Search results for "Psychosis"

2020

Abstract Background The long-term effectiveness of antipsychotic maintenance treatment after first-episode psychosis (FEP) is contested. In this real-world observational study, we examined how cumulative exposure to antipsychotics within the first 5 years from FEP was associated with the 19-year outcome. Methods Finnish national registers were used to detect all patients who were hospitalized due to non-affective psychosis in the mid-1990s, and who were treatment naïve prior to the inclusion period (N = 1318). Generalized linear models with logit link function were used to estimate how cumulative exposure to antipsychotics within the first 5 years from onset was associated with mortality, w…

Perspectives actuelles dans la microdélétion 22q11.2 : prise en charge du phénotype neurocomportemental

2015

Resume La microdeletion 22q11.2 est le syndrome microdeletionnel le plus frequent de la population generale. Le phenotype associe des anomalies de l’appareil pharynge embryonnaire a un phenotype neurocomportemental. La presentation clinique du syndrome est extremement variable d’un individu a l’autre, quelle que soit la taille de la deletion, et plus de 180 manifestations ont ete decrites, aucune n’etant pathognomonique. Les symptomes psychiatriques, particulierement de nature psychotique, sont frequents dans la microdeletion 22q11.2 et de nombreux psychiatres sont amenes a rencontrer ces patients. La prise en charge doit tenir compte des particularites du syndrome. L’evaluation de la neuro…

First-Episode Psychotic Patients Showed Longitudinal Brain Changes Using fMRI With an Emotional Auditory Paradigm

2020

[EN] Most previous longitudinal studies of functional magnetic resonance imaging (fMRI) in first-episode psychosis (FEP) using cognitive paradigm task found an increased activation after antipsychotic medications. We designed an emotional auditory paradigm to explore brain activation during emotional and nonemotional word processing. This study aimed to analyze if longitudinal changes in brain fMRI BOLD activation is present in patients vs. healthy controls. A group of FEP patients (n = 34) received clinical assessment and had a fMRI scan at baseline and follow-up (average, 25-month interval). During the fMRI scan, both emotional and nonemotional words were presented as a block design. Resu…

The Representativeness of Participants With Severe Mental Illness in a Psychosocial Clinical Trial

2018

Introduction: Cardiovascular morbidity and mortality are increased in severe mental illnesses (SMI). Trials of psychosocial health interventions to improve physical health in SMI, including in treatment-resistant schizophrenia, have shown some benefit. However, the representativeness of participants in such trials has not been determined. Method: We utilized an anonymised case register to determine if participants in a randomized controlled trial (RCT) of a novel psychosocial health intervention aiming to improve physical health in SMI had similar severity of illness to eligible non-participants. A retrospective database analysis was performed, using Health of the Nation Outcome Scale (HoNO…

'At risk mental state' clinics for psychosis - An idea whose time has come - And gone!

2019

AbstractAt Risk Mental State (ARMS) clinics are specialised mental health services for young, help-seeking people, thought to be at ultra-high risk of developing psychosis. Their stated purpose is to reduce transitions from the ARMS state to clinical psychotic disorder. Reports of ARMS clinics provide ‘evidence-based recommendations’ or ‘guidance’ for the treatment of such individuals, and claim that such clinics prevent the development of psychosis. However, we note that in an area with a very well-developed ARMS clinic (South London), only a very small proportion (4%) of patients with first episode psychosis had previously been seen at this clinic with symptoms of the ARMS. We conclude th…

ADDITIVE INTERACTION BETWEEN LIFETIME CANNABIS USE AND CHILDHOOD TRAUMA IN INCREASING THE RISK FOR PSYCHOSIS. A REPLICATION ANALYSIS ON A SAMPLE OF F…

2012

Background: Additive interaction between childhood trauma and cannabis use in increasing risk for psychotic disorders has been recently demonstrated in a prospective (Harley et al., 2009) and a cross sectional study (Konigs et al., 2011), although not replicated in another survey (Kuepper et al., 2011). This study aimed to analyse additive interaction between lifetime cannabis and severe child abuse in increasing the risk for psychosis in a sample of first episode psychosis patients and geographically matched controls. In addition, analyses were re-run separately for males and females in order to investigate whether the association was moderated by gender. Methods: The sample consisted of 2…

Cumulative social disadvantage and psychosis: findings from a southern Italy case-control study

2016

Aim: There are consistent evidence suggesting that psychotic disorders are associated to social disadvantage and isolation in adulthood, and research suggested that they these are not simply a consequence of the functional impairment related to onset of the disease (Stilo et al., 2013; Morgan et al., 2008). To date only a few studies have investigated the impact of social risk factors on psychosis in Italy. This study aimed to replicate existing findings in a case-control sample from Southern Italy. Methods: 134 individuals presenting for the first time to mental health services of Palermo (Italy) with an ICD 10 diagnosis of psychosis and 175 population controls from Palermo (Italy) were en…

"Issues like this have an impact" : the need-adapted treatment of psychosis and the psychiatrist's inner dialogue

2014

ReMindCare App for Early Psychosis: Pragmatic Real World Intervention and Usability Study

2020

Background: eHealth interventions are widely used in clinical trials and increasingly in care settings as well; however, their efficacy in real-world contexts remains unknown. ReMindCare is a smartphone app that has been systematically implemented in a first episode of psychosis program (FEPP) for patients with early psychosis since 2018. Objective: The objective of this study was to assess the efficacy of ReMindCare after 19 months of use in the clinic and varying use by individual patients. Methods: The integration of the ReMindCare app into the FEPP started in October 2018. Patients with early psychosis self-selected to the app (ReMindCare group) or treatment as usual (TAU group). The ou…

Systematic review and exploratory meta-analysis of the efficacy, safety, and biological effects of psychostimulants and atomoxetine in patients with …

2019

ObjectiveOur aim was to summarize the efficacy and safety of atomoxetine, amphetamines, and methylphenidate in schizophrenia.MethodsWe undertook a systematic review, searching PubMed/Scopus/Clinicaltrials.gov for double-blind, randomized, placebo-controlled studies of psychostimulants or atomoxetine in schizophrenia published up to 1 January 2017. A meta-analysis of outcomes reported in two or more studies is presented.ResultsWe included 22 studies investigating therapeutic effects of stimulants (k=14) or measuring symptomatic worsening/relapse prediction after stimulant challenge (k=6). Six studies of these two groups plus one additional study investigated biological effects of psychostimu…