Journal articles on the topic 'Psychotic symptoms'
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Hides, L., S. Dawe, D. J. Kavanagh, and R. M. Young. "Psychotic symptom and cannabis relapse in recent-onset psychosis." British Journal of Psychiatry 189, no. 2 (August 2006): 137–43. http://dx.doi.org/10.1192/bjp.bp.105.014308.
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BackgroundCannabis use appears to exacerbate psychotic symptoms and increase risk of psychotic relapse. However, the relative contribution of cannabis use compared with other risk factors is unclear. The influence of psychotic symptoms on cannabis use has received little attention.AimsTo examine the influence of cannabis use on psychotic symptom relapse and the influence of psychotic symptom severity on relapse in cannabis use in the 6 months following hospital admission.MethodAt baseline, 84 participants with recent-onset psychosis were assessed and 81 were followed up weekly for 6 months, using telephone and face-to-face interviews.ResultsA higher frequency of cannabis use was predictive of psychotic relapse, after controlling for medication adherence, other substance use and duration of untreated psychosis. An increase in psychotic symptoms was predictive of relapse to cannabis use, and medication adherence reduced cannabis relapse risk.ConclusionsThe relationship between cannabis use and psychosis may be bidirectional, highlighting the need for early intervention programmes to target cannabis use and psychotic symptom severity in this population.
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Ballard, Clive, J. O'Brien, Bernie Coope, A. Fairbairn, Farzhana Abid, and Gordon Wilcock. "A Prospective Study of Psychotic Symptoms in Dementia Sufferers: Psychosis in Dementia." International Psychogeriatrics 9, no. 1 (March 1997): 57–64. http://dx.doi.org/10.1017/s1041610297004201.
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Eighty-seven out of a clinical cohort of 124 patients with Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.) dementia were followed up at monthly intervals for 1 year. Psychotic symptoms were assessed using the Burns's Symptom Checklist, and cognitive functioning was evaluated with the CAMCOG. The annual incidence rate of psychotic symptoms was 47%, although many of the incident symptoms lasted less than 3 months. Fifty-three percent of patients with psychosis experienced resolution of their symptoms. Patients either experienced brief or persistent psychotic disorders, with few having an intermediary course. Persistent psychosis was significantly associated with a 3-month duration of symptoms at baseline. Neuroleptics did not significantly influence the course of psychotic symptoms.
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MR, Anitha, and Vijayanath V. "Tattooed Individuals with Psychotic Symptoms." Indian Journal of Anatomy 8, no. 3 (2019): 151–54. http://dx.doi.org/10.21088/ija.2320.0022.8319.2.
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Taylor, Pamela J. "Motives for Offending among Violent and Psychotic Men." British Journal of Psychiatry 147, no. 5 (November 1985): 491–98. http://dx.doi.org/10.1192/bjp.147.5.491.
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Two hundred and three male remanded prisoners were interviewed with respect to their current offence, mental state, and social and psychiatric histories. All but nine of the sub-group of 121 psychotic men showed active symptoms at the time of committing a criminal offence; 20% of the actively ill psychotics were directly driven to offend by their psychotic symptoms, and a further 26% probably so. If some of the indirect consequences of the psychosis were taken into account, 82% of their offences were probably attributable to the illness. Among the normal and neurotic men, none claimed psychotic motives for offending, but motives suggesting high emotional arousal such as panic or retaliation triggered the greatest violence. Within the psychotic group, those driven to offend by their delusions were most likely to have been seriously violent, and psychotic symptoms probably accounted directly for most of the very violent behaviour.
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Knolle, Franziska, Sara Garofalo, Roberto Viviani, Anna Ermakova, and Graham Murray. "M145. ALTERED SUBCORTICAL EMOTIONAL SALIENCE PROCESSING AND A ‘JUMPING TO CONCLUSIONS’ BIAS IN PARKINSON’S PATIENTS WITH PSYCHOTIC SYMPTOMS." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S190—S191. http://dx.doi.org/10.1093/schbul/sbaa030.457.
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Abstract Background Current research does not provide a clear explanation for why some patients with Parkinson’s Disease (PD) develop psychotic symptoms. In schizophrenia research the ‘aberrant salience hypothesis’ of psychosis has been influential in explaining the development of psychotic symptoms. The theory proposes that dopaminergic dysregulation leads to inappropriate attribution of salience to otherwise irrelevant or non-informative stimuli, facilitating the formation of hallucinations and delusions, by providing irrational explanations. However, this theory has received very limited attention in the context of PD-psychosis. Methods In the study, we investigated salience processing in 14 PD-patients with psychotic symptoms, 23 PD-patients without psychotic symptoms and 19 healthy controls. All patients received dopaminergic medication. There was no difference in the medication dose between the two patient groups. We examined emotional salience using a visual oddball fMRI paradigm that has been used to investigate early stages of schizophrenia spectrum psychosis, controlling for resting cerebral blood flow (arterial spin labelling fMRI). Furthermore, a subgroup of the two patient groups complete a behavioural ‘jumping to conclusions’ task. Results We found significant differences in brain responses to emotional salience between the two patient groups. PD-patients with psychotic symptoms revealed enhanced brain responses in the striatum, the hippocampus and the amygdala compared to patients without psychotic symptoms. PD-patients with psychotic symptoms showed significant correlations between the levels of dopaminergic drugs they were taking and BOLD signalling, as well as psychotic symptom scores. Furthermore, our data provide first indications for dysfunctional top-down processes, measured in a ‘jumping to conclusions’ bias. Discussion Our study suggests that enhanced signalling in the striatum, hippocampus and amygdala together with deficient top-down cognitive regulations is associated with the development of psychotic symptoms in PD, similarly to that proposed in the ‘aberrant salience hypothesis’ of psychosis in schizophrenia.
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Aleshkina, G., M. Pugacheva, and L. Bardenshteyn. "Negative symptoms of schizophrenia in patients with acute and transient psychotic disorders." European Psychiatry 64, S1 (April 2021): S802. http://dx.doi.org/10.1192/j.eurpsy.2021.2121.
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IntroductionThe ICD-10 acute and transient psychotic disorders (ATPD, F23) without symptoms of schizophrenia are considered predominantly reactive psychotic disorders or affective pathology. However, negative symptoms of schizophrenia may be revealed in some of these cases after the psychotic reduction.ObjectivesTo investigate the association between the developmental characteristics of psychosis and the negative symptoms detection after the psychotic reduction of ATPD without symptoms of schizophrenia.Methods68 adult inpatients with ATPD without symptoms of schizophrenia (F23.0) were examined. Negative symptoms were assessed with the PANSS negative symptom subscale (PANSS-NSS). The sample was divided into two groups: with PANSS-NSS score>14 (n=12) and with PANSS-NSS score≤14 (n=56), respectively. Clinical-psychopathological, psychometric and statistical methods were applied.ResultsThe results of the study are presented in Table 1.Table 1. The ATPD developmental featuresFeaturesThe 1st group (n=12)The 2nd group (n=56)Pearson’s contingency coefficient (C)Males7 (58,3%)37 (66,1%)0.062Females5 (41,7%)19 (33,9%)0.062Mean age of psychotic onset, years (М±m)24,9±10,530,8±10,2-Family history of schizophrenia*4 (33,3%)1 (1,8%)0.418Poor premorbid social adaptation*5 (41,7%)00.520Prodromal functional decline*9 (75,0%)4 (7,1%)0.550Prodromal non-psychotic symptoms9 (75,0%)30 (53,6%)0.163Associated acute stress4 (33,3%)27 (48,2%)0.113*p<0,001ConclusionsThe probability of negative symptoms detection in ATPD without symptoms of schizophrenia is relatively strongly associated with the family history of schizophrenia, poor premorbid social adaptation and functional decline prior to the psychotic onset.DisclosureNo significant relationships.
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Lindley, Steven E., Eve Carlson, and Javaid Sheikh. "Psychotic Symptoms in Posttraumatic Stress Disorder." CNS Spectrums 5, no. 9 (September 2000): 52–57. http://dx.doi.org/10.1017/s1092852900021659.
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AbstractRecent data suggest that the presence of psychotic symptoms in patients suffering from posttraumatic stress disorder (PTSD) may represent an underrecognized and unique subtype of PTSD. Among combat veterans with PTSD, 30% to 40% report auditory or visual hallucinations and/or delusions. The presence of psychotic symptoms in PTSD is associated with a more severe level of psychopathology, similar to that of chronic schizophrenia. In this review, the differential diagnosis of psychotic symptoms in PTSD is discussed, including possible comorbid schizophrenia, psychotic depression, substance-induced psychosis, and personality disorder. A recent biologic study supporting the existence of a unique subtype of PTSD with psychotic features is also addressed, as are the similarities between PTSD with psychotic features and psychotic depression disorder. Finally, data on the treatment implications of psychotic symptoms in PTSD are presented. The intriguing recent findings on psychotic symptoms in PTSD need further investigation in noncombat-related PTSD populations before findings can be generalized to all individuals with PTSD.
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Palomäki, Johanna, Martta Kerkelä, Marjo-Riitta Järvelin, Peter Jones, Graham Murray, Tanja Nordström, Sebastian Therman, and Juha Veijola. "M29. SPECIFIC SYMPTOMS IN ADOLESCENCE PREDICT PSYCHOSIS IN THE NORTHERN FINLAND BIRTH COHORT 1986." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S145. http://dx.doi.org/10.1093/schbul/sbaa030.341.
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Abstract Background A number of psychological symptoms have been found to predict psychosis. Many studies have found no specificity to separate symptoms predicting non-psychotic psychiatric disorders from those predicting psychotic disorders. Prodromal symptoms are non-specific problems often preceding frank psychosis. Previously prodromal symptoms have been studied mainly retrospectively or in high-risk clinical populations. We were able to conduct prospective study comparing adolescent symptoms predicting non-psychotic psychiatric disorders and psychotic psychiatric disorders. Methods Members of the Northern Finland Birth Cohort 1986 were asked to fill in PROD-screen questionnaire at age 15–16 years. PROD-screen includes 21 items both measuring positive prodromal symptoms, negative prodromal symptoms and general symptoms. We were able to follow 5,368 participants using Finnish Hospital Discharge Register detecting new hospital treated mental disorders till 30 years. Results Subjects who developed psychosis had significantly more commonly positive and negative symptoms than subjects without psychiatric disorder or subjects who developed non-psychotic disorder. When comparing separate symptoms in those having psychiatric hospital treatments, we found three positive symptoms and three negative symptoms predicting specifically psychotic disorders. After adjusting for confounders, the symptoms predicting psychosis were: Difficulty in controlling one’s speech, behavior or facial expression while communicating, Difficulties in understanding written text or speech heard, Feelings, thoughts or behaviors that could be considered weird or peculiar. Three of the negative symptoms also predicted psychosis: Difficulty or uncertainty in making contact with other people, Lack of initiative or difficulty in completing tasks, Difficulties in carrying out ordinary routine activities (at least one week). Discussion In this large prospective population sample both positive and negative symptoms in adolescence associated specifically with development of first episode psychosis compared to hospital treated non-psychotic disorders. This finding is in line with the other prospective general population follow-up studies. The main contribution of our study to the literature is that we had the possibility to compare the subjects who developed clinically real hospital-treated psychosis not only to healthy comparison subjects but also to subjects who developed non-psychotic psychiatric disorder.
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Brandão, D., and J. Massano. "Frontotemporal dementia and psychosis: Literature review." European Psychiatry 33, S1 (March 2016): S367. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1315.
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IntroductionFrontotemporal dementia (FTD) is a progressive neurodegenerative disease especially sporadic. About 30–40% have positive family history, with an identifiable genetic mutation in a percentage of cases increasing. Although the FTD psychosis has been recognized for many years, it is not included in the clinical criteria.ObjectivesTo assess the prevalence and characteristics of psychotic symptoms in FTD, compare the presence of psychosis in FTD C9+ versus C9− and analyze the occurrence of wrong diagnoses in FTD with psychosis.MethodsLiterature review, using computerized databases (Pubmed®). Articles were selected based on the content of their abstract and their relevance.ResultsIt is frequently the presence of psychotic symptoms in FTD associated with C9+ versus C9−. These may arise as initial symptom often leading to a psychiatric diagnosis years before obtaining diagnosis of FTD. There is no conclusive evidence about the anatomical correlation of psychotic features in the FTD, although there is the possible association with the right brain degeneration.ConclusionsThe existence of psychotic symptoms do not argues against the diagnosis of FTD verifying a high frequency of psychosis in FTD – C9+. As can be the first symptom in FTD is critical to differentiate psychiatric disorders. Further studies are needed in order to obtain a better characterization of psychotic symptoms in FTD – C9+.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Goodwin, G. M., D. A. W. Johnson, and R. G. McCreadie. "Comments on the Northwick Park ‘Functional’ Psychosis Study." British Journal of Psychiatry 154, no. 3 (March 1989): 406–9. http://dx.doi.org/10.1192/bjp.154.3.406.
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“Functional psychosis is conventionally subdivided into schizophrenia and manic depressive psychosis. Response to treatment is assumed to be a validating criterion for these diagnoses. The efficacy of pimozide (a dopamine antagonist neuroleptic), lithium, and a combination of the two was compared with that of placebo in a 4-week trial in 120 functionally psychotic patients, each of whom was assessed for psychotic symptoms, manic symptoms, and depressive symptoms. The sample was subdivided into patients with predominantly elevated mood, predominantly depressed mood, and no consistent mood change. Pimozide reduced psychotic symptoms in all groups of patients. The only significant effect of lithium was to reduce elevated mood. Thus dopamine blockade seems relevant to the resolution of psychotic symptoms in all types of ‘functional’ psychosis, but the mode of action of lithium in psychotic patients concerns only mood. Application of standardised classifications of functional psychosis to these data did not change this conclusion.”
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Seemüller, F., M. Riedel, M. Obermeier, R. Schennach-Wolff, I. Spellmann, S. Meyer, M. Bauer, et al. "The validity of self-rated psychotic symptoms in depressed inpatients." European Psychiatry 27, no. 7 (October 2012): 547–52. http://dx.doi.org/10.1016/j.eurpsy.2011.01.004.
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AbstractBackgroundSelf-ratings of psychotic experiences might be biased by depressive symptoms.MethodData from a large naturalistic multicentre trial on depressed inpatients (n = 488) who were assessed on a biweekly basis until discharge were analyzed. Self-rated psychotic symptoms as assessed with the 90-Item Symptom Checklist (SCL-90) were correlated with the SCL-90 total score, the SCL-90 depression score, the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale 21 item (HAMD-21) total score, the Montgomery Åsberg Depression Rating Scale (MADRS) total score and the clinician-rated paranoid-hallucinatory score of the Association for Methodology and Documentation in Psychiatry (AMDP) scale.ResultsAt discharge the SCL-90 psychosis score correlated highest with the SCL-90 depression score (0.78, P<0.001) and with the BDI total score (0.64, P<0.001). Moderate correlations were found for the MADRS (0.34, P<0.001), HAMD (0.37, P<0.001) and AMDP depression score (0.33, P<0.001). Only a weak correlation was found between the SCL-90 psychosis score and the AMDP paranoid-hallucinatory syndrome score (0.15, P<0.001). Linear regression showed that change in self-rated psychotic symptoms over the treatment course was best explained by a change in the SCL-90 depression score (P<0.001). The change in clinician-rated AMDP paranoid-hallucinatory score had lesser influence (P = 0.02).ConclusionsIn depressed patients self-rated psychotic symptoms correlate poorly with clinician-rated psychotic symptoms. Caution is warranted when interpreting results from epidemiological surveys using self-rated psychotic symptom questionnaires as indicators of psychotic symptoms. Depressive symptoms which are highly prevalent in the general population might influence such self-ratings.
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Subramaniam, M., E. Abdin, J. A. Vaingankar, S. Verma, and S. A. Chong. "Latent structure of psychosis in the general population: results from the Singapore Mental Health Study." Psychological Medicine 44, no. 1 (April 11, 2013): 51–60. http://dx.doi.org/10.1017/s0033291713000688.
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BackgroundFew studies have examined the latent construct of psychotic symptoms or distinguished between the latent construct and its manifest indicators. The current study aimed to investigate the latent structure of psychotic symptoms using factor mixture modeling (FMM) and to use the best-fitting model to examine its sociodemographic and clinical correlates.MethodThe Singapore Mental Health Study (SMHS) was based on an adult representative sample of the Singapore population. Psychotic symptoms were assessed by using the Psychosis Screen section of the Composite International Diagnostic Interview version 3.0 (CIDI 3.0). FMM analyses were applied to determine the latent construct of psychotic symptoms. Sociodemographic and clinical correlates of the latent structure of psychosis symptoms were examined using multiple linear and logistic regression analyses.ResultsThe overall weighted lifetime prevalence of any psychotic experience was 3.8% in the SMHS after excluding subthreshold experiences. The FMM analysis clearly supported the dimensional model of the latent structure of psychotic symptoms. On deriving the total score for ‘psychosis symptoms’ in accordance with the one latent trait model, and correlating it with sociodemographic factors, we found that female gender, vocational education, current and past smokers were positively associated with the ‘psychosis’ total score.ConclusionsThere is a need for an increased understanding of, and research into, this intermediate state of ‘psychosis symptoms’ that do not meet diagnostic criteria for psychosis. It is also important to learn more about the group of individuals in the community who may have preserved functioning to elucidate the protective factors that prevent transition to psychosis.
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Cicero, David C., Katherine G. Jonas, Kaiqiao Li, Greg Perlman, and Roman Kotov. "Common Taxonomy of Traits and Symptoms: Linking Schizophrenia Symptoms, Schizotypy, and Normal Personality." Schizophrenia Bulletin 45, no. 6 (February 9, 2019): 1336–48. http://dx.doi.org/10.1093/schbul/sbz005.
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Abstract The associations among normal personality and many mental disorders are well established, but it remains unclear whether and how symptoms of schizophrenia and schizotypal traits align with the personality taxonomy. This study examined the joint factor structure of normal personality, schizotypy, and schizophrenia symptoms in people with psychotic disorders (n = 288) and never-psychotic adults (n = 257) in the Suffolk County Mental Health Project. First, we evaluated the structure of schizotypal (positive schizotypy, negative schizotypy, and mistrust) and normal traits. In both the psychotic-disorder and never-psychotic groups, the best-fitting model had 5 factors: neuroticism, extraversion, conscientiousness, agreeableness, and psychoticism. The schizotypy traits were placed on different dimensions: negative schizotypy went on (low) extraversion, whereas positive schizotypy and mistrust went on psychoticism. Next, we added symptoms to the model. Numerous alternatives were compared, and the 5-factor model remained best-fitting. Reality distortion (hallucinations and delusions) and disorganization symptoms were placed on psychoticism, and negative symptoms were placed on extraversion. Models that separated symptom dimensions from trait dimensions did not fit well, arguing that taxonomies of symptoms and traits are aligned. This is the first study to show that symptoms of psychosis, schizotypy, and normal personality reflect the same underlying dimensions. Specifically, (low) extraversion, negative schizotypy, and negative symptoms form one spectrum, whereas psychoticism, positive schizotypy, and positive and disorganized symptoms form another. This framework helps to understand the heterogeneity of psychosis and comorbidity patterns found in psychotic disorders. It also underscores the importance of traits to understanding these disorders.
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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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Kramer, I. M. A., C. J. P. Simons, I. Myin-Germeys, N. Jacobs, C. Derom, E. Thiery, J. van Os, and M. Wichers. "Evidence that genes for depression impact on the pathway from trauma to psychotic-like symptoms by occasioning emotional dysregulation." Psychological Medicine 42, no. 2 (August 11, 2011): 283–94. http://dx.doi.org/10.1017/s0033291711001474.
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BackgroundGenes for depression may act by making individuals more sensitive to childhood trauma. Given that childhood adversity is a risk factor for adult psychosis and symptoms of depression and psychosis tend to cluster within individuals and families, the aim was to examine whether the association between childhood adversity and psychotic-like symptoms is moderated by genetic liability for depression. A secondary aim was to determine to what degree a depression-related increase in stress sensitivity or depressive symptoms themselves occasioned the moderating effect.MethodFemale twins (n=508) completed both prospective and retrospective questionnaires regarding childhood adversity [the Symptom Checklist-90 – Revised (SCL-90-R) and SCID-I (psychotic symptoms)] and psychotic trait liability [the Community Assessment of Psychic Experiences (CAPE)]. Stress sensitivity was indexed by appraisals of event-related stress and negative affect (NA) in the flow of daily life, assessed with momentary assessment technology for five consecutive days. Multilevel regression analyses were used to examine moderation of childhood adversity by genetic liability for depression in the prediction of follow-up psychotic experiences.ResultsThe effect of childhood adversity was significantly moderated by genetic vulnerability for depression in the model of both follow-up psychotic experiences (SCL-90-R) and follow-up psychotic trait liability (CAPE). The moderation by genetic liability was mediated by depressive experience but not by stress sensitivity.ConclusionsGenetic liability for depression may potentiate the pathway from childhood adversity to psychotic-like symptoms through dysfunctional emotional processing of anomalous experiences associated with childhood trauma.
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Tan, Hao-Yang, Yong-Guan Ang, Hao-Yang Tan, and Yong-Guan Ang. "First-Episode Psychosis in the Military: A Comparative Study of Prodromal Symptoms." Australian & New Zealand Journal of Psychiatry 35, no. 4 (August 2001): 512–19. http://dx.doi.org/10.1046/j.1440-1614.2001.00912.x.
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Objective: The objective of this study is to provide a retrospective description of prodromal symptoms of young military servicemen with first-episode psychosis, and a comparison with first-episode non-psychotic disorders. Method: Thirty consecutive servicemen presenting with first-episode psychosis were studied. Thirty-four randomly selected servicemen from 123 with non-psychotic disorders served as comparison. A combination of unstructured and semistructured interviews with the patient and other informants was used to describe the prodromal symptoms. Results: The most common prodromal psychotic symptoms were social withdrawal (83%); anxiety (77%); sleep disturbance (77%); disturbance in attention, concentration or memory (73%); deterioration in studies in school (70%); depressed mood (63%); odd behaviour (53%); and anger or irritability (53%). Common symptoms found in first-episode psychosis and non-psychotic patients included sleep disturbance, anxiety, depressed mood and anger or irritability. Common symptoms that were associated with the psychotic prodrome were social withdrawal (p < 0.001), deterioration in school results (p < 0.001) and disturbance in attention, concentration or memory (p < 0.001). The psychotic prodrome was also associated with apathy (p < 0.001), odd behaviour (p < 0.001), doing nothing (p = 0.004) and thought blocking (p = 0.04). Conclusion: Cognitive disturbances and attenuated negative symptoms appear to be more specific to the psychotic prodrome in young patients with first-episode psychosis.
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Bangar, S. "Treatment of cycloserine induced psychosis - a case series." European Psychiatry 26, S2 (March 2011): 1227. http://dx.doi.org/10.1016/s0924-9338(11)72932-7.
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IntroductionCycloserine is a highly effective second line anti-tuberculosis medication, the use of which has increased in recent times due to emergence of multi-drug resistance. One of the side-effects is psychosis characterized by paranoia, hallucinations and affective instability. These symptoms are usually reported within the first 2 weeks of therapy in 30–50% of patients receiving Cycloserine 500 mg. At a dose of 100mg and above it leads to a hyperdopaminergic state which in turn could lead to psychosis. However, as this is a very effective treatment in people with multi-drug resistant tuberculosis, it is not always possible to omit treatment due to remergence of life threatening illness. We present findings from few patients on this medication who were referred to us for management of psychotic symptoms.Aims and objectivesTo treat the psychotic symptoms with anti-psychotic which would enable patient to continue Cycloserine. Also to monitor the response to an anti-psychotic.MethodsData was collected from the patient’s case notes, full psychiatric assessment and interviewing the relative. Patient was followed up in the out-patient clinic to monitor response to anti-psychotic medication.ResultsPatients were treated with both typical and atypical medication with good response and it was possible to continue with Cycloserine in one case.ConclusionCycloserine induced psychosis can mimic any other psychotic illness and can be effectively treated with anti-psychotics.
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Barrett, Matthew J., Jamie C. Blair, Scott A. Sperling, Mark E. Smolkin, and T. Jason Druzgal. "Baseline symptoms and basal forebrain volume predict future psychosis in early Parkinson disease." Neurology 90, no. 18 (April 4, 2018): e1618-e1626. http://dx.doi.org/10.1212/wnl.0000000000005421.
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ObjectiveDetermining baseline predictors of future psychosis in Parkinson disease (PD) may identify those at risk for more rapidly progressive disease, i.e., a more malignant PD subtype.MethodsThis cohort study evaluated 423 patients with newly diagnosed PD collected as part of the Parkinson's Progression Markers Initiative. Psychotic symptoms were assessed with the Movement Disorders Society–Unified Parkinson Disease Rating Scale item 1.2, which assesses hallucinations and psychosis over the past week. At baseline, participants completed the Scales for Outcomes in Parkinson's Disease–Autonomic, the REM Sleep Behavior Disorder (RBD) Screening Questionnaire, and the Epworth Sleepiness Scale. Cholinergic nucleus 4 (Ch4) density was calculated for 228 participants with PD and 101 healthy controls.ResultsMultivariate logistic regression adjusted for age and sex found that greater autonomic symptoms (p = 0.002), RBD (p = 0.021), and excessive daytime sleepiness (EDS) (p = 0.003) at baseline were associated with increased risk of reporting psychotic symptoms on ≥2 occasions. Having 2 or 3 of these baseline symptoms was associated with lower Ch4 density (p = 0.007). In a logistic regression model adjusted for age and sex, higher Ch4 gray matter density was associated with lower risk of reporting psychotic symptoms on ≥2 occasions (odds ratio 0.96 [for an increase in density of 1 unit], p = 0.03).ConclusionsThis study confirms that RBD, EDS, and greater autonomic symptom burden are associated with greater risk of future psychotic symptoms in PD. Reduced Ch4 density at baseline is associated with future psychotic symptoms and a greater burden of RBD, EDS, and autonomic symptoms.
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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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Corvin, Aiden, Ed O'Mahony, Myra O'Regan, Claire Comerford, Robert O'Connell, Nick Craddock, and Michael Gill. "Cigarette smoking and psychotic symptoms in bipolar affective disorder." British Journal of Psychiatry 179, no. 1 (July 2001): 35–38. http://dx.doi.org/10.1192/bjp.179.1.35.
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BackgroundAn association exists between smoking and schizophrenia, independent of other factors and related to psychotic symptomatology.AimsTo determine whether smoking is associated with psychosis in bipolar affective disorder.MethodSmoking data were collected from 92 unrelated patients with bipolar affective disorder. An ordinal logistic regression analysis tested the relationship between smoking severity and psychotic symptomatology, allowing for potential confounders.ResultsA significant relationship was detected between smoking/heavy smoking and history of psychosis (68.7%, n=44). Smoking was less prevalent in patients who were less symptomatic (56.5%, n=13) than in patients with a more severe psychosis (75.7%, n=31). Prevalence and severity of smoking predicted severity of psychotic symptoms (P=0.001), a relationship independent of other variables (P=0.0272).ConclusionA link between smoking and psychosis exists in bipolar affective disorder and may be independent of categorical diagnosis.
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Johns, Louise C., Mary Cannon, Nicola Singleton, Robin M. Murray, Michael Farrell, Traolach Brugha, Paul Bebbington, Rachel Jenkins, and Howard Meltzer. "Prevalence and correlates of self-reported psychotic symptoms in the British population." British Journal of Psychiatry 185, no. 4 (October 2004): 298–305. http://dx.doi.org/10.1192/bjp.185.4.298.
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BackgroundThe psychosis phenotype is generally thought of as a categorical entity. However, there is increasing evidence that psychosis exists in the population as a continuum of severity rather than an all-or-none phenomenon.AimsTo investigate the prevalence and correlates of self-reported psychotic symptoms using data from the 2000 British National Survey of Psychiatric Morbidity.MethodA total of 8580 respondents aged 16–74 years were interviewed. Questions covered mental health, physical health, substance use, life events and socio-demographic variables. The Psychosis Screening Questionnaire (PSQ) was used to identify psychotic symptoms.ResultsOf the respondents, 5.5% endorsed one or more items on the PSQ. Factors independently associated with psychotic symptoms were cannabis dependence, alcohol dependence, victimisation, recent stressful life events, lower intellectual ability and neurotic symptoms. Male gender was associated with paranoid thoughts, whereas female gender predicted hallucinatory experiences.ConclusionsSelf-reported psychotic symptoms are less common in this study than reported elsewhere, because of the measure used. These symptoms have demographic and clinical correlates similar to clinical psychosis.
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Fernandez-Quintana, A., C. Quiroga-Fernandez, A. Novo-Ponte, and M. D. C. Garcia-Mahia. "Cannabis-induced Psychotic Disorders and THC use Among Patients with Psychotic Symptoms." European Psychiatry 41, S1 (April 2017): S203. http://dx.doi.org/10.1016/j.eurpsy.2017.01.2156.
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IntroductionCausality between THC and psychotic symptoms has been outlined in several studies and a potential role for THC in the development of Schizophrenia remains to be assessed.MethodsRetrospective study undertaken in a sample of 124 patients assessed in an Emergency Department (ED) due to psychotic symptoms. Medical records were reviewed to obtain clinical and sociodemographic variables.Objectives(1) To analyse the prevalence of THC consumption among psychotic patients in ED; (2) to establish the prevalence of cannabis-induced psychotic disorder; (3) to underpin the socio-demographic and clinical variables associated with cannabis-induced psychosis.ResultsPersonal history of cannabis use 31.5% (6.5% as a single drug.) Accumulated time interval of cannabis use prior to the first psychotic episode: 0 – 5 years 15% (3.9% developed psychosis during the first year of cannabis use), 5 – 10 years 9.2%, more than 10 years 20.8%. Cannabis-induced psychotic disorder (F12.5) was diagnosed in 3.3% of the sample. The prevalence of this diagnosis was the same among male and female patients. The highest prevalence of cannabis-induced psychosis was found among 36–50 years old patients (50%). All patients with a diagnosis of Cannabis-induced psychotic disorder had a personal history of THC use and urine tests had been positive for THC in 75% of the cases. Habitat: 75% urban, 25% rural. Marital status: 50% single, 50% married.ConclusionsCannabis use is highly prevalent among patients who present with psychotic symptoms in ED and THC is correlated with psychotic episodes. The prevalence of cannabis-induced psychosis has also increased. Further studies comprising larger samples are warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Adeosun, Increase Ibukun, and Oyetayo Jeje. "Symptom Profile and Severity in a Sample of Nigerians with Psychotic versus Nonpsychotic Major Depression." Depression Research and Treatment 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/815456.
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The therapeutic strategies in managing patients with psychotic major depression (PMD) differ from those with non-psychotic major depression (NMD), because of differences in clinical profile and outcome. However, there is underrecognition of psychotic symptoms in depressed patients. Previous studies in Western population suggest that certain symptom patterns, apart from psychosis which may be concealed, can facilitate the discrimination of PMD from NMD. These studies may have limited applicability to sub-Saharan Africa due to cross-cultural differences in the phenomenology of depression. This study compared the rates and severity of depressive symptoms in outpatients with PMD (n=129) and NMD (n=117) using the Structured Clinical Interview for Depression (SCID) and Hamilton Depression Rating Scale (HAM-D). Patients with PMD had statistically significantly higher rates of suicidal ideation, suicidal attempt, psychomotor agitation, insomnia, and reduced appetite. Patients with NMD were more likely to manifest psychomotor retardation and somatic symptoms. PMD was associated with greater symptom severity. On logistic regression analysis, suicidal ideation, psychomotor disturbances, insomnia, and somatic symptoms were predictive of diagnostic status. The presence of these symptoms clusters may increase the suspicion of occult psychosis in patients with depression, thereby informing appropriate intervention strategies.
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Karimova, Rumiyya. "Pathomorphosis of Vascular Dementia with Psychotic Symptoms." Neuroscience and Neurological Surgery 11, no. 1 (January 10, 2022): 01–05. http://dx.doi.org/10.31579/2578-8868/221.
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Objective: To study the pathomorphosis of vascular dementia over the past 30 years. The study of the pathomorphosis of mental disorders makes significant adjustments to the criteria for diagnosis and nosography. Dementia has also undergone pathomorphosis over the years. Materials and Methods: The research was carried out in the Psychiatric Hospitalsin Azerbaijan. A retrospective analysis was carried out for the period 1990-1999, which were compared with a similar contingent during 2010-2020. Results: The number of hospitalized patients with vascular dementia has increased over the past 10 years, which means both an increase in the incidence of the disease and an increase in symptoms requiring psychiatric treatment. Conclusions: Pathomorphosis has also manifested itself in sex. Thus, the number of female patients has increased in the last 10 years. As a result of the disease, there is a positive trend, a decrease in mortality.
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Aylott, A., A. Zwicker, L. E. MacKenzie, J. Cumby, L. Propper, S. Abidi, A. Bagnell, et al. "Like father like daughter: sex-specific parent-of-origin effects in the transmission of liability for psychotic symptoms to offspring." Journal of Developmental Origins of Health and Disease 10, no. 1 (August 29, 2018): 100–107. http://dx.doi.org/10.1017/s2040174418000612.
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AbstractChildren of parents with major mood and psychotic disorders are at increased risk of psychopathology, including psychotic symptoms. It has been suggested that the risk of psychosis may be more often transmitted from parent to opposite-sex offspring (e.g., from father to daughter) than to same-sex offspring (e.g., from father to son). To test whether sex-specific transmission extends to early manifestations of psychosis, we examined sex-specific contributions to psychotic symptoms among offspring of mothers and fathers with depression, bipolar disorder and schizophrenia. We assessed psychotic symptoms in 309 offspring (160 daughters and 149 sons) aged 8–24 years (mean=13.1, s.d.=4.3), of whom 113 had a mother with schizophrenia, bipolar disorder or major depression and 43 had a father with schizophrenia, bipolar disorder or major depression. In semi-structured interviews, 130 (42%) offspring had definite psychotic symptoms established and confirmed by psychiatrists on one or more assessments. We tested the effects of mental illness in parents on same-sex and opposite-sex offspring psychotic symptoms in mixed-effect logistic regression models. Psychotic symptoms were more prevalent among daughters of affected fathers and sons of affected mothers than among offspring of the same sex as their affected parent. Mental illness in the opposite-sex parent increased the odds of psychotic symptoms (odds ratio (OR)=2.65, 95% confidence interval (CI) 1.43–4.91, P=0.002), but mental illness in the same-sex parent did not have a significant effect on psychotic symptoms in offspring (OR=1.13, 95% CI 0.61–2.07, P=0.697). The opposite-sex-specific parent-of-origin effects may suggest X chromosome-linked genetic transmission or inherited chromosomal modifications in the etiology of psychotic symptoms.
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GOODWIN, R. D., D. M. FERGUSSON, and L. J. HORWOOD. "Neuroticism in adolescence and psychotic symptoms in adulthood." Psychological Medicine 33, no. 6 (July 31, 2003): 1089–97. http://dx.doi.org/10.1017/s0033291703007888.
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Background. The aims of this research were to examine the associations between the personality trait of neuroticism in adolescence and later psychotic symptoms, taking into account potential confounding factors.Method. Data were gathered over the course of a longitudinal study of a birth cohort of New Zealand born young people (N=1265). Over the course of the study, data were gathered on: (a) neuroticism at age 14; (b) psychotic symptoms predominantly subclinical, assessed on the Symptom Checklist (SCL-90), at ages 18 and 21; (c) a range of potential confounding factors including measures of childhood adversity and co-morbid mental disorders.Results. Young people in the highest quartile of neuroticism at age 14 had rates of psychotic symptoms that were two to three times higher than those in the lowest quartile. After statistical adjustment for confounding factors, including childhood adversity and co-morbid mental disorders, the association between neuroticism and later psychotic symptoms reduced but remained statistically significant (P<0·05). After adjustment for confounding, young people with high levels of neuroticism had rates of psychotic symptoms that were between 1·5 to 1·8 times higher than those with low levels of neuroticism.Conclusions. Early neuroticism may be a precursor to the onset of psychotic symptoms. The mechanisms underlying this association are unclear, but may relate to overlapping features between prodromal phases of psychosis and items that measure neuroticism.
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Ivanova, Veronika. "Early Diagnosis and Counseling in Adolescents With Subclinical Psychotic Symptoms." Global Psychotherapist 2, no. 1 (January 20, 2022): 62–68. http://dx.doi.org/10.52982/lkj160.
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Psychosis is a condition characterized on current diagnostic tests by impairment and may include severe disturbances of cognition, thinking, behaviour, and emotion. The need for early diagnosis and prevention of psychotic episodes in adolescents challenges traditional models of counselling, diagnosis, and treatment. The aim of the present study is to derive the main themes and psychological manifestations in the first psychotic episode in adolescents and to deepen knowledge and raise questions around the specific experiences of psychotic adolescents in order to help the clinical psychologist and psychotherapist in diagnostic and therapeutic counselling. This thus goes beyond the visible behaviour and the medical model that pays little attention to the causal relationships in psychosis and its unconscious components. Thirty-six adolescents (27 girls) with subclinical and clinical psychotic symptoms and 30 adolescents (16 girls) with neurotic symptoms were interviewed. A clinical approach was used – clinical psychological interview followed by psychotherapeutic work. Findings and statements can be found showing that early psychotic signs may change into a more severe adolescent crisis, as well as indications of the nature of anger towards parents, unstable mood and aggressivity. Leading themes in interviews and psychotherapeutic sessions may relate to feelings of insignificance in the world around them, unclear sexual identification, too close a relationship with their mothers, and anxiety about real or symbolic absence such as their mothers’ working away from home for long periods of time. In 79% of the interviews with adolescents with psychotic symptoms, we see a lack of real symbolic play in childhood. suitable for non-psychotic adolescents, in this case to change in the first psychotic episode.****What does this last sentence mean? The importance of early diagnosis is recognized and the known psychotherapeutic techniques must be used. Keywords: early psychosis, adolescent, positive psychotherapy, counselling
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Longden, Eleanor, Alison Branitsky, Andrew Moskowitz, Katherine Berry, Sandra Bucci, and Filippo Varese. "The Relationship Between Dissociation and Symptoms of Psychosis: A Meta-analysis." Schizophrenia Bulletin 46, no. 5 (March 18, 2020): 1104–13. http://dx.doi.org/10.1093/schbul/sbaa037.
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Abstract Evidence suggests that dissociation is associated with psychotic experiences, particularly hallucinations, but also other symptoms. However, until now, symptom-specific relationships with dissociation have not been comprehensively synthesized. This is the first prospectively registered (CRD42017058214) meta-analysis to quantify the magnitude of association between dissociative experiences and all symptoms of psychosis. MEDLINE, PsycINFO, PubMed, and Scopus databases were searched using exhaustive terms denoting dissociation and psychotic symptoms. We included both nonclinical (58 studies; 16 557 participants) and clinical (46 studies; 3879 patient participants) samples and evaluated study quality. Ninety-three eligible articles considering 20 436 participants were retained for analysis. There was a robust association between dissociation and clinical and nonclinical positive psychotic symptoms (r = .437; 95%CI: .386 −.486), with the observed effect larger in nonclinical studies. Symptom-specific associations were also evident across clinical and nonclinical studies, and included significant summary effects for hallucinations (r = .461; 95%CI: .386 −.531), delusions (r = .418; 95%CI: .370 −.464), paranoia (r = .447; 95%CI: .393 −.499), and disorganization (r = .346; 95%CI: .249 −.436). Associations with negative symptoms were small and, in some cases, not significant. Overall, these findings confirm that dissociative phenomena are not only robustly related to hallucinations but also to multiple positive symptoms, and less robustly related to negative symptoms. Our findings are consistent with proposals that suggest certain psychotic symptoms might be better conceptualized as dissociative in nature and support the development of interventions targeting dissociation in formulating and treating psychotic experiences.
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Spauwen, Janneke, Lydia Krabbendam, Roselind Lieb, Hans-Ulrich Wittchen, and Jim Van Os. "Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness." British Journal of Psychiatry 188, no. 6 (June 2006): 527–33. http://dx.doi.org/10.1192/bjp.bp.105.011346.
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BackgroundThe reported link between psychological trauma and onset of psychosis remains controversial.AimsTo examine associations between self-reported psychological trauma and psychotic symptoms as a function of prior evidence of vulnerability to psychosis (psychosis proneness).MethodAt baseline, 2524 adolescents aged 14–24 years provided self-reports on psychological trauma and psychosis proneness, and at follow-up (on average 42 months later) participants were interviewed for presence of psychotic symptoms.ResultsSelf-reported trauma was associated with psychotic symptoms, in particular at more severe levels (adjusted OR 1.89, 95% CI 1.16–3.08) and following trauma associated with intense fear, helplessness or horror. The risk difference between those with and without self-reported trauma at baseline was 7% in the group with baseline psychosis proneness, but only 1.8% in those without (adjusted test for difference between these two effect sizes: χ2=4.6, P=0.032).ConclusionsExposure to psychological trauma may increase the risk of psychotic symptoms in people vulnerable to psychosis.
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Yung, Alison R., and Patrick D. McGorry. "The Initial Prodrome in Psychosis: Descriptive and Qualitative Aspects." Australian & New Zealand Journal of Psychiatry 30, no. 5 (October 1996): 587–99. http://dx.doi.org/10.3109/00048679609062654.
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Objective: This study aimed to describe in detail, using a retrospective approach, the prodromal symptoms in first-episode psychosis patients. This initial prodrome, the period of disturbance preceding a first psychotic episode, is potentially important for early intervention, identification of biological markers, and understanding the process of becoming psychotic. Method: A consecutive series of 21 first-episode patients was recruited from the Early Psychosis Prevention and Intervention Centre, a specialised service for young people aged between 16 and 30 with first-episode psychosis. Subjects were interviewed in the recovery phase after the acute episode, about the period leading up to the psychosis, using a combination of unstructured and semi-structured techniques. Results: A wide variability of phenomena and sequence patterns was found, with symptoms being a mixture of attenuated psychotic symptoms, neurotic and mood-related symptoms, and behavioural changes. Symptoms were often disabling and some, such as suicidal thoughts, potentially life-threatening. Conclusions: The findings highlight the loss of information that has resulted from disregarding early phenomenological studies of the psychotic prodrome and instead focussing on behavioural features. The ground work has been laid for the development of better methodologies for assessing and measuring first psychotic prodromes with increased emphasis on experiential phenomena. This has the potential to lead to the early recognition and more accurate prediction of subsequent psychosis, as well as a deeper understanding of the neurobiology of the onset of psychotic disorder.
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Andrade, F., A. S. Machado, A. Vieira, and A. Silva. "Bipolar mania with psychosis vs without psychosis: A clinical characterization with indirect measures of severity." European Psychiatry 64, S1 (April 2021): S82—S83. http://dx.doi.org/10.1192/j.eurpsy.2021.247.
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IntroductionThe presence of psychotic symptoms is highest during acute episodes of bipolar mania. There is no evidence base regarding the implications of psychosis in the prognosis of bipolar disorder, despite common assumption that their occurrence reflects greater disease severity.ObjectivesWe aim to compare sociodemographic and clinical characteristics of inpatients admitted for bipolar mania with and without psychotic features.MethodsRetrospective observational study of inpatients admitted between January 1st 2017 and 31 October 2020 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0.ResultsBetween 2017 and October 2020 there were 103 admissions due to mania bipolar I disorder, 53.4% (n=55) with psychotic symptoms. When compared with mania without psychosis, psychotic mania was associated to male gender (71.1% to 39.7%; c2(1, N = 103) = 10,06; p = 0.02) and younger age (t(103) = -2.43; p = 0.017). The proportion of compulsory admissions and average length of stay were similar between mania with psychosis and mania without psychosis. Also, having a manic bipolar episode with psychotic symptoms was not associated to being prescribed a long-acting injectable antipsychotic.ConclusionsThe presence of psychotic symptoms in bipolar manic episodes were associated to male gender and younger age but not to indirect measures of illness severity.DisclosureNo significant relationships.
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Howes, Oliver D., Ilaria Bonoldi, Robert A. McCutcheon, Matilda Azis, Mathilde Antoniades, Matthijs Bossong, Gemma Modinos, et al. "Glutamatergic and dopaminergic function and the relationship to outcome in people at clinical high risk of psychosis: a multi-modal PET-magnetic resonance brain imaging study." Neuropsychopharmacology 45, no. 4 (October 16, 2019): 641–48. http://dx.doi.org/10.1038/s41386-019-0541-2.
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Abstract Preclinical models of psychosis propose that hippocampal glutamatergic neuron hyperactivity drives increased striatal dopaminergic activity, which underlies the development of psychotic symptoms. The aim of this study was to examine the relationship between hippocampal glutamate and subcortical dopaminergic function in people at clinical high risk for psychosis, and to assess the association with the development of psychotic symptoms. 1H-MRS was used to measure hippocampal glutamate concentrations, and 18F-DOPA PET was used to measure dopamine synthesis capacity in 70 subjects (51 people at clinical high risk for psychosis and 19 healthy controls). Clinical assessments were undertaken at baseline and follow-up (median 15 months). Striatal dopamine synthesis capacity predicted the worsening of psychotic symptoms at follow-up (r = 0.35; p < 0.05), but not transition to a psychotic disorder (p = 0.22), and was not significantly related to hippocampal glutamate concentration (p = 0.13). There were no differences in either glutamate (p = 0.5) or dopamine (p = 0.5) measures in the total patient group relative to controls. Striatal dopamine synthesis capacity at presentation predicts the subsequent worsening of sub-clinical total and psychotic symptoms, consistent with a role for dopamine in the development of psychotic symptoms, but is not strongly linked to hippocampal glutamate concentrations.
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Binbay, T., M. Drukker, K. Alptekin, H. Elbi, F. Aksu Tanık, F. Özkınay, H. Onay, N. Zağlı, and J. van Os. "Evidence that the wider social environment moderates the association between familial liability and psychosis spectrum outcome." Psychological Medicine 42, no. 12 (April 16, 2012): 2499–510. http://dx.doi.org/10.1017/s0033291712000700.
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BackgroundFamilial liability to both severe and common mental disorder predicts psychotic disorder and psychotic symptoms, and may be used as a proxy in models examining interaction between genetic risk and the environment at individual and contextual levels.MethodIn a representative general population sample (n=4011) in Izmir, Turkey, the full spectrum of expression of psychosis representing (0) no symptoms, (1) subclinical psychotic experiences, (2) low-impact psychotic symptoms, (3) high-impact psychotic symptoms and (4) full-blown clinical psychotic disorder was assessed in relation to mental health problems in the family (proxy for familial liability) and the wider social environment. Quality of the wider social environment was assessed in an independent sample using contextual measures of informal social control, social disorganization, unemployment and low income, aggregated to the neighbourhood level.ResultsThe association between familial liability to severe mental illness and expression of psychosis spectrum was stronger in more deprived neighbourhoods [e.g. this association increased from β=0.33 (p=0.01) in low-unemployment neighbourhoods to β=0.92 (p<0.001) in high-unemployment neighbourhoods] and in neighbourhoods high in social control, while neighbourhood variables did not modify the association between familial liability to common mental disorder and the psychosis outcome. Neighbourhood variables mediated urbanicity effects.ConclusionsContextual effects may be important in moderating the expression of psychosis liability in populations, representing a specific pathway independent of the link between common mental disorder and psychosis.
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Birchwood, Max, Zaffer Iqbal, Paul Chadwick, and Peter Trower. "Cognitive approach to depression and suicidal thinking in psychosis." British Journal of Psychiatry 177, no. 6 (December 2000): 516–21. http://dx.doi.org/10.1192/bjp.177.6.516.
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BackgroundDepression in schizophrenia is a rather neglected field of study, perhaps because of its confused nosological status. Three course patterns of depression in schizophrenia, including post-psychotic depression (PPD), are proposed.AimsWe chart the ontogeny of depression and psychotic symptoms from the acute psychotic episode over a 12-month period and test the validity of the proposed course patterns.MethodOne hundred and five patients with ICD–10 schizophrenia were followed up on five occasions over 12 months following the acute episode, taking measures of depression, positive symptoms, negative symptoms, neuroleptic exposure and side-effects.ResultsDepression accompanied acute psychosis in 70% of cases and remitted in line with the psychosis; 36% developed PPD without a concomitant increase in psychotic symptoms.ConclusionsThe results provided support for the validity of two of the three course patterns of depression in schizophrenia, including PPD. Post-psychotic depression occurs de novo without concomitant change in positive or negative symptoms.
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Feinstein, Anthony, George Du Boulay, and Maria A. Ron. "Psychotic Illness in Multiple Sclerosis." British Journal of Psychiatry 161, no. 5 (November 1992): 680–85. http://dx.doi.org/10.1192/bjp.161.5.680.
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Ten patients with multiple sclerosis (MS) and psychosis were assessed using the Present State Examination, and matched retrospectively with respect to age, disability, duration of symptoms, and disease type with 10 MS patients without psychosis. Both groups underwent MRI of the brain. There was a trend for the psychotic group to have a higher total lesion score, particularly around the periventricular areas. This reached statistical significance in the areas around the temporal horn. In all cases, neurological symptoms preceded the onset of psychosis. The psychotic group also had a later age of onset of psychosis than psychotic patients without brain disease. These results point to an aetiological association between the pathological process of MS and psychosis.
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Wiles, Nicola J., Stanley Zammit, Paul Bebbington, Nicola Singleton, Howard Meltzer, and Glyn Lewis. "Self-reported psychotic symptoms in the general population." British Journal of Psychiatry 188, no. 6 (June 2006): 519–26. http://dx.doi.org/10.1192/bjp.bp.105.012179.
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BackgroundScarce longitudinal data exist on the occurrence of psychotic symptoms in the general population.AimsTo estimate the incidence of, and risk factors for, self-reported psychotic symptoms in Great Britain.MethodData from the 18-month follow-up of a national survey were used. Incident cases were those who endorsed one or more items on the Psychosis Screening Questionnaire at follow-up, but not at baseline. The association between factors recorded at baseline and incident self-reported symptoms was examined.ResultsAt follow-up, 4.4% of the general population reported incident psychotic symptoms. Six factors were independently associated with incident symptoms: living in a rural area; having a small primary support group; more adverse life events; smoking tobacco; neurotic symptoms; and engaging in a harmful pattern of drinking.ConclusionsA small but not insignificant percentage of the population of Great Britain reported incident psychotic symptoms over 18 months. The risk factors for psychotic symptoms showed some similarities with risk factors for schizophrenia, but there were also some striking differences. The relationship between such risk factors and the factors that perpetuate psychotic symptoms remains to be ascertained.
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Escolà-Gascón, Álex, and Jordi Rusiñol Estragues. "Scrutinizing the Relationship between Subjective Anomalous Experiences and Psychotic Symptoms." Journal of Scientific Exploration 36, no. 1 (May 22, 2022): 24–38. http://dx.doi.org/10.31275/20222413.
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Abstract
This research was exploratory and its main objective was to analyze whether anomalous experiences related to parapsychology had similar statistical behavior to psychotic-like experiences (e.g., hallucinations). If psi phenomena have a different ontology from psychotic-like experiences, then they should have a different statistical representation and measurement. In this hypothetical scenario, there would be empirical-statistical grounds for discriminating between psychotic perceptual distortions and anomalous experiences without clinical origin. Different clinical variables common in psychotic disorders were measured in 562 participants. Psychotic-like experiences (as hallucinations) and anomalous experiences (as experiences outside the framework of psychosis) were also quantified. Several forward stepwise multiple regression models and techniques based on Exploratory Factor Analysis were used. The EFA extracted 2 factors; the first grouped the variables that measured anomalous phenomena from the continuum of psychosis model and the second gathered the variables that measured them as anomalous perceptions without scientific explanation. Both EFAs explained more than 70% of the variance. Only 3 clinical variables were necessary to predict 58.8% of psychotic –like experiences assessed from the psychopathological model. Up to 6 indicators were necessary to predict 54.5% of the unexplained anomalous experiences. There are empirical-statistical indicators in the used sample that enable the differentiation of the anomalous phenomena in the two prominent models. The variables that characterize the psychotic phenotype predict more successfully psychotic-like experiences than anomalous experiences. It is discussed whether the factors extracted in the EFA represent psychological constructs with different etiologies or if both dimensions come from the same underlying construct.
Keywords: Anomalous Experiences; Schizotypy; Psychotic-like experiences; Paranormal Beliefs; Psi Phenomena.
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Kelleher, I., H. Keeley, P. Corcoran, F. Lynch, C. Fitzpatrick, N. Devlin, C. Molloy, et al. "Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies." British Journal of Psychiatry 201, no. 1 (July 2012): 26–32. http://dx.doi.org/10.1192/bjp.bp.111.101543.
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BackgroundEpidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.AimsTo investigate the relationship between psychotic symptoms and non-psychotic psychopathology in community samples of adolescents in terms of prevalence, co-occurring disorders, comorbid (multiple) psychopathology and variation across early v. middle adolescence.MethodData from four population studies were used: two early adolescence studies (ages 11–13 years) and two mid-adolescence studies (ages 13–16 years). Studies 1 and 2 involved school-based surveys of 2243 children aged 11–16 years for psychotic symptoms and for emotional and behavioural symptoms of psychopathology. Studies 3 and 4 involved in-depth diagnostic interview assessments of psychotic symptoms and lifetime psychiatric disorders in community samples of 423 children aged 11–15 years.ResultsYounger adolescents had a higher prevalence (21–23%) of psychotic symptoms than older adolescents (7%). In both age groups the majority of adolescents who reported psychotic symptoms had at least one diagnosable non-psychotic psychiatric disorder, although associations with psychopathology increased with age: nearly 80% of the mid-adolescence sample who reported psychotic symptoms had at least one diagnosis, compared with 57% of the early adolescence sample. Adolescents who reported psychotic symptoms were at particularly high risk of having multiple co-occurring diagnoses.ConclusionsPsychotic symptoms are important risk markers for a wide range of non-psychotic psychopathological disorders, in particular for severe psychopathology characterised by multiple co-occurring diagnoses. These symptoms should be carefully assessed in all patients.
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van Dam, D. S., M. van Nierop, W. Viechtbauer, E. Velthorst, R. van Winkel, R. Bruggeman, W. Cahn, et al. "Childhood abuse and neglect in relation to the presence and persistence of psychotic and depressive symptomatology." Psychological Medicine 45, no. 7 (July 17, 2014): 1363–77. http://dx.doi.org/10.1017/s0033291714001561.
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BackgroundThe association between childhood trauma and psychotic and depressive symptomatology is well established. However, less is known about the specificity and course of these symptoms in relation to childhood trauma.MethodIn a large sample (n = 2765) of patients with psychosis (n = 1119), their siblings (n = 1057) and controls (n = 589), multivariate (mixed-effects) regression analyses with multiple outcomes were performed to examine the association between childhood trauma and psychotic and depressive symptomatology over a 3-year period.ResultsA dose–response relationship was found between childhood trauma and psychosis. Abuse was more strongly associated with positive symptoms than with negative symptoms whereas the strength of the associations between neglect and positive and negative symptoms was comparable. In patients, similar associations between childhood trauma and psychotic or depressive symptoms were found, and in siblings and controls, stronger associations were found between trauma and depressive symptomatology. Childhood trauma was not related to a differential course of symptoms over a 3-year time period.ConclusionsIn congruence with earlier work, our findings suggest that childhood trauma, and abuse in particular, is associated with (subthreshold) psychosis. However, childhood trauma does not seem to be associated with a differential course of symptoms, nor does it uniquely heighten the chance of developing (subthreshold) psychotic symptomatology. Our results indicate that trauma may instead contribute to a shared vulnerability for psychotic and depressive symptoms.
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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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Mason, Ava, Jessica Irving, Megan Pritchard, Jyoti Sanyal, Craig Colling, David Chandran, and Robert Stewart. "Association between depressive symptoms and cognitive–behavioural therapy receipt within a psychosis sample: a cross-sectional study." BMJ Open 12, no. 5 (May 2022): e051873. http://dx.doi.org/10.1136/bmjopen-2021-051873.
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ObjectivesTo examine whether depressive symptoms predict receipt of cognitive–behavioural therapy for psychosis (CBTp) in individuals with psychosis.DesignRetrospective cross-sectional analysis of electronic health records (EHRs) of a clinical cohort.SettingA secondary National Health Service mental healthcare service serving four boroughs of south London, UK.Participants20 078 patients diagnosed with an International Classification of Diseases, version 10 (ICD-10) code between F20 and 29 extracted from an EHR database.Primary and secondary outcome measuresPrimary: Whether recorded depressive symptoms predicted CBTp session receipt, defined as at least one session of CBTp identified from structured EHR fields supplemented by a natural language processing algorithm. Secondary: Whether age, gender, ethnicity, symptom profiles (positive, negative, manic and disorganisation symptoms), a comorbid diagnosis of depression, anxiety or bipolar disorder, general CBT receipt prior to the primary psychosis diagnosis date or type of psychosis diagnosis predicted CBTp receipt.ResultsOf patients with a psychotic disorder, only 8.2% received CBTp. Individuals with at least one depressive symptom recorded, depression symptom severity and 12 out of 15 of the individual depressive symptoms independently predicted CBTp receipt. Female gender, White ethnicity and presence of a comorbid affective disorder or primary schizoaffective diagnosis were independently positively associated with CBTp receipt within the whole sample and the top 25% of mentioned depressive symptoms.ConclusionsIndividuals with a psychotic disorder who had recorded depressive symptoms were significantly more likely to receive CBTp sessions, aligning with CBTp guidelines of managing depressive symptoms related to a psychotic experience. However, overall receipt of CBTp is low and more common in certain demographic groups, and needs to be increased.
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Connors, Michael H., Armando Teixeira-Pinto, and Clement T. Loy. "Psychosis and longitudinal outcomes in Huntington disease: the COHORT Study." Journal of Neurology, Neurosurgery & Psychiatry 91, no. 1 (October 13, 2019): 15–20. http://dx.doi.org/10.1136/jnnp-2019-320646.
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ObjectiveHuntington disease (HD) is an autosomal dominant neurodegenerative disease involving motor disturbances, cognitive decline and psychiatric symptoms. Psychotic symptoms occur in a significant proportion of patients. We sought to characterise the clinical outcomes of this group of patients.MethodsData were drawn from the Cooperative Huntington Observational Research Trial, a prospective, multi-centre observational study. 1082 patients with HD were recruited. Measures of cognition, function, behavioural disturbance and motor function were completed annually over 5 years.ResultsOverall, 190 patients (17.6%) displayed psychotic symptoms. These patients demonstrated worse cognition, function and behavioural disturbances than patients without psychosis over time. Patients with psychosis also demonstrated lower levels of chorea than patients without psychosis, despite adjusting for concurrent antipsychotic and tetrabenazine use.ConclusionsPsychosis in HD is associated with poorer outcomes in cognition, function and behavioural symptoms. Patients with psychotic symptoms may also have less chorea. Altogether, the findings suggest patients with psychosis have a distinct clinical course.
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Petrykiv, S., M. Arts, and L. De Jonge. "First case of new-onset psychosis due to DBS in the ventralis intermediate nucleus (Vim) of the thalamus." European Psychiatry 65, S1 (June 2022): S249. http://dx.doi.org/10.1192/j.eurpsy.2022.643.
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Introduction Known risk factors for developing of first-time psychosis in patients with deep brain stimulator (DBS) include older age, short time after implant placement and cerebral target for stimulation. In particular, stimulation of subtalamic nucleus and globus pallidus internus has been shown to elicit psychotic symptoms in various case reports. To date, there are no cases describing onset of psychosis due to DBS in the ventralis intermediate nucleus (Vim) of the thalamus. Objectives Case describtion of psychotic episode provoked by DBS in Vim region Methods Case report of 70 y.o. female with unilateral DBS from 2012 in Vim for essential tremor, who developed therapy resistant psychotic symptoms right after adjusted settings of the DBS. Results Psychotic onset of otherwise healthy 70 y.o. patient occurred and gradually worsened after adjustment of DBS settings in absence of other iatrogenic factors, including medication and comorbidity, and required involuntary hospitalization one week after beginning of psychosis. Treatment after hospitalization comprised olanzapine 10 mg. 1dd1 did not cause resolvent of psychosis. Because of therapy resistance to psychofarmaca and worsening of psychotic symptoms, by way of exception neurologists had to change the settings back to basic leading to complete and sustained remission of psychosis within two days. Conclusions Among side effects of DBS in Vim, psychotic symptoms have never been reported. However, as in our patient, psychosis occurred after changes of settings in DBS and presented acutely, was severe, resulted in involuntary hospitalization and was therapy resistant. Pathophysiology of DBS-induced psychosis in Vim region is not known and requires further investigation. Disclosure No significant relationships.
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Ghoreishizadeh, Mohammad Ali, Sepideh Herizchi, and Sara Farhang. "Psychotic experiences in patients with obsessive compulsive disorder. A cross sectional clinical study." Pakistan Journal of Medical and Health Sciences 15, no. 6 (June 30, 2021): 1829–33. http://dx.doi.org/10.53350/pjmhs211561829.
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Background: Obsessive-compulsive disorder (OCD) is associated with heterogeneous and diverse symptoms. A diagnosis is challenging when patients experience psychotic symptoms. This study aimed to evaluate the pattern of psychotic symptoms in patients with OCD. Methods: Using semi-structured clinical interviews, 185 patients meeting the DSM-IV diagnostic criteria for OCD were selected. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Scale for the Assessment of Positive/Negative Symptoms (SAPS/SANS) were used to measure the OCD severity and insight levels and the pattern of psychotic symptoms, respectively. Characteristics of patients with and without psychotic experiences were compared. Results: A total of 38 patients (20.5%) displayed psychotic symptoms. Delusions were observed in 63.2% of these patients, while in 13.2% of them, delusions were accompanied with negative symptoms. Men, those aged between 18 and 34 years, less educated, and singles displayed significantly higher rates of psychotic symptoms. The mean Y-BOCS score (26.42±5.07) was significantly higher in patients with psychotic symptoms than in those without (24.97±6.38). Conclusion: The results showed that in OCD patients, psychotic symptoms are more common in young (<30 years), single, less educated, and those with severe OCD. Keywords: obsessive-compulsive disorder; psychosis; insight.
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Folk, Tully, Blacker, Liles, Bolden, Tryon, Botello, and Niendam. "Uncharted Waters: Treating Trauma Symptoms in the Context of Early Psychosis." Journal of Clinical Medicine 8, no. 9 (September 12, 2019): 1456. http://dx.doi.org/10.3390/jcm8091456.
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Psychosis is conceptualized in a neurodevelopmental vulnerability-stress framework, and childhood trauma is one environmental factor that can lead to psychotic symptoms and the development of psychotic disorders. Higher rates of trauma are associated with higher psychosis risk and greater symptom frequency and severity, resulting in increased hospitalization rates and demand on outpatient primary care and mental health services. Despite an estimated 70% of individuals in the early stages of psychosis reporting a history of experiencing traumatic events, trauma effects (post-traumatic anxiety or depressive symptoms) are often overlooked in psychosis treatment and current interventions typically do not target commonly comorbid post-traumatic stress symptoms. We presented a protocol for Trauma-Integrated Cognitive Behavioral Therapy for Psychosis (TI-CBTp), an approach to treating post-traumatic stress symptoms in the context of early psychosis care. We provided a brief summary of TI-CBTp as implemented in the context of Coordinated Specialty Care and presented preliminary data supporting the use of TI-CBTp in early psychosis care. The preliminary results suggest that individuals with comorbid psychosis and post-traumatic stress symptoms can be appropriately and safely treated using TI-CBTp within Coordinated Specialty Care.
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Ugarte, A., M. Fernández, I. González, J. R. Peciña, A. Villamor, E. Zuhaitz, B. García, J. García, and A. González-Pinto. "Misdiagnosis and psychotic symptoms in bipolar disorder." European Psychiatry 26, S2 (March 2011): 255. http://dx.doi.org/10.1016/s0924-9338(11)71965-4.
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IntroductionEarly onset forms of bipolar disorder may be difficult to distinguish from schizophrenia. Although operational criteria have become more precise, and there are more diagnostic systems to catalogue a psychotic adolescent, the clinicians continue having difficulties.ObjectiveTo know the stability of the diagnosis of definitively bipolar patients with psychotic symptoms during the episodes, and factors that can influence other psychotic diagnoses in the first episode of the illness.Method140 bipolar patients of Araba, (Basque country) were included during 2 years. Patients were divided into two groups: unstable diagnoses (UD)(bipolar patients with an initial diagnosis of other psychosis) and stable diagnoses (SD) of bipolar disorder. Clinical and sociodemographic data were obtained.ResultsThe mean age at onset was significantly lower in the UD group (p = 0.004). It was rare to have an unstable diagnosis when the first psychotic episode occurred after age 38 (p = 0.008). There were more singles in the UD group (p = 0.010).The presence of mood incongruent psychotic symptoms was more frequent in the UD group (p < 0.001).Mood incongruent psychotic symptoms variable was the only independent factor significantly associated with an unstable diagnosis in the multivariate analysis (p = 0.036).DiscussionOne third of the patients have been previously diagnosed with other psychotic illness.This study suggests that the most important factor is the clinical picture, especially the presence of mood-incongruent psychotic symptoms. A correct diagnosis is important because patients who are prescribed mood stabilizers have lower rates of rehospitalisation than those who are not treated with mood stabilizers.
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Clamor, Annika, A. Malika Warmuth, and Tania M. Lincoln. "Arousal Predisposition as a Vulnerability Indicator for Psychosis: A General Population Online Stress Induction Study." Schizophrenia Research and Treatment 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/725136.
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Explanatory models ascribe to arousability a central role for the development of psychotic symptoms. Thus, a disposition to hyperarousal (i.e., increased arousal predisposition (AP)) may serve as an underlying vulnerability indicator for psychosis by interacting with stressors to cause symptoms. In this case, AP, stress-response, and psychotic symptoms should be linked before the development of a diagnosable psychotic disorder. We conducted a cross-sectional online study in a population sample (N=104;Mage=27.7years,SD=11.2, range 18–70). Participants rated their AP and subclinical psychotic symptoms. Participants reported their stress-levels before and after two stress inductions including an arithmetic and a social stressor. The participants with an increased AP generally felt more stressed. However, AP was not associated with the specific stress-response. As expected, positive psychotic symptoms were significantly associated with AP, but this was not mediated by general stress-levels. Its association to subtle, nonclinical psychotic symptoms supports our assumption that AP could be a vulnerability indicator for psychosis. The trait is easily accessible via a short self-report and could facilitate the identification of people at risk and be a promising target for early stress-management. Further research is needed to clarify its predictive value for stress-responses.
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Cancino Botello, M. C., M. D. L. A. Canseco Navarro, A. Peña Serrano, F. Molina López, and J. M. Hernández Sánchez. "Psychosis, cause or consequence of substance use disorder." European Psychiatry 33, S1 (March 2016): S376. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1349.
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IntroductionThe use of psychostimulants, such as amphetamines and cocaine in psychotic patients is 4 times more frequent than non-psychotic ones. It is believed that people with psychosis may use substances as a self-treatment for negative symptoms. However, early onset of substance use disorder can develop psychotic and/or negative symptoms, leading to confusion between primary or secondary psychosis.MethodSystematic review of the literature in English (PubMed) and patient's clinical record. Keywords: “Substance use disorder”; “psychosis”.Objectivesto highlight the importance of an adequate characterization of psychotic symptoms in patients with substance use disorder.CaseA 29-year-old man, with psychostimulants and cannabis abuse since adolescence and very short abstinence episodes. Later on, he developed paranoia symptoms that slightly improved once he decreased drugs dosage, but they were still present even on complete abstinence. Over the last year he has showed negative and psychotic symptoms that have been worsening with aggressive behavior during the last months, so he had to be hospitalized. During this period, he has been treated successfully with aripiprazol depot once monthly. His evolution has been positive, it has disappeared psychotic symptoms and paranoia, and after discharge he has managed to remain abstinent to psychostimulants.ConclusionsAdequate characterization of patients with psychotic symptoms and substance abuse is essential to determine whether the psychotic disorder is associated with primary or induced TUS. Therefore, it is essential a thorough clinical evaluation to make an accurate diagnosis and to draw an individualized treatment plan.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Jacobsen, Pamela, Matthew Richardson, Emma Harding, and Paul Chadwick. "Mindfulness for Psychosis Groups; Within-Session Effects on Stress and Symptom-Related Distress in Routine Community Care." Behavioural and Cognitive Psychotherapy 47, no. 4 (January 18, 2019): 421–30. http://dx.doi.org/10.1017/s1352465818000723.
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Background: There is an emerging evidence base that mindfulness for psychosis is a safe and effective intervention. However, empirical data on the within-session effects of mindfulness meditation was hitherto lacking. Aims: The aim of the study was to assess the impact of taking part in a mindfulness for psychosis group, using a within-session self-report measure of general stress, and symptom-related distress. Method: Users of a secondary mental health service (n = 34), who experienced enduring psychotic symptoms, took part in an 8-week mindfulness for psychosis group in a community setting. Mindfulness meditations were limited to 10 minutes and included explicit reference to psychotic experience arising during the practice. Participants self-rated general stress, and symptom-related distress, before and after each group session using a visual analogue scale. Results: Average ratings of general stress and symptom-related distress decreased from pre- to post-session for all eight sessions, although not all differences were statistically significant. There was no increase in general stress, or symptom-related distress across any session. Conclusions: There was evidence of positive effects and no evidence of any harmful effects arising from people with psychotic symptoms taking part in a mindfulness for psychosis session.
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Devenney, Emma M., Rebekah M. Ahmed, Jashelle Caga, Elizabeth Highton-Williamson, Eleanor Ramsey, Margaret Zoing, John Hodges, and Matthew Kiernan. "015 Unravelling psychosis in motor neurone disease – a study of clinical features, cognition, and survival." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A6.1—A6. http://dx.doi.org/10.1136/jnnp-2019-anzan.15.
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IntroductionPsychotic symptoms are now recognised to occur in patients with MND, often in association with FTD, and particularly in C9orf72 expansion carriers. As yet the impact of these symptoms on the clinical disease state is unknown and the relationship between severity and nature of these symptoms is not well understood. This study aimed to comprehensively explore the relationship between psychotic symptoms, clinical features, cognitive status and survival.MethodsIn total 148 participants; MND (n=100) and MND-FTD (n=48), were enrolled in the study. A detailed clinical interview in addition to a neurological, neuropsychological and behavioural assessment, genetic testing and brain MRI was undertaken in each participantResultsPsychotic symptoms were present in 25% of the cohort. The majority of participants in the psychosis cohort were male (83%) and were negative for the C9orf72 expansion (70%). Psychotic symptoms in younger patients were more likely to be florid, require medication and delay diagnosis. Within the MND subgroup, patients with psychotic symptoms were more impaired in the cognitive subdomains of attention, memory and executive functioning and exhibited more disinhibition, apathy and stereotypy, than patients without psychotic symptoms (all p<0.01), but no differences were identified for the MND-FTD subgroup (all p>0.2). Symptoms of depression were more common in those without psychotic symptoms (p>0.1). Survival was prolonged for patients with psychotic symptoms (HR=4.7, 95% CI: 2.1–10, p<0.001)ConclusionMND with psychosis represents a distinct clinical, cognitive and behavioural phenotype that has a positive impact on survival and may represent an overlap with psychiatric disorders.