scholarly journals Exploring the clinical relevance of a dichotomy between affective and non‐affective psychosis: Results from a first‐episode psychosis cohort study

2021 ◽  
Author(s):  
Julie Ramain ◽  
Philippe Conus ◽  
Philippe Golay
Keyword(s):  
Cohort Study ◽  
Clinical Relevance ◽  
First Episode Psychosis ◽  
First Episode ◽  
Affective Psychosis ◽  
Episode Psychosis

Estimating the incidence of first-episode psychosis using population-based health administrative data to inform early psychosis intervention services

2018 ◽  
Vol 49 (12) ◽  
pp. 2091-2099 ◽  
Author(s):  
Kelly K. Anderson ◽  
Ross Norman ◽  
Arlene G. MacDougall ◽  
Jordan Edwards ◽  
Lena Palaniyappan ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Administrative Data ◽  
Catchment Area ◽  
Population Based ◽  
First Episode Psychosis ◽  
Case Definition ◽  
First Episode ◽  
Affective Psychosis ◽  
Health Administrative Data ◽  
Episode Psychosis

AbstractBackgroundDiscrepancies between population-based estimates of the incidence of psychotic disorder and the treated incidence reported by early psychosis intervention (EPI) programs suggest additional cases may be receiving services elsewhere in the health system. Our objective was to estimate the incidence of non-affective psychotic disorder in the catchment area of an EPI program, and compare this to EPI-treated incidence estimates.MethodsWe constructed a retrospective cohort (1997–2015) of incident cases of non-affective psychosis aged 16–50 years in an EPI program catchment using population-based linked health administrative data. Cases were identified by either one hospitalization or two outpatient physician billings within a 12-month period with a diagnosis of non-affective psychosis. We estimated the cumulative incidence and EPI-treated incidence of non-affective psychosis using denominator data from the census. We also estimated the incidence of first-episode psychosis (people who would meet the case definition for an EPI program) using a novel approach.ResultsOur case definition identified 3245 cases of incident non-affective psychosis over the 17-year period. We estimate that the incidence of first-episode non-affective psychosis in the program catchment area is 33.3 per 100 000 per year (95% CI 31.4–35.1), which is more than twice as high as the EPI-treated incidence of 18.8 per 100 000 per year (95% CI 17.4–20.3).ConclusionsCase ascertainment strategies limited to specialized psychiatric services may substantially underestimate the incidence of non-affective psychotic disorders, relative to population-based estimates. Accurate information on the epidemiology of first-episode psychosis will enable us to more effectively resource EPI services and evaluate their coverage.

Metabolic parameters as possible diagnostic predictors in first‐episode psychosis: An exploratory retrospective cohort study

2021 ◽  
Author(s):  
Sofia Ramos Ferreira ◽  
Diana Moura ◽  
Pedro Oliveira ◽  
Vítor Santos ◽  
Miguel Bajouco ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
First Episode Psychosis ◽  
Metabolic Parameters ◽  
First Episode ◽  
Episode Psychosis

Suicide in first episode psychosis: A nationwide cohort study

2014 ◽  
Vol 157 (1-3) ◽  
pp. 1-7 ◽  
Author(s):  
C. Björkenstam ◽  
E. Björkenstam ◽  
A. Hjern ◽  
R. Bodén ◽  
J. Reutfors
Keyword(s):  
Cohort Study ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis

scholarly journals Neurological abnormalities and cognitive ability in first-episode psychosis

2008 ◽  
Vol 193 (3) ◽  
pp. 197-202 ◽  
Author(s):  
Paola Dazzan ◽  
Tuhina Lloyd ◽  
Kevin D. Morgan ◽  
Jolanta Zanelli ◽  
Craig Morgan ◽  
...  
Keyword(s):  
General Population ◽  
Cognitive Ability ◽  
Motor Coordination ◽  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
General Cognitive Ability ◽  
Affective Psychosis ◽  
Neurological Soft Signs ◽  
Episode Psychosis

BackgroundIt remains unclear if the excess of neurological soft signs, or of certain types of neurological soft signs, is common to all psychoses, and whether this excess is simply an epiphenomenon of the lower general cognitive ability present in psychosis.AimsTo investigate whether an excess of neurological soft signs is independent of diagnosis (schizophrenia v. affective psychosis) and cognitive ability (IQ).MethodEvaluation of types of neurological soft signs in a prospective cohort of all individuals presenting with psychoses over 2 years (n=310), and in a control group from the general population (n=239).ResultsPrimary (P<0.001), motor coordination (P<0.001), and motor sequencing (P<0.001) sign scores were significantly higher in people with any psychosis than in the control group. However, only primary and motor coordination scores remained higher when individuals with psychosis and controls were matched for premorbid and current IQ.ConclusionsHigher rates of primary and motor coordination signs are not associated with lower cognitive ability, and are specific to the presence of psychosis.

scholarly journals Acute and transient psychotic disorders: precursors, epidemiology, course and outcome

2004 ◽  
Vol 185 (6) ◽  
pp. 452-459 ◽  
Author(s):  
Swaran P. Singh ◽  
Tom Burns ◽  
Shazad Amin ◽  
Peter B. Jones ◽  
Glynn Harrison
Keyword(s):  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
Acute Onset ◽  
Favourable Outcome ◽  
First Episode ◽  
Affective Psychosis ◽  
Episode Psychosis ◽  
Icd 10 ◽  
Premorbid Functioning ◽  
Better Than

BackgroundICD–10 has introduced the diagnostic group acute and transient psychotic disorders (ATPDs; F23). Aims To validate the nosological distinctiveness of ICD–10 ATPDs by following up an inception cohort with first-episode psychosis. Method All patients with first-episode psychosis identified in Nottingham between 1992 and 1994 and diagnosed using ICD–10 criteria were reassessed 3 years later. ATPD outcomes were compared with schizophrenia and affective psychosis. Multivariate analyses were conducted to determine whether acute onset and early remission predicted favourable 3-year outcome in first-episode psychosis. Results Of 168 cases of first-episode psychosis, 32 (19%) received an intake diagnosis of ATPD. The diagnosis of ATPD was stable in women over 3 years, but not in men. Outcomes in ATPD were better than in schizophrenia and similar to affective psychosis. In non-affective psychoses, favourable outcomes were a function of gender and premorbid functioning rather than acute onset and early remission. Conclusions The ICD–10 criteria for ATPDs identify a diagnostically unstable group of disorders. Acute onset and early remission do not independently predict favourable outcome over 3 years in first-episode psychosis.

scholarly journals Stratification and prediction of remission in first-episode psychosis patients: the OPTiMiSE cohort study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Emanuela Martinuzzi ◽  
◽  
Susana Barbosa ◽  
Douglas Daoudlarian ◽  
Wafa Bel Haj Ali ◽  
...  
Keyword(s):  
Cohort Study ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis

Non-Indigenous Privilege in Health, Justice and Social Services Preceding First Episode Psychosis: A Population-Based Cohort Study

2021 ◽  
Author(s):  
Jennifer Manuel ◽  
Ruth Cunningham ◽  
Sheree Gibb ◽  
Richard J. Porter ◽  
Suzanne Pitama ◽  
...  
Keyword(s):  
Cohort Study ◽  
Social Services ◽  
Population Based ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Health Justice

scholarly journals 17.4 STRATIFICATION AND PREDICTION OF REMISSION IN FIRST-EPISODE PSYCHOSIS PATIENTS: THE OPTiMISE COHORT STUDY

2019 ◽  
Vol 45 (Supplement_2) ◽  
pp. S116-S117
Author(s):  
Nicolas Glaichenhaus ◽  
Susana Barbosa ◽  
Emanuella Martinuzzi ◽  
Cyprien Gilet ◽  
Stéphane Jamain ◽  
...  
Keyword(s):  
Cohort Study ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis

scholarly journals S102. DIAGNOSTIC CHALLENGES AT TIME OF INPATIENT ADMISSION: DIAGNOSTIC SHIFTS IN PATIENTS WITH FIRST EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S73-S73
Author(s):  
Marlene Koch ◽  
Melanie Trimmel ◽  
Josef Baumgartner ◽  
Barbara Hinterbuchinger ◽  
Zsuzsa Litvan ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
Inpatient Unit ◽  
Early Psychosis ◽  
First Episode ◽  
Organic Psychosis ◽  
Affective Psychosis ◽  
Clinical Phenotypes ◽  
Schizophrenia Spectrum ◽  
Episode Psychosis ◽  
Time Of Admission

Abstract Background First episode psychoses (FEP) may present with diffuse symptoms and a broad range of clinical phenotypes, leading to difficulties in the early detection of the different pluripotent trajectories and consequently to instability of the diagnoses. The aim of this study was to assess the stability of diagnoses at time of admission compared to discharge in patients with FEP at a newly established early psychosis inpatient unit within a general psychiatric service in a general hospital. Methods Charts of all patients admitted to the early psychosis inpatient unit of the Clinical Division of Social Psychiatry of the Medical University of Vienna between 01.01.2016 and 31.03.2017 were reviewed. FEP was defined as a first presentation of affective, schizophreniform, acute polymorphic, organic or substance-related psychosis according to ICD-10. Results 127 patients were admitted during the said period, among whom 92 (72,4%) were diagnosed with a psychotic disorder at time of admission. 39,1% (n=36) of those had a FEP, whereof 58,3% (n=21) were diagnosed with schizophrenia spectrum psychosis, 27,8% (n=10) with affective psychosis, 11,1% (n=4) with substance-related psychosis and 2,8% (n=1) with organic psychosis as main diagnosis at time of discharge. In 50% (n=18) of FEP patients, diagnosis at time of admission was not maintained. 54,2% (n=13) of FEP patients who were admitted with a schizophrenia spectrum diagnosis had a shift in diagnosis at time of discharge, whereof 46,2% (n=6) were adjusted to another diagnosis of the same spectrum and 53,8% (n=7) to a diagnosis of either affective spectrum, substance-related psychosis or organic psychosis. 100% (n=2) of those with a persistent delusional disorder had a different diagnosis at discharge, as well as 56,3% (n=9=) of those admitted with a diagnosis of acute and transient psychotic disorders. Changes in the admission diagnoses of affective psychosis were necessary in 44,4% (n=4), whereof one half was adjusted to another diagnosis of the same spectrum and the other half to a diagnosis of the schizophrenia spectrum. Discussion The diagnostic instability in this study underlines the concept of the highly dynamic and changeable nature of psychopathology in the early stages and the pluripotent trajectories of psychosis. Furthermore, inadequate information available for specific diagnosis at time of admission as well as diagnostic uncertainty at the onset of psychosis could be implicated in the described diagnostic instability. The broad range of clinical phenotypes of early psychosis and the limitations of current diagnostic risk and identification approaches for the assessment of first episode psychosis indicate psychopathology conformed to a more dimensional rather than categorical model, as well as the need of a more dynamic model of prediction, such as the clinical staging model.

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