scholarly journals S34. EFFECTIVENESS OF INDIVIDUAL METACOGNITIVE TRAINING (MCT+) IN FIRST-EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S44-S45
Author(s):  
Susana Ochoa ◽  
Raquel Lopez-Carrilero ◽  
Maria Luisa Barrigon ◽  
Esther Pousa ◽  
Eva Grasa ◽  
...  
Keyword(s):  
Repeated Measures ◽  
First Episode Psychosis ◽  
Post Treatment ◽  
First Episode ◽  
Positive Symptoms ◽  
Metacognitive Training ◽  
Cognitive Insight ◽  
Episode Psychosis ◽  
The Difference ◽  
The Individual

Abstract Background The individual Metacognitive Training (MCT+) is useful to reduce positive symptoms in people with schizophrenia, however less is known in people with first-episode psychosis (FEP). The aim of the study is to assess the effectiveness of MCT+ in FEP regarding symptoms and cognitive insight. Methods A random clinical trial was performed with people with FEP from 10 clinical centers of Spain. One group received ten sessions of MCT+ and the other group received TAU. A total of 75 patients were included in the study, however only 40 finished the final assessment. Patients were assessed before treatment, post-treatment and 6 month follow-up. The assessment includes a battery of instruments for the main aims the Positive and Negative Syndrome Scale (PANSS) and the Beck Cognitive Insight (BCIS) will be analyzed. Repeated measures statistical test were used in order to assess differences between groups. Results Both groups improved in Positive symptoms, in the MCT+ group the difference was 5.18 (SD=6.8) with a significance of p=0.002, while in the TAU group the difference was 3.38 (SD=4.9) with a significance of p=0.005. Regarding cognitive insight, in the MCT+ group patients improved in Self-reflectiveness, obtaining a score in baseline of 15.21 (SD=5.52) and 18 (SD=5.28) in post-treatment (p=0.017). The TAU group did not improve in any subscale of the BCIS. Discussion The MCT+ seems to improve more in positive symptoms than TAU, although both interventions diminished the presence of these symptoms. The MCT+ improved the self-reflectiveness, being one of the important areas for the understanding of the daily social functioning in relation to other. Further analysis should be explored.

scholarly journals Cognitive Insight in First-Episode Psychosis: Changes during Metacognitive Training

2020 ◽  
Vol 10 (4) ◽  
pp. 253
Author(s):  
Irene Birulés ◽  
Raquel López-Carrilero ◽  
Daniel Cuadras ◽  
Esther Pousa ◽  
Maria Barrigón ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Group Intervention ◽  
Composite Index ◽  
First Episode Psychosis ◽  
Post Treatment ◽  
First Episode ◽  
Metacognitive Training ◽  
Cognitive Insight ◽  
Episode Psychosis

Background: Metacognitive training (MCT) has demonstrated its efficacy in psychosis. However, the effect of each MCT session has not been studied. The aim of the study was to assess changes in cognitive insight after MCT: (a) between baseline, post-treatment, and follow-up; (b) after each session of the MCT controlled for intellectual quotient (IQ) and educational level. Method: A total of 65 patients with first-episode psychosis were included in the MCT group from nine centers of Spain. Patients were assessed at baseline, post-treatment, and 6 months follow-up, as well as after each session of MCT with the Beck Cognitive Insight Scale (BCIS). The BCIS contains two subscales: self-reflectiveness and self-certainty, and the Composite Index. Statistical analysis was performed using linear mixed models with repeated measures at different time points. Results: Self-certainty decreased significantly (p = 0.03) over time and the effect of IQ was negative and significant (p = 0.02). From session 4 to session 8, all sessions improved cognitive insight by significantly reducing self-certainty and the Composite Index. Conclusions: MCT intervention appears to have beneficial effects on cognitive insight by reducing self-certainty, especially after four sessions. Moreover, a minimum IQ is required to ensure benefits from MCT group intervention.

Moderators of cognitive insight outcome in metacognitive training for first-episode psychosis

2021 ◽  
Author(s):  
César González-Blanch ◽  
Irene Birulés ◽  
Esther Pousa ◽  
María Luisa Barrigon ◽  
Raquel López-Carrilero ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Metacognitive Training ◽  
Cognitive Insight ◽  
Episode Psychosis

Gender differences in response to metacognitive training in people with first-episode psychosis.

2020 ◽  
Vol 88 (6) ◽  
pp. 516-525 ◽  
Author(s):  
Miriam Salas-Sender ◽  
Raquel López-Carrilero ◽  
Ana Barajas ◽  
Esther Lorente-Rovira ◽  
Esther Pousa ◽  
...  
Keyword(s):  
Gender Differences ◽  
First Episode Psychosis ◽  
First Episode ◽  
Metacognitive Training ◽  
Episode Psychosis

QUALITY OF INDIVIDUAL AND GROUP LEVEL INTERVENTIONS FOR FIRST EPISODE PSYCHOSIS AT THE TERTIARY PSYCHIATRIC HOSPITAL IN UGANDA.

2020 ◽  
Author(s):  
Emmanuel Kiiza Mwesiga ◽  
Noeline Nakasujja ◽  
Lawrence Nankaba ◽  
Juliet Nakku ◽  
Seggane Musisi
Keyword(s):  
Psychiatric Hospital ◽  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
First Episode ◽  
Group Level ◽  
Group Interventions ◽  
Episode Psychosis ◽  
Essential Components ◽  
The Individual

Introduction: Individual and group level interventions have the largest effect on outcomes in patients with the first episode of psychosis. The quality of these individual and group level interventions provided to first-episode psychosis patients in Uganda is unclear.Methods: The study was performed at Butabika National Psychiatric Teaching and referral hospital in Uganda. A retrospective chart review of recently discharged adult in-patients with the first episode of psychosis was first performed to determine the proportion of participants who received the different essential components for individual and group level interventions. From the different proportions, the quality of the services across the individual and group interventions was determined using the first-Episode Psychosis Services Fidelity Scale (FEPS-FS). The FEPS-FS assigns a grade of 1-5 on a Likert scale depending on the proportion of patients received the different components of the intervention. Results: The final sample included 156 first-episode psychosis patients. The median age was 27 years [IOR (24-36)] with 55% of participants of the female gender. 13 essential components across the individual and group interventions were assessed and their quality quantified. All 13 essential components had poor quality with the range of scores on the FEPS-FS of 1-3. Only one essential component assessed (use of single antipsychotics) had moderate quality.Discussion: Among current services at the National psychiatric hospital of Uganda, the essential for individual and group level interventions for psychotic disorders are of low quality. Further studies are required on how the quality of these interventions can be improved.

Reduced TMS-evoked fast oscillations in the motor cortex predict the severity of positive symptoms in first-episode psychosis

2021 ◽  
pp. 110387
Author(s):  
Francesco Luciano Donati ◽  
Rachel Kaskie ◽  
Catarina Cardoso Reis ◽  
Armando D'Agostino ◽  
Adenauer Girardi Casali ◽  
...  
Keyword(s):  
Motor Cortex ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Episode Psychosis ◽  
Fast Oscillations

What Is Psychosis?

2021 ◽  
pp. 3-16
Author(s):  
Beth Broussard ◽  
Michael T. Compton
Keyword(s):  
Mental Illness ◽  
Young People ◽  
First Episode Psychosis ◽  
Initial Evaluation ◽  
Treatment Programs ◽  
First Episode ◽  
Her Family ◽  
Episode Psychosis ◽  
The Individual ◽  
Work Goals

This first chapter explains what psychosis is. Psychosis is a treatable mental illness. For many people with first-episode psychosis, symptoms begin to clear up partially or completely within weeks of starting treatment. Although the symptoms of psychosis may be frightening to the individual and his or her family, there are treatments for these symptoms. First-episode psychosis is the period of time when a person first begins to experience psychosis. It is during this time that young people and their families need detailed information about the initial evaluation and treatment. People who get into treatment earlier often do better. In many places, specialty treatment programs now exist that specifically focus on first-episode psychosis. Those programs often provide treatments designed to help young people get back on track in terms of school and work goals.

scholarly journals Neuroactive Steroids in First-Episode Psychosis: A Role for Progesterone?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Martino Belvederi Murri ◽  
Flaminia Fanelli ◽  
Uberto Pagotto ◽  
Elena Bonora ◽  
Federico Triolo ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Serum Levels ◽  
First Episode Psychosis ◽  
Neuroactive Steroids ◽  
First Episode ◽  
Positive Symptoms ◽  
Symptom Dimensions ◽  
Episode Psychosis ◽  
Male Patients ◽  
And Gender

Neuroactive steroids may play a role in the pathophysiology of psychotic disorders, but few studies examined this issue. We compared serum levels of cortisol, testosterone, dehydroepiandrosterone, and progesterone between a representative sample of first-episode psychosis (FEP) patients and age- and gender-matched healthy subjects. Furthermore, we analyzed the associations between neuroactive steroids levels and the severity of psychotic symptom dimensions. Male patients had lower levels of progesterone than controls (p=0.03). Progesterone levels were inversely associated with the severity of positive symptoms (p=0.007). Consistent with preclinical findings, results suggest that progesterone might have a role in the pathophysiology of psychotic disorders.

scholarly journals Randomized Controlled Trial of Clozapine and CBT for First-Episode Psychosis with Enduring Positive Symptoms: A Pilot Study

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
J. Edwards ◽  
J. Cocks ◽  
P. Burnett ◽  
D. Maud ◽  
L. Wong ◽  
...  
Keyword(s):  
Pilot Study ◽  
Negative Symptoms ◽  
Controlled Trial ◽  
Treatment Phase ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Treatment Groups ◽  
Episode Psychosis ◽  
Symptomatic Remission

Here we report the results of a pilot study investigating the relative and combined effects of a 12 week course of clozapine and CBT in first-episode psychosis patients with prominent ongoing positive symptoms following their initial treatment. Patients from our early psychosis service who met the inclusion criteria () were randomized to one of four treatment groups: clozapine, clozapine plus CBT, thioridazine, or thioridazine plus CBT. The degree of psychopathology and functionality of all participants was measured at baseline then again at 6, 12 and 24 weeks, and the treatment outcomes for each group determined by statistical analysis. A substantial proportion (52%) of those treated with clozapine achieved symptomatic remission, as compared to 35% of those who were treated with thioridazine. Overall, those who received clozapine responded more rapidly to treatment than those receiving the alternative treatments. Interestingly, during the early treatment phase CBT appeared to reduce the intensity of both positive and negative symptoms and thus the time taken to respond to treatment, as well having as a stabilizing effect over time.

scholarly journals S166. EFFECTIVE CONNECTIVITY OF FRONTOSTRIATAL SYSTEMS IN FIRST-EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S99-S100
Author(s):  
Kristina Sabaroedin ◽  
Adeel Razi ◽  
Kevin Aquino ◽  
Sidhant Chopra ◽  
Amy Finlay ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Nucleus Accumbens ◽  
Effective Connectivity ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Healthy Controls ◽  
Top Down ◽  
Imaging Protocol ◽  
Episode Psychosis

Abstract Background Neuroimaging studies have found dysconnectivity of frontostriatal circuits across a broad spectrum of psychotic symptoms. However, it is unknown whether dysconnectivity within frontostriatal circuits originates from disrupted bottom-up or top-down control signaling within these systems. Here, we used dynamic causal modelling (DCM) to examine the effective connectivity of frontostriatal systems in first-episode psychosis (FEP). Methods A total of 55 FEP patients (26 males; mean [SD] age = 19.24 [2.89]) and 24 healthy controls (15 males; mean [SD] age = 21.83 [1.93]) underwent a resting-state functional magnetic resonance imaging protocol. Biologically plausible connections between eight left hemisphere regions encompassing the dorsal and ventral frontostriatal systems were modelled using spectral DCM. The regions comprise dorsolateral prefrontal cortex, ventromedial prefrontal cortex, anterior hippocampus, amygdala, dorsal caudate, nucleus accumbens, thalamus, and the midbrain. Effective connectivity between groups were assessed using a parametric Bayesian model. Associations between effective connectivity parameters and positive symptoms, measured by the Brief Psychiatric Rating Scale positive subscale, was assessed in the patient group in a separate Bayesian general linear model. Results DCM shows evidence for differences in effective connectivity between patients and healthy controls, namely in the bottom-down connections distributed in the frontostriatal system encompassing the hippocampus, amygdala, striatum, and midbrain. Compared to healthy controls, patients also demonstrated increased disinhibition of the midbrain. In patients, positive symptoms are associated with increased top-down connections to the midbrain. Outgoing connection from the midbrain to the nucleus accumbens is also increased in association with positive symptoms. Discussion Aberrant top-down connectivity in the frontostriatal system in patients is consistent with top-down dysregulation of dopamine function in FEP, as dopaminergic activity in the midbrain is proposed to be under the control of higher brain areas. In patients, increased self-inhibition of the midbrain, as well as symptom associations in both ingoing and outgoing connections of this region, are congruous with hyperactivity of the midbrain as proposed by the dopamine dysregulation hypothesis. Here, we demonstrate that mathematical models of brain imaging signals can be used to identify the key disruptions driving brain circuit dysfunction, identifying new targets for treatment.

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