Analysis of the duration of untreated illness (DUI) in the first episode psychosis Program (FEP) in AGS South Granada

2016 ◽  
Vol 33 (S1) ◽  
pp. S577-S578
Author(s):  
B. Girela Serrano ◽  
M. Guerrero Jiménez ◽  
C.M. Carrillo de Albornoz Calahorro ◽  
J.A. Rodrigo Manzano ◽  
O.B. Martínez García
Keyword(s):  
Social Functioning ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Average Score ◽  
First Episode ◽  
Toxic Substances ◽  
Relevant Variable ◽  
Duration Of Untreated Illness ◽  
Social Functioning Scale ◽  
Competing Interest

IntroductionDuration of untreated illness (DUI) has been considered as a relevant variable used to measure the degree of disabilities that are associated with psychotic disorders. In this paper we describe a cluster of patients with a DUI superior to 1 year according to their symptoms and sociofamiliar functioning.MethodsWe compare a group with a DUI superior to 1 year (n = 7) against a group with a DUI inferior to 1 year (n = 17).ResultsThe group with a DUI superior to 1 year showed an average age of 4 years younger (21) as the duration of untreated psychosis (DUP) of 1 to 3 months in the 80% of cases and higher percentage of unemployed or without occupation. The 60% were derived from primary care, compared to the 17% of the other group. Although the consumption of toxic substances was similar in both groups, no toxic psychosis were found in comparison with the 35% present in the group with a DUI inferior to 1 year. PANSS’ profile scored more positive and less negative symptoms. Both have similar general psychopathology. There were group differences in the Social Functioning Scale (SFS) with lower scores in the superior to 1 year DUI, in the following scales: Prosocial, Autonomy, Execution and Employment. The Global Assessment of Functioning (GAF) gives an average of almost 8 points higher.DiscussionWhile the SFS shows significant differences in several areas of social functioning, both PANSS’ profile and the family questionnaire do not support greater deterioration, as evidenced in the GAF's average score.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clinical Profiles, Scope and General Findings of the Western Sydney First Episode Psychosis Project

2005 ◽  
Vol 39 (1-2) ◽  
pp. 36-43 ◽  
Author(s):  
Anthony Harris ◽  
John Brennan ◽  
Josephine Anderson ◽  
Anne Taylor ◽  
Mark Sanbrook ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Services ◽  
Social Functioning ◽  
Mood Disorders ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
The Other ◽  
First Episode ◽  
Schizophrenia Group

Objective: To examine the clinical profile, treatment and social functioning of a communitybased sample of young people presenting with their first episode of psychosis. Methods: Over a 2-year period, young people with their first episode of psychosis referred to early intervention services in two area mental health services in western Sydney were assessed with a battery of clinical, neuropsychological, psychophysiological and neuroanatomical measures. This paper reports the clinical results of the baseline section of the study. Results: Of the 224 referrals to the project, 94 subjects meet inclusion criteria and agreed to take part. Subjects were divided into three diagnostic groups – ‘Schizophrenia’, ‘Mood Disorders’ and ‘Mixed Psychosis’, the latter principally comprised of substance induced psychotic disorders. Subjects from the ‘Schizophrenia’ group differed significantly from the other two groups in that they had higher levels of negative symptoms and general psychopathology, and were less likely to be employed or engaged in study. They had poorer overall social functioning. Subjects with ‘Mixed Psychosis’ were similar to those from the ‘Schizophrenia’ group in that they were older and male, but they did not have the same burden of negative symptoms as the ‘Schizophrenia’ group. The ‘Mood Disorders’ group was younger, female and had overall a higher level of psychosocial functioning than the other two groups. Subjects from the ‘Mood Disorders’ group were more likely to be managed with mood stabilisers and multiple drug therapies. The use of atypical antipsychotic medication was almost universal. Conclusions: Even shortly after the time of presentation to mental health services young people with a schizophrenia spectrum diagnosis have a heavier burden of symptoms and are significantly more impaired by them than young people with other psychotic illnesses. This and their symptom profile differentiated them from young people with other psychotic disorders.

Characteristics and duration of untreated illness in correlation with insight level of first time diagnosed schizophrenia patients in rural region of Latvia

2017 ◽  
Vol 41 (S1) ◽  
pp. s804-s804
Author(s):  
L. Berze ◽  
K. Pavlovs ◽  
K. Slikova ◽  
V. Bodins ◽  
I. Samule ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Depression Scale ◽  
First Episode ◽  
Inclusion Criteria ◽  
Symptoms Of Depression ◽  
Duration Of Untreated Illness ◽  
Schizophrenia Spectrum ◽  
Competing Interest ◽  
First Time ◽  
Written Informed Consent

IntroductionImproved insight level among schizophrenia patients is predictive for better illness prognosis.ObjectiveExplore factors connected to insight.AimEvaluate the insight level and clinical characteristics of first time hospitalized schizophrenia spectrum patients.MethodsAll consecutive first time hospitalized schizophrenia spectrum patients in a psychiatric hospital from 01.01.2016–26.09.2016. Patients were interviewed upon hospitalization and at the discharge with Scale for the assessment of positive symptoms (SAPS) and negative symptoms (SANS), Schedule of assessment of insight-extended (SAI-E), The Calgary depression scale for schizophrenia (C-sch), sociodemographic and clinical data were collected. All participants signed written informed consent and the study was approved by the Riga Stradins University Ethics committee.ResultsFrom 45 first episode patients, 38 met the inclusion criteria. Mean age was 37.66 years (SD: 11.48 years), the average duration of untreated illness (DUI) was 40.5 months (SD: 57.35 months). Psychopathologic symptoms and insight levels evaluated in scores in the 1st and 2nd interviews were as follows: SAPS 69.11 (SD: 20.78) and 33.61 (SD: 18.04), SANS 63.21 (SD: 25.30) and 40.95 (SD: 24.47), SAI-E 15.50 and 27.24 (SD: 13.24), P < 0.001, C-sch 8.50 (SD: 5.31) and 4.27 (SD: 2.86), P < 0.05. There was no statistically significant correlation between DUI and insight level. A higher level of insight at hospitalization correlated with higher levels of depression: r = 0.569, P < 0.001.ConclusionsWe noticed a tendency that lower insight levels might correlate with longer periods of untreated illness. We found that higher insight levels correlated with higher symptoms of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Patterns and predictors of hospitalisation in first-episode psychosis

2001 ◽  
Vol 178 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Attila Sipos ◽  
Glynn Harrison ◽  
David Gunnell ◽  
Shazad Amin ◽  
Swaran P. Singh
Keyword(s):  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Psychiatric Services ◽  
First Episode ◽  
Psychotic Episode ◽  
Duration Of Untreated Illness ◽  
Specialist Services ◽  
Increased Risk ◽  
Episode Psychosis

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.

scholarly journals The effect of the environment on symptom dimensions in the first episode of psychosis: a multilevel study

2014 ◽  
Vol 44 (11) ◽  
pp. 2419-2430 ◽  
Author(s):  
F. J. Oher ◽  
A. Demjaha ◽  
D. Jackson ◽  
C. Morgan ◽  
P. Dazzan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Population Density ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Urban Environments ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Multilevel Regression ◽  
Symptom Dimensions ◽  
Reality Distortion

BackgroundThe extent to which different symptom dimensions vary according to epidemiological factors associated with categorical definitions of first-episode psychosis (FEP) is unknown. We hypothesized that positive psychotic symptoms, including paranoid delusions and depressive symptoms, would be more prominent in more urban environments.MethodWe collected clinical and epidemiological data on 469 people with FEP (ICD-10 F10–F33) in two centres of the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study: Southeast London and Nottinghamshire. We used multilevel regression models to examine neighbourhood-level and between-centre differences in five symptom dimensions (reality distortion, negative symptoms, manic symptoms, depressive symptoms and disorganization) underpinning Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Item Group Checklist (IGC) symptoms. Delusions of persecution and reference, along with other individual IGC symptoms, were inspected for area-level variation.ResultsReality distortion [estimated effect size (EES) 0.15, 95% confidence interval (CI) 0.06–0.24] and depressive symptoms (EES 0.21, 95% CI 0.07–0.34) were elevated in people with FEP living in more urban Southeast London but disorganized symptomatology was lower (EES –0.06, 95% CI –0.10 to –0.02), after controlling for confounders. Delusions of persecution were not associated with increased neighbourhood population density [adjusted odds ratio (aOR) 1.01, 95% CI 0.83–1.23], although an effect was observed for delusions of reference (aOR 1.41, 95% CI 1.12–1.77). Hallucinatory symptoms showed consistent elevation in more densely populated neighbourhoods (aOR 1.32, 95% CI 1.09–1.61).ConclusionsIn people experiencing FEP, elevated levels of reality distortion and depressive symptoms were observed in more urban, densely populated neighbourhoods. No clear association was observed for paranoid delusions; hallucinations were consistently associated with increased population density. These results suggest that urban environments may affect the syndromal presentation of psychotic disorders.

Characterising Usage of a Multicomponent Digital Intervention to Predict Treatment Outcomes in First-Episode Psychosis: A Cluster Analysis (Preprint)

2021 ◽  
Author(s):  
Shaunagh O'Sullivan ◽  
Lianne Schmaal ◽  
Simon D'Alfonso ◽  
Yara J Toenders ◽  
Lee Valentine ◽  
...  
Keyword(s):  
Young People ◽  
Treatment Outcomes ◽  
Social Functioning ◽  
Negative Symptoms ◽  
User Profile ◽  
First Episode Psychosis ◽  
First Episode ◽  
User Profiles ◽  
Episode Psychosis ◽  
Social Components

BACKGROUND Multicomponent digital interventions offer the potential for tailored and flexible interventions that aim to address high attrition rates and increase engagement, an area of concern in digital mental health. However, increased flexibility in usage makes it difficult to determine which components lead to improved treatment outcomes. OBJECTIVE This study aimed to identify user profiles on Horyzons, an 18-month digital relapse prevention intervention that incorporates therapeutic content and social networking, along with clinical, vocational and peer support, and to examine the predictive value of these user profiles for treatment outcomes. A secondary objective was to compare each user profile with young people receiving treatment as usual (TAU). METHODS Participants comprised 82 young people (16-27 years of age) with access to Horyzons and 84 receiving TAU, recovering from first-episode psychosis. Six-month usage data from the therapy and social networking components of Horyzons were used as features for K-means clustering for joint trajectories to identify user profiles. Social functioning, psychotic symptoms, depression and anxiety were assessed at baseline and six-month follow-up. General linear mixed models were used to examine the predictive value of user profiles for treatment outcomes, and between each user profile with TAU. RESULTS Three user profiles were identified based on system usage metrics including: (a) low usage; (b) maintained usage of social components; and (c) maintained usage of both therapy and social components. The maintained therapy and social group showed improvements in social functioning (F (2, 51) = 3.58; P = .04), negative symptoms (F (2, 51) = 4.45; P = .02) and overall psychiatric symptom severity (F (2, 50) = 3.23; P = .048) compared to the other user profiles. This group also showed improvements in social functioning (F (1, 62) = 4.68; P = .03), negative symptoms (F (1, 62) = 14.61; P = <.001) and overall psychiatric symptom severity (F (1, 63) = 5.66; P = .02) compared to TAU. Conversely, the maintained social group showed increases in anxiety compared to TAU (F (1, 57) = 7.65; P = .01). No differences were found between the low usage group and TAU on treatment outcomes. CONCLUSIONS Continued engagement with both therapy and social components might be key in achieving long-term recovery. Maintained social usage and low usage outcomes were broadly comparable to TAU, emphasizing the importance of maintaining engagement for improved treatment outcomes. Although the social network may be a key ingredient to increase sustained engagement, as users engaged with this more consistently, it should be leveraged as a tool to engage young people with therapeutic content to bring about social and clinical benefits.

Early psychosis in young women

2016 ◽  
Vol 33 (S1) ◽  
pp. S7-S7
Author(s):  
A. Riecher-Rössler
Keyword(s):  
Young Women ◽  
Help Seeking ◽  
Negative Symptoms ◽  
Stress Reactivity ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Seeking Behavior ◽  
Drug Naïve ◽  
Competing Interest ◽  
The University

IntroductionIt is well known that young women are at lower risk for schizophrenic psychoses than young men. However, little is known about the peculiarities of emerging psychosis in young women.ObjectivesTo describe characteristics of emerging psychosis in women.MethodsWithin the FePsy (Früherkennung von Psychosen = early detection of psychosis) study at the University of Basel Psychiatric Clinics we have examined consecutively all patients with a first episode of psychosis (FEP) or an at-risk mental state (ARMS) referred to us between 2000 and 2015.ResultsWomen did not significantly differ from men regarding psychopathology, neither in the ARMS nor in the FEP group. This was true for positive as well as negative symptoms and basic symptoms. Interestingly, women had a higher correlation of self-rating with observer-rating regarding psychotic symptoms. Duration of untreated psychosis was significantly lower in women than in men. Women seek help more quickly than men and their first contact is more often their partner.Regarding neurocognition women showed a slightly better performance in verbal tasks. They also had higher prolactin levels and larger pituitary volumes, even when drug-naive.Transition to psychosis occurred as often and as quickly in women as in men.ConclusionsThere are only few gender differences in patients with emerging psychosis, which resemble mainly those found in the general population, with women showing a better help-seeking behavior, being more partner-oriented, having a better verbal performance and potentially also a higher stress reactivity [1].Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Gender differences of patients at-risk for psychosis regarding symptomatology, drug use, comorbidity and functioning – Results from the EU-GEI study

2019 ◽  
Vol 59 ◽  
pp. 52-59 ◽  
Author(s):  
Stephanie Menghini-Müller ◽  
Erich Studerus ◽  
Sarah Ittig ◽  
Ulrike Heitz ◽  
Laura Egloff ◽  
...  
Keyword(s):  
Gender Differences ◽  
At Risk ◽  
Drug Use ◽  
Anxiety Disorders ◽  
Statistical Power ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Cannabis Use ◽  
First Episode ◽  
Global Functioning

AbstractBackground:Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated gender differences in symptomatology, drug use, comorbidity (i.e. substance use, affective and anxiety disorders) and global functioning in patients with an at-risk mental state (ARMS) for psychosis.Methods:The sample consisted of 336 ARMS patients (159 women) from the prodromal work package of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI; 11 centers). Clinical symptoms, drug use, comorbidity and functioning were assessed at first presentation to an early detection center using structured interviews.Results:In unadjusted analyses, men were found to have significantly higher rates of negative symptoms and current cannabis use while women showed higher rates of general psychopathology and more often displayed comorbid affective and anxiety disorders. No gender differences were found for global functioning. The results generally did not change when corrected for possible cofounders (e.g. cannabis use). However, most differences did not withstand correction for multiple testing.Conclusions:Findings indicate that gender differences in symptomatology and comorbidity in ARMS are similar to those seen in overt psychosis and in healthy controls. However, observed differences are small and would only be reliably detected in studies with high statistical power. Moreover, such small effects would likely not be clinically meaningful.

scholarly journals Cognitive Training and Remediation in First-Episode Psychosis: A Literature Review

2019 ◽  
Vol 26 (6) ◽  
pp. 542-554
Author(s):  
Kathleen Miley ◽  
Niloufar Hadidi ◽  
Merrie Kaas ◽  
Fang Yu
Keyword(s):  
Social Functioning ◽  
Cognitive Training ◽  
Social Cognitive ◽  
Psychotic Disorders ◽  
Cognitive Impairments ◽  
Verbal Learning ◽  
Poor Quality ◽  
Cognitive Domain ◽  
First Episode ◽  
Meta Analyses

BACKGROUND: Neurocognitive and social cognitive impairments are core characteristics of psychotic disorders, which are present in the first episode of psychosis (FEP) and strongly predict poor social functioning. Addressing cognitive impairments through cognitive training and remediation (CTR) may be a crucial component of recovery-oriented treatment. AIMS: The objectives of this review were to (1) evaluate the CTR theoretical basis and intervention components and (2) examine the effects of CTR on cognition and social functioning in FEP. METHOD: A combined search of Ovid Medline, Embase, and Psych Info databases was conducted using keywords. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quality and risk of bias were assessed using established instruments. RESULTS: Ten randomized controlled trials were included in this review and had an overall fair to poor quality. CTR interventions in FEP utilize a range of theoretical backgrounds, with most including a focus on higher order cognitive processes. Varied doses and intervention components are used. All but one study found improvements in at least one cognitive domain. Global cognition, verbal learning, and memory and executive function were most commonly improved. Three studies found an effect on a range of functional outcomes. CONCLUSIONS: A broad range of CTR interventions have promising effects for addressing cognitive impairments in FEP. Evidence of functional impact is less consistent. Further research is needed in FEP on CTR targeting sensory and perceptual processes, and to identify CTR intervention targets and treatment components that will lead to robust improvements in cognition and functioning.

scholarly journals The role of social relatedness and self-beliefs in social functioning in first-episode psychosis: Are we overestimating the contribution of illness-related factors?

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
César González-Blanch ◽  
Leonardo A. Medrano ◽  
Sarah Bendall ◽  
Simon D’Alfonso ◽  
Daniela Cagliarini ◽  
...  
Keyword(s):  
Social Cognition ◽  
Social Functioning ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Equation Modeling ◽  
First Episode ◽  
Related Factors ◽  
Social Relatedness ◽  
Episode Psychosis ◽  
Fit Index

Abstract Objective Numerous research studies have demonstrated an association between higher symptom severity and cognitive impairment with poorer social functioning in first-episode psychosis (FEP). By contrast, the influence of subjective experiences, such as social relatedness and self-beliefs, has received less attention. Consequently, a cohesive understanding of how these variables interact to influence social functioning is lacking. Method We used structural equation modeling to examine the direct and indirect relationships among neurocognition (processing speed) and social cognition, symptoms, and social relatedness (perceived social support and loneliness) and self-beliefs (self-efficacy and self-esteem) in 170 individuals with FEP. Results The final model yielded an acceptable model fit (χ2 = 45.48, comparative fit index = 0.96; goodness of fit index = 0.94; Tucker–Lewis index = 0.94; root mean square error of approximation = 0.06) and explained 45% of social functioning. Negative symptoms, social relatedness, and self-beliefs exerted a direct effect on social functioning. Social relatedness partially mediated the impact of social cognition and negative symptoms on social functioning. Self-beliefs also mediated the relationship between social relatedness and social functioning. Conclusions The observed associations highlight the potential value of targeting social relatedness and self-beliefs to improve functional outcomes in FEP. Explanatory models of social functioning in FEP not accounting for social relatedness and self-beliefs might be overestimating the effect of the illness-related factors.

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