A glimpse forward regarding psychopathology of psychotic disorders

2020 ◽  
pp. 647-651
Author(s):  
William T. Carpenter
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
Early Detection ◽  
Clinical Features ◽  
Psychotic Disorders ◽  
Clinical Care ◽  
Therapeutic Targets ◽  
Partial Solution ◽  
New Knowledge

Issues related to early detection and intervention, primary prevention, and re-conceptualizing therapeutic targets are important current themes in psychosis research. Extensive heterogeneity within each diagnostic class and overlap in clinical features, risk factors and associated features between diagnostic classes, all result in critical limitations in clinical care and research. In this chapter, concrete approaches are suggested to make progress in psychosis research. Each partial solution has a different profile of strengths and weaknesses. New knowledge will be needed to make progress, and that knowledge will be acquired incrementally.

General Practice Recruitment for People at Risk of Schizophrenia: The Buckingham Experience

2000 ◽  
Vol 34 (1_suppl) ◽  
pp. A131-A136 ◽  
Author(s):  
Ian R. H. Falloon
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Primary Care ◽  
At Risk ◽  
General Practice ◽  
Early Detection ◽  
Psychotic Disorders ◽  
Community Sample ◽  
Signs And Symptoms ◽  
Psychotic Episode

Objective The process of detecting people at high risk of schizophrenia from a community sample is a major challenge for prevention of psychotic disorders. The aim of this paper is to describe early detection procedures that can be implemented in primary care settings. Methods A selected literature review is supplemented by experiences and data obtained during the Buckingham Integrated Mental Health Care Project. Results General medical practitioners have been favoured as the agents most likely to prove helpful in detecting the key risk factors that predict the onset of schizophrenic disorders, as well as in recognising the earliest signs and symptoms of these conditions. However, the practical problems of screening for multiple and subtle risk factors in general practice are substantial, and general practitioners (GPs) often have difficulty recognising the earliest signs of a psychotic episode. A range of strategies to assist GPs detect early signs of psychosis in their patients are considered. Conclusions It is feasible to implement primary care setting early detection procedures for people at risk of schizophrenia. Implementation is aided by the use of a brief screening questionnaire, training sessions and case supervision; and increased collaboration with mental health services and other community agencies.

The Nature of Schizophrenia: Signposts to Prevention

2000 ◽  
Vol 34 (1_suppl) ◽  
pp. A14-A21 ◽  
Author(s):  
Patrick D. McGorry
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Primary Prevention ◽  
Psychotic Disorders ◽  
Early Years ◽  
First Episode ◽  
Preventive Interventions ◽  
Work Settings ◽  
The Face ◽  
National Mental Health

Objective To describe the characteristics of schizophrenia relevant to conducting indicated preventive interventions. Method A systematic review of the literature informed by experiences at the Personal Assistance and Crisis Evaluation (PACE) clinic. Results Primary prevention requires a sophisticated knowledge of key causal risk factors relevant to the expression of a disorder. The causal risk factors most useful from an intervention standpoint may turn out to be somewhat removed from the neurobiology of the disorder and may even be relatively non-specific, so that tackling them could reduce the risks for a range of mental disorders. The frontier for more specific prevention in schizophrenia and related psychosis is currently represented by indicated preventive interventions for subthreshold symptoms. Again, these may be relatively broad spectrum early in the prepsychotic phase but more proximal to onset, greater treatment specificity can be explored. However, this can be viewed more as preventively orientated treatment rather than primary prevention per se. Early detection of first episode psychosis and optimal intensive treatment of first episodes and the critical early years after diagnosis also represent increasingly attractive preventive foci in psychotic disorders. Conclusion As evidence accumulates, implementation of evidence-based practice in real work settings is a major challenge as it is throughout the mental health service system. The momentum of preventively orientated treatment must be maintained through the 2nd National Mental Health Strategy and in the face of recent misleading polemic regarding the treatability of psychotic disorders, especially schizophrenia. The evidence demonstrates that schizophrenia and related disorders have never been more treatable.

Psychosis High-Risk States

2018 ◽  
pp. 838-858
Author(s):  
Luís Madeira ◽  
Ilaria Bonoldi ◽  
Barnaby Nelson
Keyword(s):  
Early Intervention ◽  
Primary Prevention ◽  
High Risk ◽  
Mental Disorders ◽  
Translational Research ◽  
Clinical Features ◽  
Psychotic Disorders ◽  
Major Field ◽  
The World ◽  
Phenomenological Psychopathology

Psychosis High-Risk states are today a major field of research in psychiatry allowing early intervention (including primary prevention) of severe psychotic disorders. Psychosis High-Risk criteria select different clinical features and appear to be different center-wise and country-wise. As several of the phenomena accounting for symptoms are subjective in nature, both original and recent inputs from research in phenomenological psychopathology are great candidates for adding to the conceptual validity of High-Risk states. These subjects show a disturbed grip on reality–perplexity, derealization, and depersonalization—as well as a diminished presence in the world and involuntarily ruminating on things they previously ignored. Special sets of phenomena are presented including Truman symptoms, anomalous subjective self and world experiences, and abnormal bodily phenomena. Contemporary predictive and translational research will ultimately integrate phenomenological data with the neurocognitive and neurobiological models of mental disorders.

scholarly journals Role of risk factors, clinical features and treatment modality in early detection and management of Buerger’s disease: a study from tertiary care centre Pondicherry

2020 ◽  
Vol 7 (6) ◽  
pp. 1718
Author(s):  
Krithika Kiruba ◽  
Himadra Koranga ◽  
Chandrasekaran Ramaraj ◽  
Anant A. Takalkar
Keyword(s):  
Risk Factors ◽  
Early Detection ◽  
Clinical Features ◽  
Lower Limb ◽  
Treatment Modality ◽  
Tertiary Care ◽  
Age Group ◽  
Buerger’S Disease ◽  
Buerger's Disease

Background: Thromboangiitis obliterans is a disease of unknown aetiology seen under 45 years of age with no form of treatment has been successful in offering the victims of this disease a cure nor even a long-term remission. Objective of the study was to study the role of different risk factors, clinical features and treatment modality in early detection and management of Buerger’s disease.Methods: This is an experimental study carried out in 50 cases of Buerger’s disease after obtaining a well-informed written consent in department of General Surgery in Aarupadai Veedu Medical College and Hospital. Period of study was from October 2015 to October 2017. Data was analysed with SPSS 23.0 version.Results: Majority were from 31-40 years age group i.e. 30 (60%). Left lower limb was involved in 52% subjects. 80% smoked more than 20 cigarettes per day. Signs of ischemia was present in all 50 patients. Gangrene of the limb was seen in 14 patients (28%). Out of 3 patients with recurrent pain, 2 (66.7%) were relieved. Ulcer healing occurred in 5 out of 6 patients i.e. 83.3% and intermittent claudication was relieved in 2 out of 7 patients i.e. 28.6%.Conclusions: Males are commonly involved in our study. Majority of patients were in age group 31-40 years. Smoking is an important and definite risk factor in relation with the development of Buerger’s disease. Lower limb is commonly involved. Majority of patients in our series were treated by conservative management.

The burden of cardiovascular disease risk factors in the Middle East: A systematic review and meta-analysis focusing on primary prevention

2020 ◽  
Vol 18 ◽  
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Abdullah Shehab ◽  
Anhar Ullah ◽  
Jamal Rahmani
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Family History ◽  
Primary Prevention ◽  
Middle East ◽  
Disease Risk ◽  
Meta Analysis ◽  
Middle Eastern ◽  
History Of

Background: The increasing incidence of cardiovascular disease (CVD) threatens the Middle Eastern population. Several epidemiological studies have assessed CVD and its risk factors in terms of the primary prevention of CVD in the Middle East. Therefore, summarizing the information from these studies is essential. Aim: We conducted a systematic review to assess the prevalence of CVD and its major risk factors among Middle Eastern adults based on the literature published between January 1, 2012 and December 31, 2018 and carried out a meta-analysis. Methods: We searched electronic databases such as PubMed/Medline, ScienceDirect, Embase and Google Scholar to identify literature published from January 1, 2012 to December 31, 2018. All the original articles that investigated the prevalence of CVD and reported at least one of the following factors were included: hypertension, diabetes, dyslipidaemia, smoking and family history of CVD. To summarize CVD prevalence, we performed a random-effects meta-analysis. Results: A total of 41 potentially relevant articles were included, and 32 were included in the meta-analysis (n=191,979). The overall prevalence of CVD was 10.1% (95% confidence interval (CI): 7.1-14.3%, p<0.001) in the Middle East. A high prevalence of CVD risk factors, such as dyslipidaemia (43.3%; 95% CI: 21.5-68%), hypertension (26.2%; 95% CI: 19.6-34%) and diabetes (16%; 95% CI: 9.9-24.8%), was observed. The prevalence rates of other risk factors, such as smoking (12.4%; 95% CI: 7.7-19.4%) and family history of CVD (18.7%; 95% CI: 15.4-22.5%), were also high. Conclusion: The prevalence of CVD is high (10.1%) in the Middle East. The burden of dyslipidaemia (43.3%) in this region is twice as high as that of hypertension (26.2%) and diabetes mellitus (16%). Multifaceted interventions are urgently needed for the primary prevention of CVD in this region.

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