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The Australian and New Zealand Journal... Jun 2023Little research has examined the physical and mental comorbidities, and health service use patterns, of people diagnosed with psychotic disorder subtypes other than...
OBJECTIVE
Little research has examined the physical and mental comorbidities, and health service use patterns, of people diagnosed with psychotic disorder subtypes other than schizophrenia spectrum disorders. This study aims to examine the physical and mental comorbidities, and subsequent hospital service use patterns, of individuals previously hospitalised with various psychotic disorder subtypes using linked health service data.
METHODS
We included individuals hospitalised with a psychotic disorder in New South Wales, Australia, between 1 July 2002 and 31 December 2014 (N = 63,110). We examined the demographic profile of the cohort and rates of subsequent acute hospital care and ambulatory mental health service use. We compared the rates of subsequent hospital admissions, emergency department presentations and ambulatory mental health treatment days of people hospitalised with different psychotic disorder subtypes to people hospitalised with schizophrenia spectrum disorders using Poisson regression.
RESULTS
People most recently hospitalised with mood/affective disorders and psychotic symptoms had a higher rate of subsequent hospital admissions than those most recently hospitalised with schizophrenia spectrum and delusional disorders (adjusted incident rate ratio = 1.06; 95% confidence interval = [1.02, 1.10]), while people most recently hospitalised with drug-induced and other organic (adjusted incident rate ratio = 1.19; 95% confidence interval = [1.12, 1.27]) and acute psychotic disorders (adjusted incident rate ratio = 1.10; 95% confidence interval = [1.03, 1.18]) had more subsequent emergency department presentations than those most recently hospitalised with schizophrenia spectrum and delusional disorders. All three groups had fewer subsequent mental health ambulatory days than those most recently hospitalised with schizophrenia spectrum and delusional disorders (adjusted incident rate ratios = 0.85-0.91).
CONCLUSION
The health profiles and subsequent hospital service use patterns of people previously hospitalised with different psychotic disorder subtypes are heterogeneous, and research is needed to develop targeted health policies to meet their specific health needs.
Topics: Humans; Psychotic Disorders; Schizophrenia; Mental Health; Mental Health Services; Hospitals
PubMed: 35920253
DOI: 10.1177/00048674221115642 -
Acta Neurologica Belgica Mar 2016
Topics: Adolescent; Humans; Immunotherapy; Male; Psychotic Disorders; Treatment Outcome
PubMed: 26233236
DOI: 10.1007/s13760-015-0519-8 -
Journal of Psychoactive Drugs 2022Medication adherence and attitudes toward psychiatric medication affect treatment outcome. The objective of this study was to evaluate the effect and interaction of...
Medication adherence and attitudes toward psychiatric medication affect treatment outcome. The objective of this study was to evaluate the effect and interaction of psychotic symptoms, sociodemographic factors, and attitudes concerning medication use with a three-month follow-up among methamphetamine-induced psychotic male patients. In this prospective, descriptive study, 42 male patients diagnosed with a methamphetamine-induced psychotic disorder were selected on the last day of their admission period in Iran Psychiatry Hospital, Tehran, Iran. Each patient was evaluated using the Persian version of the Drug Attitude Inventory (DAI-10), Medication Possession Ratio (MPR), Positive and Negative Syndrome Scale (PANSS), as well as a sociodemographic questionnaire immediately, one month and three months after discharge. There was a significant difference in MPR between the first and third months. Moreover, the frequency of patients with a positive attitude toward their medications increased over time. Indeed, all participants stated a positive attitude at the last follow-up based on the DAI-10 cutoff. Based on our findings, medication adherence of male patients with methamphetamine-induced psychotic disorder should be an essential aspect of treatment after discharge from psychiatry inpatient wards, more specifically, through the first months.
Topics: Female; Follow-Up Studies; Humans; Iran; Male; Medication Adherence; Methamphetamine; Patient Discharge; Prospective Studies; Psychotic Disorders
PubMed: 33594958
DOI: 10.1080/02791072.2021.1883778 -
Tijdschrift Voor Psychiatrie 2016Persons with a psychotic disorder commonly experience difficulties with what is considered to be metacognitive capacity. In this article we discuss several definitions... (Review)
Review
BACKGROUND
Persons with a psychotic disorder commonly experience difficulties with what is considered to be metacognitive capacity. In this article we discuss several definitions of this concept, the measurement instruments involved and the clinical interventions that target this concept.
AIM
To present a review of various frequently used definitions of metacognition and related concepts and to describe the measurement instruments involved and the treatment options available for improving the metacognitive capacity of persons with a psychotic disorder.
METHOD
We present an overview of several definitions of metacognition in psychotic disorders and we discuss frequently used measurement instruments and treatment options. The article focuses on recent developments in a model devised by Semerari et al. The measurement instrument involved (Metacognition Assessment Scale - A) is discussed in terms of it being an addition to existing methods.
RESULTS
On the basis of the literature it appears that metacognition and related concepts are measurable constructs, although definitions and instruments vary considerably. The new conceptualisation of social information processing also leads to the development of a new form of psychotherapy that aims to help patients suffering from psychotic disorders to improve metacognitive capacity.
CONCLUSION
There seems to be evidence that metacognitive abilities are a possible target for treatment, but further research is needed.
Topics: Cognition Disorders; Humans; Metacognition; Psychotherapy; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Theory of Mind
PubMed: 27320509
DOI: No ID Found -
Acta Psychiatrica Scandinavica Dec 2013Although cannabis use among individuals with psychotic disorder is considerable, little is known about patterns of use and factors contributing to continuation of use....
OBJECTIVE
Although cannabis use among individuals with psychotic disorder is considerable, little is known about patterns of use and factors contributing to continuation of use. Therefore, we investigated craving in relation to cannabis use in patients with psychotic disorder and healthy controls.
METHOD
The study included 58 patients with non-affective psychotic disorder and 63 healthy controls; all were frequent cannabis users. Craving was assessed with the Obsessive Compulsive Drug Use Scale (OCDUS) for cannabis, as well as in daily life using the Experience Sampling Method (ESM).
RESULTS
Patients scored higher on the OCDUS (B = 1.18, P = 0.022), but did not differ from controls in ESM indices of craving (all P > 0.05). In daily life, ESM craving predicted cannabis use and this was stronger in controls (χ(2) = 4.5, P = 0.033; Bcontrols = 0.08, P < 0.001; Bpatients = 0.06, P < 0.001). In both groups ESM craving was predicted by negative affect, paranoia, and hallucinations (Bnegativeaffect = 0.12, P = 0.009; Bparanoia = 0.13, P = 0.013; Bhallucinations = 0.13, P = 0.028), and followed by an increase in negative affect at non-cannabis-using moments (B = 0.03, P = 0.002).
CONCLUSION
The temporal dynamics of craving as well as craving intensity in daily life appear to be similar in patients and controls. Further research is needed to elucidate the inconsistencies between cross-sectional and daily-life measures of craving in psychosis.
Topics: Adult; Cannabis; Comorbidity; Female; Humans; Male; Marijuana Abuse; Middle Aged; Psychiatric Status Rating Scales; Psychotic Disorders; Random Allocation; Severity of Illness Index
PubMed: 23330571
DOI: 10.1111/acps.12078 -
The American Journal of Psychiatry May 2018The authors sought to describe patterns of health care use prior to first diagnosis of a psychotic disorder in a population-based sample.
OBJECTIVE
The authors sought to describe patterns of health care use prior to first diagnosis of a psychotic disorder in a population-based sample.
METHOD
Electronic health records and insurance claims from five large integrated health systems were used to identify 624 patients 15-29 years old who received a first diagnosis of a psychotic disorder in any care setting and to record health services received, diagnoses assigned, and medications dispensed during the previous 36 months. Patterns of utilization were compared between patients receiving a first diagnosis of a psychotic disorder and matched samples of general health system members and members receiving a first diagnosis of unipolar depression.
RESULTS
During the year before a first psychotic disorder diagnosis, 29% of patients had mental health specialty outpatient care, 8% had mental health inpatient care, 24% had emergency department mental health care, 29% made a primary care visit with a mental health diagnosis, and 60% received at least one mental health diagnosis (including substance use disorders). Compared with patients receiving a first diagnosis of unipolar depression, those with a first diagnosis of a psychotic disorder were modestly more likely to use all types of health services and were specifically more likely to use mental health inpatient care (odds ratio=2.96, 95% CI=1.97-4.43) and mental health emergency department care (rate ratio=3.74, 95% CI=3.39-4.53).
CONCLUSIONS
Most patients receiving a first diagnosis of a psychotic disorder had some indication of mental health care need during the previous year. General use of primary care or mental health services, however, does not clearly distinguish people who later receive a diagnosis of a psychotic disorder from those who later receive a diagnosis of unipolar depression. Use of inpatient or emergency department mental health care is a more specific indicator of risk.
Topics: Adolescent; Adult; Ambulatory Care; Electronic Health Records; Female; Follow-Up Studies; Humans; Male; Mental Health Services; Patient Admission; Patient Care Planning; Psychotic Disorders; United States; Utilization Review; Young Adult
PubMed: 29361848
DOI: 10.1176/appi.ajp.2017.17080844 -
Acta Psychiatrica Scandinavica Jan 2020Certain migrant groups are more likely to develop a psychotic disorder compared to the native-born populations, and a younger age at migration is associated with greater...
BACKGROUND
Certain migrant groups are more likely to develop a psychotic disorder compared to the native-born populations, and a younger age at migration is associated with greater risk. However, it is not known at which stage migration has an effect on the development of psychotic disorders. We examined whether migrants were more likely to be identified as ultra-high risk for psychosis (UHR) compared to native-born young people and whether migrant status was associated with the risk of transition to a full-threshold psychotic disorder.
METHODS
The cohort included all young people aged 15-24 who were identified as UHR at a specialist clinic over a five-year period (2012-16). Australian census data were used to obtain the at-risk population. Poisson regression was used to calculate rate ratios and Cox regression analysis determined hazard ratios.
RESULTS
467 young people were identified as UHR, of which 13.5% (n = 63) were born overseas. First-generation migrants were 2.6-fold less likely to be identified as UHR compared to Australian-born young people (IRR = 0.39, 95% CI [0.30, 0.51], P < 0.001). There was no difference between migrant and native-born young people in their risk of transitioning to a psychotic disorder (HR = 0.90, 95% CI [0.39, 2.08], P = 0.81).
CONCLUSIONS
UHR first-generation migrants may be under-accessing mental health services.
Topics: Adolescent; Africa South of the Sahara; Africa, Northern; Age Factors; Asia, Southeastern; Australia; Disease Progression; Emigrants and Immigrants; Female; Health Services Accessibility; Humans; Male; Mental Health Services; Middle East; Psychotic Disorders; Risk; Risk Assessment; Young Adult
PubMed: 31520527
DOI: 10.1111/acps.13099 -
The Journal of Clinical Psychiatry Apr 2009Since stability of DSM-IV diagnoses of disorders with psychotic features requires validation, we evaluated psychotic patients followed systematically in the... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Since stability of DSM-IV diagnoses of disorders with psychotic features requires validation, we evaluated psychotic patients followed systematically in the McLean-Harvard International First Episode Project.
METHOD
We diagnosed 517 patients hospitalized in a first psychotic illness by SCID-based criteria at baseline and at 24 months to assess stability of specific DSM-IV diagnoses.
RESULTS
Among 500 patients (96.7%) completing the study, diagnoses remained stable in 77.6%, ranking as follows: bipolar I disorder (96.5%) > schizophrenia (75.0%) > delusional disorder (72.7%) > major depressive disorder (MDD), severe, with psychotic features (70.1%) > brief psychotic disorder (61.1%) > psychotic disorder not otherwise specified (NOS) (51.5%) >> schizophreniform disorder (10.5%). Most changed diagnoses (22.4% of patients) were to schizoaffective disorder (53.6% of changes in 12.0% of subjects, from psychotic disorder NOS > schizophrenia > schizophreniform disorder = bipolar I disorder most recent episode mixed, severe, with psychotic features > MDD, severe, with psychotic features > delusional disorder > brief psychotic disorder > bipolar I disorder most recent episode manic, severe, with psychotic features). Second most changed diagnoses were to bipolar I disorder (25.9% of changes, 5.8% of subjects, from MDD, severe, with psychotic features > psychotic disorder NOS > brief psychotic disorder > schizophreniform disorder). Third most changed diagnoses were to schizophrenia (12.5% of changes, 2.8% of subjects, from schizophreniform disorder > psychotic disorder NOS > brief psychotic disorder = delusional disorder = MDD, severe, with psychotic features). These 3 categories accounted for 92.0% of changes. By logistic regression, diagnostic change was associated with nonaffective psychosis > auditory hallucinations > youth > male sex > gradual onset.
CONCLUSIONS
Bipolar I disorder and schizophrenia were more stable diagnoses than delusional disorder or MDD, severe, with psychotic features, and much more than brief psychotic disorder, psychotic disorder NOS, or schizophreniform disorder. Diagnostic changes mainly involved emergence of affective symptoms and were predicted by several premorbid factors. The findings have implications for revisions of DSM and ICD.
Topics: Adult; Bipolar Disorder; Delusions; Depressive Disorder, Major; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Female; Follow-Up Studies; Humans; International Cooperation; Male; Predictive Value of Tests; Psychotic Disorders; Schizophrenia; Severity of Illness Index
PubMed: 19200422
DOI: 10.4088/jcp.08m04227 -
Australasian Psychiatry : Bulletin of... Feb 2007The aim of the study was to compare the phenomenology of hallucinations in hospitalized adolescents diagnosed with post-traumatic stress disorder (PTSD) and psychotic... (Comparative Study)
Comparative Study
OBJECTIVE
The aim of the study was to compare the phenomenology of hallucinations in hospitalized adolescents diagnosed with post-traumatic stress disorder (PTSD) and psychotic disorder.
METHODS
Diagnoses were ascertained in 66 adolescents consecutively admitted to an acute adolescent unit in Australia. Hallucinations were examined to compare their phenomenology in PTSD with psychotic disorder.
RESULTS
On most measures, hallucinations did not differ significantly in form or content between those adolescents with PTSD and those with psychotic disorder. In a minority of patients with PTSD, the hallucinations reflected a previous traumatic experience.
CONCLUSIONS
Hallucinations were found to be unreliable in distinguishing adolescent inpatients with PTSD from those with psychotic disorder.
Topics: Adolescent; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Female; Hallucinations; Hospitalization; Humans; Male; Prevalence; Psychotic Disorders; Stress Disorders, Post-Traumatic
PubMed: 17464634
DOI: 10.1080/10398560601083084 -
The American Journal of Psychiatry Oct 2002A family history approach was used to determine if posttraumatic stress disorder (PTSD) with secondary psychotic symptoms was associated with a familial vulnerability to... (Comparative Study)
Comparative Study
OBJECTIVE
A family history approach was used to determine if posttraumatic stress disorder (PTSD) with secondary psychotic symptoms was associated with a familial vulnerability to schizophrenia and other psychoses.
METHOD
Family history methods were used to compare rates of familial psychopathology in the first-degree relatives of three proband groups: 1) patients with DSM-IV PTSD with secondary psychotic symptoms, 2) patients with DSM-IV PTSD without psychotic symptoms, and 3) healthy matched comparison subjects.
RESULTS
PTSD with secondary psychotic symptoms was not associated with an excess of familial psychotic disorder but was associated with a higher morbid risk for depression.
CONCLUSIONS
PTSD with secondary psychotic symptoms was not associated with familial psychosis, suggesting it does not reflect the presence of an underlying psychotic disorder.
Topics: Anxiety Disorders; Comorbidity; Depressive Disorder; Family; Female; Genetic Predisposition to Disease; Humans; Male; Psychiatric Status Rating Scales; Psychotic Disorders; Risk Factors; Schizophrenia; Schizophrenic Psychology; Stress Disorders, Post-Traumatic
PubMed: 12359686
DOI: 10.1176/appi.ajp.159.10.1775