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Behavior Therapy Jan 2023There is currently limited research examining self-structure in clinical groups and no current data on the extent to which self-structure is amendable to change... (Randomized Controlled Trial)
Randomized Controlled Trial
There is currently limited research examining self-structure in clinical groups and no current data on the extent to which self-structure is amendable to change following psychological therapy. We address this important gap by examining self-structure in individuals with persecutory delusions using the card sort task, an established paradigm measuring key self-structure indices, including the degree to which self-structure is compartmentalized (characterized by primarily positive or negative attributes, as opposed to a mix of both), and the proportion and importance of negative attributes. In Study 1, individuals with a schizophrenia spectrum diagnosis with current persecutory delusions (clinical group, n = 27) and a healthy control group (n = 47) were compared on self-structure indices. In Study 2 (n = 27), the clinical group also completed the card sort task before and after randomization to either a 12-week mindfulness-based psychological therapy or treatment-as-usual control. In Study 1, self-structure differed significantly between the clinical and control groups. The clinical group had a greater proportion of negative attributes, assigned more importance to negative self-aspects, and had more compartmentalized self-structures compared with controls. In Study 2 there were no associations between delusion severity and self-structure. Large effect sizes for reductions in compartmentalization and proportion of negative attributes across self-aspects were found following mindfulness therapy. The findings highlight key differences in self-structure between individuals with persecutory delusions and healthy controls, and suggest that it might be possible to change self-structure following psychological therapy. These data support the central role of the self in theoretical models of paranoid thinking.
Topics: Humans; Delusions; Schizophrenia; Self Concept
PubMed: 36608970
DOI: 10.1016/j.beth.2022.07.011 -
Psychiatria Danubina 2023Misattribution of motivational salience to non-salient (neutral) stimuli could be viewed as a hallmark of psychosis in schizophrenia. Studies have recently revealed...
BACKGROUND
Misattribution of motivational salience to non-salient (neutral) stimuli could be viewed as a hallmark of psychosis in schizophrenia. Studies have recently revealed increased subjective experience of emotional arousal (EA) to neutral social stimuli in paranoid schizophrenia psychosis, suggesting a misattribution of emotional salience to them. We examined this phenomenon directly by quantifying the level of EA subjectively attributed to low-arousal, neutral-valenced faces.
SUBJECTS AND METHODS
Patients with remitted schizophrenia (PG) (n=26), first-degree relatives of schizophrenic patients (RG) (n=25), and healthy controls (HCG) (n=36) were compared in terms of oxidative stress parameters -serum Superoxide Dismutase, Catalase, Glutathione Peroxidase (GPx), Nitrite, Nitrate, Malondialdehyde, and Total Glutathione levels-, social cognition measured by the Reading the Mind in the Eyes Test and working memory measured by the N-back Task. Groups were compared, assuming that HCG had a genetically lower risk of schizophrenia compared to PG and RG.
RESULTS
HCG performed significantly better than PG and RG, who were genetically at high risk, in terms of social cognition (respectively p=0.000, p=0.014), working memory (respectively p=0.001, p=0.003), and had statistically lower Glutathione Peroxidase (GPX) level than the PG and RG (both p:0.000). After controlling for the effect of the general intellectual abilities measured by the Raven Standard Progressive Matrices Test and working memory the differences between groups on the Eyes Test disappeared (p=0.057). However, this value tended to be significant.
CONCLUSION
It was concluded that social cognition and working memory and GPx level may be used as endophenotypes and social cognition, working memory, and general intellectual skills are different but strongly related constructs. Endophenotypes guide treatment targets even after the disease has developed. The results of our study showed that in addition to psychopharmacological treatments, interventions to reduce oxidative stress and approaches to improve cognitive skills will have a positive impact on the disease's progression.
Topics: Humans; Social Cognition; Psychotic Disorders; Cognition; Schizophrenia, Paranoid; Oxidative Stress; Glutathione Peroxidase; Neuropsychological Tests
PubMed: 37992097
DOI: 10.24869/psyd.2023.523 -
Neuropsychiatric Disease and Treatment 2021Schizophrenia is a chronic relapsing and remitting disorder associated with significant impairments in social and vocational functioning and a shortened lifespan, and it...
Schizophrenia is a chronic relapsing and remitting disorder associated with significant impairments in social and vocational functioning and a shortened lifespan, and it is a disabling psychiatric brain syndrome whose phenotype is characterized by three core symptom domains: positive symptoms, such as delusions and hallucinations, negative symptoms, which include lack of motivation and social withdrawal, and cognitive impairment. Moreover, patients with schizophrenia have severe problems with personal and social relations which affect their quality of life. Antipsychotic medications in conjunction with psychosocial interventions can help patients achieve recovery. Here are described three clinical cases of schizophrenic patients treated with cariprazine for inadequate response to a previous treatment. The purpose of this clinical series is to give useful information for the use of cariprazine in clinical practice.
PubMed: 34285492
DOI: 10.2147/NDT.S315653 -
Journal of Mental Health (Abingdon,... Feb 2024Time perspective (TP) offers a new understanding of human personality, postulating that there are individual differences in how our mind assigns our experiences to...
BACKGROUND
Time perspective (TP) offers a new understanding of human personality, postulating that there are individual differences in how our mind assigns our experiences to different time categories. This concept may shed new light on the role of personality traits in shaping vulnerability to the internalized stigma.
AIM
In this paper we propose a novel approach to clarifying the underpinning of self-stigma by empirically exploring its links with TP.
METHOD
We conducted a cross-sectional study among 86 patients with ICD-10 diagnoses of paranoid schizophrenia to validate the predictive role of TP for self-stigma. We used the Zimbardo Time Perspective Inventory (ZTPI), Internalized Stigma of Mental Illness scale (ISMI) and Brief Psychiatric Rating Scale (BPRS).
RESULTS
We found significant positive correlations of self-stigma with Past-Negative, Future-Negative and Present-Fatalistic TP categories and negative correlation with the Future-Positive category. The hierarchical regression analyses revealed that two TP categories and Deviation from the Balanced Time Perspective (DBTP) are significant predictors of self-stigma over and above sociodemographic and clinical control variables. Conclusion. The results of the study confirm the hypothesis that TP opens new possibilities to understand proneness or resistance to self-stigmatization, and this may provide a basis for novel approaches to anti-self-stigma interventions.
Topics: Humans; Schizophrenia; Cross-Sectional Studies; Surveys and Questionnaires; Social Stigma; Stereotyping; Self Concept
PubMed: 36883339
DOI: 10.1080/09638237.2023.2182413 -
Ideggyogyaszati Szemle May 2023
Although rumination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small...
BACKGROUND AND PURPOSE
Although rumination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small number of research has been carried out on the topic involving both patient and non clinical participants. The aim of this study is to examine the relationship between schizotypal traits and rumination using a transdiagnostic approach, involving participants living with psychotic disorders and sine morbo individuals.
.METHODS
We recruited participants living with psychotic disorders (paranoid schizophrenia, hebephrenia, schizoaffective disorder, etc.) (n = 30) and controls who had not been diagnosed with any mental illnesses (n = 67). The connection between rumination and schizotypal traits was examined by self-report questionnaire method in a cross-sectional arrangement. The Oxford-Liverpool Inventory was used to measure schizotypal traits, and the Ruminative Thought Style Questionnaire was used to determine the level of rumination.
.RESULTS
Schizotypal symptoms (β = 0.575; p < 0.001), especially cognitive disorganization (β = 0.459; p < 0.001) and unusual experiences (β = 0.221; p = 0.029) significantly explained the degree of rumination.
.CONCLUSION
Our results support the hypothesis that the association between rumination and schizotypic traits is due to decreased cognitive inhibitory functions.
.Topics: Humans; Schizotypal Personality Disorder; Cross-Sectional Studies; Psychotic Disorders; Surveys and Questionnaires; Personality
PubMed: 37294028
DOI: 10.18071/isz.76.0149 -
Cureus Jan 2023Paraphrenia is a chronic psychotic disorder characterized by a strong delusional component with preservation of thought and personality. It was first introduced as a...
Paraphrenia is a chronic psychotic disorder characterized by a strong delusional component with preservation of thought and personality. It was first introduced as a disorder associated with paranoid dementia and paranoia, but with less personality deterioration than schizophrenia and without fulfilling the clinical features of a delusional disorder. This classic diagnostic entity is not currently listed in main diagnostic systems, rendering delusional disorders difficult to classify in cases that resemble the concept of paraphrenia. We revisit the concept of paraphrenia through a critical review based on a clinical vignette of a patient followed at the psychiatry department of the University Hospital Center of São João.
PubMed: 36726768
DOI: 10.7759/cureus.34391 -
Journal of Clinical Medicine Jul 2023Although the influence of the weather on the well-being and mental health of psychiatric patients has been widely seen, the relationships between various seasonal...
Although the influence of the weather on the well-being and mental health of psychiatric patients has been widely seen, the relationships between various seasonal weather factors and depressive, manic, anxiety, and psychotic states have not been systematized in the literature. The current article describes the seasonal changes in weather-related immune responses and their impact on the development of episodes of depression, mania, psychosis, and anxiety, highlighting the T-helper 1 (Th1) and Th2 immune balance as their potential trigger. In autumn-winter depression, the hyperactivation of the Th1 system, possibly by microbial/airborne pathogens, may lead to the inflammatory inhibition of prefrontal activity and the subcortical centers responsible for mood, drive, and motivation. Depressive mood periods are present in most people suffering from schizophrenia. In the spring and summertime, when the compensating anti-Th1 property of the Th2 immune system is activated, it decreases the Th1 response. In individuals immunogenetically susceptible to psychosis and mania, the inhibition of Th1 by the Th2 system may be excessive and lead to Th2-related frontal and subcortical hyperactivation and subsequent psychosis. In people suffering from bipolar disorder, hyperintense changes in white matter may be responsible for the partial activation of subcortical areas, preventing full paranoid psychosis. Thus, psychosis may be mood-congruent in affective disorders.
PubMed: 37510730
DOI: 10.3390/jcm12144615 -
Early Intervention in Psychiatry Dec 2022Thinking biases are posited to be involved in the genesis and maintenance of delusions. Persecutory delusions are one of the most commonly occurring delusional subtypes... (Review)
Review
AIM
Thinking biases are posited to be involved in the genesis and maintenance of delusions. Persecutory delusions are one of the most commonly occurring delusional subtypes and cause substantial distress and disability to the individuals experiencing them. Their clinical relevance confers a rationale for investigating them. Particularly, this review aims to elucidate which cognitive biases are involved in their development and persistence.
METHODS
MEDLINE, Embase, PsycINFO and Global Health were searched from the year 2000 to June 2020. A formal narrative synthesis was employed to report the findings and a quality assessment of included studies was conducted.
RESULTS
Twenty five studies were included. Overall, 18 thinking biases were identified. Hostility and trustworthiness judgement biases appeared to be specific to persecutory delusions while jumping to conclusions, self-serving attributional biases and belief inflexibility were proposed to be more closely related to other delusional subtypes. While the majority of the biases identified were suggested to be involved in delusion maintenance, hostility biases, need for closure and personalizing attributional biases were believed to also have aetiological influences.
CONCLUSIONS
These findings show that some cognitive biases are specific to paranoid psychosis and appear to be involved in the formation and/or persistence of persecutory delusions.
Topics: Humans; Delusions; Paranoid Disorders; Bias; Psychotic Disorders
PubMed: 35396904
DOI: 10.1111/eip.13292 -
Consortium Psychiatricum Mar 2021Associations of disturbances in innate and adaptive immunity during the clinical course of schizophrenia have been found in a number of studies. Yet, the relationship of...
INTRODUCTION
Associations of disturbances in innate and adaptive immunity during the clinical course of schizophrenia have been found in a number of studies. Yet, the relationship of immune parameters and systemic inflammation in relation to the clinical course of the disease and its prognosis, remains poorly understood, which highlights an interesting topic for further research. The goal of this study was to research the immuno-inflammatory changes in patients with clinical continuous and episodic paranoid schizophrenia, to assess the pathogenetic significance of these changes.
METHODS
Thirty-six patients with paranoid schizophrenia, of which 20 had episodic symptoms and 16 had continuous symptoms, consented to participate in the study, together with 30 healthy volunteers. In the study we assessed the parameters of innate immune response (serum levels of key pro-inflammatory and anti-inflammatory cytokines, C-reactive protein) and the adaptive immune response, including humoral-mediated immunity (serum immunoglobulins IgA, IgM, IgG, circulating immune complexes), as well as the cell link of adaptive immunity (key lymphocyte subpopulations). Positive and negative symptoms were assessed with the positive and negative symptoms scale; frontal dysfunction was assessed by Frontal Assessment Battery (FAB).
RESULTS
Both patient groups had higher than normal levels of C-reactive protein and IL-8. There was a significant elevation of circulating immune complexes among patients with continuous symptoms of schizophrenia, compared to patients with episodic symptoms and healthy controls. Levels of CD45+CD3+ lymphocytes (T-cells) differed between clinical groups, with higher values identified among patients with episodic symptoms and lower values among those with continuous symptoms. In addition, patients with episodic symptoms had significantly increased levels of CD45+CD3+CD4+CD25+CD127- regulatory T-cells. Finally, the level of CD45+CD3-CD19+ B-cells was significantly higher among patients with continuous symptoms vs. patients with episodic symptoms and the control groups. Markers of activation of humoral immunity were associated with the severity of frontal disorders in these patients.
DISCUSSION
Comprehensive data on the serum level of cytokines and the parameters of adaptive immunity among individuals with continuous schizophrenia, by comparison with patients with episodic schizophrenia, are practically absent in the literature. We have shown that among those with continuous schizophrenia, there are signs of systemic inflammation and chronic activation of the adaptive humoral immune response, while among patients with episodic symptoms of the disease, there are signs of systemic inflammation and certain activation of cell-mediated immunity, without significant changes in the humoral link of adaptive immunity.
CONCLUSION
More studies are needed, but the data obtained in this study are important for subsequent clinical studies of new treatment methods, based on various immunophenotypes of schizophrenia.
PubMed: 38601098
DOI: 10.17816/CP66 -
The Lancet. Psychiatry Aug 2021Predictive coding has played a transformative role in the study of psychosis, casting delusions and hallucinations as statistical inference in a system with abnormal... (Review)
Review
Predictive coding has played a transformative role in the study of psychosis, casting delusions and hallucinations as statistical inference in a system with abnormal precision. However, the negative symptoms of schizophrenia, such as affective blunting, avolition, and asociality, remain poorly understood. We propose a computational framework for emotional expression based on active inference-namely that affective behaviours such as smiling are driven by predictions about the social consequences of smiling. Similarly to how delusions and hallucinations can be explained by predictive uncertainty in sensory circuits, negative symptoms naturally arise from uncertainty in social prediction circuits. This perspective draws on computational principles to explain blunted facial expressiveness and apathy-anhedonia in schizophrenia. Its phenomenological consequences also shed light on the content of paranoid delusions and indistinctness of self-other boundaries. Close links are highlighted between social prediction, facial affect mirroring, and the fledgling study of interoception. Advances in automated analysis of facial expressions and acoustic speech patterns will allow empirical testing of these computational models of the negative symptoms of schizophrenia.
Topics: Anhedonia; Apathy; Computer Simulation; Delusions; Facial Expression; Hallucinations; Humans; Interoception; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology
PubMed: 33865502
DOI: 10.1016/S2215-0366(20)30527-7