Temporal and Effort cost Decision-making in Healthy Individuals with Subclinical Psychotic Symptoms

Psychosis is a condition characterized on current diagnostic tests by impairment and may include severe disturbances of cognition, thinking, behaviour, and emotion. The need for early diagnosis and prevention of psychotic episodes in adolescents challenges traditional models of counselling, diagnosis, and treatment. The aim of the present study is to derive the main themes and psychological manifestations in the first psychotic episode in adolescents and to deepen knowledge and raise questions around the specific experiences of psychotic adolescents in order to help the clinical psychologist and psychotherapist in diagnostic and therapeutic counselling. This thus goes beyond the visible behaviour and the medical model that pays little attention to the causal relationships in psychosis and its unconscious components. Thirty-six adolescents (27 girls) with subclinical and clinical psychotic symptoms and 30 adolescents (16 girls) with neurotic symptoms were interviewed. A clinical approach was used – clinical psychological interview followed by psychotherapeutic work. Findings and statements can be found showing that early psychotic signs may change into a more severe adolescent crisis, as well as indications of the nature of anger towards parents, unstable mood and aggressivity. Leading themes in interviews and psychotherapeutic sessions may relate to feelings of insignificance in the world around them, unclear sexual identification, too close a relationship with their mothers, and anxiety about real or symbolic absence such as their mothers’ working away from home for long periods of time. In 79% of the interviews with adolescents with psychotic symptoms, we see a lack of real symbolic play in childhood. suitable for non-psychotic adolescents, in this case to change in the first psychotic episode.****What does this last sentence mean? The importance of early diagnosis is recognized and the known psychotherapeutic techniques must be used. Keywords: early psychosis, adolescent, positive psychotherapy, counselling

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Obsessive-compulsive symptoms in schizophrenia patients and their first-degree relatives and the association with subclinical psychotic symptoms

Nordic Journal of Psychiatry ◽

10.1080/08039488.2021.1966097 ◽

2021 ◽

pp. 1-9

Author(s):

Barış Sancak ◽

Güliz Özgen Hergül

Keyword(s):

Psychotic Symptoms ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

First Degree Relatives ◽

Subclinical Psychotic Symptoms

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Age-adapted percentiles of measured glomerular filtration in healthy individuals: extrapolation to living kidney donors over 65 years

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2021-1011 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Pierre Delanaye ◽

François Gaillard ◽

Jessica van der Weijden ◽

Geir Mjøen ◽

Ingela Ferhman-Ekholm ◽

...

Keyword(s):

Decision Making ◽

Glomerular Filtration ◽

Validation Cohort ◽

External Validation ◽

Healthy Individuals ◽

Kidney Donors ◽

Internal Validation ◽

Living Kidney Donors ◽

Multi Center Study ◽

Elderly Living

Abstract Objectives Most data on glomerular filtration rate (GFR) originate from subjects <65 years old, complicating decision-making in elderly living kidney donors. In this retrospective multi-center study, we calculated percentiles of measured GFR (mGFR) in donors <65 years old and extrapolated these to donors ≥65 years old. Methods mGFR percentiles were calculated from a development cohort of French/Belgian living kidney donors <65 years (n=1,983), using quantiles modeled as cubic splines (two linear parts joining at 40 years). Percentiles were extrapolated and validated in an internal cohort of donors ≥65 years (n=147, France) and external cohort of donors and healthy subjects ≥65 years (n=329, Germany, Sweden, Norway, France, The Netherlands) by calculating percentages within the extrapolated 5th–95th percentile (P5–P95). Results Individuals in the development cohort had a higher mGFR (99.9 ± 16.4 vs. 86.4 ± 14 and 82.7 ± 15.5 mL/min/1.73 m2) compared to the individuals in the validation cohorts. In the internal validation cohort, none (0%) had mGFR below the extrapolated P5, 12 (8.2%) above P95 and 135 (91.8%) between P5–P95. In the external validation cohort, five subjects had mGFR below the extrapolated P5 (1.5%), 25 above P95 (7.6%) and 299 (90.9%) between P5–P95. Conclusions We demonstrate that extrapolation of mGFR from younger donors is possible and might aid with decision-making in elderly donors.

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The decision-making levels of urine tetrasaccharide for the diagnosis of Pompe disease in the Turkish population

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0393 ◽

2020 ◽

Vol 33 (3) ◽

pp. 391-395 ◽

Cited By ~ 1

Author(s):

Erhan Canbay ◽

Melisa Vural ◽

Sema Kalkan Uçar ◽

Ebru Demirel Sezer ◽

Hatice Karasoy ◽

...

Keyword(s):

Decision Making ◽

Pompe Disease ◽

High Performance ◽

Late Onset ◽

Turkish Population ◽

Reference Intervals ◽

Healthy Controls ◽

Age Group ◽

Healthy Individuals ◽

First Year Of Life

AbstractBackgroundRecently, urinary excretion of the tetrasaccharide 6-α-D-glucopyranosyl-maltotriose (Glc4) has been proposed as a marker for the diagnosis and monitoring of Pompe disease (PD). We aimed to determine the reference intervals and reliable decision-making levels of urine tetrasaccharide concentrations for the diagnosis of infantile- and late-onset Pompe patients in the Turkish population.MethodsIn this study, nine patients with PD (five of them with late-onset PD [LOPD]) and 226 healthy individuals (aged 0–64 years) were included. Urine Glc4 concentrations were determined using the ultra-high-performance liquid chromatography (UHPLC) tandem mass spectrometry (MS/MS) method.ResultsOur data showed that the urine tetrasaccharide levels decreased with age in healthy individuals (p < 0.001, r = −0.256). It was higher especially during the first year of life compared to that in the elder subjects. The tetrasaccharide level of Pompe patients was higher compared to that of healthy controls of the same age: 99 ± 68 mmol/mol creatinine for infantile onset vs. 4.0 ± 3.0 mmol/mol creatinine for healthy controls of the same age group and 12.1 ± 17.4 mmol/mol creatinine for late onset vs. 1.7±1.2 mmol/mol creatinine for healthy controls of the same age group.ConclusionsThe results of this study showed that the reference intervals of tetrasaccharide in urine changed over time; therefore, it is critically important to define age-based decision levels for the diagnosis of LOPD.

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S198. SELF-DISTURBANCES AND THEIR NEURAL SIGNATURES IN SCHIZOPHRENIA

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.264 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S114-S114

Author(s):

Yulia Zaytseva ◽

Eva Kozakova ◽

Pavel Mohr ◽

Filip Spaniel ◽

Aaron Mishara

Keyword(s):

Resting State ◽

Brain Connectivity ◽

Resting State Fmri ◽

Psychotic Symptoms ◽

Healthy Controls ◽

Healthy Individuals ◽

Motor Speech ◽

Cognitive Domains ◽

Aberrant Salience ◽

First Rank Symptoms

Abstract Background The self-disturbances (SDs) concept is considered to be part of the Schneider’s first rank symptoms, i.e., thought-withdrawal, thought-insertion, thought-broadcasting, somatic-passivity experiences, mental/motor automatisms, disrupted unitary self-experience (Mishara et al., 2014). SDs were originally described by W. Mayer-Gross (1920), who observed them in psychotic patients. Methods We classified Mayer-Gross’ findings on SDs into the following categories: experience is new/compelling (aberrant salience), reduced access/importance of autobiographical past, cognitions/emotions occur independently from self’s volition, foreign agents have power over self and developed an SDs scale based on these categories and cognitive domains (perception, motor, speech, thinking etc.). Scale is applied as a measure of the frequency of the experiences. In our current study on phenomenology and neurobiology of psychotic symptoms, we administered the scale to a study group of patients with schizophrenia (N=84) and healthy volunteers (N=170). Further, the resting state fMRI was performed and the group was divided into two subgroups with (N=13) and without self-disturbances (N=10) and in healthy individuals (N=39). Results We found substantial differences in the frequency of self-disturbances in patients with schizophrenia compared to healthy controls (total score differences, Z=-5.83, p< 0.001). On a neural level, patients with self-disturbances experienced a decreased functional brain connectivity of the default mode and salience networks as compared to the patients without self-disturbances and healthy controls. The differences were mainly explained by the factor ‘’foreign agents’’ and the novelty of the experience. Discussion The scale identifies self-disturbances in schizophrenia and confirms self-related processing in patients with schizophrenia to be associated with altered activation in the cortical midline structures. Supported by the grant projects MH CR AZV 17-32957A and MEYS NPU4NUDZ: LO1611.

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Prefrontal inositol levels and implicit decision-making in healthy individuals and depressed patients

European Neuropsychopharmacology ◽

10.1016/j.euroneuro.2016.06.005 ◽

2016 ◽

Vol 26 (8) ◽

pp. 1255-1263 ◽

Cited By ~ 9

Author(s):

Fabrice Jollant ◽

Stéphane Richard-Devantoy ◽

Yang Ding ◽

Gustavo Turecki ◽

Antoine Bechara ◽

...

Keyword(s):

Decision Making ◽

Healthy Individuals ◽

Depressed Patients

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Disturbances of basic self and prodromal symptoms among non-psychotic help-seeking adolescents

Psychological Medicine ◽

10.1017/s0033291712002322 ◽

2012 ◽

Vol 43 (7) ◽

pp. 1365-1376 ◽

Cited By ~ 42

Author(s):

D. Koren ◽

N. Reznik ◽

M. Adres ◽

R. Scheyer ◽

A. Apter ◽

...

Keyword(s):

Psychosocial Functioning ◽

Help Seeking ◽

Structured Interview ◽

Psychotic Symptoms ◽

Risk Markers ◽

Prodromal Symptoms ◽

The Social ◽

Prodromal Syndrome ◽

The Relationship ◽

Subclinical Psychotic Symptoms

BackgroundThe goal of this study was to explore the notion that anomalies of self-experience (ASE) are a core, ‘not-yet-psychotic’ clinical phenotype of emerging schizophrenia and its spectrum.MethodTo accomplish this goal, we examined the relationship between ASE and commonly accepted risk markers in a sample of 87 help-seeking, non-psychotic adolescents (aged 14–18 years). ASE were assessed with the Examination of Anomalous Self-Experience (EASE), subclinical psychotic symptoms were assessed with the Prodromal Questionnaire and the Structured Interview for Prodromal Syndromes, deterioration in psychosocial functioning was assessed with the Social and Role Functioning Scales, and level of distress with the Mood and Anxiety Symptoms Questionnaire.ResultsAbout 82 participants completed the entire EASE interview. The number of participants who reported ASE at a clinically meaningful level (n = 18, 22%) was smaller than that who met diagnostic criteria for a prodromal syndrome (n = 28, 34%). The degree of overlap between the two conditions was moderate but statistically significant (χ2(1) = 7.01, p = 0.008). An exploratory factor analysis revealed that ASE load on a different factor than prodromal symptoms and deterioration in functioning, but that there is a moderate correlation between the three factors.ConclusionsThese results suggest that ASE are prevalent among non-psychotic help-seeking adolescents, yet at a considerably lower rate than prodromal symptoms. In addition, they suggest that ASE and prodromal symptoms constitute distinct but moderately related dimensions of potential risk. Taken together, they provide preliminary support for the clinical usefulness of supplementing and refining the methods of early detection of risk with assessment of ASE.

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Emotional and symptomatic reactivity to stress in individuals at ultra-high risk of developing psychosis

Psychological Medicine ◽

10.1017/s0033291711001929 ◽

2011 ◽

Vol 42 (5) ◽

pp. 1003-1012 ◽

Cited By ~ 69

Author(s):

J. E. Palmier-Claus ◽

G. Dunn ◽

S. W. Lewis

Keyword(s):

High Risk ◽

Emotional Reactivity ◽

Clinical Sample ◽

Stressful Events ◽

Psychotic Symptoms ◽

Healthy Individuals ◽

Multilevel Regression ◽

Self Assessment ◽

Ultra High Risk ◽

And Gender

BackgroundThe stress–vulnerability model of psychosis continues to be influential. The aim of this study was to compare emotional and symptomatic responses to stress in individuals at ultra-high risk (UHR) of developing psychosis, in age- and gender-matched healthy controls, and in patients with non-affective psychosis.MethodA total of 27 UHR, 27 psychotic and 27 healthy individuals completed the experience sampling method, an ambulant diary technique, where they were required to fill in self-assessment questions about their emotions, symptoms and perceived stress at semi-random times of the day for 6 days. Quesionnaire and interview assessments were also completed.ResultsMultilevel regression analyses showed that individuals at UHR of developing psychosis reported greater negative emotions in response to stress than the healthy individuals. Against the initial hypotheses, the UHR individuals also experienced greater emotional reactivity to stress when compared with the patient group. No significant differences were observed between the patients and the non-clinical sample. Stress measures significantly predicted the intensity of psychotic symptoms in UHR individuals and patients, but the extent of this did not significantly differ between the groups.ConclusionsIndividuals at UHR of developing psychosis may be particularly sensitive to everyday stressors. This effect may diminish after transition to psychosis is made and in periods of stability. Subtle increases in psychotic phenomena occur in response to stressful events across the continuum of psychosis.

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Shift toward prior knowledge confers a perceptual advantage in early psychosis and psychosis-prone healthy individuals

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1503916112 ◽

2015 ◽

Vol 112 (43) ◽

pp. 13401-13406 ◽

Cited By ~ 100

Author(s):

Christoph Teufel ◽

Naresh Subramaniam ◽

Veronika Dobler ◽

Jesus Perez ◽

Johanna Finnemann ◽

...

Keyword(s):

Information Processing ◽

Prior Knowledge ◽

Early Psychosis ◽

Psychotic Symptoms ◽

Psychotic Experiences ◽

Healthy Individuals ◽

Top Down ◽

Bottom Up ◽

Psychosis Proneness ◽

Sensory Evidence

Many neuropsychiatric illnesses are associated with psychosis, i.e., hallucinations (perceptions in the absence of causative stimuli) and delusions (irrational, often bizarre beliefs). Current models of brain function view perception as a combination of two distinct sources of information: bottom-up sensory input and top-down influences from prior knowledge. This framework may explain hallucinations and delusions. Here, we characterized the balance between visual bottom-up and top-down processing in people with early psychosis (study 1) and in psychosis-prone, healthy individuals (study 2) to elucidate the mechanisms that might contribute to the emergence of psychotic experiences. Through a specialized mental-health service, we identified unmedicated individuals who experience early psychotic symptoms but fall below the threshold for a categorical diagnosis. We observed that, in early psychosis, there was a shift in information processing favoring prior knowledge over incoming sensory evidence. In the complementary study, we capitalized on subtle variations in perception and belief in the general population that exhibit graded similarity with psychotic experiences (schizotypy). We observed that the degree of psychosis proneness in healthy individuals, and, specifically, the presence of subtle perceptual alterations, is also associated with stronger reliance on prior knowledge. Although, in the current experimental studies, this shift conferred a performance benefit, under most natural viewing situations, it may provoke anomalous perceptual experiences. Overall, we show that early psychosis and psychosis proneness both entail a basic shift in visual information processing, favoring prior knowledge over incoming sensory evidence. The studies provide complementary insights to a mechanism by which psychotic symptoms may emerge.

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