Psychosis – Different presentation for designer drugs compared to cannabis abusers?

2017 ◽  
Vol 41 (S1) ◽  
pp. S393-S393
Author(s):  
F. Dumitrescu
Keyword(s):  
Negative Symptoms ◽  
Endocannabinoid System ◽  
Positive Association ◽  
Designer Drugs ◽  
Drug Misuse ◽  
Designer Drug ◽  
Psychotic Symptoms ◽  
Bath Salts ◽  
Formal Thought Disorder ◽  
Thought Disorders

Introduction“Bath salts” target the endocannabinoid system in a similar manner to cannabis. In the case of designer drug misuse, subjects seem to be at higher risk of psychotic symptoms.AimsTo investigate the nature and frequency of psychotic symptoms associated with cannabis and/or bath salts misuse in a male inpatient population.MethodThe files of 107 patients admitted to the department of addictions, “Al. Obregia” Psychiatric Hospital Bucharest July 2015–July 2016 were reviewed. Cases had a diagnosis of psychotic disorder with recorded cannabis/bath salts abuse.ResultsMean age was 26.65 years old (STDV = 5.9). Mean duration of use was of 83.94 months – cannabis; 60.48 months – bath salts and 33.75 months – both substances (BS). Sixty-three patients (73.3%) presented disorganised behaviour; 55.8% (n = 48) formal thought disorder; 45% (n = 39) paranoid delusions. A strong positive association between the length of use of cannabis and disorganised behaviour (n = 33; r = 0.05; P < 0.05) was found. Grandiose ideation was frequent in cannabis users. (X2 = 4.1; n = 0.03; P < 0.05). Multidrug abuse was associated with increased formal thought disorders compared to subjects with cannabis abuse (X2 = 10.9; n = 0.001; P < 0.05). Negative symptoms were more frequent with bath salts users than with users of both substances (X2 = 13.4; X2 = 23.21; X2 = 16.8; P < 0.05).ConclusionPositive psychotic symptoms were associated with cannabis and BS abuse, while bath salts promoted negative symptoms.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Symptoms of Psychoses

1995 ◽  
Vol 166 (2) ◽  
pp. 236-240 ◽  
Author(s):  
Toshinori Kitamura ◽  
Yuji Okazaki ◽  
Akira Fujinawa ◽  
Masahiro Yoshino ◽  
Yomishi Kasahara
Keyword(s):  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Current Knowledge ◽  
Psychiatric Patients ◽  
Psychotic Symptoms ◽  
Formal Thought Disorder ◽  
Affective Symptoms ◽  
Five Factors ◽  
Thought Disorders ◽  
Positive And Negative Symptoms

BackgroundThe literature on the statistical analysis of symptoms of psychoses was limited to positive and negative symptoms in schizophrenia. The present study explored the relationship between positive and negative symptoms as well as affective symptoms in a wider category of psychotic disorders.MethodThe symptoms of 584 psychiatric patients, consecutively admitted to any of the 95 mental hospitals in Japan, were studied. They manifested at least one of the following: (a) delusions, (b) hallucinations, (c) formal thought disorder, (d) catatonic symptoms, or (e) negative (defect) symptoms.ResultsFactor analysis yielded five factors interpretable as (a) manic symptoms, (b) depressive symptoms, (c) negative (defect) symptoms and formal thought disorders, (d) positive (psychotic) symptoms, and (e) catatonic symptoms.ConclusionThese results suggest that although major symptoms seen among psychotic patients can be categorised into positive, negative, manic, and depressive groups, corresponding to current knowledge of phenomenology, catatonic symptoms constitute a discrete syndrome, while formal thought disorders merge into the negative syndrome.

scholarly journals 457 - VERY LATE-ONSET SCHIZOPHRENIA-LIKE PSYCHOSIS… A DIAGNOSTIC DILEMMA…

2020 ◽  
Vol 32 (S1) ◽  
pp. 178-178
Author(s):  
Joana Regala ◽  
Francisco Moniz-Pereira
Keyword(s):  
Case Report ◽  
Basal Ganglia ◽  
Negative Symptoms ◽  
Late Onset ◽  
Previous History ◽  
Psychotic Symptoms ◽  
Formal Thought Disorder ◽  
Diagnostic Dilemma ◽  
Ischemic Disease ◽  
Thought Disorders

Background:The nosology and etiological underpinnings of very late -onset schizophrenia-like psychosis (VLOSLP) have remained controversial. This case report highlights its diagnostic complexity.Case report:A 64-year-old woman, with a previous history of hypertension, diabetes, mild cognitive decline, right grade-4 hemiparesis as sequelae of an ischemic-stroke (three years before), started persecutory and partition delusions. After six months, the delusions were accompanied by complex visual hallucinations (scenic, lilliputian and holocampine), elementary auditory, tactile, olfactory, and gustatory hallucinations, causing a profound daily life impact, consequently she was hospitalized. Neither negative symptoms nor formal thought disorders were present. Electroencephalography and laboratorial evaluations were unremarkable (including thyroid function, folic acid, cyanocobalamin, infectious serologies and anti-gliadin/transglutaminase antibodies). Neuroimaging displayed subcortical microvascular lesions in the left centrum semiovale, bilateral thalamic and basal ganglia lacunes. Neuropsychological examination revealed mild/moderate impairment in working-memory, sustained-attention, executive functions, abstract thinking, and visuospatial abilities. Mini-mental state examination (MMSE) scored 20/30. Clozapine was started. As psychotic symptoms ameliorated cognitive deficits also improved (MMSE score: 25/30). She was discharged with residual symptoms.Discussion:Late-life psychosis implies a thorough investigation, bringing about challenges in diagnosis. Several medical causes, including neuroinflammatory/immunologic, were ruled out. This two-stage progression, with partition delusions and multimodal hallucinations, in the absence of formal thought disorder and negative symptoms is typical of VLOSP. It is arguable to ascribe our patient’s psychosis to a previous vascular dementia or to VLOSLP. Almost half of VLOSLP patients may develop dementia. It is still debatable whether this propensity is a true characteristic of VLOPSL or reflects an initial misdiagnosis. Some neuropathological studies suggest a restricted limbic tauopathy underlying VLOSP. Notwithstanding, cognitive impairment is common in VLOSLP, including in those patients who do not develop dementia. Neuroimaging studies evidence that lacunar infarction in the basal ganglia alongside chronic white matter small vessels ischemic disease, may underlie the pathophysiology of psychosis via a disruption in the frontal-subcortical pathways. Nevertheless, cases of post-stroke psychosis usually resolve in few months. In conclusion, the neurobiological underpinnings of VLOSLP are complex and multifaceted. More systematized studies using biomarkers and neuroimaging are needed so clinicians can perform a more accurate diagnosis of VLOSLP.

scholarly journals Cognitive Behavioural Therapy for Auditory Hallucinations: Effectiveness and Predictors of Outcome in a Specialist Clinic

2010 ◽  
Vol 39 (2) ◽  
pp. 129-138 ◽  
Author(s):  
Neil Thomas ◽  
Susan Rossell ◽  
John Farhall ◽  
Frances Shawyer ◽  
David Castle
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Behavioural Therapy ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Predictors Of Outcome ◽  
Formal Thought Disorder ◽  
Behavioural Treatment ◽  
Cognitive Behavioural

Background: Cognitive behavioural therapy has been established as an effective treatment for residual psychotic symptoms but a substantial proportion of people do not benefit from this treatment. There has been little direct study of predictors of outcome, particularly in treatment targeting auditory hallucinations. Method: The Psychotic Symptom Rating Scales (PSYRATS) and Positive and Negative Syndrome Scale (PANSS) were administered pre- and post-therapy to 33 people with schizophrenia-related disorders receiving CBT for auditory hallucinations in a specialist clinic. Outcome was compared with pre-therapy measures of insight, beliefs about the origin of hallucinations, negative symptoms and cognitive disorganization. Results: There were significant improvements post-treatment on the PSYRATS and PANSS Positive and General Scales. Improvement on the PSYRATS was associated with lower levels of negative symptoms, but was unrelated to overall insight, delusional conviction regarding the origins of hallucinations, or levels of cognitive disorganization. Conclusions: Lack of insight and presence of formal thought disorder do not preclude effective cognitive-behavioural treatment of auditory hallucinations. There is a need to further understand why negative symptoms may present a barrier to therapy.

Anxiety and Schizophrenia: The Interaction of Subtypes of Anxiety and Psychotic Symptoms

CNS Spectrums ◽  
2005 ◽  
Vol 10 (9) ◽  
pp. 721-731 ◽  
Author(s):  
Jonathan D. Huppert ◽  
Thomas E. Smith
Keyword(s):  
Social Anxiety ◽  
Anxiety Disorders ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Formal Thought Disorder ◽  
Obsessive Compulsive ◽  
Comorbid Anxiety

AbstractObjectiveTo examine the interaction of specific anxiety subtypes and psychosis.IntroductionAccumulating evidence suggests that anxiety and its disorders play a significant role in patients with schizophrenia, but few studies have examined multiple types of anxiety and how they interact with different symptoms of schizophrenia.MethodsThirty-two patients diagnosed with schizophrenia or schizoaffective disorder were assessed through self-report measures and interviewer rating scales to examine symptoms of psychosis and anxiety.ResultsA majority of patients (62%) were diagnosed with at least one comorbid anxiety disorder. Obsessive-compulsive symptoms and social anxiety symptoms were related to positive symptoms, bizarre behavior, and quality of life (QOL). Furthermore, panic and social anxiety were related to suspiciousness/paranoia. No consistent relationship was found with negative symptoms. Finally, severity of anxiety disorders was negatively correlated with the severity of formal thought disorder.DiscussionThis is one of the first studies to simultaneously examine the interrelationships of different types of anxiety symptoms and psychotic symptoms. The present findings are consistent with the studies that have suggested relationships between panic and paranoia and comorbid anxiety disorders and impaired QOL. These data suggest that further research into anxiety in schizophrenia, including the cognitive and neurobiological correlates, may help elucidate the mechanisms involved in the manifestation of these psychopathologiesConclusionAnxiety disorders are common in patients with schizophrenia. The presence of such symptoms may influence the presence of core psychotic symptoms and QOL. More information is needed in terms of the relationship between treatment of these symptoms and changes in psychotic symptoms and/or relapse prevention.

Conceptual disorganization and redistribution of resting state cortical hubs in untreated first episode psychosis: A 7T MRI study

2020 ◽  
Author(s):  
Avyarthana Dey ◽  
Kara Dempster ◽  
Michael Mackinley ◽  
Peter Jeon ◽  
Tushar Das ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Superior Temporal Gyrus ◽  
Brain Regions ◽  
First Episode Psychosis ◽  
Cortical Reorganization ◽  
First Episode ◽  
Formal Thought Disorder ◽  
Whole Brain ◽  
Episode Psychosis ◽  
Positive And Negative Symptoms

Background:Network level dysconnectivity has been studied in positive and negative symptoms of schizophrenia. Conceptual disorganization (CD) is a symptom subtype which predicts impaired real-world functioning in psychosis. Systematic reviews have reported aberrant connectivity in formal thought disorder, a construct related to CD. However, no studies have investigated whole-brain functional correlates of CD in psychosis. We sought to investigate brain regions explaining the severity of CD in patients with first-episode psychosis (FEPs) compared with healthy controls (HCs).Methods:We computed whole-brain binarized degree centrality maps of 31 FEPs, 25 HCs and characterized the patterns of network connectivity in the two groups. In FEPs, we related these findings to the severity of CD. We also studied the effect of positive and negative symptoms on altered network connectivity.Results:Compared to HCs, reduced hubness of a right superior temporal gyrus (rSTG) cluster was observed in the FEPs. In patients exhibiting high CD, increased hubness of a medial superior parietal (mSPL) cluster was observed, compared to patients exhibiting low CD. These two regions were strongly correlated with CD scores but not with other symptom scores.Discussion:Our observations are congruent with previous findings of reduced but not increased hubness. We observed increased hubness of mSPL suggesting that cortical reorganization occurs to provide alternate routes for information transfer.Conclusion:These findings provide insight into the underlying neural processes mediating the presentation of symptoms in untreated FEP. A longitudinal tracking of the symptom course will be useful to assess the mechanisms underlying these compensatory changes.

Evaluation of positive and negative symptoms in schizophrenia

1986 ◽  
Vol 1 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Nancy C. Andreasen ◽  
William M. Grove
Keyword(s):  
Negative Symptoms ◽  
The United States ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
University Of Iowa ◽  
Normal Functions ◽  
Subsequent Investigation ◽  
The University ◽  
The Relationship ◽  
Positive And Negative Symptoms

SummaryMost investigators concur that schizophrenia is probably a heterogeneous group of disorders that share the common features of psychotic symptoms, partial response to neuroleptics, and a relatively poor outcome. The subdivision of schizophrenia into two subtypes, positive versus negative, has achieved wide acceptance throughout the world during recent years. This distinction has heuristic and theoretical appeal because it unites phenomenology, pathophysiology, and etiology into a single comprehensive hypothesis.In spite of its wide appeal, the distinction has a number of problems. These include the failure to distinguish between symptom syndromes and diseases; failure to deal with the mixed patient; failure to take longitudinal course into account; and failure to address conceptually and methodologically the distinction between positive and negative symptoms.This paper focuses primarily on the conceptual basis for two instruments designed to measure positive and negative symptoms, the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS), originally described in 1982. Since their description, these scales have been used in a variety of other centers. These scales are based on the hypothesis that negative symptoms represent a deficit or diminution in normal psychological functions wliile positive symptoms represent an excess or distortion of normal functions. Reliability data are now available from Italy, Spain, and Japan which suggest that these scales can be used reliably in cultural settings outside the United States. The results of these studies are summarized in this paper. In addition, a replication study involving a new sample of 117 schizophrenics collected at the University of Iowa is described. In this second study of the SANS and SAPS, internal consistency is found to be quite high in the SANS. Thus negative symptoms appear to be more internally correlated with one another than are positive symptoms. The implications of this result are discussed. A principal components analysis is used to explore the relationship between positive and negative symptoms. While the study reported in 1982 suggested that positive and negative symptoms are negatively correlated, in the present study they appear to be uncorrelated. Overall, the results suggest that the SANS and SAPS are useful comprehensive instruments for the evaluation of positive and negative symptoms. The relationship between these symptoms and external validators such as cognitive functioning or CT scan abnormalities will be reported in a subsequent investigation.

scholarly journals General psychopathology links burden of recent life events and psychotic symptoms in a network approach

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Linda T. Betz ◽  
◽  
Nora Penzel ◽  
Lana Kambeitz-Ilankovic ◽  
Marlene Rosen ◽  
...  
Keyword(s):  
Life Events ◽  
Childhood Trauma ◽  
Negative Symptoms ◽  
Psychotic Symptoms ◽  
Network Approach ◽  
General Psychopathology ◽  
Recent Onset ◽  
Syndrome Scale ◽  
Before And After ◽  
The Individual

AbstractRecent life events have been implicated in the onset and progression of psychosis. However, psychological processes that account for the association are yet to be fully understood. Using a network approach, we aimed to identify pathways linking recent life events and symptoms observed in psychosis. Based on previous literature, we hypothesized that general symptoms would mediate between recent life events and psychotic symptoms. We analyzed baseline data of patients at clinical high risk for psychosis and with recent-onset psychosis (n = 547) from the Personalised Prognostic Tools for Early Psychosis Management (PRONIA) study. In a network analysis, we modeled links between the burden of recent life events and all individual symptoms of the Positive and Negative Syndrome Scale before and after controlling for childhood trauma. To investigate the longitudinal associations between burden of recent life events and symptoms, we analyzed multiwave panel data from seven timepoints up to month 18. Corroborating our hypothesis, burden of recent life events was connected to positive and negative symptoms through general psychopathology, specifically depression, guilt feelings, anxiety and tension, even after controlling for childhood trauma. Longitudinal modeling indicated that on average, burden of recent life events preceded general psychopathology in the individual. In line with the theory of an affective pathway to psychosis, recent life events may lead to psychotic symptoms via heightened emotional distress. Life events may be one driving force of unspecific, general psychopathology described as characteristic of early phases of the psychosis spectrum, offering promising avenues for interventions.

scholarly journals Acoustic speech markers for schizophrenia-spectrum disorders: a diagnostic and symptom-recognition tool

2021 ◽  
pp. 1-11
Author(s):  
J. N. de Boer ◽  
A. E. Voppel ◽  
S. G. Brederoo ◽  
H. G. Schnack ◽  
K. P. Truong ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Structured Interview ◽  
Diagnostic Value ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum Disorder ◽  
Speech Technology ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Abstract Background Clinicians routinely use impressions of speech as an element of mental status examination. In schizophrenia-spectrum disorders, descriptions of speech are used to assess the severity of psychotic symptoms. In the current study, we assessed the diagnostic value of acoustic speech parameters in schizophrenia-spectrum disorders, as well as its value in recognizing positive and negative symptoms. Methods Speech was obtained from 142 patients with a schizophrenia-spectrum disorder and 142 matched controls during a semi-structured interview on neutral topics. Patients were categorized as having predominantly positive or negative symptoms using the Positive and Negative Syndrome Scale (PANSS). Acoustic parameters were extracted with OpenSMILE, employing the extended Geneva Acoustic Minimalistic Parameter Set, which includes standardized analyses of pitch (F0), speech quality and pauses. Speech parameters were fed into a random forest algorithm with leave-ten-out cross-validation to assess their value for a schizophrenia-spectrum diagnosis, and PANSS subtype recognition. Results The machine-learning speech classifier attained an accuracy of 86.2% in classifying patients with a schizophrenia-spectrum disorder and controls on speech parameters alone. Patients with predominantly positive v. negative symptoms could be classified with an accuracy of 74.2%. Conclusions Our results show that automatically extracted speech parameters can be used to accurately classify patients with a schizophrenia-spectrum disorder and healthy controls, as well as differentiate between patients with predominantly positive v. negatives symptoms. Thus, the field of speech technology has provided a standardized, powerful tool that has high potential for clinical applications in diagnosis and differentiation, given its ease of comparison and replication across samples.

scholarly journals Childhood adversity and psychosis: generalised or specific effects?

2015 ◽  
Vol 25 (4) ◽  
pp. 349-359 ◽  
Author(s):  
E. Longden ◽  
M. Sampson ◽  
J. Read
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Negative Symptoms ◽  
Childhood Adversity ◽  
Clinical Intervention ◽  
Current Data ◽  
Psychotic Symptoms ◽  
Multiple Exposures ◽  
Specific Effects ◽  
The Impact

Background.This study examines relationships between childhood adversity and the presence of characteristic symptoms of schizophrenia. It was hypothesised that total adversity exposures would be significantly higher in individuals exhibiting these symptoms relative to patients without. Recent proposals that differential associations exist between specific psychotic symptoms and specific adversities was also tested, namely: sexual abuse and hallucinations, physical abuse and delusions, and fostering/adoption and delusions.Method.Data were collected through auditing 251 randomly selected medical records, drawn from adult patients in New Zealand community mental health centres. Information was extracted on presence and subtype of psychotic symptoms and exposure to ten types of childhood adversity, including five types of abuse and neglect.Results.Adversity exposure was significantly higher in patients experiencing hallucinations in general, voice hearing, command hallucinations, visions, delusions in general, paranoid delusions and negative symptoms than in patients without these symptoms. There was no difference in adversity exposure in patients with and without tactile/olfactory hallucinations, grandiose delusions or thought disorder. Indication of a dose–response relationship was detected, in that total number of adversities significantly predicted total number of psychotic symptoms. Although fostering/adoption was associated with paranoid delusions, the hypothesised specificity between sexual abuse and hallucinations, and physical abuse and delusions, was not found. The two adversities showing the largest number of associations with psychotic symptoms were poverty and being fostered/adopted.Conclusions.The current data are consistent with a model of global and cumulative adversity, in which multiple exposures may intensify psychosis risk beyond the impact of single events. Implications for clinical intervention are discussed.

scholarly journals The effect of the environment on symptom dimensions in the first episode of psychosis: a multilevel study

2014 ◽  
Vol 44 (11) ◽  
pp. 2419-2430 ◽  
Author(s):  
F. J. Oher ◽  
A. Demjaha ◽  
D. Jackson ◽  
C. Morgan ◽  
P. Dazzan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Population Density ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Urban Environments ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Multilevel Regression ◽  
Symptom Dimensions ◽  
Reality Distortion

BackgroundThe extent to which different symptom dimensions vary according to epidemiological factors associated with categorical definitions of first-episode psychosis (FEP) is unknown. We hypothesized that positive psychotic symptoms, including paranoid delusions and depressive symptoms, would be more prominent in more urban environments.MethodWe collected clinical and epidemiological data on 469 people with FEP (ICD-10 F10–F33) in two centres of the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study: Southeast London and Nottinghamshire. We used multilevel regression models to examine neighbourhood-level and between-centre differences in five symptom dimensions (reality distortion, negative symptoms, manic symptoms, depressive symptoms and disorganization) underpinning Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Item Group Checklist (IGC) symptoms. Delusions of persecution and reference, along with other individual IGC symptoms, were inspected for area-level variation.ResultsReality distortion [estimated effect size (EES) 0.15, 95% confidence interval (CI) 0.06–0.24] and depressive symptoms (EES 0.21, 95% CI 0.07–0.34) were elevated in people with FEP living in more urban Southeast London but disorganized symptomatology was lower (EES –0.06, 95% CI –0.10 to –0.02), after controlling for confounders. Delusions of persecution were not associated with increased neighbourhood population density [adjusted odds ratio (aOR) 1.01, 95% CI 0.83–1.23], although an effect was observed for delusions of reference (aOR 1.41, 95% CI 1.12–1.77). Hallucinatory symptoms showed consistent elevation in more densely populated neighbourhoods (aOR 1.32, 95% CI 1.09–1.61).ConclusionsIn people experiencing FEP, elevated levels of reality distortion and depressive symptoms were observed in more urban, densely populated neighbourhoods. No clear association was observed for paranoid delusions; hallucinations were consistently associated with increased population density. These results suggest that urban environments may affect the syndromal presentation of psychotic disorders.

Sign in / Sign up

Export Citation Format

Share Document