Psychosis prevalence and physical, metabolic and cognitive co-morbidity: data from the second Australian national survey of psychosis

BackgroundThere are insufficient data from nationwide surveys on the prevalence of specific psychotic disorders and associated co-morbidities.MethodThe 2010 Australian national psychosis survey used a two-phase design to draw a representative sample of adults aged 18–64 years with psychotic disorders in contact with public treatment services from an estimated resident population of 1 464 923 adults. This paper is based on data from 1642 participants with an International Classification of Diseases (ICD)-10 psychotic disorder. Its aim is to present estimates of treated prevalence and lifetime morbid risk of psychosis, and to describe the cognitive, physical health and substance use profiles of participants.ResultsThe 1-month treated prevalence of psychotic disorders was 3.10 cases per 1000 population aged 18–64 years, not accounting for people solely accessing primary care services; lifetime morbid risk was 3.45 per 1000. Mean premorbid intelligence quotient was approximately 0.5 s.d.s below the population mean; current cognitive ability (measured with a digit symbol coding task) was 1.6 s.d.s below the population mean. For both cognitive tests, higher scores were significantly associated with better independent functioning. The prevalence of the metabolic syndrome was high, affecting 60.8% of participants, and pervasive across diagnostic groups. Of the participants, two-thirds (65.9%) were current smokers, 47.4% were obese and 32.4% were sedentary. Of the participants, half (49.8%) had a lifetime history of alcohol abuse/dependence and 50.8% lifetime cannabis abuse/dependence.ConclusionsOur findings highlight the need for comprehensive, integrative models of recovery to maximize the potential for good health and quality of life for people with psychotic illness.

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Clinical manifestations in patients with acute and transient psychosis

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1303 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S363-S364

Author(s):

Á. López Díaz ◽

A. Soler Iborte ◽

S. Galiano Rus ◽

J.L. Fernández González ◽

J.I. Aznarte López

Keyword(s):

Psychotic Disorder ◽

Psychotic Disorders ◽

Clinical Manifestations ◽

Retrospective Chart Review ◽

International Classification Of Diseases ◽

Exact Test ◽

Chi Squared ◽

Classification Of Diseases ◽

Icd 10 ◽

Competing Interest

IntroductionThe term, acute and transient psychosis, is comprehended as a heterogeneous group of disorders, which share, as a common feature, the abrupt and brief deployment of typical psychotic behaviour, either polymorph, delusional, or schizophreniform. This diversity of symptoms may also be present in other psychotic disorders, for which, some authors question its reliability.ObjetiveTo analyse the clinical manifestations present in acute and transient psychotic disorders (ATPD), and determine the differences between its different subcategories.MethodRetrospective chart review study of adult patients admitted in our psychiatric unit between 2011 and 2015, with a mean diagnosis of ATPD at hospital discharge. Diagnostic criteria was according to the International Classification of Diseases (ICD-10). Symptoms were divided under operative procedures, as set out in psychopatologic descriptions. For methodological reasons, statistical analysis was conducted between polymorphic features group (PM) and nonpolymorphic group (NPM). Chi-squared test and Fisher's exact test (as appropriate) were performed, using MedCalc software.ResultsThirty-nine patients met the inclusion criteria. Acute polymorphic psychotic disorder with and without symptoms of schizophrenia (39%), acute schizophrenia-like psychotic disorder (20%), acute predominantly delusional psychotic disorder (23%), other and NOS (18%). There were statistically significant differences between PM and NPM groups in emotional turmoil (>PM, P = 0.0006), grossly disorganized or abnormal motor behaviour (>PM, P = 0.0038), and type of onset (sudden >PM, P = 0.0145).ConclusionCurrently, the same concept encompasses two categories (PM and NPM) to be differentiated. The ATPD construct is under review, due its long-term instability.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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A case of acute and transient psychosis–What to expect?

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1306 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S364-S365

Author(s):

M. Oliveira ◽

J. Rebelo ◽

A.S. Costa ◽

C. Santos

Keyword(s):

Psychotic Disorders ◽

Fast Response ◽

International Classification Of Diseases ◽

Acute Onset ◽

Antipsychotic Treatment ◽

Duration Of Treatment ◽

Diagnostic Stability ◽

Affective Symptoms ◽

Classification Of Diseases ◽

Competing Interest

IntroductionThe Tenth Revision of the International Classification of Diseases (ICD-10) introduced the category of Acute and transient psychotic disorders (ATPD), that assimilate clinical concepts such as the French Bouffée Délirante, Kleist and Leonhard's cycloid psychosis, and the scandinavian reactive psychosis.Methods and aimsThe authors present a clinical case of ATPD and a literature review based on PubMed/MEDLINE, using the keywords: “acute and transient psychotic disorder”, “prognosis” and “diagnostic stability”, aiming to discuss the main challenges regarding the diagnosis, treatment and prognosis.ResultsThe patient is a male with 37 years old with two previous psychotic episodes (with 2.5 years of interval), both with an acute onset (of 7 and 3 days respectively), and a fast response to antipsychotic treatment, with periods of complete symptom's remission. He maintains treatment with 6 mg of paliperidone. In the literature, we found scarce information on ATPD. Though several variables have been described as having influence on the prognosis (gender, pre-morbid functioning, acute onset and presence of affective symptoms), this topic remains controversial. Another difficult aspect about ATPD seems to be its low diagnostic stability, with diagnosis changing mostly to Schizophrenia, Schizoaffective disorder and Bipolar disorder. Duration of treatment after complete remission of symptoms is another controversial aspect of this disease.ConclusionsATPD seems to have low diagnostic stability and poor research investment, and so it represents a challenge for psychiatrists on managing these patients in terms of treatment and follow-up plan. Further studies should be held regarding prognosis and treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Study of psychiatric disorders among nepalese patients working abroad and their family members

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v6i4.6718 ◽

2012 ◽

Vol 6 (4) ◽

pp. 1-6

Author(s):

B Yengkokpam ◽

SK Shah ◽

GR Bhantana

Keyword(s):

Psychiatric Disorders ◽

Psychotic Disorders ◽

Somatoform Disorders ◽

Bipolar Affective Disorder ◽

Family Members ◽

International Classification Of Diseases ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Classification Of Diseases ◽

Icd 10

This study was carried out among the patients working abroad and their family members, having various psychiatric disorders. 80 patients attending psychiatry OPD between the age of 15 to 65 years both male and female in the period of July 2009 to July 2010 were included. The results were tabulated as per the diagnostic criteria of International Classification of Diseases (ICD-10). Out of total 80 patients, 41 were males and 39 were females, whose husbands were working abroad. 30 cases were of depression,out of which 16 were males and 14 were females.18 cases were having anxiety disorders out of which 5 were males and 13 were females. 12 cases were suffering from psychotic disorders out of which 10 were males and 2 were females.7 cases were having dissociative disorders with 1 male and 6 females.4 cases were having somatoform disorders with 2 males and 2 females.1 male and 1 female were suffering from mania.1 male and 1 female were suffering from bipolar affective disorder. 2 males were alcohol dependent and 2 males were having obsessive compulsive disorder. 1 male was having organic psychosis. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 1-6 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6718

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Validation of intellectual disability coding through hospital morbidity records using an intellectual disability population-based database in Western Australia

BMJ Open ◽

10.1136/bmjopen-2017-019113 ◽

2018 ◽

Vol 8 (1) ◽

pp. e019113 ◽

Cited By ~ 6

Author(s):

Jenny Bourke ◽

Kingsley Wong ◽

Helen Leonard

Keyword(s):

Intellectual Disability ◽

International Classification Of Diseases ◽

Population Based ◽

Reliable Source ◽

Morbidity Data ◽

Classification Of Diseases ◽

Data Source ◽

Hospital Morbidity ◽

Western Australian ◽

Hospital Morbidity Data

ObjectivesTo investigate how well intellectual disability (ID) can be ascertained using hospital morbidity data compared with a population-based data source.Design, setting and participantsAll children born in 1983–2010 with a hospital admission in the Western Australian Hospital Morbidity Data System (HMDS) were linked with the Western Australian Intellectual Disability Exploring Answers (IDEA) database. The International Classification of Diseases hospital codes consistent with ID were also identified.Main outcome measuresThe characteristics of those children identified with ID through either or both sources were investigated.ResultsOf the 488 905 individuals in the study, 10 218 (2.1%) were identified with ID in either IDEA or HMDS with 1435 (14.0%) individuals identified in both databases, 8305 (81.3%) unique to the IDEA database and 478 (4.7%) unique to the HMDS dataset only. Of those unique to the HMDS dataset, about a quarter (n=124) had died before 1 year of age and most of these (75%) before 1 month. Children with ID who were also coded as such in the HMDS data were more likely to be aged under 1 year, female, non-Aboriginal and have a severe level of ID, compared with those not coded in the HMDS data. The sensitivity of using HMDS to identify ID was 14.7%, whereas the specificity was much higher at 99.9%.ConclusionHospital morbidity data are not a reliable source for identifying ID within a population, and epidemiological researchers need to take these findings into account in their study design.

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Obsessive-Compulsive Spectrum Phenomena and the DSM-V Developmental Process

CNS Spectrums ◽

10.1017/s1092852900016229 ◽

2008 ◽

Vol 13 (2) ◽

pp. 107-108 ◽

Cited By ~ 6

Author(s):

Eric Hollander

Keyword(s):

Psychotic Disorders ◽

Developmental Process ◽

International Classification Of Diseases ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Diagnostic And Statistical Manual ◽

Dsm V ◽

Classification Of Diseases ◽

Psychotic Features

Several of this month's articles and interviews touch on themes that relate to spectrum phenomena as well as the Diagnostic and Statistical Manual of Mental Disorders developmental process.First, Darrel A. Regier, MD, MPH, director of the Division of Research at American Psychiatric Association, discusses, in an interview with CNS Spectrums, the developmental process for DSM-V. He emphasizes the use of dimensional measures to determine both thresholds for disorders, and to assess response to treatments. He also highlights a focus on spectra of disorders that cut across traditional diagnostic boundaries as one way to deal with issues of comorbidity. Finally, he discusses new approaches to the five DSM axes, and the need to link together the DSM and International Classification of Diseases processes. Three other articles in this issue also clearly relate to these obsessive-compulsive spectra issues.For example, Leonardo F. Fontenelle, MD, PhD, describes how, although much attention has been paid to patients who lack insight into their obsessional beliefs, less importance has been given to individuals with obsessive-compulsive disorder (OCD) who display perceptual disturbances typically found in psychotic disorders, including schizophrenia, schizoaffective disorders, or mood disorders with psychotic features. The authors call attention to a phenomenon that has been neglected in the psychiatric literature (ie, the occurrence of hallucinations and related phenomena in patients with OCD). They describe five patients with OCD with hallucinations in several different sensory modalities, including the auditory, the visual, the tactile, the olfactory, and the cenesthetic modalities, and suggest that further psychopathological research should clarify the clinical significance of hallucinations among patients with OCD.

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P01-246-3Q29 case-control association study of co-morbid migraine in bipolar affective disorder

European Psychiatry ◽

10.1016/s0924-9338(11)71957-5 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 247-247

Author(s):

M. Schmoeger ◽

S. Cohen-Woods ◽

G. Hosang ◽

M. Schloegelhofer ◽

I. Craig ◽

...

Keyword(s):

Association Study ◽

Affective Disorder ◽

Bipolar Affective Disorder ◽

International Classification Of Diseases ◽

Case Control ◽

Genome Wide ◽

A Genome ◽

Co Morbidity ◽

Classification Of Diseases ◽

Operational Criteria

According to Oedegaard et al. (2010) the co-morbidity of migraine and bipolar disorder (BPD) is well documented in numerous epidemiological and clinical studies, and there are clear pathophysiological similarities. Interestingly, in a genome-wide scan, Lea et al. (2005) identified a susceptibility locus for a severe heritable form of common migraine on chromosome 3q29. With respect to BPD, a susceptibility region on chromosome 3q29 was identified in a genome-wide linkage scan (Bailer et al. 2002) and follow-up linkage analysis (Schosser et al. 2004). These findings were also supported by further fine-mapping of this region (Schosser et al. 2007). Since 3q29 is among the chromosomal regions implicated in migraine and bipolar linkage studies, the aim of the current study is to test for 3q29 association of migraine in sample of patients with BPD. The sample consists of 463 patients with a diagnosis of BPD (34.63% men, 65.37% women; mean age ± SD: 48.01 ± 11.26), as defined by the Diagnostic and Statistical Manual 4th edition operational criteria (DSM-IV) and the International Classification of Diseases 10th edition operational criteria (ICD-10), derived from the Bipolar Affective Disorder Case Control Study (BACCS). A total of 51 SNPs in the region of the 3q29 were genotyped using Sequenom MassARRAY® iPLEX Gold and tested for association with migraine. The results of this association study investigating the 3q29 region in a sample of patients with BPD will be presented.

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Long-Term Study about the Incidence of Epilepsy in Male Service Personnel from India: A Retrospective, Cohort Study

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0039-1700792 ◽

2019 ◽

Vol 10 (04) ◽

pp. 588-591

Author(s):

Pawan Dhull ◽

S. K. Patnaik ◽

Manoj Somasekharan ◽

K. V. S Hari Kumar

Keyword(s):

Incidence Rate ◽

Good Health ◽

International Classification Of Diseases ◽

Service Personnel ◽

Long Term Study ◽

Active Service ◽

Classification Of Diseases ◽

Alcohol Dependence Syndrome ◽

Patients With Epilepsy

Abstract Background The data on the epidemiology of epilepsy are limited for developing countries including India. We estimated the incidence of epilepsy in a cohort of service personnel from India followed for over two decades. Materials and Methods The data for this epidemiological study were derived from the electronic medical records (EMRs) of the male service personnel. The participants (age < 18 years) were enrolled into active service between 1990 and 2015 in good health. The data pertaining to the diagnosis of epilepsy were derived from the EMR using the prevalent International Classification of Diseases codes. We calculated the incidence rate as per person-years (py) using appropriate statistical methods. Results Our data included 51,217 participants (median age: 33 years, range: 17–54) with a mean follow-up of 12.5 years, giving a cumulative follow-up duration of 613,925 py. A total of 291 patients developed epilepsy during the study, giving an incidence rate of 0.47 per 1000 py (95% confidence interval: 0.42–0.53). Undifferentiated spondyloarthropathy, central nervous system disorders, and alcohol dependence syndrome were the common comorbid ailments in patients with epilepsy. Conclusion Our cohort had a comparable incidence rate of epilepsy with other studies from India and abroad.

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Symptom rating scales for schizophrenia and other primary psychotic disorders in ICD-11

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796017000270 ◽

2017 ◽

Vol 27 (3) ◽

pp. 219-224 ◽

Cited By ~ 8

Author(s):

J. W. Keeley ◽

W. Gaebel

Keyword(s):

Negative Symptoms ◽

Rating Scales ◽

Psychotic Disorders ◽

Rating Scale ◽

Field Testing ◽

International Classification Of Diseases ◽

Severity Rating ◽

Classification Of Diseases ◽

The Cost ◽

Symptom Rating

The subtype system for categorising presentations of schizophrenia will be removed from International Classification of Diseases 11th Revision. In its place will be a system for rating six domains of psychotic disorder pathology: positive symptoms, negative symptoms, depressive symptoms, manic symptoms, psychomotor symptoms and cognitive symptoms. This paper outlines the rationale and description of the proposed symptom rating scale, including current controversies. In particular, the scale could adopt either a 4-point severity rating or a 2-point presence/absence rating. The 4-point scale has the advantage of gathering more information, but potentially at the cost of reliability. The paper concludes by describing the field testing process for evaluating the proposed scale.

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Risk of dementia associated with psychotic disorders in later life: the health in men study (HIMS)

Psychological Medicine ◽

10.1017/s003329171800065x ◽

2018 ◽

Vol 49 (2) ◽

pp. 232-242 ◽

Cited By ~ 5

Author(s):

Osvaldo P. Almeida ◽

Andrew H. Ford ◽

Graeme J. Hankey ◽

Bu B. Yeap ◽

Jonathan Golledge ◽

...

Keyword(s):

Psychotic Disorder ◽

Psychotic Disorders ◽

Age Of Onset ◽

Bipolar Disorders ◽

Later Life ◽

International Classification Of Diseases ◽

Renal Diseases ◽

Increased Risk ◽

Clinical Diagnoses ◽

Classification Of Diseases

AbstractBackgroundRecent research has identified several potentially modifiable risk factors for dementia, including mental disorders. Psychotic disorders, such as schizophrenia and delusional disorder, have also been associated with increased risk of cognitive impairment and dementia, but currently available data difficult to generalise because of bias and confounding. We designed the present study to investigate if the presence of a psychotic disorder increased the risk of incident dementia in later life.MethodsProspective cohort study of a community-representative sample of 37 770 men aged 65–85 years who were free of dementia at study entry. They were followed for up to 17.7 years using electronic health records. Clinical diagnoses followed the International Classification of Diseases guidelines. As psychotic disorders increase mortality, we considered death a competing risk.ResultsA total of 8068 (21.4%) men developed dementia and 23 999 (63.5%) died during follow up. The sub-hazard ratio of dementia associated with a psychotic disorder was 2.67 (95% CI 2.30–3.09), after statistical adjustments for age and prevalent cardiovascular, respiratory, gastrointestinal and renal diseases, cancer, as well as hearing loss, depressive and bipolar disorders, and alcohol use disorder. The association between psychotic disorder and dementia risk varied slightly according to the duration of the psychotic disorder (highest for those with the shortest illness duration), but not the age of onset. No information about the use of antipsychotics was available.ConclusionOlder men with a psychotic disorder have nearly three times greater risk of developing dementia than those without psychosis. The pathways linking psychotic disorders to dementia remain unclear but may involve mechanisms other than those associated with Alzheimer's disease and other common dementia syndromes.

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Comparison of the Predictive Value of GlycA and Other Biomarkers of Inflammation for Total Death, Incident Cardiovascular Events, Noncardiovascular and Noncancer Inflammatory-Related Events, and Total Cancer Events

Clinical Chemistry ◽

10.1373/clinchem.2016.255828 ◽

2016 ◽

Vol 62 (7) ◽

pp. 1020-1031 ◽

Cited By ~ 59

Author(s):

Daniel A Duprez ◽

James Otvos ◽

Otto A Sanchez ◽

Rachel H Mackey ◽

Russell Tracy ◽

...

Keyword(s):

Acute Phase Proteins ◽

High Sensitivity ◽

Good Health ◽

International Classification Of Diseases ◽

Inflammatory Biomarkers ◽

Total Death ◽

Classification Of Diseases ◽

Total Cancer ◽

Prediction Coefficient ◽

D Dimer

Abstract BACKGROUND GlycA is a biomarker that reflects integrated concentrations and glycosylation states of several acute-phase proteins. We studied the association of GlycA and inflammatory biomarkers with future death and disease. METHODS A total of 6523 men and women in the Multi-Ethnic Study of Atherosclerosis who were free of overt cardiovascular disease (CVD) and in generally good health had a baseline blood sample taken. We assayed high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and d-dimer. A spectral deconvolution algorithm was used to quantify GlycA signal amplitudes from automated nuclear magnetic resonance (NMR) LipoProfile® test spectra. Median follow-up was 12.1 years. Among 4 primary outcomes, CVD events were adjudicated, death was by death certificate, and chronic inflammatory-related severe hospitalization and death (ChrIRD) and total cancer were classified using International Classification of Diseases (ICD) codes. We used Poisson regression to study baseline GlycA, hsCRP, IL-6, and d-dimer in relation to total death, CVD, ChrIRD, and total cancer. RESULTS Relative risk per SD of GlycA, IL-6, and d-dimer for total death (n = 915); for total CVD (n = 922); and for ChrIRD (n = 1324) ranged from 1.05 to 1.20, independently of covariates. In contrast, prediction from hsCRP was statistically explained by adjustment for other inflammatory variables. Only GlycA was predictive for total cancer (n = 663). Women had 7% higher values of all inflammatory biomarkers than men and had a significantly lower GlycA prediction coefficient than men in predicting total cancer. CONCLUSIONS The composite biomarker GlycA derived from NMR is associated with risk for total death, CVD, ChrIRD, and total cancer after adjustment for hsCRP, IL-6, and d-dimer. IL-6 and d-dimer contribute information independently of GlycA.

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