Neurocognitive status in different stages of psychosis: Changes from the first episode psychosis to remission

2017 ◽  
Vol 41 (S1) ◽  
pp. S187-S187
Author(s):  
D. Bošnjak ◽  
P. Makarić ◽  
I. Kekin ◽  
T. Sabo ◽  
M. Živković ◽  
...  
Keyword(s):  
Acute Phase ◽  
Neuropsychiatric Symptoms ◽  
Verbal Learning ◽  
First Episode Psychosis ◽  
Neurocognitive Impairment ◽  
University Hospital ◽  
First Episode ◽  
Psychotic Episode ◽  
Learning Abilities ◽  
Episode Psychosis

IntroductionNeurocognitive impairment in schizophrenia is associated with functional disability and poorer quality of life, and is the most resistant of all schizophrenia symptoms to current psychopharmacotherapy.ObjectivesTo compare the differences in neurocognitive status during the acute phase of first psychotic episode and stable symptomatic remission.AimsTo investigate the pattern of neurocognitive impairment in patients with first episode psychosis during acute phase and stable remission phase.MethodsWe performed a longitudinal study, including 150 patients with first episode of psychosis at two time points: during their hospitalization at Zagreb university hospital centre or university psychiatric hospital Vrapče, at acute phase of illness and after 12–18 months, during stable remission. Assessment included detailed clinical interview, clinical rating of neuropsychiatric symptoms using standardized psychiatric scales, self-assessment scales and comprehensive neurocognitive testing.ResultsWhile our preliminary results (n = 40) showed statistically significant improvement in various neurocognitive domains, including visuo-learning abilities, verbal learning, executive functions, attention and processing speed, initial impairment in semantic and phonetic fluency observed in acute psychosis remained unchanged in remission as well.ConclusionsAlthough our results showed improvement in most of cognitive domains during time, language abilities remained unchanged. This further confirms the hypothesis that language impairment is a trait marker of psychotic disorder.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 Does co-occurring borderline personality disorder influence acute phase treatment for first-episode psychosis?

2017 ◽  
Vol 12 (6) ◽  
pp. 1166-1172 ◽  
Author(s):  
Shona M. Francey ◽  
Martina Jovev ◽  
Christina Phassouliotis ◽  
Sue M. Cotton ◽  
Andrew M. Chanen
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Acute Phase ◽  
First Episode Psychosis ◽  
Borderline Personality ◽  
First Episode ◽  
Episode Psychosis ◽  
Acute Phase Treatment

scholarly journals Aggressive incidents in first-episode psychosis

2001 ◽  
Vol 178 (5) ◽  
pp. 433-440 ◽  
Author(s):  
John Milton ◽  
Shazad Amin ◽  
Swaran P. Singh ◽  
Glynn Harrison ◽  
Peter Jones ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Increased Risk ◽  
Episode Psychosis ◽  
Clinical Associations ◽  
Independent Effects ◽  
One Act ◽  
Service Contact

BackgroundRecent research has reported increased risk of aggressive incidents by individuals with psychotic illness.AimsTo examine acts of aggression in first-episode psychosis.MethodSubjects with a first-episode psychosis were ascertained from a defined catchment area (Nottingham, UK) and reassessed at 3 years (n=166) using clinical interview, informants, health care and forensic records.ResultsOf the subjects, 9.6% demonstrated at least one act of serious aggression (defined as weapon use, sexual assault or victim injury) during at least one psychotic episode and 23.5% demonstrated lesser acts of aggression (defined as all other acts of aggression). For all aggressive subjects (33.1%), unemployment (OR=3.6, 95%CI 1.6–8.0), comorbid substance misuse (OR=3.1, CI 1.1–8.8) and symptoms of overactivity at service contact (OR=6.9, CI 2.7–17.8) had independent effects on risk of aggression.ConclusionsWe confirmed some previously reported demographic and clinical associations with aggression in first-episode psychosis but no relationship with specific psychotic symptoms or diagnostic groups was observed.

scholarly journals White Matter Microstructural Abnormalities in the Broca’s-Wernicke’s-Putamen “Hoffman Hallucination Circuit” and Auditory Transcallosal Fibers in First-Episode Psychosis With Auditory Hallucinations

2020 ◽  
Author(s):  
Dean F Salisbury ◽  
Yiming Wang ◽  
Fang-Cheng Yeh ◽  
Brian A Coffman
Keyword(s):  
White Matter ◽  
Left Hemisphere ◽  
Structural Integrity ◽  
Right Hemisphere ◽  
First Episode Psychosis ◽  
Auditory Hallucinations ◽  
First Episode ◽  
Psychotic Episode ◽  
Arcuate Fasciculus ◽  
Episode Psychosis

Abstract Background Functional connectivity abnormalities between Broca’s and Wernicke’s areas and the putamen revealed by functional magnetic resonance imaging (fMRI) are related to auditory hallucinations (AH). In long-term schizophrenia, reduced white matter structural integrity revealed by diffusion imaging in left arcuate fasciculus (connecting Broca’s and Wernicke’s areas) is likely related to AH. The structural integrity of connections with putamen and their relation to AH are unknown. Little is known about this relationship in first-episode psychosis (FEP), although auditory transcallosal connections were reported to play a role. White matter in the Broca’s-Wernicke’s-putamen language-related circuit and auditory transcallosal fibers was examined to investigate associations with AH in FEP. Methods White matter connectivity was measured in 40 FEP and 32 matched HC using generalized fractional anisotropy (gFA) derived from diffusion spectrum imaging (DSI). Results FEP and HC did not differ in gFA in any fiber bundle. In FEP, AH severity was significantly inversely related to gFA in auditory transcallosal fibers and left arcuate fasciculus. Although the right hemisphere arcuate fasciculus-AH association did not attain significance, the left and right arcuate fasciculus associations were not significantly different. Conclusions Despite overall normal gFA in FEP, AH severity was significantly related to gFA in transcallosal auditory fibers and the left hemisphere connection between Broca’s and Wernicke’s areas. Other bilateral tracts’ gFA were weakly associated with AH. At the first psychotic episode, AH are more robustly associated with left hemisphere arcuate fasciculus and interhemispheric auditory fibers microstructural deficits, likely reflecting mistiming of information flow between language-related cortical centers.

The pathways to mental health care of first-episode psychosis patients: a systematic review

2010 ◽  
Vol 40 (10) ◽  
pp. 1585-1597 ◽  
Author(s):  
K. K. Anderson ◽  
R. Fuhrer ◽  
A. K. Malla
Keyword(s):  
Mental Health ◽  
First Episode Psychosis ◽  
Pathways To Care ◽  
First Episode ◽  
Psychotic Episode ◽  
First Psychotic Episode ◽  
Episode Psychosis ◽  
First Contact ◽  
Pathway To Care ◽  
Delay In Treatment

BackgroundAlthough there is agreement on the association between delay in treatment of psychosis and outcome, less is known regarding the pathways to care of patients suffering from a first psychotic episode. Pathways are complex, involve a diverse range of contacts, and are likely to influence delay in treatment. We conducted a systematic review on the nature and determinants of the pathway to care of patients experiencing a first psychotic episode.MethodWe searched four databases (Medline, HealthStar, EMBASE, PsycINFO) to identify articles published between 1985 and 2009. We manually searched reference lists and relevant journals and used forward citation searching to identify additional articles. Studies were included if they used an observational design to assess the pathways to care of patients with first-episode psychosis (FEP).ResultsIncluded studies (n=30) explored the first contact in the pathway and/or the referral source that led to treatment. In 13 of 21 studies, the first contact for the largest proportion of patients was a physician. However, in nine of 22 studies, the referral source for the greatest proportion of patients was emergency services. We did not find consistent results across the studies that explored the sex, socio-economic, and/or ethnic determinants of the pathway, or the impact of the pathway to care on treatment delay.ConclusionsAdditional research is needed to understand the help-seeking behavior of patients experiencing a first-episode of psychosis, service response to such contacts, and the determinants of the pathways to mental health care, to inform the provision of mental health services.

scholarly journals Neurological soft signs in first-episode psychosis: A systematic review

2002 ◽  
Vol 181 (S43) ◽  
pp. s50-s57 ◽  
Author(s):  
Paola Dazzan ◽  
Robin M. Murray
Keyword(s):  
Motor Coordination ◽  
First Episode Psychosis ◽  
The Body ◽  
First Episode ◽  
Psychotic Episode ◽  
Neurological Soft Signs ◽  
First Psychotic Episode ◽  
Cerebral Dysfunction ◽  
Episode Psychosis ◽  
First Onset

BackgroundNeurological soft signs (NSS) are minor neurological signs indicating non-specific cerebral dysfunction. Their presence has been documented extensively in schizophrenia but not during the first psychotic episode.AimsTo review studies that have specifically investigated NSS at the time of the first psychotic episode.MethodA review of studies investigating neurological function in first-episode psychosis, using a clinical examination.ResultsPatients with first-episode psychosis show an excess of NSS, particularly in the areas of motor coordination and sequencing, sensory integration and in developmental reflexes. Furthermore, NSS may be associated with a specific laterality pattern.ConclusionsMore studies on first-onset schizophrenia are needed, evaluating both sensory and motor neurological domains (scoring separately for the two sides of the body), integrating this knowledge with neuroimaging findings and clarifying the role of NSS as markers of cognitive dysfunction.

A Young Man with First-Episode Psychosis: Case Presentation and Discussion

1998 ◽  
Vol 43 (1_suppl) ◽  
pp. 4S-6S
Author(s):  
Angelo Fallu ◽  
Lili Kopala ◽  
Ashok Malla ◽  
Lilian Thorpe
Keyword(s):  
Young Patients ◽  
Antipsychotic Agents ◽  
First Episode Psychosis ◽  
First Episode ◽  
Psychotic Episode ◽  
First Psychotic Episode ◽  
Episode Psychosis ◽  
Dosing Regimens ◽  
History Of ◽  
Patient’S History

Objective: To review and discuss the issues and challenges involved in the treatment of first-episode psychosis in young patients, including choice of appropriate antipsychotic agents and adjunctive medications, dosing regimens, and biopsychosocial interventions. Methods: The case of a young man in his late teens with a history of substance abuse who experienced an acute dystonic reaction to treatment for his first psychotic episode is presented and discussed. Results: Each contributing author provides an evaluation of the intervention strategies presented in the patient's history and factors that influenced the treatment outcomes. Conclusions: The successful management of young patients with psychosis must go beyond the control of positive symptoms. A comprehensive psychosocial and psychoeducational approach combined with a well-tolerated treatment regimen can help the patient achieve positive outcomes.

scholarly journals Very Low-Dose Risperidone in First-Episode Psychosis: A Safe and Effective Way to Initiate Treatment

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Patrick D. McGorry ◽  
John Cocks ◽  
Paddy Power ◽  
Peter Burnett ◽  
Susy Harrigan ◽  
...  
Keyword(s):  
Low Dose ◽  
Chronic Schizophrenia ◽  
First Episode Psychosis ◽  
First Episode ◽  
Psychotic Episode ◽  
Open Label ◽  
First Psychotic Episode ◽  
Episode Psychosis ◽  
Open Label Trial ◽  
Risperidone Treatment

Patients experiencing a first psychotic episode have high rates of extrapyramidal symptoms (EPSs) when treated with the doses of neuroleptics used in multiepisode or chronic schizophrenia. There is some evidence that lower doses may be equally, if not more, effective but less toxic in this population. Here, we report the results of a biphasic open label trial designed to assess the efficacy, safety, and tolerability of low-dose (2–4 mg/day) risperidone treatment in a group of 96 first-episode nonaffective psychosis patients. At the end of the trial, 62% of patients met the response criteria although approximately 80% had achieved a response at some time during the study. Reports of EPS remained low, and there were no dystonic reactions. We conclude that even at a dose of 2 mg/day, risperidone was highly effective in reducing acute symptomatology in a real world sample of young first-episode psychosis patients.

scholarly journals Neurocognitive dimensions characterising patients with first-episode psychosis

2002 ◽  
Vol 181 (S43) ◽  
pp. s85-s90 ◽  
Author(s):  
S. Friis ◽  
K. Sundet ◽  
B. R. Rund ◽  
P. Vaglum ◽  
T. H. Mcglashan
Keyword(s):  
Neuropsychological Tests ◽  
Verbal Learning ◽  
First Episode Psychosis ◽  
First Episode ◽  
Motor Speed ◽  
Neurocognitive Dysfunction ◽  
Five Dimensions ◽  
Episode Psychosis ◽  
And Gender ◽  
The Relationship

BackgroundAssessment of neurocognitive dysfunction in schizophrenia is hampered by the multitude of tests used in the literature.AimsWe aimed to identify the main dimensions of an assessment battery for patients with first-episode psychosis and to estimate the relationship between dimension scores and gender, age, education, diagnosis and symptoms.MethodEight frequently used neuropsychological tests were used. We tested 219 patients 3 months after start of therapy or at remission, whichever occurred first.ResultsWe identified five dimensions: working memory (WM); verbal learning (VL); executive function (EF); impulsivity (Im); and motor speed (MS). Significant findings were that the MS score was higher for men, and the WM and VL scores were correlated with years of education.ConclusionsNeurocognitive function in first-episode psychosis is described by at least five independent dimensions.

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