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Journal of Clinical Psychopharmacology
Topics: Humans; Antipsychotic Agents; Clozapine; Myoclonus; Schizophrenia, Paranoid
PubMed: 37335194
DOI: 10.1097/JCP.0000000000001717 -
Medicina Clinica Nov 2015
Topics: Adult; Antipsychotic Agents; Biomarkers; Clozapine; Electrocardiography; Fever; Humans; Leukocytosis; Male; Myocarditis; Schizophrenia, Paranoid; Tachycardia; Ultrasonography
PubMed: 25724248
DOI: 10.1016/j.medcli.2015.01.004 -
Early Intervention in Psychiatry Aug 2019Early intervention programmes for first episode psychosis (FEP) aim to reduce the duration of untreated psychosis (DUP) and improve functional outcomes. The sustained...
AIM
Early intervention programmes for first episode psychosis (FEP) aim to reduce the duration of untreated psychosis (DUP) and improve functional outcomes. The sustained maintenance of improved outcomes depends largely on patients' adherence to prescribed treatment. This paper examines the prevalence of non-adherence in a cohort of patients with FEP and the sociodemographic and clinical factors associated with non-adherent behaviour.
METHODS
The sample included consecutive patients accepted from 2007 to 2012 into the Early Psychosis Intervention Programme (EPIP) in Singapore. Sociodemographic variables as well as DUP, insight, severity of psychopathology and clinical diagnoses were collected. Patients were assessed at baseline and 1 year with the PANSS and Global Assessment of Functioning Scale (GAF). Medication adherence was grouped into 3 categories: no-adherence, partial adherence and regular adherence.
RESULTS
Of the 445 patients included, 51% were male with a mean age of 26.3 years, 74.6% had schizophrenia spectrum and delusional disorders, 14% had affective psychosis and 11.3% had brief psychotic disorder or psychotic disorder not otherwise specified. At 1 year follow up, 65.5% reported regular adherence, 18.7% were partially adherent and 15.8% were non-adherent. Non-adherence was correlated with male gender, living alone and having poorer judgement and insight. Partial adherence was associated with Malay ethnicity and having undergone national service.
CONCLUSION
Medication adherence is prevalent in FEP and associated with a variety of factors. This study supports the use of culturally appropriate interventions in addressing barriers to adherence. Further studies would need to be done to address specific factors affecting adherence outcomes.
Topics: Adult; Affective Disorders, Psychotic; Early Medical Intervention; Ethnicity; Female; Humans; Male; Medication Adherence; Psychotic Disorders; Schizophrenia, Paranoid; Schizophrenic Psychology; Singapore; Young Adult
PubMed: 29521010
DOI: 10.1111/eip.12559 -
The Psychiatric Quarterly Jun 2016The aim of this paper is to help clinicians better understand how erotomania originates in order to facilitate treatment and make it more effective. Data sources are the...
The aim of this paper is to help clinicians better understand how erotomania originates in order to facilitate treatment and make it more effective. Data sources are the narratives of six women who spoke in detail about the beginnings of their delusional beliefs and about the nature of the evidence that convinced them that their beliefs were well-founded. In every case, low self-esteem and emotional arousal preceded the emergence of the delusion. Misperceptions and misattributions appeared responsible for keeping the delusion alive. Despite external disconfirmation, social isolation protected the delusional beliefs from revision and extinction. The erotomanic delusion provided a sense of well-being that probably contributed to its maintenance. As well, a delusion-induced boost in well-being delayed help-seeking. Recommendations for treatment include staged interventions, first establishing a therapeutic alliance with a focus on understanding the psychological factors contributing to the origin and maintenance of the delusion. The next stage is the provision of social support and strategies directed at the restoration of self-esteem. The third stage is the gradual introduction of techniques to correct cognitive biases. Medication and risk management form an integral part of overall management. Objective evidence for the effectiveness of this approach is, however, not yet available.
Topics: Adult; Disease Management; Female; Humans; Middle Aged; Schizophrenia, Paranoid; Sexual Behavior
PubMed: 26442945
DOI: 10.1007/s11126-015-9392-0 -
Schizophrenia Research Jul 2019The diagnosis of paranoia/delusional disorder has been significantly modified and redefined from DSM-III to DSM-5, which in turn also meaningfully differ from the ICD-10...
BACKGROUND
The diagnosis of paranoia/delusional disorder has been significantly modified and redefined from DSM-III to DSM-5, which in turn also meaningfully differ from the ICD-10 criteria. In this study we examined the degree to which these diagnostic systems differ on external variables.
METHOD
Two-hundred and eighty-six subjects diagnosed of paranoia/delusional disorder according to DSM-III, DSM-III-R, DSM-IV, DSM-5 or ICD-10 criteria were examined for a number of validators including risk factors, premorbid features, illness-related variables and psychosocial functioning. The prevalence rates of the diagnostic criteria and their concordance level were examined, such as the degree to which the criteria sets and their main diagnostic features were differentially related to the validators.
RESULTS
Diagnostic criteria showed poor to fair concordance. The most inclusive system was the DSM-5 (n = 274) and the most restrictive the DSM-III (n = 187). Compared with subjects fulfilling other diagnostic criteria, those with a DSM-III diagnosis showed more and stronger associations with the validators: presence of cluster A personality disorders, insidious illness onset, poor response to treatment, chronic illness course and poor psychosocial functioning. This association pattern was mainly due to the 6-month duration criterion. Stability of delusions, type of delusions and the ICD-10 3-month duration criterion were poorly related to the validators.
CONCLUSIONS
Diagnostic criteria for delusional disorder are not interchangeable. DSM-III criteria for paranoia may identify a more severe disorder mainly because the 6-month duration criterion. Type of delusions had a small impact on the validators across diagnostic systems. These findings have implications for future classifications of delusional disorder.
Topics: Adult; Aged; Diagnostic and Statistical Manual of Mental Disorders; Female; Follow-Up Studies; Humans; International Classification of Diseases; Male; Middle Aged; Paranoid Disorders; Schizophrenia, Paranoid
PubMed: 31080154
DOI: 10.1016/j.schres.2019.04.027 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2018Introduction: Providing care for patients with endogenous mental disorders is associated with significant psychosocial burden. The aim of this study was to introduce a...
OBJECTIVE
Introduction: Providing care for patients with endogenous mental disorders is associated with significant psychosocial burden. The aim of this study was to introduce a system of psychotherapeutic interventions for family caregivers of patients with paranoid schizophrenia and bipolar disorder based on understanding their prevalent coping behavior patterns and communicative coping resources evaluation.
PATIENTS AND METHODS
Materials and methods: A total of 273 family caregivers of patients with paranoid schizophrenia and bipolar disorder were involved into this survey under informed consent conditions. Control group included 55 mentally healthy respondents, in whose families there is no mentally sick family member. Test for psychological diagnostics of coping mechanisms (E. Heim) and emotional empathy test (А. Mehrabian) were chosen as psychological testing research tools. Values of p <0.05 were considered significant.
RESULTS
Results: The study revealed prevalence of certain maladaptive coping strategies and lack of communicative coping resources in family caregivers of patients with paranoid schizophrenia and bipolar disorder. These data might be among significant predictors of communicative dysfunctions in families where one of the family members has endogenous mental disorder, and must be considered while developing appropriate psychotherapeutic programs.
CONCLUSION
Conclusions: On the basis of revealed data, we have introduced an integrative system of psychotherapeutic interventions, aimed to develop adaptive forms of coping behavior in family caregivers, increase their empathetic and affiliative resources, create favorable conditions for activation of personal resources and adaptive potential of both family caregivers and patients with paranoid schizophrenia and bipolar disorder.
Topics: Adaptation, Psychological; Bipolar Disorder; Caregivers; Family; Humans; Psychotherapy; Schizophrenia, Paranoid
PubMed: 30176626
DOI: No ID Found -
Psychiatria Danubina 2021
Topics: Aged; Antipsychotic Agents; Aripiprazole; Bipolar Disorder; Delayed-Action Preparations; Dementia; Humans; Schizophrenia, Paranoid
PubMed: 34795186
DOI: 10.24869/psyd.2021.376 -
Neuropsychopharmacology : Official... Oct 2020There have been few studies performed to examine the pathophysiological differences between different types of psychosis, such as between delusional disorder (DD) and...
The role of dopamine dysregulation and evidence for the transdiagnostic nature of elevated dopamine synthesis in psychosis: a positron emission tomography (PET) study comparing schizophrenia, delusional disorder, and other psychotic disorders.
There have been few studies performed to examine the pathophysiological differences between different types of psychosis, such as between delusional disorder (DD) and schizophrenia (SZ). Notably, despite the different clinical characteristics of DD and schizophrenia (SZ), antipsychotics are deemed equally effective pharmaceutical treatments for both conditions. In this context, dopamine dysregulation may be transdiagnostic of the pathophysiology of psychotic disorders such as DD and SZ. In this study, an examination is made of the dopamine synthesis capacity (DSC) of patients with SZ, DD, other psychotic disorders, and the DSC of healthy subjects. Fifty-four subjects were recruited to the study, comprising 35 subjects with first-episode psychosis (11 DD, 12 SZ, 12 other psychotic disorders) and 19 healthy controls. All received an F-DOPA positron emission tomography (PET)/magnetic resonance (MR) scan to measure DSC (K value) within 1 month of starting antipsychotic treatment. Clinical assessments were also made, which included Positive and Negative Syndrome Scale (PANSS) measurements. The mean K was significantly greater in the caudate region of subjects in the DD group (ES = 0.83, corrected p = 0.048), the SZ group (ES = 1.40, corrected p = 0.003) and the other psychotic disorder group (ES = 1.34, corrected p = 0.0045), compared to that of the control group. These data indicate that DD, SZ, and other psychotic disorders have similar dysregulated mechanisms of dopamine synthesis, which supports the utility of abnormal dopamine synthesis in transdiagnoses of these psychotic conditions.
Topics: Antipsychotic Agents; Dopamine; Humans; Positron-Emission Tomography; Psychotic Disorders; Schizophrenia, Paranoid
PubMed: 32612207
DOI: 10.1038/s41386-020-0740-x -
Psychiatry Research Dec 2018Insight has long been linked to both prognosis and functioning in patients with schizophrenia; likewise, it is key to treatment adherence. This study seeks to assess the...
Insight has long been linked to both prognosis and functioning in patients with schizophrenia; likewise, it is key to treatment adherence. This study seeks to assess the association between insight, adherence to pharmacological treatment, and disability in schizophrenia, and to study the potential mediating role of adherence between insight and disability. Insight (SUMD), adherence (CRS), and disability (WHO-DAS) were measured in 80 clinically stable patients with DSM-IV TR paranoid schizophrenia. Psychopathology was assessed with the Positive and Negative Syndrome Scale (PANSS). In a first step, predictors of disability were identified using linear regression to identify variables related to disability and further a mediation analysis was carried out. Negative symptoms, insight, and adherence account for 54.2% of the variance in disability. Negative symptoms act directly on disability, while the effect of insight on disability is partially mediated by adherence. Insight is key in disability in schizophrenia and should be leveraged in treatment programs.
Topics: Adult; Awareness; Female; Humans; Male; Middle Aged; Patient Compliance; Schizophrenia, Paranoid; Schizophrenic Psychology
PubMed: 30278408
DOI: 10.1016/j.psychres.2018.09.021 -
The Primary Care Companion For CNS... Nov 2020
Topics: Delusions; Humans; Psychotic Disorders; Schizophrenia, Paranoid
PubMed: 33185988
DOI: 10.4088/PCC.20l02741