EEG spectral power changes in solving spatial logical task in schizophrenia patients in the first episode and in remission

2017 ◽  
Vol 41 (S1) ◽  
pp. s845-s845
Author(s):  
Y. Zaytseva ◽  
Z. Garakh ◽  
A. Morozova
Keyword(s):  
Cognitive Load ◽  
Resting State ◽  
Spectral Power ◽  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
Eeg Rhythms ◽  
Thought Disorders ◽  
Episode Psychosis ◽  
Competing Interest

IntroductionDespite the assumption that the EEG parameters in schizophrenia may be predictive for the treatment outcome, there are only a small number of such studies present. We hypothesised that the characteristics of the changes in EEG rhythms during cognitive load might differ in the first episode of psychosis and remission being dependent on the stage of the illness.MethodsThe EEG rhyths spectral power (SP) in the resting state and their changes during the performance of spatial logical task in 25 first-episode psychosis patients (FEP) and same patients in remission (REM) after 6–18 months were analysed. Control group included healthy subjects matched with patient group by gender, age and years of education.ResultsThe resting state SP values did not differ in FEP and REM. When performing a task, FEP theta SP was decreased compared to the resting state values in F7, F8, P3, T6 sites (P < 0.05), while gamma2 SP was increased in Fz (P < 0.001) and Pz (P < 0.01). REM theta, alpha, and beta1 SP was decreased in the same way as in norm in all sites (P < 0.05). Gamma2 SP increase was found in sites Fp1, F8, Fz (P < 0.05). FEP theta and beta1 SP changes during cognitive load positively correlated with the PANSS scales (delusions, thought disorders, hallucinations). REM did not have significant correlations between SP and PANSS parameters.ConclusionsThe analysed REM EEG characteristics differ less from the norm than the FEP. Based on the results, the performance of the task is related to the stage of the illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Brief psycho-education for caregivers of persons with first episode psychosis

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Praful Prabhuappa Kapse ◽  
Manisha Kiran
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
Episode Psychosis ◽  
Study Results ◽  
Before And After ◽  
Quasi Experimental ◽  
Expressed Emotions ◽  
Experimental Group ◽  
Group Family

Caring for the persons with first episode psychosis is challenging and demanding. It may lead to the increased burden, expressed emotions among the caregivers. The numerous studies have shown that high burden and negative expressed emotions among caregivers can lead to early relapse in the patients with first episode psychosis. To evaluate the effects of the brief psychoeducation on the caregivers burden and expressed emotions. A quasi experimental - before and after with control group research design was adopted for the study. A total of 60 caregivers have participated in the study, of which 30 caregivers in experimental group and 30 caregivers in the control group. Family Burden Interview Schedule (Pai and Kapoor, 1981) and Attitude Questionnaire (Sethi et al., 1981) was used to assess caregiver's burden and expressed emotions. At end of the psychoeducation intervention, burden among caregivers and negative expressed emotions of the caregivers have significantly reduced. The positive expressed emotions have been increased. Study results demonstrates the importance of psychoeducation intervention in reducing the burden and negative expressed emotions.

scholarly journals Implementation of NAVIGATE Coordinated Specialty Care for First Episode Psychosis: the Michigan Experience

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 177-178
Author(s):  
Eric D. Achtyes ◽  
Kari Kempema ◽  
Zhehui Luo ◽  
Katharine N. Thakkar ◽  
Catherine Adams ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Symptoms ◽  
The United States ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
Control Group ◽  
Evidence Based ◽  
Block Grant ◽  
Episode Psychosis

AbstractStudy ObjectivesCoordinated specialty care (CSC) is widely accepted as an evidence-based treatment for first episode psychosis (FEP). The NAVIGATE intervention from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study is a CSC intervention which offers a suite of evidence-based treatments shown to improve engagement and clinical outcomes, especially in those with shorter duration of untreated psychosis (DUP). Coincident with the publication of this study, legislation was passed by the United States Congress in 2014–15 to fund CSC for FEP via a Substance Abuse and Mental Health Services Administration (SAMHSA) block grant set-aside for each state. In Michigan (MI) the management of this grant was delegated to Network180, the community mental health authority in Kent County, with the goal of making CSC more widely available to the 10 million people in MI. Limited research describes the outcomes of implementation of CSC into community practices with no published accounts evaluating the use of the NAVIGATE intervention in a naturalistic setting. We describe the outcomes of NAVIGATE implementation in the state of MI.MethodsIn 2014, 3 centers in MI were selected and trained to provide NAVIGATE CSC for FEP. In 2016 a 4th center was added, and 2 existing centers were expanded to provide additional access to NAVIGATE. Inclusion: age 18–31, served in 1 of 4 FEP centers in MI. Data collection began in 2015 for basic demographics, global illness (CGI q3 mo), hospital/ED use and work/school (SURF q3 mo) and was expanded in 2016 to include further demographics, diagnosis, DUP, vital signs; and in 2018 for clinical symptoms with the modified Colorado Symptom Inventory (mCSI q6 mo), reported via an online portal. This analysis used data until 12/31/19. Mixed effects models adjusted by age, sex and race were used to account for correlated data within patients.ResultsN=283 had useable demographic information and were included in the analysis. Age at enrollment was 21.6 ± 3.0 yrs; 74.2% male; 53.4% Caucasian, 34.6% African American; 12.9 ± 1.7 yrs of education (N=195). 18 mo retention was 67% with no difference by sex or race. CGI scores decreased 20% from baseline (BL) to 18 mo (BL=3.5, N=134; 15–18 mo=2.8, N=60). Service utilization via the SURF was measured at BL (N=172) and 18 mo (N=72): psychiatric hospitalizations occurred in 37% at BL and 6% at 18 mo (p<0.01); ER visits occurred in 40% at BL and 13% at 18 mo (p<0.01). 44% were working or in school at BL and 68% at 18 mo (p<0.01). 21% were on antipsychotics (AP) at BL (N=178) and 85% at 18 mo (N=13) with 8% and 54% on long acting injectable-AP at BL and 18 mo, respectively. Limitations include missing data and lack of a control group.ConclusionThe implementation of the NAVIGATE CSC program for FEP in MI resulted in meaningful clinical improvement for enrollees. Further support could make this evidence-based intervention available to more people with FEP.FundingSupported by funds from the SAMHSA Medicaid State Block Grant set-aside awarded to Network180 (Achtyes, Kempema). The funders had no role in the design of the study, the analysis or the decision to publish the results.

scholarly journals Differentiating the effect of antipsychotic medication and illness on brain volume reductions in first-episode psychosis: A Longitudinal, Randomised, Triple-blind, Placebo-controlled MRI Study

2021 ◽  
Author(s):  
Sidhant Chopra ◽  
Alex Fornito ◽  
Shona M. Francey ◽  
Brian O’Donoghue ◽  
Vanessa Cropley ◽  
...  
Keyword(s):  
Antipsychotic Medication ◽  
Brain Volume ◽  
First Episode Psychosis ◽  
Common Finding ◽  
First Episode ◽  
Control Group ◽  
Grey Matter Volume ◽  
Long Term Effects ◽  
Significant Group ◽  
Episode Psychosis

AbstractChanges in brain volume are a common finding in Magnetic Resonance Imaging (MRI) studies of people with psychosis and numerous longitudinal studies suggest that volume deficits progress with illness duration. However, a major unresolved question concerns whether these changes are driven by the underlying illness or represent iatrogenic effects of antipsychotic medication. In this study, 62 antipsychotic-naïve patients with first-episode psychosis (FEP) received either a second-generation antipsychotic (risperidone or paliperidone) or a placebo pill over a treatment period of 6 months. Both FEP groups received intensive psychosocial therapy. A healthy control group (n = 27) was also recruited. Structural MRI scans were obtained at baseline, 3 months and 12 months. Our primary aim was to differentiate illness-related brain volume changes from medication-related changes within the first 3 months of treatment. We secondarily investigated long-term effects at the 12-month timepoint. From baseline to 3 months, we observed a significant group x time interaction in the pallidum (p < 0.05 FWE-corrected), such that patients receiving antipsychotic medication showed increased volume, patients on placebo showed decreased volume, and healthy controls showed no change. Across the entire patient sample, a greater increase in pallidal grey matter volume over 3 months was associated with a greater reduction in symptom severity. Our findings indicate that psychotic illness and antipsychotic exposure exert distinct and spatially distributed effects on brain volume. Our results align with prior work in suggesting that the therapeutic efficacy of antipsychotic medications may be primarily mediated through their effects on the basal ganglia.

Relapse After First-Episode Psychosis: A 3-Year Follow-Up

2017 ◽  
Vol 41 (S1) ◽  
pp. S276-S276
Author(s):  
E. Pereira ◽  
M. Mota Oliveira ◽  
R. Guedes ◽  
M.J. Peixoto ◽  
I. Ferraz ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Statistical Significance ◽  
First Episode Psychosis ◽  
Response To Treatment ◽  
First Episode ◽  
Final Sample ◽  
Episode Psychosis ◽  
Competing Interest ◽  
Relapse Rates

IntroductionRelapse after first-episode psychosis (FEP) is a frequent problem, which can lead to patients’ poorer functioning and response to treatment. Its prevention is one of the most important and challenging targets in the treatment of psychotic disorders.ObjectivesTo characterize and evaluate relapse rates after FEP, during the course of 3 years, of a group of patients admitted at a psychiatry department.MethodsA retrospective observational study was conducted. Patients with a FEP between ages 18 to 40, admitted at the Clinic of Psychiatry and Mental Health at São João Hospital Centre between January 1, 2007 and September 30, 2013. Only patients with, at least, 3 years of follow-up at the clinic were included.ResultsFinal sample of 58 patients, 39 of which were male (mean age = 26.4 years). Forty patients were excluded by not completing the 3 years follow-up at our department. The cumulative relapse rates were 32.8% at 12 months, 53.4% at 24 months and 63.8% at 36 months. Patients with at least one relapse were younger (25.78 years vs. 27.52 years) and had shorter periods of first hospitalization (19.25 days vs. 23.52 days). These data did not reach statistical significance. Non-adherence to prescribed medication was described in 73.0% (n = 27) of patients at the time of relapse. Eight of them (21.6%) presented with cannabis use.ConclusionsAlthough no statistical significance was reached, our findings are consistent with other studies. A future study with a bigger sample would be important in achieving statistical significant results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

F232. Abnormality of Resting-State Functional Connectivity in Insular Cortex in Patients With First Episode Psychosis

2018 ◽  
Vol 83 (9) ◽  
pp. S329
Author(s):  
Hironori Kuga ◽  
Andreia Faria ◽  
Lindsay Shaffer ◽  
Jeff Crawford ◽  
Takanori Ohgaru ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Resting State ◽  
Insular Cortex ◽  
First Episode Psychosis ◽  
First Episode ◽  
Resting State Functional Connectivity ◽  
Episode Psychosis

scholarly journals Brain structural correlates of functional capacity in first-episode psychosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Erkan Alkan ◽  
Geoff Davies ◽  
Kathy Greenwood ◽  
Simon L. Evans
Keyword(s):  
Functional Capacity ◽  
Gray Matter Volume ◽  
Brain Regions ◽  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
Neural Basis ◽  
Antipsychotic Therapy ◽  
Brain Volumes ◽  
Episode Psychosis

Abstract Impaired functional capacity is a core feature of schizophrenia and presents even in first-episode psychosis (FEP) patients. Impairments in daily functioning tend to persist despite antipsychotic therapy but their neural basis is less clear. Previous studies suggest that volume loss in frontal cortex might be an important contributor, but findings are inconsistent. We aimed to comprehensively investigate the brain structural correlates of functional capacity in FEP using MRI and a reliable objective measure of functioning [University of California, San Diego Performance-Based Skills Assessment (UPSA)]. In a sample of FEP (n = 39) and a well-matched control group (n = 21), we measured cortical thickness, gray matter volume, and white matter tract integrity (fractional anisotropy, FA) within brain regions implicated by previous work. The FEP group had thinner cortex in various frontal regions and fusiform, and reduced FA in inferior longitudinal fasciculus (ILF). In FEP, poorer functional capacity correlated with reduced superior frontal volume and lower FA in left ILF. Importantly, frontal brain volumes and integrity of the ILF were identified as the structural correlates of functional capacity in FEP, controlling for other relevant factors. These findings enhance mechanistic understanding of functional capacity deficits in schizophrenia by specifying the underlying neural correlates. In future, this could help inform intervention strategies.

Paliperidone palmitate log-acting injection in patients with psychotic active clinic: start, change or increase of dose

2016 ◽  
Vol 33 (S1) ◽  
pp. s249-s250
Author(s):  
A.L. Gonzalez Galdamez ◽  
M.D. Piqueras Acevedo ◽  
M.R. Raposo Hernández ◽  
I. Martínez Pérez ◽  
P. Manzur Rojas ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Descriptive Study ◽  
First Episode Psychosis ◽  
Paliperidone Palmitate ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Early Stages ◽  
Episode Psychosis ◽  
Competing Interest ◽  
Long Acting

The aim is to describe the experience of treatment with Paliperidone Palmitate long acting injection (PP) in patients with psychotic active clinic, whether diagnoses with schizophrenia or in patients with the first episode psychosis, as well as to reflect the improvement in the control of the symptoms that the patients can improve increasing the dose.MethodsWe have done a descriptive study of 34 patients hospitalized in psychiatry between January and July 2015 for psychotic active clinic who started treatment with PP or the previous dose was increased.Results91.2% of patients admitted for acute exacerbation of their usual pathology and 8.8% for a first episode psychosis. In the CGI scale, all the patients admitted scored as severe or markedly ill; going mostly mildly ill at discharge. For 55.9% of patients, the treatment was changed to PP, 29.4% of the dose was increased PP and 14.7% antipsychotic treatment was started with PP. Among patients change treatment, the main reason was non-adherence (47.4%). 70.6% of our patients were discharged with PP as only antipsychotic and 29.4% which was discharged with another antipsychotic, the most frequent association was of PP with Quetiapine (80%).ConclusionsPP is a highly effective medicament in the treatment of the schizophrenia that improves the adherence to the treatment, so in our experience and we consider it a medicament to be considered in the early stages of the disease. According to our experience and there are patients who can benefit from better control of symptoms adjusting the dose individually.Disclosure of interestThe authors have not supplied their declaration of competing interest.

5-years Follow-up of Antipsychotic Medication and Hospitalizations After First Episode Hospital-treated Psychosis in a Swedish Nation-wide Cohort

2017 ◽  
Vol 41 (S1) ◽  
pp. S99-S99
Author(s):  
P. Strålin ◽  
J. Hetta
Keyword(s):  
Suicide Attempts ◽  
Bimodal Distribution ◽  
First Episode Psychosis ◽  
First Episode ◽  
Swedish Population ◽  
Episode Psychosis ◽  
High Incidence ◽  
Competing Interest ◽  
Initial Hospitalization

IntroductionOutcome after first episode psychosis is heterogeneous, but knowledge about the distribution and predictive factors is limited.ObjectiveTo investigate medication and rehospitalizations for five years after first episode hospital treated psychosis.MethodSwedish population registers were used to select a nation-wide cohort of 962 cases (589 or 61% men) with a first hospitalization for psychosis at ages between 16–25 years. Cases were categorized year by year for 5 years after the initial hospitalization with regard to rehospitalizations and dispensations of antipsychotics and other medications.ResultsThe 5-years mortality was 4% (n = 39) with suicides in 16 cases (1.6%, 11 of which were men). Additionally, 139 cases (23% of women and 10% of men) had hospitalizations for suicide attempts within 5 years. A bimodal distribution of years with medication was found indicating two different trajectories of outcome. One peak was seen for cases with dispensations of antipsychotics 5 of 5 years (40% of the cohort). Another peak was seen at dispensations during at most 1 of 5 year (30%). During year 5, 514 (56% of 923 cases surviving 5 years) had dispensations of neuroleptics and 257 (28%) were hospitalized, whereas 356 cases (39%) had no dispensation of neuroleptics or hospitalization.ConclusionsThe population of young cases with first episode psychosis is heterogeneous with at least two clearly separable trajectories based on medication and hospitalizations. The high mortality and high incidence of suicide attempts during a five-year period demonstrate a need for careful monitoring of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Volumetric and morphological characteristics of the hippocampus are associated with progression to schizophrenia in patients with first-episode psychosis

2017 ◽  
Vol 45 ◽  
pp. 1-5 ◽  
Author(s):  
R. Sauras ◽  
A. Keymer ◽  
A. Alonso-Solis ◽  
A. Díaz ◽  
C. Molins ◽  
...  
Keyword(s):  
Morphological Changes ◽  
Morphological Characteristics ◽  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
Subcortical Structures ◽  
Episode Psychosis ◽  
Left Hippocampus ◽  
One Year

AbstractBackground:Abnormalities in the hippocampus have been implicated in the pathophysiology of psychosis. However, it is still unclear whether certain abnormalities are a pre-existing vulnerability factor, a sign of disease progression or a consequence of environmental factors. We hypothesized that first-episode psychosis patients who progress to schizophrenia after one year of follow up will display greater volumetric and morphological changes from the very beginning of the disorder.Methods:We studied the hippocampus of 41 patients with a first-episode psychosis and 41 matched healthy controls. MRI was performed at the time of the inclusion in the study. After one year, the whole sample was reevaluated and divided in two groups depending on the diagnoses (schizophrenia vs. non-schizophrenia).Results:Patients who progressed to schizophrenia showed a significantly smaller left hippocampus volume than control group and no-schizophrenia group (F = 3.54; df = 2, 77; P = 0.03). We also found significant differences in the morphology of the anterior hippocampus (CA1) of patients with first-episode psychosis who developed schizophrenia compared with patients who did not.Conclusions:These results are consistent with the assumption of hyperfunctioning dopaminergic cortico-subcortical circuits in schizophrenia, which might be related with an alteration of subcortical structures, such as the hippocampus, along the course of the disease. According with these results, hippocampus abnormalities may serve as a prognostic marker of clinical outcome in patients with a first-episode psychosis.

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