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.

Hallucinations without delusions in patients with first-episode psychosis: Clinical correlates and implications for pathophysiological models

2016 ◽  
Vol 33 (S1) ◽  
pp. S32-S32
Author(s):  
I. Melle
Keyword(s):  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Age At Onset ◽  
Diagnostic Interview ◽  
Clinical Profile ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Competing Interest

IntroductionThe symptomatic distribution in schizophrenia spectrum disorder is heterogeneous. Patients may experience hallucinations, delusions and combinations thereof, in addition to disorganized and negative symptoms. We have previously found that patients with monosymptomatic hallucinations exhibited a different clinical profile than patients with monosymptomatic delusions or combinations of the two; with an earlier age at onset and more suicidal symptoms.AimsTo replicate findings in a new group of patients with schizophrenia spectrum disorders.MethodsA total of 421 consecutive patients with schizophrenia spectrum disorders were included into the study. They were comprehensively assessed by specifically trained psychiatrists or clinical psychologists; using the SCID for DSM-IV for diagnostic purposes, the PANSS to assess current clinical symptoms and CDSS to assess current depression. Lifetime presence of different symptom types was ascertained during the diagnostic interview.ResultsA total of 346 (82%) had experienced both hallucinations and delusion, 63 (15%) had experienced delusions without hallucinations, 10 (2.5%) had experienced hallucinations without delusions and 2 patients (0.5%) had neither but experienced negative and severely disorganized symptoms. Contrary to hypothesis, we did not find any statistically significant differences in age at onset and in clinical symptoms (including suicidality) between these groups. We also did not find any differences in the type of hallucinatory experiences between hallucinating groups.ConclusionsIn a new sample of patients, we did not replicate previous findings of a different clinical profile in patients with monosymptomatic hallucinations. This type of psychotic disorder is relatively rare, which might pose a problem concerning statistical strength.Disclosure of interestThe author has not supplied his declaration of competing interest.

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.

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.

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 Predictors of Remission and Recovery in a First-Episode Schizophrenia Spectrum Disorder Sample: 2-Year Follow-up of the OPUS Trial

2008 ◽  
Vol 53 (10) ◽  
pp. 660-670 ◽  
Author(s):  
Lone Petersen ◽  
Anne Thorup ◽  
Johan Øqhlenschlæger ◽  
Torben Øqstergaard Christensen ◽  
Pia Jeppesen ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Negative Symptoms ◽  
Spectrum Disorder ◽  
First Episode ◽  
Schizophrenia Spectrum Disorder ◽  
Adherence To Medication ◽  
Premorbid Adjustment ◽  
Schizophrenia Spectrum ◽  
First Episode Schizophrenia

Objective: To examine the frequency and predictors of good outcome for patients with first-episode schizophrenia spectrum disorder (SSD). Method: We conducted a 2-year follow-up of a cohort of patients ( n = 547) with first-episode SSD. We evaluated the patients on demographic variables, diagnosis, duration of untreated psychosis (DUP), premorbid functioning, psychotic and negative symptoms, substance abuse, adherence to medication, and service use. ORs were calculated with logistic regression analyses. Results: A total of 369 patients (67%) participated in the follow-up interview. After 2 years, 36% remitted and 17% were considered fully recovered. Full recovery was associated with shorter DUP, better premorbid adjustment, fewer negative symptoms at baseline, no substance abuse at baseline, and adherence to medication and OPUS treatment. Conclusions: Several predictive factors were identified, and focus should be on potentially malleable predictors of outcome, for example, reducing DUP and paying special attention to patients who are unlikely to achieve good outcome, for example, patients with a substance abuse problem and poor premorbid adjustment.

scholarly journals Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders

2013 ◽  
Vol 23 (3) ◽  
pp. 271-279 ◽  
Author(s):  
B. Schrank ◽  
M. Amering ◽  
A. Grant Hay ◽  
M. Weber ◽  
I. Sibitz
Keyword(s):  
Negative Symptoms ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Positive Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Stigma Of Mental Illness ◽  
Relevant Variables ◽  
Spectrum Disorders ◽  
Positive And Negative Symptoms

Aims.Insight, positive and negative symptoms, hope, depression and self-stigma are relevant variables in schizophrenia spectrum disorders. So far, research on their mutual influences has been patchy. This study simultaneously tests the associations between these variables.Methods.A total of 284 people with schizophrenia spectrum disorders were assessed using the Schedule for the Assessment of Insight, Positive and Negative Syndrome Scale, Integrative Hope Scale, Centre for Epidemiological Studies Depression Scale and Internalized Stigma of Mental Illness scale. Path analysis was applied to test the hypothesized relationships between the variables.Results.Model support was excellent. Strong and mutual causal influences were confirmed between hope, depression and self-stigma. The model supported the assumption that insight diminishes hope and increases depression and self-stigma. While negative symptoms directly affected these three variables, reducing hope and increasing depression and self-stigma, positive symptoms did not. However, positive symptoms diminished self-stigma on a pathway via insight.Conclusions.This study provides a comprehensive synopsis of the relationships between six variables relevant for schizophrenia spectrum disorders. Research implications include the need to investigate determinants of consequences of insight, and the sequence of influences exerted by positive and negative symptoms. Clinical implications include the importance of interventions against self-stigma and of taking a contextualized approach to insight.

Measuring Motivation in Patients with Schizophrenia with Apathy Evaluation Scale (AES). Pilot Study of the Russian Version

2017 ◽  
Vol 41 (S1) ◽  
pp. S274-S274 ◽  
Author(s):  
M. Minyaycheva ◽  
K. Kiselnikova ◽  
L. Movina ◽  
I. Gladyshev ◽  
O. Papsuev
Keyword(s):  
Negative Symptoms ◽  
Psychosocial Treatment ◽  
Strong Correlations ◽  
Schizophrenia Spectrum Disorders ◽  
Russian Version ◽  
Schizophrenia Spectrum ◽  
Psychometric Tool ◽  
Spectrum Disorders ◽  
Competing Interest ◽  
Positive Correlations

IntroductionReduction of mental productivity and motivation in patients with schizophrenia is one of the core features of negative symptoms of schizophrenia spectrum disorders. Lack of motivation affects social functioning and outcomes, reduces effects of psychosocial treatment and rehabilitation.ObjectivesTo research AES abilities in measuring motivation in patients with schizophrenia spectrum disorders. The aim of the study was to investigate correlations of Russian translation of clinician-rated and self-rated versions with PANSS amotivation subscale and negative subscale items.MethodsFifty patients with schizophrenia spectrum disorders were recruited to participate in the study and were assessed with PANSS, AES-C and AES-S by trained raters. Only patients in “stabilized” state that met inclusion criteria of PANSS total score ≤ 80 points were eligible for consecutive AES assessment.ResultsOverall, moderate positive correlations were established between AES-C and PANSS amotivation subscale N2 and N4 items, N6 item and total PANSS negative subscale. No significant correlations with G16 item were registered. AES-C and AES-S versions also showed positive Spearman correlations (r = 0.43; P < 0.05), while no correlations between AES-S and amotivation PANSS items were registered.DiscussionModerately strong correlations between AES-C and PANSS N2, N4 and N6 items show feasibility of AES-C version in terms of measuring motivation in patients with schizophrenia spectrum disorders. Results of AES-S analysis demonstrate certain problems in patients’ abilities in self-assessing motivation. Patients with prevailing paranoid syndrome showed poorer results in AES-S scores.ConclusionsAES-C is a sensitive psychometric tool with good properties in measuring amotivation in patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Signs and symptoms in the pre-psychotic phase: description and implications for diagnostic trajectories

2008 ◽  
Vol 38 (8) ◽  
pp. 1147-1156 ◽  
Author(s):  
S. N. Iyer ◽  
L. Boekestyn ◽  
C. M. Cassidy ◽  
S. King ◽  
R. Joober ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Signs And Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Related Factors ◽  
Affective Psychosis ◽  
Duration Of Untreated Illness ◽  
Early Signs

BackgroundFew studies have examined the underlying factor structure of signs and symptoms occurring before the first psychotic episode. Our objective was to determine whether factors derived from early signs and symptoms are differentially associated with non-affective versus affective psychosis.MethodA principal components factor analysis was performed on early signs and symptoms reported by 128 individuals with first-episode psychosis. Factor scores were examined for their associations with duration of untreated illness, drug abuse prior to onset of psychosis, and diagnosis (schizophrenia versus affective psychosis).ResultsOf the 27 early signs and symptoms reported by patients, depression and anxiety were the most frequent. Five factors were identified based on these early signs and symptoms: depression, disorganization/mania, positive symptoms, negative symptoms and social withdrawal. Longer duration of untreated illness was associated with higher levels of depression and social withdrawal. Individuals with a history of drug abuse prior to the onset of psychosis scored higher on pre-psychotic depression and negative symptoms. The two mood-related factors, depression and disorganization/mania, distinguished the eventual first-episode diagnosis of affective psychosis from schizophrenia. Individuals with affective psychosis were also more likely to have a ‘mood-related’ sign and symptom as their first psychiatric change than individuals later diagnosed with schizophrenia.ConclusionsFactors derived from early signs and symptoms reported by a full diagnostic spectrum sample of psychosis can have implications for future diagnostic trajectories. The findings are a step forward in the process of understanding and characterizing clinically important phenomena to be observed prior to the onset of psychosis.

scholarly journals Symptom Outcome 1 Year after Admission to an Early Psychosis Program

2003 ◽  
Vol 48 (3) ◽  
pp. 204-207 ◽  
Author(s):  
Jean Addington ◽  
Erin Leriger ◽  
Donald Addington
Keyword(s):  
Negative Symptoms ◽  
Depression Scale ◽  
Early Psychosis ◽  
First Episode ◽  
First Year ◽  
Positive Symptoms ◽  
Syndrome Scale ◽  
Assessment Measures ◽  
Symptom Outcome ◽  
Negative Syndrome

Objective: To determine the change in positive, negative, and depressive symptoms after 1 year in an early psychosis program. Method: One hundred and eighty subjects were included from the first 257 admissions for a first episode of psychosis to a comprehensive early psychosis program. Most had a diagnosis of schizophrenia or schizophreniform disorder. Subjects were assessed on admission to the program and at 3, 6, and 12 months after admission. All 180 subjects completed the 1-year assessment. Assessment measures included the Positive and Negative Syndrome Scale and the Calgary Depression Scale for Schizophrenia. Results: There was a clinically and statistically significant improvement in positive symptoms by 3 months, depression increased at 3 months but significantly improved by 12 months, and negative symptoms changed little over the first year. Conclusions: The differential changes in symptoms in the first year after admission have implications for treatment.

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