Dynamic interplay between life events and course of psychotic disorders: 10-year longitudinal study following first admission

2020 ◽  
pp. 1-8
Author(s):  
Kayla R. Donaldson ◽  
Katherine G. Jonas ◽  
Yuan Tian ◽  
Emmett M. Larsen ◽  
Daniel N. Klein ◽  
...  
Keyword(s):  
Life Events ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Negative Events ◽  
First Onset ◽  
Specific Symptoms ◽  
The Impact ◽  
The Relationship ◽  
Reality Distortion ◽  
First Admission

Abstract Background Life events (LEs) are a risk factor for first onset and relapse of psychotic disorders. However, the impact of LEs on specific symptoms – namely reality distortion, disorganization, negative symptoms, depression, and mania – remains unclear. Moreover, the differential effects of negative v. positive LEs are poorly understood. Methods The present study utilizes an epidemiologic cohort of patients (N = 428) ascertained at first-admission for psychosis and followed for a decade thereafter. Symptoms were assessed at 6-, 24-, 48-, and 120-month follow-ups. Results We examined symptom change within-person and found that negative events in the previous 6 months predicted an increase in reality distortion (β = 0.07), disorganized (β = 0.07), manic (β = 0.08), and depressive symptoms (β = 0.06), and a decrease in negative symptoms (β = −0.08). Conversely, positive LEs predicted fewer reality distortion (β = −0.04), disorganized (β = −0.04), and negative (β = −0.13) symptoms, and were unrelated to mood symptoms. A between-person approach to the same hypotheses confirmed that negative LEs predicted change in all symptoms, while positive LEs predicted change only in negative symptoms. In contrast, symptoms rarely predicted future LEs. Conclusions These findings confirm that LEs have an effect on symptoms, and thus contribute to the burden of psychotic disorders. That LEs increase positive symptoms and decrease negative symptoms suggest at least two different mechanisms underlying the relationship between LEs and symptoms. Our findings underscore the need for increased symptom monitoring following negative LEs, as symptoms may worsen during that time.

Impact of life events on symptoms in psychotic disorders: 10-year longitudinal study following first admission

2020 ◽  
Author(s):  
Kayla Donaldson ◽  
Katherine Jonas ◽  
Yuan Tian ◽  
Emmett M. Larsen ◽  
Daniel Klein ◽  
...  
Keyword(s):  
Life Events ◽  
Structural Equation ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Equation Modeling ◽  
Negative Events ◽  
First Onset ◽  
Specific Symptoms ◽  
The Impact ◽  
First Admission

Life events (LEs) are a risk factor for first onset and relapse of psychotic disorders. However, the impact of LEs on specific symptoms—namely psychosis, disorganization, negative symptoms, depression, and mania—remains unclear. Moreover, the differential effects of negative versus positive LEs is poorly understood. The present study utilizes an epidemiologic cohort of patients (N=428) ascertained at first-admission for psychosis and followed for a decade thereafter. Symptoms were assessed at 6-, 24-, 48- and 120-month follow-ups. We examined symptom change within-person and found that negative events in the previous 6 months predicted an increase in psychotic (β= .07), disorganized (β= .07), manic (β= .08), and depressive symptoms (β= .06), and a decrease in negative symptoms (β= -.08). Conversely, positive LEs predicted fewer psychotic (β= -.04), disorganized (β= -.04), and negative (β= -.13) symptoms, and were unrelated to mood symptoms. Structural equation modeling confirmed that negative LEs predicted change in all symptoms, while positive LEs predicted change only in negative symptoms. In contrast, symptoms rarely predicted future LEs. These findings confirm that LEs have an effect on symptoms, and thus contribute to the burden of psychotic disorders. That LEs increase positive symptoms and decrease negative symptoms suggests at least two different mechanisms underlying the relationship between LEs and symptoms. Our findings underscore the need for close symptom monitoring in months following negative LEs, as symptoms may worsen during that time.

scholarly journals The Impact of the FKBP5 Gene Polymorphisms on the Relationship between Traumatic Life Events and Psychotic-Like Experiences in Non-Clinical Adults

2021 ◽  
Vol 11 (5) ◽  
pp. 561
Author(s):  
Filip Stramecki ◽  
Dorota Frydecka ◽  
Łukasz Gawęda ◽  
Katarzyna Prochwicz ◽  
Joanna Kłosowska ◽  
...  
Keyword(s):  
Physical Abuse ◽  
Life Events ◽  
Psychotic Disorders ◽  
Traumatic Events ◽  
Psychosis Proneness ◽  
Traumatic Life Events ◽  
History Of ◽  
The Impact ◽  
The Relationship ◽  
Pituitary Adrenal Axis

Common variations of the FKBP5 gene are implicated in psychotic disorders, by modulating the hypothalamic–pituitary–adrenal axis reactivity to stress. It has been demonstrated that some of them might moderate the effects of childhood trauma on psychosis proneness. However, these associations have not been investigated with respect to traumatic life events (TLEs). Therefore, we aimed to explore whether the FKBP5 polymorphisms moderate the effects of TLEs on the level of psychotic-like experiences (PLEs). A total of 535 non-clinical adults were approached for participation, and genotyping of six FKBP5 polymorphisms (rs3800373, rs9470080, rs4713902, rs737054, rs1360780 and rs9296158) was performed. The Prodromal Questionnaire-16 (PQ-16) and the Traumatic Events Checklist (TEC) were administered to assess PLEs and TLEs, respectively. Among the rs1360780 CC homozygotes, a history of physical abuse was associated with significantly higher PQ-16 scores. This difference was not significant in the rs1360780 T allele carriers. Similarly, a history of physical abuse was associated with significantly higher PQ-16 scores in the rs9296158 GG homozygotes but not in the rs9296158 A allele carriers. Finally, emotional neglect was related to significantly higher PQ-16 scores in the rs737054 T allele carriers but not in the rs737054 CC homozygotes. The present study indicates that variation in the FKBP5 gene might moderate the effects of lifetime traumatic events on psychosis proneness.

scholarly journals The effect of the environment on symptom dimensions in the first episode of psychosis: a multilevel study

2014 ◽  
Vol 44 (11) ◽  
pp. 2419-2430 ◽  
Author(s):  
F. J. Oher ◽  
A. Demjaha ◽  
D. Jackson ◽  
C. Morgan ◽  
P. Dazzan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Population Density ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Urban Environments ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Multilevel Regression ◽  
Symptom Dimensions ◽  
Reality Distortion

BackgroundThe extent to which different symptom dimensions vary according to epidemiological factors associated with categorical definitions of first-episode psychosis (FEP) is unknown. We hypothesized that positive psychotic symptoms, including paranoid delusions and depressive symptoms, would be more prominent in more urban environments.MethodWe collected clinical and epidemiological data on 469 people with FEP (ICD-10 F10–F33) in two centres of the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study: Southeast London and Nottinghamshire. We used multilevel regression models to examine neighbourhood-level and between-centre differences in five symptom dimensions (reality distortion, negative symptoms, manic symptoms, depressive symptoms and disorganization) underpinning Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Item Group Checklist (IGC) symptoms. Delusions of persecution and reference, along with other individual IGC symptoms, were inspected for area-level variation.ResultsReality distortion [estimated effect size (EES) 0.15, 95% confidence interval (CI) 0.06–0.24] and depressive symptoms (EES 0.21, 95% CI 0.07–0.34) were elevated in people with FEP living in more urban Southeast London but disorganized symptomatology was lower (EES –0.06, 95% CI –0.10 to –0.02), after controlling for confounders. Delusions of persecution were not associated with increased neighbourhood population density [adjusted odds ratio (aOR) 1.01, 95% CI 0.83–1.23], although an effect was observed for delusions of reference (aOR 1.41, 95% CI 1.12–1.77). Hallucinatory symptoms showed consistent elevation in more densely populated neighbourhoods (aOR 1.32, 95% CI 1.09–1.61).ConclusionsIn people experiencing FEP, elevated levels of reality distortion and depressive symptoms were observed in more urban, densely populated neighbourhoods. No clear association was observed for paranoid delusions; hallucinations were consistently associated with increased population density. These results suggest that urban environments may affect the syndromal presentation of psychotic disorders.

The deficit syndrome in first-admission patients with psychotic and non-psychotic disorders

1997 ◽  
Vol 12 (2) ◽  
pp. 53-57 ◽  
Author(s):  
H Gerbaldo ◽  
K Georgi ◽  
D Pieschl
Keyword(s):  
Negative Symptom ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Deficit Syndrome ◽  
Schizophrenic Patients ◽  
First Admission

SummaryThe authors study the frequency of primary enduring negative symptoms in first-admission patients with schizophrenic and non-schizophrenic disorders. Carpenter's criteria for distinguishing the primary, enduring negative symptoms from the more transient negative symptoms (secondary to different factors) were applied. Furthermore, they compare negative symptom complexes between first-admission patients and patients with recurrent hospitalizations (within 5 years after first admission). There was a trend for patients with recurrent admissions to show more frequently a deficit syndrome than first-admission patients. Nevertheless, this difference was not significant (χ2 = 0.90). First-admission patients with deficit syndrome had significantly higher affective blunting (P < 0.05) and anhedonia (P < 0.001) than those with recurrent admissions. First-admission subjects with psychotic disorders had significantly higher frequency of deficit syndrome than those first-admission patients with non-psychotic disorders (P < 0.05). These results show that negative symptoms observed in first-admitted non-schizophrenic patients can also be enduring and primary. Thereby this work does not contribute to support the specificity of primary enduring negative symptoms for schizophrenia. Moreover, data suggest, that primary anhedonia and affective blunting can decrease within the first 5 years after discharge.

scholarly journals S131. NEIGHBOURHOOD-LEVEL SOCIAL CAPITAL, MARGINALIZATION, AND THE INCIDENCE OF PSYCHOTIC DISORDERS IN TORONTO, CANADA: A RETROSPECTIVE POPULATION-BASED COHORT STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S85-S85
Author(s):  
Martin Rotenberg ◽  
Andrew Tuck ◽  
Kelly Anderson ◽  
Kwame McKenzie
Keyword(s):  
Social Capital ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Population Based ◽  
Ethnic Concentration ◽  
Schizophrenia Spectrum ◽  
Neighbourhood Level ◽  
Incident Cases ◽  
The Impact ◽  
The Relationship

Abstract Background Previous studies have shown mixed results regarding the relationship between social capital and the risk of developing a psychotic disorder, and this has yet to be studied in North America. This study aims to examine the relationship between neighbourhood-level social capital, marginalization, and the incidence of psychotic disorders in Toronto, Canada. Methods A retrospective cohort of people aged 14 to 40 years residing in Toronto, Canada in 1999 (followed to 2008) was constructed from population-based health administrative data. Incident cases of schizophrenia spectrum psychotic disorders were identified using a validated algorithm. Voter participation rates in a municipal election were used as a proxy neighbourhood-level indicator of social capital. Exposure to neighbourhood-level marginalization was obtained from the Ontario Marginalization Index. Poisson regression models adjusting for age and sex were used to calculate incidence rate ratios (IRR) for each social capital quintiles and marginalization quintile. Results In the study cohort (n = 640,000) over the 10-year follow-up period, we identified 4,841 incident cases of schizophrenia spectrum psychotic disorders. We observed elevated rates of psychotic disorders in areas with the highest levels (IRR = 1.13, 95% CI 1.00–1.27) and moderate levels (IRR = 1.23, 95% CI 1.12–1.36) of social capital, when compared to areas with the lowest levels of social capital, after adjusting for neighbourhood-level indicators of marginalization. The risk associated with social capital was not present when analyzed in only the females in the cohort. All neighbourhood marginalization indicators, other than ethnic concentration, were significantly associated with risk. Discussion The risk of developing a psychotic disorder in Toronto, Canada is associated with socioenvironmental exposures. Social capital is associated with risk, however, the impact of social capital on risk differs by sex and social capital quintile. Across the entire cohort, exposure to all neighbourhood-level marginalization indicators, except ethnic concentration, impacts risk. Future research should examine how known individual-level risk factors, including immigration, ethnicity, and family history of a mental disorder may interact with these findings.

Life Events and Psychiatric Disorder: the Role of a Natural Disaster

1987 ◽  
Vol 151 (3) ◽  
pp. 362-367 ◽  
Author(s):  
Alexander C. McFarlane
Keyword(s):  
Psychiatric Disorder ◽  
Life Events ◽  
Psychological Health ◽  
Psychiatric Illness ◽  
General Health Questionnaire ◽  
Health Questionnaire ◽  
Fire Fighters ◽  
The Impact ◽  
The Relationship

Examining the impact of natural disasters on psychological health provides an opportunity to study the role played by extreme adversity in the onset of psychiatric disorder. Four hundred and sixty-nine fire-fighters who had been intensely exposed to an Australian bushfire disaster completed a detailed inventory of their experiences four months later. They also completed a brief life events schedule and the 12-item General Health Questionnaire. Only 9% of the GHQ score variance could be accounted for by the disaster and other life events; the effects of the disaster appeared to be separate and additive. This is similar to the relationship between life events and psychiatric illness found in other settings. It is suggested that vulnerability is a more important factor in breakdown than the degree of stress experienced.

Quality of life and burden on caregivers of chronic psychotic patient: Analysys and correlation with psycopathology

2011 ◽  
Vol 26 (S2) ◽  
pp. 1453-1453
Author(s):  
D.P.E. Monteiro ◽  
T.H. Freitas ◽  
C.M. Clemente ◽  
J.P. Pinto
Keyword(s):  
Quality Of Life ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Demographic Data ◽  
Subjective Burden ◽  
General Psychopathology ◽  
Primary Schooling ◽  
Burden Scale ◽  
The Impact

ObjectivesTo evaluate the subjective impact on quality of life and burden of caregivers of chronic psychotic patients and correlate with the impact that the type of patient’s symptoms according to PANSS (negative, positive, mixed or none).MethodsWe used the Caregiver's Burden scale to measure quality of life and subjective burden of caregivers of chronic psychotic patients followed up by the Psychotic Disorders Clinic of the Hospital Mental Health Messejana, in Fortaleza, Ceará, and the PANSS for the patients of the relatated caregiver. Then we correlated the data in order to observe whether the patient’s symptoms interfere with the quality of life and the burden of the caregivers.ResultsWe observed that most caregivers were women, mothers of patients who had incomplete primary schooling, married, with incomes between one and two minimum wages. In most cases also with incomplete primary degree and mean disease duration was 16.51 (± 9.64) years. We found that higher scores on scales of positive and PANSS general psychopathology in the patient, the worse the quality of life and caregiver burden. In this sample, negative symptoms measured by the PANSS negative scale does not seem to interfere with quality of life and caregiver burden.OuvirLer foneticamente Dicionário - Ver dicionário detalhadoConclusionDemographic data did not affect the quality of life of caregivers; the main factors that contributed to a poorer quality of life and caregiver's burden were high scores in positive and general psychopathology of PANSS.

scholarly journals Cognitive impairment as a risk factor for psychosis

2005 ◽  
Vol 7 (1) ◽  
pp. 31-38 ◽  
Keyword(s):  
Risk Factor ◽  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Brain Function ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Epidemiological Studies ◽  
Psychotic Symptoms ◽  
Future Research ◽  
The Relationship

Since the time of Kraepelin and Bleuler, it has been recognized that schizophrenia is associated with a profound and persistent cognitive impairment. This paper reviews the major clinical and epidemiological studies of cognitive functioning in schizophrenia and other psychotic disorders, and presents several possible models to explain the association between cognitive impairment and psychosis. Cognitive impairment is present in the majority of patients with schizophrenia, and, in some, it is already evident in the premorbid stages of the disorder. This cognitive impairment is not secondary to psychotic symptoms, negative symptoms, or socioeconomic status. Cognitive impairment can also be observed in nonpsychotic family members of psychotic patients. On the basis of this evidence, it has been proposed that abnormal cognitive functioning can be considered as a possible causal risk factor for psychosis. Recent studies assessing the relationship between genetic background, cognition, brain function, and schizophrenia are presented here as an outline for future research.

Which depressions are related to life stress?

2002 ◽  
Vol 14 (4) ◽  
pp. 167-172 ◽  
Author(s):  
E. S. Paykel
Keyword(s):  
Life Events ◽  
Life Stress ◽  
Suicide Attempts ◽  
Negative Events ◽  
Stress Effects ◽  
Social Rhythm ◽  
Insidious Development ◽  
Relationship Of ◽  
The Relationship ◽  
Course Of Depression

This paper examines the relationship of recent life events to specific kinds of depression using published studies and the author's own work. An overall effect of life events on depression has been found consistently and is moderate in degree. In suicide attempts there are stronger and more immediate effects than in depression. Life events precede both non-melancholic and melancholic depressions. It is only in recurrent depressions that life events are less common with melancholic pictures. Life events influence bipolar disorder as well as unipolar. Mania may be preceded by life events, particularly those involving social rhythm disruption, but it is harder to rule out events which are consequences of insidious development of illness. There are strong effects of life events and social support in postpartum depressions but in postpartum psychoses these effects are absent. Events precede depression comorbid with other disorders as well as pure depression. The course of depression is also influenced by life stress with less remission where negative events occur after onset and better outcome where earlier adverse events are neutralized. Relapse is related to immediately preceding life events. However, where depressions are both severe and recurrent life stress effects weaken and as the number of episodes increases preceding life events lessen. These findings suggest that some kinds of depression are more related to psychosocial causation and some are more biological in origin.

Group programmes for recovery from early psychosis

1998 ◽  
Vol 172 (S33) ◽  
pp. 117-121 ◽  
Author(s):  
Dianne J. Albiston ◽  
Shona M. Francey ◽  
Susan M. Harrigan
Keyword(s):  
Negative Symptoms ◽  
Positive Impact ◽  
Early Psychosis ◽  
First Episode ◽  
Premorbid Adjustment ◽  
Comprehensive Service ◽  
First Onset ◽  
Group Programme ◽  
The Impact

BackgroundWe evaluate the impact of a group-based, transitional, psychosocial programme, within a comprehensive service (the Early Psychosis Prevention and Intervention Centre, EPPIC), on recovery from first-episode psychosis.MethodIndividuals using the service (and meeting study criteria) were assessed on a range of symptom and functioning instruments at entry, after 6 weeks and 6 months. Participants received comprehensive case management and services according to their identified needs. Thirty-four people who had attended the group programme were compared at 6 month follow-up with 61 EPPIC patients who had not attended.ResultsThe people attending the group programme had a lower level of premorbid adjustment than the comparison group, and a trend towards exhibiting a higher level of negative symptoms, prior to commencing the group programme. However, at 6 month follow-up, no significant differences were found between the groups.ConclusionsInvolvement in the group programme may have had a positive impact on a subgroup of EPPIC subjects with poor level of premorbid adjustment, by providing a ‘holding pattern’ in the critical period following the emergence of first-onset psychosis, and thus prevented deterioration and the development of disability.

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