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PeerJ 2022This article describes the most likely classes of proteins and molecular processes that specifically characterize schizophrenic spectrum disorders such as simple and...
This article describes the most likely classes of proteins and molecular processes that specifically characterize schizophrenic spectrum disorders such as simple and paranoid schizophrenia, schizotypal disorder, and acute polymorphic psychotic disorder (APPD). The identification of patients' serum proteins was carried out using mass spectrometry. For patients with paranoid schizophrenia, the proteins responsible for translation and transcription are characteristic. A significant part of the proteins of patients with simple schizophrenia regulate the cell's main metabolic and transport processes. These are proteins of the receptor system, vesicular transport, and extracellular matrix, which mainly carry out catabolic processes. The proteins of patients with schizotypal disorder mostly coincided with the classes of other patients, apart from chaperone proteins, which were not found in other studied groups. These proteins are mainly involved in anabolic processes. The main classes of proteins found in patients with APPD are responsible for the metabolism of nucleic acids. Active apoptosis processes were also revealed in these patients. These results from our basic knowledge about the molecular mechanisms of the pathogenesis of these disorders.
Topics: Humans; Proteomics; Schizophrenic Psychology; Psychotic Disorders; Schizotypal Personality Disorder; Schizophrenia, Paranoid
PubMed: 36061748
DOI: 10.7717/peerj.13907 -
Current Behavioral Neuroscience Reports Jun 2017Paranoid Personality Disorder (PPD) has historically been neglected by science out of proportion to its prevalence or its association with negative clinical outcomes....
PURPOSE OF REVIEW
Paranoid Personality Disorder (PPD) has historically been neglected by science out of proportion to its prevalence or its association with negative clinical outcomes. This review provides an update on what is known about PPD regarding its prevalence, demographics, comorbidity, biological mechanism, risk factors, and relationship to psychotic disorders.
RECENT FINDINGS
PPD has long been the subject of a rich and prescient theoretical literature which has provided a surprisingly coherent account of the psychological mechanism of non-delusional paranoia. Available data indicate that PPD has a close relationship with childhood trauma and social stress. Descriptive data on a sample of 115 individuals with Paranoid Personality Disorder is examined in comparison with a group of individuals with Borderline Personality Disorder. The descriptive data largely confirm previously identified relationships between Paranoid Personality Disorder and childhood trauma, violence, and race. We identify important similarities to and differences from Borderline Personality Disorder.
SUMMARY
PPD continues to be an important construct in the clinic and the laboratory. Available data lead to a reconsideration of the disorder as more closely related to trauma than to schizophrenia.
PubMed: 29399432
DOI: 10.1007/s40473-017-0116-7 -
Psychiatria Polska Apr 2018The purpose of the study was to investigate the dependence between the sense of coherence (SOC) and symptomatic improvement as it is the determinant of recovery process...
OBJECTIVES
The purpose of the study was to investigate the dependence between the sense of coherence (SOC) and symptomatic improvement as it is the determinant of recovery process of patients with schizophrenia spectrum disorders.
METHODS
The group of 134 patients was surveyed. 118 of them suffered from paranoid schizophrenia and 16 suffered from schizoaffective disorders, all were hospitalized in psychiatric clinics. Mean age was 36.22 years (SD = 8.51). Research was based on the Orientation to Life Questionnaire by A. Antonovsky. The level of psychopathological symptoms intensity was investigated twice, at the start and at the end of hospitalization with the Positive and Negative Syndrome Scale (PANSS). The rate of recovery was the margin between psychopathological symptoms intensification at the beginning and at the end of hospitalization.
RESULTS
The analysis show that higher sense of comprehensibility (SOCCOM) favors lesser intensity of negative symptoms and overall psychiatric symptomatology in PANSS while starting the hospitalization. Also patients with higher level of sense of coherence (SOC) show less negative symptoms escalation during hospital admission. Results show that higher level of sense of coherence (SOC) and higher level of sense of comprehensibility (SOCCOM) coexist with lesser difference in the intensification of psychopathological symptoms.
CONCLUSIONS
This article tries to show the role of sense of coherence in the recovery process among people with schizophrenic disorders. Coexistence of higher sense of coherence with greater negative symptoms and psychopathological symptoms can be perceived as an insight to the illness, which can be recognized as an expression of recovery.
Topics: Adaptation, Psychological; Adult; Female; Humans; Male; Quality of Life; Schizophrenia; Schizophrenic Psychology; Sense of Coherence; Surveys and Questionnaires; Young Adult
PubMed: 29975362
DOI: 10.12740/PP/OnlineFirst/69697 -
Consciousness and Cognition May 2015Delusional beliefs are typically pathological. Being pathological is clearly distinguished from being false or being irrational. Anna might falsely believe that his... (Review)
Review
Delusional beliefs are typically pathological. Being pathological is clearly distinguished from being false or being irrational. Anna might falsely believe that his husband is having an affair but it might just be a simple mistake. Again, Sam might irrationally believe, without good evidence, that he is smarter than his colleagues, but it might just be a healthy self-deceptive belief. On the other hand, when a patient with brain damage caused by a car accident believes that his father was replaced by an imposter or another patient with schizophrenia believes that "The Organization" painted the shops on a street in red and green to convey a message, these beliefs are not merely false or irrational. They are pathological. What makes delusions pathological? This paper explores the negative features because of which delusional beliefs are pathological. First, I critically examine the proposals according to which delusional beliefs are pathological because of (1) their strangeness, (2) their extreme irrationality, (3) their resistance to folk psychological explanations or (4) impaired responsibility-grounding capacities of people with them. I present some counterexamples as well as theoretical problems for these proposals. Then, I argue, following Wakefield's harmful dysfunction analysis of disorder, that delusional beliefs are pathological because they involve some sorts of harmful malfunctions. In other words, they have a significant negative impact on wellbeing (=harmful) and, in addition, some psychological mechanisms, directly or indirectly related to them, fail to perform the jobs for which they were selected in the past (=malfunctioning). An objection to the proposal is that delusional beliefs might not involve any malfunctions. For example, they might be playing psychological defence functions properly. Another objection is that a harmful malfunction is not sufficient for something to be pathological. For example, false beliefs might involve some malfunctions according to teleosemantics, a popular naturalist account of mental content, but harmful false beliefs do not have to be pathological. I examine those objections in detail and show that they should be rejected after all.
Topics: Delusions; Humans
PubMed: 25467777
DOI: 10.1016/j.concog.2014.10.008 -
PCN Reports : Psychiatry and Clinical... Jun 2023In the 1960s and 1970s, there was widespread discussion in Japan about the pathological experience of "unpleasant odors emanating from one's body." This symptom is... (Review)
Review
In the 1960s and 1970s, there was widespread discussion in Japan about the pathological experience of "unpleasant odors emanating from one's body." This symptom is called "Jikoshu," and this term was used in combination with various words, such as "Genkaku" (hallucination) and "Moso" (delusion), reflecting its symptomatological ambiguity. The best-known term in the English-language literature is ( phobia). By further abstracting this symptom and viewing it as a delusion-like experience of "something leaking out of me," egorrhea syndrome (Fujinawa) was proposed, which was considered to be partly a pathology of schizophrenia. Similar cases were characteristically observed during adolescence, and a study emerged suggesting that the syndrome was "adolescent paranoia" (Murakami), distinct from schizophrenia. However, the terms "Jikoshu-Taiken" ( experience; Kasahara et al.) and "Jikoshu-Sho" ( syndrome; Miyamoto) were proposed to emphasize the nosological ambiguity. Considered a culture-bound syndrome unique to Japan or East Asia, received little attention in the English-language literature apart from a 1971 study of olfactory reference syndrome (Pryse-Phillips), which presents with similar symptoms. In recent years, research has placed this disorder within the obsessive-compulsive spectrum, and it has been adopted as an ICD-11 disorder under the term "olfactory reference disorder."
PubMed: 38868136
DOI: 10.1002/pcn5.112 -
The Cochrane Database of Systematic... Oct 2017Delivering the diagnosis of a serious illness is an important skill in most fields of medicine, including mental health. Research has found that communication skills can... (Review)
Review
BACKGROUND
Delivering the diagnosis of a serious illness is an important skill in most fields of medicine, including mental health. Research has found that communication skills can impact on a person's recall and understanding of the diagnosis, treatment options and prognosis. People may feel confused and perplexed when information about their illness is not communicated properly. Sharing information about diagnosis of a serious mental illness is particularly challenging. The nature of mental illness is often difficult to explain since there may be no clear aetiology, and the treatment options and prognosis may vary enormously. In addition, newly diagnosed psychiatric patients, who are actively ill, often may not accept their diagnosis due to lack of insight or stigma attached to the condition. There are several interventions that aim to help clinicians to communicate life changing medical diagnoses to people; however, little is known specifically for delivering a diagnosis of schizophrenia.
OBJECTIVES
To evaluate evidence from randomised controlled trials (RCTs) for the efficacy of different communication strategies used by clinicians to inform people about the diagnosis and outcome of schizophrenia compared with treatment as usual and to compare efficacy between different communication strategies.
SEARCH METHODS
On 22 June 2015 and 29 June 2016, we searched the Cochrane Schizophrenia Group's Study-Based Register of Trials. We also searched sources of grey literature (e.g., dissertations, theses, clinical reports, evaluations published on websites, clinical guidelines and reports from regulatory agencies).
SELECTION CRITERIA
We planned to include all relevant RCTs that included adults with schizophrenia or related disorders, including schizophreniform disorder, schizoaffective disorder and delusional disorder. The trials would have investigated the effects of communication strategy or strategies that helped clinicians deliver information specifically about a diagnosis of schizophrenia (which can also include communication regarding the treatment options available and prognosis).
DATA COLLECTION AND ANALYSIS
Review authors independently examined all reports from the searches for any relevant studies. We planned to extract data independently. For binary outcomes, we would have calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data, we would have estimated the mean difference (MD) between groups and its 95% CI. We would have employed a random-effects model for analyses. We planned to assess risk of bias for included studies. We created a 'Summary of findings' table using GRADE.
MAIN RESULTS
The searches identified 44 records which appeared to be relevant to the aims of the review. We obtained full reports for seven potential studies; however, after close inspection none of these studies met the inclusion criteria.
AUTHORS' CONCLUSIONS
Good communication of diagnosis can affect treatment planning, compliance and patient outcomes, especially in the case of conditions such as schizophrenia, which has the potential to cause serious life disruption for both people with schizophrenia and their carers. Currently, there is no evidence based on findings from RCTs assessing the effects of communication strategies for disclosing the diagnosis of schizophrenia and related disorders. Research is required.
Topics: Communication; Disclosure; Humans; Schizophrenia; Schizophrenic Psychology
PubMed: 29064090
DOI: 10.1002/14651858.CD011707.pub2 -
Psychiatria Polska Oct 2023We present a case of a 32-years-old female patient diagnosed with paranoid schizophrenia for many years who has developed neuroleptic malignant syndrome (NMS) as a... (Review)
Review
We present a case of a 32-years-old female patient diagnosed with paranoid schizophrenia for many years who has developed neuroleptic malignant syndrome (NMS) as a result of long-acting antipsychotic's injection. Since the initial ineffectiveness of benzodiazepines, the course of electroconvulsive therapy (ECT) has been carried out. In spite of the initial promising response to ECT 3 weeks after the admission her somatic and mental state deteriorated greatly, that was hardly explicable solely by the potential loss of effectiveness of ECT or laboratory tests. Diagnostics extended with imaging tests and gynecological examination revealed the connective tissue-covered cap of a popular multivitamin supplement in patient's vagina. During the following deepened interview, she admitted that in fact 6 months ago a piece had gotten stuck while masturbating. However due to the sense of shame and subjective lack of disturbing symptoms she had left it unsaid. One month after the evacuation of the foreign body she has been discharged from the hospital remaining the full remission. The presented case shows that inflammation in the body can complicate catatonia and NMS, causing a non-specific course and difficulties in diagnosis and treatment. In some patients, the inflammatory process may be caused by a foreign body located in various natural orifices in the body. It appears significant in the group of psychiatric patients. Once again it highlights the tremendous role of meticulously conducted interview including the patient's autoerotic life.
Topics: Humans; Female; Adult; Masturbation; Neuroleptic Malignant Syndrome; Benzodiazepines; Electroconvulsive Therapy; Foreign Bodies; Antipsychotic Agents; Catatonia
PubMed: 36542768
DOI: 10.12740/PP/OnlineFirst/138338 -
Psychiatria Polska Feb 2021The aim of the paper is to analyze the case of a man suffering from paranoid schizophrenia who experiences delusions and hallucinations concerning gender change, and to... (Review)
Review
The aim of the paper is to analyze the case of a man suffering from paranoid schizophrenia who experiences delusions and hallucinations concerning gender change, and to present ashort overview of the literature. The data presented in the case study were collected during a clinical interview, in the six-month diagnostic process. The interview was partly structured; the battery of tests were also used: MMPI-2, SCID-I, SCID-II, IPP, MoCA, and WAIS-R. A case study of a person whose birth-assigned sex was male but who identifies as female. In the diagnostic process, it turned out that he had delusions and hallucinations, which seem to have a dominant impact on the gender incongruence. The results of the tests seem to confirm the hypothesis that the diagnosis of paranoid schizophrenia was right. Taking into consideration the presented case study, it can be stated that, diagnosing transsexualism, it is vital to distinguish it from psychotic disorders.
Topics: Diagnosis, Differential; Female; Humans; Male; Psychotic Disorders; Transsexualism
PubMed: 34021547
DOI: 10.12740/PP/OnlineFirst/112442 -
Cureus Feb 2023Delusional infestation disorders are characterized by fixed but false beliefs about infection by a parasite, insect, or other living organism. Shared psychotic disorders...
Delusional infestation disorders are characterized by fixed but false beliefs about infection by a parasite, insect, or other living organism. Shared psychotic disorders are characterized by a single delusion instigated by a "primary" index patient and then induced in one or more "secondary" persons. We describe a case report of shared delusional infestation among an index patient and two family members that generated many healthcare encounters over the course of 12-15 months. This case report highlights the challenges in diagnosing and treating these conditions in the Emergency Department setting and their disproportionate utilization of healthcare resources. We discuss risk factors and characteristics of delusional infestations and shared psychotic disorders, as well as best practices to approach diagnosis, treatment, and disposition in the Emergency Department.
PubMed: 36879695
DOI: 10.7759/cureus.34546 -
Biological Psychiatry. Cognitive... Nov 2022Persecutory delusions are among the most common delusions in schizophrenia and represent the extreme end of the paranoia continuum. Paranoia is accompanied by...
BACKGROUND
Persecutory delusions are among the most common delusions in schizophrenia and represent the extreme end of the paranoia continuum. Paranoia is accompanied by significant worry and distress. Identifying cognitive mechanisms underlying paranoia is critical for advancing treatment. We hypothesized that aberrant belief updating, which is related to paranoia in human and animal models, would also contribute to persecutory beliefs in individuals with schizophrenia.
METHODS
Belief updating was assessed in 42 participants with schizophrenia and 44 healthy control participants using a 3-option probabilistic reversal learning task. Hierarchical Gaussian Filter was used to estimate computational parameters of belief updating. Paranoia was measured using the Positive and Negative Syndrome Scale and the revised Green et al. Paranoid Thoughts Scale. Unusual thought content was measured with the Psychosis Symptom Rating Scale and the Peters et al. Delusions Inventory. Worry was measured using the Dunn Worry Questionnaire.
RESULTS
Paranoia was significantly associated with elevated win-switch rate and prior beliefs about volatility both in schizophrenia and across the whole sample. These relationships were specific to paranoia and did not extend to unusual thought content or measures of anxiety. We observed a significant indirect effect of paranoia on the relationship between prior beliefs about volatility and worry.
CONCLUSIONS
This work provides evidence that relationships between belief updating parameters and paranoia extend to schizophrenia, may be specific to persecutory beliefs, and contribute to theoretical models implicating worry in the maintenance of persecutory delusions.
Topics: Humans; Paranoid Disorders; Schizophrenia; Delusions; Anxiety; Surveys and Questionnaires
PubMed: 35430406
DOI: 10.1016/j.bpsc.2022.03.013