The Impact of Age on the Prevalence and Clinical Relevance of Attenuated Psychotic Symptoms in Patients of an Early Detection Service

2017 ◽  
Vol 41 (S1) ◽  
pp. S84-S84
Author(s):  
F. Schultze-Lutter ◽  
C. Michel ◽  
B.G. Schimmelmann ◽  
D. Hubl
Keyword(s):  
Psychosocial Functioning ◽  
Reference Group ◽  
Clinical Sample ◽  
Age Groups ◽  
Structured Interview ◽  
Age Effect ◽  
Psychotic Symptoms ◽  
Current Axis ◽  
Axis I ◽  
The Impact

IntroductionCompared to 16–40-year-olds, 8–15-year-olds of the community reported higher frequencies of perceptual and lesser clinical significance of non-perceptual attenuated psychotic symptoms (APS).Objectives/aimsWe examined if a similar age effect is present in a clinical never-psychotic sample (n = 133) referred to a specialized service for clinical suspicion of developing psychosis.MethodsAPS and brief intermittent psychotic symptoms (BIPS) were assessed using items P1-3 and P5 (non-perceptual) and P4 (perceptual) of the structured interview for psychosis-risk syndromes, current axis-I disorders with the mini-international neuropsychiatric interview and psychosocial functioning with the Social and Occupational Functioning Assessment Scale (score < 71 indicative of at least some difficulty in social, occupational, or school functioning).ResultsOverall, 64% reported APS (61%) or BIPS (7%); any perceptual APS/BIPS was reported by 43% and any non-perceptual APS/BIPS by 44%. In correspondence to the results of the community study, perceptual but not non-perceptual APS/BIPS were significantly more frequent in younger age groups below the age of 16 (8–12 yrs: OR = 4.7 (1.1–19.5); 13–15 yrs: OR = 2.7 (0.9–7.7); 20–24-year-olds as reference group). An age effect of APS/BIPS on presence of any current axis-I disorder (59%) or functional difficulties (67%) could not be detected. Yet, when APS onset requirements were met, the likelihood of a psychiatric diagnosis increased significantly with advancing age.ConclusionOverall, the replicated age effect on perceptual APS in this clinical sample highlights the need to examine ways to distinguish clinically relevant perceptual APS from perceptual aberrations likely remitting over the course of adolescence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Impact of Co-Occurring Substance use on 6 Month Outcomes for Young People Seeking Mental Health Treatment

2007 ◽  
Vol 41 (11) ◽  
pp. 896-902 ◽  
Author(s):  
Kathryn D. Baker ◽  
Dan I. Lubman ◽  
Elizabeth M. Cosgrave ◽  
Eoin J. Killackey ◽  
Hok Pan Yuen ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Young People ◽  
Psychosocial Functioning ◽  
Mental Health Treatment ◽  
Structured Interview ◽  
Health Treatment ◽  
Axis I ◽  
The Impact

Objective: Co-occurring substance use and mental health disorders are highly prevalent among young people attending services, yet few studies have examined the effect of such comorbidity among those referred for treatment. The aim of the current study was to examine the impact of co-occurring substance use disorders (SUDs) on 6 month outcomes for young people seeking mental health treatment. Method: One hundred and six young people (aged 15–24 years) with a non-psychotic DSM-IV Axis I disorder were assessed following referral to a specialist youth public mental health service. Participants were given a structured interview, as well as questionnaires assessing drug use, psychopathology, psychosocial functioning and self-esteem at baseline and 6 month follow up. Results: At baseline, 23 participants met criteria for a co-occurring SUD and 83 had a non-psychotic Axis I disorder. Both the non-SUD and the co-occurring SUD groups had high levels of psychopathology, serious impairments in functioning and moderate levels of suicidal ideation, although those with co-occurring SUD had significantly poorer levels of functioning. At 6 month follow up the co-occurring SUD group continued to experience substantial problems with symptoms and functioning whereas the non-SUD group had significant improvement in both of these domains. Conclusions: The present findings are consistent with studies examining the impact of co-occurring substance use and mental health issues across different treatment settings, and reinforce recommendations that young people with co-occurring disorders require more intensive and integrated interventions. The present findings also highlight the need for routine assessment and management of substance use issues within youth mental health settings.

Prevalence and Burden of at-Risk Criteria of Psychosis and Help-Seeking Behaviour - a Population Survey

2011 ◽  
Vol 26 (S2) ◽  
pp. 1128-1128
Author(s):  
F. Schultze-Lutter ◽  
C. Michel ◽  
B. Schimmelmann
Keyword(s):  
At Risk ◽  
Psychosocial Functioning ◽  
Help Seeking ◽  
Psychotic Disorders ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
List Type ◽  
Risk Criteria ◽  
Help Seeking Behaviour ◽  
Axis I

ObjectiveIn the discussion of the inclusion of an at-risk syndrome of psychosis in DSM-V, the validity of current at-risk criteria had been questioned based on studies reporting much higher prevalence rates of psychotic-like experiences in general population samples (GPS) compared to psychotic disorders. Thus the 3-month prevalence of at-risk criteria and symptoms in GPS, age 16–35, was assessed by trained clinicians in telephone interviews using established standardized assessments.MethodsOf 85 enrolled persons, 60 persons (70.5%) participated, two of them met exclusion criteria (psychosis, language problems). The 22 psychopathological at-risk symptoms were assessed for their occurrence and severity within the three months prior to the telephone interview using the(i)Schizophrenia Prediction Instrument, Adult version (SPI-A) and(ii)the Structured Interview for Prodromal Syndromes (SIPS).ResultsOnly one person (1.7%) fulfilled ‘attenuated psychotic symptoms’ (APS)-criteria according to SIPS. At 1.7%, the 3-month prevalence of at-risk criteria was rather low; at 20.7%, the prevalence of sub-threshold at-risk symptoms, however, was much higher. Yet the presence of these sub-threshold symptoms was already associated with lower psychosocial functioning and with psychiatric axis I diagnoses.

Disturbances of basic self and prodromal symptoms among non-psychotic help-seeking adolescents

2012 ◽  
Vol 43 (7) ◽  
pp. 1365-1376 ◽  
Author(s):  
D. Koren ◽  
N. Reznik ◽  
M. Adres ◽  
R. Scheyer ◽  
A. Apter ◽  
...  
Keyword(s):  
Psychosocial Functioning ◽  
Help Seeking ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
Risk Markers ◽  
Prodromal Symptoms ◽  
The Social ◽  
Prodromal Syndrome ◽  
The Relationship ◽  
Subclinical Psychotic Symptoms

BackgroundThe goal of this study was to explore the notion that anomalies of self-experience (ASE) are a core, ‘not-yet-psychotic’ clinical phenotype of emerging schizophrenia and its spectrum.MethodTo accomplish this goal, we examined the relationship between ASE and commonly accepted risk markers in a sample of 87 help-seeking, non-psychotic adolescents (aged 14–18 years). ASE were assessed with the Examination of Anomalous Self-Experience (EASE), subclinical psychotic symptoms were assessed with the Prodromal Questionnaire and the Structured Interview for Prodromal Syndromes, deterioration in psychosocial functioning was assessed with the Social and Role Functioning Scales, and level of distress with the Mood and Anxiety Symptoms Questionnaire.ResultsAbout 82 participants completed the entire EASE interview. The number of participants who reported ASE at a clinically meaningful level (n = 18, 22%) was smaller than that who met diagnostic criteria for a prodromal syndrome (n = 28, 34%). The degree of overlap between the two conditions was moderate but statistically significant (χ2(1) = 7.01, p = 0.008). An exploratory factor analysis revealed that ASE load on a different factor than prodromal symptoms and deterioration in functioning, but that there is a moderate correlation between the three factors.ConclusionsThese results suggest that ASE are prevalent among non-psychotic help-seeking adolescents, yet at a considerably lower rate than prodromal symptoms. In addition, they suggest that ASE and prodromal symptoms constitute distinct but moderately related dimensions of potential risk. Taken together, they provide preliminary support for the clinical usefulness of supplementing and refining the methods of early detection of risk with assessment of ASE.

The impact of students’ educational background, interest in learning, formal reasoning and visualisation abilities on gas context-based exercises achievements with submicro-animations

2019 ◽  
Vol 20 (3) ◽  
pp. 633-649
Author(s):  
Jerneja Pavlin ◽  
Saša A. Glažar ◽  
Miha Slapničar ◽  
Iztok Devetak
Keyword(s):  
Age Groups ◽  
Structured Interview ◽  
Educational Background ◽  
Eye Tracker ◽  
Formal Reasoning ◽  
Reasoning Abilities ◽  
Total Fixation ◽  
Starting Point ◽  
Chemical Concepts ◽  
The Impact

The purpose of this paper is to explore and explain students’ achievements in solving context-based gas exercises comprising the macroscopic and submicroscopic levels of chemical concepts. The influence of specific variables, such as interest in learning, formal-reasoning abilities, and visualisation abilities, is a significant factor that should be considered when explaining students’ achievements with context-based exercises. Seventy-nine students of three age groups (12, 16, and 23) participated in the study. Questionnaires, tests, and a semi-structured interview including computer-displayed context-based exercises were used to collect data. In addition, an eye-tracker was used to determine the exact location of the participants’ points of gaze. The results show that students on average answered correctly from 40 to 79% of all questions in the context-based exercises. The context-based exercise related to air compression is indicated as being difficult for students. In students’ explanations of different levels of chemical concepts, representation difficulties are detected in all three age groups of students. Students’ achievements in solving context-based gas exercises do not depend on interest in learning chemistry and visualisation abilities. However, statistically significant differences exist in total fixation duration on the correct submicrorepresentation animation between students with different formal-reasoning abilities. The results serve as a starting point for the planning of different context-based exercises and problems comprising the chemistry triplet with 3D dynamic submicrorepresentations.

Il livello di speranza nei pazienti oncologici in cura chemioterapica. Un’indagine sperimentale / The level of hope in the cancer patients receiving chemotherapy. An experimental investigation

2018 ◽  
Vol 67 (5) ◽  
pp. 525-543
Author(s):  
Melissa Maioni
Keyword(s):  
Cancer Patients ◽  
Clinical Sample ◽  
Age Groups ◽  
Stage Iv ◽  
Sono State ◽  
Human Dimensions ◽  
Disease Stage ◽  
Experimental Sample ◽  
Stage Iv Cancer ◽  
The Impact

La speranza è una caratteristica multidimensionale che coinvolge diverse dimensioni umane, il cui costrutto è stato più volte studiato in molteplici ambiti disciplinari. Il presente studio si propone di: valutare l’impatto della patologia in relazione al livello di speranza; comparare il livello di speranza con altre variabili cliniche e socio-demografiche, attraverso lo studio di 83 pazienti oncologici del Policlinico Campus Bio-Medico di Roma in cura chemioterapica, e di 83 soggetti sani, con caratteristiche socio-demografiche comparabili al campione clinico, a cui sono state sottoposte due scale: l’HHI (Herth Hope Scale) e la SF-12 (Questionario sullo stato di salute). L’analisi statistica utilizzata è finalizzata a valutare l’interdipendenza lineare tra le due variabili considerate (la speranza e lo stato di salute) sulla popolazione in generale e nelle sottopopolazioni considerate, tramite il calcolo dell’indice R2. I risultati mostrano che: a) il campione sperimentale composto per l’84,3% da pazienti affetti da cancro al IV stadio, ha mediamente un medio livello di speranza (media ± es = 35.47 ± 0.78); b) non emerge una correlazione significativa tra lo stato di salute e il livello di speranza; c) non emergono differenze significative riguardo il livello di speranza, mentre emergono delle differenze significative relativamente alla PCS (stato di salute fisica). I dati raccolti indicherebbero come la speranza sia una dimensione indipendente dalla diagnosi, dalla stadiazione della patologia, dal sesso, dal tipo di ospedalizzazione, dallo stato civile e non si modifichi nelle varie fasce d’età. Sembrerebbe un costrutto che si mantiene stabile nel tempo e che viene scarsamente influenzato da altre variabili. ---------- Hope is a multidimensional characteristic that involves different human dimensions, the construction of which has been studied several times in multiple disciplinary fields. The present study aims to: assess the impact of the pathology in relation to the level of hope; compare the level of hope with other clinical and socio-demographic variables, through the study of 83 cancer patients receiving chemotherapy at the Policlinico Campus Bio-Medico in Rome, and 83 healthy subjects, with socio-demographic characteristics comparable to the clinical sample, who were given two scales: the HHI (Herth Hope Index) and the SF-12 (SF-12 Health Survey). The statistical analysis used is aimed at assessing the linear interdependence between the two variables under consideration (hope and health) for the general population and the subpopulations under consideration, by calculating the R2 index. The results show that: a) the experimental sample, 84.3% of which was composed of stage IV cancer patients, had an average hope level (mean ± es = 35.47 ± 0.78); b) there was no significant correlation between health and hope; c) there were no significant differences in hope levels, while there were significant differences in physical health (PCS). The data collected would indicate that hope is a dimension independent of diagnosis, disease stage, sex, type of hospitalization, marital status and does not change in the various age groups. It would seem to be a construct that remains stable over time and is poorly influenced by other variables.

Mental Disorder among Refugees and the Impact of Persecution and Exile: Some Findings from an Out-Patient Population

1996 ◽  
Vol 169 (6) ◽  
pp. 726-732 ◽  
Author(s):  
Nils Johan Lavik ◽  
Edvard Hauff ◽  
Anders Skrondal ◽  
Øivind Solberg
Keyword(s):  
At Risk ◽  
Mental Disorder ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
Main Diagnosis ◽  
Check List ◽  
Post Traumatic ◽  
The Impact

BackgroundRefugees have long been considered at risk for mental disorder. We sought to characterise this risk in an out-patient refugee sample by analysing the relationship between psychiatric symptoms and dysfunction, and between symptoms and the socio-demographic background and stressors specific to this refugee sample.MethodA consecutive sample of 231 refugee patients referred to the psychiatric out-patient unit at the Psychosocial Centre for Refugees, University of Oslo, was examined with a semi-structured interview guide, Brief Psychiatric Rating Scale (BPRS), Hopkins Symptom Check-List (HSCL-25) and a check-list for post-traumatic symptoms (PTSS-10). Global Assessment of Function (GAF) scores were obtained; and the data were analysed using nine predictor variables.ResultsIt was found that 46.6% of the patients had a post-traumatic stress disorder according to the criteria for DSM–III–R as the main diagnosis, while the mean GAF score for the patients was 57.3. Analysis of the GAF and BPRS data did not reveal any predictor of psychotic behaviour. However, torture emerged as an important predictor of emotional withdrawal/retardation. Also, age, gender and no employment or education predicted for anxiety/depression, while refugee status and no employment or school predicted for hostility/aggression.ConclusionsThe results confirm earlier findings that refugees constitute a population at risk for mental disorder. Past traumatic stressors and current existence in exile constitute independent risk factors. However, stressors other than those discussed here appear to be important also, particularly with regard to psychotic symptoms.

scholarly journals Deconstructing Individual Differences in Long-Term Personality Disorder and Trait Change

2019 ◽  
Author(s):  
William C. Woods ◽  
Aidan G.C. Wright ◽  
Andrew E. Skodol ◽  
Leslie C. Morey ◽  
Christopher James Hopwood
Keyword(s):  
Psychosocial Functioning ◽  
Clinical Sample ◽  
Structured Interview ◽  
Assessment Method ◽  
Self Report ◽  
Personality Pathology ◽  
Symptom Presentation ◽  
Change Analysis ◽  
Impairment Severity

Converging lines of evidence suggest that personality pathology is comprised of shared and unique impairments. The current study leveraged a large clinical sample (N=505) and a person-centered statistical approach, ipsative change analysis, to decompose individuals’ multidimensional profiles at two time points into a metric which captures change in the elevation of the profile (i.e., impairment severity) and change in relationships between dimensions in the profile (i.e., stylistic symptom presentation). Results demonstrated that both severity and style change were predictors of overall pathology change, although the relative importance of these metrics was influenced by assessment method. Specifically, structured interview showed strong effects of severity change relative to style change, whereas self-report was less definitive. In addition, severity change was the stronger predictor of changes in psychosocial functioning. Results support earlier evidence of shared and unique factors in personality pathology while highlighting the influence of assessment method on models of pathology structure.

Implications of COMT and Subclinical Psychiatric Symptoms on the Phenotypic Variability of 22q11.2 Deletion Syndrome: A Transversal and Longitudinal Approach

2017 ◽  
Vol 41 (S1) ◽  
pp. S82-S83
Author(s):  
S. Guerrera ◽  
M. Armando ◽  
M. Pontillo ◽  
F. Papaleo ◽  
S. Vicari
Keyword(s):  
Negative Symptoms ◽  
Psychiatric Symptoms ◽  
Phenotypic Variability ◽  
22Q11.2 Deletion Syndrome ◽  
Structured Interview ◽  
Deletion Syndrome ◽  
Psychotic Symptoms ◽  
22Q11.2 Deletion ◽  
Comt Polymorphism ◽  
The Impact

Introduction22q11.2 deletion syndrome (22q11.2DS) results from a hemizygous microdeletion on chromosome 22 and is characterized by phenotypic variability. Several studies have been conducted on the impact of COMT functional polymorphism in 22q11DS, suggesting that attenuated psychotic manifestations are frequent in children and adolescents and represent one of the strongest predictors for the onset of psychotic disorder.ObjectivesWe explored possible interaction between COMT polymorphism and subclinical psychiatric symptoms in a 22q11.2DS cohort of 42 participants aged 6 to 26 years: 17 hemizygosity for COMT-Met and 25 hemizygosity for COMT-Val.AimsTo analyse impact of COMT gene in 22q11DS and its related psychiatric correlates.MethodEach participant, genotyped for the catechol O-methyltransferase (COMT) Met/Val polymorphism, underwent structured psychiatric and cognitive assessment. Analysis of positive and negative symptoms was performed by the structured interview for prodromal syndromes (SIPS). Finally, longitudinal data available in a subsample of 24 individuals were used to explore the developmental trajectories of psychotic symptoms one year later.ResultsThere was a significant positive correlation between COMT Val polymorphism and positive symptoms; at follow-up, no significant correlation were found between COMT polymorphism and psychiatric symptoms. No other significant differences were found between groups (Comt/Met-Comt/Val) on any other CBCL or QI score.ConclusionsCOMT and additional genes microdeleted might interact in the susceptibility to schizophrenia in 22q11.2DS: psychotic symptoms might result from an epistatic interaction with other genes. Moreover, gene-environment, in presence of genetic vulnerability could increase the risk of schizophrenia in 22q11DS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals What Is the Impact of COVID-19 Pandemic on Patients with Pre-Existing Mood or Anxiety Disorder? An Observational Prospective Study

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 304
Author(s):  
Antonio Tundo ◽  
Sophia Betro’ ◽  
Roberta Necci
Keyword(s):  
Prospective Study ◽  
Psychological Impact ◽  
Structured Interview ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Observational Prospective Study ◽  
Axis I ◽  
Obsessive Compulsive Disorders ◽  
The Impact ◽  
Compulsive Disorders

Background and Objectives: This observational prospective study aims to examine the psychological and psychopathological impact of the pandemic stress on patients with pre-existing mood, anxiety and obsessive–compulsive disorders. Materials and Methods: The study includes 386 consecutive patients recruited from 10 March to 30 June 2020 among those being treated at the Institute of Psychopathology in Rome (Italy) with an age ≥18 years and meeting DSM-5 criteria for major depressive disorder (MDD) (35.2%), bipolar I (BD-I) (21.5%) or II (BD-II) (28.8%) disorder, obsessive–compulsive disorder (OCD) (7.5%), panic disorder (PD) (7.0%) or social anxiety (SA). A total of 34.2% had lifetime comorbid Axis I disorders and 15.3% had alcohol/drug abuse disorders. Using a semi-structured interview, we investigated if the impact of COVID-19 stress for patients has been similar, higher or lower than that of their family and friends and, for patients with relapse/symptoms worsening, if there was a relationship between the clinical condition worsening and the pandemic stress. Results: Compared with that experienced by their family members and friends, the psychological impact of pandemic stress was similar in 52.1% of the sample, better in 37.1% and worse in 10.8%. In 21 patients (5.4%), the stress triggered a recurrence or worsened the symptoms. Patients with OCD had a higher rate of worsening due to pandemic stress compared to patients with MDD (p = 0.033), although, overall, the χ2 test was not significant among primary diagnoses (χ2 = 8.368; p = 0.057). Conclusions: The psychological and psychopathological consequences of COVID-19 stress in our outpatients were very modest. The continuity of care offered during the lockdown could explain the results.

scholarly journals When Cannabis Use Goes Wrong: Mental Health Side Effects of Cannabis Use That Present to Emergency Services

2021 ◽  
Vol 12 ◽  
Author(s):  
Candice E. Crocker ◽  
Alix J. E. Carter ◽  
Jason G. Emsley ◽  
Kirk Magee ◽  
Paul Atkinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mental Illness ◽  
Adverse Events ◽  
Age Groups ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Clear Understanding ◽  
Knowledge Mobilization ◽  
The Impact

Cannabis use is a modifiable risk factor for the development and exacerbation of mental illness. The strongest evidence of risk is for the development of a psychotic disorder, associated with early and consistent use in youth and young adults. Cannabis-related mental health adverse events precipitating Emergency Department (ED) or Emergency Medical Services presentations can include anxiety, suicidal thoughts, psychotic or attenuated psychotic symptoms, and can account for 25–30% of cannabis-related ED visits. Up to 50% of patients with cannabis-related psychotic symptoms presenting to the ED requiring hospitalization will go on to develop schizophrenia. With the legalization of cannabis in various jurisdiction and the subsequent emerging focus of research in this area, our understanding of who (e.g., age groups and risk factors) are presenting with cannabis-related adverse mental health events in an emergency situation is starting to become clearer. However, for years we have heard in popular culture that cannabis use is less harmful or no more harmful than alcohol use; however, this does not appear to be the case for everyone. It is evident that these ED presentations should be considered another aspect of potentially harmful outcomes that need to be included in knowledge mobilization. In the absence of a clear understanding of the risk factors for mental health adverse events with cannabis use it can be instructive to examine what characteristics are seen with new presentations of mental illness both in emergency departments (ED) and early intervention services for mental illness. In this narrative review, we will discuss what is currently known about cannabis-related mental illness presentations to the ED, discussing risk variables and outcomes both prior to and after legalization, including our experiences following cannabis legalization in Canada. We will also discuss what is known about cannabis-related ED adverse events based on gender or biological sex. We also touch on the differences in magnitude between the impact of alcohol and cannabis on emergency mental health services to fairly present the differences in service demand with the understanding that these two recreational substances may impact different populations of individuals at risk for adverse events.

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