FC07-01 - Cognitive functions in first episode psychosis

2011 ◽  
Vol 26 (S2) ◽  
pp. 1846-1846
Author(s):  
H.F. Elsawy ◽  
M.A. Abd Elhay ◽  
A.B. Abd Elkrem
Keyword(s):  
Bipolar Disorder ◽  
Schizoaffective Disorder ◽  
Cognitive Functions ◽  
Wisconsin Card Sorting Test ◽  
First Episode ◽  
Psychotic Episode ◽  
Control Group ◽  
Early Stages ◽  
First Psychotic Episode ◽  
Significant Difference

BackgroundCognitive impairment is recognized as an important feature of psychosis in its early stages and is a determinant of prognosis and management of these disorders.Aim of the studyTo test the cognitive functions in first psychotic episode in patients with disorders of schizophrenia, schizoaffective disorder, bipolar disorder and depression with psychotic disorder and to compare them to controls.Subjects and methodsThe study included 254 patients diagnosed according to Diagnostic and Statistical criteria of Mental disorders, 4th edition (91 schizophrenics, 21 with schizoaffective disorder, 107 with bipolar disorder and 31 with psychotic depression) and experiencing their first psychotic episode. Seventy healthy volunteers matched as regards age and sex with patients were used as controls. All are subjected to cognitive evaluation by Trail Making Test, part B, Wisconsin card sorting test 128, Benton Visual Retention Test and Wechsler Adult Intelligence Test.ResultsAll patients showed significant cognitive deterioration in all tests compared to control group. On comparing patients to each other, there was no significant difference between schizophrenics and patients with bipolar disorder, but both showed marked deterioration in comparison to depressive group.ConclusionCognitive impairments are present in early stages of psychosis and need careful assessment and management.

scholarly journals Altered Risk-Taking Behavior in Early-Stage Bipolar Disorder With a History of Psychosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Sandra Chi Yiu Wong ◽  
Mary Chung Mun Ng ◽  
Joe Kwun Nam Chan ◽  
Martha Sin Ki Luk ◽  
Simon Sai Yu Lui ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Risk Aversion ◽  
Risk Taking ◽  
Cognitive Functions ◽  
Early Stage ◽  
First Episode ◽  
Increased Risk ◽  
Significant Difference ◽  
History Of ◽  
Risk Taking Behavior

Altered risk-taking propensity is an important determinant of functional impairment in bipolar disorder. However, prior studies primarily assessed patients with chronic illness, and risk-taking has not been evaluated in the early illness course. This study investigated risk-taking behavior in 39 euthymic early-stage bipolar disorder patients aged 16–40 years who were treated within 3 years from their first-episode mania with psychotic features and 36 demographically-matched healthy controls using the Balloon Analog Risk Task (BART), a well-validated risk-taking performance-based paradigm requiring participants to make responses for cumulative gain at increasing risk of loss. Relationships of risk-taking indices with symptoms, self-reported impulsivity, cognitive functions, and treatment characteristics were also assessed. Our results showed that patients exhibited significantly lower adjusted scores (i.e., average balloon pumps in unexploded trials) (p = 0.001), lower explosion rate (p = 0.007) and lower cumulative scores (p = 0.003) than controls on BART, indicating their suboptimal risk-taking performance with increased propensity for risk aversion. Risk-taking indices were not correlated with any symptom dimensions, self-reported impulsivity, cognitive functions or antipsychotic dose. No significant difference was observed between patients with and without antipsychotic medications on self-reported impulsivity or any of the BART performance indices. This is the first study to examine risk-taking behavior in early-stage bipolar disorder with history of psychosis and indicates that patients displayed altered risk-taking with increased risk aversion compared with controls. Further research is needed to clarify longitudinal trajectory of risk-taking propensity and its relationships with psychosis and functional outcome in the early stage of bipolar disorder.

The Prevalence of Comorbid Anxiety in Schizophrenia, Schizoaffective Disorder and Bipolar Disorder

1998 ◽  
Vol 32 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Susan J. Cosoff ◽  
R. Julian Hafner
Keyword(s):  
Bipolar Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Schizoaffective Disorder ◽  
Psychiatric Symptoms ◽  
Psychotic Episode ◽  
Obsessive Compulsive ◽  
General Anxiety ◽  
Admission Rates ◽  
Clinical Benefits

Objective: The aim of this study to determine the prevalence of anxiety disorders in publically treated psychiatric inpatients with a DSM-IV diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder. Method: Using the Structured Clinical Interview for DSM-III-R (SCID), 100 consecutive inpatients with a psychotic disorder were examined for the presence or absence of an anxiety disorder. Questionnaire measures of phobias, obsessive-compulsive and general anxiety symptoms were also applied. Results: The prevalences of social phobia (17%), obsessiv-ompulsive disorder (13%) and generalised anxiety disorder in schizophrenia were relatively high, as were prevalences of obsessive-compulsive (30%) and panic disorder (15%) in bipolar disorder. The proportion of subjects with an anxiety disorder (4345%) was almost identical across the three psychoses, with some evidence of gender differences. Although self-ratings of overall psychiatric symptoms were significantly elevated in those with anxiety disorders, hospital admission rates were not. Conclusions: Almost none of those with anxíeGty disorders were being treated for them, primarily because the severity of the acute psychotic illness required full diagnostic and therapeutic attention. Patients were generally discharged as soon as their psychotic episode was resolved, with little recognition of the presence of an anxiety disorder. Given that anxiety disorders are relatively responsive to treatment, greater awareness of their comorbidity with psychosis should yield worthwhile clinical benefits.

scholarly journals Brief psychotic disorder associated with quarantine and mild COVID-19

2020 ◽  
Vol 13 (12) ◽  
pp. e240088
Author(s):  
Peter M Haddad ◽  
Majid Al Abdulla ◽  
Javed Latoo ◽  
Yousaf Iqbal
Keyword(s):  
Psychotic Disorder ◽  
Physical Symptoms ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Psychiatric Medication ◽  
Diagnostic And Statistical Manual ◽  
First Psychotic Episode ◽  
Episode Psychosis ◽  
Brief Psychotic Disorder

A 30-year-old man with no significant previous or family psychiatric history became severely anxious about his health after a positive COVID-19 test. Physical symptoms of COVID-19 were mild, with no evidence of hypoxia or pneumonia, throughout his illness. He was admitted to a quarantine facility. He remained highly anxious, and 1 week later, he developed paranoid delusions and auditory hallucinations (his first psychotic episode). He was treated with lorazepam 1 mg four times a day, mirtazapine 30 mg nocte and risperidone 1 mg two times a day. His psychotic symptoms lasted 1 week. He stopped psychiatric medication after 4 weeks and had remained well when reviewed 3 months later. A Diagnostic and Statistical Manual of Mental Disorders fifth edition diagnosis of brief psychotic disorder with marked stressor (brief reactive psychosis) was made. Anxiety about his health and social isolation appeared the main aetiological factors but an inflammatory component cannot be excluded. The case highlights that first episode psychosis can be associated with mild COVID-19.

scholarly journals Effects of Occupation-Based Intervention for Older People with Mild Dementia in the Institution

2021 ◽  
Vol 6 (16) ◽  
pp. 119-125
Author(s):  
Syamsul Anwar Sultan Ibrahim ◽  
Akehsan Dahlan ◽  
Ahmad Zamir Che Daud
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Cognitive Functions ◽  
Social Relationship ◽  
Publishing House ◽  
Control Group ◽  
Mild Dementia ◽  
People With Dementia ◽  
Significant Difference

Older people with dementia always experience the cognitive difficulties that are believed to impact their daily life significantly. However, information regarding occupation-based intervention toward older people with mild dementia in the institution is inconclusive. The results of this randomized controlled trial indicate a significant difference in cognitive functions, social relationship, and the quality of life. Participants in the experimental group improved significantly compared to the participants in the control group. Engagement in occupational activities should be encouraged to older people with mild dementia in institution to facilitate the cognitive functions, social relationship, and quality of life. Keywords: older people; mild dementia; occupation-based; quality of life eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v6i16.2727

scholarly journals Brain Volumetric Changes and Cognitive Functions in Epileptic Patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A Ashour ◽  
A M A Nassef ◽  
E M Awad ◽  
A M Hazzou ◽  
M A Nada ◽  
...  
Keyword(s):  
Cognitive Functions ◽  
Brain Volume ◽  
Control Group ◽  
Healthy Controls ◽  
Whole Brain ◽  
Significant Difference ◽  
Epileptic Patients ◽  
Generalized Epilepsy ◽  
Patients With Epilepsy ◽  
And Control

Abstract Background Epilepsy is a serious common neurological disorder that can affect any age. Cognitive functions are highly prevalent in patients with epilepsy and is more likely to occur in patients with idiopathic generalized epilepsy (IGE). Associations were found between cognitive functions and brain volume loss in patients with epilepsy. Objective This work was carried out to assess the volumetric changes in brain of epileptic patients to use it as a biomarker for cognitive dysfunction in adult and adolescent patients with epilepsy. Patients and Methods A case control study was conducted to include 61 patients, 20 of which diagnosed with idiopathic generalized epilepsy (IGE), 21 with temporal lobe epilepsy (TLE) and 20 with frontal lobe epilepsy (FLE) who were selected from the epilepsy outpatient clinic in Ain Shams university hospitals along with 23 age and sex matched healthy controls. Both cases and control groups were subjected to Magnetic resonance imaging MRI brain volumetry and detailed cognitive testing. An informed consent was taken from each adult patient, guardian of adolescent patient and healthy control. Results Statistically significant difference in comprehension subcategory of the Wechsler adult intelligence scale (WAIS) between patients with IGE and healthy controls denoting poorer social judgment in the IGE group. The IGE group also showed poorer performance in digit symbol subcategory of the same test denoting worse psychomotor speed and sustained attention. Also, significant difference in similarities subcategory was found between TLE group and control group denoting poorer abstract thinking among the TLE group. The IGE and TLE groups also showed lower attention and concentration than control group in the mental control subcategory of the Wechsler memory scale (WMS) yet failed to show superiority over each other. No statistically significant difference was found on comparing the whole brain volume between cases and control groups. A statistically significant direct relationship was found between the arithmetic subcategory of WAIS and the whole brain volume of the patients among the patients of the FLE group. Conclusion Patients with IGE had worse psychomotor speed, sustained attention and concentration than healthy controls in addition to poorer social judgment. Also, patients with TLE showed lower attention and concentration together with poorer abstract thinking despite normal IQ. The study also concluded that increased whole brain volume in patients with frontal lobe epilepsy is associated with better mathematical problem solving.

The relationship of emotion recognition with neuropsychological performance in patients with first episode psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. S190-S190
Author(s):  
A. Dardagani ◽  
E. Dandi ◽  
S. Tsotsi ◽  
M. Nazou ◽  
A. Lagoudis ◽  
...  
Keyword(s):  
Emotion Recognition ◽  
Visual Memory ◽  
Emotion Perception ◽  
First Episode ◽  
Psychotic Episode ◽  
Visuospatial Ability ◽  
Cognitive Domains ◽  
Neuropsychological Dysfunction ◽  
First Psychotic Episode ◽  
The Relationship

The relationship between neuropsychological dysfunction and emotion perception has been frequently noted in various studies. Attention, for example, has been found to play an important role in emotion processing and recognition. Not many studies though, have examined this relationship in first psychotic episode patients. The aim of the present study was to explore the nature of the relation between performance in cognitive tests and a test that measures emotion perception. In a sample of 46 first psychotic episode patients (22 male), we administered a comprehensive battery of neuropsychological non-verbal tests and an emotion recognition test. The cognitive domains of attention, memory, working memory, visuospatial ability and executive function were examined, by using specific tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). The emotion recognition assessment comprised a new test that includes 35 coloured pictures of individuals expressing six basic emotions (happiness, sadness, anger, disgust, surprise, fear) and a neutral emotion. We used partial correlation–controlling for the effect of age–and we found a statistically significant relationship between emotion recognition and overall cognitive performance. More specifically, attention, visual memory and visuospatial ability positively correlated with emotion recognition. In regard to specific cognitive domains, attention positively correlated with anger and fear, whereas visual memory correlated with happiness and fear. In conclusion, it seems that the role of underlying visual processes in emotion perception has to be further examined and evaluated in this group of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Agomelatine vs fluoxetine: Efficacy and improvement of cognitive functions in patients with MDD

2016 ◽  
Vol 33 (S1) ◽  
pp. S405-S405
Author(s):  
E. Aydın ◽  
M. Güleç ◽  
E. Oral ◽  
A.G. Daloğlu
Keyword(s):  
Cognitive Functions ◽  
Rating Scale ◽  
Word Association ◽  
Digit Span ◽  
Verbal Learning ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Neurocognitive Functions ◽  
Significant Difference ◽  
Competing Interest

IntroductionIn major depressive disorder (MDD) neurocognitive functions are impaired. In addition to melatonergic properties of agomelatine, via 5-HT2C antagonism it increases extracellular noradrenaline and dopamine in frontal cortex and may improve the neurocognitive functions of patients with MDD.Aims and objectivesTo investigate the extent of neurocognitive improvement and efficacy of agomelatine and fluoxetine in patients with MDD.Material and methodAgomelatine 25 mg/day (n: 24) and fluoxetine 20 mg/day (n: 24) were administered to drug-naive unipolar, non-psychotic, non-suicidal MDD patients according to DSM-IV. Evaluations were performed just before the treatment and at the sixth week of treatment via administering Hamilton Depression Rating Scale, Rey Auditory Verbal Learning Test, Controlled Oral Word Association Test (COWAT), Digit Span Test (DST), Trail Making Test (TMT-A/B), Stroop Test and Wisconsin Card Sorting Test.ResultsBoth agomelatine and fluoxetine was found to be efficacious for the treatment of MDD (P < 0.05 for both). Further there was no difference between the antidepressant efficacy of two drugs. Both of the drugs improved measured neurocognitive functions (P < 0.05), except scores of DST (P > 0.05) and only fluoxetine improved significantly scores of COWAT (P < 0.05). Only in terms of TMT-B there was significant difference between groups and agomelatine was superior to fluoxetine (P < 0.05).ConclusionAgomelatine and fluoxetine were efficacious in treatment of MDD. Furthermore both of the drugs improved cognitive functions in patients with MDD. Superiority of agomelatine in improvement of executive functioning (TMT-B) is important and therefore it could be an appropriate choice for MDD patients who have pronounced executive disturbances.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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.

First Psychotic Episode and Predictors of Bipolar Disorder Progression

2017 ◽  
Vol 41 (S1) ◽  
pp. S117-S117
Author(s):  
N. Halouani ◽  
K. Yaich ◽  
F. Guermazi ◽  
R. Ennaoui ◽  
S. Chouayekh ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychotic Disorders ◽  
Demographic Data ◽  
Psychotic Episode ◽  
Acute Psychosis ◽  
Evolutionary Potential ◽  
Prodromal Phase ◽  
Bipolar Mood Disorder ◽  
First Psychotic Episode ◽  
Competing Interest

IntroductionMany studies on the identification and early treatment of psychotic disorders have focussed less on a solution to the issue of the evolution of an acute psychosis.ObjectiveTo identify some predictive elements of an evolution to bipolar disorder during a first psychotic episode.MethodsWe proceed with a retrospective study concerning 55 patients having developed a first psychotic episode and admitted in the psychiatry B department during the period extending between January 2010 and December 2015. Data were collected on a predetermined questionnaire exploring the following items (socio-demographic data, personal and psychiatric family antecedent, prodromes and psychotic episode symptomatology).ResultsOur sample was composed by 55 patients divided into 74% (n = 41) men and 26% (n = 14) women with a mean age of 26.5 ± 6.27 years. The evolution to a bipolar mood disorder concerned 22% of patients. The prodromal phase was always present. Prodromes correlated with progression to bipolar disorder are: thymic symptoms 44.1% of patients (P = 0.001), modification of volition 42.9% (P = 0.05), anger/irritability 66.7% (P = 0.032) and sadness 83.3% of patients (P = 0.05). Psychotic episode's symptoms correlated with the evolution towards a bipolar disorder corresponded to thymic symptoms. The latter was present in 44.1% of patients (P = 0.01).ConclusionThrough our study, we were able to identify some factors positively correlated with a progression towards bipolarity during a first psychotic disorder. So it would be important to monitor closely and to educate our patients and their families about the evolutionary potential of a first psychotic episode.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Incidence of bipolar affective disorder in three UK cities

2005 ◽  
Vol 186 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Tuhina Lloyd ◽  
Noel Kennedy ◽  
Paul Fearon ◽  
James Kirkbride ◽  
Rosemarie Mallett ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Ethnic Groups ◽  
Bipolar Affective Disorder ◽  
Incidence Rates ◽  
First Episode ◽  
Minority Ethnic Groups ◽  
Incidence Studies ◽  
Significant Difference ◽  
Minority Ethnic

BackgroundThere has been a relative dearth of epidemiological research into bipolar affective disorder. Furthermore, incidence studies of bipolar disorder have been predominantly retrospective and most only included hospital admission cases.AimsTo determine the incidence of operationally defined bipolar disorder in three areas of the UK and to investigate any differences in gender and ethnicity.MethodAll patients who contacted mental health services with first-episode psychosis or non-psychotic mania between September 1997 and August 1999 were identified and diagnosed according to ICD–10 criteria. Incidence rates of bipolar affective disorder were standardised for age and stratified by gender and ethnic group across the three areas.ResultsThe incidence rate per 100 000 per year in south-east London was over twice that in Nottingham and Bristol. There was no significant difference in the rates of disorder in men and women. Incidence rates of bipolar disorder in the combined Black and minority ethnic groups in all three areas were significantly higher than those of the comparison White groups.ConclusionsThe incidence of bipolar disorder was higher in south-east London than in the other two areas, and was higher among Black and minority ethnic groups than in the White population.

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