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L'Encephale Apr 2023
Topics: Humans; SARS-CoV-2; COVID-19; Myasthenia Gravis; Brain Diseases; Psychotic Disorders
PubMed: 35973847
DOI: 10.1016/j.encep.2022.04.001 -
Canadian Family Physician Medecin de... Dec 2023To describe the provision of care for young people following first diagnosis of psychotic disorder.
OBJECTIVE
To describe the provision of care for young people following first diagnosis of psychotic disorder.
DESIGN
Retrospective cohort study using health administrative data.
SETTING
Ontario.
PARTICIPANTS
People aged 14 to 35 years with a first diagnosis of nonaffective psychotic disorder in Ontario between 2005 and 2015 (N=39,449).
MAIN OUTCOME MEASURES
Models of care, defined by psychosis-related service contacts with primary care physicians and psychiatrists during the 2 years after first diagnosis of psychotic disorder.
RESULTS
During the 2-year follow-up period, 29% of the cohort received only primary care, 30% received only psychiatric care, and 32% received both primary and psychiatric care (shared care). Among the shared care group, 72% received care predominantly from psychiatrists, 20% received care predominantly from primary care physicians, and 9% received approximately equal care from psychiatry and primary care. Variation in patient and physician characteristics was observed across the different models of care.
CONCLUSION
One in 3 young people with psychotic disorder received shared care during the 2-year period after first diagnosis. The findings highlight opportunities for increasing collaboration between primary care physicians and psychiatrists to enhance the quality of care for those with early psychosis.
Topics: Humans; Adolescent; Retrospective Studies; Ontario; Psychotic Disorders; Physicians
PubMed: 38092451
DOI: 10.46747/cfp.6912859 -
Schizophrenia Research Oct 2019
Topics: Acute Disease; Adult; Female; Humans; International Classification of Diseases; Male; Psychotic Disorders
PubMed: 31387825
DOI: 10.1016/j.schres.2019.07.043 -
Schizophrenia Research Dec 2018Classifications of psychotic disorders are moving towards utilizing dimensional symptom domains as the preferred mechanism for describing psychotic symptomatology. The...
Classifications of psychotic disorders are moving towards utilizing dimensional symptom domains as the preferred mechanism for describing psychotic symptomatology. The ICD-11 has proposed six symptom domains (Positive symptoms, Negative symptoms, Depressive symptoms, Manic symptoms, Psychomotor symptoms, and Cognitive symptoms) that would be rated in addition to providing a psychotic disorder diagnosis. This study investigated clinicians' use of dichotomous versus multi-point scales for rating these six domains. Global mental health professionals (n = 273) rated case vignettes using both a 2-point and 4-point version of a rating scale for the six domains. Clinicians were more accurate using the 2-point scale in absolute terms, but after correcting for chance guessing and disagreements, the two versions of the scale were equally accurate. Clinicians believed the 2-point scale would be easier to use, although they also indicated that the 4-point scale would provide richer clinical information. Participants were able to detect the presence of psychotic symptom domains in the vignettes with good reliability with no special training using either scale. We recommend that clinicians and researchers use the version of the scale that best matches their purpose (i.e., to maximize accuracy or enhance case description). Future work should develop the implementation characteristics of the scale to improve its potential for global application.
Topics: Attitude of Health Personnel; Female; Health Personnel; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Psychotic Disorders
PubMed: 30017460
DOI: 10.1016/j.schres.2018.07.006 -
The British Journal of Clinical... Sep 2005Recent research is starting to identify individuals at an increased risk of developing a psychotic disorder. This review seeks to identify the 'state of the art' with... (Review)
Review
PURPOSE
Recent research is starting to identify individuals at an increased risk of developing a psychotic disorder. This review seeks to identify the 'state of the art' with respect to the clinical identification and treatment of individuals at 'ultra-high risk'.
METHOD
The research and clinical literature are reviewed with respect to a wide range of predictors relevant across development.
RESULTS
The review draws on evidence from childhood and adolescence to suggest that a range of biological, cognitive, personality, and social features are predictive of, but often not specific to, psychosis within the context of the diathesis-stress model. Much evidence supports the view that environmental stressors act in combination with vulnerability factors to increase risk of transition, often during late adolescence and early adulthood.
CONCLUSIONS
Recent clinical research has used both retrospective and prospective means of identifying individuals at ultra-high risk and has made substantial gains in predicting transition. The clinical implications of their identification are discussed in the context of current pharmacological and psychosocial treatment studies. However, significant unresolved clinical and ethical issues remain with both types of study.
Topics: Adolescent; Adolescent Behavior; Adult; Cognition; Humans; Models, Psychological; Personality; Psychotic Disorders; Risk Factors; Social Behavior; Stress, Psychological
PubMed: 16238884
DOI: 10.1348/014466505X34615 -
Clinical Schizophrenia & Related... 2016
Topics: Adult; Humans; Iron Metabolism Disorders; Male; Neuroaxonal Dystrophies; Psychotic Disorders
PubMed: 27732100
DOI: 10.3371/1935-1232.10.3.178 -
Schizophrenia Research Apr 2017Schizophrenia, schizoaffective disorder, and psychotic bipolar disorder overlap with regard to symptoms, structural and functional brain abnormalities, and genetic risk...
BACKGROUND
Schizophrenia, schizoaffective disorder, and psychotic bipolar disorder overlap with regard to symptoms, structural and functional brain abnormalities, and genetic risk factors. Neurobiological pathways connecting genes to clinical phenotypes across the spectrum from schizophrenia to psychotic bipolar disorder remain largely unknown.
METHODS
We examined the relationship between structural brain changes and risk alleles across the psychosis spectrum in the multi-site Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) cohort. Regional MRI brain volumes were examined in 389 subjects with a psychotic disorder (139 schizophrenia, 90 schizoaffective disorder, and 160 psychotic bipolar disorder) and 123 healthy controls. 451,701 single-nucleotide polymorphisms were screened and processed using parallel independent component analysis (para-ICA) to assess associations between genes and structural brain abnormalities in probands.
RESULTS
482 subjects were included after quality control (364 individuals with psychotic disorder and 118 healthy controls). Para-ICA identified four genetic components including several risk genes already known to contribute to schizophrenia and bipolar disorder and revealed three structural components that showed overlapping relationships with the disease risk genes across the three psychotic disorders. Functional ontologies representing these gene clusters included physiological pathways involved in brain development, synaptic transmission, and ion channel activity.
CONCLUSIONS
Heritable brain structural findings such as reduced cortical thickness and surface area in probands across the psychosis spectrum were associated with somewhat distinct genes related to putative disease pathways implicated in psychotic disorders. This suggests that brain structural alterations might represent discrete psychosis intermediate phenotypes along common neurobiological pathways underlying disease expression across the psychosis spectrum.
Topics: Brain; Female; Genetic Association Studies; Genotype; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Polymorphism, Single Nucleotide; Principal Component Analysis; Psychotic Disorders
PubMed: 27789186
DOI: 10.1016/j.schres.2016.10.026 -
Revista Colombiana de Psiquiatria... 2023Shared paranoid disorder is characterised by the development of psychotic symptoms in people who have a close affective bond with a subject suffering from a mental...
INTRODUCTION
Shared paranoid disorder is characterised by the development of psychotic symptoms in people who have a close affective bond with a subject suffering from a mental disorder. This case is the first case of burn injuries reported in the context of this disorder.
CASE
We describe a young couple, with a similar pattern of burns caused by contact with a griddle. The injuries are the result of the aggression caused by a relative of one of them, who presented psychotic symptoms, related to the previously undiagnosed spectrum of schizophrenia.
CONCLUSIONS
The impact of this condition encompasses social, physical and psychological components, requiring multidisciplinary management and a high index of diagnostic suspicion.
Topics: Humans; Shared Paranoid Disorder; Colombia; Psychotic Disorders; Schizophrenia; Burns
PubMed: 37460342
DOI: 10.1016/j.rcpeng.2021.04.004 -
Schizophrenia Research Oct 2012Individuals with schizophrenia have significant deficits in premorbid social and academic adjustment compared to individuals with non-psychotic diagnoses. However, it is... (Comparative Study)
Comparative Study
Individuals with schizophrenia have significant deficits in premorbid social and academic adjustment compared to individuals with non-psychotic diagnoses. However, it is unclear how severity and developmental trajectory of premorbid maladjustment compare across psychotic disorders. This study examined the association between premorbid functioning (in childhood, early adolescence, and late adolescence) and psychotic disorder diagnosis in a first-episode sample of 105 individuals: schizophrenia (n=68), schizoaffective disorder (n=22), and mood disorder with psychotic features (n=15). Social and academic maladjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. Worse social functioning in late adolescence was associated with higher odds of schizophrenia compared to odds of either schizoaffective disorder or mood disorder with psychotic features, independently of child and early adolescent maladjustment. Greater social dysfunction in childhood was associated with higher odds of schizoaffective disorder compared to odds of schizophrenia. Premorbid decline in academic adjustment was observed for all groups, but did not predict diagnosis at any stage of development. Results suggest that social functioning is disrupted in the premorbid phase of both schizophrenia and schizoaffective disorder, but remains fairly stable in mood disorders with psychotic features. Disparities in the onset and time course of social dysfunction suggest important developmental differences between schizophrenia and schizoaffective disorder.
Topics: Adaptation, Psychological; Adolescent; Adult; Child; Female; Humans; Male; Middle Aged; Mood Disorders; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Young Adult
PubMed: 22858353
DOI: 10.1016/j.schres.2012.07.008 -
The British Journal of Psychiatry : the... Oct 2020A growing body of research suggests that childhood adversities are associated with later psychosis, broadly defined. However, there remain several gaps and unanswered...
BACKGROUND
A growing body of research suggests that childhood adversities are associated with later psychosis, broadly defined. However, there remain several gaps and unanswered questions. Most studies are of low-level psychotic experiences and findings cannot necessarily be extrapolated to psychotic disorders. Further, few studies have examined the effects of more fine-grained dimensions of adversity such as type, timing and severity.
AIMS
Using detailed data from the Childhood Adversity and Psychosis (CAPsy) study, we sought to address these gaps and examine in detail associations between a range of childhood adversities and psychotic disorder.
METHOD
CAPsy is population-based first-episode psychosis case-control study in the UK. In a sample of 374 cases and 301 controls, we collected extensive data on childhood adversities, in particular household discord, various forms of abuse and bullying, and putative confounders, including family history of psychotic disorder, using validated, semi-structured instruments.
RESULTS
We found strong evidence that all forms of childhood adversity were associated with around a two- to fourfold increased odds of psychotic disorder and that exposure to multiple adversities was associated with a linear increase in odds. We further found that severe forms of adversity, i.e. involving threat, hostility and violence, were most strongly associated with increased odds of disorder. More tentatively, we found that some adversities (e.g. bullying, sexual abuse) were more strongly associated with psychotic disorder if first occurrence was in adolescence.
CONCLUSIONS
Our findings extend previous research on childhood adversity and suggest a degree of specificity for severe adversities involving threat, hostility and violence.
Topics: Adolescent; Adult; Adult Survivors of Child Abuse; Adverse Childhood Experiences; Case-Control Studies; Child; Child Abuse; Female; Hostility; Humans; Male; Psychotic Disorders
PubMed: 32778182
DOI: 10.1192/bjp.2020.133