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Frontiers in Psychiatry 2021Identifying the characteristics of behavioral and psychological symptoms of dementia (BPSD) associated with different dementia types may be a promising strategy to...
Identifying the characteristics of behavioral and psychological symptoms of dementia (BPSD) associated with different dementia types may be a promising strategy to effectively deal with BPSD. We aimed to synthesize the prevalence rates of BPSD characteristics in community-dwelling dementia patients. We searched Medline, EMBASE, and PsycARTICLES databases for original clinical studies published until December 2020 that enrolled at least 300 community-dwelling dementia patients. The methodological qualities of prevalence studies were assessed using the Joanna Briggs Institute's critical appraisal checklist. Thirty studies were included. The prevalence of the BPSD characteristic ranged from 4 (elation and mania) to 32% (apathy) in the pooled samples. The prevalence of delusions, anxiety, apathy, irritability, elation and mania, and aberrant motor behavior in Alzheimer's disease patients was 1.72-2.88 times greater than that in vascular dementia (VD) patients, while the prevalence of disinhibition in VD patients was 1.38 times greater. The prevalence of anxiety, irritability, and agitation and aggression, delusion, hallucinations, apathy, disinhibition, and aberrant motor behavior tended to increase as the severity of dementia increased, while that of depression, eating disorder, sleep disorders, and elation and mania tended to stable. In community-dwelling patients with dementia, the pooled prevalence of apathy, depression, anxiety, irritability, agitation and aggression, sleep disorders, and eating disorder was higher than 20%, while that of disinhibition and elation and mania was lower than 10%. Overall, the pooled prevalence of apathy, depression, anxiety, irritability, agitation and aggression, sleep disorders, and eating disorder was generally high in patients with dementia. Also, the prevalence of some BPSD characteristics differed according to the type and the severity of dementia. The methodological quality of the included studies is not the best, and high heterogeneity may affect the certainty of the findings. However, the results of this review can deepen our understanding of the prevalence of BPSD. https://osf.io/dmj7k, identifier: 10.17605/OSF.IO/DMJ7K.
PubMed: 34744832
DOI: 10.3389/fpsyt.2021.741059 -
Neurological Sciences : Official... Jul 2021Psychosis in Parkinson's disease (PD) is common and consists of hallucinations, illusions, and delusions. Among the latter, delusional jealousy, also named Othello... (Review)
Review
INTRODUCTION
Psychosis in Parkinson's disease (PD) is common and consists of hallucinations, illusions, and delusions. Among the latter, delusional jealousy, also named Othello syndrome (OS), might impair the quality of life of both patients and their partners. We aimed to perform a systematic review and report a series of PD patients presenting with OS.
METHODS
A systematic review research was performed in PubMed database, excluding non-English articles, single case reports, reviews and neuropathology articles, comments, and articles concerning OS associated with deep brain stimulation (DBS) and levodopa-carbidopa intestinal gel infusion. We also described eleven PD patients (9 M and 2 F) with OS, identified in a cohort of consecutive 153 patients, comparing them with eleven matched no OS (nOS) PD subjects taken from the same cohort.
RESULTS
We included eight articles (four case series and four cross-sectional studies). OS resulted more common among males than females. We did not find higher levodopa dose and levodopa equivalent dose for dopamine agonists and for all anti-parkinsonian drugs in our OS group. In our case series, OS patients showed visual hallucinations (p=0.001) and a trend to have depression (p=0.080) more frequently than nOS ones.
CONCLUSIONS
OS is not a rare disorder in PD, probably due not only to abnormal dopaminergic stimulation but also to serotonergic dysfunction in biologically predisposed subjects. Visual hallucinations and other concomitant psychiatric diseases, in particular depression, might represent a risk factor for the OS development.
Topics: Antiparkinson Agents; Cross-Sectional Studies; Delusions; Dopamine Agonists; Female; Humans; Levodopa; Male; Parkinson Disease; Quality of Life
PubMed: 33978871
DOI: 10.1007/s10072-021-05249-4 -
World Psychiatry : Official Journal of... Feb 2021Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge...
Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge of how developmental trauma induces vulnerability to psychotic symptoms. Understanding the psychological processes involved in this association is crucial to the development of preventive interventions and improved treatments. We sought to systematically review the literature and combine findings using meta-analytic techniques to establish the potential roles of psychological processes in the associations between developmental trauma and specific psychotic experiences (i.e., hallucinations, delusions and paranoia). Twenty-two studies met our inclusion criteria. We found mediating roles of dissociation, emotional dysregulation and post-traumatic stress disorder (PTSD) symptoms (avoidance, numbing and hyperarousal) between developmental trauma and hallucinations. There was also evidence of a mediating role of negative schemata, i.e. mental constructs of meanings, between developmental trauma and delusions as well as paranoia. Many studies to date have been of poor quality, and the field is limited by mostly cross-sectional research. Our findings suggest that there may be distinct psy-chological pathways from developmental trauma to psychotic phenomena in adulthood. Clinicians should carefully ask people with psychosis about their history of developmental trauma, and screen patients with such a history for dissociation, emotional dysregulation and PTSD symptoms. Well conducted research with prospective designs, including neurocognitive assessment, is required in order to fully understand the biopsychosocial mechanisms underlying the association between developmental trauma and psychosis.
PubMed: 33432756
DOI: 10.1002/wps.20841 -
Psychiatria Polska 2016The aim of this paper is to review results of studies on the effectiveness of metacognitive training (MCT) for patients with schizophrenia in reduction of psychotic... (Review)
Review
OBJECTIVES
The aim of this paper is to review results of studies on the effectiveness of metacognitive training (MCT) for patients with schizophrenia in reduction of psychotic symptoms and cognitive biases. Furthermore, other variables, like social functioning, insight and neurocognitive functions, are analyzed.
METHODS
Systematic search in databases PubMed, EBSCO, Google Scholar, EMBASE, Cochrane Central Register of Controlled Trials and PsycINFO regarding studies on the effectiveness of the MCT was made. The review included 14 studies published in years 2009-2015, in which design of the study made comparison between MCT group and control group possible.
RESULTS
Combined number of patients in MCT group was 354 and 355 in control group. The largest effect size was obtained for severity of delusions (d < 0.23; 1 >), especially reduction of conviction and distress of delusional beliefs. An effect size regarding negative symptoms reduction was small. Large effect size was observed for insight improvement (d < 0.45; 1.32 >). Positive impact of MCT on cognitive biases severity (d < 0.21; 0.83 >, especially jumping to conclusions) and improvement in some aspects of neurocognitive functions was observed (d < 0.2; 0.63 >). There was no improvement in social functioning of patients in MCT group. Follow-up studies show sustainability in symptoms improvement lasting at least 6 months.
CONCLUSIONS
MCT is an effective form of therapy in reduction of delusions, cognitive biases related to schizophrenia and improvement of insight. Relatively easy accessibility and sustainability of therapeutic effects indicates that MCT can by effectively used in therapy of schizophrenia. To enhance training efficacy, especially in patients' general functioning, combining it with others forms of therapy is to be considered.
Topics: Cognitive Behavioral Therapy; Delusions; Female; Humans; Male; Psychiatric Status Rating Scales; Psychotherapy, Group; Schizophrenia; Schizophrenic Psychology; Severity of Illness Index; Treatment Outcome
PubMed: 27847929
DOI: 10.12740/PP/59113 -
International Journal of Environmental... Aug 2020(1) : Virtual Reality (VR) is a fully immersive computer simulated experience consisting of a three-dimensional interactive virtual environment, through a head-mounted...
(1) : Virtual Reality (VR) is a fully immersive computer simulated experience consisting of a three-dimensional interactive virtual environment, through a head-mounted display (HMD) and controller. The use of virtual reality has recently been proposed for the treatment of various psychiatric conditions, including the spectrum of schizophrenia. Our review aims to investigate the current available evidence regarding the use of immersive virtual reality in the treatment of psychotic symptoms. (2) : From April 2019 to June 2020, we conducted a systematic review aimed at identifying therapeutic applications in immersive virtual reality for the spectrum of schizophrenia, searching for relevant studies on Web of Science, EMBASE, PsycINFO and CINHAL. (3) : We identified a total of 2601 unique records. Of these, 64 full-text articles were assessed for eligibility, and six out of these met the inclusion criteria and were included in the final systematic review. (4) : The available data on immersive virtual reality are currently limited due to the few studies carried out on the topic; however, it has demonstrated its effectiveness and versatility in successfully treating various psychotic symptoms including delusions, hallucinations, or cognitive and social skills. Existing literature agrees on safe, tolerable, and long-term persistence of the therapeutic effects obtained by immersive VR. No serious side effects have been reported. In some specific cases, VR therapy was found to be very effective compared to usual treatment, allowing effective drug free interventions, and therefore without side effects for patients, even in those resistant to normal drug therapies.
Topics: Humans; Quality of Life; Schizophrenia; Virtual Reality; Virtual Reality Exposure Therapy
PubMed: 32842579
DOI: 10.3390/ijerph17176111 -
Human Brain Mapping Apr 2024Schizophrenia is a chronic psychiatric disorder with characteristic symptoms of delusions, hallucinations, lack of motivation, and paucity of thought. Recent evidence... (Review)
Review
Schizophrenia is a chronic psychiatric disorder with characteristic symptoms of delusions, hallucinations, lack of motivation, and paucity of thought. Recent evidence suggests that the symptoms of schizophrenia, negative symptoms in particular, vary widely between the sexes and that symptom onset is earlier in males. A better understanding of sex-based differences in functional magnetic resonance imaging (fMRI) studies of schizophrenia may provide a key to understanding sex-based symptom differences. This study aimed to summarize sex-based functional magnetic resonance imaging (fMRI) differences in brain activity of patients with schizophrenia. We searched PubMed and Scopus to find fMRI studies that assessed sex-based differences in the brain activity of patients with schizophrenia. We excluded studies that did not evaluate brain activity using fMRI, did not evaluate sex differences, and were nonhuman or in vitro studies. We found 12 studies that met the inclusion criteria for the current systematic review. Compared to females with schizophrenia, males with schizophrenia showed more blood oxygen level-dependent (BOLD) activation in the cerebellum, the temporal gyrus, and the right precuneus cortex. Male patients also had greater occurrence of low-frequency fluctuations in cerebral blood flow in frontal and parietal lobes and the insular cortex, while female patients had greater occurrence of low-frequency fluctuations in the hippocampus, parahippocampus, and lentiform nucleus. The current study summarizes fMRI studies that evaluated sex-based fMRI brain differences in schizophrenia that may help to shed light on the underlying pathophysiology and further understanding of sex-based differences in the clinical presentation and course of the disorder.
Topics: Humans; Male; Female; Magnetic Resonance Imaging; Sex Characteristics; Brain; Schizophrenia; Brain Mapping
PubMed: 38520370
DOI: 10.1002/hbm.26664 -
Journal of Psychiatric Research Sep 2022Preliminary data suggest that patients with COVID-19 may experience psychiatric symptoms, including psychosis. We systematically reviewed the literature to evaluate the... (Review)
Review
BACKGROUND
Preliminary data suggest that patients with COVID-19 may experience psychiatric symptoms, including psychosis. We systematically reviewed the literature to evaluate the concurrence of new-onset psychosis or exacerbation of clinically stable psychosis through case reports and case series.
METHODS
Six databases were searched, followed by an electronic and manual search of the relevant articles. Studies were identified using predetermined eligibility criteria. We evaluated the demographic characteristics, clinical history, course of illness, management, and prognosis of the patients in these studies.
RESULTS
Case reports and case series, altogether consisting of 57 unique cases were included. The mean patient age for onset of psychotic symptoms was 43.4 years for men and 40.3 years for women. About 69% of patients had no prior history of psychiatric disorders. Most patients had mild COVID-19-related symptoms, with only 15 (26.3%) presenting with moderate to severe COVID-19-related disease and complications. The most commonly reported psychotic symptoms were delusions and hallucinations. Patients with psychotic symptoms were treated with antipsychotics, benzodiazepines, valproic acid, and electroconvulsive treatment. In 36 cases, psychotic symptoms resolved completely or improved significantly. Ten cases had partial improvement with residual psychotic symptoms, and one patient died due to cardiac arrest.
CONCLUSION
Most patients responded to a low-to-moderate dose of antipsychotics with a quick recovery. However, the residual psychiatric symptoms highlight the need for careful monitoring and longer follow-up. Clinicians should be mindful of the occurrence of psychosis due to COVID-19 infection in a subset of COVID-19 patients that can be misdiagnosed as a psychotic disorder alone.
Topics: Adult; Antipsychotic Agents; COVID-19; Female; Hallucinations; Humans; Male; Pandemics; Psychotic Disorders
PubMed: 35797814
DOI: 10.1016/j.jpsychires.2022.06.041 -
BMJ Open Jul 2022Consumption of the drug khat is high across East Africa and the South-Western Arabian Peninsula despite evidence for its adverse psychiatric effects. This systematic... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Consumption of the drug khat is high across East Africa and the South-Western Arabian Peninsula despite evidence for its adverse psychiatric effects. This systematic review aims to explore cross-sectional research in the field to determine the strength of the association between khat use and psychiatric symptoms METHODS: Six databases were searched in October 2021-Ovid Medline, Embase, APA PsycINFO, CINAHL, Scopus and Proquest-using the following search terms: "khat" OR "qat" OR "qaad" OR "catha" OR "miraa" OR "mairungi" AND "depression" OR "anxiety" OR "mania" OR "psych*" OR "schiz*" OR "mental" OR "hallucinations" OR "delusions" OR "bipolar". Eligible studies were cross-sectional studies of any population or setting comparing the prevalence of psychiatric symptoms in long term or dependent khat users with non-users. The quality of each study was appraised by the Newcastle-Ottawa scale. A meta-analysis was planned using a random effects model to produce an OR with 95% CIs-using the Mantel-Haenszel method-alongside an I statistic to represent heterogeneity. The quality of this meta-analysis was appraised using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) scoring system.
RESULTS
35 studies were eligible for inclusion (total participants=31 893), spanning 5 countries (Ethiopia, Somalia, Kenya, Saudi Arabia, UK). Meta-analysis suggests that khat use is associated with an 122% increased prevalence of psychiatric symptoms (OR 2.22, 95% CIs 1.76 to 2.79, p<0.00001, GRADE score: 'very low').
CONCLUSIONS
The high heterogeneity of the meta-analysis is likely due to the wide variation between the studies within the evidence base. To perform a more accurate systematic review, further primary studies are needed with standardised measurements of variables, particularly khat consumption.
PROSPERO REGISTRATION NUMBER
CRD42020224510.
Topics: Catha; Ethiopia; Humans; Prevalence; Saudi Arabia; Somalia; Substance-Related Disorders
PubMed: 35879018
DOI: 10.1136/bmjopen-2022-061865 -
Psychopathology 2023Delusional misidentification syndromes (DMS) are a group of psychopathological experiences occurring in psychosis, involving the misidentification of a person or place....
INTRODUCTION
Delusional misidentification syndromes (DMS) are a group of psychopathological experiences occurring in psychosis, involving the misidentification of a person or place. DMS are often accompanied by hostility towards the object of delusional misidentification. This is of a particular concern in perinatal mental illness due to the potential disruption of the mother-infant bond, and risk of neglect, violence, or infanticide towards a misidentified child. This review aimed to collate all published cases of DMS in postpartum psychosis to further understand how these syndromes present in perinatal mental illness.
METHODS
In August 2021, an online database search was conducted using PubMed, MEDLINE, PsycINFO, CINAHL, and Embase to identify all publications reporting DMS in the perinatal period.
RESULTS
Nine papers were included in the review involving 8 case reports of Capgras syndrome and one case series involving 4 cases of Fregoli syndrome. Three cases identified organic pathology, which may have contributed to the presentation. The most common subject of misidentification was the patient's husband (n = 7), followed by their baby (n = 6), hospital staff (n = 4), other family members (n = 3), and self (n = 1). Five cases remark on the impact of perinatal illness on the maternal-infant bond, of which four result in the mother being unwilling to care for the infant as the result of their delusional beliefs.
CONCLUSION
This is the first systematic review of the literature in this field. Although small in number, these cases reveal several important learning points including that DMS can occur with or without underlying organic disease. Active exploration of the nature of delusions in postpartum psychosis is required to mitigate the risk of harm to the infant and mother-infant bond. It may also uncover that these syndromes are more common in postpartum psychosis than previously realized.
Topics: Female; Child; Humans; Capgras Syndrome; Psychotic Disorders; Delusions; Mothers; Postpartum Period
PubMed: 36116435
DOI: 10.1159/000526129 -
Frontiers in Genetics 2019Childhood-onset schizophrenia (COS), a very rare and severe chronic psychiatric condition, is defined by an onset of positive symptoms (delusions, hallucinations and...
Childhood-onset schizophrenia (COS), a very rare and severe chronic psychiatric condition, is defined by an onset of positive symptoms (delusions, hallucinations and disorganized speech or behavior) before the age of 13. COS is associated with other neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder. Copy number variations (CNVs) represent well documented neurodevelopmental disorder risk factors and, recently, single nucleotide variations (SNVs) in genes involved in brain development have also been implicated in the complex genetic architecture of COS. Here, we aim to review the genetic changes (CNVs and SNVs) reported for COS, going from previous studies to the whole genome sequencing era. We carried out a systematic review search in PubMed using the keywords "childhood(early)-onset schizophrenia(psychosis)" and "genetic(s) or gene(s) or genomic(s)" without language and date limitations. The main inclusion criteria are COS (onset before 13 years old) and all changes/variations at the DNA level (CNVs or SNVs). Thirty-six studies out of 205 met the inclusion criteria. Cytogenetic abnormalities (n = 72, including 66 CNVs) were identified in 16 autosomes and 2 sex chromosomes (X, Y), some with a higher frequency and clinical significance than others (e.g., 2p16.3, 3q29, 15q13.3, 22q11.21 deletions; 2p25.3, 3p25.3 and 16p11.2 duplications). Thirty-one single nucleotide mutations in genes principally involved in brain development and/or function have been found in 12 autosomes and one sex chromosome (X). We also describe five SNVs in X-linked genes inherited from a healthy mother, arguing for the X-linked recessive inheritance hypothesis. Moreover, (19q13.2) is the only gene carrying more than one SNV in more than one patient, making it a strong candidate for COS. Mutations were distributed in various chromosomes illustrating the genetic heterogeneity of COS. More than 90% of CNVs involved in COS are also involved in ASD, supporting the idea that there may be genetic overlap between these disorders. Different mutations associated with COS are probably still unknown, and pathogenesis might also be explained by the association of different genetic variations (two or more CNVs or CNVs and SNVs) as well as association with early acquired brain lesions such as infection, hypoxia, or early childhood trauma.
PubMed: 31921276
DOI: 10.3389/fgene.2019.01137