use of ADAS-Noncog in clinical practice was also explored. Results A total of 1014 patients (463 with higher and 551 with lower BPSD scores were included (mean age 77 ± 7 years, 65% women. Almost all patients (90% had BPSD at inclusion, 17% of which reported psychotic outbreaks. The most prevalent symptoms were lack of concentration (56%, tremors (56%, depression (44%, lack of cooperation (36%, and delusions (32%. Patients with higher BPSD scores showed a significantly higher prevalence of psychotic symptoms (delusions, hallucinations, and delirium and tremors, while emotional symptoms (tearfulness and apathy predominated in patients with lower BPSD scores. MMSE and ADAS-Noncog scores were negatively associated (p = 0.0284, suggesting a correlation between cognitive impairment and BPSD. Lack of concentration and appetite change significantly correlated with MMSE (p = 0.0472 and p = 0.0346, respectively. Rivastigmine and donepezil were the first choice therapies in mild to moderate dementia. ADAS-Noncog was generally considered better or similar to other scales (82%, and 68% of the investigators were

  16. Schizophrenia-like topological changes in the structural connectome of individuals with subclinical psychotic experiences.

    Science.gov (United States)

    Drakesmith, Mark; Caeyenberghs, Karen; Dutt, Anirban; Zammit, Stanley; Evans, C John; Reichenberg, Abraham; Lewis, Glyn; David, Anthony S; Jones, Derek K

    2015-07-01

    Schizophrenia is often regarded as a "dysconnectivity" disorder and recent work using graph theory has been used to better characterize dysconnectivity of the structural connectome in schizophrenia. However, there are still little data on the topology of connectomes in less severe forms of the condition. Such analysis will identify topological markers of less severe disease states and provide potential predictors of further disease development. Individuals with psychotic experiences (PEs) were identified from a population-based cohort without relying on participants presenting to clinical services. Such individuals have an increased risk of developing clinically significant psychosis. 123 individuals with PEs and 125 controls were scanned with diffusion-weighted MRI. Whole-brain structural connectomes were derived and a range of global and local GT-metrics were computed. Global efficiency and density were significantly reduced in individuals with PEs. Local efficiency was reduced in a number of regions, including critical network hubs. Further analysis of functional subnetworks showed differential impairment of the default mode network. An additional analysis of pair-wise connections showed no evidence of differences in individuals with PEs. These results are consistent with previous findings in schizophrenia. Reduced efficiency in critical core hubs suggests the brains of individuals with PEs may be particularly predisposed to dysfunction. The absence of any detectable effects in pair-wise connections illustrates that, at less severe stages of psychosis, white-matter alterations are subtle and only manifest when examining network topology. This study indicates that topology could be a sensitive biomarker for early stages of psychotic illness.

  17. Evidence for inert gas narcosis mechanisms in the occurrence of psychotic-like episodes at pressure environment.

    Science.gov (United States)

    Abraini, J H

    1995-11-27

    Psychotic-like episodes in divers exposed to high pressure have been attributed to either the high-pressure neurological syndrome, confinement in pressure chamber, the subject's personality, or the addition of nitrogen or hydrogen to the basic helium-oxygen breathing mixture used for deep diving. Alternatively, it is suggested that these disorders are in fact paroxysmal narcotic symptoms that result from the sum of the individual narcotic potencies of each inert gas in the breathing mixture. This hypothesis is tested against a variety of lipid solubility theories of narcosis. The results clearly support the hypothesis and provide new information about the cellular interactions between inert gases at raised pressure and pressure itself.

  18. The CCC2000 Birth Cohort Study of Register-Based Family History of Mental Disorders and Psychotic Experiences in Offspring

    DEFF Research Database (Denmark)

    Jeppesen, Pia; Tidselbak Larsen, Janne; Clemmensen, Lars

    2015-01-01

    in childhood was predicted by a family history of mental disorder with psychosis rather than a family history of nonpsychotic mental disorder and whether this association differed by severity of PE. The study examined data on 1632 children from a general population birth cohort assessed at age 11-12 years...... by use of a semistructured interview covering 22 psychotic symptoms. The Danish national registers were linked to describe the complete family history of hospital-based psychiatric diagnoses. Uni- and multivariable logistic regressions were used to test whether a family history of any mental disorder...... with psychosis, or of nonpsychotic mental disorder, vs no diagnoses was associated with increased risk of PE in offspring (hierarchical exposure variable). The occurrence of PE in offspring was significantly associated with a history of psychosis among the first-degree relatives (adjusted relative risk [RR] = 3...

  19. Subjective symptoms in euthymic bipolar disorder and remitted schizophrenia patients: A comparative study

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    Manish Kumar

    2016-01-01

    Full Text Available Background: Subjective experience means subtle, not yet psychotic abnormalities of experience that might be present during remitted phase and also in prodromal phase of schizophrenia and might be accurately efficient in identifying individuals at risk of eminent psychosis (Parnas et al., 2003. Apart from schizophrenic patients, bipolar patients also experience certain subjective symptoms in their euthymic state. They often experience subtle cognitive impairment and functional disturbances during their euthymic states. These subjective experiences may be related to distorted cognitive functions in these patients. These experiences include a great variety of cognitive dysfunction complaints about attention, perception, memory, thinking, language, movement, and emotion. Objective: To measure the experience of subjective symptoms and compare them between euthymic bipolar and remitted schizophrenia patients. Materials and Methods: Thirty euthymic bipolar patients and 30 remitted schizophrenia patients as per International Classification of Diseases Tenth Revision were selected for the purpose of the study. At first, sociodemographic data were collected. And then, the patients were assessed using the scales; positive and negative syndrome scale, Young Mania Rating Scale, Hamilton Depression Rating Scale, Symptom Checklist-90-Revised, and Frankfurt Complaint Questionnaire-24. Results: Both the groups showed significant differences in terms of subjective symptoms. However, no significant correlation has been found between the objective psychopathology and subjective experience in the two groups. Conclusion: It can be suggested that the patients with schizophrenia show significantly higher subjective experience when compared with the patients of bipolar disorder.

  20. Associations between problematic gaming and psychiatric symptoms among adolescents in two samples.

    Science.gov (United States)

    Vadlin, Sofia; Åslund, Cecilia; Hellström, Charlotta; Nilsson, Kent W

    2016-10-01

    The aim of the present study was to investigate associations between problematic gaming and psychiatric symptoms among adolescents. Data from adolescents in the SALVe cohort, including adolescents in Västmanland who were born in 1997 and 1999 (N=1868; 1034 girls), and data from consecutive adolescent psychiatric outpatients in Västmanland (N=242; 169 girls) were analyzed. Adolescents self-rated on the Gaming Addiction Identification Test (GAIT), Adult ADHD Self-Report Scale Adolescent version (ASRS-A), Depression Self-Rating Scale Adolescent version (DSRS-A), Spence Children's Anxiety Scale (SCAS), and psychotic-like experiences (PLEs). Multivariable logistic regression analyses were performed, and adjusted for sex, age, study population, school bullying, family maltreatment, and interactions by sex, with two-way interactions between psychiatric measurements. Boys had higher self-rated problematic gaming in both samples, whereas girls self-rated higher in all psychiatric domains. Boys had more than eight times the probability, odds ratio (OR), of having problematic gaming. Symptoms of ADHD, depression and anxiety were associated with ORs of 2.43 (95% CI 1.44-4.11), 2.47 (95% CI 1.44-4.25), and 2.06 (95% CI 1.27-3.33), respectively, in relation to coexisting problematic gaming. Problematic gaming was associated with psychiatric symptoms in adolescents; when problematic gaming is considered, the probability of coexisting psychiatric symptoms should also be considered, and vice versa.

  1. Depression with psychotic features in a child with SLE: successful therapy with psychotropic medications--case report.

    Science.gov (United States)

    Milovancevic, Milica Pejovic; Miletic, Vladimir; Deusic, Smiljka Popovic; Gajic, Saveta Draganic; Tosevski, Dusica Lecic

    2013-04-01

    Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune disease of unknown etiology, which affects multiple organ systems, including the central nervous system (CNS). Neuropsychiatric manifestations are seen in 13-75% of all SLE patients, with equal frequency in children and adults. Despite a high prevalence of psychiatric manifestations, there is no consensus on the proper treatment of such cases. We report here a case of an 11-year-old girl diagnosed with a severe depressive episode with psychotic features, treated successfully with risperidone and sertraline as an adjunct to immunosuppressive therapy.

  2. On a soma-psychotic part of the personality: a clinical and theoretical approach to the somatic.

    Science.gov (United States)

    Vaslamatzis, Grigoris; Chatzistavrakis, George

    2012-04-01

    Inspired by Bion, the concept of a soma-psychotic part of the personality is suggested. The authors present four clinical vignettes to illustrate certain clinical phenomena in which the body played a key role in the patient's personal history, during the analytic process, or both. Certain aspects of analytic technique with these severely disturbed patients are briefly referred to, including the analyst's reverie and transformational capacity, and some observations made in these cases lead to tentative generalizations on mental functioning and psychosomatic unity. A theoretical model is constructed to contain both data and conclusions, and to offer a solution for the integration of the somatic in psychoanalytic theory.

  3. Experience in using sulpiride in non-psychotic endogenous depressive-hypochondriacal disorders

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    Nina Arkadyevna Tyuvina

    2012-01-01

    Full Text Available Objective: to study the efficacy of sulpiride in different types of non-psychotic types of endogenous depressive-hypochondriacal syndrome. Patients and methods. Forty-seven patients (36 women and 11 men with a depressive episode (n = 15, recurrent depressive disorder (n = 14, and slowly progressive schizophrenia (SPS (n = 18 were examined clinically and using the psychometric scales: the Clinical Global Impression Scale; Montgomery-Esberg Depression Rating Scale (MADRS, the Hamilton Anxiety Rating Scale (HARS, and Udvalg for Kliniske Undersшgelser Side Effect Rating Scale. Sulpiride was given in an initial dose of50—100 mg/day; the dose was, if required, increased up to 400—600 mg/day. Results. After 2 months of treatment in the patients with affective di