Journal articles on the topic 'Fist Episode of Psychosis'
To see the other types of publications on this topic, follow the link: Fist Episode of Psychosis.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Fist Episode of Psychosis.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Harvey, Samuel B., Kimberlie Dean, Craig Morgan, Elizabeth Walsh, Arsime Demjaha, Paola Dazzan, Kevin Morgan, et al. "Self-harm in first-episode psychosis." British Journal of Psychiatry 192, no. 3 (March 2008): 178–84. http://dx.doi.org/10.1192/bjp.bp.107.037192.
Abstract:
BackgroundLittle is known about self-harm occurring during the period of untreated first-episode psychosis.AimsTo establish the prevalence, nature, motivation and risk factors for self-harm occurring during the untreated phase of first-episode psychosis.MethodAs part of the æSOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study, episodes of self-harm were identified among all incident cases of psychosis presenting to services in south-east London and Nottingham over a 2-year period.ResultsOf the 496 participants, 56 (11.3%) had engaged in self-harm between the onset of psychotic symptoms and first presentation to services. The independent correlates of self-harm were: male gender, belonging to social class I/II, depression and a prolonged period of untreated psychosis. Increased insight was also associated with risk of self-harm.ConclusionsSelf-harm is common during the pre-treatment phase of first-episode psychosis. A unique set of fixed and malleable risk factors appear to operate in those with first-episode psychosis. Reducing treatment delay and modifying disease attitudes may be key targets for suicide prevention.
2
Zanetti, Marcus V., Maristela S. Schaufelberger, Cláudio C. de Castro, Paulo R. Menezes, Márcia Scazufca, Philip K. McGuire, Robin M. Murray, and Geraldo F. Busatto. "White-matter hyperintensities in first-episode psychosis." British Journal of Psychiatry 193, no. 1 (July 2008): 25–30. http://dx.doi.org/10.1192/bjp.bp.107.038901.
Abstract:
BackgroundWhite-matter hyperintensities have been associated with both schizophrenia and mood disorders, particularly bipolar disorder, but results are inconsistent across studiesAimsTo examine whether white-matter hyperintensities are a vulnerability marker for psychosis or are specifically associated with bipolar disorderMethodT2-weighted magnetic resonance imaging data were acquired in 129 individuals with first-episode psychosis (either affective or non-affective psychoses) and 102 controls who were randomly selected from the same geographical areas. Visual white-matter hyperintensity ratings were used for group and subgroup comparisonsResultsThere were no statistically significant between-group differences in white-matter hyperintensity frequency or severity scores. No significant correlations were found between white-matter hyperintensity scores and duration of illness, duration of untreated psychosis, or severity of psychotic, manic or depressive symptomsConclusionsWhite-matter hyperintensities are not associated with vulnerability to psychosis in general, or specifically with affective psychoses. Further, first-episode psychosis investigations using more quantitative methods are warranted to confirm these findings
3
Amini, Homayoun, Javad Alaghband-Rad, Abbas Omid, Vandad Sharifi, Rozita Davari-Ashtiani, Farzad Momeni, and Zahra Aminipour. "Diagnostic Stability in Patients with First-Episode Psychosis." Australasian Psychiatry 13, no. 4 (December 2005): 388–92. http://dx.doi.org/10.1080/j.1440-1665.2005.02199.x.
Abstract:
Objective: To examine the short-term stability of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) and International Classification of Diseases (10th revision; ICD-10) diagnoses in a group of patients with first-episode psychosis. Method: Sixty patients with first-episode psychosis admitted consecutively to Roozbeh Hospital, Tehran, were sampled; their illnesses could not be attributed to any medical or substance-induced conditions. Patients were assessed at the time of discharge from the hospital, and at 3, 6and 12 month intervals following admission. Ateach visit, two psychiatrists made consensusDSM-IV and ICD10 diagnoses, based on all available information. Stability was discerned as the consistency between diagnoses at the time of discharge and at 12 month follow up. Results: Forty-eight patients completed follow up. Affective psychotic disorders and schizophrenia in both classification systems were highly stable. In addition, all patients with DSM-IV brief psychotic disorder and ICD-10 acute and transient psychotic disorders remained the same at follow up. Conclusions: Affective psychoses and schizophrenia, in line with previous findings, remained stable. Diagnoses of brief psychoses were highly stable as well; this could reflect a non-relapsing course ofacute brief psychoses, especially in developing countries.
4
Singh, Swaran P., Tom Burns, Shazad Amin, Peter B. Jones, and Glynn Harrison. "Acute and transient psychotic disorders: precursors, epidemiology, course and outcome." British Journal of Psychiatry 185, no. 6 (December 2004): 452–59. http://dx.doi.org/10.1192/bjp.185.6.452.
Abstract:
BackgroundICD–10 has introduced the diagnostic group acute and transient psychotic disorders (ATPDs; F23). Aims To validate the nosological distinctiveness of ICD–10 ATPDs by following up an inception cohort with first-episode psychosis. Method All patients with first-episode psychosis identified in Nottingham between 1992 and 1994 and diagnosed using ICD–10 criteria were reassessed 3 years later. ATPD outcomes were compared with schizophrenia and affective psychosis. Multivariate analyses were conducted to determine whether acute onset and early remission predicted favourable 3-year outcome in first-episode psychosis. Results Of 168 cases of first-episode psychosis, 32 (19%) received an intake diagnosis of ATPD. The diagnosis of ATPD was stable in women over 3 years, but not in men. Outcomes in ATPD were better than in schizophrenia and similar to affective psychosis. In non-affective psychoses, favourable outcomes were a function of gender and premorbid functioning rather than acute onset and early remission. Conclusions The ICD–10 criteria for ATPDs identify a diagnostically unstable group of disorders. Acute onset and early remission do not independently predict favourable outcome over 3 years in first-episode psychosis.
5
Mahdi Al Har, Sumeiya. "Association of IL-β1, PGj2 Among Patient with First Episode Psychosis (Case-control study)." Medical Science Journal for Advance Research 3, no. 4 (December 23, 2022): 149–54. http://dx.doi.org/10.46966/msjar.v3i4.77.
Abstract:
Background: A first episode of psychosis is the primary point in time a person experiences a psychotic period. it is frequently very confusing. frightening and distressing, particularly for the reason that it is an unusual experience. unluckily, there are moreover many negative misconceptions and stereotypes linked with psychosis that can additional to one’s distress. Aim of the study Investigate the association between some inflammatory biomarkers with first episode psychosis (FEP) and to find out the correlation with different socio demographic profile
Methods: A case-control study was involve patients with first episode psychosis and healthy control. peripheral Blood samples collected from 44 cases they were attending AL-Hakeem General hospital, Psychiatric Department, in the period between January, 2019 to may, 2019. the cases included females and males, and the age was 18-70 years. Control: 44 healthy controls who had no history or clinical evidence of fist episode psychosis or any other disease.
Results: revealed that increase in the level of Interlaken β1, and decrease PGJ-2 among FEP patients (1591.8±108.6, and 3.82±0.36) respectively in comparison to control were mean (554.8±54.8, and 9.94±0.67).
Conclusion: The inflammatory response is an immune system that allow the individual to cope with various menacing advise, but in long-lasting conditions and pathological, the continuous of this stimulate could develop into harmful. The regulation of the all development involves endogenous counter-balancing mechanisms that control special effects of deleterious pro inflammatory mediators. information showing a misbalance in some pro inflammatory/anti inflammatory in blood of person with FES.
6
Pariante, Carmine M., Konstantina Vassilopoulou, Dennis Velakoulis, Lisa Phillips, Bridget Soulsby, Stephen J. Wood, Warrick Brewer, et al. "Pituitary volume in psychosis." British Journal of Psychiatry 185, no. 1 (July 2004): 5–10. http://dx.doi.org/10.1192/bjp.185.1.5.
Abstract:
BackgroundPatients with psychosis have activation of the hypothalamic-pituitary-adrenal (HPA) axis during the acute phase of the psychosis. Whether this has any morphological consequences for the pituitary gland is currently unknown.AimsTo examine pituitary volume variation in people at different stages of psychotic disorder.MethodPituitary volume was measured using 1.5 mm, coronal magnetic resonance images in 24 people with first-episode psychosis, 51 with established schizophrenia and 59 healthy controls.ResultsCompared with the control group, the people with first-episode psychosis had pituitary volumes that were 10% larger, whereas those with established schizophrenia had pituitary volumes that were 17% smaller. In both of the groups with psychosis, there was no difference in pituitary volume between those receiving typical antipsychotic drugs and those receiving atypical antipsychotics.ConclusionsThe first episode of a psychosis is associated with a larger pituitary volume, which we suggest is due to activation of the HPA axis. The smaller pituitary volume in the group with established schizophrenia could be the consequence of repeated episodes of HPA axis hyperactivity.
7
Milton, John, Shazad Amin, Swaran P. Singh, Glynn Harrison, Peter Jones, Tim Croudace, Ian Medley, and John Brewin. "Aggressive incidents in first-episode psychosis." British Journal of Psychiatry 178, no. 5 (May 2001): 433–40. http://dx.doi.org/10.1192/bjp.178.5.433.
Abstract:
BackgroundRecent research has reported increased risk of aggressive incidents by individuals with psychotic illness.AimsTo examine acts of aggression in first-episode psychosis.MethodSubjects with a first-episode psychosis were ascertained from a defined catchment area (Nottingham, UK) and reassessed at 3 years (n=166) using clinical interview, informants, health care and forensic records.ResultsOf the subjects, 9.6% demonstrated at least one act of serious aggression (defined as weapon use, sexual assault or victim injury) during at least one psychotic episode and 23.5% demonstrated lesser acts of aggression (defined as all other acts of aggression). For all aggressive subjects (33.1%), unemployment (OR=3.6, 95%CI 1.6–8.0), comorbid substance misuse (OR=3.1, CI 1.1–8.8) and symptoms of overactivity at service contact (OR=6.9, CI 2.7–17.8) had independent effects on risk of aggression.ConclusionsWe confirmed some previously reported demographic and clinical associations with aggression in first-episode psychosis but no relationship with specific psychotic symptoms or diagnostic groups was observed.
8
Karki, B. D., D. Joshi, and A. P. Adhikari. "Stressful Life Events In First Episode Psychosis." Journal of Psychiatrists' Association of Nepal 10, no. 1 (October 14, 2021): 38–42. http://dx.doi.org/10.3126/jpan.v10i1.40346.
Abstract:
Introduction: First episode psychosis refers to the first time someone experiences psychotic symptoms or a psychotic episode. There are evidences related to the role of major life events and childhood trauma in the development of first episode psychosis. There are few studies regarding the environmental exposure to stressful life events and how these events might influence the onset of a psychotic disorder, and role of perceived stress. This study aimed to identify the relationship between stressful life events and first episode psychosis in Nepalese context.
Material And Method: It was a hospital based cross-sectional, descriptive study. A total of 50 cases of first episode psychosis were included and the diagnosis was made according to ICD 10- Diagnostic Criteria for Research and verified by two consultant psychiatrists. Semi Structured Performa was designed to collect the information about the socio demographic data and perceived stress was assessed with Presumptive Stressful Life Events Scale (PSLES).
Results: There were 62% female and 38% male patients with first episode psychosis with mean age 26.32 years. Majority of the participants were from rural areas (94%), married (58%), educated up to primary level (38%) and housewife (40%). 60.7% of ATPD had stressful life events (P =0. 000)which was higher than the stressful life events in patient with Schizophrenia (P =0. 005). There was a positive correlation between stressful life events and gender, setting, socioeconomic status and Diagnosis (P <0.05).
Conclusion: Results show the relevance of presence of stressful life events as a potent source of perceived stress in first episode psychosis sample. Therefore this study highlights the importance of psychosocial intervention in this vulnerable group for management of illness and might be an important strategy for prevention.
9
Coentre, R., D. Barrocas, I. Chendo, and P. Levy. "First Psychotic Episode and Early Intervention: An Opportunity to Change the Course of the Illness." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71358-6.
Abstract:
Aims:Early intervention in psychosis constitutes an important opportunity to change the classic limited outcome associated with the patients who suffer of psychotic disease.Methods:Based on literature review the authors analyse the evidence for early intervention in first psychotic episode.Results:The evidence for the effectiveness of interventions in early psychosis can be considered in two stages:1.first stage before the onset of full symptoms of psychosis, in people with high risk of developing psychosis or in the prodrome phase of the illness;2.second stage includes the therapeutic focus on the period after the first psychotic episode, reducing the duration of untreated psychosis (DUP) and ameliorate the recovery.Preventing psychosis by intervene in the prodrome or in people with high risk of developing psychosis remains ethically contentious because of the non-specificity of the symptoms. by the contrary there is evidence that early and specialised intervention in first psychotic episode improves outcome. Besides the controversy of the relation between long DUP and poor outcome, there is agreement that clinicians should identify and treat psychosis early with a great impact in patients and their family's life. Effective care during first psychotic episode includes proactive engagement and initiation of low doses of antipsychotics and psychosocial treatments, aiming for maximal symptomatic and functional recovery and the prevention of relapse.Conclusion:There is evidence that early intervention in first psychotic episode improve clinical effectiveness over standard care. Further studies are important to make evidence more robust.
10
Edwards, Jane, Dana Maude, Patrick D. McGorry, Susan M. Harrigan, and John T. Cocks. "Prolonged recovery in first-episode psychosis." British Journal of Psychiatry 172, S33 (June 1998): 107–16. http://dx.doi.org/10.1192/s0007125000297754.
Abstract:
Background Early identification and specialised treatment of individuals with enduring positive symptoms may assist in alleviating symptoms and has the potential to change the course of illness.Method Prevalence and descriptive data on enduring positive symptoms in two first-episode samples are outlined. Attempts to incorporate the focus of early intervention for persisting psychosis into routine clinical care of individuals with first-episode psychosis are described.Results Of the 227 individuals with first-episode psychosis who were assessed using the Brief Psychiatric Rating Scale at 3/6 months and 12 months following initial stabilisation (from a total sample of 347), 6.6% experienced enduring positive symptoms at all three time points. When the analysis was restricted to schizophrenia, schizophreniform and schizoaffective disorders (n=158) the percentage increased to 8.9%. These patients had significantly longer mean duration of untreated psychosis prior to initiation of treatment and, at 12-month follow-up, significantly higher depression and poorer psychosocial functioning.Conclusions The association of untreated psychosis with treatment resistance supports the argument for early intervention as soon as possible following the onset of psychotic symptoms.
11
Patel, Kamlesh, and Rachel Upthegrove. "Self-harm in first-episode psychosis." Psychiatric Bulletin 33, no. 3 (March 2009): 104–7. http://dx.doi.org/10.1192/pb.bp.108.020362.
Abstract:
Aims and MethodSuicide in schizophrenia remains frequent. One of the best predictors of suicide, previous self-harm, is increasing in young people. the aim of this case-note review was to investigate the frequency of a history of self-harm for individuals presenting to psychiatric services with a first episode of psychosis in our local area and study their demographic characteristics.ResultsA history of self-harm was found in 32% of the cohort. the predominant method of self-harm was self-laceration. In univariate analyses, age and gender were significant predictors of self-harming behaviour.Clinical ImplicationsThe rate of self-harm among those with first-episode psychosis is high. Efforts to reduce the rate of completed suicide in psychotic illness need to focus on this risk, which often predates contact with psychiatric services. This emphasises again the need for early detection and intervention in psychotic illness.
12
Gil-Berrozpe, G., V. Peralta, A. Sánchez-Torres, L. Moreno-Izco, E. Garcia De Jalon, D. Peralta, L. Janda, and M. Cuesta. "Psychopathological networks in psychosis and changes over time: A long-term cohort study of first-episode psychosis." European Psychiatry 65, S1 (June 2022): S247. http://dx.doi.org/10.1192/j.eurpsy.2022.637.
Abstract:
Introduction First-episode psychosis is a critical period for early interventions to reduce the risk of poor outcomes and relapse as much as possible. There are now many studies revealing the patterns of course in the short and medium terms, but uncertainties about the long-term outcomes of symptomatology remain to be ascertained. Objectives First, we ascertained whether the structure of psychopathological symptoms, dimensions and domains of psychopathology remains invariant over time between first-episode psychosis and long-term follow-up. Second, we analysed the changes in the interrelationships of psychopathological symptoms, dimensions and domains of psychopathology between FEP and long-term follow-up at three levels. Methods We performed network analysis to investigate first-episode and long-term stages of psychosis at three levels of analysis: micro, meso and macro. The sample was a cohort of 510 patients with first-episode psychoses from the SEGPEP study, who were reassessed at the long-term follow-up (n = 243). We used the Comprehensive Assessment of Symptoms and History (CASH) for their assessments. Results Our results showed a similar pattern of clustering between first episodes and long-term follow-up in seven psychopathological dimensions at the micro level, 3 and 4 dimensions at the meso level, and one at the macro level. They also revealed significant differences between first-episode and long-term network structure and centrality measures at the three levels. Conclusions Our findings suggest that disorganization symptoms have more influence in long-term stabilized patients. The main results of the current study add evidence to the hierarchical, dimensional and longitudinal structuring of first-episode psychoses. Disclosure No significant relationships.
13
Rogers, Paul. "First episode psychosis." Mental Health Practice 9, no. 3 (November 2005): 37. http://dx.doi.org/10.7748/mhp.9.3.37.s31.
14
Sandor, A. "First episode psychosis." BMJ 324, no. 7343 (April 20, 2002): 976a—976. http://dx.doi.org/10.1136/bmj.324.7343.976/a.
15
Dazzan, Paola, Tuhina Lloyd, Kevin D. Morgan, Jolanta Zanelli, Craig Morgan, Ken Orr, Gerard Hutchinson, et al. "Neurological abnormalities and cognitive ability in first-episode psychosis." British Journal of Psychiatry 193, no. 3 (September 2008): 197–202. http://dx.doi.org/10.1192/bjp.bp.107.045450.
Abstract:
BackgroundIt remains unclear if the excess of neurological soft signs, or of certain types of neurological soft signs, is common to all psychoses, and whether this excess is simply an epiphenomenon of the lower general cognitive ability present in psychosis.AimsTo investigate whether an excess of neurological soft signs is independent of diagnosis (schizophrenia v. affective psychosis) and cognitive ability (IQ).MethodEvaluation of types of neurological soft signs in a prospective cohort of all individuals presenting with psychoses over 2 years (n=310), and in a control group from the general population (n=239).ResultsPrimary (P<0.001), motor coordination (P<0.001), and motor sequencing (P<0.001) sign scores were significantly higher in people with any psychosis than in the control group. However, only primary and motor coordination scores remained higher when individuals with psychosis and controls were matched for premorbid and current IQ.ConclusionsHigher rates of primary and motor coordination signs are not associated with lower cognitive ability, and are specific to the presence of psychosis.
16
Cantwell, Roch, John Brewin, Cristine Glazebrook, Tim Dalkin, Richard Fox, Ian Medley, and Glynn Harrison. "Prevalence of substance misuse in first-episode psychosis." British Journal of Psychiatry 174, no. 2 (February 1999): 150–53. http://dx.doi.org/10.1192/bjp.174.2.150.
Abstract:
BackgroundReports suggest a high prevalence of substance misuse in psychotic disorders but few studies examine comorbidity at onset of psychosis.AimsTo identify the prevalence and pattern of substance use and misuse in first-episode psychosis, and relationships with diagnosis, mode of presentation and demographic variables.MethodConsensus diagnoses for 168 subjects presenting with first-episode psychosis were made using ICD–10 diagnostic criteria. Information on substance use and misuse was obtained from multiple sources. We examined associations between substance misuse, diagnosis and demographic factors.ResultsCriteria for drug use, drug misuse or alcohol misuse were met by 37% of the sample. One-year prevalence rates were 19.5% (drug misuse) and 11.7% (alcohol misuse). Thirteen subjects (8.4%) received a primary diagnosis of substance-related psychotic disorder; a significant increase compared with an earlier cohort from the same catchment area. Drug misuse was associated with younger age of onset of psychosis, male gender and non–African–Caribbean ethnicity.ConclusionsThis study confirms high rates of substance misuse at onset of psychosis. There is evidence for an increase in diagnosis of substance-related psychotic disorders over time. Those most at risk of substance misuse are young males.
17
Tan, Hao-Yang, Yong-Guan Ang, Hao-Yang Tan, and Yong-Guan Ang. "First-Episode Psychosis in the Military: A Comparative Study of Prodromal Symptoms." Australian & New Zealand Journal of Psychiatry 35, no. 4 (August 2001): 512–19. http://dx.doi.org/10.1046/j.1440-1614.2001.00912.x.
Abstract:
Objective: The objective of this study is to provide a retrospective description of prodromal symptoms of young military servicemen with first-episode psychosis, and a comparison with first-episode non-psychotic disorders. Method: Thirty consecutive servicemen presenting with first-episode psychosis were studied. Thirty-four randomly selected servicemen from 123 with non-psychotic disorders served as comparison. A combination of unstructured and semistructured interviews with the patient and other informants was used to describe the prodromal symptoms. Results: The most common prodromal psychotic symptoms were social withdrawal (83%); anxiety (77%); sleep disturbance (77%); disturbance in attention, concentration or memory (73%); deterioration in studies in school (70%); depressed mood (63%); odd behaviour (53%); and anger or irritability (53%). Common symptoms found in first-episode psychosis and non-psychotic patients included sleep disturbance, anxiety, depressed mood and anger or irritability. Common symptoms that were associated with the psychotic prodrome were social withdrawal (p < 0.001), deterioration in school results (p < 0.001) and disturbance in attention, concentration or memory (p < 0.001). The psychotic prodrome was also associated with apathy (p < 0.001), odd behaviour (p < 0.001), doing nothing (p = 0.004) and thought blocking (p = 0.04). Conclusion: Cognitive disturbances and attenuated negative symptoms appear to be more specific to the psychotic prodrome in young patients with first-episode psychosis.
18
Marques, S., F. Godinho, A. L. Melo, and D. Barrocas. "First-episode psychosis: What does it mean?" European Psychiatry 33, S1 (March 2016): s258. http://dx.doi.org/10.1016/j.eurpsy.2016.01.656.
Abstract:
IntroductionFirst-Episode Psychosis (FEP) is a variable condition, characterized by the emergence of new psychotic features for a period of at least 1 week. The majority of existing studies about FEP only address schizophrenia spectrum psychosis (SSP), which may limit the capacity to fully characterize this entity.Objectives/AimsReport the clinical and socio-demographic characteristics of patients with FEP in real-world setting, and compare the differences among SSP and affective FEP.MethodsRetrospective analysis of clinical files of patients admitted to our hospital unit with FEP diagnosis from January/2012 to April/2015. Clinician-rated dimensions of psychosis symptom severity scales (DSM-5) were applied.ResultsAnnual incidence of FEP was 11,3/100,000. From a total of 755 patients, 57 (7,5%) corresponded to FEP; 38 (66,7%) were diagnosed with SSP, 11 (19,3%) affective psychosis, 3 (5,2%) toxic psychosis and 5 (8,8%) organic psychosis. Most were female (61,4%), with a mean age of 49 years. The majority were unemployed (66,7%), lived with family (57,9%), and presented with moderate-severe delusions (80,1%), but without hallucinations (57,8%), disorganized speech (59,6%) or negative symptoms (85,9%). Affective FEP patients were older (61 vs 45 years), presented with less severe psychotic symptoms (7,2 vs 8,3 points), but with higher hospital admission (26,1 vs 21,1 days).ConclusionsRegardless the growing interest concerning FEP, its conceptualization and characterization remains controversial. Our results differ from pre-existing literature data, especially concerning gender and age. By including all the possible etiologies of FEP, we aimed to obtain a more realistic characterization of this entity in a real-world setting.Disclosure of interestThe authors have not supplied their declaration of competing interest.
19
Lloyd, T., P. Dazzan, K. Dean, S. B. G. Park, P. Fearon, G. A. Doody, J. Tarrant, et al. "Minor physical anomalies in patients with first-episode psychosis: their frequency and diagnostic specificity." Psychological Medicine 38, no. 1 (July 30, 2007): 71–77. http://dx.doi.org/10.1017/s0033291707001158.
Abstract:
BackgroundAn increased prevalence of minor physical anomalies (MPAs) has been extensively documented in schizophrenia but their specificity for the disorder remains unclear. We investigated the prevalence and the predictive power of MPAs in a large sample of first-episode psychotic patients across a range of diagnoses.MethodMPAs were examined in 242 subjects with first-episode psychosis (50% schizophrenia, 45% affective psychosis and 5% substance-induced psychosis) and 158 healthy controls. Categorical principal components analysis and analysis of variance were undertaken, and individual items with the highest loading were tested using the χ2 test.ResultsOverall facial asymmetry, assymetry of the orbital landmarks, and frankfurt horizontal significantly differentiated patients with schizophrenia and affective psychosis from controls, as did a ‘V-shaped’ palate, reduced palatal ridges, abnormality of the left ear surface and the shape of the left and right ears. Patients with affective psychosis had significantly lowered eye fissures compared with control subjects.ConclusionsMPAs are not specific to schizophrenia, suggesting a common developmental pathway for non-affective and affective psychoses. The topographical distribution of MPAs in this study is suggestive of an insult occurring during organogenesis in the first trimester of pregnancy.
20
De La Fuente Ruiz, E. "Autoimmunity associated with first psychotic episode. A Systematic review." European Psychiatry 66, S1 (March 2023): S992—S993. http://dx.doi.org/10.1192/j.eurpsy.2023.2110.
Abstract:
IntroductionAutoimmunity mechanisms involve many cells that produce inflammatory cytokines which damage different organs, like the brain. There is a relationship between neuropsychiatric diseases, such as psychosis, and autoimmune diseases. In this article we try to demonstrate that treating autoimmune diseases appropriately improves clinical evolution of patients with a first psychotic episode.ObjectivesThe purpose of this article is to emphasize the importance of a multidisciplinary approach to a first psychotic episode. It is very important to perform autoimmunity tests to rule out secondary psychoses, even more so if the patient does not respond correctly to treatment with antipsychotics, to improve his/her prognosis and quality of life.MethodsWe performed a literature search of PubMed database using the following MeSH terms: “Autoimmune Diseases” and “Psychotic Disorders”. 134 studies were published between 2017-2022. We selected the original papers that analyzed the association between autoimmune diseases and first psychotic episodes. Finally, 18 were selected.ResultsIn secondary psychoses, early diagnosis and treatment of the underlying pathology can lead to rapid improvement.ConclusionsA multidisciplinary approach is necessary from the first moment that a FPE is diagnosed, even more so in middle-aged women.Disclosure of InterestNone Declared
21
Mota-Oliveira, M., M. J. Peixoto, I. Ferraz, E. Pereira, R. Guedes, A. Norton, and C. Silveira. "Diagnostic Stability in First Psychotic Episode after 5 years follow-up." European Psychiatry 41, S1 (April 2017): S197. http://dx.doi.org/10.1016/j.eurpsy.2017.01.2138.
Abstract:
IntroductionThe diagnosis of psychosis is based on the presence or absence of characteristic symptoms. The presence of such symptoms varies during the course and treatment, raising the question of diagnostic stability after a first psychotic episode.Aims and objectivesThe aim of this study is to evaluate the diagnostic stability after a first psychotic episode in the long term (five years after the first inpatient admission).MethodologyA retrospective study that included patients with first psychotic episode between 2007 and 2011 admitted to the inpatient unit of the psychiatry and mental health clinic of São João hospital center, Oporto, Portugal and re-evaluation of the diagnosis after five years.ResultsWe included 60 patients with a first psychosis episode, 22 of which were drop-outs after five years. Of the 38 patients evaluated, it was possible to see that after 5 years 68.4% (n = 26) maintained the same diagnosis during follow-up. In particular, the diagnosis of schizophrenia was kept in 83.3% of patients after 5 years (n = 15, 18 patients with the diagnosis of schizophrenia after first admission). Diagnosis of acute and transient psychotic disorder and psychosis not otherwise specified were the least stable diagnosis after 5 years.ConclusionsThe diagnosis after a first psychotic episode has important therapeutic and prognostic implications. The presence of characteristic symptomatology, with periods of partial or total remission between subsequent episodes emphasizes the need for regular monitoring, since this group of patients appears to be more vulnerable to changes in diagnosis over time.Disclosure of interestThe authors have not supplied their declaration of competing interest.
22
Kopala, Lili C. "Maximizing Function After First-Episode Psychosis." CNS Spectrums 9, S11 (October 2004): 34–39. http://dx.doi.org/10.1017/s1092852900025116.
Abstract:
AbstractInterest in early and preventive interventions in patients with psychotic disorders has increased over the past few years as a result of die intuitive appeal of such interventions. Results of studies point to an association between longer duration of untreated psychosis and poor outcome, atypical antipsychotic agents less likely to cause extrapyramidal side effects, and a shift from hospital to community-based care for many patients with severe mental illness. Treatment strategies specifically directed to firsUepisode psychosis may help to improve outcomes. Such strategies include the use of lower doses of antipsychotic medications, the predominant use of atypical antipsychotic agents, and the deployment of psychological interventions that address the unique needs of young, first-episode patients and their families.
23
Breitborde, Nicholas J. K., Cindy Woolverton, R. Brock Frost, and Nicole A. Kiewel. "Self-Determination Theory and First-Episode Psychosis: A Replication." Advances in Psychiatry 2014 (September 8, 2014): 1–5. http://dx.doi.org/10.1155/2014/240125.
Abstract:
Self-determination theory (SDT) posits that human well-being depends on the satisfaction of three basic psychological needs: autonomy, competence, and relatedness. Although many scholars have suggested that SDT may be relevant to psychotic disorders, only one empirical study of SDT in individuals with psychosis has been completed to date by Breitborde and colleagues (2012). This study revealed that individuals with first-episode psychosis reported lower satisfaction of the three basic psychological needs as compared to individuals without psychosis. Moreover, greater satisfaction of basic psychological needs was modestly associated with lower general symptoms (e.g., anxiety and depression), greater social functioning, and better quality of life. Thus, the goal of this project was to replicate Breitborde et al.’s (2012) investigation of basic psychological need satisfaction among individuals with first-episode psychosis. Our results supported the conclusion that individuals with first-episode psychosis report lower autonomy, competence, and relatedness than individuals without psychosis. Moreover, our results comport with the finding that greater need satisfaction was associated with less severe symptomatology and better social functioning and quality of life. In total, the findings lend further credence to the hypothesis that SDT may help to inform the development of improved clinical services for individuals with psychotic disorders.
24
Yung, Alison R., and Patrick D. McGorry. "The Initial Prodrome in Psychosis: Descriptive and Qualitative Aspects." Australian & New Zealand Journal of Psychiatry 30, no. 5 (October 1996): 587–99. http://dx.doi.org/10.3109/00048679609062654.
Abstract:
Objective: This study aimed to describe in detail, using a retrospective approach, the prodromal symptoms in first-episode psychosis patients. This initial prodrome, the period of disturbance preceding a first psychotic episode, is potentially important for early intervention, identification of biological markers, and understanding the process of becoming psychotic. Method: A consecutive series of 21 first-episode patients was recruited from the Early Psychosis Prevention and Intervention Centre, a specialised service for young people aged between 16 and 30 with first-episode psychosis. Subjects were interviewed in the recovery phase after the acute episode, about the period leading up to the psychosis, using a combination of unstructured and semi-structured techniques. Results: A wide variability of phenomena and sequence patterns was found, with symptoms being a mixture of attenuated psychotic symptoms, neurotic and mood-related symptoms, and behavioural changes. Symptoms were often disabling and some, such as suicidal thoughts, potentially life-threatening. Conclusions: The findings highlight the loss of information that has resulted from disregarding early phenomenological studies of the psychotic prodrome and instead focussing on behavioural features. The ground work has been laid for the development of better methodologies for assessing and measuring first psychotic prodromes with increased emphasis on experiential phenomena. This has the potential to lead to the early recognition and more accurate prediction of subsequent psychosis, as well as a deeper understanding of the neurobiology of the onset of psychotic disorder.
25
Menezes, Paulo R., Marcia Scazufca, Geraldo F. Busatto, Letícia M. S. Coutinho, Philip K. Mcguire, and Robin M. Murray. "Incidence of first-contact psychosis in São Paulo, Brazil." British Journal of Psychiatry 191, S51 (December 2007): s102—s106. http://dx.doi.org/10.1192/bjp.191.51.s102.
Abstract:
BackgroundLittle is known about the incidence of first-episode psychosis in urban centres of low- or middle-income countriesAimsTo estimate the incidence of psychosis in São Paulo, a large metropolis of BrazilMethodProspective survey of first-episode psychosis among residents aged 18–64 years resident in a defined area of São Paulo, over a 30-month period (July 2002- December 2004). Assessments were carried out with the SCID–I, and diagnoses given according to DSM – IV criteria. Population at risk was drawn from the 2000 Census dataResultsThere were 367 first-episode cases identified (51% women), and almost 40% fulfilled criteria for schizophrenia or schizophreniform disorder. The incidence rate for any psychosis was 15.8/100 000 person-years at risk (95% CI 14.3–17.6). Incidence of non-affective psychoses was higher among younger malesConclusionsIncidence of psychosis in São Paulo was lower than expected for a large metropolis
26
Schimmelmann, B., S. Kupferschmid, P. Conus, S. Cotton, P. McGorry, and M. Lambert. "Cannabis use disorders and age at onset of psychosis in 606 patients with first episode psychosis." European Psychiatry 26, S2 (March 2011): 1500. http://dx.doi.org/10.1016/s0924-9338(11)73204-7.
Abstract:
BackgroundAge at onset of psychosis (AAO) may be younger in patients with cannabis use disorders (CUD) compared to those without CUD (NCUD). Most previous studies did not control for potential confounders, did not report effect sizes and included mostly adult patients from non-representative samples.MethodsControlling for relevant confounders, differences in AAO between patients with and without lifetime CUD were analysed in a large epidemiologically based cohort of 606 first-episode psychosis (FEP) patients (age 14 to 29 years) admitted within three years to the Melbourne Early Psychosis Prevention and Intervention Centre. Data were collected from medical files using a standardized scale.ResultsOverall, AAO was not significantly different in CUD (n = 449; 74.1%) compared to NCUD, neither univariate nor when controlling for gender and premorbid functioning. However, AAO was younger in those with early CUD (starting before age 14) compared to NCUD (F(1) = 11.3; p = 0.001; partial η2 = 0.042). When considering the subgroups of early versus late onset psychosis, AAO was even later in early onset psychosis patients with CUD compared to those with NCUD (F(1) = 8.4; p = 0.004; partial η2 = 0.072). These findings were consistent for patients with non-affective psychoses, in those with CUD without other substance use disorders and in those with CUD explicitly starting in the pre-psychotic phase. Notably, 89.1% started cannabis before the onset of psychotic symptoms.ConclusionsCUD starting before age 14 was associated with an earlier AAO at a small effect size, but only in adult onset FEP patients.
27
Marques, Tiago Reis, Shubulade Smith, Stefania Bonaccorso, Fiona Gaughran, Anna Kolliakou, Paola Dazzan, Valeria Mondelli, et al. "Sexual dysfunction in people with prodromal or first-episode psychosis." British Journal of Psychiatry 201, no. 2 (August 2012): 131–36. http://dx.doi.org/10.1192/bjp.bp.111.101220.
Abstract:
BackgroundSexual dysfunction is common in psychotic disorder but it is not clear whether it is intrinsic to the development of the illness or secondary to other factors.AimsTo compare sexual function in people at ultra-high risk (UHR) of a psychotic disorder, patients with first-episode psychosis predominantly taking antipsychotic drugs and healthy volunteers.MethodSexual function was assessed in a UHR group (n = 31), a group with first-episode psychosis (n = 37) and a matched control group of healthy volunteers (n = 56) using the Sexual Function Questionnaire.ResultsThere was a significant effect of group on sexual function (P<0.001). Sexual dysfunction was evident in 50% of the UHR group, 65% of first-episode patients and 21% of controls. Within the UHR group, sexual dysfunction was more marked in those who subsequently developed psychosis than in those who did not. Across all groups the severity of sexual dysfunction was correlated with the severity of psychotic symptoms (P<0.001). Within the first-episode group there was no significant difference in sexual dysfunction between patients taking prolactin-raising v. prolactin-sparing antipsychotics.ConclusionsSexual dysfunction is present prior to onset of psychosis, suggesting it is intrinsic to the development of illness unlikely to be related to the prolactin-raising properties of antipsychotic medication.
28
Buckley, Peter F., Christoph U. Correll, and Alexander L. Miller. "First-Episode Psychosis: A Window of Opportunity for Best Practices." CNS Spectrums 12, S15 (2007): 1–16. http://dx.doi.org/10.1017/s1092852900026213.
Abstract:
AbstractPatients experiencing a first psychotic episode or early stages of psychosis present with key diagnostic issues for clinicians. At the time of first-episode psychosis presentation, it is crucial that clinicians select the most effective treatment option as immediate intervention offers the best chance for containing the illness. Functional impairment occurs most rapidly at the early stage of illness, and such impairment can influence the patient's future prognosis, alter the level of necessary treatment, and affect morbidity. Although research has shown a decrease in brain gray matter as well as signs of functional impairment in those who develop psychosis, many of these patients remain untreated for extended periods of time and do not visit a clinician due to fear of stigma, a failure to recognize the problem, or complexities of their care system. Prior studies have shown that untreated psychosis results in worse outcome for patients compared to psychosis that is treated earlier in the course of illness. There is a range of treatment options for psychosis, including use of first-generation or second-generation antipsychotic medication. Clinicians should note that both medication types are associated with certain side effects, such as tardive dyskinesia and weight gain, respectively. For all antipsychotics, doses should be lower for patients with a first psychotic episode than for patients with chronic psychosis. Finally, clinicians must consider that patients may present with various comorbidities, such as substance abuse, that also may affect treatment.This expert roundtable supplement will address the diagnosis and treatment selection for first-episode psychosis as well as comorbidities related to the condition. The use of first- or second-generation antipsychotics for psychosis treatment, dosing guidelines, and the antipsychotic side-effect profile will also be addressed.
29
Melo, B., C. Alves Pereira, R. Cajão, J. Ribeiro Silva, S. Pereira, and E. Monteiro. "First-episode psychosis intervention – description of our early intervention model." European Psychiatry 41, S1 (April 2017): s823. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1607.
Abstract:
IntroductionThe research about the benefits of early diagnosis and treatment of first-episode psychosis had significantly increased in last decades. There have been several early intervention programs in psychotic disease, implemented worldwide, in order to improve the prognosis of these psychotic patients.ObjectivesTo present a brief description of the first-episode psychosis intervention team of Tondela-Viseu Hospital Centre–Portugal and its model. We aim to further characterize our population and describe its evolution since 2008.AimsWe aim to clarify the benefits of an early intervention in psychosis.MethodsWe conducted a retrospective cohort study of patients being followed by our team from November 2008 to September 2016. Demographic and medical data were collected (such as diagnosis, duration of untreated psychosis, treatments and its clinical effectiveness, relapse rate and hospital admissions) in patient's clinical records. The intervention model protocol of this team was also described and analyzed.ResultsThis multidisciplinary team consists of three psychiatrists, one child Psychiatrist, one psychologist and five reference therapists (areas of nursing, social service and occupational therapy). It includes patients diagnosed with first-episode psychosis, aged 16 to 42 years old, followed for five years. The team followed, since its foundation, 123 patients, mostly male. The most prevalent diagnosis are schizophrenia and schizophreniform psychosis. The team is currently following 51 patients.ConclusionsThis team's intervention have progressively assumed a more relevant importance in the prognosis of patients with first-episode psychosis, by reducing the duration of untreated psychosis, the relapse rate and by promoting social reintegration.Disclosure of interestThe authors have not supplied their declaration of competing interest.
30
Coentre, Ricardo, Amilcar Silva-dos-Santos, and Miguel Cotrim Talina. "Retrospective study on structural neuroimaging in first-episode psychosis." PeerJ 4 (May 26, 2016): e2069. http://dx.doi.org/10.7717/peerj.2069.
Abstract:
Background.No consensus between guidelines exists regarding neuroimaging in first-episode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT) and magnetic resonance imaging (MRI)) in the initial medical work-up of patients presenting first-episode psychosis.Methods.The study subjects were 32 patients aged 18–48 years (mean age: 29.6 years), consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI) were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI) and respective reports were analysed by an experienced consultant psychiatrist.Results.None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly andfalx cerebricalcification). No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay andcannabisuse were found between patients who had neuroimaging abnormalitiesversusthose without.Discussion.This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age.
31
Falfel, D., W. Homri, F. Ghrissi, M. Stambouli, M. Ben Bechir, L. Mouelhi, N. Bram, I. Ben Romdhane, and R. Labbane. "Acute family marital psychosis." European Psychiatry 64, S1 (April 2021): S322. http://dx.doi.org/10.1192/j.eurpsy.2021.865.
Abstract:
IntroductionAcute marital psychosis is an acute psychotic episode occurring in a particular context which is marriage. In fact, marriage represents an event with a very important emotional load especially in the Arab-Muslim culture. This event can, in some people, induce a relapse of certain psychiatric disorders, particularly psychotic ones. We propose in this work to report two clinical observations concerning two brothers who both presented, a few years apart, an acute nuptial psychosis with two different evolutions.ObjectivesStuding the characteristics of nuptial psychotic episode in a one family and the different evolution of each one.MethodsReporting two clinical cases of two brothers who represented both acute psychotic episode in a nuptial context with different evolution.ResultsThe two patients are brothers with common psychiatric background which is their mother treated for chronic psychotic disorder. They were hospitalized in our psychiatric service for acute psychotic episode occuring in a nuptial context with chronic evolution for the first one and a partial recovery for the second one.ConclusionsMarriage represents an event with a very important emotional load especially in the Arab-Muslim culture. In thiscontext, acute psychotic episode can occur with different evolution for patients predisposed. Studing socio-cultral circumstances related to psychotic episode can help mental health professional to improve the quality of health care service.
32
Amin, Shazad, Swaran P. Singh, John Brewin, Peter B. Jones, Ian Medley, and Glyn Harrison. "Diagnostic stability of first-episode psychosis." British Journal of Psychiatry 175, no. 6 (December 1999): 537–43. http://dx.doi.org/10.1192/bjp.175.6.537.
Abstract:
BackgroundThe temporal stability of a diagnosis is one measure of its predictive validity.AimsTo measure diagnostic stability in first-episode psychosis using ICD–10 and DSM–III–R.MethodBetween 1992 and 1994 we ascertained a cohort of persons with first-episode psychosis (n=168), assigning to each a consensus diagnosis. At three-year follow-up, longitudinal consensus diagnoses, blind to onset diagnoses, were made. Stability was measured by the positive predictive values (PPVs) of onset diagnoses. For onset schizophrenia, we also calculated sensitivity, specificity and concordance (κ).ResultsFirst-episode ICD–10 and DSM–III–R schizophrenia had a PPV of over 80% at three years. Over one-third of cases with ICD–10 F20 schizophrenia at three years had non-schizophrenia diagnoses at onset. Manic psychoses showed the highest PPV (91%). For onset schizophrenia, both systems had high specificity (ICD–10: 89; DSM–III–R: 93%), but low sensitivity (ICD–10: 64%; DSM–III–R: 51%) and moderate concordance (ICD–10: 0.54; DSM–III–R: 0.46).ConclusionsBipolar disorders and schizophrenia showed the highest stability. DSM–III–R schizophrenia did not have greater stability than ICD–10 schizophrenia.
33
Teixeira-Dias, Maria, Amber Kaur Dadwal, and Graham Blackman. "#3117 Fregoli syndrome in primary and secondary psychosis: a case level meta-analysis." Journal of Neurology, Neurosurgery & Psychiatry 92, no. 8 (July 16, 2021): A18. http://dx.doi.org/10.1136/jnnp-2021-bnpa.41.
Abstract:
Objectives/AimsFregoli syndrome is a rare delusion characterised by the misidentification of an individual, typically of someone who the patient has an emotional link towards. The pathoaetiology of Fregoli syndrome remains largely a mystery, however, it has been described in patients experiencing either a primary or secondary (organic) psychosis. We sought to compare the neuropsychiatric features of Fregoli syndrome in primary and secondary psychosis.MethodsA patient-level meta-analysis was conducted. Five databases were searched for any descriptions of Fregoli syndrome. The patients and the psychotic episodes details alongside the co-occurring neuropsychiatric features and treatment responses were extracted. A risk of bias assessment was carried by scoring the methodological quality of all case studies. Random-effects models were used to pool the data and odds ratios and 95% confidence intervals were estimated for each of the neuropsychiatric features extracted between primary and secondary psychoses groups.ResultsA total of 119 patients (62 with primary psychosis, 50 with secondary psychosis and 7 with mixed or unknown aetiology) with Fregoli syndrome were identified in the English literature. Persecutory features were more likely to occur in patients with primary Fregoli syndrome (OR = 0.26, 95% CI[0.10;0.67], p < 0.01). In addition, Fregoli syndrome in the context of a first-episode psychosis (OR = 11.00, 95% CI [2.45;49.39], p < 0.01) and in the presence of neuroimaging abnormalities (OR = 20.19, 95% CI [4.36; 93.47], p < 0.01) was significantly associated with secondary aetiology. Patients in the secondary psychosis group (n=14) showed more right hemisphere lesions than patients in the primary psychosis group (n=1), however this trend was not significant (p = 0.10). Furthermore, no statistical differences between psychoses groups were found for the demographic, clinical and neurophysiological features analysed.ConclusionsThis is the first meta-analysis investigating the features of Fregoli syndrome in primary and secondary psychosis.Findings suggest that secondary causes of Fregoli syndrome are associated with a first-episode of psychosis and that neuroimaging abnormalities, particularly in the right hemisphere, are associated with a secondary organic cause.
34
Elsawy, H. F., M. A. Abd Elhay, and A. B. Abd Elkrem. "FC07-01 - Cognitive functions in first episode psychosis." European Psychiatry 26, S2 (March 2011): 1846. http://dx.doi.org/10.1016/s0924-9338(11)73550-7.
Abstract:
BackgroundCognitive impairment is recognized as an important feature of psychosis in its early stages and is a determinant of prognosis and management of these disorders.Aim of the studyTo test the cognitive functions in first psychotic episode in patients with disorders of schizophrenia, schizoaffective disorder, bipolar disorder and depression with psychotic disorder and to compare them to controls.Subjects and methodsThe study included 254 patients diagnosed according to Diagnostic and Statistical criteria of Mental disorders, 4th edition (91 schizophrenics, 21 with schizoaffective disorder, 107 with bipolar disorder and 31 with psychotic depression) and experiencing their first psychotic episode. Seventy healthy volunteers matched as regards age and sex with patients were used as controls. All are subjected to cognitive evaluation by Trail Making Test, part B, Wisconsin card sorting test 128, Benton Visual Retention Test and Wechsler Adult Intelligence Test.ResultsAll patients showed significant cognitive deterioration in all tests compared to control group. On comparing patients to each other, there was no significant difference between schizophrenics and patients with bipolar disorder, but both showed marked deterioration in comparison to depressive group.ConclusionCognitive impairments are present in early stages of psychosis and need careful assessment and management.
35
Martínez, L., A. Mané, R. Cortizo, I. Cáceres, D. Treen, L. Galindo, P. Salgado, and D. Berge. "Insight and Social Cognition in First Episode of Psychosis." European Psychiatry 41, S1 (April 2017): S272. http://dx.doi.org/10.1016/j.eurpsy.2017.02.102.
Abstract:
IntroductionImpairment of insight in psychotic disorder is associated with adverse impact in treatment compliance, outcome and social functioning although its underlying mechanisms are still unknown. Social cognition and more specifically Theory of mind have been proposed to be correlated to insight. However, the relationship between both factors is still not well defined.AimsTo study the association between social cognition and insight into mental illness in individuals with early psychosis included in the first episode of psychosis program of Hospital del Mar.MethodsFrom the 94 patients included in the first psychotic episode program between January 2011 and January 2016, thirty-eight patients were evaluated six months after the episode. The three initial items of SUMD (Scale Unawareness of Mental Disorder) were used to measure insight and MSCEIT (Mayer-Salovey-Caruso Emotional Intelligence Test) was used to assess social cognition. Linear correlation analysis by Pearson correlation was conducted.ResultsInsight results of SUMD six months after the first episode of psychosis were significantly associated with several subsections of MSCEIT, such as experiential area total punctuation (r = –0.574; P = 0.025), emotional facilitation section (r = –0.633; P = 0.011) and the facial emotion perception task (r = –0.572; P = 0.026).ConclusionsResults suggest an association between insight and emotional perception and facilitation performance in first episode patients, which may suggest a role of social cognition in psychosis insight impairment. Further research to better define the participation of social cognition in insight into psychosis alteration is mandatory to understand the etiology of insight, define treatment targets and consequently improve the disorder prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
36
Schaufelberger, M. S., J. M. Lappin, F. L. S. Duran, P. G. P. Rosa, R. R. Uchida, L. C. Santos, R. M. Murray, et al. "Lack of progression of brain abnormalities in first-episode psychosis: a longitudinal magnetic resonance imaging study." Psychological Medicine 41, no. 8 (December 10, 2010): 1677–89. http://dx.doi.org/10.1017/s0033291710002163.
Abstract:
BackgroundSome neuroimaging studies have supported the hypothesis of progressive brain changes after a first episode of psychosis. We aimed to determine whether (i) first-episode psychosis patients would exhibit more pronounced brain volumetric changes than controls over time and (ii) illness course/treatment would relate to those changes.MethodLongitudinal regional grey matter volume and ventricle:brain ratio differences between 39 patients with first-episode psychosis (including schizophrenia and schizophreniform disorder) and 52 non-psychotic controls enrolled in a population-based case-control study.ResultsWhile there was no longitudinal difference in ventricle:brain ratios between first-episode psychosis subjects and controls, patients exhibited grey matter volume changes, indicating a reversible course in the superior temporal cortex and hippocampus compared with controls. A remitting course was related to reversal of baseline temporal grey matter deficits.ConclusionsOur findings do not support the hypothesis of brain changes indicating a progressive course in the initial phase of psychosis. Rather, some brain volume abnormalities may be reversible, possibly associated with a better illness course.
37
Hui, C. L. M., Y. K. Li, A. W. Y. Li, E. H. M. Lee, W. C. Chang, S. K. W. Chan, S. Y. Lam, et al. "Visual working memory deterioration preceding relapse in psychosis." Psychological Medicine 46, no. 11 (June 16, 2016): 2435–44. http://dx.doi.org/10.1017/s0033291716000751.
Abstract:
BackgroundRelapse is distressingly common after the first episode of psychosis, yet it is poorly understood and difficult to predict. Investigating changes in cognitive function preceding relapse may provide new insights into the underlying mechanism of relapse in psychosis. We hypothesized that relapse in fully remitted first-episode psychosis patients was preceded by working memory deterioration.MethodVisual memory and verbal working memory were monitored prospectively in a 1-year randomized controlled trial of remitted first-episode psychosis patients assigned to medication continuation (quetiapine 400 mg/day) or discontinuation (placebo). Relapse (recurrence of positive symptoms of psychosis), visual (Visual Patterns Test) and verbal (Letter–Number span test) working memory and stressful life events were assessed monthly.ResultsRemitted first-episode patients (n = 102) participated in the study. Relapsers (n = 53) and non-relapsers (n = 49) had similar baseline demographic and clinical profiles. Logistic regression analyses indicated relapse was associated with visual working memory deterioration 2 months before relapse [odds ratio (OR) 3.07, 95% confidence interval (CI) 1.19–7.92, P = 0.02], more stressful life events 1 month before relapse (OR 2.11, 95% CI 1.20–3.72, P = 0.01) and medication discontinuation (OR 5.52, 95% CI 2.08–14.62, P = 0.001).ConclusionsVisual working memory deterioration beginning 2 months before relapse in remitted first-episode psychosis patients (not baseline predictor) may reflect early brain dysfunction that heralds a psychotic relapse. The deterioration was found to be unrelated to a worsening of psychotic symptoms preceding relapse. Testable predictors offer insight into the brain processes underlying relapse in psychosis.
38
Bergaoui, E., R. Lansari, O. Chehaider, M. Moalla, A. Larnaout, and W. Melki. "Cannabis use during first episode psychosis in Tunisia." European Psychiatry 66, S1 (March 2023): S756. http://dx.doi.org/10.1192/j.eurpsy.2023.1592.
Abstract:
IntroductionCannabis use is frequent among patients with psychotic disorders. However, the relationship between cannabis consumption and transition to psychosis has not been fully elucidated.ObjectivesThe aim of this study was to assess the prevalence of cannabis use in first episode psychosis and its correlation with transistion to psychosis and severity of symptoms.MethodsA cross-sectional study was conducted at the psychiatric department D of Razi hospital including 50 patients hospitalized for first episode psychosis. The evaluation focused on sociodemographic and clinical characteristics of the patients. We used the cannabis abuse screening test (CAST) and positive and negative syndrome scale (PANSS).ResultsThe sex ratio of our patients was 4 men per 1 woman. The mean age was 25.6±6.16 years. Two-thirds of the patients had secondary education (n=24). Half of them had no occupation (n=17). Twenty-five patients (71%) had no psychiatric history. The total PANSS score showed a mean of 58.29±12.90 with extremes between 35 and 91. About 60% of the patients used cannabis with high addiction risk in 81% of cases. The mean duration of cannabis use was 7,04 years, 3 times a week. Cannabis use was correlated to the gender. However, no correlation was found between cannabis use and duration of untreated psychosis niether the negative or positive symptoms.ConclusionsAlthough cannabis use is knownto accelerate transition to psychosis, it does not affect the severity of symptoms. Further work is necessary to identify the factors that underlie individual vulnerability to cannabinoid-related psychosis and to elucidate the biological mechanisms underlying this risk.Disclosure of InterestNone Declared
39
Melle, I., S. Friis, U. Haahr, J. O. Johannesen, T. K. Larsen, S. Opjordsmoen, J. I. Roessberg, et al. "Measuring quality of life in first-episode psychosis." European Psychiatry 20, no. 7 (November 2005): 474–83. http://dx.doi.org/10.1016/j.eurpsy.2005.03.002.
Abstract:
AbstractQuality of life (QoL) measures are increasingly recognized as necessary parts of outcome assessments in psychosis. The present paper is a comprehensive study of patients with first-episode psychosis where QoL is measured by the commonly used Lehman Quality of Life Interview (L-QoLI). The aim is to examine if the L-QoLI maintain its original structure when used in a group of patients with first-episode psychosis, and to investigate what determines global subjective QoL with a specific emphasis on premorbid adjustment, duration of untreated psychosis (DUP) and clinical symptoms. The study indicates that the psychometric properties of the L-QoLI do not change significantly when used in first-episode samples. The patients report subjective and objective QoL in the fair to good range, with only a moderate association between the objective and subjective measures. Poor global satisfaction is predicted by being single, abusing drugs, being depressed, having a diagnosis of psychotic affective disorder, having poor premorbid social adjustment and DUP over 10 weeks. The study supports the notion that patients with first-episode psychosis construct QoL in the same way as other groups, and that longer durations of compromised function at this stage produces poor satisfaction with life rather than a downward readjustment of expectations.
40
Kapse, Praful Prabhuappa, and Manisha Kiran. "Psychosocial Needs of the Families with a Person with First Episode Psychosis." Indian Journal of Psychiatric Social Work 10, no. 1 (January 31, 2019): 56. http://dx.doi.org/10.29120/ijpsw.2019.v10.i1.138.
Abstract:
Background: The people who experience psychotic symptoms first time can be frightening for them and their close family members. It is crucial to provide family support and care to persons with first episode psychosis. Aim: To assess the needs of family members presenting to a tertiary care centre. Methods: Cross-sectional outpatient based study design was adapted to collect data from the family members of persons with first episode psychosis presented to a tertiary care centre. Total 60 family members were randomly selected for the study and assessed for the burden, attitude, ways of coping and quality of life. Results: Study results indicate the high burden; it has noted that high negative expressed emotions among family members. Negative coping styles were also found and the family members and having a poor quality of life. Conclusion: First episode of psychosis can traumatizing to the patients and their family members. Family members can experience the burden of caregiving including financial burden, can have faulty ways of coping and negative expressed emotions towards their own wards having psychosis which can lead to poor treatment outcome. Findings indicated that need to provide psychosocial intervention for family members of persons with first episode psychosis.
Keyword: Family, psychosocial intervention, needs, first episode psychosis, expressed emotions, burden
41
Gleeson, John. "Preventing Episode II: Relapse Prevention in First-Episode Psychosis." Australasian Psychiatry 13, no. 4 (December 2005): 384–87. http://dx.doi.org/10.1080/j.1440-1665.2005.02198.x.
Abstract:
Objective: This paper outlines a rationale for expanding research and clinical innovations focused upon relapse prevention following a first episode of psychosis. Some general principles for further progress are extracted from an overview of the first-episode psychosis (FEP) relapse literature. A cognitive behaviour therapy intervention for relapse prevention for FEP, that has been developed at the Early Psychosis Prevention and Intervention Centre, is described to illustrate these principles. Conclusions: Further progress is needed in refining interventions specific to the prevention of relapse following FEP. Future progress is dependent upon improved understanding of the interaction of biological, interpersonal and psychological processes underpinning relapse.
42
Хвостова, И. И., И. В. Бондарь, Т. В. Докукина, О. В. Ткаченко, and Е. Т. Зубовская. "Postpartum Psychosis and the First Psychotic Episode in a Woman’s Life: Clinical and Anamnestic Features, the State of Cellular and Humoral Immunity." Психиатрия, психотерапия и клиническая психология, no. 3 (November 21, 2022): 258–68. http://dx.doi.org/10.34883/pi.2022.13.3.005.
Abstract:
Цель. Изучение и сравнение преморбидных характеристик, клинических особенностей и показателей иммунограммы у пациенток с послеродовым психозом и первым в жизни психотическим эпизодом. Материалы и методы. В открытое поперечное исследование были включены 23 пациентки с послеродовым психозом и 65 – с первым в жизни психотическим эпизодом. Использовались клиническое интервью, шкала общего клинического впечатления, метод проточной цитофлуориметрии. Результаты. У женщин с послеродовыми психозами чаще встречались заболевания нервной и эндокринной систем (р<0,05), кратковременное течение психотических расстройств (р<0,001), наличие аффективного синдрома (р<0,05), более низкое относительное и абсолютное содержание В-лимфоцитов (p<0,01). При тяжелом течении послеродового психоза чаще регистрировались отклонения от нормальных уровней цитотоксических Т-лимфоцитов (p<0,05) и иммунорегуляторного индекса (p<0,001). Заключение. Частота присутствия в анамнезе пациенток заболеваний нервной и эндокринной систем, угнетение гуморального звена иммунитета и его связь с тяжестью течения психического расстройства могут свидетельствовать в пользу активного участия иммунной дисрегуляции в генезе послеродовых психозов. Purpose. To study and to compare premorbid characteristics, clinical features and immunogram findings in patients with postpartum psychosis and a first-in-life psychotic episode. Materials and methods. 23 patients with postpartum psychosis and 65 patients with a first-in-life psychotic episode were included in the open-label cross-sectional study. Clinical interview, general clinical impression scale, and flow cytofluorimetry method were used. Results. Diseases of nervous and endocrine systems (p<0.05), short-term course of psychotic disorders (p<0.001), presence of affective syndrome (p<0.05), lower relative and absolute content of B-lymphocytes (p<0.01) were more common in women with postpartum psychosis. In severe postpartum psychosis, deviations from the normal levels of cytotoxic T-lymphocytes (p<0.05) and the immunoregulatory index (p<0.001) were more often recorded. Conclusion. The frequency of nervous and endocrine system diseases in patients’ history, the suppression of the humoral link of immunity and its relationship with the severity of the course of mental disorder may be indicative of an active participation of immune dysregulation in genesis of postpartum psychoses. postpartum psychosis, first psychotic episode, premorbid characteristics, immunogram
43
Lasalvia, Antonio, Chiara Bonetto, Sarah Tosato, Gioia Zanatta, Doriana Cristofalo, Damiano Salazzari, Lorenza Lazzarotto, et al. "First-contact incidence of psychosis in north-eastern Italy: influence of age, gender, immigration and socioeconomic deprivation." British Journal of Psychiatry 205, no. 2 (August 2014): 127–34. http://dx.doi.org/10.1192/bjp.bp.113.134445.
Abstract:
BackgroundConsiderable variations in the incidence of psychosis have been observed across countries, in terms of age, gender, immigration status, urbanicity and socioeconomic deprivation.AimsTo evaluate the incidence rate of first-episode psychosis in a large area of north-eastern Italy and the distribution of the above-mentioned risk factors in individuals with psychoses.MethodEpidemiologically based survey. Over a 3-year period individuals with psychosis on first contact with services were identified and diagnosed according to ICD-10 criteria.ResultsIn total, 558 individuals with first-episode psychosis were identified during 3 077 555 person-years at risk. The annual incidence rate per 100 000 was 18.1 for all psychoses, 14.3 for non-affective psychoses and 3.8 for affective psychoses. The rate for all psychoses was higher in young people aged 20–29 (incidence rate ratio (IRR) = 4.18, 95% CI 2.77–6.30), immigrants (IRR = 2.26, 95% CI 1.85–2.75) and those living in the most deprived areas (IRR = 2.09, 95% CI 1.54–2.85).ConclusionsThe incidence rate in our study area was lower than that found in other European and North American studies and provides new insights into the factors that may increase and/or decrease risk for developing psychosis.
44
Ricci, Valerio, Giovanni Martinotti, Domenico De Berardis, and Giuseppe Maina. "Lurasidone use in Cannabis-Induced Psychosis: A Novel Therapeutic Strategy and Clinical Considerations in Four Cases Report." International Journal of Environmental Research and Public Health 19, no. 23 (November 30, 2022): 16057. http://dx.doi.org/10.3390/ijerph192316057.
Abstract:
Background: Lurasidone is an atypical antipsychotic approved for the acute and maintenance treatment of schizophrenia. Recently, lurasidone was also extended FDA approval for adults with major depressive episodes associated with bipolar I disorder (bipolar depression), as either a monotherapy or as adjunctive therapy with lithium or valproate. The use of low doses of atypical antipsychotics is an essential component of early intervention in psychosis, but little has yet been studied on first episode cannabis-induced psychosis. For its particular performance and tolerability, lurasidone is becoming an important option for the treatment of first-episode psychosis in youth. Case presentation four patients experiencing first cannabis-induced psychotic episode were treated with lurasidone. In all patients, there was an improvement in the clinical picture of psychosis. The recovery was positive, not only with the remission of positive and negative symptoms, but also regarding disruptive behaviour, with the return of functioning. All the patients were treated with lurasidone, with a target dose of 74–128 mg/day. No significant side effects were reported. Conclusion: There are non-controlled studies for the use of lurasidone in first episode psychosis cannabis induced. These findings suggest that lurasidone is an atypical antipsychotic beneficial in this clinical picture. Treatment with medium-high doses of lurasidone could be effective and tolerable in this phase of the disorder. Randomized control trials with longer follow-up are recommended to confirm these positive results.
45
Garcia Ayala, L., M. Gómez Revuelta, C. Martín Requena, E. Saez de Adana Garcia de Acilu, O. Porta Olivares, M. Juncal Ruiz, N. Nuñez Morales, et al. "Clozapine: Since the very beginning?" European Psychiatry 41, S1 (April 2017): S752—S753. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1402.
Abstract:
IntroductionPsychosis in childhood and adolescence could be defined as having hallucinations, with the hallucinations occurring in the absence of insight. A broader definition includes symptoms such as delirious thoughts, disorganized speech, disorganized behavior, cognitive and mood symptoms and what is called negative symptoms. Several researches have been done focused in the treatment of first episode of psychosis showing clozapine as a keystone in the treatment of psychosis, especially in refractory first episodes.ObjectivesClozapine has unique efficacy in improving treatment-resistant patients with chronic schizophrenia but the moment of instauration remains unclear. There have always been doubts about the right moment to start clozapine, after two or more previous anti-psychotics or as first option.Materials and methodsWe report a 18-year- old woman with family history of severe psychosis. Her mum reasserted patient's symptoms contributing to a longer period of non-treating psychosis (about 10 months). Auditory hallucinations, incongruent mood and incoherent language appeared for the first time at the age of 17. High doses of two consecutive anti-psychotics were tried without remission and finally clozapine was initiated with clinical improvement.DiscussionIn clinical practice, a subgroup of psychotic patients experience, significant ongoing positive symptoms despite of using first line anti-psychotic medication.ConclusionMost recent research; suggest that clozapine may have an important role in the early treatment of first-episode patients, even becoming a first line option to consider.Disclosure of interestThe authors have not supplied their declaration of competing interest.
46
MORGAN, CRAIG, PAUL FEARON, GERARD HUTCHINSON, KWAME McKENZIE, JULIA M. LAPPIN, RUDWAN ABDUL-AL, KEVIN MORGAN, et al. "Duration of untreated psychosis and ethnicity in the ÆSOP first-onset psychosis study." Psychological Medicine 36, no. 2 (December 1, 2005): 239–47. http://dx.doi.org/10.1017/s0033291705006604.
Abstract:
Background. There is a common assumption that Black patients with a psychotic mental illness experience longer treatment delays during a first episode. We sought to investigate this issue in a large cohort of patients with a first episode of psychosis.Method. All patients with a first episode of psychosis presenting to secondary mental health services within tightly defined catchment areas in south-east London and Nottingham over a 2-year period were included in the study. Data relating to duration of untreated psychosis (DUP) and clinical and sociodemographic characteristics were collected from patients, relatives and case-notes.Results. There was no evidence that African-Caribbean or Black African patients experienced longer periods of untreated psychosis than White British patients prior to first contact with services. There was evidence that Black African patients experienced shorter periods of untreated psychosis than White British patients.Conclusions. Contrary to what is commonly assumed, our study suggests that Black patients with a psychotic mental illness do not experience longer treatment delays prior to first contact with services than White British patients. This suggests that strategies to reduce treatment delays targeted specifically at Black patients will be of limited value.
47
Molina, V., J. Sanz, S. Reig, R. Martínez, F. Sarramea, R. Luque, C. Benito, J. D. Gispert, J. Pascau, and M. Desco. "Hypofrontality in men with first-episode psychosis." British Journal of Psychiatry 186, no. 3 (March 2005): 203–8. http://dx.doi.org/10.1192/bjp.186.3.203.
Abstract:
BackgroundDecreased metabolic activity in the prefrontal cortex during cognitive activation is a recurrent finding and a likely functional marker of schizophrenia.AimsTo investigate the occurrence of hypofrontality in patients with first-episode psychosis, with or without evolution to schizophrenia.MethodWe used fluorodeoxyglucose positron emission tomography during the performance of an attention task and magnetic resonance imaging to study the dorsolateral prefrontal region in 13 men with a first episode of psychosis. Data from patients who progressed to schizophrenia were compared with those of patients who did not meet criteria for this diagnosis after 2 years.ResultsPatients who developed schizophrenia demonstrated a significant hypofrontality in the dorsolateral prefrontal cortex in comparison with the non-schizophrenia and control groups.ConclusionsOur results suggest that hypofrontality could be a marker of schizophrenia at the time of the first psychotic episode, in agreement with neurodevelopmental theories of schizophrenia.
48
Koch, Marlene, Melanie Trimmel, Josef Baumgartner, Barbara Hinterbuchinger, Zsuzsa Litvan, Fabian Friedrich, and Nilufar Mossaheb. "S102. DIAGNOSTIC CHALLENGES AT TIME OF INPATIENT ADMISSION: DIAGNOSTIC SHIFTS IN PATIENTS WITH FIRST EPISODE PSYCHOSIS." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S73. http://dx.doi.org/10.1093/schbul/sbaa031.168.
Abstract:
Abstract Background First episode psychoses (FEP) may present with diffuse symptoms and a broad range of clinical phenotypes, leading to difficulties in the early detection of the different pluripotent trajectories and consequently to instability of the diagnoses. The aim of this study was to assess the stability of diagnoses at time of admission compared to discharge in patients with FEP at a newly established early psychosis inpatient unit within a general psychiatric service in a general hospital. Methods Charts of all patients admitted to the early psychosis inpatient unit of the Clinical Division of Social Psychiatry of the Medical University of Vienna between 01.01.2016 and 31.03.2017 were reviewed. FEP was defined as a first presentation of affective, schizophreniform, acute polymorphic, organic or substance-related psychosis according to ICD-10. Results 127 patients were admitted during the said period, among whom 92 (72,4%) were diagnosed with a psychotic disorder at time of admission. 39,1% (n=36) of those had a FEP, whereof 58,3% (n=21) were diagnosed with schizophrenia spectrum psychosis, 27,8% (n=10) with affective psychosis, 11,1% (n=4) with substance-related psychosis and 2,8% (n=1) with organic psychosis as main diagnosis at time of discharge. In 50% (n=18) of FEP patients, diagnosis at time of admission was not maintained. 54,2% (n=13) of FEP patients who were admitted with a schizophrenia spectrum diagnosis had a shift in diagnosis at time of discharge, whereof 46,2% (n=6) were adjusted to another diagnosis of the same spectrum and 53,8% (n=7) to a diagnosis of either affective spectrum, substance-related psychosis or organic psychosis. 100% (n=2) of those with a persistent delusional disorder had a different diagnosis at discharge, as well as 56,3% (n=9=) of those admitted with a diagnosis of acute and transient psychotic disorders. Changes in the admission diagnoses of affective psychosis were necessary in 44,4% (n=4), whereof one half was adjusted to another diagnosis of the same spectrum and the other half to a diagnosis of the schizophrenia spectrum. Discussion The diagnostic instability in this study underlines the concept of the highly dynamic and changeable nature of psychopathology in the early stages and the pluripotent trajectories of psychosis. Furthermore, inadequate information available for specific diagnosis at time of admission as well as diagnostic uncertainty at the onset of psychosis could be implicated in the described diagnostic instability. The broad range of clinical phenotypes of early psychosis and the limitations of current diagnostic risk and identification approaches for the assessment of first episode psychosis indicate psychopathology conformed to a more dimensional rather than categorical model, as well as the need of a more dynamic model of prediction, such as the clinical staging model.
49
Takase, Masayuki, Hisoshi Kimura, Nobuhisa Kanahara, Yusuke Nakata, and Masaomi Iyo. "Plasma monoamines change under dopamine supersensitivity psychosis in patients with schizophrenia: A comparison with first-episode psychosis." Journal of Psychopharmacology 34, no. 5 (January 21, 2020): 540–47. http://dx.doi.org/10.1177/0269881119900982.
Abstract:
Background: Patients with first-episode psychosis respond well to initial antipsychotic treatment, but among patients experiencing a relapse of psychosis, the response rate falls to approximately 30%. The mechanism of this discrepancy has not been clarified, but the development of dopamine supersensitivity psychosis with the underlying up-regulation of post-synaptic dopamine D2 receptors could be involved in this lesser response. It is uncertain whether elevated dopamine synthesis and release occurs in patients with dopamine supersensitivity psychosis, in contrast to those with first-episode psychosis. Patients and methods: We examined a first-episode psychosis group ( n=6) and a chronic schizophrenia group, i.e. patients experiencing relapse ( n=23) including those who relapsed due to dopamine supersensitivity psychosis ( n=18). Following the initiation of treatment, we measured the patients’ blood concentrations of homovanillic acid and 3-methoxy-4-hydroxyphenylglycol at two weeks and four weeks after the baseline measurements. Results: The first-episode psychosis group tended to show decreased homovanillic acid, accompanied by an improvement of symptoms. The chronic schizophrenia group showed no alteration of homovanillic acid or 3-methoxy-4-hydroxyphenylglycol over the treatment period. These results were the same in the dopamine supersensitivity psychosis patients alone. Conclusions: Our findings suggest that unlike first-episode psychosis, the release of dopamine from presynaptic neurons did not increase in relapse episodes in the patients with dopamine supersensitivity psychosis. This indirectly indicates that the development of supersensitivity of post-synapse dopamine D2 receptor is involved in relapse in dopamine supersensitivity psychosis patients.
50
RAUNE, DAVID, PAUL BEBBINGTON, GRAHAM DUNN, and ELIZABETH KUIPERS. "Event attributes and the content of psychotic experiences in first-episode psychosis." Psychological Medicine 36, no. 2 (December 7, 2005): 221–30. http://dx.doi.org/10.1017/s003329170500615x.
Abstract:
Background. Previous psychosocial stress research, contemporary cognitive models, and new cognitive behavioural treatments for psychosis converge in suggesting that stressful events influence the content of psychotic experiences. In this paper we test whether the attributes of stressful events preceding the initial onset of psychosis are associated with core themes of the illness.Method. Forty-one people who had experienced a first episode of psychosis were assessed on the attributes of stressful events occurring in the year before onset, the themes (persecutory, depressive, and grandiose) associated with their delusions and the content of their auditory hallucinations.Results. Principal component analysis yielded four components accounting for 72% of the variance. As hypothesized, intrusive events were associated with the development of delusions with persecutory themes. Grandiose delusions were negatively associated with loss events. Depressive delusions appear to be associated with danger events rather than loss events.Conclusion. There are links between stressful event attributes and core psychotic themes at first-episode psychosis. This has implications for theoretical models of, and early psychological intervention for, psychosis.