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Georgian Medical News May 2023The socio-demographic and clinical characteristics of patients of the Kazakh ethnic group suffering from paranoid schizophrenia were studied in order to increase the...
The socio-demographic and clinical characteristics of patients of the Kazakh ethnic group suffering from paranoid schizophrenia were studied in order to increase the efficiency of providing them with specialized psychiatric care in the Republic of Kazakhstan. The analysis of social and demographic characteristics of the examined group of 1200 patients of the Kazakh population with a clinically verified diagnosis: "Paranoid schizophrenia" (F20.0) in the period from 2021 to 2023 showed that these were mainly people of average working age (31-50 years - 55.59%), a significant part of whom, despite a fairly good level of education, were socially maladapted in family and household terms, more than 80% of them had a disability due to mental illness, which it may indicate the severity of the underlying mental disorder. The analysis of clinical characteristics (according to the PANSS scale) showed that in patients with a continuous type of paranoid schizophrenia, the severity of mental disorders (93.06 points) significantly exceeded the same indicator in patients with an episodic type of the disease (76.87 points), mainly due to the difference in the scale of general psychopathological symptoms. It is established that for people of the Kazakh ethnic group suffering from paranoid schizophrenia, concomitant narcological pathology is not characteristic.
Topics: Humans; Adult; Middle Aged; Schizophrenia, Paranoid; Kazakhstan
PubMed: 37419463
DOI: No ID Found -
Annals of Agricultural and... Jun 2023The aim of the study was to evaluate the peripheral level of brain-derived neurotrophic factor (BDNF) and matrix metalloproteinase-9 (MMP-9) during rehabilitation...
INTRODUCTION AND OBJECTIVE
The aim of the study was to evaluate the peripheral level of brain-derived neurotrophic factor (BDNF) and matrix metalloproteinase-9 (MMP-9) during rehabilitation therapy, combined with neurofeedback in schizophrenic patients, and to investigate whether these biomarkers are related to psychopathological symptoms, changes in auditory evoked potentials (AEPs), and quantitative EEG (QEEGs) mapping.
MATERIAL AND METHODS
The study involved two groups of patients diagnosed with paranoid schizophrenia in partial remission who participated in a 3-month structured rehabilitation programme combined with neurofeedback (REH group) and a standard support group (CON group). The following parameters were assessed: BDNF and MMP-9 serum levels, AEPs, QEEGs, and psychopathological symptoms (PANSS).
RESULTS
A clinical improvement within the 3-month rehabilitation therapy course was correlated with the increase in BDNF and MMP-9 serum level. Despite the increase in BDNF and MMP-9 during the 3-month rehabilitation therapy, it was not possible to demonstrate any strong and significant correlation between the 2 examined neuropeptides. During the 3-month rehabilitation therapy, the theta waveform share reduction in QEEG, P50 latency reduction and amplitude increase correlated with PANSS Total and MMP-9 results.
CONCLUSIONS
All clinical (PANSS Positive, Negative, General, Total) and biochemical results (BDNF, MMP-9) of the REH group changed significantly over the 3-month period. Positive symptoms improved only in the CON group.
Topics: Humans; Brain-Derived Neurotrophic Factor; Matrix Metalloproteinase 9; Patients; Pilot Projects; Schizophrenia
PubMed: 37387382
DOI: 10.26444/aaem/163327 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2023To establish clinico-pathogenetic ratios of delusional psychoses constituting the psychopathological space of paranoid schizophrenia and to determine clinical and...
OBJECTIVE
To establish clinico-pathogenetic ratios of delusional psychoses constituting the psychopathological space of paranoid schizophrenia and to determine clinical and pathogenetic validity of concepts of a single delusional psychosis (a model of chronic delusion with a staged course) and two endogenous delusional psychoses.
MATERIAL AND METHODS
A sample consisted of 56 patients (19 women, 37 men; the average age 39.7±9.3 years; average duration of the disease 10.6±9.1 years) with a diagnosis of paranoid schizophrenia, continuous type of course (F20.00), developed at the age above 18 years. At the time of examination, the condition of the patients was determined by persistent delusional or hallucinatory delusional disorders. Clinical, pathopsychological, psychometric (SANS, SAPS, PANSS), immunological and statistical methods were used.
RESULTS
The study substantiates a bimodal model of a single delusional psychosis with a polar arrangement of interpretive delusions and delusions of influence based on the phenomena of mental automatism, both in terms of the vector of development (toward the poles of negative/positive disorders) and in terms of the rate of progression. Psychopathological manifestations of interpretive delusions correlate with the slow evolving development of psychosis, the dimensional structure of the paranoid is limited to the limits of the delusional register; functional activity is represented by affiliation to negative changes, integration with personality anomalies ends with the transformation of positive disorders into pathocharacterological ones, corresponding to the post-processual development of the personality. Manifestation of delusional impact (syndrome of mental automatism) is manifested by the complication and maximum expansion of the spectrum of positive disorders; the dimensional structure is represented by a wide range of psychopathological disorders and is formed with the participation of processes of mental dissociation, reaching the level of delusional depersonalization; functional activity is high, which creates conditions for the formation of a «new» subpsychotic structure, a «psychotic character», which is an attenuated duplicate of delusional psychosis. In both groups of patients, a significant increase in the activity of inflammatory markers of leukocyte elastase (249.2 ((231.1-270.0); 272.2 (236.0-292.6) nmol/min∙ml) and alpha - 1 proteinase inhibitor (48.8 (46.0-55.0); 50.4 (42.1-54.8) IU/ml) was shown compared with controls (205.0 (199.8-217.3) nmol/min∙mL and 33.0 (31.0-36.0) IU/mL, <0.01, respectively). In the group of patients with delusions of influence, an increased level of antibodies to S-100B was also observed (0.88 (0.67-1.0) opt.density units) compared with the control values (0.7 (0.65-0.77) opt.density units, <0.05).
CONCLUSION
The concept of the model is supported by the results of the immunological study, according to which interpretive delusions and delusion based on the mental automatism, indicates the different level of immunity tension, and a qualitative changes in immune reactivity (also due to different genetic burden).
Topics: Male; Humans; Female; Adult; Middle Aged; Adolescent; Psychotic Disorders; Psychopathology; Schizophrenia, Paranoid; Personality Disorders; Dissociative Disorders; alpha 1-Antitrypsin
PubMed: 37382977
DOI: 10.17116/jnevro202312306144 -
The British Journal of Clinical... Sep 2023Previous research has shown a link between childhood sexual abuse (CSA) and more severe symptoms of psychosis. There is also evidence that self-compassion is a key...
BACKGROUND
Previous research has shown a link between childhood sexual abuse (CSA) and more severe symptoms of psychosis. There is also evidence that self-compassion is a key mechanism linking adverse childhood experiences and mental health problems such as post-traumatic stress disorder and depression, but no research has examined these links in psychosis.
METHODS
We analysed existing cross-sectional data, including 55 individuals with psychosis and 166 individuals from the general population. Participants completed standardized measures of CSA, self-compassion, paranoia, positive psychotic symptoms and distress linked to psychosis.
RESULTS
The clinical group had higher scores on CSA and all psychosis measures, but we found no differences in self-compassion between the groups. Higher levels of CSA correlated with lower self-compassion and higher paranoia and positive symptoms in both groups. CSA also correlated with distress linked to psychosis in the non-clinical group. Lower self-compassion mediated the association between higher levels of CSA and more severe paranoia in both groups. In the non-clinical group, lower self-compassion also mediated the association between greater CSA and more positive psychotic symptoms and more severe distress.
CONCLUSIONS
This is the first study to show that self-compassion mediates the link between CSA and both paranoia and psychotic symptoms in adulthood. Self-compassion may therefore be an important transdiagnostic candidate target in therapy to mitigate the impact of early adversity on paranoia in both clinical and non-clinical groups. Limitations include the small clinical sample and inclusion of a cannabis-using non-clinical sample, though recent cannabis use did not impact self-compassion levels.
Topics: Humans; Self-Compassion; Cross-Sectional Studies; Psychotic Disorders; Paranoid Disorders; Sex Offenses
PubMed: 37382313
DOI: 10.1111/bjc.12429 -
Cognitive Neuropsychiatry Jul 2023Although delusions in Parkinson's disease (PD) are rare, when they occur they frequently take the form of "Othello syndrome": the irrational belief that a spouse or...
Although delusions in Parkinson's disease (PD) are rare, when they occur they frequently take the form of "Othello syndrome": the irrational belief that a spouse or partner is being unfaithful. Hitherto dismissed as either a by-product of dopamine therapy or cognitive impairment, there are still no convincing theoretical accounts to explain why only some patients fall prey to this delusion, or why it persists despite clear disconfirmatory evidence. We discuss the limitations of existing explanations of this delusion, namely hyperdopaminergia-induced anomalous perceptual experiences and cognitive impairment, before describing how Bayesian predictive processing accounts can provide a more comprehensive explanation by foregrounding the importance of prior experience and its impact upon computation of probability. We illustrate this new conceptualisation with three case vignettes. We suggest that in those with prior experience of romantic betrayal, hyperdominergic-induced aberrant prediction errors enable anomalous perceptual experiences to accrue greater prominence, which is then maintained through Bayes-optimal inferencing to confirm cognitive distortions, eliciting and shaping this dangerous delusion. We propose the first comprehensive mechanistic account of Othello syndrome in PD and discuss implications for clinical interventions.
Topics: Humans; Delusions; Parkinson Disease; Bayes Theorem; Schizophrenia, Paranoid; Cognitive Dysfunction
PubMed: 37366042
DOI: 10.1080/13546805.2023.2229080 -
Journal of Clinical Psychopharmacology
Topics: Humans; Antipsychotic Agents; Clozapine; Myoclonus; Schizophrenia, Paranoid
PubMed: 37335194
DOI: 10.1097/JCP.0000000000001717 -
Schizophrenia Bulletin Sep 2023While the evolution of our modern concepts of mania and melancholia over the 19th century is relatively well-understood, no such clear narrative exists for the...
While the evolution of our modern concepts of mania and melancholia over the 19th century is relatively well-understood, no such clear narrative exists for the nonaffective psychotic syndromes that culminated in Kraepelin's concept of dementia praecox in 1899. These narratives were relatively distinct in Germany and France. An important milestone in the French literature is the 1852 essay by the alienist and polymath Charles Lasègue which contained the first detailed modern description of a persecutory delusional syndrome. Lasègue was a careful clinical observer who emphasized a symptomatic approach to psychiatric nosology and was less concerned with course and outcome. He details the evolution of persecutory delusions from increasing referential observations of real events, to the resulting anxious confusion and then the emergence of explanatory delusional beliefs. Once formed, these beliefs, he notes, are relatively impervious to correction. Lasègue was unusual for his time in emphasizing a "first-person perspective" on psychotic experiences, and quotes from his patients in his case history, of which he presents 15. Of these, 12 had auditory hallucinations and 4 passivity phenomena. While conceptualized differently than mid-19th century pre-Kraepelinian German writing on delusional syndromes, and unique on its focus on persecutory delusions, Lasègue's important essay shared a common view on the key features of a broad nonaffective delusional-hallucinatory syndrome. It was this syndrome that Kraepelin, over multiple drafts in the first 6 editions of his textbook from 1883 to 1899, was to divide into his mature concepts of paranoia and the paranoid subtype of dementia praecox.
Topics: Humans; History, 19th Century; Delusions; Syndrome; Psychiatry; Paranoid Disorders; Hallucinations; Schizophrenia
PubMed: 37318157
DOI: 10.1093/schbul/sbad086 -
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 -
Asian Journal of Psychiatry Aug 2023We conducted a retrospective chart review to examine the gender differences in young onset Persistent Delusional Disorder (PDD) subjects (N = 236) with onset of...
We conducted a retrospective chart review to examine the gender differences in young onset Persistent Delusional Disorder (PDD) subjects (N = 236) with onset of illness before the age of 30 years. Gender differences in marital and employment status were significant (p-0.001). Delusion of infidelity and erotomania were more common in females, while males had more body dysmorphic and persecutory delusions (X-20.45, p-0.009). Males had more substance dependence (X-21.31, p < 0.001), as well as a family history of substance abuse and PDD (X-18.5, p < 0.01). To conclude, gender differences in PDD comprised some psychopathology, co-morbidity, and family history among those with young onset PDD.
Topics: Male; Female; Humans; Adult; Delusions; Schizophrenia, Paranoid; Sex Factors; Retrospective Studies; Comorbidity; Substance-Related Disorders
PubMed: 37270876
DOI: 10.1016/j.ajp.2023.103653 -
Psychiatric Services (Washington, D.C.) Dec 2023Black adults in the United States are more likely to be diagnosed as having schizophrenia spectrum disorders and to report experiences of paranoia than are White adults....
Black adults in the United States are more likely to be diagnosed as having schizophrenia spectrum disorders and to report experiences of paranoia than are White adults. Cultural mistrust, or marginalized groups' adaptive skepticism toward dominant historically White institutions, is associated with paranoia among Black individuals, suggesting that experiences of paranoia may be culturally mediated. The authors aimed to explore thematic differences between Black and White adults with schizophrenia spectrum disorders in their experiences of paranoia, including potential differences in persecutory content, cultural mistrust, and related themes. The authors conducted a thematic content analysis of archival qualitative data on experiences of paranoia reported by Black and White adults with schizophrenia spectrum disorders (N=21) in a structured clinical interview. Distinct themes related to cultural mistrust and persecutory paranoia emerged among the participants, suggesting that lived experiences of persecution and discrimination may affect how Black adults with schizophrenia spectrum disorders interpret threat and express paranoia. These findings highlight the importance of culturally responsive approaches in assessment and conceptualization of clinical paranoia versus cultural mistrust.
Topics: Adult; Humans; Paranoid Disorders; Schizophrenia; White; Interpersonal Relations
PubMed: 37254507
DOI: 10.1176/appi.ps.20220089