Perceived Stress and Life Events in Patients Affected by Schizophrenia and Schizoaffective and Bipolar Disorder: Is There a Role for Self-Reported Basic Symptoms?

2021 ◽  
pp. 1-8
Author(s):  
Giovanna Parmigiani ◽  
Gabriele Mandarelli ◽  
Lorenzo Tarsitani ◽  
Valentina Roselli ◽  
Ilaria Gaviano ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Life Events ◽  
Perceived Stress ◽  
Psychotic Disorders ◽  
Psychiatric Symptoms ◽  
Study Groups ◽  
Psychotic Symptoms ◽  
Subjective Perception ◽  
University Hospitals ◽  
Basic Symptoms

<b><i>Introduction:</i></b> The stress-diathesis model of psychotic disorders describes, in vulnerable individuals, the role of psychosocial stress in the onset and exacerbation of psychotic symptoms. Another interesting approach to the study of vulnerability in the development of psychosis is represented by the basic symptoms concept. <b><i>Objective:</i></b> The present study aims at proposing an integration between these two models and investigating possible associations between psychotic symptoms, basic symptoms, perceived stress, and life events in a sample of patients affected by schizophrenia (SZ), schizoaffective (SA), and bipolar disorder with and without psychotic symptoms. <b><i>Methods:</i></b> 112 patients were recruited in two university hospitals. Severity of psychiatric symptoms (Positive and Negative Syndrome Scale, PANSS), basic symptoms (Frankfurt Complaint Questionnaire, FCQ), perceived stress (Stress-related Vulnerability Scale, SVS), and life events (Paykel’s interview for recent life events) were assessed. <b><i>Results:</i></b> Patients affected by bipolar disorder (both with and without psychotic symptoms) showed a higher number of independent life events (<i>p</i> &#x3c; 0.01) and tended to report more frequently at least 1 life event in the previous 6 months (<i>p</i> &#x3c; 0.01) than patients affected by SZ or SA disorder. No differences emerged between the study groups in perceived stress nor in measures of basic symptoms. In the whole sample, a logistic regression analysis showed that the SVS total score (<i>p</i> &#x3c; 0.05) and PANSS total score (<i>p</i> &#x3c; 0.001) were associated with the presence of psychotic symptoms. <b><i>Conclusions:</i></b> In the study sample, life events and basic symptoms did not play a major role in influencing psychotic symptoms, compared to the subjective perception of stress and the severity of psychopathology. Taken together, these results can be informative for rehabilitation therapies aimed at enhancing resilience and coping strategies in this vulnerable group of patients.

What Diagnoses Are Associated with Psychosis?

2021 ◽  
pp. 35-48
Author(s):  
Beth Broussard ◽  
Michael T. Compton
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Healthcare Provider ◽  
Psychotic Disorders ◽  
Definitive Diagnosis ◽  
Psychotic Symptoms ◽  
Specific Diagnosis ◽  
Substance Related Disorders

In this chapter we discuss the different diagnoses associated with psychosis. Schizophrenia is one of several primary psychotic disorders, a group of psychiatric disorders that primarily cause psychosis. Other disorders can cause psychotic symptoms—or symptoms similar to these—but are not considered psychotic disorders. A few examples of such disorders are major depressive disorder, bipolar disorder, and some substance-related disorders. It is often difficult to make a specific diagnosis when long-term information is not available at first. In instances in which a definitive diagnosis is uncertain, a working diagnosis allows the healthcare provider to begin effective treatments for psychosis even before a more certain diagnosis is made.

scholarly journals Alcohol Use Disorder Is Differently Associated With Psychotic Symptoms According To Underlying Psychiatric Disorders: A General Population Study

2019 ◽  
Author(s):  
Baptiste Pignon ◽  
Guillaume Sescousse ◽  
Ali Amad ◽  
Imane Benradia ◽  
Guillaume Vaiva ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
General Population ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Alcohol Use Disorder ◽  
Psychotic Disorders ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Depression And Anxiety ◽  
General Population Study

Abstract Aims Psychotic symptoms can occur in the general population, and alcohol use disorder (AUD) is an identified vulnerability factor. However, it remains unclear how AUD is associated with psychotic symptoms, depending on the underlying psychiatric condition. We aimed to compare the prevalence of psychotic symptoms among subjects with different types of psychiatric disorders, i.e. unipolar or bipolar disorders, anxiety disorders, psychotic disorders or no psychiatric disorder, depending on whether or not there was an underlying AUD. Methods In a 38,694-subject general population study, we compared the likelihood of occurrence of seven types of psychotic symptoms, depending on the AUD status and the underlying psychiatric disorders, after adjustment for age, sex, marital status, education and income levels. Results In unipolar depression and anxiety disorders, almost all types of psychotic symptoms were found associated with AUD (odds ratios (ORs) between 1.98 and 2.19). In contrast, in bipolar disorder, only auditory hallucinations were associated with AUD (OR = 2.50). In psychotic disorders, only thought broadcasting was more frequent among subjects with AUD (OR = 1.78). Conclusion Our findings in depression and anxiety disorders are in line with the ‘dual diagnosis’ concept, which posits that comorbid psychiatric/addictive disorders form distinctive entities that are more frequently associated with non-specific severity factors, here psychotic symptoms. The co-occurrence of AUD in bipolar/psychotic disorders was not associated with a generalized increased occurrence of psychotic symptoms but altered their manifestations with an increased risk of auditory hallucinations for bipolar disorder and thought broadcasting for psychotic disorders.

The use of Polygenic Risk Scores to Inform Aetiology of Mood and Psychotic Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S166-S166
Author(s):  
J. Harrison ◽  
S. Mistry
Keyword(s):  
Bipolar Disorder ◽  
Genetic Basis ◽  
Psychotic Disorders ◽  
Mental Illnesses ◽  
Risk Scores ◽  
Psychotic Symptoms ◽  
Polygenic Risk ◽  
Genetic Overlap ◽  
Competing Interest

IntroductionPolygenic risk scores (PRS) incorporate many small genetic markers that are associated with conditions. This technique was first used to investigate mental illnesses in 2009. Since then, it has been widely used.ObjectivesWe wanted to explore how PRS have been used to the study the aetiology of psychosis, schizophrenia, bipolar disorder and depression.AimsWe aimed to conduct a systematic review, identifying studies that have examined associations between PRS for bipolar disorder, schizophrenia/psychosis and depression and psychopathology-related outcome measures.MethodsWe searched EMBASE, Medline and PsychInfo from 06/08/2009 to 14/03/2016. We hand-searched the reference lists of related papers.ResultsAfter removing duplicates, the search yielded 1043 publications. When irrelevant articles were excluded, 33 articles remained. We found 24 studies using schizophrenia PRS, three using bipolar PRS and nine using depression PRS. Many studies successfully used PRS to predict case/control status. Some studies showed associations between PRS and diagnostic sub-categories. A range of clinical phenotypes and symptoms has been explored. For example, specific PRS are associated with cognitive performance in schizophrenia, psychotic symptoms in bipolar disorder, and frequency of episodes of depression. PRS have also demonstrated genetic overlap between mental illnesses. It was difficult to assess the quality of some studies as not all reported sufficient methodological detail.ConclusionsPRS have enabled us to explore the polygenic architecture of mental illness and demonstrate a genetic basis for some observed features. However, they have yet to give insights into the biology, which underpin mental illnesses.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychiatric symptoms’ treatment to patients addicted to alcohol, cocaine and crack

2011 ◽  
Vol 26 (S2) ◽  
pp. 112-112
Author(s):  
A.M. Silva ◽  
M.L. Pequeno ◽  
M.D. Feltrin ◽  
J.A. Gonçalves ◽  
F.J. Ropero Pelaez ◽  
...  
Keyword(s):  
Illicit Drugs ◽  
Psychotic Disorders ◽  
Psychiatric Symptoms ◽  
Public Mental Health ◽  
Psychotic Symptoms ◽  
Limiting Factor ◽  
Atypical Neuroleptics ◽  
Consciousness Level ◽  
Public Mental Health Service ◽  
Level Reduction

IntroductionExtrapyramidal side-effects (EPS) related to the use of neuroleptics are an limiting factor to patients’ compliance during the treatment with this group of drugs.ObjectiveThe aim of this study was to identify which drugs are mostly prescribed for cocaine, crack and alcohol addicts’ psychotic symptoms.MethodsThis study selected 31 patients with mean age of 33.61 ± 1.90 enrolled with psychotic disorders related to use of illicit drugs in an public mental health service.ResultsPatients under this study were addict to alcohol (61,29%), cocaine or crack, associated (38,71%).The percentage of patients addicted to alcohol treated with typical neuroleptic-(typical-neurol) was 42,11%, with atypical neuroleptic-(atypical-neurol) was 26,32%, with association of typical and atypical neuroleptics-(typical/atypical-neurol) (21,60%), and with benzodiazepines associated with serotonin-reuptake-inhibitors (BZD-SSRI) (10,00)%. The cocaine or crack associated or not with alcohol patients were treated with typical-neurol (41,67%), atypical-neurol (41,67%), typical/atypical-neurolol (8,33%) and BZD-SSRI (8,33%).The EPS related to the use of neuroleptics in patients addicted to alcohol were given biperiden (52,65%), promethazine or anticolvulsant (Prometh/Anticonv) (42,11%) and no-treatment (5,26%). For those patients, addicted to cocaine, crack and alcohol altogether were given biperiden (58,34%), Prometh/Anticonv (25,00%) and no-treatment (16,67%).ConclusionsIn the case of using neuroleptics, the EPS should be reversed with biperiden in an dose combined with the neuroleptic prescribed to each individual, in an effort to minimized hallucination. Also, if sedation was indicated using Prometh/Anticonv to patients that are taking neuroleptics, then the health care professional team in charge must be aware of consciousness level-reduction.

scholarly journals Lipid and Glycemic Profiles in Patients with Bipolar Disorder: Cholesterol Levels Are Reduced in Mania

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 28
Author(s):  
Laura Fusar-Poli ◽  
Andrea Amerio ◽  
Patriciu Cimpoesu ◽  
Antimo Natale ◽  
Virginio Salvi ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Psychiatric Symptoms ◽  
Density Lipoprotein ◽  
Blood Cholesterol ◽  
Mental Condition ◽  
Blood Levels ◽  
University Hospitals ◽  
Cholesterol Levels

Background and Objectives: Bipolar disorder (BD) is a severe mental condition with a lifetime prevalence estimated around 2% among the general population. Due to risk factors, etiological mechanisms, and the chronic use of psychotropic medications, people with BD are frequently affected by medical comorbidities, such as metabolic syndrome (MetS), associated with altered blood levels of glucose, cholesterol, and triglycerides. Moreover, the lipid concentration may be associated with the severity of psychiatric symptoms. Materials and Methods: Five hundred and forty-two in- and outpatients (418 affected by BD and 124 affected by schizophrenia) were recruited in two Italian university hospitals. A blood examination assessing the fasting glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides was performed. Results: No significant differences were found in the lipid and glycemic profiles between patients with BD and schizophrenia. When considering only the BD sample, we found that patients experiencing a manic episode had significantly lower total cholesterol, HDL, and LDL than euthymic patients. Moreover, the total and LDL cholesterol levels were significantly lower in (hypo)manic than depressed patients. Mood episodes did not influence the triglyceride and glucose levels in our sample. Conclusions: Clinicians should pay attention to blood cholesterol levels in patients with BD, as differences in concentrations may predispose them to severe medical conditions and can be associated with the onset of mood episodes.

scholarly journals Differences in Demographic and Clinical Characteristics of Patients With Depressive vs. Manic First Episode of Bipolar Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhonggang Wang ◽  
Yuying Cao ◽  
Yaya Zhu ◽  
Kunkun Li ◽  
Xianfei Jiang ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Characteristics ◽  
Psychiatric Symptoms ◽  
Education Level ◽  
Chinese Patients ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Clinical Variables ◽  
Depression Group ◽  
Initial Symptoms

Background: Bipolar disorder is a serious mental disease marked by episodes of depression, mania, hypomania, or mixed states. Patients with bipolar disorder may present with different symptoms at first onset. The aim of this study is to compare demographic and clinical variables based on a patient's first episode of bipolar disorder, including risk of recurrence over a 2-year period.Methods: A large cohort (N = 742) of patients with bipolar disorder in China was analyzed. Patients were divided into two groups according to their first episode of bipolar disorder, either depression or mania. Patients in mixed state first episode were classified based on predominant symptoms. Three hundred eighteen patients of the cohort had a first episode of mania and 424 patients had initial symptoms of depression. Demographic and clinical data were collected. All patients were followed up for 24 months. Data on compliance with follow-up appointments and recurrence of symptoms after 6, 12, 18, and 24 months were collected. Clinical characteristics (course of disease, age of onset, psychiatric family history, etc.) were compared between the mania group and depression groups.Results: More patients with bipolar disorder had a first episode of depression than mania (57.14 vs. 42.86%). Compared with the depression group, the mania group had later age of diagnosis of bipolar disorder [(38.64 ± 13.50) vs. (36.34 ± 14.94), P = 0.028], lower education level [(9.37 ± 4.34) vs. (10.17 ± 4.81), P = 0.017] and longer latency between an initial episode of psychiatric symptoms and formal bipolar diagnosis [(10.80 ± 10.76) vs. (8.85 ± 9.90), P = 0.012]. More patients in the mania group were male and without psychotic symptoms (all P &lt; 0.05). In comparison with the mania group, more patients in the depression group were female, with higher frequency of a reported precipitating event before first mood episode (all P &lt; 0.05). Compared with the depression group, the mania group had more recurrences of illness at the end of 12 months (Z =-2.156, P = 0.031), 18 months (Z =-2.192, P = 0.028), and 24 months (Z = −2.364, P = 0.018).Conclusions: In our study, there are a number of differences in demographic and clinical characteristics of patients with different onset syndromes of bipolar disorder. These differences include gender, education level, diagnosis age, the rate of recurrences, and others. These data of a cohort of Chinese patients add to the growing international literature on the relationship between index episode of bipolar disorder and clinical variables and outcomes. These results and further study may allow clinicians to offer patients and families more reliable prognostic information at the onset of disease.

scholarly journals Stressful Life Events In First Episode Psychosis

2021 ◽  
Vol 10 (1) ◽  
pp. 38-42
Author(s):  
B.D. Karki ◽  
D. Joshi ◽  
A.P. Adhikari
Keyword(s):  
Life Events ◽  
Perceived Stress ◽  
Stressful Life Events ◽  
First Episode Psychosis ◽  
Stressful Life ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Episode Psychosis

Introduction: First episode psychosis refers to the first time someone experiences psychotic symptoms or a psychotic episode. There are evidences related to the role of major life events and childhood trauma in the development of first episode psychosis. There are few studies regarding the environmental exposure to stressful life events and how these events might influence the onset of a psychotic disorder, and role of perceived stress. This study aimed to identify the relationship between stressful life events and first episode psychosis in Nepalese context. Material And Method: It was a hospital based cross-sectional, descriptive study. A total of 50 cases of first episode psychosis were included and the diagnosis was made according to ICD 10- Diagnostic Criteria for Research and verified by two consultant psychiatrists. Semi Structured Performa was designed to collect the information about the socio demographic data and perceived stress was assessed with Presumptive Stressful Life Events Scale (PSLES). Results: There were 62% female and 38% male patients with first episode psychosis with mean age 26.32 years. Majority of the participants were from rural areas (94%), married (58%), educated up to primary level (38%) and housewife (40%). 60.7% of ATPD had stressful life events (P =0. 000)which was higher than the stressful life events in patient with Schizophrenia (P =0. 005). There was a positive correlation between stressful life events and gender, setting, socioeconomic status and Diagnosis (P <0.05). Conclusion: Results show the relevance of presence of stressful life events as a potent source of perceived stress in first episode psychosis sample. Therefore this study highlights the importance of psychosocial intervention in this vulnerable group for management of illness and might be an important strategy for prevention.

Clinical overlap between behavioral variant of frontotemporal dementia and bipolar disorder: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S335-S336 ◽  
Author(s):  
P. Oliveira ◽  
C. Roque ◽  
V. Santos ◽  
N. Madeira
Keyword(s):  
Bipolar Disorder ◽  
Frontotemporal Dementia ◽  
Psychiatric Symptoms ◽  
Late Onset ◽  
Single Photon ◽  
Photon Emission ◽  
Interpersonal Behavior ◽  
Psychotic Symptoms ◽  
Emission Computed Tomography ◽  
Global Pattern

The behavioral variant of frontotemporal dementia (FTD) often begins with psychiatric symptoms, including changes in personal conduct and/or interpersonal behavior. Prior to developing cognitive impairment, differentiating FTD from primary psychiatric disorders might be challenging.This work presents a case of a manic episode with psychotic features in a 61-year-old man, whom personality changes and daily life difficulties arouse and persist after optimal management of the active manic and psychotic symptoms. Neuropsychological assessment detailed severe deficits among visuospatial and planning performances. Structural neuroimaging (CT-scan) primary revealed a global pattern of brain volume reduction. Severe perfusion deficits on frontal and both parietal lobes were shown on 99mTc-HMPAO single-photon emission computed tomography (SPECT). The hypothesis of probable FTD (behavioral variant) was established.The present case highlights how putative atypical and late-onset forms of bipolar disorder (BD) might instead progress to FTD. Several links are being advanced between the BD and FTD, for instance the close involvement of the C9ORF72 gene in a group of BD patients which progresses to dementia. These relations have actually been on focus recently. The field is however still relatively unexplored.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Exploring the neuroanatomical bases of psychotic features in bipolar disorder

2017 ◽  
Vol 26 (4) ◽  
pp. 358-363 ◽  
Author(s):  
E. Maggioni ◽  
A. C. Altamura ◽  
P. Brambilla
Keyword(s):  
Bipolar Disorder ◽  
Grey Matter ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Grey Matter Volume ◽  
Healthy Controls ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Matter Volume ◽  
Psychotic Features

Although bipolar disorder (BD) is traditionally conceptualised as one diagnostic entity, the heterogeneity of pathophysiological manifestations in BD suggests the need to classify the subtypes of the illness based on neural markers. Specifically, the presence of psychotic symptoms seems to be relevant for the clinical outcome and may have specific neuroanatomical bases. The main objective of the present review was to assess whether the distinction between psychotic BD (PBD) and non-psychotic BD (NPBD) can improve the identification of the neurobiological markers of this complex illness. To this end, we summarised the findings from the magnetic resonance imaging studies that explored the cerebral correlates of psychosis in BD in terms of grey matter volume (GMV). Overall, the results suggest the presence of peculiar GMV differences between PBD and NPBD. Specifically, psychosis in BD seems to be associated with cortical GMV deficits compared with both healthy controls and NPBD, mainly in the frontal region. Conversely, NPBD patients showed GMV deficits in selective regions of the basal ganglia when compared with the other groups. Taken together, this evidence confirms the importance to classify BD based on the psychotic dimension, which may have a specific neurobiological architecture that partially overlaps across multiple psychotic disorders.

Acute psychosis induced by short-term treatment with methylprednisolone – a case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S626-S626 ◽  
Author(s):  
I.A. Andrei ◽  
A.M. Cristache ◽  
M.E. Parfene-Banu ◽  
A.A. Frunză ◽  
M.C. Boer ◽  
...  
Keyword(s):  
Glucocorticoid Receptors ◽  
Psychotic Disorders ◽  
Psychiatric Symptoms ◽  
Early Recognition ◽  
Corticosteroid Treatment ◽  
Hippocampal Volume ◽  
Term Treatment ◽  
Psychotic Symptoms ◽  
Short Term Treatment ◽  
Disc Protrusion

Steroid treatment has been widely used for immunologic and inflammatory disorders. Psychiatric symptoms are not uncommon complications of the corticosteroid treatment. Correlations between the hypothalamic-pituitary-adrenal (HPA) axis and various psychoses have been already established in the specialty literature (modified HPA activity by drugs or not, glucocorticoid receptors downregulation, reduced hippocampal volume). The prevalence of corticosteroid-induced psychotic disorders varies around 5–6%. Most corticosteroid-induced symptoms start during the first few weeks after treatment initiation, but their onset can also be in the first 3–4 days. We would like to report the case of a 30-year-old woman who was taken to the psychiatry emergency room for psychomotor agitation, auditory and visual hallucinations, and bizarre delusions, disorganized thinking and modified behavior. The patient had no personal or family history of psychiatric illness. One month earlier, she was admitted in a neurosurgery ward and underwent lumbar surgery for L4–L5 disc protrusion; at discharge, eight days later, she began treatment with methylprednisolone 80 mg/day for three days. One week later, psychotic symptoms emerged that resulted in her hospitalization in our ward for apparent steroid-induced psychosis. Treatment with risperidone (up to 6 mg/day) and diazepam (10 mg/day, rapidly discontinued) was initiated. The endocrinology examination revealed modified plasmatic cortisol. The psychosis resolved several weeks later and the patient was discharged. Psychiatric complications induced by steroids underline the role of physicians that have to educate the patients and their families about these side effects and their early recognition.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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