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Neuropsychopharmacology Reports Mar 2024Cenesthopathy is a rare syndrome characterized by strange bodily and oral sensations and is classified as a delusional disorder, somatic type, according to the fifth...
Cenesthopathy is a rare syndrome characterized by strange bodily and oral sensations and is classified as a delusional disorder, somatic type, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Cenesthopathy has been considered difficult to treat. However, to improve cenesthopathy, many pharmacotherapeutic options are reported, including antidepressants and antipsychotics. In this case report, vortioxetine significantly alleviated the distress of oral cenesthopathy in a patient with cerebral ischemia and depression without any adverse effects. To the best of our knowledge, this is the first report on the efficacy of vortioxetine in treating cenesthopathy. Though it is unclear why vortioxetine was effective for cenesthopathy in our case, we stated two possibilities for improving his oral cenesthopathy. When treating oral cenesthopathy in elderly patients, clinicians consider to be one of the options to prescribe vortioxetine.
Topics: Humans; Aged; Vortioxetine; Schizophrenia, Paranoid; Antidepressive Agents; Antipsychotic Agents
PubMed: 37794715
DOI: 10.1002/npr2.12384 -
The American Journal of Case Reports Sep 2023BACKGROUND Many patients with dementia with Lewy bodies (DLB) experience cholinesterase inhibitor- and antipsychotic-resistant psychosis. The new second-generation...
BACKGROUND Many patients with dementia with Lewy bodies (DLB) experience cholinesterase inhibitor- and antipsychotic-resistant psychosis. The new second-generation antipsychotic pimavanserin has been used with some success in the treatment of psychosis in other forms of dementia, including Alzheimer disease and Parkinson disease dementia. It is possible that pimavanserin may also be useful in the treatment of psychosis in DLB. We sought to describe the disease course and treatment of psychosis in 4 patients with DLB who were prescribed pimavanserin after other medications failed to reduce the frequency or severity of hallucinations and delusions. CASE REPORT This is a case series of 4 male patients (ages 56 to 74 at the beginning of the reports) who developed DLB and psychosis (eg, visual illusions, visual and olfactory hallucinations, and paranoid delusions). All 4 patients were prescribed cholinesterase inhibitors (eg, donepezil or rivastigmine) prior to pimavanserin, and only 1 patient experienced improved psychosis while on cholinesterase inhibitors. All 3 patients who were prescribed first-generation antipsychotics (eg, haloperidol) or traditional second-generation antipsychotics (eg, olanzapine, risperidone, or quetiapine) experienced initial or lasting side effects with no improvement of psychosis. Conversely, all 4 patients tolerated pimavanserin well, and 3 of the 4 patients experienced significant improvement of psychosis (eg, fewer hallucinations, fewer delusions, reduced paranoia, and/or reduced distress or agitation related to hallucinations and delusions) when prescribed pimavanserin. CONCLUSIONS This case series suggests that pimavanserin is tolerable in older males with DLB and that it may be useful for the reduction of distressful hallucinations, delusions, and paranoia in patients with DLB.
Topics: Humans; Male; Aged; Antipsychotic Agents; Lewy Body Disease; Dementia; Cholinesterase Inhibitors; Parkinson Disease; Psychotic Disorders; Hallucinations; Piperidines; Urea
PubMed: 37775968
DOI: 10.12659/AJCR.939806 -
Health Psychology Open 2023Given the risk of developing vicarious trauma through news media has increased during the pandemic, we explored risk factors associated with media induced secondary...
AIMS
Given the risk of developing vicarious trauma through news media has increased during the pandemic, we explored risk factors associated with media induced secondary trauma, and its behavioral and psychological implications.
METHODS
An international study ( = 1066), with a diverse sample, was administered in July 2020. We used standardized and validated questionnaires to measure news consumption, media-related trauma, compliance, and paranoia.
RESULTS
Greater frequency of news consumption, accessing news via social media and WHO, and believing in conspiracy theories increased likelihood of developing media-induced secondary trauma. News related trauma was associated with greater compliance with safety measures and increased paranoid ideation. Media-trauma however exhibited a greater association with paranoia than compliance.
CONCLUSION
Findings highlight the need to facilitate a collaborative intervention, with public, media houses, health safety officials, and social scientists to have a deeper understanding of potential psychological costs of news consumption patterns.
PubMed: 37746585
DOI: 10.1177/20551029231199578 -
The Apple Doesn't Fall Far from the Tree? Paranoia and Safety Behaviours in Adolescent-Parent-Dyads.Research on Child and Adolescent... Feb 2024Paranoia is a common experience in adolescence that may entail the use of safety behaviours (e.g. avoidance), which are assumed to maintain paranoia in the long run. As...
Paranoia is a common experience in adolescence that may entail the use of safety behaviours (e.g. avoidance), which are assumed to maintain paranoia in the long run. As the development of paranoia and related safety behaviours in youth may be influenced by their caregivers, we aimed to investigate the associations of paranoia and safety behaviours in adolescents and their parents. Adolescents from the general population aged 14-17 and one of their parents (N = 142 dyads) were recruited via Qualtrics to complete online surveys including measures of paranoia, safety behaviour use, anxiety, and demographics. We fitted an Actor-Partner-Interdependence Model (APIM) for testing dyadic parent-child interaction by using structural equation modelling and controlled for adolescents' and parents' anxiety. Results indicated that paranoia positively predicted safety behaviour use in adolescents and in parents. There were significant positive intra-dyad (i.e. parent-adolescent) correlations for both paranoia and safety behaviour use. One partner effect was significant: parental paranoia positively predicted the safety behaviour use of their adolescent child. Conversely, adolescents' paranoia did not predict their parents' safety behaviour use. Our findings corroborate prior research demonstrating an association between paranoia and safety behaviours among adults, and extend this association to adolescents. Children of parents experiencing paranoia are at increased risk of developing paranoia and safety behaviours, which indicates the need for interventions that target paranoia and safety behaviours in family systems.
Topics: Adult; Humans; Adolescent; Paranoid Disorders; Adolescent Behavior; Parents; Health Behavior; Surveys and Questionnaires
PubMed: 37740777
DOI: 10.1007/s10802-023-01128-y -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Jul 2023Family risk factors are crucial to adolescent mental health. Few studies have investigated the complex relationship between family risk factors and adolescent mental...
OBJECTIVES
Family risk factors are crucial to adolescent mental health. Few studies have investigated the complex relationship between family risk factors and adolescent mental health. This study aims to investigate the complex relationship between family cumulative risk (FCR) and adolescent mental health, and to clarify the factors contributing to adolescent mental health problems.
METHODS
This study recruited 903 junior high school students and 991 senior high school students in Changsha, Hunan and was conducted through an offline computer-based questionnaire survey using the Middle School Student Mental Health Scale (MSSMHS) and the Family Cumulative Risk Questionnaire (FCRQ) to assess the mental health status and FCR factors, respectively. Statistical analyses were conducted to clarify the demographic factors influencing MSSMHS total and factor scores, and to analyze the relationship between FCRQ and MSSMHS total and factor scores.
RESULTS
Females exhibited more mental health problems than males in various MSSMHS factors (all <0.05); adolescents were prone to different mental health problems at different stages (junior high school first-grade vs. senior high school first-grade); senior high school first-grade students were more likely to experience academic pressure and maladjustment than junior high school first-grade students (<0.01), and junior high school first-grade students were more likely to exhibit obsessive, paranoia, and hostility symptoms than senior high school first-grade students (all <0.01); adolescents with low family intimacy and high family conflict reported more symptoms in every dimension of MSSMHS (all <0.05); adolecents with poor parent-child separation reported higher obsessive-compulsive symptoms, interpersonal sensitivity, anxiety, academic pressure, maladjustment, emotional instability, and unbalanced mind than those with good parent-child separation (all <0.05).
CONCLUSIONS
Female, low family intimacy, high family conflict, and poor parent-child separation are risk factors of adolescent mental health problems. Higher-grade middle school students are prone to exhibit academic pressure and maladjustment, while lower-grade middle school students are prone to exhibit obsessive, paranoia, and hostility symptoms.
Topics: Male; Adolescent; Female; Humans; Mental Health; Anxiety; Anxiety Disorders; Risk Factors; Students
PubMed: 37724411
DOI: 10.11817/j.issn.1672-7347.2023.230065 -
BMC Psychiatry Sep 2023Literature has typically associated delusional disorder with a poorer prognosis relative to schizophrenia, without considering the confounding effect of age despite the...
BACKGROUND
Literature has typically associated delusional disorder with a poorer prognosis relative to schizophrenia, without considering the confounding effect of age despite the differential age of onset. This study therefore aims to investigate the diagnostic stability, clinical, functional, and neurocognitive differences of Chinese first-episode psychosis age-matched patients with delusional disorder and schizophrenia at four years.
METHODS
71 delusional disorder and 71 age-matched schizophrenia patients were followed up for four years after their initial episode. Their symptoms, insight in psychosis, side effects of medication, medication compliance, functioning, and neurocognitive performance were assessed at four years.
RESULTS
At four years, 65% of DD patients maintained the same diagnosis, while the rest shifted to SZ. Only those without a diagnostic shift were included in the analysis. Delusional disorder patients (n = 46) experienced greater general psychopathology and poorer insight, but better attitude towards medication than schizophrenia patients (n = 71). Social and occupational functioning, quality of life, and cognitive functioning, however, were similar in delusional disorder and schizophrenia patients.
CONCLUSIONS
Results indicate that delusional disorder is less diagnostically stable than schizophrenia. Their outcomes in a Chinese population were largely similar at four years after removing the confounding age factor, implying that delusional disorder and schizophrenia may not be as distinct as previously thought.
Topics: Humans; Child, Preschool; Follow-Up Studies; Quality of Life; Schizophrenia, Paranoid; Psychotic Disorders; Age Factors
PubMed: 37723482
DOI: 10.1186/s12888-023-05175-z -
Neuro-oncology Practice Oct 2023The objective of this scoping review was to describe the intervention characteristics and effectiveness of psychosocial interventions aimed at managing personality and... (Review)
Review
BACKGROUND
The objective of this scoping review was to describe the intervention characteristics and effectiveness of psychosocial interventions aimed at managing personality and behavior changes in people with brain tumors. A secondary objective was to explore if these interventions had an impact on outcomes for carers. Personality and behavior changes considered included aggression, apathy, paranoia, disinhibition, and emotional lability.
METHODS
This review was conducted following the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Searches were conducted in PsycINFO, CINAHL, Medline (Ovid), and Scopus. We synthesized studies published from 1996 to 2022 that evaluated interventions to manage brain tumor related personality and behavioral changes in adults. A data extraction tool were used based on the Joanna Briggs Institute template. Results are presented in a summary table and a narrative synthesis was conducted.
RESULTS
Three thousand and five hundred and ninety-four records were screened. Title and abstract screening resulted in 29 potentially eligible studies. Full screening excluded 24 articles and 5 interventions met the inclusion criteria. The interventions were diverse in duration, delivery modality, setting, and participation (eg, the patient individually or patient and carer). The interventions reported improvements in the targeted personality and behavior change symptoms for patients with primary brain tumors. Four studies included a measure of personality and behavior change symptoms and two studies included a measure of outcomes for carers and reported improvements in carer knowledge and a reduction in carer distress. All studies sampled fewer than 100 participants. Studies had limited follow-up data and different tools were used to assess the presence and nature of personality and behavior changes.
CONCLUSIONS
There is a dearth of psychosocial interventions to support patients and their carers to manage brain tumor related personality and behavior changes.
PubMed: 37720389
DOI: 10.1093/nop/npad031 -
BMJ Open Sep 2023Cognitive behavioural therapy for psychosis (CBTp) has demonstrated effectiveness in reducing positive symptoms, improving depression, enhancing coping skills and...
INTRODUCTION
Cognitive behavioural therapy for psychosis (CBTp) has demonstrated effectiveness in reducing positive symptoms, improving depression, enhancing coping skills and increasing awareness of illness. However, compared with cognitive behavioural therapy for depression and anxiety, the spread of CBTp in clinical practice is minimal. The present study designed a randomised controlled trial (RCT) research protocol to evaluate whether real-time remote video-conference CBTp (vCBTp) could facilitate access to psychosocial interventions and effectively improve symptoms compared with usual care (UC) for patients with schizophrenia.
METHODS AND ANALYSIS
This exploratory RCT will consist of two parallel groups (vCBTp+UC and UC alone) of 12 participants (n=24) diagnosed with schizophrenia, schizoaffective disorder or paranoid disorder, who remain symptomatic following pharmacotherapy. Seven 50-min weekly vCBTp interventions will be administered to test efficacy. The primary outcome will be the positive and negative syndrome scale score at week 8. The secondary outcome will be the Beck Cognitive Insight Scale to assess insight, the Patient Health Questionnaire-9 to assess depression, the Generalised Anxiety Disorder-7 to assess anxiety, the 5-level EuroQol 5-dimensional questionnaire to assess quality of life and the Impact of Event Scale-Revised to assess subjective distress about a specific stressful life event. We will take all measurements at 0 weeks (baseline) and at 8 weeks (post-intervention), and apply intention-to-treat analysis.
ETHICS AND DISSEMINATION
We will conduct this study in the outpatient department of Cognitive Behavioral Therapy Center at Chiba University Hospital. Further, all participants will be informed of the study and will be asked to sign consent forms. We will report according to the Consolidated Standards of Reporting Trials.
TRIAL REGISTRATION NUMBER
UMIN000043396.
Topics: Humans; Schizophrenia; Outpatients; Psychotic Disorders; Anxiety; Cognitive Behavioral Therapy; Randomized Controlled Trials as Topic
PubMed: 37696635
DOI: 10.1136/bmjopen-2022-069734 -
Social Psychiatry and Psychiatric... May 2024To explore gender differences of the associations between childhood adversity (CA) subtypes and psychiatric symptoms in the general population.
PURPOSE
To explore gender differences of the associations between childhood adversity (CA) subtypes and psychiatric symptoms in the general population.
METHODS
Data of 791 participants were retrieved from a general population twin cohort. The Symptom Checklist-90 Revised (SCL-90) and the Childhood Trauma Questionnaire were used to assess overall psychopathology with nine symptom domains scores and total CA with exposure to five CA subtypes, respectively. The associations between CA and psychopathology were analyzed in men and women separately and were subsequently compared.
RESULTS
Total CA was associated with total SCL-90 and all symptom domains without significant gender differences. However, the analyses of CA subtypes showed that the association between emotional abuse and total SCL-90 was stronger in women compared to men [χ(1) = 4.10, P = 0.043]. Sexual abuse was significantly associated with total SCL-90 in women, but emotional neglect and physical neglect were associated with total SCL-90 in men. Exploratory analyses of CA subtypes and SCL-90 subdomains confirmed the pattern of gender-specific associations. In women, emotional abuse was associated with all symptom domains, and sexual abuse was associated with all except phobic anxiety and interpersonal sensitivity. In men, emotional neglect was associated with depression, and physical neglect was associated with phobic anxiety, anxiety, interpersonal sensitivity, obsessive-compulsive, paranoid ideation, and hostility subdomains.
CONCLUSION
CA is a trans-syndromal risk factor regardless of gender. However, differential associations between CA subtypes and symptom manifestation might exist. Abuse might be particularly associated with psychopathology in women, whereas neglect might be associated with psychopathology in men.
Topics: Humans; Female; Male; Adult; Sex Factors; Adverse Childhood Experiences; Middle Aged; Psychopathology; Surveys and Questionnaires; Mental Disorders; Child; Adult Survivors of Child Abuse; Child Abuse; Emotional Abuse; Psychiatric Status Rating Scales
PubMed: 37624463
DOI: 10.1007/s00127-023-02546-5