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European Archives of Psychiatry and... Oct 2020Primary schizophreniform psychoses are thought to be caused by complex gene-environment interactions. Secondary forms are based on a clearly identifiable organic cause,... (Review)
Review
Autoimmune encephalitis as a differential diagnosis of schizophreniform psychosis: clinical symptomatology, pathophysiology, diagnostic approach, and therapeutic considerations.
Primary schizophreniform psychoses are thought to be caused by complex gene-environment interactions. Secondary forms are based on a clearly identifiable organic cause, in terms of either an etiological or a relevant pathogenetic factor. The secondary or "symptomatic" forms of psychosis have reentered the focus stimulated by the discovery of autoantibody (Ab)-associated autoimmune encephalitides (AEs), such as anti-NMDA-R encephalitis, which can at least initially mimic variants of primary psychosis. These newly described secondary, immune-mediated schizophreniform psychoses typically present with the acute onset of polymorphic psychotic symptoms. Over the course of the disease, other neurological phenomena, such as epileptic seizures, movement disorders, or reduced levels of consciousness, usually arise. Typical clinical signs for AEs are the acute onset of paranoid hallucinatory symptoms, atypical polymorphic presentation, psychotic episodes in the context of previous AE, and additional neurological and medical symptoms such as catatonia, seizure, dyskinesia, and autonomic instability. Predominant psychotic courses of AEs have also been described casuistically. The term autoimmune psychosis (AP) was recently suggested for these patients. Paraclinical alterations that can be observed in patients with AE/AP are inflammatory cerebrospinal fluid (CSF) pathologies, focal or generalized electroencephalographic slowing or epileptic activity, and/or suspicious "encephalitic" imaging findings. The antibody analyses in these patients include the testing of the most frequently found Abs against cell surface antigens (NMDA-R, CASPR2, LGI1, AMPA-R, GABA-R), intracellular antigens (Hu, Ri, Yo, CV2/CRMP5, Ma2 [Ta], amphiphysin, GAD65), thyroid antigens (TG, TPO), and antinuclear Abs (ANA). Less frequent antineuronal Abs (e.g., against DPPX, GABA-R, glycine-R, IgLON5) can be investigated in the second step when first step screening is negative and/or some specific clinical factors prevail. Beyond, tissue-based assays on brain slices of rodents may detect previously unknown antineuronal Abs in some cases. The detection of clinical and/or paraclinical pathologies (e.g., pleocytosis in CSF) in combination with antineuronal Abs and the exclusion of alternative causes may lead to the diagnosis of AE/AP and enable more causal therapeutic immunomodulatory opportunities.
Topics: Autoimmune Diseases of the Nervous System; Diagnosis, Differential; Encephalitis; Humans; Psychotic Disorders; Schizophrenia
PubMed: 32166503
DOI: 10.1007/s00406-020-01113-2 -
Psychodynamic Psychiatry 2022Borderline personality disorder (BPD) is fundamentally a syndrome composed of symptoms (primarily of emotional dysregulation) and a number of true personality traits...
Borderline personality disorder (BPD) is fundamentally a syndrome composed of symptoms (primarily of emotional dysregulation) and a number of true personality traits (such as inordinate anger, impulsivity, and a tendency to stress-related paranoid ideation). Whereas schizotypal personality disorder, with its cognitive peculiarities (ideas of reference, odd beliefs, eccentric speech), is closely linked as a genetic condition-"borderline" to the major condition schizophrenia-BPD is less closely linked to bipolar disorder. Some cases of BPD are linked genetically to and are in the "border" of bipolar disorder. But the condition can also arise from adverse post-natal factors: parental cruelty or neglect, or incest. In some BPD patients, both are present: risk genes for bipolar disorder and adverse conditions within the family. The genetic risk is often overlooked. To avoid this, initial evaluations should always include a careful and extensive family history for mood disorders, and should extend out to grandparents, aunts, uncles, and cousins. Where the history suggests a genetic link to bipolar disorder, a mood stabilizer such as lithium or lamotrigine, even in modest doses, may be particularly beneficial, more so than conventional antidepressants. In some patients, ADHD was present in childhood, BPD was diagnosed during or after puberty, and a form of bipolar disorder becomes apparent during their 20s. As for the psychotherapeutic component, the patient's cognitive style and capacity for introspection will help determine whether a primarily expressive (psychoanalytically oriented) technique is preferable or a primarily cognitive-behavioral technique. Flexibility is necessary, since during emotional crises, supportive and limit-setting interventions will be needed, along with psychotropic medications, and where necessary, programs to help combat substance abuse (which is common among patients with BPD).
Topics: Antidepressive Agents; Bipolar Disorder; Borderline Personality Disorder; Humans; Personality; Substance-Related Disorders
PubMed: 35235397
DOI: 10.1521/pdps.2022.50.1.45 -
Alternative Therapies in Health and... Jul 2023Schizophrenia is a mental condition that is affecting approx. 1.0 percent of the worldwide population, with devastating consequences for affected individuals and their... (Review)
Review
CONTEXT
Schizophrenia is a mental condition that is affecting approx. 1.0 percent of the worldwide population, with devastating consequences for affected individuals and their families. Homoeopathy could be an effective alternative mode of treatment and can minimize the consequences of it.
OBJECTIVE
This study is done to have a brief review of the condition of Schizophrenia and to evaluate the role of Homoeopathy as an alternative mode of treatment in patients suffering from this condition.
DESIGN
The research team performed a narrative review by searching Pubmed, IJRH, ISOR-JDMS, WHO, and Medscape databases. Reference books related to medicine and homoeopathy were also reviewed. The search used the keywords like Schizophrenia, Homoeopathy, psychiatry, hallucinations, paranoia, ICD-10, DSM-5, etc.
SETTING
This study is conducted at Faculty of Homoeopathic Sciences in Jayoti Vidyapeeth Women's University.
RESULTS
Schizophrenia alters the thinking, feeling and behavior of affected person and is presented in form of delusion, hallucination with social withdrawal. Homoeopathy can be an alternative mode of treatment to not only help in improving this condition but also treat the same. There are not much studies that has been conducted to evaluate the role of Homoeopathy in schizophrenia. Out of few, one study has suggested improvement in the symptoms of paranoid schizophrenia using Brief Psychiatric Rating Scale (BPRS) score system.
CONCLUSIONS
Schizophrenia is a psychiatric condition not only affecting routine of daily of life but also the Quality of life. Homoeopathy is a non-toxic, gentle, permanent treatment which is based on totality of symptoms (TOS) and individualization. In the process of construction of TOS and individualization, more importance is given to mental symptoms. As again pschizophrenia is a psychiatric condition which affects the mental process of patient, Homoeopathy can be used as an effective method of treatment but to establish the efficacy of it, more studies including randomized controlled trials are suggested.
Topics: Humans; Female; Schizophrenia; Homeopathy; Quality of Life
PubMed: 34453506
DOI: No ID Found -
Philosophy, Ethics, and Humanities in... Nov 2023Schizophrenia stands as one of the most studied and storied disorders in the history of clinical psychology; however, it remains a nexus of conflicting and competing... (Review)
Review
Schizophrenia stands as one of the most studied and storied disorders in the history of clinical psychology; however, it remains a nexus of conflicting and competing conceptualizations. Patients endure great stigma, poor treatment outcomes, and condemnatory prognosis. Current conceptualizations suffer from unstable categorical borders, heterogeneity in presentation, outcome and etiology, and holes in etiological models. Taken in aggregate, research and clinical experience indicate that the class of psychopathologies oriented toward schizophrenia are best understood as spectra of phenomenological, cognitive, and behavioral modalities. These apparently taxonomic expressions are rooted in normal human personality traits as described in both psychodynamic and Five Factor personality models, and more accurately represent explicable distress reactions to biopsychosocial stress and trauma. Current categorical approaches are internally hampered by axiomatic bias and systemic inertia rooted in the foundational history of psychological inquiry; however, when such axioms are schematically decentralized, convergent cross-disciplinary evidence outlines a more robust explanatory construct. By reconceptualizing these disorders under a dimensional and cybernetic model, the aforementioned issues of instability and inaccuracy may be resolved, while simultaneously opening avenues for both early detection and intervention, as well as for more targeted and effective treatment approaches.
Topics: Humans; Schizotypal Personality Disorder; Schizophrenia, Paranoid; Schizoid Personality Disorder; Personality; Paranoid Personality Disorder
PubMed: 37936219
DOI: 10.1186/s13010-023-00142-8 -
Anxiety, Stress, and Coping May 2023Anxiety is a dominant emotion in schizophrenia. It is most often diagnosed by questionnaire-based methods. In this study, it was decided to analyse the utterances of...
BACKGROUND AND OBJECTIVES
Anxiety is a dominant emotion in schizophrenia. It is most often diagnosed by questionnaire-based methods. In this study, it was decided to analyse the utterances of patients with schizophrenia for the occurrence of lexical indicators of anxiety, which are a good predictor of experienced anxiety and lie beyond the subject's control.
DESIGN
The indicators most frequently described in the literature and considered to be of the most significant diagnostic value were selected: first-person pronouns and verbs; causal expressions and conjunctions; affirmative and negative particles; and dogmatic expressions. It was assumed that more of these would appear in the utterances of people with schizophrenia than in the utterances of healthy subjects.
METHODS
The study was conducted on 130 patients with paranoid schizophrenia and 130 healthy subjects. They were asked to describe five pictures.
RESULTS
In all verbal indicators of anxiety (except for negative particles) patients with positive schizophrenia attained the highest values, differing significantly from the results for the control groups.
CONCLUSION
This result is consistent with the subject literature, which emphasizes the high level of anxiety in schizophrenia, especially in its first phase, when the generative symptoms of the illness predominate.
Topics: Humans; Schizophrenia, Paranoid; Anxiety; Anxiety Disorders; Emotions; Surveys and Questionnaires
PubMed: 35561064
DOI: 10.1080/10615806.2022.2076081