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The Lancet. Psychiatry Apr 2016Psychosis has been recognised as an abnormal state in need of care throughout history and by diverse cultures. Present classifications of psychotic disorder remain based... (Review)
Review
Psychosis has been recognised as an abnormal state in need of care throughout history and by diverse cultures. Present classifications of psychotic disorder remain based on the presence of specific psychotic symptoms, relative to affective and other symptoms, and their sequence and duration. Although extant diagnostic classifications have restricted validity, they have proven reliability and most clinicians and some patients find them useful. Moreover, these classifications have yet to be replaced by anything better. We propose that an expansion of the subgrouping approach inherent to classification will provide incremental improvement to present diagnostic constructs-as has worked in the rest of medicine. We also propose that subgroups could be created both within and across present diagnostic classifications, taking into consideration the potential value of continuous measures (eg, duration of psychotic symptoms and intelligence quotient). Health-care workers also need to work with service users and carers to develop and adapt approaches to diagnosis that are seen as helpful.
Topics: Humans; Psychotic Disorders; Randomized Controlled Trials as Topic; Reproducibility of Results
PubMed: 27063387
DOI: 10.1016/S2215-0366(15)00577-5 -
Child and Adolescent Psychiatric... Jul 2020Autism seldom occurs in its pure form. Often labeled as behavioral disorders or psychological reactions, comorbid psychiatric disorders are common. Bipolar disorder is... (Review)
Review
Autism seldom occurs in its pure form. Often labeled as behavioral disorders or psychological reactions, comorbid psychiatric disorders are common. Bipolar disorder is one of the most common psychiatric disorders that occur in persons with autism across their life spans. It can be comorbid with and mistaken for several other conditions. Similarly, psychosis occurs in several psychiatric disorders. Schizophrenia is the prototype psychotic disorder that has a close but controversial relationship with autism. Assessment and treatment of bipolar disorder and psychosis should be based on their individual characteristics, family dynamics, and community resources.
Topics: Autistic Disorder; Bipolar Disorder; Comorbidity; Humans; Psychotic Disorders
PubMed: 32471593
DOI: 10.1016/j.chc.2020.02.004 -
Pharmacopsychiatry May 2018We present an online decision aid to involve patients with a psychotic disorder in shared decision-making concerning the selection of antipsychotic medication. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
We present an online decision aid to involve patients with a psychotic disorder in shared decision-making concerning the selection of antipsychotic medication.
METHOD
Patients selected effectiveness and adverse effects criteria from the Subject's Response to Antipsychotics-34 questionnaire. Numerical data from meta-analyses, clinical trial data, receptor affinities and expert opinions were used to rank antipsychotics on each criterion. When using the the tool, patients indicate on a 5-point Likert scale how they value each (adverse) effect. The Likert scale values are combined in an algorithm with the rank orders of antipsychotics to create a personalized ranking.
RESULTS
Criteria used were: effectiveness concerning psychotic, depressive and cognitive symptoms, weight gain, sexual dysfunction, drowsiness, hypersomnia, extrapyramidal symptoms, anticholinergic adverse effects, hypersalivation, nausea, dizziness, energy loss, blunted affect/less need for companionship. High-level evidence was available for ranking weight gain, sexual dysfunction, menstrual disorders, extrapyramidal symptoms and effectiveness on psychotic symptoms. We used lower level evidence ranking the remaining criteria.
DISCUSSION
A transparent procedure has resulted in an updateable tool to produce individual ranking of antipsychotics based on the patients' input.
Topics: Algorithms; Antipsychotic Agents; Databases, Bibliographic; Decision Making; Female; Humans; Male; Patient Compliance; Psychotic Disorders
PubMed: 28810270
DOI: 10.1055/s-0043-116854 -
The American Journal of Psychiatry Jun 2018
Review
Topics: Humans; Psychotic Disorders; Recurrence
PubMed: 29869551
DOI: 10.1176/appi.ajp.2017.17030282 -
The Lancet. Psychiatry Apr 2016Psychotic disorders are currently grouped under broad phenomenological diagnostic rubrics. Researchers hope that progress in identifying aetiological mechanisms will... (Review)
Review
Psychotic disorders are currently grouped under broad phenomenological diagnostic rubrics. Researchers hope that progress in identifying aetiological mechanisms will ultimately enable more precise division of heterogeneous diagnoses into specific and valid subgroups. This goal has been an aim of psychiatry since the 19th century, when patients with general paresis were thought to have "insanity" similar to dementia praecox and manic depressive illness. Nowadays, the constructs of organic-induced and substance-induced psychotic disorder show that our diagnostic classification system already reflects, in part, aetiological factors. Most recently, gene copy number variation and autoimmunity have been associated with schizophrenia. We suggest how, on the basis of recent scientific advances, we can progress the identification of further putative subgroups and make the most of currently available interventions. Prompt diagnosis and treatment, and a more routine search for causes, could preserve function and improve outcome, and therefore be more acceptable to patients and carers.
Topics: Biomarkers; Humans; Psychotic Disorders; Randomized Controlled Trials as Topic
PubMed: 27063388
DOI: 10.1016/S2215-0366(16)00021-3 -
Psychopathology 2023There is a growing interest in understanding the impact of video games in the clinical field, given that their excessive use could be associated with health issues.... (Review)
Review
BACKGROUND
There is a growing interest in understanding the impact of video games in the clinical field, given that their excessive use could be associated with health issues. Particularly, gaming disorder (GD) is considered as an addictive behavioral disorder. Clinicians widely recognize the comorbidity of gaming and psychotic disorders (PDs). Furthermore, association between addictive (i.e., substance use disorders) and PDs are well recognized by clinicians. It seems of high interest to explore GD among people with PDs. To this day, little is known about the consequences of GD in vulnerable populations.
OBJECTIVES
The aim of this scoping review was to summarize the available research on the comorbidity between GD and PD and to identify the knowledge gaps in this field.
METHODS
We used Levac's six-stage methodology for scoping review. Two-hundred and forty-two articles from seven databases were identified. Eight articles respected our inclusion and exclusion criteria.
RESULTS
No available study has assessed the prevalence or incidence of GD among patients with PDs. The cases reported highlight the possibility that excessive video gameplay or abrupt gaming disruption could trigger psychosis in some patients.
CONCLUSION
The results highlight a significant lack of knowledge concerning PDs associated with GD as only a few reported cases and one empirical study exposed the potential association between those conditions.
Topics: Humans; Video Games; Behavior, Addictive; Psychotic Disorders; Comorbidity; Prevalence; Internet
PubMed: 36318899
DOI: 10.1159/000527143 -
Schizophrenia Bulletin Mar 2024Individuals with psychotic symptoms experience substantial morbidity and have shortened life expectancies; early treatment may mitigate the worst effects. Understanding... (Review)
Review
BACKGROUND
Individuals with psychotic symptoms experience substantial morbidity and have shortened life expectancies; early treatment may mitigate the worst effects. Understanding care preceding a first psychotic disorder diagnosis is critical to inform early detection and intervention.
STUDY DESIGN
In this observational cohort study using comprehensive information from the Massachusetts All-Payer Claims Database, we identified the first psychotic disorder diagnosis in 2016, excluding those with historical psychotic disorder diagnoses in the prior 48 months among those continuous enrollment data. We reviewed visits, medications, and hospitalizations 2012-2016. We used logistic regression to examine characteristics associated with pre-diagnosis antipsychotic use.
STUDY RESULTS
There were 2505 individuals aged 15-35 years (146 per 100 000 similarly aged individuals in the database) with a new psychotic disorder diagnosis in 2016. Most (97%) had at least one outpatient visit in the preceding 48 months; 89% had a prior mental health diagnosis unrelated to psychosis (eg, anxiety [60%], depression [60%]). Many received psychotropic medications (77%), including antipsychotic medications (46%), and 68% had a visit for injury or trauma during the preceding 48 months. Characteristics associated with filling an antipsychotic medication before the psychotic disorder diagnosis included male sex and Medicaid insurance at psychosis diagnosis.
CONCLUSIONS
In this insured population of Massachusetts residents with a new psychotic disorder diagnosis, nearly all had some healthcare utilization, visits for injury or trauma were common, and nearly half filled an antipsychotic medication in the preceding 48 months. These patterns of care could represent either pre-disease signals, delays, or both in receiving a formal diagnosis.
Topics: United States; Humans; Male; Antipsychotic Agents; Psychotic Disorders; Early Diagnosis; Logistic Models; Psychotherapy; Observational Studies as Topic
PubMed: 37606279
DOI: 10.1093/schbul/sbad125 -
Semergen Oct 2021
Topics: Acne Vulgaris; Dermatologic Agents; Humans; Isotretinoin; Psychotic Disorders
PubMed: 34257010
DOI: 10.1016/j.semerg.2021.06.004 -
The Permanente Journal May 2021Amidst a rapidly changing legal landscape, cannabis use in the United States has become increasingly common in the past several years. There is strong evidence to... (Review)
Review
Amidst a rapidly changing legal landscape, cannabis use in the United States has become increasingly common in the past several years. There is strong evidence to suggest that chronic and early cannabis use increases the risk of developing a psychotic disorder, and there is at least moderate evidence that suggests ongoing cannabis use among individuals with a psychotic disorder worsens clinical outcomes (eg, decreased psychiatric medication adherence, more frequent psychiatric hospitalizations). In this Review Article, we provide a focused, clinically oriented overview of the epidemiology and characteristics of cannabis use among individuals with first-episode psychosis; evaluation of cannabis use; and treatment modalities, focusing on behavioral interventions suitable for outpatient primary care settings. We discuss the limited data supporting pharmacologic interventions for cannabis use disorder, specifically among individuals with first-episode psychosis, and the unique potential of cannabidiol to serve as a harm-reduction strategy for individuals who are not able or willing to achieve abstinence for cannabis.
Topics: Analgesics; Cannabidiol; Cannabis; Humans; Marijuana Abuse; Psychotic Disorders
PubMed: 35348056
DOI: 10.7812/TPP/20.179 -
The Journal of Nervous and Mental... Nov 2018The ICD-11 International Classification of Diseases and Related Health Problems will move toward a narrower concept of "acute and transient psychotic disorders" (ATPD)... (Review)
Review
The ICD-11 International Classification of Diseases and Related Health Problems will move toward a narrower concept of "acute and transient psychotic disorders" (ATPD) characterized by the remnant "polymorphic psychotic disorder" (APPD) of the current ICD-10 category, also including schizophrenic and predominantly delusional subtypes. To assess the validity of APPD, relevant articles published between January 1993 and September 2017 were found through searches in PubMed and Web of Science. APPD is a rare mental disorder and affects significantly more women than men in early-middle adulthood. Its diagnostic reliability is relatively low, and its consistency reaches just 53.8% on average over 8.8 years, but is significantly greater than either of ATPD subtypes, which are more likely to progress to schizophrenia and related disorders. Although APPD has distinctive features and higher predictive power, its rarity and the fleeting and polymorphic nature of its symptoms could reduce its usefulness in clinical practice and discourage research.
Topics: Humans; International Classification of Diseases; Psychotic Disorders; Reproducibility of Results
PubMed: 30256333
DOI: 10.1097/NMD.0000000000000882