Holmes–Rahe Social Readjustment Rating Scale and life events involving social defeat in first episode psychosis: preliminary results of a Delphi study

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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Service innovations

Psychiatric Bulletin ◽

10.1192/pb.27.4.148 ◽

2003 ◽

Vol 27 (4) ◽

pp. 148-151 ◽

Cited By ~ 1

Author(s):

Rahul Tomar ◽

Neil Brimblecombe ◽

Geraldine O'Sullivan

Keyword(s):

Rating Scale ◽

Diagnostic Category ◽

First Episode Psychosis ◽

Community Services ◽

Home Treatment ◽

First Episode ◽

Crisis Resolution ◽

Episode Psychosis ◽

Significant Difference ◽

At Home

Aims and MethodDemographic and clinical details were recorded for individuals with first-episode psychosis, potentially requiring hospital admission, who were assessed by two home treatment/crisis resolution teams over an 18-month period. The aims were to identify the proportion of such individuals that can be treated at home, factors associated with successful home treatment and reasons for hospitalisation when this took place.ResultsSuccessful home management was achieved in 20 (54%) of cases. No significant difference was found in any demographic variable, diagnostic category and initial Brief Psychiatric Rating Scale (BPRS) ratings between those who were hospitalised and those who were not. The most common reason recorded for admission was that of risk to self.Clinical ImplicationsMany patients with first-episode psychosis otherwise requiring hospitalisation can be managed successfully at home by an intensive home-treatment team. These findings have significant implications for both in-patient and community services, in view of the planned increases in home treatment/crisis resolution services proposed in the NHS Plan.

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O8.4. CORTICAL DOPAMINE RELEASE IN RESPONSE TO A COGNITIVE CHALLENGE: PRELIMINARY RESULTS IN FIRST EPISODE PSYCHOSIS AND CLINICAL HIGH RISK

Schizophrenia Bulletin ◽

10.1093/schbul/sbz021.236 ◽

2019 ◽

Vol 45 (Supplement_2) ◽

pp. S184-S184

Author(s):

Abanti Tagore ◽

Naren Rao ◽

Christin Schifani ◽

Huai-Hsuan Tseng ◽

Pablo Rusjan ◽

...

Keyword(s):

High Risk ◽

Dopamine Release ◽

First Episode Psychosis ◽

First Episode ◽

Clinical High Risk ◽

Preliminary Results ◽

Episode Psychosis ◽

Cognitive Challenge

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Trauma and Migration in First Episode Psychosis

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.067 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S66-S66

Author(s):

S. Tosato ◽

C. Bonetto ◽

I. Tarricone ◽

M. Ruggeri ◽

S. Tomassi ◽

...

Keyword(s):

Life Events ◽

Stressful Life Event ◽

First Episode Psychosis ◽

Stressful Life ◽

First Episode ◽

Targeted Prevention ◽

Biological Stress ◽

Increased Risk ◽

Episode Psychosis ◽

And Migration

IntroductionResearches show that the period of migration, or the migration process itself, may confer an increased risk for psychosis. Some studies have addressed whether the high rates of psychosis found in migrants could be due to higher genetic or environmental risk factors. Facing severe or chronic stress such as trauma, social isolation, low socio-economic status, late-life social adversity may result in long term, sometimes permanent, alterations of the biological stress response system, leading to the onset of psychosis.ObjectivesThis study aims to examine, in a large sample of first episode psychosis patients, whether negative social experiences like stressful life events and difficulties, trauma and isolation have significantly higher frequencies in migrants with respect to natives.MethodsThe present study is conducted within the framework of the EUGEI (European Network of National Schizophrenia Networks Studying Gene Environment Interactions) study, a Europe-wide incidence and case–control study of psychosis conducted in 12 centers chosen to include areas with large first and subsequent generation migrant populations.Data about age, gender, migration history, trauma, life events, ethnicity, social class and family history of mental disorders have been collected.ResultsPreliminary data on the relationship between trauma and migration in first episode psychosis will be presented.ConclusionsSince migration is an important stressful life event, and difficulties in integration in host countries may remain chronic, it is important to identify in each context the most vulnerable minority groups in order to implement targeted prevention interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Predicting 5-year outcome in first episode psychosis-construction of a prognostic rating scale

European Psychiatry ◽

10.1016/j.eurpsy.2008.01.785 ◽

2008 ◽

Vol 23 ◽

pp. S115

Author(s):

L. Flyckt ◽

M. Mattsson ◽

G. Edman ◽

R. Carlsson ◽

J. Cullberg

Keyword(s):

Rating Scale ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis

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Incidence of stressful life events and influence of sociodemographic and clinical variables on the onset of first-episode psychosis

Psychiatry Research ◽

10.1016/j.psychres.2016.08.030 ◽

2016 ◽

Vol 245 ◽

pp. 108-115 ◽

Cited By ~ 10

Author(s):

Anna Butjosa ◽

Juana Gómez-Benito ◽

Elena Huerta-Ramos ◽

Núria Del cacho ◽

Ana Barajas ◽

...

Keyword(s):

Life Events ◽

Stressful Life Events ◽

First Episode Psychosis ◽

Stressful Life ◽

First Episode ◽

Clinical Variables ◽

Episode Psychosis

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Service innovations

Psychiatric Bulletin ◽

10.1192/s0955603600001860 ◽

2003 ◽

Vol 27 (04) ◽

pp. 148-151

Author(s):

Rahul Tomar ◽

Neil Brimblecombe ◽

Geraldine O'Sullivan

Keyword(s):

Rating Scale ◽

Diagnostic Category ◽

First Episode Psychosis ◽

Community Services ◽

Home Treatment ◽

First Episode ◽

Crisis Resolution ◽

Episode Psychosis ◽

Significant Difference ◽

At Home

Aims and MethodDemographic and clinical details were recorded for individuals with first-episode psychosis, potentially requiring hospital admission, who were assessed by two home treatment/crisis resolution teams over an 18-month period. The aims were to identify the proportion of such individuals that can be treated at home, factors associated with successful home treatment and reasons for hospitalisation when this took place.ResultsSuccessful home management was achieved in 20 (54%) of cases. No significant difference was found in any demographic variable, diagnostic category and initial Brief Psychiatric Rating Scale (BPRS) ratings between those who were hospitalised and those who were not. The most common reason recorded for admission was that of risk to self.Clinical ImplicationsMany patients with first-episode psychosis otherwise requiring hospitalisation can be managed successfully at home by an intensive home-treatment team. These findings have significant implications for both in-patient and community services, in view of the planned increases in home treatment/crisis resolution services proposed in the NHS Plan.

Download Full-text