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Sample records for psychotic symptoms patients

  1. 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.

  2. 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

  3. 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.

  4. Correlates of psychotic symptoms among elderly outpatients.

    Science.gov (United States)

    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.

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

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    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.

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

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    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.

  7. 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

  8. 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

  9. 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

  10. 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.

  11. A Dementia Case Presenting with Psychotic Symptoms

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    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

  12. 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

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. Psychotic symptoms in normal pressure hydrocephalus.

    Science.gov (United States)

    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

  6. [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.

  7. 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

  8. 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.

  9. 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

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    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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    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…

  12. An integrated network model of psychotic symptoms.

    Science.gov (United States)

    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.

  13. 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

  14. 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.

  15. 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...

  16. Etiological and Clinical Features of Childhood Psychotic Symptoms

    Science.gov (United States)

    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

  17. 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...

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

    Science.gov (United States)

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

    2017-06-07

    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.

  19. 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.

  20. 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.

  1. 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....

  2. 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.

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

    Science.gov (United States)

    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.

  4. 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

  5. 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

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

    NARCIS (Netherlands)

    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

  7. 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

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Yahya Ayhan Acar

    2014-01-01

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

  10. 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...

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

    Directory of Open Access Journals (Sweden)

    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

  12. 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.

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

    Science.gov (United States)

    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.

  14. Functional Connectivity Anomalies in Adolescents with Psychotic Symptoms

    Science.gov (United States)

    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

  15. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. A Chinese version of the Psychotic Symptom Rating Scales: psychometric properties in recent-onset and chronic psychosis

    Science.gov (United States)

    Chien, Wai-Tong; Lee, Isabella Yuet-Ming; Wang, Li-Qun

    2017-01-01

    The purpose of this study was to test the reliability, validity, and factor structure of a Chinese version of the Psychotic Symptom Rating Scale (PSYRATS) in 198 and 202 adult patients with recent-onset and chronic psychosis, respectively. The PSYRATS has been translated into different language versions and has been validated for clinical and research use mainly in chronic psychotic patients but not in recent-onset psychosis patients or in Chinese populations. The psychometric analysis of the translated Chinese version included assessment of its content validity, semantic equivalence, interrater and test–retest reliability, reproducibility, sensitivity to changes in psychotic symptoms, internal consistency, concurrent validity (compared to a valid psychotic symptom scale), and factor structure. The Chinese version demonstrated very satisfactory content validity as rated by an expert panel, good semantic equivalence with the original version, and high interrater and test–retest (at 2-week interval) reliability. It also indicated very good reproducibility of and sensitivity to changes in psychotic symptoms in line with the symptom severity measured with the Positive and Negative Syndrome Scale (PANSS). The scale consisted of four factors for the hallucination subscale and two factors for the delusion subscale, explaining about 80% of the total variance of the construct, indicating satisfactory correlations between the hallucination and delusion factors themselves, between items, factors, subscales, and overall scale, and between factors and relevant item and subscale scores of the PANSS. The Chinese version of the PSYRATS is a reliable and valid instrument to measure symptom severity in Chinese psychotic patients complementary to other existing measures mainly in English language.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. 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,

  12. 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

  13. 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.

  14. 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...

  15. 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...

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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…

  6. 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.

  7. 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 

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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-

  13. 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

  14. Attenuated psychotic and basic symptom characteristics in adolescents with ultra-high risk criteria for psychosis, other non-psychotic psychiatric disorders and early-onset psychosis.

    Science.gov (United States)

    Lo Cascio, Nella; Saba, Riccardo; Hauser, Marta; Vernal, Ditte Lammers; Al-Jadiri, Aseel; Borenstein, Yehonatan; Sheridan, Eva M; Kishimoto, Taishiro; Armando, Marco; Vicari, Stefano; Fiori Nastro, Paolo; Girardi, Paolo; Gebhardt, Eva; Kane, John M; Auther, Andrea; Carrión, Ricardo E; Cornblatt, Barbara A; Schimmelmann, Benno G; Schultze-Lutter, Frauke; Correll, Christoph U

    2016-10-01

    While attenuated psychotic symptoms (APS) and basic symptoms (BS) are the main current predictors of psychosis in adults, studies in adolescents are scarce. Thus, we (1) described the prevalence and severity of positive, negative, disorganization, general, and basic symptoms in adolescent patients at ultra-high risk for psychosis (UHR), with other non-psychotic psychiatric disorders (PC) and with early-onset psychosis (EOP); and (2) investigated BS criteria in relation to UHR criteria. Sixty-nine 12-18-year-old adolescents (15.3 ± 1.7 years, female = 58.0 %, UHR = 22, PC = 27, EOP = 20) were assessed with the structured interview for prodromal syndromes (SIPS) and the schizophrenia proneness instrument-child and youth version (SPI-CY). Despite similar current and past 12-month global functioning, both UHR and EOP had significantly higher SIPS total and subscale scores compared to PC, with moderate-large effect sizes. Expectedly, UHR had significantly lower SIPS positive symptom scores than EOP, but similar SIPS negative, disorganized, and general symptom scores. Compared to PC, both EOP and UHR had more severe basic thought and perception disturbances, and significantly more often met cognitive disturbances criteria (EOP = 50.0 %, UHR = 40.9 %, PC = 14.8 %). Compared to UHR, both EOP and PC significantly less often met cognitive-perceptive BS criteria (EOP = 35.0 %, UHR = 68.2 %, PC = 25.9 %). BS were significantly more prevalent in both EOP and UHR than PC, and UHR were similar to EOP in symptom domains. Given the uncertain outcome of adolescents at clinical high-risk of psychosis, future research is needed to determine whether the combined assessment of early subjective disturbances with observable APS can improve the accuracy of psychosis prediction.

  15. 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.

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

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    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.

  17. 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

  18. 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.

  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. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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

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

    Science.gov (United States)

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

    2016-01-01

    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

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. 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 ...

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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.

  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. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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

  14. [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.

  15. 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.

  16. 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...

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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....

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. "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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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....

  18. 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.

  19. 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.

  20. [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.

  1. 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

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    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

  2. 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

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

    OpenAIRE

    Beatriz Sabina Roméu; Daimí Sarmiento González; Mario Isaías Alzuri Falcato; Anais Leyva Madrigales

    2016-01-01

    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...

  4. 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.

  5. 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.

  6. 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

  7. 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。

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

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    Sheridan Rains Luke

    2012-08-01

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

  9. 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

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

    NARCIS (Netherlands)

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

    2010-01-01

    Background: Patients suffering from psychotic disorders have an increased risk of comorbid somatic diseases such as cardiovascular disorders and diabetes mellitus. Doctor-related factors, such as unfamiliarity with these patients, as well as patient-related factors, such as cognitive disturbance and

  11. 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...

  12. 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.

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

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    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

  14. PATIENT WITH HUNTINGTON’S DISEASE, PRESENTING AS PSYCHOTIC DISORDER – CASE REPORT

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    Lilijana Horvat

    2001-06-01

    Full Text Available Background. Huntington’s disease (HD is rare. It usually starts with choreatic movements and cognitive impairment, progressing to dementia. A case report revealing diagnostic difficulties in a patient with HD, which began as psychotic disorder is presented. Patient was treated for almost five years in psychiatric outpatients’ service and psychiatric hospital due to a treatment-resistant psychotic disorder. Choreatic movements emerged during the fourth year of the treatment and were misdiagnosed as tardive dyskinesia. Prominent deterioration of cognitive functions demanded further diagnostics. With genetic tests HD was diagnosed.Conclusions. The start of HD with psychotic disorder is less common. In patients with treatment-resistant psychoses other somatic disorders should be considered.

  15. 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.

  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. Psychiatrists' view on the risk factors for aggressive behavior in psychotic patients

    NARCIS (Netherlands)

    A.F. Nederlof (Angela F.); G.V. Koppenol-Gonzalez (Gabriela); P.E.H.M. Muris (Peter); J.E.J.M. Hovens (Hans)

    2013-01-01

    textabstractIn meta-analytic studies it was found that patients diagnosed with a psychotic disorder are at increased risk for displaying violent behavior. However, it remains largely unclear which specific factors contribute to the heightened risk for aggression in this patient group, nor what the

  18. Antipsychotic treatment and the Rorschach Perceptual Thinking Index (PTI) in psychotic disorder patients: Effects of treatment.

    Science.gov (United States)

    Biagiarelli, Mario; Curto, Martina; Di Pomponio, Ileana; Comparelli, Anna; Baldessarini, Ross J; Ferracuti, Stefano

    2017-02-16

    The Rorschach-based Perceptual Thinking Index (PTI) is used to identify and rate features of psychotic disorders, but effects of antipsychotic treatment on such ratings is not clear. Accordingly, we examined potential effects of antipsychotic drugs on PTI measures in 114 patients with a psychotic or bipolar-I disorder. Use and doses of antipsychotic drugs (as chlorpromazine-equivalent [CPZ-eq] mg/day) were unrelated to PTI total or subscale scores in any diagnostic group. PTI scores were independently and significantly associated with psychotic symptomatic severity (PANSS score) and less with female sex. These findings support the validity and value of the PTI in identifying features of psychosis even in the presence of antipsychotic treatment.

  19. 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.

  20. 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).

  1. 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-

  2. THE EFFICACY OF ECT IN PSYCHOTIC DEPRESSION IN A PATIENT AFTER RENAL TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    Wójcik, Maciej

    2014-06-01

    Full Text Available Objectives. The aim of the study was to present the case of a patient after renal transplantation who developed psychotic depression. Methods. Analysis of the clinical case and medical history. Results. 33-year-old patient with an earlier episode of psychotic depression and kidney transplant was admitted to the ward in critical condition. Due to the heavy somatic condition, denial of food, fluids and medications intake, urinary tract infection, inefficiency and nephrotoxicity of pharmacotherapy we decided to apply electroconvulsive therapy with phenomenal therapeutic response after the first treatment. Conclusions. Psychotic depression is a severe disorder often requiring rapid and complex treatment. In this case, an attempt of applying electroconvulsive therapy (ECT, because of life threatened state, was tried. Due to the lack of literature, and to date not fully elucidated the mechanism of action of ECT, it remains a mystery the fact that the therapeutic response was so clear and rapid. The authors hypothesize that this is due to the young age of the patient, the absence of organic changes and a brief medical history. Further research in this area may contribute to a better understanding of the described changes. The present case may be an indication for clinicians to attempt the use of ECT in patients after kidney transplantation with concomitant psychotic depression.

  3. 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

  4. 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

  5. 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.

  6. On the nature of intuitive and delusional thought: its implications in clinical work with psychotic patients.

    Science.gov (United States)

    De Masi, Franco

    2003-10-01

    The author tries to differentiate intuitive imagination from delusional imagination and hypothesises that psychosis alters the system of intuitive thinking, which consequently cannot develop in a dynamic and selective way. Scholars of different disciplines, far removed from psychoanalysis, such as Einstein, Hadamard or Poincaré, believe that intuitive thinking works in the unconscious by means of hidden processes, which permit a creative meeting of ideas. Thanks to Bion's work, psychoanalysts have begun to understand that waking thinking is unconsciously intertwined with dream-work. The delusional construction is similar to a dreamlike sensorial production but, unlike a real dream, it remains in the waking memory and creates characters which live independently of the 'dreamer's' awareness. It is a dream that never ends. On the contrary, the real dream disappears when it has brought its communicative task to an end. In the analysis of psychotic patients it is very important to analyse the delusional imagination which dominates the personality and continuously transforms the mental state, twisting emotional truth. The delusional imagination is so deeply rooted in the patient's mental functioning that, even after systematic analysis, the delusional world, which had seemed to disappear, re-emerges under new configurations. The psychotic core remains encapsulated; it produces unsteadiness and may induce further psychotic states in the patient. The author reports some analytic material of a patient, who, after a delusional episode treated with drugs, shows a vivid psychotic functioning. Some considerations are added on the nature of the psychotic state and on the therapeutic approach used to transform the delusional structure. This paper particularly deals with the difficulty in working through the psychotic episode and in 'deconstructing'the delusional experience because of the terror connected with it. In the reported case, the analytic work changed the delusional

  7. 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....

  8. 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....

  9. 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

  10. [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.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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:

  16. 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.

  17. 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.

  18. [Incidence and etiology of psychotic disorders in HIV infected patients].

    Science.gov (United States)

    Niederecker, M; Naber, D; Riedel, R; Perro, C; Goebel, F D

    1995-05-01

    There are numerous case reports on psychoses in AIDS patients and, although more seldom, also in HIV-positive patients in early stages of infection; however, systematic investigations on the frequency, e.g., relevant for the indication of an HIV test in psychiatric patients, are missing. For this study, 1046 HIV-positive patients were examined regarding psychoses. A total of 301 patients (28.8%) were HIV-positive but asymptomatic, and 380 patients (36.2%) had the lymphadenopathy syndrome. One hundred thirty-two patients (12.6%) suffered from an AIDS-related complex and 233 patients (22.3%) from AIDS. Of these 1046 patients, only 9 (0.9%) suffered from psychoses. One patient with a paranoid-hallucinatory syndrome was asymptomatic; one in the lymphadenopathy syndrome was manic. The other 7 patients were all in late stages of the infection. A causal relationship between HIV infection and psychosis and probable in only 3 patients. These data do not indicate a markedly elevated prevalence of psychosis in HIV-positive or AIDS patients.

  19. 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.

  20. 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...

  1. 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

  2. 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 ...

  3. 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...

  4. 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. 

  5. 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.

  6. 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...

  7. 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.

  8. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Mahlet Fikreyesus

    2016-10-01

    Full Text Available Abstract Background Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH. Methods Data were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS to assess compliance to medication and abnormal involuntary movement scale (AIMS to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value <0.25 in the bivariate analyses were entered into multivariate logistic regression and variables with P-value < 0.05 in the final model were declared to be significantly associated with the outcome variable. Results The prevalence of relapse among patients with psychotic disorder was 24.6 % (n = 95. Of this, 25.4 and 22.4 % were males and females respectively. The odds of developing psychotic relapse among patients living with family was 72 % lower than that of patients living alone (aOR = 0.28, 95 % CI = 0.08, 0.93. The odds of developing psychotic relapse among patients compliant to medication was 69 % lower than that of patients who were not compliant to medications (aOR = 0.31, 95 % CI = 0.12, 0.80. The odds of developing psychotic relapse among patients having high score on social support score was 48 % lower than that of patients who were compliant to medications (aOR = 0.52, 95 % CI = 0.28, 0.95. The odds of developing psychotic relapse among patients reporting to have sought religious support was 45 % lower than that of patients who have not sought religious support (aOR = 0.55, 95 % CI = 0.31, 0.96. On the other hand, the odds of developing

  9. 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

  10. 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.

  11. Changes in extra-striatal functional connectivity in patients with schizophrenia in a psychotic episode.

    Science.gov (United States)

    Peters, Henning; Riedl, Valentin; Manoliu, Andrei; Scherr, Martin; Schwerthöffer, Dirk; Zimmer, Claus; Förstl, Hans; Bäuml, Josef; Sorg, Christian; Koch, Kathrin

    2017-01-01

    In patients with schizophrenia in a psychotic episode, intra-striatal intrinsic connectivity is increased in the putamen but not ventral striatum. Furthermore, multimodal changes have been observed in the anterior insula that interact extensively with the putamen. We hypothesised that during psychosis, putamen extra-striatal functional connectivity is altered with both the anterior insula and areas normally connected with the ventral striatum (i.e. altered functional connectivity distinctiveness of putamen and ventral striatum). We acquired resting-state functional magnetic resonance images from 21 patients with schizophrenia in a psychotic episode and 42 controls. Patients had decreased functional connectivity: the putamen with right anterior insula and dorsal prefrontal cortex, the ventral striatum with left anterior insula. Decreased functional connectivity between putamen and right anterior insula was specifically associated with patients' hallucinations. Functional connectivity distinctiveness was impaired only for the putamen. Results indicate aberrant extra-striatal connectivity during psychosis and a relationship between reduced putamen-right anterior insula connectivity and hallucinations. Data suggest that altered intrinsic connectivity links striatal and insular pathophysiology in psychosis. © The Royal College of Psychiatrists 2017.

  12. 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

  13. Cost of care: A study of patients hospitalized for treatment of psychotic illness

    Directory of Open Access Journals (Sweden)

    P P Rejani

    2015-01-01

    Full Text Available Background: Combination of ill health and poverty poses special challenges to health care providers. Mental illness and costs are linked in terms of long-term treatment and lost productivity, and it affects social development. The purpose of the present study is to assess the economic burden of poor families when a family member needs hospitalization due to psychosis. Materials and Methods: The information was gathered from caregivers of 100 psychotic inpatients of Medical College Hospital of Kerala during a period of 6 months. Data regarding components of expenses such as cost of medicine, laboratory investigations, food, travel, and other miscellaneous expenses during their inpatient period were collected by direct personal interview using specially designed proforma. The data were analyzed using Epi-info software. The patients below the poverty line (BPL were compared with those above poverty line (APL. Results: There was no significant difference between patients from BPL and APL in respect of amounts spent on the studied variables except for laboratory investigations during the hospital stay. Conclusions: The results showed that the studied subjects are facing financial difficulties not only due to hospitalization, but also due to the recurrent expense of their ongoing medication. The study recommends the need of financial support from the government for the treatment of psychotic patients.

  14. 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...

  15. 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…

  16. 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.

  17. 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

  18. Qualitative analysis of interviews of future non-affective psychotic disorder patients and non-psychiatric controls: preliminary results

    Directory of Open Access Journals (Sweden)

    Katya Rubinstein

    2014-03-01

    Conclusions: The findings of this unique historical-prospective qualitative analysis of interviews performed before the onset of psychosis, confirmed previous findings of premorbid abnormality of future non-affective psychosis patients. Using qualitative analysis enabled obtaining a more in-depth understanding of the real-life experience of the premorbid period among patients with non-affective psychotic disorders.

  19. Predictive validity of the Trauma Screening Questionnaire in detecting post-traumatic stress disorder in patients with 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.

    2015-01-01

    Background Post-traumatic stress disorder (PTSD) is highly prevalent in patients with a psychotic disorder. Because a PTSD diagnosis is often missed in patients with psychosis in routine care, a valid screening instrument could be helpful. Aims To determine the validity of the Trauma Screening Quest

  20. Self-image and perception of mother and father in psychotic and borderline patients.

    Science.gov (United States)

    Armelius, K; Granberg

    2000-02-01

    Psychotic and borderline patients rated their self-image and their perception of their mother and father using the Structural Analysis of Social Behavior model (SASB). The borderline patients had more negative images of themselves and their parents, especially their fathers, than did the psychotic patients and the normal subjects, while the psychotic patients' ratings did not differ much from those of the normal subjects. The self-image was related to the images of both parents for borderline patients and normal subjects, while for the psychotic patients only the image of the mother was important for the self-image. In addition, the psychotic patients did not differentiate between the poles of control and autonomy in the introjected self-image. It was concluded that borderline patients are characterized by negative attachment, while psychotic patients are characterized by poor separation from the mother and poor differentiation between autonomy and control. The paper also discusses how this may influence the patients' relations to others. Psychotische und Borderline Patienten beurteilten ihr Selbstbild und ihre Wahrnehmung von Mutter und Vater mit Hilfe der strukturalen Analyse sozialen Verhaltens (SASB). Die Borderline Patienten hattten negativere Selbstbilder und Elternbilder (speziell Vaterbilder) als die psychotischen Patienten und gesunde Personen. Die Beurteilungen der psychotischen Patienten unterschieden sich dagegen nicht besonders von jenen Gesunder. Das Selbstbild stand in Beziehung zu beiden Elternbildern bei den Borderline Patienten und den Gesunden, während bei den psychotischen Patienten nur das Mutterbild für das Selbstbild bedeutsam war. Außerdem konnte bei den psychotischen Patienten nicht zwischen den Polen der Kontrolle und Autonomie bzgl. der introjizierten Selbstbilder differenziert werden. Aus den Ergebnissen wird gefolgert, dass Borderline Patienten durch eine negative Bindung charackterisiert sind, psychotische Patienten dagegen durch

  1. 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

  2. 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

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

    Directory of Open Access Journals (Sweden)

    Susanta Kumar Padhy

    2016-01-01

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

  4. Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

    Directory of Open Access Journals (Sweden)

    Matheus F. Oliveira

    2014-06-01

    Full Text Available Normal pressure hydrocephalus (NPH is characterized by gait disturbance, dementia and/or urinary incontinence associated with dilation of ventricular system with normal opening cerebrospinal fluid pressure. Wide scientifical evidence confirms association between NPH and psychiatric symptoms. We selected 35 patients with idiopathic normal pressure hydrocephalus from January 2010 to January 2012 in a Brazilian tertiary hospital and performed a formal psychiatric evaluation to identify psychiatric disorders. Psychiatric disorders were present in 71% of these patients, especially anxiety, depression and psychotic syndromes. NPH patients may develop symptoms with frontal dominance, such as personality changes, anxiety, depression, psychotic syndromes, obsessive compulsive disorder, Othello syndrome; shoplifting and mania. Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment.

  5. 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…

  6. 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

  7. 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

  8. The occurrence and nature of early signs of schizophrenia and psychotic mood disorders among former child and adolescent psychiatric patients followed into adulthood

    Directory of Open Access Journals (Sweden)

    Rydelius Per-Anders

    2008-10-01

    Full Text Available Abstract Background This investigation was designed to characterize psychotic disorders among patients originally treated as in- and outpatients by child and adolescent psychiatric services and subsequently followed-up into mid-adulthood. The age at the first onset on symptoms, possible changes in diagnoses, early signs noted prior to or upon admission to child and adolescent psychiatric care and possible differences between patients with early- and later-onset disorder were of particular interest. Methods The study population consisted of patients (285 in- and 1115 outpatients born between 1957 and 1976 and admitted to and treated by child and adolescent psychiatric care units in Jämtland County, Sweden, between 1975 and 1990. The status of their mental health was monitored until 2003 using official registries and hospital records. Diagnoses based on the ICD-8 and -9 systems, which were used in Sweden from 1968–1997, converted to diagnoses according to ICD-10, which has been in use since 1997. The Comprehensive Assessment of at Risk Mental States was employed to assess the information concerning psychopathology provided by the hospital records. Results By the end of the follow-up period 62 former child and adolescent psychiatric patients (36 females and 26 males, 4.4% of the entire study group, had received an ICD-10 diagnosis of "F20–29: Schizophrenia, schizotypal and delusional disorders" (48 and/or "F30–39: Psychotic mood disorders" (14. One-third (21 of these individuals were given their initial diagnosis of psychosis in connection with child and adolescent psychiatric care. Two of these 21 were not treated later for this disorder in general (adult psychiatric care whereas the remaining 19 individuals were diagnosed for the same type of disorder as adults. The other 41 patients were diagnosed as psychotic only in connection with general (adult psychiatric care. The mean age at the time of first onset of symptoms was 21.4 years (SD 6

  9. Assessment of posttraumatic symptoms in patients with first-episode psychosis.

    LENUS (Irish Health Repository)

    2011-11-01

    Posttraumatic stress disorder is common among patients with psychotic disorders. The present study examined the internal reliability and comparability of the Impact of Event Scale (IES) in a sample of 38 patients with first-episode psychosis and 47 controls exposed to severe physical and\\/or sexual abuse. The IES total score and both subscales showed high internal consistency in both groups (Cronbach\\'s alpha coefficients of approximately 0.9 or higher). Given their equivalent trauma reporting, the lack of differences in IES scores between patients and controls seems to indicate that patients are likely to report accurately and neither exaggerate nor minimize their posttraumatic symptoms. Overall, the findings suggest that the IES can be used to assess symptoms of posttraumatic stress in patients with psychotic disorders as in other populations.

  10. Containing psychotic patients with fragile boundaries: a single-session group case study.

    Science.gov (United States)

    Lavarenne, Anaïs; Segal, Emily; Sigman, Maxine

    2013-01-01

    This case study describes a single group psychotherapy session of six individuals suffering from schizophrenia or schizoaffective illness, which was characterized by numerous manifestations of fragile Ego boundaries. Based on these illustrations of fragile Ego boundaries, we explore some of the group's core therapeutic actions against psychosis. We discuss how the group (1) provides access to a structuring auxiliary Ego, (2) acts as a containing object by establishing firm boundaries and by mentalizing patients' psychotic productions, and (3) may become a solid object representation introjected by individuals wrestling with porous Ego boundaries and a poor sense of self. We conclude that, in addition to the known role of group therapy in increasing mature defenses, developing insight and providing social support, the group promotes healthier Ego boundaries, and eventually improves self-differentiation, and also tolerance to interpersonal proximity. This case study clarifies group therapy dynamics with individuals suffering from psychosis.

  11. Is aripiprazole the only choice of treatment of the patients who developed anti-psychotic agents-induced leucopenia and neutropenia? A case report.

    Science.gov (United States)

    Yalcin, Demet Ozen; Goka, Erol; Aydemir, M Cigdem; Kisa, Cebrail

    2008-05-01

    Leucopenia and neutropenia could be side effects of anti-psychotic drugs, especially clozapine. However, there is evidence that other anti-psychotics can cause leucopenia and neutropenia. We present the clinical follow-up and treatment process of a patient, who had initially developed quetiapine and amisulpride related neutropenia, but not with aripiprazole.

  12. Relationship between the Rorschach Perceptual Thinking Index (PTI) and the Positive and Negative Syndrome Scale (PANSS) in psychotic patients: a validity study.

    Science.gov (United States)

    Biagiarelli, Mario; Roma, Paolo; Comparelli, Anna; Andraos, Maria Paola; Di Pomponio, Ileana; Corigliano, Valentina; Curto, Martina; Masters, Grace Allison; Ferracuti, Stefano

    2015-02-28

    The aim of this study is to demonstrate the validity of the Rorschach Perceptual Thinking Index (PTI) in the assessment of reality testing in patients with psychosis. We evaluated the relationship between the PTI criteria and the Positive and Negative Syndrome Scale (PANSS) scores in 98 psychotic disorder affected patients. Thirty four were evaluated during the acute episode (AP) and 64 were chronically treated and stable (CP). The PANSS positive score resulted significantly higher in AP than in CP group, but no significant difference was found in the PTI score. The PTI positively correlated with the PANSS total score. The PTI1 and PTI2 criteria significantly correlated with the PANSS negative score, the PTI4 and PTI5 with the positive. The Rorschach variable X-% significantly correlated with the negative symptoms; the WSum6 with thought disorders; and the M- with delusions. PTI score, X-% and WSum6 predicted impaired judgment and insight. These results suggest that PTI is a valid instrument to assess impairment in reality testing, regardless of the patient׳s current psychiatric presentation. The presence of conceptual disorganization, delusions, lack of judgment and insight don׳t have effects on the PTI, supporting its strength as an assessment tool for psychotic disorders.

  13. Neurocognition, presence and acceptance of a VR programme for psychotic patients: a correlational study.

    Science.gov (United States)

    Rus-Calafell, Mar; Gutiérrez-Maldonado, José; Ribas-Sabaté, Joan

    2013-01-01

    Patients with psychosis exhibit a wide range of cognitive deficits which are associated with poor functioning and poor outcomes in psychosocial interventions. Recently, virtual reality (VR) has been demonstrated to be a useful tool for treatment and rehabilitation of these patients. We have developed and applied an integrated VR programme to improve social skills in people with schizophrenia: the Soskitrain. The aim of the present study is to evaluate the relationship between patients' cognitive deficits, their sense of presence and their ratings of the programme's acceptability. Twelve clinically stabilized outpatients with a well-established diagnosis of schizophrenia or schizoaffective disorder underwent neuropsychological assessment prior to treatment, while after the intervention they completed a questionnaire about their sense of presence and the acceptability of the VR programme. Post-treatment results revealed a high sense of presence among patients, as well as good verisimilitude and high acceptance of the virtual environments. In addition, there were significant negative correlations between sense of presence and deficits in both delayed verbal learning and processing speed. The paper discusses the implications of cognitive impairment for the experience and acceptance of VR when treating psychotic patients.

  14. 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

  15. Overview of Medicare Part D prescription drug benefit: potential implications for patients with psychotic disorders.

    Science.gov (United States)

    Rosenberg, Jack M

    2007-01-15

    Medicare Part D prescription drug benefits are reviewed. Potential implications for patients with psychotic disorders in relation to Medicare Part D are discussed. The newly created Medicare Part D provides prescription drug benefits to many individuals formerly without prescription benefits and, possibly, lower-cost benefits to those who previously relied on other benefits. Participating prescription plans use a variety of pharmacy management tools to minimize costs while providing benefit plans that meet Part D requirements for composition and coverage. Patients then have the challenge of choosing a prescription drug plan that will best satisfy their prescriptions needs. The rollout of Part D has not been without problems, and although more Medicare participants are receiving prescription drug benefits at a greater savings, there are concerns that Part D may not provide adequate coverage for all patients or for patients requiring certain types of medications, especially some psychotropic medications. Pharmacists have voiced concerns about the Medicare Part D drug plan in regard to both the degree of coverage it provides to enrollees and the difficulty in administering the benefit.

  16. 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...

  17. Long-term benzodiazepine treatment in patients with psychotic disorders attending a mental health service in rural Greece

    Directory of Open Access Journals (Sweden)

    Vaios Peritogiannis

    2016-01-01

    Full Text Available Introduction: Long-term benzodiazepine (BZD treatment in patients with mental disorders is widespread in clinical practice, and this is also the case of patients with schizophrenia, although the evidence is weak and BZD prescription is discouraged by guidelines and medical authorities. Data on BZD prescription are usually derived from national or regional databases whereas information on the use of BZD by patients with schizophrenia and related psychoses in general population-based samples is limited. Materials and Methods: Information for 77 patients with psychotic disorders who were regularly attending follow-up appointments with the multidisciplinary Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia, Northwest Greece, during 1-year period (2015 was obtained from our database. Results: From the total of 77 engaged patients, 30 (39% were regularly prescribed BZDs in the long term, as part of their treatment regimen. Prescribed BZDs were mostly diazepam and lorazepam, in 43.3% of cases each. The mean daily dose of these compounds was 13 mg and 3.77 mg, respectively. Statistical analysis showed a correlation of long-term BZD use with the history of alcohol/substance abuse. Most patients were receiving BZD continuously for several years, and the mean dose was steady within this interval. Conclusions: A large proportion of patients with psychotic disorders were regularly prescribed BZD in long term. It appears that when BZDs are prescribed for some period in the course of a psychotic disorder, their use commonly exceeds the recommended interval and then becomes a regular part of the chronic treatment regimen. Future research should address the factors that may be related to the long-term BZD use by patients with psychotic disorders. Interventions for the reduction of regular BZD prescription should target the primary care setting and all those who treat first episode patients.

  18. 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.

  19. [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.

  20. 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.

  1. 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)

  2. 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...

  3. 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.

  4. Money for medication : A randomized controlled study on the effectiveness of financial incentives to improve medication adherence in patients with psychotic disorders

    NARCIS (Netherlands)

    E.L. Noordraven (Ernst); C.H. Audier (Charlotte); A.B.P. Staring (Anton); A.I. Wierdsma (André); P. Blanken (Peter); B.E.A. van der Hoorn (Bas); L. van Hakkaart-van Roijen (Leona); C.L. Mulder (Niels)

    2014-01-01

    markdownabstractBackground: Non-adherence with antipsychotic medication is a frequently occurring problem, particularly among patients with psychotic disorders. Prior research has generally shown encouraging results for interventions based on ‘Contingency Management’ (CM), in which desirable

  5. Money for medication : A randomized controlled study on the effectiveness of financial incentives to improve medication adherence in patients with psychotic disorders

    NARCIS (Netherlands)

    E.L. Noordraven (Ernst); C.H. Audier (Charlotte); A.B.P. Staring (Anton); A.I. Wierdsma (André); P. Blanken (Peter); B.E.A. van der Hoorn (Bas); L. van Hakkaart-van Roijen (Leona); C.L. Mulder (Niels)

    2014-01-01

    markdownabstractBackground: Non-adherence with antipsychotic medication is a frequently occurring problem, particularly among patients with psychotic disorders. Prior research has generally shown encouraging results for interventions based on ‘Contingency Management’ (CM), in which desirable behavio

  6. Role of the General Practitioner in the Care of Patients Recently Discharged From the Hospital After a First Psychotic Episode: Influence of Length of Stay

    Science.gov (United States)

    Rivoiron-Besset, Emmanuelle; David, Michel; Jaussent, Isabelle; Prudhomme, Cindy; Boulenger, Jean-Philippe; Mann, Anthony H.; Ritchie, Karen A.; Capdevielle, Delphine

    2011-01-01

    implication of general practitioners in providing postdischarge care to first-episode psychotic patients, irrespective of their length of hospital stay. Yet, the general practitioner has a role to play in coordinating and providing care for somatic health problems as well as psychiatric symptoms, specifically in the case of early discharge. PMID:22295272

  7. 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

  8. 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

  9. Associations of Quality of Life with Service Satisfaction in Psychotic Patients: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Eleni Petkari

    Full Text Available Quality of life (QoL has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients. Yet, the relationship between the patients' satisfaction with services and QoL has not been clearly established, perhaps due to the multidimensionality of the QoL concept and the variability in its assessment.This is the first systematic meta-analysis of all available evidence assessing the relationship between QoL and service satisfaction.In all, 19 studies reporting data of 21 independent samples (N = 5,337 were included in the present meta-analysis. In moderator analyses, effects of age, sex, diagnoses (schizophrenia vs. other psychoses, treatment context (inpatients vs. outpatients, study design (cross-sectional vs. longitudinal, and QoL domain (subjective vs. health-related were examined.Analyses revealed a highly significant medium-sized effect (r = .30, p < .001 for the associations of QoL and service satisfaction. Effect sizes were significantly stronger for subjective than health-related quality of life (r = .35 vs. r = .14, respectively. Moreover, associations with subjective QoL remained largely robust when accounting for moderating variables, although there was a trend of stronger associations for outpatients compared to inpatients. In contrast, effect sizes for health-related QoL were small and only observable for samples with longitudinal designs.Associations between QoL and service satisfaction appear to be robust but are differentiated in regard to QoL domain. Our findings suggest that agents responsible for service design and implementation need to take the patients' perception of the service adequacy for achieving QoL enhancement into account.

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

    Directory of Open Access Journals (Sweden)

    Roosenschoon BJ

    2009-07-01

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

  12. 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.

  13. 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...

  14. Reduction of Severity of Recurrent Psychotic Episode by Sustained Treatment with Aripiprazole in a Schizophrenic Patient with Dopamine Supersensitivity: A Case Report

    Science.gov (United States)

    Tadokoro, Shigenori; Nonomura, Naho; Kanahara, Nobuhisa; Hashimoto, Kenji; Iyo, Masaomi

    2017-01-01

    Dopamine supersensitivity psychosis (DSP) is a type of acute exacerbation of recurrent psychosis caused by long-term treatment with antipsychotics in schizophrenic patients. Although DSP is exceedingly troublesome for clinicians, effective treatment has not yet been established. Based on clinical research and our animal study, we hypothesize that aripiprazole, an atypical anti-psychotic, may reduce the exacerbation of recurrent psychotic episodes. We report the case of a 46-year-old female who suffered from schizophrenia with DSP. In this case, sustained treatment with a high dose of aripiprazole gradually reduced the severity of her recurrent psychotic episodes. In conclusion, sustained treatment with aripiprazole may reduce the exacerbation of recurrent psychotic episodes in schizophrenic patients with DSP, and may be an effective treatment of DSP. PMID:28138118

  15. Symptom monitoring in treatment of cancer patients

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective To examine self-reported symptoms by the patients receiving cancer therapy, and find out the symptoms that should be coped with and managed during the treatment. Methods A pilot study was conducted on self-reported symptoms on 185 patients receiving chemotherapy and/or radiotherapy for different cancers. The Therapy-Related Symptoms Checklist (TRSC) was used. Results Severe symptoms on the TRSC subscales: loss of appetite, feeling sluggish, weight loss, nausea and hair loss, were reported by the p...

  16. 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.

  17. Associations of Quality of Life with Service Satisfaction in Psychotic Patients: A Meta-Analysis

    Science.gov (United States)

    Petkari, Eleni; Pietschnig, Jakob

    2015-01-01

    Background Quality of life (QoL) has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients. Yet, the relationship between the patients’ satisfaction with services and QoL has not been clearly established, perhaps due to the multidimensionality of the QoL concept and the variability in its assessment. Aim This is the first systematic meta-analysis of all available evidence assessing the relationship between QoL and service satisfaction. Methods: In all, 19 studies reporting data of 21 independent samples (N = 5,337) were included in the present meta-analysis. In moderator analyses, effects of age, sex, diagnoses (schizophrenia vs. other psychoses), treatment context (inpatients vs. outpatients), study design (cross-sectional vs. longitudinal), and QoL domain (subjective vs. health-related) were examined. Results Analyses revealed a highly significant medium-sized effect (r = .30, p service satisfaction. Effect sizes were significantly stronger for subjective than health-related quality of life (r = .35 vs. r = .14, respectively). Moreover, associations with subjective QoL remained largely robust when accounting for moderating variables, although there was a trend of stronger associations for outpatients compared to inpatients. In contrast, effect sizes for health-related QoL were small and only observable for samples with longitudinal designs. Conclusion Associations between QoL and service satisfaction appear to be robust but are differentiated in regard to QoL domain. Our findings suggest that agents responsible for service design and implementation need to take the patients’ perception of the service adequacy for achieving QoL enhancement into account. PMID:26275139

  18. Association between neurological soft signs, temperament and character in patients with schizophrenia and non-psychotic relatives

    Science.gov (United States)

    Pastoriza, Francisco; Bergé, Daniel; Mané, Anna; Picado, Marisol; Bulbena, Antonio; Robledo, Patricia; Pérez, Victor; Vilarroya, Oscar; Cloninger, Claude Robert

    2016-01-01

    The heritability of schizophrenia and most personality traits has been well established, but the role of personality in susceptibility to schizophrenia remains uncertain. The aim of this study was to test for an association between personality traits and Neurological Soft Signs (NSS), a well-known biological marker of schizophrenia, in non-psychotic relatives of patients with schizophrenia. For this purpose, we evaluated the NSS scale and personality measured by the Temperament and Character inventory (TCI-R) in three groups of subjects: 29 patients with schizophrenia, 24 unaffected relatives and 37 controls. The results showed that patients with schizophrenia were more asocial (higher harm avoidance and lower reward dependence), more perseverative (higher persistence), and more schizotypal (lower self-directedness and cooperativeness, higher self-transcendence). The unaffected relatives showed higher harm avoidance, lower self-directedness and cooperativeness than the healthy controls. Higher NSS scores and sub-scores were found in patients and non-psychotic relatives compared with the controls. Among all the patients, total NSS scores were positively correlated with harm avoidance but negatively correlated with novelty seeking and persistence. Total NSS were also correlated with low scores on self-directedness and cooperativeness, which are indicators of personality disorder. Our results show that susceptibility to NSS and to schizophrenia are both related to individual differences in the temperament and character features in non-psychotic relatives of patients with schizophrenia. High harm avoidance, low persistence, low self-directedness and low cooperativeness contribute to both the risk of NSS and schizophrenia. These findings highlight the value of using both assessments to study high risk populations. PMID:27168955

  19. Financial incentives to improve adherence to anti-psychotic maintenance medication in non-adherent patients - a cluster randomised controlled trial (FIAT

    Directory of Open Access Journals (Sweden)

    Firn Mike

    2009-09-01

    Full Text Available Abstract Background Various interventions have been tested to achieve adherence to anti-psychotic maintenance medication in non-adherent patients with psychotic disorders, and there is no consistent evidence for the effectiveness of any established intervention. The effectiveness of financial incentives in improving adherence to a range of treatments has been demonstrated; no randomised controlled trial however has tested the use of financial incentives to achieve medication adherence for patients with psychotic disorders living in the community. Methods/Design In a cluster randomised controlled trial, 34 mental health teams caring for difficult to engage patients in the community will be randomly allocated to either the intervention group, where patients will be offered a financial incentive for each anti-psychotic depot medication they receive over a 12 month period, or the control group, where all patients will receive treatment as usual. We will recruit 136 patients with psychotic disorders who use these services and who have problems adhering to antipsychotic depot medication, although all conventional methods to achieve adherence have been tried. The primary outcome will be adherence levels, and secondary outcomes are global clinical improvement, number of voluntary and involuntary hospital admissions, number of attempted and completed suicides, incidents of physical violence, number of police arrests, number of days spent in work/training/education, subjective quality of life and satisfaction with medication. We will also establish the cost effectiveness of offering financial incentives. Discussion The study aims to provide new evidence on the effectiveness and cost effectiveness of offering financial incentives to patients with psychotic disorders to adhere to antipsychotic maintenance medication. If financial incentives improve adherence and lead to better health and social outcomes, they may be recommended as one option to improve the

  20. Contingent negative variation in patients with deficit schizophrenia or bipolar I disorder with psychotic features: measurement and correlation with clinical characteristics.

    Science.gov (United States)

    Li, Zhe; Deng, Wei; Liu, Xiang; Zheng, Zhong; Li, Mingli; Li, Yinfei; Han, Yuanyuan; Ma, Xiaohong; Wang, Qiang; Liu, Xiehe; Li, Tao

    2015-04-01

    Schizophrenia is a highly heterogeneous disease. Event-related potentials have been regarded to establish intermediate phenotypes of schizophrenia. Our previous study found that patients with deficit schizophrenia (DS) are relatively homogeneous and show a significantly longer onset latency of contingent negative variation (CNV) expectancy wave. To further examine CNV in patients with first-episode and drug-naïve DS or bipolar I disorder (BP I) with psychotic features, and also investigate correlations between CNV and clinical characteristics in DS and BP I. We elicited a CNV using an alarm (S1)-imperative (S2) paradigm in 30 DS patients or 33 BP I with psychotic features as well as 40 healthy controls. CNV amplitude was significantly smaller and reaction time significantly longer in the DS and BP I groups than in healthy controls. Post-imperative negative variation (PINV) interval was significantly shorter in the DS group than in healthy controls. The onset latency of CNV expectancy wave was significantly longer and PINV area significantly smaller in the DS group than in the other groups. In the DS group, CNV amplitude and PINV interval correlated negatively with the subscale of negative symptoms on the Positive and Negative Syndrome Scale (PANSS); CNV amplitude also correlated negatively with disease duration. In the BP I group, CNV amplitude and reaction time showed no correlation with clinical features. CNV amplitude is a common trait marker for psychosis. The onset latency of CNV expectancy wave appears to be a specific trait marker and may be used to identify candidate genes for DS.

  1. Symptom attributions in patients with colorectal cancer

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær; Hvidberg, Line; Pedersen, Anette Fischer

    2015-01-01

    Størstedelen af kolorektal cancere opdages gennem patienters symptomatiske henvendelse i almen praksis. Man ved dog ikke meget om, hvordan patienter selv oplever deres symptomer. Formålet med studiet var, at undersøge om symptom attributioner er associeret med hvilket symptom man oplevede før...

  2. 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.

  3. Theory of mind reasoning in schizophrenia patients and non-psychotic relatives.

    Science.gov (United States)

    Cassetta, Briana; Goghari, Vina

    2014-08-15

    Research consistently demonstrates that schizophrenia patients have theory of mind (ToM) impairments. Additionally, there is some evidence that family members of schizophrenia patients also demonstrate impairments in ToM, suggesting a genetic vulnerability for the disorder. This study assessed ToM abilities (i.e., sarcasm comprehension) in schizophrenia patients and their first-degree biological relatives during video-taped social interactions, to be representative of real-world interactions and to assess for disease-specific and/or genetic liability effects. Additionally, we assessed whether ToM abilities predicted social and global functioning in schizophrenia patients, and whether symptoms were associated with ToM deficits. Schizophrenia patients demonstrated impairments in sarcasm comprehension compared to controls and relatives, whereas relatives showed intact comprehension. Symptoms of schizophrenia significantly predicted worse ToM abilities. Furthermore, in schizophrenia patients, impaired ToM reasoning predicted worse social and global functioning. Given schizophrenia patients demonstrated impairments in ToM reasoning in a task that resembles real-life interactions, this might be a key area for remediation.

  4. 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.

  5. 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.

  6. 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

  7. Immunological findings in psychotic syndromes: a tertiary care hospital´s CSF sample of 180 patients

    Directory of Open Access Journals (Sweden)

    Dominique eEndres

    2015-09-01

    Full Text Available Immunological mechanisms and therapy approaches in psychotic syndromes were recently supported by the discovery of autoantibody-associated limbic and non-limbic encephalitis. However, how clinical diagnostic procedures in psychiatry should be adapted to these new insights is still unclear. In this study, we analyzed the cerebrospinal fluid (CSF and neuroimmunological alterations and their association with cerebral MRI (cMRI and electroencephalographic (EEG findings. From 2006 until 2013, we acquired 180 CSF samples from psychotic patients. Between 2006 and 2009, CSF examinations were only performed in cases in which organic brain disease was suspected. Since then, this procedure has been integrated into our routine diagnostic workup. CSF basic diagnostics were supplemented by measuring antineuronal antibodies against intracellular synaptic antigens, antibodies against intracellular onconeural antigens, antibodies against neuronal cell surface antigens and thyroid antibodies. In addition, cMRIs and EEGs were conducted. We found white cell counts elevated in 3.4% of the cases, albumin quotient elevated in 21.8%, and protein concentration elevated in 42.2%. Evidence of intrathecal immunoglobulin synthesis was found in 7.2% of the cases. Antibodies measured against neuronal cell surface antigens were positive in 3.2%. Reactivity on antibodies against intracellular onconeural antigens were detected in 3.5%. Serum thyroid antibodies were elevated in 24.7%. Abnormalities were found in 39.5% of cMRIs and in 34.3% of EEGs. The main finding of our study was the high prevalence of CSF and autoantibody abnormalities in 54.4% of psychotic patients. In combination with cMRIs and EEGs, 75.6% showed abnormal findings. Our results are discussed with regard to the concept of immunological encephalopathy. Future studies should analyze the efficacy of immunomodulatory therapies.

  8. 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

  9. 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

  10. Interpersonal Community Psychiatric Treatment for non-psychotic chronic patients and nurses in outpatient mental health care : A controlled pilotstudy on feasibility and effects

    NARCIS (Netherlands)

    Koekkoek, Bauke; Meijel, B. van; Schene, A.; Kaasenbrood, A.; Hutschemaekers, G.; Smit, A.

    2012-01-01

    In psychiatric care professionals perceive some patients as ‘difficult’, especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It

  11. Interpersonal Community Psychiatric Treatment for non-psychotic chronic patients and nurses in outpatient mental health care: A controlled pilot study on feasibility and effects

    NARCIS (Netherlands)

    Koekkoek, B.; Meijel, B. van; Schene, A.; Smit, A.; Kaasenbrood, A.; Hutschemaekers, G.

    2011-01-01

    In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It

  12. The Therapeutic Effects of Ling Gui Zhu Gan Tang Mixture in 50 Psychotic Patients with Obesity Induced by the Psychoactive Drugs

    Institute of Scientific and Technical Information of China (English)

    丁国安; 余国汉; 张教东; 梁绍材; 刘丽勤; 黄鹏; 陈惠娟; 肖爱祥; 李小芳; 蔡颖莲

    2005-01-01

    @@ In order to observe the therapeutic effects of Ling Gui Zhu Gan Tang Mixture (芩桂术甘汤) on obesity induced by psychoactive drugs, 100 psychotics with obesity induced by psychoactive drugs were randomly divided into a treatment group (50 cases)and a control group (50 cases) for a 8-week treatment.The changes were determined by means of the Brief Psychiatric Rating Scale (BPRS) and the Treatment Emergent Symptom Scale (TESS) with the body weight recorded before and after treatment. The results showed that the total effective rate was 72% in the treatment group, and 14% in the control group,with the former obviously superior to the latter (P<0.01). The BPRS scores were 33.02t7.34 in the treatment group and 32.39± 3.51 in the control group before treatment; and 20.38±5.10 in the treatment group and 20.82± 1.75 in the control group after treatment. The BPRS scores were obviously reduced after treatment in the two groups (both P<0.01), but with no significant difference between the two groups (P>0.05). This indicates that the Ling Gui Zhu Gan Tang Mixture does not influence the curative effect of the psychoactive drugs while showing the body weight-reducing effect. Therefore, the Ling Gui Zhu Gan Tang Mixture can be used for those psychotic patients with obesity induced by the psychoactive drugs (the incidence is 10-25%) in their continuous course of treatment with the latter drugs.

  13. 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

  14. 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.

  15. 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.

  16. Symptom monitoring in treatment of cancer patients

    Institute of Scientific and Technical Information of China (English)

    Yao Wanxia; Lin Miao; Lü Ye; Yang Biao; Yao Cong; Liu Juan; Wang Wenru

    2008-01-01

    Objective To examine self-reported symptoms by the patients receiving cancer therapy, and find out the symptoms that should be coped with and managed during the treatment. Methods A pilot study was conducted on self-reported symptoms on 185 patients receiving chemotherapy and/or radiotherapy for different cancers. The Therapy-Related Symptoms Checklist (TRSC) was used. Results Severe symptoms on the TRSC subscales: loss of appetite,feeling sluggish, weight loss, nausea and hair loss, were reported by the patients. The frequently reported symptoms by those on chemotherapy were nausea, feeling sluggish, weight loss, vomiting, and taste change. The frequently reported symptoms by those on radiotherapy were feeling sluggish, weight loss, loss of appetite, difficult sleeping, and changing taste. The symptoms of loss of appetite, feeling sluggish, weight loss, hair loss, and nausea were both frequently reported by those on radiotherapy and those on chemotherapy. Conclusion Symptom monitoring may be facilitated by TRSC, based on the severity and frequency of reported symptoms, more patients and caregivers could know which symptoms should be preferential interventions.

  17. [Off-label use of acetazolamide in a patient with familial hemiplegic migraine and concomitant psychotic episodes].

    Science.gov (United States)

    Koch, Horst J; Sykora, André; Hausn, Patrick

    2010-04-01

    A 42-year-old patient with cognitive deficits due to childhood meningitis suffered from recurrent episodes of familial hemiplegic migraine. Additionally, he developed concomitant psychotic episodes requiring subsequent in-patient psychiatric treatment. Following combined neurological and psychiatric treatment he always recovered from the episodes within a few weeks time. Prophylactic treatment of migraine using topiramate and acetazolamide (off-label) prevented attacks for several months. When off-label compensation was refused and, as a consequence, the drug discontinued, hemiplegia relapsed within a few days. Hence, acetazolamide was prescribed again and the family paid for the medication. Since that time, the patient did not show severe attacks for at least 8 months apart from a transient attack induced by acute flu-like illness. Copyright Georg Thieme Verlag KG Stuttgart . New York.

  18. 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.

  19. The Impact of Religiosity on Quality of Life and Psychological Symptoms in Chronic Mental Patients.

    Science.gov (United States)

    Šimunović, Martina; Tokmakčija, Stanija; Pavlović, Marko; Babić, Romana; Vasilj, Marina; Martinac, Marko; Vasilj, Ivan; Babić, Dragan

    2017-05-01

    In recent decades, there is more and more scientific research and evidence that religiosity has a positive impact on quality of life and mental health. The aim this study is to evaluate the impact of religiosity on the quality of life and psychological symptoms of chronic mental patients. The test group was consisted of 100 chronic mental patients at the Clinic for Psychiatry UCH Mostar, and control group was consisted of 80 somatic patients surveyed from the Infirmary of family medicine of the Health Center Mostar. The survey was conducted by the social and demographic questionnaire, a questionnaire on the quality of life of the World Health Organization WHOQOL-BREF, the questionnaire on religiosity and self-assessment questionnaire for psychological symptoms SCL-90(th). For the socio-demographic data we obtained results that chronic mental patients as opposed to chronic somatic patients have significantly higher percent of an average lifestyle habits. There is statistically significant difference in the place of residence, chronic mental patients live in the city as opposed to somatic who live in the countryside. On the question of religiosity we received information that the chronic mental patients in relation to chronic somatic patients significantly more attend public religious gatherings, but however, chronic somatic patients compared to chronic mental significantly more use religiosity for better financial position, social comfort. In self evaluation of psychological symptoms we received information that the chronic mental patients as opposed to chronic somatic patients had significantly more psychotic features. To test the quality of life between the two groups, we received the information that chronic mental patients have significantly better physical and mental health, social relationships and caring for the environment as opposed to chronic somatic patients. Quality of life was significantly better in the chronic mental patients. Also, chronic mental

  20. 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...

  1. [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.

  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. Psychotic symptoms, cognition and affect as predictors of psychosocial problems and functional change in first-episode psychosis

    NARCIS (Netherlands)

    Stouten, Luyken H.; Veling, Wim; Laan, Winfried; van der Helm, Mischa; van der Gaag, Mark

    2014-01-01

    Objective: To enable further understanding of how cognitive deficits and psychopathology impact psychosocial functioning in first-episode psychosis patients, we investigated how psychopathology and cognitive deficits are associated with psychosocial problems at baseline, and how these predict psycho

  4. A STUDY OF PSYCHOPHARMACA EFFECT ON ELECTRODERMAL ACTIVITY, SUBJECTIVE MOOD CHANGE, PSYCHOTIC SYMPTOMS AND RESULTS OF TREATMENT

    OpenAIRE

    1995-01-01

    The aim of this study was to examine the possibility that skin conductance level (SCL) and a patient's subjective mood change during intravenous drip injection of psychopharmaca could predict the results of, or response to, phycopharmacotherapy. Sixty-six patients with depression, 42 with neurosis, 25 with schizophrenia and 8 with other psychiatric disorders were investigated on SCL, subjective mood change, and score of Brief Psychiatric Rating Scale (BPRS) during intravenous drip injection o...

  5. 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.

  6. Psychogenic Polydipsia: The Result, or Cause of, Deteriorating Psychotic Symptoms? A Case Report of the Consequences of Water Intoxication

    Directory of Open Access Journals (Sweden)

    Melissa Gill

    2015-01-01

    Full Text Available Water intoxication is a rare condition characterised by overconsumption of water. It can occur in athletes engaging in endurance sports, users of MDMA (ecstasy, and patients receiving total parenteral nutrition. This case outlines water intoxication in a patient with psychogenic polydipsia. When the kidney’s capacity to compensate for exaggerated water intake is exceeded, hypotonic hyperhydration results. Consequences can involve headaches, behavioural changes, muscular weakness, twitching, vomiting, confusion, irritability, drowsiness, and seizures. Cerebral oedema can lead to brain damage and eventual death. In this case, psychogenic polydipsia led to significant hyponatraemia, cerebral oedema, and tonic-clonic seizures. Differential diagnoses for hyponatraemia are outlined. The aetiology of psychogenic polydipsia is uncertain, but postulated hypotheses are explored. Psychogenic polydipsia occurs in up 20% of psychiatric patients and this case serves to remind us to be cognizant of water overconsumption.

  7. Would I take antipsychotics, if I had psychotic symptoms? Examining determinants of the decision to take antipsychotics.

    Science.gov (United States)

    Berna, Fabrice; Göritz, Anja S; Llorca, Pierre-Michel; Vidailhet, Pierre; Fond, Guillaume; Moritz, Steffen

    2017-03-22

    Poor adherence to treatment in schizophrenia is mainly associated to patients-related factors. However, social negative representations of schizophrenia and its treatment may also contribute to patients' decision to take or not to take antipsychotics. A web-based study on 1807 participants was conducted during which participants imagined that they had a particular chronic illness based on clinical vignettes (mental illnesses: schizophrenia, depression; somatic illnesses: multiple sclerosis, rheumatoid arthritis). Participants rated their subjective distress and perceived social stigma associated with each illness. They also rated the perceived treatability of the illness, their belief in the effectiveness of treatment, and their treatment preference regarding medication. Results show that schizophrenia was considered more distressful, less treatable and associated with higher social stigma than somatic illnesses. Medication was less preferred for treating schizophrenia compared to somatic illnesses. Perceived treatability of illness and belief in the effectiveness of pharmacological treatment were the factors driving preference for medication in schizophrenia and depression respectively; these factors had weaker influence on preference for medication in somatic illnesses. Our study points out more severe negative representations of mental illnesses in general, and their treatment, particularly schizophrenia. These attitudes are not confined to patients, and may influence patients' decisions to take psychotropic drugs.

  8. Vulvar symptoms in paediatric and adolescent patients.

    Science.gov (United States)

    Piippo, S; Lenko, H; Vuento, R

    2000-04-01

    Vulvovaginal symptoms in children and young adolescents are not yet very well understood, nor is the actual incidence known. This study evaluates the character and possible infectious aetiology of vulvar symptoms of females aged up to 16 y. The signs, symptoms and bacteriological findings of 68 consecutive cases were studied. The study was conducted in the University Hospital of Tampere at a special gynaecological consultation clinic for children and adolescents. Sixty-eight patients were included in the study: 48 girls (71%) were prepubertal, at Tanner stage M1P1, 26 patients were 2-4-y-old and 15 were 5-7-y-old. The duration of symptoms was known for 46 patients: 41% had had symptoms for >1 mo and 20% for >6 mo. Forty-eight patients had abnormal clinical findings on examination and 16 (33%) of them had an infectious aetiology. Streptococcus pyogenes infection was identified in 11 (16%) patients, all of whom had symptoms. Candida was identified in 6 (9%) patients. No infectious aetiology was found among 26 patients who had symptoms and abnormal clinical findings. Vulvovaginal symptoms during childhood are more common among younger children (<7 y). In 67% of patients no infectious aetiology could be found. Samples for microbiological culture should be taken from symptomatic patients and symptomatic areas. Cultures of Candida and bacteria are necessary but usually sufficient. If a microbiological aetiology is established, treatment can be assigned accordingly. Patients with vulvar symptoms and findings but with an unclear aetiology need support and advice on proper hygiene and can intermittently use mild corticosteroids locally.

  9. “Attenuated psychotic symptoms syndrome” as a risk syndrome of psychosis, diagnosis in DSM-V: The debate

    OpenAIRE

    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 c...

  10. 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.

  11. Feasibility and Effects of a Brief Compassion-Focused Imagery Intervention in Psychotic Patients with Paranoid Ideation: A Randomized Experimental Pilot Study.

    Science.gov (United States)

    Ascone, Leonie; Sundag, Johanna; Schlier, Björn; Lincoln, Tania M

    2016-02-17

    Paranoia is characterized by a lack of perceived social safeness and associated negative affect. Low self-esteem, negative self-concepts and negative emotions have been shown to contribute to paranoid symptom formation. Thus, interventions focusing on affiliation and positive affect might be particularly helpful for patients with paranoia. The present study experimentally tested the effect of a one-session, brief compassion-focused imagery derived from Compassion-Focused Therapy (Gilbert, 2009) versus a control imagery condition in a repeated measures randomized design. A negative affective state was induced via in-sensu exposure to a recent distressful social situation in order to provide a minimum level of threat-related arousal to be down-regulated by the interventions thereafter. The sample consisted of psychotic patients with paranoid ideation (N = 51) who were randomly assigned to one of the experimental conditions. Effects on postulated causal mechanisms, i.e., self-relating (self-reassurance, self-compassion, self-criticism), and affect (self-reported affective states, skin conductance levels) as well as on state paranoia, were tested. Subjective benefit and appraisals of the intervention were explored. There were no specific intervention effects on negative self-relating, negative affect and skin-conductance or on paranoia. However, compassion-focused imagery had significant effects on self-reassurance and happiness. Explorative analyses revealed that the majority of the participants appraised the intervention in a positive manner, indicating good acceptance. The intervention showed an effect on some of the postulated mechanisms but not on others, which might have been because of its brevity. Further investigation of interventions targeting affiliation for people with paranoid experiences appears worthwhile. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Affiliative imagery work is feasible and appraised positively in psychotic

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

    DEFF Research Database (Denmark)

    Castagnini, Augusto; Foldager, Leslie

    2014-01-01

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

  13. [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.

  14. [Investigation of community support measures for patients with comorbid substance use disorder and psychotic disorder: nationwide survey of drug addiction rehabilitation centers].

    Science.gov (United States)

    Ikeda, Tomohiro; Koike, Junko; Kouda, Minoru; Inamoto, Atsuko; Morota, Nobuaki

    2014-12-01

    In psychiatric care practice, patients are often seen who have difficulty with their social lives due to protracted psychiatric symptoms despite years without drug abuse. The difficulty of dealing with such cases and the lack of preparedness of the legal system leave circumstantial care as the only option. Western.countries have recently begun using the name 'concurrent disorder' as a diagnosis for patients deemed unable to recover solely through such treatment for drug addiction, signifying the presence of both a substance use disorder (SUD) and a mental health disorder. Various assessment and intervention methods are being investigated, and many studies have been reported. Based on the hypothesis that Drug Addiction Rehabilitation Center (DARC) are partly involved in supporting those with psychotic concurrent disorders (PSCD) in Japan, we conducted a survey to clarify the actual support for PSCD patients at DARC and the challenges they face. Surveys were administered to DARC-related institutions all over Japan (44 governing organizations and 66 institutions). Complete responses from 86 full-time employees and 445 DARC users were analyzed. DARC users were divided into two groups: psychiatric concurrent disorders (PSCD group, n = 178) and those without such symptoms (SUD group, n = 267), with the PSCD group accounting for 40% of the DARC users surveyed. Compared to the SUD group, the PSCD group was significantly less satisfied with their lifestyle and interpersonal relations at the DARC and a significantly higher proportion of the PSCD group requested assistance in communicating with others. When employees were presented with a hypothetical PSCD case and asked what was needed to deal with it, some responses were, "an institution that can treat both drug addiction and other mental health disorders," "a psychiatric care institution that provides 24-hour care," and "sufficient manpower and training." In the future, a treatment system must be established based on

  15. Maintenance of recovery from severe psychotic depression following successful electroconvulsive therapy in an elderly patient with “natural support”

    Directory of Open Access Journals (Sweden)

    Mohiuddin Ahmed, PhD

    2014-09-01

    Full Text Available This is a case report of an elderly man who recovered fully from an extreme regressed level of functioning associated with psychotic depression after successful treatment with electroconvulsive therapy. He has maintained his “recovery status” without any drugs, follow-up electroconvulsive therapy, or psychotherapy by his own choice for more than five years. This case illustrates the need for the judicious use of psychiatric intervention and the willingness of the psychiatric community to encourage the maintenance of a patient's recovered functioning with “natural support,” specifically for people who value personal independence, have a strong motivation to stay well, have strong family support, and have “a good monitoring process.”

  16. A linguistic comparison between auditory verbal hallucinations in patients with a psychotic disorder and in nonpsychotic individuals: Not just what the voices say, but how they say it.

    Science.gov (United States)

    de Boer, J N; Heringa, S M; van Dellen, E; Wijnen, F N K; Sommer, I E C

    2016-11-01

    Auditory verbal hallucinations (AVH) in psychotic patients are associated with activation of right hemisphere language areas, although this hemisphere is non-dominant in most people. Language generated in the right hemisphere can be observed in aphasia patients with left hemisphere damage. It is called "automatic speech", characterized by low syntactic complexity and negative emotional valence. AVH in nonpsychotic individuals, by contrast, predominantly have a neutral or positive emotional content and may be less dependent on right hemisphere activity. We hypothesize that right hemisphere language characteristics can be observed in the language of AVH, differentiating psychotic from nonpsychotic individuals. 17 patients with a psychotic disorder and 19 nonpsychotic individuals were instructed to repeat their AVH verbatim directly upon hearing them. Responses were recorded, transcribed and analyzed for total words, mean length of utterance, proportion of grammatical utterances, proportion of negations, literal and thematic perseverations, abuses, type-token ratio, embeddings, verb complexity, noun-verb ratio, and open-closed class ratio. Linguistic features of AVH overall differed between groups F(13,24)=3.920, p=0.002; Pillai's Trace 0.680. AVH of psychotic patients compared with AVH of nonpsychotic individuals had a shorter mean length of utterance, lower verb complexity, and more verbal abuses and perseverations (all p<0.05). Other features were similar between groups. AVH of psychotic patients showed lower syntactic complexity and higher levels of repetition and abuses than AVH of nonpsychotic individuals. These differences are in line with a stronger involvement of the right hemisphere in the origination of AVH in patients than in nonpsychotic voice hearers. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. 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.

  18. 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

  19. Subjective symptoms in euthymic bipolar disorder and remitted schizophrenia patients: A comparative study

    Directory of Open Access Journals (Sweden)

    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. 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

  1. 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),

  2. Patients with persistent medically unexplained physical symptoms

    DEFF Research Database (Denmark)

    A, Aamland; Malterud, Kirsti; Werner, E.

    2014-01-01

    for all variables and split analysis on gender and age. RESULTS: The GPs registered 526 patients among their total of 17 688 consultations, giving a consultation prevalence of persistent MUPS of 3%. The mean age of patients was 46 years, and 399 (76%) were women. The most frequent group of symptoms...... was musculoskeletal problems, followed by asthenia/fatigue. There was no significant gender difference in symptom pattern. Almost half of the patients were currently working (45%), significantly more men. The major GP management strategy was supportive counseling. CONCLUSION: A consultation prevalence rate of 3......% implies that patients with persistent MUPS are common in general practice. Our study disclosed heterogeneity among the patients such as differences in employment status, which emphasizes the importance of personalized focus rather than unsubstantiated stereotyping of "MUPS patients" as a group....

  3. [Three patients with the same diagnosis but very different symptoms].

    Science.gov (United States)

    Knechtle, Beat; Rüst, Christoph A; Rosemann, Thomas

    2015-01-02

    We present three cases of patients with a thoracic disc herniation with misinterpretation of the initial symptoms. In a first case, pulmonary symptoms were prominent; in a second case, the patient complained of cardiac symptoms; and in a third case, the patient reported neurological symptoms. Ineffective investigation of thoracic symptoms should raise the suspicion of a thoracic disc herniation.

  4. 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...

  5. Effects of extended cannabis abstinence on clinical symptoms in cannabis dependent schizophrenia patients versus non-psychiatric controls.

    Science.gov (United States)

    Rabin, Rachel A; Kozak, Karolina; Zakzanis, Konstantine K; Remington, Gary; George, Tony P

    2017-03-08

    Rates of cannabis use among patients with schizophrenia are high, however little is understood about clinical effects of continued cannabis use and cessation after illness onset. Therefore, we investigated the effects of 28-days of cannabis abstinence on psychotic and depressive symptomatology in cannabis dependent patients with schizophrenia. Males with cannabis dependence and co-morbid schizophrenia (n=19) and non-psychiatric controls (n=20) underwent 28-days of monitored cannabis abstinence. Clinical symptoms were assessed at baseline and then weekly. Abstinence was encouraged using weekly therapy sessions and contingency reinforcement, confirmed by twice-weekly urine assays. Forty-two percent (8/19) of patients and 55% (11/20) of controls achieved 28-days of sustained cannabis abstinence. In patients, PANSS subscores did not change over time irrespective of abstinence status. In contrast, patient abstainers demonstrated a more pronounced reduction in depression scores compared to non-abstainers, however, the Abstinence Status x Time interaction was non-significant. Short-term (28-days) cannabis abstinence is not associated with improvement in psychotic symptoms, but may be associated with improvement in depressive symptomatology in patients with schizophrenia. Future studies employing larger samples as well as a continuous cannabis-using group may help to better characterize the causal effects of cannabis on symptom outcomes in this disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Correlation between Burning Mouth Syndrome and Psychological Symptoms in Patients Attending to Zahedan Dental School

    Directory of Open Access Journals (Sweden)

    NM Bakhshan

    2012-06-01

    Full Text Available Introduction: Burning mouth syndrome is characterized by an oral burning sensation , usually in the absence of clinical and laboratory findings. BMS is estimated to involve 1 to 5% of the adult population and is mostly reported within middle-aged women. The etiology of this disease is not thoroughly identified yet and there is a debate over the significance of Psychological factors in creating BMS. This study intended to examine the relationship between psychological factors with pain reports and psychosocial profiles of BMS patients to determine whether psychological factors are related to pain reports and burning mouth of patients. Therefore frequencies of psychological factors were analyzed. Methods: 30 patients with BMS participated in this study. They were homogenous regarding age, sex with the control group. In addition, education was possibly homogenized. The participants completed SCL-90 questionnaire for their anxiety, depression, somatic and psychotic symptoms to be scrutinized. Then, t-test was applied to analyze the research data. Results: Mean of anxiety(case20/8, control 9/53, depression(case 26/53, control 13/40, somatic(case 23/7, control 15/26 and psychotic(case 19/60, control 8/10 symptoms were higher in BMS group rather than in control groups. T-test results indicated there was no statically significant difference between BMS and control group in regard to psychological symptoms(p< 0.0001. Conclusion: The study findings indicate that psychological disorders may predispose the patients to the development of BMS.

  7. Behavioural symptoms in patients with Alzheimer's disease and their association with cognitive impairment

    Directory of Open Access Journals (Sweden)

    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

  8. Psychosis in patients with narcolepsy as an adverse effect of sodium oxybate

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    Tomi eSarkanen

    2014-08-01

    Full Text Available Aim: Hypnagogic and hypnopompic hallucinations are characteristic symptoms of narcolepsy, as are excessive daytime sleepiness, cataplexy and sleep paralysis. Narcolepsy patients may also experience daytime hallucinations unrelated to sleep-wake transitions. The effect of medication on hallucinations is of interest since treatment of narcolepsy may provoke psychotic symptoms. We aim to analyze the relation between sodium oxybate (SXB treatment and psychotic symptoms in narcolepsy patients. Furthermore, we analyze the characteristics of hallucinations to determine their nature as mainly psychotic or hypnagogic and raise a discussion about whether SXB causes psychosis or if psychosis occurs as an endogenous complication in narcolepsy.Method: We present altogether four patients with narcolepsy who experienced psychotic symptoms during treatment with SXB. In addition, we searched the literature for descriptions of hallucinations in narcolepsy and similarities and differences with psychotic symptoms in schizophrenia.Results: Three out of four patients had hallucinations typical for psychosis and one had symptoms that resembled aggravated hypnagogic hallucinations. Two patients also had delusional symptoms primarily associated with mental disorders. Tapering down SXB was tried and helped in two out of four cases. Adding antipsychotic treatment (risperidone alleviated psychotic symptoms in two cases. Conclusion: Psychotic symptoms in narcolepsy may appear during SXB treatment. Hallucinations resemble those seen in schizophrenia however the insight that symptoms are delusional is usually preserved. In case of SXB-induced psychotic symptoms or hallucinations, reducing SXB dose or adding antipsychotic medication can be tried.

  9. Prevalence of Psychotic Disorders in Patients with Obsessive-Compulsive Disorder

    NARCIS (Netherlands)

    de Haan, Lieuwe; Dudek-Hodge, Christine; Verhoeven, Yolanda; Denys, Damiaan

    2009-01-01

    Introduction: The co-occurrence of obsessive-compulsive disorder (OCD) in patients with schizophrenia and related disorders has been increasingly recognized. However, the rate of psychosis comorbidity in OCD patients has yet to be systematically evaluated. Methods: The prevalence of the Diagnostic a

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

    NARCIS (Netherlands)

    Oud, Marian J. T.; Schuling, Jan; Slooff, Cees J.; Meyboom-de Jong, Betty

    2007-01-01

    Background: In primary care, GPs usually provide care for patients with chronic diseases according to professional guidelines. However, such guidelines are not available in the Netherlands for patients with recurring psychoses. It seems that the specific difficulties that GPs experience in providing

  11. Renal provider recognition of symptoms in patients on maintenance hemodialysis.

    Science.gov (United States)

    Weisbord, Steven D; Fried, Linda F; Mor, Maria K; Resnick, Abby L; Unruh, Mark L; Palevsky, Paul M; Levenson, David J; Cooksey, Stephen H; Fine, Michael J; Kimmel, Paul L; Arnold, Robert M

    2007-09-01

    Although several studies have found that the burden of symptoms in patients who are on maintenance hemodialysis is substantial, little is known about renal providers' awareness of these symptoms. The aim of this study was to assess renal provider recognition of symptoms and their severity in hemodialysis patients. The Dialysis Symptom Index, a 30-item measure of symptoms and their severity, was administered to patients during a routine hemodialysis session. Immediately after surveying patients, the renal provider who evaluated the patient completed the Dialysis Symptom Index to report the symptoms that he or she believed were present in that patient. Sensitivity, specificity, and positive and negative predictive values of provider reports of symptoms were calculated using patient reports as the reference standard. Patient-provider agreement on the presence and severity of symptoms was assessed using the kappa statistic. Surveys were completed by 75 patients and 18 providers. For 27 of 30 symptoms, the sensitivity of provider responses was <50%, and provider responses for 25 symptoms were characterized by positive predictive values of <75%. kappa scores for 25 symptoms including those pertaining to pain, sexual dysfunction, sleep disturbance, and psychologic distress were <0.20, indicating poor provider recognition of these symptoms. Providers underestimated the severity of 19 of 30 symptoms. Renal providers are largely unaware of the presence and severity of symptoms in patients who are on maintenance hemodialysis. Implementation of a standardized symptom assessment process may improve provider recognition of symptoms and promote use of symptom-alleviating treatments.

  12. [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.

  13. Preemptive analgesia with butorphanol in psychotic patients following modified electroconvulsive therapy A randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    Lingxi Wu; Handong Zou; Qingshan Zhou; Zhongchun Liu; Bangchang Cheng

    2008-01-01

    BACKGROUND: Preemptive analgesia involves introducing an analgesic prior to the onset of pain stimulation to prevent sensitizing the nervous system to subsequent stimuli that could amplify pain. OBJECTIVE: To treat psychiatric patients with intravenous (i.v.) injection of butorphanol prior to modified electroconvulsive therapy, and to observe its effect on alleviating myalgia after treatment and adverse reactions. DESIGN: A randomized controlled observation. SETTING: Renmin Hospital of Wuhan University.PARTICIPANTS: A total of 120 psychiatric patients, who accepted modified electroconvulsive therapy, were selected from the Mental Health Center of Wuhan University from June to September in 2006. All patients corresponded to the Chinese Classification and Diagnostic Criteria of Mental Disorders, and those with diseases of heart, liver, lung and kidney, glaucoma, intracranial hypertension, hyperthyreosis, and hyperkalemia were excluded. The patients were randomly divided into a control group (n = 60) and treatment group (n = 60). In the control group, there were 42 males and 18 females, aged 17–50 years, with a mean age of (34 ± 11) years. The patients weighed 50–70 kg, with a mean body mass of (63 ± 18) kg. In the treatment group, there were 40 males and 20 females, aged 20–54 years, with a mean age of (36 ± 13) years. The patients weighed 48–72 kg, with a mean body mass of (64 ± 16) kg. Approval was obtained from the Hospital's Ethics Committee. Informed consents were obtained from the patients' relatives. A SPECTRUM5000Q multifunctional mobile electroconvulsive therapy apparatus (CORPERATION, USA) was used.METHODS: ① Treatments: In the control group, the patients were anesthetized by I.v. Injection of propofol (AstraZeneca, Italy, No.CN309) containing 0.075% efedrina, and then modified electroconvulsive therapy was performed. Circulation, respiration, and firing of brain electrical activity were continuously monitored. In the treatment group, the

  14. The relationship between working status and symptoms, quality of life and self-esteem in patients with schizophrenia in Turkey.

    Science.gov (United States)

    Hacioglu Yildirim, Munevver; Alantar, Zeynep; Yildirim, Ejder A

    2014-11-01

    Schizophrenia is a severe mental disorder with substantial socioeconomic burden associated with poorer psychosocial functioning during the course of illness. In schizophrenia patients, multiple factors play a role in occupational functioning. It was aimed to investigate the relationship between different working conditions and quality of life and self-esteem on patients with schizophrenia in Turkey. A total of 100 patients diagnosed as schizophrenic were divided into three groups: competitive working, supported working and unemployed. The groups did not differ significantly with regard to psychotic symptoms, self-esteem and illness history. Working was associated with higher scores on quality of life subscales especially in supported working group, whereas unemployed patients had more depressive symptoms and autonomic drug side effects. Structured working programs which may improve social life of patients with schizophrenia in many aspects is warranted in Turkey. © The Author(s) 2013.

  15. Ambivalent connections. Improving community mental health care for non-psychotic chronic patients perceived as 'difficult'

    NARCIS (Netherlands)

    Bauke van Koekkoek

    2011-01-01

    Depression is a widespread psychiatric disorder, which becomes chronic in 25-30% of cases. When psychiatric and psychological treatments are ineffective, chronic depressive patients are often assigned to long-term care which is mostly provided by mental health nurses. Due to factors strongly

  16. Social cognition in patients with schizophrenia spectrum and bipolar disorders with and without psychotic features

    Directory of Open Access Journals (Sweden)

    George C. Nitzburg

    2015-03-01

    Conclusions: MSCEIT deficits were found in SSD but not BD− or BD+, suggesting that social cognition may represent an underlying difference between SSD and BD. However, variance in MSCEIT performance among BD patients may also suggest latent BD subgroups characterized by social-cognitive deficits. Findings can help inform future investigations into how social cognition and social brain development differ between SSD and BD.

  17. Opposite Cannabis-Cognition Associations in Psychotic Patients Depending on Family History

    Science.gov (United States)

    González-Pinto, Ana; González-Ortega, Itxaso; Alberich, Susana; Ruiz de Azúa, Sonia; Bernardo, Miguel; Bioque, Miquel; Cabrera, Bibiana; Corripio, Iluminada; Arango, Celso; Lobo, Antonio; Sánchez-Torres, Ana M.; Cuesta, Manuel J.

    2016-01-01

    The objective of this study is to investigate cognitive performance in a first-episode psychosis sample, when stratifying the interaction by cannabis use and familial or non-familial psychosis. Hierarchical-regression models were used to analyse this association in a sample of 268 first-episode psychosis patients and 237 controls. We found that cannabis use was associated with worse working memory, regardless of family history. However, cannabis use was clearly associated with worse cognitive performance in patients with no family history of psychosis, in cognitive domains including verbal memory, executive function and global cognitive index, whereas cannabis users with a family history of psychosis performed better in these domains. The main finding of the study is that there is an interaction between cannabis use and a family history of psychosis in the areas of verbal memory, executive function and global cognition: that is, cannabis use is associated with a better performance in patients with a family history of psychosis and a worse performance in those with no family history of psychosis. In order to confirm this hypothesis, future research should explore the actual expression of the endocannabinoid system in patients with and without a family history of psychosis. PMID:27513670

  18. Ambivalent connections. Improving community mental health care for non-psychotic chronic patients perceived as 'difficult'

    NARCIS (Netherlands)

    Koekkoek, Bauke

    2011-01-01

    Depression is a widespread psychiatric disorder, which becomes chronic in 25-30% of cases. When psychiatric and psychological treatments are ineffective, chronic depressive patients are often assigned to long-term care which is mostly provided by mental health nurses. Due to factors strongly associa

  19. 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....

  20. Opposite Cannabis-Cognition Associations in Psychotic Patients Depending on Family History.

    Science.gov (United States)

    González-Pinto, Ana; González-Ortega, Itxaso; Alberich, Susana; Ruiz de Azúa, Sonia; Bernardo, Miguel; Bioque, Miquel; Cabrera, Bibiana; Corripio, Iluminada; Arango, Celso; Lobo, Antonio; Sánchez-Torres, Ana M; Cuesta, Manuel J

    2016-01-01

    The objective of this study is to investigate cognitive performance in a first-episode psychosis sample, when stratifying the interaction by cannabis use and familial or non-familial psychosis. Hierarchical-regression models were used to analyse this association in a sample of 268 first-episode psychosis patients and 237 controls. We found that cannabis use was associated with worse working memory, regardless of family history. However, cannabis use was clearly associated with worse cognitive performance in patients with no family history of psychosis, in cognitive domains including verbal memory, executive function and global cognitive index, whereas cannabis users with a family history of psychosis performed better in these domains. The main finding of the study is that there is an interaction between cannabis use and a family history of psychosis in the areas of verbal memory, executive function and global cognition: that is, cannabis use is associated with a better performance in patients with a family history of psychosis and a worse performance in those with no family history of psychosis. In order to confirm this hypothesis, future research should explore the actual expression of the endocannabinoid system in patients with and without a family history of psychosis.

  1. 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.

  2. Psychiatric Symptoms in Patients with Alopecia Areata

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    Burak

    2011-12-01

    Full Text Available Background and Design: Alopecia areata is a chronic inflammatory disease characterized by sudden hair loss. Existing evidence suggests that alopecia areata may be associated with personality traits altering the susceptibility to stress and psychiatric conditions associated with stress. The aim of this study was to compare the intensity of depressive and anxiety symptoms and the level of alexithymia in patients with alopecia areata and healthy control subjects.Materials and methods: Fifty patients with the diagnosis of alopecia areata and 30 healthy volunteers were compared in terms of scores of Beck depression inventory, Beck anxiety inventory, and Toronto alexithymia scale.Results: There were no statistically significant differences between alopecia areata cases and healthy controls regarding intensity of anxiety and level of alexythimia (p=0.053 and p=0.120, respectively. The intensity of depressive symptoms exhibited by alopecia areata patients was found to be significantly higher than that in healthy controls (p=0.010 and there was no statistically significant relationship between intensity of depressive symptoms and duration of the current alopecia areata episode (p=0.873.Conclusion: It is suggested that psychiatric evaluation should also be performed in all alopecia areata cases during the clinical follow-up period. (Turk­derm 2011; 45: 203-5

  3. Neurocysticercosis masquerading psychotic disorder: A case report

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    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. One-year follow-up study of psychotic patients treated with blonanserin: a case series.

    Science.gov (United States)

    Takahashi, Sakae; Suzuki, Masahiro; Uchiyama, Makoto

    2013-09-01

    Blonanserin is a relatively new atypical antipsychotic drug, and has been used in Korea and Japan for 1 and 3 years, respectively. Therefore, the clinical characteristics of blonanserin remain unclear. In this study, to clarify the features of blonanserin, we performed prospective and long-term comparative investigations of patients treated with blonanserin. We followed 10 psychiatric patients who were switched to blonanserin from other antipsychotics for 1 year (schizophrenia: 8; mental retardation: 2). In the light of quality of life, we focused on adverse effects of patients during the follow-up. In the long-term follow-up, (i) hyperprolactinemia is more frequently in risperidone than in blonanserin; however, it is more often in blonanserin than in olanzapine; and (ii) weight gain is more common in olanzapine than in blonanserin. We switched to blonanserin from other antipsychotic drugs within the same case, and then followed the case for 1 year. We consider that long-term observations within the same case lead to obvious comparisons among drugs. On the basis of our findings, we conclude that blonanserin may be useful for the maintenance treatment of schizophrenia without inducing hyperprolactinemia and weight gain. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. Severe Burns and Amputation of Both Arms in the First Psychotic Episode of a Schizophrenic Patient

    Directory of Open Access Journals (Sweden)

    Lizardo Cruzado

    2015-01-01

    Full Text Available An alleged reduction of sensitivity to pain in people with schizophrenia has been reported, but the nature of this complex phenomenon has not been elucidated yet. Reports of insensitivity to burns from people with schizophrenia are extremely rare. We report the case of a 24-year-old man who set both of his arms on fire during the first break of paranoid schizophrenia. As a result of severe tissue damage, both of his limbs had to be amputated. Today, at the age of 59, the patient is physically and mentally rehabilitated and is adherent to treatment. Additionally, given the uncertainty about the true nature of the alleged hypoalgesia in schizophrenia, we postulate the need for a comprehensive phenomenological approach in the study of embodiment in people with this condition.

  10. Detecting psychogeriatric problems in primary care: factors related to psychiatric symptoms in older community patients.

    Science.gov (United States)

    Olivera, Javier; Benabarre, Sergio; Lorente, Teófilo; Rodriguez, Mariano; Barros, Alfonso; Quintana, Carmen; Pelegrina, Virtudes; Aldea, Carmen

    2011-03-01

    Objective The aim was to determine the relationship and influence of different variables on the psychiatric symptomatology of older people who reside in the community, as detected by family practitioners.Design A cross-sectional and multi-centre study.Setting Twenty-eight general practices and two psychiatric practices in Huesca, Spain, from 19 primary care health centres.Subjects A sample of 324 patients aged over 65 years, representative of the older people who reside in the community in the province of Huesca.Main outcome measures Symptoms of depression (Yesavage GDS), cognitive impairment (MMSE), anxiety (GADS), psychotic symptoms, obsessive symptoms and hypochondriacal ideas (GMS) were measured by family practitioner and were detected following specific questions from the Geriatric Mental State (GMS-B) examination, following DSM-IV criteria, being defined as 'concern and fear of suffering, or the idea of having a serious disease based on the interpretation of somatic symptoms'. Sociodemographic, physical and somatic, functional and social data were evaluated. Analysis was carried out in three phases: univariate, bivariate and multivariate with logistic regression.Results At the time of the study, 46.1% of the older people studied suffered from some psychiatric symptom; 16.4% had cognitive impairment, 15.7% anxiety, 14.3% depression, 6.1% hallucinations and delusions, 7.2% hypochondriacal ideas and 4.4% obsessive symptoms. Female gender was significantly associated with depression (prevalence ration (PR) 3.3) and anxiety (PR 3.9). Age was a factor associated with cognitive impairment (PR 4.4). Depression was significantly related to severity of the physical illness (PR 61.7 in extremely severe impairment). Isolation (PR 16.3) and being single (PR 13.4) were factors which were strongly associated with anxiety; living in a nursing home was associated with psychotic symptoms (PR 7.6).Conclusions Severity of physical illness, isolation, living in a nursing home and

  11. Cognition and Social Cognition in non-psychotic siblings of patients with schizophrenia.

    Science.gov (United States)

    Cella, Matteo; Hamid, Sobia; Butt, Kate; Wykes, Til

    2015-01-01

    Deficits in Social Cognition are common in people with schizophrenia. However, it is not clear if these deficits are a vulnerability marker and whether they are independent to cognitive difficulties. This study investigates these two issues in individuals with a genetic liability to psychosis. Twenty-one healthy siblings of patients with schizophrenia were compared with 21 healthy individuals on a range of cognitive and social cognitive measures. Significant differences in cognitive domains were controlled for when comparing the two groups on measures of social cognition. Siblings of people with schizophrenia performed significantly worst on tests of theory of mind and social perception but not on affect recognition. Scores on tests of executive function, processing speed and general IQ were also lower in the sibling group. When controlled for differences in cognitive tests, the two groups still retained significant differences in theory of mind and social perception. However, executive function significantly contributed to theory of mind and processing speed to social perception differences. These results further suggest that difficulties in some domains of social cognition are associated with a genetic vulnerability for schizophrenia. In these areas, cognitive difficulties account only partially for social cognition problems suggesting that these two domains may represent relatively independent liability factors.

  12. Symptom prevalence in lung and colorectal cancer patients.

    Science.gov (United States)

    Walling, Anne M; Weeks, Jane C; Kahn, Katherine L; Tisnado, Diana; Keating, Nancy L; Dy, Sydney M; Arora, Neeraj K; Mack, Jennifer W; Pantoja, Philip M; Malin, Jennifer L

    2015-02-01

    Relatively few data are available about symptoms among cancer patients. To describe the prevalence and severity of symptoms among a large, representative cohort of newly diagnosed cancer patients. We collected survey data about symptoms (pain, fatigue, depression, nausea/vomiting, cough, dyspnea, and diarrhea) from 5422 patients with incident lung and colorectal cancer from the diverse, nationally representative Cancer Care Outcomes Research and Surveillance Consortium cohort. We described the prevalence of any symptoms and moderate/severe symptoms approximately four to six months after diagnosis. We used logistic regression to identify patient and clinical characteristics associated with symptoms, and calculated adjusted proportions of patients with symptoms. In total, 5067 (93.5%) patients reported at least one symptom in the four weeks before their survey, with 51% reporting at least one moderate/severe symptom. Lung cancer patients reported more symptoms than colorectal cancer patients. Patients who received treatment or had more comorbidities were more likely to report symptoms. For example, after adjustment, patients who received chemotherapy during the six weeks before the survey were more likely than others to report at least one symptom (97.3% vs. 90.8%, Pcolorectal cancer patients have cancer-related symptoms regardless of stage, and more than half have at least one moderate/severe symptom. Published by Elsevier Inc.

  13. Medication adherence in patients with psychotic disorders: an observational survey involving patients before they switch to long-acting injectable risperidone.

    Science.gov (United States)

    Baylé, Franck Jean; Tessier, Arnaud; Bouju, Sophie; Misdrahi, David

    2015-01-01

    Maintaining antipsychotic therapy in psychosis is important in preventing relapse. Long-acting depot preparations can prevent covert non-adherence and thus potentially contribute to better patient outcomes. In this observational survey the main objective is to evaluate medication adherence and its determinants for oral treatment in a large sample of patients with psychosis. In this cross-sectional survey medication adherence for oral treatment was assessed by patients using the patient-rated Medication Adherence Questionnaire (MAQ). Data were collected by physicians on patients with a recent acute psychotic episode before switching to long-acting injectable risperidone. Other evaluations included disease severity (Clinical Global Impression - Severity), patients' insight (Positive and Negative Syndrome Scale item G12), treatment acceptance (clinician-rated Compliance Rating Scale), and therapeutic alliance (patient-rated 4-Point ordinal Alliance Scale). A total of 399 psychiatrists enrolled 1,887 patients (mean age 36.8±11.9 years; 61.6% had schizophrenia). Adherence to oral medication was "low" in 53.2% of patients, "medium" in 29.5%, and "high" in 17.3%. Of patients with psychiatrist-rated active acceptance of treatment, 70% had "medium" or "high" MAQ scores (Padherence was significantly associated with therapeutic alliance (4-Point ordinal Alliance Scale score; PPatient age was significantly associated with adherence: mean age increased with greater adherence (35.6, 36.7, and 38.6 years for patients with "low", "medium", and "high" levels of adherence, respectively; P=0.0007), while age adherence was also associated with a diagnosis of schizophrenia (P=0.0083), more severe disease (Clinical Global Impression - Severity ≥4; Padherence was low in most patients, with a strong positive association between self-reported adherence and psychiatrists' assessment of treatment acceptance. Understanding factors associated with poor medication adherence may help

  14. 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.

  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. Comparative dynamics of self-consciousness of schizophrenic patients and patients with acute and transient psychotic disorders in the process of compulsory treatment

    Directory of Open Access Journals (Sweden)

    Yur’yeva L.N.

    2013-10-01

    Full Text Available Article presents the materials of empirical research of life sense orientations, self-relation and level of claims of schizophrenic patients and patients with acute and transient psychotic disorders, who have committed socially hazardous actions and to whom forced measures of medical character are temporarily applied. Changes in the self- consciousness of patients with schizophrenia in dynamics were examined: in comparing the results obtained at first and fourth stages of patients' stay in mental hospital with strict supervision (the first stage – adaptation and diagnostics, the fourth stage – the consolidation of treatment results and preparation of patient to be discharged. Research was done by D. Leontiev’s test of life sense orientations (LSO, by S. Pantileyev – V. Stolin’s techniques and by Shwarzlander’s “Motor test”. Statistical processing of the obtained results of differences by indices of life sense orientations, of selfattitude and level of claims between the group under study with Student's t-criterion was used.

  17. 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.

  18. Potential drug-drug interactions in Alzheimer patients with behavioral symptoms.

    Science.gov (United States)

    Pasqualetti, Giuseppe; Tognini, Sara; Calsolaro, Valeria; Polini, Antonio; Monzani, Fabio

    2015-01-01

    The use of multi drug regimens among the elderly population has increased tremendously over the last decade although the benefits of medications are always accompanied by potential harm, even when prescribed at recommended doses. The elderly populations are particularly at an increased risk of adverse drug reactions considering comorbidity, poly-therapy, physiological changes affecting the pharmacokinetics and pharmacodynamics of many drugs and, in some cases, poor compliance due to cognitive impairment and/or depression. In this setting, drug-drug interaction may represent a serious and even life-threatening clinical condition. Moreover, the inability to distinguish drug-induced symptoms from a definitive medical diagnosis often results in addition of yet another drug to treat the symptoms, which in turn increases drug-drug interactions. Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, are the most widely prescribed agents for Alzheimer's disease (AD) patients. Behavioral and psychological symptoms of dementia, including psychotic symptoms and behavioral disorders, represent noncognitive disturbances frequently observed in AD patients. Antipsychotic drugs are at high risk of adverse events, even at modest doses, and may interfere with the progression of cognitive impairment and interact with several drugs including anti-arrhythmics and acetylcholinesterase inhibitors. Other medications often used in AD patients are represented by anxiolytic, like benzodiazepine, or antidepressant agents. These agents also might interfere with other concomitant drugs through both pharmacokinetic and pharmacodynamic mechanisms. In this review we focus on the most frequent drug-drug interactions, potentially harmful, in AD patients with behavioral symptoms considering both physiological and pathological changes in AD patients, and potential pharmacodynamic/pharmacokinetic drug interaction mechanisms.

  19. Potential drug–drug interactions in Alzheimer patients with behavioral symptoms

    Directory of Open Access Journals (Sweden)

    Pasqualetti G

    2015-09-01

    Full Text Available Giuseppe Pasqualetti, Sara Tognini, Valeria Calsolaro, Antonio Polini, Fabio Monzani Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy Abstract: The use of multi drug regimens among the elderly population has increased tremendously over the last decade although the benefits of medications are always accompanied by potential harm, even when prescribed at recommended doses. The elderly populations are particularly at an increased risk of adverse drug reactions considering comorbidity, poly-therapy, physiological changes affecting the pharmacokinetics and pharmacodynamics of many drugs and, in some cases, poor compliance due to cognitive impairment and/or depression. In this setting, drug–drug interaction may represent a serious and even life-threatening clinical condition. Moreover, the inability to distinguish drug-induced symptoms from a definitive medical diagnosis often results in addition of yet another drug to treat the symptoms, which in turn increases drug–drug interactions. Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, are the most widely prescribed agents for Alzheimer’s disease (AD patients. Behavioral and psychological symptoms of dementia, including psychotic symptoms and behavioral disorders, represent noncognitive disturbances frequently observed in AD patients. Antipsychotic drugs are at high risk of adverse events, even at modest doses, and may interfere with the progression of cognitive impairment and interact with several drugs including anti-arrhythmics and acetylcholinesterase inhibitors. Other medications often used in AD patients are represented by anxiolytic, like benzodiazepine, or antidepressant agents. These agents also might interfere with other concomitant drugs through both pharmacokinetic and pharmacodynamic mechanisms. In this review we focus on the most frequent drug–drug interactions, potentially harmful, in AD patients with

  20. 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

  1. Bizarreness in dream reports and waking fantasies of psychotic schizophrenic and manic patients: empirical evidences and theoretical consequences.

    Science.gov (United States)

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

    2011-09-30

    Several overlapping features have frequently been described between psychosis and the subjective experience of dreaming from the neurobiological to the phenomenological level, but whether this similarity reflects the cognitive organization of schizophrenic thought or rather that of psychotic mentation independent of diagnostic categories is still unclear. In this study, 40 actively psychotic inpatients were equally divided in two age- and education-matched groups according to their diagnosis (Schizophrenia and Bipolar Disorder). Participants were asked to report their dreams upon awakening and the Thematic Apperception Test (TAT) was administered to elicit waking fantasies; the same procedure was used in a control group of 20 non-psychiatric subjects. Two highly trained judges scored the collected material according to a Dream Bizarreness scale. The same level of cognitive bizarreness was found in TAT and dream reports of schizophrenic and manic subjects but was almost completely absent in the TAT stories of the control group. Two-way analysis of variance for repeated measures assessed the effect of diagnosis and experimental conditions (TAT stories and dream reports) on bizarreness yielding a significant interaction. Cognitive bizarreness seems to be a shared feature of dreaming and psychotic mentation, beyond diagnostic categorizations. Although these findings must be considered preliminary, this experimental measure of the cognitive architecture of thought processes seems to support the view that dreaming could be a useful model for the psychoses.

  2. 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.

  3. 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

  4. Primeiras crises psicóticas: identificação de pródromos por pacientes e familiares First psychotic crisis: prodroms identification by patients and family members

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    Nerícia Regina de Carvalho

    2008-01-01

    Full Text Available Este artigo é resultado de uma dissertação de mestrado que procurou caracterizar as crises psicóticas por meio da fala de pacientes e de seus familiares que passaram pelas suas primeiras crises, baseada na literatura e pesquisas recentes sobre intervenção precoce nas psicoses (McGorry & Edwards, 2002, nos estudos sobre crise (DiTomasso & Kovnat, 1995; Miermont e cols., 1994; Tavares, 2004 e sobre família (Addington e cols., 2005. Os dados obtidos foram trabalhados de acordo com a análise de conteúdo (Bardin, 1988; Franco, 2003. Constatou-se que as crises psicóticas, embora questionáveis do ponto de vista diagnóstico, se manifestaram conforme a literatura corrente (CID-10, 1993; McGorry & Edwards, 2002. Ansiedade, medo, isolamento social e desconfiança foram os pródromos identificados, e alucinação e delírio, os sintomas recorrentes.This article is the result of a master's degree thesis which tried to characterize psychotic crisis by the account of patients and family members in their first crisis. The study was based on recent literature, surveys regarding early intervention in psychosis (McGorry & Edwards, 2002, studies about crisis (DiTomasso & Kovnat, 1995; Miermont e cols., 1994; Tavares, 2004 and about family (Addington et al., 2005. The data obtained was processed through Content Analysis (Bardin, 1988; Franco, 2003. It was noted that psychotic crisis were manifested according to literature states (CID-10, 1993; McGorry & Edwards, 2002. Anxiety, social isolation, fear and suspicion were the identified prodroms, and hallucination and delirium, the related symptoms.

  5. Qualities of Life of Patients with Psychotic Disorders and Their Family Caregivers: Comparison between Hospitalised and Community-Based Treatment in Beijing, China

    Science.gov (United States)

    Ma, Xin; Weng, Yongzhen; Liang, Wannian

    2016-01-01

    Background Community healthcare in mainland China is still at an early stage. The qualities of life (QOLs) of patients with psychotic disorders undergoing rehabilitation in hospitals or in the community, as well as those of their caregivers, may differ from each other. Objectives The study was performed to evaluate the QOL of patients with psychotic disorders and assess the differences in the QOLs between patients receiving care in diverse settings (hospital vs. the community). Methods This study was a descriptive study, in which all cases were collected from two psychiatric hospitals and five communities. Patients (n = 43) and caregivers (n = 40) in the psychiatric hospitals were grouped according to the length of illness and areas of residence and these criteria were also used to group patients (n = 55) and caregivers (n = 59) in the community. All participants were assessed using the WHOQOL-BREF (Chinese version). ANOVA was adopted to compare the QOL scores among the four groups (cases and caregivers in two settings), while confounding factors, such as age and marital status, were adjusted. Results Among the four groups of participants, namely, hospitalised and community patients and their corresponding caregivers, community samples had a significantly lower QOL score. The QOL score for the social relationships domain of the hospitalised patients’ caregivers was significantly higher than that of the caregivers of community patients (P = 0.019). Conclusion Community patients and their caregivers tend to have lower QOL scores than their hospitalised counterparts. The support of family members is urgently needed to provide better care for patients. PMID:27870906

  6. 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...

  7. 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...

  8. Managing myelodysplastic symptoms in elderly patients

    Directory of Open Access Journals (Sweden)

    R Ria

    2009-10-01

    Full Text Available R Ria, M Moschetta, A Reale, G Mangialardi, A Castrovilli, A Vacca, F DammaccoDepartment of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari Medical School, Bari, ItalyAbstract: Most patients with myelodysplastic syndromes (MDS are elderly (median age range 65 to 70 years; as a consequence, the incidence and prevalence of these diseases are rising as the population ages. Physicians are often uncertain about how to identify patients who may benefit from specific treatment strategies. The International Prognostic Scoring System is a widely used tool to assess the risk of transformation to leukemia and to guide treatment decisions, but it fails to take into account many aspects of treating elderly patients, including comorbid illnesses, secondary causes of MDS, prior therapy for MDS, and other age-related health, functional, cognitive, and social problems that affect the outcome and managing of myelodysplastic symptoms. Patients with low-risk disease traditionally have been given only best supportive care, but evidence is increasing that treatment with novel non-conventional drugs such as lenalidomide or methyltransferase inhibitors may influence the natural history of the disease and should be used in conjunction with supportive-care measures. Supportive care of these patients could also be improved in order to enhance their quality of life and functional performance. Elderly patients commonly have multiple medical problems and use medications to deal with these. In addition, they are more likely to have more than one health care provider. These factors all increase the risk of drug interactions and the consequent treatment of toxicities. Manifestations of common toxicities or illnesses may be more subtle in the elderly, owing to age-associated functional deficits in multiple organ systems. Particularly important to the elderly MDS patient is the age-related decline in normal bone

  9. 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...

  10. 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.

  11. 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

  12. Premorbid Negative Symptoms in First-Episode Psychosis

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    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.

  13. Neurological symptoms in psoriasis patients under treatment with infliximab简

    Institute of Scientific and Technical Information of China (English)

    Elham; Behrangi; Amir; Houshang; Ehsani; Forouzandeh; Sadrzadeh; Gholamhossein; Ghaffarpour; Shooka; Esmaeeli; Mansour; Deylami; Romina; Espahbodi; Zahra; Azizian

    2015-01-01

    Objective: To study the neurological symptoms of psoriasis patients who used infliximab.Methods: We studied psoriasis patients who used infliximab in two referral general hospitals in Tehran from January 2013 to January 2014. We completed neurological symptoms checklists by questioning the patients.Results: Sixty patients with psoriasis were included in this study. Among them, 3 patients had sensory symptoms as side effect and one patient showed motor symptoms as side effect. There was no statistically significant difference between age, gender, and session count with the sensory and motor side effects(P > 0.05).Conclusions: Neurological symptoms can be detected among 6% of patients under treatment with infliximab and there is no significant association between symptoms and gender, duration of drug use as well as age.

  14. Neurological symptoms in psoriasis patients under treatment with inlfiximab

    Institute of Scientific and Technical Information of China (English)

    Elham Behrangi; Amir Houshang Ehsani; Forouzandeh Sadrzadeh; Gholamhossein Ghaffarpour; Shooka Esmaeeli; Mansour Deylami; Romina Espahbodi; Zahra Azizian

    2015-01-01

    Objective:To study the neurological symptoms of psoriasis patients who used infliximab. Methods: We studied psoriasis patients who used infliximab in two referral general hospitals in Tehran from January 2013 to January 2014. We completed neurological symptoms checklists by questioning the patients. Results: Sixty patients with psoriasis were included in this study. Among them, 3 patients had sensory symptoms as side effect and one patient showed motor symptoms as side effect. There was no statistically significant difference between age, gender, and session count with the sensory and motor side effects (P > 0.05). Conclusions: Neurological symptoms can be detected among 6% of patients under treatment with infliximab and there is no significant association between symptoms and gender, duration of drug use as well as age.

  15. Subtyping patients with heroin addiction at treatment entry: factor derived from the Self-Report Symptom Inventory (SCL-90

    Directory of Open Access Journals (Sweden)

    Maremmani Icro

    2010-04-01

    Full Text Available Abstract Background Addiction is a relapsing chronic condition in which psychiatric phenomena play a crucial role. Psychopathological symptoms in patients with heroin addiction are generally considered to be part of the drug addict's personality, or else to be related to the presence of psychiatric comorbidity, raising doubts about whether patients with long-term abuse of opioids actually possess specific psychopathological dimensions. Methods Using the Self-Report Symptom Inventory (SCL-90, we studied the psychopathological dimensions of 1,055 patients with heroin addiction (884 males and 171 females aged between 16 and 59 years at the beginning of treatment, and their relationship to age, sex and duration of dependence. Results A total of 150 (14.2% patients with heroin addiction showed depressive symptomatology characterised by feelings of worthlessness and being trapped or caught; 257 (24.4% had somatisation symptoms, 205 (19.4% interpersonal sensitivity and psychotic symptoms, 235 (22.3% panic symptomatology, 208 (19.7% violence and self-aggression. These dimensions were not correlated with sex or duration of dependence. Younger patients with heroin addiction were characterised by higher scores for violence-suicide, sensitivity and panic anxiety symptomatology. Older patients with heroin addiction showed higher scores for somatisation and worthlessness-being trapped symptomatology. Conclusions This study supports the hypothesis that mood, anxiety and impulse-control dysregulation are the core of the clinical phenomenology of addiction and should be incorporated into its nosology.

  16. Executive function does not predict coping with symptoms in stable patients with a diagnosis of schizophrenia

    OpenAIRE

    Walraven Wil; Huistra Karola; Delespaul Philippe; Krabbendam Lydia; Bak Maarten; van Os Jim

    2008-01-01

    Abstract Background Associations between coping with and control over psychotic symptoms were examined using the Maastricht Assessment of Coping Strategies-24, testing the hypothesis that the cognitive domain of executive functioning predicted quality and quantity of coping. Methods MACS-24 was administered to 32 individuals with a diagnosis of schizophrenia. For each of 24 symptoms, experience of distress, type of coping and the resulting degree of perceived control were assessed. Coping typ...

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

    Science.gov (United States)

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

    1999-11-01

    principles for first-episode psychosis are to maximise benefit and minimise side effects because the first experience of medication may influence a patient's future attitudes of therapy of all types. Effective strategies which may reduce long-term morbidity and improve recovery are currently available but their implementation is too often delayed. The time lag between the onset of symptoms and the start of treatment can be many months or years and this delay can have serious consequences. The critical period of the first 2-5 years after the first psychotic episode is a time of maximum vulnerability and of maximum opportunity. Consequently, actions should be undertaken to promote early recognition and assistance in psychotic disorders: understanding of the factors that may cause delay in treatment can help minimise this problem and lead to the initiation of appropriate treatment at the earliest opportunity. Training the general practitioners who have an important part to play in the early recognition is also of crucial importance.

  18. Altered depth of the olfactory sulcus in ultra high-risk individuals and patients with psychotic disorders.

    Science.gov (United States)

    Takahashi, Tsutomu; Wood, Stephen J; Yung, Alison R; Nelson, Barnaby; Lin, Ashleigh; Yücel, Murat; Phillips, Lisa J; Nakamura, Yumiko; Suzuki, Michio; Brewer, Warrick J; Proffitt, Tina M; McGorry, Patrick D; Velakoulis, Dennis; Pantelis, Christos

    2014-03-01

    A shallow olfactory sulcus has been reported in schizophrenia, possibly reflecting abnormal forebrain development during early gestation. However, it remains unclear whether this anomaly exists prior to the onset of psychosis and/or differs according to illness stage. In the current study, magnetic resonance imaging was used to investigate the length and depth of the olfactory sulcus in 135 ultra high-risk (UHR) individuals [of whom 52 later developed psychosis (UHR-P) and 83 did not (UHR-NP)], 162 patients with first-episode psychosis (FEP), 89 patients with chronic schizophrenia, and 87 healthy controls. While there was no group difference in the length of the sulcus, UHR-P subjects had significantly shallower olfactory sulcus at baseline as compared with UHR-NP and control subjects. The depth of this sulcus became increasingly more superficial as one moved from UHR-P subjects to FEP patients to chronic schizophrenia patients. Finally, the depth of the olfactory sulcus in the UHR-P subjects was negatively correlated with the severity of negative symptoms. These findings suggest that the altered depth of the olfactory sulcus, which exists before psychosis onset, could be predictive of transition to psychosis, but also suggest ongoing changes of the sulcus morphology during the course of the illness.

  19. 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.

  20. Undertreatment of symptoms in patients on maintenance hemodialysis.

    Science.gov (United States)

    Claxton, René N; Blackhall, Leslie; Weisbord, Steven D; Holley, Jean L

    2010-02-01

    Hemodialysis patients suffer a large symptom burden, and little is known about how effectively symptoms are treated. To assess the management of treatable symptoms in hemodialysis patients, we administered a 30-item questionnaire on physical and emotional symptoms to patients receiving outpatient hemodialysis at the University of Virginia. We asked patients whether they were prescribed therapy for potentially treatable symptoms and assessed who prescribed the therapy. By means of chart review, we also documented whether medications were prescribed for these symptoms. We approached 87 patients and enrolled 62 (71%). The most commonly reported, potentially treatable symptoms included bone/joint pain, insomnia, mood disturbance, sexual dysfunction, paresthesia, and nausea. Only 45% of patients with bone/joint pain reported receiving an analgesic medication. Twenty-three percent of patients with trouble falling asleep and 53% of patients with nausea reported receiving a medication to alleviate this symptom. Chart review revealed that 58% of patients who reported the presence of bone/joint pain were prescribed an analgesic, 23% of patients with trouble falling asleep were prescribed a sleep aid, and 42% of patients with nausea received an antiemetic. Primary care providers were more likely than nephrologists to provide for all symptoms except nausea and numbness or tingling in the feet, and this difference was significant for the treatment of worrying (3/3 vs. 0/3, P=0.05) and nervousness (4/5 vs. 0/5, P=0.02). Potentially treatable symptoms in hemodialysis are undertreated. Pharmacologic therapy, particularly for emotional symptoms, was more commonly prescribed by primary care providers than nephrologists. Additional study of the barriers to symptom treatment and interventions that increase nephrologist and primary care provider symptom management are needed. Copyright 2010 U.S. Cancer Pain Relief Committee. All rights reserved.

  1. Development of a symptom assessment instrument for chronic hemodialysis patients: the Dialysis Symptom Index.

    Science.gov (United States)

    Weisbord, Steven D; Fried, Linda F; Arnold, Robert M; Rotondi, Armando J; Fine, Michael J; Levenson, David J; Switzer, Galen E

    2004-03-01

    Little is known about the prevalence, severity, or impact of symptoms in hemodialysis patients because of the lack of a validated symptom assessment instrument. We systematically developed an index to assess physical and emotional symptom burden in this patient population. We employed four steps in the generation of this index: a review of dialysis quality-of-life instruments, three focus groups, experts' content validity assessment, and test-retest reliability measurement. Seventy-five symptoms were identified. Of these, 46 appeared in > or = 4 of the instruments/focus groups and were considered for inclusion. Twelve were grouped into other symptom constructs and experts judged four of the remaining items not to be pertinent, leaving 30 items in the new index. Overall kappa statistic was 0.48+/-0.22. These steps allowed the systematic development of a 30-item symptom assessment index for hemodialysis patients. Additional reliability and validity testing is needed prior to its widespread use.

  2. Insecure attachment is associated with paranoia but not hallucinations in psychotic patients: the mediating role of negative self-esteem.

    Science.gov (United States)

    Wickham, S; Sitko, K; Bentall, R P

    2015-05-01

    A growing body of research has investigated associations between insecure attachment styles and psychosis. However, despite good theoretical and epidemiological reasons for hypothesising that insecure attachment may be specifically implicated in paranoid delusions, few studies have considered the role it plays in specific symptoms. We examined the relationship between attachment style, paranoid beliefs and hallucinatory experiences in a sample of 176 people with a diagnosis of schizophrenia spectrum disorders and 113 healthy controls. We also investigated the possible role of negative self-esteem in mediating this association. Insecure attachment predicted paranoia but not hallucinations after co-morbidity between the symptoms was controlled for. Negative self-esteem partially mediated the association between attachment anxiety and clinical paranoia, and fully mediated the relationship between attachment avoidance and clinical paranoia. It may be fruitful to explore attachment representations in psychological treatments for paranoid patients. If future research confirms the importance of disrupted attachment as a risk factor for persecutory delusions, consideration might be given to how to protect vulnerable young people, for example those raised in children's homes.

  3. Pantoea agglomerans in Immunodeficient Patients with Different Respiratory Symptoms

    OpenAIRE

    Erika Odilia Flores Popoca; Maximino Miranda García; Socorro Romero Figueroa; Aurelio Mendoza Medellín; Horacio Sandoval Trujillo; Hilda Victoria Silva Rojas; Ninfa Ramírez Durán

    2012-01-01

    The aim of this paper was to determine in 32 patients from 4 different Mexican hospitals the frequency of opportunistic bacteria in the 2010 to 2011 time period. The patients were divided in 4 groups. Group 1 included 21 HIV positive patients with acute respiratory syndrome. Four HIV positive patients with tuberculosis symptoms were included in Group 2; two patients with tuberculosis symptoms and one asymptomatic person formed Group 3. Reference Group 4 included 4 patients from whom 4 strains...

  4. 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 ...

  5. 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.

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

    Science.gov (United States)

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

    2015-09-01

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

  7. Depressive and paradepressive symptoms clinical features in patients with schizophrenia

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    K. A. Sincha

    2016-01-01

    Full Text Available Aim. Depressive symptoms in patients with schizophrenia, etiology and pathogenesis of which is still not completely uncovered and cause number of complications, decrease quality of life and hinder rehabilitation of the patients. Materials and metods. In order to establish depression and paradepressive symptoms features in patients with schizophrenia the next methods were used: clinical- psychopathological, anamnestic and catamnestic methods. 107 patients with schizophrenia (F20 and 30 patients with schizoaffective disorder, mixed type (F25 were examined. Conclusion. Correlative relationship between depressive, hallucinatory-delusional, deficits and neuroleptic manifestations symptoms has been indicated. factors of induction and amplification of depressive symptoms in patients with schizophrenia were determined. Ethiopsychopathogenic variants of depressive symptoms in patients with schizophrenia were obtained.

  8. [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

  9. 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.

  10. Prevalence of obsessive compulsive symptoms among patients with schizophrenia

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    Smita Hemrom

    2009-01-01

    Full Text Available Background: Obsessive compulsive symptoms in schizophrenia are well recognized but are a less-researched entity. These symptoms have important implications for management and prognosis. Aim: To find out the prevalence of obsessive compulsive symptoms among patients with schizophrenia. Materials and Methods: A total of 90 hospitalized patients with schizophrenia diagnosed according to DCR of ICD-10 criteria were selected for the study. Padua inventory and Yale-Brown Obsessive Compulsive Scale were applied to find out the prevalence and nature of obsessive compulsive symptoms . Results: It was found that 10% of schizophrenic patients had obsessive compulsive symptoms. Conclusion: Obsessive compulsive symptoms are prevalent in patients with schizophrenia. The presence of comorbidity should be explored for adequate management.

  11. Reviewing the Dissociative Symptoms in Patients With Schizophreniaand their Association With Positive and Negative Symptoms

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    Ghoreishi, Abolfazl; Shajari, Zahra

    2014-01-01

    Objective: The present study aimed to clarify dissociative symptoms in patients with schizophrenia and its association with negative and positive symptom of schizophrenia. Methods: Based on the 4th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria, 80 schizophrenic subjects were randomly selected from patients who referred to the clinics of psychiatry hospital in Kerman, Iran. Eighty non-schizophrenic patients were chosen as the control group. Both groups were evaluated for dissociation symptom using the Dissociative Experience Scale (DES). Positive and Negative Syndrome Scale (PANSS) score was also used in the case group for determination of positive and negative symptom of schizophrenia. Results: The prevalence of dissociation symptom was 13% and 4% among schizophrenic and control groups, respectively (p = 0.02). In addition, there was a statistical significant association between DES score and positive symptom in schizophrenia (p = 0.02). Conclusion: The association between dissociative symptom and schizophrenia was significant and dissociative symptoms were associated with positive symptoms of schizophrenia. Declaration of interest: None. PMID:24995025

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

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    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.

  13. Tramadol-related psychosis in a patient with bipolar I disorder.

    Science.gov (United States)

    Chen, Kuan-Jen; Lu, Mong-Liang; Shen, Winston W

    2015-04-01

    Tramadol hydrochloride (HCl) is a centrally acting synthetic opioid analgesic. Psychotic symptoms are relatively rare in reported adverse events. Here, we report a patient who presented with tramadol-related psychotic symptoms. A 59-year-old female had underlying bipolar I disorder and received lithium treatment with stable affective status. 1 month before hospitalisation, she had been taking tramadol HCl/acetaminophen for joint pain. She then developed obvious persecutory delusion. However, her clinical picture did not meet the criteria of any mood episode. After treatment of risperidone in addition to lithium, she was discharged without any psychotic symptom. She remained euthymic without any psychotic symptom on monotherapy of lithium (300 mg) three tablets once daily. Tramadol HCl is commonly prescribed in clinical practice and psychotic symptoms related to it are uncommon. We should be careful about the rare but important adverse events while prescribing tramadol HCl.

  14. Prevalence of acromegaly in patients with symptoms of sleep apnea

    Science.gov (United States)

    Resmini, Eugenia; Sambo, Marcel; Blanco, Concepción; Calvo, Fernando; Pazos, Fernando; Fernández-Catalina, Pablo; Martínez de Icaya, Purificación; Páramo, Concepción; Fajardo, Carmen; Marazuela, Mónica; Álvarez-Escolá, Cristina; Díez, Juan Jose; Perea, Verónica

    2017-01-01

    Acromegaly is a rare disease with nonspecific symptoms with acral enlargement being almost universally present at diagnosis. The estimated prevalence is 40–125 cases/million but targeted universal screening studies have found a higher prevalence (about 10 fold). The aim of the ACROSAHS study was to investigate the prevalence of acromegaly and acromegaly comorbidities in patients with sleep apnea symptoms and acral enlargement. ACROSAHS was a Spanish prospective non-interventional epidemiological study in 13 Hospital sleep referral units. Facial and acral enlargement symptoms including: ring size and shoe size increase, tongue, lips and jaws enlargement, paresthesia or carpal tunnel syndrome and widening of tooth spaces, as well as other typical acromegaly comorbidities were recorded with a self-administered questionnaire of patients who attended a first visit for sleep apnea symptoms between 09/2013 and 07/2014. Serum insulin-like growth factor type 1 (IGF1) was measured in patients with ≥1 acral symptom to determine the prevalence of acromegaly. Of the 1557 patients enrolled, 1477 with complete data (72% male) were analyzed. 530 patients (36%) reported at least 1 acral enlargement symptom and were tested for IGF-1, 41 were above range, persisted in 7, and among those, 2 cases of acromegaly were diagnosed (prevalence of at least 1.35 cases/1000). Overall, 1019 patients (69%) had ≥2 acromegaly symptoms and should have been screened according to guidelines; moreover 373 patients (25%) had ≥1 symptom of acral enlargement plus ≥3 other acromegaly symptoms. In conclusion, in patients with sleep apnea symptoms and acral enlargement, we found an acromegaly prevalence of at least 1.35 cases per 1000 and a high prevalence of typical acromegaly symptoms. It is important that sleep specialists are aware of acromegaly symptoms to aid with acromegaly diagnosis. PMID:28898247

  15. Symptom burden among patients with Renal Cell Carcinoma (RCC: content for a symptom index

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    Mahadevia Parthiv J

    2007-06-01

    Full Text Available Abstract Background Renal cell carcinoma (RCC has multiple symptoms stemming from disease and treatments. There are few validated scales for evaluating RCC symptoms. Methods A national cross-sectional study of adult RCC patients was conducted from October to December 2003 to define patient-reported RCC symptomology. Participants were asked open-ended questions regarding their signs and symptoms and completed an 86-item pilot questionnaire of physical and psychological symptoms. Patients were asked to rate the relevancy and clarity of each pilot question using a 5-point Likert scale. Subsequent open-ended caregiver interviews and a provider panel relevance ranking contributed additional information. Results The average age of the participants (n = 31 was 55 years; 55% of patients were male, 74% had attended college, and 97% were Caucasian. The five most frequent symptoms among localized-stage patients (n = 14 were irritability (79%, pain (71%, fatigue (71%, worry (71%, and sleep disturbance (64%. Among metastatic patients (n = 17, the five most frequent symptoms were fatigue (82%, weakness (65%, worry (65%, shortness of breath (53%, and irritability (53%. More than 50% of localized and metastatic-stage patients reported pain, weakness, fatigue, sleep disturbance, urinary frequency, worry, and mood disorders as being moderately to highly relevant. Conclusion A brief, self-administered RCC Symptom Index was created that captures the relevant signs and symptoms of both localized and metastatic patients. Pending additional content validation, the Index can be used to assess the signs and symptoms of RCC and the clinical benefit resulting from RCC treatment.

  16. 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.

  17. Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease

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    Zlatica Goseva

    2014-09-01

    CONCLUSION: GER symptoms are more prevalent in patients with severe airways obstruction when compared to less airways obstructed group and controls. We could suggest an association between the degree of airways obstruction in patients with COPD and the increased rate of GER symptoms.

  18. Internet Use for Prediagnosis Symptom Appraisal by Colorectal Cancer Patients

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    Thomson, Maria D.; Siminoff, Laura A.; Longo, Daniel R.

    2012-01-01

    Background: This study explored the characteristics of colorectal cancer (CRC) patients who accessed Internet-based health information as part of their symptom appraisal process prior to consulting a health care provider. Method: Newly diagnosed CRC patients who experienced symptoms prior to diagnosis were interviewed. Brief COPE was used to…

  19. Patients with carcinoid syndrome exhibit symptoms of aggressive impulse dysregulation

    NARCIS (Netherlands)

    Russo, S; Boon, JC; Kema, IP; Willemse, PHB; den Boer, JA; Korf, J; de Vries, EGE

    2004-01-01

    Objective: Carcinoid tumors can produce excessive amounts of biogenic amines, notably serotonin. We assessed psychiatric symptoms in carcinoid patients and peripheral metabolism of tryptophan, the precursor of serotonin. Methods: Twenty consecutive patients with carcinoid syndrome underwent a struct

  20. Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms.

    NARCIS (Netherlands)

    Zannad, Faiez; McMurray, John J. V.; Krum, Henry; van Veldhuisen, Dirk J.; Swedberg, Karl; Shi, Harry; Vincent, John; Pocock, Stuart J.; Pitt, Bertram

    2011-01-01

    Background: Mineralocorticoid antagonists improve survival among patients with chronic, severe systolic heart failure and heart failure after myocardial infarction. We evaluated the effects of eplerenone in patients with chronic systolic heart failure and mild symptoms. Methods: In this randomized,

  1. [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.

  2. Aural symptoms in patients referred for temporomandibular pain/dysfunction.

    Science.gov (United States)

    Mejersjö, Christina; Näslund, Ingrid

    2016-01-01

    With the aim of studying frequency of aural symptoms and associations with symptoms of TMD new patients referred to the Orofacial Pain Clinic, Odontologen, Göteborg, were asked, at their first appointment and before meeting a specialist, to report any symptoms regarding pain or fullness/swelling of the ear, impaired hearing, sensitivity to sound, and irritation/itching of the ear. They also answered a standardized questionnaire regarding temporomandibular pain and/or dysfunction, and classified their degree of TMD symptoms on a five-point verbal scale and a visual analogue scale. 108 consecutive patients were included in the study, they completed the questionnaires and were examined and diagnosed by different specialists at the clinic. Any ear symptoms were reported by 68% of the patients, fullness of ear by 44% and impaired hearing by 37%. 38% of the patients had previously consulted a physician, and most of them had had pharmacological treatment due to their ear symptoms. Females reported more pain in the ear (P = 0.034) and more sensitivityto sound (P = 0.046) than men. No significant association was found between age and aural symptoms. The degree of TMD- symptoms, as reported by the five grade scale, showed significant association with aural symptoms (P osteoartrosis) and disc displacement. Itching in the ear was frequently reported (24%) and was associated with myalgia (P = 0.003) and tension headache (P = 0.018). A medical examination by an ear-nose-throat specialist of 19 patients reporting a sensation of fullness of ear, did not reveal any objectifiable ear disease. To conclude, aural symptoms are common in patients with temporomandibular pain and/or dysfunction, are associated with TMD-symptoms and should be regarded as possible symptoms of TMD. A cooperation between physicians and dentists can give these patients a good treatment.

  3. Medication adherence in patients with psychotic disorders: an observational survey involving patients before they switch to long-acting injectable risperidone

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    Baylé FJ

    2015-09-01

    Full Text Available Franck Jean Baylé,1 Arnaud Tessier,2,3 Sophie Bouju,4 David Misdrahi2,3 1Sainte-Anne Hospital (SHU, Paris V-Descartes University, Paris, 2Hôpital Charles Perrens, Pôle de Psychiatrie Adulte, 3CNRS UMR 5287-INCIA, Bordeaux University, Bordeaux, 4Janssen-Cilag France, Issy Les Moulineaux, Paris, France Background: Maintaining antipsychotic therapy in psychosis is important in preventing relapse. Long-acting depot preparations can prevent covert non-adherence and thus potentially contribute to better patient outcomes. In this observational survey the main objective is to evaluate medication adherence and its determinants for oral treatment in a large sample of patients with psychosis.Methods: In this cross-sectional survey medication adherence for oral treatment was assessed by patients using the patient-rated Medication Adherence Questionnaire (MAQ. Data were collected by physicians on patients with a recent acute psychotic episode before switching to long-acting injectable risperidone. Other evaluations included disease severity (Clinical Global Impression – Severity, patients’ insight (Positive and Negative Syndrome Scale item G12, treatment acceptance (clinician-rated Compliance Rating Scale, and therapeutic alliance (patient-rated 4-Point ordinal Alliance Scale.Results: A total of 399 psychiatrists enrolled 1,887 patients (mean age 36.8±11.9 years; 61.6% had schizophrenia. Adherence to oral medication was “low” in 53.2% of patients, “medium” in 29.5%, and “high” in 17.3%. Of patients with psychiatrist-rated active acceptance of treatment, 70% had “medium” or “high” MAQ scores (P<0.0001. Medication adherence was significantly associated with therapeutic alliance (4-Point ordinal Alliance Scale score; P<0.0001. Patient age was significantly associated with adherence: mean age increased with greater adherence (35.6, 36.7, and 38.6 years for patients with “low”, “medium”, and “high” levels of adherence

  4. PATIENTS WITH METASTATIC GESTATIONAL TROPHOBLASTIC NEOPLASMS AND NO GYNECOLOGICAL SYMPTOMS

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    F. Ghaemmaghami T. Ashraf Ganjoie

    2008-04-01

    Full Text Available Early recognition of Gestational Trophoblastic Neoplasm (GTN will maximize the chances of cure with chemotherapy but some patients present with many different symptoms months or even years after the causative pregnancy making diagnosis difficult. Clinicians should be aware of the possibility of GTN in any reproductive age woman with bizarre central nervous system, gastrointestinal, pulmonary symptoms or radiographic evidence of metastatic tumor of unknown primary origin. We reported five cases of metastatic gestational trophoblastic neoplasms with bizarre pulmonary symptoms, acute abdomen, neurologic symptoms presenting without gynecological symptoms.

  5. Cancer Carepartners: Improving patients' symptom management by engaging informal caregivers

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    Silveira Maria J

    2011-11-01

    Full Text Available Abstract Background Previous studies have found that cancer patients undergoing chemotherapy can effectively manage their own symptoms when given tailored advice. This approach, however, may challenge patients with poor performance status and/or emotional distress. Our goal is to test an automated intervention that engages a friend or family member to support a patient through chemotherapy. Methods/Design We describe the design and rationale of a randomized, controlled trial to assess the efficacy of 10 weeks of web-based caregiver alerts and tailored advice for helping a patient manage symptoms related to chemotherapy. The study aims to test the primary hypothesis that patients whose caregivers receive alerts and tailored advice will report less frequent and less severe symptoms at 10 and 14 weeks when compared to patients in the control arm; similarly, they will report better physical function, fewer outpatient visits and hospitalizations related to symptoms, and greater adherence to chemotherapy. 300 patients with solid tumors undergoing chemotherapy at two Veteran Administration oncology clinics reporting any symptom at a severity of ≥4 and a willing informal caregiver will be assigned to either 10 weeks of automated telephonic symptom assessment (ATSA alone, or 10 weeks of ATSA plus web-based notification of symptom severity and problem solving advice to their chosen caregiver. Patients and caregivers will be surveyed at intake, 10 weeks and 14 weeks. Both groups will receive standard oncology, hospice, and palliative care. Discussion Patients undergoing chemotherapy experience many symptoms that they may be able to manage with the support of an activated caregiver. This intervention uses readily available technology to improve patient caregiver communication about symptoms and caregiver knowledge of symptom management. If successful, it could substantially improve the quality of life of veterans and their families during the stresses of

  6. 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.

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

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    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.

  8. Shared Psychotic Disorder (Folie à Deux in Turkey

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    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

  9. [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

  10. Ocular symptoms reported by patients infested with Demodex mites.

    Science.gov (United States)

    Sędzikowska, Aleksandra; Osęka, Maciej; Grytner-Zięcina, Barbara

    2016-12-01

    The purpose of this study was to determine subjective ocular symptoms occurring in patients infested with Demodex. The number of Demodex mites in the obtained material that correlated with the appearance of ocular symptoms was estimated. The study material were eyelashes collected from 1499 patients. The material were observed under a light microscope. T-test, the logistic regression method, and Pearson correlation coefficient were used for the analysis. Demodex mites were detected in 47% patients. The mean ages of infected women and men were 64 and 59 years, respectively. 64% infected patients complained of one or more ophthalmological symptoms. The most commonly reported symptoms included itching (28%), redness of eyelids (21%), and watery eyes (15%). Positive correlation was found between itching, redness, pain, purulence or eyelash loss and the presence of Demodex. The mentioned symptoms increase the probability of Demodex infestation in a statistically significant manner (pDemodex was revealed by the study. The threshold average number of seven Demodex mites per eight collected eyelashes with which the risk of the occurrence of an ocular symptom increases significantly was defined. In patients with a low number of Demodex mites, symptoms may be absent. The risk of the occurrence of ocular symptom in patients with demodicosis increases with the increase in the average number of Demodex mites.

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

    Science.gov (United States)

    Wickham, Sophie; Bentall, Richard

    2016-08-01

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

  12. Neuropsychiatric symptoms in patients with thymoma- associated ...

    African Journals Online (AJOL)

    Symptoms of moderate or severe depression and anxiety were present in around 30%. ... scores and a tendency to suicidal behaviour. ... stabilised on immunosuppressive therapy and a thymectomy was ... The quantified MG score, recent thyroid studies, .... examining broader psychopathology, e.g. cognitive impairment,.

  13. 急性短暂精神病性障碍患者血清性激素水平%Serum levels of sex hormone in patients with acute and transient psychotic disorders

    Institute of Scientific and Technical Information of China (English)

    严辞; 苑杰

    2015-01-01

    目的:探讨急性而短暂的精神病性障碍患者血清性激素的水平。方法选择21例急性而短暂的精神病性障碍患者和21例健康对照为研究对象。采用放射免疫法分析测定其血清性激素水平并进行比较分析。结果无论男性组还是女性组血清催乳素水平与对照组相比均有升高,且有统计学意义(P <0.05)。结论急性而短暂的精神病性障碍患者具有性激素代谢紊乱的现象,其特点是血清催乳素水平升高,血清卵泡刺激素、黄体生成素、雌二醇水平正常。%Objective To investigate the serum levels of sex hormone in patients with acute and transient psychotic disorders .Methods 21 acute and transient psychotic disorders patients and 21 health‐y controls were enrolled .Their sex hormone levels were measured by radioimmunoassay .Results The prolactin levels with acute and transient psychotic disorders were significant higher than that of the nor‐mal controls in both men and women group (P< 0 .05) .Conclusions Sexual hormone disorders exist in patients with acute and transient psychotic disorders .Acute and transient psychotic disorders has higher prolactin level ,however ,the luteotropic hormone levels ,the follicle-stimulating hormone levels and the estradiol levelsare normal .

  14. Help-seeking Behaviors Among Caregivers of Schizophrenia and other Psychotic Patients: A Hospital-based Study in Two Geographically and Culturally Distinct Indian Cities

    Directory of Open Access Journals (Sweden)

    Sujit Kumar Naik

    2012-01-01

    Full Text Available Background: India is a country of several diversities and cultures, which may influence the help-seeking behavior of mentally ill patients and families. Only a few Indian studies have focused on help seeking, especially for severe mental disorders. Objective: The study aimed to describe and compare the help-seeking behaviors among caregivers of psychotic patients visiting psychiatric clinics at two distinct cities of India. Materials and Methods: This was a cross-sectional exploratory study of key caregivers (N=50 of patients with a DSM-IV TR diagnosis of schizophrenia and other psychotic disorders, visiting psychiatric out-patient departments of VIMHANS, New Delhi, and CIMS, Bilaspur, Chhattisgarh. After due informed consent was taken, a semi-structured proforma was administered for socio-demographic profile, illness details, causative beliefs, and information on help seeking. Results: Supernatural forces were held responsible by 40% of the Bilaspur sample in contrast to 8% in New Delhi sample. Faith-healers were initial contacts for 56% and 64% of sample, respectively, at New Delhi and Bilaspur. Faith-healers followed by a psychiatrist formed the commonest pathway of care at both centers (32% and 36%, respectively. The sample at New Delhi spent significantly more money (median: $4000 vs. $10 and traveled greater distances (median: 35 km vs. 10 km for faith-healers during the course of illness. Two-thirds of sample in New Delhi and one-third at Bilaspur were aware of the nearby psychiatrist at the time of initial help seeking; however, only 28% and 12%, respectively, chose psychiatrist as an initial contact. The New Delhi sample reported a fear of medication adverse effects and stigma as perceived disadvantages of psychiatric help. The median time lost at both the centers was 1 month, with a maximum of 8.4 years in New Delhi and 4.9 years in Bilaspur. Of the total, 16% caregivers at New Delhi and 32% at Bilaspur center reported an intention to

  15. Do asthma patients prefer to monitor symptoms or peak flow?

    Science.gov (United States)

    Harver, Andrew; Humphries, C Thomas; Kotses, Harry

    2009-11-01

    We administered a 65-item survey to patients to assess preference of symptoms and peak flow to detect worsening asthma and to collect information about asthma triggers, asthma knowledge sources, and barriers to peak flow meter use. It was completed by 139 asthma patients. Survey responses were comparable for adult and pediatric patients and for those who owned peak flow meters and those who did not. But patients who owned a peak flow meter reported more severe asthma than others. On average, the patients preferred symptoms to peak flow for assessing worsening asthma. It is likely that the preference for symptom over peak flow monitoring was effort related: Patients preferred symptom monitoring because it was the easier of the two to conduct.

  16. 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.

  17. A pioneer work on electric brain stimulation in psychotic patients. Rudolph Gottfried Arndt and his 1870s studies.

    Science.gov (United States)

    Steinberg, Holger

    2013-07-01

    Today's brain stimulation methods are commonly traced back historically to surgical brain operations. With this one-sided historical approach it is easy to overlook the fact that non-surgical electrical brain-stimulating applications preceded present-day therapies. The first study on transcranial electrical brain stimulation for the treatment of severe mental diseases in a larger group of patients was carried out in the 1870s. Between 1870 and 1878 German psychiatrist Rudolph Gottfried Arndt published the results of his studies in three reports. These are contextualized with contemporary developments of the time, focusing in particular on the (neuro-) sciences. As was common practice at the time, Arndt basically reported individual cases in which electricity was applied to treat severe psychoses with depressive symptoms or even catatonia, hypochondriac delusion and melancholia. Despite their lengthiness, there is frequently a lack of precise physical data on the application of psychological-psychopathological details. Only his 1878 report includes general rules for electrical brain stimulation. Despite their methodological shortcomings and lack of precise treatment data impeding exact understanding, Arndt's studies are pioneering works in the field of electric brain stimulation with psychoses and its positive impacts. Today's transcranial direct current stimulation, and partly vagus nerve stimulation, can be compared with Arndt's methods. Although Arndt's only tangible results were indications for the application of faradic electricity (for inactivity, stupor, weakness and manic depressions) and galvanic current (for affective disorders and psychoses), a historiography of present-day brain stimulation therapies should no longer neglect studies on electrotherapy published in German and international psychiatric and neurological journals and monographs in the 1870s and 1880s. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Severity of negative symptoms significantly affects cognitive functioning in patients with chronic schizophrenia: the slowing in cognitive processing

    Directory of Open Access Journals (Sweden)

    Flavia S. Galaverna

    2014-09-01

    Full Text Available Background and Objectives: Studies in patients with schizophrenia have shown a decreased overall cognitive performance, and it was found that processing speed and working memory functions are affected. The aim of this study was to describe the general cognitive performance of patients with chronic schizophrenia and analyze its relationship with the severity of psychotic symptoms. Methods: Forty-eight patients diagnosed with DSM IV-TR schizophrenia disorder were examined for symptom improvement, measured by scales SAPS and SANS. Participants also completed the full scale WAIS-III. Results: The results show a generalized cognitive deficit, reflected in the low level of general intelligence, as well as the different index that comprise the scale. The most compromised index was the processing speed. The correlations showed that the overall severity of negative symptoms significantly affects cognitive functioning of chronic patients. The formal thought disorder and alogia significantly correlated with almost all the WAIS-III measures. Conclusions: Multiple studies of specific cognitive domains in schizophrenia have shown that deficits in processing speed are the core element of cognitive impairment in schizophrenia. We support the hypothesis about the slowing in cognitive processing affect both the performance of the basic and more complex cognitive task.

  19. Cultural comparison of symptoms in patients on maintenance hemodialysis.

    Science.gov (United States)

    Weisbord, Steven D; Bossola, Maurizio; Fried, Linda F; Giungi, Stefania; Tazza, Luigi; Palevsky, Paul M; Arnold, Robert M; Luciani, Giovanna; Kimmel, Paul L

    2008-10-01

    Although symptoms are common and frequently severe in patients on maintenance hemodialysis, little is known about the relationship between cultural background and symptom burden. The aim of this study was to explore differences in the prevalence and severity of symptoms between American and Italian hemodialysis patients. We administered the 30-item Dialysis Symptom Index to American and Italian patients receiving maintenance hemodialysis during routine dialysis sessions. The prevalence and severity of individual symptoms were compared between patient populations, adjusting for multiple comparisons. Multivariable logistic regression and ordinal logistic regression were used to assess the independent associations of cultural background with the prevalence and severity of symptoms, respectively. We enrolled 75 American and 61 Italian patients. American patients were more likely to be black (36% vs. 0%, P<0.001) and diabetic (53% vs. 13%, P<0.001). Italian patients were more likely to report decreased interest in sex, decreased sexual arousal, feeling nervous, feeling irritable, and worrying (P<0.001, respectively). Adjustment for demographic and clinical variables had no impact on these cultural differences in symptom prevalence. The median severity of 11 symptoms including muscle soreness, muscle cramps, and itching was greater among Americans (P<0.001, respectively), although nearly all of these differences were rendered nonstatistically significant with adjustment for race, diabetes, and/or Kt/V. Italian patients receiving chronic hemodialysis report a greater burden of symptoms than American patients, particularly those related to sexual dysfunction and psychosocial distress. These findings suggest that cultural background may affect adaptation to chronic hemodialysis therapy.

  20. 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.

  1. Prevalence of lower urinary tract symptoms (LUTS) in stroke patients

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Gard, Gunvor; Klarskov, Peter

    2008-01-01

    AIMS: The aims of this study were primarily to investigate the prevalence, severity and impact on daily life of Lower Urinary Tract Symptoms (LUTS) in a clinical sample of stroke patients and secondly to identify factors associated with LUTS. MATERIALS AND METHODS: This was a cross-sectional, hos......AIMS: The aims of this study were primarily to investigate the prevalence, severity and impact on daily life of Lower Urinary Tract Symptoms (LUTS) in a clinical sample of stroke patients and secondly to identify factors associated with LUTS. MATERIALS AND METHODS: This was a cross......-sectional, hospital based survey whereby stroke patients were invited by letter to complete The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire at least 1 month following their stroke. Subjects were asked to report the frequency and severity of their symptoms (symptom score) and the impact of each symptom...... on their daily life (bother score) over the previous fortnight. Of 519 stroke patients invited, 482 subjects were eligible. RESULTS: The response rate was 84%. The period prevalence of at least one symptom was 94%; the most frequent symptom was nocturia (76%) followed by urgency (70%) and daytime frequency (59...

  2. Functional impairments as symptoms in the symptom cluster analysis of patients newly diagnosed with advanced cancer.

    Science.gov (United States)

    Fodeh, Samah J; Lazenby, Mark; Bai, Mei; Ercolano, Elizabeth; Murphy, Terrence; McCorkle, Ruth

    2013-10-01

    Symptoms and subsequent functional impairment have been associated with the biological processes of disease, including the interaction between disease and treatment in a measurement model of symptoms. However, hitherto cluster analysis has primarily focused on symptoms. This study among patients within 100 days of diagnosis with advanced cancer explored whether self-reported physical symptoms and functional impairments formed clusters at the time of diagnosis. We applied cluster analysis to self-reported symptoms and activities of daily living of 111 patients newly diagnosed with advanced gastrointestinal (GI), gynecological, head and neck, and lung cancers. Based on content expert evaluations, the best techniques and variables were identified, yielding the best solution. The best cluster solution used a K-means algorithm and cosine similarity and yielded five clusters of physical as well as emotional symptoms and functional impairments. Cancer site formed the predominant organizing principle of composition for each cluster. The top five symptoms and functional impairments in each cluster were Cluster 1 (GI): outlook, insomnia, appearance, concentration, and eating/feeding; Cluster 2 (GI): appetite, bowel, insomnia, eating/feeding, and appearance; Cluster 3 (gynecological): nausea, insomnia, eating/feeding, concentration, and pain; Cluster 4 (head and neck): dressing, eating/feeding, bathing, toileting, and walking; and Cluster 5 (lung): cough, walking, eating/feeding, breathing, and insomnia. Functional impairments in patients newly diagnosed with late-stage cancers behave as symptoms during the diagnostic phase. Health care providers need to expand their assessments to include both symptoms and functional impairments. Early recognition of functional changes may accelerate diagnosis at an earlier cancer stage. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  3. 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.

  4. 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...

  5. Gastrointestinal symptoms and weight loss in cancer patients receiving chemotherapy.

    Science.gov (United States)

    Sánchez-Lara, Karla; Ugalde-Morales, Emilio; Motola-Kuba, Daniel; Green, Dan

    2013-03-14

    Cancer patients receiving chemotherapy have a high risk of malnutrition secondary to the disease and treatment, and 40-80 % of cancer patients suffer from different degrees of malnutrition, depending on tumour subtype, location, staging and treatment strategy. Malnutrition in cancer patients affects the patient's overall condition, and it increases the number of complications, the adverse effects of chemotherapy and reduces the quality of life. The aim of the present study was to evaluate weight-loss prevalence depending on the tumour site and the gastrointestinal (GI) symptoms of oncology patients receiving chemotherapy. We included 191 cancer patients receiving chemotherapy. Files of all patients were reviewed to identify symptoms that might potentially influence weight loss. The nutritional status of all patients was also determined. The cancer sites in the patients were as follows: breast (31·9 %); non-colorectal GI (18·3 %); colorectal (10·4 %); lung (5·8 %); haematological (13·1 %); others (20·5 %). Of these patients, 58 % experienced some degree of weight loss, and its prevalence was higher among the non-colorectal GI and lung cancer patients. Common symptoms included nausea (59·6 %), anorexia (46 %) and constipation (31·9 %). A higher proportion of patients with ≥ 5 % weight loss experienced anorexia, nausea and vomiting (OR 9·5, 2·15 and 6·1, respectively). In conclusion, these results indicate that GI symptoms can influence weight loss in cancer patients, and they should be included in early nutritional evaluations.

  6. Prevalence of symptoms of depression among patients with chronic ...

    African Journals Online (AJOL)

    chronic kidney disease (CKD) and these include depression, dementia ..... mortality among patients hospitalized with congestive heart failure. Am J ... quality of life, depressive symptoms, anemia, and malnutrition at hemodialysis initiation.

  7. Initial symptoms and delay in patients with penile carcinoma.

    Science.gov (United States)

    Skeppner, Elisabet; Andersson, Swen-Olof; Johansson, Jan-Erik; Windahl, Torgny

    2012-10-01

    This study aimed to assess initial symptoms and factors associated with patients' and doctors' delay in penile carcinoma. Fifty consecutive patients with penile carcinoma treated with an organ-sparing technique and nine with partial amputation were enrolled in a prospective study at the Department of Urology, Örebro University Hospital, between 2005 and 2009. Face-to-face structured interviews in combination with self-assessment forms were used for the patients' descriptions of clinical symptoms, treatment seeking and reasons for delay. Data were also extracted from the medical records confirming time-lag between GP assessment, specialist care and time for diagnosis. Erythema, rash and eczema were the most common initial symptoms (35%). In total, 65% had a patients' delay of more than 6 months, and among these there was a small, but not statistically significant, predominance for pT1 and pTis tumours. Living with a stable partner did not affect the delay. The most common reason for patients' delay was the feeling of embarrassment over symptoms localized in a sexual body area. Nine patients had a doctors' delay of more than 3 months from first special visit to diagnosis. Eight of these patients consulted dermatologists and were subjected to repeated biopsies, leaving premalignant results. A considerable proportion of the patients had a patients' delay of more than 6 months, perhaps due to benign initial symptoms as erythema, rash or eczema. Psychological factors such as embarrassment and denial may also be involved, as well as insufficient awareness or knowledge.

  8. Patient with neuropsychiatric symptoms and insulinoma of difficult preoperative localization

    Directory of Open Access Journals (Sweden)

    Angélica María González-Clavijo

    2014-10-01

    Full Text Available This paper describes the case of a patient with neuropsychiatric symptoms who was diagnosed with hyperinsulinemic hypoglycemia with high suspicion of insulinoma, even after conventional diagnostic imaging was unable to locate it. A selective angiography of the pancreatic arteries and a calcium stimulation test were conducted to determine its location. The patient underwent a distal pancreatectomy using an intraoperative ultrasound, resulting in the disappearance of her symptoms.

  9. Genetic association between APOE*4 and neuropsychiatric symptoms in patients with probable Alzheimer's disease is dependent on the psychosis phenotype

    Directory of Open Access Journals (Sweden)

    Christie Drew

    2012-12-01

    Full Text Available Abstract Background Neuropsychiatric symptoms such as psychosis are prevalent in patients with probable Alzheimer’s disease (AD and are associated with increased morbidity and mortality. Because these disabling symptoms are generally not well tolerated by caregivers, patients with these symptoms tend to be institutionalized earlier than patients without them. The identification of protective and risk factors for neuropsychiatric symptoms in AD would facilitate the development of more specific treatments for these symptoms and thereby decrease morbidity and mortality in AD. The E4 allele of the apolipoprotein E (APOE gene is a well-documented risk factor for the development of AD. However, genetic association studies of the APOE 4 allele and BPS in AD have produced conflicting findings. Methods This study investigates the association between APOE and neuropsychiatric symptoms in a large sample of clinically well-characterized subjects with probable AD (n=790 who were systematically evaluated using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD Behavioral Rating Scale for Dementia (BRSD. Results Our study found that hallucinations were significantly more likely to occur in subjects with no APOΕ4 alleles than in subjects with two Ε4 alleles (15% of subjects and 5% of subjects, respectively; p=.0066, whereas there was no association between the occurrence of delusions, aberrant motor behavior, or agitation and the number of Ε4 alleles. However, 94% of the subjects with hallucinations also had delusions (D+H. Conclusion These findings suggest that in AD the Ε4 allele is differentially associated with D+H but not delusions alone. This is consistent with the hypothesis that distinct psychotic subphenotypes may be associated with the APOE allele.

  10. Antipsychotic drugs attenuate aberrant DNA methylation of DTNBP1 (dysbindin) promoter in saliva and post-mortem brain of patients with schizophrenia and Psychotic bipolar disorder.

    Science.gov (United States)

    Abdolmaleky, Hamid M; Pajouhanfar, Sara; Faghankhani, Masoomeh; Joghataei, Mohammad Taghi; Mostafavi, Ashraf; Thiagalingam, Sam

    2015-12-01

    Due to the lack of genetic association between individual genes and schizophrenia (SCZ) pathogenesis, the current consensus is to consider both genetic and epigenetic alterations. Here, we report the examination of DNA methylation status of DTNBP1 promoter region, one of the most credible candidate genes affected in SCZ, assayed in saliva and post-mortem brain samples. The Illumina DNA methylation profiling and bisulfite sequencing of representative samples were used to identify methylation status of the DTNBP1 promoter region. Quantitative methylation specific PCR (qMSP) was employed to assess methylation of DTNBP1 promoter CpGs flanking a SP1 binding site in the saliva of SCZ patients, their first-degree relatives and control subjects (30, 15, and 30/group, respectively) as well as in post-mortem brains of patients with SCZ and bipolar disorder (BD) versus controls (35/group). qRT-PCR was used to assess DTNBP1 expression. We found DNA hypermethylation of DTNBP1 promoter in the saliva of SCZ patients (∼12.5%, P = 0.036), particularly in drug-naïve patients (∼20%, P = 0.011), and a trend toward hypermethylation in their first-degree relatives (P = 0.085) versus controls. Analysis of post-mortem brain samples revealed an inverse correlation between DTNBP1 methylation and expression, and normalization of this epigenetic change by classic antipsychotic drugs. Additionally, BD patients with psychotic depression exhibited higher degree of methylation versus other BD patients (∼80%, P = 0.025). DTNBP1 promoter DNA methylation may become a key element in a panel of biomarkers for diagnosis, prevention, or therapy in SCZ and at risk individuals pending confirmatory studies with larger sample sizes to attain a higher degree of significance.

  11. Family Functioning in First-Episode and Chronic Psychosis: The Role of Patient's Symptom Severity and Psychosocial Functioning.

    Science.gov (United States)

    Koutra, Katerina; Triliva, Sofia; Roumeliotaki, Theano; Basta, Maria; Lionis, Christos; Vgontzas, Alexandros N

    2016-08-01

    The aim of the present study was to assess the relationship between illness-related characteristics, such as symptom severity and psychosocial functioning, and specific aspects of family functioning both in patients experiencing their first episode of psychosis (FEP) and chronically ill patients. A total of 50 FEP and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) and their family caregivers participated in the study. Family functioning was evaluated in terms of cohesion and flexibility (FACES IV Package), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Patients' symptom severity (BPRS) and psychosocial functioning (GAS) were assessed by their treating psychiatrist within 2 weeks from the caregivers' assessment. Increased symptom severity was associated with greater dysfunction in terms of family cohesion and flexibility (β coefficient -0.13; 95 % CI -0.23, -0.03), increased caregivers' EE levels on the form of emotional overinvolvement (β coefficient 1.03; 95 % CI 0.02, 2.03), and psychological distress (β coefficient 3.37; 95 % CI 1.29, 5.45). Family burden was found to be significantly related to both symptom severity (β coefficient 3.01; 95 % CI 1.50, 4.51) and patient's functioning (β coefficient -2.04; 95 % CI -3.55, -0.53). No significant interaction effect of chronicity was observed in the afore-mentioned associations. These findings indicate that severe psychopathology and patient's low psychosocial functioning are associated with poor family functioning. It appears that the effect for family function is significant from the early stages of the illness. Thus, early psychoeducational interventions should focus on patients with severe symptomatology and impaired functioning and their families.

  12. Executive function does not predict coping with symptoms in stable patients with a diagnosis of schizophrenia

    Directory of Open Access Journals (Sweden)

    Walraven Wil

    2008-05-01

    Full Text Available Abstract Background Associations between coping with and control over psychotic symptoms were examined using the Maastricht Assessment of Coping Strategies-24, testing the hypothesis that the cognitive domain of executive functioning predicted quality and quantity of coping. Methods MACS-24 was administered to 32 individuals with a diagnosis of schizophrenia. For each of 24 symptoms, experience of distress, type of coping and the resulting degree of perceived control were assessed. Coping types were reduced to two contrasting coping categories: symptomatic coping (SC and non-symptomatic coping (NSC; combining active problem solving, passive illness behaviour, active problem avoiding, and passive problem avoiding. Cognitive functioning was assessed using the GIT (Groninger Intelligence Test, the Zoo map (BADS: Behavioural Assessment of Dysexecutive function, Stroop-test and Trail making. Results Cognitive function was not associated with frequency of coping, nor did cognitive function differentially predict SC or NSC. Cognitive function similarly was not associated with symptom distress or level of perceived control over the symptom. Conclusion There was no evidence that cognitive function predicts quantity or quality of coping with symptoms in people with a diagnosis of schizophrenia. Variation in the realm of emotion regulation and social cognition may be more predictive of coping with psychotic symptoms.

  13. Evaluation of the symptoms and treatment prescribed to hospitalized patients

    Directory of Open Access Journals (Sweden)

    Mariana da Silva Roldi

    Full Text Available Summary Objective: Evaluation of the presence of symptoms and suitability in the treatment of patients admitted to medical wards at HU-UFSC. Identification of patients eligible for palliative care (PC. Method: A prospective cohort study, which evaluated patients in the first 48 hours of hospitalization (D1 and after 48 hours (D2. On D1, palliative performance and symptom assessment scales were applied (PPS/ESAS. The treatment established for the control of detected symptoms was also identified. On D2, the ESAS scale was applied again, and the medical prescription reviewed. When the presence of severe symptoms was found, the attending physician was informed. Patients who presented PPS≤60 were eligible for PC prioritization. For statistical analysis Student’s t and χ2 tests were used. Results: 168 patients were studied. Of these, 26.8% had PPS≤60. PC was described in one medical chart. Patients with mild symptoms reported significant worsening in the second evaluation, especially worsening in pain (32.3% and well-being (49.3%. Symptoms considered severe showed significant improvement. There was no control of pain reported as moderate. Prescriptions for pain control were predominantly “if necessary”, prevailing the use of non-opioid analgesics and weak opioids. The attending physician was informed of 116 (69% patients with ESAS score≥4. Conclusion: The control of symptoms, especially those considered mild, was unsatisfactory. Drug prescription was inadequate to control pain, and non-existent for some reported symptoms. There was no adequate prioritization of PC. There is a need for optimization and dissemination of PC among health professionals.

  14. 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.

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

    Science.gov (United States)

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

    2011-09-30

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

  16. Measuring negative symptoms in patients with schizophrenia: reliability and validity of the Korean version of the Motivation and Pleasure Scale-Self-Report

    Directory of Open Access Journals (Sweden)

    Kim JS

    2016-05-01

    Full Text Available Ji-Sun Kim,1 Seon-Kyeong Jang,1 Seon-Cheol Park,2 Jung-Seo Yi,3 Joong-Kyu Park,4 Jung Suk Lee,5 Kee-Hong Choi,6 Seung-Hwan Lee1,7 1Clinical Emotion and Cognition Research Laboratory, Goyang, 2Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, 3Department of Psychiatry, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, 4Department of Rehabilitation Psychology, Daegu University, Daegu, 5Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, 6Department of Psychology, Korea University, Seoul, 7Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea Background: The Clinical Assessment Interview for Negative Symptoms (CAINS is one of the validated interview measures of negative symptoms in psychotic disorders. The Motivation and Pleasure Scale-Self-Report (MPSR is a self-report measure that assesses the motivation and pleasure domains of negative symptoms based on the CAINS. This study evaluated the reliability and validity of a Korean version of the MPSR.Methods: A total of 139 patients with schizophrenia completed the MPSR, CAINS, Scale for the Assessment of Negative Symptoms (SANS, Brief Psychiatric Rating Scales, Calgary Depression Scale for Schizophrenia, and other measures of trait and cognitive function.Results: The 15-item MPSR showed good internal consistency. In addition, it also had a good convergent validity with the Motivation and Pleasure subscale of the CAINS and the anhedonia/avolition subscale of the SANS. The scale was not associated with psychotic symptoms, agitation/mania, and depression/anxiety, and it showed good discriminant validity. MPSR scores were significantly correlated with Behavioral Activation System total score for trait measure.Conclusion: The Korean version of the MPSR is a notable self-report method for examining the severity of negative symptoms in schizophrenia. Keywords: Korean

  17. Personality traits in established schizophrenia: aspects of usability and differences between patients and controls using the Swedish universities Scales of Personality

    OpenAIRE

    2016-01-01

    Abstract Background: Personality is considered as an important aspect that can affect symptoms and social function in persons with schizophrenia. The personality questionnaire Swedish universities Scales of Personality (SSP) has not previously been used in psychotic disorder. Aims: To investigate if SSP has a similar internal consistency and factor structure in a psychosis population as among healthy controls and if patients with psychotic disorders differ from non-psychotic individuals in th...

  18. 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.

  19. Studying the Physical and Psychological Symptoms of Patients With Cancer

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    Memnun Seven

    2013-06-01

    Full Text Available Objectives; Aim of the descriptive study was to evaluate the frequency and severity of physical and psychological symptoms so as to determine palliative care needs of cancer patients. Methods; Total 142 patients who were treated in oncology clinic at an university hospital were enrolled in the cross sectional research. “Descriptive Information Questionnaire” was developed by the authors and the adapted “Beck Depression Inventory (BAI” and “Beck Anxiety Inventory (BDI”, “Edmonton Symptom Assessment System (ESAS” to evaluate psychological and physical symptoms were used to collect data. Results; The mean age was 49,35±36,61 years and 54.9% of them were out-patients. %16.2 of the patients were diagnosed with colon and 13.4% breast cancer. The mean BDI score was 8.59±6.36, and 88.7% the patients have depressive symptoms. The mean BAI score was 11.39±7.53. The three most frequent problems were fatigue (87.3%, breathlessness (76.1%, and insomnia (67.6%. The mean of the highest-ranking problems were anorexia (6.02+2.77, fatigue (5.33+2.09 and insomnia (0.04+2.42. Conclusion: The study shows that some symptoms might be experienced by majority of the cancer patients as well as some symptoms might be felt more severe by fewer patients. Therefore, It should be assessed that both the frequency and severity of symptoms that patients experienced associated with cancer and its’ treatment individually and focusing on primary care. [TAF Prev Med Bull 2013; 12(3.000: 219-224

  20. [Symptom Clusters in Korean Patients with Acute Myocardial Infarction].

    Science.gov (United States)

    Park, Eunjin; Lee, Jia

    2015-06-01

    Acute myocardial infarction (AMI) leads to death if the patient does not receive emergency treatment. Thus it is very important to recognize the symptoms in the early stage. The purpose of this study was to identify clusters of symptoms that represent AMI in Koreans. The study used a retrospective, descriptive design with secondary data analysis. Data were abstracted from 725 medical records of AMI patients admitted from June 1, 2006 to August 15, 2014 at a university hospital. Analysis of the AMI symptoms revealed five symptom clusters; Cluster 1 (n=140): middle chest pain (100%), shortness of breath, and cold sweating, Cluster 2 (n=256): substernal pain (100%), cold sweating, and shortness of breath, Cluster 3 (n=47): substernal pain (95.7%), left arm pain, shortness of breath, cold sweating, left shoulder pain, right arm pain, and the lower neck pain, Cluster 4 (n=212): shortness of breath (28.3%), left chest pain, and upper abdominal pain, and Cluster 5 (n=70): cold sweating (100%), left chest pain, shortness of breath, left shoulder pain, and upper abdominal pain. Length of hospital stay and mortality rate were significantly different according to symptom clusters (F=2.52, p=.040; F=3.62, p=.006, respectively). Symptom clusters of AMI from this study can be used for AMI patients in order to recognize their symptoms at an early stage. The study findings should be considered when developing educational prevention programs for Koreans with AMI.

  1. Anxiety and depression symptoms in patients with dengue fever and their correlation with symptom severity.

    Science.gov (United States)

    Hashmi, Ali M; Butt, Zeeshan; Idrees, Zaidan; Niazi, Mehreen; Yousaf, Zohaib; Haider, Syed Furqan; Bhatti, Muhammad R

    2012-01-01

    To study the prevalence of anxiety and depression symptoms in patients with dengue and to examine their correlation with symptom severity. In this cross sectional study, 531 consecutive patients who met the World Health Organization criteria for dengue fever admitted to Mayo Hospital, Lahore between September and November 2011 were administered the Hospital Anxiety and Depression Scale (HADS). In addition to the HADS, the severity of their symptoms, like headache, myalgias/arthralgias, fever, and retro/periorbital pain, was assessed on a 3-point scale (mild, moderate, and severe). About 60% of the patients in our study met the criteria for anxiety and 62.2% of the patients met criteria for depression. Severity of fever, headache, myalgias and arthralgias, and retro/periorbital pain was positively correlated with both anxiety (Correlation coefficients: 0.148, 0.247, 0.184, 0.184 respectively and P dengue have anxiety and depression symptoms. Psychiatric evaluation should be done in all Dengue patients so timely treatment can be initiated.

  2. Genetic and Environmental Determinants of Cognitive Dysfunction and Psychotic-Like Experiences in Neuropsychiatric Patients and Healthy Individuals

    NARCIS (Netherlands)

    Vreeker, A.

    2015-01-01

    Background: Bipolar disorder and schizophrenia are severe neuropsychiatric disorders that are highly heritable. Although both disorders partly share clinical characteristics, it is unclear whether bipolar disorder patients have similar lower IQ as that observed in schizophrenia patients. In the firs

  3. Pain Symptoms in Fibromyalgia Patients with and without Provoked Vulvodynia

    Directory of Open Access Journals (Sweden)

    Anna Ghizzani

    2014-01-01

    Full Text Available Objective. The aim of the study was to compare the pain symptoms of fibromyalgia patients exhibiting (FMS+PVD and not exhibiting (FMS comorbidity with provoked vulvodynia. Study Design. The case control study was performed in 39 patients who had been diagnosed with FMS and accepted to undergo gynaecological examination and in 36 healthy women (C. All patients completed standardized questionnaires for pain intensity, pain area, and psychological functioning. The gynaecological examination included vulvar pain pressure reactivity (Q-tip, pelvic tone assessment (Kegel manoeuver, and a semistructured interview collecting detailed information about pelvic symptoms and sexual function. Results. FMS+PVD patients displayed a higher number of associated symptoms than FMS patients. The vulvar excitability was significantly higher in FMS+PVD than in FMS and in both groups than in Controls. Half of FMS+PVD patients were positive to Kegel manoeuver and displayed higher scores in widespread pain intensity, STAI-Y2, and CESD levels than Kegel negative patients. Conclusions. The study reveals that increased vulvar pain excitability may occur in FMS patients independently of the presence of coital pain. Results suggest that coital pain develops in patients with higher FMS symptoms severity due to the cooperative effects of peripheral and central sensitization mechanisms.

  4. Lower subjective quality of life and the development of social anxiety symptoms after the discharge of elderly patients with remitted schizophrenia: a 5-year longitudinal study.

    Science.gov (United States)

    Kumazaki, Hirokazu; Kobayashi, Hiroyuki; Niimura, Hidehito; Kobayashi, Yasushi; Ito, Shinya; Nemoto, Takahiro; Sakuma, Kei; Kashima, Haruo; Mizuno, Masafumi

    2012-10-01

    Remitted schizophrenic patients living in the community often encounter difficulties in their daily lives, possibly leading to the development of social anxiety symptoms. Although several studies have reported the significance of social anxiety as a comorbidity in patients with schizophrenia, few longitudinal data are available on the development of social anxiety symptoms in patients with remitted schizophrenia, especially in association with the process of "deinstitutionalization." The aims of this study were to assess the social anxiety symptoms in remitted outpatients with schizophrenia and to examine whether the development of social anxiety symptoms was associated with psychotic symptoms, social functioning, or subjective quality of life. Fifty-six people with schizophrenia who were discharged through a deinstitutionalization project were enrolled in this longitudinal study and prospectively assessed with regard to their symptoms, social functioning, and subjective quality of life. The severity of social anxiety symptoms was measured using the Liebowitz Social Anxiety Scale (LSAS). Global/Social functioning and subjective quality of life were evaluated using the Global Assessment of Functioning Scale, the Social Functioning Scale, and the World Health Organization-Quality of Life 26 (WHO-QOL26). Thirty-six patients completed the reassessment at the end of the 5-year follow-up period. The mean LSAS total score worsened over time, whereas other symptoms improved from the baseline. The mean WHO-QOL26 score in the worsened LSAS group was significantly lower than that in the stable LSAS group. At baseline, WHO-QOL26 scores were associated with an increase in the severity of social anxiety symptoms. In community-dwelling patients with remitted schizophrenia, a lower subjective quality of life might lead to the development of social anxiety symptoms, both concurrently and prospectively. To achieve a complete functional recovery, additional interventions for social

  5. Prevalence of anxiety and depressive symptoms among patients with hypothyroidism

    Directory of Open Access Journals (Sweden)

    Manish Bathla

    2016-01-01

    Full Text Available Context: The association between depression and thyroid function is well known. Both conditions express many similar symptoms, thus making the diagnosis and treatment difficult. Aims: To find the prevalence of anxiety and depressive symptoms among patients with hypothyroid. Settings and Design: Cross-sectional study. Materials and Methodology: A total of 100 patients diagnosed as hypothyroidism were evaluated using Hamilton depression rating scale (HDRS and Hamilton scale for anxiety (HAM-A. Statistical Analysis Used: The data were analyzed using the SPSS for Windows version 17.0 software. The quantitative data were expressed in number and percentage. The results obtained were compared using the Chi-square test. Results: Females constituted 70% of the sample. A total of 60% reported some degree of depression based on HDRS (males – 56.63% and females – 64.29% whereas about 63% out of the total patients screened showed some degree of anxiety (males –56.66% and females – 65.72% based on HAM-A. The most common depressive symptom among the males was depressed mood (73.33% and among females was gastrointestinal somatic symptoms (68.54%. The most common anxiety symptom among the males was depressed mood (70.0% and among females was anxious mood (92.85%. Conclusions: Psychiatric symptoms/disorders are common in patients with thyroid dysfunction.

  6. 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.

  7. 急性而短暂的精神病性障碍患者的探究性眼球轨迹运动%Exploratory eye tracking movement in patients with acute and transient psychotic disorders

    Institute of Scientific and Technical Information of China (English)

    邱琳琳; 朱日升; 韩永华; 张岱

    2011-01-01

    目的:研究急性而短暂的精神病性障碍(ATPD)患者探究性眼球轨迹运动及其对疾病转归的临床意义.方法:对符合国际疾病和相关健康问题统计分类第十版( ICD-10)诊断标准的来自病房或门诊的34例ATPD患者、33例精神分裂症患者及29例正常对照进行探究性眼球轨迹运动检查并分析眼动参数.三组受试年龄、性别和受教育程度均匹配.用阳性和阴性症状量表( PANSS)评定患者的精神症状.ATPD患者在入组时及入组1个月后各行1次眼动检查,另外两组均行1次眼动检查.对ATPD患者进行随访以了解诊断变化.结果:ATPD患者眼动参数反应性探究分、认知性探究分均低于正常对照(P<0.05),判别分析(discriminant analysis,D分)值高于正常对照.经至少1个月随访,18例ATPD患者改诊为精神分裂症,其中首次D分值为正分占72.22%;这18例患者首次D分值高于正常对照和16例改诊为其他精神障碍者(P<0.05),而与精神分裂症患者差异无统计学意义.结论:急性而短暂的精神病性障碍患者探究性眼球轨迹运动存在异常;判别分析值正分可能为急性而短暂的精神病性障碍转归为精神分裂症提供一种有价值的预测指标.%Objective:To investigate the characteristics of exploratory eye tracking movement in patients with acute and transient psychotic disorders (ATPD) and assess its clinical significance. Methods: Thirty-four patients with ATPD and 33 schizophrenic patients diagnosed according to the International Classification of Diseases and Related Health Problem, Tenth Revision (ICD-10) criteria, and 29 healthy controls were tested for exploratory eye tracking movement Parameters of exploratory eye tracking movement were analyzed subsequently. The groups were matched in age, gender and education. Symptoms of each patient were accessed with the Positive and Negative Syndrome Scale. The exploratory eye tracking movement in ATPD group was

  8. 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.

  9. 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.

  10. Correlation of Visual Prostate Symptom Score with International Prostate Symptom Score and Uroflowmetry Parameters in Nepalese Male Patients with Lower Urinary Tract Symptoms.

    Science.gov (United States)

    Bhomi, K K; Subedi, N; Panta, P P

    2017-01-01

    International prostate symptom score is a validated questionnaire used to evaluate the lower urinary tract symptoms in benign prostatic hyperplasia. Visual prostate symptom score is a new simplified symptom score with pictograms to evaluate the same. We evaluated the correlation of visual prostate symptom score with international prostate symptom score and uroflowmetry parameters in Nepalese male patients with lower urinary tract symptoms. Male patients aged ≥40 years attending the Urology clinic were enrolled in the study. They were given international prostate symptom score and visual prostate symptom score questionnaires to complete providing assistance whenever needed. Demographic data, examination findings and uroflowmetry parameters were noted. Correlation and regression analysis was used to identify correlation of the two scoring systems and uroflowmetry parameters. Among the 66 patients enrolled, only 10 (15.15%) patients were able to understand English language. There was a statistically significant correlation between total visual prostate symptom score and international prostate symptom score (r= 0.822; Pcorrelations between individual scores of the two scoring systems related to force of urinary stream, frequency, nocturia and quality of life were also statistically significant. There was also a statistically significant correlation of both scores with maximum flow rate and average flow rate. There is a statistically significant correlation of visual prostate symptom score with international prostate symptom score and uroflowmetry parameters. IPSS can be replaced with simple VPSS in evaluation of lower urinary tract symptoms in elderly male patients.

  11. Patients with Paranoid Symptoms: Considerations for the Optometrist

    Directory of Open Access Journals (Sweden)

    Mark Bampton, MS

    2013-05-01

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

  12. Symptoms in patients with takotsubo syndrome: a qualitative interview study

    Science.gov (United States)

    Ulin, Kerstin; Omerovic, Elmir; Ekman, Inger

    2016-01-01

    Objective The aim of the study was to investigate the meaning of narrated symptoms in connection to takotsubo syndrome. Design, method, participants and setting Qualitative study consisting of 25 interviews, 23 women and 2 men aged 39–84 and living in Region Västra Götaland, Sweden. The transcribed text was analysed with phenomenological hermeneutics. Results The interviewees reported a large number of symptoms before, during and after the acute onset of takotsubo syndrome, including pain, affected breathing, lassitude, malaise and nausea. Several of these have not been reported previously. Symptoms before the acute onset were, even if they had been prominent, ignored by the interviewees for various reasons. During the acute phase, the symptoms could no longer be ignored and the interviewees sought healthcare. The remaining residual symptom after discharge from hospital caused a great deal of worry because the interviewees feared that they would be permanent and they felt they could not live this way. On the whole, becoming ill and having a large number of symptoms greatly impacted the lives of the interviewees and made them re-evaluate how they had been living. Furthermore, they reported feeling alone and lost regarding their symptom burden, especially in relation to their residual symptoms, which affected their health and ability to return to daily life. Conclusions Acute symptoms, and symptoms before and after the acute ones, are a major part of the illness experience for patients with takotsubo syndrome and affect their health and well-being. Assessment of symptoms should be an integrated part of care to promote health. One way of achieving this is through the patients’ own narratives of their experiences, which are an important component in person-centred care. PMID:27707826

  13. 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...

  14. Symptom dimensions of affective disorders in migraine patients

    NARCIS (Netherlands)

    Louter, M. A.; Pijpers, J. A.; Wardenaar, K. J.; van Zwet, E. W.; van Hemert, A. M.; Zitman, F. G.; Ferrari, M. D.; Penninx, B. W.; Tervvindt, G. M.

    2015-01-01

    Objective: A strong association has been established between migraine and depression. However, this is the first study to differentiate in a large sample of migraine patients for symptom dimensions of the affective disorder spectrum. Methods: Migraine patients (n = 3174) from the LUMINA (Leiden Univ

  15. Deficits of social-cognitive and social-perceptual aspects of theory of mind in remitted patients with schizophrenia: effect of residual symptoms.

    Science.gov (United States)

    Bora, Emre; Gökçen, Sezen; Kayahan, Bülent; Veznedaroglu, Baybars

    2008-02-01

    Although ToM deficit in schizophrenia is widely accepted, findings regarding remitted schizophrenia patients are contradictory. Because residual symptoms are present out of psychotic exacerbation periods, the differences between definition of remission may be important to interpret these findings. The purpose of this study was to investigate the relationship between performance of 2 different aspects of theory of mind (ToM) and residual clinical symptoms and other cognitive deficits in schizophrenia. Ninety-one stable outpatients with schizophrenia and 55 healthy controls were assessed with a neuropsychological battery. Both social-cognitive and social-perceptual aspects of ToM were impaired in schizophrenia, even in patients who were totally free of residual symptoms. Still, the results showed that ToM deficit is related to residual symptoms of schizophrenia. Social-cognitive ToM abilities seem to be related to both positive and negative symptoms. The ToM deficits of fully remitted patients without persistent negative symptoms may be secondary to a more general cognitive dysfunction in schizophrenia.

  16. Rectal Sensitivity in Diabetes Patients with Symptoms of Gastroparesis

    Directory of Open Access Journals (Sweden)

    Eirik Søfteland

    2014-01-01

    Full Text Available In a clinical setting, diabetic autonomic complications (cardiac, gastrointestinal, urogenital, etc. are often handled as separate entities. We investigated rectal sensitivity to heat, mechanical distension, and electrical stimulations in 20 patients with diabetes and symptoms of gastroparesis, to evaluate the extent of visceral neuronal damage. Furthermore, to evaluate the relation between the nervous structures we examined gastric emptying and cardiac autonomic function with the hypothesis being an association between these. We found that 60% of patients had delayed gastric empting. Rectal hyposensitivity was a general finding as they tolerated 67% higher thermal, 42% more mechanical, and 33% higher electrical current intensity compared to healthy controls. In patients, most heart rate variability parameters were reduced; they reported significantly more gastrointestinal symptoms and a reduced quality of life in all SF-36 domains. Shortened RR interval correlated with reduced rectal temperature sensitivity, and gastric retention rate was negatively associated with symptoms of nausea and vomiting. To conclude, in these patients with signs and symptoms of diabetic gastroparesis, rectal sensitivity was reduced, and heart rate variability was impaired. Thus, we suggest regarding diabetic autonomic neuropathy as a diffuse disorder. Symptoms of widespread autonomic dysfunction and sensory disorders should be expected and treated in these patients.

  17. 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.

  18. 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.

  19. Symptom cluster analyses based on symptom occurrence and severity ratings among pediatric oncology patients during myelosuppressive chemotherapy.

    Science.gov (United States)

    Baggott, Christina; Cooper, Bruce A; Marina, Neyssa; Matthay, Katherine K; Miaskowski, Christine

    2012-01-01

    Symptom cluster research is an emerging field in symptom management. The ability to identify symptom clusters that are specific to pediatric oncology patients may lead to improved understanding of symptoms' underlying mechanisms among patients of all ages. The purpose of this study, in a sample of children and adolescents with cancer who underwent a cycle of myelosuppressive chemotherapy, was to compare the number and types of symptom clusters identified using patients' ratings of symptom occurrence and symptom severity. Children and adolescents with cancer (10-18 years of age; N = 131) completed the Memorial Symptom Assessment Scale 10-18 on the day they started a cycle of myelosuppressive chemotherapy, using a 1-week recall of experiences. Symptom data based on occurrence and severity ratings were examined using exploratory factor analysis. The defined measurement model suggested by the best exploratory factor analysis model was then examined with a latent variable analysis. Three clusters were identified when symptom occurrence ratings were evaluated, which were classified as a chemotherapy sequela cluster, mood disturbance cluster, and a neuropsychological discomfort cluster. Analysis of symptom severity ratings yielded similar cluster configurations. Cluster configurations remained relatively stable between symptom occurrence and severity ratings. The evaluation of patients at a common point in the chemotherapy cycle may have contributed to these findings. Additional uniformity in symptom clusters investigations is needed to allow appropriate comparisons among studies. The dissemination of symptom cluster research methodology through publication and presentation may promote uniformity in this field.

  20. Course of illness in a sample of 265 patients with first-episode psychosis--five-year follow-up of the Danish OPUS trial

    DEFF Research Database (Denmark)

    Bertelsen, Mette; Jeppesen, Pia; Petersen, Lone;

    2009-01-01

    -sample of the OPUS trial of 265 first-episode psychotic patients after five years. Recovery, defined as no psychotic or negative symptoms, living independently, GAF (f)>59, working or studying, was reached for 18% after five years, whereas 13% were institutionalized either at hospital or supported housing after five...

  1. Clinical symptoms and risk factors in cerebral microangiopathy patients.

    Directory of Open Access Journals (Sweden)

    Sandra Okroglic

    Full Text Available OBJECTIVE: Although the clinical manifestation and risk factors of cerebral microangiopathy (CM remain unclear, the number of diagnoses is increasing. Hence, patterns of association among lesion topography and severity, clinical symptoms and demographic and disease risk factors were investigated retrospectively in a cohort of CM patients. METHODS: Patients treated at the Department of Neurology, University of Bonn for CM (n = 223; 98m, 125f; aged 77.32±9.09 from 2005 to 2010 were retrospectively enrolled. Clinical symptoms, blood chemistry, potential risk factors, demographic data and ratings of vascular pathology in the brain based on the Wahlund scale were analyzed using Pearson's chi square test and one-way ANOVA. RESULTS: Progressive cognitive decline (38.1%, gait apraxia (27.8%, stroke-related symptoms and seizures (24.2%, TIA-symptoms (22% and vertigo (17% were frequent symptoms within the study population. Frontal lobe WMLs/lacunar infarcts led to more frequent presentation of progressive cognitive decline, seizures, gait apraxia, stroke-related symptoms, TIA, vertigo and incontinence. Parietooccipital WMLs/lacunar infarcts were related to higher frequencies of TIA, seizures and incontinence. Basal ganglia WMLs/lacunar infarcts were seen in patients with more complaints of gait apraxia, vertigo and incontinence. Age (p = .012, arterial hypertension (p<.000, obesity (p<.000 and cerebral macroangiopathy (p = .018 were positively related to cerebral lesion load. For increased glucose level, homocysteine, CRP and D-Dimers there was no association. CONCLUSION: This underlines the association of CM with neurological symptoms upon admission in a topographical manner. Seizures and vertigo are symptoms of CM which may have been missed in previous studies. In addition to confirming known risk factors such as aging and arterial hypertension, obesity appears to increase the risk as well. Since the incidence of CM is increasing, future

  2. Depression symptom ratings in geriatric patients with bipolar mania.

    Science.gov (United States)

    Sajatovic, Martha; Al Jurdi, Rayan; Gildengers, Ariel; Greenberg, Rebecca L; Tenhave, Thomas; Bruce, Martha L; Mulsant, Benoit; Young, Robert C

    2011-11-01

    Given the paucity of information available regarding standardized ratings of depression symptoms in bipolar manic states, and in particular those in older adults, we explored depression ratings in symptomatic participants in a multicenter study of treatment of bipolar I disorder in late life. Baseline data was obtained from the first 100 patients enrolled in an NIMH-funded, 9-week, randomized, double-blind RCT comparing treatment with lithium or valproate in patients of age 60 years and older with Type I Bipolar mania or hypomania. This multi-site study was conducted at six academic medical centers in the United States and enrolled inpatients and outpatients with a total Young Mania Rating Scale (YMRS) score of 18 or greater. Depressive symptoms were evaluated with the Hamilton Depression Rating Scale (HAM-D) and the Montgomery-Asberg Depression Rating Scale (MADRS). The criterion for at least moderate bipolar depressive symptoms was the European College of Neuropsychopharmacology (ECNP) Consensus Meeting definition of HAM-D 17 total score >20. Eleven percent of patients had mixed symptoms defined by depression scale severity according to ECNP criterion. In the overall sample, total scores on the two depression scales were highly correlated. Total YMRS scores of this mixed symptom group were similar to the remainder of the sample. These preliminary findings suggest that moderate to severe depressive symptoms occur in about one in ten bipolar manic elders. Future studies are needed to further evaluate symptom profiles, clinical correlates, and treatments for bipolar older adults with combined manic and depressive symptoms. Copyright © 2011 John Wiley & Sons, Ltd.

  3. Pantoea agglomerans in Immunodeficient Patients with Different Respiratory Symptoms

    Directory of Open Access Journals (Sweden)

    Erika Odilia Flores Popoca

    2012-01-01

    Full Text Available The aim of this paper was to determine in 32 patients from 4 different Mexican hospitals the frequency of opportunistic bacteria in the 2010 to 2011 time period. The patients were divided in 4 groups. Group 1 included 21 HIV positive patients with acute respiratory syndrome. Four HIV positive patients with tuberculosis symptoms were included in Group 2; two patients with tuberculosis symptoms and one asymptomatic person formed Group 3. Reference Group 4 included 4 patients from whom 4 strains of Mycobacterium spp. had been reported. The strains were isolated and identified by 16S rRNA gene amplification, API 20E and 50CH, biochemical test, and antibiotic sensitivity. The strains found were 10 Pantoea agglomerans, 6 Mycobacterium spp., 6 Pseudomonas spp. and 10 strains of normal floral species: Thermoactinomycetes bacterium (1, Enterococcus faecium (2, Bacillus licheniformis (1, Lactobacillus rhamnosus (2, Streptococcus oralis (2, Streptococcus anginosus (1, and Enterobacter hormaechei (1.

  4. Pantoea agglomerans in Immunodeficient Patients with Different Respiratory Symptoms

    Science.gov (United States)

    Flores Popoca, Erika Odilia; Miranda García, Maximino; Romero Figueroa, Socorro; Mendoza Medellín, Aurelio; Sandoval Trujillo, Horacio; Silva Rojas, Hilda Victoria; Ramírez Durán, Ninfa

    2012-01-01

    The aim of this paper was to determine in 32 patients from 4 different Mexican hospitals the frequency of opportunistic bacteria in the 2010 to 2011 time period. The patients were divided in 4 groups. Group 1 included 21 HIV positive patients with acute respiratory syndrome. Four HIV positive patients with tuberculosis symptoms were included in Group 2; two patients with tuberculosis symptoms and one asymptomatic person formed Group 3. Reference Group 4 included 4 patients from whom 4 strains of Mycobacterium spp. had been reported. The strains were isolated and identified by 16S rRNA gene amplification, API 20E and 50CH, biochemical test, and antibiotic sensitivity. The strains found were 10 Pantoea agglomerans, 6 Mycobacterium spp., 6 Pseudomonas spp. and 10 strains of normal floral species: Thermoactinomycetes bacterium (1), Enterococcus faecium (2), Bacillus licheniformis (1), Lactobacillus rhamnosus (2), Streptococcus oralis (2), Streptococcus anginosus (1), and Enterobacter hormaechei (1). PMID:22619600

  5. Pantoea agglomerans in immunodeficient patients with different respiratory symptoms.

    Science.gov (United States)

    Flores Popoca, Erika Odilia; Miranda García, Maximino; Romero Figueroa, Socorro; Mendoza Medellín, Aurelio; Sandoval Trujillo, Horacio; Silva Rojas, Hilda Victoria; Ramírez Durán, Ninfa

    2012-01-01

    The aim of this paper was to determine in 32 patients from 4 different Mexican hospitals the frequency of opportunistic bacteria in the 2010 to 2011 time period. The patients were divided in 4 groups. Group 1 included 21 HIV positive patients with acute respiratory syndrome. Four HIV positive patients with tuberculosis symptoms were included in Group 2; two patients with tuberculosis symptoms and one asymptomatic person formed Group 3. Reference Group 4 included 4 patients from whom 4 strains of Mycobacterium spp. had been reported. The strains were isolated and identified by 16S rRNA gene amplification, API 20E and 50CH, biochemical test, and antibiotic sensitivity. The strains found were 10 Pantoea agglomerans, 6 Mycobacterium spp., 6 Pseudomonas spp. and 10 strains of normal floral species: Thermoactinomycetes bacterium (1), Enterococcus faecium (2), Bacillus licheniformis (1), Lactobacillus rhamnosus (2), Streptococcus oralis (2), Streptococcus anginosus (1), and Enterobacter hormaechei (1).

  6. [Embracement and anxiety symptoms in patients before cardiac surgery].

    Science.gov (United States)

    Assis, Cinthia Calsinski; Lopes, Juliana de Lima; Nogueira-Martins, Luiz Antônio; de Barros, Alba Lucia Bottura Leite

    2014-01-01

    This is a randomized clinical trial, aimed to compare the frequency and intensity of symptoms of anxiety in patients of preoperative cardiac surgery who received empathic behavior from nurse or family or those who received no specific type of empathic behavior. The sample consisted of 66 patients in preoperative of cardiac surgery, which were divided in three groups: empathic behavior by nurses, without specific empathic behavior and by family. Anxiety was assessed at two points in time: before and after the intervention. The instrument used was developed and validated by Suriano, comprising 19 defining characteristics of the nursing diagnosis anxiety. It was observed that the reduction of anxiety symptoms was higher in the group receiving empathic behavior of relatives when compared to the other two groups. The results suggested that encouraging the participation of family members can contribute to the reduction of anxiety symptoms in patients in preoperative cardiac surgery.

  7. Patients' relatives delayed help seeking after a first psychotic episode Demora na procura por tratamento pelos familiares de pacientes após um primeiro episódio psicótico

    Directory of Open Access Journals (Sweden)

    Vera B M Monteiro

    2006-06-01

    Full Text Available OBJECTIVE: Recent studies show that proper treatment after the first psychotic episode may be delayed for a long time. Some patients remain without care even while exhibiting serious symptoms. The objective of the study was to understand the reasons why patients' relatives waited at least 6 months to look for psychiatric counseling and treatment. METHOD: Qualitative analyses of semi-structured interviews with 15 relatives (of patients with first psychotic episode who have waited more than six months before seeking psychiatric treatment were applied. The interviews were recorded; transcribed and relevant portions were codified and grouped, forming terms, concepts or categories. RESULTS: These family members referred to individuals with mental problems in other families in a stereotyped fashion, citing negative aspects such as violence and criminality. They used softer terms when referring to their family members. Not knowing that their sick relative to be a case of mental illness, relatives classified certain observed behaviors as coming principally from spiritual problems and drug use. The initial delay in seeking medical help for the sick person was influenced by: 1 stereotyped misconceptions used by relatives to understand mental problems; 2 explanatory models elaborated to try to understand the sick person's behavior; 3 fear of psychiatric treatment; and 4 negative experiences with psychiatric services. CONCLUSIONS: Cultural aspects are present at all levels of this elaboration process. Their proper understanding by physicians can considerably diminish relatives' pain and suffering.OBJETIVO: Estudos recentes demonstram que o início do tratamento apropriado após o primeiro episódio psicótico pode ser adiado por um longo tempo. Alguns pacientes permanecem sem atenção profissional mesmo apresentando sintomas graves. O objetivo deste estudo foi o de compreender as razões pelas quais os parentes dos pacientes demoram pelo menos seis meses

  8. 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.

  9. A Register-Based Study of Occupational Functioning in Non-Psychotic Patients Before and After Psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Poulsen, Stig Bernt; Mortensen, Erik Lykke;

    2013-01-01

    . Patients who completed treatment (completer patients) had, on average, 15.7 days on sick leave two years before treatment and 23.1 days on sick leave two years after treatment, while the control group had 5.4 and 7.5 days, respectively. Regarding disability pension, completer patients had 7.6 days before...... higher number of days on sick leave (pp=0.010) compared to the control group, while the change in days with unemployment was insignificant (p=0.501). Conclusion: Occupational outcome of psychotherapy may be less advantageous than shown in previous studies. Differences can...... perhaps be explained by the length and symmetry of the observation period before and after intervention. Other possible reasons for the outcome are: disorder chronicity; a labor market that excludes individuals with mental disorders; and that psychotherapy does not address occupational functioning....

  10. [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.

  11. Prevalence of temporomandibular disorders symptoms in patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Lucas S. C. Carvalho

    2014-06-01

    Full Text Available The aim of the present study was to assess the prevalence of symptoms of temporomandibular disorders (TMD in patients with the relapsing-remitting form of multiple sclerosis (MS, the relationship between TMD and the severity of MS, and the presence of TMD symptoms in the evaluated groups. Sixty individuals were evaluated: 30 patients diagnosed with relapsing-remitting MS and 30 control individuals matched for gender and age range with no neurologic pathology. In order to investigate the TMD symptoms, the questionnaires of the EACD (European Academy of Craniomandibular Disorders and the RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders, both validated for TMD research, were administered. To assess the extent of disability produced by MS, the Expanded Disability Status Scale (EDSS was used. The prevalence of TMD symptoms in patients with MS was 56.7% versus 16.7% for the control group, with a statistically significant difference between the groups (p=0.0016. No correlation was found between the severity of MS and the prevalence of TMD symptoms (Fisher's test, p=1.0.

  12. Urinary Symptoms and Urodynamics Findings in Patients with Friedreich's Ataxia

    Directory of Open Access Journals (Sweden)

    Andre F. A. Musegante

    2013-12-01

    Full Text Available Purpose To assess the prevalence of LUTS, urinary tract and urodynamics changes in patients with Friedreich's Ataxia (FA, the most common form of hereditary ataxia. Materials and Methods This study evaluated 258 patients with genetically confirmed diagnoses of FA. Of the patients, 158 responded to a questionnaire which assessed their urinary symptoms. Patients with clinical changes underwent renal function examinations, ultrasound, and urodynamic studies (UDS. Results The sample analyzed showed that 82% of the patients complained of LUTS, although only 22% related the symptoms with quality of life impairment. Twenty eight (18% of them agreed to undergo urodynamic evaluation. Urgency was the most common symptom. The exam was normal in 4 (14% and detrusor underactivity was the most common finding. 14% (4 patients presented with dilatation of the upper urinary tract at ultrasound scans. None of them had creatinine alterations. Conclusions LUTS was found in a large percentage of patients with FA, but only a few related it to their quality of life impairment. Although creatinine levels was normal in this sample, some patients may show upper urinary tract abnormalities, with deserves close observation and proper care.

  13. 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.

  14. Multiple Prescription Drug Abuse and Salt Craving in a Psychotic Patient: A Case Report From a Teaching Hospital in Jordan

    OpenAIRE

    Jaber,, N; Al Awwa; Wazaify

    2015-01-01

    Introduction Diuretics and laxative abuse as a means of purging is common in patients with bulimia nervosa and there may be an underestimation of the true prevalence of diuretic abuse, as some are also available without prescription. Case Presentation A 28-year-old woman presented with tetany due to hypocalcemia, hypokalemia and hypomagnesemia. She had a history of laxative and diuretic abuse, and salt craving. Psychiatric evaluat...

  15. First episode of psychosis in a middle-aged patient with a 14-year history of conversion disorder.

    Science.gov (United States)

    Peritogiannis, Vaios; Manthopoulou, Thiresia; Mavreas, Venetsanos

    2014-01-01

    We present a case of a middle-aged male patient with a long history of conversion disorder and histrionic personality, who presented with newly onset psychotic symptoms while being engaged to treatment with a community mental health team in a primary care setting. The symptoms could not be attributed to an organic cause. After a short course of olanzapine treatment which caused adverse effects, the symptomatology responded well to low dose amisulpride. Conversion symptoms were stable throughout the psychotic episode. This case illustrates the complex interplay between disorders classified in different categories (somatoform versus psychotic disorders).

  16. First Episode of Psychosis in a Middle-Aged Patient with a 14-Year History of Conversion Disorder

    Directory of Open Access Journals (Sweden)

    Vaios Peritogiannis

    2014-01-01

    Full Text Available We present a case of a middle-aged male patient with a long history of conversion disorder and histrionic personality, who presented with newly onset psychotic symptoms while being engaged to treatment with a community mental health team in a primary care setting. The symptoms could not be attributed to an organic cause. After a short course of olanzapine treatment which caused adverse effects, the symptomatology responded well to low dose amisulpride. Conversion symptoms were stable throughout the psychotic episode. This case illustrates the complex interplay between disorders classified in different categories (somatoform versus psychotic disorders.

  17. [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

  18. Chronobiology, cognitive function and depressive symptoms in surgical patients

    DEFF Research Database (Denmark)

    Hansen, Melissa Voigt

    2014-01-01

    in this limited population. With regard to safety in our study, melatonin treatment for three months did not cause any serious adverse effects. Finally, we systematically reviewed the literature on the prophylactic or therapeutic effect of melatonin for depression or depressive symptoms in adult patients...... disorders, such as anxiety and depression, are common problems arising around the time of surgery or in the course of a cancer diagnosis and subsequent treatment period. The importance of investigating prevention or treatment possibilities in these populations is significant due to the extent...... investigated the effect of 6 mg oral melatonin on depressive symptoms, anxiety, sleep, cognitive function and fatigue in patients with breast cancer in a three month time period after surgery. Melatonin had an effect on reducing the risk of developing depressive symptoms and also increased sleep efficiency...

  19. 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.

  20. 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...

  1. Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient.

    Science.gov (United States)

    Morgado, Pedro; Ribeiro, Ricardo; Cerqueira, João J

    2015-01-01

    Introduction. Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method. We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Results. Although there are few descriptions of this syndrome in schizophrenia, patients usually present depressive mood and psychomotor retardation, features not seen in our patient. Loss of the sense of the inner self, present in schizophrenia, could explain patient's symptomatology but neurobiological bases of this syndrome remain unclear. Conclusion. Despite not being considered in actual classifications, Cotard syndrome is still relevant and psychiatric evaluation is critical to diagnosing and treating this condition in psychiatric patients.

  2. [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.

  3. G-autonomy of EEG recordings of psychotic patients undergoing the primitive expression form of dance therapy

    Science.gov (United States)

    Ventouras, E.-C.; Lardi, I.; Dimitriou, S.; Margariti, A.; Chondraki, P.; Kalatzis, I.; Economou, N.-T.; Tsekou, H.; Paparrigopoulos, T.; Ktonas, P. Y.

    2015-09-01

    Primitive expression (PE) is a form of dance therapy (DT) that involves an interaction of ethologically and socially based forms which are supplied for re-enactment. Brain connectivity has been measured in electroencephalographic (EEG) data of patients with schizophrenia undergoing PE DT, using the correlation coefficient and mutual information. These parameters do not measure the existence or absence of directionality in the connectivity. The present study investigates the use of the G-autonomy measure of EEG electrode voltages of the same group of schizophrenic patients. G-autonomy is a measure of the “autonomy” of a system. It indicates the degree by which prediction of the system's future evolution is enhanced by taking into account its own past states, in comparison to predictions based on past states of a set of external variables. In the present research, “own” past states refer to voltage values in the time series recorded at a specific electrode and “external” variables refer to the voltage values recorded at other electrodes. Indication is provided for an acute effect of early-stage PE DT expressed by the augmentation of G-autonomy in the delta rhythm and an acute effect of late- stage PE DT expressed by the reduction of G-autonomy in the theta and alpha rhythms.

  4. Specialized psychosocial treatment plus treatment as usual (TAU) versus TAU for patients with cannabis use disorder and psychosis: the CapOpus randomized trial

    DEFF Research Database (Denmark)

    Hjorthøj, Carsten Rygaard; Fohlmann, A; Larsen, A.-M.

    2013-01-01

    BACKGROUND: Cannabis abuse in psychotic patients is associated with rehospitalizations, reduced adherence and increased symptom severity. Previous psychosocial interventions have been ineffective in cannabis use, possibly because of low sample sizes and short interventions. We investigated whethe...

  5. 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.

  6. Sleep features and central sensitization symptoms in primary headache patients.

    Science.gov (United States)

    de Tommaso, Marina; Delussi, Marianna; Vecchio, Eleonora; Sciruicchio, Vittorio; Invitto, Sara; Livrea, Paolo

    2014-09-26

    Association between sleep disorders and headache is largely known. The aim of the present study was to evaluate sleep quality and quantity in a large cohort of primary headache patients, in order to correlate these scores with symptoms of central sensitization as allodynia, pericranial tenderness and comorbidity with diffuse muscle-skeletal pain. One thousand six hundreds and seventy primary headache out patients were submitted to the Medical Outcomes Study (MOS) within a clinical assessment, consisting of evaluation of frequency of headache, pericranial tenderness, allodynia and coexistence of fibromyalgia syndrome (FM). Ten groups of primary headache patients were individuated, including patients with episodic and chronic migraine and tension type headache, mixed forms, cluster headache and other trigeminal autonomic cephalalgias. Duration but not sleep disturbances score was correlated with symptoms of central sensitization as allodynia and pericranial tenderness in primary headache patients. The association among allodynia, pericranial tenderness and short sleep characterized chronic migraine more than any other primary headache form. Patients presenting with FM comorbidity suffered from sleep disturbances in addition to reduction of sleep duration. Self reported duration of sleep seems a useful index to be correlated with allodynia, pericranial tenderness and chronic headache as a therapeutic target to be assessed in forthcoming studies aiming to prevent central sensitization symptoms development.

  7. DSM-5 somatic symptom disorder in patients with vertigo and dizziness symptoms.

    Science.gov (United States)

    Limburg, Karina; Sattel, Heribert; Radziej, Katharina; Lahmann, Claas

    2016-12-01

    DSM-5 somatic symptom disorder (SSD) could potentially be a highly relevant diagnosis for patients with vertigo and dizziness. The criteria of SSD, particularly the B-criterion with its three components (cognitive, affective, behavioral), have however not yet been investigated in this patient group. We evaluated a large sample (n=399) of outpatients presenting in a neurological setting. Physical examinations and a psychometric assessment (SCID-I) were conducted; patients completed self-report questionnaires. The diagnosis of SSD was assigned retrospectively. The prevalence of SSD, its diagnostic criteria, and its overlap with former DSM-IV somatoform disorders were evaluated; comparisons were drawn between (1) patients fulfilling different components of the B-criterion and (2) patients with diagnoses after DSM-IV vs. DSM-5. SSD was almost twice as common as DSM-IV somatoform disorders. Patients with all three components of the B-criterion reported the highest impairment levels. Patients with both DSM-IV somatoform disorders and DSM-5 SSD were more impaired compared to groups with one of the diagnoses; patients with DSM-IV somatoform disorders only were more impaired than those with SSD only. Our findings demonstrate that SSD is highly prevalent in patients with vertigo and dizziness. The classification of severity based on the number of psychological symptoms appears valid and may assist in finding suitable treatment options according to clinical practice guidelines. Future studies should investigate the overlap of SSD and other psychiatric disorders, this may assist in better defining the diagnostic criteria of SSD. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Tobacco smoking in treatment-resistant schizophrenia patients is associated with impaired cognitive functioning, more severe negative symptoms, and poorer social adjustment

    Directory of Open Access Journals (Sweden)

    Iasevoli F

    2013-08-01

    Full Text Available Felice Iasevoli, Raffaele Balletta, Valentina Gilardi, Sara Giordano, Andrea de Bartolomeis Unit on Treatment Resistance in Psychiatry and Laboratory of Molecular and Translational Psychiatry, Section of Psychiatry, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University School of Medicine ‘Federico II’, Naples, Italy Abstract: Tobacco smoking is common in schizophrenia patients. It has been reported that schizophrenia patients who are tobacco smokers have better cognitive performances compared to those who are nonsmokers. However, little is known on the effects of tobacco smoking in treatment-resistant schizophrenia (TRS patients. The aim of this study was to compare cognitive performances, psychotic symptoms, and social adjustment in tobacco smoker TRS patients compared to nonsmoker TRS patients. Smoker and nonsmoker TRS patients did not differ in demographics and in mean daily antipsychotic dose. Smoker TRS patients had significantly higher scores than nonsmoker patients on the positive and negative syndrome scale (PANSS and on the negative symptoms subscale. These patients also performed worse than nonsmoker patients on problem-solving cognitive domain. Social adjustment was not significantly different between the two groups. In both groups of patients, worse cognitive performances were mostly predicted by higher severity of negative symptoms. Worse performances on the verbal memory and problem-solving cognitive domains were correlated with social-functioning impairment in tobacco smoker TRS patients but not in nonsmoker ones. The results showed that tobacco smoking was not significantly associated with better cognitive performances in TRS patients, while it was significantly associated with higher negative symptoms. Even if a direct causative mechanism cannot be inferred and despite the fact that these patients may use tobacco to self-medicate, it could be speculated that these associations may, at least

  9. Diagnosis of chest pain with foregut symptoms in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    Bo Deng; Ru-Wen Wang; Yao-Guang Jiang; Qun-You Tan; Xiang-Li Liao; Jing-Hai Zhou; Yun-Ping Zhao; Tai-Qian Gong; Zheng Ma

    2009-01-01

    AIM: To evaluate the diagnosis of chest pain with foregut symptoms in Chinese patients. METHODS: Esophageal manomet r ic studies, 24-h introesophageal pH monitoring and 24-h electrocardiograms (Holter electrocardiography) were performed in 61 patients with chest pain. RESULTS: Thirty-nine patients were diagnosed with non-specific esophageal motility disorders (29 patients with abnormal gastroesophageal reflux and eight patients with myocardial ischemia). Five patients had diffuse spasm of the esophagus plus abnormal gastroesophageal reflux (two patients had concomitant myocardial ischemia), and one patient was diagnosed with nutcracker esophagus. CONCLUSION: The esophageal manometric studies, 24-h intra-esophageal pH monitoring and Holter electrocardiography are significant for the differential diagnosis of chest pain, particularly in patients with foregut symptoms. In cases of esophageal motility disorders, pathological gastroesophageal reflux may be a major cause of chest pain with non-specific esophageal motility disorders. Spasm of the esophageal smooth muscle might affect the heart-coronary smooth muscle, leading to myocardial ischemia.

  10. 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.

  11. 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