-
Schizophrenia Research Jan 2021To synthesise and investigate how sleep disturbances relate to psychotic symptoms, functioning and Quality of Life (QoL) in At Risk Mental State (ARMS) youth. (Meta-Analysis)
Meta-Analysis Review
AIMS
To synthesise and investigate how sleep disturbances relate to psychotic symptoms, functioning and Quality of Life (QoL) in At Risk Mental State (ARMS) youth.
METHOD
A comprehensive search of six databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science and CENTRAL) was conducted. Eligible studies provided data on sleep disturbances or disorders in ARMS patients.
RESULTS
Sixteen studies met the inclusion criteria (n = 1962 ARMS patients) including 7 cross-sectional studies, 2 RCT's and 7 cohort studies. Narrative synthesis revealed that self-reported sleep (e.g., general disturbances, fragmented night time sleep and nightmares) was poorer among ARMS patients compared to healthy controls. In the limited studies (n = 4) including objective measurements of sleep disturbances, ARMS patients experienced higher levels of movement during sleep, more daytime naps and increased sleep latency compared to controls. Furthermore, sleep disturbances were associated with attenuated psychotic symptoms and functional outcomes cross-sectionally and longitudinally. Only one study investigated the relationship between sleep and QoL. The exploratory meta-analysis revealed a significant difference in self-reported sleep disturbances measured by the PSQI (mean difference in score: 3.30 (95% CI 1.87, 4.74), p < 0.00001) and SIPS (mean difference in score: 1.58 (95% CI 0.80, 2.35), p < 0.00001) of ARMS patients compared to control groups.
CONCLUSIONS
ARMS individuals report impaired sleep quality and reduced sleep quantity compared to healthy controls. However, further research is needed to explore the longitudinal relationship between sleep disruptions and QoL in early psychosis. Significant variations in how sleep is measured across studies highlight a need to assess disturbances to sleep using robust and consistent approaches in this patient group.
Topics: Adolescent; Cross-Sectional Studies; Humans; Psychotic Disorders; Quality of Life; Sleep; Sleep Wake Disorders
PubMed: 32646803
DOI: 10.1016/j.schres.2020.06.027 -
Psychological Medicine Apr 2018Large amount of data have been published on non-psychotic depression (NPD), schizophrenia (SZ), and bipolar disorder, while psychotic depression (PD) as an own entity... (Meta-Analysis)
Meta-Analysis
Large amount of data have been published on non-psychotic depression (NPD), schizophrenia (SZ), and bipolar disorder, while psychotic depression (PD) as an own entity has received much smaller attention. We performed a systematic review and meta-analyses on epidemiology, especially incidence and prevalence, risk factors, and outcomes of PD. A systematic search to identify potentially relevant studies was conducted using four electronic databases and a manual search. The search identified 1764 unique potentially relevant articles, the final study included 99 articles. We found that the lifetime prevalence of PD varies between 0.35% and 1%, with higher rates in older age. Onset age of PD was earlier than that of NPD in younger samples, but later in older samples. There were no differences in gender distribution in PD v. NPD, but higher proportion of females was found in PD than in SZ or in psychotic bipolar disorder (PBD). Risk factors have rarely been studied, the main finding being that family history of psychosis and bipolar disorder increases the risk of PD. Outcomes of PD were mostly worse when compared with NPD, but better compared with SZ and schizoaffective disorder. The outcome compared with PBD was relatively similar, and somewhat varied depending on the measure of the outcome. Based on this review, the amount of research on PD is far from that of NPD, SZ, and bipolar disorder. Based on our findings, PD seems distinguishable from related disorders and needs more scientific attention.
Topics: Age of Onset; Bipolar Disorder; Depressive Disorder, Major; Humans; Incidence; Psychotic Disorders; Schizophrenia
PubMed: 28893329
DOI: 10.1017/S0033291717002501 -
Schizophrenia Research Nov 2021Vitamin D deficiency is prevalent among people with psychosis and may play a role in the aetiology of psychotic disorders. However, its impact on clinical symptom... (Review)
Review
BACKGROUND
Vitamin D deficiency is prevalent among people with psychosis and may play a role in the aetiology of psychotic disorders. However, its impact on clinical symptom severity has not been independently reviewed.
METHODS
We conducted a systematic search of randomized trials and observational studies that assessed the relationship between vitamin D and symptom domains (positive and negative psychotic symptoms, total and general psychopathology, cognitive and depressive) in people with a psychotic disorder.
RESULTS
1040 articles were identified, of which 29 were eligible for inclusion: 26 observational studies and 3 randomized trials. Five studies included people with First-Episode Psychosis (FEP) and 24 included people with enduring psychosis. Most observational studies found that vitamin D was inversely associated with negative symptoms (57%; 13/23), positively associated with cognitive performance (63%; 5/8), and bore no association with positive symptoms (68%; 15/22), total psychopathology (64%; 7/11), general psychopathology (57%; 4/7) or depressive symptoms (64%; 9/14). Randomized controlled trials indicated that vitamin D supplementation improved cognitive performance (100%; 1/1) and, in some cases, reduced total psychopathology (50%; 1/2), general psychopathology (50%; 1/2) and negative symptoms (30%; 1/3), but had no effect on positive (100%; 3/3) or depressive (100%; 3/3) symptoms. Some positive associations were attenuated when controlled for potential confounders.
CONCLUSION
Low vitamin D was found to be inversely associated with more severe clinical symptoms in some, but not all symptom domains in people with psychosis. These preliminary findings warrant further exploration, particularly in regard to cognitive performance and negative symptoms.
Topics: Humans; Psychopathology; Psychotic Disorders; Vitamin D; Vitamin D Deficiency
PubMed: 34509104
DOI: 10.1016/j.schres.2021.08.001 -
Schizophrenia Research Apr 2023Schizophrenia spectrum disorders (SSD) have heterogeneous outcomes. If we could predict individual outcome and identify predictors of outcome, we could personalize and... (Meta-Analysis)
Meta-Analysis Review
Systematic review and meta-analysis on predictors of prognosis in patients with schizophrenia spectrum disorders: An overview of current evidence and a call for prospective research and open access to datasets.
BACKGROUND
Schizophrenia spectrum disorders (SSD) have heterogeneous outcomes. If we could predict individual outcome and identify predictors of outcome, we could personalize and optimize treatment and care. Recent research showed that recovery rates tend to stabilize early in the course of disease. Short- to medium- term treatment goals are most relevant for clinical practice.
METHODS
We performed a systematic review and meta-analysis to identify predictors of outcome ≤1 year in prospective studies of patients with SSD. For our meta-analysis risk of bias was assessed with the QUIPS tool.
RESULTS
178 studies were included for analysis. Our systematic review and meta-analysis showed that the chance of symptomatic remission was lower in males, and in patients with longer duration of untreated psychosis, more symptoms, worse global functioning, more previous hospital admissions and worse treatment adherence. The chance of readmission was higher for patients with more previous admissions. The chance of functional improvement was lower in patients with worse functioning at baseline. For other proposed predictors of outcome, like age at onset and depressive symptoms, limited to no evidence was found.
DISCUSSION
This study illuminates predictors of outcome of SSD. Level of functioning at baseline was the best predictor of all investigated outcomes. Furthermore, we found no evidence for many predictors proposed in original research. Possible reasons for this include the lack of prospective research, between-study heterogeneity and incomplete reporting. We therefore recommend open access to datasets and analysis scripts, enabling other researchers to reanalyze and pool the data.
Topics: Humans; Access to Information; Prognosis; Prospective Studies; Psychotic Disorders; Schizophrenia
PubMed: 36863229
DOI: 10.1016/j.schres.2023.02.024 -
Journal of Neurology, Neurosurgery, and... Aug 2018A preregistered systematic review of poststroke psychosis examining clinical characteristics, prevalence, diagnostic procedures, lesion location, treatments, risk...
A preregistered systematic review of poststroke psychosis examining clinical characteristics, prevalence, diagnostic procedures, lesion location, treatments, risk factors and outcome. Neuropsychiatric outcomes following stroke are common and severely impact quality of life. No previous reviews have focused on poststroke psychosis despite clear clinical need. CINAHL, MEDLINE and PsychINFO were searched for studies on poststroke psychosis published between 1975 and 2016. Reviewers independently selected studies for inclusion, extracted data and rated study quality. Out of 2442 references, 76 met inclusion criteria. Average age for poststroke psychosis was 66.6 years with slightly more males than females affected. Delayed onset was common. Neurological presentation was typical for stroke, but a significant minority had otherwise 'silent strokes'. The most common psychosis was delusional disorder, followed by schizophrenia-like psychosis and mood disorder with psychotic features. Estimated delusion prevalence was 4.67% (95% CI 2.30% to 7.79%) and hallucinations 5.05% (95% CI 1.84% to 9.65%). Twelve-year incidence was 6.7%. No systematic treatment studies were found. Case studies frequently report symptom remission after antipsychotics, but serious concerns about under-representation of poor outcome remain. Lesions were typically right hemisphere, particularly frontal, temporal and parietal regions, and the right caudate nucleus. In general, poststroke psychosis was associated with poor functional outcomes and high mortality. Poor methodological quality of studies was a significant limitation. Psychosis considerably adds to illness burden of stroke. Delayed onset suggests a window for early intervention. Studies on the safety and efficacy of antipsychotics in this population are urgently needed.
Topics: Aged; Delusions; Female; Humans; Male; Middle Aged; Psychotic Disorders; Stroke
PubMed: 29332009
DOI: 10.1136/jnnp-2017-317327 -
Neuroscience and Biobehavioral Reviews Jan 2021Both dysconnectivity and dopamine hypotheses are two well researched pathophysiological models of psychosis. However, little is known about the association of dopamine... (Review)
Review
Both dysconnectivity and dopamine hypotheses are two well researched pathophysiological models of psychosis. However, little is known about the association of dopamine dysregulation with brain functional connectivity in psychotic disorders, specifically through the administration of antipsychotic medication. In this systematic review, we summarize the existing evidence on the association of dopaminergic effects with electro- and magnetoencephalographic (EEG/MEG) resting-state brain functional connectivity assessed by sensor- as well as source-level measures. A wide heterogeneity of results was found amongst the 20 included studies with increased and decreased functional connectivity in medicated psychosis patients vs. healthy controls in widespread brain areas across all frequency bands. No systematic difference in results was seen between studies with medicated and those with unmedicated psychosis patients and very few studies directly investigated the effect of dopamine agents with a pre-post design. The reported evidence clearly calls for longitudinal EEG and MEG studies with large participant samples to directly explore the association of antipsychotic medication effects with neural network changes over time during illness progression and to ultimately support the development of new treatment strategies.
Topics: Brain; Brain Mapping; Dopamine Agents; Electroencephalography; Humans; Magnetic Resonance Imaging; Magnetoencephalography; Psychotic Disorders
PubMed: 33171145
DOI: 10.1016/j.neubiorev.2020.10.021 -
Tijdschrift Voor Psychiatrie 2015From the second half of the 19th century eminent psychiatrists began referring to alcohol-induced psychotic disorder (AIPD) as a specific alcoholic psychosis. Over the... (Review)
Review
BACKGROUND
From the second half of the 19th century eminent psychiatrists began referring to alcohol-induced psychotic disorder (AIPD) as a specific alcoholic psychosis. Over the last decades interest in AIPD seems to have declined: the last review dates form 1989.
AIM
To review the recent literature on AIPD, revive interest in the disorder, evaluate the current scientific evidence and assess its clinical value.
METHOD
We performed a Medline search based on the following terms: 'Psychoses, Alcoholic' [Mesh] OR 'alcohol induced psychotic disorder' OR 'alcoholic hallucinosis' OR 'alcohol hallucinosis'. Our search was restricted to articles written in English or Dutch and published between 1-1-1988 and 31-1-2013.
RESULTS
We found 164 papers, from which we selected 21 for further discussion. The quality of the papers selected was variable, most of the papers being the result of clinical research. The most important findings referred to epidemiology: 0.4% lifetime prevalence in the general population, 4.0% in patients with alcohol dependence. We found only limited evidence of psychopathological differentiation between delirium and primary psychotic disorder. Correct diagnosis of AIPD is important because of the implications regarding the length and nature of the treatment: short or long course of antipsychotics, referral to a substance-abuse unit.
CONCLUSION
AIPD has survived as a clinical entity. However, scientific evidence of this is limited. Further research is needed because it is vitally important that the patient receives the most appropriate treatment.
Topics: Comorbidity; Delirium; Humans; Neuroimaging; Psychoses, Alcoholic; Schizophrenia
PubMed: 25856742
DOI: No ID Found -
Journal of Parkinson's Disease 2022Psychotic symptoms are highly frequent in Parkinson's disease (PD) patients and are associated with poor prognosis. They include hallucinations, delusions, and minor... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Psychotic symptoms are highly frequent in Parkinson's disease (PD) patients and are associated with poor prognosis. They include hallucinations, delusions, and minor psychotic phenomena, including sense of presence, passage hallucinations, and illusions.
OBJECTIVE
To evaluate the frequency of psychosis in PD patients.
METHODS
A systematic review and meta-analysis of clinical trials, prospective and retrospective cohort studies, case-control studies, and cross-sectional studies reporting the frequency of psychosis, hallucinations, and delusions in PD.
RESULTS
Electronic database search wielded 3536 articles, an additional 91 were identified through citation chaining. Of these, 163 were fully inspected, 57 removed, and 106 included as relevant for neuropsychiatric events frequency, with 32 meeting our inclusion criteria (psychosis and/or specific psychotic phenomena). The pooled frequency of psychosis was 20.7% (95% CI 14.5 to 28.6; I2 = 94%, 15 studies; combined n = 2919). None of the pre-defined meta-regressions or subgroup analyses were statistically significant or helped explain the statistical heterogeneity. The pooled frequency of any form of hallucination was 21.6% (95% CI 14.7 to 30.6; I2 = 95%; 18 studies; combined n = 3161). Duration of PD at baseline and mean baseline Hoehn & Yahr stage helped explain the statistical heterogeneity in the meta-analysis of hallucinations.
CONCLUSION
Based on the available evidence, around a fifth of PD patients experience psychosis or hallucinations. The risk of developing hallucinations is likely moderated by the disease duration, Hoehn & Yahr stage, and the cognitive status.
Topics: Cross-Sectional Studies; Hallucinations; Humans; Parkinson Disease; Prospective Studies; Psychotic Disorders; Retrospective Studies
PubMed: 34806620
DOI: 10.3233/JPD-212930 -
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 -
Journal of the American Academy of... May 2022Psychosis is one of the most extreme and feared forms of psychopathology. Because early intervention leads to better outcomes for psychotic disorders, our field is...
Psychosis is one of the most extreme and feared forms of psychopathology. Because early intervention leads to better outcomes for psychotic disorders, our field is highly motivated to identify this problem in its earliest stages. Ideally, early intervention during childhood and adolescence would be optimal to help restore healthy brain development and prevent the onset of a psychotic disorder. Structural clinical interviews have been developed to identify youth who are at high risk for psychosis, based largely on the presence of attenuated and/or transient psychotic symptoms. However, these evaluations are challenging because of vast developmental differences among children, adolescents, and adults in how these experiences are understood and expressed. In the wake of a growing body of literature examining the utility of assessments for At Risk Mental States (ARMS) for predicting later transition to a psychotic disorder, the time is ripe for a systematic review to assess the state of this emerging field.
Topics: Adolescent; Adult; Child; Humans; Psychopathology; Psychotic Disorders
PubMed: 34678426
DOI: 10.1016/j.jaac.2021.10.007