Risperidone was effective for a first psychotic episode

A 30-year-old man with no significant previous or family psychiatric history became severely anxious about his health after a positive COVID-19 test. Physical symptoms of COVID-19 were mild, with no evidence of hypoxia or pneumonia, throughout his illness. He was admitted to a quarantine facility. He remained highly anxious, and 1 week later, he developed paranoid delusions and auditory hallucinations (his first psychotic episode). He was treated with lorazepam 1 mg four times a day, mirtazapine 30 mg nocte and risperidone 1 mg two times a day. His psychotic symptoms lasted 1 week. He stopped psychiatric medication after 4 weeks and had remained well when reviewed 3 months later. A Diagnostic and Statistical Manual of Mental Disorders fifth edition diagnosis of brief psychotic disorder with marked stressor (brief reactive psychosis) was made. Anxiety about his health and social isolation appeared the main aetiological factors but an inflammatory component cannot be excluded. The case highlights that first episode psychosis can be associated with mild COVID-19.

Download Full-text

Family psycho-education in early onset psychosis: Effects on relapse and on the use of clinical services after the first psychotic episode (Results derived from the PIENSA program)

Neuropsychiatrie de l Enfance et de l Adolescence ◽

10.1016/j.neurenf.2012.04.785 ◽

2012 ◽

Vol 60 (5) ◽

pp. S284 ◽

Cited By ~ 1

Author(s):

M. Rapado-Castro ◽

A. Calvo ◽

C. Moreno ◽

T. Sánchez-Gutiérrez ◽

G. Chiclana ◽

...

Keyword(s):

Early Onset ◽

Psychotic Episode ◽

Clinical Services ◽

First Psychotic Episode ◽

Early Onset Psychosis

Download Full-text

P-1308 - Clinical characterization of a sample of first psychotic episode inpatients: a retrospective study

European Psychiatry ◽

10.1016/s0924-9338(12)75475-5 ◽

2012 ◽

Vol 27 ◽

pp. 1

Author(s):

C. Silveira ◽

A. Norton ◽

I. Ferraz ◽

E. Osório ◽

M. Fontoura ◽

...

Keyword(s):

Retrospective Study ◽

Psychotic Episode ◽

First Psychotic Episode

Download Full-text

Early Diagnosis and Counseling in Adolescents With Subclinical Psychotic Symptoms

The Global Psychotherapist ◽

10.52982/lkj160 ◽

2022 ◽

Vol 2 (1) ◽

pp. 62-68

Author(s):

Veronika Ivanova

Keyword(s):

Early Diagnosis ◽

Medical Model ◽

Psychotic Symptoms ◽

Clinical Psychologist ◽

Psychotic Episode ◽

Clinical Approach ◽

First Psychotic Episode ◽

Psychotherapeutic Techniques ◽

Sexual Identification ◽

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

Download Full-text

Maintenance treatment for patients with a first psychotic episode

Current Opinion in Psychiatry ◽

10.1097/yco.0000000000000494 ◽

2019 ◽

Vol 32 (3) ◽

pp. 147-156 ◽

Cited By ~ 1

Author(s):

Iris E.C. Sommer ◽

Priscilla P. Oomen ◽

Alkomiet Hasan

Keyword(s):

Maintenance Treatment ◽

Psychotic Episode ◽

First Psychotic Episode

Download Full-text

M38. PATIENT-PERSPECTIVE: NEED FOR CARE AFTER A FIRST PSYCHOSIS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.350 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S148-S149

Author(s):

Inge Heijden-Hobus ◽

Inge van der Heijden-Hobus ◽

Bram-Sieben Rosema ◽

Jacob Vorstman ◽

Martien Kas ◽

...

Keyword(s):

Family Support ◽

Qualitative Interviews ◽

Psychotic Episode ◽

Need For Care ◽

Care Needs ◽

First Psychotic Episode ◽

Basic Set ◽

Near Future ◽

First Time ◽

Clear Information

Abstract Background Only little is information is available about the needs and preferences regarding care and treatment of people who are going through a psychosis for the first time. A first psychotic episode is often an intense experience, which may not directly be recognized as a mental health problem. Given the unfamiliarity with the available options of care, it probably differs from subsequent psychoses. In order to design first psychosis programs to optimally meet patients preferences, we need to learn the care needs of these usually young people. Furthermore, peoples’ needs during the first psychosis, and the need for care after a psychotic episode have to be explored, in order to be able picking up life again after complete or incomplete remission. Methods Qualitative interviews were conducted with people (n = 20) who are in complete or partial remission after their first psychosis about their personal care needs. Interviews were conducted by an experience expert and a researcher together and lasted between 1 and 3 hours. Interviews were non-structured, but a basic set of 5 topics was used. Results Preliminary results of the interviews conducted so far (n = 14) show that people with a first psychosis have a great need for information about the symptoms they are suffering from. In addition, they believe that medication is an important ‘cornerstone’ to get rid of their symptoms. Furthermore, nearly all participants hope to be able to stop medication in the near future. Admission to a ward is in most cases experienced as frightening. One person indicated that the tranquility during admission was very welcome. At this stage, experience experts are not being reached out to yet, nor is there a clear need for social work in this stage of the disease. During and shortly after their first psychosis, the interviewees especially appreciate the support of family and close friends. Discussion Clear information about a first psychosis was mentioned as the first need. Family and close friends are most appreciated as “auxiliary troops”. Family support is therefore an important contributor in care for patients suffering from psychosis. Medication was appreciated as an important cornerstone, but only to induce remission, not as a mean for maintenance treatment. Admission was by most patients experienced as stressful. Additional research is recommended to further map what information this should be exactly, and how to bring it to the patient and his relatives.

Download Full-text