Stressful and intrusive life events preceding first episode psychosis

2009 ◽  
Vol 18 (3) ◽  
pp. 221-228 ◽  
Author(s):  
David Raune ◽  
Elizabeth Kuipers ◽  
Paul Bebbington
Keyword(s):  
Life Events ◽  
Patient Group ◽  
Stressful Life Events ◽  
Conflicts Of Interest ◽  
Statistical Significance ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Comparison Groups ◽  
First Onset

SUMMARYAim – To test the hypothesis that stressful life events, in particular intrusive events, would cluster before the first onset of psychosis. Method – Forty-one patients with first episode psychosis were interviewed with the Life Events and Difficulties Schedule to assess events in the year before the onset of illness. Events were rated contextually on timing, independence, threat, and intrusiveness. Within-patient group clustering was evaluated, and the patient group was compared with two general population surveys from London. Results – Events were very frequent in the year before the onset of psychosis. Stressful and intrusive events were more common in the three months before onset compared with the previous nine months, although few analyses reached conventional statistical significance. Threatening and intrusive events were much more frequent in patients than in the comparison groups. First episode psychosis patients were strikingly more likely to report an intrusive event in the three months before onset (OR=17.1, 34% v 3%), and also showed an excess between three months and one year before onset (OR=8.1, 11% v 3%). Conclusions – Events may trigger many cases of first episode psychosis. The effect emerges several months before onset, particularly if the events are intrusive. This has both theoretical and clinical implications.Declaration of Interest: DR was supported by a UK Medical Research Council studentship. The authors have no conflicts of interest in writing this paper.

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

2016 ◽  
Vol 245 ◽  
pp. 108-115 ◽  
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

scholarly journals Stressful Life Events In First Episode Psychosis

2021 ◽  
Vol 10 (1) ◽  
pp. 38-42
Author(s):  
B.D. Karki ◽  
D. Joshi ◽  
A.P. Adhikari
Keyword(s):  
Life Events ◽  
Perceived Stress ◽  
Stressful Life Events ◽  
First Episode Psychosis ◽  
Stressful Life ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Episode Psychosis

Introduction: First episode psychosis refers to the first time someone experiences psychotic symptoms or a psychotic episode. There are evidences related to the role of major life events and childhood trauma in the development of first episode psychosis. There are few studies regarding the environmental exposure to stressful life events and how these events might influence the onset of a psychotic disorder, and role of perceived stress. This study aimed to identify the relationship between stressful life events and first episode psychosis in Nepalese context. Material And Method: It was a hospital based cross-sectional, descriptive study. A total of 50 cases of first episode psychosis were included and the diagnosis was made according to ICD 10- Diagnostic Criteria for Research and verified by two consultant psychiatrists. Semi Structured Performa was designed to collect the information about the socio demographic data and perceived stress was assessed with Presumptive Stressful Life Events Scale (PSLES). Results: There were 62% female and 38% male patients with first episode psychosis with mean age 26.32 years. Majority of the participants were from rural areas (94%), married (58%), educated up to primary level (38%) and housewife (40%). 60.7% of ATPD had stressful life events (P =0. 000)which was higher than the stressful life events in patient with Schizophrenia (P =0. 005). There was a positive correlation between stressful life events and gender, setting, socioeconomic status and Diagnosis (P <0.05). Conclusion: Results show the relevance of presence of stressful life events as a potent source of perceived stress in first episode psychosis sample. Therefore this study highlights the importance of psychosocial intervention in this vulnerable group for management of illness and might be an important strategy for prevention.

Visual working memory deterioration preceding relapse in psychosis

2016 ◽  
Vol 46 (11) ◽  
pp. 2435-2444 ◽  
Author(s):  
C. L. M. Hui ◽  
Y. K. Li ◽  
A. W. Y. Li ◽  
E. H. M. Lee ◽  
W. C. Chang ◽  
...  
Keyword(s):  
Working Memory ◽  
Visual Working Memory ◽  
Life Events ◽  
Stressful Life Events ◽  
First Episode Psychosis ◽  
Stressful Life ◽  
First Episode ◽  
Medication Discontinuation ◽  
Episode Psychosis ◽  
Memory Deterioration

BackgroundRelapse is distressingly common after the first episode of psychosis, yet it is poorly understood and difficult to predict. Investigating changes in cognitive function preceding relapse may provide new insights into the underlying mechanism of relapse in psychosis. We hypothesized that relapse in fully remitted first-episode psychosis patients was preceded by working memory deterioration.MethodVisual memory and verbal working memory were monitored prospectively in a 1-year randomized controlled trial of remitted first-episode psychosis patients assigned to medication continuation (quetiapine 400 mg/day) or discontinuation (placebo). Relapse (recurrence of positive symptoms of psychosis), visual (Visual Patterns Test) and verbal (Letter–Number span test) working memory and stressful life events were assessed monthly.ResultsRemitted first-episode patients (n = 102) participated in the study. Relapsers (n = 53) and non-relapsers (n = 49) had similar baseline demographic and clinical profiles. Logistic regression analyses indicated relapse was associated with visual working memory deterioration 2 months before relapse [odds ratio (OR) 3.07, 95% confidence interval (CI) 1.19–7.92, P = 0.02], more stressful life events 1 month before relapse (OR 2.11, 95% CI 1.20–3.72, P = 0.01) and medication discontinuation (OR 5.52, 95% CI 2.08–14.62, P = 0.001).ConclusionsVisual working memory deterioration beginning 2 months before relapse in remitted first-episode psychosis patients (not baseline predictor) may reflect early brain dysfunction that heralds a psychotic relapse. The deterioration was found to be unrelated to a worsening of psychotic symptoms preceding relapse. Testable predictors offer insight into the brain processes underlying relapse in psychosis.

scholarly journals T1. STRESSFUL LIFE EVENTS AND PERCEIVED STRESS IN THE SAMPLE OF PATIENTS WITH FIRST-EPISODE PSYCHOSIS AND HEALTHY CONTROLS: PRELIMINARY RESULTS

2018 ◽  
Vol 44 (suppl_1) ◽  
pp. S113-S113
Author(s):  
Anna Butjosa ◽  
Regina Vila-Badia ◽  
Núria Del Cacho ◽  
Itziar Riera-López de Aguileta ◽  
Mar Álvarez ◽  
...  
Keyword(s):  
Life Events ◽  
Perceived Stress ◽  
Stressful Life Events ◽  
First Episode Psychosis ◽  
Stressful Life ◽  
First Episode ◽  
Healthy Controls ◽  
Preliminary Results ◽  
Episode Psychosis

scholarly journals The Implementation and Review of Cognitive Remediation Training for First Episode Psychosis in Singapore

2021 ◽  
Vol 12 ◽  
Author(s):  
Nigel Ian Ming Chong ◽  
Yogeswary Maniam ◽  
Yi Chian Chua ◽  
Charmaine Tang
Keyword(s):  
Verbal Memory ◽  
Cognitive Abilities ◽  
Statistical Significance ◽  
Real Life ◽  
Cognitive Remediation ◽  
First Episode Psychosis ◽  
Early Psychosis ◽  
First Episode ◽  
Educational Approach ◽  
Episode Psychosis

Objective: Early intervention in patients with first episode psychosis (FEP) can improve cognitive abilities, with both short- and long-term benefits. In this paper, we describe the implementation and review of cognitive remediation training (CRT) in an Asian FEP population. The outcomes of the training are also evaluated and discussed.Methods: This naturalistic paper describes in detail the real-life implementation and conduct of CRT in an early psychosis intervention service. One hundred and nine patients with FEP underwent a 24-session CRT programme, using Cogpack and Neuropsychological Educational Approach to Remediation. The program is evaluated with pre- and post-CRT assessment scores which included Montreal Cognitive Assessment and Brief Assessment of Cognition in Schizophrenia. The rates of improvement on these cognitive assessments were evaluated using paired t-tests, with statistical significance set at p ≤ 0.05.Results: Of the 109 patients who underwent CRT, a total of 92 (84.4%) completed all 24 sessions. Paired t-tests between pre- and post-CRT assessments scores revealed that participants significantly improved on majority of the measures, including verbal memory, digit sequencing, and symbol coding.Conclusion: As with other cognitive remediation programmes, CRT has shown to improve cognitive functioning in patients with FEP. The results support the use of CRT in an Asian context and may serve as guidance for the implementation of similar training programmes in other Asian early psychosis intervention services.

scholarly journals Relationship between substance abuse and first-episode psychosis - a South African perspective

2003 ◽  
Vol 9 (1) ◽  
pp. 5 ◽  
Author(s):  
Sandra Brink ◽  
Piet Oosthuizen ◽  
Robin Emsley ◽  
Irene Mbanga ◽  
Natasha Keyter
Keyword(s):  
Substance Abuse ◽  
South African ◽  
Age Of Onset ◽  
First Episode Psychosis ◽  
First Episode ◽  
Younger Age ◽  
Co Morbidity ◽  
Episode Psychosis ◽  
First Onset ◽  
African Perspective

Background. Co-morbidity between substance abuse and psy- chotic disorders is high. Few studies have examined therelationship between first-episode psychosis and substance abuse. Several questions emerge from this common relationship and many of them remain unanswered.Objectives. To determine the effect of substance abuse on psychosis in terms of onset, duration, severity of symptoms, use of medication and outcome.Method. Thirty - three subjects with first-episode psychosis, as well as primary caregivers, were interviewed re g a rding substance abuse and its relation to illness. Thirty-six control subjects were also interv i e w e d .Results. Twenty-seven per cent of subjects abused substances in the 3 months before onset of illness, and 77.8% of the abusers w e re male. Subjects in the first-episode psychosis group were m o re likely to choose cannabis as their substance of abuse than c o n t rols. They also started abusing substances at a younger age than controls. Subjects with first-episode psychosis who abused substances presented at an earlier age than non-abusers. Substances affected symptoms at baseline presentation .Conclusions. Substance abuse has a significant impact on first- onset psychosis as far as age of onset and symptom severity are c o n c e rned. Subjects with an underlying vulnerability to psychosis seem to start abusing substances at an earlier age than the general population. Males are more likely to abuse substances than females.

Trauma and Migration in First Episode Psychosis

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.

Relapse After First-Episode Psychosis: A 3-Year Follow-Up

2017 ◽  
Vol 41 (S1) ◽  
pp. S276-S276
Author(s):  
E. Pereira ◽  
M. Mota Oliveira ◽  
R. Guedes ◽  
M.J. Peixoto ◽  
I. Ferraz ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Statistical Significance ◽  
First Episode Psychosis ◽  
Response To Treatment ◽  
First Episode ◽  
Final Sample ◽  
Episode Psychosis ◽  
Competing Interest ◽  
Relapse Rates

IntroductionRelapse after first-episode psychosis (FEP) is a frequent problem, which can lead to patients’ poorer functioning and response to treatment. Its prevention is one of the most important and challenging targets in the treatment of psychotic disorders.ObjectivesTo characterize and evaluate relapse rates after FEP, during the course of 3 years, of a group of patients admitted at a psychiatry department.MethodsA retrospective observational study was conducted. Patients with a FEP between ages 18 to 40, admitted at the Clinic of Psychiatry and Mental Health at São João Hospital Centre between January 1, 2007 and September 30, 2013. Only patients with, at least, 3 years of follow-up at the clinic were included.ResultsFinal sample of 58 patients, 39 of which were male (mean age = 26.4 years). Forty patients were excluded by not completing the 3 years follow-up at our department. The cumulative relapse rates were 32.8% at 12 months, 53.4% at 24 months and 63.8% at 36 months. Patients with at least one relapse were younger (25.78 years vs. 27.52 years) and had shorter periods of first hospitalization (19.25 days vs. 23.52 days). These data did not reach statistical significance. Non-adherence to prescribed medication was described in 73.0% (n = 27) of patients at the time of relapse. Eight of them (21.6%) presented with cannabis use.ConclusionsAlthough no statistical significance was reached, our findings are consistent with other studies. A future study with a bigger sample would be important in achieving statistical significant results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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