Neuroendocrine markers of high risk for psychosis: salivary testosterone in adolescent boys with prodromal symptoms

2011 ◽  
Vol 41 (9) ◽  
pp. 1815-1822 ◽  
Author(s):  
S. van Rijn ◽  
A. Aleman ◽  
L. de Sonneville ◽  
M. Sprong ◽  
T. Ziermans ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Age Of Onset ◽  
Early Adulthood ◽  
Total Sample ◽  
Psychotic Symptoms ◽  
Pubertal Stage ◽  
Prodromal Symptoms ◽  
Salivary Testosterone ◽  
Male Adolescents ◽  
Neuroendocrine Factors

BackgroundThe peak in age of onset of psychotic disorders such as schizophrenia during puberty and early adulthood suggests a relationship between the expression of psychopathology and the changes in the brain and body that take place during this dynamic maturational period, including a dramatic increase in circulating oestrogens and androgens. This study examined levels of salivary testosterone and oestradiol in adolescents with prepsychotic, prodromal symptoms, as this may mediate risk for psychosis by having an impact on brain development.MethodIn 21 male adolescents with prodromal symptoms and 21 male non-clinical controls levels of testosterone and oestradiol were measured in saliva. Tanner pubertal stage and prodromal symptoms were also assessed.ResultsLevels of testosterone were significantly lower in adolescents with prodromal symptoms as compared with non-clinical controls. No group differences in oestradiol were found. In the total sample, level of testosterone was significantly correlated with age and Tanner pubertal stage.ConclusionsOur observations are in line with current hypotheses stressing the role of neuroendocrine factors during adolescence in the expression of psychotic symptoms. From a developmental perspective, susceptibility to psychotic disorders increases during adolescence. Our data suggest that testosterone might, in part, mediate this increased vulnerability. Further research is needed to assess the mediating, neural, mechanisms through which testosterone may have an impact on the development of psychotic symptoms. In the search for early risk markers for psychosis, studying neuroendocrine factors might increase our understanding of ‘at-risk’ developmental pathways.

scholarly journals Relationship Pattern of Personality Disorder Traits in Major Psychiatric Disorders: A Cross-Sectional Study

2021 ◽  
pp. 025371762199953
Author(s):  
Bhavneesh Saini ◽  
Pir Dutt Bansal ◽  
Mamta Bahetra ◽  
Arvind Sharma ◽  
Priyanka Bansal ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Psychiatric Disorders ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Psychiatric Patients ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Sectional Study ◽  
Cross Sectional ◽  
Neurotic Disorders

Background: Normal personality development, gone awry due to genetic or environmental factors, results in personality disorders (PD). These often coexist with other psychiatric disorders, affecting their outcome adversely. Considering the heterogeneity of data, more research is warranted. Methods: This was a cross-sectional study on personality traits in psychiatric patients of a tertiary hospital, over 1 year. Five hundred and twenty-five subjects, aged 18–45 years, with substance, psychotic, mood, or neurotic disorders were selected by convenience sampling. They were evaluated for illness-related variables using psychiatric pro forma; diagnostic confirmation and severity assessment were done using ICD-10 criteria and suitable scales. Personality assessment was done using the International Personality Disorder Examination after achieving remission. Results: Prevalence of PD traits and PDs was 56.3% and 4.2%, respectively. While mood disorders were the diagnostic group with the highest prevalence of PD traits, it was neurotic disorders for PDs. Patients with PD traits had a past psychiatric history and upper middle socioeconomic status (SES); patients with PDs were urban and unmarried. Both had a lower age of onset of psychiatric illness. Psychotic patients with PD traits had higher and lower PANSS positive and negative scores, respectively. The severity of personality pathology was highest for mixed cluster and among neurotic patients. Clusterwise prevalence was cluster C > B > mixed > A (47.1%, 25.2%, 16.7%, and 11.4%). Among subtypes, anankastic (18.1%) and mixed (16.7%) had the highest prevalence. Those in the cluster A group were the least educated and with lower SES than others. Conclusions: PD traits were present among 56.3% of the patients, and they had many significant sociodemographic and illness-related differences from those without PD traits. Cluster C had the highest prevalence. Among patients with psychotic disorders, those with PD traits had higher severity of psychotic symptoms.

Age of onset of mental disorders and use of mental health services: needs, opportunities and obstacles

2011 ◽  
Vol 21 (1) ◽  
pp. 47-57 ◽  
Author(s):  
G. de Girolamo ◽  
J. Dagani ◽  
R. Purcell ◽  
A. Cocchi ◽  
P. D. McGorry
Keyword(s):  
Early Intervention ◽  
Mental Disorders ◽  
Transition To Adulthood ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Early Stage ◽  
Early Adulthood ◽  
Special Focus ◽  
Long Term Effects ◽  
Health Services Needs

Purpose of review.In this review, we provide an update of recent studies on the age of onset (AOO) of the major mental disorders, with a special focus on the availability and use of services providing prevention and early intervention.Recent findings.The studies reviewed here confirm previous reports on the AOO of the major mental disorders. Although the behaviour disorders and specific anxiety disorders emerge during childhood, most of the high-prevalence disorders (mood, anxiety and substance use) emerge during adolescence and early adulthood, as do the psychotic disorders. Early AOO has been shown to be associated with a longer duration of untreated illness, and poorer clinical and functional outcomes.Summary.Although the onset of most mental disorders usually occurs during the first three decades of life, effective treatment is typically not initiated until a number of years later. There is increasing evidence that intervention during the early stages of disorder may help reduce the severity and/or the persistence of the initial or primary disorder, and prevent secondary disorders. However, additional research is needed on effective interventions in early-stage cases, as well as on the long-term effects of early intervention, and for an appropriate service design for those with emerging mental disorders. This will mean not only the strengthening and re-engineering of existing systems, but is also crucial the construction of new streams of care for young people in transition to adulthood.

scholarly journals M26. CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT OFFSPRING OF PATIENTS DIAGNOSED WITH SCHIZOPHERNIA: A COMPARATIVE STUDY WITH ADHD CHILDREN

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S143-S144
Author(s):  
Elena De la Serna ◽  
Gisela Sugranyes ◽  
Daniel Ilzarbe ◽  
Patricia Camprodon ◽  
Inmaculada Baeza ◽  
...  
Keyword(s):  
Psychosocial Functioning ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Child And Adolescent ◽  
Psychotic Symptoms ◽  
Adhd Group ◽  
Mixed Effect ◽  
Prodromal Symptoms ◽  
Adolescent Offspring ◽  
History Of

Abstract Background Recent studies have observed high rates of psychopathology in child and adolescent offspring of patients with schizophrenia (SZoff). Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent psychopathology in SZoff (Sanchez-Gistau, et al., 2015). The high prevalence of ADHD observed in SZoff can conceal the vulnerability characteristics specific to schizophrenia. The aim of this study is to analyze the clinical characteristics of a sample of child and adolescent SZoff diagnosed with ADHD (SZoff-ADHD) compared to a sample of children with ADHD without a family history of psychotic disorders and a sample of healthy controls. We hypothesize that SZoff-ADHD will show more psychopathology and more prodromal psychotic symptoms than the other two groups. Methods we studied a sample of 22 SZoff-ADHD children, 15 children with ADHD with no familiar history of psychotic disorders and 40 healthy controls (HC) between 6 and 17 years old and we conducted a complete clinical assessment which included: Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Structured interview for Prodromal Symptoms (SOPS) and Global Assessment Functioning (GAF). In order to detect significant differences between groups, multilevel mixed-effect logistic regression models (categorical variables) or multilevel mixed-effect linear regression models (continuous variables) were performed with group as the fixed factor and the fact of having a sibling in the same study (identified by the family number) as the random variable. Results significant differences between groups were found in socio-economic status which was lower in the SZoff-ADHD group than in the other two groups (F=15.886; p<0.001). Moreover the SZoff-ADHD also showed a higher percentage of males (90.9%) compared with the ADHD group (62.5%) and the HC (45%) (F=12.647; p=0.002). No significant age differences between groups were detected. Regarding clinical assessments, the SZoff-ADHD group showed a higher percentage of conduct disorders (F=3.720; p=0.039) than the ADHD group. No significant differences were observed in other psychopathological diagnoses. Furthermore the SZoff-ADHD group also obtained higher scores than the HC group on the following scales: YMRS, positive, negative, general and total sub-scales of the SOPS and lower scores in the GAF. The ADHD group obtained significantly higher scores than the HC group in the sub-scale of SOPS general prodromal symptoms and lower scores on the GAF. Significant differences were detected between SZoff-ADHD and ADHD in the YMRS and the positive and negative sub-scales of the SOPS where the SZoff-ADHD group showed higher scores than the ADHD group. Discussion Compared with the HC group, the SZoff-ADHD displayed more manic, prodromal psychotic symptoms and worse psychosocial functioning. The ADHD group showed an intermediate pattern between the SZoff-ADHD and the HC group, with more general prodromal symptoms and lower psychosocial functioning than the HC group but lower scores than the SZoff-ADHD in the psychotic prodromal symptoms interview.

scholarly journals The Influence of Mental Health Literacy, Migration, and Education on the Duration of Untreated Psychosis

2021 ◽  
Vol 9 ◽  
Author(s):  
Naomi Takizawa ◽  
Ingrid Melle ◽  
Elizabeth Ann Barrett ◽  
Mari Nerhus ◽  
Akiah A. Ottesen
Keyword(s):  
Mental Health ◽  
Health Literacy ◽  
Mental Health Literacy ◽  
Psychotic Disorders ◽  
Mental Health Problems ◽  
Age Of Onset ◽  
Clinical Information ◽  
Independent Effect ◽  
Psychotic Symptoms ◽  
Duration Of Untreated Psychosis

Background: Duration of untreated psychosis (DUP) is associated with outcome in psychotic disorders and influenced by contextual factors such as immigration. Here we aimed to investigate the effect of mental health literacy (MHL) on duration of untreated psychosis considering the influence of migration and education.Methods: A total of 269 participants who received their first adequate medical treatment for a psychotic disorder within the current or past year were included to the Thematically Organized Psychosis study in Oslo, Norway. Sociodemographic and clinical information was collected through systematic interviews. MHL was measured as “recognition of psychotic symptoms” and assessed by “The Attitudes and Beliefs about Mental Health Problems” schizophrenia version. Influence of education, migration and MHL on DUP was analyzed with hierarchical block-wise multiple regression analysis.Results: Recognition of psychotic symptoms explained a small but unique variance (2.3%) in DUP after the effects of other important predictors were controlled for. Longer DUP was also associated with less education, lower premorbid social, and academic functioning, a diagnosis within schizophrenia spectrum disorder, and earlier age of onset. The model explained 26% of variance in DUP. Migration after the age of six and length of education were associated with MHL but did not have a significant interaction with MHL in predicting DUP.Conclusions: MHL, measured as recognition of psychotic symptoms, has a small but significant independent effect on DUP. The effect of MHL was larger than years of education and migration history, and did not interact with either, in predicting DUP. This suggests that MHL is an independent factor in prevention strategies for early psychosis.

First-Episode Psychosis in the Military: A Comparative Study of Prodromal Symptoms

2001 ◽  
Vol 35 (4) ◽  
pp. 512-519 ◽  
Author(s):  
Hao-Yang Tan ◽  
Yong-Guan Ang ◽  
Hao-Yang Tan ◽  
Yong-Guan Ang
Keyword(s):  
Sleep Disturbance ◽  
Depressed Mood ◽  
Psychotic Disorders ◽  
Social Withdrawal ◽  
Young Patients ◽  
First Episode Psychosis ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Prodromal Symptoms ◽  
Episode Psychosis

Objective: The objective of this study is to provide a retrospective description of prodromal symptoms of young military servicemen with first-episode psychosis, and a comparison with first-episode non-psychotic disorders. Method: Thirty consecutive servicemen presenting with first-episode psychosis were studied. Thirty-four randomly selected servicemen from 123 with non-psychotic disorders served as comparison. A combination of unstructured and semistructured interviews with the patient and other informants was used to describe the prodromal symptoms. Results: The most common prodromal psychotic symptoms were social withdrawal (83%); anxiety (77%); sleep disturbance (77%); disturbance in attention, concentration or memory (73%); deterioration in studies in school (70%); depressed mood (63%); odd behaviour (53%); and anger or irritability (53%). Common symptoms found in first-episode psychosis and non-psychotic patients included sleep disturbance, anxiety, depressed mood and anger or irritability. Common symptoms that were associated with the psychotic prodrome were social withdrawal (p < 0.001), deterioration in school results (p < 0.001) and disturbance in attention, concentration or memory (p < 0.001). The psychotic prodrome was also associated with apathy (p < 0.001), odd behaviour (p < 0.001), doing nothing (p = 0.004) and thought blocking (p = 0.04). Conclusion: Cognitive disturbances and attenuated negative symptoms appear to be more specific to the psychotic prodrome in young patients with first-episode psychosis.

35 A case of topiramate induced psychosis in a patient treated for seizure disorder and comprehensive literature review

2020 ◽  
Vol 91 (8) ◽  
pp. e22.2-e22
Author(s):  
Michael Heinz ◽  
Karissa Tauber ◽  
William Schleyer ◽  
William Keller
Keyword(s):  
Literature Review ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Case Reports ◽  
Psychiatric Inpatient ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
Current Case ◽  
Comprehensive Literature Review ◽  
Pubmed Database

Objectives/aimsThe objective of this paper is to present a case report of a patient with what we believe to be topiramate-induced psychosis. We also aim to persuade the reader to consider such a diagnosis in the differential of patients like ours. We present a comprehensive literature review of other similar cases, as well as a possible mechanism by which topiramate causes psychosis.MethodsWe reviewed the patient‘s chart in our electronic medical record and we conducted review of current case reports documenting associations between antiepileptic medications and psychosis. We used the PubMed database, using search terms ‘psychotic disorders,’ ‘hallucinations,’ ‘delusions,’ ‘psychosis’ in conjunction with ‘topiramate,’ ‘Topamax,’ ‘anti-seizure medication,’ ‘anti-epileptic medication.’ResultsWe present the case of a 66 year old woman admitted to the psychiatric inpatient unit for management of severe, recent onset psychotic delusions and hallucinations. Prior to this psychotic episode, she had no known psychiatric history and had functioned independently at home. The patient was recently transitioned to topiramate 100 mg BID for migraines and seizures, the latter of which had started after traumatic subdural hematoma 9 years prior. The patient had an extensive medical work-up on the inpatient psychiatry unit, including head imaging, EEG, and lab tests, all of which were non-contributory. She was started on risperidone and showed little improvement. At the recommendation of neurology, topiramate was discontinued in favor of an alternative antiepileptic. With discontinuation of topiramate, the patient had almost complete resolution of psychotic symptoms. She was discharged home.ConclusionTopiramate-induced psychosis should be considered in patients being treated with topiramate who present with psychosis. Special consideration of this diagnosis should be made in patients like ours, in whom older age of onset makes primary psychotic illness less likely. Continued study in this area will be necessary to definitely establish a causal relationship and identify the mechanism of this phenomenon.

scholarly journals Epidemiology of Psychotic Disorders Based on Demographic Variables in Iranian Children and Adolescents

2021 ◽  
Author(s):  
Seyyed Salman Alavi ◽  
Mohammad Reza Mohammadi ◽  
Zahra Hooshyar ◽  
Soroush Mohammadi Kalhori ◽  
Mona Salehi ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Rural Areas ◽  
Psychotic Disorders ◽  
Total Sample ◽  
Demographic Variables ◽  
Psychotic Symptoms ◽  
Cluster Sampling ◽  
Logistic Regression Method ◽  
Urban And Rural Areas ◽  
Iranian Children

Objective: Psychosis is still among the most debilitating and severe mental disorders. The main objective of the present study was to investigate the estimated prevalence of psychotic disorders and finding the main predictors of psychotic disorders among Iranian children and adolescents. Method: Our total sample consisted of 30 553 individuals (49% males and 51%females) from 30 provinces of Iran, aged between 6 and 18 years, who were selected via cluster sampling method from urban and rural areas of all provinces. The data were analyzed using descriptive statistical analysis and multiple logistic regression method. Results: The results of multiple regression analysis showed that prevalence estimate of psychotic disorders was 0.25%. It was 0.3% and 0.2% in males and females, respectively. The age of 10-14 (OR = 2.24; 95% CI, 1.11-4.55) and the age of 15-18 (OR = 3.42; 95% CI, 1.74-6.75) were significant positive predictors, whereas none of the demographic variables were predictors for psychotic symptoms. Conclusion: This research highlights the main predictors of psychosis in children and adolescents. The study design also allowed a better understanding of predictors of psychotic disorders. The assessment of the prevalence

Psychosocial Risks and Management for Children and Adolescents With 22q11.2 Deletion Syndrome

2019 ◽  
Vol 4 (4) ◽  
pp. 633-640 ◽  
Author(s):  
Canice E. Crerand ◽  
Ari N. Rabkin
Keyword(s):  
Cognitive Abilities ◽  
Psychotic Disorders ◽  
Developmental Stages ◽  
Early Adulthood ◽  
22Q11.2 Deletion Syndrome ◽  
Deletion Syndrome ◽  
22Q11.2 Deletion ◽  
Psychosocial Risks ◽  
Empirically Supported ◽  
Specific Education

Purpose This article reviews the psychosocial risks associated with 22q11.2 deletion syndrome, a relatively common genetic condition associated with a range of physical and psychiatric problems. Risks associated with developmental stages from infancy through adolescence and early adulthood are described, including developmental, learning, and intellectual disabilities as well as psychiatric disorders including anxiety, mood, and psychotic disorders. Other risks related to coping with health problems and related treatments are also detailed for both affected individuals and their families. Conclusion The article ends with strategies for addressing psychosocial risks including provision of condition-specific education, enhancement of social support, routine assessment of cognitive abilities, regular mental health screening, and referrals for empirically supported psychiatric and psychological treatments.

Effect of Marriage on Pre-existing Psychoses: A Convenient or Futile Solution for Severe Mental Disorders?

2020 ◽  
Vol 2 (3-4) ◽  
pp. 273-276
Author(s):  
Prakash B. Behere ◽  
Aniruddh P. Behere ◽  
Debolina Chowdhury ◽  
Amit B. Nagdive ◽  
Richa Yadav
Keyword(s):  
Mental Disorders ◽  
Age Of Onset ◽  
Social Stigma ◽  
Positive Family History ◽  
Mental Illnesses ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Contractual Relationship ◽  
History Of ◽  
Paranoid Type

Marriage can be defined as the state of being united as spouses in a consensual and contractual relationship recognized by law. The general population generally believes marriage to be a solution to mental illnesses. It can be agreed that mental disorders and marital issues have some relation. Parents of patients with psychoses expect that marriage is the solution to the illness and often approach doctors and seek validation about the success of the marriage of their mentally ill child, which is a guarantee no doctor can give in even normal circumstances. Evidence on sexual functioning in patients of psychosis is limited and needs further understanding. Studies show about 60%–70% women of the schizophrenia spectrum and illness to experience sexual difficulties. Based on available information, sexual dysfunction in population with psychosis can be attributed to a variety of psychosocial factors, ranging from the psychotic symptoms in itself to social stigma and institutionalization and also due to the antipsychotic treatment. Despite the decline in sexual activity and quality of life in general, it is very rarely addressed by both the treating doctor and by the patient themselves hence creating a lacuna in the patient’s care and availability of information regarding the illness’ pathophysiology. Patients become noncompliant with medications due to this undesirable effect and hence it requires to be given more attention during treatment. It was also found that paranoid type of schizophrenia patient had lower chances of separation than patients with other types of schizophrenia. The risk of relapse in cases with later age of onset of the disease, lower education, a positive family history of psychosis or a lower income increased more than other populations.

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