-
Psychology and Psychotherapy Jun 2014It has been argued that attachment theory could enhance our knowledge and understanding of psychotic phenomenology. (Review)
Review
OBJECTIVES
It has been argued that attachment theory could enhance our knowledge and understanding of psychotic phenomenology.
DESIGN
We systematically reviewed and critically appraised research investigating attachment and psychotic phenomenology in clinical and non-clinical samples.
METHODS
We searched databases Pub Med, PsycINFO, Medline and Web of Science using the keywords. Attachment, Adult Attachment, Psychosis, Schizotypy and Schizophrenia and identified 29 studies assessing adult attachment in combination with psychotic phenomenology.
RESULT
The findings indicated that both insecure anxious and insecure avoidant attachment are associated with psychotic phenomenology. Insecurely attached individuals are more vulnerable to developing maladaptive coping strategies in recovering from psychosis. The importance of attachment experiences for processing social information, mentalization skills and developing social relationships, including therapeutic relationships, in samples with psychosis is also highlighted.
CONCLUSION
Attachment style is a clinically relevant construct in relation to development, course and treatment of psychosis.
PRACTITIONER POINTS
Understanding the role of attachment in symptoms may help to gain insight into the development or persistence of symptoms. Associations between attachment and recovery style suggest that it may be helpful to improve attachment security in a context of therapeutic relationships or other social relationships before encouraging people to explore their experiences of psychosis. Associations between insecure attachment and impaired mentalization skills may help in understanding interpersonal difficulties and this knowledge can be used to improve recovery.
Topics: Adult; Humans; Interpersonal Relations; Interview, Psychological; Models, Psychological; Object Attachment; Psychological Theory; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Schizotypal Personality Disorder; Self Report; Theory of Mind
PubMed: 23818184
DOI: 10.1111/papt.12010 -
Human Psychopharmacology Jul 2016We used systematic review methodology to identify and evaluate short-term pharmacological interventions for agitation associated with schizophrenia or bipolar disorder. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
We used systematic review methodology to identify and evaluate short-term pharmacological interventions for agitation associated with schizophrenia or bipolar disorder.
METHOD
We searched electronic databases for randomised controlled trials involving comparisons between current treatments for agitation, benzodiazepines, antipsychotics and placebo. The patient population was adults with agitation associated with psychotic or bipolar disorder treated in specialist mental health services. The outcome of interest was change in agitation measured by accepted standard scales. Paired meta-analyses and network meta-analyses are presented.
RESULTS
Seventeen randomised controlled trials were identified (n = 3841). Treatments included haloperidol, olanzapine, aripiprazole, risperidone and lorazepam. The primary outcome was change in Positive and Negative Syndrome Scale Excited Component scores. Pair-wise comparisons suggest that after 60 min, olanzapine is superior to haloperidol; no other treatment was more effective than any other. At 120 min, loxapine 10 mg is more effective than loxapine 5 mg, and olanzapine is more effective than lorazepam. In the network meta-analyses, no treatment was superior to any other.
CONCLUSION
Because of limitations of available research, firm conclusions could not be drawn regarding the efficacy and safety of any identified intervention. Based on our results, there is no evidence that one drug is more effective or preferred over any other and treatment decisions could be made based on individual patient needs or costs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Topics: Acute Disease; Antipsychotic Agents; Bipolar Disorder; Humans; Psychomotor Agitation; Psychotic Disorders; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 27151529
DOI: 10.1002/hup.2535 -
Social Psychiatry and Psychiatric... Dec 2016Epidemiological studies in the Netherlands have reported an excessive gender gap in the risk for non-affective psychotic disorder (NAPD) among immigrants from Morocco... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Epidemiological studies in the Netherlands have reported an excessive gender gap in the risk for non-affective psychotic disorder (NAPD) among immigrants from Morocco with a higher risk elevation in males compared to females. We examined the consistency of these findings and their generalizability to immigrants from the Maghreb (Mauritania, Morocco, Algeria, Tunisia and Libya) in other European countries.
METHODS
Systematic review and meta-analysis. Medline, PsychINFO and EMBASE databases were searched for publications in the period from January 1970 to April 2014. We included incidence and prevalence studies of non-affective psychotic disorder (NAPD) among migrants from the Maghreb in Europe and studies of subclinical psychotic symptoms (SPS) in representative samples. A meta-analysis was performed on the subgroup of incidence studies.
RESULTS
Five incidence and three prevalence studies of NAPD, and two prevalence studies of SPS, conducted in the Netherlands (n=7), Belgium (n=1), France (n=1) and Italy (n=1) met our inclusion criteria. Across all research designs, the risks of NAPD and SPS were consistently increased among male, not female immigrants from the Maghreb. The meta-analysis of incidence studies of NAPD yielded male-to-female risk ratios of 5.1 [95 % confidence interval (CI) 3.1-8.4] for migrants from the Maghreb, 2.0 (95 % CI 1.6-2.5) for other migrant groups, and 1.8 (95 % CI 1.3-2.5) for non-migrant Europeans.
CONCLUSIONS
The marked gender gap in psychosis risk among migrants from the Maghreb appears a consistent finding, foremost among the Moroccan-Dutch. The small number of studies limits the strength of conclusions that can be drawn about countries other than the Netherlands. Achievement-expectation mismatch, social marginalization and an increased prevalence of illicit drug use are possible explanations.
Topics: Africa, Northern; Emigrants and Immigrants; Europe; Female; Humans; Male; Psychotic Disorders; Sex Factors
PubMed: 27372300
DOI: 10.1007/s00127-016-1261-0 -
Psychiatric Rehabilitation Journal Mar 2021For individuals with a psychotic disorder, dating can present several challenges and lead many to be excluded from intimate relationships. These difficulties may stem...
UNLABELLED
For individuals with a psychotic disorder, dating can present several challenges and lead many to be excluded from intimate relationships. These difficulties may stem from a number of factors, including impairments in social and sexual functioning. Although scientific interest in this topic is mounting, the last quantitative review of the literature dates back to 2003.
OBJECTIVES
The aim of this systematic review was to collect, evaluate, and synthesize quantitative data from studies published in the last 15 years on romantic relationships and sexuality in the context of a psychotic disorder.
METHODS
Articles were retrieved from PsycINFO, PubMed, Web of Science, and ProQuest databases and were retained if they met the following inclusion criteria: (a) original research or meta-analysis, (b) complete or partial sample with a psychotic disorder diagnosis, (c) provision of quantitative data specific to the population of interest, and (d) studies focusing on romantic relationship and/or sexuality variables as correlates, predictors, mediators, or outcomes. Study quality was evaluated using PRISMA criteria.
RESULTS
43 studies were identified, 24 of which were categorized as obstacle-related (e.g., focusing on negative aspects of intimacy, such as risky behaviors) and 19 of which were deemed neutral or recovery-oriented (e.g., focusing on positive aspects of intimacy, such as marital functioning).
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
Results highlight a need for greater communication and assistance in the areas of intimacy and sexuality for persons with psychotic disorders. Better access to resources such as dating skills and couples therapy programs as well as more consumer-oriented research is needed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Humans; Interpersonal Relations; Psychotic Disorders; Sexual Behavior; Sexual Partners; Sexuality
PubMed: 32191102
DOI: 10.1037/prj0000409 -
Acta Psychiatrica Scandinavica Jan 2022To evaluate whether accelerated brain aging occurs in individuals with mood or psychotic disorders. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate whether accelerated brain aging occurs in individuals with mood or psychotic disorders.
METHODS
A systematic review following PRISMA guidelines was conducted. A meta-analysis was then performed to assess neuroimaging-derived brain age gap in three independent groups: (1) schizophrenia and first-episode psychosis, (2) major depressive disorder, and (3) bipolar disorder.
RESULTS
A total of 18 papers were included. The random-effects model meta-analysis showed a significantly increased neuroimaging-derived brain age gap relative to age-matched controls for the three major psychiatric disorders, with schizophrenia (3.08; 95%CI [2.32; 3.85]; p < 0.01) presenting the largest effect, followed by bipolar disorder (1.93; [0.53; 3.34]; p < 0.01) and major depressive disorder (1.12; [0.41; 1.83]; p < 0.01). The brain age gap was larger in older compared to younger individuals.
CONCLUSION
Individuals with mood and psychotic disorders may undergo a process of accelerated brain aging reflected in patterns captured by neuroimaging data. The brain age gap tends to be more pronounced in older individuals, indicating a possible cumulative biological effect of illness burden.
Topics: Aged; Bipolar Disorder; Brain; Depressive Disorder, Major; Humans; Psychotic Disorders; Schizophrenia
PubMed: 34510423
DOI: 10.1111/acps.13371 -
BMC Psychiatry Nov 2019Schizophrenia and other psychotic disorders constitute a huge global burden of disease and they are major contributors to disability as well as premature mortality among... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Schizophrenia and other psychotic disorders constitute a huge global burden of disease and they are major contributors to disability as well as premature mortality among homeless people. This systematic review and meta-analysis aimed to estimate the pooled prevalence of schizophrenia and other psychotic disorders among homeless people.
METHODS
PubMed, Embase, and Scopus were searched to identify pertinent studies. We used a fixed- or random-effect meta-analysis to pool data from the included studies depending on the anticipated heterogeneity. A predesigned search strategy, as well as inclusion and exclusion criteria, were used. We also performed subgroup and sensitivity analysis and Cochran's Q- and the I test was employed to compute heterogeneity. Egger's test and visual inspection of the symmetry in funnel plots were used to assess publication bias.
RESULTS
Thirty-one studies involving 51,925 homeless people were included in the final analysis. The meta-analysis showed a remarkably higher prevalence of psychosis [21.21% (95% CI:13.73, 31.29), I = 99.43%], schizophrenia [10.29% (95%, CI: 6.44, 16.02), I = 98.76%], schizophreniform disorder [2.48% (95% CI: 6.16, 28.11), I = 88.84%] schizoaffective disorder [3.53% (95% CI: 1.33, 9.05), I = 31.63%,] as well as psychotic disorders not otherwise specified [9% (95% CI: 6.92, 11.62), I = 33.38%] among homeless people. The prevalence estimate of psychosis was higher in developing (29.16%) as compared to developed (18.80%) countries. Similarly, the prevalence of schizophrenia was highest in developing (22.15%) than developed (8.83%) countries.
CONCLUSION
This systematic review and meta-analysis revealed that schizophrenia and other psychotic disorders are highly prevalent among homeless people, indicating an urgent need for studies to help develop better mechanisms of prevention, detection as well as treatment of those disorders among homeless people.
Topics: Female; Ill-Housed Persons; Humans; Male; Prevalence; Psychotic Disorders; Schizophrenia
PubMed: 31775786
DOI: 10.1186/s12888-019-2361-7 -
Psychosomatics 2017It is unclear as to which interventions are effective at improving medication adherence in individuals with serious and persistent mental illness. The goal of this... (Review)
Review
BACKGROUND
It is unclear as to which interventions are effective at improving medication adherence in individuals with serious and persistent mental illness. The goal of this systematic review is to synthesize evidence examining the effectiveness, harms, and costs of interventions to improve medication adherence in patients with psychotic spectrum disorders and bipolar disorder.
METHODS
We conducted a systematic search of several electronic databases through January 2015 using a structured search strategy. Studies were included if they involved adult patients in general mental health settings, reported both measures of medication adherence and clinical outcomes, and were of sufficient methodological rigor. Studies were quality assessed and synthesized using established methods.
RESULTS
We identified 24 studies that met inclusion criteria. Overall, 20 studies addressed interventions in patients with psychotic spectrum disorders. These interventions varied widely, with generally mixed findings contributing to low or insufficient strength of evidence; studies involving family members and technology interventions were the most consistently associated with a positive effect; however, the strength of the evidence was low because of intervention heterogeneity. The evidence was insufficient to determine the effectiveness of interventions in patients with bipolar disorder.
CONCLUSIONS
In individuals with psychotic spectrum disorders, interventions with family members or technology had the most consistent positive effect on adherence, although replication with objective adherence measures along with evaluation of harms and costs is needed. There was insufficient evidence to draw conclusions about interventions in individuals with bipolar disorder.
Topics: Antipsychotic Agents; Bipolar Disorder; Counseling; Humans; Medication Adherence; Patient Education as Topic; Psychotherapy; Psychotic Disorders
PubMed: 28139249
DOI: 10.1016/j.psym.2016.09.009 -
Neuroscience and Biobehavioral Reviews Mar 2022Evidence suggests that individuals with autism spectrum disorder have increased rates of co-occurring psychosis and/or bipolar disorder. Considering the peak age of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Evidence suggests that individuals with autism spectrum disorder have increased rates of co-occurring psychosis and/or bipolar disorder. Considering the peak age of onset for psychosis and bipolar disorder occurs in adulthood, we investigated the co-occurrence of these disorders in adults with autism.
METHODS
We conducted a systematic review and meta-analysis (PROSPERO Registration Number: CRD42018104600) to (1) examine the prevalence of psychosis and bipolar disorder in adults with autism, and (2) review potential risk factors associated with their co-occurrence.
RESULTS
Fifty-three studies were included. The pooled prevalence for the co-occurrence of psychosis in adults with autism was 9.4 % (N = 63,657, 95 %CI = 7.52, 11.72). The pooled prevalence for the co-occurrence of bipolar disorders in adults with autism was 7.5 % (N = 31,739, 95 %CI = 5.79, 9.53).
CONCLUSIONS
Psychosis and bipolar disorder occur at a substantially higher prevalence in adults with autism compared to general population estimates. While there is an overall dearth of research examining risk factors for these disorders in autism, males had increased likelihood of co-occurring psychosis, and females of co-occurring bipolar disorder. These results highlight the need for ongoing assessment and monitoring of these disorders in adults with autism.
Topics: Adult; Autism Spectrum Disorder; Autistic Disorder; Bipolar Disorder; Female; Humans; Male; Prevalence; Psychotic Disorders
PubMed: 35063494
DOI: 10.1016/j.neubiorev.2022.104543 -
PloS One 2018The purpose of this study is to provide an updated systematic review to identify studies describing the prevalence of psychosis in order to explore methodological... (Review)
Review
OBJECTIVES
The purpose of this study is to provide an updated systematic review to identify studies describing the prevalence of psychosis in order to explore methodological factors that could account for the variation in prevalence estimates.
METHODS
Studies with original data related to the prevalence of psychosis (published between 1990 and 2015) were identified via searching electronic databases and reviewing manual citations. Prevalence estimates were sorted according to prevalence type (point, 12-months and lifetime). The independent association between key methodological variables and the mean effect of prevalence was examined (prevalence type, case-finding setting, method of confirming diagnosis, international classification of diseases, diagnosis category, and study quality) by meta-analytical techniques and random-effects meta-regression.
RESULTS
Seventy-three primary studies were included, providing a total of 101 estimates of prevalence rates of psychosis. Across these studies, the pooled median point and 12-month prevalence for persons was 3.89 and 4.03 per 1000 respectively; and the median lifetime prevalence was 7.49 per 1000. The result of the random-effects meta-regression analysis revealed a significant effect for the prevalence type, with higher rates of lifetime prevalence than 12-month prevalence (p<0.001). Studies conducted in the general population presented higher prevalence rates than those carried out in populations attended in health/social services (p = 0.006). Compared to the diagnosis of schizophrenia only, prevalence rates were higher in the probable psychotic disorder (p = 0.022) and non-affective psychosis (p = 0.009). Finally, a higher study quality is associated with a lower estimated prevalence of psychotic disorders (p<0.001).
CONCLUSIONS
This systematic review provides a comprehensive comparison of methodologies used in studies of the prevalence of psychosis, which can provide insightful information for future epidemiological studies in adopting the most relevant methodological approach.
Topics: Epidemiologic Studies; Humans; Prevalence; Psychotic Disorders
PubMed: 29649252
DOI: 10.1371/journal.pone.0195687 -
Psychological Medicine Apr 2018Large amount of data have been published on non-psychotic depression (NPD), schizophrenia (SZ), and bipolar disorder, while psychotic depression (PD) as an own entity... (Meta-Analysis)
Meta-Analysis
Large amount of data have been published on non-psychotic depression (NPD), schizophrenia (SZ), and bipolar disorder, while psychotic depression (PD) as an own entity has received much smaller attention. We performed a systematic review and meta-analyses on epidemiology, especially incidence and prevalence, risk factors, and outcomes of PD. A systematic search to identify potentially relevant studies was conducted using four electronic databases and a manual search. The search identified 1764 unique potentially relevant articles, the final study included 99 articles. We found that the lifetime prevalence of PD varies between 0.35% and 1%, with higher rates in older age. Onset age of PD was earlier than that of NPD in younger samples, but later in older samples. There were no differences in gender distribution in PD v. NPD, but higher proportion of females was found in PD than in SZ or in psychotic bipolar disorder (PBD). Risk factors have rarely been studied, the main finding being that family history of psychosis and bipolar disorder increases the risk of PD. Outcomes of PD were mostly worse when compared with NPD, but better compared with SZ and schizoaffective disorder. The outcome compared with PBD was relatively similar, and somewhat varied depending on the measure of the outcome. Based on this review, the amount of research on PD is far from that of NPD, SZ, and bipolar disorder. Based on our findings, PD seems distinguishable from related disorders and needs more scientific attention.
Topics: Age of Onset; Bipolar Disorder; Depressive Disorder, Major; Humans; Incidence; Psychotic Disorders; Schizophrenia
PubMed: 28893329
DOI: 10.1017/S0033291717002501