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Psychiatry Research. Neuroimaging Dec 2022The extent and nature of cognitive impairment in brief psychotic disorder remains unclear, being rarely studied unlike schizophrenia. The present study hence sought to...
The extent and nature of cognitive impairment in brief psychotic disorder remains unclear, being rarely studied unlike schizophrenia. The present study hence sought to directly compare the visual cognitive dysfunction and its associated brain networks in brief psychotic disorder and schizophrenia. Data from picture completion (a complex visual task) and whole-brain functional connectome from resting-state fMRI were acquired from a sample of clinically stable patients with an established psychotic disorder (twenty with brief psychotic disorder, twenty with schizophrenia) and twenty-nine healthy controls. Group differences and the inter-relationships in task performances and brain networks were tested. Picture completion task deficits were found in brief psychotic disorder compared with healthy controls, though the deficits were less than schizophrenia. Task performance also correlated with severity of psychotic symptoms in patients. The task performance was inversely correlated with the functional connectivity between peripheral visual and attentional networks (dorsal attention and salience ventral attention), with increased functional connectivity in brief psychotic disorder compared with healthy controls and in schizophrenia compared with brief psychotic disorder. Present findings showed pronounced visual cognitive impairments in brief psychotic disorder that were worse in schizophrenia, underpinned by abnormal interactions between higher-order attentional and lower-order visual processing networks.
Topics: Humans; Schizophrenia; Nerve Net; Psychotic Disorders; Cognition; Attention
PubMed: 36272310
DOI: 10.1016/j.pscychresns.2022.111545 -
Primary Care Jun 1999Psychotic disorders are relatively rare in the primary care setting, compared with depressive and anxiety disorders, but patient suffering is significantly higher for... (Review)
Review
Psychotic disorders are relatively rare in the primary care setting, compared with depressive and anxiety disorders, but patient suffering is significantly higher for patients with psychotic symptoms. Primary care physicians are assuming more responsibility for the area of these patients in today's managed care environment. The practitioner needs to eliminate medical, substance, and mood origins of the psychotic symptoms before assuming a patient has a psychotic disorder (e.g., schizophrenia). This article outlines a diagnostic and treatment approach for patients with psychotic symptoms who are managed in the primary care setting.
Topics: Algorithms; Antipsychotic Agents; Decision Trees; Diagnosis, Differential; Family Practice; Humans; Primary Health Care; Psychotic Disorders; Referral and Consultation
PubMed: 10318751
DOI: 10.1016/s0095-4543(08)70009-5 -
JAMA Psychiatry Mar 2018Individuals with psychotic disorders have increased mortality, and recent research suggests a marked increase shortly after diagnosis.
IMPORTANCE
Individuals with psychotic disorders have increased mortality, and recent research suggests a marked increase shortly after diagnosis.
OBJECTIVE
To use population-based data to examine overall and cause-specific mortality after first diagnosis of a psychotic disorder.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study used records from 5 integrated health systems that serve more than 8 million members in 5 states. Members aged 16 through 30 years who received a first lifetime diagnosis of a psychotic disorder from September 30, 2009, through September 30, 2015, and 2 comparison groups matched for age, sex, health system, and year of diagnosis were selected from all members making an outpatient visit (general outpatient group) and from all receiving a first diagnosis of unipolar depression (unipolar depression group).
EXPOSURES
First recorded diagnosis of schizophrenia, schizoaffective disorder, mood disorder with psychotic symptoms, or other psychotic disorder in any outpatient, emergency department, or inpatient setting.
MAIN OUTCOMES AND MEASURES
Death within 3 years after the index diagnosis or visit date, ascertained from health system electronic health records, insurance claims, and state mortality records.
RESULTS
A total of 11 713 members with first diagnosis of a psychotic disorder (6976 [59.6%] men and 4737 [40.4%] women; 2368 [20.2%] aged 16-17 and 9345 [79.8%] aged 18-30 years) were matched to 35 576 outpatient service users and 23 415 members with a first diagnosis of unipolar depression. During the year after the first diagnosis, all-cause mortality was 54.6 (95% CI, 41.3-68.0) per 10 000 in the psychotic disorder group compared with 20.5 (95% CI, 14.7-26.3) per 10 000 in the unipolar depression group and 6.7 (95% CI, 4.0-9.4) per 10 000 in the general outpatient group. After adjustment for race, ethnicity, and preexisting chronic medical conditions, the relative hazard of death in the psychotic disorder group compared with the general outpatient group was 34.93 (95% CI, 8.19-149.10) for self-inflicted injury or poisoning and 4.67 (95% CI, 2.01-10.86) for other type of injury or poisoning. Risk of death due to heart disease or diabetes did not differ significantly between the psychotic disorder and the general outpatient groups (hazard ratio, 0.78; 95% CI, 0.15-3.96). Between the first and third years after diagnosis, all-cause mortality in the psychotic disorder group decreased from 54.6 to 27.1 per 10 000 persons and injury and poisoning mortality decreased from 30.6 to 15.1 per 10 000 persons. Both rates, however, remained 3 times as high as in the general outpatient group (9.0 per 10 000 for all causes; 4.8 per 10 000 for injury or poisoning).
CONCLUSIONS AND RELEVANCE
Increases in early mortality underscore the importance of systematic intervention for young persons experiencing the first onset of psychosis. Clinicians should attend to the elevated suicide risk after the first diagnosis a psychotic disorder.
Topics: Adolescent; Adult; Cause of Death; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Male; Poisoning; Psychotic Disorders; Reference Values; Risk; Wounds and Injuries; Young Adult
PubMed: 29387876
DOI: 10.1001/jamapsychiatry.2017.4437 -
International Journal of Geriatric... Oct 2020The objective of this study was to predict rehospitalisation in a psychiatric clinic in older inpatients with a psychotic disorder. (Observational Study)
Observational Study
OBJECTIVE
The objective of this study was to predict rehospitalisation in a psychiatric clinic in older inpatients with a psychotic disorder.
METHODS/DESIGN
In this prospective, observational study, all eligible inpatients aged 55 years and over with a primary psychotic disorder, admitted to a specialised ward for older psychotic patients in a large psychiatric inpatient clinic in the Netherlands, were asked to participate. Whether or not patients were rehospitalised and time to rehospitalisation were assessed 1 year after discharge from the ward. We recorded age, gender, living arrangement, psychiatric diagnosis, severity of psychotic symptoms, duration of index episode, age of onset of psychotic disorder, number of previous admissions, involuntary admission and use of depot medication at discharge. All patients underwent a neuropsychological assessment.
RESULTS
Of the 90 patients that were included, 32 (35.6%) had been readmitted within 1 year after discharge. None of the demographic or clinical variables predicted rehospitalisation or the time to rehospitalisation.
CONCLUSION
Factors that predict rehospitalisationin younger adult patients with schizophrenia may not predict rehospitalisationin older patients with a psychotic disorder, of which the majority suffered from schizophrenia. We expect that other factors than those investigated may be of greater importance to predict rehospitalisation, as for example social support and coping mechanisms.
Topics: Aged; Humans; Inpatients; Netherlands; Patient Readmission; Prospective Studies; Psychotic Disorders
PubMed: 32419240
DOI: 10.1002/gps.5337 -
Acta Psychiatrica Scandinavica Jun 1995The relationship between DSM-III-R schizophreniform disorder, delusional disorder (DD) and psychotic disorder not otherwise specified (PD-NOS) and schizophrenia and... (Comparative Study)
Comparative Study
The relationship between DSM-III-R schizophreniform disorder, delusional disorder (DD) and psychotic disorder not otherwise specified (PD-NOS) and schizophrenia and affective illness (AI) remains uncertain. We explore this question in the Roscommon Family Study by examining symptoms, outcome and patterns of psychopathology in relatives. Probands were selected from a population-based case registry in the west of Ireland with an ICD-9 diagnosis of schizophrenia or AI. Personal interviews were conducted with 88% of traceable, living probands, a mean of 16 years after onset, and 86% of traceable, living first-degree relatives. Best-estimate diagnoses were made at follow-up. Schizophreniform disorder, DD and PD-NOS constituted 6.4%, 2.8% and 7.5%, respectively, of all probands with a registry diagnosis of schizophrenia. Probands with schizophreniform disorder had prominent positive psychotic symptoms, negligible negative symptoms and a good outcome, comparable to that seen in AI probands. Their relatives had an excess risk of schizophrenia spectrum illness but not AI. Probands with DD had prominent delusions but no other psychotic symptoms, few negative symptoms, fair to good outcome and an increased risk in relatives for alcoholism. Probands with PD-NOS had both moderate positive and negative psychotic symptoms, a poor to fair outcome and a substantially elevated risk in relatives of schizophrenia and schizophrenia spectrum disorders but not AI.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Adult; Age of Onset; Delusions; Female; Follow-Up Studies; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Psychotic Disorders
PubMed: 7676834
DOI: 10.1111/j.1600-0447.1995.tb09796.x -
La Revue Du Praticien Feb 2015An acute substance induced psychotic disorder is a cause to raise with a state of agitation in an acute delusional clinical setting. Patients are most often seen in...
An acute substance induced psychotic disorder is a cause to raise with a state of agitation in an acute delusional clinical setting. Patients are most often seen in hospital emergency rooms. Rapid diagnosis must be made. An integrated therapeutic management should be considered. Both psychiatric and addiction problems must be taken into account.
Topics: Acute Disease; Humans; Psychotic Disorders; Substance-Related Disorders
PubMed: 25939230
DOI: No ID Found -
Comprehensive Psychiatry 1993We describe our experience with a case of folie à famille with role reversal, including the long-term course. In addition, the case reports published since 1974 were... (Review)
Review
We describe our experience with a case of folie à famille with role reversal, including the long-term course. In addition, the case reports published since 1974 were reviewed and an overview is given of the psychoanalytic and system theory concepts on the pathogenesis of induced psychotic disorder. The inductor often appears to be suffering from schizophrenia. No further indications could be found in the literature for a hereditary predisposition in the recipient. It is sometimes difficult to distinguish between the inductor and the recipient, owing to the circular character of induced psychotic disorder and the role reversal that sometimes occurs. The DSM-III-R criteria for induced psychotic disorder were found to be lacking in practice because of their disregard for the circular causality and the strict exclusion criteria. In the short term, physical separation of the inductor and recipient leads to better treatment results than nonseparation, particularly in the case of recipient children. Long-term results are seldom mentioned. On the basis of theoretical considerations, interventions that aim at separation in psychological terms are necessary to achieve favorable long-term treatment results.
Topics: Adult; Combined Modality Therapy; Defense Mechanisms; Delusions; Diagnosis, Differential; Family; Family Therapy; Humans; Male; Mental Healing; Psychotic Disorders; Religion and Psychology; Shared Paranoid Disorder
PubMed: 8485980
DOI: 10.1016/0010-440x(93)90056-a -
Current Psychiatry Reports Jun 2010Early views of borderline personality disorder (BPD) were based on the idea that patients with this pathology were "on the border" of psychosis. However, more recent... (Review)
Review
Early views of borderline personality disorder (BPD) were based on the idea that patients with this pathology were "on the border" of psychosis. However, more recent studies have not supported this view, although they have found evidence of a malevolent interpersonal evaluation and a significant proportion of BPD patients showing psychotic symptoms. For example, in one study, 24% of BPD patients reported severe psychotic symptoms and about 75% had dissociative experiences and paranoid ideation. Thus, we start with an overview regarding the prevalence of psychotic symptoms in BPD patients. Furthermore, we report findings of studies investigating the role of comorbidity (eg, post-traumatic stress disorder) in the severity and frequency of psychotic symptoms in BPD patients. We then present results of genetic and neurobiological studies comparing BPD patients with patients with schizophrenia or nonschizophrenic psychotic disorders. In conclusion, this review reveals that psychotic symptoms in BPD patients may not predict the development of a psychotic disorder but are often permanent and severe and need careful consideration by clinicians. Therefore, adequate diagnosis and treatment of psychotic symptoms in BPD patients is emphasized.
Topics: Antipsychotic Agents; Borderline Personality Disorder; Child; Comorbidity; Dissociative Disorders; Humans; Life Change Events; Psychotic Disorders; Stress Disorders, Post-Traumatic
PubMed: 20425279
DOI: 10.1007/s11920-010-0107-9 -
Supportive Care in Cancer : Official... Jul 2003We report here a terminally ill patient with uterine cervical cancer who developed a brief psychotic disorder after bereavement following the loss of three close friends... (Review)
Review
We report here a terminally ill patient with uterine cervical cancer who developed a brief psychotic disorder after bereavement following the loss of three close friends also suffering from gynecological cancer. A 49-year-old housewife, who was diagnosed as having uterine cervical cancer and was receiving palliative care was referred for psychiatric consultation because of an abrupt onset of delusions, bizarre behavior, disorganized speech, and catatonic behavior. On psychiatric examination, she showed delusional thought and catatonic behavior. Laboratory data were unremarkable, as was brain MRI. She had no history of psychiatric illness or drug or alcohol abuse. After receiving haloperidol, psychiatric symptoms disappeared, and she returned to the previous level of functioning after 3 days. The patient explained that the death of three of her friend due to gynecological cancer was shocking event for her. She focused her attention on her own fears of dying from the same disease. Brief psychotic disorder in cancer patients is rare in the literature. However, our report of brief psychotic disorder associated with bereavement may highlight possible precipitating factors, which have not been adequately emphasized in the literature to date. From a clinical perspective, it would be informative for liaison psychiatrists to inquire about the patient's experience of loss of significant others with the same disease. This may provide useful information helpful to understanding the patient's conception of the disease process. Cancer patients' bereaving friends who had cancer is not rare in clinical settings. Therefore, medical staff should be mindful of interpersonal relationships between patients and bereavement arising from these relationships.
Topics: Bereavement; Fear; Female; Humans; Middle Aged; Palliative Care; Psychotic Disorders; Terminally Ill; Uterine Neoplasms
PubMed: 12690544
DOI: 10.1007/s00520-003-0461-9 -
CNS Spectrums Aug 2009The co-occurrence of obsessive-compulsive disorder (OCD) in patients with schizophrenia and related disorders has been increasingly recognized. However, the rate of...
INTRODUCTION
The co-occurrence of obsessive-compulsive disorder (OCD) in patients with schizophrenia and related disorders has been increasingly recognized. However, the rate of psychosis comorbidity in OCD patients has yet to be systematically evaluated.
METHODS
The prevalence of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychotic disorders was evaluated in 757 subjects consecutively referred to a specialised diagnostic and treatment facility for OCD. Demographic and clinical characteristics were assessed.
RESULTS
Thirteen OCD patients (1.7%) also met the DSM-IV criteria for a psychotic disorder. We found no significant differences in clinical characteristic between OCD patients with and without a psychotic disorder, although patients with OCD and a psychotic disorder more likely used illicit substances and more likely were male.
CONCLUSION
Relatively few patients referred to a specialized treatment OCD center suffer from a psychotic disorder.
Topics: Adult; Female; Humans; Male; Netherlands; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia; Young Adult
PubMed: 19890235
DOI: 10.1017/s1092852900020381