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Sample records for positive psychotic symptoms

  1. Typologies of positive psychotic symptoms in methamphetamine dependence

    PubMed Central

    Bousman, Chad A.; McKetin, Rebecca; Burns, Richard; Woods, Steven Paul; Morgan, Erin E.; Atkinson, J. Hampton; Everall, Ian P.; Grant, Igor

    2014-01-01

    Background and Objectives Understanding methamphetamine associated psychotic (MAP) symptom typologies could aid in identifying individuals at risk of progressing to schizophrenia and guide early intervention. Methods Latent class analysis (LCA) of psychotic symptoms collected from 40 methamphetamine dependent individuals with a history of psychotic symptoms but no history of a primary psychotic disorder. Results Three typologies were identified. In one, persecutory delusions dominated (Type 1), in another persecutory delusions were accompanied by hallucinations (Type 2), and in the third a high frequency of all the assessed hallucinatory and delusional symptoms was observed (Type 3). Discussion and Conclusion MAP is a heterogeneous syndrome with positive symptom typologies. Scientific Significance This study represents the first attempt at identifying typologies of MAP and highlights the potential utility of LCA in future large-scale studies. PMID:25864598

  2. Attenuated positive psychotic symptoms and social anxiety: Along a psychotic continuum or different constructs?

    PubMed

    Cooper, Shanna; Klugman, Joshua; Heimberg, Richard G; Anglin, Deidre M; Ellman, Lauren M

    2016-01-30

    Social anxiety commonly occurs across the course of schizophrenia, including in the premorbid and prodromal phases of psychotic disorders. Some have posited that social anxiety may exist on a continuum with paranoia; however, empirical data are lacking. The study aim was to determine whether attenuated positive psychotic symptoms are related to social anxiety. Young adults (N=1378) were administered the Prodromal Questionnaire (PQ), which measures attenuated positive psychotic symptoms (APPS), and the Social Phobia Scale (SPS), which measures a subset of social anxiety symptoms. Confirmatory factor analyses were conducted to address the extent to which social anxiety and APPS tap distinct dimensions. Confirmatory factor analyses support the existence of a separate social anxiety factor scale and four separate, though interrelated, APPS factor domains (unusual thought content, paranoia/suspiciousness, disorganized thinking, and perceptual abnormalities). Additionally, social anxiety was significantly, but not differently related to each APPS domain, although the magnitude was reduced between social anxiety and distressing APPS. The current study suggests that social anxiety and attenuated positive psychotic symptoms are separable constructs, but are significantly associated with each other.

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    Catalan, Ana; Simons, Claudia J. P.; Bustamante, Sonia; Olazabal, Nora; Ruiz, Eduardo; Gonzalez de Artaza, Maider; Penas, Alberto; Maurottolo, Claudio; González, Andrea; van Os, Jim; Gonzalez-Torres, Miguel Angel

    2015-01-01

    Background Jumping to conclusions (JTC) is associated with psychotic disorder and psychotic symptoms. If JTC represents a trait, the rate should be (i) increased in people with elevated levels of psychosis proneness such as individuals diagnosed with borderline personality disorder (BPD), and (ii) show a degree of stability over time. Methods The JTC rate was examined in 3 groups: patients with first episode psychosis (FEP), BPD patients and controls, using the Beads Task. PANSS, SIS-R and CAPE scales were used to assess positive psychotic symptoms. Four WAIS III subtests were used to assess IQ. Results A total of 61 FEP, 26 BPD and 150 controls were evaluated. 29 FEP were revaluated after one year. 44% of FEP (OR = 8.4, 95% CI: 3.9–17.9) displayed a JTC reasoning bias versus 19% of BPD (OR = 2.5, 95% CI: 0.8–7.8) and 9% of controls. JTC was not associated with level of psychotic symptoms or specifically delusionality across the different groups. Differences between FEP and controls were independent of sex, educational level, cannabis use and IQ. After one year, 47.8% of FEP with JTC at baseline again displayed JTC. Conclusions JTC in part reflects trait vulnerability to develop disorders with expression of psychotic symptoms. PMID:26147948

  5. Psychotic symptoms in young people warrant urgent referral.

    PubMed

    Deakin, Julia; Lennox, Belinda

    2013-03-01

    There is a worse prognosis for psychosis and schizophrenia when onset is in childhood or adolescence. However, outcomes are improved with early detection and treatment. Psychotic symptoms can be associated with a variety of disorders including schizophrenia, schizoaffective disorder, drug-induced psychosis, personality disorder, epilepsy and autistic spectrum disorder. Positive symptoms include hallucinations and delusions. Negative symptoms include apathy, lack of drive, poverty of speech, social withdrawal and self-neglect. The DSM IV criteria for schizophrenia include two or more of the following: hallucinations, delusions, disorganised speech, grossly disorganised or catatonic behaviour and negative symptoms. Adults may raise concerns about social withdrawal, bizarre ideas, a change in behaviour or a decline in achievement. Most children and young people with psychotic symptoms will not go on to develop psychosis or schizophrenia. Direct enquiry may be needed to elicit suspected unusual beliefs or hallucinations. To distinguish unusual ideas from delusions the ideas should be tested for fixity. For example by asking: 'Are you sure? Could there be another explanation?' Mood and anxiety symptoms should be explored. The assessment should include a developmental history with particular attention to premorbid functioning. Failure to make expected progress whether personal, social or academic is significant. Better outcomes in terms of symptoms and social function are associated with a shorter duration of untreated psychosis. The detection of psychotic symptoms in primary care therefore warrants an urgent referral to secondary care mental health services for assessment and treatment.

  6. Psychotic and compulsive symptoms in Parkinson's disease.

    PubMed

    Verbaan, Dagmar; van Rooden, Stephanie M; Visser, Martine; Marinus, Johan; Emre, Murat; van Hilten, Jacobus J

    2009-04-15

    The objective of this study is to evaluate psychiatric symptoms in Parkinson's disease (PD) patients and to assess their relation with other clinical aspects of PD. Psychotic symptoms (PS) and compulsive symptoms (CS) as well as other nonmotor and motor features were evaluated in 353 PD patients. Psychotic and compulsive symptom scores did not correlate significantly. PS occurred in 65% of patients, with item frequencies ranging from 10% (paranoid ideation) to 55% (altered dream phenomena). Regression analysis showed that autonomic impairment accounted for 20% of the 32% explained variance of PS, whereas cognitive problems, depression, daytime sleepiness, and dopamine agonist (DA) dose explained the rest. CS occurred in 19%, with item frequencies of 10% for both sexual preoccupation and compulsive shopping/gambling. Patients with more severe CS (score > or = 2 on one or both items) were significantly more often men, had a younger age at onset, a higher DA dose and experienced more motor fluctuations compared to the other patients. PS and CS are common but unrelated psychiatric symptoms in PD. The relations found between PS and cognitive problems, depression, daytime sleepiness, and autonomic impairment suggests a resemblance with Dementia with Lewy Bodies. The prominent association between PS and autonomic impairment may be explained by a shared underlying mechanism. Our results confirm previous reports on the profile of patients developing CS, and mechanisms underlying motor fluctuations may also play a role in the development of CS in PD.

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2017-01-01

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

  10. Cerebral correlates of psychotic symptoms in Alzheimer's disease

    PubMed Central

    Mega, M.; Lee, L.; Dinov, I.; Mishkin, F.; Toga, A.; Cummings, J.

    2000-01-01

    BACKGROUND—Psychotic symptoms are produced by distributed neuronal dysfunction. Abnormalities of reality testing and false inference implicate frontal lobe abnormalities.
OBJECTIVES—To identify the functional imaging profile of patients with Alzheimer's disease manifesting psychotic symptoms as measured by single photon emission computed tomography (SPECT).
METHODS—Twenty patients with Alzheimer's disease who had SPECT and clinical evaluations were divided into two equal groups with similar mini mental status examination (MMSE), age, sex, and the range of behaviours documented by the neuropsychiatric inventory (NPI), except delusions and hallucinations. SPECT studies, registered to a probabilistic anatomical atlas, were normalised across the combined group mean intensity level, and subjected to a voxel by voxel subtraction of the non-psychotic minus psychotic groups. Subvolume thresholding (SVT) corrected random lobar noise to produce a three dimensional functional significance map.
RESULTS—The significance map showed lower regional perfusion in the right and left dorsolateral frontal, left anterior cingulate, and left ventral striatal regions along with the left pulvinar and dorsolateral parietal cortex, in the psychotic versus non-psychotic group.
CONCLUSION—Patients with Alzheimer's disease who manifest psychosis may have disproportionate dysfunction of frontal lobes and related subcortical and parietal structures.

 PMID:10896687

  11. Correlates of transient versus persistent psychotic symptoms among dependent methamphetamine users.

    PubMed

    McKetin, Rebecca; Gardner, Jonathon; Baker, Amanda L; Dawe, Sharon; Ali, Robert; Voce, Alexandra; Leach, Liana S; Lubman, Dan I

    2016-04-30

    This study examined correlates of transient versus persistent psychotic symptoms among people dependent on methamphetamine. A longitudinal prospective cohort study of dependent methamphetamine users who did not meet DSM-IV criteria for lifetime schizophrenia or mania. Four non-contiguous one-month observation periods were used to identify participants who had a) no psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient psychotic symptoms, n=85); and, (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent psychotic symptoms, n=37). Psychotic symptoms were defined as a score of 4 or greater on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content. Relative no psychotic symptoms, both transient and persistent psychotic symptoms were associated with childhood conduct disorder and comorbid anxiety disorders. Earlier onset methamphetamine use and being male were more specifically related to transient psychotic symptoms, while a family history of a primary psychotic disorder and comorbid major depression were specifically related to persistent psychotic symptoms. We conclude that there are overlapping but also distinct clinical correlates of transient versus persistent psychotic symptoms, suggesting potentially heterogeneous etiological pathways underpinning the psychotic phenomena seen amongst people who use methamphetamine.

  12. The attribution of psychotic symptoms to jinn in Islamic patients.

    PubMed

    Lim, Anastasia; Hoek, Hans W; Blom, Jan Dirk

    2015-02-01

    Patients with an Islamic background who suffer from hallucinations or other psychotic symptoms may attribute these experiences to jinn (i.e., invisible spirits). In this paper, we review the medical literature on jinn as an explanatory model in the context of psychotic disorders. We conducted a systematic search for papers on jinn and psychosis in Pubmed, EMBASE, Ovid Medline, PsycINFO, and Google Scholar databases. Our search yielded 105 scientific texts on jinn and their relationship with mental disorders, including 47 case reports. Among the case reports a definite biomedical diagnosis was provided in 66% of the cases, of which 45.2% involved a schizophrenia spectrum disorder. Fully 10 of 16 hallucinating patients experienced multimodal hallucinations. Although infrequently documented in the biomedical literature, the attribution of psychiatric symptoms to jinn appears to be quite common among Islamic patients, and to have significant impact on the diagnosis, treatment, and course of mental disorders, particularly psychotic disorders.

  13. Psychotic-like experiences, symptom expression, and cognitive performance in combat veterans with posttraumatic stress disorder.

    PubMed

    Lindley, Steven E; Carlson, Eve B; Hill, Kimberly R

    2014-02-01

    Apparent psychotic symptoms are often associated with posttraumatic stress disorder (PTSD), but these symptoms are poorly understood. In a sample of 30 male Vietnam combat veterans with severe and chronic PTSD, we conducted detailed assessments of psychotic symptom endorsement, insight, symptom severity, neurocognitive function, and feigning. Two thirds of the subjects endorsed a psychotic item but did not believe that the experiences were real. Those endorsing psychotic items were higher in PTSD severity, general psychopathology, and dissociation but not depression, functional health, cognitive function, or feigned effort. Severity of psychotic symptoms correlated with dissociation, combat exposure, and attention but not PTSD, depression, or functional health. Those endorsing psychotic items scored higher on a screen but not on a detailed structured interview for malingering. Endorsement of psychotic experiences by combat veterans with PTSD do not seem to reflect psychotic symptoms or outright malingering.

  14. A study of psychotic symptoms in borderline personality disorder.

    PubMed

    Pearse, Laura J; Dibben, Claire; Ziauddeen, Hisham; Denman, Chess; McKenna, Peter J

    2014-05-01

    Patients with borderline personality disorder (BPD) report psychotic symptoms, but it has been questioned whether they are intrinsic to BPD. Thirty patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for BPD were drawn from a specialist personality disorder service. Exclusion criteria included a preexisting clinical diagnosis of nonaffective psychotic disorder. Participants underwent structured psychiatric interview using the Present State Examination (PSE), lifetime version. Approximately 60% of the patients reported psychotic symptoms unrelated to drugs or affective disorder. Auditory hallucinations were the most common symptom (50%), which were persistent in the majority of cases. A fifth of the patients reported delusions, half of whom (three patients) also met DSM-IV criteria for schizophrenia, who were previously undiagnosed. The form of auditory hallucinations was similar to that in schizophrenia; the content was predominantly negative and critical. Persistent auditory hallucinations are intrinsic symptoms of BPD. This may inform current diagnostic criteria and have implications for approaches to treatment, both pharmacological and psychological. The presence of delusions may indicate a comorbid axis I disorder.

  15. Head Injury With Subsequent, Intermittent, Nonschizophrenic, Psychotic Symptoms and Violence

    PubMed Central

    Bell, Carl C.; Kelly, Ruby P.

    1987-01-01

    A young, black, adult woman presented to an outpatient clinic for treatment with a history of intermittent, nonschizophrenic, psychotic symptoms. Blacks, because of their situational sociology, may be more predisposed to severe head injuries, and this acquired biologic factor may be, in part, responsible for the high rates of black-on-black murder. The use of beta blockers is discussed as an adjunct in the treatment of violence occurring in patients with a past history of severe head injury. PMID:3694693

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

    PubMed

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

    2011-01-01

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

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

    PubMed Central

    Chiu, Chui-De; Tseng, Mei-Chih Meg; Chien, Yi-Ling; Liao, Shih-Cheng; Liu, Chih-Min; Yeh, Yei-Yu; Hwu, Hai-Gwo

    2016-01-01

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

  18. Trauma exposure, PTSD and psychotic-like symptoms in post-conflict Timor Leste: an epidemiological survey

    PubMed Central

    2012-01-01

    Background Studies in developed countries indicate that psychotic-like symptoms are prevalent in the community and are related to trauma exposure and PTSD. No comparable studies have been undertaken in low-income, post-conflict countries. This study aimed to assess the prevalence of psychotic-like symptoms in conflict-affected Timor Leste and to examine whether symptoms were associated with trauma and PTSD. Methods The Psychosis Screening Questionnaire and the Harvard Trauma Questionnaire (assessing trauma exposure and PTSD) were administered in an epidemiological survey of 1245 adults (response rate 80.6%) in a rural and an urban setting in Timor Leste. We defined PSQ screen-positive cases as those people reporting at least one psychotic-like symptom (paranoia, hallucinations, strange experiences, thought interference, hypomania). Results The prevalence of PSQ screen-positive cases was 12 percent and these persons were more disabled. PSQ cases were more likely to reside in the urban area, experienced higher levels of trauma exposure and a greater prevalence of PTSD. PTSD only partially mediated the relationship between trauma exposure and psychotic-like symptoms. Conclusions Psychotic-like symptoms may be prevalent in countries exposed to mass conflict. The cultural and contextual meaning of psychotic-like symptoms requires further inquiry in low-income, post-conflict settings such as Timor Leste. PMID:23249370

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

    PubMed

    Isvoranu, Adela-Maria; van Borkulo, Claudia D; Boyette, Lindy-Lou; Wigman, Johanna T W; Vinkers, Christiaan H; Borsboom, Denny

    2017-01-01

    Childhood trauma (CT) has been identified as a potential risk factor for the onset of psychotic disorders. However, to date, there is limited consensus with respect to which symptoms may ensue after exposure to trauma in early life, and whether specific pathways may account for these associations. The aim of the present study was to use the novel network approach to investigate how different types of traumatic childhood experiences relate to specific symptoms of psychotic disorders and to identify pathways that may be involved in the relationship between CT and psychosis. We used data of patients diagnosed with a psychotic disorder (n = 552) from the longitudinal observational study Genetic Risk and Outcome of Psychosis Project and included the 5 scales of the Childhood Trauma Questionnaire-Short Form and all original symptom dimensions of the Positive and Negative Syndrome Scale. Our results show that all 5 types of CT and positive and negative symptoms of psychosis are connected through symptoms of general psychopathology. These findings are in line with the theory of an affective pathway to psychosis after exposure to CT, with anxiety as a main connective component, but they also point to several additional connective paths between trauma and psychosis: eg, through poor impulse control (connecting abuse to grandiosity, excitement, and hostility) and motor retardation (connecting neglect to most negative symptoms). The results of the current study suggest that multiple paths may exist between trauma and psychosis and may also be useful in mapping potential transdiagnostic processes.

  20. Altered Insular Function during Aberrant Salience Processing in Relation to the Severity of Psychotic Symptoms

    PubMed Central

    Walter, Anna; Suenderhauf, Claudia; Smieskova, Renata; Lenz, Claudia; Harrisberger, Fabienne; Schmidt, André; Vogel, Tobias; Lang, Undine E.; Riecher-Rössler, Anita; Eckert, Anne; Borgwardt, Stefan

    2016-01-01

    There is strong evidence for abnormal salience processing in patients with psychotic experiences. In particular, there are indications that the degree of aberrant salience processing increases with the severity of positive symptoms. The aim of the present study was to elucidate this relationship by means of brain imaging. Functional magnetic resonance imaging was acquired to assess hemodynamic responses during the Salience Attribution Test, a paradigm for reaction time that measures aberrant salience to irrelevant stimulus features. We included 42 patients who were diagnosed as having a psychotic disorder and divided them into two groups according to the severity of their positive symptoms. Whole brain analysis was performed using Statistical Parametric Mapping. We found no significant behavioral differences with respect to task performance. Patients with more positive symptoms showed increased hemodynamic responses in the left insula corresponding to aberrant salience than in patients with less positive symptoms. In addition, left insula activation correlated negatively with cumulative antipsychotic medication. Aberrant salience processing in the insula may be increased in psychosis, depending on the severity of positive symptoms. This study indicates that clinically similar psychosis manifestations share the same functional characteristics. In addition, our results suggest that antipsychotic medication can modulate insular function. PMID:27933003

  1. Does change in definition of psychotic symptoms in diagnosis of schizophrenia in DSM-5 affect caseness?

    PubMed

    Tandon, Rajiv; Bruijnzeel, Dawn; Rankupalli, Babu

    2013-08-01

    Psychotic symptoms are a central element in the diagnosis of schizophrenia, although their precise definition has varied through the multiple iterations of DSM and the ICD. Schneiderian first-rank symptoms (FRS) have received a particularly prominent position in the diagnostic criteria of schizophrenia since ICD-9 and DSM-III. In the current iteration of DSM (DSM-IV-TR), whereas two characteristic symptoms are ordinarily required to meet criterion A, only a single symptom is necessary if the psychotic symptom happens to be a FRS, notably a bizarre delusion or auditory hallucination of a running commentary or 'conversing voices'. Because of limited data in support of the special treatment of FRS, DSM-5 has made changes to criterion A, requiring that at least two psychotic symptoms be present in all cases with at least one of these symptoms being a delusion, hallucination, or disorganized speech. To assess the impact of these changes on the prevalence of schizophrenia, we examined a research dataset of 221 individuals with DSM-IV schizophrenia to study the prevalence and co-occurrence of various criterion A symptoms. Although bizarre delusions and/or Schneiderian hallucinations were present in 124 patients (56.1%), they were singly determinative of diagnosis in only one patient (0.46%). Additionally, only three of the 221 patients (1.4%) with DSM-IV schizophrenia did not have a delusion, hallucination, or disorganized speech. DSM-5 changes in criteria A should have a negligible effect on the prevalence of schizophrenia, with over 98% of individuals with DSM-IV schizophrenia continuing to receive a DSM-5 diagnosis of schizophrenia in this dataset.

  2. Association of impaired reality processing with psychotic symptoms in schizophrenia.

    PubMed

    Lee, Jung Suk; Chun, Ji Won; Lee, Sang-hoon; Kang, Dong-Il; Kim, Jae-Jin

    2013-12-30

    Reality evaluation (i.e., the discrimination of things existing outside of oneself and figments of others' imagination) may be impaired in patients with schizophrenia, and impairment in reality evaluation may be related to psychotic symptoms such as hallucinations and delusions. In this study, we investigated the nature of impairment of reality processing and its relationship with hallucinations and delusions in schizophrenia. Twenty-six patients with schizophrenia and 25 healthy controls completed the reality evaluation task, in which subjects judged whether scenes in a series of drawings were real or unreal and whether they were familiar or novel. The patient group exhibited significantly lower accuracy in reality evaluation than the control group, and lower accuracy in the patient group was related to more severe hallucinations and delusions. These findings provide preliminary evidence that impaired reality evaluation is related to the formation or maintenance of hallucinations and delusions in schizophrenia.

  3. Five Supplements and Multiple Psychotic Symptoms: A Case Report

    PubMed Central

    Wong, Michelle K.; Darvishzadeh, Ayeh; Maler, Neal A.; Bota, Robert G.

    2016-01-01

    Dietary supplements, including vitamins, minerals, herbs, amino acids, and enzymes, have become increasingly more common and are used by approximately half of the US population. About three-fourths of supplements are obtained with no prescription from a physician, which raises medical concerns regarding safety as these products do not require US Food and Drug Administration approval. Common reasons for taking dietary supplements include improved mood, improved mental function, depression relief, anxiety reduction, and treatment of simple and migraine headaches. The use of herbs for medicinal purposes has a long-standing history among many cultures. We present the case of a 43-year-old man, who was taking dietary supplements, with a 6-month history of psychotic symptoms that increasingly caused impairment in functioning and eventually led to involuntary hospitalization. The published data with regard to supplements causing psychosis, herb-to-herb interaction, and reliability of herbal supplement manufacturers are discussed. PMID:27247830

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

    PubMed

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

    2012-03-20

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

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

    PubMed Central

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

    2017-01-01

    The purpose of this study was to test the reliability, validity, and factor structure of a Chinese version of the Psychotic Symptom Rating Scale (PSYRATS) in 198 and 202 adult patients with recent-onset and chronic psychosis, respectively. The PSYRATS has been translated into different language versions and has been validated for clinical and research use mainly in chronic psychotic patients but not in recent-onset psychosis patients or in Chinese populations. The psychometric analysis of the translated Chinese version included assessment of its content validity, semantic equivalence, interrater and test–retest reliability, reproducibility, sensitivity to changes in psychotic symptoms, internal consistency, concurrent validity (compared to a valid psychotic symptom scale), and factor structure. The Chinese version demonstrated very satisfactory content validity as rated by an expert panel, good semantic equivalence with the original version, and high interrater and test–retest (at 2-week interval) reliability. It also indicated very good reproducibility of and sensitivity to changes in psychotic symptoms in line with the symptom severity measured with the Positive and Negative Syndrome Scale (PANSS). The scale consisted of four factors for the hallucination subscale and two factors for the delusion subscale, explaining about 80% of the total variance of the construct, indicating satisfactory correlations between the hallucination and delusion factors themselves, between items, factors, subscales, and overall scale, and between factors and relevant item and subscale scores of the PANSS. The Chinese version of the PSYRATS is a reliable and valid instrument to measure symptom severity in Chinese psychotic patients complementary to other existing measures mainly in English language. PMID:28331325

  6. Recognition and treatment of psychotic symptoms: spiritists compared to mental health professionals in Puerto Rico and Brazil.

    PubMed

    Moreira-Almeida, Alexander; Koss-Chioino, Joan D

    2009-01-01

    This article expands psychosocial and cultural perspectives on the experience and expression of psychotic symptoms and the treatment of schizophrenia by exploring how Spiritism, a popular religion in Latin America, provides healing to persons with severe mental illness. Beliefs and treatment by Spiritist healers of persons with psychotic symptoms, some diagnosed with schizophrenia, are described. Reactions by mental health professionals (psychologists, mental health technicians and psychiatrists) to this alternative treatment are described. Qualitative data have been collected through in-depth interviews with 49 Spiritist mediums in Puerto Rico, and case histories of 22 patients and their family members, all of whom gave informed consent. In Brazil, interviews were conducted with a sample of 115 Spiritist mediums, with their informed consent. These mediums responded to semi-structured interviews and standard measures of social adjustment and mental health. As expected, beliefs and practices of Spiritist healers regarding psychotic symptoms, whether manifested by themselves or by clients diagnosed with schizophrenia or other disorders, differ substantively from conventional psychiatric constructs and treatment approaches. According to patients' self reports and researchers' observations, spirit healers often achieve positive results with persons manifesting psychotic symptoms or diagnosed with schizophrenia in that symptoms become less frequent and/or social adjustment improves. We suggest psychosocial mechanisms to explain these findings and raise questions for future research.

  7. The Association between Negative Symptoms, Psychotic Experiences and Later Schizophrenia: A Population-Based Longitudinal Study

    PubMed Central

    Werbeloff, Nomi; Dohrenwend, Bruce P.; Yoffe, Rinat; van Os, Jim; Davidson, Michael; Weiser, Mark

    2015-01-01

    Background Psychotic experiences are common in the general population, and predict later psychotic illness. Much less is known about negative symptoms in the general population. Method This study utilized a sample of 4,914 Israel-born individuals aged 25–34 years who were screened for psychopathology in the 1980's. Though not designed to specifically assess negative symptoms, data were available on 9 self-report items representing avolition and social withdrawal, and on 5 interviewer-rated items assessing speech deficits, flat affect and poor hygiene. Psychotic experiences were assessed using the False Beliefs and Perceptions subscale of the Psychiatric Epidemiology Research Interview. Psychiatric hospitalization was ascertained 24 years later using a nation-wide psychiatric hospitalization registry. Results After removing subjects with diagnosable psychotic disorders at baseline, 20.2% had at least one negative symptom. Negative symptoms were associated with increased risk of later schizophrenia only in the presence of strong (frequent) psychotic experiences (OR = 13.0, 9% CI: 2.1–79.4). Conclusions Negative symptoms are common in the general population, though the majority of people with negative symptoms do not manifest a clinically diagnosed psychiatric disorder. Negative symptoms and psychotic experiences critically depend on each other’s co-occurrence in increasing risk for later schizophrenia. PMID:25748557

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

    PubMed

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

    2014-05-01

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

  9. Childhood trauma are not associated with the intensity of transient cocaine induced psychotic symptoms.

    PubMed

    Karsinti, Emily; Jarroir, Marine; Zerdazi, El-Hadi; Bloch, Vanessa; Dupuy, Gaël; Belforte, Beatriz; Coeuru, Philippe; Plat, Arnaud; Deschenau, Alice; Cottencin, Olivier; Gay, Aurelia; Lack, Philippe; Pelissier-Alicot, Anne-Laure; Bellivier, Frank; Lépine, Jean-Pierre; Brousse, George; Vorspan, Florence

    2015-08-30

    A personal history of childhood trauma has been associated with the severity of psychotic symptoms in several disorders. We evaluated retrospectively cocaine-induced psychotic symptoms with the SAPS-CIP and childhood trauma with the CTQ in a clinical sample of 144 cocaine users. The SAPS-CIP score was not statistically associated with the presence or number or intensity of trauma, but was associated with rapid routes of administration (intravenous and smoked) and with frequent cocaine use.

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

    PubMed Central

    Lu, Da-Li; Lin, Xiao-Ling

    2016-01-01

    Psychotic symptoms can occur in some clinical conditions related to alcohol, such as intoxication, withdrawal, and other alcohol-induced neuropsychiatric disorders. Here, we present a case report of a 24-year-old man, without a known psychiatric history, who developed brief psychotic symptoms following ingestion of small quantities of alcohol repeatedly. To our knowledge, no related previous literature regarding this has been reported. PMID:27703363

  11. Effects of Multidimensional Treatment Foster Care on Psychotic Symptoms in Girls

    PubMed Central

    Poulton, Richie; Van Ryzin, Mark J.; Harold, Gordon T.; Chamberlain, Patricia; Fowler, David; Cannon, Mary; Arseneault, Louise; Leve, Leslie D.

    2014-01-01

    Objective Neurodevelopmental theories of psychosis highlight the potential benefits of early intervention, prevention, and/or preemption. How early intervention should take place has not been established, nor if interventions based on social learning principles can have preemptive effects. The objective was to test if a comprehensive psychosocial intervention can significantly alter psychotic symptom trajectories during adolescence – a period of heightened risk for a wide range of psychopathology. Method This study was a randomized controlled trial (RCT) of Multidimensional Treatment Foster Care (MTFC) for delinquent adolescent girls. Assessment of psychotic symptoms took place at baseline and then 6, 12, 18, and 24 months post-baseline using a standardized self-report instrument (Brief Symptom Inventory). A second source of information about psychotic symptoms was obtained at baseline or 12 months, and again at 24 months using a structured diagnostic interview (the Diagnostic Interview Schedule for Children [DISC]). Results Significant benefits for MTFC over treatment-as-usual for psychosis symptoms were observed over a 24-month period. Findings were replicated across both measures. Effects were independent of substance use and initial symptom severity, and persisted beyond the initial intervention period. Conclusion Ameliorating non-clinical psychotic symptoms trajectories beginning in early adolescence via a multifaceted psychosocial intervention is possible. Developmental research on non-clinical psychotic symptoms and their prognostic value should be complemented by more psychosocial intervention research aimed at modifying these symptom trajectories early in their natural history. PMID:25457926

  12. Functional Connectivity Anomalies in Adolescents with Psychotic Symptoms

    PubMed Central

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

    2017-01-01

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

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

    PubMed Central

    Baratta, Stefano; Di Vittorio, Cristina; Lester, David; Girardi, Paolo; Pompili, Maurizio

    2013-01-01

    Objectives. The aim of this naturalistic study was to investigate whether treatment with clozapine and other atypical antipsychotics for at least 2 years was associated with a reduction in psychotic and depressive symptoms and an improvement in chronic schizophrenia patients' awareness of their illness. Methods. Twenty-three adult outpatients (15 men and 8 women) treated with clozapine and 23 patients (16 men and 7 women) treated with other atypical antipsychotics were included in the study. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms were assessed with the Calgary Depression Scale for Schizophrenia (CDSS), and insight was assessed with the Scale to Assess Unawareness of Mental Disorder (SUMD). Results. The sample as a whole had a significant reduction in positive, negative, and general symptoms, whereas the reduction in depression was significant only for patients with CDSS scores of 5 and higher at the baseline. At the follow-up, patients treated with other atypical antipsychotics reported a greater reduction in depression than patients treated with clozapine, but not when limiting the analyses to those with clinically relevant depression. Conclusions. Atypical antipsychotics may be effective in reducing psychotic and depressive symptoms and in improving insight in patients with chronic schizophrenia, with no differences in the profiles of efficacy between compounds. PMID:23401771

  14. Atypical antipsychotics in the treatment of depressive and psychotic symptoms in patients with chronic schizophrenia: a naturalistic study.

    PubMed

    Innamorati, Marco; Baratta, Stefano; Di Vittorio, Cristina; Lester, David; Girardi, Paolo; Pompili, Maurizio; Amore, Mario

    2013-01-01

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

  15. Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders.

    PubMed

    McKetin, Rebecca; Baker, Amanda L; Dawe, Sharon; Voce, Alexandra; Lubman, Dan I

    2017-05-01

    We examined the lifetime experience of hallucinations and delusions associated with transient methamphetamine-related psychosis (MAP), persistent MAP and primary psychosis among a cohort of dependent methamphetamine users. Participants were classified as having (a) no current psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient MAP, n=85); (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent MAP, n=37), or (d) meeting DSM-IV criteria for lifetime schizophrenia or mania (primary psychosis, n=52). Current psychotic symptoms were classified as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content in the past month. Lifetime psychotic diagnoses and symptoms were assessed using the Composite International Diagnostic Interview. Transient MAP was associated with persecutory delusions and tactile hallucinations (compared to the no symptom group). Persistent MAP was additionally associated with delusions of reference, thought interference and complex auditory, visual, olfactory and tactile hallucinations, while primary psychosis was also associated with delusions of thought projection, erotomania and passivity. The presence of non-persecutory delusions and hallucinations across various modalities is a marker for persistent MAP or primary psychosis in people who use methamphetamine.

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

    PubMed Central

    Ivanenko, Anna

    2009-01-01

    Narcolepsy is an uncommon chronic, neurological disorder characterized by abnormal manifestations of rapid eye movement sleep and perturbations in the sleep-wake cycle. Accurate diagnosis of psychotic symptoms in a person with narcolepsy could be difficult due to side effects of stimulant treatment (e.g., hallucinations) as well as primary symptoms of narcolepsy (e.g., sleep paralysis and hypnagogic and/or hypnapompic hallucinations). Pertinent articles from peer-reviewed journals were identified to help understand the complex phenomenology of psychotic symptoms in patients with narcolepsy. In this ensuing review and discussion, we present an overview of narcolepsy and outline diagnostic and management approaches for psychotic symptoms in patients with narcolepsy. PMID:19724760

  17. Presence and Persistence of Psychotic Symptoms in Cocaine- versus Methamphetamine-Dependent Participants

    PubMed Central

    Mahoney, James J.; Kalechstein, Ari D.; De La Garza, Richard; Newton, Thomas F.

    2012-01-01

    The primary objective of this study was to compare and contrast psychotic symptoms reported by cocaine and methamphetamine-dependent individuals. Participants included 27 cocaine-dependent and 25 methamphetamine-dependent males, as well as 15 cocaine-dependent and 18 methamphetamine-dependent females. After screening, participants were excluded if they met criteria for any Axis I diagnosis other than nicotine dependence, or methamphetamine or cocaine dependence (ie, participants had to use either methamphetamine or cocaine but were excluded if they met dependence criteria for both). The participants were administered the newly developed Psychotic Symptom Assessment Scale (PSAS), which assesses psychotic symptoms. A high proportion of both cocaine- and methamphetamine-dependent men and women reported delusions of paranoia and auditory hallucinations. However, during the abstinent and intoxicated conditions, methamphetamine-dependent men and women were more likely than cocaine-dependent men and women to report psychotic symptoms. Future studies will compare psychotic symptoms reported by non-dependent recreational stimulant users to stimulant-dependent individuals. PMID:18393050

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

    PubMed

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

    2016-10-01

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

  19. Donepezil as add-on treatment of psychotic symptoms in patients with dementia of the Alzheimer's type.

    PubMed

    Bergman, Joseph; Brettholz, Izidor; Shneidman, Michael; Lerner, Vladimir

    2003-01-01

    Traditionally, the neuropsychiatric symptoms of Alzheimer's disease (AD) have been managed with neuroleptics or benzodiazepines, which have serious side effects. Preliminary observations suggest the possible value of cholinesterase inhibitors in the amelioration of psychotic symptoms in patients with dementia of the Alzheimer's type, dementia with Lewy bodies, and in patients with Parkinson's disease. Twelve inpatients with AD with psychotic symptoms and lack of improvement of their delusions/hallucinations during perphenazine treatment (8 mg/day) for 3 weeks received random open-label donepezil 5 mg daily in addition to an ongoing treatment of 8 mg/day perphenazine or 16 mg/day perphenazine. Assessments conducted at baseline and after weeks 2 and 4 included the Mini-Mental State Examination, the Global Deterioration Scale, the Positive and Negative Symptoms Scale, and the Clinical Global Impressions scale. Frequency of extrapyramidal symptoms was measured according to the Abnormal Involuntary Movement Scale. The donepezil-perphenazine group exhibited substantially greater and clinical improvements in mental state. At the end of the trial (4 weeks), Positive and Negative Symptoms Scale scores revealed significant differences between both groups (p = 0.006). The Clinical Global Impressions scale and the Mini-Mental State Examination scores also showed significant differences between the donepezil-perphenazine group and the perphenazine group (p = 0.028 and p = 0.027 respectively). No significant differences were found in the Global Deterioration Scale scores. Abnormal Involuntary Movement Scale scores showed a significant deterioration in extrapyramidal symptoms in the perphenazine group compared with the donepezil-perphenazine group (p = 0.016). Donepezil augmentation of neuroleptics may be appropriate for those patients for whom neuroleptic monotherapy either does not lead to symptom remission or is associated with intolerable adverse effects. This was an open

  20. Khat Use, PTSD and Psychotic Symptoms among Somali Refugees in Nairobi – A Pilot Study

    PubMed Central

    Widmann, Marina; Warsame, Abdulkadir Hussein; Mikulica, Jan; von Beust, Johannes; Isse, Maimuna Mohamud; Ndetei, David; al’Absi, Mustafa; Odenwald, Michael G.

    2014-01-01

    In East-African and Arab countries, khat leaves are traditionally chewed in social settings. They contain the amphetamine-like alkaloid cathinone. Especially among Somali refugees, khat use has been associated with psychiatric symptoms. We assessed khat-use patterns and psychiatric symptoms among male Somali refugees living in a disadvantaged urban settlement area in Kenya, a large group that has not yet received scientific attention. We wanted to explore consume patterns and study the associations between khat use, traumatic experiences, and psychotic symptoms. Using privileged access sampling, we recruited 33 healthy male khat chewers and 15 comparable non-chewers. Based on extensive preparatory work, we assessed khat use, khat dependence according to DSM-IV, traumatic experiences, posttraumatic stress disorder (PTSD), and psychotic symptoms using standardized diagnostic instruments that had been adapted to the Somali language and culture. Hazardous use patterns like chewing for more than 24 h without interruption were frequently reported. All khat users fulfilled the DSM-IV-criteria for dependence and 85% reported functional khat use, i.e., that khat helps them to forget painful experiences. We found that the studied group was heavily burdened by traumatic events and posttraumatic symptoms. Khat users had experienced more traumatic events and had more often PTSD than non-users. Most khat users experience khat-related psychotic symptoms and in a quarter of them we found true psychotic symptoms. In contrast, among control group members no psychotic symptoms could be detected. We found first evidence for the existence and high prevalence of severely hazardous use patterns, comorbid psychiatric symptoms, and khat use as a self-medication of trauma-consequences among male Somali refugees in urban Kenyan refugee settlements. There is a high burden by psychopathology and adequate community-based interventions urgently need to be developed. PMID:25072043

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

    PubMed

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

    2013-06-01

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

  2. [Acute paranoid psychotic symptoms after i.m. injection of nandrolone].

    PubMed

    Teuber, Isabel; Freiwald, Daniel; Volz, Hans-Peter

    2003-05-01

    Affective disorders and impulsivity are quite common when using anabolic substances, in this case-study one of the rather rare cases of a psychotic disorder following the abuse of androgenic steroids is described. A 30-year old formerly healthy white male was admitted as inpatient to psychiatric hospital showing symptoms of anxiety and paranoid ideation. In the last 1.5 years he had consumed androgenic steroids, directly before the onset of the first psychotic symptoms 8 weeks before admission he had received an i.m.-injection of nandrolone. Under therapy with neuroleptics the patient recovered completely within 2 months.

  3. Evidence for a Shared Etiological Mechanism of Psychotic Symptoms and Obsessive-Compulsive Symptoms in Patients with Psychotic Disorders and Their Siblings.

    PubMed

    Swets, Marije; Van Dael, Frank; Roza, Sabine; Schoevers, Robert; Myin-Germeys, Inez; de Haan, Lieuwe

    2015-01-01

    The prevalence of obsessive-compulsive disorder in subjects with psychotic disorder is much higher than in the general population. The higher than chance co-occurrence has also been demonstrated at the level of subclinical expression of both phenotypes. Both extended phenotypes have been shown to cluster in families. However, little is known about the origins of their elevated co-occurrence. In the present study, evidence for a shared etiological mechanism was investigated in 3 samples with decreasing levels of familial psychosis liability: 987 patients, 973 of their unaffected siblings and 566 healthy controls. The association between the obsessive-compulsive phenotype and the psychosis phenotype c.q. psychosis liability was investigated. First, the association was assessed between (subclinical) obsessive-compulsive symptoms and psychosis liability. Second, in a cross-sib cross-trait analysis, it was examined whether (subclinical) obsessive-compulsive symptoms in the patient were associated with (subclinical) psychotic symptoms in the related unaffected sibling. Evidence was found for both associations, which is compatible with a partially shared etiological pathway underlying obsessive-compulsive and psychotic disorder. This is the first study that used a cross-sib cross-trait design in patients and unaffected siblings, thus circumventing confounding by disease-related factors present in clinical samples.

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

    PubMed

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

    2011-04-01

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

  5. A rating scale for psychotic symptoms (RSPS) part I: theoretical principles and subscale 1: perception symptoms (illusions and hallucinations).

    PubMed

    Chouinard, G; Miller, R

    1999-08-17

    The authors present a new rating scale for the psychotic symptoms of schizophrenia and related psychoses. The scale links specific symptoms of psychopathology to dysfunction and overactivity of dopaminergic mechanisms underlying the processes of reward and selective attention. The Rating Scale for Psychotic Symptoms (RSPS) is a 44-item rating instrument with a seven-point severity scale for each item. Psychotic symptoms are classified into three groups: Pathological amplification of mental images (perception symptoms) (subscale 1), Distraction symptoms (including catatonia and passivity experiences) (subscale 2), and Delusions (subscale 3). A dimensional, rather than a categorical, conceptualization of psychosis is assumed. Rating is accomplished through a manual and a semi-structured interview (SSCI-RSPS). In this first of two papers, general issues about the construction of the scale and the derivation of symptom groups are discussed. Dopamine-mediated modification of cortico-striatal synapses is seen as being of critical importance in all three groups of symptoms. In this first paper, we present subscale I (perception symptoms), which includes both amplified perceptual images (illusions) and hallucinations. A total of seven illusions and 11 hallucinations are rated as individual items.

  6. Clinical assessment of psychotic and mood disorder symptoms for risk of future violence.

    PubMed

    Scott, Charles L; Resnick, Phillip J

    2014-10-01

    This article reviews important components to consider when evaluating the relationship of psychotic and mood disorder symptoms to violence. Particular attention is given to assessing persecutory delusions and command auditory hallucinations. Clinical implications of research findings to evaluating violence risk in psychiatric patients are reviewed.

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

    PubMed

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

    2016-05-30

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

  8. Internalized stigma of mental illness and depressive and psychotic symptoms in homeless veterans over 6 months.

    PubMed

    Boyd, Jennifer E; Hayward, H'Sien; Bassett, Elena D; Hoff, Rani

    2016-06-30

    We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery.

  9. Factors associated with psychotic symptoms in Alzheimer's disease

    PubMed Central

    Hirono, N.; Mori, E.; Yasuda, M.; Ikejiri, Y.; Imamura, T.; Shimomura, T.; Ikeda, M.; Hashimoto, M.; Yamashita, H.

    1998-01-01

    OBJECTIVES—Many clinical and biological factors have been reported to be associated with the presence of psychosis in patients with Alzheimer's disease, although the associations were variable. The aim of this study was to clarify factors associated with the presence of psychosis in patients with Alzheimer's disease.
METHODS—Psychiatric functioning was studied in 228 patients with Alzheimer's disease based on the results of the behavioural pathology in Alzheimer's disease rating scale or the neuropsychiatric inventory. The effects of sex, education level, age, duration of illness, cognitive function, and apolipoprotein E genotype were investigated for dichotomous psychotic status with a multiple logistic regression analysis.
RESULTS—Of the 228 patients with Alzheimer's disease, 118 (51.8%) showed evidence of delusions or hallucinations. Of these, 94 had delusions only, three had hallucinations only, and 21 had both. Older age, female sex, longer duration of illness, and more severe cognitive impairment were the factors independently associated with the presence of psychosis. The presence of psychosis was not significantly related to either educational level or apolipoprotein E genotype.
CONCLUSIONS—Age, sex, and severity of illness were independent factors associated with the presence of psychosis in patients with Alzheimer's disease. The reason why some patients with Alzheimer's disease develop psychosis remains unclear. There may be distinctive subtypes of Alzheimer's disease or the presence of individual factors which affect the development of psychosis.

 PMID:9598682

  10. Symptom Dimensions of the Psychotic Symptom Rating Scales in Psychosis: A Multisite Study

    PubMed Central

    Woodward, Todd S.; Jung, Kwanghee; Hwang, Heungsun; Yin, John; Taylor, Laura; Menon, Mahesh; Peters, Emmanuelle; Kuipers, Elizabeth; Waters, Flavie; Lecomte, Tania; Sommer, Iris E.; Daalman, Kirstin; van Lutterveld, Remko; Hubl, Daniela; Kindler, Jochen; Homan, Philipp; Badcock, Johanna C.; Chhabra, Saruchi; Cella, Matteo; Keedy, Sarah; Allen, Paul; Mechelli, Andrea; Preti, Antonio; Siddi, Sara; Erickson, David

    2014-01-01

    The Psychotic Symptom Rating Scales (PSYRATS) is an instrument designed to quantify the severity of delusions and hallucinations and is typically used in research studies and clinical settings focusing on people with psychosis and schizophrenia. It is comprised of the auditory hallucinations (AHS) and delusions subscales (DS), but these subscales do not necessarily reflect the psychological constructs causing intercorrelation between clusters of scale items. Identification of these constructs is important in some clinical and research contexts because item clustering may be caused by underlying etiological processes of interest. Previous attempts to identify these constructs have produced conflicting results. In this study, we compiled PSYRATS data from 12 sites in 7 countries, comprising 711 participants for AHS and 520 for DS. We compared previously proposed and novel models of underlying constructs using structural equation modeling. For the AHS, a novel 4-dimensional model provided the best fit, with latent variables labeled Distress (negative content, distress, and control), Frequency (frequency, duration, and disruption), Attribution (location and origin of voices), and Loudness (loudness item only). For the DS, a 2-dimensional solution was confirmed, with latent variables labeled Distress (amount/intensity) and Frequency (preoccupation, conviction, and disruption). The within-AHS and within-DS dimension intercorrelations were higher than those between subscales, with the exception of the AHS and DS Distress dimensions, which produced a correlation that approached the range of the within-scale correlations. Recommendations are provided for integrating these underlying constructs into research and clinical applications of the PSYRATS. PMID:24936086

  11. Symptom dimensions of the psychotic symptom rating scales in psychosis: a multisite study.

    PubMed

    Woodward, Todd S; Jung, Kwanghee; Hwang, Heungsun; Yin, John; Taylor, Laura; Menon, Mahesh; Peters, Emmanuelle; Kuipers, Elizabeth; Waters, Flavie; Lecomte, Tania; Sommer, Iris E; Daalman, Kirstin; van Lutterveld, Remko; Hubl, Daniela; Kindler, Jochen; Homan, Philipp; Badcock, Johanna C; Chhabra, Saruchi; Cella, Matteo; Keedy, Sarah; Allen, Paul; Mechelli, Andrea; Preti, Antonio; Siddi, Sara; Erickson, David

    2014-07-01

    The Psychotic Symptom Rating Scales (PSYRATS) is an instrument designed to quantify the severity of delusions and hallucinations and is typically used in research studies and clinical settings focusing on people with psychosis and schizophrenia. It is comprised of the auditory hallucinations (AHS) and delusions subscales (DS), but these subscales do not necessarily reflect the psychological constructs causing intercorrelation between clusters of scale items. Identification of these constructs is important in some clinical and research contexts because item clustering may be caused by underlying etiological processes of interest. Previous attempts to identify these constructs have produced conflicting results. In this study, we compiled PSYRATS data from 12 sites in 7 countries, comprising 711 participants for AHS and 520 for DS. We compared previously proposed and novel models of underlying constructs using structural equation modeling. For the AHS, a novel 4-dimensional model provided the best fit, with latent variables labeled Distress (negative content, distress, and control), Frequency (frequency, duration, and disruption), Attribution (location and origin of voices), and Loudness (loudness item only). For the DS, a 2-dimensional solution was confirmed, with latent variables labeled Distress (amount/intensity) and Frequency (preoccupation, conviction, and disruption). The within-AHS and within-DS dimension intercorrelations were higher than those between subscales, with the exception of the AHS and DS Distress dimensions, which produced a correlation that approached the range of the within-scale correlations. Recommendations are provided for integrating these underlying constructs into research and clinical applications of the PSYRATS.

  12. Medication nonadherence and substance abuse in psychotic disorders: impact of depressive symptoms and social stability.

    PubMed

    Elbogen, Eric B; Swanson, Jeffrey W; Swartz, Marvin S; Van Dorn, Richard

    2005-10-01

    Although studies have consistently shown a strong relationship between medication nonadherence and substance abuse in psychotic disorders, less is understood about the mechanisms underlying this relationship. The purpose of this study was to examine whether the relationship between substance abuse and medication nonadherence in psychosis is mediated by depressive symptoms and social stability. Participants interviewed (N = 528) were adults with schizophrenia and related disorders receiving public mental health services in four US states. Multivariate analyses showed substance abuse, depressive symptoms, and living stability each contributed to medication nonadherence; thus, the relationship between substance abuse and medication adherence in psychotic disorders did not appear to be mediated by the selected variables. Instead, a robust association between depressive symptoms and medication adherence was found, attesting to the utility of assessing for depression when evaluating adherence among people with psychosis. Living instability was common and related to medication nonadherence, too, warranting further investigation.

  13. Resting-state connectivity deficits associated with impaired inhibitory control in non-treatment-seeking adolescents with psychotic symptoms

    PubMed Central

    McEwen, S. C. Jacobson; Connolly, C. G.; Kelly, A. M. C.; Kelleher, I.; O’Hanlon, E.; Clarke, M.; Blanchard, M.; McNamara, S.; Connor, D.; Sheehan, E.; Donohoe, G.; Cannon, M.; Garavan, H.

    2013-01-01

    Objective Psychotic symptoms are common in the population and index risk for a range of severe psychopathological outcomes. We wished to investigate functional connectivity in a community sample of adolescents who reported psychotic symptoms (the extended psychosis phenotype). Method This study investigated intrinsic functional connectivity (iFC) during resting-state functional magnetic resonance imaging (fMRI; rs-fMRI). Following screening in schools, 11 non-treatment seeking, youth with psychotic symptoms (aged 11–13) and 14 community controls participated in the study. Seed regions of interest comprised brain regions previously shown to exhibit aberrant activation during inhibitory control in adolescents with psychotic symptoms. Results Relative to controls, adolescents with psychotic symptoms exhibited reduced iFC between regions supporting inhibitory control. Specifically, they showed weaker iFC between the right inferior frontal gyrus (IFG) and the cingulate, IFG and the striatum, anterior cingulate and claustrum, and precuneus and supramarginal gyrus. Conversely, the psychotic symptoms group exhibited stronger iFC between the superior frontal gyrus and claustrum and IFG and lingual gyrus. Conclusion The present findings are the first to reveal aberrant functional connectivity in resting-state networks in a community sample of adolescents with psychotic symptoms and suggest that disruption in integration between distributed neural networks (particularly between prefrontal, cingulate and striatal brain regions) may be a key neurobiological feature of the extended psychosis phenotype. PMID:23621452

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

    PubMed Central

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

    2016-01-01

    Background: Urban upbringing is associated with a 2-fold adulthood psychosis risk, and this association replicates for childhood psychotic symptoms. No study has investigated whether specific features of urban neighborhoods increase children’s risk for psychotic symptoms, despite these early psychotic phenomena elevating risk for schizophrenia and other psychiatric disorders in adulthood. Methods: Analyses were conducted on over 2000 children from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of UK-born twins. Neighborhood-level characteristics were assessed for each family via: a geodemographic discriminator indexing neighborhood-level deprivation, postal surveys of over 5000 residents living alongside the children, and in-home interviews with the children’s mothers. Children were interviewed about psychotic symptoms at age 12. Analyses were adjusted for important family-level confounders including socioeconomic status (SES), psychiatric history, and maternal psychosis. Results: Urban residency at age-5 (OR = 1.80, 95% CI = 1.16–2.77) and age-12 (OR = 1.76, 95% CI = 1.15–2.69) were both significantly associated with childhood psychotic symptoms, but not with age-12 anxiety, depression, or antisocial behavior. The association was not attributable to family SES, family psychiatric history, or maternal psychosis, each implicated in childhood mental health. Low social cohesion, together with crime victimization in the neighborhood explained nearly a quarter of the association between urbanicity and childhood psychotic symptoms after considering family-level confounders. Conclusions: Low social cohesion and crime victimization in the neighborhood partly explain why children in cities have an elevated risk of developing psychotic symptoms. Greater understanding of the mechanisms leading from neighborhood-level exposures to psychotic symptoms could help target interventions for emerging childhood psychotic symptoms

  15. Impairments of working memory in schizophrenia and bipolar disorder: the effect of history of psychotic symptoms and different aspects of cognitive task demands.

    PubMed

    Frydecka, Dorota; Eissa, Abeer M; Hewedi, Doaa H; Ali, Manal; Drapała, Jarosław; Misiak, Błażej; Kłosińska, Ewa; Phillips, Joseph R; Moustafa, Ahmed A

    2014-01-01

    Comparisons of cognitive impairments between schizophrenia (SZ) and bipolar disorder (BPD) have produced mixed results. We applied different working memory (WM) measures (Digit Span Forward and Backward, Short-delay and Long-delay CPT-AX, N-back) to patients with SZ (n = 23), psychotic BPD (n = 19) and non-psychotic BPD (n = 24), as well as to healthy controls (HC) (n = 18) in order to compare the level of WM impairments across the groups. With respect to the less demanding WM measures (Digit Span Forward and Backward, Short-delay CPT-AX), there were no between group differences in cognitive performance; however, with respect to the more demanding WM measures (Long-delay CPT-AX, N-back), we observed that the groups with psychosis (SZ, psychotic BPD) did not differ from one another, but performed poorer than the group without a history of psychosis (non-psychotic BPD). A history of psychotic symptoms may influence cognitive performance with respect to WM delay and load effects as measured by Long-delay CPT-AX and N-back tests, respectively. We observed a positive correlation of WM performance with antipsychotic treatment and a negative correlation with depressive symptoms in BPD and with negative symptoms in SZ subgroup. Our study suggests that WM dysfunctions are more closely related to a history of psychosis than to the diagnostic categories of SZ and BPD described by psychiatric classification systems.

  16. Confirmatory Factor Analysis and Differential Relationships of the Two Subdomains of Negative Symptoms in Chronically Ill Psychotic Patients

    PubMed Central

    Stiekema, Annemarie P. M.; Liemburg, Edith J.; van der Meer, Lisette; Castelein, Stynke; Stewart, Roy; van Weeghel, Jaap; Aleman, André; Bruggeman, Richard

    2016-01-01

    Research suggests a two factor structure for negative symptoms in patients with psychotic disorders: social amotivation (SA) and expressive deficits (ED). Applying this two-factor structure in clinical settings may provide valuable information with regard to outcomes and to target treatments. We aimed to investigate 1) whether the factor structure is also supported in chronically ill patients with a psychotic disorder and 2) what the relationship is between these factors and functioning (overall functioning and living situation), depressive symptoms and quality of life. 1157 Patients with a psychotic disorder and a duration of illness of 5 years or more were included in the analysis (data selected from the Pharmacotherapy Monitoring Outcome Survey; PHAMOUS). A confirmatory factor analysis was performed using items of the Positive and Negative Syndrome Scale that were previously identified to reflect negative symptoms (N1-4, N6, G5, G7, G13, G16). Subsequently, regression analysis was performed on outcomes. The results confirmed the distinction between SA (N2, N4, G16) and ED (N1, N3, N6, G5, G7, G13) in chronically ill patients. Both factors were related to worse overall functioning as measured with the Health of the Nation Outcome Scales, ED was uniquely associated with residential living status. Higher scores for SA were associated with more depressive symptoms and worse quality of life. Thus, SA is most strongly related to level of social-emotional functioning, while ED are more related to living situation and thereby are indicative of level of everyday functioning. This subdivision may be useful for research purposes and be a valuable additional tool in clinical practice and treatment development. PMID:26895203

  17. Distribution of Response Time, Cortical, and Cardiac Correlates during Emotional Interference in Persons with Subclinical Psychotic Symptoms

    PubMed Central

    Holper, Lisa K. B.; Aleksandrowicz, Alekandra; Müller, Mario; Ajdacic-Gross, Vladeta; Haker, Helene; Fallgatter, Andreas J.; Hagenmuller, Florence; Kawohl, Wolfram; Rössler, Wulf

    2016-01-01

    A psychosis phenotype can be observed below the threshold of clinical detection. The study aimed to investigate whether subclinical psychotic symptoms are associated with deficits in controlling emotional interference, and whether cortical brain and cardiac correlates of these deficits can be detected using functional near-infrared spectroscopy (fNIRS). A data set derived from a community sample was obtained from the Zurich Program for Sustainable Development of Mental Health Services. 174 subjects (mean age 29.67 ± 6.41, 91 females) were assigned to four groups ranging from low to high levels of subclinical psychotic symptoms (derived from the Symptom Checklist-90-R). Emotional interference was assessed using the emotional Stroop task comprising neutral, positive, and negative conditions. Statistical distributional methods based on delta plots [behavioral response time (RT) data] and quantile analysis (fNIRS data) were applied to evaluate the emotional interference effects. Results showed that both interference effects and disorder-specific (i.e., group-specific) effects could be detected, based on behavioral RTs, cortical hemodynamic signals (brain correlates), and heart rate variability (cardiac correlates). Subjects with high compared to low subclinical psychotic symptoms revealed significantly reduced amplitudes in dorsolateral prefrontal cortices (interference effect, p < 0.001) and middle temporal gyrus (disorder-specific group effect, p < 0.001), supported by behavioral and heart rate results. The present findings indicate that distributional analyses methods can support the detection of emotional interference effects in the emotional Stroop. The results suggested that subjects with high subclinical psychosis exhibit enhanced emotional interference effects. Based on these observations, subclinical psychosis may therefore prove to represent a valid extension of the clinical psychosis phenotype. PMID:27660608

  18. Genome-wide association study of Alzheimer's disease with psychotic symptoms.

    PubMed

    Hollingworth, P; Sweet, R; Sims, R; Harold, D; Russo, G; Abraham, R; Stretton, A; Jones, N; Gerrish, A; Chapman, J; Ivanov, D; Moskvina, V; Lovestone, S; Priotsi, P; Lupton, M; Brayne, C; Gill, M; Lawlor, B; Lynch, A; Craig, D; McGuinness, B; Johnston, J; Holmes, C; Livingston, G; Bass, N J; Gurling, H; McQuillin, A; Holmans, P; Jones, L; Devlin, B; Klei, L; Barmada, M M; Demirci, F Y; DeKosky, S T; Lopez, O L; Passmore, P; Owen, M J; O'Donovan, M C; Mayeux, R; Kamboh, M I; Williams, J

    2012-12-01

    Psychotic symptoms occur in ~40% of subjects with Alzheimer's disease (AD) and are associated with more rapid cognitive decline and increased functional deficits. They show heritability up to 61% and have been proposed as a marker for a disease subtype suitable for gene mapping efforts. We undertook a combined analysis of three genome-wide association studies (GWASs) to identify loci that (1) increase susceptibility to an AD and subsequent psychotic symptoms; or (2) modify risk of psychotic symptoms in the presence of neurodegeneration caused by AD. In all, 1299 AD cases with psychosis (AD+P), 735 AD cases without psychosis (AD-P) and 5659 controls were drawn from Genetic and Environmental Risk in AD Consortium 1 (GERAD1), the National Institute on Aging Late-Onset Alzheimer's Disease (NIA-LOAD) family study and the University of Pittsburgh Alzheimer Disease Research Center (ADRC) GWASs. Unobserved genotypes were imputed to provide data on >1.8 million single-nucleotide polymorphisms (SNPs). Analyses in each data set were completed comparing (1) AD+P to AD-P cases, and (2) AD+P cases with controls (GERAD1, ADRC only). Aside from the apolipoprotein E (APOE) locus, the strongest evidence for association was observed in an intergenic region on chromosome 4 (rs753129; 'AD+PvAD-P' P=2.85 × 10(-7); 'AD+PvControls' P=1.11 × 10(-4)). SNPs upstream of SLC2A9 (rs6834555, P=3.0 × 10(-7)) and within VSNL1 (rs4038131, P=5.9 × 10(-7)) showed strongest evidence for association with AD+P when compared with controls. These findings warrant further investigation in larger, appropriately powered samples in which the presence of psychotic symptoms in AD has been well characterized.

  19. Genome-wide Association Study of Alzheimer’s disease with Psychotic Symptoms

    PubMed Central

    Hollingworth, Paul; Sweet, Robert A.; Sims, Rebecca; Harold, Denise; Russo, Giancarlo; Abraham, Richard; Stretton, Alexandra; Jones, Nicola; Gerrish, Amy; Chapman, Jade; Ivanov, Dobril; Moskvina, Valentina; Lovestone, Simon; Priotsi, Petroula; Lupton, Michelle; Brayne, Carol; Gill, Michael; Lawlor, Brian; Lynch, Aoibhinn; Craig, David; McGuinness, Bernadette; Johnston, Janet; Holmes, Clive; Livingston, Gill; Bass, Nicholas J.; Gurling, Hugh; McQuillin, Andrew; Holmans, Peter; Jones, Lesley; Devlin, Bernie; Klei, Lambertus; Barmada, M. Michael; Demirci, F. Yesim; DeKosky, Steven T.; Lopez, Oscar L.; Passmore, Peter; Owen, Michael J; O’Donovan, Michael C; Mayeux, Richard; Kamboh, M. Ilyas; Williams, Julie

    2011-01-01

    Psychotic symptoms occur in approximately 40% of subjects with Alzheimer’s disease (AD) and are associated with more rapid cognitive decline and increased functional deficits. They show heritability up to 61% and have been proposed as a marker for a disease subtype suitable for gene mapping efforts. We undertook a combined analysis of three genome-wide association studies (GWAS) to identify loci that a) increase susceptibility to an AD and subsequent psychotic symptoms; or b) modify risk of psychotic symptoms in the presence of neurodegeneration caused by AD. 1299 AD cases with psychosis (AD+P), 735 AD cases without psychosis (AD−P) and 5659 controls were drawn from GERAD1, the NIA-LOAD family study and the University of Pittsburgh ADRC GWAS. Unobserved genotypes were imputed to provide data on > 1.8 million SNPs. Analyses in each dataset were completed comparing a) AD+P to AD−P cases, and b) AD+P cases with controls (GERAD1, ADRC only). Aside from the APOE locus, the strongest evidence for association was observed in an intergenic region on chromosome 4 (rs753129; ‘AD+PvAD−P’ P=2.85 × 10−7; ‘AD+PvControls’ P=1.11 × 10−4). SNPs upstream of SLC2A9 (rs6834555, P=3.0×10−7) and within VSNL1 (rs4038131, P=5.9×10−7) showed strongest evidence for association with AD+P when compared to controls. These findings warrant further investigation in larger, appropriately powered samples in which the presence of psychotic symptoms in AD has been well characterised. PMID:22005930

  20. Genome-wide association analysis of age at onset and psychotic symptoms in bipolar disorder.

    PubMed

    Belmonte Mahon, Pamela; Pirooznia, Mehdi; Goes, Fernando S; Seifuddin, Fayaz; Steele, Jo; Lee, Phil Hyoun; Huang, Jie; Hamshere, Marian L; Depaulo, J Raymond; Kelsoe, John R; Rietschel, Marcella; Nöthen, Markus; Cichon, Sven; Gurling, Hugh; Purcell, Shaun; Smoller, Jordan W; Craddock, Nick; Schulze, Thomas G; McMahon, Francis J; Potash, James B; Zandi, Peter P

    2011-04-01

    Genome-wide association studies (GWAS) have identified several susceptibility loci for bipolar disorder (BP), most notably ANK3. However, most of the inherited risk for BP remains unexplained. One reason for the limited success may be the genetic heterogeneity of BP. Clinical sub-phenotypes of BP may identify more etiologically homogeneous subsets of patients, which can be studied with increased power to detect genetic variation. Here, we report on a mega-analysis of two widely studied sub-phenotypes of BP, age at onset and psychotic symptoms, which are familial and clinically significant. We combined data from three GWAS: NIMH Bipolar Disorder Genetic Association Information Network (GAIN-BP), NIMH Bipolar Disorder Genome Study (BiGS), and a German sample. The combined sample consisted of 2,836 BP cases with information on sub-phenotypes and 2,744 controls. Imputation was performed, resulting in 2.3 million SNPs available for analysis. No SNP reached genome-wide significance for either sub-phenotype. In addition, no SNP reached genome-wide significance in a meta-analysis with an independent replication sample. We had 80% power to detect associations with a common SNP at an OR of 1.6 for psychotic symptoms and a mean difference of 1.8 years in age at onset. Age at onset and psychotic symptoms in BP may be influenced by many genes of smaller effect sizes or other variants not measured well by SNP arrays, such as rare alleles.

  1. Clinical correlates of obsessive-compulsive symptom dimensions in at-risk mental states and psychotic disorders at early stages.

    PubMed

    Mariné, Rosa; Creus, Marta; Solé, Montse; Cabezas, Ángel; Algora, Maria José; Moreno, Irene; Izquierdo, Eduard; Stojanovic-Pérez, Alexander; Labad, Javier

    2015-08-30

    We studied the clinical correlates of obsessive-compulsive symptom dimensions in 109 individuals with early psychosis (31 At-Risk Mental States [ARMS], 78 psychotic disorders with <3 years of illness) and 59 healthy subjects. Obsessive-compulsive symptoms were assessed by the Obsessive-Compulsive Inventory - Revised. We also assessed the severity of psychotic symptoms, depressive symptoms and functioning. ARMS and psychotic disorder patients reported more obsessive-compulsive symptoms than did healthy subjects. The ARMS individuals also reported more overall and checking obsessive-compulsive symptoms compared with the PD patients. Different types of obsessive-compulsive symptoms were related with depressive symptoms in both diagnostic groups. However, a different pattern was observed in the relationship between obsessive-compulsive dimensions and functioning by diagnosis (better functioning in ARMS; poorer functioning in psychotic disorders). Our study suggests that obsessive-compulsive symptoms are present in the early stages of psychotic illness, as well as in individuals at risk for psychosis. Future prospective studies are needed to elucidate how obsessive-compulsive symptoms in ARMS may influence the prognosis in terms of global functioning and the risk of psychosis transition.

  2. [Antiphospolipid syndrome related chorea gravidarum case with psychotic symptoms misdiagnosed as conversion disorder: case report].

    PubMed

    Kuz Tekşut, Tuba; Özcan, Halil; Işık, Mein; Karslı, Fatih

    2013-01-01

    Chorea gravidarum (CG) is a rare movement disorder characterized by rapid, irregular randomly distributed involuntary movements during pregnancy. Similar to Sydenham chorea, psychiatric symptoms may be observed in cases of CG. CG may be idiopathic or secondary to an underlying cause. One of the most common causes of CG is antiphospholipid syndrome. Herein we present a case of recurrent CG that was considered to be due to antiphospholipid syndrome. The patient had a history of 3 pregnancy losses and her fourth pregnancy was treated appropriately, resulting in the birth of healthy full-term baby. During the patient's first pregnancy CG was accompanied by psychotic symptoms and was misdiagnosed as conversion disorder.

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

    PubMed

    Demily, Caroline; Franck, Nicolas

    2016-11-01

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

  4. School Mobility and Prospective Pathways to Psychotic-like Symptoms in Early Adolescence: A Prospective Birth Cohort Study

    PubMed Central

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

    2014-01-01

    Objective Social adversity and urban upbringing increase the risk of psychosis. We tested the hypothesis that these risks may be partly attributable to school mobility and examined the potential pathways linking school mobility to psychotic-like symptoms. Method A community sample of 6,448 mothers and their children born between 1991 and 1992 were assessed for psychosocial adversities (i.e., ethnicity, urbanicity, family adversity) from birth to 2 years, school and residential mobility up to 9 years, and peer difficulties (i.e., bullying involvement and friendship difficulties) at 10 years. Psychotic-like symptoms were assessed at age 12 years using the Psychosis-like Symptoms Interview (PLIKSi). Results In regression analyses, school mobility was significantly associated with definite psychotic-like symptoms (odds ratio [OR] =1.60; 95% CI =1.07–2.38) after controlling for all confounders. Within path analyses, school mobility (probit coefficient [β] = 0.108; p = .039), involvement in bullying (β = 0.241; p < .001), urbanicity (β = 0.342; p = .016), and family adversity (β = 0.034; p < .001) were all independently associated with definite psychotic-like symptoms. School mobility was indirectly associated with definite psychotic-like symptoms via involvement in bullying (β = 0.018; p = .034). Conclusions School mobility is associated with increased risk of psychotic-like symptoms, both directly and indirectly. The findings highlight the potential benefit of strategies to help mobile students to establish themselves within new school environments to reduce peer difficulties and to diminish the risk of psychotic-like symptoms. Awareness of mobile students as a possible high-risk population, and routine inquiry regarding school changes and bullying experiences, may be advisable in mental health care settings. PMID:24745952

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

    PubMed

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

    1999-10-01

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

  6. Psychotic symptoms, self-harm and violence in individuals with schizophrenia and substance misuse problems.

    PubMed

    Haddock, Gillian; Eisner, Emily; Davies, Gabriel; Coupe, Nia; Barrowclough, Christine

    2013-12-01

    When schizophrenia is combined with substance misuse, rates are consistently higher. However research findings on the relationship between violence, self-harm and schizophrenia are inconclusive. This study aimed to examine links between specific psychotic symptoms, substance misuse and violence in people dually diagnosed with schizophrenia and substance misuse. Presence and frequency of violence to self and others were examined in relation to the type and severity of psychotic symptoms and level of substance use over a 24 month period in 327 people with schizophrenia and substance misuse problems. 32.3% had an incident of violence to others during the study period and 28.6% had a self-harm/suicide incident. 39 (11.9%) participants reported command hallucinations (CH) and 157 (48.0%) had threat control override symptoms (TCOS). Presence of TCOS and presence of CH were not associated with violence to others but were both associated with self-harm. Different command hallucination sub-types were associated with different types of violence. Delusional and hallucination severity and distress were mainly associated with self-harm. These findings suggest that specific symptoms are related to different outcomes, particularly in relation to self-harm, and these effects remain even after substance use is controlled for. This has important implications for assessment and treatment of this group.

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

    PubMed Central

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

    2016-01-01

    Background There is increasing interest in elucidating the association of different childhood adversities with psychosis-spectrum symptoms as well as the mechanistic processes involved. This study used experience sampling methodology to examine (i) associations of a range of childhood adversities with psychosis symptom domains in daily life; (ii) whether associations of abuse and neglect with symptoms are consistent across self-report and interview methods of trauma assessment; and (iii) the role of different adversities in moderating affective, psychotic-like, and paranoid reactivity to situational and social stressors. Method A total of 206 nonclinical young adults were administered self-report and interview measures to assess childhood abuse, neglect, bullying, losses, and general traumatic events. Participants received personal digital assistants that signaled them randomly eight times daily for one week to complete questionnaires about current experiences, including symptoms, affect, and stress. Results Self-reported and interview-based abuse and neglect were associated with psychotic-like and paranoid symptoms, whereas only self-reported neglect was associated with negative-like symptoms. Bullying was associated with psychotic-like symptoms. Losses and general traumatic events were not directly associated with any of the symptom domains. All the childhood adversities were associated with stress reactivity in daily life. Interpersonal adversities (abuse, neglect, bullying, and losses) moderated psychotic-like and/or paranoid reactivity to situational and social stressors, whereas general traumatic events moderated psychotic-like reactivity to situational stress. Also, different interpersonal adversities exacerbated psychotic-like and/or paranoid symptoms in response to distinct social stressors. Discussion The present study provides a unique examination of how childhood adversities impact the expression of spectrum symptoms in the real world and lends support

  8. War experiences and psychotic symptoms among former child soldiers in Northern Uganda: the mediating role of post-war hardships – the WAYS Study

    PubMed Central

    Amone-P’Olak, Kennedy; Otim, Balaam Nyeko; Opio, George; Ovuga, Emilio; Meiser-Stedman, Richard

    2014-01-01

    Psychotic symptoms have been associated with post-traumatic stress disorder and war experiences. However, the relationships between types of war experiences, the onset and course of psychotic symptoms, and post-war hardships in child soldiers have not been investigated. This study assessed whether various types of war experiences contribute to psychotic symptoms differently and whether post-war hardships mediated the relationship between war experiences and later psychotic symptoms. In an ongoing longitudinal cohort study (the War-Affected Youths Survey), 539 (61% male) former child soldiers were assessed for psychotic symptoms, post-war hardships, and previous war experiences. Regression analyses were used to assess the contribution of different types of war experiences on psychotic symptoms and the mediating role of post-war hardships in the relations between previous war experiences and psychotic symptoms. The findings yielded ‘witnessing violence’, ‘deaths and bereavement’, ‘involvement in hostilities’, and ‘sexual abuse’ as types of war experiences that significantly and independently predict psychotic symptoms. Exposure to war experiences was related to psychotic symptoms through post-war hardships (β = .18, 95% confidence interval = [0.10, 0.25]) accounting for 50% of the variance in their relationship. The direct relation between previous war experiences and psychotic symptoms attenuated but remained significant (β = .18, 95% confidence interval = [0.12, 0.26]). Types of war experiences should be considered when evaluating risks for psychotic symptoms in the course of providing emergency humanitarian services in post-conflict settings. Interventions should consider post-war hardships as key determinants of psychotic symptoms among war-affected youths. PMID:24718435

  9. Persistent psychotic symptoms after long-term heavy use of mephedrone: A two-case series.

    PubMed

    Barrio, Pablo; Gaskell, Matthew; Goti, Javier; Vilardell, Sergi; Fàbregas, Josep Maria

    2016-06-15

    Mephedrone (4-methylmethcathinone) is a synthetic stimulant drug of the cathinone class. Similar effects to those of cocaine and ecstasy are reported by users, with a high addictive potential. Given its increasing rate of consumption in Europe, it is getting more and more attention from the addiction field. In spite of that, little is known about the long-term consequences of prolonged heavy use. The two following cases might depict some of them. Case 1 was a middle-age man who reported three years of intravenous use of mephedrone. He used to binge for several days in a row. Psychotic symptoms appeared after a few months, especially paranoid delusions. Sent to aftercare in a therapeutic community, delusions kept reappearing after prolonged abstinence. A good response to risperidone was observed. Case 2 was a young man who used mephedrone heavily for two years, always snorted. Upon admission to the therapeutic community, the patient reported auditory hallucinations that partially remitted with olanzapine. Both cases showed a good insight and no personality deterioration. Given its similarities to other substances that are known to induce psychotic symptoms, and the increasing consumption of mephedrone around Europe, similar cases are expected in the near future. Conventional antipsychotic treatment seems a reasonable pharmacological approach.

  10. [Differential Diagnosis of Schizophrenia: Psychotic Symptoms in Neurodevelopmental Disorders and Psychotic Disorders due to other Medical Conditions].

    PubMed

    Kokurcan, Ahmet; Atbaşoğlu, Eşref Cem

    2015-01-01

    This review focuses on the differentiation of schizophrenia in the setting of adult psychiatry from neurodevelopmental disorders (NDD's) and psychosis due to other medical conditions (PDMC). Psychotic disorders in early adulthood are most frequently diagnosed with the schizophrenia spectrum or mood disorders. However, they may be the manifestation of neurologic, endocrine or immunologic disease. Individuals with NDD's such as the autism spectrum disorder (ASD) or intellectual developmental disorder (IDD) may also present initially in adulthood. Therefore it is not uncommon that the psychiatrist is the first physician to assess a psychotic patient with underlying medical illness or a NDD. Failure to identify the underlying cause will delay appropriate management. Overdiagnosis of primary psychiatric disorders may be misleading in planning the treatment, as evidence-based treatment algorithms relevant to psychosis are intended for primary psychotic disorders like schizophrenia, and symptomatic treatment may result in unnecessary exposure to antipsychotic drugs. Exclusion of other medical conditions and NDD's is essential before establishing a diagnosis of schizophrenia.

  11. Schizophrenia and psychotic symptoms in families of two American Indian tribes

    PubMed Central

    Robin, Robert W; Gottesman, Irving I; Albaugh, Bernard; Goldman, David

    2007-01-01

    the general population. Vulnerabilities to early onset alcohol and drug use disorders do not lend convincing support to a diathesis-stressor model with these stressors, commonly reported with these tribes. Nearly one-fifth of the respondents reported experiencing psychotic-like symptoms, reaffirming the need to examine sociocultural factors actively before making positive diagnoses of psychosis or schizophrenia. PMID:17598920

  12. Adult Psychotic Symptoms, Their Associated Risk Factors and Changes in Prevalence in Men and Women Over a Decade in a Poor Rural District of Kenya

    PubMed Central

    Jenkins, Rachel; Othieno, Caleb; Ongeri, Linnet; Ogutu, Bernards; Sifuna, Peter; Kingora, James; Kiima, David; Ongecha, Michael; Omollo, Raymond

    2015-01-01

    There have been no repeat surveys of psychotic symptoms in Kenya or indeed subSaharan Africa. A mental health epidemiological survey was therefore conducted in a demographic surveillance site of a Kenyan household population in 2013 to test the hypothesis that the prevalence of psychotic symptoms would be similar to that found in an earlier sample drawn from the same sample frame in 2004, using the same overall methodology and instruments. This 2013 study found that the prevalence of one or more psychotic symptoms was 13.9% with one or more symptoms and 3.8% with two or more symptoms, while the 2004 study had found that the prevalence of single psychotic symptoms in rural Kenya was 8% of the adult population, but only 0.6% had two symptoms and none had three or more psychotic symptoms. This change was accounted for by a striking increase in psychotic symptoms in women (17.8% in 2013 compared with 6.9% in 2004, p < 0.001), whereas there was no significant change in men (10.6% in 2013 compared with 9.4% in 2004, p = 0.582). Potential reasons for this increase in rate of psychotic symptoms in women are explored. PMID:25996885

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

    PubMed

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

    2010-03-01

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

  14. A Pilot RCT of Psychodynamic Group Art Therapy for Patients in Acute Psychotic Episodes: Feasibility, Impact on Symptoms and Mentalising Capacity

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-02-28

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

  16. Prognostic Value of Affective Symptoms in First-Admission Psychotic Patients

    PubMed Central

    Arrasate, Marta; González-Ortega, Itxaso; García-Alocén, Adriana; Alberich, Susana; Zorrilla, Iñaki; González-Pinto, Ana

    2016-01-01

    Background: Very little research has been conducted in patients with first-episode psychosis using a dimensional approach. Affective dimensional representations might be useful to predict the clinical course and treatment needs in such patients. Methods: Weincluded 112 patients with first-episode psychosis in a longitudinal-prospective study with a five-year follow-up (N = 82). Logistic analyses were performed to determine the predictive factors associated with depressive, manic, activation, and dysphoric dimensions. Results: High scores on the depressive dimension were associated with the best prognosis. On the other hand, high scores on the activation dimension and the manic dimension were associated with a poorer prognosis in terms of relapses. Only the dysphoric dimension was not associated with syndromic or functional prognosis. Conclusion: Ourresults suggest that the pattern of baseline affective symptoms helps to predict the course of psychotic illness. Therefore, the systematic assessment of affective symptoms would enable us to draw important conclusions regarding patients’ prognosis. Interventions for patients with high scores on manic or activation dimensions could be beneficial in decreasing relapses in first-episode psychosis. PMID:27376266

  17. Cognitive phenotype of psychotic symptoms in Alzheimer's disease: evidence for impaired visuoperceptual function in the misidentification subtype

    PubMed Central

    Clark‐Papasavas, Chloe; Gould, Rebecca L.; Ffytche, Dominic; Howard, Robert J.

    2015-01-01

    Background Establishing the cognitive phenotype of psychotic symptoms in Alzheimer's disease (AD) could localise discrete pathology and target symptomatic treatment. This study aimed to establish whether psychotic symptoms would be associated with poorer performance on neuropsychological tests known to correlate with striatal dopaminergic function and to investigate whether these differences would be attributed to the paranoid (persecutory delusions) or misidentification (misidentification phenomena +/− hallucinations) subtype. Methods Seventy patients with probable AD (34 psychotic and 36 nonpsychotic) were recruited to the study. Analysis of covariance was used to compare motor speed and the rapid visual processing test of sustained visual attention, after adjusting for potential confounding factors. Multivariate analyses were used to compare performance across other cognitive domains. Significant findings were explored by separating patients on the basis of subtype. Results Rapid visual processing performance accuracy was reduced in patients with psychotic symptoms (F 1,58 = 5.94, p = 0.02) and differed significantly across subtypes (F 2,51 = 3.94, p = 0.03), largely because of poorer performance in the misidentification compared with nonpsychotic group. Multivariate analyses (corrected for multiple comparisons) showed poorer performance on the incomplete letters task in psychotic patients (F 1,63 = 8.77, p = 0.004) and across subtypes (F 2,55 = 10.90, p < 0.001), similarly attributed to the misidentification subtype. Conclusions These findings provide further support of the involvement of dopaminergic networks in the psychosis endophenotype in AD and, in addition, implicate the ventral (temporo‐occipital) pathway in the misidentification subtype. Future studies should investigate the early trajectory of neuropathological change in vivo across psychosis subtypes.© 2015 The Authors. International Journal of Geriatric

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

    PubMed Central

    Özcan, Muhammed Emin; İnce, Bahri; Karadeli, Hasan Hüseyin; Asil, Talip

    2014-01-01

    Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Psychiatric symptoms are not infrequent during MS, yet onset of MS with psychosis is rarely encountered. A 27-year-old Caucasian male was admitted due to numbness in his right arm and difficulty in walking. His clinical and laboratorial exams lead to the MS diagnosis. Nine months earlier, he also developed psychotic disorder, not otherwise specified (PD-NOS). His sudden onset of PD-NOS, his rapid and complete response to antipsychotics, and a relatively short interval between psychiatric and neurological signs indicate a high likelihood that PD-NOS was a manifestation of underlying MS. He also suffers from hypertrophic obstructive cardiomyopathy (HOCM). The patient's neurological complaints were recovered with methylprednisolone (1 g/day, i.v.) given for five days. Glatiramer acetate (1 × 1 tb.s.c.) was prescribed for consolidation and, after nine months of his admission, the patient fully recovered from neurological and psychiatric complaints. Interestingly, very recent studies indicate specific alpha-actinin antibodies in MS and alpha-actinin mutations cause HOCM. Thus, concurrence of MS with HOCM can be even a new syndrome, if further genetic studies prove. PMID:25197588

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

    PubMed

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

    2013-10-01

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

  20. Towards Using Microstate-Neurofeedback for the Treatment of Psychotic Symptoms in Schizophrenia. A Feasibility Study in Healthy Participants.

    PubMed

    Diaz Hernandez, Laura; Rieger, Kathryn; Baenninger, Anja; Brandeis, Daniel; Koenig, Thomas

    2016-03-01

    Spontaneous EEG signal can be parsed into sub-second periods of stable functional states (microstates) that assumingly correspond to brief large scale synchronization events. In schizophrenia, a specific class of microstate (class "D") has been found to be shorter than in healthy controls and to be correlated with positive symptoms. To explore potential new treatment options in schizophrenia, we tested in healthy controls if neurofeedback training to self-regulate microstate D presence is feasible and what learning patterns are observed. Twenty subjects underwent EEG-neurofeedback training to up-regulate microstate D presence. The protocol included 20 training sessions, consisting of baseline trials (resting state), regulation trials with auditory feedback contingent on microstate D presence, and a transfer trial. Response to neurofeedback was assessed with mixed effects modelling. All participants increased the percentage of time spent producing microstate D in at least one of the three conditions (p < 0.05). Significant between-subjects across-sessions results showed an increase of 0.42 % of time spent producing microstate D in baseline (reflecting a sustained change in the resting state), 1.93 % of increase during regulation and 1.83 % during transfer. Within-session analysis (performed in baseline and regulation trials only) showed a significant 1.65 % increase in baseline and 0.53 % increase in regulation. These values are in a range that is expected to have an impact upon psychotic experiences. Additionally, we found a negative correlation between alpha power and microstate D contribution during neurofeedback training. Given that microstate D has been related to attentional processes, this result provides further evidence that the training was to some degree specific for the attentional network. We conclude that microstate-neurofeedback training proved feasible in healthy subjects. The implementation of the same protocol in schizophrenia patients may promote

  1. Diagnostic and Prognostic Significance of Brief Limited Intermittent Psychotic Symptoms (BLIPS) in Individuals at Ultra High Risk

    PubMed Central

    Fusar-Poli, Paolo; Cappucciati, Marco; De Micheli, Andrea; Rutigliano, Grazia; Bonoldi, Ilaria; Tognin, Stefania; Ramella-Cravaro, Valentina; Castagnini, Augusto; McGuire, Philip

    2017-01-01

    Background: Brief Limited Intermittent Psychotic Symptoms (BLIPS) are key inclusion criteria to define individuals at ultra high risk for psychosis (UHR). Their diagnostic and prognostic significance is unclear. Objectives: To address the baseline diagnostic relationship between BLIPS and the ICD-10 categories and examine the longitudinal prognostic impact of clinical and sociodemographic factors. Methods: Prospective long-term study in UHR individuals meeting BLIPS criteria. Sociodemographic and clinical data, including ICD-10 diagnoses, were automatically drawn from electronic health records and analyzed using Kaplan–Meier failure function (1-survival), Cox regression models, bootstrapping methods, and Receiver Operating Characteristics (ROC) curve. Results: Eighty BLIPS were included. At baseline, two-thirds (68%) of BLIPS met the diagnostic criteria for ICD-10 Acute and Transient Psychotic Disorder (ATPD), most featuring schizophrenic symptoms. The remaining individuals met ICD-10 diagnostic criteria for unspecified nonorganic psychosis (15%), mental and behavioral disorders due to use of cannabinoids (11%), and mania with psychotic symptoms (6%). The overall 5-year risk of psychosis was 0.54. Recurrent episodes of BLIPS were relatively rare (11%) but associated with a higher risk of psychosis (hazard ratio [HR] 3.98) than mono-episodic BLIPS at the univariate analysis. Multivariate analysis revealed that seriously disorganizing or dangerous features increased greatly (HR = 4.39) the risk of psychosis (0.89 at 5-year). Bootstrapping confirmed the robustness of this predictor (area under the ROC = 0.74). Conclusions: BLIPS are most likely to fulfill the ATPD criteria, mainly acute schizophrenic subtypes. About half of BLIPS cases develops a psychotic disorder during follow-up. Recurrent BLIPS are relatively rare but tend to develop into psychosis. BLIPS with seriously disorganizing or dangerous features have an extreme high risk of psychosis. PMID:28053130

  2. Interaction of social role functioning and coping in people with recent-onset attenuated psychotic symptoms: a case study of three Chinese women at clinical high risk for psychosis

    PubMed Central

    Zhang, TianHong; Li, HuiJun; Woodberry, Kristen A; Seidman, Larry J; Chow, Annabelle; Xiao, ZePing; Wang, JiJun

    2015-01-01

    Clinical high risk of psychosis is defined as the period in which the first signs of psychotic symptoms begin to appear. During this period, there is an increased probability of developing frank psychosis. It is crucial to investigate the interaction between psychotic symptoms and the individual’s personality and life experiences in order to effectively prevent, or delay the development of psychosis. This paper presents case reports of three Chinese female subjects with attenuated positive symptoms, attending their initial outpatient assessment in a mental health service, and their longitudinal clinical outcomes. Information regarding each subject’s symptoms and life stressors was collected at 2-month intervals over a 6-month period. The assessments indicated that these women were suffering from the recent onset of symptoms in different ways. However, all three hid their symptoms from others in their school or workplace, and experienced a decline in performance related to their social roles and in their daily functioning. They were often excluded from the social groups to which they had previously belonged. A decline in social activities may be a risk factor in the development of psychosis and a mediator of functional sequelae in psychosis. Effective treatment strategies may include those that teach individuals to gain insights related to their symptoms and a service that provides a context in which individuals can discuss their psychotic symptoms. PMID:26185448

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

    PubMed Central

    2012-01-01

    Background Delusions and hallucinations are classic positive symptoms of schizophrenia. A contemporary cognitive theory called the ‘forward output model’ suggests that the misattribution of self-generated actions may underlie some of these types of symptoms, such as delusions of control – the experience of self-generated action being controlled by an external agency. In order to examine the validity of this suggestion, we performed a longitudinal functional magnetic resonance imaging (fMRI) study examining neuronal activation associated with motor movement during acute psychosis. Methods We studied brain activation using fMRI during a motor task in 11 patients with schizophrenia and 9 healthy controls. The patient group was tested at two time points separated by 6–8 weeks. Results At initial testing, the patient group had a mean Positive and Negative Syndrome Scale score of 56.3, and showed significantly increased activation within the left inferior parietal lobe (IPL) compared to controls. Patients reported significantly decreased positive symptoms at 6–8 week followup and IPL activation had returned to normal. Our results demonstrate that first-rank positive symptoms are associated with hyperactivation in the secondary somatosensory cortex (IPL). Conclusions These findings lend further credence to the theory that a dysfunction in the sensory feedback system located in the IPL, and which is thought to underlie our sense of agency, may contribute to the aetiology of delusions of control. PMID:22871335

  4. Hippocampal temporal-parietal junction interaction in the production of psychotic symptoms: a framework for understanding the schizophrenic syndrome

    PubMed Central

    Wible, Cynthia G.

    2012-01-01

    A framework is described for understanding the schizophrenic syndrome at the brain systems level. It is hypothesized that over-activation of dynamic gesture and social perceptual processes in the temporal-parietal occipital junction (TPJ), posterior superior temporal sulcus (PSTS) and surrounding regions produce the syndrome (including positive and negative symptoms, their prevalence, prodromal signs, and cognitive deficits). Hippocampal system hyper-activity and atrophy have been consistently found in schizophrenia. Hippocampal activity is highly correlated with activity in the TPJ and may be a source of over-excitation of the TPJ and surrounding regions. Strong evidence for this comes from in-vivo recordings in humans during psychotic episodes. Many positive symptoms of schizophrenia can be reframed as the erroneous sense of a presence or other who is observing, acting, speaking, or controlling; these qualia are similar to those evoked during abnormal activation of the TPJ. The TPJ and PSTS play a key role in the perception (and production) of dynamic social, emotional, and attentional gestures for the self and others (e.g., body/face/eye gestures, audiovisual speech and prosody, and social attentional gestures such as eye gaze). The single cell representation of dynamic gestures is multimodal (auditory, visual, tactile), matching the predominant hallucinatory categories in schizophrenia. Inherent in the single cell perceptual signal of dynamic gesture representations is a computation of intention, agency, and anticipation or expectancy (for the self and others). Stimulation of the TPJ resulting in activation of the self representation has been shown to result a feeling of a presence or multiple presences (due to heautoscopy) and also bizarre tactile experiences. Neurons in the TPJ are also tuned, or biased to detect threat related emotions. Abnormal over-activation in this system could produce the conscious hallucination of a voice (audiovisual speech), a person

  5. An exploration of how psychotic-like symptoms are experienced, endorsed, and understood from the National Latino and Asian American Study and National Survey of American Life

    PubMed Central

    Earl, Tara; Fortuna, Lisa R.; Gao, Shan; Williams, David R.; Neighbors, Harold W.; Takeuchi, David; Alegría, Margarita

    2016-01-01

    Objective To examine racial/ethnic differences in the endorsement and attribution of psychotic-like symptoms in a nationally representative sample of African Americans, Asians, Caribbean Blacks, and Latinos living in the United States. Design Data were drawn from a total of 979 respondents who endorsed psychotic-like symptoms as part of the National Latino and Asian American Study (NLAAS) and the National Survey of American Life (NSAL). We use a mixed qualitative and quantitative analytical approach to examine sociodemographic and ethnic variations in the prevalence and attributions of hallucinations and other psychotic-like symptoms in the NLAAS and NSAL. The lifetime presence of psychotic-like symptoms was assessed using the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) psychotic symptom screener. We used logistic regression models to examine the probability of endorsing the four most frequently occurring thematic categories for psychotic-like experiences by race/ethnicity (n>100). We used qualitative methods to explore common themes from participant responses to open ended questions on their attributions for psychotic-like symptoms. Results African Americans were significantly less likely to endorse visual hallucinations compared to Caribbean Blacks (73.7% and 89.3%, p<.001), but they endorsed auditory hallucinations symptoms more than Caribbean Blacks (43.1% and 25.7, p<.05). Endorsing delusions of reference and thought insertion/withdrawal were more prevalent for Latinos than for African Americans (11% and 4.7%, p<.05; 6.3% and 2.7%, p<.05, respectively). Attribution themes included: supernatural, ghosts/unidentified beings, death and dying, spirituality or religiosity, premonitions, familial and other. Respondents differed by race/ethnicity in the attributions given to psychotic like symptoms. Conclusion Findings suggest that variations exist by race/ethnicity in both psychotic-like symptom endorsement and in self

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

    PubMed

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

    2016-08-01

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

  7. Psychotic experiences and psychotic disorders at age 18 in relation to psychotic experiences at age 12 in a longitudinal population-based cohort study.

    PubMed

    Zammit, Stanley; Kounali, Daphne; Cannon, Mary; David, Anthony S; Gunnell, David; Heron, Jon; Jones, Peter B; Lewis, Shôn; Sullivan, Sarah; Wolke, Dieter; Lewis, Glyn

    2013-07-01

    OBJECTIVE The authors examined the development of psychotic experiences and psychotic disorders in a large population-based sample of young adults and explored their relationship to psychotic phenomena earlier in childhood. METHOD The authors conducted a longitudinal birth cohort study of individuals assessed with the semistructured Psychosis-Like Symptom Interviews at ages 12 and 18 years. RESULTS Of the 4,724 individuals interviewed at age 18, 433 (9.2%) had either suspected (N=203 [4.3%]) or definite (N=230 [4.9%]) psychotic experiences. Of these, 79 (1.7%) met criteria for a psychotic disorder, and of those, only 50% sought professional help. All psychotic outcomes were more likely in young women and in those from socioeconomically disadvantaged backgrounds. Of the participants who had psychotic experiences at age 12, 78.7% had remitted by age 18. The risk of psychotic disorders at age 18 was greater in those with suspected (odds ratio=5.6, 95% CI=2.6-12.1) and especially in those with definite (odds ratio=12.7, 95% CI=6.2-26.1) psychotic experiences at age 12, and also among those with psychotic experiences at age 12 attributed to sleep or fever or with nonpsychotic experiences such as depersonalization. The positive predictive values for increasing frequency of experiences at age 12 predicting psychotic disorders at age 18 ranged from 5.5% to 22.8%. CONCLUSIONS Despite evidence for a continuum of psychotic experiences from as early as age 12, positive predictive values for predicting psychotic disorders were too low to offer real potential for targeted interventions. Psychotic disorders in young adults are relatively uncommon, but they constitute an important unmet need for care given that half of the individuals in this study who met criteria for a psychiatric disorder had not sought help for these problems despite high levels of associated distress and impairment.

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

    PubMed Central

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

    2014-01-01

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

  9. Appraisals and Responses to Experimental Symptom Analogues in Clinical and Nonclinical Individuals With Psychotic Experiences

    PubMed Central

    Ward, Thomas A.; Gaynor, Keith J.; Hunter, Mike D.; Woodruff, Peter W. R.; Garety, Philippa A.; Peters, Emmanuelle R.

    2014-01-01

    Objective: Cognitive models of psychosis suggest that anomalous experiences alone do not always lead to clinical psychosis, with appraisals and responses to experiences being central to understanding the transition to “need for care”. Methods: The appraisals and response styles of Clinical (C; n = 28) and Nonclinical (NC; n = 34) individuals with psychotic experiences were compared following experimental analogues of thought interference (Cards Task) and auditory hallucinations (Virtual Acoustic Space Paradigm). Results: The groups were matched in terms of their psychotic experiences. As predicted, the C group scored higher than the NC group on maladaptive appraisals following both tasks, rated the experience as more personally significant, and was more likely to incorporate the experimental setup into their ongoing experiences. The C group also appraised the Cards Task as more salient, distressing, and threatening; this group scored higher on maladaptive—and lower on adaptive—response styles, than the NC group on both tasks. Conclusions: The findings are consistent with cognitive models of psychosis, with maladaptive appraisals and response styles characterizing the C group only. Clinical applications of both tasks are suggested to facilitate the identification and modification of maladaptive appraisals. PMID:23858493

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

    PubMed

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

    2015-02-28

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

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

    PubMed

    den Hertog, Thijs N; Gilmoor, Andrew R

    2017-03-01

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

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

    PubMed

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

    2010-09-01

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

  13. Targeting glutamate system for novel antipsychotic approaches: relevance for residual psychotic symptoms and treatment resistant schizophrenia.

    PubMed

    de Bartolomeis, Andrea; Sarappa, Chiara; Magara, Salvatore; Iasevoli, Felice

    2012-05-05

    Antipsychotics are the mainstay of schizophrenia treatment. However, approximately one third of schizophrenic patients do not respond or respond poorly to antipsychotics. Therefore, there is a need for new approaches that can improve schizophrenia treatment significantly. Promising strategies arise from the modulation of glutamatergic system, according to its proposed involvement in schizophrenia pathogenesis. In this review, we critically updated preclinical and clinical data on the modulation of glutamate N-methyl-D-aspartate (NMDA) receptor activity by NMDA-Rs co-agonists, glycine transporters inhibitors, AMPAkines, mGluR5 agonists, NMDA-Rs partial agonists. We focused on: 1) preclinical results in animal models mimicking the pathophysiology of psychosis, mainly believed to be responsible of negative and cognitive symptoms, and predicting antipsychotic-like activity of these compounds; and 2) clinical efficacy in open-label and double-blind trials. Albeit promising preclinical findings for virtually all compounds, clinical efficacy has not been confirmed for D-cycloserine. Contrasting evidence has been reported for glycine and D-serine, that may however have a role as add-on agents. More promising results in humans have been found for glycine transporter inhibitors. AMPAkines appear to be beneficial as pro-cognitive agents, while positive allosteric modulators of mGluR5 have not been tested in humans. Memantine has been proposed in early stages of schizophrenia, as it may counteract the effects of glutamate excitotoxicity correlated to high glutamate levels, slowing the progression of negative symptoms associated to more advanced stages of the illness.

  14. Drug Dependence and Psychotic Symptoms: A Retrospective Study of Adolescents Who Abuse Drugs at Al-Amal Hospital in Jeddah, Saudi Arabia

    PubMed Central

    Elawad, Nagi; Misau, Yusuf A.; Shaikh, Tarteel M.; Allam, Nedal

    2012-01-01

    Drug abuse is reported to be on the increase among young persons using illicit substances but little is known about the frequency with which they occur, the symptoms on presentation to health institutions, and the different substances abused. To establish this, we reviewed patient data collected at Al-Amal Hospital in Jeddah Kingdom of Saudi Arabia on young persons who are refered to the hospital for problems related to drug abuse. Data on 69 adolescent drug users were reviewed and analyzed using the Composite International Diagnostic Interview - Substance Abuse Model (CIDI-SAM) to assess dependence on substances including amphetamines, cannabis, cocaine, and opioids. Furthermore, we assessed the adolescents’ data on history of delusions and hallucinations in the context of use of, or withdrawal from, these specific substances. Our analysis shows that 10 to 79.6% of users of amphetamines, cannabis, cocaine, and opiates met DSM-III-R dependence criteria for each specific substance. The prevalence of psychotic symptoms associated with each specific substance ranged from users with no diagnosis to users with severe dependence as follows: amphetamines (3-100%), cannabis (7-60.0%), cocaine (5-70.7%), and opiates (4-88%). The risk of psychotic symptoms increased for respondents who abused (OR=7.2) or had mild (OR=8.1), moderate (OR=20.0), or severe dependence (OR=14.0) on cocaine when compared to those who were users with no diagnosis. A similar pattern was evident in cannabis, opiate, and amphetamine users. In conclusion, most adolescent drug users in Saudi Arabia who are dependent on illicit substances experience psychotic symptoms in the context of use of, or withdrawal from, these substances. Psychotic symptoms increased with the severity of the disorders associated with use of all four substances. These findings underscore the importance of developing services to target this population; a population at risk of developing psychotic symptoms. PMID:28299079

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

    PubMed

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

    2002-01-01

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

  16. Brief psychotic disorder

    MedlinePlus

    ... short-term display of psychotic behavior, such as hallucinations or delusions, which occurs with a stressful event. ... Hearing or seeing things that aren't real (hallucinations) Strange speech or language The symptoms are not ...

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

    PubMed

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

    2011-01-01

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

  18. From the prodrome to chronic schizophrenia: the neurobiology underlying psychotic symptoms and cognitive impairments.

    PubMed

    Howes, O D; Fusar-Poli, P; Bloomfield, M; Selvaraj, S; McGuire, P

    2012-01-01

    Schizophrenia is a chronic psychotic disorder that remains a considerable cause of global disease burden. Cognitive impairments are common and contribute significantly to the morbidity of the disorder. Over the last two decades or so molecular imaging studies have refined understanding of the pathophysiology underlying the development of psychosis and cognitive impairments. Firstly they have consistently implicated presynaptic dopaminergic dysfunction in the disorder, finding that dopamine synthesis capacity, dopamine release and baseline dopamine levels are increased in the illness. Secondly recent findings show that dopamine synthesis capacity is elevated in those that go on to develop psychosis in the following year, but not in those that do not, and appears to increase further with the development of psychosis. Thirdly evidence links greater dopamine synthesis capacity to poorer cognitive performance and altered frontal cortical function measured using functional imaging during cognitive tasks. Finally they have provided data on the nature of other neurofunctional alterations in the disorder, in particular in the serotonergic system and neuroinflammation. We review these findings and discuss their implications for understanding the neurobiology of psychosis and cognitive impairments in schizophrenia.

  19. Anomalous Self-Experiences and positive symptoms are independently associated with emotion processing deficits in schizophrenia.

    PubMed

    Cicero, David C; Klaunig, Mallory J; Trask, Christi L; Neis, Aaron M

    2016-10-01

    Social-cognitive models posit a role of Anomalous Self-Experiences (ASEs), disturbances in the subjective experience of the self, in the development and maintenance of psychosis. Theorists have suggested that ASEs may underlie the social-cognitive deficits that are common in people with schizophrenia. Positive symptoms, negative symptoms, and ASEs may interfere with the ability to perceive, use, understand, and manage emotions. In the current study, 45 people with schizophrenia and 28 healthy controls completed the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE), the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), and were rated on the Positive and Negative Syndrome Scale (PANSS). Participants with schizophrenia had higher IPASE scores and lower MSCEIT scores than the comparison group. In a series of simultaneous regressions, ASEs, but not positive or negative symptoms, were associated with Total MSCEIT scores and the Using Emotions branch score. In contrast, positive symptoms, but not ASEs or negative symptoms were associated with Perceiving and Managing Emotions branches. Both ASEs and positive symptoms independently contributed to Emotional Experiencing scores. The severity of negative symptoms was not associated with deficits in any MSCEIT scores. These results suggest unique roles for ASEs and positive symptoms in emotion processing deficits in people with schizophrenia.

  20. Decision Making about Children with Psychotic Symptoms: Using the Best Evidence in Choosing a Treatment

    ERIC Educational Resources Information Center

    Shaw, Philip; Rapoport, Judith L.

    2006-01-01

    This paper presents Peter, an 11-year-old boy, with brief self-limited hallucinations and persecutory ideation (if not frank delusions) on a background of a gradual deterioration in overall functioning. Affective symptoms are not prominent, and there is little to suggest an organic contribution. This raises the possibility that he has, or is on…

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

    PubMed

    Holka-Pokorska, Justyna; Jarema, Marek

    2014-01-01

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

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

    PubMed

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

    2006-09-30

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

  3. [Clinical justification of medico-psychological care to the victims of technogenic accidents and catastrophes with prevalence of anxious and depressive symptoms of non-psychotic register].

    PubMed

    Volobuev, V V

    2014-01-01

    In the article the clinical justification of medico-psychological care to the victims of technogenic accidents and catastrophes with prevalence of anxious and depressive symptoms of non-psychotic register is described. The necessity of differentiated approach is analyzed in accomplishing of psychotherapy of this contingent of patients taking into account the high level of anxiety, emotional stress, decreased mood, low levels of the quality of life in the remote period of strong stressful factor's action.

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

    PubMed

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

    2012-03-20

    Spinocerebellar ataxia type 2 (SCA2) is a progressive neurodegenerative disorder, characterised by ataxic gait, slow saccades and peripheral neuropathy. Levodopa-responsive parkinsonism could be a clinical phenotype of SCA2, especially those of Chinese origin. In addition to these motor symptoms, SCA2 has been associated with depression and cognitive dysfunction, with only rare reports of psychosis. The authors report the presence of severe psychosis, major depression and multiple system atrophy in affected subjects of a Taiwanese family with intermediate CAG repeats within the ATXN2 gene. The identification of this rare and distinctive SCA2 phenotype expands the current knowledge of the phenotypic variability of SCA2 and suggests that modifier genes could influence the clinical phenotype of SCA2.

  5. Decreased gray matter volume is associated with the subtypes of psychotic symptoms in patients with antipsychotic-naïve mild or moderate Alzheimer's disease: A voxel-based morphometry study.

    PubMed

    Lee, Young-Min; Chung, Young-In; Park, Je-Min; Lee, Byung-Dae; Moon, Eunsoo; Jeong, Hee-Jeong; Kim, Ji-Hoon; Kim, Hak-Jin; Mun, Chi-Woong; Kim, Tae-Hyung; Kim, Young-Hoon; Kim, Eun-Joo

    2016-03-30

    The purpose of this study was to investigate the association between brain regional gray matter volume and two subtypes of psychotic symptoms, namely paranoid and misidentification subtypes, in antipsychotic-naïve mild or moderate Alzheimer's disease (AD) patients. Forty AD patients with psychotic symptoms and 25 AD patients without psychotic symptoms were assessed for cognitive and functional impairment. Presence and subtype of psychotic symptoms were assessed by using the delusion and hallucination subscale of the Korean Neuropsychiatric Inventory (K-NPI). Structural MRI images were acquired on a 3 T scanner, and were analyzed using voxel-based morphometry (VBM) for automated analysis. The misidentification subtype is associated with more severe gray matter atrophy, and paranoid subtype is associated with less severe gray matter atrophy compared to non-psychosis group. These results suggest that the misidentification, the paranoid subtype and the non-psychosis group have a distinct neural correlation.

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

    PubMed Central

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

    2016-01-01

    Objective Self-stigma is highly prevalent in schizophrenia and can be seen as an important factor leading to low self-esteem. It is however unclear how psychological factors and actual adverse events contribute to self-stigma. This study empirically examines how symptom severity and the experience of being victimized affect both self-stigma and self-esteem. Methods Persons with a schizophrenia spectrum disorder (N = 102) were assessed with a battery of self-rating questionnaires and interviews. Structural equation modelling (SEM) was subsequently applied to test the fit of three models: a model with symptoms and victimization as direct predictors of self-stigma and negative self-esteem, a model with an indirect effect for symptoms mediated by victimization and a third model with a direct effect for negative symptoms and an indirect effect for positive symptoms mediated by victimization. Results Results showed good model fit for the direct effects of both symptoms and victimization: both lead to an increase of self-stigma and subsequent negative self-esteem. Negative symptoms had a direct association with self-stigma, while the relationship between positive symptoms and self-stigma was mediated by victimization. Conclusions Our findings suggest that symptoms and victimization may contribute to self-stigma, leading to negative self-esteem in individuals with a schizophrenia spectrum disorder. Especially for patients with positive symptoms victimization seems to be an important factor in developing self-stigma. Given the burden of self-stigma on patients and the constraining effects on societal participation and service use, interventions targeting victimization as well as self-stigma are needed. PMID:27783677

  7. Interoception and Positive Symptoms in Schizophrenia

    PubMed Central

    Ardizzi, Martina; Ambrosecchia, Marianna; Buratta, Livia; Ferri, Francesca; Peciccia, Maurizio; Donnari, Simone; Mazzeschi, Claudia; Gallese, Vittorio

    2016-01-01

    The present study focuses on the multifaceted concept of self-disturbance in schizophrenia, adding knowledge about a not yet investigated aspect, which is the interoceptive accuracy. Starting from the assumption that interoceptive accuracy requires an intact sense of self, which otherwise was proved to be altered in schizophrenia, the aim of the present study was to explore interoceptive accuracy in a group of schizophrenia patients, compared to healthy controls. Furthermore, the possible association between interoceptive accuracy and patients’ positive and negative symptomatology was assessed. To pursue these goals, a group of 23 schizophrenia patients and a group of 23 healthy controls performed a heartbeat perception task. Patients’ symptomatology was assessed by means of the Positive and Negative Syndrome Scale (PANSS). Results demonstrated significantly lower interoceptive accuracy in schizophrenia patients compared to healthy controls. This difference was not accounted for participants’ age, BMI, anxiety levels, and heart rate. Furthermore, patients’ illness severity, attention and pharmacological treatment did not influence their interoceptive accuracy levels. Interestingly, a strong positive relation between interoceptive accuracy and positive symptoms severity, especially Grandiosity, was found. The present results demonstrate for the first time that interoceptive accuracy is altered in schizophrenia. Furthermore, they prove a specific association between interoceptive accuracy and positive symptomatology, suggesting that the symptom Grandiosity might be protective against an altered basic sense of self in patients characterized by higher sensibility to their inner bodily sensations. PMID:27512369

  8. Genetic blockade of adenosine A2A receptors induces cognitive impairments and anatomical changes related to psychotic symptoms in mice.

    PubMed

    Moscoso-Castro, Maria; Gracia-Rubio, Irene; Ciruela, Francisco; Valverde, Olga

    2016-07-01

    Schizophrenia is a chronic severe mental disorder with a presumed neurodevelopmental origin, and no effective treatment. Schizophrenia is a multifactorial disease with genetic, environmental and neurochemical etiology. The main theories on the pathophysiology of this disorder include alterations in dopaminergic and glutamatergic neurotransmission in limbic and cortical areas of the brain. Early hypotheses also suggested that nucleoside adenosine is a putative affected neurotransmitter system, and clinical evidence suggests that adenosine adjuvants improve treatment outcomes, especially in poorly responsive patients. Hence, it is important to elucidate the role of the neuromodulator adenosine in the pathophysiology of schizophrenia. A2A adenosine receptor (A2AR) subtypes are expressed in brain areas controlling motivational responses and cognition, including striatum, and in lower levels in hippocampus and cerebral cortex. The aim of this study was to characterize A2AR knockout (KO) mice with complete and specific inactivation of A2AR, as an animal model for schizophrenia. We performed behavioral, anatomical and neurochemical studies to assess psychotic-like symptoms in adult male and female KO and wild-type (WT) littermates. Our results show impairments in inhibitory responses and sensory gating in A2AR KO animals. Hyperlocomotion induced by d-amphetamine and MK-801 was reduced in KO animals when compared to WT littermates. Moreover, A2AR KO animals show motor disturbances, social and cognitive alterations. Finally, behavioral impairments were associated with enlargement of brain lateral ventricles and decreased BDNF levels in the hippocampus. These data highlight the role of adenosine in the pathophysiology of schizophrenia and provide new possibilities for the therapeutic management of schizophrenia.

  9. [Psychotic and non-psychotic denial of pregnancy].

    PubMed

    Lieb, M; Hummel, I; Fürst, S; Baghai, T C; Mokhtari-Nejad, R; Palm, U

    2012-05-01

    We report about two patients with denial of pregnancy. While the first patient was free of psychopathological symptoms besides denial of pregnancy until rupture of the membranes, and was able to accomodate the new born, the second patient with psychotic denial of pregnancy could not accomodate the child because of the schizophrenia, so that an adoption was necessary. On the basis of the two cases aetiological, epidemiological, clinical und prognostic implications of psychotic and non-psychotic denial of pregnancy are discussed.

  10. [A long-acting second generation anti-psychotic--experience in Israel].

    PubMed

    Stein-Reisner, Orit; Preisman, Olga; Alfici, Susana; Melamed, Yuval; Bleich, Avi

    2004-06-01

    Schizophrenia is a chronic disease characterized by psychotic symptoms as well as negative symptoms such as affective flattening, social withdrawal and occupational dysfunction. Anti-psychotic medications reduce the risk of psychotic exacerbations and hospitalization. Poor compliance is common among patients with schizophrenia. Long-acting medications have such advantages as stabilizing drug levels and improving compliance. Second generation anti-psychotic medications were found to be more effective and tolerable compared to first generation drugs. These medications cause less extra-pyramidal symptoms, and compliance with them was shown to be better. Until recently there were only first generation long-acting anti-psychotics in use. Recently a new second generation long-acting anti-psychotic drug was introduced in Israel. We present our experience with a first schizophrenic patient treated with long-acting Risperidone (Risperdal Consta). The patient was treated in the past with several first generation anti-psychotics and suffered severe extra-pyramidal symptoms. His compliance with treatment was poor. Under treatment with oral Risperidone a considerable improvement was recorded, however compliance remained poor. Under treatment with long-acting Risperidone, Intramuscularly 25 Mg every two week, both positive and negative symptoms improved substantially, as well as compliance with treatment. The results of this case study encourage us to believe that many more patients will benefit from the advantages of both a second-generation anti-psychotic and a long-acting preparation.

  11. A patient with medication-resistant epilepsy featuring psychosensorial and psychotic symptoms presenting with significant functional improvement on psychotherapeutic treatment: a case report

    PubMed Central

    2013-01-01

    Background Partial complex epilepsy with psychosensorial and psychotic symptoms remains a relatively rare condition that can sometimes be mistaken for an axis I psychiatric disorder. There is no specific treatment for this particular type of epilepsy, anti-epileptic medication being the cornerstone of therapeutic intervention with the occasional addition of neuroleptics. Lack of response to anti-epileptic agents is often a sign of poor prognosis and requires risky and sometimes invasive interventions with high morbidity for patients. Case presentation We report the case of a 21-year-old right-handed Caucasian man of French-Canadian descent who was living with his mother immediately before being hospitalized in a psychiatric setting for the first time. He seemed obsessed with developing new concepts to reach a more ‘perfect’ existence. He also claimed feeling odd sensations in his mind and in his body that could be linked to some sort of ‘evolutionary’ process resulting from spiritual uplift. He reported non-specific visual hallucinations and what sounded like auditory hallucinations and telepathic powers. The first diagnosis was a possible schizophreniform disorder and our patient was hospitalized. Shortly afterwards, an electroencephalogram showed an important subcortical epileptic activity, compatible with partial complex epilepsy with psychosensorial and psychotic symptoms. Despite a negative response to medication, symptoms proper to this type of epilepsy were substantially alleviated using a psychotherapeutical treatment intended for patients with psychotic disorders, namely integrated psychological therapy (IPT). Significant functional improvement in our patient has been achieved since then. Conclusions This case report illustrates that despite a negative response to medication, symptoms proper to this type of epilepsy could be substantially alleviated using psychotherapeutical treatment modalities. To the best of our knowledge, this is the first time

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

    PubMed Central

    Jalbrzikowski, Maria; Villalon-Reina, Julio E.; Karlsgodt, Katherine H.; Senturk, Damla; Chow, Carolyn; Thompson, Paul M.; Bearden, Carrie E.

    2014-01-01

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

  13. [Influence of positive and negative symptoms on suicidal behaviour in schizophrenia. Review of current literature].

    PubMed

    Makara-Studzińska, Marta; Koślak, Anna

    2009-01-01

    Suicide is the main cause of death among persons with schizophrenia. The risk of suicide among this group is continually high and it is estimated at 10%. The aim of the study was a review of current literature concerning positive and negative symptoms on suicidal behaviour in schizophrenia. Some studies showed, that the active phase of the disease and worsening of the sickness increase the risk of suicide among those diagnosed with schizophrenia. It is contradictory to the works, which prove that suicide of a schizophrenic person is not a result of experiencing psychotic symptoms. According to literature on the subject, the influence of positive symptoms on the incidence of suicide attempts made in schizophrenia is still inconclusive, also researchers' opinions about the negative symptoms are divided. None of the hitherto studies present statistically significant proof that commanding auditory hallucinations increase the risk of suicide among schizophrenics. The results of the investigations quoted below did not allow to unambiguously recognize the influence of positive and negative symptoms on suicidal behaviour, as well as to qualify them to a group of risk factors or a group of variables, playing a protective role.

  14. Family problem solving interactions and 6-month symptomatic and functional outcomes in youth at ultra-high risk for psychosis and with recent onset psychotic symptoms: A longitudinal study

    PubMed Central

    O'Brien, Mary P.; Zinberg, Jamie L.; Ho, Lorena; Rudd, Alexandra; Kopelowicz, Alex; Daley, Melita; Bearden, Carrie E.; Cannon, Tyrone D.

    2009-01-01

    This study prospectively examined the relationship between social problem solving behavior exhibited by youths at ultra-high risk for psychosis (UHR) and with recent onset psychotic symptoms and their parents during problem solving discussions, and youths' symptoms and social functioning six months later. Twenty-seven adolescents were administered the Structured Interview for Prodromal Syndromes and the Strauss-Carpenter Social Contact Scale at baseline and follow-up assessment. Primary caregivers participated with youth in a ten minute discussion that was videotaped, transcribed, and coded for how skillful participants were in defining problems, generating solutions, and reaching resolution, as well as how constructive and/or conflictual they were during the interaction. Controlling for social functioning at baseline, adolescents' skillful problem solving and constructive communication, and parents' constructive communication, were associated with youths' enhanced social functioning six months later. Controlling for symptom severity at baseline, we found that there was a positive association between adolescents' conflictual communications at baseline and an increase in positive symptoms six months later. Taken together, findings from this study provide support for further research into the possibility that specificfamily interventions, such as problem solving and communication skills training, may improve the functional prognosis of at-risk youth, especially in terms of their social functioning. PMID:18996681

  15. Self-Reported ADHD Symptoms among College Students: Item Positioning Affects Symptom Endorsement Rates

    ERIC Educational Resources Information Center

    Mitchell, John T.; Knouse, Laura E.; Nelson-Gray, Rosemery O.; Kwapil, Thomas R.

    2009-01-01

    Objective: The effect of manipulating item positioning on self-reported ADHD symptoms was examined. We assessed whether listing DSM-IV ADHD symptoms serially or interspersed affected (a) the correlation between ADHD symptoms and (b) the rate of symptom endorsement. Method: In Study 1, an undergraduate sample (n = 102) completed a measure that…

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

    PubMed

    Yuan, Neal; Glezer, Anna

    2013-01-01

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

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

    PubMed

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

    2013-01-01

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

  18. Acute psychotic disorder and hypoglycemia.

    PubMed

    Singh, S K; Agrawal, J K; Srivastava, A S; Bhardwaj, V K; Bose, B S

    1994-04-01

    A variable array of neuroglycopenic symptoms are frequently encountered in the hypoglycemic stage, but acute psychotic disorders are quite rare. A fifty five year old female presented with an acute psychosis following oral sulfonylurea induced hypoglycemia without preceding features of adrenomedullary stimulation. This case report suggests that an acute and transient psychotic disorder may be an important neuroglycopenic feature and its early recognition protects the patient from severe hypoglycemic brain damage in a state of hypoglycemia unawareness.

  19. Relation of Positive and Negative Parenting to Children's Depressive Symptoms

    ERIC Educational Resources Information Center

    Dallaire, Danielle H.; Pineda, Ashley Q.; Cole, David A.; Ciesla, Jeffrey A.; Jacquez, Farrah; LaGrange, Beth; Bruce, Alanna E.

    2006-01-01

    This study examined the combined and cumulative effects of supportive-positive and harsh-negative parenting behaviors on children's depressive symptoms. A diverse sample of 515 male and female elementary and middle school students (ages 7 to 11) and their parents provided reports of the children's depressive symptoms. Parents provided self-reports…

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  1. Khat use as risk factor for psychotic disorders: A cross-sectional and case-control study in Somalia

    PubMed Central

    Odenwald, Michael; Neuner, Frank; Schauer, Maggie; Elbert, Thomas; Catani, Claudia; Lingenfelder, Birke; Hinkel, Harald; Häfner, Heinz; Rockstroh, Brigitte

    2005-01-01

    Background Little is known about the prevalence of khat-induced psychotic disorders in East African countries, where the chewing of khat leaves is common. Its main psycho-active component cathinone produces effects similar to those of amphetamine. We aimed to explore the prevalence of psychotic disorders among the general population and the association between khat use and psychotic symptoms. Methods In an epidemiological household assessment in the city of Hargeisa, North-West Somalia, trained local interviewers screened 4,854 randomly selected persons from among the general population for disability due to severe mental problems. The identified cases were interviewed based on a structured interview and compared to healthy matched controls. Psychotic symptoms were assessed using the items of the WHO Composite International Diagnostic Interview and quantified with the Positive and Negative Symptoms Scale. Statistical testing included Student's t-test and ANOVA. Results Local interviewers found that rates of severe disability due to mental disorders were 8.4% among males (above the age of 12) and differed according to war experiences (no war experience: 3.2%; civilian war survivors: 8.0%; ex-combatants: 15.9%). The clinical interview verified that in 83% of positive screening cases psychotic symptoms were the most prominent manifestations of psychiatric illness. On average, cases with psychotic symptoms had started to use khat earlier in life than matched controls and had been using khat 8.6 years before positive symptoms emerged. In most cases with psychotic symptoms, a pattern of binge use (> two 'bundles' per day) preceded the onset of psychotic symptoms, in contrast to controls of the same age. We found significant correlations between variables of khat consumption and clinical scales (0.35 to 0.50; p < 0.05), and between the age of onset of khat chewing and symptom onset (0.70; p <0.001). Conclusion Evidence indicates a relationship between the consumption of

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

    PubMed

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

    2016-07-01

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

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

    PubMed Central

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

    2016-01-01

    Evidence suggests a causal role for trauma in psychosis, particularly for childhood victimization. However, the establishment of underlying trauma-related mechanisms would strengthen the causal argument. In a sample of people with relapsing psychosis (n = 228), we tested hypothesized mechanisms specifically related to impaired affect regulation, intrusive trauma memory, beliefs, and depression. The majority of participants (74.1%) reported victimization trauma, and a fifth (21.5%) met symptomatic criteria for Posttraumatic Stress Disorder. We found a specific link between childhood sexual abuse and auditory hallucinations (adjusted OR = 2.21, SE = 0.74, P = .018). This relationship was mediated by posttraumatic avoidance and numbing (OR = 1.48, SE = 0.19, P = .038) and hyperarousal (OR = 1.44, SE = 0.18, P = .045), but not intrusive trauma memory, negative beliefs or depression. In contrast, childhood emotional abuse was specifically associated with delusions, both persecutory (adjusted OR = 2.21, SE = 0.68, P = .009) and referential (adjusted OR = 2.43, SE = 0.74, P = .004). The link with persecutory delusions was mediated by negative-other beliefs (OR = 1.36, SE = 0.14, P = .024), but not posttraumatic stress symptoms, negative-self beliefs, or depression. There was no evidence of mediation for referential delusions. No relationships were identified between childhood physical abuse and psychosis. The findings underline the role of cognitive-affective processes in the relationship between trauma and symptoms, and the importance of assessing and treating victimization and its psychological consequences in people with psychosis. PMID:27460616

  4. Psychotic Disorders

    MedlinePlus

    ... Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that ... that the TV is sending you secret messages. Hallucinations are false perceptions, such as hearing, seeing, or ...

  5. [Psychotic symptoms in Parkinson's disease].

    PubMed

    Fénelon, Gilles

    2006-12-01

    About one third of patients with Parkinson's disease (PD) experience hallucinations, mostly of a complex visual type, less often auditory or tactile. Minor hallucinatory phenomena, including sense of presence, passage hallucinations and visual illusions are frequent. Hallucinations primarily occur in a context of clear sensorium in patients with longstanding PD. They are more frequent in the evening or during the night. Insight in the hallucinatory nature of the phenomenon may be retained, partial, fluctuating, or abolished. An altered insight is common when cognitive impairment is present, and may be associated with delusions and (or) delusional misidentifications. Pharmacological factors such as dopaminergic treatment clearly trigger or increase the occurence of hallucinations in PD. However, in the recent years, emphasis has been made on disease-related factors including cognitive impairment, diurnal somnolence, visual disorders (either contrast and color discrimination impairment due to PD, or coincident ocular disorders), long duration of PD, late onset, severe axial impairment and autonomic dysfunction. The pathophysiology of hallucinations of PD is poorly understood but is likely to be multifactorial. The first steps of the treatment consist in giving information and reassurance to the patient and his/her caregiver, re-evaluating the antiparkinsonian treatment and associated medications, and evaluating the patient for mood disorder, visual impairment, and cognitive impairment. Cholinesterase inhibitors, when prescribed for associated cognitive impairment, may be beneficial on hallucinations. In the more severe forms, clozapine has been proved to be safe and effective.

  6. Transient Cocaine-Associated Behavioral Symptoms Rated with a New Instrument, the Scale for Assessment of Positive Symptoms for Cocaine-Induced Psychosis (SAPS-CIP)

    PubMed Central

    Tang, Yi-lang; Kranzler, Henry R.; Gelernter, Joel; Farrer, Lindsay A.; Pearson, Deborah; Cubells, Joseph F.

    2010-01-01

    Chronic use of cocaine is associated with a variety of behavioral symptoms. The current report describes the assessment of cocaine-related behavioral symptoms (CRB) using the Scale for Assessment of Positive Symptoms of Cocaine-Induced Psychosis (SAPS-CIP). The CRB section, one of the three domains in the SAPS-CIP, consists of sub-domains, including Aggressive/Agitated Behavior, Repetitive/Stereotyped Behavior, Unusual Social or Sexual Behavior. Severity scores are assigned according to operational criteria, and range from 0 (not present) to 5 (severe). We interviewed 261 unrelated cocaine-abusing adults using the SAPS-CIP, and 243 of them met criteria for inclusion in the study. The proportion of subjects endorsing different classes of CRBs varied across categories, with 109 of 243 (44.9%) subjects reporting aggressive and agitated behaviors, 180 subjects (74.1%) repetitive/stereotyped behaviors, and 192 (79.0%) unusual social/sexual behaviors. A substantial minority of the subjects (10.3-25.1%) reported that they experienced marked-to-severe behavioral symptoms associated with cocaine use. The proportions of subjects endorsing CRB did not differ by ethnic/racial group or by sex. Correlations among the different domains of CRB were strong, but behaviors rated in the CRB section were less well correlated with psychotic symptoms, which were rated in the hallucination and delusion sections of the instrument. A variety of CRBs are common in cocaine-dependent subjects, and many of these are highly intercorrelated. CRBs also correlate with hallucinations and delusions induced by cocaine, but to a lesser degree. Our findings suggest that there may be some common vulnerability factors that contribute to both cocaine-induced psychosis and CRBs. PMID:19874151

  7. Positive symptoms and water diffusivity of the prefrontal and temporal cortices in schizophrenia patients: a pilot study.

    PubMed

    Park, Jin Young; Park, Hae-Jeong; Kim, Dae-Jin; Kim, Jae-Jin

    2014-10-30

    The development of diffusion tensor imaging (DTI) has provided information about microstructural changes in the brain. Most DTI studies have focused on white matter (WM). Few DTI studies have examined the gray matter (GM) in schizophrenia and, to date, there has been no attempt to identify the relationship between water diffusivity and symptom severity in schizophrenia. The present study aimed to examine microstructural deficits in the dorsal prefrontal cortex (DPFC) and temporal cortex in schizophrenia patients using fractional anisotropy (FA) and water diffusivity. This study also explored the relationship between DTI measurements and psychotic symptoms. Magnetic resonance imaging (MRI) and DTI were used to study 19 schizophrenia patients and 19 healthy controls. Fractional anisotropy, axial diffusivity, radial diffusivity, and regional volumes were measured in the prefrontal cortex and temporal cortex. On DTI measurements, patients showed increased axial and radial diffusivities in the prefrontal cortex and temporal cortex, but they did not demonstrate any difference in fractional anisotropy and regional volumes. Additionally, axial and radial diffusivities were significantly correlated with positive symptom scores in all regions of interest. These results indicate that water diffusivity measurements, including axial and radial diffusivities, can be used to identify microstructural changes in the gray matter in schizophrenia that may be related to symptom severity.

  8. Sleep Symptoms, Race/Ethnicity, and Socioeconomic Position

    PubMed Central

    Grandner, Michael A.; Petrov, Megan E. Ruiter; Rattanaumpawan, Pinyo; Jackson, Nicholas; Platt, Alec; Patel, Nirav P.

    2013-01-01

    Study Objectives: Growing evidence indicates sleep is a major public health issue. Race/ethnicity and socioeconomics may contribute to sleep problems. This study assessed whether sleep symptoms were more prevalent among minorities and/or the socioeconomically disadvantaged. Design: Cross-sectional. Setting: Epidemiologic survey. Patients or Participants: 2007-2008 National Health and Nutrition Examination Survey (N = 4,081). Interventions: None. Measurements and Results: Sociodemographics included age, sex, race/ethnicity, marital status, and immigration. Socioeconomics included poverty, education, private insurance, and food insecurity. Sleep symptoms assessed were sleep latency > 30 min, difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, non-restorative sleep, daytime sleepiness, snorting/gasping, and snoring. Decreased reported problems for most symptoms were found among minorities, immigrants, and lower education levels. In general, in fully adjusted models, long sleep latency was associated with female gender, being black/African American, lower education attainment, no private insurance, and food insecurity. Difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, and non-restorative sleep were also associated with female gender and food insecurity. Daytime sleepiness was seen in female and divorced respondents. Snorting/gasping was more prevalent among male, other-Hispanic/Latino, and 9th- to 11th-grade-level respondents. Snoring was prevalent among male, other-Hispanic/Latino, less-educated, and food-insecure respondents. Conclusions: Sleep symptoms were associated with multiple sociodemographic and economic factors, though these relationships differed by predictor and sleep outcome. Also, reports depended on question wording. Citation: Grandner MA; Petrov MER; Rattanaumpawan P; Jackson N; Platt A; Patel NP. Sleep symptoms, race/ethnicity, and socioeconomic position. J Clin Sleep Med 2013

  9. Psychotic-Like Experiences and Their Cognitive Appraisal Under Short-Term Sensory Deprivation

    PubMed Central

    Daniel, Christina; Lovatt, Anna; Mason, Oliver John

    2014-01-01

    Aims: This study aimed to establish and compare the effects of brief sensory deprivation on individuals differing in trait hallucination proneness. Method: Eighteen participants selected for high hallucination proneness were compared against 18 participants rating low on this trait. The presence of psychotic-like experiences (PLEs), and participants’ cognitive appraisals of these, was evaluated in three different settings: at baseline, in a “secluded office” environment, and in light-and-sound sensory deprivation. Results: Psychotic-like experiences were experienced significantly more often in sensory deprivation for both groups. In particular, both experienced slight increases in perceptual distortions and anhedonia in seclusion, and these increased further during sensory deprivation. Highly hallucination prone individuals showed a significantly greater increase in perceptual distortions in sensory deprivation than did non-prone individuals suggesting a state-trait interaction. Their appraisals of these anomalous experiences were compared to both clinical and non-clinical individuals experiencing psychotic symptoms in everyday life. Conclusion: Short-term sensory deprivation is a potentially useful paradigm to model psychotic experiences, as it is a non-pharmacological tool for temporarily inducing psychotic-like states and is entirely safe at short duration. Experiences occur more frequently, though not exclusively, in those at putative risk of a psychotic disorder. The appraisals of anomalous experiences arising are largely consistent with previous observations of non-clinical individuals though importantly lacked the general positivity of the latter. PMID:25177302

  10. Early psychotic experiences: Interventions, problems and perspectives.

    PubMed

    Dimitrakopoulos, S; Kollias, C; Stefanis, N C; Kontaxakis, V

    2015-01-01

    Psychotic or psychotic-like experiences and symptoms may precede and be indicative of later psychosis emergence. DSM-5 has introduced Attenuated Psychosis Syndrome (APS) as a condition for further study, arguing for its clinical validity and the need for identifying sub- threshold psychotic states. Early psychosis intervention has an already established role in reducing the Duration of Untreated Psychosis (DUP), delaying psychosis onset and relieving Ultra High Risk (UHR) individuals from their presenting symptoms. Pharmacological and mainly psycho-therapeutical approaches are suggested for this purpose. Cognitive Behavior Therapy (CBT) seems to have clear evidence of favorable outcome concerning transition to psychosis rates, omega-3 fatty acids lower but promising evidence, while low-dose antipsychotic medication or antidepressant treatment may seem beneficial, but it remains unclear if the reported favorable effects persist in the long term and how long intervention in UHR subjects should be given for. Case management and close monitoring based on principles of social psychiatry are considered key elements for the management of UHR individuals. However, the blazing case about early psychosis concerns the accurate specification of the prodromal stage of psychosis, which may set the basis for meaningful and effective early intervention. Although psychometric tools have been developed and provide a common criteria-based recognition method, debate is alive and well regarding "false positive" cases, since most UHR subjects will not finally develop psychosis. Moreover, transition rates to psychosis have been declining over the years, leading to fierce criticism over the validity of the UHR/ APS state and legitimacy of its treatment. On this framework, ethical issues of stigmatizing through unnecessary diagnosing and antipsychotics' prescribing are matters of serious questioning. Clinical heterogeneity and high comorbidity are further implications of the UHR state

  11. Subjective Symptoms of Schizophrenia in Research and the Clinic: The Basic Symptom Concept

    PubMed Central

    Schultze-Lutter, Frauke

    2009-01-01

    Recent focus on early detection and intervention in psychosis has renewed interest in subtle psychopathology beyond positive and negative symptoms. These are self-experienced subclinical disturbances termed basic symptoms (BS). The phenomenologies of BS and their development in the course of psychotic disorders will be described. PMID:19074497

  12. French views on positive and negative symptoms: a conceptual history.

    PubMed

    Berrios, G E

    1991-01-01

    The history of the positive/negative terminology, as applied to psychiatric symptoms, can be divided into an early period of original meanings, a second one of French elaboration, and the current revival. This report addresses issues concerning the meaning, referent, and nature of the link between the positive and the negative as dealt with in French publications by Ribot, Janet, de Clérambault, Nayrac, Von Monakow and Mourgue, and Ey. It is shown how these authors modified the old Reynoldian terminology to meet ongoing epistemological needs, and in doing so exhausted the conceptual permutations through which the positive/negative dichotomy can be put. To render their views intelligible, the historical origin of concepts such as evolutionism, Jacksonian, inhibition, psychological automatism, and synchrony and diachrony is briefly mentioned. It is suggested that the French writers helped to bridge the gap between Reynolds and the present, but that the conceptual subtlety that characterized their work has not been matched by the leaders of the current revival.

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

    PubMed

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

    2014-01-01

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

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

    PubMed

    Peralta, V; Cuesta, M J

    1998-01-01

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

  15. Positive symptoms in first-episode psychosis patients experiencing low maternal care and stressful life events: a pilot study to explore the role of the COMT gene.

    PubMed

    Ira, Elisa; De Santi, Katia; Lasalvia, Antonio; Bonetto, Chiara; Zanatta, Gioia; Cristofalo, Doriana; Bertani, Mariaelena; Bissoli, Sarah Saviana; Riolo, Rossana; Gardellin, Francesco; Morandin, Idana; Ramon, Luana; Tansella, Michele; Ruggeri, Mirella; Tosato, Sarah

    2014-09-01

    COMT Val(158)Met moderates the effect of stress on psychotic symptoms. Exposure to stress is also associated with mesolimbic dopamine release in individuals experiencing low maternal care. We therefore test the hypothesis that recent stressful life events are associated with more severe positive symptoms (associated with mesolimbic dopamine release) in first-episode psychosis (FEP) patients who experienced low maternal care during childhood. We hypothesized that COMT Val(158)Met moderates this association. A total of 149 FEP patients recruited within the Psychosis Incident Cohort Outcome Study (PICOS) participated in the present study. Maternal care was assessed by the Parental Bonding Instrument (PBI), stressful life events were collected by the List of Events Scale and positive symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). We found that low maternal care and recent stressful life events were associated with higher level of positive symptoms at the onset (analysis of variance [ANOVA], p = 0.012), and that patients who were also homozygotes for the COMT Val(158) allele had the highest level of positive symptoms (ANOVA, p = 0.024). Low maternal care and severe stressful life events may contribute to a symptomatology characterized by more severe positive symptoms at the onset, possibly due to an increased mesolimbic dopamine release. Homozygosity for the COMT Val(158) allele seems to confer a biological predisposition to the stress-related hyperactivity of the mesolimbic dopaminergic system. The data imply that the mesolimbic dopaminergic system is involved in the mediation/modulation of the effect of stressful events on the vulnerability for psychosis.

  16. Semi-metric analysis of the functional brain network: Relationship with familial risk for psychotic disorder

    PubMed Central

    Peeters, Sanne; Simas, Tiago; Suckling, John; Gronenschild, Ed; Patel, Ameera; Habets, Petra; van Os, Jim; Marcelis, Machteld

    2015-01-01

    Background Dysconnectivity in schizophrenia can be understood in terms of dysfunctional integration of a distributed network of brain regions. Here we propose a new methodology to analyze complex networks based on semi-metric behavior, whereby higher levels of semi-metricity may represent a higher level of redundancy and dispersed communication. It was hypothesized that individuals with (increased risk for) psychotic disorder would have more semi-metric paths compared to controls and that this would be associated with symptoms. Methods Resting-state functional MRI scans were obtained from 73 patients with psychotic disorder, 83 unaffected siblings and 72 controls. Semi-metric percentages (SMP) at the whole brain, hemispheric and lobar level were the dependent variables in a multilevel random regression analysis to investigate group differences. SMP was further examined in relation to symptomatology (i.e., psychotic/cognitive symptoms). Results At the whole brain and hemispheric level, patients had a significantly higher SMP compared to siblings and controls, with no difference between the latter. In the combined sibling and control group, individuals with high schizotypy had intermediate SMP values in the left hemisphere with respect to patients and individuals with low schizotypy. Exploratory analyses in patients revealed higher SMP in 12 out of 42 lobar divisions compared to controls, of which some were associated with worse PANSS symptomatology (i.e., positive symptoms, excitement and emotional distress) and worse cognitive performance on attention and emotion processing tasks. In the combined group of patients and controls, working memory, attention and social cognition were associated with higher SMP. Discussion The results are suggestive of more dispersed network communication in patients with psychotic disorder, with some evidence for trait-based network alterations in high-schizotypy individuals. Dispersed communication may contribute to the clinical

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

    PubMed

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

    2016-10-01

    Antiepileptic drug treatment can induce psychosis in some patients. However, there are no agreed definitions or diagnostic criteria for antiepileptic drug-induced psychotic disorder in the classification systems of either epileptology or psychiatry. In this study we investigated the clinical spectrum of antiepileptic drug-induced psychotic disorder in patients with epilepsy. The medical records of all patients with epilepsy who were diagnosed by a neuropsychiatrist as having a psychotic disorder at the Royal Melbourne Hospital from January 1993 to June 2015 were reviewed. Data were extracted regarding epilepsy and its treatment, psychotic symptoms profile and outcome. The diagnosis of epilepsy was established in accordance to the classification system of the International League Against Epilepsy while that of psychotic disorder was made according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition and the proposal on neuropsychiatric disorders in epilepsy. Patients with antiepileptic drug-induced psychotic disorder were compared to those with psychotic disorders unrelated to antiepileptic drugs assessed over the same period (non-antiepileptic drug induced psychotic disorder group). Univariate comparisons were performed and variables with a value of P < 0.1 were selected for the multivariate logistic regression analysis. The records of 2630 in-patients and outpatients with epilepsy were screened, from which 98 (3.7%) with psychotic disorders were identified. Among these, 14 (14.3%) were diagnosed to have antiepileptic drug-induced psychotic disorder. Excluding one patient who developed psychosis after valproate withdrawal, 76.9% in the antiepileptic drug induced psychotic disorder group were female and the percentage of temporal lobe involvement was higher in the antiepileptic drug induced psychotic disorder group (69.2% versus 38.1%, P < 0.05). Current use of levetiracetam was higher in antiepileptic drug-induced psychotic disorder group (84

  18. A twin study of genetic and environmental determinants of abnormal persistence of psychotic experiences in young adulthood.

    PubMed

    Wigman, Johanna T W; van Winkel, Ruud; Jacobs, Nele; Wichers, Marieke; Derom, Catherine; Thiery, Evert; Vollebergh, Wilma A M; van Os, Jim

    2011-07-01

    Evidence suggests that subclinical psychotic experiences are more likely to cause transition to psychotic disorder if their expression becomes persistent. The study of longitudinal patterns of subclinical psychotic experiences may help to distinguish subgroups with transient and persistent psychotic symptoms, who may differ in risk of later psychosis. The current study investigated patterns of developmental course of subclinical psychotic experiences in a general population sample of 566 female twins, aged 18-45 years. The positive symptoms subscale of the Community Assessment of Psychic Experiences (CAPE), completed three times in 2 years, was analyzed with growth modeling. Using Latent Class Analysis, two developmental courses were distinguished: a Persistent and a Low (expression of subclinical psychotic experiences) group. The Persistent group reported significantly higher levels of depressive and negative symptoms and worse functioning in daily life. Childhood trauma (OR: 3.26, P < 0.0001) and stressful life events over the study period (OR: 3.15, P = 0.031) predicted membership of the Persistent group. Of the monozygotic (MZ) twins with their co-twin in the Persistent group, 49% also were in the Persistent group themselves (OR: 9.32, P < 0.0001), compared to only 14% in the dizygotic (DZ) co-twins (OR: 1.56, P = 0.42) (χ(2)(2) = 22.97; P < 0.001). The findings suggest that persistence of subclinical psychosis is influenced by both genetic and environmental factors, providing the possibility to study the (possibly modifiable) etiology underlying the longitudinal process of persistence of the early expression of psychosis liability.

  19. Major depression with psychotic features

    MedlinePlus

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

  20. Psychotic mania in glucose-6-phosphate-dehydrogenase-deficient subjects

    PubMed Central

    Bocchetta, Alberto

    2003-01-01

    Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency has been associated with acute psychosis, catatonic schizophrenia, and bipolar disorders by previous inconclusive reports. A particularly disproportionate rate of enzyme deficiency was found in manic schizoaffective patients from 662 lithium patients surveyed in Sardinia. The purpose of this study was to describe clinical characteristics which may be potentially associated with G6PD deficiency. Methods Characteristics of episodes, course of illness, family pattern of illness, laboratory tests, and treatment response of 29 G6PD-deficient subjects with a Research Diagnostic Criteria diagnosis of manic schizoaffective disorder were abstracted from available records. Results The most peculiar pattern was that of acute recurrent psychotic manic episodes, mostly characterized by loosening of associations, agitation, catatonic symptoms, and/or transient confusion, concurrent hyperbilirubinemia, positive psychiatric family history, and partial response to long-term lithium treatment. Conclusions A relationship between psychiatric disorder and G6PD deficiency is to be searched in the bipolar spectrum, particularly among patients with a history of acute episodes with psychotic and/or catatonic symptoms or with transient confusion. PMID:12844366

  1. Primary and substance-induced psychotic disorders in methamphetamine users.

    PubMed

    Hides, Leanne; Dawe, Sharon; McKetin, Rebecca; Kavanagh, David J; Young, Ross McD; Teesson, Maree; Saunders, John B

    2015-03-30

    This study investigates the rates of primary psychotic disorders (PPD) and substance-induced psychotic disorders (SIPDs) in methamphetamine (MA) users accessing needle and syringe programs (NSPs). The aim was to determine if there are systematic differences in the characteristics of MA users with PPDs and SIPDs compared to those with no psychotic disorder. Participants were 198 MA users reporting use in the previous month. Diagnosis was determined using the Psychiatric Research Interview for DSM-IV Substance and Mental Disorders (PRISM-IV). Current psychiatric symptoms and substance use were also measured. Just over half (n=101) of participants met DSM-IV criteria for a lifetime psychotic disorder, including 81 (80%) with a SIPD and 20 (20%) with a PPD. Those with a younger age of onset of weekly MA use were at increased risk of a lifetime SIPD. A current psychotic disorder was found in 62 (39%), comprising 49 SIPDs (79%) and 13 PPDs (21%). MA users with a current PPD were more likely to have received psychiatric treatment in the past month than those with a current SIPD, despite a similar level of psychotic symptom severity. A high proportion of MA users accessing NSPs have psychotic disorders, the majority of which are substance-induced.

  2. Dangerousness and command hallucinations: an investigation of psychotic inpatients.

    PubMed

    Kasper, M E; Rogers, R; Adams, P A

    1996-01-01

    Forensic consultations with psychotic inpatients frequently include issues of risk management, such as dangerousness and civil commitment. An important dimension of these consultations is the role of command hallucinations in producing an increased risk of aggressive behavior. In the present study, psychotic patients with command hallucinations (N = 27) were compared with patients with other hallucinations (N = 27) and with other psychotic patients (N = 30). The groups did not differ on aggressive behavior or most nonhallucinatory symptoms. However, most patients (84.0%) with command hallucinations had recently obeyed them. Among those with command hallucinations, almost one-half had heard and attempted to obey messages of self-harm during the last month.

  3. Metacognition in first-episode psychosis and its association with positive and negative symptom profiles.

    PubMed

    Trauelsen, Anne Marie; Gumley, Andrew; Jansen, Jens Einar; Pedersen, Marlene Buch; Nielsen, Hanne-Grethe Lyse; Trier, Christopher Høier; Haahr, Ulrik H; Simonsen, Erik

    2016-04-30

    There is growing evidence that metacognitive abilities which include the ability to synthesize knowledge regarding mental states in self and others and use this ability to solve problems are impaired in non-affective psychosis and associated with positive and negative symptom severity. We sought to (a) investigate the severity of metacognitive impairments in first-episode psychosis (FEP) compared to non-clinical controls and (b) explore associations with positive and negative symptom profiles. Ninety-seven people with FEP were compared to 101 control persons. Metacognition was assessed with interviews and the Metacognitive assessment scale-abbreviated. Four groups based on positive and negative symptoms were identified by cluster analysis and compared on metacognition, childhood adversities, duration of untreated psychosis and premorbid social and academic adjustment. Those with high levels of negative symptoms had poorer metacognitive abilities. Those with high positive and low negative symptoms did not have poorer metacognitive abilities than those with low positive and negative symptoms. None of the other predictors differed between the groups. The FEP group had poorer metacognitive abilities than the control group. Inclusion of metacognition in psychosis models may improve our understanding of negative symptoms, while previous findings of a relation with positive symptoms may have been confounded. Implications for current interventions are discussed.

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

    PubMed

    Schultze-Lutter, Frauke; Schimmelmann, Benno G

    2014-05-01

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

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

    PubMed

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

    1999-11-01

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

  6. Metacognitive functioning predicts positive and negative symptoms over 12 months in first episode psychosis.

    PubMed

    McLeod, Hamish J; Gumley, Andrew I; Macbeth, Angus; Schwannauer, Matthias; Lysaker, Paul H

    2014-07-01

    The negative symptoms of schizophrenia are a major source of impairment and distress but both pharmacological and psychological treatment options provide only modest benefit. Developing more effective psychological treatments for negative symptoms will require a more sophisticated understanding of the psychological processes that are implicated in their development and maintenance. We extended previous work by demonstrating that metacognitive functioning is related to negative symptom expression across the first 12 months of first episode psychosis (FEP). Previous studies in this area have either been cross-sectional or have used much older participants with long-standing symptoms. In this study, forty-five FEP participants were assessed three times over 12 months and provided data on PANSS rated symptoms, premorbid adjustment, metacognitive functioning, and DUP. Step-wise linear regression showed that adding metacognition scores to known predictors of negative symptoms (baseline symptom severity, gender, DUP, and premorbid academic and social adjustment) accounted for 62% of the variance in PANSS negative symptom scores at six months and 38% at 12 months. The same predictors also explained 47% of the variance in positive symptoms at both six and 12 months. However, exploration of the simple correlations between PANSS symptom scores and metacognition suggests a stronger univariate relationship between metacognition and negative symptoms. Overall, the results indicate that problems with mental state processing may be important determinants of negative symptom expression from the very early stages of psychosis. These results provide further evidence that metacognitive functioning is a potentially relevant target for psychological interventions.

  7. Positive association of female overactive bladder symptoms and estrogen deprivation

    PubMed Central

    Cheng, Chen-Li; Li, Jian-Ri; Lin, Ching-Heng; de Groat, William C.

    2016-01-01

    Abstract Objective: Estrogen is considered to be a unique hormone in females that has an impact on voiding function. Animal models and clinical epidemiologic studies showed high correlation between estrogen deficiency and female overactive bladder (OAB) symptoms. We designed a population-based cohort study from a national health database to assess the association of estrogen deprivation therapy and female OAB. Materials and methods: This study examined the records of 16,128 patients ranging in age from 18 to 40 that were included in the Taiwan National Health Insurance Research Database (NHIRD) in the years between 2001 and 2010. Of these, 1008 had breast cancer with hormone therapy only and the other 15,120 controls did not have breast cancer or hormone therapy. All patients with neurologic diseases and those with pre-existing OAB identified by information in the NHIRD database were excluded. OAB was defined by medications prescribed for at least 1 month. Risk of new onset OAB in the breast cancer and nonbreast cancer groups was estimated. Fourteen patients (1.4%) experienced OAB in the breast cancer group. Overall, breast cancer with estrogen deprivation therapy increased the risk of OAB by 14.37-fold (adjusted hazard ratio, 95% confidence interval 7.06–29.27). Subgroup analysis showed that in the older age breast cancer group (36–40), a lower Charlson comorbidity index (CCI) score and antidepressant medication use for at least 30 days had an impact on the increase of OAB risk. After adjustment of variables, the higher CCI and the use of antipsychotic drugs increased risk of OAB 3.45-fold and 7.45-fold, respectively. The Kaplan–Meier analysis of OAB-free survival in the breast cancer group showed a significant time-dependent increase in incidence of OAB. Conclusion: Estrogen deprivation in young patients with breast cancer increased the risk of OAB. The OAB development rate was steady and fast in the beginning 3 years after estrogen deprivation. This result

  8. [The variety of symptoms in patients with benign paroxysmal positional vertigo--revision].

    PubMed

    Pollak, Lea

    2013-02-01

    Despite its frequent occurrence and effective treatment options, benign paroxysmal positional vertigo (BPPV) still remains underestimated in the community. Acquaintance of the physician with the various presentation symptoms assists in recognition of the entity. We report the complaints and subjective outcome in our cohort of BPPV patients and discuss the possible origin of the atypical, but common, symptoms.

  9. The SWAN Captures Variance at the Negative and Positive Ends of the ADHD Symptom Dimension

    ERIC Educational Resources Information Center

    Arnett, Anne B.; Pennington, Bruce F.; Friend, Angela; Willcutt, Erik G.; Byrne, Brian; Samuelsson, Stefan; Olson, Richard K.

    2013-01-01

    Objective: The Strengths and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN) Rating Scale differs from previous parent reports of ADHD in that it was designed to also measure variability at the positive end of the symptom spectrum. Method: The psychometric properties of the SWAN were tested and compared with an established measure of ADHD,…

  10. Impact of childhood adversities on the short-term course of illness in psychotic spectrum disorders.

    PubMed

    Schalinski, Inga; Fischer, Yolanda; Rockstroh, Brigitte

    2015-08-30

    Accumulating evidence indicates an impact of childhood adversities on the severity and course of mental disorders, whereas this impact on psychotic disorders remains to be specified. Effects of childhood adversities on comorbidity, on symptom severity of the Positive and Negative Syndrome Scale and global functioning across four months (upon admission, 1 and 4 months after initial assessment), as well as the course of illness (measured by the remission rate, number of re-hospitalizations and dropout rate) were evaluated in 62 inpatients with psychotic spectrum disorders. Adverse experiences (of at least 1 type) were reported by 73% of patients. Patients with higher overall level of childhood adversities (n=33) exhibited more co-morbid disorders, especially alcohol/substance abuse and dependency, and higher dropout rates than patients with a lower levels of adverse experiences (n=29), together with higher levels of positive symptoms and symptoms of excitement and disorganization. Emotional and physical neglect were particularly related to symptom severity. Results suggest that psychological stress in childhood affects the symptom severity and, additionally, a more unfavorable course of disorder in patients diagnosed with psychoses. This impact calls for its consideration in diagnostic assessment and psychiatric care.

  11. On the transmethylation hypothesis: stress, N,N-dimethyltryptamine, and positive symptoms of psychosis.

    PubMed

    Grammenos, Dionysios; Barker, Steven A

    2015-06-01

    Past research suggests a relationship between stress and positive symptoms of psychosis. However, the biological substrate of this relationship remains unknown. According to the transmethylation hypothesis, schizophrenia could result from a biochemical disruption in the stress mechanism. This biochemical disruption would lead to the production of a substance that would account for the symptoms of psychosis. Moreover, some studies have tested endogenous N,N-dimethyltryptamine (DMT) in the context of the transmethylation hypothesis. Stress has been found to elevate DMT levels in rodents. Also, elevated DMT levels have been associated with positive features of psychosis in psychiatric patients. Additionally, healthy participants treated with exogenous DMT experience predominantly positive symptoms of psychosis. The present paper examines endogenous DMT as a possible biological mediator of the relationship between stress and positive symptoms of psychosis.

  12. Association between Genetic Variation in the Oxytocin Receptor Gene and Emotional Withdrawal, but not between Oxytocin Pathway Genes and Diagnosis in Psychotic Disorders

    PubMed Central

    Haram, Marit; Tesli, Martin; Bettella, Francesco; Djurovic, Srdjan; Andreassen, Ole Andreas; Melle, Ingrid

    2015-01-01

    Social dysfunction is common in patients with psychotic disorders. Oxytocin is a neuropeptide with a central role in social behavior. This study aims to explore the relationship between oxytocin pathway genes and symptoms related to social dysfunction in patients with psychotic disorders. We performed association analyses between four oxytocin pathway genes (OXT, OXTR, AVP, and CD38) and four areas of social behavior-related psychopathology as measured by Positive and Negative Syndrome Scale. For this purpose, we used both a polygenic risk score (PGRS) and single OXTR candidate single nucleotide polymorphism previously reported in the literature (rs53576, rs237902, and rs2254298). A total of 734 subjects with DSM-IV psychotic spectrum disorders and 420 healthy controls were included. Oxytocin pathway PGRSs were calculated based on the independent Psychiatric Genomics Consortium study sample. There was a significant association between symptom of Emotional Withdrawal and the previously reported OXTR risk allele A in rs53576. No significant associations between oxytocin pathway gene variants and a diagnosis of psychotic disorder were found. Our findings indicate that while oxytocin pathway genes do not appear to contribute to the susceptibility to psychotic disorders, variations in the OXTR gene might play a role in the development of impaired social behavior. PMID:25667571

  13. Pleasure Now, Pain Later: Positive Fantasies About the Future Predict Symptoms of Depression.

    PubMed

    Oettingen, Gabriele; Mayer, Doris; Portnow, Sam

    2016-03-01

    Though common sense suggests that positive thinking shelters people from depression, the four studies reported here showed that this intuition needs to be qualified: Positive thinking in the form of fantasies about the future did indeed relate to decreased symptoms of depression when measured concurrently; however, positive fantasies predicted more depressive symptoms when measured longitudinally. The pattern of results was observed for different indicators of fantasies and depression, in adults and in schoolchildren, and for periods of up to 7 months (Studies 1-4). In college students, low academic success partially mediated the predictive relation between positive fantasies and symptoms of depression (Study 4). Results add to existing research on the problematic effects of positive fantasies on performance by suggesting that indulging in positive fantasies predicts problems in mental health.

  14. [Psychotic episode due to Hashimoto's thyroiditis].

    PubMed

    Nazou, M; Parlapani, E; Nazlidou, E-I; Athanasis, P; Bozikas, V P

    2016-01-01

    Thyroid hormones are crucial in adult brain metabolic activity. As a result, abnormal thyroid gland function and in particular hypofunction, might cause principally depression and neurocognitive dysfunction. Psychosis, presented mainly with thought disorders and perceptual disturbances, is a much rarer manifestation of hypothyreoidism. A correlation between hypothyreoidism and psychosis has been described since 1888, especially in cases of advanced hypothyreoidism. A few years later (1949), Asher first added the terminology "myxedema madness" to the literature. Psychotic symptoms typically appear after the onset of physical symptoms, usually with a delay of months or years. The case of a female patient who presented a psychotic episode as a first manifestation of hypothyroidism will be described. NE, a 48 yearold female patient, was admitted for the first time to an inpatient mental health care unit due to delusions of persecution and reference, as well as auditory hallucinations that appeared a few weeks ago. After the patient admission, routine laboratory examination was conducted. In order to relieve the patient from her sense of discomfort and while awaiting laboratory results, olanzapine, 5 mg/day, was administered. Neurological examination and cranial computed tomography scan were unremarkable. Hormonal laboratory tests though revealed severe low thyroid hormone levels. Thyroid antibody testing certified Hashimoto's thyroiditis. Olanzapine was discontinued and the patient received thyroid hormone substitution, levothyroxine 75 μg/day, instead. The patient was discharged showing a significant improvement of psychotic symptoms after a 12-day hospitalization. A month later the patient was reevaluated. She had fully recovered from the psychotic episode. A year later, the patient continues to remain free from psychiatric symptoms, while thyroid hormone levels have been restored within normal range. The patient continues receiving only thyroid hormone substitution

  15. Rating scales measuring the severity of psychotic depression

    PubMed Central

    Østergaard, Søren D.; Rothschild, Anthony J.; Flint, Alastair J.; Mulsant, Benoit H.; Whyte, Ellen M.; Leadholm, Anne Katrine; Bech, Per; Meyers, Barnett S.

    2015-01-01

    Objective Unipolar psychotic depression (PD) is a severe and debilitating syndrome, which requires intensive monitoring. The objective of this study was to provide an overview of the rating scales used to assess illness severity in PD. Method Selective review of publications reporting results on non-self-rated, symptom-based rating scales utilized to measure symptom severity in PD. The clinical and psychometric validity of the identified rating scales was reviewed. Results A total of 14 rating scales meeting the predefined criteria were included in the review. These scales grouped into the following categories: I. Rating scales predominantly covering depressive symptoms, II. Rating scales predominantly covering psychotic symptoms, III. Rating scales covering delusions, and IV. Rating scales covering psychotic depression. For the vast majority of the scales, the clinical and psychometric validity had not been tested empirically. The only exception from this general tendency was the 11-item Psychotic Depression Assessment Scale (PDAS), which was developed specifically to assess the severity of PD. Conclusion In PD, the Psychotic Depression Assessment Scale (PDAS) represents the only empirically derived rating scale for the measurement of overall severity of illness. The PDAS should be considered in future studies of PD and in clinical practice. PMID:26016647

  16. The Use of Electroconvulsive Therapy in Atypical Psychotic Presentations

    PubMed Central

    Vasu, Devi

    2007-01-01

    Convulsive therapy and its progeny, electroconvulsive therapy (ECT), were originally used for the treatment of catatonic schizophrenia, and there is little doubt that ECT remains an effective intervention for the treatment of schizophrenia. However, current practice tends to favor the use of ECT in severe or treatment refractory affective disorders, and its use in schizophrenia and other nonaffective (atypical) psychotic disorders has become controversial. Case reports have suggested a role for ECT in two specific atypical psychotic disorders: Cotard's syndrome and cycloid psychosis. In this article, we review the atypical psychotic disorders and report a series of five case examples that signify the role of ECT in atypical psychotic presentations, particularly when the symptoms resemble those found in Cotard's syndrome and cycloid psychosis. PMID:20428309

  17. Impact of Cannabis Use on the Development of Psychotic Disorders.

    PubMed

    Wilkinson, Samuel T; Radhakrishnan, Rajiv; D'Souza, Deepak Cyril

    2014-06-01

    The link between cannabis use and psychosis comprises three distinct relationships: acute psychosis associated with cannabis intoxication, acute psychosis that lasts beyond the period of acute intoxication, and persistent psychosis not time-locked to exposure. Experimental studies reveal that cannabis, tetrahydrocannabinol (THC) and synthetic cannabinoids reliably produce transient positive, negative, and cognitive symptoms in healthy volunteers. Case-studies indicate that cannabinoids can induce acute psychosis which lasts beyond the period of acute intoxication but resolves within a month. Exposure to cannabis in adolescence is associated with a risk for later psychotic disorder in adulthood; this association is consistent, temporally related, shows a dose-response, and is biologically plausible. However, cannabis is neither necessary nor sufficient to cause a persistent psychotic disorder. More likely it is a component cause that interacts with other factors to result in psychosis. The link between cannabis and psychosis is moderated by age at onset of cannabis use, childhood abuse and genetic vulnerability. While more research is needed to better characterize the relationship between cannabinoid use and the onset and persistence of psychosis, clinicians should be mindful of the potential risk of psychosis especially in vulnerable populations, including adolescents and those with a psychosis diathesis.

  18. Subtyping Schizophrenia by Treatment Response: Antipsychotic Development and the Central Role of Positive Symptoms.

    PubMed

    Lee, Jimmy; Takeuchi, Hiroyoshi; Fervaha, Gagan; Sin, Gwen Li; Foussias, George; Agid, Ofer; Farooq, Saeed; Remington, Gary

    2015-11-01

    We have recently proposed a model for subtyping schizophrenia based on antipsychotic (AP) treatment response. Evidence suggests that APs, both old and new, are comparable in terms of efficacy; however, one AP, clozapine, is uniquely effective in one subgroup of patients (that is, those with treatment-resistant schizophrenia [TRS]). This permits us to subdivide schizophrenia into 3 specific groups: AP responsive, clozapine responsive, and clozapine resistant. Here, we integrate this model with current criteria related to TRS and ultraresistant schizophrenia, the latter referred to in our model as clozapine resistant. We suggest several modifications to existing criteria, in line with current evidence and practice patterns, particularly emphasizing the need to focus on positive symptoms. While APs can favourably impact numerous dimensions related to schizophrenia, it is their effect on positive symptoms that distinguishes them from other psychotropics. Further, it is positive symptoms that are central to AP and clozapine resistance, and it is these people that place the greatest demands on acute and long-term inpatient resources. In moving AP development forward, we advocate specifically focusing on positive symptoms and capitalizing on the evidence we have of 3 subtypes of psychosis (that is, positive symptoms) based on treatment response, implicating 3 distinguishable forms of underlying pathophysiology. Conversely, pooling these groups risks obfuscating potentially identifiable differences. Such a position does not challenge the importance of dopamine D2 receptor blockade, but rather highlights the need to better isolate those other subgroups that require something more or entirely different.

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

    PubMed

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

    2004-01-01

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

  20. Replicated Evidence of Absence of Association between Serum S100B and (Risk of) Psychotic Disorder

    PubMed Central

    van der Leeuw, Christine; Marcelis, Machteld; Peeters, Sanne C. T.; Verbeek, Marcel M.; Menheere, Paul P. C. A.; de Haan, Lieuwe; van Os, Jim; van Beveren, Nico J. M.

    2013-01-01

    Background S100B is a potential marker of neurological and psychiatric illness. In schizophrenia, increased S100B levels, as well as associations with acute positive and persisting negative symptoms, have been reported. It remains unclear whether S100B elevation, which possibly reflects glial dysfunction, is the consequence of disease or compensatory processes, or whether it is an indicator of familial risk. Methods Serum samples were acquired from two large independent family samples (n = 348 and n = 254) in the Netherlands comprising patients with psychotic disorder (n = 140 and n = 82), non-psychotic siblings of patients with psychotic disorder (n = 125 and n = 94) and controls (n = 83 and n = 78). S100B was analyzed with a Liaison automated chemiluminescence system. Associations between familial risk of psychotic disorder and S100B were examined. Results Results showed that S100B levels in patients (P) and siblings (S) were not significantly different from controls (C) (dataset 1: P vs. C: B = 0.004, 95% CI −0.005 to 0.013, p = 0.351; S vs. C: B = 0.000, 95% CI −0.009 to 0.008, p = 0.926; and dataset 2: P vs. C: B = 0.008, 95% CI −0.011 to 0.028, p = 0.410; S vs. C: B = 0.002, 95% CI −0.016 to 0.021, p = 0.797). In patients, negative symptoms were positively associated with S100B (B = 0.001, 95% CI 0.000 to 0.002, p = 0.005) in one of the datasets, however with failure of replication in the other. There was no significant association between S100B and positive symptoms or present use or type of antipsychotic medication. Conclusions S100B is neither an intermediate phenotype, nor a trait marker for psychotic illness. PMID:24358202

  1. Amisulpride Augmentation for Clozapine-Refractory Positive Symptoms: Additional Benefit in Reducing Hypersialorrhea

    PubMed Central

    Bogorni, Fabiani; Moreira, Frederico Fernandes; Pimentel, Eduardo Mylius; Grohs, Géder Evandro Motta; Diaz, Alexandre Paim

    2015-01-01

    One-third to half of patients taking clozapine suffer from refractory symptoms despite adequate treatment. Among other adverse effects, clozapine-induced hypersalivation (CIH) occurs in approximately half of all patients. This is a case of a 30-year-old male with refractory schizophrenia; in this patient, the remission of residual positive symptoms, as well as the reduction of CIH, was achieved by treatment with clozapine augmented with amisulpride. PMID:25838958

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  3. Capgras Syndrome in First-Episode Psychotic Disorders

    PubMed Central

    Salvatore, Paola; Bhuvaneswar, Chaya; Tohen, Mauricio; Khalsa, Hari-Mandir K.; Maggini, Carlo; Baldessarini, Ross J.

    2014-01-01

    Background Misidentification phenomena, including the delusion of “imposters” named after Joseph Capgras, occur in various major psychiatric and neurological disorders but have rarely been studied systematically in broad samples of modern patients. This study investigated the prevalence and correlated clinical factors of Capgras phenomenon in a broad sample of patient-subjects with first-lifetime episodes of psychotic affective and non affective disorders. Methods We evaluated 517 initially hospitalized, first-episode psychotic-disorder patients for prevalence of Capgras phenomenon and its association with DSM-IV-TR diagnoses including schizophreniform, brief psychotic, unspecified psychotic, delusional, and schizoaffective disorders, schizophrenia, bipolar-I disorder and major depression with psychotic features, and with characteristics of interest including antecedent psychiatric and neurological morbidity, onset-type and presenting psychopathological phenomena, using standard bivariate and multivariate statistical methods. Results Capgras syndrome was identified in 73/517 (14.1%) patients (8.2%–50% across diagnoses). Risk was greatest with acute or brief psychotic disorders (schizophreniform [50%], brief [34.8%], or unspecified [23.9%] psychoses), intermediate in major depression (15%), schizophrenia (11.4%) and delusional disorder (11.1%), and lowest in bipolar-I (10.3%) and schizoaffective disorders (8.2%). Associated were somatosensory, olfactory and tactile hallucinations, Schneiderian (especially delusional perception), and cycloid features as described by Perris and Brockington including polymorphous psychotic phenomena, rapidly shifting psychomotor and affective symptoms, pan-anxiety, ecstasy, over-concern with death, and perplexity or confusion, as well as rapid-onset, but not sex, age, abuse-history, dissociative features, or indications of neurological disorders. Conclusions Capgras syndrome was prevalent across a broad spectrum of first

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

    PubMed

    Lyne, John P; Kinsella, Anthony; O'Donoghue, Brian

    2012-02-01

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

  5. Cognitive and Emotional Associations to Positive Schizotypy during Adolescence

    ERIC Educational Resources Information Center

    Debbane, Martin; Van der Linden, Martial; Gex-Fabry, Marianne; Eliez, Stephan

    2009-01-01

    Background: Sub-clinical symptoms of psychosis such as hallucinations and delusions, known as positive schizotypy, constitute one of the strongest predictive factors for adult psychotic disorders. Recent cognitive models suggest that the expression of positive schizotypy is associated with depression, anxiety, metacognitive beliefs and…

  6. Longitudinal study of stressful life events and daily stressors among adolescents at high risk for psychotic disorders.

    PubMed

    Tessner, Kevin D; Mittal, Vijay; Walker, Elaine F

    2011-03-01

    Psychosocial stress preceding the onset or recurrence of psychotic symptoms has been identified in patients with schizophrenia; yet there is limited understanding of the effects of stress in typically developing adolescents or those who show behavioral signs of risk for schizophrenia spectrum disorders. This study examined the developmental course of symptom progression as a function of stressful life events and daily hassles in adolescents with schizotypal personality disorder (SPD), other personality disorders, or no Axis II disorder. In this prospective longitudinal study, life events and daily stressors were assessed in adolescents aged 12 to 18 years. Results revealed that adolescents with SPD and other personality disorders reported significantly greater total, independent, and undesirable life events than individuals with no Axis II disorders. Youth with SPD report daily hassles to cause more distress compared to peers. Correlational analyses and hierarchal linear regression was used to evaluate the relationship of life events and daily stressors with psychiatric symptoms measured concurrently and 1 year later. Across diagnostic groups, the incidence of independent and undesirable life events were associated with current prodromal symptoms, while the frequency of daily stressors predicted a significant increment in positive, but not negative, prodromal symptoms over time. Therefore, adolescents who report greater daily stressors exhibit an increase in prodromal symptoms over a 1 year period. Psychosocial stress has been implicated in the etiology of schizophrenia, and these findings suggest the importance of life events and daily hassles as potential risk factors in the onset of psychotic symptoms during adolescence.

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

    PubMed

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

    2000-04-01

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

  8. TCF4 sequence variants and mRNA levels are associated with neurodevelopmental characteristics in psychotic disorders.

    PubMed

    Wirgenes, K V; Sønderby, I E; Haukvik, U K; Mattingsdal, M; Tesli, M; Athanasiu, L; Sundet, K; Røssberg, J I; Dale, A M; Brown, A A; Agartz, I; Melle, I; Djurovic, S; Andreassen, O A

    2012-05-08

    TCF4 is involved in neurodevelopment, and intergenic and intronic variants in or close to the TCF4 gene have been associated with susceptibility to schizophrenia. However, the functional role of TCF4 at the level of gene expression and relationship to severity of core psychotic phenotypes are not known. TCF4 mRNA expression level in peripheral blood was determined in a large sample of patients with psychosis spectrum disorders (n = 596) and healthy controls (n = 385). The previously identified TCF4 risk variants (rs12966547 (G), rs9960767 (C), rs4309482 (A), rs2958182 (T) and rs17512836 (C)) were tested for association with characteristic psychosis phenotypes, including neurocognitive traits, psychotic symptoms and structural magnetic resonance imaging brain morphometric measures, using a linear regression model. Further, we explored the association of additional 59 single nucleotide polymorphisms (SNPs) covering the TCF4 gene to these phenotypes. The rs12966547 and rs4309482 risk variants were associated with poorer verbal fluency in the total sample. There were significant associations of other TCF4 SNPs with negative symptoms, verbal learning, executive functioning and age at onset in psychotic patients and brain abnormalities in total sample. The TCF4 mRNA expression level was significantly increased in psychosis patients compared with controls and positively correlated with positive- and negative-symptom levels. The increase in TCF4 mRNA expression level in psychosis patients and the association of TCF4 SNPs with core psychotic phenotypes across clinical, cognitive and brain morphological domains support that common TCF4 variants are involved in psychosis pathology, probably related to abnormal neurodevelopment.

  9. Children's Perceptions of Their ADHD Symptoms: Positive Illusions, Attributions, and Stigma

    ERIC Educational Resources Information Center

    Wiener, Judith; Malone, Molly; Varma, Angela; Markel, Clarisa; Biondic, Daniella; Tannock, Rosemary; Humphries, Tom

    2012-01-01

    This study investigated the perceptions of children with Attention-Deficit/Hyperactivity Disorder (ADHD) of their ADHD symptoms in terms of the positive illusory bias (PIB), their attributions for their problem behaviors, and their beliefs about whether their problem behaviors and disorder are stigmatizing. Participants were 152 9- to 14-year-old…

  10. Positive Adult Support and Depression Symptoms in Adolescent Females: The Partially Mediating Role of Eating Disturbances

    ERIC Educational Resources Information Center

    Linville, Deanna; O'Neil, Maya; Huebner, Angela

    2011-01-01

    This study examined linkages between depression symptoms (DEP) and positive adult support (PAS) in female adolescents and the partially mediating influence of eating disturbances (ED). Structural equation modeling was used to establish measurement models for each of the latent constructs, determine the relationships among the latent constructs,…

  11. Psychotic-like Experiences and Substance Use in College Students.

    PubMed

    Fonseca-Pedrero, Eduardo; Ortuño-Sierra, Javier; Paino, Mercedes; Muñiz, José

    2016-03-02

    Psychotic disorders, as well as psychotic-like experiences and substance use, have been found to be associated. The main goal of the present study was to analyse the relationship between psychoticlike experiences and substance use in college students. The simple comprised a total of 660 participants (M = 20.3 years, SD = 2.6). The results showed that 96% of the sample reported some delusional experience, while 20.3% reported at least one positive psychotic-like experience. Some substance use was reported by 41.1% of the sample, differing in terms of gender. Substance users reported more psychoticlike experiences than non-users, especially in the positive dimension. Also, alcohol consumption predicted in most cases extreme scores on measures of delusional ideation and psychotic experiences. The association between these two variables showed a differentiated pattern, with a stronger relationship between substance use and cognitive-perceptual psychotic-like experiences. To some extent, these findings support the dimensional models of the psychosis phenotype and contribute a better understanding of the links between psychoticlike experiences and substance use in young adults. Future studies should further explore the role of different risk factors for psychotic disorders and include models of the gene-environment interaction.

  12. Positive psychological factors are associated with lower PTSD symptoms among police officers: post Hurricane Katrina.

    PubMed

    McCanlies, Erin C; Mnatsakanova, Anna; Andrew, Michael E; Burchfiel, Cecil M; Violanti, John M

    2014-12-01

    Following Hurricane Katrina, police officers in the New Orleans geographic area faced a number of challenges. This cross-sectional study examined the association between resilience, satisfaction with life, gratitude, posttraumatic growth, and symptoms of posttraumatic stress disorder in 84 male and 30 female police officers from Louisiana. Protective factors were measured using the Connor-Davidson Resilience scale, Satisfaction with Life Scale, the Gratitude Questionnaire, and the Posttraumatic Growth inventory. Symptoms of posttraumatic stress disorder were measured using the Posttraumatic Stress Disorder Checklist--Civilian (PCL-C). Potential associations were measured using linear regression and analysis of variance. Models were adjusted for age, sex, race, education, and alcohol. Mean PCL-C symptoms were 29.5 ± 14.5 for females and 27.8 ± 12.1 for males. Adjusted mean levels of PCL-C symptoms significantly decreased as quartiles of resilience (p < .001), satisfaction with life (p < .001), and gratitude (p < .001) increased. In contrast, PCL-C symptoms were not associated with posttraumatic growth in this sample. These results indicate that positive factors such as resilience, satisfaction with life, and gratitude may help mitigate symptoms of posttraumatic stress disorder. To further explore these relationships, longitudinal follow-up in a larger population would be of interest.

  13. Positive Psychological Factors are Associated with Lower PTSD Symptoms among Police Officers: Post Hurricane Katrina

    PubMed Central

    McCanlies, Erin C.; Mnatsakanova, Anna; Andrew, Michael E.; Burchfiel, Cecil M.; Violanti, John M.

    2015-01-01

    Following Hurricane Katrina, police officers in the New Orleans geographic area faced a number of challenges. This cross-sectional study examined the association between resilience, satisfaction with life, gratitude, posttraumatic growth, and symptoms of posttraumatic stress disorder in 84 male and 30 female police officers from Louisiana. Protective factors were measured using the Connor–Davidson Resilience scale, Satisfaction with Life Scale, the Gratitude Questionnaire, and the Posttraumatic Growth inventory. Symptoms of posttraumatic stress disorder were measured using the Posttraumatic Stress Disorder Checklist—Civilian (PCL-C). Potential associations were measured using linear regression and analysis of variance. Models were adjusted for age, sex, race, education, and alcohol. Mean PCL-C symptoms were 29.5 ± 14.5 for females and 27.8 ± 12.1 for males. Adjusted mean levels of PCL-C symptoms significantly decreased as quartiles of resilience (p <.001), satisfaction with life (p <.001), and gratitude (p <.001) increased. In contrast, PCL-C symptoms were not associated with posttraumatic growth in this sample. These results indicate that positive factors such as resilience, satisfaction with life, and gratitude may help mitigate symptoms of posttraumatic stress disorder. To further explore these relationships, longitudinal follow-up in a larger population would be of interest. PMID:25476965

  14. Adolescent Romance and Depressive Symptoms: The Moderating Effects of Positive Coping and Perceived Friendship Competence

    PubMed Central

    Szwedo, David E.; Chango, Joanna M.; Allen, Joseph P.

    2014-01-01

    Objective Youths' ability to positively cope with negative emotions and their self-perceived friendship competence were examined as potential moderators of links between multiple aspects of romantic relationships and residualized increases in depressive symptoms from late adolescence into early adulthood. Method Participants included 184 teens (46% male; 42% non-white) assessed at ages 15-19 and 21, as well as a sub-sample of 62 romantic partners of participants assessed when teens were 18. Results Results of hierarchical linear regressions showed that positive coping served as a buffer against depressive symptoms for romantically involved adolescents and also for teens receiving more intense emotional support from their romantic partners, but not for youth whose relationship had ended and had not been replaced by a new relationship. Higher perceived friendship competence served as a buffer against depressive symptoms for youth enduring the dissolution and non-replacement of their romantic relationship. Conclusions Greater use of positive coping skills and higher perceived friendship competence may help protect adolescents from depressive symptoms in different types of romantic experiences. PMID:24645877

  15. Adolescent romance and depressive symptoms: the moderating effects of positive coping and perceived friendship competence.

    PubMed

    Szwedo, David E; Chango, Joanna M; Allen, Joseph P

    2015-01-01

    Youths' ability to positively cope with negative emotions and their self-perceived friendship competence were examined as potential moderators of links between multiple aspects of romantic relationships and residualized increases in depressive symptoms from late adolescence into early adulthood. Participants included 184 teens (46% male; 42% non-White) assessed at ages 15 to 19 and 21, as well as a subsample of 62 romantic partners of participants assessed when teens were 18. Results of hierarchical linear regressions showed that positive coping served as a buffer against depressive symptoms for romantically involved adolescents and also for teens receiving more intense emotional support from their romantic partners, but not for youth whose relationship had ended and had not been replaced by a new relationship. Higher perceived friendship competence served as a buffer against depressive symptoms for youth enduring the dissolution and nonreplacement of their romantic relationship. Greater use of positive coping skills and higher perceived friendship competence may help protect adolescents from depressive symptoms in different types of romantic experiences.

  16. [Therapeutic effect of zuclopenthixol acetate on positive and negative symptoms in schizophrenia].

    PubMed

    Szafrański, T; Jarema, M; Białek, J; Buksowicz, M; Marciniak, E; Choma, M E; Ruzikowska, A; Milej, M

    1997-01-01

    Fifty schizophrenic in-patients (DSM-IV) were treated in an open study with zuclopenthixol acetate. Mental status, improvement and side-effects were measured before administration of the drug as well as after the 1st, 2nd and 3rd injection. Positive and negative symptoms were evaluated with the use of PANSS. 60% of patients received three injections. Usually the intervals between injections lasted 48 hours. The improvement after the 3rd injection of zuclopenthixol acetate was found in 80% of patients. All positive symptoms improved after the treatment (p < 0.001), among them excitement (54% reduction vs. baseline), hostility (49%) suspiciousness/persecution (45%). The study revealed that parallel to the decrease of positive symptoms, the severity of negative symptoms also decreased, in particular: difficulty in abstract thinking (28%) and stereotyped thinking (27%) (p < 0.001). Passive/apathetic social withdrawal and lack of spontaneity as well as flow of conversation only slightly improved (p < 0.05). 50% of patients experienced side-effects--usually extrapyramidal reactions.

  17. Pantomimic Representation in Psychotic Children

    ERIC Educational Resources Information Center

    Curcio, Frank; Piserchia, Elizabeth Ann

    1978-01-01

    Twenty-four psychotic children (5-15 years old) were required to represent absent objects (e.g. toothbrush) via pantomime after receiving verbal instructions or instructions accompanied by a model demonstrating the pantomime. (Author/CL)

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

    PubMed

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

    2017-02-21

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

  19. Acculturation, out-group positivity and eating disorders symptoms among Emirati women.

    PubMed

    Thomas, Justin; O'Hara, Lily; Quadflieg, Susanne; Weissgerber, Sophia Christin

    2017-03-27

    Western acculturation has been implicated in the development of eating disorders among populations living outside Europe and North America. This study explored the relationship between Western acculturation, in-group/out-group evaluations and eating disorders symptoms among female citizens of the United Arab Emirates (UAE). Emirati college women (N = 209) completed an affective priming task, designed to implicitly assess in-group (Emirati) and out-group (American) evaluations. Participants also completed the Westernization Survey, a widely used self-report measure of acculturation, and the Eating Attitudes Test (EAT-26). Across the whole sample, out-group positivity was correlated with higher levels of eating disorder symptoms. Participants classified as at risk for eating disorders showed a clear out-group preference (out-group positivity greater than in-group positivity). Western acculturation was also positively correlated with eating disorder symptoms. Overall, these findings lend further support to the acculturation hypothesis of eating disorders in the context of Emirati college women.

  20. Creativity and positive symptoms in schizophrenia revisited: Structural connectivity analysis with diffusion tensor imaging.

    PubMed

    Son, Shuraku; Kubota, Manabu; Miyata, Jun; Fukuyama, Hidenao; Aso, Toshihiko; Urayama, Shin-ichi; Murai, Toshiya; Takahashi, Hidehiko

    2015-05-01

    Both creativity and schizotypy are suggested to be manifestations of the hyperactivation of unusual or remote concepts/words. However, the results of studies on creativity in schizophrenia are diverse, possibly due to the multifaceted aspects of creativity and difficulties of differentiating adaptive creativity from pathological schizotypy/positive symptoms. To date, there have been no detailed studies comprehensively investigating creativity, positive symptoms including delusions, and their neural bases in schizophrenia. In this study, we investigated 43 schizophrenia and 36 healthy participants using diffusion tensor imaging. We used idea, design, and verbal (semantic and phonological) fluency tests as creativity scores and Peters Delusions Inventory as delusion scores. Subsequently, we investigated group differences in every psychological score, correlations between fluency and delusions, and relationships between these scores and white matter integrity using tract-based spatial statistics (TBSS). In schizophrenia, idea and verbal fluency were significantly lower in general, and delusion score was higher than in healthy controls, whereas there were no group differences in design fluency. We also found positive correlation between phonological fluency and delusions in schizophrenia. By correlation analyses using TBSS, we found that the anterior part of corpus callosum was the substantially overlapped area, negatively correlated with both phonological fluency and delusion severity. Our results suggest that the anterior interhemispheric dysconnectivity might be associated with executive dysfunction, and disinhibited automatic spreading activation in the semantic network was manifested as uncontrollable phonological fluency or delusions. This dysconnectivity could be one possible neural basis that differentiates pathological positive symptoms from adaptive creativity.

  1. Thinking and acting beyond the positive: the role of the cognitive and negative symptoms in schizophrenia.

    PubMed

    Carbon, Maren; Correll, Christoph U

    2014-12-01

    Since currently available antipsychotic medications predominantly treat hallucinations, delusions, disorganized thoughts and behavior, and related agitation/aggression, attention has traditionally been focused on managing positive symptoms. However, prominent negative symptoms and clinically relevant cognitive impairment affect approximately 40% and 80% of people with schizophrenia, respectively. Moreover, negative and cognitive symptoms are closely related to functional outcomes, and contribute substantially to the overall illness burden. Therefore, approaches to describe, measure, and manage these symptom domains are relevant. This article summarizes the phenomenology, prevalence, assessment, and treatment of negative and cognitive symptoms in patients with schizophrenia, including pharmacologic and nonpharmacologic management strategies that can be used in clinical care now, as well as pharmacologic approaches that are being tested. Currently, no approved treatments targeting negative or cognitive symptomatology in schizophrenia are available. It is hoped that progress in the understanding of the neurobiology of these important symptom domains of schizophrenia will help develop effective treatment strategies in the future. However, until this goal is achieved, clinicians should avoid therapeutic nihilism. Rather, the severity and impact of negative and cognitive symptoms should be determined, quantified, and monitored. Further, psychosocial treatments have shown therapeutic benefits. Thus, cognitive behavioral therapy, cognitive remediation, social skills training, and computer-assisted training programs should be offered in conjunction with antipsychotic treatment. Several non-antipsychotic augmentation strategies can be tried off-label. Treatment plans that incorporate currently available management options for negative and cognitive symptomatology in patients with schizophrenia should be adapted over time and based on the individual's needs, with the aim to

  2. MINORITY STRESS, POSITIVE IDENTITY DEVELOPMENT, AND DEPRESSIVE SYMPTOMS: IMPLICATIONS FOR RESILIENCE AMONG SEXUAL MINORITY MALE YOUTH

    PubMed Central

    Bruce, Douglas; Harper, Gary W.; Bauermeister, Jose A.

    2015-01-01

    Introduction Minority stress processes have been shown to have significant associations with negative mental health outcomes among sexual minority populations. Given that adversity may be experienced growing up as a sexual minority in heteronormative, if not heterosexist, environments, our research on resilience among sexual minority male youth proposes that positive identity development may buffer the effects of a range of minority stress processes. Methods An ethnically diverse sample of 200 sexual minority males ages 16–24 (mean age, 20.9 years) was recruited using mixed recruitment methods. We developed and tested two new measures: concealment stress during adolescence and sexual minority-related positive identity development. We then tested a path model that assessed the effects of minority stressors, positive identity development, and social support on major depressive symptoms. Results Experience of stigma was associated with internalized homophobia (β=.138, p<.05) and major depressive symptoms (β=1.076, OR=2.933, p<.001), and internalized homophobia partially mediated experience’s effects on major depression (β=.773, OR=2.167, p<.001). Concealment stress was associated with positive identity development (β=.155, p<.05) and internalized homophobia (β=.418, p<.001), and positive identity development partially mediated concealment stress’s effects on internalized homophobia (β=−.527, p<.001). Concealment stress demonstrated a direct effect on major depression (β=1.400, OR=4.056, p<.001), and indirect paths to social support through positive identity development. Conclusions With these results, we offer an exploratory model that empirically identifies significant paths among minority stress dimensions, positive identity development, and major depressive symptoms. This study helps further our understanding of minority stress, identity development, and resources of resilience among sexual minority male youth. PMID:26478901

  3. Oxytocin and Social Cognition in Affective and Psychotic Disorders

    PubMed Central

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

    2014-01-01

    Impairments in social cognition are now recognized as core illness features in psychotic and affective disorders. Despite the significant disability caused by social cognitive abnormalities, treatments for this symptom dimension are lacking. Here, we describe the evidence demonstrating abnormalities in social cognition in schizophrenia, major depressive disorder, and bipolar disorder, as well as the neurobiology of social cognition including the role of oxytocin. We then review clinical trials of oxytocin administration in psychotic and affective disorders and the impact of this agent on social cognition. To date, several studies have demonstrated that oxytocin may improve social cognition in schizophrenia; too few studies have been conducted in affective disorders to determine the effect of oxytocin on social cognition in these disorders. Future work is needed to clarify which aspects of social cognition may be improved with oxytocin treatment in psychotic and affective disorders. PMID:25153535

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

    PubMed

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

    2015-02-01

    Impairments in social cognition are now recognized as core illness features in psychotic and affective disorders. Despite the significant disability caused by social cognitive abnormalities, treatments for this symptom dimension are lacking. Here, we describe the evidence demonstrating abnormalities in social cognition in schizophrenia, major depressive disorder, and bipolar disorder, as well as the neurobiology of social cognition including the role of oxytocin. We then review clinical trials of oxytocin administration in psychotic and affective disorders and the impact of this agent on social cognition. To date, several studies have demonstrated that oxytocin may improve social cognition in schizophrenia; too few studies have been conducted in affective disorders to determine the effect of oxytocin on social cognition in these disorders. Future work is needed to clarify which aspects of social cognition may be improved with oxytocin treatment in psychotic and affective disorders.

  5. Symptom reporting among prevalent tuberculosis cases who smoke, are HIV-positive or have hyperglycaemia.

    PubMed

    Sattar, S; Van Schalkwyk, C; Claassens, M; Dunbar, R; Floyd, S; Enarson, D A; Godfrey-Faussett, P; Ayles, H; Beyers, N

    2014-12-21

    Data from a tuberculosis (TB) prevalence survey conducted in 24 communities in Zambia and the Western Cape, South Africa, January-December 2010, were analysed to determine the influence of smoking, hyperglycaemia and human immunodeficiency virus (HIV) infection on TB symptom reporting in culture-confirmed TB cases. Of 123 790 adults eligible for enrolment, 90 601 (73%) consented and 64 463 had evaluable sputum samples. ORs and 95%CIs were calculated using a robust standard errors logistic regression model adjusting for clustering at community level. HIV-positive TB cases were more likely to report cough, weight loss, night sweats and chest pain than non-HIV-positive TB cases. TB cases who smoked or had hyperglycaemia did not report symptoms differently from cases without these comorbidities.

  6. Structure of the psychotic disorders classification in DSM-5.

    PubMed

    Heckers, Stephan; Barch, Deanna M; Bustillo, Juan; Gaebel, Wolfgang; Gur, Raquel; Malaspina, Dolores; Owen, Michael J; Schultz, Susan; Tandon, Rajiv; Tsuang, Ming; Van Os, Jim; Carpenter, William

    2013-10-01

    Schizophrenia spectrum disorders attract great interest among clinicians, researchers, and the lay public. While the diagnostic features of schizophrenia have remained unchanged for more than 100 years, the mechanism of illness has remained elusive. There is increasing evidence that the categorical diagnosis of schizophrenia and other psychotic disorders contributes to this lack of progress. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) continues the categorical classification of psychiatric disorders since the research needed to establish a new nosology of equal or greater validity is lacking. However, even within a categorical system, the DSM-5 aims to capture the underlying dimensional structure of psychosis. The domains of psychopathology that define psychotic disorders are presented not simply as features of schizophrenia. The level, the number, and the duration of psychotic signs and symptoms are used to demarcate psychotic disorders from each other. Finally, the categorical assessment is complemented with a dimensional assessment of psychosis that allows for more specific and individualized assessment of patients. The structure of psychosis as outlined in the DSM-5 may serve as a stepping-stone towards a more valid classification system, as we await new data to redefine psychotic disorders.

  7. Subclinical psychotic experiences and subsequent contact with mental health services

    PubMed Central

    Maccabe, James H.; Hatch, Stephani L.; Hotopf, Matthew; Boydell, Jane; McGuire, Philip

    2017-01-01

    Background Although psychotic experiences in people without diagnosed mental health problems are associated with mental health service use, few studies have assessed this prospectively or measured service use by real-world clinical data. Aims To describe and investigate the association between psychotic experiences and later mental health service use, and to assess the role of symptoms of common mental health disorders in this association. Method We linked a representative survey of south-east London (SELCoH-1, n=1698) with health records from the local mental healthcare provider. Cox regression estimated the association of PEs with rate of mental health service use. Results After adjustments, psychotic experiences were associated with a 1.75-fold increase in the rate of subsequent mental health service use (hazard ratio (HR) 1.75, 95% CI 1.03–2.97) compared with those without PEs. Participants with PEs experienced longer care episodes compared with those without. Conclusions Psychotic experiences in the general population are important predictors of public mental health need, aside from their relevance for psychoses. We found psychotic experiences to be associated with later mental health service use, after accounting for sociodemographic confounders and concurrent psychopathology. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license. PMID:28357132

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

    PubMed

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

    2015-06-30

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

  9. Positive symptoms are associated with clinicians' global impression in treatment-resistant schizophrenia.

    PubMed

    Lee, Jimmy; Fervaha, Gagan; Takeuchi, Hiroyoshi; Powell, Valerie; Remington, Gary

    2015-06-01

    Previous investigations on the relationship between global rating measures and symptoms have not considered the additional role of functioning. In this naturalistic study, we examined the relationship between symptom domains and functioning on Clinical Global Impression scales for severity (CGI-S) and improvement (CGI-I) in a sample of patients with schizophrenia assessed to be treatment resistant. Participants were patients with a diagnosis of schizophrenia or schizoaffective disorder who failed 2 prior antipsychotic trials and were considered candidates for clozapine. They were assessed on the 18-item Brief Psychiatric rating Scale (BPRS), Social Occupational Functioning Assessment Scale (SOFAS), and CGI-S at baseline. A subset of patients was followed up at 6 weeks after initiation of clozapine and assessed on the CGI-I. The independent effects of symptom domains and functioning on the CGI scales were examined via multivariate regression models. Brief Psychiatric rating Scale positive factor (P < 0.001) and SOFAS (P < 0.001) scores were significant determinants of CGI-S at baseline. Multivariate models suggested that relative change measures had a better fit for the CGI-I compared to absolute change measures (R = 0.72 vs R = 0.61, respectively). Improvements in BPRS positive (P < 0.001) and affect (P = 0.002) factors and SOFAS (P = 0.030) scores were significant determinants of CGI-I. Ratings of 1 and 2 on the CGI-I corresponded to a mean relative change in the BPRS total of 65% and 41%, respectively. Positive symptoms were a key determinant of clinicians' impression of severity and improvement in this study. Although psychosocial functioning played a large part in determining severity, it was not as significant in the assessment of improvement.

  10. Postnatal depression symptoms are associated with increased diarrhea among infants of HIV-positive Ghanaian mothers.

    PubMed

    Okronipa, Harriet E T; Marquis, Grace S; Lartey, Anna; Brakohiapa, Lucy; Perez-Escamilla, Rafael; Mazur, Robert E

    2012-11-01

    HIV infection is linked to increased prevalence of depression which may affect maternal caregiving practices and place infants at increased risk of illness. We examined the incidence and days ill with diarrhea among infants of HIV positive (HIV-P), HIV negative (HIV-N), and unknown HIV status (HIV-U) women, and determined if symptoms of maternal postnatal depression (PND) modulated the risk of diarrhea. Pregnant women (n = 492) were recruited from three antenatal clinics; mothers and infants were followed for 12 months postpartum. Diarrheal incidence was 0.6 episodes/100 days at risk. More HIV-P than HIV-N and HIV-U women tended to report PND symptoms (χ(2) = 4.76; P = 0.09). Reporting symptoms was associated with an increased risk of infantile diarrhea only among HIV-P and HIV-U but not HIV-N women (interaction term, χ(2) = 7.84; P = 0.02). Health care providers should be aware of the increased risk of infantile diarrhea when both maternal HIV and PND symptoms are present and take preventive action.

  11. Postnatal Depression Symptoms are Associated with Increased Diarrhea among Infants of HIV-Positive Ghanaian Mothers

    PubMed Central

    Okronipa, Harriet E.T.; Marquis, Grace S.; Lartey, Anna; Brakohiapa, Lucy; Perez-Escamilla, Rafael; Mazur, Robert E.

    2014-01-01

    HIV infection is linked to increased prevalence of depression which may affect maternal caregiving practices and place young infants at increased risk of illness. We examined the incidence and days ill with diarrhea among infants of HIV positive (HIV-P), HIV negative (HIV-N), and unknown HIV status (HIV-U) women, and determined if symptoms of maternal postnatal depression (PND) modulated the risk of diarrhea. Pregnant women (n=492) were recruited from 3 antenatal clinics; mothers and infants were followed for 12 mo postpartum. Diarrheal incidence was 0.6 episodes/100-d at risk. More HIV-P than HIV-N and HIV-U women tended to report PND symptoms (P=0.09). PND symptoms increased the risk of infantile diarrhea only for HIV-P and HIV-U but not HIV-N women (interaction term, P=0.02). Health care providers should be aware of the increased risk of infantile diarrhea when both maternal HIV and PND symptoms are present and take preventive action to reduce morbidity. PMID:22331392

  12. [Comparative regions of interest study in schizophrenia, panic disorder and its comorbidity: the relationship between hippocampal volume and positive psychotic symptoms].

    PubMed

    Cortizo-Vidal, Romina; Carmona-Canabate, Susana; Picado-Rossi, Marisol; Pailhez-Vindual, Guillem; Vilarroya-Oliver, Óscar; Bulbena-Vilarasa, Antoni

    2015-01-16

    Introduccion. En la esquizofrenia y en el trastorno de panico se han descrito anomalias limbicas que sugieren una reduccion del volumen del hipocampo y la amigdala. Los resultados son contradictorios y no disponemos de estudios de neuroimagen que evaluen las alteraciones que implica la comorbilidad entre ambas patologias. Objetivo. Determinar el tipo y magnitud de las alteraciones limbicas en la esquizofrenia, el trastorno de panico y su comorbilidad. Sujetos y metodos. Se midio el volumen de la amigdala y el hipocampo empleando el metodo de segmentacion manual de regiones de interes en pacientes con diagnostico de esquizofrenia (grupo 1), trastorno de panico (grupo 2) y ambos diagnosticos (grupo 3), incluyendo un grupo control de sujetos sanos (grupo 4). Resultados. Los pacientes de los grupos 1 y 3 presentan un volumen del hipocampo izquierdo significativamente inferior al grupo control. En estos grupos existe una correlacion positiva significativa entre la sintomatologia psicotica positiva y el volumen del hipocampo izquierdo. No se hallaron diferencias entre los grupos en el volumen de la amigdala. Conclusiones. Los resultados confirman una reduccion del volumen del hipocampo izquierdo asociada a la esquizofrenia. La relacion entre la gravedad de la sintomatologia positiva y el volumen del hipocampo sugiere que los pacientes que presentan mayor volumen del hipocampo tendran tambien mayor predisposicion a presentar una respuesta de miedo condicionada ante estimulos neutros y, por tanto, a presentar, en mayor medida, ideas delirantes y fenomenos alucinatorios.

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

    PubMed

    Ranjan, R; Meltzer, H Y

    1996-08-15

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

  14. Cerebral correlates of psychotic syndromes in neurodegenerative diseases

    PubMed Central

    Jellinger, Kurt A

    2012-01-01

    Abstract Psychosis has been recognized as a common feature in neurodegenerative diseases and a core feature of dementia that worsens most clinical courses. It includes hallucinations, delusions including paranoia, aggressive behaviour, apathy and other psychotic phenomena that occur in a wide range of degenerative disorders including Alzheimer’s disease, synucleinopathies (Parkinson’s disease, dementia with Lewy bodies), Huntington’s disease, frontotemporal degenerations, motoneuron and prion diseases. Many of these psychiatric manifestations may be early expressions of cognitive impairment, but often there is a dissociation between psychotic/behavioural symptoms and the rather linear decline in cognitive function, suggesting independent pathophysiological mechanisms. Strictly neuropathological explanations are likely to be insufficient to explain them, and a large group of heterogeneous factors (environmental, neurochemical changes, genetic factors, etc.) may influence their pathogenesis. Clinico-pathological evaluation of behavioural and psychotic symptoms (PS) in the setting of neurodegenerative and dementing disorders presents a significant challenge for modern neurosciences. Recognition and understanding of these manifestations may lead to the development of more effective preventive and therapeutic options that can serve to delay long-term progression of these devastating disorders and improve the patients’ quality of life. A better understanding of the pathophysiology and distinctive pathological features underlying the development of PS in neurodegenerative diseases may provide important insights into psychotic processes in general. PMID:21418522

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

    PubMed Central

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

    2013-01-01

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

  16. Differential relations of depression and social anxiety symptoms to the facets of extraversion/positive emotionality.

    PubMed

    Naragon-Gainey, Kristin; Watson, David; Markon, Kristian E

    2009-05-01

    Previous research has shown that both depression and social anxiety--2 facets of internalizing psychopathology--are characterized by low levels of extraversion/positive emotionality (E/PE). However, little is known about the relations of the facets of E/PE with the symptoms of depression and social anxiety. This study utilized multiple measures of each facet of E/PE, as well as depression and social anxiety symptoms. Self-report data were collected from large samples of college students and psychiatric outpatients. Separate factor analyses in each sample revealed a 4-factor structure of E/PE consisting of Sociability, Positive Emotionality, Ascendance, and Fun-Seeking. Structural equation modeling revealed that, after controlling for the higher order internalizing factor and the overlap among the E/PE facets, social anxiety was broadly related to all 4 facets of E/PE, whereas depression was strongly related to only low positive emotionality. Implications for hierarchical models of personality and psychopathology, assessment and treatment, and etiological models are discussed.

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

    PubMed

    Kurmann, Julius

    2015-09-30

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

  18. Magnetic Resonance Imaging in Studying Schizophrenia, Negative Symptoms, and the Glutamate System

    PubMed Central

    Gruber, Oliver; Chadha Santuccione, Antonella; Aach, Helmut

    2014-01-01

    Schizophrenia is characterized by positive, negative, and cognitive symptoms. While positive symptoms occur periodically during psychotic exacerbations, negative and cognitive symptoms often emerge before the first psychotic episode and persist with low functional outcome and poor prognosis. This review article outlines the importance of modern functional magnetic resonance imaging techniques for developing a stratified therapy of schizophrenic disorders. Functional neuroimaging evidence on the neural correlates of positive and particularly negative symptoms and cognitive deficits in schizophrenic disorders is briefly reviewed. Acute dysregulation of dopaminergic neurotransmission is crucially involved in the occurrence of psychotic symptoms. However, increasing evidence also implicates glutamatergic pathomechanisms, in particular N-methyl-d-aspartate (NMDA) receptor dysfunction in the pathogenesis of schizophrenia and in the appearance of negative symptoms and cognitive dysfunctions. In line with this notion, several gene variants affecting the NMDA receptor’s pathway have been reported to increase susceptibility for schizophrenia, and have been investigated using the imaging genetics approach. In recent years, several attempts have been made to develop medications modulating the glutamatergic pathway with modest evidences for efficacy. The most successful approaches were those that aimed at influencing this pathway using compounds that enhance NMDA receptor function. More recently, the selective glycine reuptake inhibitor bitopertin has been shown to improve NMDA receptor hypofunction by increasing glycine concentrations in the synaptic cleft. Further research is required to test whether pharmacological agents with effects on the glutamatergic system can help to improve the treatment of negative symptoms in schizophrenic disorders. PMID:24765078

  19. The linguistics of schizophrenia: thought disturbance as language pathology across positive symptoms.

    PubMed

    Hinzen, Wolfram; Rosselló, Joana

    2015-01-01

    We hypothesize that linguistic (dis-)organization in the schizophrenic brain plays a more central role in the pathogenesis of this disease than commonly supposed. Against the standard view, that schizophrenia is a disturbance of thought or selfhood, we argue that the origins of the relevant forms of thought and selfhood at least partially depend on language. The view that they do not is premised by a theoretical conception of language that we here identify as 'Cartesian' and contrast with a recent 'un-Cartesian' model. This linguistic model empirically argues for both (i) a one-to-one correlation between human-specific thought or meaning and forms of grammatical organization, and (ii) an integrative and co-dependent view of linguistic cognition and its sensory-motor dimensions. Core dimensions of meaning mediated by grammar on this model specifically concern forms of referential and propositional meaning. A breakdown of these is virtually definitional of core symptoms. Within this model the three main positive symptoms of schizophrenia fall into place as failures in language-mediated forms of meaning, manifest either as a disorder of speech perception (Auditory Verbal Hallucinations), abnormal speech production running without feedback control (Formal Thought Disorder), or production of abnormal linguistic content (Delusions). Our hypothesis makes testable predictions for the language profile of schizophrenia across symptoms; it simplifies the cognitive neuropsychology of schizophrenia while not being inconsistent with a pattern of neurocognitive deficits and their correlations with symptoms; and it predicts persistent findings on disturbances of language-related circuitry in the schizophrenic brain.

  20. The linguistics of schizophrenia: thought disturbance as language pathology across positive symptoms

    PubMed Central

    Hinzen, Wolfram; Rosselló, Joana

    2015-01-01

    We hypothesize that linguistic (dis-)organization in the schizophrenic brain plays a more central role in the pathogenesis of this disease than commonly supposed. Against the standard view, that schizophrenia is a disturbance of thought or selfhood, we argue that the origins of the relevant forms of thought and selfhood at least partially depend on language. The view that they do not is premised by a theoretical conception of language that we here identify as ‘Cartesian’ and contrast with a recent ‘un-Cartesian’ model. This linguistic model empirically argues for both (i) a one-to-one correlation between human-specific thought or meaning and forms of grammatical organization, and (ii) an integrative and co-dependent view of linguistic cognition and its sensory-motor dimensions. Core dimensions of meaning mediated by grammar on this model specifically concern forms of referential and propositional meaning. A breakdown of these is virtually definitional of core symptoms. Within this model the three main positive symptoms of schizophrenia fall into place as failures in language-mediated forms of meaning, manifest either as a disorder of speech perception (Auditory Verbal Hallucinations), abnormal speech production running without feedback control (Formal Thought Disorder), or production of abnormal linguistic content (Delusions). Our hypothesis makes testable predictions for the language profile of schizophrenia across symptoms; it simplifies the cognitive neuropsychology of schizophrenia while not being inconsistent with a pattern of neurocognitive deficits and their correlations with symptoms; and it predicts persistent findings on disturbances of language-related circuitry in the schizophrenic brain. PMID:26236257

  1. [Position statement for the diagnosis and treatment of men with benign prostate enlargement and lower urinary tract symptoms].

    PubMed

    Greenstein, Alexander; Ferman, Zvi; Stav, Kobi; Gruenwald, Ilan; Matzkin, Haim; Ramon, Jacob

    2014-09-01

    Benign prostate enlargement causing lower urinary symptoms is a common progressive phenomenon in adult men. Lower urinary tract symptoms may emerge during the storage, voiding, and post micturition phases, harm quality of life and may be caused by a variety of factors. The purpose of evaluation is to identify benign prostate enlargement and factors other than enlarged prostate as the cause of symptoms, and recognize the risk factors for progression of the condition. The goal of treatment is to alleviate symptoms and improve quality of life, and to prevent deterioration of symptoms and development of complications. Medical therapy is the basic approach, whereas surgery and minimally invasive procedures are reserved for patients not interested in medical therapy or for those in whom symptoms were not alleviated by means of medical therapy. In the present position statement, we present the approach to the evaluation and treatment of lower urinary tract symptoms in men with benign prostate enlargement.

  2. Mismatch Negativity to Threatening Voices Associated with Positive Symptoms in Schizophrenia

    PubMed Central

    Chen, Chenyi; Liu, Chia-Chien; Weng, Pei-Yuan; Cheng, Yawei

    2016-01-01

    Although the general consensus holds that emotional perception is impaired in patients with schizophrenia, the extent to which neural processing of emotional voices is altered in schizophrenia remains to be determined. This study enrolled 30 patients with chronic schizophrenia and 30 controls and measured their mismatch negativity (MMN), a component of auditory event-related potentials (ERP). In a passive oddball paradigm, happily or angrily spoken deviant syllables dada were randomly presented within a train of emotionally neutral standard syllables. Results showed that MMN in response to angry syllables and angry-derived non-vocal sounds was significantly decreased in individuals with schizophrenia. P3a to angry syllables showed stronger amplitudes but longer latencies. Weaker MMN amplitudes were associated with more positive symptoms of schizophrenia. Receiver operator characteristic analysis revealed that angry MMN, angry-derived MMN, and angry P3a could help predict whether someone had received a clinical diagnosis of schizophrenia. The findings suggested general impairments of voice perception and acoustic discrimination in patients with chronic schizophrenia. The emotional salience processing of voices showed an atypical fashion at the preattentive level, being associated with positive symptoms in schizophrenia. PMID:27471459

  3. Bcl-2 associated with positive symptoms of schizophrenic patients in an acute phase.

    PubMed

    Tsai, Meng-Chang; Liou, Chia-Wei; Lin, Tsu-Kung; Lin, I-Mei; Huang, Tiao-Lai

    2013-12-30

    B cell lymphoma protein-2 (Bcl-2) may contribute to the pathophysiology of schizophrenia in the brain. The aim of this study was to investigate the serum levels of Bcl-2 in schizophrenic patients in an acute phase, and evaluate Bcl-2 level changes after antipsychotic treatment. We consecutively enrolled 41 schizophrenia patients in an acute phase; 28 were followed up with a 4-week antipsychotic treatment. Serum Bcl-2 levels were measured with assay kits. All patients were evaluated by examining the correlation between Bcl-2 levels and Positive and Negative Syndrome Scale (PANSS) scores, using Pearson correlation coefficients. In schizophrenic patients in an acute phase, positive PANSS subscores were significantly negatively correlated with Bcl-2 levels. In addition, we found Bcl-2 levels had a significantly negative correlation with PANSS total scores and positive subscores in male patients in an acute phase. Using the paired t-test, we found no significant changes in Bcl-2 levels in schizophrenia patients who had received the 4-week treatment with antipsychotic drugs (n=28). In conclusion, our results suggest that Bcl-2 might be an indicator of schizophrenia severity in the acute phase. In addition, Bcl-2 levels might be associated with positive symptoms in male patients with schizophrenia.

  4. Differential effects of childhood abuse and neglect: mediation by posttraumatic distress in neurotic disorder and negative symptoms in schizophrenia?

    PubMed

    Vogel, Matthias; Meier, Johanna; Grönke, Stephanie; Waage, Marco; Schneider, Wolfgang; Freyberger, Harald Jürgen; Klauer, Thomas

    2011-08-30

    Dissociation, though understood as a response to trauma, lacks a proven etiology. The assumption of a dose-response relationship between trauma, dissociation and Schneiderian symptoms led to the proposal of a dissociative subtype of schizophrenia characterized by severe child maltreatment, dissociation and psychosis. Child maltreatment and dissociation are common features of neurotic disorders as well, and the link between trauma, dissociation, and hallucinations is not specific for schizophrenia. This study compares childhood abuse and neglect, posttraumatic distress and adult dissociation in patients with psychotic vs. non-psychotic disorder. Thirty-five participants with non-psychotic disorder and twenty-five with schizophrenia were analyzed using the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Montgomery-Åsberg Depression Rating Scale (MADRS), the Posttraumatic Stress Diagnostic Scale PDS (PDS), the Childhood Trauma Questionnaire (CTO) and the Arbeitsgemeinschaft Methodik und Dokumentation in der Psychiatrie (AMDP)-module on dissociation. Trauma and clinical syndromes were compared by means of T-testing and logistic regression between 1) the diagnoses and 2) groups with and without post-traumatic stress disorder (PTSD), marked dissociation and psychotic symptoms. While non-psychotic disorder was related to abuse, schizophrenia showed an association with neglect. Childhood trauma predicted posttraumatic symptomatology and negative symptoms. Childhood abuse and neglect may effectuate different outcomes in neurotic and psychotic disorder. The underlying mechanisms, including dissociation, dovetail with cognitive, emotional and behavioural changes involved in depression, posttraumatic distress and chronic schizophrenia symptoms rather than being directly linked to trauma.

  5. Co-occurring psychotic and addictive disorders: neurobiology and diagnosis.

    PubMed

    Ross, Stephen; Peselow, Eric

    2012-01-01

    Psychosis and substance abuse are intimately related. Psychotic spectrum illnesses commonly co-occur with substance use disorders (SUDs), and many substances of abuse can cause or exacerbate psychotic symptoms along a temporal spectrum from acute to chronic presentations. Despite the common co-occurrence between psychotic spectrum illnesses and SUDs, they are often under-recognized and undertreated, leading to poor treatment outcomes. Accurate detection and diagnosis of individuals with psychotic illness co-occurring with addictive disorders is key to properly treat such disorders. This article will review the nature of the relationship between psychosis and substance abuse by examining prevalence rates of each disorder alone and their rates of co-occurrence, the neurobiological basis for substance abuse comorbidity in schizophrenia spectrum disorders, key and salient aspects related to accurate diagnosis along a continuum from acute to subacute to chronic conditions, and pitfalls associated with diagnostic dilemmas. A case example will be used to highlight key points related to diagnostic challenges.

  6. Associations between the Five-Factor Model personality traits and psychotic experiences in patients with psychotic disorders, their siblings and controls.

    PubMed

    Boyette, Lindy-Lou; Korver-Nieberg, Nikie; Verweij, Kim; Meijer, Carin; Dingemans, Peter; Cahn, Wiepke; de Haan, Lieuwe

    2013-12-15

    Earlier studies indicated that personality characteristics contribute to symptomatic outcome in patients with psychotic disorders. The aim of the present study was to further explore this connection by examining the relationship between the Five-Factor Model (FFM) personality traits and a dimensional liability for psychosis. FFM traits according to the NEO-FFI and levels of subclinical psychotic symptoms according to the CAPE were assessed in 217 patients with psychotic disorders, 281 of their siblings and 176 healthy controls. Psychotic symptoms according to the PANSS were assessed in the patient group. Patients differed from siblings and controls on four of the five FFM traits, all but Openness. Siblings reported higher levels of Neuroticism than controls, but lower levels than patients. Particularly lower Agreeableness, and to a lesser degree, higher Neuroticism and lower Extraversion were associated with more severe symptoms in patients. Furthermore, higher Neuroticism and higher Openness were associated with higher levels of subclinical psychotic experiences in all three groups. Associations were strongest in patients. Our findings suggest that levels of Neuroticism increase with the level of familial risk for psychosis. Levels of Openness may reflect levels of impairment that distinguish clinical from subclinical symptomatology.

  7. A two-year longitudinal study of gender differences in responses to positive affect and depressive symptoms during middle adolescence.

    PubMed

    Gomez-Baya, Diego; Mendoza, Ramon; Paino, Susana; Gillham, Jane E

    2017-04-01

    This study aimed to analyze the prospective associations during adolescence between depressive symptoms and response styles to positive affect and to examine gender differences. A longitudinal study was conducted with three waves separated by 1 year each to assess a non-clinical sample of 622 Spanish adolescents who were 13 and 14 years old (50.2% boys, 49.8% girls). The participants completed self-report measures of depressive symptoms and responses to positive affect (emotion-focused positive rumination, self-focused positive rumination and dampening of positive emotion). The results showed that the increase in depressive symptoms was associated with an increase in dampening and decreases in emotion-focused and self-focused positive rumination. Furthermore, girls presented more depressive symptoms, as well as higher dampening and lower self-focused positive rumination, than boys. The conclusions highlight the need to consider responses to positive affect in explaining gender differences in depressive symptoms during mid-adolescence, as well as in designing prevention programs.

  8. Default Mode Network Connectivity as a Function of Familial and Environmental Risk for Psychotic Disorder

    PubMed Central

    Peeters, Sanne C. T.; van de Ven, Vincent; Gronenschild, Ed H. B. M; Patel, Ameera X.; Habets, Petra; Goebel, Rainer; van Os, Jim; Marcelis, Machteld

    2015-01-01

    Background Research suggests that altered interregional connectivity in specific networks, such as the default mode network (DMN), is associated with cognitive and psychotic symptoms in schizophrenia. In addition, frontal and limbic connectivity alterations have been associated with trauma, drug use and urban upbringing, though these environmental exposures have never been examined in relation to DMN functional connectivity in psychotic disorder. Methods Resting-state functional MRI scans were obtained from 73 patients with psychotic disorder, 83 non-psychotic siblings of patients with psychotic disorder and 72 healthy controls. Posterior cingulate cortex (PCC) seed-based correlation analysis was used to estimate functional connectivity within the DMN. DMN functional connectivity was examined in relation to group (familial risk), group × environmental exposure (to cannabis, developmental trauma and urbanicity) and symptomatology. Results There was a significant association between group and PCC connectivity with the inferior parietal lobule (IPL), the precuneus (PCu) and the medial prefrontal cortex (MPFC). Compared to controls, patients and siblings had increased PCC connectivity with the IPL, PCu and MPFC. In the IPL and PCu, the functional connectivity of siblings was intermediate to that of controls and patients. No significant associations were found between DMN connectivity and (subclinical) psychotic/cognitive symptoms. In addition, there were no significant interactions between group and environmental exposures in the model of PCC functional connectivity. Discussion Increased functional connectivity in individuals with (increased risk for) psychotic disorder may reflect trait-related network alterations. The within-network “connectivity at rest” intermediate phenotype was not associated with (subclinical) psychotic or cognitive symptoms. The association between familial risk and DMN connectivity was not conditional on environmental exposure. PMID

  9. Transdiagnostic neural markers of emotion-cognition interaction in psychotic disorders.

    PubMed

    Sabharwal, Amri; Szekely, Akos; Kotov, Roman; Mukherjee, Prerona; Leung, Hoi-Chung; Barch, Deanna M; Mohanty, Aprajita

    2016-10-01

    Deficits in working memory (WM) and emotion processing are prominent impairments in psychotic disorders, and have been linked to reduced quality of life and real-world functioning. Translation of knowledge regarding the neural circuitry implementing these deficits into improved diagnosis and targeted treatments has been slow, possibly because of categorical definitions of disorders. Using the dimensional Research Domain Criteria (RDoC) framework, we investigated the clinical and practical utility of transdiagnostic behavioral and neural measures of emotion-related WM disruption across psychotic disorders. Behavioral and functional MRI data were recorded while 53 participants with psychotic disorders and 29 participants with no history of psychosis performed a modified n-back task with fear and neutral distractors. Hierarchical regression analyses showed that psychotic symptoms entered after diagnosis accounted for unique variance in fear versus neutral accuracy and activation in the ventrolateral, dorsolateral, and dorsomedial prefrontal cortex, but diagnostic group entered after psychotic symptoms did not. These results remained even after controlling for negative symptoms, disorganized symptoms, and dysphoria. Finally, worse accuracy and greater prefrontal activity were associated with poorer social functioning and unemployment across diagnostic groups. Present results support the transdiagnostic nature of behavioral and neuroimaging measures of emotion-related WM disruption as they relate to psychotic symptoms, irrespective of diagnosis. They also provide support for the practical utility of these markers in explaining real-world functioning. Overall, these results elucidate key aspects of the RDoC construct of WM maintenance by clarifying its transdiagnostic importance and clinical utility in psychotic disorders. (PsycINFO Database Record

  10. Prenatal stress: Role in psychotic and depressive diseases

    PubMed Central

    Markham, Julie A.

    2011-01-01

    Rationale The birth of neurons, their migration to appropriate positions in the brain, and their establishment of the proper synaptic contacts happen predominately during the prenatal period. Environmental stressors during gestation can exert a major impact on brain development and thereby contribute to the pathogenesis of neuropsychiatric illnesses, such as depression and psychotic disorders including schizophrenia. Objective The objectives here are to present recent preclinical studies of the impact of prenatal exposure to gestational stressors on the developing fetal brain and discuss their relevance to the neurobiological basis of mental illness. The focus is on maternal immune activation, psychological stresses, and malnutrition, due to the abundant clinical literature supporting their role in the etiology of neuropsychiatric illnesses. Results Prenatal maternal immune activation, viral infection, unpredictable psychological stress, and malnutrition all appear to foster the development of behavioral abnormalities in exposed offspring that may be relevant to the symptom domains of schizophrenia and psychosis, including sensorimotor gating, information processing, cognition, social function, and subcortical hyperdopaminergia. Depression-related phenotypes, such as learned helplessness or anxiety, are also observed in some model systems. These changes appear to be mediated by the presence of proinflammatory cytokines and/or corticosteroids in the fetal compartment that alter the development the neuroanatomical substrates involved in these behaviors. Conclusion Prenatal exposure to environmental stressors alters the trajectory of brain development and can be used to generate animal preparations that may be informative in understanding the pathophysiological processes involved in several human neuropsychiatric disorders. PMID:20949351

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

    PubMed

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

    2016-11-01

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

  12. Reduced levels of vasopressin and reduced behavioral modulation of oxytocin in psychotic disorders.

    PubMed

    Rubin, Leah H; Carter, C Sue; Bishop, Jeffrey R; Pournajafi-Nazarloo, Hossein; Drogos, Lauren L; Hill, S Kristian; Ruocco, Anthony C; Keedy, Sarah K; Reilly, James L; Keshavan, Matcheri S; Pearlson, Godfrey D; Tamminga, Carol A; Gershon, Elliot S; Sweeney, John A

    2014-11-01

    Oxytocin (OT) and arginine vasopressin (AVP) exert robust influence on social affiliation and specific cognitive processes in healthy individuals. Abnormalities in these neuroendocrine systems have been observed in psychotic disorders, but their relation to impairments in behavioral domains that these endocrines modulate is not well understood. We compared abnormalities of OT and AVP serum concentrations in probands with schizophrenia (n = 57), schizoaffective disorder (n = 34), and psychotic bipolar disorder (n = 75); their first-degree relatives without a history of psychosis (n = 61, 43, 91, respectively); and healthy controls (n = 66) and examined their association with emotion processing and cognition. AVP levels were lower in schizophrenia (P = .002) and bipolar probands (P = .03) and in relatives of schizophrenia probands (P = .002) compared with controls. OT levels did not differ between groups. Familiality estimates were robust for OT (h(2) = 0.79, P = 3.97e-15) and AVP (h(2) = 0.78, P = 3.93e-11). Higher levels of OT were associated with better emotion recognition (β = 0.40, P < .001) and general neuropsychological function (β = 0.26, P = .04) in healthy controls as expected but not in any proband or relative group. In schizophrenia, higher OT levels were related to greater positive symptom severity. The dissociation of OT levels and behavioral function in all proband and relative groups suggests that risk and illness factors associated with psychotic disorders are not related to reduced OT levels but to a disruption in the ability of physiological levels of OT to modulate social cognition and neuropsychological function. Decreased AVP levels may be a marker of biological vulnerability in schizophrenia because alterations were seen in probands and relatives, and familiality was high.

  13. Verbal hallucinations in psychotic patients.

    PubMed

    Ettinger, B; Telerand, A; Kronenberg, Y; Gaoni, B

    1991-01-01

    "Verbal hallucinations" are sentences that psychotic patients may say repeatedly throughout a conversation which are out of context or unconnected to the topic of conversation. These hallucinations are not the outcome of a remembrance of an experience or an event and do not bring about any emotional relief or catharsis, but they supply valuable information. They resemble Jacques Lacan's description of the psychotic mechanism "Forclusion." This mechanism relates to experiences that did not undergo the process of primary symbolization through language, and experiences where words were attached but were not bound to the language structure. The result being that these experiences did not enter into the unconscious discourse of the subject. This information can reappear as verbal hallucinations in the psychotic patient. In such cases, the therapist, with the assistance of the patient's family, must investigate the meaning of the verbal hallucinations through research into the patient's and family's history in the phase prior to language development. When such a connection is discovered, the therapist must then bridge the hallucinations with the events unknown to the patient but contained in his subconscious. The therapist's role in such cases resembles that of a parent with a child: To translate the subject's experience through language from the physical schema to the body image and symbolic plane and in so doing, give meaning to meaninglessness. In our paper three short clinical cases are presented.

  14. The relationship between malocclusion, benign joint hypermobility syndrome, condylar position and TMD symptoms.

    PubMed

    Barrera-Mora, José Ma; Espinar Escalona, Eduardo; Abalos Labruzzi, Camilo; Llamas Carrera, José Ma; Ballesteros, Emilio Jiménez-Castellanos; Solano Reina, Enrique; Rocabado, Mariano

    2012-04-01

    The current study investigated the association between temporomandibular disorders, malocclusion patterns, benign joint hypermobility syndrome and the initial condylar position. One hundred sixty-two subjects were analyzed using the Rocabado Temporomandibular Pain Analysis; Helkimo Index parameters; the Carter-Wilkinson modified test; and a mounting cast with condylar position indicator registration (MPI). The study revealed a significant association between: 1. Delta H, skeletal pattern (p = 0.034); 2. Delta Y, transversal malocclusion (p = 0.04); 3. right and left, Delta Z, right and left posteroinferior synovial pain (p < 0.05); 4. hypermobility scale, gender (p < 0.001), malocclusion pattern (p = 0.021); 5. TMJ function impairment, gender (p = 0.043); 6. sagittal malocclusion pattern, right temporomandibular pain analysis joint (TPAJ) (p = 0.0034); 7. TMJ function impairment, left and right TPAJ (p = 0.007); and 8. mandibular motion, left and right TPAJ (p = 0.035, p = 0.015). The conclusion was that anterior crossbite and condylar displacements in the vertical plane are risk factors in developing TMJ symptoms.

  15. False-positive rates associated with the use of multiple performance and symptom validity tests.

    PubMed

    Larrabee, Glenn J

    2014-06-01

    Performance validity test (PVT) error rates using Monte Carlo simulation reported by Berthelson and colleagues (in False positive diagnosis of malingering due to the use of multiple effort tests. Brain Injury, 27, 909-916, 2013) were compared with PVT and symptom validity test (SVT) failure rates in two nonmalingering clinical samples. At a per-test false-positive rate of 10%, Monte Carlo simulation overestimated error rates for: (i) failure of ≥2 out of 5 PVTs/SVT for Larrabee (in Detection of malingering using atypical performance patterns on standard neuropsychological tests. The Clinical Neuropsychologist, 17, 410-425, 2003) and ACS (Pearson, Advanced clinical solutions for use with WAIS-IV and WMS-IV. San Antonio: Pearson Education, 2009) and (ii) failure of ≥2 out of 7 PVTs/SVT for Larrabee (Detection of malingering using atypical performance patterns on standard neuropsychological tests. The Clinical Neuropsychologist, 17, 410-425, 2003; Malingering scales for the Continuous Recognition Memory Test and Continuous Visual Memory Test. The Clinical Neuropsychologist, 23, 167-180, 2009 combined). Monte Carlo overestimation is likely because PVT performances are atypical in pattern or degree for what occurs in actual neurologic, psychiatric, or developmental disorders. Consequently, PVT scores form skewed distributions with performance at ceiling and restricted range, rather than forming a standard normal distribution with mean of 0 and standard deviation of 1.0. These results support the practice of using ≥2 PVT/SVT failures as representing probable invalid clinical presentation.

  16. Maternal Prenatal Positive Affect, Depressive and Anxiety Symptoms and Birth Outcomes: The PREDO Study

    PubMed Central

    Kuusinen, Tiina; Tuovinen, Soile; Villa, Pia; Hämäläinen, Esa; Laivuori, Hannele; Kajantie, Eero; Räikkönen, Katri

    2016-01-01

    Background We investigated whether maternal prenatal emotions are associated with gestational length and birth weight in the large PREDO Study with multiple measurement points of emotions during gestation. Methods Altogether 3376 pregnant women self-assessed their positive affect (PA, Positive and Negative Affect Schedule) and depressive (Center for Epidemiologic Studies Depression Scale, CES-D) and anxiety (Spielberger State Anxiety Scale, STAI) symptoms up to 14 times during gestation. Birth characteristics were derived from the National Birth Register and from medical records. Results One standard deviation (SD) unit higher PA during the third pregnancy trimester was associated with a 0.05 SD unit longer gestational length, whereas one SD unit higher CES-D and STAI scores during the third trimester were associated with 0.04–0.05 SD unit shorter gestational lengths (P-values ≤ 0.02), corresponding to only 0.1–0.2% of the variation in gestational length. Higher PA during the third trimester was associated with a significantly decreased risk for preterm (< 37 weeks) delivery (for each SD unit higher positive affect, odds ratio was 0.8-fold (P = 0.02). Mothers with preterm delivery showed a decline in PA and an increase in CES-D and STAI during eight weeks prior to delivery. Post-term birth (≥ 42 weeks), birth weight and fetal growth were not associated with maternal prenatal emotions. Conclusions This study with 14 measurements of maternal emotions during pregnancy show modest effects of prenatal emotions during the third pregnancy trimester, particularly in the weeks close to delivery, on gestational length. From the clinical perspective, the effects were negligible. No associations were detected between prenatal emotions and birth weight. PMID:26919119

  17. Determinants of subjective and objective burden of informal caregiving of patients with psychotic disorders

    PubMed Central

    Flyckt, Lena; Fatouros-Bergman, Helena; Koernig, Thomas

    2015-01-01

    Background: In a previous study, the objective burden of informal caregiving to patients with psychotic disorders amounted to 22 hours/week, and the subjective burden was huge with predominately anxiety and depression as main symptoms. In this study, determinants of the informal caregiving burden are analyzed to find foci for interventions to ease the size of burden. Methods: Patients with psychotic disorders (n = 107) and their informal caregivers (n = 118) were included. They were assessed with a comprehensive battery of rating scales including patient and caregiver characteristics as well as the amount and quality of health-care provision. Results: A multiple linear regression analysis showed that the subjective burden was significantly lower when patients had higher levels of functioning and when the health status of the informal caregivers was good. No significant determinants were found for the objective burden, but an association was found between a higher socioeconomic status of the caregivers and the amount of money provided for the patient. An association was also found between a positive perception of caregiving and more hours spent on caregiving. Conclusion: The functioning level of the patients was the main determinant of the subjective burden of informal care. For the objective burden, no main determinant was found. PMID:25770207

  18. D-cycloserine increases positive symptoms in chronic schizophrenic patients when administered in addition to antipsychotics: a double-blind, parallel, placebo-controlled study.

    PubMed

    van Berckel, B N; Evenblij, C N; van Loon, B J; Maas, M F; van der Geld, M A; Wynne, H J; van Ree, J M; Kahn, R S

    1999-08-01

    A hypofunction of the glutamatergic system and NMDA receptors in schizophrenia has been hypothesized. Therefore, stimulation of these receptors could be of benefit to patients with schizophrenia. D-cycloserine has been used for this purpose. This study reports the effects of 100 mg D-cycloserine, when added to typical antipsychotics in chronic schizophrenic patients exhibiting prominent negative symptoms, using a placebo-controlled, double-blind, parallel, design. D-cycloserine slightly worsened psychotic symptoms and general psychopathology as compared to placebo. D-cycloserine failed to change negative symptoms and had no effect on extrapyramidal symptoms. The exacerbation of schizophrenic symptoms may be explained by the antagonistic effects of this dose of D-cycloserine at the glycine recognition site of the NMDA receptor due to competition with the endogenous agonist glycine. Another explanation for the increase in psychopathology may be an interaction with the effects of antipsychotics on NMDA mediated neurotransmission. Thus, D-cycloserine in this study did not ameliorate schizophrenic symptoms. However, the fact that they actually worsened suggests that NMDA systems may be involved in the pathogenesis of schizophrenia. Further placebo-controlled studies with lower dosages of D-cycloserine, preferably in drug-free patients, are necessary to evaluate if D-cycloserine is of use for the treatment of patients with schizophrenia.

  19. [Intervention for psychotic experience involved in offending behavior].

    PubMed

    Kikuchi, Akiko

    2010-01-01

    Cognitive behaviour therapy for psychosis (CBTp) as an adjunct to standard psychiatric care can make substantial difference in symptom distress, insight, and adherence to treatment. However, studies on the effect of cognitive behaviour therapy on offending behaviours influenced by psychotic experience are in its very early stage. This paper summarizes the conceptualization, treatment programme development, and individual therapy to address psychotic experience involved in offending behaviours in mentally disordered offenders (MDOs). It is argued that, 1) intensive intervention is recommended for those MDOs with general risk factors in addition to psychosis-related-risk factors, 2) MDOs may benefit from CBTp and general offending behaviour programmes, 3) it is important to focus on aggression-neutralization cognitions.

  20. Characterization of Psychotic Experiences in Adolescence Using the Specific Psychotic Experiences Questionnaire: Findings From a Study of 5000 16-Year-Old Twins

    PubMed Central

    Ronald, Angelica; Sieradzka, Dominika; Cardno, Alastair G.; Haworth, Claire M. A.; McGuire, Philip; Freeman, Daniel

    2014-01-01

    We aimed to characterize multiple psychotic experiences, each assessed on a spectrum of severity (ie, quantitatively), in a general population sample of adolescents. Over five thousand 16-year-old twins and their parents completed the newly devised Specific Psychotic Experiences Questionnaire (SPEQ); a subsample repeated it approximately 9 months later. SPEQ was investigated in terms of factor structure, intersubscale correlations, frequency of endorsement and reported distress, reliability and validity, associations with traits of anxiety, depression and personality, and sex differences. Principal component analysis revealed a 6-component solution: paranoia, hallucinations, cognitive disorganization, grandiosity, anhedonia, and parent-rated negative symptoms. These components formed the basis of 6 subscales. Correlations between different experiences were low to moderate. All SPEQ subscales, except Grandiosity, correlated significantly with traits of anxiety, depression, and neuroticism. Scales showed good internal consistency, test-retest reliability, and convergent validity. Girls endorsed more paranoia, hallucinations, and cognitive disorganization; boys reported more grandiosity and anhedonia and had more parent-rated negative symptoms. As in adults at high risk for psychosis and with psychotic disorders, psychotic experiences in adolescents are characterized by multiple components. The study of psychotic experiences as distinct dimensional quantitative traits is likely to prove an important strategy for future research, and the SPEQ is a self- and parent-report questionnaire battery that embodies this approach. PMID:24062593

  1. Intraoperative Motor Symptoms during Brain Tumor Resection in the Supplementary Motor Area (SMA) without Positive Mapping during Awake Surgery.

    PubMed

    Nakajima, Riho; Nakada, Mitsutoshi; Miyashita, Katsuyoshi; Kinoshita, Masashi; Okita, Hirokazu; Yahata, Tetsutaro; Hayashi, Yutaka

    2015-01-01

    Awake surgery could be a useful modality for lesions locating in close proximity to the eloquent areas including primary motor cortex and pyramidal tract. In case with supplementary motor area (SMA) lesion, we often encounter with intraoperative motor symptoms during awake surgery even in area without positive mapping. Although the usual recovery of the SMA syndrome has been well documented, rare cases with permanent deficits could be encountered in the clinical setting. It has been difficult to evaluate during surgery whether the intraoperative motor symptoms lead to postoperative permanent deficits. The purpose of this study was to demonstrate the intraoperative motor symptoms could be reversible, further to provide useful information for making decision to continue surgical procedure of tumor resection. Eight consecutive patients (from July 2012 to June 2014, six men and two women, aged 33-63 years) with neoplastic lesions around the SMA underwent an awake surgery. Using a retrospective analysis of intraoperative video records, intraoperative motor symptoms during tumor resection were investigated. In continuous functional monitoring during resection of SMA tumor under awake conditions, the following motor symptoms were observed during resection of the region without positive mapping: delayed motor weakness, delay of movement initiation, slowness of movement, difficulty in dual task response, and coordination disturbance. In seven patients hemiparesis observed immediately after surgery recovered to preoperative level within 6 weeks. During awake surgery for SMA tumors, the above-mentioned motor symptoms could occur in area without positive mapping and might be predictors for reversible SMA syndrome.

  2. A change in electrographic activity and blood flow during interictal and postictal psychotic states in a patient with epilepsy

    PubMed Central

    Yasumoto, Shingo; Motooka, Hiromichi; Ito, Yuji; Uchimura, Naohisa

    2015-01-01

    We report a patient with epilepsy who experienced interictal and postictal psychoses. Her psychiatric symptoms consisted of grandiose and fantastic delusions during both psychotic states. During remission, electroencephalography showed bitemporal epileptiform discharges that were predominant in the right temporal region. Epileptiform discharges present during the psychotic states were predominant in the left temporal region. Single-photon emission computed tomography showed hyperperfusion in the left basal ganglia during the interictal psychotic state and hyperperfusion in the right temporal lobe and left basal ganglia during the postictal psychotic state. We suggest that the occurrence of postictal and interictal psychotic states in this patient were associated with a common change in electrographic activity and blood flow. PMID:26106577

  3. Depression symptoms, social support and overall health among HIV-positive individuals in Kenya.

    PubMed

    Kingori, Caroline; Haile, Zelalem T; Ngatia, Peter

    2015-03-01

    In Kenya, there was a reported decline in HIV incidence and prevalence among those aged 15 to 64 years and children. Despite the decline, closer assessment of psychosocial issues like depression, contextual factors (family and community), and social support is necessary given the likely impact on overall health and HIV prevention. This paper examines an association between symptoms of depression and social support on overall health among HIV-positive participants recruited from an HIV clinic in Kenya. Descriptive statistics and logistic regression analyses were utilized. Findings reveal that compared to those with minimal depression (referent category) participants with mild, moderate, moderately severe/severe depression had higher odds of having poor health. For social support, compared with participants with no social support (referent category), participants with high social support had lower odds of having poor overall health in both unadjusted and multivariable-adjusted models. In conclusion, this study suggests that HIV clinics and interventions need to focus more on the psychological and/or mental health status of HIV-infected individuals while providing avenues such as social support groups that can be a buffer against the negative impact of HIV infection and depression on overall health outcomes.

  4. Cognitive reappraisal and secondary control coping: associations with working memory, positive and negative affect, and symptoms of anxiety/depression.

    PubMed

    Andreotti, Charissa; Thigpen, Jennifer E; Dunn, Madeleine J; Watson, Kelly; Potts, Jennifer; Reising, Michelle M; Robinson, Kristen E; Rodriguez, Erin M; Roubinov, Danielle; Luecken, Linda; Compas, Bruce E

    2013-01-01

    The current study examined the relations of measures of cognitive reappraisal and secondary control coping with working memory abilities, positive and negative affect, and symptoms of anxiety and depression in young adults (N=124). Results indicate significant relations between working memory abilities and reports of secondary control coping and between reports of secondary control coping and cognitive reappraisal. Associations were also found between measures of secondary control coping and cognitive reappraisal and positive and negative affect and symptoms of depression and anxiety. Further, the findings suggest that reports of cognitive reappraisal may be more strongly predictive of positive affect whereas secondary control coping may be more strongly predictive of negative affect and symptoms of depression and anxiety. Overall, the results suggest that current measures of secondary control coping and cognitive reappraisal capture related but distinct constructs and suggest that the assessment of working memory may be more strongly related to secondary control coping in predicting individual differences in distress.

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

    PubMed

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

    2017-04-01

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

  6. Exploring correlations between positive psychological resources and symptoms of psychological distress among hematological cancer patients: a cross-sectional study.

    PubMed

    Wang, Zi-Yue; Liu, Li; Shi, Meng; Wang, Lie

    2016-07-01

    Hematological cancer patients experience high levels of psychological distress during diagnoses and intensive treatments. The aim of the present study is to explore the effects of positive psychological resources on depressive and anxiety symptoms in hematological cancer patients. This survey was conducted in a hospital during the period from July 2013 to April 2014. A total of 300 inpatients were recruited and finally 227 of them completed the questionnaires. Questionnaires included demographic and clinical variables, the Center for Epidemiologic Studies Depression Scale, the Self-Rating Anxiety Scale, the Life Orientation Scale-Revised, the General Perceived Self-Efficacy Scale, and the Resilience Scale-14. Results showed that the prevalence of depressive and anxiety symptoms was 66.1 and 45.8%, respectively. Both optimism (β = -.479, p < .001) and resilience (β = -.174, p < .05) were negatively associated with depressive symptoms, and optimism (β = -.393, p < .001) was negatively associated with anxiety symptoms. However, resilience (β = -.133, p > .05) was not significantly associated with anxiety symptoms, and self-efficacy was not significantly associated with depressive (β = -.032, p > .05) or anxiety symptoms (β = -.055, p > .05). The results suggest that hematological cancer patients who possess high levels of positive psychological resources may have fewer symptoms of psychological distress. The findings indicate that enhancing positive psychological resources can be considered in developing intervention strategies for decreasing depressive and anxiety symptoms.

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

    PubMed

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

    2016-11-01

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

  8. Applying Prevention and Positive Youth Development Theory to Predict Depressive Symptoms among Young People

    ERIC Educational Resources Information Center

    Olson, Jonathan R.; Goddard, H. Wallace

    2015-01-01

    The purpose of this study was to identify predictors of depressive symptoms among adolescents using concepts drawn from two theoretical models that underlie popular youth-focused programs. Specifically, we assessed the degree to which family-level risk factors increase the likelihood of depressive symptoms, and the degree to which community and/or…

  9. Medication Adherence and HIV Symptom Distress in Relation to Panic Disorder Among HIV-Positive Adults Managing Opioid Dependence

    PubMed Central

    Kosiba, Jesse D.; Gonzalez, Adam; O'Cleirigh, Conall

    2015-01-01

    Panic disorder (PD) occurs at greater rates among those with HIV compared to those without HIV. Rates of PD may be elevated among those with opioid dependence (persons who inject drugs, PWID). Persons with HIV experience common bodily symptoms as a result of the disease and these symptoms overlap with those of PD which may contribute to a “fear of fear” cycle present in PD. HIV-positive, PWID represent an at-risk population in terms of poor medication adherence. HIV symptoms and HIV medication side-effects commonly overlap with panic symptoms and may affect HIV medication adherence. The aim of this investigation was to examine the impact of PD on HIV-related symptom distress and HIV medication adherence in HIV-positive adults (N = 131) in treatment for opioid use. Those with a diagnosis of PD evidenced greater levels of HIV symptom distress and lower levels of medication adherence than those without current PD. Results highlight the clinical importance of assessing for and treating PD among individuals with HIV that are prescribed antiretroviral therapy. Future work would benefit from examining observed associations longitudinally and identifying potential mechanisms involved. PMID:26146476

  10. A reduction in positive self-judgment bias is uniquely related to the anhedonic symptoms of depression.

    PubMed

    Dunn, Barnaby D; Stefanovitch, Iolanta; Buchan, Kate; Lawrence, Andrew D; Dalgleish, Tim

    2009-05-01

    Identifying patterns of biased cognitive processing specific to depression has proved difficult. The tripartite model of mood disorders [Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316-336] suggests that a clearer processing 'blueprint' may emerge if depression is viewed dimensionally rather than categorically and by focusing on variations in the degree of positive, rather than negative, processing bias. To investigate this possibility, the present study examined the extent to which a reduced positive self-judgment bias previously found in depressed individuals relates to depression-specific anhedonic symptoms. Sixty participants with varying levels of anxiety and depression symptoms evaluated their own performance on a working memory task in the absence of external feedback. Overall, participants showed a positive self-judgment bias, overestimating the number of trials they had performed correctly relative to objective criteria. Consistent with the tripartite framework, the extent of this positive self-judgment bias was significantly and uniquely related to depression-specific symptoms, with the positive bias reducing as anhedonia severity increased across three different symptom measures.

  11. Psychotic disorders in DSM-5 and ICD-11.

    PubMed

    Biedermann, Falko; Fleischhacker, W Wolfgang

    2016-08-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published by the American Psychiatric Association (APA) in 2013, and the Work Group on the Classification of Psychotic disorders (WGPD), installed by the World Health Organization (WHO), is expected to publish the new chapter about schizophrenia and other primary psychotic disorders in 2017. We reviewed the available literature to summarize the major changes, innovations, and developments of both manuals. If available and possible, we outline the theoretical background behind these changes. Due to the fact that the development of ICD-11 has not yet been completed, the details about ICD-11 are still proposals under ongoing revision. In this ongoing process, they may be revised and therefore have to be seen as proposals. DSM-5 has eliminated schizophrenia subtypes and replaced them with a dimensional approach based on symptom assessments. ICD-11 will most likely go in a similar direction, as both manuals are planned to be more harmonized, although some differences will remain in details and the conceptual orientation. Next to these modifications, ICD-11 will provide a transsectional diagnostic criterion for schizoaffective disorders and a reorganization of acute and transient psychotic and delusional disorders. In this manuscript, we will compare the 2 classification systems.

  12. Developing therapeutics for schizophrenia and other psychotic disorders.

    PubMed

    Marek, Gerard; Merchant, Kalpana

    2005-10-01

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

  13. Maternal Positive and Negative Interaction Behaviors and Early Adolescents' Depressive Symptoms: Adolescent Emotion Regulation as a Mediator

    ERIC Educational Resources Information Center

    Yap, Marie B. H.; Schwartz, Orli S.; Byrne, Michelle L.; Simmons, Julian G.; Allen, Nicholas B.

    2010-01-01

    This study examined the relation between mothers' positive and negative interaction behaviors during mother-child interactions and the emotion regulation (ER) and depressive symptoms of their adolescent offspring. Event-planning (EPI) and problem-solving interactions (PSI) were observed in 163 mother-adolescent dyads, and adolescents also provided…

  14. Duration of attenuated positive and negative symptoms in individuals at clinical high risk: Associations with risk of conversion to psychosis and functional outcome.

    PubMed

    Carrión, Ricardo E; Demmin, Docia; Auther, Andrea M; McLaughlin, Danielle; Olsen, Ruth; Lencz, Todd; Correll, Christoph U; Cornblatt, Barbara A

    2016-10-01

    Research in individuals at clinical high-risk (CHR) for psychosis has focused on subjects with no more than 12 months of present or worsened attenuated positive symptoms. However, the impact of long duration attenuated positive and/or negative prodromal symptoms on outcomes is unclear. Seventy-six CHR subjects with attenuated positive symptoms and at least moderate severity level negative symptoms rated on the Scale of Prodromal Symptoms (SOPS) were prospectively followed for a mean of 3.0 ± 1.6 years. Social and Role functioning was assessed with the Global Functioning: Social and Role scales. Correlations between attenuated positive and negative symptom duration and severity and conversion to psychosis and functional outcomes were analyzed. The average onset of SOPS rated negative symptoms (M = 53.24 months, SD = 48.90, median = 37.27) was approximately twelve months prior to the emergence of attenuated positive symptom (M = 40.15 months, SD = 40.33, median = 24.77, P < 0.05). More severe positive symptoms (P = 0.004), but not longer duration of positive (P = 0.412) or negative (P = 0.754) symptoms, predicted conversion to psychosis. Neither positive symptom duration (P = 0.181) nor severity (P = 0.469) predicted role or social functioning at study endpoint. Conversely, longer negative symptom duration predicted poor social functioning (P = 0.004). Overall, our findings suggest that the severity of attenuated positive symptoms at baseline may be more important than symptom duration for determining individuals at increased risk of developing psychosis. In contrast, long-standing negative symptoms may be associated with persistent social difficulties and therefore have an important position in the treatment of disability.

  15. HIV infection duration, social support and the level of trauma symptoms in a sample of HIV-positive Polish individuals.

    PubMed

    Rzeszutek, Marcin; Oniszczenko, Włodzimierz; Żebrowska, Magdalena; Firląg-Burkacka, Ewa

    2015-01-01

    The aim of this study was to investigate the relationship between the average HIV infection duration and the level of quantitatively rated post-traumatic stress disorder (PTSD) symptoms and social support dimensions in a sample of 562 Polish HIV+ adults. Possible moderating effects of social support on the relationship between the average HIV infection duration and the level of PTSD symptoms were also analysed. The results of this study suggest that the average HIV infection duration may intensify PTSD symptoms and deteriorate the perceived availability of social support in HIV+ individuals. However, a positive relationship between HIV infection duration and the level of trauma symptoms was observed only in the group of HIV+ individuals with low perceived available social support, but not in the group of HIV-infected individuals with high perceived available social support. This research provided some new insight into the psychological and social aspects of living with HIV. In particular, our results suggest that although HIV infection duration may intensify trauma symptoms and deteriorate social support, perceived available social support may act as a buffer against HIV-related trauma symptoms.

  16. [A case of shared psychotic disorder (folie à deux) with original aspects associated with cross-cultural elements].

    PubMed

    Cuoco, Valentina; Colletti, Chiara; Anastasia, Annalisa; Weisz, Filippo; Bersani, Giuseppe

    2015-01-01

    Shared psychotic disorder (folie à deux) is a rare condition characterized by the transmission of delusional aspects from a patient (the "dominant partner") to another (the "submissive partner") linked to the first by a close relationship. We report the case of two Moroccan sisters who have experienced a combined delusional episode diagnosed as shared psychotic disorder. In these circumstances, assessment of symptoms from a cross-cultural perspective is a key factor for proper diagnostic evaluation.

  17. Effectiveness of rivastigmine on positive, negative, and cognitive symptoms of schizophrenia: a double-blind clinical trial

    PubMed Central

    Shoja Shafti, Saeed; Azizi Khoei, Abbas

    2016-01-01

    Background: Several lines of evidence suggest that the cholinergic system may be disrupted in schizophrenia and so this may contribute to the cognitive impairments of schizophrenic patients. Because such deficits do not respond to neuroleptic treatment, different approaches have been done by acetylcholinesterase inhibitors (AChEIs). The objective of the present assessment was to evaluate the safety and clinical effects of rivastigmine, as an adjunctive drug, on the clinical symptoms of schizophrenia. Methods: A total of 46 patients with a diagnosis of schizophrenia entered into a 12-week, double-blind, clinical trial for random assignment to rivastigmine or placebo, as adjuvant to their current antipsychotic medication. Positive and Negative Symptom Scale (PANSS) and Mini Mental State Examination (MMSE) had been used as the primary outcome measures. Clinical Global Impressions- Improvement (CGI-I) Scale and Extrapyramidal Symptom Rating Scale (ESRS) had been used as the secondary measures. Treatment efficacy was evaluated by a Student’s t test and repeated-measures analysis of variance (ANOVA). Statistical significance was defined as a two-sided p value ⩽ 0.05. Cohen’s standard (d) and correlation measures of effect size (r) had been calculated for comparing baseline to endpoint changes. Results: According to the findings, except for significant enhancement of MMSE by rivastigmine (p < 0.001), no significant improvement in PANSS (negative symptoms), PANSS (positive symptoms), and PANSS (general psychopathology) was evident in the target group. Also, except for significant improvement of CGI-I by rivastigmine in intragroup analysis, no significant effectiveness was evident in between-group analysis or repeated-measures ANOVA. ESRS, also, did not show any significant alteration in either group. Effect size (ES) analysis showed a large improvement in MMSE by rivastigmine. Conclusions: According to the findings, while rivastigmine could not induce significant

  18. The Reliability and Validity of Liu´s Self-Report Questionnaire for Screening Putative Pre-Psychotic States (BQSPS) in Adolescents

    PubMed Central

    Núñez, D.; Arias, V. B.; Campos, S.

    2016-01-01

    The usage of rigorous analyses based on contemporary methods to enhance psychometric properties of screening questionnaires aimed to address psychotic-like experiences (PLE) is currently being encouraged. The Brief Self-Report Questionnaire for Screening Putative Pre-psychotic States (BQSPS) is a recently created tool addressing PLE beyond attenuated positive symptoms (APS). Its psychometric properties as a screening tool for first step assessment seems to be adequate, but further research is needed to evaluate certain validity aspects, particularly its dimensionality, internal structure, and psychometric properties in different populations. We assessed the reliability, construct validity, and criterion validity of BQSPS in two samples: 727 adolescents aged 13–18 years, and 245 young adults aged 18–33 years. We used exploratory structural equation modeling (ESEM), confirmatory factor analysis (CFA), and Structural Equation Modeling (SEM). The original four-factor structure was not replicated. The best fit in adolescents was obtained by a structure of three-correlated factors: social anxiety (SA), negative symptoms (NS), and positive symptoms (PS). This structure was confirmed in young adult subjects. The three-factor model reached a predictive capability with suicidality as external criterion. PLE are represented by a three-factor structure, which is highly stable between adolescent and young-adult samples. Although the BQSPS seems to be a valid tool for screening PLE, its psychometric properties should be improved to obtain a more accurate measurement. PMID:27973533

  19. Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis.

    PubMed

    Sin, Nancy L; Lyubomirsky, Sonja

    2009-05-01

    Do positive psychology interventions-that is, treatment methods or intentional activities aimed at cultivating positive feelings, positive behaviors, or positive cognitions-enhance well-being and ameliorate depressive symptoms? A meta-analysis of 51 such interventions with 4,266 individuals was conducted to address this question and to provide practical guidance to clinicians. The results revealed that positive psychology interventions do indeed significantly enhance well-being (mean r=.29) and decrease depressive symptoms (mean r=.31). In addition, several factors were found to impact the effectiveness of positive psychology interventions, including the depression status, self-selection, and age of participants, as well as the format and duration of the interventions. Accordingly, clinicians should be encouraged to incorporate positive psychology techniques into their clinical work, particularly for treating clients who are depressed, relatively older, or highly motivated to improve. Our findings also suggest that clinicians would do well to deliver positive psychology interventions as individual (versus group) therapy and for relatively longer periods of time.

  20. Exposure to conflict and disaster: A national survey on the prevalence of psychotic experiences in Sri Lanka.

    PubMed

    Keraite, Arune; Sumathipala, Athula; Siriwardhana, Chesmal; Morgan, Craig; Reininghaus, Ulrich

    2016-03-01

    Recent research conducted in high-income countries suggests psychotic experiences are common in the general population, but evidence from low- and middle-income countries (LMIC) remains limited. Sri Lanka is a LMIC affected by three decades of civil conflict and, in 2004, a devastating tsunami. This study aimed to investigate the prevalence of psychotic experiences in a general population sample in Sri Lanka and associations with conflict- and tsunami-related trauma. This is a first National Mental Health Survey conducted in Sri Lanka. A cross-sectional, multi-stage, cluster sampling design was used to estimate the prevalence of psychotic symptoms. Data on socio-demographic characteristics, conflict- and tsunami-related trauma, and psychotic experiences were collected using culturally validated measures in a sample of 5927 participants. The weighted prevalence of psychotic symptoms was 9.7%. Exposure to one or more conflict-related events (adj. OR 1.79, 95% CI 1.40-2.31, p<0.001) and loss or injury of a family member or friend through conflict (adj. OR, 1.83, 95% CI 1.42-2.37, p<0.001) were associated with increased odds of reporting psychotic experiences. Psychotic experiences were more common in individuals directly exposed to tsunami disaster (adj. OR, 1.68, 95% CI 1.04-2.73, P=0.035) and in those who had a family member who died or was injured as result of tsunami (adj. OR, 1.42, 95% CI 1.04-1.94, p=0.029). Our findings suggest that psychotic experiences are common in the Sri Lankan population. Exposure to traumatic events in armed conflicts and natural disasters may be important socio-environmental factors in the development of psychotic experiences.

  1. Childhood trauma, BDNF Val66Met and subclinical psychotic experiences. Attempt at replication in two independent samples.

    PubMed

    de Castro-Catala, Marta; van Nierop, Martine; Barrantes-Vidal, Neus; Cristóbal-Narváez, Paula; Sheinbaum, Tamara; Kwapil, Thomas R; Peña, Elionora; Jacobs, Nele; Derom, Catherine; Thiery, Evert; van Os, Jim; van Winkel, Ruud; Rosa, Araceli

    2016-12-01

    Childhood trauma exposure is a robust environmental risk factor for psychosis. However, not all exposed individuals develop psychotic symptoms later in life. The Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism (rs6265) has been suggested to moderate the psychosis-inducing effects of childhood trauma in clinical and nonclinical samples. Our study aimed to explore the interaction effect between childhood trauma and the BDNF Val66Met polymorphism on subclinical psychotic experiences (PEs). This was explored in two nonclinical independent samples: an undergraduate and technical-training school student sample (n = 808, sample 1) and a female twin sample (n = 621, sample 2). Results showed that childhood trauma was strongly associated with positive and negative PEs in nonclinical individuals. A BDNF Val66Met x childhood trauma effect on positive PEs was observed in both samples. These results were discordant in terms of risk allele: while in sample 1 Val allele carriers, especially males, were more vulnerable to the effects of childhood trauma regarding PEs, in sample 2 Met carriers presented higher PEs scores when exposed to childhood trauma, compared with Val carriers. Moreover, in sample 2, a significant interaction was also found in relation to negative PEs. Our study partially replicates previous findings and suggests that some individuals are more prone to develop PEs following childhood trauma because of a complex combination of multiple factors. Further studies including genetic, environmental and epigenetic factors may provide insights in this field.

  2. Patterns and Determinants of Treatment Seeking among Previously Untreated Psychotic Patients in Aceh Province, Indonesia: A Qualitative Study

    PubMed Central

    Marthoenis, Marthoenis; Aichberger, Marion C.; Schouler-Ocak, Meryam

    2016-01-01

    Immediate treatment of first-episode psychosis is essential in order to achieve a positive outcome. However, Indonesian psychiatric patients often delay accessing health services, the reason for which is not yet fully understood. The current study aimed to understand patterns of treatment seeking and to reveal determinants of the delay in accessing psychiatric care among first-time user psychotic patients. Qualitative interviews were conducted with sixteen family members who accompanied the patients to a psychiatric hospital. Many families expressed beliefs that mental illness appertains to village sickness and not hospital sickness; therefore, they usually take the patients to traditional or religious healers before taking them to a health professional. They also identified various factors that potentially delay accessing psychiatric treatment: low literacy and beliefs about the cause of the illness, stigmatisation, the role of extended family, financial problems, and long distance to the psychiatric hospital. On the other hand, the family mentioned various factors related to timely help seeking, including being a well-educated family, living closer to health facilities, previous experience of successful psychotic therapy, and having more positive symptoms of psychosis. The findings call for mental health awareness campaigns in the community. PMID:27382501

  3. [Travel and psychotic disorders: clinical aspects and practical recommendations].

    PubMed

    Vermersch, Charles; Geoffroy, Pierre Alexis; Fovet, Thomas; Thomas, Pierre; Amad, Ali

    2014-12-01

    Psychotic disorders are frequent among travelers (10 to 20 % of medical evacuations). The travel is a concentrate of stressors. Psychotic disorders are not a contraindication to travel. Special precautions should be taken for patients with psychotic disorders wishing to travel. These precautions could apply to patients at risk of transition to a psychotic disorder.

  4. Indirect Effects of Attributional Style for Positive Events on Depressive Symptoms Through Self-Esteem During Early Adolescence.

    PubMed

    Rueger, Sandra Yu; George, Rachel

    2017-04-01

    Research on adolescent depression has overwhelmingly focused on risk factors, such as stressful negative events and cognitive vulnerabilities, but much important information can be gained by focusing on protective factors. Thus, the current study aimed to broaden understanding on adolescent depression by considering the role of two positive elements as protective factors, attributional style for positive events and self-esteem, in a model of depression. The sample included 491 middle school students (52 % female; n = 249) with an age range from 12 to 15 years (M = 13.2, SD = .70). The sample was ethnically/racially diverse, with 55 % White, 22 % Hispanic, 10 % Asian American, 3 % African American, and 10 % Biracial/Other. Correlational analyses indicated significant cross-sectional and longitudinal associations between an enhancing attributional style (internal, stable, global attributions for positive events), self-esteem and depressive symptoms. Further, prospective analyses using bootstrapping methodology demonstrated significant indirect effects of an enhancing attributional style on decreases in depressive symptoms through its effects on self-esteem. These findings highlight the importance of considering attributional style for positive events as a protective factor in the developmental course of depressive symptoms during early adolescence.

  5. Hypothesis: Grandiosity and Guilt Cause Paranoia; Paranoid Schizophrenia is a Psychotic Mood Disorder; a Review

    PubMed Central

    Lake, Charles Raymond

    2008-01-01

    Delusional paranoia has been associated with severe mental illness for over a century. Kraepelin introduced a disorder called “paranoid depression,” but “paranoid” became linked to schizophrenia, not to mood disorders. Paranoid remains the most common subtype of schizophrenia, but some of these cases, as Kraepelin initially implied, may be unrecognized psychotic mood disorders, so the relationship of paranoid schizophrenia to psychotic bipolar disorder warrants reevaluation. To address whether paranoia associates more with schizophrenia or mood disorders, a selected literature is reviewed and 11 cases are summarized. Comparative clinical and recent molecular genetic data find phenotypic and genotypic commonalities between patients diagnosed with schizophrenia and psychotic bipolar disorder lending support to the idea that paranoid schizophrenia could be the same disorder as psychotic bipolar disorder. A selected clinical literature finds no symptom, course, or characteristic traditionally considered diagnostic of schizophrenia that cannot be accounted for by psychotic bipolar disorder patients. For example, it is hypothesized here that 2 common mood-based symptoms, grandiosity and guilt, may underlie functional paranoia. Mania explains paranoia when there are grandiose delusions that one's possessions are so valuable that others will kill for them. Similarly, depression explains paranoia when delusional guilt convinces patients that they deserve punishment. In both cases, fear becomes the overwhelming emotion but patient and physician focus on the paranoia rather than on underlying mood symptoms can cause misdiagnoses. This study uses a clinical, case-based, hypothesis generation approach that warrants follow-up with a larger representative sample of psychotic patients followed prospectively to determine the degree to which the clinical course observed herein is typical of all such patients. Differential diagnoses, nomenclature, and treatment implications

  6. Hypothesis: grandiosity and guilt cause paranoia; paranoid schizophrenia is a psychotic mood disorder; a review.

    PubMed

    Lake, Charles Raymond

    2008-11-01

    Delusional paranoia has been associated with severe mental illness for over a century. Kraepelin introduced a disorder called "paranoid depression," but "paranoid" became linked to schizophrenia, not to mood disorders. Paranoid remains the most common subtype of schizophrenia, but some of these cases, as Kraepelin initially implied, may be unrecognized psychotic mood disorders, so the relationship of paranoid schizophrenia to psychotic bipolar disorder warrants reevaluation. To address whether paranoia associates more with schizophrenia or mood disorders, a selected literature is reviewed and 11 cases are summarized. Comparative clinical and recent molecular genetic data find phenotypic and genotypic commonalities between patients diagnosed with schizophrenia and psychotic bipolar disorder lending support to the idea that paranoid schizophrenia could be the same disorder as psychotic bipolar disorder. A selected clinical literature finds no symptom, course, or characteristic traditionally considered diagnostic of schizophrenia that cannot be accounted for by psychotic bipolar disorder patients. For example, it is hypothesized here that 2 common mood-based symptoms, grandiosity and guilt, may underlie functional paranoia. Mania explains paranoia when there are grandiose delusions that one's possessions are so valuable that others will kill for them. Similarly, depression explains paranoia when delusional guilt convinces patients that they deserve punishment. In both cases, fear becomes the overwhelming emotion but patient and physician focus on the paranoia rather than on underlying mood symptoms can cause misdiagnoses. This study uses a clinical, case-based, hypothesis generation approach that warrants follow-up with a larger representative sample of psychotic patients followed prospectively to determine the degree to which the clinical course observed herein is typical of all such patients. Differential diagnoses, nomenclature, and treatment implications are

  7. The association between depressive symptoms, anger, and perceived support resources among underserved older HIV positive black/African American adults.

    PubMed

    Whitehead, Nicole Ennis; Hearn, Lauren E; Burrell, Larry

    2014-09-01

    By 2015, half of those living with HIV in the United States will be ≥50 years of age. Research suggests that perceived social support is an important factor in maintaining positive health behaviors in this population. The present study examined the relationship between depressive symptoms and trait anger on perceived social support in a sample of low-income HIV positive (HIV+) African Americans ≥50 years of age. Additionally, we examined life stressors moderated the relationship between mental health and perceived support. This study includes 95 HIV+ men and women ≥50 years of age who identify as black/African American. As expected, depressive symptoms and trait anger showed a strong inverse relationship with perceived support resources. Furthermore, life stressors also showed a strong inverse relationship with perceived support. However, life stressors did not moderate the relationship between depressive symptoms and anger. Instead life stressors demonstrated a strong independent relationship with perceived support. The association between depressive symptoms, trait anger, life stressors, and lower perceived support suggests that these factors play a role in one's ability to access needed support resources. Greater perceived support is associated with improved health in HIV+ persons, and may be especially important in tailoring interventions for those ≥50 years of age.

  8. HIV status disclosure, depressive symptoms, and sexual risk behavior among HIV-positive young men who have sex with men

    PubMed Central

    Cook, Stephanie H.; Valera, Pamela

    2015-01-01

    The rate of HIV infection among young men who have sex with men (YMSM) is increasing in the United States, and targeted research is needed to inform interventions aimed at reducing HIV transmission in this population. This study aims to understand the association between HIV status disclosure and sexual risk behavior among HIV-positive YMSM. A particular focus is given to depressive symptoms and their potential role in explaining the association between HIV disclosure and sexual risk behavior. In a sample of 991 YMSM receiving care at 20 clinics across the United States, Univariate and multivariate analyses were conducted to explore these associations. Approximately one-half (52.4 %) of participants reported disclosing to their current sexual/romantic partner. Disclosure to family members was negatively associated with sexual risk behavior. Also, depressive symptoms were positively associated with sexual risk behavior. We discuss the implications of our findings for future research and intervention. PMID:25773478

  9. A positive influence of vision on motor symptoms during sensory attention focused exercise for Parkinson's disease.

    PubMed

    Sage, Michael D; Almeida, Quincy J

    2010-01-15

    This study evaluated the effect of increased attention to sensory feedback during exercise. Two 12-week exercise programs that differed only in the presence (PD SAFEx) or absence (non-SAFE control group) of increased attention focused on sensory feedback were compared. Participants were assessed symptomatically using the Unified Parkinson's Disease Rating Scale (UPDRS) before the start of the exercise program, immediately following the 12-week program and after a 6-week nonexercise washout period. Secondary outcome measures included the Timed-Up-and-Go (TUG), Grooved Pegboard (GP) and velocity and step length of self-paced gait. Both groups significantly improved on the TUG, GP, velocity, and step length, and this was maintained after a 6-week washout period. Of additional interest, only the PD SAFEx program significantly improved motor symptoms (UPDRS). These gains were maintained in the PD SAFEx group 6 weeks after the exercise was stopped, while motor symptoms significantly worsened in the non-SAFE group. These results suggest that increasing awareness of sensory feedback may be a critical factor that specifically impacts motor symptoms. Future work should strive to uncover the underlying neurophysiological mechanism behind this effect.

  10. Gastroesophageal reflux symptoms in Turkish people: a positive correlation with abdominal obesity in women

    PubMed Central

    Karayaka, Sergul; Mesci, Banu; Oguz, Aytekin; Tamer, Gonca

    2015-01-01

    OBJECTIVE: Metabolic syndrome (MetS) is increasing around the world due to abdominal obesity with altered eating habits and decreased physical activity. The aim of this study was to determine the risk factors for gastroesophagial reflux disease (GERD) symptoms and the prevalence of GERD in patients with MetS. METHODS: Five hundred patients (MetS, n=300 and the control group, n=200) were enrolled in the study. A detailed questionnaire reflux symptoms and behavioral habits was performed. RESULTS: Sixty percent of the subjects were with MetS. GERD rate was significantly higher in the group with MetS compared to subjects without MetS (50.7% vs 26%). Women were more likely to have GERD in both groups (62.6% of women and 28.6% of men ın the MetS group while corresponding rates were 37% vs 16.7% in the control group). Waist circumferences were found to be higher in female MetS patients with GERD. CONCLUSION: GERD is present approximately in every one of the two patients with MetS. Every patient who has MetS should be evaluated in terms of GERD symptoms. PMID:28058320

  11. Positive Psychology Interventions Addressing Pleasure, Engagement, Meaning, Positive Relationships, and Accomplishment Increase Well-Being and Ameliorate Depressive Symptoms: A Randomized, Placebo-Controlled Online Study.

    PubMed

    Gander, Fabian; Proyer, René T; Ruch, Willibald

    2016-01-01

    Seligman (2002) suggested three paths to well-being, the pursuit of pleasure, the pursuit of meaning, and the pursuit of engagement, later adding two more, positive relationships and accomplishment, in his 2011 version. The contribution of these new components to well-being has yet to be addressed. In an online positive psychology intervention study, we randomly assigned 1624 adults aged 18-78 (M = 46.13; 79.2% women) to seven conditions. Participants wrote down three things they related to either one of the five components of Seligman's Well-Being theory (Conditions 1-5), all of the five components (Condition 6) or early childhood memories (placebo control condition). We assessed happiness (AHI) and depression (CES-D) before and after the intervention, and 1-, 3-, and 6 months afterwards. Additionally, we considered moderation effects of well-being levels at baseline. Results confirmed that all interventions were effective in increasing happiness and most ameliorated depressive symptoms. The interventions worked best for those in the middle-range of the well-being continuum. We conclude that interventions based on pleasure, engagement, meaning, positive relationships, and accomplishment are effective strategies for increasing well-being and ameliorating depressive symptoms and that positive psychology interventions are most effective for those people in the middle range of the well-being continuum.

  12. Positive Psychology Interventions Addressing Pleasure, Engagement, Meaning, Positive Relationships, and Accomplishment Increase Well-Being and Ameliorate Depressive Symptoms: A Randomized, Placebo-Controlled Online Study

    PubMed Central

    Gander, Fabian; Proyer, René T.; Ruch, Willibald

    2016-01-01

    Seligman (2002) suggested three paths to well-being, the pursuit of pleasure, the pursuit of meaning, and the pursuit of engagement, later adding two more, positive relationships and accomplishment, in his 2011 version. The contribution of these new components to well-being has yet to be addressed. In an online positive psychology intervention study, we randomly assigned 1624 adults aged 18–78 (M = 46.13; 79.2% women) to seven conditions. Participants wrote down three things they related to either one of the five components of Seligman's Well-Being theory (Conditions 1–5), all of the five components (Condition 6) or early childhood memories (placebo control condition). We assessed happiness (AHI) and depression (CES-D) before and after the intervention, and 1-, 3-, and 6 months afterwards. Additionally, we considered moderation effects of well-being levels at baseline. Results confirmed that all interventions were effective in increasing happiness and most ameliorated depressive symptoms. The interventions worked best for those in the middle-range of the well-being continuum. We conclude that interventions based on pleasure, engagement, meaning, positive relationships, and accomplishment are effective strategies for increasing well-being and ameliorating depressive symptoms and that positive psychology interventions are most effective for those people in the middle range of the well-being continuum. PMID:27242600

  13. Working Memory Capacity and Psychotic-Like Experiences in a General Population Sample of Adolescents and Young Adults

    PubMed Central

    Ziermans, Tim B.

    2013-01-01

    Working memory (WM) impairment is a common feature in individuals with schizophrenia and high-risk for psychosis and a promising target for early intervention strategies. However, it is unclear to what extent WM impairment parallels specific behavioral symptoms along the psychosis continuum. To address this issue, the current study investigated the relation of WM capacity with psychotic-like experiences (PLEs) in a large Swedish population sample (N = 1012) of adolescents and young adults (M = 24.4 years, range 12–35). WM was assessed with two online computer tasks: a task where participants had to identify and remember the location of an odd shape and a task of remembering and following instructions. PLE scores were derived from a translated symptom questionnaire (Community Assessment of Psychic Experiences), which includes positive, negative, and depressive symptom scales. Positive and negative symptom scales were further subdivided into symptom clusters based on factor analyses. The results showed that low WM capacity was modestly associated with increased reports of bizarre experiences (BE) and depressive symptoms, after controlling for age, gender, and global symptom scores. Interestingly, when analyses were repeated for separate age groups, low WM was exclusively associated with a higher frequency of BE for young adults (20–27 years) and with depressive symptoms for older adults (28–35 years). These findings suggest that specific PLEs can be indicative of reduced WM capacity in early adulthood, which in turn may reflect an increased risk for psychosis and a greater need for targeted intervention. In contrast, during adolescence individual differences in cognitive development may influence the strength of the relationships and thereby mask potential vulnerabilities for psychopathology. PMID:24348432

  14. Comorbid depressive symptoms in the developmental course of adolescent-onset psychosis

    PubMed Central

    Myles-Worsley, Marina; Weaver, Starla; Blailes, Francisca

    2008-01-01

    Aim Depressive symptoms are common in the early prodromal phase of schizophrenia and other psychotic disorders. The objectives of the present study were to retrospectively examine the severity of depressive symptoms and their relationship to positive symptoms over the developmental course of adolescent-onset psychosis (AO-PSY). Methods The subjects were 62 unmedicated adolescents with DSM-IV psychosis and 104 normal controls from a Pacific island isolate with an elevated prevalence of schizophrenia. We used a modified K-SADS-PL to assess adolescents for a full range of Axis I psychopathology and quantified severity of depressive and positive symptoms over the adolescent’s lifespan. Results Among AO-PSY subjects, 84% reported abnormal levels of depressive symptoms with mean onset 1.3 years prior to transition to psychosis. In 60% of the AO-PSY subjects with depressive symptoms, positive symptoms began first. A continuous linear increase in depressive symptom severity over the developmental course of illness mirrored the steady rise in positive symptom severity as psychosis emerged. Conclusions We found that it is typically a combination of positive symptoms and depressive symptoms building in parallel that leads from the prodrome to frank psychosis. These results suggest that depressive symptoms represent more of an integral component of disease progression than an independent risk factor that predicts transition to early onset psychosis. PMID:19079763

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

    PubMed

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

    2015-01-01

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

  16. Reporting a Case of Injecting Methylphenidate (Ritalin) Tablets, Intensified Symptoms of Schizoph-renia or Induce Separate Mental Disorder?

    PubMed Central

    Ghaffarinejad, Alireza; Kheradmand, Ali

    2009-01-01

    Background: Methylphenidate is one of the classic amphetamines which can cause or exacerbate psychotic symptoms in schizophrenia patients. Case Report: In this paper, a young man is presented with injection of methylphenidate tablets with acute cellulitis due to this injection and the related symptoms. In the first hospitalization and after recovery from psychotic disorder due to tablet injections, he was under treatment with anti-psychotics because of other symptoms related to schizophrenia. Although the patient was regularly under schizophrenic medication after discharge, he was hospitalized twice more due to psychotic symptoms that appeared after injecting methylphenidate. Conclusion: This report shows psychotic symptoms in schizophrenic patients after injecting methylphenidate. These symptoms cannot be prevented even by anti-psychotic medication of background disease. This case shows the existence of two kinds of psychoses, functional (due to schizophrenia) and organic psychoses (due to methylphenidate use) in the same patient. PMID:24494093

  17. Statin-associated muscle symptoms: position paper from the Luso-Latin American Consortium.

    PubMed

    Sposito, Andrei C; Faria Neto, José Rocha; Carvalho, Luiz Sergio F de; Lorenzatti, Alberto; Cafferata, Alberto; Elikir, Gerardo; Esteban, Eduardo; Morales Villegas, Enrique C; Bodanese, Luiz Carlos; Alonso, Rodrigo; Ruiz, Alvaro J; Rocha, Viviane Z; Faludi, André A; Xavier, Hermes T; Coelho, Otávio Rizzi; Assad, Marcelo H V; Izar, Maria C; Santos, Raul D; Fonseca, Francisco A H; Mello E Silva, Alberto; Silva, Pedro Marques da; Bertolami, Marcelo C

    2017-02-01

    In the last two decades, statin therapy has proved to be the most potent isolated therapy for attenuation of cardiovascular risk. Its frequent use has been seen as one of the most important elements for the reduction of cardiovascular mortality in developed countries. However, the recurrent incidence of muscle symptoms in statin users raised the possibility of causal association, leading to a disease entity known as statin associated muscle symptoms (SAMS). Mechanistic studies and clinical trials, specifically designed for the study of SAMS have allowed a deeper understanding of the natural history and accurate incidence. This set of information becomes essential to avoid an unnecessary risk of severe forms of SAMS. At the same time, this concrete understanding of SAMS prevents overdiagnosis and an inadequate suspension of one of the most powerful prevention strategies of our times. In this context, the Luso-Latin American Consortium gathered all available information on the subject and presents them in detail in this document as the basis for the identification and management of SAMS.

  18. A Review of Biomarkers in Mood and Psychotic Disorders: A Dissection of Clinical vs. Preclinical Correlates

    PubMed Central

    Brand, Sarel J.; Möller, Marisa; Harvey, Brian H.

    2015-01-01

    Despite significant research efforts aimed at understanding the neurobiological underpinnings of mood (depression, bipolar disorder) and psychotic disorders, the diagnosis and evaluation of treatment of these disorders are still based solely on relatively subjective assessment of symptoms as well as psychometric evaluations. Therefore, biological markers aimed at improving the current classification of psychotic and mood-related disorders, and that will enable patients to be stratified on a biological basis into more homogeneous clinically distinct subgroups, are urgently needed. The attainment of this goal can be facilitated by identifying biomarkers that accurately reflect pathophysiologic processes in these disorders. This review postulates that the field of psychotic and mood disorder research has advanced sufficiently to develop biochemical hypotheses of the etiopathology of the particular illness and to target the same for more effective disease modifying therapy. This implies that a “one-size fits all” paradigm in the treatment of psychotic and mood disorders is not a viable approach, but that a customized regime based on individual biological abnormalities would pave the way forward to more effective treatment. In reviewing the clinical and preclinical literature, this paper discusses the most highly regarded pathophysiologic processes in mood and psychotic disorders, thereby providing a scaffold for the selection of suitable biomarkers for future studies in this field, to develope biomarker panels, as well as to improve diagnosis and to customize treatment regimens for better therapeutic outcomes. PMID:26411964

  19. Association between RGS4 variants and psychotic-like experiences in nonclinical individuals.

    PubMed

    de Castro-Catala, Marta; Cristóbal-Narváez, Paula; Kwapil, Thomas R; Sheinbaum, Tamara; Peña, Elionora; Barrantes-Vidal, Neus; Rosa, Araceli

    2017-02-01

    The psychosis phenotype is expressed across a continuum known as schizotypy, which ranges from personality variation through subclinical symptoms to severe psychopathology. The study of subclinical manifestations in non-affected individuals minimizes confounding factors associated with the clinical phenotype and facilitates the differentiation of dimension-specific etiological mechanisms. The aim of the present study was to investigate the association between the variation in the regulator of G-protein signaling 4 (RGS4) gene, a putative candidate gene for psychosis previously associated with schizophrenia endophenotypes, and psychotic-like experiences (PLEs). In total, 808 healthy individuals completed the community assessment of psychic experiences (CAPE) to measure positive and negative PLEs and provided a DNA sample. Two RGS4 single-nucleotide polymorphisms (SNPs) (rs951436 [SNP4] and rs2661319 [SNP18]) were genotyped. Analyses of covariance (ANCOVA) were used to explore the association of positive and negative PLEs with RGS4 variation. Our results showed associations of positive and negative PLEs with the two polymorphisms studied: subjects with the T allele (SNP4) and the A allele (SNP18) had higher scores on both the positive and the negative dimensions. Haplotypic analyses supported these results, showing the highest scores in those with the TA haplotype (SNP4-SNP18). The RGS4 variants might exert gene-specific modulating effects on psychosis proneness.

  20. The role of body position and gravity in the symptoms and treatment of various medical diseases.

    PubMed

    Martin-Du Pan, Rémy C; Benoit, Raymond; Girardier, Lucia

    2004-09-18

    Postural medicine studies the effects of gravity on human body functions and the ability to influence various diseases by changing the body's position. Orthostasis requires numerous cardiovascular and neurohumoral adaptations to prevent hypotension and a resulting decrease in cerebral perfusion. Sitting upright or in a semi-sitting position reduces venous return in patients with heart failure, intracranial pressure in patients with intracranial hypertension, intraocular pressure in glaucoma patients and may decrease gastro-oesophageal reflux. A left recumbent posture also decreases reflux. A right lateral position results in a lower sympathetic tone than lying on the left side and is beneficial in patients with heart failure or after an infarction without bradycardia. A 40 to 70% decreased prevalence of the sudden infant death syndrome has been observed since the recommendation to avoid laying infants to sleep in a prone position. Sleeping in a supine posture increases the severity of sleep apnoea compared to a lateral position. In patients with acute respiratory distress syndrome, a prone position can rapidly improve blood oxygenation. Idiopathic oedema, orthostatic proteinuria, intradiscal pressure and venous circulation in legs are improved in the decubitus position, whereas arterial flow is reduced. Health risks due to microgravity and prolonged bed rest, such as osteoporosis, venous thrombosis or pressure sores, are discussed.

  1. Prefrontal NAA and Glx Levels in Different Stages of Psychotic Disorders: a 3T 1H-MRS Study

    PubMed Central

    Liemburg, Edith; Sibeijn-Kuiper, Anita; Bais, Leonie; Pijnenborg, Gerdina; Knegtering, Henderikus; van der Velde, Jorien; Opmeer, Esther; de Vos, Annerieke; Dlabac-De Lange, Jozarni; Wunderink, Lex; Aleman, André

    2016-01-01

    H-Magnetic Resonance Spectroscopy (1H-MRS) can offer insights in various neuropathologies by measuring metabolite levels in the brain. In the current study we investigated the levels of glutamate + glutamine (Glx, neurotransmitter and precursor) and N-Acetyl Aspartate + glutamic acid (NAA + NAAG; neuronal viability) in the prefrontal cortex of patients with a psychotic disorder and people at Ultra High Risk (UHR) for psychosis. A 1H-MRS spectrum was acquired in 31 patients with a recent onset psychotic disorder and 60 with a chronic state, 16 UHR patients and 36 healthy controls. Absolute metabolite levels were calculated using LCModel with a reference water peak. Groups were compared while taking into account age and partial volume effects. Moreover, we investigated associations with positive and negative symptoms, duration of illness, and antipsychotic treatment in patients. The most notable finding is that chronicity of schizophrenia was related to decreased levels of Glx and NAA. On the other hand, although on an exploratory note, UHR showed increased levels of prefrontal Glx and NAA levels with increasing age. Our results may indicate an initial Glx and NAA increase and subsequent decrease during illness progression that may be related to the neurotoxic effects of glutamate. PMID:26903078

  2. Prefrontal NAA and Glx Levels in Different Stages of Psychotic Disorders: a 3T 1H-MRS Study.

    PubMed

    Liemburg, Edith; Sibeijn-Kuiper, Anita; Bais, Leonie; Pijnenborg, Gerdina; Knegtering, Henderikus; van der Velde, Jorien; Opmeer, Esther; de Vos, Annerieke; Dlabac-De Lange, Jozarni; Wunderink, Lex; Aleman, André

    2016-02-23

    H-Magnetic Resonance Spectroscopy ((1)H-MRS) can offer insights in various neuropathologies by measuring metabolite levels in the brain. In the current study we investigated the levels of glutamate + glutamine (Glx, neurotransmitter and precursor) and N-Acetyl Aspartate + glutamic acid (NAA + NAAG; neuronal viability) in the prefrontal cortex of patients with a psychotic disorder and people at Ultra High Risk (UHR) for psychosis. A (1)H-MRS spectrum was acquired in 31 patients with a recent onset psychotic disorder and 60 with a chronic state, 16 UHR patients and 36 healthy controls. Absolute metabolite levels were calculated using LCModel with a reference water peak. Groups were compared while taking into account age and partial volume effects. Moreover, we investigated associations with positive and negative symptoms, duration of illness, and antipsychotic treatment in patients. The most notable finding is that chronicity of schizophrenia was related to decreased levels of Glx and NAA. On the other hand, although on an exploratory note, UHR showed increased levels of prefrontal Glx and NAA levels with increasing age. Our results may indicate an initial Glx and NAA increase and subsequent decrease during illness progression that may be related to the neurotoxic effects of glutamate.

  3. Implicit measurement of positive and negative future thinking as a predictor of depressive symptoms and hopelessness.

    PubMed

    Kosnes, Liv; Whelan, Robert; O'Donovan, Aoife; McHugh, Louise A

    2013-09-01

    Research using explicit measures has linked decreased positive future thinking, but not increased negative future thinking, with clinical depression. However, individuals may be unable or unwilling to express thoughts about the future, and can be unaware of implicit beliefs that can influence their behavior. Implicit measures of cognition may shed light on the role of future thinking in depression. To our knowledge, the current study presents the first implicit measure of positive and negative future thinking. A sample of 71 volunteers (38 healthy; 33 with sub-clinical depression) completed both implicit and explicit measures of positive and negative future thinking. The findings indicate differences in the evaluation of both positive and negative future events between the two groups. However, group differences were more pronounced on the implicit measure. These findings point to the potential utility of an implicit measure of future thinking in mental health research and clinical practice.

  4. Toddler Inhibitory Control, Bold Response to Novelty, and Positive Affect Predict Externalizing Symptoms in Kindergarten

    PubMed Central

    Buss, Kristin A.; Kiel, Elizabeth J.; Morales, Santiago; Robinson, Emily

    2013-01-01

    Poor inhibitory control and bold-approach have been found to predict the development of externalizing behavior problems in young children. Less research has examined how positive affect may influence the development of externalizing behavior in the context of low inhibitory control and high approach. We used a multimethod approach to examine how observed toddler inhibitory control, bold-approach, and positive affect predicted externalizing outcomes (observed, adult- and self-reported) in additive and interactive ways at the beginning of kindergarten. 24-month-olds (N = 110) participated in a laboratory visit and 84 were followed up in kindergarten for externalizing behaviors. Overall, children who were low in inhibitory control, high in bold-approach, and low in positive affect at 24-months of age were at greater risk for externalizing behaviors during kindergarten. PMID:25018589

  5. Extreme Appraisals of Internal States and Bipolar Symptoms: The Hypomanic Attitudes and Positive Predictions Inventory

    ERIC Educational Resources Information Center

    Dodd, Alyson L.; Mansell, Warren; Morrison, Anthony P.; Tai, Sara

    2011-01-01

    The Hypomanic Attitudes and Positive Predictions Inventory (HAPPI; W. Mansell, 2006) was developed to assess multiple, extreme, self-relevant appraisals of internal states. The present study aimed to validate the HAPPI in a clinical sample. Participants (N = 50) with a diagnosis of bipolar disorder (confirmed by a structured clinical interview)…

  6. Joint Attention Initiation with and without Positive Affect: Risk Group Differences and Associations with ASD Symptoms

    ERIC Educational Resources Information Center

    Gangi, Devon N.; Ibañez, Lisa V.; Messinger, Daniel S.

    2014-01-01

    Infants at risk for autism spectrum disorders (ASD) may have difficulty integrating smiles into initiating joint attention (IJA) bids. A specific IJA pattern, anticipatory smiling, may communicate preexisting positive affect when an infant smiles at an object and then turns the smile toward the social partner. We compared the development of…

  7. Monoamine Oxidase A and B Gene Polymorphisms and Negative and Positive Symptoms in Schizophrenia

    PubMed Central

    Camarena, Beatriz; Fresán, Ana; Aguilar, Alejandro; Escamilla, Raúl; Saracco, Ricardo; Palacios, Jorge; Tovilla, Alfonso; Nicolini, Humberto

    2012-01-01

    Given that schizophrenia is a heterogeneous disorder, the analysis of clinical characteristics could help to identify homogeneous phenotypes that may be of relevance in genetic studies. Linkage and association studies have suggested that a locus predisposing to schizophrenia may reside within Xp11. We analyzed uVNTR and rs1137070, polymorphisms from MAOA and rs1799836 of MAOB genes to perform single SNP case-control association study in a sample of 344 schizophrenia patients and 124 control subjects. Single polymorphism analysis of uVNTR, rs1137070 and rs1799836 SNPs did not show statistical differences between cases and controls. Multivariate ANOVA analysis of clinical characteristics showed statistical differences between MAOB/rs1799836 and affective flattening scores (F = 4.852, P = 0.009), and significant association between MAOA/uVNTR and affective flattening in female schizophrenia patients (F = 4.236, P = 0.016) after Bonferroni's correction. Our preliminary findings could suggest that severity of affective flattening may be associated by modifier variants of MAOA and MAOB genes in female Mexican patients with schizophrenia. However, further large-scale studies using quantitative symptom-based phenotypes and several candidate variants should be analyzed to obtain a final conclusion. PMID:23738213

  8. Qualitative and quantitative EEG in psychotic children.

    PubMed

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

    1976-05-01

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

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

    PubMed Central

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

    2017-01-01

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

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

    PubMed

    Tomás-Vila, Miguel

    2015-05-01

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

  11. Incidence of psychotic illness in London: comparison of ethnic groups.

    PubMed Central

    King, M.; Coker, E.; Leavey, G.; Hoare, A.; Johnson-Sabine, E.

    1994-01-01

    OBJECTIVE--To compare annual incidences of psychosis in people from different ethnic groups as defined in the 1991 census. SETTING--Catchment area of district psychiatric hospital. DESIGN--All people aged 16 to 54 years who made contact with a wide range of community and hospital services between 1 July 1991 and 30 June 1992 were screened for psychotic symptoms. Patients with such symptoms were interviewed face to face to collect information on demography, ethnic group, psychiatric history and symptoms, drug use, and how care had been sought. A key informant, usually a close relative, was also interviewed. MAIN OUTCOME MEASURES--Age standardised incidence of schizophrenia and non-affective psychosis according to the ninth edition of the International Classification of Diseases in each ethnic group. RESULTS--Ninety three patients took part, of whom 38 were assigned a certain or very likely diagnosis of schizophrenia (15 in white population, 14 in black, seven in Asian, and two in others). The age standardised annual incidence of schizophrenia was 2.2 (95% confidence interval 1.5 to 2.9) per 10,000 of the population. The incidence ratio for schizophrenia in all ethnic minority groups compared with the white population was 3.6 (1.9 to 7.1); the corresponding figure for non-affective psychosis was 3.7 (2.2 to 6.2). CONCLUSIONS--Raised incidences of schizophrenia were not specific to the African Caribbeans, which suggests that the current focus on schizophrenia in this population is misleading. Members of all ethnic minority groups were more likely to develop a psychosis but not necessarily schizophrenia. The personal and social pressures of belonging to any ethnic minority group in Britain are important determinants in the excess of psychotic disorders found. PMID:7755702

  12. Measuring Positive Emotion With the Mood and Anxiety Symptom Questionnaire: Psychometric Properties of the Anhedonic Depression Scale.

    PubMed

    Kendall, Ashley D; Zinbarg, Richard E; Bobova, Lyuba; Mineka, Susan; Revelle, William; Prenoveau, Jason M; Craske, Michelle G

    2016-02-01

    Low positive emotion distinguishes depression from most types of anxiety. Formative work in this area employed the Anhedonic Depression scale from the Mood and Anxiety Symptom Questionnaire (MASQ-AD), and the MASQ-AD has since become a popular measure of positive emotion, often used independently of the full MASQ. However, two key assumptions about the MASQ-AD-that it should be represented by a total scale score, and that it measures time-variant experiences-have not been adequately tested. The present study factor analyzed MASQ-AD data collected annually over 3 years (n = 618, mean age = 17 years at baseline), and then decomposed its stable and unstable components. The results suggested the data were best represented by a hierarchical structure, and that less than one quarter of the variance in the general factor fluctuated over time. The implications for interpreting past findings from the MASQ-AD, and for conducting future research with the scale, are discussed.

  13. Psychotic Experiences and Overhasty Inferences Are Related to Maladaptive Learning.

    PubMed

    Stuke, Heiner; Stuke, Hannes; Weilnhammer, Veith Andreas; Schmack, Katharina

    2017-01-01

    Theoretical accounts suggest that an alteration in the brain's learning mechanisms might lead to overhasty inferences, resulting in psychotic symptoms. Here, we sought to elucidate the suggested link between maladaptive learning and psychosis. Ninety-eight healthy individuals with varying degrees of delusional ideation and hallucinatory experiences performed a probabilistic reasoning task that allowed us to quantify overhasty inferences. Replicating previous results, we found a relationship between psychotic experiences and overhasty inferences during probabilistic reasoning. Computational modelling revealed that the behavioral data was best explained by a novel computational learning model that formalizes the adaptiveness of learning by a non-linear distortion of prediction error processing, where an increased non-linearity implies a growing resilience against learning from surprising and thus unreliable information (large prediction errors). Most importantly, a decreased adaptiveness of learning predicted delusional ideation and hallucinatory experiences. Our current findings provide a formal description of the computational mechanisms underlying overhasty inferences, thereby empirically substantiating theories that link psychosis to maladaptive learning.

  14. Psychotic Experiences and Overhasty Inferences Are Related to Maladaptive Learning

    PubMed Central

    Stuke, Heiner; Stuke, Hannes; Weilnhammer, Veith Andreas; Schmack, Katharina

    2017-01-01

    Theoretical accounts suggest that an alteration in the brain’s learning mechanisms might lead to overhasty inferences, resulting in psychotic symptoms. Here, we sought to elucidate the suggested link between maladaptive learning and psychosis. Ninety-eight healthy individuals with varying degrees of delusional ideation and hallucinatory experiences performed a probabilistic reasoning task that allowed us to quantify overhasty inferences. Replicating previous results, we found a relationship between psychotic experiences and overhasty inferences during probabilistic reasoning. Computational modelling revealed that the behavioral data was best explained by a novel computational learning model that formalizes the adaptiveness of learning by a non-linear distortion of prediction error processing, where an increased non-linearity implies a growing resilience against learning from surprising and thus unreliable information (large prediction errors). Most importantly, a decreased adaptiveness of learning predicted delusional ideation and hallucinatory experiences. Our current findings provide a formal description of the computational mechanisms underlying overhasty inferences, thereby empirically substantiating theories that link psychosis to maladaptive learning. PMID:28107344

  15. Dreams and fantasies in psychodynamic group psychotherapy of psychotic patients.

    PubMed

    Restek-Petrović, Branka; Orešković-Krezler, Nataša; Grah, Majda; Mayer, Nina; Bogović, Anamarija; Mihanović, Mate

    2013-09-01

    Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness.

  16. Associations of perceived social support and positive psychological resources with fatigue symptom in patients with rheumatoid arthritis

    PubMed Central

    Xu, NeiLi; Zhao, Shuai; Xue, HongXia; Fu, WenYi; Liu, Li; Zhang, TianQi; Huang, Rui; Zhang, Ning

    2017-01-01

    Objective This study aimed to assess the association between perceived social support (PSS) and fatigue and the roles of hope, optimism, general self-efficacy and resilience as mediators or moderators on PSS-fatigue association among Rheumatoid Arthritis (RA) patients in China. Methods A multi-center, cross-sectional study was conducted withinpatients diagnosed with RA in northeast China, in which 305 eligible inpatients were enrolled. The Multidimensional Fatigue Inventory, Multidimensional Scale of Perceived Social Support, Herth Hope Index, Life Orientation Test Revised, General Self-Efficacy Scale and Ego-Resiliency Scale were completed. The associations of PSS, hope, optimism, general self-efficacy and resilience with fatigue and the moderating roles of these positive psychological constructs were tested by hierarchical linear regression. Asymptotic and resampling strategies were utilized to assess the mediating roles of hope, optimism, general self-efficacy and resilience. Results The mean score of the MFI was 57.88 (SD = 9.50). PSS, hope, optimism and resilience were negatively associated with RA-related fatigue, whereas DAS28-CRP was positively associated. Only resilience positively moderated the PSS-fatigue association (B = 0.03, β = 0.13, P<0.01). Hope, optimism and resilience may act as partial mediators in the association between PSS and fatigue symptoms (hope: a*b = -0.16, BCa 95%CI: -0.27, -0.03; optimism: a*b = -0.20, BCa 95%CI: -0.30, -0.10; resilience: a*b = -0.12, BCa 95%CI: -0.21–0.04). Conclusions Fatigue is a severe symptom among RA patients. Resilience may positively moderate the PSS-fatigue association. Hope, optimism and resilience may act as partial mediators in the association. PSS, hope, optimism and resilience may contribute as effective recourses to alleviate fatigue, upon which PSS probably has the greatest effect. PMID:28291837

  17. Positive effects of neurofeedback on autism symptoms correlate with brain activation during imitation and observation.

    PubMed

    Datko, Michael; Pineda, Jaime A; Müller, Ralph-Axel

    2017-02-28

    Autism has been characterized by atypical task-related brain activation and functional connections, coinciding with deficits in sociocommunicative abilities. However, evidence of the brain's experience-dependent plasticity suggests that abnormal activity patterns may be reversed with treatment. In particular, neurofeedback training (NFT), an intervention based on operant conditioning resulting in self-regulation of brain electrical oscillations, has shown increasing promise in addressing abnormalities in brain function and behavior. We examined the effects of ≥ 20 h of sensorimotor mu-rhythm-based NFT in children with high-functioning autism spectrum disorders (ASD) and a matched control group of typically developing children (ages 8-17). During an functional magnetic resonance imaging imitation and observation task, the ASD group showed increased activation in regions of the human mirror neuron system following the NFT, as part of a significant interaction between group (ASD vs. controls) and training (pre- vs. post-training). These changes were positively correlated with behavioral improvements in the ASD participants, indicating that mu-rhythm NFT may be beneficial to individuals with ASD.

  18. Assessment and Treatment of Psychotic Speech in an Autistic Child.

    ERIC Educational Resources Information Center

    Durand, V. Mark; Crimmins, Daniel B.

    1987-01-01

    Analysis of the psychotic speech of a nine-year-old autistic boy suggested that psychotic speech (intelligible but out of context phrases) was maintained through escape from task demands and that teaching an appropriate equivalent phrase ("Help me") reduced the frequency of psychotic speech. (Author/DB)

  19. Examining the relationships between posttraumatic stress disorder symptoms, positive smoking outcome expectancies, and cigarette smoking in people with substance use disorders: a multiple mediator model.

    PubMed

    Hruska, Bryce; Bernier, Jennifer; Kenner, Frank; Kenne, Deric R; Boros, Alec P; Richardson, Christopher J; Delahanty, Douglas L

    2014-01-01

    Cigarette smoking is highly prevalent in people with substance use disorders (SUDs) and is associated with significant physical health problems. Posttraumatic stress disorder (PTSD) is also highly associated with both SUDs and cigarette smoking and may serve as a barrier to smoking cessation efforts. In addition, people with PTSD are more likely to hold positive smoking outcome expectancies (i.e., beliefs that smoking cigarettes results in positive outcomes); these beliefs may contribute to cigarette smoking in people with SUDs experiencing PTSD symptoms. The present study examined the relationship between PTSD symptoms and typical daily cigarette smoking/cigarette dependence symptoms in a sample of 227 trauma-exposed current smokers with SUDs (59.9% male, 89.4% Caucasian) seeking detoxification treatment services. Additionally, the indirect effects of multiple types of positive smoking outcome expectancies on these relationships were examined. Participants completed questionnaires assessing PTSD symptoms, positive smoking outcome expectancies, cigarette consumption, and cigarette dependence symptoms. Results indicated that PTSD symptoms were not directly related to cigarette consumption or cigarette dependence symptoms. However, negative affect reduction outcome expectancies were shown to have a significant indirect effect between PTSD symptoms and cigarette consumption, while negative affect reduction, boredom reduction, and taste-sensorimotor manipulation outcome expectancies were all found to have significant indirect effects between PTSD symptoms and cigarette dependence symptoms. The indirect effect involving negative affect reduction outcome expectancies was statistically larger than that of taste sensorimotor manipulation outcome expectancies, while negative affect reduction and boredom reduction outcome expectancies were comparable in magnitude. These results suggest that expectancies that smoking can manage negative affective experiences are related to

  20. Symptom assessment in early psychosis: the use of well-established rating scales in clinical high-risk and recent-onset populations.

    PubMed

    Fulford, Daniel; Pearson, Rahel; Stuart, Barbara K; Fisher, Melissa; Mathalon, Daniel H; Vinogradov, Sophia; Loewy, Rachel L

    2014-12-30

    Symptom assessment in early psychosis research typically relies on scales validated in chronic schizophrenia samples. Our goal was to inform investigators who are selecting symptom scales for early psychosis research. We described measure characteristics, baseline scores, and scale inter-relationships in clinical-high-risk (CHR) and recent-onset psychotic disorder (RO) samples using the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, Scale for the Assessment of Positive Symptoms, and Scale for the Assessment of Negative Symptoms; for the CHR group only, we included the Scale of Prodromal Symptoms. For investigators selecting symptom measures in intervention or longitudinal studies, we also examined the relationship of symptom scales with psychosocial functioning. In both samples, symptom subscales in the same domain, across measures, were moderately to highly intercorrelated. Within all measures, positive symptoms were not correlated with negative symptoms, but disorganized symptoms overlapped with both positive and negative symptoms. Functioning was significantly related to negative and disorganized, but not positive, symptoms in both samples on most measures. Findings suggest strong overlap in symptom severity ratings among the most common scales. In recent-onset samples, each has strengths and weaknesses. In CHR samples, they appear to add little information above and beyond the SOPS.

  1. Dual Cases of Type 1 Narcolepsy with Schizophrenia and Other Psychotic Disorders

    PubMed Central

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

    2014-01-01

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

  2. From psychotic "tragedy" to hysterical "drama": Anna history.

    PubMed

    Cesario, L; Santilli, V B; Valerio, C; Bianchi di Castelbianco, A; Valitutti, C

    1992-01-01

    The authors present a multiple personality case. The characteristics of the family system seemed to be typical of psychotic families, but after a rightway look on the case, the therapists focussed their attention on several elements which had not come out before. Carefully analysing the case, they were able to find out well played "roles" or "masks", (particularly a "great-seducer father", and a "very depressed mother") a stressed "characterization" of the players and a double level of reality, as if members, although maintaining an inner capacity of self-definition, play a particular "role" on the family "stage", never revealing themselves to the others. These elements are to be considered as primal "clues" of "emerging qualities" of that family. The symptom metaphorically points out a different reality behind the "masks" and with its dramatization, its quick and short rising, its modifications depending on the environment, confirm a different interpretation of the case.

  3. Child Perfectionism and its Relationship with Personality, Excessive Parental Demands, Depressive Symptoms and Experience of Positive Emotions.

    PubMed

    Oros, Laura B; Iuorno, Ornella; Serppe, Mónica

    2017-02-13

    While adaptive perfectionism ensures good overall performance, maladaptive perfectionism is associated with emotional disorders for which psychological treatment is sought. There are many factors that can explain the development of this disorder throughout childhood. The present study analyzed to what extent the child's personality traits and excessive parental demands can predict maladaptive perfectionism, and, in turn, also analyzed how this relates to positive emotions and depressive symptoms in a sample of 404 Argentinian children (M age = 10.30; SD = 1.03). Stepwise multiple regression analyses and Kruskal-Wallis and Mann-Whitney tests were performed. Results showed that excessive parental demands, together with high child neuroticism increased the likelihood of developing perfectionism (p < .001) throughout childhood. It was also noted that child perfectionism increased the symptoms of depression (p < .001), decreased feelings of gratitude (p = .018), increased the recognition of self-worth (p = .009) and activated certain aspects of sympathy towards others' pain (p = .043). These processes linked to perfectionism are discussed, clarifying their effects on children's mental health.

  4. Personal Identity Development in Hispanic Immigrant Adolescents: Links with Positive Psychosocial Functioning, Depressive Symptoms, and Externalizing Problems.

    PubMed

    Schwartz, Seth J; Unger, Jennifer B; Meca, Alan; Lorenzo-Blanco, Elma I; Baezconde-Garbanati, Lourdes; Cano, Miguel Ángel; Piña-Watson, Brandy; Szapocznik, José; Zamboanga, Byron L; Córdova, David; Romero, Andrea J; Lee, Tae Kyoung; Soto, Daniel W; Villamar, Juan A; Lizzi, Karina M; Des Rosiers, Sabrina E; Pattarroyo, Monica

    2017-04-01

    The present study was designed to examine trajectories of personal identity coherence and confusion among Hispanic recent-immigrant adolescents, as well as the effects of these trajectories on psychosocial and risk-taking outcomes. Personal identity is extremely important in anchoring young immigrants during a time of acute cultural change. A sample of 302 recently immigrated (5 years or less in the United States at baseline) Hispanic adolescents (Mage = 14.51 years at baseline; SD = 0.88 years, range 14-17) from Miami and Los Angeles (47 % girls) completed measures of personal identity coherence and confusion at the first five waves of a six-wave longitudinal study; and reported on positive psychosocial functioning, depressive symptoms, and externalizing problems at baseline and at Time 6. Results indicated that identity coherence increased linearly across time, but that there were no significant changes in confusion over time and no individual differences in confusion trajectories. Higher baseline levels of, and improvements in, coherence predicted higher levels of self-esteem, optimism, and prosocial behavior at the final study timepoint. Higher baseline levels of confusion predicted lower self-esteem, greater depressive symptoms, more aggressive behavior, and more rule breaking at the final study timepoint. These results are discussed in terms of the importance of personal identity for Hispanic immigrant adolescents, and in terms of implications for intervention.

  5. [Efficacy of zuclopenthixol acetate on psychotic anxiety evaluated in an open study].

    PubMed

    Romain, J L; Dermain, P; Greslé, P; Grignon, S; Moisan, P; Nore, D; Pech, G; Benyaya, J; Perret, I

    1996-01-01

    The first scale evaluating psychotic anxiety specifically is the "Psychotic Anxiety Scale": PAS was proposed and validated by O. Blin et al. in 1988. Zuclopenthixol acetate formulation is a both rapid and middle prolonged (2-3 days) acting neuroleptic used to start the treatment in an acute episode of the psychotic illness. It has been established as an effective drug for a broad spectrum of symptoms in schizophrenia and other psychosis, but its "angolytic" effect had never been quantified. It was interesting to study the efficacy of zuclopenthixol acetate on psychotic anxiety with PAS during the first 9 days of hospitalisation of psychotic patients. During the study, the clinical evaluation was made with the Psychotic Anxiety Scale (PAS) for the main criteria; Clinical Global Impression (CGI) and the Nordic side effect scale (UKU) for the secondary criteria. Assessments were performed at days, 0, 1, 3, 4, 6, 7 and 9. Zuclopenthixol acetate was administered at Day 0, Day 3, and Day 6. Protocol allowed an additional injection at D1 in case of insufficient efficacy. Forty six patients were included into this open non comparative multicenter study: 23 patients were male and 23 female. Their mean age (X +/- S) was 32 +/- 10 years, and according to DSM III-R, 28 of them got schizophrenia diagnosis, 13 suffered from brief psychotic disorder and 3 from schizophreniform disorder (diagnosis was missing for two subjects). The mean dosage of zuclopenthixol acetate by injection, foreseen in the protocol, was between 126 to 138 mg. Four patients were treated with high dose: more than 800 mg during the 9 days of the study and 6 patients had 5 injections or more. Between D0 and D9, the total PAS score decreased from 63 (from moderated to severe anxiety) to 25 (absence of anxiety) and the reduction of score was statistically significant from 24 hours after the first injection (p < 0.01). Various items analysis of PAS has showed a statistically significant reduction from 24 hours

  6. Position and Orientation Tracking in a Ubiquitous Monitoring System for Parkinson Disease Patients With Freezing of Gait Symptom

    PubMed Central

    Català, Andreu; Rodríguez Martín, Daniel; van der Aa, Nico; Chen, Wei; Rauterberg, Matthias

    2013-01-01

    Background Freezing of gait (FoG) is one of the most disturbing and least understood symptoms in Parkinson disease (PD). Although the majority of existing assistive systems assume accurate detections of FoG episodes, the detection itself is still an open problem. The specificity of FoG is its dependency on the context of a patient, such as the current location or activity. Knowing the patient's context might improve FoG detection. One of the main technical challenges that needs to be solved in order to start using contextual information for FoG detection is accurate estimation of the patient's position and orientation toward key elements of his or her indoor environment. Objective The objectives of this paper are to (1) present the concept of the monitoring system, based on wearable and ambient sensors, which is designed to detect FoG using the spatial context of the user, (2) establish a set of requirements for the application of position and orientation tracking in FoG detection, (3) evaluate the accuracy of the position estimation for the tracking system, and (4) evaluate two different methods for human orientation estimation. Methods We developed a prototype system to localize humans and track their orientation, as an important prerequisite for a context-based FoG monitoring system. To setup the system for experiments with real PD patients, the accuracy of the position and orientation tracking was assessed under laboratory conditions in 12 participants. To collect the data, the participants were asked to wear a smartphone, with and without known orientation around the waist, while walking over a predefined path in the marked area captured by two Kinect cameras with non-overlapping fields of view. Results We used the root mean square error (RMSE) as the main performance measure. The vision based position tracking algorithm achieved RMSE = 0.16 m in position estimation for upright standing people. The experimental results for the proposed human orientation

  7. Impaired error processing in late-phase psychosis: Four-year stability and relationships with negative symptoms.

    PubMed

    Foti, Dan; Perlman, Greg; Hajcak, Greg; Mohanty, Aprajita; Jackson, Felicia; Kotov, Roman

    2016-10-01

    Error processing is impaired in psychosis, and numerous event-related potential studies have found reductions in the error-related negativity (ERN) and, more recently, the error positivity (Pe). The stability of reduced ERN/Pe in psychosis, however, is unknown. In a previous cross-sectional report, reduced ERN was associated with negative symptom severity and reduced Pe with a diagnosis of schizophrenia versus other psychosis. Here, we test the stability of impaired error processing over a four-year follow-up and relationships with subdimensions of negative symptoms. The ERN and Pe were recorded from individuals with psychotic disorders twice: 79 individuals were assessed 15years after first hospitalization, and 69 were assessed at 19years; 59 (26 with schizophrenia, 33 with other psychotic disorders) had data at both assessments. At 19years the Pe was blunted in schizophrenia. The ERN and Pe exhibited temporal stability over the four years (r=0.59 and 0.60, respectively). Reduced ERN and Pe correlated with the negative symptom subdimensions of inexpressivity and avolition, respectively, and not with psychotic or disorganized symptoms. Moreover, 15-year ERN predicted an increase in inexpressivity by year 19. No evidence was found for the reverse: negative symptoms did not predict change in ERN/Pe. Similar to non-clinical samples, the ERN and Pe show impressive four-year stability in late-phase psychosis. The ERN and Pe are promising neural measures for capturing individual differences in psychotic disorders, particularly with regard to negative symptomatology. They may prove to be useful clinically for forecasting illness course and as treatment targets.

  8. The effects of neuroticism, extraversion, and positive and negative life events on a one-year course of depressive symptoms in euthymic previously depressed patients versus healthy controls.

    PubMed

    Spinhoven, Philip; Elzinga, Bernet; Roelofs, Karin; Hovens, Jacqueline G F M; van Oppen, Patricia; Zitman, Frans G; Penninx, Brenda W J H

    2011-09-01

    We investigated a) the concurrent impact of positive and negative life events on the course of depressive symptoms in persons remitted from depression and healthy controls, b) whether the impact of life events on symptom course is moderated by the history of depression and the personality traits of neuroticism and extraversion, and c) whether life events mediate possible relationships of history of depression and personality traits with symptom course. Using data from the Netherlands Study of Depression and Anxiety, we examined 239 euthymic participants with a previous depressive disorder based on DSM-IV and 450 healthy controls who completed a) baseline assessments of personality dimensions (NEO Five-Factor Inventory) and depression severity (Inventory of Depressive Symptoms [IDS]) and b) 1-year follow-up assessments of depression severity and the occurrence of positive and negative life events during the follow-up period (List of Threatening Events Questionnaire). Remitted persons reported higher IDS scores at 1-year follow-up than did the controls. Extraversion and positive and negative life events independently predicted the course of depressive symptoms. The impact of life events on symptom course was not moderated by history of depression or personality traits. The effect of extraversion on symptom course was partly caused by differential engagement in positive life events.

  9. Daily Stressors and Adult Day Service Use by Family Caregivers: Effects on Depressive Symptoms, Positive Mood and DHEA-S

    PubMed Central

    Zarit, Steven H.; Whetzel, Courtney A.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Rovine, Michael J.; Klein, Laura Cousino

    2014-01-01

    Objectives This study examines effects of daily use of adult day services (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms. Design We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and non-intervention days to evaluate within- and between-person effects of the intervention. Setting Caregivers were interviewed daily by telephone at home. Participants 151 family caregivers of IWD who were using ADS. Measurements Saliva samples were collected from caregivers 5 times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood. Results DHEA-S levels were significantly higher on days following ADS use. Daily DHEA-S levels covaried significantly with daily positive mood, but not depressive symptoms. Conclusions These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiological damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiological demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors. PMID:24566240

  10. Avolition, Negative Symptoms, and a Clinical Science Journey and Transition to the Future.

    PubMed

    Carpenter, William T; Frost, Katherine H; Whearty, Kayla M; Strauss, Gregory P

    2016-01-01

    The concepts and investigations reviewed above suggest the following * Schizophrenia is a clinical syndrome that can be deconstructed into meaningful domains of psychopathology. * Individual patients vary substantially on which domains are present as well as severity. * Negative symptoms are common in persons with schizophrenia, but only primary negative symptoms are a manifestation of schizophrenia psychopathology in the "weakening of the wellsprings of volition" sense that Kraepelin described. * The failure to distinguish primary from secondary negative symptoms has profound consequences as viewed in the vast majority of clinical trials that report negative symptom efficacy without regard for causation and without controlling for pseudospecificity. * Schizophrenia is now broadly defined with positive psychotic symptoms, and a subgroup with primary negative symptoms is a candidate disease entity. * Evidence of negative symptoms as a taxon supports the separate classification of persons with primary negative symptoms. * Negative symptoms are an unmet therapeutic need. * Two factors best define the negative symptom construct and these may have different pathophysiological and treatment implications. * The avolitional component may not be based on a diminished capacity to experience pleasure, but difficulty using mental representations of affective value to guide decision-making and goal-directed behavior. Part II in this volume by Strauss et al. will address the range of laboratory-based investigations of negative symptoms, clarify current hypotheses and theories concerning negative symptom pathology, and address future directions for negative symptom research and clinical care.

  11. Meta-analysis of the effects of repetitive transcranial magnetic stimulation (rTMS) on negative and positive symptoms in schizophrenia

    PubMed Central

    Freitas, Catarina; Fregni, Felipe; Pascual-Leone, Alvaro

    2009-01-01

    Background A growing body of evidence suggests that repetitive transcranial magnetic stimulation (rTMS) can alleviate negative and positive symptoms of refractory schizophrenia. However, trials to date have been small and results are mixed. Methods We performed meta-analyses of all prospective studies of the therapeutic application of rTMS in refractory schizophrenia assessing the effects of high-frequency rTMS to the left dorsolateral prefrontal cortex (DLPFC) to treat negative symptoms, and low-frequency rTMS to the left temporo-parietal cortex (TPC) to treat auditory hallucinations (AH) and overall positive symptoms. Results When analyzing controlled (active arms) and uncontrolled studies together, the effect sizes showed significant and moderate effects of rTMS on negative and positive symptoms (based on PANSS-N or SANS, and PANSS-P or SAPS, respectively). However, the analysis for the sham-controlled studies revealed a small non-significant effect size for negative (0.27, p=0.417) and for positive symptoms (0.17, p=0.129). When specifically analyzing AH (based on AHRS, HCS or SAH), the effect size for the sham-controlled studies was large and significant (1.04; p=0.002). Conclusions These meta-analyses support the need for further controlled, larger trials to assess the clinical efficacy of rTMS on negative and positive symptoms of schizophrenia, while suggesting the need for exploration for alternative stimulation protocols. PMID:19138833

  12. Treating Negative Symptoms in Schizophrenia: an Update.

    PubMed

    Remington, Gary; Foussias, George; Fervaha, Gagan; Agid, Ofer; Takeuchi, Hiroyoshi; Lee, Jimmy; Hahn, Margaret

    Interest in the negative symptoms of schizophrenia has increased rapidly over the last several decades, paralleling a growing interest in functional, in addition to clinical, recovery, and evidence underscoring the importance negative symptoms play in the former. Efforts continue to better define and measure negative symptoms, distinguish their impact from that of other symptom domains, and establish effective treatments as well as trials to assess these. Multiple interventions have been the subject of investigation, to date, including numerous pharmacological strategies, brain stimulation, and non-somatic approaches. Level and quality of evidence vary considerably, but to this point, no specific treatment can be recommended. This is particularly problematic for individuals burdened with negative symptoms in the face of mild or absent positive symptoms. Presently, clinicians will sometimes turn to interventions that are seen as more "benign" and in line with routine clinical practice. Strategies include use of atypical antipsychotics, ensuring the lowest possible antipsychotic dose that maintains control of positive symptoms (this can involve a shift from antipsychotic polypharmacy to monotherapy), possibly an antidepressant trial (given diagnostic uncertainty and the frequent use of these drugs in schizophrenia), and non-somatic interventions (e.g., cognitive behavioral therapy, CBT). The array and diversity of strategies currently under investigation highlight the lack of evidence-based treatments and our limited understanding regarding negative symptoms underlying etiology and pathophysiology. Their onset, which can precede the first psychotic break, also means that treatments are delayed. From this perspective, identification of biomarkers and/or endophenotypes permitting earlier diagnosis and intervention may serve to improve treatment efficacy as well as outcomes.

  13. Diagnostic pitfalls in a young Romanian ranger with an acute psychotic episode

    PubMed Central

    Nagy, Előd Ernő; Rácz, Attila; Urbán, Edit; Terhes, Gabriella; Berki, Timea; Horváth, Emőke; Georgescu, Anca M; Zaharia-Kézdi, Iringó E

    2016-01-01

    The identification and distinction of the pathological conditions underlying acute psychosis are often challenging. We present the case of a 35-year-old ranger who had no history of acute or chronic infectious disease or any previous neuropsychiatric symptoms. He arrived at the Psychiatry Clinic and was admitted as an emergency case, displaying bizarre behavior, hallucinations, paranoid ideation, and delusional faults. These symptoms had first appeared 7 days earlier. An objective examination revealed abnormalities of behavior, anxiety, visual hallucinations, choreiform, and tic-like facial movements. After the administration of neuroleptic and antidepressant treatment, he showed an initial improvement, but on day 10 entered into a severe catatonic state with signs of meningeal irritation and was transferred to the intensive care unit. An electroencephalogram showed diffuse irritative changes, raising the possibility of encephalitis. Taking into consideration the overt occupational risk, Borrelia antibody tests were prescribed and highly positive immunoglobulin (Ig)M and IgG titers were obtained from serum, along with IgG and antibody index positivity in cerebrospinal fluid. In parallel, anti-N-methyl-D-aspartate receptor antibodies and a whole battery of other autoimmune encephalitis markers showed negative. A complex program of treatment was applied, including antibiotics, beginning with ceftazidime and ciprofloxacin – for suspected aspiration bronchopneumonia – and thereafter with ceftriaxone. A gradual improvement was noticed and the treatment continued at the Infectious Disease Clinic. Finally, the patient was discharged with a doxycycline, antidepressant, and anxiolytic maintenance treatment. On his first and second control (days 44 and 122 from the disease onset), the patient was stable with no major complaints, Borrelia seropositivity was confirmed both for IgM and IgG while the cerebrospinal fluid also showed reactivity for IgG on immunoblot. On the

  14. Diagnostic and symptomatological features in chronic psychotic patients according to cannabis use status.

    PubMed

    Maremmani, Icro; Lazzeri, Antonio; Pacini, Matteo; Lovrecic, Mercedes; Placidi, Gian Franco; Perugi, Giulio

    2004-06-01

    The prevalence and the clinical meaning of cannabis use in patients with chronic psychosis has not been systematically explored. The authors have compared the diagnostic and symptomatological characteristics of 111 male patients affected by chronic psychosis with and without past or current use of cannabis. Sixty-six patients were still using or had used cannabis; in all cases the use preceded the onset of psychotic symptoms. Forty-three patients were cannabis-positive on urinary screening at the moment of hospitalization and 23 were currently cannabis-free but reported the use of cannabis in the past. Forty-five patients were negative on urinary screening and reported no past history of cannabis use. In evaluating the psychopathological features, the Brief Psychiatric Rating Scale (BPRS) and the Overt Aggression Rating Scale (AORS) were used. The three groups showed similar demographic data, except for age, which was lower in current cannabis users than in nonusers; no differences were found between current and past users. As regards diagnostic features, "mood cluster" was significantly better represented in cannabis users and "schizophrenic cluster" in nonusers; bipolar spectrum disorders were more frequently reported than unipolar ones. When past and current users were grouped together, only blunted affect score was significantly higher in nonusers than in users, while clastic violence showed higher scores in users. These data indicate that chronic, psychosis, whether associated with past or with current use of cannabis, is frequently associated with bipolar spectrum disorders and tends to display less blunted affect and more clastic behavior.

  15. Depressive and Anxiety Symptoms Predict Sustained Quality of Life Deficits in HIV-Positive Ugandan Adults Despite Antiretroviral Therapy

    PubMed Central

    Ezeamama, Amara E; Woolfork, Makhabele N; Guwatudde, David; Bagenda, Danstan; Manabe, Yukari C; Fawzi, Wafaie W; Smith Fawzi, Mary C

    2016-01-01

    Abstract The impact of psychosocial status at onset of antiretroviral therapy on changes in quality of life (QOL) and subjectively rated health (SRH) among adults on highly active antiretroviral therapy (HAART) in resource-limited settings is poorly understood. Therefore, we evaluate the association between stigma, anxiety, depression, and social support and change in QOL and SRH in HIV-infected Ugandan adults during an 18-month period. Psychosocial indicators were assessed at enrollment using structured questionnaires. QOL and SRH measures were assessed at months 0, 6, 12, and 18 using the Medical Outcomes Survey-HIV. Linear mixed models determined risk estimated differences in QOL and SRH in relation to quartiles of each psychosocial status indicator. Repeated measures generalized estimating equations modeling was implemented to assess differences in likelihood of improved versus nonimproved SRH during follow-up. QOL scores and SRH improved significantly for all participants over 18 months (P < 0.0001). The gain in QOL increased dose-dependently as baseline depressive symptoms (time∗depression P < 0.001) and anxiety levels (time∗anxiety P < 0.001) declined. Lower social support was associated with worse QOL at baseline (P = 0.0005) but QOL improvement during follow-up was not dependent on baseline level of social support (time∗social support P = 0.8943) or number of stigmatizing experiences (time∗stigma P = 0.8662). Psychosocial determinants did not predict changes in SRH in this study. High levels of depression and anxiety symptoms at HAART initiation predicts lower gains in QOL for HIV-positive patients for as long as 18 months. Long-term QOL improvements in HIV-infected adults may be enhanced by implementation of psychosocial interventions to reduce depression and anxiety in HIV-infected adults. PMID:26945347

  16. Numbing of Positive, Negative, and General Emotions: Associations With Trauma Exposure, Posttraumatic Stress, and Depressive Symptoms Among Justice-Involved Youth.

    PubMed

    Kerig, Patricia K; Bennett, Diana C; Chaplo, Shannon D; Modrowski, Crosby A; McGee, Andrew B

    2016-04-01

    Increasing attention has been drawn to the symptom of emotional numbing in the phenomenology of posttraumatic stress disorder (PTSD), particularly regarding its implications for maladaptive outcomes in adolescence such as delinquent behavior. One change in the definition of emotional numbing according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) was the limitation to the numbing of positive emotions. Previous research with youth, however, has implicated general numbing or numbing of negative emotions in PTSD, whereas numbing of positive emotions may overlap with other disorders, particularly depression. Consequently, the goal of this study was to investigate whether numbing of positive emotions was associated with PTSD symptoms above and beyond numbing of negative emotions, general emotional numbing, or depressive symptoms among at-risk adolescents. In a sample of 221 detained youth (mean age = 15.98 years, SD = 1.25; 50.7% ethnic minority), results of hierarchical multiple regressions indicated that only general emotional numbing and numbing of anger accounted for significant variance in PTSD symptoms (total R(2) = .37). In contrast, numbing of sadness and positive emotions were statistical correlates of depressive symptoms (total R(2) = .24). Further tests using Hayes' Process macro showed that general numbing, 95% CI [.02, .45], and numbing of anger, 95% CI [.01, .42], demonstrated indirect effects on the association between trauma exposure and PTSD symptoms.

  17. Assessment and treatment of psychotic speech in an autistic child.

    PubMed

    Durand, V M; Crimmins, D B

    1987-03-01

    The psychotic speech of autistic and other developmentally disabled children can be defined as words or phrases that are intelligible, but appear out of context. In the present investigation we conducted an analysis of the psychotic speech of a 9-year-old autistic boy. Three experiments were constructed to determine the functional significance of this child's psychotic speech and a method of intervention. The first study involved an analysis of the role of adult attention and task demands in the maintenance of psychotic speech. When task demands were increased, the frequency of psychotic speech increased. Varying adult attention had no effect on psychotic speech. We then performed a second analysis in which the consequence for psychotic speech was a 10-second time-out. Psychotic speech increased, suggesting that it may have been maintained through escape from task demands. Finally, the third experiment involved teaching an appropriate escape response ("Help me"). Psychotic speech was greatly reduced by this intervention. Thus, teaching an appropriate equivalent phrase proved to be a viable alternative to interventions using aversive consequences. The present study represents the first observation that psychotic speech may serve to remove children from unpleasant situations and also introduces a nonaversive intervention for this behavior.

  18. Methylphenidate and the risk of psychotic disorders and hallucinations in children and adolescents in a large health system

    PubMed Central

    Man, K K C; Coghill, D; Chan, E W; Lau, W C Y; Hollis, C; Liddle, E; Banaschewski, T; McCarthy, S; Neubert, A; Sayal, K; Ip, P; Wong, I C K

    2016-01-01

    Previous studies have suggested that risk of psychotic events may be increased in children exposed to methylphenidate (MPH). However, this risk has not been fully examined, and the possibility of confounding factors has not been excluded. Patients aged 6–19 years who received at least one MPH prescription were identified using Hong Kong population-based electronic medical records on the Clinical Data Analysis and Reporting System (2001–2014). Using the self-controlled case series design, relative incidence of psychotic events was calculated comparing periods when patients were exposed to MPH with non-exposed periods. Of 20,586 patients prescribed MPH, 103 had an incident psychotic event; 72 (69.9%) were male and 31 (30.1%) female. The mean age at commencement of observation was 6.95 years and the mean follow-up per participant was 10.16 years. On average, each participant was exposed to MPH for 2.17 years. The overall incidence of psychotic events during the MPH exposure period was 6.14 per 10,000 patient-years. No increased risk was found during MPH-exposed compared with non-exposed periods (incidence rate ratio (IRR) 1.02 (0.53–1.97)). However, an increased risk was found during the pre-exposure period (IRR 4.64 (2.17–9.92)). Results were consistent across all sensitivity analyses. This study does not support the hypothesis that MPH increases risk of incident psychotic events. It does indicate an increased risk of psychotic events before the first prescription of MPH, which may be because of an association between psychotic events and the behavioural and attentional symptoms that led to psychiatric assessment and initiation of MPH treatment. PMID:27845780

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

    PubMed

    Huber, G; Gross, G

    1989-12-01

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

  20. [Treatment of psychotic patients with music therapy].

    PubMed

    Inselmann, U

    1995-01-01

    The present contribution describes the experience taken from music therapy of psychotic patients. The emotional and cognitive music perception and its possible influence on self perception and strengthening of ego are discussed. Since exercise instructions were limited the observed improvement of communication seems rather due to intra- and interpersonal effects of active improvisation than to a training process. With regard to schizophrenic patients possible effects of music therapy are discussed in the light of self-object-differentiation.

  1. Cortical Morphology Differences in Subjects at Increased Vulnerability for Developing a Psychotic Disorder: A Comparison between Subjects with Ultra-High Risk and 22q11.2 Deletion Syndrome

    PubMed Central

    Bakker, Geor; Caan, Matthan W. A.; Vingerhoets, Wilhelmina A. M.; da Silva- Alves, Fabiana; de Koning, Mariken; Boot, Erik; Nieman, Dorien H.; de Haan, Lieuwe; Bloemen, Oswald J.; Booij, Jan; van Amelsvoort, Thérèse A. M. J.

    2016-01-01

    Introduction Subjects with 22q11.2 deletion syndrome (22q11DS) and subjects with ultra-high risk for psychosis (UHR) share a risk of approximately 30% to develop a psychotic disorder. Studying these groups helps identify biological markers of pathophysiological processes involved in the development of psychosis. Total cortical surface area (cSA), total cortical grey matter volume (cGMV), cortical thickness (CT), and local gyrification index (LGI) of the cortical structure have a distinct neurodevelopmental origin making them important target markers to study in relation to the development of psychosis. Materials and Methods Structural T1-weighted high resolution images were acquired using a 3 Tesla Intera MRI system in 18 UHR subjects, 18 22q11DS subjects, and 24 matched healthy control (HC) subjects. Total cSA, total cGMV, mean CT, and regional vertex-wise differences in CT and LGI were assessed using FreeSurfer software. The Positive and Negative Syndrome Scale was used to assess psychotic symptom severity in UHR and 22q11DS subjects at time of scanning. Results 22q11DS subjects had lower total cSA and total cGMV compared to UHR and HC subjects. The 22q11DS subjects showed bilateral lower LGI in the i) prefrontal cortex, ii) precuneus, iii) precentral gyrus and iv) cuneus compared to UHR subjects. Additionally, lower LGI was found in the left i) fusiform gyrus and right i) pars opercularis, ii) superior, and iii) inferior temporal gyrus in 22q11DS subjects compared to HC. In comparison to 22q11DS subjects, the UHR subjects had lower CT of the insula. For both risk groups, positive symptom severity was negatively correlated to rostral middle frontal gyrus CT. Conclusion A shared negative correlation between positive symptom severity and rostral middle frontal gyrus CT in UHR and 22q11DS may be related to their increased vulnerability to develop a psychotic disorder. 22q11DS subjects were characterised by widespread lower degree of cortical gyrification linked to

  2. [Trauma and psychosis--part 1. On the association of early childhood maltreatment in clinical populations with psychotic disorders].

    PubMed

    Kapfhammer, Hans-Peter

    2012-01-01

    A comprehensive literature stresses a high percentage of severe childhood maltreatment in the history of many psychotically ill patients treated in mental health services. Early childhood abuse seems to be associated among other things with a more severe clinical state, a more chronic course of illness and a more unfavourable psychosocial adaptation. In order not to jump to unwarranted causal conclusions, several conceptual und methodological problems have to be clarified before. From a conceptual perspective psychotic disorders diagnosed according to conventional criteria define only a minor subgroup within a much broader psychosis continuum in general population. Early childhood abuse has to be differentiated according to type, severity, timing, and context. The rates of early childhood abuse are high in general population. The methods of measurement of psychotic symptoms on the one side, of early trauma on the other side have to be critically evaluated. There is an empirically well founded association of childhood maltreatment and psychological and psychosomatic morbidity during adult years in general. In order to establish a potential conditional link also to psychotic disorders, clinical populations have to be compared to adequate control groups at least. A systematic literature search shows a very small number of studies including control groups at all. These studies underline that early childhood abuse may be significantly associated to the risk of psychosis indeed. The conditional role of early childhood abuse, however, has to be investigated only within a multifactorial biopsychosocial model of psychotic illness.

  3. The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients.

    PubMed

    Rouleau, Codie R; Garland, Sheila N; Carlson, Linda E

    2015-01-01

    Research on the use of mindfulness-based stress reduction and related mindfulness-based interventions (MBIs) in cancer care has proliferated over the past decade. MBIs have aimed to facilitate physical and emotional adjustment to life with cancer through the cultivation and practice of mindfulness (ie, purposeful, nonjudgmental, moment-to-moment awareness). This descriptive review highlights three categories of outcomes that have been evaluated in MBI research with cancer patients - namely, symptom reduction, positive psychological growth, and biological outcomes. We also examine the clinical relevance of each targeted outcome, while describing recently published original studies to highlight novel applications of MBIs tailored to individuals with cancer. Accumulating evidence suggests that participation in a MBI contributes to reductions in psychological distress, sleep disturbance, and fatigue, and promotes personal growth in areas such as quality of life and spirituality. MBIs may also influence markers of immune function, hypothalamic-pituitary-adrenal axis regulation, and autonomic nervous system activity, though it remains unclear whether these biological changes translate to clinically important health benefits. We conclude by discussing methodological limitations of the extant literature, and implications of matching MBIs to the needs and preferences of cancer patients. Overall, the growing popularity of MBIs in cancer care must be balanced against scientific evidence for their impact on specific clinical outcomes.

  4. The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients

    PubMed Central

    Rouleau, Codie R; Garland, Sheila N; Carlson, Linda E

    2015-01-01

    Research on the use of mindfulness-based stress reduction and related mindfulness-based interventions (MBIs) in cancer care has proliferated over the past decade. MBIs have aimed to facilitate physical and emotional adjustment to life with cancer through the cultivation and practice of mindfulness (ie, purposeful, nonjudgmental, moment-to-moment awareness). This descriptive review highlights three categories of outcomes that have been evaluated in MBI research with cancer patients – namely, symptom reduction, positive psychological growth, and biological outcomes. We also examine the clinical relevance of each targeted outcome, while describing recently published original studies to highlight novel applications of MBIs tailored to individuals with cancer. Accumulating evidence suggests that participation in a MBI contributes to reductions in psychological distress, sleep disturbance, and fatigue, and promotes personal growth in areas such as quality of life and spirituality. MBIs may also influence markers of immune function, hypothalamic–pituitary–adrenal axis regulation, and autonomic nervous system activity, though it remains unclear whether these biological changes translate to clinically important health benefits. We conclude by discussing methodological limitations of the extant literature, and implications of matching MBIs to the needs and preferences of cancer patients. Overall, the growing popularity of MBIs in cancer care must be balanced against scientific evidence for their impact on specific clinical outcomes. PMID:26064068

  5. Evaluating dosage effects for the positive action program: How implementation impacts internalizing symptoms, aggression, school hassles, and self-esteem.

    PubMed

    Smokowski, Paul R; Guo, Shenyang; Wu, Qi; Evans, Caroline B R; Cotter, Katie L; Bacallao, Martica

    2016-01-01

    Positive Action (PA) is a school-based intervention for elementary-, middle-, and high-school students that aims to decrease problem behaviors (e.g., violence, substance use) and increase positive behaviors (e.g., academic achievement, school engagement). PA has a long history of documented success achieving these aims, making it an Evidence Based Practice (EBP). Intervention research on EBP's has established the importance of implementation fidelity, especially with regard to program dosage; failure to properly implement an EBP can have negative consequences on targeted outcomes, especially if participants are exposed to a low dosage of the program (e.g., fewer lessons than specified). Much of the current research on PA has neglected to examine how program dosage impacts PA's effect on targeted outcomes. Using propensity score models, multiple imputation, and a 2-level hierarchical linear model, the current study fills this gap and examines how different dosages of PA as measured by years participating in PA and number of PA lessons, impacts adolescent internalizing symptoms, aggression, perceptions of school hassles, and self-esteem over a 3-year period. The current sample included middle school students in grades 6, 7, and 8 (N = 5,894). The findings indicate that students who received 3 years of the PA intervention and a high number of PA lessons had a significantly higher self-esteem score than those who received 0 years of PA or zero lessons. Participants who received 1 year of PA also reported significantly lower school hassle scores than those who received 0 years. Dosage had no statistically significant effects on aggression or internalizing score. Implications are discussed. (PsycINFO Database Record

  6. Condylar axis position, as determined by the occlusion and measured by the CPI instrument, and signs and symptoms of temporomandibular dysfunction.

    PubMed

    Crawford, S D

    1999-04-01

    The importance of occlusion as an etiologic factor in signs and symptoms of TMD has been a source of controversy. Very few studies have examined occlusion-dictated condylar position using instrumentation, and none has compared an ideal sample against an untreated control. The purpose of this study was to determine if there is a relationship between condylar axis position as determined by the occlusion and signs and symptoms of TMD, using the condylar position indicator (CPI). A sample of subjects with ideal occlusions, defined as centric relation approximating centric occlusion, was compared with a control sample of untreated subjects. The comparison was based on written patient histories, clinical exams, and CPI measurements. The ideal sample of 30 subjects was selected from a population that had undergone full-mouth reconstruction using gnathologic principles that included centric relation (CR) being coincident with centric occlusion (CO). The control group consisted of 30 untreated subjects from the general population and was matched with the ideal sample with regard to sex. A duplicate written exam was given to the subjects in the ideal sample to assess symptoms prior to treatment. The CR bite registration technique developed by Roth was used. When the pre- and posttreatment examination scores of the ideal sample were compared, an 84% reduction in symptoms was found after treatment. A high correlation (p<.001) between signs and symptoms of TMD and CPI values was documented. Since condylar axis position is dictated upon closure of the dentition into maximum intercuspation and since condylar axis position was shown in this study to be strongly correlated with TMD symptomatology, it can be concluded that a statistically significant relationship exists between occlusion-dictated condylar position and symptoms of TMD.

  7. Morphological and positional assessments of TMJ components and lateral pterygoid muscle in relation to symptoms and occlusion of patients with temporomandibular disorders.

    PubMed

    Liu, Z J; Yamagata, K; Kuroe, K; Suenaga, S; Noikura, T; Ito, G

    2000-10-01

    Disc displacement is accepted as one of major findings in temporomandibular disorders (TMD). However, the associations of disc positions with morphological and positional changes of temporomandibular joint (TMJ) components and lateral pterygoid (LP), TMD clinical symptoms, and occlusion have rarely been discussed quantitatively. In this study, the morphological and positional changes of TMJ components and LP were assessed by means of magnetic resonance imaging (MRI) and tomography of the TMJ in 41 TMD and nine control (CN) subjects. Disc positions in TMD subjects were divided into normal position (NP) and anterior displacement with and without reduction (ADR+ and ADR-, respectively). From MRI scans and tomograms, the morphological and positional changes of TMJ components and LP were measured and compared among CN, NP, ADR+ and ADR- groups. Correlations between these measurements and the scored clinical symptoms and occlusal factors were analysed in TMD subjects. The results indicated that: (1) TMJ osseous structures and LP showed no significant difference among CN and the three TMD groups, except for a posterior seat of condyle and shorter/steeper condylar movement during jaw opening; (2) disc length and inclination were significantly shorter and steeper, respectively, in ADR+ and ADR-; (3) disc positions were not specified by clinical symptoms and occlusal factors, except for the dominant TMJ sounds in ADR+; (4) an uncoordinated movement of the condyle/disc complex was found in ADR+ and/or ADR-; (5) TMJ osseous structures and the disc were weakly associated with clinical symptoms and occlusal factors. However, the LP showed negative associations with palpable pain for both the TMJ and jaw muscles and the static occlusal factors. These findings suggest that TMJ internal derangements are more related to the positional changes or spatial relationships of TMJ components but less to the individual morphologies of TMJ osseous structures, disc and LP, as well as specific

  8. Prediction and prevention of the first psychotic episode: new directions and opportunities

    PubMed Central

    Piras, Sara; Casu, Gianluca; Casu, Maria Antonietta; Orrù, Alessandro; Ruiu, Stefania; Pilleri, Antonio; Manca, Gabriella; Marchese, Giorgio

    2014-01-01

    In the last few decades, substantial research has focused on the possibility of early detection and prevention of the first psychotic episode in young individuals at risk of developing this mental disturbance; however, unresolved clinical and ethical issues still call for further investigations. New perspectives and opportunities may come from the identification of selective psychopathological and instrumental markers linking the appearance of subtle psychotic symptoms with the clinical outcome of specific mental pathologies. Furthermore, empirically derived algorithms and risk staging models should facilitate the identification of targeted prevention therapies, possibly improving the efficacy of well-tolerated therapeutic approaches, such as psychological interventions and natural compound supplementations. To date, the collected evidence on the efficacy and tolerability of pharmacological prevention therapies raises more doubts than hopes. A very early detection of risk and appropriate symptomatic pattern classifications may provide a chance to better match prevention strategies with the development of psychosis. PMID:24729711

  9. Bipolar Disorder With Psychotic Features and Ocular Toxoplasmosis: A Possible Pathogenetic Role of the Parasite?

    PubMed

    Del Grande, Claudia; Contini, Carlo; Schiavi, Elisa; Rutigliano, Grazia; Maritati, Martina; Seraceni, Silva; Pinto, Barbara; Dell'Osso, Liliana; Bruschi, Fabrizio

    2017-03-01

    Recent evidence suggests the involvement of Toxoplasma gondii infection in the emergence of psychotic and affective disorders. In this report, we describe the case of a young Brazilian woman affected by recurrent ocular toxoplasmosis and presenting with a manic episode with psychotic features in the context of a diagnosis of Bipolar Disorder (BD), type I. We observed a relationship between ocular manifestations and the clinical course of bipolar illness, confirmed by molecular analyses (nested-PCR), as well as by the high level of T. gondii specific IgG. This case report is the first showing the presence of circulating parasite DNA at the time of occurrence of psychiatric symptoms, thus providing further support for a possible role of the parasite in the pathogenesis of some cases of BD.

  10. Velo-cardio-facial syndrome and psychotic disorders: Implications for psychiatric genetics

    SciTech Connect

    Chow, W.C.; Bassett, A.S.; Weksberg, R.

    1994-06-15

    Psychiatric disorders have been reported in over 10% of patients with velo-cardio-facial syndrome (VCFS) in long-term follow-up. To further explore the behavioral and psychiatric findings associated with VCFS in adulthood, detailed clinical histories of two patients - one with VCFS who developed a psychotic illness, and one with schizophrenia who was found to have dysmorphological features associated with VCFS - are described in the current report. The observed overlap of physical and psychiatric symptoms in these two patients suggests that VCFS and psychotic disorders may share a pathogenetic mechanism. This could be consistent with a contiguous gene model for VCFS and psychosis, suggesting chromosome 22q11 as a possible candidate region for genetic studies of schizophrenia. 26 refs., 2 tabs.

  11. Experience of Subjective Symptoms in Euthymic Patients with Bipolar Disorder

    PubMed Central

    Joe, Soohyun; Joo, Yeonho

    2008-01-01

    Bipolar patients often experience subjective symptoms even if they do not have active psychotic symptoms in their euthymic state. Most studies about subjective symptoms are conducted in schizophrenia, and there are few studies involving bipolar patients. We examined the nature of the subjective symptoms of bipolar patients in their euthymic state, and we also compared it to that of schizophrenia and normal control. Thirty bipolar patients, 25 patients with schizophrenia, and 21 normal control subjects were included. Subjective symptoms were assessed using the Korean version of the Frankfurter Beschwerde Fragebogen (K-FBF) and the Symptom Check List 90-R (SCL90-R). Euthymic state was confirmed by assessing objective psychopathology with the Positive and Negative Syndrome scale of Schizophrenia (PANSS), the Young Mania Rating Scale (YMRS), and the Montgomery Asberg Depression Rating Scale (MADRS). K-FBF score was significantly higher in bipolar patients than in normal controls, but similar to that in schizophrenia patients (F=5.86, p=0.004, R2=2033.6). In contrast, SCL90-R scores did not differ significantly among the three groups. Euthymic bipolar patients experience subjective symptoms that are more confined to cognitive domain. This finding supports the hypothesis that subtle cognitive impairments persists in euthymic bipolar patients. PMID:18303193

  12. Basic symptoms in schizophrenic and affective psychoses.

    PubMed

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

    1989-01-01

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

  13. Shared versus specific features of psychological symptoms and cigarettes per day: structural relations and mediation by negative- and positive-reinforcement smoking.

    PubMed

    Ameringer, Katherine J; Chou, Chih-Ping; Leventhal, Adam M

    2015-04-01

    This study examined the extent to which shared versus specific features across multiple manifestations of psychological symptoms (depression, anxiety, ADHD, aggression, alcohol misuse) associated with cigarettes per day. Subsequently, we investigated whether negative- (i.e., withdrawal relief) and positive- (i.e., pleasure enhancement) reinforcement smoking motivations mediated relations. Adult daily smokers (N = 338) completed self-report measures and structural equation modeling was used to construct a 3-factor (low positive affect-negative affect-disinhibition) model of affective and behavioral symptoms and to test relations of each latent factor (shared features) and indicator residual (specific features) to smoking level. Shared dimensions of low positive affect, negative affect, and disinhibition associated with smoking rate. Negative-reinforcement smoking mediated the link between latent negative affect and heavier daily smoking. Specific features of psychological symptoms unique from latent factors were generally not associated with cigarettes per day. Features shared across several forms of psychological symptoms appear to underpin relations between psychological symptoms and smoking rate.

  14. Do current beliefs predict hypomanic symptoms beyond personality style? Factor analysis of the hypomanic attitudes and positive predictions inventory (HAPPI) and its association with hypomanic symptoms in a student population.

    PubMed

    Mansell, Warren; Rigby, Zoe; Tai, Sara; Lowe, Christine

    2008-04-01

    A self-report scale called the Hypomanic Attitudes and Positive Predictions Inventory (HAPPI) has been developed to assess cognitions that distinguish between bipolar disorder and nonclinical controls (Mansell, 2006; Mansell & Jones, 2006). We recruited 191 undergraduate students to assess the associations between the HAPPI and self-reported past (MDQ; Hirschfeld et al., 2000) and present (ISS; Bauer et al., 1991) bipolar symptoms, and to explore the factor structure of the scale. The HAPPI correlated with past and present symptoms independently of the BIS/BAS subscales (Carver & White, 1994) and the HPS (Eckblad & Chapman, 1986). Five factors of the HAPPI were identified: success activation and triumph over fear, activating response style, reduced social regulation, loss of control when activated, and catastrophic beliefs about internal states. The HAPPI factors showed specific relationships with current bipolar symptoms that largely fitted with predictions based on the model. Further work is required to establish whether they have a causal role.

  15. [Relationship of insight with depression and suicidal ideation in psychotic disorders].

    PubMed

    Patelaros, E; Zournatzis, E; Kontstantakopoulos, G

    2015-01-01

    The associations of insight into psychosis (i.e., awareness of illness) with clinical variables have been examined by a great number of studies. Most of these studies revealed that the level of insight is negatively correlated with psychotic symptoms but positively correlated with depression and suicidal ideation. The aim of this study was to test these findings in a Greek sample of patients. Forty-three outpatients (30 men and 13 women) with schizophrenia or delusional disorder being followed up at the Mental Health Centre of Kavala took part in the study. Patients with bipolar or schizoaffective disorder were excluded. Patients' mean age was 40.7 years and the mean duration of illness was 18.67 years. All participants were under treatment and clinically stable at the time of the study. We used the Positive and Negative Syndrome Scale (PANSS) for the assessment of positive and negative symptoms, the Schedule for the Assessment of Insight-Expanded (SAI-E) to assess the insight into psychosis, and the Montgomery-Asberg Depression Rating Scale (MADRS) for the evaluation of depression recording separately the score for item 10 as an estimate of suicidal ideation. All the scales used have been adapted to Greek population. We used Spearman rho coefficient to assess the strength of correlations between the scales because the distributions of some scores were not normal. In order to assess the predictive value of insight for depression and suicidal ideation, we used hierarchical linear regression analysis. Correlation coefficients between SAI-E and the clinical scales of psychopathology, depression and suicide ideation was statistically significant at the p<0.01 level. The correlations between the clinical scales and the three subscales of SAI-E were also significant at the aforementioned p level. The regression analysis showed that our model of positive and negative psychopathology and insight explained 47.4% of the variance of depression and 32.2% of the variance of

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

    PubMed

    Hassamal, Sameer; Jolles, Paul; Pandurangi, Ananda

    2016-11-01

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

  17. Suicide as escape from psychotic panic.

    PubMed

    Goldblatt, Mark J; Ronningstam, Elsa; Schechter, Mark; Herbstman, Benjamin; Maltsberger, John T

    2016-01-01

    Suicides of patients in states of acute persecutory panic may be provoked by a subjective experience of helpless terror threatening imminent annihilation or dismemberment. These patients are literally scared to death and try to run away. They imagine suicide is survivable and desperately attempt to escape from imaginary enemies. These states of terror occur in a wide range of psychotic illnesses and are often associated with command hallucinations and delusions. In this article, the authors consider the subjective experience of persecutory panic and the suicide response as an attempt to flee from danger.

  18. Prevalence of Vitamin B12 and folic acid deficiency in HIV-positive patients and its association with neuropsychiatric symptoms and immunological response

    PubMed Central

    Adhikari, Prabha M. R.; Chowta, Mukta N.; Ramapuram, John T.; Rao, Satish; Udupa, Karthik; Acharya, Sahana Devdas

    2016-01-01

    Background: Deficiency of micronutrients is prevalent even before the development of symptoms of HIV disease and is associated with accelerated HIV disease progression. Aims: This study evaluates the prevalence of folate and Vitamin B12 deficiency in HIV-positive patients with or without tuberculosis (TB) and its association with neuropsychiatric symptoms and immunological response. Settings and Design: Cross-sectional, observational study in an outpatient setting. Patients and Methods: Four groups of HIV-positive patients with TB (Group I), HIV-positive patients with neuropsychiatric symptoms (Group II), HIV-positive patients without neuropsychiatric symptoms or TB (Group III), and HIV-negative controls with neuropsychiatric symptoms (Group IV). Vitamin B12 and folate estimation was done using carbonyl metallo-immunoassay method. Statistical Analysis Used: ANOVA, Kruskal–Wallis and Mann–Whitney, Pearson's correlation. Results: The prevalence of folic acid deficiency was 27.1% in the Group I, 31.9% in the Group II, 23.4% in the Group III, and 32% in the Group IV being higher in patients with neuropsychiatric symptoms in both HIV and non-HIV patients. The prevalence of Vitamin B12 deficiency was 18.8% in Group I, 9.1% in Group II, 4.8% in Group III, and 16.7% in Group IV. The patients with folate deficiency had more severe depression and anxiety. Conclusion: Nearly, 30% of the HIV patients had a folic acid deficiency, and about 10% of the HIV patients had Vitamin B12 deficiency. The folate deficiency was highest among neuropsychiatric patients with or without HIV infection and Vitamin B12 deficiency was higher among HIV patients with TB. PMID:27890954

  19. Examining the Effects of Self-Reported Posttraumatic Stress Disorder Symptoms and Positive Relations with Others on Self-Regulated Learning for Student Service Members/Veterans

    ERIC Educational Resources Information Center

    Ness, Bryan M.; Middleton, Michael J.; Hildebrandt, Michael J.

    2015-01-01

    Objectives: To examine the relationships between self-reported posttraumatic stress disorder (PTSD) symptoms, perceived positive relations with others, self-regulation strategy use, and academic motivation among student service members/veterans (SSM/V) enrolled in postsecondary education. Participants: SSM/V (N = 214), defined as veterans, active…

  20. A Longitudinal Examination of Perceived Discrimination and Depressive Symptoms in Ethnic Minority Youth: The Roles of Attributional Style, Positive Ethnic/Racial Affect, and Emotional Reactivity

    ERIC Educational Resources Information Center

    Stein, Gabriela L.; Supple, Andrew J.; Huq, Nadia; Dunbar, Angel S.; Prinstein, Mitchell J.

    2016-01-01

    Although perceived ethnic/racial discrimination is well established as a risk factor for depressive symptoms in ethnic minority youth, few studies have examined their longitudinal relationship over time. This study examined whether a negative attributional style, positive ethnic/racial affect, and emotional reactivity moderated the longitudinal…

  1. Acceptance and Efficacy of Metacognitive Training (MCT) on Positive Symptoms and Delusions in Patients With Schizophrenia: A Meta-analysis Taking Into Account Important Moderators.

    PubMed

    Eichner, Carolin; Berna, Fabrice

    2016-07-01

    Metacognitive training (MCT) is a new, widely used intervention for psychosis. The present meta-analysis examines the efficacy of MCT in schizophrenia. Fifteen studies comparing effects of MCT on positive symptoms, delusions or acceptance of MCT with a control group were included in this meta-analysis. These studies comprised a total of 408 patients in the MCT condition and 399 in the control condition. The moderating effects of masking of outcome assessment, randomization, incomplete outcome data, use of an active control intervention, and individual vs group MCT were investigated. Possible effects of sensitivity analyses and publication bias were also examined. The results show a significant overall effect of MCT for positive symptoms (g = -0.34, 95% CI [-0.53, -0.15]), delusions (g = -0.41, 95% CI [-0.74, -0.07]) and acceptance of the intervention (g = -0.84, 95% CI [-1.37, -0.31]). Using only studies being at low risk for bias regarding randomization, masking and incomplete outcome data reduced effect sizes for positive symptoms and delusions (g = -0.28, 95% CI [-0.50, -0.06] and g = -0.18, 95% CI [-0.43, 0.06]), respectively. This meta-analysis demonstrates that MCT exerts a small to moderate effect on delusions and positive symptoms and a large effect on acceptance of the intervention. The effect on delusions is reduced, but remains significant when potential biases are considered.

  2. Epidemiological and clinical characterization following a first psychotic episode in major depressive disorder: comparisons with schizophrenia and bipolar I disorder in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS).

    PubMed

    Owoeye, Olabisi; Kingston, Tara; Scully, Paul J; Baldwin, Patrizia; Browne, David; Kinsella, Anthony; Russell, Vincent; O'Callaghan, Eadbhard; Waddington, John L

    2013-07-01

    While recent research on psychotic illness has focussed on the nosological, clinical, and biological relationships between schizophrenia and bipolar disorder, little attention has been directed to the most common other psychotic diagnosis, major depressive disorder with psychotic features (MDDP). As this diagnostic category captures the confluence between dimensions of psychotic and affective psychopathology, it is of unappreciated heuristic potential to inform on the nature of psychotic illness. Therefore, the epidemiology and clinical characteristics of MDDP were compared with those of schizophrenia and bipolar disorder within the Cavan-Monaghan First Episode Psychosis Study (n = 370). Epidemiologically, the first psychotic episode of MDDP (n = 77) was uniformly distributed across the adult life span, while schizophrenia (n = 73) and bipolar disorder (n = 73) were primarily disorders of young adulthood; the incidence of MDDP, like bipolar disorder, did not differ between the sexes, while the incidence of schizophrenia was more common in males than in females. Clinically, MDDP was characterized by negative symptoms, executive dysfunction, neurological soft signs (NSS), premorbid intellectual function, premorbid adjustment, and quality of life similar to those for schizophrenia, while bipolar disorder was characterized by less prominent negative symptoms, executive dysfunction and NSS, and better quality of life. These findings suggest that what we currently categorize as MDDP may be more closely aligned with other psychotic diagnoses than has been considered previously. They indicate that differences in how psychosis is manifested vis-à-vis depression and mania may be quantitative rather than qualitative and occur within a dimensional space, rather than validating categorical distinctions.

  3. Positioning.

    ERIC Educational Resources Information Center

    Conone, Ruth M.

    The key to positioning is the creation of a clear benefit image in the consumer's mind. One positioning strategy is creating in the prospect's mind a position that takes into consideration the company's or agency's strengths and weaknesses as well as those of its competitors. Another strategy is to gain entry into a position ladder owned by…

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

    PubMed Central

    Lehmann, Jennifer; Gracious, Barbara L.; Arnold, L. Eugene; Young, Andrea S.; Fristad, Mary A.

    2015-01-01

    Abstract Objectives: Therapeutic benefits of omega-3 fatty acids (Ω3) for mood disorders, psychosis, and anxiety have been reported in the literature. The purpose of the present article is to provide a literature review of Ω3 supplementation for affective disorders and to illustrate the benefits of Ω3 with a case presentation of a young girl with a history of bipolar disorder-type 1 with psychotic features and generalized anxiety disorder. Methods: Reviewed literature includes treatment studies of the impact of Ω3 on child mood disorders supplemented by review of meta-analyses within the adult mood disorders literature. The subject of this case report participated in 11 in-depth diagnostic and functional assessments over 5 years as part of an unrelated study. Three years were presupplementation and 2 years were with supplementation with no other medication changes, thus making a naturalistic multiple-baseline single-subject experiment. Results: Augmentation over a 2 year period was notable for clinically significant and sustained improvement in depressive, manic, and psychotic symptoms. Conclusion: Ω3 supplementation may be a safe, adjunct intervention for treating bipolar disorder in children and adolescents, even in the presence of psychotic and anxious features. The 2 year follow-up in this case offers hope of an accumulating and enduring benefit. Further research into mechanisms of Ω3 action and of combination treatment with other well-known interventions for mood disorders would be beneficial. PMID:26288263

  5. Psychotic experiences as indicators of suicidal ideation in a non-clinical college sample.

    PubMed

    DeVylder, Jordan E; Thompson, Elizabeth; Reeves, Gloria; Schiffman, Jason

    2015-04-30

    Suicide is a leading cause of preventable death. Epidemiological studies have shown strong associations between sub-threshold psychotic experiences and risk for suicidal ideation and behavior. Screens designed to assess psychotic experiences may have clinical utility in improving suicide prevention efforts. In the current study, we hypothesized that the Prodromal Questionnaire-Brief (PQ-B) would reliably distinguish levels of suicidal ideation within a sample of college students (n=376). As predicted, PQ-B scores varied significantly across levels of suicidal ideation, both when treated as a raw count of sub-threshold psychotic experiences and when taking into account subjective distress associated with those symptoms. In addition, we explored the feasibility of developing a short screen based on the most discriminating items, finding that a six-item version of the PQ-B yielded higher accuracy for detecting elevated suicidal ideation over the full measure. The PQ-B has the potential for clinical utility in detecting groups that might be at increased risk for suicidal ideation.

  6. Prodromal Signs and Symptoms of Schizophrenic Relapse.

    ERIC Educational Resources Information Center

    Subotnik, Kenneth L.; Nuechterlein, Keith H.

    Increasing evidence that decompensation into acute psychosis by schizophrenics can often be avoided with active pharmacological and psychosocial intervention at the early signs of relapse has stimulated research into the signs and symptoms prodromal to acute psychosis. In this study, 6-week periods prior to 17 psychotic relapses and to 11 relapses…

  7. A Schizophrenia-Like Psychotic Disorder Secondary to an Arachnoid Cyst Remitted with Neurosurgical Treatment of the Cyst

    PubMed Central

    Baquero, G.A.; Molero, P.; Pla, J.; Ortuño, F.

    2014-01-01

    We describe a case of delusional psychosis that was terminated by neurosurgical removal of a large arachnoid cyst. The patient was suffering his first psychotic episode and had symptoms typical of schizophrenia. The case underscores the importance of considering that an arachnoid cyst can induce psychopathological symptoms, even those of schizophrenia. Indeed, such symptoms may be the cyst's only clinical manifestation. In addition, the case highlights the importance of doing a structural imaging test when confronted with a first episode of psychosis, especially if the episode is relatively late in appearance. Such imaging may lead to a diagnosis that in turn can enable a definitive neurosurgical resolution of the psychosis. PMID:24653786

  8. Difficulty of pinching behind the back: an atypical symptom of carpal tunnel syndrome related to a specific wrist position. Two case reports.

    PubMed

    Shimizu, Satoru; Tachibana, Shigekuni; Fujii, Kiyotaka

    2012-01-01

    Carpal tunnel syndrome (CTS) may be overlooked in the absence of typical sensory symptoms. Two patients with CTS lacked the attendant sensory symptoms but experienced difficulties performing a pinching action behind the back (manipulation of the buckle of a baby sling or the hook of a brassiere), a mode of pinching that required wrist flexion. The causative mechanism was probably exacerbation of a latent weakness of the intrinsic muscles of the thumb by wrist flexion, in which the strength of the extrinsic flexors of the thumb and index finger were decreased due to loosening of the tendons. Such symptoms, induced by a specific wrist position, may be help to diagnose a latent weakness in the intrinsic muscles of the thumb, present in patients with CTS.

  9. Change in Autism Symptoms and Maladaptive Behaviors in Adolescence and Adulthood: The Role of Positive Family Processes

    ERIC Educational Resources Information Center

    Woodman, Ashley C.; Smith, Leann E.; Greenberg, Jan S.; Mailick, Marsha R.

    2015-01-01

    Little is known about outcomes for individuals with autism spectrum disorders (ASD) into adulthood. Several characteristics of individuals with ASD predict long-term outcomes, and the family environment may also play a role. The present study uses a prospective, longitudinal design to describe and predict trajectories of autism symptoms and…

  10. Positive Traits versus Previous Trauma: Racially Different Correlates with PTSD Symptoms among Hurricane Katrina-Rita Volunteers

    ERIC Educational Resources Information Center

    Ai, Amy L.; Plummer, Carol; Kanno, Hanae; Heo, Grace; Appel, Hoa B.; Simon, Cassandra E.; Spigner, Clarence

    2011-01-01

    This study compared risks and protective factors for acquiring symptoms of posttraumatic stress disorder (PTSD) between African-American (n = 299) and European-American (n = 206) student volunteers 3 months after Hurricanes Katrina and Rita (H-KR). Respondents retrospectively provided information on peritraumatic emotional reactions and previous…

  11. The development of psychotic disorders in adolescence: a potential role for hormones.

    PubMed

    Trotman, Hanan D; Holtzman, Carrie W; Ryan, Arthur T; Shapiro, Daniel I; MacDonald, Allison N; Goulding, Sandra M; Brasfield, Joy L; Walker, Elaine F

    2013-07-01

    This article is part of a Special Issue "Puberty and Adolescence". The notion that adolescence is characterized by dramatic changes in behavior, and often by emotional upheaval, is widespread and longstanding in popular western culture. In recent decades, this notion has gained increasing support from empirical research showing that the peri- and post-pubertal developmental stages are associated with a significant rise in the rate of psychiatric symptoms and syndromes. As a result, interest in adolescent development has burgeoned among researchers focused on the origins of schizophrenia and other psychotic disorders. Two factors have fueled this trend: 1) increasing evidence from longitudinal research that adolescence is the modal period for the emergence of "prodromal" manifestations, or precursors of psychotic symptoms, and 2) the rapidly accumulating scientific findings on brain structural and functional changes occurring during adolescence and young adulthood. Further, gonadal and adrenal hormones are beginning to play a more prominent role in conceptualizations of adolescent brain development, as well as in the origins of psychiatric symptoms during this period (Walker and Bollini, 2002; Walker et al., 2008). In this paper, we begin by providing an overview of the nature and course of psychotic disorders during adolescence/young adulthood. We then turn to the role of hormones in modulating normal brain development, and the potential role they might play in the abnormal brain changes that characterize youth at clinical high-risk (CHR) for psychosis. The activational and organizational effects of hormones are explored, with a focus on how hormone-induced changes might be linked with neuropathological processes in the emergence of psychosis.

  12. Neurocognitive impairment on motor imagery associated with positive symptoms in patients with first-episode schizophrenia: evidence from event-related brain potentials.

    PubMed

    Chen, Jiu; Wei, Dunhong; Yang, Laiqi; Wu, Xingqu; Ma, Wentao; Fu, Qinghai; Wang, Haun; Liu, Guangxiong; Deng, Zihe; Ye, Ming; Zhang, Yan; Zhang, Zhijun

    2015-03-30

    Motor imagery provides direct insight into an anatomically interconnected system involved in the integration of sensory information with motor actions, a process that is associated with positive symptoms in schizophrenia (SCZ). However, very little is known about the electrophysiological processing of motor imagery in first episode SCZ. In the current study, we used a visual hand mental rotation (MR) paradigm to manipulate the processing of motor imagery while event-related brain potentials (ERPs) were recorded in 42 SCZ participants and 40 healthy controls (HC). The 400-600 ms window was measured and analyzed for peak latencies and amplitudes. Participants with SCZ had slower reaction time (RT) and made more errors than did HC participants. Moreover, SCZ participants had lower amplitudes in the 400-600 ms window and the typical MR function for amplitudes of MR was lacking. Interestingly, the scalp activity maps for MR in SCZ exhibited an absence of activation in the left parietal site as shown in HC. Furthermore, deficits of amplitude for MR were positively correlated with positive symptom scores in SCZ. These results provide novel evidence for relationships between the electrophysiological processing of motor imagery and positive symptoms in SCZ. They further suggest that the impaired information processing of motor imagery indexed by amplitudes and specific topographic characteristics of the EEG during MR tasks may be a potentially useful and early defining biomarker for SCZ.

  13. The role of workload and driver coping styles in predicting bus drivers' need for recovery, positive and negative affect, and physical symptoms.

    PubMed

    Machin, M Anthony; Hoare, P Nancey

    2008-10-01

    A survey was conducted on a sample of 159 Australian bus drivers to determine the extent to which workload and self-reported driver coping styles predicted their subjective health status. The model that was proposed incorporated the hours spent driving as a measure of workload, both adaptive and maladaptive driver coping styles, and self-report measures of need for recovery (i.e., fatigue), positive and negative affect (PA and NA), and physical symptoms. The results of hierarchical regression analyses revealed that the workload was a significant predictor of drivers' need for recovery, but not of their PA and NA nor of their physical symptoms. Need for recovery was in turn a significant predictor of PA and NA and of their physical symptoms, indicating that it mediates the influence of workload on PA and NA and physical symptoms. Two maladaptive coping strategies added to the prediction of need for recovery, as well as to the prediction of NA, even after controlling for the influence of need for recovery. One adaptive coping strategy added to the prediction of PA. Strategies for management of fatigue in bus drivers should focus on the assessment and remediation of maladaptive coping strategies which impact of drivers' need for recovery, which in turn predicts PA and NA and physical symptoms.

  14. Psychotic disorder due to traumatic brain injury: analysis of case studies in the literature.

    PubMed

    Fujii, Daryl; Fujii, Daniel C

    2012-01-01

    The present study utilized methodology from a previous descriptive study that analyzed case studies of psychotic disorder due to traumatic brain injury (PD-TBI) reported in psychiatry and neurology journals. The purpose was to replicate findings from the PD-TBI literature and to elucidate a pattern of characteristics that would differentiate PD-TBI from schizophrenia. The findings supported both objectives. PD-TBI data were highly consistent with previous studies: PD-TBI differed from schizophrenia in showing more focal frontal and temporal abnormalities on neurological studies and a lower rate of negative symptoms. The authors discuss implications of these findings for conceptualizing psychosis as a neurobiological syndrome.

  15. Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness.

    PubMed

    Koekkoek, Bauke; van Tilburg, Willem

    2010-11-29

    This case report offers a different perspective on a patient with a long-term non-psychotic psychiatric disorder that was difficult to specify. The patient, a man in his 50s, was unable to profit from outpatient treatment and became increasingly dependent on mental healthcare - which could not be understood based on his history and psychiatric symptoms alone. By separating symptoms from illness behaviour, the negative course of this patient's treatment is analysed. Focusing on ineffective chronic illness behaviour by the patient, and mutual ineffective treatment behaviour by the clinicians, it becomes clear that basic requirements of effective treatment were unmet. By making a proper diagnosis, clarifying expectations and offering a suitable therapy, ineffective illness behaviour was diminished and this 'difficult' case became much easier for both patient and clinicians. The illness behaviour framework offers a useful, systematic tool to analyse difficulties between patients and clinicians beyond psychiatric symptoms or explanations.

  16. Positive and negative affectivity in children: confirmatory factor analysis of a two-factor model and its relation to symptoms of anxiety and depression.

    PubMed

    Lonigan, C J; Hooe, E S; David, C F; Kistner, J A

    1999-06-01

    The positive affect (PA) and negative affect (NA) framework that is embodied in the tripartite model of anxiety and depression has proved useful with adult populations; however, there is as yet little investigation with children concerning either the measurement of PA and NA or the relation between PA and NA and levels of adjustment. A confirmatory factor analysis was used in this study to examine the structure of self-reported affect and its relation to depressive and anxious symptoms in school children (4th to 11th grade). Results supported a 2-factor orthogonal model that was invariant across age and sex. Support for the expected pattern of relations between NA and PA with symptoms of depression and anxiety was strong for the older sample (M = 14.2 years) but weaker for the younger sample (M = 10.3 years). Results also provide preliminary support for the reliability and validity of the Positive and Negative Affect Schedule for children.

  17. The mGluR2 positive allosteric modulator, SAR218645, improves memory and attention deficits in translational models of cognitive symptoms associated with schizophrenia

    PubMed Central

    Griebel, Guy; Pichat, Philippe; Boulay, Denis; Naimoli, Vanessa; Potestio, Lisa; Featherstone, Robert; Sahni, Sukhveen; Defex, Henry; Desvignes, Christophe; Slowinski, Franck; Vigé, Xavier; Bergis, Olivier E.; Sher, Rosy; Kosley, Raymond; Kongsamut, Sathapana; Black, Mark D.; Varty, Geoffrey B.

    2016-01-01

    Normalization of altered glutamate neurotransmission through activation of the mGluR2 has emerged as a new approach to treat schizophrenia. These studies describe a potent brain penetrant mGluR2 positive allosteric modulator (PAM), SAR218645. The compound behaves as a selective PAM of mGluR2 in recombinant and native receptor expression systems, increasing the affinity of glutamate at mGluR2 as inferred by competition and GTPγ35S binding assays. SAR218645 augmented the mGluR2-mediated response to glutamate in a rat recombinant mGluR2 forced-coupled Ca2+ mobilization assay. SAR218645 potentiated mGluR2 agonist-induced contralateral turning. When SAR218645 was tested in models of the positive symptoms of schizophrenia, it reduced head twitch behavior induced by DOI, but it failed to inhibit conditioned avoidance and hyperactivity using pharmacological and transgenic models. Results from experiments in models of the cognitive symptoms associated with schizophrenia showed that SAR218645 improved MK-801-induced episodic memory deficits in rats and attenuated working memory impairment in NMDA Nr1neo−/− mice. The drug reversed disrupted latent inhibition and auditory-evoked potential in mice and rats, respectively, two endophenotypes of schizophrenia. This profile positions SAR218645 as a promising candidate for the treatment of cognitive symptoms of patients with schizophrenia, in particular those with abnormal attention and sensory gating abilities. PMID:27734956

  18. The mGluR2 positive allosteric modulator, SAR218645, improves memory and attention deficits in translational models of cognitive symptoms associated with schizophrenia.

    PubMed

    Griebel, Guy; Pichat, Philippe; Boulay, Denis; Naimoli, Vanessa; Potestio, Lisa; Featherstone, Robert; Sahni, Sukhveen; Defex, Henry; Desvignes, Christophe; Slowinski, Franck; Vigé, Xavier; Bergis, Olivier E; Sher, Rosy; Kosley, Raymond; Kongsamut, Sathapana; Black, Mark D; Varty, Geoffrey B

    2016-10-13

    Normalization of altered glutamate neurotransmission through activation of the mGluR2 has emerged as a new approach to treat schizophrenia. These studies describe a potent brain penetrant mGluR2 positive allosteric modulator (PAM), SAR218645. The compound behaves as a selective PAM of mGluR2 in recombinant and native receptor expression systems, increasing the affinity of glutamate at mGluR2 as inferred by competition and GTPγ(35)S binding assays. SAR218645 augmented the mGluR2-mediated response to glutamate in a rat recombinant mGluR2 forced-coupled Ca(2+) mobilization assay. SAR218645 potentiated mGluR2 agonist-induced contralateral turning. When SAR218645 was tested in models of the positive symptoms of schizophrenia, it reduced head twitch behavior induced by DOI, but it failed to inhibit conditioned avoidance and hyperactivity using pharmacological and transgenic models. Results from experiments in models of the cognitive symptoms associated with schizophrenia showed that SAR218645 improved MK-801-induced episodic memory deficits in rats and attenuated working memory impairment in NMDA Nr1(neo-/-) mice. The drug reversed disrupted latent inhibition and auditory-evoked potential in mice and rats, respectively, two endophenotypes of schizophrenia. This profile positions SAR218645 as a promising candidate for the treatment of cognitive symptoms of patients with schizophrenia, in particular those with abnormal attention and sensory gating abilities.

  19. Change in self-stigma among persons with schizophrenia enrolled in rehabilitation: associations with self-esteem and positive and emotional discomfort symptoms.

    PubMed

    Lysaker, Paul H; Roe, David; Ringer, Jamie; Gilmore, Emily M; Yanos, Philip T

    2012-08-01

    Self-stigma is a barrier to the recovery of persons with schizophrenia. Little is known about whether participation in rehabilitation is naturalistically linked to declines in self-stigma, and if so, what is correlated with changes in self-stigma. The current study examined in a quasi-experimental design the rate of change of self-stigma and whether changes were correlated with self-esteem, positive symptoms, and emotional distress for persons enrolled in rehabilitation. Symptoms were measured using the Positive and Negative Syndrome Scale (Kay, Fizsbein, & Opler, 1987), self-esteem was measured with the Multidimensional Self-Esteem Inventory (Lysaker, Ringer, & Davis, 2008), and self-stigma was assessed using the Internalized Stigma of Mental Illness Scale (Ritsher, Otilingam, & Grajales, 2003). Seventy persons with schizophrenia who worked at least one month in a vocational rehabilitation program were assessed on all measures at baseline and five months later. Results indicated a 25% decrease in self-stigma for 38% of the sample; these individuals tended to have less emotional distress both at baseline and follow-up, and had higher levels of self-esteem at follow-up. No differences in positive symptoms were found for groups whose stigma did or did not decrease. Results suggest that decreases in self-stigma may be correlated with increased self-esteem, while higher levels of emotional distress may be a barrier to stigma reduction.

  20. Neurological symptoms in patients whose cerebrospinal fluid is culture- and/or polymerase chain reaction-positive for Mycoplasma pneumoniae.

    PubMed

    Socan, M; Ravnik, I; Bencina, D; Dovc, P; Zakotnik, B; Jazbec, J

    2001-01-15

    We describe 13 patients with neurological signs and symptoms associated with Mycoplasma pneumoniae infection. M. pneumoniae was isolated from the cerebrospinal fluid (CSF) of 9 patients: 5 with meningoencephalitis, 2 with meningitis, and 1 with cerebrovascular infarction. One patient had headache and difficulties with concentration and thinking for 1 month after the acute infection. M. pneumoniae was detected, by means of PCR, in the CSF of 4 patients with negative culture results. Two had epileptic seizures, 1 had blurred vision as a consequence of edema of the optic disk, and 1 had peripheral nerve neuropathy.

  1. Changes in allergy symptoms and depression scores are positively correlated in patients with recurrent mood disorders exposed to seasonal peaks in aeroallergens.

    PubMed

    Postolache, Teodor T; Lapidus, Manana; Sander, Evan R; Langenberg, Patricia; Hamilton, Robert G; Soriano, Joseph J; McDonald, Jessica S; Furst, Nancy; Bai, Jie; Scrandis, Debra A; Cabassa, Johanna A; Stiller, John W; Balis, Theodora; Guzman, Alvaro; Togias, Alkis; Tonelli, Leonardo H

    2007-12-17

    Although growing evidence supports an association between allergy, allergens and depression, it remains unknown if this relationship is between "states" (possible triggers) or "traits" (possible vulnerabilities). We hypothesized that patients with recurrent mood disorders who are sensitized to tree pollen (as determined by allergen specific IgE antibodies), in comparison to those who are not sensitized, would report larger negative changes in mood during exposure to tree pollen in spring. We also hypothesized that differences between high and low tree pollen periods in self reported allergy symptoms would correlate positively with differences in self reported depression scores. We present 1-year preliminary data on the first 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female, twelve patients were tree-pollen IgE positive). Ratings of mood and allergic disease status were performed once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations. Linear regression models were developed to examine associations of changes in depression scores (dependent variable) with tree pollen sensitization, changes in the allergy symptom severity score, adjusted for gender and order of testing. We did not confirm the hypothesized relationship between a specific tree pollen sensitization and changes in mood during tree pollen exposure. We did confirm the hypothesized positive relationship between the changes in allergy symptoms and changes in subjects' depression scores (adjusted p<0.05). This result is consistent with previous epidemiological evidence connecting allergy with depression, as well as our recent reports of increased expression of cytokines in the prefrontal cortex in victims of suicide and in experimental animals sensitized and exposed to tree pollen. A relationship between changes in allergy symptom scores and changes in depression scores supports a state

  2. Posttraumatic Stress Disorder Symptoms and Risky Behaviors among Trauma-exposed Inpatients with Substance Dependence: The Influence of Negative and Positive Urgency

    PubMed Central

    Weiss, Nicole H.; Tull, Matthew T.; Sullivan, Tami P.; Dixon-Gordon, Katherine L.; Gratz, Kim L.

    2015-01-01

    Background Posttraumatic stress disorder (PTSD) among inpatients with substance use disorders (SUDs) is associated with heightened engagement in a variety of risky, self-destructive, and health-compromising behaviors (e.g., risky sexual behavior, aggression). Extant research provides support for the role of emotion dysregulation in the PTSD-risky behavior relation among inpatients with SUD; however, this research has been limited by a focus on emotion dysregulation involving negative (versus positive) emotions. The goal of the current study was to extend past research on the PTSD-risky behavior relation by examining the potential mediating roles of negative and positive urgency (two domains of emotion dysregulation defined by the tendency to engage in risky behavior in the context of negative and positive emotions, respectively). Methods Participants were 158 trauma-exposed inpatients with (n = 91) and without (n = 67) lifetime PTSD consecutively admitted to a residential SUD treatment facility (M age = 34.34; 59.5% White, 50.6% female). Patients were administered diagnostic interviews and completed self-report questionnaires. Results Significant positive associations were found among lifetime PTSD symptoms, negative and positive urgency, and risky behaviors. Moreover, findings revealed significant indirect effects of lifetime PTSD symptoms on risky behaviors through the pathways of both negative and positive urgency. Conclusions Results provide initial support for the mediating roles of both negative and positive urgency in the PTSD-risky behavior relation, highlighting the potential utility of teaching trauma-exposed inpatients with PTSD-SUD skills for tolerating negative and positive emotional states without engaging in maladaptive behaviors. PMID:26278196

  3. Psychotic Experiences and Working Memory: A Population-Based Study Using Signal-Detection Analysis

    PubMed Central

    Rossi, Rodolfo; Zammit, Stanley; Button, Katherine S.; Munafò, Marcus R.; Lewis, Glyn; David, Anthony S.

    2016-01-01

    Psychotic Experiences (PEs) during adolescence index increased risk for psychotic disorders and schizophrenia in adult life. Working memory (WM) deficits are a core feature of these disorders. Our objective was to examine the relationship between PEs and WM in a general population sample of young people in a case control study. 4744 individuals of age 17–18 from Bristol and surrounding areas (UK) were analyzed in a cross-sectional study nested within the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study. The dependent variable was PEs, assessed using the semi-structured Psychosis-Like Symptom Interview (PLIKSi). The independent variable was performance on a computerized numerical n-back working memory task. Signal-Detection Theory indices, including standardized hits rate, false alarms rate, discriminability index (d’) and response bias (c) from 2-Back and 3-Back tasks were calculated. 3576 and 3527 individuals had complete data for 2-Back and 3-Back respectively. Suspected/definite PEs prevalence was 7.9% (N = 374). Strongest evidence of association was seen between PEs and false alarms on the 2-Back, (odds ratio (OR) = 1.17 [95% confidence intervals (CI) 1.01, 1.35]) and 3-back (OR = 1.35 [1.18, 1.54]) and with c (OR = 1.59 [1.09, 2.34]), and lower d’ (OR = 0.76 [0.65, 0.89]), on the 3-Back. Adjustment for several potential confounders, including general IQ, drug exposure and different psycho-social factors, and subsequent multiple imputation of missing data did not materially alter the results. WM is impaired in young people with PEs in the general population. False alarms, rather than poor accuracy, are more closely related to PEs. Such impairment is consistent with different neuropsychological models of psychosis focusing on signal-to-noise discrimination, probabilistic reasoning and impaired reality monitoring as a basis of psychotic symptoms. PMID:27120349

  4. The effect of treating obstructive sleep apnea with positive airway pressure on depression and other subjective symptoms: A systematic review and meta-analysis.

    PubMed

    Gupta, Madhulika A; Simpson, Fiona C; Lyons, Danika C A

    2016-08-01

    Patients with obstructive sleep apnea (OSA) frequently present with symptoms of depression and anxiety. The objective of this study is to determine if treatment with positive airway pressure (PAP) improves symptoms of depression and anxiety. A systematic review was conducted to identify clinical trials of PAP that contained a validated measure of depression severity. Meta-analysis was conducted for depression, anxiety, excessive daytime sleepiness (EDS), quality of life (QoL) and respiratory variables. The systematic review included 33 reports. Pre-post-test analysis of PAP showed a moderate effect size (Hedge's g, 95% CI) for depression 0.524 [0.401-0.647], but a low effect size compared to oral placebo (0.355 [0.187-0.524]) and no effect when compared to dental appliances (0.107 [-0.72-0.287]) and sham PAP (-0.049 [-0.292-0.194]). Anxiety, EDS, and QoL showed similar improvement in pre-post-test analysis, but a lack of superiority to dental appliances and sham PAP. PAP was superior to all comparators for respiratory variables. PAP has a moderate clinical effect on symptoms of depression and anxiety in OSA, but it is not superior to dental appliances or sham PAP. The improvement in subjective symptoms, such as depression and anxiety, may be mediated by patient expectations and contact with healthcare providers.

  5. Imagination in human social cognition, autism, and psychotic-affective conditions.

    PubMed

    Crespi, Bernard; Leach, Emma; Dinsdale, Natalie; Mokkonen, Mikael; Hurd, Peter

    2016-05-01

    Complex human social cognition has evolved in concert with risks for psychiatric disorders. Recently, autism and psychotic-affective conditions (mainly schizophrenia, bipolar disorder, and depression) have been posited as psychological 'opposites' with regard to social-cognitive phenotypes. Imagination, considered as 'forming new ideas, mental images, or concepts', represents a central facet of human social evolution and cognition. Previous studies have documented reduced imagination in autism, and increased imagination in association with psychotic-affective conditions, yet these sets of findings have yet to be considered together, or evaluated in the context of the diametric model. We first review studies of the components, manifestations, and neural correlates of imagination in autism and psychotic-affective conditions. Next, we use data on dimensional autism in healthy populations to test the hypotheses that: (1) imagination represents the facet of autism that best accounts for its strongly male-biased sex ratio, and (2) higher genetic risk of schizophrenia is associated with higher imagination, in accordance with the predictions of the diametric model. The first hypothesis was supported by a systematic review and meta-analysis showing that Imagination exhibits the strongest male bias of all Autism Quotient (AQ) subscales, in non-clinical populations. The second hypothesis was supported, for males, by associations between schizophrenia genetic risk scores, derived from a set of single-nucleotide polymorphisms, and the AQ Imagination subscale. Considered together, these findings indicate that imagination, especially social imagination as embodied in the default mode human brain network, mediates risk and diametric dimensional phenotypes of autism and psychotic-affective conditions.

  6. Three year stability of Five-Factor Model personality traits in relation to changes in symptom levels in patients with schizophrenia or related disorders.

    PubMed

    Boyette, Lindy-Lou; Nederlof, Jan; Meijer, Carin; de Boer, Froukje; de Haan, Lieuwe

    2015-09-30

    Five-Factor Model (FFM) personality traits are related to a wide range of clinical outcome in patients with psychotic disorders. However, it is not sufficiently clear whether psychotic illness, particularly fluctuation in negative symptoms and psychotic relapse, affects personality. The current study examined the 3-year temporal stability of FFM traits in 91 patients with non-affective psychotic disorders with a maximum duration of illness of 10 years and 32 control subjects without a (family member with) a diagnosis of psychotic illness. In patients, change in negative symptoms predicted changes in Neuroticism and (inversely) in Extraversion and Openness. However, when correcting for depressive symptoms, negative symptoms no longer predicted change in any FFM trait. Clinical characteristics, such as psychotic relapse, were also not found to be related to change in FFM traits. Patients showed a slight increase in Conscientiousness levels, the other FFM traits showed mean-level stability. Rank-order stability of the FFM traits was moderate to strong, although weaker for Neuroticism in patients. Our findings indicate that psychotic symptoms exert limited effect on the stability of FFM traits in patients with psychotic disorders. Consistent with general population findings, one should guard against state-trait confusion between Neuroticism/Extraversion and depression.

  7. Neurocognitive Function Differentiation from the Effect of Psychopathologic Symptoms in the Disability Evaluation of Patients with Mild Traumatic Brain Injury

    PubMed Central

    Kim, Jin-Sung; Koo, Bon-Hoon; Kim, Min-Su; Kim, Soon-Sub; Cheon, Eun-Jin

    2013-01-01

    Objective We determined whether the relationship between the neuropsychological performance of patients with mild traumatic brain injury (TBI) and their psychopathological characteristics measured by disability evaluation are interrelated. In addition, we assessed which psychopathological variable was most influential on neuropsychological performance via statistical clustering of the same characteristics of mild TBI. Methods A total of 219 disability evaluation participants with mild brain injury were selected. All participants were classified into three groups, based on their psychopathological characteristics, via a two-step cluster analysis using validity and clinical scales from the Minnesota Multiphasic Personality Inventory (MMPI) and Symptom Checklist-90-revised (SCL-90-R). The Korean Wechsler Adult Intelligence Scale (K-WAIS), Korean Memory Assessment Scale (K-MAS) and the Korean Boston Naming Test (K-BNT) were used to evaluate the neurocognitive functions of mild TBI patients. Results Over a quarter (26.9%) experienced severe psychopathological symptoms and 43.4% experienced mild or moderate psychopathological symptoms, and all of the mild TBI patients showed a significant relationship between neurocognitive functions and subjective and/or objective psychopathic symptoms, but the degree of this relationship was moderate. Variances of neurocognitive function were explained by neurotic and psychotic symptoms, but the role of these factors were different to each other and participants did not show intelligence and other cognitive domain decrement except for global memory abilities compared to the non-psychopathology group. Conclusion Certain patients with mild TBI showed psychopathological symptoms, but these were not directly related to cognitive decrement. Psychopathology and cognitive decrement are discrete aspects in patients with mild TBI. Furthermore, the neurotic symptoms of mild TBI patients made positive complements to decrements or impairments of

  8. Changes in Depressive Symptoms among Older Adults with Multiple Chronic Conditions: Role of Positive and Negative Social Support.

    PubMed

    Ahn, SangNam; Kim, Seonghoon; Zhang, Hongmei

    2016-12-26

    Depression severely affects older adults in the United States. As part of the social environment, significant social support was suggested to ameliorate depression among older adults. We investigate how varying forms of social support moderate depressive symptomatology among older adults with multiple chronic conditions (MCC). Data were analyzed using a sample of 11,400 adults, aged 65 years or older, from the 2006-2012 Health and Retirement Study. The current study investigated the moderating effects of positive or negative social support from spouse, children, other family, and friends on the association between MCC and depression. A linear mixed model with repeated measures was used to estimate the effect of MCC on depression and its interactions with positive and negative social support in explaining depression among older adults. Varying forms of social support played different moderating roles in depressive symptomatology among older adults with MCC. Positive spousal support significantly weakened the deleterious effect of MCC on depression. Conversely, all negative social support from spouse, children, other family, and friends significantly strengthened the deleterious effect of MCC on depression. Minimizing negative social support and maximizing positive spousal support can reduce depression caused by MCC and lead to successful aging among older adults.

  9. Remission of positive symptoms according to the "remission in Schizophrenia Working Group" criteria: a longitudinal study of cognitive functioning.

    PubMed

    Braw, Y; Sitman, R; Cohen, M; Berger, U; Lev-Ran, S; Segev, A; Bloch, Y; Levkovitz, Y

    2013-06-01

    Schizophrenia patients in positive symptomatic remission (PSR; n=39) were assessed using a longitudinal research design. The patients were found to exhibit widespread cognitive impairments that were stable over the three-year follow-up period. The findings support a generalized and stable cognitive impairment profile among schizophrenia patients in partial symptomatic remission.

  10. Changes in Depressive Symptoms among Older Adults with Multiple Chronic Conditions: Role of Positive and Negative Social Support

    PubMed Central

    Ahn, SangNam; Kim, Seonghoon; Zhang, Hongmei

    2016-01-01

    Depression severely affects older adults in the United States. As part of the social environment, significant social support was suggested to ameliorate depression among older adults. We investigate how varying forms of social support moderate depressive symptomatology among older adults with multiple chronic conditions (MCC). Data were analyzed using a sample of 11,400 adults, aged 65 years or older, from the 2006–2012 Health and Retirement Study. The current study investigated the moderating effects of positive or negative social support from spouse, children, other family, and friends on the association between MCC and depression. A linear mixed model with repeated measures was used to estimate the effect of MCC on depression and its interactions with positive and negative social support in explaining depression among older adults. Varying forms of social support played different moderating roles in depressive symptomatology among older adults with MCC. Positive spousal support significantly weakened the deleterious effect of MCC on depression. Conversely, all negative social support from spouse, children, other family, and friends significantly strengthened the deleterious effect of MCC on depression. Minimizing negative social support and maximizing positive spousal support can reduce depression caused by MCC and lead to successful aging among older adults. PMID:28035968

  11. [Acute Paranoid Symptoms Following Intramuscular Injection of Nandrolone

    PubMed

    Teuber, Isabel; Freiwald, Daniel; Volz, Hans-Peter

    2003-05-01

    Affective disorders and impulsivity are quite common when using anabolic substances, in this case-study one of the rather rare cases of a psychotic disorder following the abuse of androgenic steroids is described. A 30-year old formerly healthy white male was admitted as inpatient to psychiatric hospital showing symptoms of anxiety and paranoid ideation. In the last 1,5 years he had consumed androgenic steroids, directly before the onset of the first psychotic symptoms 8 weeks before admission he had received an i. m.-injection of nandrolone. Under therapy with neuroleptics the patient recovered completely within 2 months.

  12. Positive symptoms, substance use, and psychopathic traits as predictors of aggression in persons with a schizophrenia disorder.

    PubMed

    van Dongen, Josanne D M; Buck, Nicole M L; van Marle, Hjalmar J C

    2016-03-30

    It is still not clear what the unique contribution of particular psychopathological factors is in explaining aggression in schizophrenia. The current study examined whether persecutory ideations, psychopathy and substance use are associated with different measures of aggressive behavior. We expected that persecutory ideations are associated with reactive aggression, and psychopathic traits are more associated with proactive aggression of inpatients. 59 inpatients with schizophrenia were included. Persecutory ideations we assessed using the Persecutory Ideation Questionnaire (PIQ), psychopathic traits with the revised version of Psychopathic Personality Inventory (PPI-R) and substance use was assessed using the Comprehensive Assessment of Symptoms and History (CASH). In addition, aggression was measured with the Reactive and Proactive Aggression Questionnaire (RPQ), in an experimental task using the Point Subtraction Aggression Paradigm (PSAP) and on the ward using the Social Dysfunction and Aggression Scale (SDAS). Results showed that psychopathy explains most of the variance in self-reported proactive and reactive aggression. In contrast, persecutory ideations explain most of the variance in observed aggression on the ward. Results implicate that it is important to acknowledge comorbid factors in patients with schizophrenia for more precise risk assessment and appropriate treatment for aggressive patients with schizophrenia.

  13. Differences in resting-state fMRI functional network connectivity between schizophrenia and psychotic bipolar probands and their unaffected first-degree relatives

    PubMed Central

    Meda, Shashwath A.; Gill, Adrienne; Stevens, Michael C.; Lorenzoni, Raymond P.; Glahn, David C.; Calhoun, Vince D.; Sweeney, John A.; Tamminga, Carol A.; Keshavan, Matcheri S.; Thaker, Gunvant; Pearlson, Godfrey D.

    2013-01-01

    Background Schizophrenia and bipolar disorder share overlapping symptoms and genetic etiology. Functional brain dysconnectivity is seen in both disorders. Methods We compared 70 schizophrenia and 64 psychotic bipolar probands, their respective unaffected first-degree relatives (N= 70 and 52) and 118 healthy subjects, all group age-, sex- and ethnicity-matched. We used functional network connectivity (FNC) analysis to measure differential connectivity among 16 fMRI RSNs. First, we examined connectivity differences between probands and controls. Next, we probed these dysfunctional connections in relatives for potential endophenotypes. Network connectivity was then correlated with PANSS scores to reveal clinical relationships. Results Three different network pairs were differentially connected in probands (FDR-corrected q<0.05) involving 5 individual resting-state networks: (A) Fronto/Occipital, (B) anterior Default Mode/Prefrontal, (C) Meso/Paralimbic, (D) Fronto-Temporal/Paralimbic & (E) Sensory-motor. One abnormal pair was unique to schizophrenia, (C-E), one unique to bipolar, (C-D) and one (A-B) shared. Two of these 3 combinations (A-B, C-E) were also abnormal in bipolar relatives, but none in schizophrenia relatives (non-significant trend for C-E). The Paralimbic circuit (C-D), that uniquely distinguished bipolar probands, contained multiple mood-relevant regions. Network relationship C-D correlated significantly with PANSS negative scores in bipolar probands and A-B was correlated to PANSS positive and general scores in schizophrenia. Conclusions Schizophrenia and psychotic bipolar probands share several abnormal RSN connections, but there are also unique neural network underpinnings between disorders. We identified specific connections and clinical relationships that may also be candidate psychosis endophenotypes, although these do not segregate straightforwardly with conventional diagnoses. PMID:22401986

  14. Can a Positive Allosteric Modulation of GABAergic Receptors Improve Motor Symptoms in Patients with Parkinson's Disease? The Potential Role of Zolpidem in the Treatment of Parkinson's Disease

    PubMed Central

    Daniele, Antonio; Panza, Francesco; Greco, Antonio; Logroscino, Giancarlo; Seripa, Davide

    2016-01-01

    At present, patients with advanced Parkinson's disease (PD) are unsatisfactorily controlled by currently used anti-Parkinsonian dopaminergic drugs. Various studies suggest that therapeutic strategies based on nondopaminergic drugs might be helpful in PD. Zolpidem, an imidazopyridine widely used as sleep inducer, shows high affinity only for GABAA receptors containing the α-1 subunit and facilitates GABAergic neurotransmission through a positive allosteric modulation of GABAA receptors. Various observations, although preliminary, consistently suggest that in PD patients zolpidem may induce beneficial (and sometimes remarkable) effects on motor symptoms even after single doses and may also improve dyskinesias. Since a high density of zolpidem binding sites is in the two main output structures of the basal ganglia which are abnormally overactive in PD (internal globus pallidus, GPi, and substantia nigra pars reticulata, SNr), it was hypothesized that in PD patients zolpidem may induce through GABAA receptors an inhibition of GPi and SNr (and, possibly, of the subthalamic nucleus also), resulting in an increased activity of motor cortical areas (such as supplementary motor area), which may give rise to improvement of motor symptoms of PD. Randomized clinical trials are needed in order to assess the efficacy, safety, and tolerability of zolpidem in treating motor symptoms of PD. PMID:27293955

  15. Can a Positive Allosteric Modulation of GABAergic Receptors Improve Motor Symptoms in Patients with Parkinson's Disease? The Potential Role of Zolpidem in the Treatment of Parkinson's Disease.

    PubMed

    Daniele, Antonio; Panza, Francesco; Greco, Antonio; Logroscino, Giancarlo; Seripa, Davide

    2016-01-01

    At present, patients with advanced Parkinson's disease (PD) are unsatisfactorily controlled by currently used anti-Parkinsonian dopaminergic drugs. Various studies suggest that therapeutic strategies based on nondopaminergic drugs might be helpful in PD. Zolpidem, an imidazopyridine widely used as sleep inducer, shows high affinity only for GABAA receptors containing the α-1 subunit and facilitates GABAergic neurotransmission through a positive allosteric modulation of GABAA receptors. Various observations, although preliminary, consistently suggest that in PD patients zolpidem may induce beneficial (and sometimes remarkable) effects on motor symptoms even after single doses and may also improve dyskinesias. Since a high density of zolpidem binding sites is in the two main output structures of the basal ganglia which are abnormally overactive in PD (internal globus pallidus, GPi, and substantia nigra pars reticulata, SNr), it was hypothesized that in PD patients zolpidem may induce through GABAA receptors an inhibition of GPi and SNr (and, possibly, of the subthalamic nucleus also), resulting in an increased activity of motor cortical areas (such as supplementary motor area), which may give rise to improvement of motor symptoms of PD. Randomized clinical trials are needed in order to assess the efficacy, safety, and tolerability of zolpidem in treating motor symptoms of PD.

  16. The enhanced Aussie Optimism Positive Thinking Skills Program: The relationship between internalizing symptoms and family functioning in children aged 9-11 years old.

    PubMed

    Kennedy, Patricia; Rooney, Rosanna M; Kane, Robert T; Hassan, Sharinaz; Nesa, Monique

    2015-01-01

    The family context plays a critical role in the health of the child. This was the first study to examine the usefulness of the General Functioning subscale of the Family Assessment Device (FAD-GF) in assessing family functioning and its relationship to internalizing symptoms in school-aged children aged between 9 and 11 years of age. Eight hundred and forty-seven year 4 and 5 students from 13 schools (607 intervention students, and 240 control students) participated in the Aussie Optimism Positive Thinking Skills Program (AO-PTS) - a universal school-based program targeting internalizing symptoms. Students rated how 'healthy' they perceived their family to be at pre-test and at 6-months follow-up. Although some aspects of validity and reliability could be improved, results indicated that perceptions of family functioning at pre-test were predictive of internalizing symptoms at the 6-months follow-up. The FAD-GF therefore showed promise as a potential measure of family functioning for children as young as 9 years old. Regardless of children's pre-test levels of perceived family functioning, no intervention effects were found on the anxiety and depression scales; this finding suggests that child perceptions of family functioning may act as a general protective factor against internalizing symptomology.

  17. Absence of Symptom and Intact Liver Function Are Positive Prognosticators for Patients Undergoing Radiotherapy for Lymph Node Metastasis From Hepatocellular Carcinoma

    SciTech Connect

    Kim, Kyubo; Chie, Eui Kyu; Kim, Won; Kim, Yoon Jun; Yoon, Jung Hwan; Lee, Hyo-Suk; Ha, Sung W.

    2010-11-01

    Purpose: The positive role of radiotherapy for patients with lymph node (LN) metastasis from hepatocellular carcinoma has recently been reported. The outcome and prognostic factors for these patients were analyzed. Methods and Materials: Between May 2004 and October 2007, 38 patients with LN metastases from hepatocellular carcinoma underwent radiotherapy. The median age was 59 years (range, 42-81). The radiation dose was 35-56 Gy with a fraction size of 1.8-3 Gy, for a biologically effective dose of 43.75-67.2 Gy{sub 10} (median, 59.0). The median follow-up period was 8 months. Results: The median survival time was 10 months. On univariate analysis, Child-Pugh class B (p = .0006), distant metastasis (p = .0095), symptoms related to metastatic LNs (p <.0001), and a biologically effective dose <60 Gy{sub 10} (p = .0042) were significant prognostic factors predicting for poor overall survival. On multivariate analysis after adjustment using the Benjamini and Hochberg (false discovery rate) method, Child-Pugh class B (p = .04095) and the presence of symptoms (p = .04095) were associated with inferior overall survival. When patients were divided into three groups according to these two risk factors, the median survival for patients with no, either, or both risk factors was 20, 7, and 4 months, respectively (p <.0001). Conclusion: Patients with intact liver function and without related symptoms had the best prognosis when undergoing radiotherapy for LN metastasis from hepatocellular carcinoma.

  18. Effects of Heated Humidification and Topical Steroids on Compliance, Nasal Symptoms, and Quality of Life in Patients with Obstructive Sleep Apnea Syndrome Using Nasal Continuous Positive Airway Pressure

    PubMed Central

    Ryan, Silke; Doherty, Liam S.; Nolan, Geraldine M.; McNicholas, Walter T.

    2009-01-01

    Background: Nasal side effects are common in patients with obstructive sleep apnea syndrome (OSAS) starting on nasal continuous positive airway pressure (CPAP) therapy. We tested the hypothesis that heated humidification or nasal topical steroids improve compliance, nasal side effects and quality of life in this patient group. Methods: 125 patients with the established diagnosis of OSAS (apnea/hypopnea index ≥ 10/h), who tolerated CPAP via a nasal mask, and who had a successful CPAP titration were randomized to 4 weeks of dry CPAP, humidified CPAP or CPAP with additional topical nasal steroid application (fluticasone, GlaxoWellcome). Groups were similar in all demographic variables and in frequency of nasal symptoms at baseline. Outcome measures were objective compliance, quality of life (short form 36), subjective sleepiness (Epworth Sleepiness Scale score) and nasal symptoms such as runny, dry or blocked nose, sneezing and headaches; all variables assessed using a validated questionnaire and by direct interview. Results: There was no difference in compliance between groups after 4 weeks (dry: 5.21 ± 1.66 h/night, fluticasone: 5.66 ± 1.68, humidifier: 5.21 ± 1.84; p = 0.444). Quality of life and subjective sleepiness improved in all groups, but there were no differences in the extent of improvement. Nasal Symptoms were less frequently reported in the humidifier group (28%) than in the remaining groups (dry: 70%, fluticasone: 53%, p = 0.002). However, the addition of fluticasone resulted in increased frequency of sneezing. Conclusion: The addition of a humidifier, but not nasal steroids decreases the frequency of nasal symptoms in unselected OSAS patients initiating CPAP therapy; however compliance and quality of life remain unaltered. Citation: Ryan S; Doherty LS; Nolan GM; McNicholas WT. Effects of heated humidification and topical steroids on compliance, nasal symptoms, and quality of life in patients with obstructive sleep apnea syndrome using nasal

  19. Necessary, but not sufficient: links between neurocognition, social cognition, and metacognition in schizophrenia are moderated by disorganized symptoms.

    PubMed

    Minor, Kyle S; Lysaker, Paul H

    2014-10-01

    Intact neurocognition has been posited as a necessary, but not sufficient prerequisite for efficient social cognition and metacognition in schizophrenia. Disorganized symptoms likely play a prominent role in these cognitive processes, given the detrimental effects of disorganization on one's ability to synthesize discrete information into an organized whole. However, the relationship between disorganized symptoms and cognitive processes remains unclear. In this study, we examined whether disorganized symptoms: 1) exhibited stronger inverse relationships with cognitive processes than other symptoms, and 2) moderated links between neurocognition and a) social cognition, and b) metacognition. Trained raters assessed psychotic symptoms, neurocognition, social cognition, and metacognition in patients with schizophrenia from a Midwestern VA Medical Center (n=68) using validated, clinician-rated instruments. We observed significantly greater inverse associations with cognitive processes for disorganized compared to reality distortion symptoms; inverse associations with neurocognition and social cognition were significantly greater for disorganized than negative symptoms. Our hypotheses that disorganized symptoms would moderate relationships between neurocognition and a) social cognition, and b) metacognition were also supported. These findings highlight the importance of disorganized symptoms in elucidating links between neurocognition and social cognitive and metacognitive abilities. Future work should assess whether similar findings occur across the schizophrenia-spectrum, and investigate if targeting disorganization can ameliorate social cognitive and metacognitive impairments in schizophrenia.

  20. [Clinical symptoms of branchio-oto-renal syndrome in a family with a positive test for EYA1 gene].

    PubMed

    Markova, T G

    2006-01-01

    Three families with branchio-oto-renal syndrome (BOR syndrome) were examined. In one of the families all its members with BOR syndrome had deletion of cytosine in position 759 (759delC) in DNA sequence of EYA1 gene in exone 8. Clinical characteristics of BOR syndrome in the family are given. Molecular-genetic analysis confirmed the diagnosis clinically in case of all signs of the syndrome presence among the members of the family. Rare cases of hereditary syndromes with hearing problems provide more knowledge about structure of hereditary hypoacusis forms in the population. The syndromal forms reflect a complex genetic basis of the processes of sound perception.

  1. Prodromal and autistic symptoms in schizotypal personality disorder and 22q11.2 deletion syndrome.

    PubMed

    Esterberg, Michelle L; Ousley, Opal Y; Cubells, Joseph F; Walker, Elaine F

    2013-02-01

    Despite clear diagnostic distinctions, schizophrenia and autism share symptoms on several dimensions. Recent research has suggested the two disorders overlap in etiology, particularly with respect to inherited and noninherited genetic factors. Studying the relationship between psychotic-like and autistic-like symptoms in risk groups such as 22q11 deletion syndrome (22q11DS) and schizotypal personality disorder (SPD) has the potential to shed light on such etiologic factors; thus, the current study examined prodromal symptoms and autistic features in samples of 22q11DS and SPD subjects using standardized diagnostic measures, including the Structured Interview for Prodromal Symptoms (SIPS) and the Autism Diagnostic Inventory-Revised (ADI-R). Results showed that SPD subjects manifested significantly more severe childhood and current social as well as stereotypic autistic features, as well as more severe positive prodromal symptoms. The two groups did not differ on negative, disorganized, or general prodromal symptoms, but were distinguishable based on correlations between prodromal and autistic features; the relationships between childhood autistic features and current prodromal symptoms were stronger for the SPD group. The results suggest that childhood autistic features are less continuous with subsequent prodromal signs in 22q11DS patients relative to those with SPD, and the findings highlight the importance of studying the overlap in diagnostic phenomenology in groups at risk for developing psychosis and/or autism.

  2. An examination of associations between the inability to taste phenylthiocarbamide (PTC) and clinical characteristics and trait markers in first-episode, nonaffective psychotic disorders.

    PubMed

    Compton, Michael T; Ionescu, Dawn F; Broussard, Beth; Cristofaro, Sarah L; Johnson, Stephanie; Haggard, Patrick J; Potts, Amy A; Wan, Claire Ramsay; Walker, Elaine F

    2013-08-30

    Research findings are mixed as to whether or not the inability to taste phenylthiocarbamide (PTC) might represent an endophenotypic trait marker for schizophrenia. We hypothesized associations between PTC-tasting status and select clinical characteristics and trait markers in patients with psychotic disorders that, if present, would provide support for the inability to taste PTC as a trait marker. In a first-episode psychosis sample (n=93), we measured PTC tasting, family history of psychosis, age at onset of prodrome and psychosis, severity of positive and negative symptoms, global impairment in functioning, neurological soft signs, and four neurocognitive domains (verbal learning/memory, visual learning/memory, verbal working memory, and spatial working memory). Associations between PTC-non-tasting and clinical/neurocognitive variables were examined with χ(2) tests and independent samples t tests. Among participants, 67.7% tasted PTC in comparison to a strip of control paper, and 25.8% were non-tasters. Tasters and non-tasters did not show statistically significant differences with respect to family history, age at onset, severity of symptoms, neurological soft signs, or the four neurocognitive domains. In conjunction with other findings, it is unlikely that PTC-non-tasting is a trait marker of schizophrenia, though a conclusive study is warranted.

  3. [A case of an anti-Ma2 antibody-positive patient presenting with variable CNS symptoms mimicking multiple system atrophy with a partial response to immunotherapy].

    PubMed

    Shiraishi, Wataru; Iwanaga, Yasutaka; Yamamoto, Akifumi

    2015-01-01

    A 70-year-old man with a 5-month history of progressive bradykinesia of the bilateral lower extremities was admitted to our hospital. At the age of 64, he underwent proximal gastrectomy for gastric cancer. He also had a history of subacute combined degeneration of the spinal cord since the age of 67, which was successfully treated with vitamin B12 therapy. Four weeks before admission to our hospital, he admitted himself to his former hospital complaining of walking difficulty. Two weeks later, however, his symptoms progressed rapidly; he was immobilized for two weeks and did not respond to the vitamin therapy. On admission to our hospital, he showed moderate paralysis of the lower extremities, cog-wheel rigidity of the four extremities, and dystonic posture of his left hand. He also showed orthostatic hypotension and vesicorectal disorders. Blood examination and cerebrospinal fluid analysis revealed no remarkable abnormalities. Electroencephalography showed frontal dominant, high voltage, sharp waves. His brain and spinal MRI revealed no notable abnormalities. We suspected autoimmune disease and commenced one course of intravenous methylprednisolone therapy, resulting in improvement of the parkinsonism and orthostatic hypotension. Based on these results, we investigated possible neural antigens and detected anti-Ma2 antibody. In addition to limbic encephalitis, anti-Ma2 antibody-positive neural disorders are characterized by rapid eye movement sleep behavior disorders or parkinsonism. Here, we report an anti-Ma2 antibody positive patient presenting variable CNS symptoms mimicking multiple system atrophy, who responded to immunotherapy.

  4. Mitragyna speciosa Leaf Extract Exhibits Antipsychotic-Like Effect with the Potential to Alleviate Positive and Negative Symptoms of Psychosis in Mice

    PubMed Central

    Vijeepallam, Kamini; Pandy, Vijayapandi; Kunasegaran, Thubasni; Murugan, Dharmani D.; Naidu, Murali

    2016-01-01

    In this study, we investigated the antipsychotic-like effect of methanolic extract of Mitragyna speciosa leaf (MMS) using in vivo and ex vivo studies. In vivo studies comprised of apomorphine-induced climbing behavior, haloperidol-induced catalepsy, and ketamine-induced social withdrawal tests in mice whereas the ex vivo study was conducted utilizing isolated rat vas deferens preparation. Acute oral administration of MMS (50–500 mg/kg) showed an inverted bell-shaped dose-response in apomorphine-induced cage climbing behavior in mice. The effective inhibitory doses of MMS (75 and 100 mg/kg, p.o.) obtained from the apomorphine study was further tested on haloperidol (subcataleptic dose; 0.1 mg/kg, i.p.)-induced catalepsy in the mouse bar test. MMS (75 and 100 mg/kg, p.o.) significantly potentiated the haloperidol-induced catalepsy in mice. Interestingly, MMS at the same effective doses (75 and 100 mg/kg, p.o.) significantly facilitated the social interaction in ketamine-induced social withdrawal mice. Furthermore, MMS inhibited the dopamine-induced contractile response dose-dependently in the isolated rat vas deferens preparations. In conclusion, this investigation provides first evidence that MMS exhibits antipsychotic-like activity with potential to alleviate positive as well as negative symptoms of psychosis in mice. This study also suggests the antidopaminergic activity of MMS that could be responsible for alleviating positive symptoms of psychosis. PMID:27999544

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

    PubMed

    Pestalozzi, Julia

    2003-06-01

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

  6. Psychotic disorders in Asian Americans and DSM-5.

    PubMed

    Pandurangi, Anand K

    2014-02-01

    The DSM-5 lists 13 psychotic disorders and introduces modest but significant changes in their diagnosis. Asian Americans bring unique issues to the assessment, diagnosis and treatment of these disorders. They may exhibit greater prevalence of culturally influenced psychosis-like experiences that may or may not constitute a pathological condition such as psychosis risk syndrome or attenuated psychosis. Acute psychotic disorders with good prognosis may be more prevalent in Asians and may sometimes be misdiagnosed as schizophrenia or schizoaffective disorder. Catatonic disorders are also more prevalent in Asians, and are likely to receive more appropriate labeling with DSM-5. The expanded cultural formulation in DSM-5 is a progressive step but its benefits might be limited by lack of culturally trained clinicians and/or limited time for assessment. There is a dearth of systematic data on psychotic disorders in Asian Americans and it is hoped that the DSM-5 will stimulate this much needed research.

  7. The history of artistic creativity in psychotic patients.

    PubMed

    Klavora, Vlasta Meden

    2008-06-01

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

  8. Melatonin: an overlooked factor in schizophrenia and in the inhibition of anti-psychotic side effects.

    PubMed

    Anderson, George; Maes, Michael

    2012-06-01

    This paper reviews melatonin as an overlooked factor in the developmental etiology and maintenance of schizophrenia; the neuroimmune and oxidative pathophysiology of schizophrenia; specific symptoms in schizophrenia, including sleep disturbance; circadian rhythms; and side effects of antipsychotics, including tardive dyskinesia and metabolic syndrome. Electronic databases, i.e. PUBMED, Scopus and Google Scholar were used as sources for this review using keywords: schizophrenia, psychosis, tardive dyskinesia, antipsychotics, metabolic syndrome, drug side effects and melatonin. Articles were selected on the basis of relevance to the etiology, course and treatment of schizophrenia. Melatonin levels and melatonin circadian rhythm are significantly decreased in schizophrenic patients. The adjunctive use of melatonin in schizophrenia may augment the efficacy of antipsychotics through its anti-inflammatory and antioxidative effects. Further, melatonin would be expected to improve sleep disorders in schizophrenia and side effects of anti-psychotics, such as tardive dyskinesia, metaboilic syndrome and hypertension. It is proposed that melatonin also impacts on the tryptophan catabolic pathway via its effect on stress response and cortisol secretion, thereby impacting on cortex associated cognition, amygdala associated affect and striatal motivational processing. The secretion of melatonin is decreased in schizophrenia, contributing to its etiology, pathophysiology and management. Melatonin is likely to have impacts on the metabolic side effects of anti-psychotics that contribute to subsequent decreases in life-expectancy.

  9. Behavioural and molecular endophenotypes in psychotic disorders reveal heritable abnormalities in glutamatergic neurotransmission.

    PubMed

    Scoriels, L; Salek, R M; Goodby, E; Grainger, D; Dean, A M; West, J A; Griffin, J L; Suckling, J; Nathan, P J; Lennox, B R; Murray, G K; Bullmore, E T; Jones, P B

    2015-03-31

    Psychotic disorders such as schizophrenia are biologically complex and carry huge population morbidity due to their prevalence, persistence and associated disability. Defined by features such as delusions and hallucinations, they involve cognitive dysfunction and neurotransmitter dysregulations that appear mostly to involve the dopaminergic and glutamatergic systems. A number of genetic and environmental factors are associated with these disorders but it has been difficult to identify the biological pathways underlying the principal symptoms. The endophenotype concept of stable, heritable traits that form a mechanistic link between genes and an overt expression of the disorder has potential to reduce the complexity of psychiatric phenotypes. In this study, we used a genetically sensitive design with individuals with a first episode of psychosis, their non-affected first-degree relatives and non-related healthy controls. Metabolomic analysis was combined with neurocognitive assessment to identify multilevel endophenotypic patterns: one concerned reaction times during the performance of cognitive and emotional tests that have previously been associated with the glutamate neurotransmission system, the other involved metabolites involved directly and indirectly in the co-activation of the N-methyl-D-aspartate receptor, a major receptor of the glutamate system. These cognitive and metabolic endophenotypes may comprise a single construct, such that genetically mediated dysfunction in the glutamate system may be responsible for delays in response to cognitive and emotional functions in psychotic disorders. This focus on glutamatergic neurotransmission should guide drug discovery and experimental medicine programmes in schizophrenia and related disorders.

  10. Effect of video self-observations vs. observations of others on insight in psychotic disorders.

    PubMed

    David, Anthony S; Chis Ster, Irina; Zavarei, Hooman

    2012-04-01

    Improving insight in patients with schizophrenia and related disorders is a worthwhile goal. Previous work has suggested that patients' insight may improve if they see videos of themselves taken when ill. Our aim was to test the hypothesis that schizophrenia patients improve their insight after viewing videos of themselves when unwell more so than after viewing an actor. Forty patients admitted with an acute psychotic disorder underwent a videotaped recording of a clinical interview. The patients were then randomized to viewing this or a "control" video of a same-sex actor displaying psychotic symptoms approximately 3 weeks later. Insight, psychopathology, and mood were assessed before and 24 to 48 hours after viewing the videos. All participants showed general improvement across all measures. There was a trend for scores on the Schedule for the Assessment of Insight to improve more in those who viewed themselves when ill, but there were no clear statistically significant differences between the "self" and "other" video groups. In conclusion, video self-confrontation seems to be a safe and potentially effective means of enhancing insight, but evidence for a specific effect is lacking.

  11. A Longitudinal Evaluation of the Positive Action Program in a Low-Income, Racially Diverse, Rural County: Effects on Self-Esteem, School Hassles, Aggression, and Internalizing Symptoms.

    PubMed

    Guo, Shenyang; Wu, Qi; Smokowski, Paul R; Bacallao, Martica; Evans, Caroline B R; Cotter, Katie L

    2015-12-01

    Positive Action is a school-based program that aims to decrease problem behaviors (e.g., violence, substance use) and increase positive behaviors (e.g., school engagement, academic achievement). Although a number of studies have shown that Positive Action successfully achieves these goals, few studies have evaluated the program's effectiveness in rural schools. Given that rural youth are at an increased risk for risky behaviors (e.g., violence, substance use), this is a critical gap in the existing Positive Action research base. The current study assesses the impact of Positive Action on change rates of self-esteem, school hassles, aggression, and internalizing symptoms in a group (N = 1246, 52% female) of ethnically/racially diverse (27% White, 23% African American, 12% mixed race/other, 8% Latino, 30% as American Indian) middle school youth (age range 9-20) located in two violent, low-income rural counties in North Carolina. One county engaged in Positive Action over the 3-year study window while the other county did not. Following multiple imputation and propensity score analysis, 4 two-level hierarchical linear models were run using each of the outcome measures as dependent variables. The results indicate that the program generates statistically significant beneficial effects for youth from the intervention county on self-esteem scores and school hassles scores. Although the program generates beneficial effects for intervention youth on the change in aggression scores, the finding is not statistically significant. The finding on the change in internalizing scores shows a non-significant detrimental effect: the youth from the comparison county have lower internalizing scores than those from the intervention county. Implications are discussed.

  12. The prodrome and clinical risk for psychotic disorders.

    PubMed

    Goulding, Sandra M; Holtzman, Carrie W; Trotman, Hanan D; Ryan, Arthur T; Macdonald, Allison N; Shapiro, Daniel I; Brasfield, Joy L; Walker, Elaine F

    2013-10-01

    The psychosis prodrome offers great promise for identifying neural mechanisms involved in psychotic disorders and offers an opportunity to implement empirical interventions to delay, and ultimately ameliorate, illness onset. This article summarizes the literature on individuals in the putatively prodromal phase of psychosis/deemed at clinical high risk (CHR) for psychosis onset. Standardized measurement and manifestation of the CHR syndromes are discussed, followed by empirical findings that highlight the psychological deficits and biological abnormalities seen in CHR syndromes and psychotic disorders. Current controversies surrounding the diagnosis of CHR syndromes and issues related to the treatment of CHR individuals are also presented.

  13. Suicidal behaviors in children and adolescents with psychotic disorders.

    PubMed

    Lincoln, Sarah Hope; Norkett, Emily; Graber, Kelsey; Tembulkar, Sahil; Morelli, Nicholas; Gonzalez-Heydrich, Joseph; D'Angelo, Eugene

    2017-01-01

    Suicide is the leading cause of premature death in individuals with psychotic disorders. Risk for onset of suicidal behaviors tends to begin in adolescence, remaining high into young adulthood. The present study aims to evaluate the interplay of early onset psychosis and suicide risk by examining suicidal behaviors (ideation, planning, and attempts) in children and adolescents with psychotic disorders (PD) compared to typically developing peers (TD). Twenty five youths were recruited and were diagnostically evaluated for psychosis. We found that the PD children exhibited significantly higher levels of suicidal behaviors than TD children, even when parsed into individual at-risk behaviors.

  14. Handedness and schizotypy in non-psychotic relatives of patients with schizophrenia.

    PubMed

    Tsuang, Hui-Chun; Liu, Chih-Min; Hwang, Tzung J; Hsieh, Ming H; Faraone, Stephen V; Tsuang, Ming T; Hwu, Hai-Gwo; Chen, Wei J

    2011-11-01

    Existing studies have found the relationship between handedness and schizotypy to be inconsistent, and had limited generalisability since only highly homogeneous groups have been investigated. This study aimed to examine the relation between handedness and the four schizotypal factors identified from a previous confirmatory factor analysis in a population of high familial loading for schizophrenia. Study participants consisted of non-psychotic first-degree relatives (850 parents and 334 siblings) of sib-pairs who were co-affected with schizophrenia. All participants were interviewed with the Diagnostic Interview for Genetic Studies, which contains a section of the modified Structured Interview for Schizotypy, and the Annett handedness questionnaire. Both categorical and continuous indicators for handedness were examined. Non-right-handed siblings of schizophrenia patients displayed more positive schizotypal features than their right-handed counterparts when the two-way Annett's handedness classification was adopted. No association was found when handedness was treated as continuous. The relationship between handedness and schizotypy was insignificant for parents probably due to the strong social pressure against left-handedness. We concluded that categorical non-right-handedness was associated with positive schizotypy in non-psychotic siblings of schizophrenia patients. The results indicate that an atypical cerebral lateralisation underlying non-right-handedness may be also a contributing factor to positive schizotypy.

  15. Impulsivity and risk-taking in co-occurring psychotic disorders and substance abuse.

    PubMed

    Duva, Stephanie Marcello; Silverstein, Steven Michael; Spiga, Ralph

    2011-04-30

    Impulsivity is a risk-factor associated with substance use disorders. On paper-and-pencil measures, people with comorbid psychotic disorders and substance abuse have been shown to be more impulsive than their non-using counterparts. However, there has been little research on the behavioral components that, collectively, define the construct of impulsivity, which have been identified as: temporal discounting, risk taking, underestimating time, and failure to inhibit extraneous responding. This study compared people with psychotic disorders who did and did not use cocaine on behavioral measures of these components. One group (COC-now) had a positive urine drug screen (UDS) for cocaine (N=20). A second group (COC-past) had a negative UDS, but a positive cocaine history (N=20). Finally, the third group (control) had no history of cocaine use (N=20). Those with a current or past history of cocaine use engaged in more risk-taking behaviors and seemed to be less affected by anticipated loss and more attuned to monetary gains. However, contrary to our hypothesis, patients in the COC-now group selected larger, delayed rewards over the smaller, immediate rewards. Performance on the immediate/delay task also suggested greater attentiveness to the magnitude of the monetary reward for patients with a positive UDS.

  16. Topiramate improves psychiatric symptoms in a patient with Lewy body dementia.

    PubMed

    Ochoa, Juan G

    2014-12-01

    Many patients with Lewy body dementia develop visual hallucinations and other psychiatric symptoms. These patients are hypersensitive to antipsychotic drugs. Although patients tolerate atypical better than typical antipsychotics, both types can cause major extrapyramidal side effects. The anticonvulsant mood stabilizer topiramate, which does not cause parkinsonism, has been used as adjuvant therapy for both the positive and negative symptoms of schizophrenia; these symptoms can resemble those of Lewy body dementia. This report documents a 65-year-old woman with a 3-year history of progressive dementia that over the past 2 years had become complicated by severe extrapyramidal symptoms and agitated hallucinations. Her hallucinations became daily and were disrupting to her family. She was given a clinical diagnosis of Lewy body dementia after imaging and laboratory studies ruled out other etiologies. Treatment with olanzapine relieved her psychotic symptoms but caused severe dystonias, daily myoclonic jerks, and tremors. Stopping the olanzapine and starting topiramate 25 mg daily eliminated the hallucinations and agitation without worsening her extrapyramidal side effects. However, the topiramate was stopped because the patient reportedly developed anorexia and significant weight loss. Her hallucinations returned. When topiramate was reinstated at 12.5 mg a day, her agitation resolved, although her hallucinations continued. After 6 months on this dose, her agitation was still fairly well controlled without serious side effects or worsening of her parkinsonian symptoms.

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

    PubMed

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

    2003-02-15

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

  18. The relation of antipsychotic and antidepressant medication with baseline symptoms and symptom progression: A naturalistic study of the North American Prodrome Longitudinal Sample

    PubMed Central

    Walker, Elaine F.; Cornblatt, Barbara A.; Addington, Jean; Cadenhead, Kristin S.; Cannon, Tyrone D.; McGlashan, Thomas H.; Perkins, Diana O.; Seidman, Larry J.; Tsuang, Ming T.; Woods, Scott W.; Heinssen, Robert

    2009-01-01

    A substantial number of patients who meet criteria for a prodromal syndrome for first psychosis are treated with antipsychotic and/or antidepressant medications. There is suggestive evidence that both classes of medication may reduce prodromal symptoms. This longitudinal study examined the relation of antipsychotic and antidepressant medication with prodromal symptom severity at baseline and 6-month follow-up. Participants met Structured Interview for Prodromal Syndromes (SIPS) criteria for the prodrome, and were evaluated at eight centers as part of the North American Prodrome Longitudinal Study (NAPLS).Symptom ratings (positive, negative, disorganized and general) and data on antipsychotics, SSRIs, and other antidepressant medications were obtained at baseline and 6-month follow-up. Analyses revealed that all symptom dimensions declined in severity over time, but there were differences in the magnitude of the decline as a function of antipsychotic medication. Those never on antipsychotics showed less reduction in positive and disorganized symptoms over time. SSRIs and other antidepressants were not linked with declines in symptom severity. Consistent with findings from small-sample, clinical trials, the present results suggest that atypical antipsychotics may be effective in reducing the severity of attenuated positive symptoms associated with the prodrome to psychotic disorders. Limitations of the present study are noted, including the fact that it is not a randomized trial, and data on duration and dosage of medication and 2-year follow-up were not available for most participants. The results are discussed in light of the relative risks and benefits of preventive interventions, both medication and cognitive therapies, and the importance of future clinical trials. PMID:19709859

  19. Structural Neuroimaging in Adolescents with a First Psychotic Episode

    ERIC Educational Resources Information Center

    Moreno, Dolores; Burdalo, Maite; Reig, Santiago; Parellada, Mara; Zabala, Arantzazu; Desco, Manuel; Baca-Baldomero, Enrique; Arango, Celso

    2005-01-01

    Objective: The objective of the present study is to replicate findings in first-episode psychosis reporting a smaller volume in brain structures in a population with adolescent onset. Method: Magnetic resonance imaging studies were performed on 23 psychotic adolescents (12-18 years old, 17 males, 6 females) consecutively admitted to an adolescent…

  20. Immigration, social environment and onset of psychotic disorders.

    PubMed

    Bourque, François; van der Ven, Elsje; Fusar-Poli, Paolo; Malla, Ashok

    2012-01-01

    The recent decade has been characterized by a resurging interest for socio-environmental determinants of psychotic disorders, largely as a result of findings from studies of migration and psychotic disorders. This contribution reviews recent meta-analytic findings which confirm higher incidence rates of schizophrenia and related disorders among first- and second-generation immigrants than in non-immigrant populations, as well as substantial risk variation according to both ethnic minority groups and host society contexts. The relevance of social contexts in the onset of psychosis is also suggested by incidence variation according to the neighbourhood level ethnic density. While limited, an emerging literature suggests potential variations in psychotic-like experiences and at-risk mental states according to ethnic minority status. We then discuss the meaning of findings from migrant studies, as well as integrative models that attempt to account for ethnic variations in the incidence of psychosis and psychotic-like phenomena. In conclusion, there remain numerous gaps in our understanding of the relation between migration, ethnicity, social contexts and the onset of psychosis and we propose future research avenues to address these. In particular, there is a need for multilevel approaches integrating disciplines and methodologies across the psychosis continuum.

  1. Classes of Psychotic Experiences in Kenyan Children and Adolescents

    ERIC Educational Resources Information Center

    Mamah, Daniel; Owoso, Akinkunle; Mbwayo, Anne W.; Mutiso, Victoria N.; Muriungi, Susan K.; Khasakhala, Lincoln I.; Barch, Deanna M.; Ndetei, David M.

    2013-01-01

    Psychotic-like experiences (PLEs) have been observed worldwide in both adults and children outside the context of a clinical disorder. In the current study, we investigate the prevalence and patterns of PLEs among children and adolescents in Kenya. Among 1,971 students from primary and secondary schools around Nairobi (aged 8-19), 22.1 % reported…

  2. Endothelial function, folate pharmacogenomics, and neurocognition in psychotic disorders.

    PubMed

    Grove, Tyler; Taylor, Stephan; Dalack, Gregory; Ellingrod, Vicki

    2015-05-01

    Cardiovascular disease (CVD) is a well-described complication of schizophrenia, however, mechanisms connecting CVD with other facets of psychotic disorders, such as neurocognition, are not understood. The current study examined folate metabolism as a potential mechanism of CVD and neurocognitive deficits by: 1) using endothelial dysfunction as a biomarker of CVD, and 2) comparing enzymes associated with neurocognition, CVD, and critical to folate metabolism, methylenetetrahydrofolate reductase (MTHFR) and catechol-o-methyl transferase (COMT). Endothelial function was assessed in 147 participants with schizophrenia, schizoaffective disorder, and psychotic disorder not otherwise specified grouped by MTHFR and COMT allele status. Regression models were used to compare neurocognitive performance based on the Brief Assessment of Cognition in Schizophrenia (BACS). Overall, endothelial function predicted BACS composite z-scores after controlling for age, race, level of education, serum folate levels, and MTHFR/COMT risk allele status. Participants with at least one or more MTHFR and/or COMT risk alleles had lower BACS Composite and BACS Symbol Coding adjusted mean z-scores than those with both MTHFR CC and COMT Met/Met genotypes. Thus, endothelial dysfunction may contribute to the neurocognitive deficits seen in psychotic disorders. CVD interventions may not only reduce CVD-related morbidity, but also lessen progressive neurocognitive deficits reported in psychotic disorders.

  3. [Psychotic women and motherhood: what risks for the child?].

    PubMed

    Cazas, O

    2007-10-01

    Desire for child in psychotic patients: what risks for the child? Here are two very different questions. When mentally ill patients express the desire to have a child, professionals are apprehensive regarding the child's future and express eugenics temptation. Nevertheless, it is a topical question as neuroleptic drugs efficiency as well as mental health policy encourage them to live as close to normality as possible. Therefore, they have sexual relations, they have children. Since 1975, children born from psychotic mothers have been considered by the World Health Organisation (WHO) to be at high risk. This means they justify close support measures and prevention. The child runs 3 risks: a risk to develop a mental illness partly hereditary, a risk regarding his or her development, risks related to suffering, as these children are confronted with the illness of their parents. The major role played by environmental factors guide prevention behaviours; in particular towards parents-to-be psychotic adult patients and during the pregnancy, a privileged moment for preventive strategies consistent with the Perinatal Plan 2005-2007. A clinical label will provide an example of the difficulty to establish a mother-child link observed with a psychotic woman, because the imaginary child overrides the real baby. To conclude the emphasis should be put on multidisciplinary and evolutionary strategies. These imply some optimism.

  4. [A psychotic symbiotic child. Clinical and psychopathological study].

    PubMed

    Ledoux, M H

    1993-01-01

    Through the case study of a psychotic girl, we have tried to outline the psychotic mechanisms involved in this mental functioning. Anxieties of an autistic type have been found, as well as anxieties of a more psychotic type (i.e. symbiotic and schizophrenic). Characteristics of this psychotic functioning were: omnipotence, primitive identification mechanisms, fragmenting separation anxiety, search for sameness and for a low of identical repetition, difficulties in accessing to symbolism. Difficulties in defusion from the symbiotic object and the potential role played by this object in the difficulties are noteworthy. But it is not possible to conceptualize them in terms of direct causal relationship, because the object has also a counterphobic function and compensates for the void of subject as well as for the dissolution of the self. Also present is a schizoparanoïd aspect, with a temptation to cuddle inside the object. The sudden breaking through of informations or requirements from reality provokes surprise, panic reactions and retirement from the objectal world. Otherness triggers psychic pain and vacillation of symbiotic bounds. Thus the avoidance of, and retirement from, reality and the recourse to delusional thinking, especially when attempts to controlling with a rigid system are failing and deceiving. Threats of intrusion and loss of control are experienced as a threat of fragmentation and dissolution of the psyche. Far less threatening to the subject's internal balance is the policy of rigidly maintaining sameness and cuddling inside the object.

  5. Correlates of Suicidality among Patients with Psychotic Depression

    ERIC Educational Resources Information Center

    Schaffer, Ayal; Flint, Alastair J.; Smith, Eric; Rothschild, Anthony J.; Mulsant, Benoit H.; Szanto, Katalin; Peasley-Miklus, Catherine; Heo, Moonseong; Papademetriou, Eros; Meyers, Barnett S.

    2008-01-01

    The independent association of age and other factors with suicidality in patients with major depression with psychotic features was examined. Of the 183 study participants, 21% had a suicide attempt during the current episode. Male gender, Hispanic background, past suicide attempt, higher depression scores, and higher cognitive scores were each…

  6. Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver.

    PubMed

    Silva, Camila Nicácio da; Ribeiro, Karyna Myrelly O B de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Britho Macedo; Guerra, Ricardo Oliveira

    2016-01-01

    Introduction Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common and treatable causes of peripheral vestibular vertigo in adults. Its incidence increases with age, eventually leading to disability and a decreased quality of life. Objective The research aims to assess short-term effects of Otolith Repositioning Maneuver (ORM) on dizziness symptoms, quality of life, and postural balance in elderly people with Benign Paroxysmal Positional Vertigo. Methods A quasi-experimental study, which evaluated 14 elderly people that underwent the Otolith Repositioning Maneuver and reevaluation after one week. The authors performed statistical analysis by descriptive analysis of central tendency and dispersion; for pre- and post-treatment conditions, the authors used the Wilcoxon test. Results All aspects of the Dizziness Handicap Inventory (physical, functional, emotional, and total scores) as well as the Visual Analogue Scale (VAS) decreased after therapy (p < 0.05 and p = 0.001, respectively). However, more than half of the elderly participants did not achieve negative Dix-Hallpike. Regarding static and dynamic balance, there were significant differences in some parameters of the modified Clinical Test of Sensory Interaction and Balance, Limits of Stability and gait assessment measured by the Dizziness Gait Index (p < 0.05). Conclusion Results reveal clinical and functional benefits in elderly people with Benign Paroxysmal Positional Vertigo submitted to Otolith Repositioning Maneuver. However, most of the participants did not overcome Benign Paroxysmal Positional Vertigo and not all aspects of postural balance improved. Therefore, a longer follow-up period and a multidisciplinary team are required to establish comprehensive care for elderly patients with dizziness complaints.

  7. Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver

    PubMed Central

    Silva, Camila Nicácio da; Ribeiro, Karyna Myrelly O. B. de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Britho Macedo; Guerra, Ricardo Oliveira

    2015-01-01

    Introduction Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common and treatable causes of peripheral vestibular vertigo in adults. Its incidence increases with age, eventually leading to disability and a decreased quality of life. Objective The research aims to assess short-term effects of Otolith Repositioning Maneuver (ORM) on dizziness symptoms, quality of life, and postural balance in elderly people with Benign Paroxysmal Positional Vertigo. Methods A quasi-experimental study, which evaluated 14 elderly people that underwent the Otolith Repositioning Maneuver and reevaluation after one week. The authors performed statistical analysis by descriptive analysis of central tendency and dispersion; for pre- and post-treatment conditions, the authors used the Wilcoxon test. Results All aspects of the Dizziness Handicap Inventory (physical, functional, emotional, and total scores) as well as the Visual Analogue Scale (VAS) decreased after therapy (p < 0.05 and p = 0.001, respectively). However, more than half of the elderly participants did not achieve negative Dix-Hallpike. Regarding static and dynamic balance, there were significant differences in some parameters of the modified Clinical Test of Sensory Interaction and Balance, Limits of Stability and gait assessment measured by the Dizziness Gait Index (p < 0.05). Conclusion Results reveal clinical and functional benefits in elderly people with Benign Paroxysmal Positional Vertigo submitted to Otolith Repositioning Maneuver. However, most of the participants did not overcome Benign Paroxysmal Positional Vertigo and not all aspects of postural balance improved. Therefore, a longer follow-up period and a multidisciplinary team are required to establish comprehensive care for elderly patients with dizziness complaints. PMID:26722348

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

    PubMed Central

    2012-01-01

    Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were “irritability, regressive behavior, apathy, crying and truancy” which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg’s sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5 mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg’s sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3 months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6 months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features especially with accompanying

  9. Depressive and Anxiety Symptoms Predict Sustained Quality of Life Deficits in HIV-Positive Ugandan Adults Despite Antiretroviral Therapy: A Prospective Cohort Study.

    PubMed

    Ezeamama, Amara E; Woolfork, Makhabele N; Guwatudde, David; Bagenda, Danstan; Manabe, Yukari C; Fawzi, Wafaie W; Smith Fawzi, Mary C

    2016-03-01

    The impact of psychosocial status at onset of antiretroviral therapy on changes in quality of life (QOL) and subjectively rated health (SRH) among adults on highly active antiretroviral therapy (HAART) in resource-limited settings is poorly understood. Therefore, we evaluate the association between stigma, anxiety, depression, and social support and change in QOL and SRH in HIV-infected Ugandan adults during an 18-month period. Psychosocial indicators were assessed at enrollment using structured questionnaires. QOL and SRH measures were assessed at months 0, 6, 12, and 18 using the Medical Outcomes Survey-HIV. Linear mixed models determined risk estimated differences in QOL and SRH in relation to quartiles of each psychosocial status indicator. Repeated measures generalized estimating equations modeling was implemented to assess differences in likelihood of improved versus nonimproved SRH during follow-up.QOL scores and SRH improved significantly for all participants over 18 months (P < 0.0001). The gain in QOL increased dose-dependently as baseline depressive symptoms (time*depression P < 0.001) and anxiety levels (time*anxiety P < 0.001) declined. Lower social support was associated with worse QOL at baseline (P = 0.0005) but QOL improvement during follow-up was not dependent on baseline level of social support (time*social support P = 0.8943) or number of stigmatizing experiences (time*stigma P = 0.8662). Psychosocial determinants did not predict changes in SRH in this study. High levels of depression and anxiety symptoms at HAART initiation predicts lower gains in QOL for HIV-positive patients for as long as 18 months. Long-term QOL improvements in HIV-infected adults may be enhanced by implementation of psychosocial interventions to reduce depression and anxiety in HIV-infected adults.

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

    PubMed

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

    2016-02-17

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

  11. Sustained reduction in health care costs after adjunctive treatment of graded intensive short-term dynamic psychotherapy in patients with psychotic disorders.

    PubMed

    Abbass, Allan; Bernier, Denise; Kisely, Steve; Town, Joel; Johansson, Robert

    2015-08-30

    The aim of this pilot study was to evaluate the changes in symptom severity and long-term health care cost after intensive short-term dynamic psychotherapy (ISTDP) individually tailored and administered to patients with psychotic disorders undergoing standard psychiatric care. Eleven therapists with different levels of expertise delivered an average of 13 one-hour sessions of graded ISTDP to 38 patients with psychotic disorders. Costs for health care services were compiled for a one-year period prior to the start of ISTDP (baseline) along with four one-year periods after termination. Two validated self-report scales, the Brief Symptom Inventory and the Inventory of Interpersonal Problems, were administered at intake and termination of ISTDP. Results revealed that health care cost reductions were significant for the one-year post-treatment period relative to baseline year, for both physician costs and hospital costs, and the reductions were sustained for the follow-up period of four post-treatment years. Furthermore, at treatment termination self-reported symptoms and interpersonal problems were significantly reduced. These preliminary findings suggest that this brief adjunctive psychotherapy may be beneficial and reduce costs in selected patients with psychotic disorders, and that gains are sustained in long-term follow-up. Future research directions are discussed.

  12. Are symptoms associated with increased levels of perceived stress in first-episode psychosis?

    PubMed

    Renwick, Laoise; Jackson, Deirdre; Turner, Niall; Sutton, Marie; Foley, Sharon; McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard

    2009-06-01

    Several studies report on the presence of external stress and life events prior to the onset and exacerbation of psychotic illness. However, the relationship between the subjective appraisal of stress at first presentation with psychosis is less well understood. This paper reports on the relationship between the individual perception of stress and symptomatology in individuals with first-episode psychosis at presentation to community mental health services. We assessed 123 individuals using standardized measures of symptoms, quality of life, perceived stress, global functioning, and duration of untreated psychosis. At first presentation, people with more depressive symptoms and reduced overall functioning were more likely to report increased levels of perceived stress. In addition, people with less positive symptoms of psychosis were experiencing higher levels of subjective stress. In terms of stress vulnerability models, it is important to consider how functioning and symptoms can influence individual appraisal of stress. Acknowledging this interaction can provide opportunities for nursing interventions directed at enhancing adaptive coping and provide benchmarks for assessing the effectiveness of nursing interventions provided in the acute phase of psychosis. Further research should focus on the interaction between symptoms and individually-appraised stress over time.

  13. Evidence for a common biological basis of the Absorption trait, hallucinogen effects, and positive symptoms: epistasis between 5-HT2a and COMT polymorphisms.

    PubMed

    Ott, Ulrich; Reuter, Martin; Hennig, Juergen; Vaitl, Dieter

    2005-08-05

    Absorption represents a disposition to experience altered states of consciousness characterized by intensively focused attention. It is correlated with hypnotic susceptibility and includes phenomena ranging from vivid perceptions and imaginations to mystical experiences. Based on the assumption that drug-induced and naturally occurring mystical experiences share common neural mechanisms, we hypothesized that Absorption is influenced by the T102C polymorphism affecting the 5-HT2a receptor, which is known to be an important target site of hallucinogens like LSD. Based on the pivotal role ascribed to the prefrontal executive control network for absorbed attention and positive symptoms in schizophrenia, it was further hypothesized that Absorption is associated with the VAL158MET polymorphism of the catechol-O-methyltransferase (COMT) gene affecting the dopaminergic neurotransmitter system. The Tellegen Absorption Scale was administered to 336 subjects (95 male, 241 female). Statistical analysis revealed that the group with the T/T genotype of the T102C polymorphism, implying a stronger binding potential of the 5-HT2a receptor, indeed had significantly higher Absorption scores (F = 10.00, P = 0.002), while no main effect was found for the COMT polymorphism. However, the interaction between T102C and COMT genotypes yielded significance (F = 3.89; P = 0.049), underlining the known functional interaction between the 5-HT and the dopaminergic system. These findings point to biological foundations of the personality trait of Absorption.

  14. Prevention of depression and anxiety symptoms in adolescents: 42 and 54 months follow-up of the Aussie Optimism Program-Positive Thinking Skills.

    PubMed

    Johnstone, Julie; Rooney, Rosanna M; Hassan, Shari; Kane, Robert T

    2014-01-01

    Anxiety and depression are the most commonly reported mental health problems amongst Australian children and adolescents. The Aussie Optimism: Program-Positive Thinking Skills (AOP-PTS) is a universal intervention program based on cognitive and behavioral strategies and aimed to prevent anxiety and depression in the middle primary school children aged 9-10 years old. 370 students randomly assigned to the intervention and control condition participated in the 42 and 54 months follow-up study. The intervention group received the AOP-PTS 10-week program and the control group received the regular health education curriculum. Students were assessed on anxiety, depression and attribution style at school whilst parents reported on their child's externalizing and internalizing problems at home. Results showed there were no significant reductions across groups in the depressive and anxiety symptoms, and attribution style at either 42 or 54 months follow-up. These findings suggest that AOP-PTS has short and medium term effects but were not sustained in longer term period. Future strategies to achieve the desirable outcomes in a longitudinal study are discussed.

  15. Negative symptoms: psychopathological models.

    PubMed Central

    Ananth, J; Djenderdjian, A; Shamasunder, P; Costa, J; Herrera, J; Sramek, J

    1991-01-01

    The psychopathological manifestations of schizophrenia have been broadly divided into positive and negative symptom groups. Even though there is no definitive consensus, psychomotor agitation, motor excitement, hallucinations, delusions and thought disorder constitute positive and psychomotor retardation, amotivation, apathy and decreased emotional expression are grouped into negative symptoms. The negative symptoms have been reported to appear late in the course of the illness and resistant to treatment with neuroleptics. While these claims have not been substantiated, the current interest on negative symptoms is related to the fact that many nonfunctioning institutionalized as well as ambulatory schizophrenics manifest negative symptoms. As chronic psychiatric beds have become scarce, many patients with negative symptoms who were harbored in the chronic mental hospitals have been released to the community care and some of these patients live on the streets. Thus their visibility has challenged psychiatry to focus its efforts on the etiology and treatment of negative symptoms. PMID:2049366

  16. Genetic moderation of the effects of cannabis: catechol-O-methyltransferase (COMT) affects the impact of Δ9-tetrahydrocannabinol (THC) on working memory performance but not on the occurrence of psychotic experiences.

    PubMed

    Tunbridge, Elizabeth M; Dunn, Graham; Murray, Robin M; Evans, Nicole; Lister, Rachel; Stumpenhorst, Katharina; Harrison, Paul J; Morrison, Paul D; Freeman, Daniel

    2015-11-01

    Cannabis use can induce cognitive impairments and psychotic experiences. A functional polymorphism in the catechol-O-methyltransferase (COMT) gene (Val(158)Met) appears to influence the immediate cognitive and psychotic effects of cannabis, or ∆(9)-tetrahydrocannabinol (THC), its primary psychoactive ingredient. This study investigated the moderation of the impact of experimentally administered THC by COMT. Cognitive performance and psychotic experiences were studied in participants without a psychiatric diagnosis, using a between-subjects design (THC vs. placebo). The effect of COMT Val(158)Met genotype on the cognitive and psychotic effects of THC, administered intravenously in a double-blind, placebo-controlled manner to 78 participants who were vulnerable to paranoia, was examined. The results showed interactive effects of genotype and drug group (THC or placebo) on working memory, assayed using the Digit Span Backwards task. Specifically, THC impaired performance in COMT Val/Val, but not Met, carriers. In contrast, the effect of THC on psychotic experiences, measured using the Community Assessment of Psychic Experiences (CAPE) positive dimension, was unaffected by COMT genotype. This study is the largest to date examining the impact of COMT genotype on response to experimentally administered THC, and the first using a purely non-clinical cohort. The data suggest that COMT genotype moderates the cognitive, but not the psychotic, effects of acutely administered THC.

  17. Psychotic denial of pregnancy: phenomenology and clinical management.

    PubMed

    Miller, L J

    1990-11-01

    Psychotic denial of pregnancy in chronic mentally ill women may place the women and their fetuses at high risk of postpartum emotional disturbance, precipitous or unassisted delivery, fetal abuse, and neonaticide. Psychotic denial of pregnancy is illustrated with case reports from an inpatient program for pregnant mentally ill women. Women who denied their pregnancies tended to have a diagnosis of chronic schizophrenia, to have previously lost custody of children, and to anticipate separation from the baby they were carrying. The author suggests that treatment for such patients should take place in a setting that integrates comprehensive psychiatric and obstetrical care and may include pharmacotherapy, supportive psychotherapy, and evaluation of the patient's parenting skills and support network to assess whether she is able to keep her baby.

  18. An update on the epigenetics of psychotic diseases and autism.

    PubMed

    Abdolmaleky, Hamid Mostafavi; Zhou, Jin-Rong; Thiagalingam, Sam

    2015-01-01

    The examination of potential roles of epigenetic alterations in the pathogenesis of psychotic diseases have become an essential alternative in recent years as genetic studies alone are yet to uncover major gene(s) for psychosis. Here, we describe the current state of knowledge from the gene-specific and genome-wide studies of postmortem brain and blood cells indicating that aberrant DNA methylation, histone modifications and dysregulation of micro-RNAs are linked to the pathogenesis of mental diseases. There is also strong evidence supporting that all classes of psychiatric drugs modulate diverse features of the epigenome. While comprehensive environmental and genetic/epigenetic studies are uncovering the origins, and the key genes/pathways affected in psychotic diseases, characterizing the epigenetic effects of psychiatric drugs may help to design novel therapies in psychiatry.

  19. Neuropsychiatric Symptoms and Regional Neocortical Atrophy in Mild Cognitive Impairment and Alzheimer’s Disease

    PubMed Central

    Rafii, Michael S.; Taylor, Curtis S.; Kim, Hyun T.; Desikan, Rahul S.; Fleisher, Adam S.; Katibian, David; Brewer, James B.; Dale, Anders M.; Aisen, Paul S.

    2017-01-01

    Background To assess the relationship between regional neocortical atrophy and psychotic symptoms in adults with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Methods Rates of change in regional neocortical atrophy as measured by longitudinal magnetic resonance imaging scans and the occurrence of psychotic symptoms and/or the long-term use of antipsychotic medications in 389 outpatients with MCI or AD in Alzheimer’s Disease Neuroimaging Initiative. Results Atrophy rate of 3 specific neocortical regions, lateral frontal, lateral parietal, and anterior cingulate gyrus, was significantly associated with the onset of psychosis including delusions, agitation, wandering, and hallucinations and/or the need for chronic antipsychotic medications. Atrophy rate of the lateral frontal lobe correlated most significantly with onset of psychotic symptoms or need for chronic antipsychotic medications. Conclusions Psychosis was associated with volume loss in specific regions of the lateral frontal and parietal lobes as well as anterior cingulate gyrus. PMID:24164929

  20. Psychotic experiences in the population: Association with functioning and mental distress.

    PubMed

    Kelleher, Ian; Wigman, Johanna T W; Harley, Michelle; O'Hanlon, Erik; Coughlan, Helen; Rawdon, Caroline; Murphy, Jennifer; Power, Emmet; Higgins, Niamh M; Cannon, Mary

    2015-06-01

    Psychotic experiences are far more common in the population than psychotic disorder. They are associated with a number of adverse outcomes but there has been little research on associations with functioning and distress. We wished to investigate functioning and distress in a community sample of adolescents with psychotic experiences. Two hundred and twelve school-going adolescents were assessed for psychotic experiences, mental distress associated with these experiences, global (social/occupational) functioning on the Children's Global Assessment Scale, and a number of candidate mediator variables, including psychopathology, suicidality, trauma (physical and sexual abuse and exposure to domestic violence) and neurocognitive functioning. Seventy five percent of participants who reported psychotic experiences reported that they found these experiences distressing (mean score for severity of distress was 6.9 out of maximum 10). Participants who reported psychotic experiences had poorer functioning than participants who did not report psychotic experiences (respective means: 68.6, 81.9; OR=0.25, 95% CI=0.14-0.44). Similarly, participants with an Axis-1 psychiatric disorder who reported psychotic experiences had poorer functioning than participants with a disorder who did not report psychotic experiences (respective means: 61.8, 74.5; OR=0.28, 95% CI=0.12-0.63). Candidate mediator variables explained some but not all of the relationship between psychotic experiences and functioning (OR=0.48, 95% CI=0.22-1.05, P<0.07). Young people with psychotic experiences have poorer global functioning than those who do not, even when compared with other young people with psychopathology (but who do not report psychotic experiences). A disclosure of psychotic experiences should alert treating clinicians that the individual may have significantly more functional disability than suggested by the psychopathological diagnosis alone.

  1. Hallucinations in the psychotic state: Psychoanalysis and the neurosciences compared.

    PubMed

    De Masi, Franco; Davalli, Cesare; Giustino, Gabriella; Pergami, Andrea

    2015-04-01

    In this contribution, which takes account of important findings in neuroscientific as well as psychoanalytic research, the authors explore the meaning of the deep-going distortions of psychic functioning occurring in hallucinatory phenomena. Neuroscientific studies have established that hallucinations distort the sense of reality owing to a complex alteration in the balance between top-down and bottom-up brain circuits. The present authors postulate that hallucinatory phenomena represent the outcome of a psychotic's distorted use of the mind over an extended period of time. In the hallucinatory state the psychotic part of the personality uses the mind to generate auto-induced sensations and to achieve a particular sort of regressive pleasure. In these cases, therefore, the mind is not used as an organ of knowledge or as an instrument for fostering relationships with others. The hallucinating psychotic decathects psychic (relational) reality and withdraws into a personal, bodily, and sensory space of his own. The opposing realities are not only external and internal but also psychic and sensory. Visual hallucinations could thus be said to originate from seeing with the 'eyes' of the mind, and auditory hallucinations from hearing with the mind's 'ears'. In these conditions, mental functioning is restricted, cutting out the more mature functions, which are thus no longer able to assign real meaning to the surrounding world and to the subject's psychic experience. The findings of the neurosciences facilitate understanding of how, in the psychotic hallucinatory process, the mind can modify the working of a somatic organ such as the brain.

  2. Subcortical grey matter alterations in cocaine dependent individuals with substance-induced psychosis compared to non-psychotic cocaine users.

    PubMed

    Willi, Taylor S; Lang, Donna J; Honer, William G; Smith, Geoff N; Thornton, Allen E; Panenka, William J; Procyshyn, Ric M; Vila-Rodriguez, Fidel; Su, Wayne; Vertinsky, A Talia; Leonova, Olga; Rauscher, Alexander; MacEwan, G William; Barr, Alasdair M

    2016-10-01

    After prolonged psychostimulant abuse, transient psychotic symptoms referred to as "substance-induced psychosis" (SIP) can develop - closely resembling symptoms observed in schizophrenia spectrum disorders. The comparability in psychotic presentation between SIP and schizophrenias suggests that similar underlying neural deficits may contribute to the expression of psychosis across these disorders. To date, neuroanatomical characterization of grey matter structural alterations in SIP has been limited to methamphetamine associated psychosis, with no studies controlling for potential neurotoxic effects of the psychostimulant that precipitates psychosis. To investigate grey matter subcortical alterations in SIP, a voxel-based analysis of magnetic resonance images (MRI) was performed between a group of 74 cocaine dependent nonpsychotic individuals and a group of 29 individuals with cocaine-associated psychosis. The cocaine-associated psychosis group had significantly smaller volumes of the thalamus and left hippocampus, controlling for age, total brain volume, current methamphetamine dependence, and current marijuana dependence. No differences were present in bilateral caudate structures. The findings of reduced thalamic and hippocampal volumes agree with previous reports in the schizophrenia literature, suggesting alterations of these structures are not specific to schizophrenia, but may be common to multiple forms of psychosis.

  3. Psychotic denial of pregnancy: legal and treatment considerations for clinicians.

    PubMed

    Nau, Melissa; Bender, H Eric; Street, Judith

    2011-01-01

    The authors examine the legal questions raised by the involuntary medical and psychiatric treatment of a patient with psychotic denial of pregnancy. A case is presented, and psychotic denial of pregnancy is defined. Legal cases are reviewed that set precedent for state intervention on behalf of either the pregnant mother or the fetus when the mother refuses care. Included are specific cases that have a bearing on the rights of pregnant women with co-morbid mental illness. A distinction is made between cases in which the mother is competent versus incompetent to make treatment decisions, and particular attention is paid to California law. The authors conducted systematic Westlaw and LexisNexis searches of relevant case law and legal precedent. Laws that address the rights of pregnant women are complex, and courts have allowed medical interventions against objection in cases of both competent and incompetent mothers. No clear legal precedent was found to guide decision-making in the specific case of a woman with psychotic denial of pregnancy. The principles of substituted judgment and best interest may help guide clinicians in making decisions about the treatment of pregnant patients in the absence of clear legal precedent.

  4. Inflammation theories in psychotic disorders: a critical review.

    PubMed

    Suvisaari, Jaana; Mantere, Outi

    2013-02-01

    Recent research suggests that inflammation and immunity may have a role in the etiology of psychotic disorders. There is evidence of proinflammatory activation of the innate immune system and an activation of the T-cells of the adaptive immune system in both schizophrenia and bipolar disorder. Studies of antipsychotic-naïve patients with first-episode psychosis have found that inflammation is present already at this stage. Some of these abnormalities resolve after the initiation of treatment, suggesting that they are state markers of acute psychosis, but other abnormalities persist. There is also evidence for prenatal infections being involved in the etiology of schizophrenia. Several hypotheses link inflammation and immunity with psychotic disorders. In this review, we focus on hypotheses related to prenatal development, disturbed regulation of neurogenesis, microglial activation, autoimmunity and microbial environment, and consider the potential confounding effects related to stress, childhood adversities, lifestyle and medical comorbidity as well as some methodological limitations. We also review the current evidence for the effectiveness of anti-inflammatory medication in the treatment of psychotic disorders.

  5. Olfactory function in psychotic disorders: Insights from neuroimaging studies

    PubMed Central

    Good, Kimberley P; Sullivan, Randii Lynn

    2015-01-01

    Olfactory deficits on measures of identification, familiarity, and memory are consistently noted in patients with psychotic disorders relative to age-matched controls. Olfactory intensity ratings, however, appear to remain intact while the data on hedonics and detection threshold are inconsistent. Despite the behavioral abnormalities noted, no specific regional brain hypoactivity has been identified in psychosis patients, for any of the olfactory domains. However, an intriguing finding emerged from this review in that the amygdala and pirifom cortices were not noted to be abnormal in hedonic processing (nor was the amygdala identified abnormal in any study) in psychotic disorders. This finding is in contrast to the literature in healthy individuals, in that this brain region is strongly implicated in olfactory processing (particularly for unpleasant odorants). Secondary olfactory cortex (orbitofrontal cortices, thalamus, and insula) was abnormally activated in the studies examined, particularly for hedonic processing. Further research, using consistent methodology, is required for better understanding the neurobiology of olfactory deficits. The authors suggest taking age and sex differences into consideration and further contrasting olfactory subgroups (impaired vs intact) to better our understanding of the heterogeneity of psychotic disorders. PMID:26110122

  6. Corpus callosum area in patients with bipolar disorder with and without psychotic features: an international multicentre study

    PubMed Central

    Sarrazin, Samuel; d’Albis, Marc-Antoine; McDonald, Colm; Linke, Julia; Wessa, Michèle; Phillips, Mary; Delavest, Marine; Emsell, Louise; Versace, Amelia; Almeida, Jorge; Mangin, Jean-François; Poupon, Cyril; Le Dudal, Katia; Daban, Claire; Hamdani, Nora; Leboyer, Marion; Houenou, Josselin

    2015-01-01

    Background Previous studies have reported MRI abnormalities of the corpus callosum (CC) in patients with bipolar disorder (BD), although only a few studies have directly compared callosal areas in psychotic versus nonpsychotic patients with this disorder. We sought to compare regional callosal areas in a large international multicentre sample of patients with BD and healthy controls. Methods We analyzed anatomic T1 MRI data of patients with BD-I and healthy controls recruited from 4 sites (France, Germany, Ireland and the United States). We obtained the mid-sagittal areas of 7 CC subregions using an automatic CC delineation. Differences in regional callosal areas between patients and controls were compared using linear mixed models (adjusting for age, sex, handedness, brain volume, history of alcohol abuse/dependence, lithium or antipsychotic medication status, symptomatic status and site) and multiple comparisons correction. We also compared regional areas of the CC between patients with BD with and without a history of psychotic features. Results We included 172 patients and 146 controls in our study. Patients with BD had smaller adjusted mid-sagittal CC areas than controls along the posterior body, the isthmus and the splenium of the CC. Patients with a positive history of psychotic features had greater adjusted area of the rostral CC region than those without a history of psychotic features. Limitations We found small to medium effect sizes, and there was no calibration technique among the sites. Conclusion Our results suggest that BD with psychosis is associated with a different pattern of interhemispheric connectivity than BD without psychosis and could be considered a relevant neuroimaging subtype of BD. PMID:26151452

  7. Sustaining remission of psychotic depression: rationale, design and methodology of STOP-PD ΙΙ

    PubMed Central

    2013-01-01

    Background Psychotic depression (PD) is a severe disabling disorder with considerable morbidity and mortality. Electroconvulsive therapy and pharmacotherapy are each efficacious in the treatment of PD. Expert guidelines recommend the combination of antidepressant and antipsychotic medications in the acute pharmacologic treatment of PD. However, little is known about the continuation treatment of PD. Of particular concern, it is not known whether antipsychotic medication needs to be continued once an episode of PD responds to pharmacotherapy. This issue has profound clinical importance. On the one hand, the unnecessary continuation of antipsychotic medication exposes a patient to adverse effects, such as weight gain and metabolic disturbance. On the other hand, premature discontinuation of antipsychotic medication has the potential risk of early relapse of a severe disorder. Methods/design The primary goal of this multicenter randomized placebo-controlled trial is to assess the risks and benefits of continuing antipsychotic medication in persons with PD once the episode of depression has responded to treatment with an antidepressant and an antipsychotic. Secondary goals are to examine age and genetic polymorphisms as predictors or moderators of treatment variability, potentially leading to more personalized treatment of PD. Individuals aged 18-85 years with unipolar psychotic depression receive up to 12 weeks of open-label treatment with sertraline and olanzapine. Participants who achieve remission of psychosis and remission/near-remission of depressive symptoms continue with 8 weeks of open-label treatment to ensure stability of remission. Participants with stability of remission are then randomized to 36 weeks of double-blind treatment with either sertraline and olanzapine or sertraline and placebo. Relapse is the primary outcome. Metabolic changes are a secondary outcome. Discussion This trial will provide clinicians with much-needed evidence to guide the

  8. Symptom control.

    PubMed

    Chang, Victor T; Ingham, Jane

    2003-01-01

    Symptom control has become increasingly recognized as an important goal in patient care. In this article, advances in symptom assessment, and various definitions of symptom improvement are reviewed. Theoretical concepts underlying symptom control and clinically significant change are presented, as well as the role of symptom control as an endpoint in clinical trials. Symptom control is then surveyed in two broad categories for selected symptoms. The first area is therapy related symptoms, secondary to chemotherapy, radiation, hormonal therapy, and surgery. Symptoms reviewed include chemotherapy related mucositis, emesis, fatigue; hot flashes; and radiation related dermatitis, xerostomia, and mucositis. The second area is palliative oncologic approaches to disease-related symptoms. Results in palliative chemotherapy, palliative radiation therapy, cancer pain, and lack of appetite are summarized. Areas requiring further research are noted. Findings are presented in both a clinical and research context to help guide the reader with interpreting symptom control studies.

  9. [Relationship between clozapine plasma levels and withdrawal symptoms].

    PubMed

    Berecz, R; de la Rubia Martínez, A; Norberto Gamero, M J; Gutiérrez Casares, J R; Glaub, T; Degrell, I; Llerena, A

    2002-01-01

    Discontinuation of clozapine and an attempt to change his medication to sertindol has led to serious psychotic and somatic symptoms in an schizophrenic patient treated with clozapine for five years, however after readministration of clozapine these symptoms rapidly disappeared. To further analyse the case we have developed an HPLC method for the measurement of plasma levels of clozapine and its main metabolite N-desmethyl clozapine in order to monitor the plasma levels of clozapine and to correlate with the clinical symptoms. The present results confirmed that after discontinuation of clozapine no measurable amount of drug or its main metabolite were present in the plasma of the patient. The correlation between the plasma levels of clozapine and the changes in the clinical state of the patient confirmed that the patient's severe psychotic and somatic symptoms were the result of discontinuation of clozapine treatment. The clozapine plasma concentration of the patient reported here was low (100 ng/ml) compared to the generally accepted plasma levels for antipsychotic action of clozapine (350 ng/ml), however the somatic and psychotic clozapine withdrawal symptoms rapidly and completely disappeared.

  10. Default mode and task-positive networks connectivity during the N-Back task in remitted depressed patients with or without emotional residual symptoms.

    PubMed

    Delaveau, Pauline; Arruda Sanchez, Tiago; Steffen, Ricardo; Deschet, Karine; Jabourian, Maritza; Perlbarg, Vincent; Gasparetto, Emerson Leandro; Dubal, Stéphanie; Costa E Silva, Jorge; Fossati, Philippe

    2017-04-08

    Clinical remission of depression may be associated with emotional residual symptoms. We studied the association of emotional blunting, rumination with neural networks dynamics in remitted depressed patients and cognitive performance during an N-Back task. Twenty-six outpatients in remission of depression (Hamilton Depressive rating scale score <7) performed an N-Back task during fMRI assessment. All patients had been treated by paroxetine for a minimum of 4 months. Two subgroups of patients [Nonemotionally blunted (NEB) = 14 and emotionally blunted (EB) = 12] were determined. To identify functional network maps across participants, the Network Detection using Independent Component Analysis approach was employed. Within and between Task Positive Network (TPN) and Default Mode Network (DMN) connectivity were assessed and related to variability of performance on the N-Back task and rumination. EB and NEB patients were not different for the level of accurate responses at the N-Back. However over the entire working memory task, the negative correlation between DMN and TPN was significantly lower in the EB than NEB group and was differently related to cognitive performance and rumination. The stronger the negative correlation between DMN and TPN was, the less variable the reaction time during 3-Back task in NEB patients. Moreover the greater the negative correlation between DMN and TPN was, the lower the rumination score in EB patients. Emotional blunting may be associated with compromised monitoring of rumination and cognitive functioning in remitted depressed patients through altered cooperation between DMN and TPN. The study suggests clinical remission in depression is associated with biological heterogeneity. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.

  11. Effects of omega-3 dietary supplement in prevention of positive, negative and cognitive symptoms: a study in adolescent rats with ketamine-induced model of schizophrenia.

    PubMed

    Gama, Clarissa S; Canever, Lara; Panizzutti, Bruna; Gubert, Carolina; Stertz, Laura; Massuda, Raffael; Pedrini, Mariana; de Lucena, David F; Luca, Renata D; Fraga, Daiane B; Heylmann, Alexandra S; Deroza, Pedro F; Zugno, Alexandra I

    2012-11-01

    Omega-3 has shown efficacy to prevent schizophrenia conversion in ultra-high risk population. We evaluated the efficacy of omega-3 in preventing ketamine-induced effects in an animal model of schizophrenia and its effect on brain-derived neurotrophic factor (BDNF). Omega-3 or vehicle was administered in Wistar male rats, both groups at the 30th day of life for 15days. Each group was split in two to receive along the following 7days ketamine or saline. Locomotor and exploratory activities, memory test and social interaction between pairs were evaluated at the 52nd day of life. Prefrontal-cortex, hippocampus and striatum tissues were extracted right after behavioral tasks for mRNA BDNF expression analysis. Bloods for serum BDNF were withdrawn 24h after the end of behavioral tasks. Locomotive was increased in ketamine-treated group compared to control, omega-3 and ketamine plus omega-3 groups. Ketamine group had fewer contacts and interaction compared to other groups. Working memory and short and long-term memories were significantly impaired in ketamine group compared to others. Serum BDNF levels were significantly higher in ketamine plus omega-3 group. There was no difference between groups in prefrontal-cortex, hippocampus and striatum for mRNA BDNF expression. Administration of omega-3 in adolescent rats prevents positive, negative and cognitive symptoms in a ketamine animal model of schizophrenia. Whether these findings are consequence of BDNF increase it is unclear. However, this study gives compelling evidence for larger clinical trials to confirm the use of omega-3 to prevent schizophrenia and for studies to reinforce the beneficial role of omega-3 in brain protection.

  12. The Search for Elusive Structure: A Promiscuous Realist Case for Researching Specific Psychotic Experiences Such as Hallucinations

    PubMed Central

    Bentall, Richard P.

    2014-01-01

    Problems in psychiatric classification have impeded research into psychopathology for more than a century. Here, I briefly review several new approaches to solving this problem, including the internalizing-externalizing-psychosis spectra, the 5-factor model of psychotic symptoms, and the more recent network approach. Researchers and clinicians should probably adopt an attitude of promiscuous realism and assume that a single classification system is unlikely to be effective for all purposes, and that different systems will need to be chosen for research into etiology, public mental health research, and clinical activities. Progress in understanding the risk factors and mechanisms that lead to psychopathology is most likely to be achieved by focusing on specific types of experience or symptoms such as hallucinations. PMID:24936080

  13. Comparison of Visuospatial and Verbal Abilities in First Psychotic Episode of Schizophrenia Spectrum Disorder: Impact on Global Functioning and Quality of Life

    PubMed Central

    Rodriguez, Mabel; Spaniel, Filip; Konradova, Lucie; Sedlakova, Katerina; Dvorska, Karolina; Prajsova, Jitka; Kratochvilova, Zuzana; Levcik, David; Vlcek, Kamil; Fajnerova, Iveta

    2015-01-01

    Objectives: Deficit in visuospatial functions can influence both simple and complex daily life activities. Despite the fact that visuospatial deficit was reported in schizophrenia, research on visuospatial functions as an independent entity is limited. Our study aims to elucidate the impact of visuospatial deficit in comparison with verbal deficit on global functioning and quality of life in the first psychotic episode of schizophrenia spectrum disorder (FES). The significance of clinical symptoms and antipsychotic medication was also studied. Methods: Thirty-six FES patients and a matched group of healthy controls (HC group) were assessed with a neuropsychological battery focused on visuospatial (VIS) and verbal (VERB) functions. Using multiple regression analysis, we evaluated the cumulative effect of VERB and VIS functions, psychiatric symptoms (PANSS) and antipsychotic medication on global functioning (GAF) and quality of life (WHOQOL-BREF) in the FES group. Results: The FES group demonstrated significant impairment both in VIS and VERB cognitive abilities compared to the HC group. Antipsychotic medication did not significantly affect either VIS or VERB functioning. PANSS was not related to cognitive functioning, apart from the Trail Making Test B. In the FES group, the GAF score was significantly affected by the severity of positive symptoms and VERB functioning, explaining together 60% of GAF variability. The severity of negative and positive symptoms affected only the Physical health domain of WHOQOL-BREF. The degree of VERB deficit was associated with both Physical and Psychological health. Although we did not find any relation between VIS functioning, GAF, and WHOQOL-BREF, a paradoxical finding emerged in the Environment quality domain, where a worse quality of the environment was associated with better VIS functioning. Conclusions: Our results suggest that the deficit in VIS functions is an integral part of cognitive deficit in schizophrenia spectrum

  14. [S-II symptom questionnaire].

    PubMed

    Aleksandrowicz, J W

    2000-01-01

    "S-II" Symptom Check-list which allows for a fast diagnosis of neurotic disorders. A result of 165 points suggests the incidence of such disorders with the probability of 90%. The methodology of the construction of the check-list intends for the application of questions most common in those ill due to neurotic disorders (owing to the change in frequency) and the most possibly equal amount of questions on the symptoms common to women and men. Thanks to this the norm for women and men is identical. SCL S-II Symptom Check-list is a shortened and actualised version of the "O" Symptom Check-list, developed in 1975. It is similar to the SCL-90 and highly correlated with it, but it does not contain the variables concerning the psychotic symptoms. Thanks to this, its' accuracy (specificity) in the diagnosis of neurotic disorders is high. 4 pairs of questions allow for the judgement of answer reliability. 10 scales were singled out in the questionnaire. They are only of a helpful value and do not allow for a one-sided diagnosis of the type of the disorder, listed in the ICD-10. The scale results can, however make the correct diagnosis easier.

  15. Schizophrenia patients with polydipsia and water intoxication are characterized by greater severity of psychotic illness and a more frequent history of alcohol abuse.

    PubMed

    Poirier, Simon; Legris, Geneviève; Tremblay, Philippe; Michea, Rodrigo; Viau-Guay, Laurence; Mérette, Chantal; Bouchard, Roch-Hugo; Maziade, Michel; Roy, Marc-André

    2010-05-01

    Polydipsia and water intoxication (PWI) are relatively frequent among schizophrenic subjects, particularly in institutional settings and may lead to severe complications. However, little is known on their association with other characteristics of psychosis. Hence, we took advantage of a cohort of 114 subjects extensively assessed on natural history and clinical variables to examine the correlates of PWI in chronic schizophrenia. We randomly sampled DSM-IV schizophrenic subjects from: i) a lower functioning subgroup, i.e., long-term psychiatric wards or highly structured group housing facilities; and ii) a higher functioning subgroup, i.e., patients living in the community without supervision. Subjects were assessed from multiple sources for lifetime severity of positive, disorganisation, negative and depressive symptoms, premorbid adjustment, age of onset, level of functioning, comorbid diagnoses of substance abuse and lifetime history of PWI. Twelve subjects (10.5%) met our PWI criteria. We observed more severe psychotic symptoms, earlier onset, poorer current adjustment and more frequent prior alcohol use disorder in PWI subjects. When restricting comparisons to patients living in institutional setting, differences on clinical and natural history variables vanished but the association between PWI and prior alcohol abuse persisted (72.7% in PWI vs. 21.4% in non-PWI subjects, p<0.01). Onset of alcohol abuse predated the onset of PWI by a mean of 12.8 years. PWI schizophrenic subjects are characterized by a non-specific greater severity on a broad array of clinical and natural history variables and by a specific association with prior alcohol abuse. Thus, our data suggest that a greater severity of illness and a prior history of alcohol use disorders interact in increasing the risk of developing PWI in chronic schizophrenic patients.

  16. Psychotic experiences as a predictor of the natural course of suicidal ideation: a Swedish cohort study

    PubMed Central

    Kelleher, Ian; Cederlöf, Martin; Lichtenstein, Paul

    2014-01-01

    Psychotic experiences are far more prevalent in the population than psychotic disorders and are associated with a wide range of depressive, anxiety and behavioral disorders, as well as increased risk for psychotic disorder. Recently, psychotic experiences have been highlighted as a potentially valuable clinical marker of risk for suicidal behavior. There have been few studies to date, however, to assess psychotic experiences as a predictor of suicidality over time. We wished to assess whether young persons with suicidal ideation at baseline assessment who reported psychotic experiences were at higher risk for persistence of suicidal ideation at follow-up than young persons who also reported suicidal ideation at baseline but who did not report co-occurring psychotic experiences. A total of 2,263 adolescents were assessed at age 13 to 14 years for psychotic experiences, suicidal ideation and internalizing and externalizing psychopathology. Participants were re-assessed at ages 16 to 17 years and 19 to 20 years. Among 13- to 14-year olds with suicidal ideation, co-occurring psychotic experiences did not predict an increased odds of persistence of suicidal ideation to age 16 to 17 years (OR=0.94, 95% CI: 0.19-4.78). Among 16- to 17-year olds with suicidal ideation, however, co-occurring psychotic experiences predicted a 6-fold increased odds of persistence of suicidal ideation to age 19 to 20 years (OR=5.53, 95% CI: 1.33-23.00). Psychotic experiences are an important but under-recognized marker of risk for persistence of suicidal ideation, in particular from mid-adolescence. An increased emphasis on the clinical assessment of psychotic experiences in mental health services should be a priority. PMID:24890071

  17. Mentalization-based treatment for psychosis: linking an attachment-based model to the psychotherapy for impaired mental state understanding in people with psychotic disorders.

    PubMed

    Brent, Benjamin K; Holt, Daphne J; Keshavan, Matcheri S; Seidman, Larry J; Fonagy, Peter

    2014-01-01

    Disturbances of mentalization have been increasingly associated with the symptoms and functional impairment of people with psychotic disorders. it has been proposed that psychotherapy designed to foster self and other understanding, such as mentalization-based treatment (mBt), may play an important part in facilitating recovery from psychosis. Here, we present an attachment-based understanding of mentalization impairments. We then outline a neuropsychological model that links disruptions of mentalization associated with disturbances in the caregiving environment to the pathophysiology of psychosis in genetically at-risk individuals. this is followed by an illustration of some of the core mBt techniques for the rehabilitation of the capacity to mentalize as applied to the treatment of a patient with a psychotic disorder.

  18. Sudden psychotic episode probably due to meningoencephalitis and Chlamydia pneumoniae acute infection

    PubMed Central

    2005-01-01

    Background Since 9% to 20% of all cases of acute psychosis presenting to an Emergency Department (ED) are due to a general medical condition, cautious medical workup should be mandatory in such patients. Differential diagnosis must consider conditions as diverse as renal failure or CNS infection. Acute Chlamydia pneumoniae infection usually causes a self-limited respiratory syndrome. Rarely, acute neurological complications occur, with acute meningoencephalitis most frequently reported. Diagnosis requires a high level of suspicion and is difficult to confirm. Case report We describe a 22 year-old female Caucasian who, three days after a mild pharingitis, developed an acute psychosis with exuberant symptoms interspersed with periods of lucidity, in a background of normal consciousness and orientation. Initial medical and imagiological workup were inconclusive. After 20 days of unsuccessful treatment with antipsychotics she developed a high fever and was re-evaluated medically. Lumbar puncture revealed an inflammatory cerebrospinal fluid. MRI showed irregular thickening and nodularity of the lateral ventricles' lining. An anti-Chlamydia pneumoniae IgM antibody titter of 85 IU/ml was detected. All symptoms cleared after treatment with antibiotics and corticosteroids. Conclusion This is, to our knowledge, the first reported case of acute CP-associated meningoencephalitis manifesting as an acute psychotic episode. It illustrates the principle that non-organic psychiatric syndromes must remain a diagnosis of exclusion in first-time acute psychosis. PMID:16164756

  19. The course of neuropsychological impairment and brain structure abnormalities in psychotic disorders.

    PubMed

    Woodward, Neil D

    2016-01-01

    Neuropsychological impairment and abnormalities in brain structure are commonly observed in psychotic disorders, including schizophrenia and bipolar disorder. Shared deficits in neuropsychological functioning and abnormalities in brain structure suggest overlapping neuropathology between schizophrenia and bipolar disorder which has important implications for psychiatric nosology, treatment, and our understanding of the etiology of psychotic illnesses. However, the emergence and trajectory of brain dysfunction in psychotic disorders is less well understood. Differences in the course and progression of neuropsychological impairment and brain abnormalities among psychotic disorders may point to unique neuropathological processes. This article reviews the course of neuropsychological impairment and brain structure abnormalities in schizophrenia and bipolar disorder.

  20. Subjective Symptoms in Euthymic Bipolar Disorder and Remitted Schizophrenia Patients: A Comparative Study

    PubMed Central

    Kumar, Manish; Sinha, Vinod Kumar; Mondal, Anwesha

    2016-01-01

    Background: Subjective experience means subtle, not yet psychotic abnormalities of experience that might be present during remitted phase and also in prodromal phase of schizophrenia and might be accurately efficient in identifying individuals at risk of eminent psychosis (Parnas et al., 2003). Apart from schizophrenic patients, bipolar patients also experience certain subjective symptoms in their euthymic state. They often experience subtle cognitive impairment and functional disturbances during their euthymic states. These subjective experiences may be related to distorted cognitive functions in these patients. These experiences include a great variety of cognitive dysfunction complaints about attention, perception, memory, thinking, language, movement, and emotion. Objective: To measure the experience of subjective symptoms and compare them between euthymic bipolar and remitted schizophrenia patients. Materials and Methods: Thirty euthymic bipolar patients and 30 remitted schizophrenia patients as per International Classification of Diseases Tenth Revision were selected for the purpose of the study. At first, sociodemographic data were collected. And then, the patients were assessed using the scales; positive and negative syndrome scale, Young Mania Rating Scale, Hamilton Depression Rating Scale, Symptom Checklist-90-Revised, and Frankfurt Complaint Questionnaire-24. Results: Both the groups showed significant differences in terms of subjective symptoms. However, no significant correlation has been found between the objective psychopathology and subjective experience in the two groups. Conclusion: It can be suggested that the patients with schizophrenia show significantly higher subjective experience when compared with the patients of bipolar disorder. PMID:27114621

  1. The prodromal stage of psychotic illness: Observation, detection or intervention?

    PubMed Central

    Addington, Jean

    2003-01-01

    Accurate identification of individuals in the earliest symptomatic stages of psychosis offers perhaps the best hope for more effective treatment strategies. Recently, research clinics have been set up to identify and possibly treat individuals who are seen as being at high risk of a psychotic disorder. However, there have been concerns about beginning treatment at this stage. We need to address these concerns so that individuals who are at risk of psychosis come to no harm, yet the development of potential interventions is not delayed. This article briefly reviews some of the newer developments and concerns in this area of psychosis research. PMID:12670126

  2. [Psychotic states in young migrants and children of migrants].

    PubMed

    Baubet, T; Taïeb, O; Guillaume, J; Moro, M R

    2009-12-01

    Psychiatric literature documenting increased rates of psychotic illness among migrants in European countries has been more and more reported during the past two decades. Social causes to this phenomenon have been highlighted. In this paper, we review and discuss this literature from the cultural psychiatry perspective. We can point three limitations to these works : the definition of the studied groups, the cultural validity diagnoses, and the psychic impact of migration and its complexity not being considered enough. The above considerations lead us to go forward with studies addressing this question. The need to construct methodologies addressing psychiatric epidemiology, transcultural psychiatry and human sciences is underlined.

  3. Incautious Reasoning as a Pathogenetic Factor for the Development of Psychotic Symptoms in Schizophrenia

    PubMed Central

    Moritz, Steffen; Woodward, Todd S; Hausmann, Daniel

    2006-01-01

    Previous studies indicate that schizophrenia patients draw decisions more hastily than controls. The aim of the present study was to obtain convergent evidence with a new paradigm, designed after the Who Wants to Be a Millionaire television game show. Thirty-two schizophrenia patients and 38 healthy subjects were administered 20 knowledge questions, along with 4 response alternatives. Participants were required to provide probability estimates for each alternative. Whenever a subject was confident that one of the alternatives was correct or was wrong, the subject was asked to indicate this via a decision or rejection rating. Thus, probability estimates and decisions were independently assessed, allowing determination of the point at which probability estimates translate into decisions. Patients and controls gave comparable probability estimates for all alternatives. However, patients committed more erroneous responses, owing to their making decisions in the face of low subjective probability ratings and rejecting alternatives despite rather high probability ratings. The results provide further evidence for the claim that schizophrenia patients make strong judgments based on little information. We propose that a lowered threshold for accepting alternatives provides a parsimonious explanation for the data-gathering bias reported in the literature. PMID:16339971

  4. Friends and Symptom Dimensions in Patients with Psychosis: A Pooled Analysis

    PubMed Central

    Giacco, Domenico; McCabe, Rose; Kallert, Thomas; Hansson, Lars; Fiorillo, Andrea; Priebe, Stefan

    2012-01-01

    Background Having friends is associated with more favourable clinical outcomes and a higher quality of life in mental disorders. Patients with schizophrenia have fewer friends than other mentally ill patients. No large scale studies have evaluated so far what symptom dimensions of schizophrenia are associated with the lack of friendships. Methods Data from four multi-centre studies on outpatients with schizophrenia and related disorders (ICD F20-29) were included in a pooled analysis (N = 1396). We established whether patients had close friends and contact with friends by using the equivalent items on friendships of the Manchester Short Assessment of Quality of Life or of the Lancashire Quality of Life Profile. Symptoms were measured by the Brief Psychiatric Rating Scale or by the identical items included in the Positive and Negative Syndrome Scale. Results Seven hundred and sixty-nine patients (55.1%) had seen a friend in the previous week and 917 (65.7%) had someone they regarded as a close friend. Low levels of negative symptoms and hostility were significantly associated with having a close friend and contact with a friend. Overall, almost twice as many patients with absent or mild negative symptoms had met a friend in the last week, compared with those with moderate negative symptoms. Conclusions Higher levels of negative symptoms and hostility are specifically associated with the lack of friendships in patients with psychotic disorders. These findings suggest the importance of developing effective treatments for negative symptoms and hostility in order to improve the probability of patients with schizophrenia to have friends. PMID:23185552

  5. Anthrax: Symptoms

    MedlinePlus

    ... and cause severe illness and even death. Cutaneous anthrax symptoms can include: A group of small blisters ... on the face, neck, arms, or hands Inhalation anthrax symptoms can include: Fever and chills Chest Discomfort ...

  6. The association between duration of untreated psychosis in first psychotic episode patients and help seeking behaviors in Jogjakarta, Indonesia

    PubMed Central

    Marchira, Carla R.; Supriyanto, Irwan; Subandi; Soewadi; Good, Byron J.

    2016-01-01

    ABSTRACT Help seeking is predictor of prognosis in the first episode of psychotic disorders. Caregivers play a key role in deciding from whom to seek help. In Indonesia, caregivers often seek help from alternative healers first and health professionals later, which is believed to result in delayed psychiatric treatment and risk for poor prognosis. This study measured the duration of untreated psychosis (DUP) in a sample of 100 persons being treated for a first episode of psychosis in Yogyakarta, Indonesia. We attempted to measure and determine associations among caregivers’ explanatory models, help seeking behaviors and DUP in this sample. The data were then statistically analyzed. The DUP for this population was very short. Most caregivers were parents or spouses (72 and 12%, respectively) and at the time of being interviewed described medical explanatory models for the psychotic symptoms (60%). A majority described having visited traditional/alternative healers prior to their visit to health professionals (67%). Despite this, the DUP was not significantly different for these two groups. Thus, first resort to traditional/alternative healers did not predict prolonged DUP. Further study with a larger sample is needed to better understand the relationship between care seeking, use of alternative healers and DUP in Indonesia. PMID:27226809

  7. Early Therapeutic Alliance, Treatment Retention, and 12-Month Outcomes in a Healthy Lifestyles Intervention for People with Psychotic Disorders.

    PubMed

    Andrews, Michelle; Baker, Amanda L; Halpin, Sean A; Lewin, Terry J; Richmond, Robyn; Kay-Lambkin, Frances J; Filia, Sacha L; Castle, David; Williams, Jill M; Clark, Vanessa; Callister, Robin

    2016-12-01

    Engaging and retaining individuals with psychotic disorders in psychosocial treatments is difficult. Early therapeutic alliance, treatment retention, and 12-month outcomes were examined in a subsample of smokers with a psychotic disorder (N = 178) participating in a healthy lifestyles study comparing a telephone versus face-to-face delivered intervention. Therapeutic alliance was assessed using the Agnew Relationship Measure; primary outcomes were treatment retention and changes in symptoms and health behaviors. Contrary to expectations, early alliance did not predict treatment retention. However, elements of both client- and therapist-rated alliance predicted some clinical outcomes (e.g., higher confidence in the therapeutic alliance at session 1 predicted improvements in 12-month depression). Some modest interactions between early alliance and intervention condition were also identified (e.g., clients initially with lower self-perceived initiative, or higher therapist-perceived bonding benefited preferentially from the telephone-delivered intervention), highlighting the need to further examine the interplay between therapeutic alliance and treatment modality.

  8. [Schizophrenia and other psychotic disorders in DSM-5: summary of the changes compared to DSM-IV].

    PubMed

    Paulzen, M; Schneider, F

    2014-05-01

    With the introduction of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) numerous changes in the area of the schizophrenia spectrum and psychotic disorders have been implemented. Establishing a metastructure based on the characteristics of the spectrum of psychopathological disturbances should improve clarity. The classical subtypes of schizophrenia were eliminated and specific psychopathological dimensions for the assessment of disease severity were added. The special role of Schneiderian first rank symptoms was abandoned and a higher delineation towards schizoaffective disorders is made. The nosological status of catatonia is clarified and occurs together with a consistent use of catatonic disturbances over all chapters. The attenuated psychosis syndrome is added as a new condition for further study. The shared psychotic disorder in the sense of a folie à deux is no longer maintained. However, the initial goal to integrate more disorder-specific etiopathogenetic information into the reconceptualization could not be achieved. Contemporaneously to the development process of DSM-5 the National Institute of Mental Health (NIMH) carried out the research domain criteria project (RDoC) attempting to incorporate the current growth in knowledge of genetics, neurocognitive and cognitive sciences in future diagnostic systems. This article gives an overview of the changes that have been made within the revision process from DSM-IV to DSM-5.

  9. Socio-neuro risk factors for suicidal behavior in criminal offenders with psychotic disorders.

    PubMed

    Harenski, Carla L; Brook, Michael; Kosson, David S; Bustillo, Juan R; Harenski, Keith A; Caldwell, Michael F; Van Rybroek, Gregory J; Koenigs, Michael; Decety, Jean; Thornton, David M; Calhoun, Vince D; Kiehl, Kent A

    2017-01-08

    Relative to the general population, individuals with psychotic disorders have a higher risk of suicide. Suicide risk is also elevated in criminal offenders. Thus, psychotic-disordered individuals with antisocial tendencies may form an especially high-risk group. We built upon prior risk analyses by examining whether neurobehavioral correlates of social cognition were associated with suicidal behavior in criminal offenders with psychotic disorders. We assessed empathic accuracy and brain structure in four groups: (i) incarcerated offenders with psychotic disorders and past suicide attempts, (ii) incarcerated offenders with psychotic disorders and no suicide attempts, (iii) incarcerated offenders without psychotic disorders and (iv) community non-offenders without psychotic disorders. Established suicide risk variables were examined along with empathic accuracy and gray matter in brain regions implicated in social cognition. Relative to the other groups, offenders with psychotic disorders and suicide attempts had lower empathic accuracy and smaller temporal pole volumes. Empathic accuracy and temporal pole volumes were significantly associated with suicide attempts independent of other risk variables. The results indicate that brain and behavioral correlates of social cognition may add incremental value to models of suicide risk.

  10. Staff Knowledge of the Side Effects of Anti-Psychotic Medication

    ERIC Educational Resources Information Center

    Fretwell, Christine; Felce, David

    2007-01-01

    Background: Anti-psychotic medications are widely prescribed to people with intellectual disabilities and have a range of negative side effects. The aim was to identify the level of knowledge of anti-psychotic medications and their side effects among key carers or home managers of adults with intellectual disabilities living in residential group…

  11. Prevalence and correlates of psychotic experiences amongst children of depressed parents.

    PubMed

    Bevan Jones, Rhys; Mars, Becky; Collishaw, Stephan; Potter, Robert; Thapar, Ajay; Craddock, Nick; Thapar, Anita; Zammit, Stanley

    2016-09-30

    Psychotic experiences in young people are substantially more common than psychotic disorders, and are associated with distress and functional impairment. Family history of depression as well as of schizophrenia increases risk for psychotic experiences, but the prevalence of such experiences and their clinical relevance in offspring of depressed parents is unknown. Our objectives were to explore i) the prevalence of psychotic experiences amongst offspring of parents with recurrent unipolar depression and ii) the relationship between psychotic experiences and other psychopathology. Data were drawn from the 'Early Prediction of Adolescent Depression' longitudinal study of high-risk offspring (aged 9-17 years at baseline) of 337 parents with recurrent depression. Three assessments were conducted over four years. Psychopathology was assessed using the Child and Adolescent Psychiatric Assessment. Seventy-eight percent of families (n=262) had complete data on psychotic experiences at each of the three time points. During the study, 8.4% (n=22; 95% CI 5.0%, 11.8%) of offspring reported psychotic experiences on at least one occasion, and these were associated with psychiatric disorder, specifically mood and disruptive disorders, and suicidal thoughts/behaviour. Psychotic experiences amongst offspring of depressed parents index a range of psychopathology. Further research is needed to examine their clinical significance and long-term consequences.

  12. The Ice Cream Stories: A Study in Normal and Psychotic Narrations.

    ERIC Educational Resources Information Center

    Chaika, Elaine; Alexander, Paul

    1986-01-01

    Indicates that the psychotic and normal populations showed definable differences in encoding strategies when presented with an adaption of the Pear Stories study. Supports theories claiming that faulty filtering mechanisms, vulnerability to distraction, and attentional deficits account for psychotic subjects' reactions. (JD)

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

    PubMed

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

    2017-01-01

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

  14. Midline Brain Abnormalities Across Psychotic and Mood Disorders.

    PubMed

    Landin-Romero, Ramón; Amann, Benedikt L; Sarró, Salvador; Guerrero-Pedraza, Amalia; Vicens, Victor; Rodriguez-Cano, Elena; Vieta, Eduard; Salvador, Raymond; Pomarol-Clotet, Edith; Radua, Joaquim

    2016-01-01

    Patients with schizophrenia are known to have increased prevalence of abnormalities in midline brain structures, such as a failure of the septum pellucidum to fuse (cavum septum pellucidum) and the absence of the adhesio interthalamica. This is the first study to investigate the prevalence of these abnormalities across a large multidiagnostic sample. Presence of cavum septum pellucidum and absence of the adhesio interthalamica was assessed in 639 patients with chronic schizophrenia, delusional disorder, schizoaffective disorder, bipolar disorder, major depressive disorder, or a first episode of psychosis, mania or unipolar depression. This was compared with 223 healthy controls using logistic-regression-derived odds ratios (OR). Patients with psychotic or mood disorders showed an increased prevalence of both abnormalities (OR of cavum septum pellucidum = 2.1, OR of absence of the adhesio interthalamica = 2.6, OR of both cavum septum pellucidum and absence of the adhesio interthalamica = 3.8, all P < .001). This increased prevalence was separately observed in nearly all disorders as well as after controlling for potential confounding factors. This study supports a general increased prevalence of midline brain abnormalities across mood and psychotic disorders. This nonspecificity may suggest that these disorders share a common neurodevelopmental etiology.

  15. The advantages of "Dance-group" for psychotic patients.

    PubMed

    Tavormina, Romina; Tavormina, Maurilio Giuseppe Maria; Nemoianni, Eugenio

    2014-11-01

    Psychosocial rehabilitation and in particular group dances allow the recovery of lost or compromised ability of patients with mental illness, and they facilitate their reintegration into the social context. The dance group has enabled users of the Day Centre of the Unit of Mental Health Torre del Greco ASL NA 3 south to achieve the objectives of rehabilitation such as: taking care of themselves, of their bodies and their interests, improving self-esteem , the management of pathological emotions, socialization and integration, overcoming the psychotic closing and relational isolation. In particular, patients with schizophrenia, psychotic and mood disorders had a concrete benefit from such rehabilitation activities, facilitating interpersonal relationships, therapy compliance and significantly improved mood, quality of life, providing them with the rhythm and the security in their relationship with each other. The dance group and for some individuals, also psychotherapy and drug therapy, have facilitated social inclusion, improved the quality of life and cured their diseases. The work is carrying out in a group with patients, practitioners, family members, volunteers, social community workers, following the operating departmental protocols. Using the chorus group "Sing that you go" as an operational tool for psychosocial rehabilitation and therapeutic element we promote the psychological well-being and the enhancement of mood.

  16. Midline Brain Abnormalities Across Psychotic and Mood Disorders

    PubMed Central

    Landin-Romero, Ramón; Amann, Benedikt L.; Sarró, Salvador; Guerrero-Pedraza, Amalia; Vicens, Victor; Rodriguez-Cano, Elena; Vieta, Eduard; Salvador, Raymond; Pomarol-Clotet, Edith; Radua, Joaquim

    2016-01-01

    Patients with schizophrenia are known to have increased prevalence of abnormalities in midline brain structures, such as a failure of the septum pellucidum to fuse (cavum septum pellucidum) and the absence of the adhesio interthalamica. This is the first study to investigate the prevalence of these abnormalities across a large multidiagnostic sample. Presence of cavum septum pellucidum and absence of the adhesio interthalamica was assessed in 639 patients with chronic schizophrenia, delusional disorder, schizoaffective disorder, bipolar disorder, major depressive disorder, or a first episode of psychosis, mania or unipolar depression. This was compared with 223 healthy controls using logistic-regression-derived odds ratios (OR). Patients with psychotic or mood disorders showed an increased prevalence of both abnormalities (OR of cavum septum pellucidum = 2.1, OR of absence of the adhesio interthalamica = 2.6, OR of both cavum septum pellucidum and absence of the adhesio interthalamica = 3.8, all P < .001). This increased prevalence was separately observed in nearly all disorders as well as after controlling for potential confounding factors. This study supports a general increased prevalence of midline brain abnormalities across mood and psychotic disorders. This nonspecificity may suggest that these disorders share a common neurodevelopmental etiology. PMID:26187283

  17. Relationship between cognition, clinical and cognitive insight in psychotic disorders: a review and meta-analysis.

    PubMed

    Nair, Akshay; Palmer, Emma Claire; Aleman, André; David, Anthony S

    2014-01-01

    The neurocognitive theory of insight posits that poor insight in psychotic illnesses is related to cognitive deficits in cognitive self-appraisal mechanisms. In this paper we perform a comprehensive meta-analysis examining relationships between clinical insight and neurocognition in psychotic disorders. We have also completed a meta-analysis of studies examining 'cognitive insight', as measured by the Beck Cognitive Insight Scale (BCIS), and its relationship with neurocognitive function in patients with psychosis. The clinical insight analysis included data from 72 studies and a total population of 5429 patients. We found that insight in psychosis was significantly associated with total cognition (r=0.16, p<0.001), IQ (r=0.16, p<0.001), memory (r=0.13, p<0.001) and executive function (r=0.14, p<0.001). All of these correlations were stronger when examined in patients with schizophrenia only. In the BCIS analysis we included 7 studies and 466 patients in total. We found that no significant associations were found between the self-reflectiveness sub-component and neurocognition. By contrast there were significant correlations between the self-certainty subcomponent and memory (r=-0.23, p<0.001), IQ (r=-0.19, p<0.001) and total cognition (r=-0.14, p=0.01). We did not find evidence of significant publication bias in any analyses. Overall, our results indicate that there is a small but significant relationship between clinical insight, some aspects of cognitive insight and neurocognition. These findings reflect the complexity of the insight construct and indicate that while the neurocognitive model is important it is likely to be one of many which contribute to the understanding of this phenomenon.

  18. Generalized and specific neurocognitive deficits in psychotic disorders: utility for evaluating pharmacological treatment effects and as intermediate phenotypes for gene discovery.

    PubMed

    Reilly, James L; Sweeney, John A

    2014-05-01

    A growing body of research suggests that schizophrenia and bipolar disorder share overlapping clinical, neurobiological, and genetic features, raising important questions about the boundaries and distinctiveness of these 2 major psychiatric disorders. A generalized cognitive impairment has long been understood to be a core feature of schizophrenia. More recently, it has become apparent that cognitive impairment also occurs in bipolar disorder, particularly in those patients with a history of psychotic symptoms. Whether a generalized deficit exists across a spectrum of psychotic disorders is less clearly established. Additionally, in the context of a broad impairment, it remains a significant challenge to identify deficits in specific cognitive processes that may have distinct neurochemical or regional brain substrates and linkages to particular risk-associated genetic factors. In this article, we review the findings from neuropsychological studies across a spectrum that includes schizophrenia, schizoaffective and bipolar disorders, and conclude the available evidence strongly supports that a generalized deficit is present across psychotic disorders that differs in severity more so than form. We then consider the implications of generalized and specific deficits in psychosis for 2 areas of research--the evaluation of pharmacological treatments targeting cognitive deficits, and the investigation of cognitive intermediate phenotypes in family genetic studies. Examples from the literature that touch on the relevance of the generalized deficit in these contexts are provided, as well as consideration for the continued need to identify specific impairments that are separable from the generalized deficit in order to advance drug and gene discovery.

  19. Current developments and challenges in the assessment of negative symptoms.

    PubMed

    Lincoln, Tania M; Dollfus, Sonia; Lyne, John

    2016-03-05

    Reliable and valid assessment of negative symptoms is crucial to further develop etiological models and improve treatments. Our understanding of the concept of negative symptoms has undergone significant advances since the introduction of quantitative assessments of negative symptoms in the 1980s. These include the conceptualization of cognitive dysfunction as separate from negative symptoms and the distinction of two main negative symptom factors (avolition and diminished expression). In this review we provide an overview of existing negative symptom scales, focusing on both observer-rated and self-rated measurement of negative symptoms. We also distinguish between measures that assess negative symptoms as part of a broader assessment of schizophrenia symptoms, those specifically developed for negative symptoms and those that assess specific domains of negative symptoms within and beyond the context of psychotic disorders. We critically discuss strengths and limitations of these measures in the light of some existing challenges, i.e. observed and subjective symptom experiences, the challenge of distinguishing between primary and secondary negative symptoms, and the overlap between negative symptoms and related factors (e.g. personality traits and premorbid functioning). This review is aimed to inform the ongoing development of negative symptom scales.

  20. Bullying Mediates Between Attention-Deficit/Hyperactivity Disorder in Childhood and Psychotic Experiences in Early Adolescence.

    PubMed

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

    2016-11-01

    Although a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) is known to be linked to psychotic experiences and psychotic disorders in later life, the developmental trajectories that could explain this association are unknown. Using a sample from the prospective population-based Avon Longitudinal Study of Parents and Children (ALSPAC) (N = 8247), we hypothesized that the previously reported association of ADHD combined subtype in childhood and psychotic experiences in early adolescence is mediated by traumatic events and by involvement in bullying. Moreover, we expected this mediation to be specific to ADHD and tested this by comparison with specific phobia. Children with ADHD combined subtype at age 7 were more often involved in bullying at age 10 (OR 3.635, 95% CI 1.973-6.697) and had more psychotic experiences at age 12 (OR 3.362, 95% CI 1.781-6.348). Moreover, children who were involved in bullying had more psychotic experiences (2.005, 95% CI 1.684-2.388). Bullying was a significant mediator between ADHD and psychotic experiences accounting for 41%-50% of the effect. Traumatic events from birth to age 11 were also significantly associated with ADHD combined subtype and psychotic experiences; however, there was no evidence of mediation. Specific phobia was significantly associated with psychotic experiences, but not with bullying. To conclude, bullying is a relevant translating mechanism from ADHD in childhood to psychotic experiences in early adolescence. Interventions that eliminate bullying in children with ADHD could potentially reduce the risk of having psychotic experiences in later life by up to 50%. Clinicians should thus screen for bullying in routine assessments of children with ADHD.

  1. A Population-Based Study of Genetic Variation and Psychotic Experiences in Adolescents

    PubMed Central

    Zammit, Stanley; Hamshere, Marian; Dwyer, Sarah; Georgiva, Lyudmila; Timpson, Nic; Moskvina, Valentina; Richards, Alexander; Evans, David M; Lewis, Glyn; Jones, Peter; Owen, Michael J.; O’Donovan, Michael C.

    2014-01-01

    Psychotic experiences are not uncommon in general population samples, but no studies have examined to what extent confirmed risk variants for schizophrenia are associated with such experiences. A total of 3483 children in a birth cohort study participated in semistructured interviews for psychotic experiences at ages 12 and 18. We examined whether (1) a composite measure of risk for schizophrenia conferred by common alleles (polygenic score) was associated with psychotic experiences, (2) variants with genome-wide evidence for association with schizophrenia were associated with psychotic experiences, and (3) we could identify genetic variants for psychotic experiences using a genome-wide association (GWA) approach. We found no evidence that a schizophrenia polygenic score, or variants showing genome-wide evidence of association with schizophrenia, were associated with adolescent psychotic experiences within the general population. In fact, individuals who had a higher number of risk alleles for genome-wide hits for schizophrenia showed a decreased risk of psychotic experiences. In the GWA study, no variants showed GWA for psychotic experiences, and there was no evidence that the strongest hits (P < 5 × 10−5) were enriched for variants associated with schizophrenia in large consortia. Although polygenic scores are weak tools for prediction of schizophrenia, they show strong evidence of association with this disorder. Our findings, however, lend little support to the hypothesis that psychotic experiences in population-based samples of adolescents share a comparable genetic architecture to schizophrenia, or that utilizing a broader and more common phenotype of psychotic experiences will be an efficient approach to increase understanding of the genetic etiology of schizophrenia. PMID:24174267

  2. Anti-NMDAR antibodies in new-onset psychosis. Positive results in an HIV-infected patient.

    PubMed

    Arboleya, Susana; Clemente, Antonio; Deng, Savannah; Bedmar, Marta; Salvador, Isabel; Herbera, Patricia; Cunill, Vanessa; Vives-Bauza, Cristòfol; Haro, Josep Maria; Canellas, Francesca; Julià, Maria Rosa

    2016-08-01

    The role of neuronal surface autoantibodies (NSAs) in non-encephalitic psychosis is of recent and controversial interest. Most of the studies relating NSAs with psychosis are retrospective and only focused on the N-methyl-d-aspartate glutamate receptor (NMDAR). Our goal was to evaluate the prevalence of IgG antibodies against the NMDAR NR1 subunit (NMDAR-Abs) along with five additional NSAs in 61 first psychotic episode patients and 47 matched controls. We found two patients positive for NMDAR-Abs (3.3%). One of them was eventually considered to have been misdiagnosed and reclassified as encephalitis. The other met the criteria for bipolar I disorder, presented no neurological symptoms and had a comorbid HIV infection of vertical transmission. This is the first reported case of an HIV-infected patient with psychosis associated with NSAs. This study shows that patients presenting with clinically incomplete forms of anti-NMDAR encephalitis, with predominant or isolated psychiatric symptoms, can remain undetected if no ancillary tests are performed. To improve patient diagnosis and treatment of individuals with a first psychotic episode, more detailed neurological examinations might be needed. Further studies are required to better clarify the role of NSAs in the neuropsychiatric effects of HIV infection.

  3. [The formation of clinical and functional remission during the treatment of non-psychotic depression with escitalopram (lenuxin)].

    PubMed

    Kanaeva, L S; Dashkina, G K

    2013-01-01

    The results of this study showed a high frequency of clinical remission (45.26%) during therapy of 98 patients with non-psychotic d