Does co-occurring borderline personality disorder influence acute phase treatment for first-episode psychosis?

Objective: Caregivers of individuals with severe mental illness often experience significant negative experiences of care, which can be associated with higher levels of expressed emotion. Expressed emotion is potentially a modifiable target early in the course of illness, which might improve outcomes for caregivers and patients. However, expressed emotion and caregiver experiences in the early stages of disorders might be moderated by the type of severe mental illness. The aim was to determine whether experiences of the caregiver role and expressed emotion differ in caregivers of young people with first-episode psychosis versus young people with ‘first-presentation’ borderline personality disorder features. Method: Secondary analysis of baseline (pre-treatment) data from three clinical trials focused on improving caregiver outcomes for young people with first-episode psychosis and young people with borderline personality disorder features was conducted (ACTRN12616000968471, ACTRN12616000304437, ACTRN12618000616279). Caregivers completed self-report measures of experiences of the caregiver role and expressed emotion. Multivariate generalised linear models and moderation analyses were used to determine group differences. Results: Data were available for 265 caregivers. Higher levels of negative experiences and expressed emotion, and stronger correlations between negative experiences and expressed emotion domains, were found in caregivers of young people with borderline personality disorder than first-episode psychosis. Caregiver group (borderline personality disorder, first-episode psychosis) moderated the relationship between expressed emotion and caregiver experiences in the domains of need to provide backup and positive personal experiences. Conclusion: Caregivers of young people with borderline personality disorder experience higher levels of negative experiences related to their role and expressed emotion compared with caregivers of young people with first-episode psychosis. The mechanisms underpinning associations between caregiver experiences and expressed emotion differ between these two caregiver groups, indicating that different supports are needed. For borderline personality disorder caregivers, emotional over-involvement is associated with both negative and positive experiences, so a more detailed understanding of the nature of emotional over-involvement for each relationship is required to guide action.

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Aripiprazole vs Risperidone for the acute-phase treatment of first-episode psychosis: A 6-week randomized, flexible-dose, open-label clinical trial

European Neuropsychopharmacology ◽

10.1016/j.euroneuro.2021.02.009 ◽

2021 ◽

Author(s):

Marcos Gómez-Revuelta ◽

José María Pelayo-Terán ◽

Javier Vázquez-Bourgon ◽

Víctor Ortiz-García de la Foz ◽

Jacqueline Mayoral -van Son ◽

...

Keyword(s):

Clinical Trial ◽

Acute Phase ◽

First Episode Psychosis ◽

First Episode ◽

Open Label ◽

Episode Psychosis ◽

Flexible Dose ◽

Acute Phase Treatment

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Factors associated with borderline personality disorder in major depressive patients and their relationship to bipolarity

European Psychiatry ◽

10.1016/j.eurpsy.2012.11.007 ◽

2013 ◽

Vol 28 (8) ◽

pp. 463-468 ◽

Cited By ~ 1

Author(s):

J.M. Azorin ◽

A. Kaladjian ◽

M. Adida ◽

E. Fakra ◽

R. Belzeaux ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Age At Onset ◽

Borderline Personality ◽

First Episode ◽

Contributory Factor ◽

Structured Interviews ◽

Major Depressive ◽

History Of ◽

Depressive Patients

AbstractObjectiveTo analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.MethodsAs part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD−).ResultsCompared to BPD (−), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.ConclusionsThe hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.

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Testing the Interpersonal-Cognitive Model of Auditory Verbal Hallucinations in Youths with Either Early-Stage Borderline Personality Disorder or First-Episode Schizophrenia Spectrum Disorder

Psychopathology ◽

10.1159/000505194 ◽

2020 ◽

Vol 53 (1) ◽

pp. 23-35

Author(s):

Marialuisa Cavelti ◽

Katherine Thompson ◽

Carol Hulbert ◽

Jennifer Betts ◽

Henry Jackson ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Early Stage ◽

Cognitive Model ◽

Borderline Personality ◽

First Episode ◽

Schizophrenia Spectrum Disorder ◽

Auditory Verbal Hallucinations ◽

Schizophrenia Spectrum ◽

First Episode Schizophrenia

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Peripheral blood gene expression of acute phase proteins in people with first episode psychosis

Brain Behavior and Immunity ◽

10.1016/j.bbi.2017.06.006 ◽

2017 ◽

Vol 65 ◽

pp. 337-341 ◽

Cited By ~ 4

Author(s):

Jie Yin Yee ◽

Milawaty Nurjono ◽

Wai Yee Ng ◽

Stephanie Ruth Teo ◽

Tih-Shih Lee ◽

...

Keyword(s):

Gene Expression ◽

Acute Phase ◽

Peripheral Blood ◽

Acute Phase Proteins ◽

First Episode Psychosis ◽

First Episode ◽

Blood Gene Expression ◽

Peripheral Blood Gene Expression ◽

Episode Psychosis

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Neurocognitive status in different stages of psychosis: Changes from the first episode psychosis to remission

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2109 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S187-S187

Author(s):

D. Bošnjak ◽

P. Makarić ◽

I. Kekin ◽

T. Sabo ◽

M. Živković ◽

...

Keyword(s):

Acute Phase ◽

Neuropsychiatric Symptoms ◽

Verbal Learning ◽

First Episode Psychosis ◽

Neurocognitive Impairment ◽

University Hospital ◽

First Episode ◽

Psychotic Episode ◽

Learning Abilities ◽

Episode Psychosis

IntroductionNeurocognitive impairment in schizophrenia is associated with functional disability and poorer quality of life, and is the most resistant of all schizophrenia symptoms to current psychopharmacotherapy.ObjectivesTo compare the differences in neurocognitive status during the acute phase of first psychotic episode and stable symptomatic remission.AimsTo investigate the pattern of neurocognitive impairment in patients with first episode psychosis during acute phase and stable remission phase.MethodsWe performed a longitudinal study, including 150 patients with first episode of psychosis at two time points: during their hospitalization at Zagreb university hospital centre or university psychiatric hospital Vrapče, at acute phase of illness and after 12–18 months, during stable remission. Assessment included detailed clinical interview, clinical rating of neuropsychiatric symptoms using standardized psychiatric scales, self-assessment scales and comprehensive neurocognitive testing.ResultsWhile our preliminary results (n = 40) showed statistically significant improvement in various neurocognitive domains, including visuo-learning abilities, verbal learning, executive functions, attention and processing speed, initial impairment in semantic and phonetic fluency observed in acute psychosis remained unchanged in remission as well.ConclusionsAlthough our results showed improvement in most of cognitive domains during time, language abilities remained unchanged. This further confirms the hypothesis that language impairment is a trait marker of psychotic disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Alteration of Cerebral Blood Flow Measured with SPECT in Patients with First Episode Psychosis

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.099 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S271-S271

Author(s):

P. Makarić ◽

D. Bošnjak ◽

I. Kekin ◽

P. Jelacic ◽

M. Haupert ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Acute Phase ◽

Photon Emission ◽

First Episode Psychosis ◽

Small Sample ◽

First Episode ◽

Emission Computed Tomography ◽

Episode Psychosis ◽

Perfusion Deficits

IntroductionSingle-photon emission computed tomography (SPECT) is a valid method for measuring regional cerebral blood flow (rCBF). Recent studies regarding rCBF in patients with first episode psychosis (FEP) reported heterogeneous results, but were limited with small sample size. Neuroimaging can help us in setting the diagnosis of illness, as well as in following the progress and finding more effective treatment for psychotic disorders.ObjectivesTo compare, baseline alterations of the rCBF using SPECT with psychopathological status in FEP during acute phase.AimsTo investigate the changes of rCBF in patients with FEP during acute phase.MethodsWe conducted a study on 40 drug – naïve patients with FEP at acute phase of illness during their hospitalization at Zagreb University hospital centre. The diagnosis was confirmed using diagnostic and statistical manual of mental disorders, fifth edition. rCBF was measured with SPECT and psychopathological status rated with the Positive and Negative Syndrome Scale.ResultsOur findings showed moderate to severe parieto-temporal perfusion deficits, mild to moderate parieto-fronto-temporal perfusion deficits or borderline perfusion deficits in all but one patient.ConclusionOur results showed alteration in rCBF at the beginning of the illness that indicate a biological market of psychotic disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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