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Neuroscience and Biobehavioral Reviews Mar 2022Evidence suggests that individuals with autism spectrum disorder have increased rates of co-occurring psychosis and/or bipolar disorder. Considering the peak age of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Evidence suggests that individuals with autism spectrum disorder have increased rates of co-occurring psychosis and/or bipolar disorder. Considering the peak age of onset for psychosis and bipolar disorder occurs in adulthood, we investigated the co-occurrence of these disorders in adults with autism.
METHODS
We conducted a systematic review and meta-analysis (PROSPERO Registration Number: CRD42018104600) to (1) examine the prevalence of psychosis and bipolar disorder in adults with autism, and (2) review potential risk factors associated with their co-occurrence.
RESULTS
Fifty-three studies were included. The pooled prevalence for the co-occurrence of psychosis in adults with autism was 9.4 % (N = 63,657, 95 %CI = 7.52, 11.72). The pooled prevalence for the co-occurrence of bipolar disorders in adults with autism was 7.5 % (N = 31,739, 95 %CI = 5.79, 9.53).
CONCLUSIONS
Psychosis and bipolar disorder occur at a substantially higher prevalence in adults with autism compared to general population estimates. While there is an overall dearth of research examining risk factors for these disorders in autism, males had increased likelihood of co-occurring psychosis, and females of co-occurring bipolar disorder. These results highlight the need for ongoing assessment and monitoring of these disorders in adults with autism.
Topics: Adult; Autism Spectrum Disorder; Autistic Disorder; Bipolar Disorder; Female; Humans; Male; Prevalence; Psychotic Disorders
PubMed: 35063494
DOI: 10.1016/j.neubiorev.2022.104543 -
The Lancet. Psychiatry Nov 2021In foundational texts on schizophrenia, the mental disorder was constitutively linked to a specific disintegration of subjectivity (often termed a self-disorder). Apart...
In foundational texts on schizophrenia, the mental disorder was constitutively linked to a specific disintegration of subjectivity (often termed a self-disorder). Apart from Scharfetter's work on ego-pathology, research on self-disorders generally faded into oblivion, and self-disorders were only rediscovered as notable psychopathological features of the schizophrenia spectrum nearly two decades ago. Subsequently, the Examination of Anomalous Self-Experience (EASE) scale was constructed to allow systematic assessment of non-psychotic self-disorders. This Review is the first systematic review of empirical studies on self-disorders based on the EASE or other related scales. The results consistently show that self-disorders hyper-aggregate in schizophrenia spectrum disorders but not in other mental disorders; that self-disorders are found in individuals at a clinical risk of developing psychosis; that self-disorders show a high degree of temporal stability; that self-disorders predict the later development of schizophrenia spectrum disorders; and that self-disorders correlate with the canonical dimensions of the psychopathology of schizophrenia, impaired social functioning, and suicidality. Issues with the methods of the reviewed literature are critically discussed and the role of self-disorders in clinical psychiatry and future research is outlined.
Topics: Adult; Diagnostic Self Evaluation; Humans; Predictive Value of Tests; Psychopathology; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Self Concept; Social Interaction; Suicidal Ideation; Time Perception
PubMed: 34688345
DOI: 10.1016/S2215-0366(21)00097-3 -
Psychiatry Research Feb 2022Longitudinal studies of substance-induced psychosis (SIP) suggest that approximately 11-46% of persons will progress to schizophrenia with differential risk of... (Review)
Review
Longitudinal studies of substance-induced psychosis (SIP) suggest that approximately 11-46% of persons will progress to schizophrenia with differential risk of progression depending on the type of substance used. The findings suggest SIP may be a distinct variant of a psychotic disorder, yet SIP is understudied and the disease expression is not well characterized, particularly the cognitive phenotype. There is some evidence for cognitive dysfunction in SIP, but a synthesis of this literature has not been undertaken. We systematically reviewed all empirical research (up to December 31, 2020) that examined cognition in SIP using clinical neuropsychological measures. The cognitive outcomes are summarized by type of SIP (methamphetamine, other stimulants, alcohol, cannabis, undifferentiated). There was evidence for global and domain-specific cognitive dysfunction in SIP compared to controls and non-psychotic persons who use substances. Impairments were of similar magnitude compared to persons with schizophrenia. Delineation of a specific cognitive profile in SIP was precluded by lack of literature with comparable study designs and outcomes. Variation in visual-based cognition may be a distinct feature of SIP, but this requires further investigation. More rigorously controlled studies of cognition in SIP are needed to inform differential diagnosis and identify the unique clinical needs of this population.
Topics: Central Nervous System Stimulants; Cognition; Cognitive Dysfunction; Humans; Neuropsychological Tests; Psychotic Disorders; Schizophrenia
PubMed: 34979380
DOI: 10.1016/j.psychres.2021.114361 -
Revista de Psiquiatria Y Salud Mental 2021Schizoaffective disorder is defined by the appearance of positive psychotic symptomatology as well as affective features, even when it is considered a controversial... (Review)
Review
Schizoaffective disorder is defined by the appearance of positive psychotic symptomatology as well as affective features, even when it is considered a controversial nosologic entity, proving difficult to accord on its definition or diagnostic criteria. Due to these conceptual differences, it has been a challenge to study effective therapeutic measures and, consequently, the availability of data in the current literature, resulting in the extrapolation of clinical guidelines and recommendations initially established for patients with schizophrenia or bipolar disorder. The current study aimed to systematically search and summarize the published evidence to date about the use of clozapine in patients with schizoaffective disorder. Seven studies were identified, that are heterogeneous on their designs and methodology, including samples of patients mixed with bipolar or schizophrenic disorders. The evidence was summarized both in a table and a narrative fashion, suggesting that clozapine may be an effective treatment for both psychotic and affective symptoms, indistinctively of an acute or maintenance phase.
Topics: Bipolar Disorder; Clozapine; Humans; Psychotic Disorders; Schizophrenia; Treatment Outcome
PubMed: 34400122
DOI: 10.1016/j.rpsmen.2021.07.001 -
BMC Psychiatry Nov 2019Schizophrenia and other psychotic disorders constitute a huge global burden of disease and they are major contributors to disability as well as premature mortality among... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Schizophrenia and other psychotic disorders constitute a huge global burden of disease and they are major contributors to disability as well as premature mortality among homeless people. This systematic review and meta-analysis aimed to estimate the pooled prevalence of schizophrenia and other psychotic disorders among homeless people.
METHODS
PubMed, Embase, and Scopus were searched to identify pertinent studies. We used a fixed- or random-effect meta-analysis to pool data from the included studies depending on the anticipated heterogeneity. A predesigned search strategy, as well as inclusion and exclusion criteria, were used. We also performed subgroup and sensitivity analysis and Cochran's Q- and the I test was employed to compute heterogeneity. Egger's test and visual inspection of the symmetry in funnel plots were used to assess publication bias.
RESULTS
Thirty-one studies involving 51,925 homeless people were included in the final analysis. The meta-analysis showed a remarkably higher prevalence of psychosis [21.21% (95% CI:13.73, 31.29), I = 99.43%], schizophrenia [10.29% (95%, CI: 6.44, 16.02), I = 98.76%], schizophreniform disorder [2.48% (95% CI: 6.16, 28.11), I = 88.84%] schizoaffective disorder [3.53% (95% CI: 1.33, 9.05), I = 31.63%,] as well as psychotic disorders not otherwise specified [9% (95% CI: 6.92, 11.62), I = 33.38%] among homeless people. The prevalence estimate of psychosis was higher in developing (29.16%) as compared to developed (18.80%) countries. Similarly, the prevalence of schizophrenia was highest in developing (22.15%) than developed (8.83%) countries.
CONCLUSION
This systematic review and meta-analysis revealed that schizophrenia and other psychotic disorders are highly prevalent among homeless people, indicating an urgent need for studies to help develop better mechanisms of prevention, detection as well as treatment of those disorders among homeless people.
Topics: Female; Ill-Housed Persons; Humans; Male; Prevalence; Psychotic Disorders; Schizophrenia
PubMed: 31775786
DOI: 10.1186/s12888-019-2361-7 -
The International Journal of Social... Mar 2023Schizoaffective psychosis is a severe and chronic psychiatric disorder defined by the presence of mood symptoms, like mania and/or depression and schizophrenia, such as... (Review)
Review
BACKGROUND
Schizoaffective psychosis is a severe and chronic psychiatric disorder defined by the presence of mood symptoms, like mania and/or depression and schizophrenia, such as hallucinations and/or delusions.
AIMS
We aim to find out whether there is a correlation between schizoaffective psychosis and being homeless.
METHOD
To do so, a literature search was carried out in the PubMed platform in April 2022, using the keywords 'schizoaffective' and 'homeless'.
RESULTS
In this review, 28 articles from this search were included. Intrinsic characteristics, rates of psychiatric readmission, prediction of homelessness, medication noncompliance, and substance use were explored, as they were the main themes of the results.
CONCLUSIONS
The homeless population suffers from great diagnostic variability and the diagnosis schizoaffective psychosis is still evolving contributing to such diagnostic and treatment difficulties. Their frequent visits to the healthcare services, especially emergency room leads to consequent interaction with multiple healthcare professionals, resulting in a myriad of diagnoses, with clinical remission and therapeutic goals not being attained. More studies are necessary for a better evaluation of this super difficult population.
Topics: Humans; Psychotic Disorders; Schizophrenia; Hallucinations; Ill-Housed Persons
PubMed: 36317594
DOI: 10.1177/00207640221131247 -
PloS One 2018The purpose of this study is to provide an updated systematic review to identify studies describing the prevalence of psychosis in order to explore methodological... (Review)
Review
OBJECTIVES
The purpose of this study is to provide an updated systematic review to identify studies describing the prevalence of psychosis in order to explore methodological factors that could account for the variation in prevalence estimates.
METHODS
Studies with original data related to the prevalence of psychosis (published between 1990 and 2015) were identified via searching electronic databases and reviewing manual citations. Prevalence estimates were sorted according to prevalence type (point, 12-months and lifetime). The independent association between key methodological variables and the mean effect of prevalence was examined (prevalence type, case-finding setting, method of confirming diagnosis, international classification of diseases, diagnosis category, and study quality) by meta-analytical techniques and random-effects meta-regression.
RESULTS
Seventy-three primary studies were included, providing a total of 101 estimates of prevalence rates of psychosis. Across these studies, the pooled median point and 12-month prevalence for persons was 3.89 and 4.03 per 1000 respectively; and the median lifetime prevalence was 7.49 per 1000. The result of the random-effects meta-regression analysis revealed a significant effect for the prevalence type, with higher rates of lifetime prevalence than 12-month prevalence (p<0.001). Studies conducted in the general population presented higher prevalence rates than those carried out in populations attended in health/social services (p = 0.006). Compared to the diagnosis of schizophrenia only, prevalence rates were higher in the probable psychotic disorder (p = 0.022) and non-affective psychosis (p = 0.009). Finally, a higher study quality is associated with a lower estimated prevalence of psychotic disorders (p<0.001).
CONCLUSIONS
This systematic review provides a comprehensive comparison of methodologies used in studies of the prevalence of psychosis, which can provide insightful information for future epidemiological studies in adopting the most relevant methodological approach.
Topics: Epidemiologic Studies; Humans; Prevalence; Psychotic Disorders
PubMed: 29649252
DOI: 10.1371/journal.pone.0195687 -
Psychological Medicine Apr 2015Schizotypy is a complex concept, commonly defined as a genetic vulnerability to schizophrenia that falls on a continuum between healthy variation and severe mental... (Review)
Review
BACKGROUND
Schizotypy is a complex concept, commonly defined as a genetic vulnerability to schizophrenia that falls on a continuum between healthy variation and severe mental illness. There is a growing body of evidence supporting an association between childhood trauma and increased psychotic experiences and disorders. However, the evidence as to whether there is a similar association with schizotypy has yet to be systematically synthesized and assessed.
METHOD
We conducted a systematic search of published articles on the association between childhood trauma and schizotypy in four major databases. The search covered articles from 1806 to 1 March 2013 and resulted in 17,003 articles in total. Twenty-five original research studies met the eligibility criteria and were included in this review.
RESULTS
All 25 studies supported the association between at least one type of trauma and schizotypy, with odds ratios (ORs) ranging between 2.01 and 4.15. There was evidence supporting the association for all types of trauma, with no differential effects. However, there was some variability in the quality of the studies, with most using cross-sectional designs. Individuals who reported adverse experiences in childhood scored significantly higher on positive and negative/disorganized schizotypy compared to those who did not report such experiences.
CONCLUSIONS
All forms of childhood trauma and other stressful events (e.g. bullying) were found to be associated with schizotypy, with especially strong associations with positive schizotypy. However, because of the methodological limitations of several studies and a lack of further exploration of different possible mechanistic pathways underlying this association, more research is required.
Topics: Adult Survivors of Child Abuse; Adult Survivors of Child Adverse Events; Humans; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Schizotypal Personality Disorder
PubMed: 25273151
DOI: 10.1017/S0033291714002086 -
International Psychogeriatrics Oct 2022The primary aim was to systematically review the literature regarding the effectiveness of clozapine in reducing symptoms of primary psychotic and bipolar disorders in... (Review)
Review
OBJECTIVES
The primary aim was to systematically review the literature regarding the effectiveness of clozapine in reducing symptoms of primary psychotic and bipolar disorders in older adults. The secondary aim was to describe other reported patient and caregiver outcomes of clozapine treatment in older adults.
DESIGN
MEDLINE, Embase, PsychINFO, ProQuest, and PubMed databases were searched according to PRISMA guidelines for original empirical research examining the effectiveness of clozapine in adults aged 65 years or more with primary psychotic and bipolar disorders. Identified studies were assessed for methodological quality using the QualSyst tool.
RESULTS
1121 records were screened, of which 7 studies met the inclusion criteria. In total, 128 subjects participated in the included studies (111 of whom were from a single study), with an age range of 65-86 years, and diagnoses including schizophrenia, schizoaffective disorder, bipolar disorder, and delusional disorder. Indications for clozapine use included treatment resistance and inability to tolerate other treatments. While six out of seven studies reported some improvement on the primary measure of psychopathology after treatment with clozapine, the group effects were modest and based on low-level evidence. Additional reported outcomes included discharge destination, death, and relapse. Most of the included studies were only of adequate methodological quality, with significant risks of bias identified.
CONCLUSIONS
Clozapine may have positive effects for primary psychotic and bipolar illnesses in some older adults, but the group effects reported were modest and based on low-level evidence studies with methodological limitations. Based on these findings, clinical decision-making about whether or not to trial clozapine should involve an individualized analysis of potential benefits and risks in collaboration with patients and their families and caregivers.
Topics: Aged; Aged, 80 and over; Antipsychotic Agents; Bipolar Disorder; Clozapine; Humans; Psychotic Disorders; Schizophrenia
PubMed: 33612141
DOI: 10.1017/S1041610220004172 -
Revista Espanola de Sanidad... 2023Autism is a neurodevelopmental disorder characterized by intolerance of change, empathy deficits, misunders- tandings, and emotional dysregulation. Core symptoms can...
INTRODUCTION
Autism is a neurodevelopmental disorder characterized by intolerance of change, empathy deficits, misunders- tandings, and emotional dysregulation. Core symptoms can determine criminal behaviour and subsequent interactions with the penal system. A significant presence of such symptoms is detected in forensic settings. The objective of this study is to analyze the characteristics of autism within the prison context, summarizing and updating the knowledge in this field.
MATERIAL AND METHOD
Systematic review through databases on studies that analyze the socio-demographic, clinical, and judi- cial characteristics of prisoners diagnosed with autism spectrum disorder.
RESULTS
Autistic traits constitute an independent risk factor for incarceration. Those inmates with autism spectrum disorder frequently present a psychiatric comorbidity, especially substance use disorder, psychotic disorders, and other neuro-develop- mental disorders. They are associated with a greater probability of self-harming thoughts and disruptive behaviours, which are not predicted by the usual evaluation tools.
DISCUSSION
Prisoners with autism spectrum disorder have a differential socio-demographic, clinical, and criminal profile. A specific approach that is different from the one provided for neurotypical prisoners should be offered to these inmates. In- frastructures should be adapted to reduce fragility, make the environment more flexible and specific methods for evaluation and treatment should be developed.
Topics: Humans; Prisons; Autism Spectrum Disorder; Prisoners; Psychotic Disorders; Autistic Disorder
PubMed: 37335535
DOI: 10.18176/resp.00064