scholarly journals The Social Defeat Hypothesis of Schizophrenia: an Update

2017 ◽  
Vol 41 (S1) ◽  
pp. S66-S66
Author(s):  
E. Van der Ven
Keyword(s):  
Psychotic Disorder ◽  
Minority Groups ◽  
Social Defeat ◽  
Autism Spectrum ◽  
Psychotic Symptoms ◽  
Mesolimbic Dopamine System ◽  
Behavioral Expression ◽  
Future Challenges ◽  
Competing Interest ◽  
Socially Excluded

Research provides strong evidence of an elevated risk for developing psychotic symptoms and psychotic disorder among various ethnic and other minority groups. Furthermore, ethnicity may modify the risk for autism-spectrum disorder, but the evidence of this is still thin. Misdiagnosis, selective migration and other methodological artefacts are implausible explanations for the findings on psychotic disorder. Instead, we propose that ‘social defeat’, defined as the chronic experience of being excluded from the majority group, may increase the risk for psychotic disorder by sensitizing the mesolimbic dopamine system. Future challenges lie in connecting the underlying biological mechanisms to behavioral expression in socially excluded groups, as well as in bridging the gap with the clinical field and the wider society by stimulating the implementation of strategies that strengthen the position of minority populations.Disclosure of interestThe author has not supplied his declaration of competing interest.

Corticosteroid-induced psychosis: Case report and review of the literature

2017 ◽  
Vol 41 (S1) ◽  
pp. s840-s840
Author(s):  
M. Tenorio Guadalupe ◽  
I. Alberdi Páramo
Keyword(s):  
Psychotic Disorder ◽  
Clinical Presentation ◽  
Scientific Literature ◽  
Case Reports ◽  
Corticosteroid Treatment ◽  
Psychotic Symptoms ◽  
Clinical Aspects ◽  
Psychotic State ◽  
Competing Interest ◽  
Improved Methods

IntroductionSteroid psychosis still presents many unsettled clinical aspects. Despite several reviews and case reports are available, modes of onset and recovery need a more accurate description. We will focus on a 53-year-old woman who was hospitalized against her will because of her agitated psychotic state. Her symptoms were indicative of an acute psychotic disorder resulting from the use of corticosteroids. We considered it important to report this case because corticosteroids have been widely prescribed since about 1950 to treat a broad spectrum of somatic illnesses and to emphasize the relevance of the dose of steroids in this case.ObjectivesWe describe a case of substance-induced psychotic disorder resulting from corticosteroids administration and we review the scientific literature about this topic.AimsTo obtain more information about the incidence of steroid-induced psychotic symptoms, the relation between the type of steroids, its dose and the clinical presentation, the most important risk factors and how to prevent psychotic episodes during steroids-treatment.MethodsAfter discussing the case, we studied the literature systematically using official medical browsers.ResultsVery little reliable evidence has been available relating to steroid-induced psychosis.ConclusionsThere is much to learn about adverse psychiatric reactions to corticosteroid treatment. It should be improved awareness of the limited available knowledge and to stimulate research aimed at improved methods of prevention, recognition and treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Folie à deux

2016 ◽  
Vol 33 (S1) ◽  
pp. S576-S576
Author(s):  
C. Cocho ◽  
M. Baquero ◽  
I. Vera ◽  
J. Alvarez-arenas
Keyword(s):  
Psychotic Disorder ◽  
Close Association ◽  
Rare Condition ◽  
Psychotic Symptoms ◽  
Mother And Daughter ◽  
Folie À Deux ◽  
Competing Interest ◽  
The Relationship ◽  
Shared Psychotic Disorder ◽  
Folie A Deux

IntroductionThe induced delusional disorder or folie à deux, is a rare condition characterized by psychotic symptoms at least in two individuals in close association.ObjectivesWe report a case of shared psychotic disorder between mother and daughter. We briefly review both classical and current literature.MethodsWe summarized the results from articles identified via MEDLINE/PubMed using “induced delusional/shared psychotic disorder” as keywords. We report a case of a woman who develops psychotic symptoms characterized by delusions of persecution. Her daughter started, during the first high school grade with referring sexual threats and having delusions of persecution lived by her mother like a fact. They have very symbiotic relationship. Seven years later, the mother has required hospitalization for chronic delusions.ResultsThe term folie à deux was first coined by Lasègue and Falret, they assume the transmission of delusions was possible when an individual dominated the other and existed relative isolation. Recent studies found no significant differences in age and sex, although described higher comorbidity with other psychiatric diseases. Relative to treatment, separation by itself is insufficient; an effective neuroleptic treatment is required.ConclusionsOur case meets criteria for shared psychotic disorder. The daughter, with a ruling attitude who dominates the relationship, was the inducer. The mother showed no resistance in accepting delusions and remains them active after separation. This leads us to consider the possible predisposition to psychotic illness by both patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Lifetime Autism Spectrum Features in a Patient with a Psychotic Mixed Episode Who Attempted Suicide

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Marly Simoncini ◽  
Mario Miniati ◽  
Federica Vanelli ◽  
Antonio Callari ◽  
Giulia Vannucchi ◽  
...  
Keyword(s):  
Case Report ◽  
Psychotic Disorder ◽  
Attempted Suicide ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Autism Spectrum ◽  
Psychotic Symptoms ◽  
Childhood Onset ◽  
Mixed Episode ◽  
Patient’S History

We present a case report of a young man who attempted suicide during a mixed episode with psychotic symptoms. The patient’s history revealed the lifetime presence of signs and features belonging to the autism spectrum realm that had been completely overlooked. We believe that this case is representative of an important and barely researched topic: what happens to children with nondiagnosed and nontreated subthreshold forms of autism when they grow old. The issue of early recognition of autism spectrum signs and symptoms is discussed, raising questions on the diagnostic boundaries between autism and childhood onset psychotic spectrums among patients who subsequently develop a full-blown psychotic disorder.

First psychotic episode on the fifth decade? Differential diagnosis of psychotic symptoms, about a case

2016 ◽  
Vol 33 (S1) ◽  
pp. S635-S635
Author(s):  
P. Manzur Rojas ◽  
P. Botias Cegarra ◽  
A.L. Gonzalez Galdamez ◽  
M.I. Ibernon Caballero ◽  
M.R. Raposo Hernandez ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Temporal Lobe ◽  
Brain Mri ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
Complex Partial Seizures ◽  
Sensory Aphasia ◽  
Competing Interest ◽  
Structural Epilepsy

The postictal psychosis is a psychotic disorder that begins shortly after a crisis. Most often it affects patients with partial epilepsy and especially those with temporal lobe epilepsy. The postictal psychosis according to several publications can occur in up to 25% of patients with epilepsy. The psychotic disorder usually occurs within 24–48 hours after, be transient, with good response to treatment with antipsychotics and complete remission of psychotic symptoms. This case is for a woman of 58 years diagnosed with structural epilepsy after brain abscess left temporal intervened in childhood. The patient is being followed by neurology for complex partial seizures with secondary generalization in anti-epileptic treatment. The patient has previous studies of EEG, video EEG and brain MRI, evidence involvement of temporal lobe and hippocampus. The patient is brought to the emergency room after episode of sensory aphasia, unconsciousness and tonic-clonic limb movements, decreasing with diazepam. The patient, during the stay under observation, has auditory hallucinations, that generate anxiety must initiate being him quetiapina and clonazepam orally, yielding partially psychotic disorder, acute intracranial lesions are discarded and the patient is admitted by neurology. The evolution of psychotic disorder with antipsychotic down in a few weeks remaining asymptomatic. Epileptic psychosis is more common in refractory epilepsy. In all cases, you should make a joint approach between psychiatry and neurology, usually they have good response to antipsychotics.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cannabis-induced Psychotic Disorders and THC use Among Patients with Psychotic Symptoms

2017 ◽  
Vol 41 (S1) ◽  
pp. S203-S203
Author(s):  
A. Fernandez-Quintana ◽  
C. Quiroga-Fernandez ◽  
A. Novo-Ponte ◽  
M.D.C. Garcia-Mahia
Keyword(s):  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Cannabis Use ◽  
Personal History ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
Time Interval ◽  
Old Patients ◽  
History Of ◽  
Competing Interest

IntroductionCausality between THC and psychotic symptoms has been outlined in several studies and a potential role for THC in the development of Schizophrenia remains to be assessed.MethodsRetrospective study undertaken in a sample of 124 patients assessed in an Emergency Department (ED) due to psychotic symptoms. Medical records were reviewed to obtain clinical and sociodemographic variables.Objectives(1) To analyse the prevalence of THC consumption among psychotic patients in ED; (2) to establish the prevalence of cannabis-induced psychotic disorder; (3) to underpin the socio-demographic and clinical variables associated with cannabis-induced psychosis.ResultsPersonal history of cannabis use 31.5% (6.5% as a single drug.) Accumulated time interval of cannabis use prior to the first psychotic episode: 0 – 5 years 15% (3.9% developed psychosis during the first year of cannabis use), 5 – 10 years 9.2%, more than 10 years 20.8%. Cannabis-induced psychotic disorder (F12.5) was diagnosed in 3.3% of the sample. The prevalence of this diagnosis was the same among male and female patients. The highest prevalence of cannabis-induced psychosis was found among 36–50 years old patients (50%). All patients with a diagnosis of Cannabis-induced psychotic disorder had a personal history of THC use and urine tests had been positive for THC in 75% of the cases. Habitat: 75% urban, 25% rural. Marital status: 50% single, 50% married.ConclusionsCannabis use is highly prevalent among patients who present with psychotic symptoms in ED and THC is correlated with psychotic episodes. The prevalence of cannabis-induced psychosis has also increased. Further studies comprising larger samples are warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychosis in adolescence: A prognosis or a diagnosis? Integrated treatment with psychodynamic peer support

2017 ◽  
Vol 41 (S1) ◽  
pp. S126-S127
Author(s):  
L. Ciampa ◽  
F. Gucci
Keyword(s):  
Peer Support ◽  
Social Relations ◽  
Intervention Strategy ◽  
Real Life ◽  
Integrated Treatment ◽  
Psychotic Symptoms ◽  
Psychodynamically Oriented ◽  
Rehabilitative Intervention ◽  
Competing Interest ◽  
One Year

IntroductionOur work comprises an integrated intervention strategy for the treatment of psychotic manifestations and functioning in adolescents which, following the theories of Laufer and Chan, questions the usefulness of the diagnosis ‘psychotic’ during adolescence. We apply an “open light treatment” (IPOLT), which includes psychodynamically oriented peer-support.ObjectivesTo build a new form of therapeutic alliance with peer-support based on shared real life experiences enabling adolescents to reintegrate within their environment and re-establish cognitive functioning which has become disorganised, aiding a gradual return of the cohesion of ego and self and in some cases, cessation of psychotic symptoms.MethodologyAn observational study of one year on a group of ten adolescents aged 17 to 20 in institutional and private settings with psychotic manifestations and functioning. The group were tested at the start and end of the study using WAIS-IV and MMPI-A.ResultsThe adolescents recruited showed a faster recovery of the cohesive processes of their fragmented ego as well as a quicker resumption of social relations. Our model provided an organising function and a flexible yet secure ‘container’ (Bion, 1988) for the young people's psychic structure. The tests showed a demonstrable improvement in their verbal comprehension, visual-spazial reasoning, fluid reasoning, working memory and processing speed.ConclusionsPsychotic manifestations occurring in adolescence may decrease with an immediate integrated and rehabilitative intervention, without need of an institutional psychiatric setting. In conclusion, we find that “psychosis” in adolescence is a prognosis and not a diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comparison of cognitive functions children with the autism spectrum disorders and schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S457-S458
Author(s):  
N. Zvereva ◽  
N. Simashkova ◽  
A. Koval-Zaitsev
Keyword(s):  
Autism Spectrum Disorder ◽  
Visual Perception ◽  
Cognitive Functioning ◽  
Cognitive Functions ◽  
Early Onset ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Early Onset Schizophrenia ◽  
Competing Interest ◽  
Autistic Disorders

IntroductionAutism spectrum disorder and early onset schizophrenia have many similar symptoms, however, these are different disorders. It is important to identify the main similarities\differences in the structure of cognitive impairment to define further assistance these children correctly. We distinguished two options for cognitive defect (total and partial) in children with schizophrenia.AimsComparison of cognitive functions at children with autism spectrum disorder and early onset schizophrenia.ObjectivesTwo groups with autism spectrum disorder (ASD1 – 22 patients of MHRC mean age 8.9; ASD2 – 27 pupils of special school mean age 7,4). Two groups with early onset schizophrenia (F20.8 – 16 patients of MHRC mean age 10,2; F21 – 18 patients of MHRC mean age 10.0).MethodsBattery of pathopsychological tests for assessing cognitive functions (memory, attention, thinking), test figures of Leeper for visual perception. Z-scales were used for estimation of cognitive deficit or defect.ResultsPatients demonstrate variety of cognitive functioning. Normal cognitive functioning: ASD1* – 22%, F20.8 – 18%, F21* – 50% (* – P ≤ 0.05); partial cognitive defect: ASD1 – 27%, F20.8 – 18%, F21 – 22%; total cognitive defect: ASD1** – 50%, F20.8 – 64%, F21** – 27% (** – P ≤ 0.01). ASD1 and F20 were the worth in thinking. Children ASD1 and ASD2 demonstrate similar success in recognizing Leeper's figures.ConclusionsThere are some common features of cognitive development in children with severe forms of ASD and early onset schizophrenia, first of all in thinking.No significant differences obtained between severe – mild forms of autistic disorders in visual perception (ASD1 and ASD2).Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals What makes the psychosis ‘clinical high risk’ state risky: psychosis itself or the co-presence of a non-psychotic disorder?

2021 ◽  
Vol 30 ◽  
Author(s):  
Laila Hasmi ◽  
Lotta-Katrin Pries ◽  
Margreet ten Have ◽  
Ron de Graaf ◽  
Saskia van Dorsselaer ◽  
...  
Keyword(s):  
High Risk ◽  
Drug Use ◽  
Psychotic Disorder ◽  
Positive Family History ◽  
Mental Health Service Use ◽  
Psychotic Symptoms ◽  
Polygenic Risk Score ◽  
Clinical High Risk ◽  
Drug Use Disorders ◽  
Per Se

Abstract Aims Although attenuated psychotic symptoms in the psychosis clinical high-risk state (CHR-P) almost always occur in the context of a non-psychotic disorder (NPD), NPD is considered an undesired ‘comorbidity’ epiphenomenon rather than an integral part of CHR-P itself. Prospective work, however, indicates that much more of the clinical psychosis incidence is attributable to prior mood and drug use disorders than to psychosis clinical high-risk states per se. In order to examine this conundrum, we analysed to what degree the ‘risk’ in CHR-P is indexed by co-present NPD rather than attenuated psychosis per se. Methods We examined the incidence of early psychotic experiences (PE) with and without NPD (mood disorders, anxiety disorders, alcohol/drug use disorders), in a prospective general population cohort (n = 6123 at risk of incident PE at baseline). Four interview waves were conducted between 2007 and 2018 (NEMESIS-2). The incidence of PE, alone (PE-only) or with NPD (PE + NPD) was calculated, as were differential associations with schizophrenia polygenic risk score (PRS-Sz), environmental, demographical, clinical and cognitive factors. Results The incidence of PE + NPD (0.37%) was lower than the incidence of PE-only (1.04%), representing around a third of the total yearly incidence of PE. Incident PE + NPD was, in comparison with PE-only, differentially characterised by poor functioning, environmental risks, PRS-Sz, positive family history, prescription of antipsychotic medication and (mental) health service use. Conclusions The risk in ‘clinical high risk’ states is mediated not by attenuated psychosis per se but specifically the combination of attenuated psychosis and NPD. CHR-P/APS research should be reconceptualised from a focus on attenuated psychotic symptoms with exclusion of non-psychotic DSM-disorders, as the ‘pure' representation of a supposedly homotypic psychosis risk state, towards a focus on poor-outcome NPDs, characterised by a degree of psychosis admixture, on the pathway to psychotic disorder outcomes.

Handedness in Children with Autism Spectrum Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S214-S214 ◽  
Author(s):  
L. Kobylinska ◽  
C.G. Anghel ◽  
I. Mihailescu ◽  
F. Rad ◽  
I. Dobrescu
Keyword(s):  
Autism Spectrum Disorders ◽  
Training Programs ◽  
Hand Preference ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Left Handedness ◽  
Children With Asd ◽  
Hand Laterality ◽  
Spectrum Disorders ◽  
Competing Interest

Children with autism spectrum disorders (ASD) have a less definitive hand preference for certain actions as opposed to neurotypical children. Moreover, left-handedness in children with ASD has been associated with more echolalia. The objective was to conduct a screening of potential risk and associated features for autism spectrum disorders, among which the hand preference of the child. The current aim is to compare the perceived handedness of children with autism spectrum disorders with that of children with other psychiatric pathologies.MethodsEight hundred and forty-two parents completed our risk and associated features screening questionnaire. Out of these, 494 answered the question regarding handedness (209 had children diagnosed with ASD). This asked the parents to state how they perceived their child's handedness. An ADOS assessment has been conducted for 170 of the children whose parents were included in the study, based on clinical relevance for the case. The data were analysed using Excel and SPSS 22.0. For the comparisons, Chi2 and the Kruskal–Wallis test were used.ResultsChildren with ASD had more left-handedness (χ2(2) = 12.54, P = 0.002). There were no differences between boys and girls in terms of perceived handedness in any of the groups. There were no differences in the ADOS scores according to the perceived hand laterality (χ2(2) = 0.58, P = 0.74).ConclusionRightward-asymmetry in regions of corpus callosum has been reported to correlate with symptoms severity in ASD. The finding of different perceived handedness in children with ASD versus children with other psychiatric pathologies is useful for designing appropriate, individualized training programs for motor therapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Frontal Lobe Epilepsy Presenting as a Psychotic Disorder With Delusions and Hallucinations: A Case Study

CNS Spectrums ◽  
1999 ◽  
Vol 4 (9) ◽  
pp. 64-66,82 ◽  
Author(s):  
Bonnie J. Ramsey
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Frontal Lobe ◽  
Psychotic Disorder ◽  
Temporal Lobe ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Frontal Lobe Epilepsy ◽  
Unique Case ◽  
Frontal Lobe Seizures

AbstractAlthough psychotic symptoms are a recognized manifestation of epilepsy, these are more often associated with seizures of the temporal lobe type. While 10% of children with temporal lobe epilepsy develop a psychotic disorder by adulthood, the literature does not report any cases of psychotic disorders associated with frontal lobe seizures in children. This article presents a unique case of a girl whose frontal lobe seizures were associated with delusional psychotic symptoms. Once her seizure disorder was identified through electroencephalography (EEG) and appropriate anticonvulsant therapy was initiated, her associated psychotic symptoms resolved.

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