Journal articles on the topic 'Psychosis'
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Gerada, Clare, and Adrianne Reveley. "Schizophreniform Psychosis Associated with the Menstrual Cycle." British Journal of Psychiatry 152, no. 5 (May 1988): 700–702. http://dx.doi.org/10.1192/bjp.152.5.700.
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The premenstrual and menstrual periods are associated with increased psychiatric disturbances, both of a psychotic and neurotic nature. Pre-existing psychosis can worsen in the premenstrual period, or, as we describe in the following case report, a psychosis can occur in the premenstrual period with complete remission once the bleeding has ceased. The role of menstruation in the timing and pathogenesis of the major psychoses is largely ignored in present-day psychiatry. In the nineteenth century, however, psychosis coincident with menstruation was thought to merit its own special term (Menstruationpsychose), and Kraepelin himself described the importance of the association (Kraepelin, 1909). In contrast, premenstrual tension has been the subject of continuous interest since the term was first used by Frank (1931), and there have been cases described of premenstrual tension in association with psychosis. Williams & Weeks (1952), for example, reported on 16 cases where the psychosis was characteristic of mania or catatonic schizophrenia, and more recently, Price & DiMarzio (1986) found that 60% of a group of rapidly cycling manic-depressive psychotics suffered from severe premenstrual tension. Psychosis associated with the menstrual cycle without concomitant symptoms of premenstrual tension has also been described. Lingjaerde & Bredland (1954) presented a case of a 24-year-old woman who developed a manic–depressive (manic-type) psychosis synchronous with her menstrual cycle, after childbirth. A Japanese cohort of patients diagnosed as suffering from “periodic psychosis” (Wakoh et al, 1960) showed significant correlation between acute psychosis and the luteal phase of the menstrual cycle. The premenstrual period is also known to exacerbate pre-existing psychosis; Ota et al (1954) and Gregory (1957) have shown a significant increase in psychotic behaviour in the last 10 days of the menstrual cycle. We present a patient with a schizophreniform psychosis occurring irregularly but concomitant with her menstrual cycle, with total remission during the interval stage.
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Gayane Kirakosyan and Alina Frolova. "Understanding psychosis: diagnosis and clinical presentation (updates for clinicians)." World Journal of Advanced Research and Reviews 13, no. 1 (January 30, 2022): 065–71. http://dx.doi.org/10.30574/wjarr.2022.13.1.0759.
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Psychosis is understood as the brightest manifestations of mental illness, in which the patient's mental activity does not correspond to the surrounding reality, the reflection of the real world in consciousness is sharply distorted, which manifests itself in behavioral disorders, abnormal pathological symptoms and syndromes. Psychosis is a combination of biological (genetic, neuroanatomical, neurophysiological), psychological and social factors in various proportions. Psychoses are classified according to their origin (etiology) and reasons (pathogenetic mechanisms of development) into endogenous (including endogenous psychoses include schizophrenia, schizoaffective disorder, some psychotic forms of affective disorders), organic, somatogenic, psychogenic (reactive, situational), intoxication, withdrawal and post-withdrawal. Most often, psychoses develop in the framework of so-called endogenous disorder. The concepts of psychosis and schizophrenia are often equated, which is incorrect as psychotic disorders can occur in a number of mental illnesses: Alzheimer's disease and other types of dementia, chronic alcoholism, drug addiction, epilepsy, intellectual disabilities, etc. Other types of psychosis, such as infectious, somatic and intoxication psychoses are quite often find among patients in non-psychiatric practices. This review article is a good educational material for medical and psychological practitioners whose goal is to improve knowledge and diagnostic processes of psychosis and its related disorders.
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Filatova, S., R. Marttila, H. Koivumaa-Honkanen, T. Nordström, J. Veijola, P. Mäki, G. M. Khandaker, et al. "A comparison of the cumulative incidence and early risk factors for psychotic disorder in young adults in the Northern Finland Birth Cohorts 1966 and 1986." Epidemiology and Psychiatric Sciences 26, no. 3 (March 28, 2016): 314–24. http://dx.doi.org/10.1017/s2045796016000123.
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Aims.Few studies have compared time trends for the incidence of psychosis. To date, the results have been inconsistent, showing a decline, an increase or no significant change. As far as we know, no studies explored changes in prevalence of early risk factors. The aim of this study was to investigate differences in early risk factors and cumulative incidences of psychosis by type of psychosis in two comparable birth cohorts.Methods.The Northern Finland Birth cohorts (NFBCs) 1966 (N = 12 058) and 1986 (N = 9432) are prospective general population-based cohorts with the children followed since mother's mid-pregnancy. The data for psychoses, i.e. schizophrenia (narrow, spectrum), bipolar disorder with psychotic features, major depressive episode with psychotic features, brief psychosis and other psychoses (ICD 8–10) were collected from nationwide registers including both inpatients and outpatients. The data on early risk factors including sex and place of birth of the offspring, parental age and psychosis, maternal education at birth were prospectively collected from the population registers. The follow-up reached until the age of 27 years.Results.An increase in the cumulative incidence of all psychoses was seen (1.01% in NFBC 1966 v. 1.90% in NFBC 1986; p < 0.001), which was due to an increase in diagnosed affective and other psychoses. Earlier onset of cases and relatively more psychoses in women were observed in the NFBC 1986. Changes in prevalence of potential early risk factors were identified, but only parental psychosis was a significant predictor in both cohorts (hazard ratios ≥3.0; 95% CI 1.86–4.88). The difference in psychosis incidence was not dependent on changes in prevalence of studied early risk factors.Conclusions.Surprisingly, increase in the cumulative incidence of psychosis and also changes in the types of psychoses were found between two birth cohorts 20 years apart. The observed differences could be due to real changes in incidence or they can be attributable to changes in diagnostic practices, or to early psychosis detection and treatment.
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Quattrone, Diego. "Genetic substrates of cannabis-associated psychosis." Revista Española de Drogodependencias 47, no. 4 (December 30, 2022): 86–102. http://dx.doi.org/10.54108/10030.
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This paper will summarise the main substrates of cannabis-associated psychoses. First, an epistemological framework will be introduced to support the existence of a specific ‘cannabisassociated psychosis’ as a nosological entity distinct from idiopathic schizophrenia and other psychotic disorders. Then, the main clinical characteristics of cannabis-associated psychoses will be examined. Finally, the biological and genetic correlates of cannabis-associated psychosis will be presented.
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Alharbi, F. "A comparison and contrast of cannabis and amphetamine-type stimulant induced psychoses." European Psychiatry 41, S1 (April 2017): s856. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1705.
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BackgroundThe term “psychosis” is very broad. Substance users represent one group with particularly high rates of psychotic symptoms.ObjectiveThis review will present an update on cannabis and amphetamine-type Stimulant (ATS) and will try to differentiate and compare their associated psychotic features.MethodA systematic literature search was conducted from 1980 to date in the following databases: MEDLINE, PsycINFO and PubMed. Articles were included if they were highlighting substances induced psychoses, with particular emphasis on stimulants/amphetamine/methamphetamine and cannabis/marijuana induced psychoses, schizophrenia-spectrum disorder or schizophrenia.ResultsThere are many differences between these two substances regarding source, neurobiological processes, average latency periods before developing psychosis, clinical features as compared to schizophrenia, risk of using drugs and developing psychosis and drugs use and development of schizophrenia and urine screening test. With the recent proposals to regulate cannabis use, a further investigation of the association of this use with psychosis is required.ConclusionsOur search elicited many studies of one substance and its association with psychosis but few comparative studies across substances. Yet in our opinion, these comparisons could shed further insight on the development of psychotic features.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Nitzgen, Dieter. "Comment on Vollon, Gimenez and Bonnet: ‘The psychotic transference in groups’." Group Analysis 52, no. 4 (September 6, 2019): 561–70. http://dx.doi.org/10.1177/0533316419874468.
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In his written work, Foulkes never gave a systematic account of psychosis, psychotic disturbances and psychotic transference(s). Instead we find scattered remarks and reflections on the subject of psychosis throughout his writings. However, it is noteworthy that his first psychoanalytic article (Foulkes, 1930) was dedicated to Observations on the significance of the name in a schizophrenic (Foulkes, 1990: 3–20). Moreover, in his first group analytic article (Foulkes and Lewis, 1944), he mentioned and encouraged the treatment of psychotic patients in mixed groups (Foulkes, 1984, case 8, 10, 11 and 12: 30–33) but cautioned that in a group ‘psychoses should not be in the majority’ and ‘groups with psychotics only were a different matter’ (Foulkes, 1984: 35). However, some his most consistent statements on psychosis are given in his late articles. For instance, the view that ‘undoubtedly, the person who later develops a psychosis, is also conditioned by his early group, and vice versa’ (Foulkes, 1990: 276). And the conviction that ‘psychotic mechanisms are operative in all of us, and that psychosis-like mechanisms and defences are produced very early’ (Foulkes, 1990: 276). However, he cautioned that ‘later psychotic illness’ should not be considered as ‘regressions to these early stages as one might say that neurosis or neurotic reactions are’ (Foulkes, 1990: 276; cf. Wälder, 1937). And although Foulkes acknowledged that ‘early development produces many of the phenomena that are stressed by Melanie Klein’ (Foulkes, 1990: 276; italics mine), he posited that they were ‘being brought about by the interaction of the whole family on these primitive levels’ (Foulkes, 1990: 276). ‘Complicated emotions’, he wrote, ‘can be felt even by the small child as actually represented and transmitted, however unconsciously, by the parents, brothers and sisters and so on’ (Foulkes, 1990: 276).
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Caton, Carol L. M., Deborah S. Hasin, Patrick E. Shrout, Robert E. Drake, Boanerges Domínguez, Michael B. First, Sharon Samet, and Bella Schanzer. "Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis." British Journal of Psychiatry 190, no. 2 (February 2007): 105–11. http://dx.doi.org/10.1192/bjp.bp.105.015784.
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BackgroundThe stability of the diagnostic distinction between a substance-induced psychosis and a primary psychotic disorder co-occurring with substance use is not established.AimsTo describe DSM – IV diagnostic changes over 1 year and determine the predictive validity of baseline indicators of the substance-induced psychosis v. primary psychosis distinction.MethodWe conducted a 1-year follow-up study of 319 psychiatric emergency department admissions with diagnoses of early-phase psychosis and substance use comorbidity.ResultsOf those with a baseline DSM—IV diagnosis of substance-induced psychosis, 25% had a diagnosis of primary psychosis at follow-up. These patients had poorer premorbid functioning, less insight into psychosis and greater family mental illness than patients with a stable diagnosis of substance-induced psychosis. Reclassifying change cases to primary psychoses on follow-up, key baseline predictors of the primary/substance-induced distinction at 1 year also included greater family history of mental illness in the primary psychosis group.ConclusionsFurther study of substance-induced psychoses should employ neuroscientific and behavioural approaches. Study findings can guide more accurate diagnoses at first treatment.
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Nosov, S. G., L. М. Yuryeva, T. Y. Shusterman, and O. V. Nekrasova. "Clinical and pathogenetic prediction of the dynamics of the course of psychoses in epilepsy." Medicni perspektivi 27, no. 3 (September 30, 2022): 97–102. http://dx.doi.org/10.26641/2307-0404.2022.3.265945.
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Transient epileptic psychoses in 30-40% of cases turn into psychotic states with a long, paroxysmal or chronic course. The objective of this article is to conduct a systematic analysis of modern literature sources to clarify the factors, clinical and pathogenetic patterns of transformation of transient (short-term) epileptic psychosis into psychotic states with prolonged and chronic course, as well as to identify pathogenetically oriented principles of treatment of such patients. The prognostic value of clinical and neurophysiological factors regarding increasing of the psychotic process duration has been noticed, clinical patterns of transformation of short-term psychosis into long-term (changes in the dynamics and structure of psychosis, features of the relationship with organic personality disorder and dementia in epilepsy, as well as epileptic seizures) have been shown. A number of important neurophysiological pathogenetic mechanisms of increasing the psychosis duration (growing cerebral hypofrontality, temporal localization and regular spread of the epileptic process) have been identified. Pathogenetically oriented principles of treatment tactics of patients with epileptic psychoses have been described and analyzed taking into account the revealed regularities of increasing of their duration.
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Susser, Ezra, Vijoy K. Varma, S. K. Mattoo, Molly Finnerty, Ramin Mojtabai, B. M. Tripathi, Arun K. Misra, and N. N. Wig. "Long-term course of acute brief psychosis in a developing country setting." British Journal of Psychiatry 173, no. 3 (September 1998): 226–30. http://dx.doi.org/10.1192/bjp.173.3.226.
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BackgroundThis study in North India compared acute brief psychosis – defined by acute onset, brief duration and no early relapse – with other remitting psychoses, over a 12-year course and outcome.MethodIn a cohort of incident psychoses, we identified 20 cases of acute brief psychosis and a comparison group of 43 other remitting psychoses based on two-year follow-up. Seventeen people (85%) in the acute brief psychosis group and 36 (84%) in the comparison group were reassessed at five, seven and 12 years after onset, and were rediagnosed using ICD–10 criteria.ResultsAt 12-year follow-up, the proportion with remaining signs of illness was 6% (n=1) for acute brief psychosis versus 50% (n=18) for the comparison group (P=0.002). Using ICD–10 criteria, the majority in both groups were diagnosed as having schizophrenia.ConclusionsAcute brief psychosis has a distinctive and benign long-term course when compared with other remitting psychoses. This finding supports the ICD– 10 concept of a separable group of acute and transient psychotic disorders. To effectively separate this group, however, the ICD–10 criteria need modification.
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Burke, Aggrey. "Distinguishing vulnerable clients from psychotic patients with follow-up mortality data." BJPsych Open 7, S1 (June 2021): S11—S12. http://dx.doi.org/10.1192/bjo.2021.90.
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AimsThe aim of the present study is to determine whether vulnerable non-psychotic clients presenting in court proceedings do not share the same mortality profile as psychotic patients in similar environments. It is hypothesised that the two display quite separate mortality profiles.BackgroundThe increased mortality of psychiatric patients and prisoners has been documented but less is known of the outcomes among other vulnerable populations .The population for study is a consecutive series of assessments in court proceedings of carers of children at risk and violent offenders.MethodAssistants not involved in the initial assessments transferred data from case notes and this material was transferred to computer files. Statistical analysis SPSS19Formal psychiatric diagnoses were those agreed in court proceedings. National mortality records were searched and copies of death certificates obtained. A small number of cases known to have returned overseas were excluded. 772 cases were studied. One in five were assessed in prison, twice as many gave a history of violent criminal behaviour. Over a half suffered abuse or neglect or admitted to being unhappy in childhood. Three subgroups have been identified: Vulnerable with no psychotic illness(60%), psychosis with no evidence of personality disorder or of mixed psychosis(18%), linked psychosis(22%). It was found that demographic variables , deprivation factors, adverse childhood experiences and outcomes and clinical variables are in excess among linked psychotics compared with other groups. Linear regression of unnatural death among psychotic patients identifies five risk factors. The distribution of high-risk factors among linked psychosis is more than twice that found in other groups.ResultNatural mortality is most evident among clients suffering from psychosis without personality disorder or mixed disorder.Unnatural mortality is more than 10 times greater among patients with linked psychosis, compared with those with no psychosis and four times greater than other psychoses. Risk factors for unnatural mortality are: physical illness, stressful relationship, violence to self or others, detained and history of behaviour disorder.ConclusionThe findings of the present study demonstrate that vulnerable clients without psychosis are less likely to die by unnatural causes than clients who suffer psychosis coexisting with personality disorder or mixed psychosis. The null hypothesis is upheld. The findings suggest that risk assessment of vulnerable populations should take account of risk factors of unnatural death which have been identified in this study.
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Gilenko, M. V., and V. Yu Gulyaeva. "Forensic Psychiatry Aspects of Exogenous Organic Psychotic Disorders." Doctor.Ru 21, no. 8 (2022): 60–65. http://dx.doi.org/10.31550/1727-2378-2022-21-8-60-65.
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Objective of the Review: To summarise the references related to the forensic psychiatry aspects of exogenous organic psychotic disorders. Key Points. The majority of acute exogenous organic psychotic disorders during a wrongdoing are more or less associated with the use of psychoactive substances (PAS). This literature overview discusses typical forensic psychotic conditions appearing in acute intoxication with PAS (short-term psychotic disorders, abnormal alcoholic intoxication, abnormal forms of alcoholic intoxication, PAS-induced psychosis) and psychosis associated with withdrawal. Key challenges in the diagnosis of these conditions, changes in approaches to their forensic psychiatric assessment and the modern idea of legally relevant skills of wrongdoers who committed an illegal act during an exogenous psychosis, are analysed here. Conclusion. The matter of acute exogenous psychoses which is a relevant issue for forensic and psychiatric examination, is discussed insufficiently in recent literature sources. Further studies are needed, and approaches to a forensic and psychiatric examination of legally relevant skills of wrongdoers should be developed. Keywords: organic psychotic disorder, exogenous psychosis, PAS-induced psychosis, forensic and psychiatric examination.
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PERALTA, VICTOR, and MANUEL J. CUESTA. "Cycloid psychosis: a clinical and nosological study." Psychological Medicine 33, no. 3 (April 2003): 443–53. http://dx.doi.org/10.1017/s0033291702007055.
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Background. Despite its clinical relevance, the diagnosis of cycloid psychosis has been relatively neglected in the psychiatric literature and in the current nosological systems. This study examined the clinical validity and nosological status of the cycloid psychosis concept.Method. Six-hundred and sixty psychotic in-patients were assessed for psychosis-related variables and diagnosed according to DSM-III-R, DSM-IV, ICD-10 and the Perris & Brockington criteria for cycloid psychosis. The cycloid psychosis diagnosis (N=68, 10·3%) was examined in regard to its discriminant validity, concordance with other psychotic disorders, and predictive validity in relation to schizophrenia and psychotic mood disorders. To address putative heterogeneity within cycloid psychosis, affective (N=38) and non-affective (N=30) subgroups were examined.Results. Cycloid psychosis had good discriminant validity regarding other psychoses (95% of correctly classified cases) and poor concordance with individual diagnoses from the formal diagnostic systems (κ<0·22). Cycloid patients had levels of psychotic, disorganization and first-rank symptoms comparable to schizophrenia, and levels of affective symptoms in-between schizophrenia and mood disorders. Regarding most clinical variables and morbidity risk of mood disorders, cycloid psychosis was closer to mood disorders. Cycloid psychosis had higher psychosocial stressors than schizophrenia and mood disorders. Affective and non-affective groups of cycloid psychosis differed in a number of variables indicating an overall better outcome for the non-affective group.Conclusions. Cycloid psychosis does not correspond closely to any DSM-III-R, DSM-IV or ICD-10 category of psychosis, and more specifically this nosological concept is not well represented by the different formal definitions of remitting psychotic disorders. Cycloid psychosis seems to be an heterogeneous condition in that affective and non-affective subgroups can be differentiated.
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Javadpour, Ali, Maryam Sehatpour, Arash Mani, and Ali Sahraian. "Assessing Diagnosis and Symptoms Profiles of Late-Life Psychosis." GeroPsych 26, no. 4 (January 1, 2013): 205–9. http://dx.doi.org/10.1024/1662-9647/a000090.
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Background: There are many controversies with regard to the nosology and conditions causing psychosis in old age people. This study defines a symptom profile and differential diagnosis of late-onset psychosis. Method: 201 elderly persons with psychotic symptoms were recruited. All patients were interviewed based on SCID-1 to confirm the possible diagnosis. Results: The most delusional symptom reported by the subjects was persecutory delusion, and visual hallucinations were the most common hallucination. The most repeated diagnosis was dementia, followed by psychosis due to mood disorders, primary psychotic disorders, delirium, and psychosis due to medical conditions. Conclusions: Results from the current study indicate that late-life psychoses form a heterogeneous group of disorders with varying symptom profiles and etiologies.
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Obuaya, Chi-Chi, Gayathri Thivyaa Gangatharan, and Efthimia Karra. "Brucella-Induced Acute Psychosis: A Novel Cause of Acute Psychosis." Case Reports in Infectious Diseases 2021 (March 4, 2021): 1–4. http://dx.doi.org/10.1155/2021/6649717.
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Background. Infections have long been linked to psychosis and categorised within “secondary” psychoses. To date, there have been few reports of psychosis linked to brucellosis. This case report aims to present one such case. Case Presentation. A 31-year-old man was admitted to a general hospital with pyrexia, severe right upper quadrant pain, and an acute psychosis following a two-week holiday in South East Asia and the Mediterranean. Serological tests revealed that he had brucellosis. Following antibiotic treatment, the psychotic symptoms abated and he was discharged within ten days of hospitalisation. Conclusions. This case of organic psychosis highlights the importance of considering brucellosis as a rare cause of acute psychosis. The exact mechanism of Brucella-induced psychosis remains unclear.
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Brown, Kayla, Laura Corlin, Maureen Dubreuil, Tien Tran, Hannah Brown, and Christina Borba. "M87. PREVALENCE OF AUTOIMMUNE DISEASES IN INDIVIDUALS WITH PRIMARY PSYCHOTIC DISORDERS AT BOSTON MEDICAL CENTER." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S167—S168. http://dx.doi.org/10.1093/schbul/sbaa030.399.
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Abstract Background The prevalence of autoimmune diseases is higher among individuals with psychiatric illnesses than in the general population. It is unknown if the prevalence of autoimmune diseases differs among people with different primary psychotic disorders. Our objective was to assess whether the prevalence of autoimmune diseases differs among people with schizophrenia/schizoaffective disorder, affective (bipolar/depression) psychosis, and other psychotic disorders (delusional, brief psychotic, schizophreniform, or unspecified psychosis). Methods For our cross-sectional study, we used International Classification of Diseases (ICD) codes to identify individuals with primary psychotic disorders/unspecified psychoses who received treatment at Boston Medical Center between October 2003 and May 2019. Individuals with other/unspecified psychosis with an organic cause and individuals with unspecified psychosis, brief psychotic disorder with coinciding drug withdrawal, post-partum psychosis, or drug-induced mental illness, confusion, or seizure were excluded. Autoimmune diseases were categorized as systemic or as one of seven organ-specific subgroups (dermatological, endocrinological, gastroenterological, hematological, non-systemic connective tissue, and neurological). Multivariable logistic regression was used to compare differences in prevalence of autoimmune diseases among individuals with different psychoses adjusting for age, sex, and race. We also considered sex and race-stratified analyses. Results Of the 13,938 individuals (mean age = 43 years; 58% male) diagnosed with psychosis, 55% had schizophrenia, 17% had affective psychosis, and 29% had other/unspecified psychosis. Overall, nearly 9% of individuals with psychosis had at least one autoimmune disease (8% with schizophrenia, 11% with affective psychosis, and 8% with other/unspecified psychosis). The most prevalent autoimmune disease subgroups were systemic (39%), dermatological (26%), and endocrinological (23%). Compared to individuals with schizophrenia, individuals with affective psychosis had increased odds of having any autoimmune disease (OR: 1.38; 95% CI: 1.17, 1.63), dermatological autoimmune diseases (OR: 1.55; 95% CI: 1.15, 2.07), or endocrinological autoimmune diseases (OR: 1.56; 95% CI: 1.14, 2.12). Compared to individuals with schizoaffective as the only psychosis diagnosis, individuals with affective psychosis had increased odds of having any autoimmune disease (OR: 1.31; 95% CI: 1.03, 1.66) and individuals with schizophrenia had decreased odds of having neurological autoimmune diseases (OR: 0.46; 95% CI: 0.23, 0.96). Among individuals with any psychotic disorder, females were 95% more likely to have any autoimmune disease (OR: 1.95; 95% CI: 1.72, 2.20). No racial differences were observed overall; however, compared to individuals who identified as white, individuals who identified as Black, Hispanic, and Asian had decreased odds of having gastroenterological autoimmune diseases (OR: 0.52; 95% CI: 0.35, 0.76), neurological autoimmune diseases (OR: 0.32; 95% CI: 0.10, 0.83), and systemic autoimmune diseases (OR: 0.25; 95% CI: 0.04, 0.80), respectively, while Black individuals had increased odds of having systemic autoimmune diseases (OR: 1.45; 95% CI: 1.17, 1.81). Discussion The prevalence of autoimmune diseases varied among people with different primary psychotic disorders, and certain associations were modified by sex and race. Clinicians may consider additional screening for autoimmune diseases among individuals with psychosis.
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Hsiung, Kimberly, and Maja Skikic. "Mood Disorder or Psychotic Disorder? Yes: A Case Report on Cycloid Psychosis." Journal of Psychiatric Practice 29, no. 4 (July 2023): 333–39. http://dx.doi.org/10.1097/pra.0000000000000717.
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Cycloid psychosis is a disorder defined by episodic, acute psychoses involving thought, affect, and motor disturbances with polymorphous symptomatology followed by periods of full remission. Antipsychotics, benzodiazepines, and electroconvulsive therapy have been used empirically in acute treatment. This disorder has faced nosologic challenges and is not yet identified as a diagnostic entity by the Diagnostic and Statistical Manual of Mental Disorders (DSM). Questions remain as to whether cycloid psychosis is a primary psychotic or primary affective disorder, given that its course and episodicity are like that of affective disorders, while its clinical manifestations include prominent psychotic symptoms. This report describes the case of a 38-year-old male with classic features of cycloid psychosis and highlights the unique characteristics that distinguish cycloid psychosis from other similar diagnoses.
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Riecher-Rössler, A. "Early psychosis in young women." European Psychiatry 33, S1 (March 2016): S7. http://dx.doi.org/10.1016/j.eurpsy.2016.01.789.
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IntroductionIt is well known that young women are at lower risk for schizophrenic psychoses than young men. However, little is known about the peculiarities of emerging psychosis in young women.ObjectivesTo describe characteristics of emerging psychosis in women.MethodsWithin the FePsy (Früherkennung von Psychosen = early detection of psychosis) study at the University of Basel Psychiatric Clinics we have examined consecutively all patients with a first episode of psychosis (FEP) or an at-risk mental state (ARMS) referred to us between 2000 and 2015.ResultsWomen did not significantly differ from men regarding psychopathology, neither in the ARMS nor in the FEP group. This was true for positive as well as negative symptoms and basic symptoms. Interestingly, women had a higher correlation of self-rating with observer-rating regarding psychotic symptoms. Duration of untreated psychosis was significantly lower in women than in men. Women seek help more quickly than men and their first contact is more often their partner.Regarding neurocognition women showed a slightly better performance in verbal tasks. They also had higher prolactin levels and larger pituitary volumes, even when drug-naive.Transition to psychosis occurred as often and as quickly in women as in men.ConclusionsThere are only few gender differences in patients with emerging psychosis, which resemble mainly those found in the general population, with women showing a better help-seeking behavior, being more partner-oriented, having a better verbal performance and potentially also a higher stress reactivity [1].Disclosure of interestThe author has not supplied his declaration of competing interest.
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Stein, Daniel, Aharon Hanukoglu, Slulamit Blank, and Avner Elizur. "Cyclic Psychosis Associated with the Menstrual Cycle." British Journal of Psychiatry 163, no. 6 (December 1993): 824–28. http://dx.doi.org/10.1192/bjp.163.6.824.
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Psychotic symptoms are not included under accepted definitions of premenstrual syndrome (PMS). We present a 14-year-old girl with PMS, who developed a late luteal cyclic psychosis during two consecutive premenstrual periods, which resolved completely after the onset of menses. She was treated with dehydroxyprogesterone for two cycles, and later with placebo for the next three consecutive cycles. Psychotic symptoms did not reappear following two psychotic cycles, and the PMS resolved within the next menstrual cycle. We suggest that cyclic psychoses associated with the menstrual cycle may be a specific benign entity, not included under the recognised functional psychoses. In some cases these psychoses could be classified as a subgroup of PMS.
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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.
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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
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Aleixo, M. A., C. A. Moreira, G. Sobreira, J. Oliveira, and L. Carvalhão Gil. "Atypical psychosis – historical and current perspective." European Psychiatry 33, S1 (March 2016): S362. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1298.
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IntroductionClinical concepts regarding atypical psychosis such as the French bouffeé délirante, the German cycloid psychosis, and the Scandinavian reactive and schizophreniform psychoses are now under the category of F23 ‘Acute and transient psychotic disorders’ (ATPD) of the tenth revision of the International Classification of Mental and Behavioural Disorders (ICD-10).AimsThe authors’ aim is to highlight the clinical and scientific relevance of atypical psychosis from the historical concepts to the current perspective.MethodsA Pubmed database search using as keywords “atypical psychosis”, “acute and transient psychotic disorders”, and “brief psychotic disorder” and retrieved papers were selected according to their relevance.ResultsDifferent psychiatric schools, often of a regional or national character, have provided concepts for transient psychotic states. The acute and transient psychotic disorders of ICD-10 and the brief psychotic disorder of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) reflect the diversity of the history of such concepts. The available evidence suggests that case identification and follow-up is difficult in ATPD due to the heterogeneous and infrequent nature of this clinical phenomenon. Furthermore ATPD has a low diagnostic stability and there are few studies focused on brief psychotic disorders.ConclusionsThe present definition of acute and transient psychotic disorders and brief psychotic disorder, while taking into account the history of the concepts involved, leave many questions open to further studies.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Jupe, T., E. Myslimi, I. Giannopoulos, and B. Zenelaj. "Drug-Induced Psychosis: Causes, Symptoms, and Treatment." European Psychiatry 66, S1 (March 2023): S677. http://dx.doi.org/10.1192/j.eurpsy.2023.1415.
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IntroductionA relationship between drug abuse and the onset of psychotic symptoms is strongly supported. A struggling clinical dilemma is how to clearly identify a substance-induced psychosis from a primary psychotic illness or a psychotic illness with comorbid substance use.ObjectivesIn this review, the presence of associated psychotic symptoms and the differences in clinical presentation will be analyzed for each substance.MethodsΑ bibliographical review was performed using the PubMED platform. All relevant articles were found using the keywords: substance-Induced Psychoses, symptoms, treatmentResultsPresent review shows a picture of the complex relationship between psychotic symptoms and the use and abuse of illicit drugs. Furthermore, in most cases, chronological criteria are not sufficient to prove a direct causal effect between the substance and psychosis. The subjects who presented psychotic symptoms after substance abuse seemed to have a higher risk of the development of a primary psychotic illness.ConclusionsPsychosis due to substance abuse is a common issue in clinical practice and the propensity to develop psychosis seems to be associated with the severity of use and dependence.Disclosure of InterestNone Declared
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Bravve, L. V., and N. V. Zakharova. "COVID-19-Associated Schizophrenia-Like Psychosis." Psikhiatriya 20, no. 4 (January 11, 2023): 44–53. http://dx.doi.org/10.30629/2618-6667-2022-20-4-44-53.
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Background: COVID-19-associated psychoses are psychotic disorders that have developed during a new coronavirus infection. Criteria of these psychoses are the manifestation of psychosis simultaneously with infection with the SARS-CoV-2 virus and the presence of documented COVID-19 disease. Information about these diseases appears as brief reports of mental services or with rare clusters. The need to study COVID-19-associated psychoses is due to the relatively high risk of their development, reaching 2.8%. The aim of study was to analyse the identified cases of COVID-19-associated psychosis in comparison with the results presented in the scientific literature. Patients and methods: 50 cases of COVID-19-associated psychosis were analyzed using a clinical method, taking into account the results of physical examination from April 2020 to September 2021. Results: 27 women and 23 men aged 20 to 57 were examined. Common symptoms were revealed: simultaneously or immediately after infection and identification of the virus against the background of growing anxiety and dissomnia, delusional ideas were formed, which quickly turned into fantastic delusion with disturbing agitation and hallucinations and subsequent marked disorganization of behavior with possible confusion of consciousness at the peak of psychosis. Perceptual deceptions were the most common, auditory hallucinations were the most prevalent, and catatonia was relatively common. The cupping therapy led to reduction of psychotic symptoms, and returned patients to a pre-morbid level of functioning. In most cases, there was a critical resolution of the attack, which probably indicates a favorable outcome of the disorder. Such dynamics is consistent with scientific literature data. Conclusion: the question of the primary or secondary nature of COVID-19-associated psychoses remains unresolved. It is necessary to continue the study of COVID-19-associated psychosis with the identification of risk factors for the development of psychosis, manifestation features, psychopathological picture, outcome options to determine the optimal rehabilitation program.
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Klapheck, K., S. Nordmeyer, H. Cronjäger, D. Naber, and T. Bock. "Subjective experience and meaning of psychoses: the German Subjective Sense in Psychosis Questionnaire (SUSE)." Psychological Medicine 42, no. 1 (July 7, 2011): 61–71. http://dx.doi.org/10.1017/s0033291711001103.
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BackgroundClinical research on subjective determinants of recovery and health has increased, but no instrument has been developed to assess the subjective experience and meaning of psychoses. We have therefore constructed and validated the Subjective Sense in Psychosis Questionnaire (SUSE) to measure sense making in psychotic disorders.MethodSUSE was based on an item pool generated by professionals and patients. For pre-testing, 90 psychosis patients completed the instrument. Psychometric properties were assessed using methods of classical test theory. In the main study, SUSE was administered to a representative sample of 400 patients. Factor structure, reliability and validity were assessed and confirmatory factor analyses (CFAs) were used for testing subscale coherence and adequacy of the hypothesized factor structure. Response effects due to clinical settings were tested using multilevel analyses.ResultsThe final version of SUSE comprises 34 items measuring distinct aspects of the experience and meaning of psychoses in a consistent overall model with six coherent subscales representing positive and negative meanings throughout the course of psychotic disorders. Multilevel analyses indicate independence from clinical context effects. Patients relating psychotic experiences to life events assessed their symptoms and prospects more positively. 76% of patients assumed a relationship between their biography and the emergence of psychosis, 42% reported positive experience of symptoms and 74% ascribed positive consequences to their psychosis.ConclusionsSUSE features good psychometric qualities and offers an empirical acquisition to subjective assessment of psychosis. The results highlight the significance of subjective meaning making in psychoses and support a more biographical and in-depth psychological orientation for treatment.
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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.
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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.
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Bebbington, Paul, Soraya Wilkins, Peter Jones, Alice Foerster, Robin Murray, Brian Toone, and Shôn Lewis. "Life Events and Psychosis." British Journal of Psychiatry 162, no. 1 (January 1993): 72–79. http://dx.doi.org/10.1192/bjp.162.1.72.
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Data from the Camberwell Collaborative Psychosis Study were used to examine the proposition that there is an excess of life events preceding the onset of psychoses of all types. Of 97 patients from the study who had episodes within the past year that were datable, 51 had developed psychotic symptoms from an essentially symptom-free state, 29 had been suffering only from neurotic symptoms, and 17 had experienced a marked exacerbation of psychotic symptoms. DSM–III diagnoses were collapsed into three major groups: 51 cases of schizophrenia; 31 cases of mania; and 14 cases of depressive psychosis. Life-event histories were taken for the six months before onset, and when these were compared with equivalent histories from a psychiatrically healthy sample from the local general population, there was a significant excess of life events, particularly in the three months before onset of psychosis. This was apparent in all groups, and remained even when events were restricted to the independent category. The excess of events began rather earlier than has been found in previous studies. In our view, this study provides some of the strongest evidence for a link between life events and the emergence of psychotic symptoms.
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Phanjoo, A. "Treatment of psychoses in the elderly." Advances in Psychiatric Treatment 2, no. 3 (May 1996): 133–39. http://dx.doi.org/10.1192/apt.2.3.133.
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Psychotic disorders in the elderly can be divided into three types: disorders that have started in earlier life and persist into old age; disorders that start de novo after the age of 60, and psychoses associated with brain disease, including the dementias. The classification of psychoses in late life has provoked controversy for nearly a century. The debate concerns whether schizophrenia can present at any stage of life or whether functional psychoses, arising for the first time in late life, represent different illnesses. The nomenclature of such disorders consists of numerous terms including late onset schizophrenia, late paraphrenia, paranoid psychosis of late life and schizophreniform psychosis. This plethora of terms has made research difficult to interpret.
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Clarke, David J., Tessa Webb, and Joyce P. Bachmann-Clarke. "Prader-Willi syndrome and psychotic symptoms: report of a further case." Irish Journal of Psychological Medicine 12, no. 1 (March 1995): 27–29. http://dx.doi.org/10.1017/s0790966700002019.
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AbstractA 21 year-old woman with Prader-Willi syndrome (PWS) and a delusional disorder (paranoid psychosis) is described. Other reports of psychoses associated with PWS are reviewed. Reasons for the co-existence of the two disorders are considered, with discussion of the possible role of auditory information processing deficits in the genesis of psychotic symptoms. Such symptoms must be differentiated from maladaptive behaviours not arising from psychosis, the latter being relatively common in PWS. Treatment with a small dose of flupenthixol greatly reduced the impact of the patient's psychotic symptoms, with a corresponding improvement in her quality of life.
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Strik, Werner K. "Anxiety as a Primary Symptom in Cycloid Psychosis." CNS Spectrums 5, no. 9 (September 2000): 47–51. http://dx.doi.org/10.1017/s1092852900021647.
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AbstractPsychotic anxiety has not been systematically included in standard psychopathologic and diagnostic literature, presumably because anxiety is implicitly perceived to be an emphatically comprehensible consequence of the cognitive symptoms of psychosis. This review gives an overview of neurophysiologic studies that indicate different pathogenic mechanisms for different types of psychosis. Convergent and complementary structural and functional imaging findings, biochemical and neuropsychological data allow conjecture as to neurophysiologic-psychopathologic links in cycloid psychosis. Intriguing results suggest that in cycloid psychosis, a generalized hyperasousal related to the tonus of the noradrenergic system may be the basic disturbance causing the delusionary and perceptual psychotic distortions. The findings are specific for cycloid psychoses, which are diagnosed as polymorphous psychosis in the International Classification of Diseases and Related Health Problems, 10th Edition. Furthermore, these findings are consistent with the author's hypothesis that the emotional derailment is the primary disturbance in cycloid psychosis (anxiety-elation). In contrast, cognitive disturbances are secondary and remit after the exceptional emotional state is rebalanced.
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Ungvari, Gabor Sandor, and Paul Edward Mullen. "Reactive Psychoses Revisited." Australian & New Zealand Journal of Psychiatry 34, no. 3 (June 2000): 458–67. http://dx.doi.org/10.1080/j.1440-1614.2000.00752.x.
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Objective and Method: This paper describes the overlap between reactive (psychogenic) psychosis and other brief psychotic episodes, and explores the gradual disappearance of reactive psychoses as a distinct nosological entity from international classifications. Clinical and conceptual issues concerning reactive psychosis are examined on the basis of a critical review of major classical and modern papers. A brief illustrative case history is also provided. Results: Reactive psychoses are conceptualised as severe disturbances of mental state, on occasion chameleon-like in their shifting form and content, arising in response to a stressful event or life situation. Reactive psychoses have an abrupt onset and usually run their course to complete resolution in a matter of days or weeks. Precipitants include overwhelming fear, threat of imminent destruction, social isolation (as can occur with imprisonment, immigration or deafness), bereavement and intense sexual or interpersonal conflicts. The emergence of a reactive psychosis usually occurs against the background of a predisposing vulnerability in terms of personality disorder, organic impairment, or a history of sensitising experiences, occasionally operating in combination. Conclusions: The increasing failure to recognise reactive psychoses diminishes clinical psychiatry because it removes an important opportunity for understanding mental disorder in terms of an integration, and totalisation, of developmental history, psychological makeup, social context and current realities, and in so doing lessens our awareness of the links between psychosis and our common humanity.
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Mollon, Josephine, Emma Knowles, Samuel Mathias, Amanda Rodrigue, Marinka Koenis, Godfrey Pearlson, and David Glahn. "T67. TRAUMA IN AFFECTIVE AND NONAFFECTIVE PSYCHOSIS: ASSOCIATIONS AND DISSOCIATIONS WITH COGNITIVE FUNCTIONING IN CHILDHOOD AND ADULTHOOD." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S256—S257. http://dx.doi.org/10.1093/schbul/sbaa029.627.
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Abstract Background Childhood trauma and cognitive impairment are important risk factors for psychotic disorders. However, the relationship between trauma and psychosis throughout the lifespan, as well as between lifetime trauma and cognitive functioning, remain unclear. Methods Using data from a case-control study of African-American adults with psychotic disorders, we examined childhood and adult trauma, as well as their interaction with cognitive functioning, in adults with affective psychotic disorders (n=101), nonaffective psychotic disorders (n=109), non-psychotic psychiatric disorders (n=105), compared to controls (n=211). Childhood trauma was measured using the Childhood Trauma Questionnaire (CTQ), which produces dimensional measures of physical neglect, emotional neglect, physical abuse, emotional abuse, and sexual abuse. Adult trauma was measured using the Trauma History Questionnaire (THQ), which ascertains the presence of death-, and personal-related traumas throughout adulthood. Cognitive functioning was measured using a comprehensive computerized battery (‘Charlie’, https://github.com/sammosummo/Charlie). Results All three psychiatric groups showed greater childhood trauma compared to controls, but the affective psychosis group showed the most trauma (Cohen d=0.97–1.29, p<0.001), followed by the nonaffective psychosis group (d=0.54–0.72, p<0.001), and then the non-psychotic group (d=0.05–0.16, p<0.04). Despite the fact that childhood trauma was significantly associated with adult trauma (OR=0.67–2.08,p<0.002), only the affective psychosis group showed a significantly increased likelihood of experiencing both death- and personal-related traumas in adulthood (OR=0.86–2.14, p<0.01), while the nonaffective psychosis group showed an increased likelihood of experiencing personal-related traumas (OR=1.00, p=0.003). Significant childhood-trauma-by-group interactions on cognitive functioning showed that greater childhood neglect was associated with better performance in the affective psychosis group on measures of processing speed (d=0.52, p=0.011), social processing (d=0.57, p=0.020), and executive functioning (d=0.50–0.71,p<0.020). A similar pattern emerged in the affective psychosis group with both death- and personal-related adult traumas on measures of processing speed (d=0.67–0.74, p<0.010), memory (d=0.67–0.68, p<0.014), and emotional processing (d=0.79, p=0.008). In the domain of complex reasoning, on the other hand, increased childhood sexual abuse in the affective psychosis group, and personal-related adult traumas in the psychosis group, showed a deleterious effect (d=–0.44, p=0.025; d=–0.65, p=0.010). Discussion Individuals with psychotic disorders, especially affective psychoses, experienced more childhood and adult trauma than controls, and also individuals with non-psychotic psychiatric disorders. However, both childhood neglect and adult trauma were associated with better cognitive functioning in the affective psychosis group. One explanation for this seemingly paradoxical finding may be that traumatic experiences in childhood and adulthood lead to increased cognitive vulnerability, as typically seen in psychotic disorders. Thus, individuals who experience more lifetime trauma may follow a different pathway to psychosis, involving less neurodevelopmental impairment, but greater environmental stress, leading to more affective, rather than nonaffective, manifestations of psychosis.
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Harrison, Glynn, Shazad Amin, Swaran P. Singh, Tim Croudace, and Peter Jones. "Outcome of psychosis in people of African–Caribbean family origin." British Journal of Psychiatry 175, no. 1 (July 1999): 43–49. http://dx.doi.org/10.1192/bjp.175.1.43.
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BackgroundAn increased incidence of psychotic disorders has repeatedly been reported among African–Caribbeans in the UK.AimsTo test whether the increased incidence of psychotic disorders in first-and second-generation African–Caribbeans in the UK could be caused by a relative excess of affective-related psychoses with good prognosis.MethodThirty-three patients of African–Caribbean family origin identified in a population-based study of first-episode psychoses were compared with the remaining cases. Three-year outcomes and patterns of course were compared.ResultsThere was a trend for better outcomes in African–Caribbean patients for symptoms and social disability, but patterns of course were similar (odds ratio=0.9 (–0.50 to –2.00)). Pattern of course improved after adjustment for confounding by gender, social class, age, diagnosis and duration of untreated illness (odds ratio=0.59 (–0.21 to –1.66)). Diagnostic profiles were similar, with no evidence of greater diagnostic instability in the African–Caribbean group.ConclusionPattern of course of psychosis did not differ significantly by ethnic family background. An excess of good-prognosis affective psychoses is an unlikely explanation for increased rates of psychosis in African–Caribbeans.
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Manrique-Garcia, E., S. Zammit, C. Dalman, T. Hemmingsson, S. Andreasson, and P. Allebeck. "Cannabis, schizophrenia and other non-affective psychoses: 35 years of follow-up of a population-based cohort." Psychological Medicine 42, no. 6 (October 17, 2011): 1321–28. http://dx.doi.org/10.1017/s0033291711002078.
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BackgroundThere is now strong evidence that cannabis use increases the risk of psychoses including schizophrenia, but the relationship between cannabis and different psychotic disorders, as well as the mechanisms, are poorly known. We aimed to assess types of psychotic outcomes after use of cannabis in adolescence and variation in risk over time.MethodA cohort of 50 087 military conscripts with data on cannabis use in late adolescence was followed up during 35 years with regard to in-patient care for psychotic diagnoses.ResultsOdds ratios for psychotic outcomes among frequent cannabis users compared with non-users were 3.7 [95% confidence interval (CI) 2.3–5.8] for schizophrenia, 2.2 (95% CI 1.0–4.7) for brief psychosis and 2.0 (95% CI 0.8–4.7) for other non-affective psychoses. Risk of schizophrenia declined over the decades in moderate users but much less so in frequent users. The presence of a brief psychosis did not increase risk of later schizophrenia more in cannabis users compared with non-users.ConclusionsOur results confirm an increased risk of schizophrenia in a long-term perspective, although the risk declined over time in moderate users.
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Girgis, Ragy R. "The neurobiology of suicide in psychosis: A systematic review." Journal of Psychopharmacology 34, no. 8 (July 8, 2020): 811–19. http://dx.doi.org/10.1177/0269881120936919.
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The lifetime risk of dying by suicide in schizophrenia and related psychoses has been estimated to be approximately between 5% and 7%, though some have estimated that the number is closer to 10%. The highest risk for suicide occurs within the first year after presentation, when patients have a 12 times greater risk of dying by suicide than the general population, or a 60% higher risk compared with patients in other phases of psychosis, although the risk continues for many years. Some 31% of all deaths in first and early episode samples are due to suicide. Studies in individuals at clinical high-risk for psychosis (CHR) or with attenuated positive symptoms also demonstrate that suicidality is common and problematic in these individuals. Therefore, suicide in psychosis is a particularly severe problem. In order to develop interventions aimed at reducing the risk of suicide in psychotic individuals, it will be critical to understand the neurobiology of suicide in psychosis. In this paper, I report on the results of a systematic review of the work done to date on the neurobiology of suicide in psychosis and on suicidality in the CHR period. I will also identify gaps in knowledge and discuss future strategies for studying the neurobiology of suicidality in psychosis that may help to disentangle the links between suicide and psychosis and, by doing so, allow us to gain a greater understanding of the relationship between suicide and psychosis, which is critical for developing interventions aimed at reducing the risk of suicide in psychotic individuals.
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FEARON, PAUL, JAMES B. KIRKBRIDE, CRAIG MORGAN, PAOLA DAZZAN, KEVIN MORGAN, TUHINA LLOYD, GERARD HUTCHINSON, et al. "Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study." Psychological Medicine 36, no. 11 (August 29, 2006): 1541–50. http://dx.doi.org/10.1017/s0033291706008774.
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Background. The incidence of schizophrenia in the African-Caribbean population in England is reported to be raised. We sought to clarify whether (a) the rates of other psychotic disorders are increased, (b) whether psychosis is increased in other ethnic minority groups, and (c) whether particular age or gender groups are especially at risk.Method. We identified all people (n=568) aged 16–64 years presenting to secondary services with their first psychotic symptoms in three well-defined English areas (over a 2-year period in Southeast London and Nottingham and a 9-month period in Bristol). Standardized incidence rates and incidence rate ratios (IRR) for all major psychosis syndromes for all main ethnic groups were calculated.Results. We found remarkably high IRRs for both schizophrenia and manic psychosis in both African-Caribbeans (schizophrenia 9·1, manic psychosis 8·0) and Black Africans (schizophrenia 5·8, manic psychosis 6·2) in men and women. IRRs in other ethnic minority groups were modestly increased as were rates for depressive psychosis and other psychoses in all minority groups. These raised rates were evident in all age groups in our study.Conclusions. Ethnic minority groups are at increased risk for all psychotic illnesses but African-Caribbeans and Black Africans appear to be at especially high risk for both schizophrenia and mania. These findings suggest that (a) either additional risk factors are operating in African-Caribbeans and Black Africans or that these factors are particularly prevalent in these groups, and that (b) such factors increase risk for schizophrenia and mania in these groups.
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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.
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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.
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Garver, David L., Kathleen Kelly, Karen A. Fried, Mary Magnusson, and Jack Hirschowitz. "Drug response patterns as a basis of nosology for the mood-incongruent psychoses (the schizophrenias)." Psychological Medicine 18, no. 4 (November 1988): 873–85. http://dx.doi.org/10.1017/s0033291700009818.
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SynopsisInteraction of therapeutic drugs with a series of different biopathological substrates of psychosis might be expected to generate a series of different response patterns. Herein the authors suggest that multi-modal response patterns following lithium and neuroleptic treatment of psychotic patients may aid in resolving the heterogeneity of psychotic disorders and lead to a new nosology of the psychoses.
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Castillejos, M. C., C. Martín-Pérez, and B. Moreno-Küstner. "A systematic review and meta-analysis of the incidence of psychotic disorders: the distribution of rates and the influence of gender, urbanicity, immigration and socio-economic level." Psychological Medicine 48, no. 13 (February 22, 2018): 2101–15. http://dx.doi.org/10.1017/s0033291718000235.
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BackgroundConsidering existing knowledge on the relationship between certain environmental factors and incidence rates of psychosis, we carried out a systematic review to provide a broad and updated picture of the incidences of different psychotic disorder subgroups worldwide and how some environmental factors influence these rates.MethodsStudies with original data related to the incidence of psychosis (published between 2000 and 2015) were identified via searching electronic databases (CINAHL, MEDLINE, PSYCINFO, PUBMED, and SCOPUS). Data on the following risk factors were extracted: gender, urbanicity, immigration and socio-economic level. Descriptive appraisals of variation in incidence rates (IR) and incidence rate ratios (IRR), with a 95% confidence interval were calculated. In addition, a meta-analysis was performed to calculate IR pooled by diagnosis group and IRR pooled by diagnosis and gender, urbanity, immigration and socio-economic level, using a random effects model.ResultsWe identified 33 reports to analyse. Overall IR per 100 000 persons for non-affective psychoses (IR pooled = 22.53 (16.51–28.54)) were higher than affective psychoses (IR pooled = 7.12 (5.03–9.22)). There was an increase in rates of psychosis in men v. women (IRR pooled = 1.54 (1.37–1.72)), in urban v. rural areas (IRR pooled = 1.64 (1.38–1.95)), in immigrants v. natives (IRR pooled = 3.09 (2.74–3.49)), and in lower socio-economic level areas (IRR pooled = 1.78 (1.43–2.22)).ConclusionsIR among different psychotic disorders was found to vary depending on gender, urbanicity, and immigration (as most of the previous literature focuses on non-affective psychosis or schizophrenia).
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Zaremba, Malgorzata, Pawel Serafin, and Patrycja Kleczkowska. "Antipsychotic Drugs Efficacy in Dextromethorphan-Induced Psychosis." Biomedicines 11, no. 1 (January 3, 2023): 123. http://dx.doi.org/10.3390/biomedicines11010123.
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Psychosis is known as a broad term of symptoms that cause serious disorganization of behavior, thinking, and perception of reality. One of the medicines that recently gained much attention in terms of its psychotic potential is dextromethorphan (DXM). DXM, a widely used antitussive drug, is a commonly abused drug because of its euphoric, hallucinogenic, and dissociative properties. To date, DXM is a legally marketed cough suppressant that is neither a controlled substance nor a regulated chemical under the Controlled Substances Act. The management of DXM-related psychosis is dependent on the type of psychotic symptoms. Atypical neuroleptics (i.e., olanzapine, risperidone, quetiapine) and typical haloperidol have been used in symptomatic treatment due to their efficacy, especially in positive symptoms (hallucinations and delusions). These agents are also recognized as the preferred option in the symptomatic treatment of DXM-related psychosis due to their better efficacy and safety profile than typical haloperidol in the short-term course. The focus of the present review concerns the current stage of knowledge about DXM psychotic potency as well as the management of DXM-related psychoses with a special emphasis on atypical antipsychotic drugs (i.e., olanzapine, risperidone, quetiapine, and haloperidol).
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Mellers, John D. C., Niall P. Quinn, and Maria A. Ron. "Psychotic and Depressive Symptoms in Parkinson's Disease a Study of the Growth Hormone Response to Apomorphine." British Journal of Psychiatry 167, no. 4 (October 1995): 522–26. http://dx.doi.org/10.1192/bjp.167.4.522.
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BackgroundThe growth hormone (GH) response to apomorphine, thought to reflect central dopaminergic receptor sensitivity, has been reported as enhanced in acute schizophrenia. We investigated this response in relation to the psychotic episodes associated with Parkinson's disease (PD).MethodThe GH response to apomorphine was measured in three groups of patients with Parkinson's disease: those currently psychotic (n = 9), those with a past history of psychosis (n = 7) and those who had never been psychotic (n = 8).ResultsApomorphine-induced GH response was not related to psychosis but was unexpectedly associated with measures of depression.ConclusionsVisual hallucinations were a prominent feature in the psychotic patients and the atypical nature of these psychoses might explain why we found no evidence of dopaminergic sensitivity. Serotonergic dysfunction would be in keeping with this. Dopaminergic mechanisms may contribute to the minor depressive symptomatology seen in PD.
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Yakovleva, Y. A., M. Y. Kissin, Y. V. Popov, A. A. Pichikov, N. Y. Safonova, and T. M. Goguadze. "Dynamics of ideas about the concept of epileptic psychosis." V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY 57, no. 4 (December 30, 2021): 113–21. http://dx.doi.org/10.31363/2313-7053-2021-57-4-113-121.
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Introduction: psychosis in epilepsy is more common than in the general population. The frequency of psychotic mental disorders varies from 0,5% to 10%. The article presents the dynamics of the development of the concept of epileptic psychosis, depending on the evolutionary approaches to the study of the problem of mental disorders in epilepsy. Materials and methods: the analysis of Russian—and English language articles in scientific databases on keywords from 1971 to 2011 was carried out. Results: the first systematic descriptions of mental disorders occurring in epilepsy date back to the 19th century. The contribution of foreign and domestic authors to the study of the problem is described. There are six main periods of the concept formation, including the definitions of the concept of epileptic psychosis, the dynamics of clinical manifestations, the role of the influence of biological, personal and social factors in the genesis and development of psychotic disorders in epilepsy. The following risk factors for the development of psychosis are considered: the form of epilepsy; age of onset of seizures, lateralization of the epileptic focus, gender, and drug therapy. Variants of classification approaches to the problem are presented. The article discusses the differences in the systematization of «endoform» syndromes, as well as the parallels between schizophrenia and psychoses in epilepsy. The dynamics of scientific views on the interest in the formation of epileptic psychoses in various parts of the brain: the temporal lobe (amygdala, hippocampus, paralimbic zones and parahippocampal bend), as well as GABA-ergic neurons of the upper tubercles of the quadriplegic, posterior hypothalamus and serotonergic neurons of the dorsal suture and noradrenergic neurons of the blue spot are reflected. The association of psychopathological manifestations with neurophysiological, biochemical, genetic and morphofunctional correlates is noted. The authors‘ interest in psychoses associated with the use of antiepileptic drugs is emphasized. Conclusion: despite all attempts to systematize these conditions, the factors that provoke the development of psychoses in patients with epilepsy, their structure and prognosis remain poorly predictable and require further in-depth study.
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Verri, Annapia, and Anna Cremante. "Psychotic disorder and its characteristics in sex chromosome aneuploidies." Clinical Management Issues 3, no. 3 (September 15, 2009): 123–32. http://dx.doi.org/10.7175/cmi.v3i3.548.
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Sex chromosome anomalies have been associated with psychoses. We report a patient with XYY chromosome anomaly who developed a paranoid psychosis. The second case deal with a 51-year-old woman affected by Turner Syndrome and Psychotic Disorder, with a prevalent somatic and sexual focus.
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Howard, R., and R. Levy. "Personality structure in the paranoid psychoses of later life." European Psychiatry 8, no. 2 (1993): 59–66. http://dx.doi.org/10.1017/s0924933800001346.
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SummaryAbnormal premorbid personality has long been considered to be an important feature of patients who develop schizophrenia, or schizophrenic-like psychoses late in life. Schizoid and paranoid personality traits in particular are repeatedly reported to have preceded the development of psychosis by many years. Such personality abnormalities have been viewed as part of a schizophrenic spectrum disorder, causally invoked in the aetiology of psychosis, or even regarded as an adaptive protection of vulnerable individuals against psychotic breakdown. An ICD-10 diagnosable personality disorder, however, is seen in only about 50% of patients who develop a paranoid psychosis late in life. The premorbid personality abnormalities encountered in late-onset paranoid states and delusional disorder are different from those reported in schizophrenia and there appears to be a genetic basis for these differences. The role of such personality disturbance in the aetiology of psychosis is controversial but probably only minor.
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Murrie, Benjamin, Julia Lappin, Matthew Large, and Grant Sara. "Transition of Substance-Induced, Brief, and Atypical Psychoses to Schizophrenia: A Systematic Review and Meta-analysis." Schizophrenia Bulletin 46, no. 3 (October 16, 2019): 505–16. http://dx.doi.org/10.1093/schbul/sbz102.
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Abstract Some people who experience substance-induced psychosis later develop an enduring psychotic disorder such as schizophrenia. This study examines the proportion of people with substance-induced psychoses who transition to schizophrenia, compares this to other brief and atypical psychoses, and examines moderators of this risk. A search of MEDLINE, PsychINFO, and Embase identified 50 eligible studies, providing 79 estimates of transition to schizophrenia among 40 783 people, including 25 studies providing 43 substance-specific estimates in 34 244 people. The pooled proportion of transition from substance-induced psychosis to schizophrenia was 25% (95% CI 18%–35%), compared with 36% (95% CI 30%–43%) for brief, atypical and not otherwise specified psychoses. Type of substance was the primary predictor of transition from drug-induced psychosis to schizophrenia, with highest rates associated with cannabis (6 studies, 34%, CI 25%–46%), hallucinogens (3 studies, 26%, CI 14%–43%) and amphetamines (5 studies, 22%, CI 14%–34%). Lower rates were reported for opioid (12%), alcohol (10%) and sedative (9%) induced psychoses. Transition rates were slightly lower in older cohorts but were not affected by sex, country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration of follow-up. Substance-induced psychoses associated with cannabis, hallucinogens, and amphetamines have a substantial risk of transition to schizophrenia and should be a focus for assertive psychiatric intervention.
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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.
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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.
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Najla Taslim and Dustin Edge. "Prescription medication-induced psychosis: A high alert for drug experts." Journal of Contemporary Pharmacy 4, no. 1 (July 31, 2020): 15–21. http://dx.doi.org/10.56770/jcp2020414.
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Psychosis is a complex mental illness of behavioral, psychological, and emotional disturbances. Secondary psychosis can be elicited by prescription medications and literature is replete with examples of such drugs. Objectives: The goal of this article is to gather information from multiple published sources to highlight the culprit prescription medications that are linked with psychotic episodes and compose the findings into a simplified, standalone publication for readers to conveniently become aware of this phenomenon. It is also intended to reiterate the critical role and significance of the pharmacist as a vital player in a health care team. Methods: The scientific literature was searched on the PubMed database using the key search phrase “psychosis, medicines or drug or prescription.” The search was limited to the time period from 1960-2019 to ensure the inclusion of the vast majority of previously reported cases of currently available medicines and their related psychoses. Conclusion: Commonly prescribed medications can cause serious, albeit preventable, psychiatric issues. Pharmacists as vital players in patient care can avert the untoward psychotic episode by taking timely steps in notifying the prescribers or counseling the patient on measures to avoid serious and fatal psychotic issues.
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Becerra Darriba, H. "A complex polymorphous psychosis or a cycloid psychosis with a different onset?" European Psychiatry 66, S1 (March 2023): S1058—S1059. http://dx.doi.org/10.1192/j.eurpsy.2023.2246.
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IntroductionAcute and transitory psychotic disorders comprise a polymorphous picture such as Leonhard’s cycloid psychoses, which alternate episodes of affective symptoms such as psychosis between two poles (anguish/happiness, incoherence/stupor, or akinesia/hyperkinesia).ObjectivesTo describe a case report of a 20-year-old man, in outpatient psychiatric follow-up, after debuting at age 18 with a severe depressive episode of endogenomorphic characteristics without psychotic symptoms, with subsequent complete remission. Two years after clinical stability, he required prolonged hospitalization due to polymorphous psychotic syndrome of abrupt onset in a context of previous continuous use of cannabis and cocaine. Suspicion towards parents, bizarre behaviors, rushing desires, unmotivated laughter, fixed gaze, bewilderment, anguish with a feeling of imminent death, alternates with euphoria and senseless purchases.MethodsWe present the case report of this patient with a mental examination of conscious, scattered attention with marked distractibility, confusion and experiences of strangeness, memory gaps, subjective sensation of well-being with tachypsychia, which fluctuates with thymic oscillations and alternates with episodes of marked indefinite anguish, intense anxiety with delusional fear of the death of him or his family. Little systematized ideas of reference and prejudice based on intuitions or delusional occurrences in their environment. Megalomaniac and religious-messianic ideation. No sensory perception disturbances. Disintegrated course of thought, with frequent illogical associations, ambivalence of thought, affectivity and psychomotricity. Motor restlessness and behavioral disorganization. Global insomnia. Judgment of reality and superior functions diminished. No auto/heteroaggressiveness.ResultsVarious psychoactive drugs were tested for two months, obtaining a response only with valproic acid 1500mg, pregabalin 450mg and olanzapine 15mg, presenting slow improvement in a situation of absence of consumption, with a predominance of symptomatic polymorphism, decreasing fluctuation between episodes of expansiveness and psychotic anguish, remitting disorganization and motility alterations, persisting poor awareness of the disease and cognitive complaints. He was referred for follow-up at the mental health center where his gradual recovery continued.A differential diagnosis of polymorphous psychosis is proposed, compatible with a cycloid psychosis of the anxiety-happiness type with marked affective symptoms, precipitated by substance use.ConclusionsCycloid anxiety-happiness psychosis stands out for intense and fluctuating anxiety, oscillating with feelings of happiness, ecstasy, and placidity, mystical-religious delusions, and preoccupation with death, which may comprise a different psychotic debut.Disclosure of InterestNone Declared
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Skuridin, P. S. "Prof. V.M.Bekhterev. On periodic acute paranoia, as a special type of periodical psychoses. — Review. crazy. 1899. No. 4." Neurology Bulletin VIII, no. 1 (November 25, 2020): 213–17. http://dx.doi.org/10.17816/nb51057.
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Prof. Bekhterev, pointing out the attempt of prof. Ziehen'a in 1898 to establish, except for three known forms of periodical psychoses (mania, melancholia, psychosis hallucinatoria periodica), 2 more types - periodical neurasthenic mental disorder and periodical acute simple (not psychotic) paranoid, he said that he appeared im for a long time, still being his professor at Kazan University. On the recognition of periodic acute paranoia, as a special form of psychosis, he was led by a case of practice in the Kazan District Hospital in 1892. Further, the author expounds in great detail 3 stories of the illness of one patient, E.I.
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Westhoff, Martin Lennart Schulze, Johannes Ladwig, Johannes Heck, Rasmus Schülke, Adrian Groh, Maximilian Deest, Stefan Bleich, Helge Frieling, and Kirsten Jahn. "Early Detection and Prevention of Schizophrenic Psychosis—A Review." Brain Sciences 12, no. 1 (December 23, 2021): 11. http://dx.doi.org/10.3390/brainsci12010011.
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Psychotic disorders often run a chronic course and are associated with a considerable emotional and social impact for patients and their relatives. Therefore, early recognition, combined with the possibility of preventive intervention, is urgently warranted since the duration of untreated psychosis (DUP) significantly determines the further course of the disease. In addition to established diagnostic tools, neurobiological factors in the development of schizophrenic psychoses are increasingly being investigated. It is shown that numerous molecular alterations already exist before the clinical onset of the disease. As schizophrenic psychoses are not elicited by a single mutation in the deoxyribonucleic acid (DNA) sequence, epigenetics likely constitute the missing link between environmental influences and disease development and could potentially serve as a biomarker. The results from transcriptomic and proteomic studies point to a dysregulated immune system, likely evoked by epigenetic alterations. Despite the increasing knowledge of the neurobiological mechanisms involved in the development of psychotic disorders, further research efforts with large population-based study designs are needed to identify suitable biomarkers. In conclusion, a combination of blood examinations, functional imaging techniques, electroencephalography (EEG) investigations and polygenic risk scores should be considered as the basis for predicting how subjects will transition into manifest psychosis.
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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.
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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.
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Accinni, Tommaso, Marianna Frascarelli, Antonino Buzzanca, Luca Carlone, Francesco Ghezzi, Martina Fanella, Carolina Putotto, et al. "S51. ANALYSIS OF SOCIAL COGNITION AS A PREDICTIVE FACTOR OF PSYCHOSIS IN 22Q11 DELETION SYNDROME (DS). DATA FROM THE MULTICENTER STUDY OF THE ITALIAN NETWORK FOR RESEARCH ON PSYCHOSES." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S52. http://dx.doi.org/10.1093/schbul/sbaa031.117.
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Abstract Background 22q11DS is the most important genetic risk factor for schizophrenia: up to 28% of these subjects develop psychosis in adulthood. At present this syndrome represents the strongest biological model to investigate neurobiological underpinnings of schizophrenia. We expected Theory of Mind impairments in subjects at risk for psychosis (22q11DS) and more severe impairments in subjects with an established psychotic disorder. Furthermore we sought to investigate eventual correlations between social cognition and self-esteem levels, hypothesizing that both would be impaired in psychotic groups. Methods Data come from Italian Network for Research on Psychoses for the Schizophrenic (SCZ, N=260) and Control groups (HC, N=111). 22q11DS psychotic (22q11DS_SCZ, N=17) and non-psychotic patients (22q11DS, N=46) were enrolled at Policlinico Umberto I, in Rome. The Awareness and Social Inference Test (TASIT) and Self-Esteem Rating Scale (SERS) were administered. Results The three main TASIT variables, Emotion Recognition, Minimal Social Inference and Enriched Social Inference, showed no different scores between the three clinical groups, which were significantly lower respect to the control group. The SERS total score showed no significant differences between clinical groups but was for all three significantly lower than control group score. No significant correlation was observed between SERS and TASIT scores for clinical groups. Discussion Social Cognition impairments are present in 22q11DS at the same extent as in idiopathic schizophrenia, and thus they represent an endophenotype of psychosis. A low Self-Esteem, even though associated to psychosis, does not affect neurocognitive process, impaired on a neurobiological basis.