#3117 Fregoli syndrome in primary and secondary psychosis: a case level meta-analysis

2021 ◽  
Vol 92 (8) ◽  
pp. A18-A18
Author(s):  
Maria Teixeira-Dias ◽  
Amber Kaur Dadwal ◽  
Graham Blackman
Keyword(s):  
Right Hemisphere ◽  
English Literature ◽  
Meta Analysis ◽  
First Episode ◽  
Bias Assessment ◽  
Random Effects Models ◽  
Episode Psychosis ◽  
Treatment Responses ◽  
The Right

Objectives/AimsFregoli syndrome is a rare delusion characterised by the misidentification of an individual, typically of someone who the patient has an emotional link towards. The pathoaetiology of Fregoli syndrome remains largely a mystery, however, it has been described in patients experiencing either a primary or secondary (organic) psychosis. We sought to compare the neuropsychiatric features of Fregoli syndrome in primary and secondary psychosis.MethodsA patient-level meta-analysis was conducted. Five databases were searched for any descriptions of Fregoli syndrome. The patients and the psychotic episodes details alongside the co-occurring neuropsychiatric features and treatment responses were extracted. A risk of bias assessment was carried by scoring the methodological quality of all case studies. Random-effects models were used to pool the data and odds ratios and 95% confidence intervals were estimated for each of the neuropsychiatric features extracted between primary and secondary psychoses groups.ResultsA total of 119 patients (62 with primary psychosis, 50 with secondary psychosis and 7 with mixed or unknown aetiology) with Fregoli syndrome were identified in the English literature. Persecutory features were more likely to occur in patients with primary Fregoli syndrome (OR = 0.26, 95% CI[0.10;0.67], p < 0.01). In addition, Fregoli syndrome in the context of a first-episode psychosis (OR = 11.00, 95% CI [2.45;49.39], p < 0.01) and in the presence of neuroimaging abnormalities (OR = 20.19, 95% CI [4.36; 93.47], p < 0.01) was significantly associated with secondary aetiology. Patients in the secondary psychosis group (n=14) showed more right hemisphere lesions than patients in the primary psychosis group (n=1), however this trend was not significant (p = 0.10). Furthermore, no statistical differences between psychoses groups were found for the demographic, clinical and neurophysiological features analysed.ConclusionsThis is the first meta-analysis investigating the features of Fregoli syndrome in primary and secondary psychosis.Findings suggest that secondary causes of Fregoli syndrome are associated with a first-episode of psychosis and that neuroimaging abnormalities, particularly in the right hemisphere, are associated with a secondary organic cause.

A meta-analysis of factors associated with quality of life in first episode psychosis

2018 ◽  
Vol 202 ◽  
pp. 26-36 ◽  
Author(s):  
Philip Watson ◽  
Jian-Ping Zhang ◽  
Asra Rizvi ◽  
Jonathan Tamaiev ◽  
Michael L. Birnbaum ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Meta Analysis ◽  
First Episode Psychosis ◽  
First Episode ◽  
Factors Associated ◽  
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.

First-line contact aspiration versus first-line stent retriever for acute posterior circulation strokes: an updated meta-analysis

2021 ◽  
pp. neurintsurg-2021-017497
Author(s):  
Gengfan Ye ◽  
Xuebin Wen ◽  
Hongcai Wang ◽  
Chengfeng Sun ◽  
Zhihao Pan ◽  
...  
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Functional Independence ◽  
Posterior Circulation ◽  
Stent Retriever ◽  
First Line ◽  
Random Effects Models ◽  
First Pass

BackgroundBoth stent retriever (SR) and contact aspiration (CA) are widely used as first-line strategies for acute posterior circulation strokes (PCS). However, it is still unclear how CA and SR compare as the first-line treatment of acute PCS. Several new studies have been published recently, so we aimed to perform an updated meta-analysis.MethodsThe meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. Random-effects models were performed to pool the outcomes and the value of I2 was calculated to assess the heterogeneity.ResultsTen observational studies with 1189 patients were included, among whom 492 received first-line CA and 697 received first-line SR. The pooled results revealed that first-line CA could achieve a significantly higher proportion of modified Thrombolysis In Cerebral Infarction (mTICI) 2b/3 (OR 1.90, 95% CI 1.33 to 2.71, I2=0%), mTICI 3 (OR 1.95, 95% CI 1.15 to 3.31, I2=59.6%), first-pass effect (OR 2.91, 95% CI 1.51 to 5.58, I2=0%), lower incidence of new-territory embolic events (OR 0.20, 95% CI 0.05 to 0.83, I2=0%), and shorter procedure time (mean difference −29.4 min, 95% CI −46.8 to −12.0 min, I2=62.8%) compared with first-line SR. At 90-day follow-up, patients subjected to first-line CA showed a higher functional independence (modified Rankin Scale score 0–2; OR 1.38, 95% CI 1.01 to 1.87, I2=23.5%) and a lower mortality (OR 0.71, 95% CI 0.50 to 1.00, p=0.050, I2=0%) than those subjected to first-line SR.ConclusionsThis meta-analysis suggests that the first-line CA strategy could achieve better recanalization and clinical outcomes for acute PCS than first-line SR. Limited by the quality of included studies, this conclusion should be drawn with caution.

scholarly journals Systematic Review with Meta-Analysis: Endoscopic and Surgical Resection for Ampullary Lesions

2020 ◽  
Vol 9 (11) ◽  
pp. 3622
Author(s):  
Christian Heise ◽  
Einas Abou Ali ◽  
Dirk Hasenclever ◽  
Francesco Auriemma ◽  
Aiste Gulla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Significant Risk ◽  
Significant Heterogeneity ◽  
Incomplete Resection ◽  
Quality Of Data ◽  
Surgical Interventions ◽  
Random Effects Models ◽  
Fixed And Random Effects

Ampullary lesions (ALs) can be treated by endoscopic (EA) or surgical ampullectomy (SA) or pancreaticoduodenectomy (PD). However, EA carries significant risk of incomplete resection while surgical interventions can lead to substantial morbidity. We performed a systematic review and meta-analysis for R0, adverse-events (AEs) and recurrence between EA, SA and PD. Electronic databases were searched from 1990 to 2018. Outcomes were calculated as pooled means using fixed and random-effects models and the Freeman-Tukey-Double-Arcsine-Proportion-model. We identified 59 independent studies. The pooled R0 rate was 76.6% (71.8–81.4%, I2 = 91.38%) for EA, 96.4% (93.6–99.2%, I2 = 37.8%) for SA and 98.9% (98.0–99.7%, I2 = 0%) for PD. AEs were 24.7% (19.8–29.6%, I2 = 86.4%), 28.3% (19.0–37.7%, I2 = 76.8%) and 44.7% (37.9–51.4%, I2 = 0%), respectively. Recurrences were registered in 13.0% (10.2–15.6%, I2 = 91.3%), 9.4% (4.8–14%, I2 = 57.3%) and 14.2% (9.5–18.9%, I2 = 0%). Differences between proportions were significant in R0 for EA compared to SA (p = 0.007) and PD (p = 0.022). AEs were statistically different only between EA and PD (p = 0.049) and recurrence showed no significance for EA/SA or EA/PD. Our data indicate an increased rate of complete resection in surgical interventions accompanied with a higher risk of complications. However, studies showed various sources of bias, limited quality of data and a significant heterogeneity, particularly in EA studies.

scholarly journals 4327 Structural Neural Correlates of Social Functioning in First Episode Psychosis and Malleability in Response to Targeted Cognitive Training

2020 ◽  
Vol 4 (s1) ◽  
pp. 37-38
Author(s):  
Kathleen Miley ◽  
Fang Yu ◽  
Ian Ramsay ◽  
Sophia Vinogradov
Keyword(s):  
Social Functioning ◽  
Cognitive Training ◽  
Gray Matter Volume ◽  
Neural Correlates ◽  
Parahippocampal Gyrus ◽  
First Episode ◽  
Posterior Cingulate ◽  
Episode Psychosis ◽  
The Right ◽  
The Relationship

OBJECTIVES/GOALS: Development of interventions that improve social functioning (SF) in first episode psychosis (FEP) is hindered by a poor understanding of the neural mechanisms underlying SF deficits. This research aims to identify neural correlates of social functioning in FEP, and to evaluate whether this substrate is malleable in response to cognitive training. METHODS/STUDY POPULATION: This is a secondary data-analysis of participants in an ongoing randomized clinical trial investigating whether 12 weeks of targeted cognitive training is neuroprotective in FEP, versus treatment as usual. Baseline and post-training assessments include a brain MRI, three measures of SF, and a neurocognitive battery. Healthy controls complete MRI only. Differences in cortical thickness (CTh) and gray matter volume (GMV) in regions of interest between FEP and controls will be determined with ANCOVA. Multiple linear regression will be used to determine the relationship between neural substrate and SF in FEP. Linear mixed models will be used to examine the relationship between change in CTh and GMV and change in SF. Data collection is ongoing for this study. RESULTS/ANTICIPATED RESULTS: In preliminary data including 12 FEP and 9 healthy controls, FEP demonstrated cortical loss in the right superior frontal cortex and the right isthmus-posterior cingulate. Greater cortical thickness in the posterior cingulate cortex was associated with better social functioning across multiple measures when controlling for global cognition. Gray matter volume in the parahippocampal gyrus was also associated with better social functioning. Preliminary results evaluating whether targeted cognitive training is neuroprotective in these regions of interest in a manner that is associated with improved social functioning will also be presented. DISCUSSION/SIGNIFICANCE OF IMPACT: Preliminary results link the posterior cingulate and parahippocampal gyrus to SF in FEP. Further research will investigate the contribution of changes in these brain regions to improved SF. The identification of biological treatment targets for SF may lead to development and optimization of novel interventions to alleviate SF deficits in FEP.

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