The Psychotic Symptom Rating Scales (PSYRATS): Their usefulness and properties in first episode psychosis

AimsWe here present preliminary results from our study to understand better the changes in people’ s experience of food in the months after diagnosis with first episode psychosis (FEP). Weight gain often occurs in the weeks/months after diagnosis and is related to an increase in appetite and food intake. Many drugs that are effective in treating psychosis are associated with changes in the way that people experience reward when they eat.The aim of this project is to increase our understanding of exactly why this happens in terms of an individual's experience of food reward and reduced satiety – and therefore how we can help people with FEP to keep their weight down. At this stage we are looking at the feasibility of applying currently available evaluation tools to people in this situation.MethodA convenience sample was used to recruit 10 service users from RDaSH NHS FT Early Intervention Services. This is a feasibility study which will provide data to underpin a fully powered, larger trial.Rating scales applied were:Power of food questionnaire: measures responsiveness to the food environment.Intuitive Eating Scale: measures an individual's tendency to follow their physical hunger and satiety cues.The loss of control over eating scale (LOCES): measures a global sense of whether individuals experience LOC over eating.Dutch Eating Behaviour Questionnaire (DEBQ): measures restrained eating, emotional eating and external eating.ResultThe ages of the participants ranged from 17-26 years. All were started on Olanzapine at the dose of 5 or 10 mg daily.Baseline total scores for the Power of Food (2.47-3.80)/5 (higher score = more responsiveness) and Intuitive Eating scales (2.10-2.62)/5 (higher score = greater tendency to follow hunger and satiety cues) were in the mid-range, while the LOCES scores varied widely from 1.50-2.38/5.The DEBQ restrained subscale score range was 2.40-2.80/5 (higher indicates greater restraint with food) while the DEBQ external subscale ranged from 2.70—3.00/5 (higher = greater tendency to overeat) and the DEBQ emotional subtotal score was 1.92-1.94/5, in keeping with a relatively low emotional drive to eat.ConclusionOur preliminary results reveal at the beginning of antipsychotic treatment a moderate responsiveness to food and tendency to follow hunger/ satiety cues, with scores for Loss of Control of eating in the low to moderate range and a low emotional drive to eat. The difference between these and the follow-up eating behaviour scores will provide important clues as to the precise changes in eating behaviour with anti-psychotic treatment in FEP.

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THE RELATIONSHIP BETWEEN SOCIAL COGNITIVE FUNCTIONING AND PSYCHOTIC SYMPTOM CLUSTERS IN FIRST EPISODE PSYCHOSIS

Schizophrenia Research ◽

10.1016/j.schres.2010.02.567 ◽

2010 ◽

Vol 117 (2-3) ◽

pp. 331

Author(s):

Alicia Papas ◽

Linda Byrne ◽

Andy Thompson

Keyword(s):

Cognitive Functioning ◽

Psychotic Symptom ◽

Social Cognitive ◽

First Episode Psychosis ◽

Symptom Clusters ◽

First Episode ◽

Episode Psychosis ◽

The Relationship

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Paradigm shift? Purity, progress and the origins of first-episode psychosis

Medical Humanities ◽

10.1136/medhum-2017-011383 ◽

2018 ◽

Vol 44 (3) ◽

pp. 172-180

Author(s):

Suze G Berkhout

Keyword(s):

Early Intervention ◽

Paradigm Shift ◽

Rating Scales ◽

First Episode Psychosis ◽

The Body ◽

First Episode ◽

Atypical Antipsychotic Drug ◽

Episode Psychosis ◽

Sociohistorical Context ◽

Significant Attention

First-episode psychosis has garnered significant attention and resources within mental health services in North America, Europe and Australia/New Zealand since the 1990s. Despite this widespread embrace, little scholarship exists that examines underlying concepts, ideologies and imagery embedded within the early intervention paradigm. In this paper, I offer a sociohistorical analysis of the emergence of first-episode psychosis and early intervention as entities in psychiatry, drawing on contemporary philosophical thought to explore various concepts embedded in them. Although scattered references to ‘prodrome’ and ‘incipient cases’ exist in the historic psychiatric literature, the notion of first-episode psychosis as a distinct chronological stage emerged in the late 1980s. This occurred in response to a desire for a homogeneous, medication-naive population within schizophrenia research. Thematically, concerns regarding ‘purity’ as well as notions of ‘progress’ can be read off of the body of work surrounding the creation of the term and its development into a clinical organising concept. Furthermore, examining the sociohistorical context of the term demonstrates its entanglement with the course of atypical antipsychotic drug development, the expansion of clinical rating scales and wider neoliberal biopolitics within healthcare. Within psychiatry, the early intervention model has been termed a ‘paradigm shift,’ with the promise that earlier interventions will translate into shorter durations of untreated illness, improved utilisation of services and better prognoses for recovery. While these are laudable goals, they are tied to assumptions about biomedical progress and idealisations of clinical populations that feminist and disability critiques problematise.

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Differences in Facial Emotional Recognition Between Patients With the First-Episode Psychosis, Multi-episode Schizophrenia, and Healthy Controls

Journal of the International Neuropsychological Society ◽

10.1017/s1355617718001029 ◽

2018 ◽

Vol 25 (2) ◽

pp. 165-173 ◽

Cited By ~ 3

Author(s):

Dina Bosnjak Kuharic ◽

Porin Makaric ◽

Ivana Kekin ◽

Iva Lukacevic Lovrencic ◽

Aleksandar Savic ◽

...

Keyword(s):

Effect Size ◽

Rating Scales ◽

Recognition Task ◽

First Episode Psychosis ◽

Hospital Treatment ◽

First Episode ◽

Healthy Controls ◽

Emotional Recognition ◽

Episode Psychosis ◽

Patient Groups

AbstractObjectives: The aim of our study was to assess the differences in facial emotional recognition (FER) between patients with first-episode psychosis (FEP), patients with multi-episode schizophrenia (SCH), and healthy controls (HC) and to find possible correlations of FER with psychopathology in the two patient groups. Methods: We performed a cross-sectional study enrolling 160 patients from two psychiatric hospitals in Croatia (80 FEP and 80 SCH) and 80 HC during the period from October 2015 until October 2017. Patients were assessed once during their hospital treatment, using the Penn Emotion Recognition Task for assessment of FER, rating scales for psychopathology and depression and self-reporting questionnaires for impulsiveness, aggression, and quality of life. Results: The number of correctly identified emotions significantly decreased from HC to FEP [Δ −7%; 95% confidence interval (CI) [−12% to −3%], effect size r = 0.30] and more markedly in SCH (Δ −15%; 95% CI [−25% to −10%], effect size r = 0.59) after the adjustment for age and gender and correction for multiple testing. Correct FER for negative emotions, but not for happiness and neutral emotions, had a statistically significant negative correlation with some features on the scales of psychopathology, impulsivity and aggression in both patient groups. Conclusions: Impairment of FER is present from the first episode of schizophrenia and increases further with multiple psychotic episodes, but it may depend on or contribute to clinical symptoms. Therefore, assessment of FER should be included in the clinical assessment and integrated in the plan of treatment from the beginning of the illness. (JINS, 2019, 25, 165–173)

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Longitudinal changes of insight in first episode psychosis and its relation to clinical symptoms, treatment adherence and global functioning: One-year follow-up from the Eiffel study

European Psychiatry ◽

10.1016/j.eurpsy.2010.06.003 ◽

2012 ◽

Vol 27 (1) ◽

pp. 43-49 ◽

Cited By ~ 30

Author(s):

R. Segarra ◽

N. Ojeda ◽

J. Peña ◽

J. García ◽

A. Rodriguez-Morales ◽

...

Keyword(s):

Functional Outcome ◽

Treatment Adherence ◽

Rating Scales ◽

Clinical Symptoms ◽

Clinical Course ◽

First Episode Psychosis ◽

First Episode ◽

Global Functioning ◽

Episode Psychosis

AbstractObjectivesThe Eiffel study is a longitudinal, naturalistic study of patients with first episode psychosis (FEP) designed to evaluate the predictive value of defective insight on treatment adherence and global functioning.MethodsFive hundred seventy-seven patients with FEP were assessed at baseline and at a 1-year follow-up. They were compared in terms of sociodemographic factors, psychopathology, insight, treatment adherence and functional outcome. Longitudinal functionality was prospectively assessed with the clinical global impression (CGI) and global assessment of functioning (GAF) rating scales.ResultsAt baseline, up to 50% of our sample presented with a lack of insight. Most clinical symptoms, including insight, improved over the follow-up period. Insight, education and social withdrawal significantly predicted CGI and GAF at follow-up. Insight and level of education were predictive of treatment adherence.ConclusionsInsight significantly predicted the general clinical course, treatment adherence and functional outcome in our FEP sample after 1 year. Only education additionally accounted for the longitudinal course. Since our results suggest that better insight improves treatment adherence and consequently clinical course and functional outcome, insight could be a specific target of treatment in early intervention programs.

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Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial

The British Journal of Psychiatry ◽

10.1192/bjp.191.51.s140 ◽

2007 ◽

Vol 191 (S51) ◽

pp. s140-s146 ◽

Cited By ~ 109

Author(s):

Mette Bertelsen ◽

Pia Jeppesen ◽

Lone Petersen ◽

Anne Thorup ◽

Johan ⊘hlenschlæger ◽

...

Keyword(s):

High Risk ◽

Suicidal Behaviour ◽

Rating Scales ◽

First Episode Psychosis ◽

Psychotic Symptoms ◽

First Episode ◽

Suicidal Thoughts ◽

Episode Psychosis ◽

Suicidal Plans

BackgroundThose with first-episode psychosis are at high-risk of suicideAimsTo identify predictive factors for suicidal thoughts, plans and attempts, and to investigate the rate of suicides and other deaths during the 5 years after first diagnosis and initiation of treatmentMethodA longitudinal, prospective, 5-year follow-up study of 547 individuals with first-episode schizophrenia spectrum psychosis. Individuals presenting for their first treatment in mental health services in two circumscribed urban areas in Denmark were included in a randomised controlled trial of integrated v. standard treatment. All participants were followed in the Danish Cause of Death Register for 5 years. Suicidal behaviour and clinical and social status were assessed using validated interviews and rating scales at entry, and at 1- and 2-year follow-upsResultsSixteen participants died during the follow-up. We found a strong association between suicidal thoughts, plans and previous attempts, depressive and psychotic symptoms and young age, and with suicidal plans and attempts at 1- and 2-year follow-upConclusionsIn this first-episode cohort depressive and psychotic symptoms, especially hallucinations, predicted suicidal plans and attempts, and persistent suicidal behaviour and ideation were associated with high risk of attempted suicide

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