scholarly journals Trauma-intrusive hallucinations and the dissociative state

BJPsych Open ◽  
2018 ◽  
Vol 4 (5) ◽  
pp. 385-388 ◽  
Author(s):  
Deborah Wearne ◽  
Guy Curtis ◽  
Winston Choy ◽  
Richard Magtengaard ◽  
Mathew Samuel ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Rating Scale ◽  
Psychotic Symptoms ◽  
Potential Treatment ◽  
Ptsd Symptoms ◽  
Hearing Voices ◽  
Dissociative Experience ◽  
Dissociative Subtype ◽  
Specific Symptoms ◽  
Dissociative State

BackgroundResearch has supported a model of dissociation mediating the experience of hearing voices in traumatised individuals.AimsTo further understand this model by examining subtypes of the dissociative experience involved in trauma-intrusive hallucinations.MethodThe study involved four hospitals, 11 psychiatrists and 69 participants assessed using the Psychotic Symptoms Rating scale, the PTSD Symptoms Scale Interview and the Dissociative Subtype of PTSD ScoreResultsIn total, 59% (n = 41) of the participants heard voices and they were compared with the 41% (n = 28) who did not. The severity of PTSD symptoms did not predict experience of hearing voices. Regression analysis indicated that two scales of dissociation (derealisation/depersonalisation and loss of awareness) were equally good predictors of the extent of hearing voices. Adding other possible predictors (age of trauma <18, sexual violence) was relevant but did not enhance the prediction.ConclusionsThis research supports the proposal that trauma-intrusive voices are mediated by symptoms of dissociation. The supported model describes general, rather than trauma specific, symptoms of dissociation mediating the experience of hearing voices. The concept of anchoring is discussed and suggests a potential treatment strategy, which could be useful in the clinical management of hearing voices.Declaration of interestNone.

Concurrent Validity of the Global Assessment of Functioning Scale for Clients with Schizophrenia

2007 ◽  
Vol 100 (2) ◽  
pp. 571-574 ◽  
Author(s):  
Robert C. Schwartz
Keyword(s):  
Regression Analysis ◽  
Functional Assessment ◽  
Concurrent Validity ◽  
Global Assessment ◽  
Rating Scale ◽  
Psychotic Symptoms ◽  
Global Assessment Of Functioning ◽  
Global Functioning ◽  
Gaf Scores ◽  
Danger To Others

Although the Global Assessment of Functioning (GAF) scale is a widely utilized instrument, little data on construct validity is available about its use with clients having schizophrenia. This study compared point-specific GAF scores with concurrent ratings of symptomatology and social and occupational impairments using the Functional Assessment Rating Scale (Ward & Dow, 1994). A linear multiple regression analysis of empirical data from investigations of clients' global functioning showed that increased work and school-related problems, danger to others, and psychotic symptoms predicted lower GAF scores. In general, GAF scores seem to reflect the construct of global psychological, social, and occupational functioning that the scale was designed to measure.

Association between severity of schizophrenic symptoms and urinary retention

2001 ◽  
Vol 16 (8) ◽  
pp. 497-500 ◽  
Author(s):  
R. Shiloh ◽  
A. Weizman ◽  
P. Dorfman-Etrog ◽  
N. Weizer ◽  
H. Munitz
Keyword(s):  
Urinary Retention ◽  
Rating Scale ◽  
Medical Condition ◽  
Paranoid Schizophrenia ◽  
Temporal Correlation ◽  
Continuous Treatment ◽  
Psychotic Symptoms ◽  
General Medical Condition ◽  
Haloperidol Treatment ◽  
Psychotic Exacerbation

SummaryA case is presented in which severe urinary retention (UR) occurred during an acute psychotic exacerbation of paranoid schizophrenia. The voiding dysfunction was apparent during continuous treatment with unchanged doses of haloperidol, and it completely resolved with the remission of the psychotic symptoms. A clear temporal correlation was evident between the patient’s mental status, the Brief Psychiatric Rating Scale (BPRS) score and the degree of the UR as assessed by quantitatively measuring the total daily postvoiding urine residues. We could not relate the UR to any apparent general medical condition or to the haloperidol treatment. The presented data suggests that UR in schizophrenic patients might be the end-result of various psychosis-related mechanisms.

scholarly journals Clinical benefits, referral practice and cost implications of an in-hospital pain service: results of a service evaluation in a London teaching hospital

2016 ◽  
Vol 11 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Maya Sussman ◽  
Elizabeth Goodier ◽  
Izabella Fabri ◽  
Jessica Borrowman ◽  
Sarah Thomas ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Pain Management ◽  
Teaching Hospital ◽  
Rating Scale ◽  
Service Evaluation ◽  
Rank Test ◽  
Future Research ◽  
Binary Logistic Regression Analysis ◽  
Significant Difference ◽  
Referral Practice

Background: In-hospital pain services (IPS) are commonplace, but evidence of efficacy is inadequate, and patients’ pain management in any hospital ward remains problematic. This service evaluation aimed to measure the effect of a contemporary IPS, its appropriate use and cost-efficacy. Methods: Records of 249 adults reviewed by the IPS in an inner London Teaching Hospital over an 8-month period were analysed for demographic data, interventions, workload and change in pain intensity measured by numerical rating scale (NRS). Non-parametric tests were used to evaluate differences between initial and final NRS. Spearman’s rank correlation analysis was used to create a correlation matrix to evaluate associations between all identified independent variables with the change in NRS. All strongly correlated variables (ρ > 0.5) were subsequently included in a binary logistic regression analysis to identify predictors of pain resolution greater than 50% NRS and improvement rather than deterioration or no change in NRS. Finally, referral practice and cost of inappropriate referrals were estimated. Referrals were thought to be inappropriate when pain was not optimised by the referring team; they were identified using a set algorithm. Results: Initial median NRS and final median NRS were significantly different when a Wilcoxon signed-rank test was applied to the whole cohort; Z = –5.5 (p = 0.000). Subgroup analysis demonstrated no significant difference in the ‘mild’ pain group; z = –1.1 (p = 0.253). Regression analysis showed that for every unit increase in initial NRS, there was a 62% chance of general and a 33% chance of >50% improvement in final NRS. An estimated annual cost-saving potential of £1546 to £4558 was found in inappropriate referrals and patients experiencing no benefit from the service. Discussion: Results suggest that patients with moderate to severe pain benefit most from IPS input. Also pain management resources are often distributed inefficiently. Future research is required to develop algorithms for easy identification of potential treatment responders.

Deinstitutionalisation for Long-Term Mental Illness: A 2-Year Clinical Evaluation

2000 ◽  
Vol 34 (3) ◽  
pp. 476-483 ◽  
Author(s):  
Coletta Hobbs ◽  
Christopher Tennant ◽  
Alan Rosen ◽  
Lesley Newton ◽  
Helen M. Lapsley ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Social Behaviour ◽  
Rating Scale ◽  
Longitudinal Design ◽  
Psychiatric Service ◽  
Clinical Effectiveness ◽  
Psychotic Symptoms ◽  
Service Support ◽  
Community Psychiatric Service

Objective: The closure of a long-stay psychiatric hospital in Sydney caused the transfer of an initial 40 very long-term patients to four community residences, each with 10 beds, for a continuing process of deinstitutionalisation. Community psychiatric service support and 24-h supervision were provided. This paper describes the residents' clinical progress which was assessed over a 2-year period. Method: This study employed a quasi-experimental longitudinal design. Evaluation commenced prior to discharge and continued for 2 years following community relocation using the Brief Psychiatric Rating Scale, Life Skills Profile, Social Behaviour Scale, Montgomery Asberg Depression Rating Scale and Quality Of Life measures. Readmission, demographic, case history and medication data were also collected. Results: Of the 40 patients initially transferred to the community, seven required long-term readmission to hospital (either prior to or after amalgamation) and one patient died of medical causes. Additional patients transferred from the hospital to the community following the readmissions. Three of these additional patients had achieved a 2-year community tenure during the study period and were included in the clinical evaluation. The 35 residents in total who remained in the community for 2 years, demonstrated a significant improvement in psychotic symptoms, without significant change in the level of neuroleptic medication. Importantly, the 2 years of community living resulted in a significant increase in the residents' life satisfaction. There were no statistically significant changes in residents' living skills, depressive symptoms or social behaviour problems over the 2 years, indicative of the need for supervision and community service support following deinstitutionalisation. Over the 2-year period, some 37% of the residents required temporary readmission. Conclusion: This study demonstrates the clinical effectiveness of deinstitutionalisation, when planned within a mental health system with adequate community resources.

scholarly journals The use of an antagonist 5-HT2a/c for depression and motor function in Parkinson' disease

2009 ◽  
Vol 67 (2b) ◽  
pp. 407-412 ◽  
Author(s):  
Antonio Luiz dos Santos Werneck ◽  
Ana Lucia Rosso ◽  
Maurice Borges Vincent
Keyword(s):  
Parkinson Disease ◽  
Motor Function ◽  
Rating Scale ◽  
Statistical Significance ◽  
Psychotic Symptoms ◽  
Initial Moment ◽  
The Mean ◽  
Group 2 ◽  
To Receive ◽  
Group 1

OBJECTIVE: To test the ability of a 5HT2a/c (trazodone) antagonist, to improve depression and motor function in Parkinson' disease (PD). METHOD: Twenty PD patients with and without depression were randomly assigned to receive trazodone (group 1) or not (group 2). They were evaluated through UPDRS and Hamilton Depression Rating Scale (HAM-D). RESULTS: For the UPDRS the mean score of group 2 was 33.1 ± 19.7 and 37.1 ± 18.0 at the end. For the group 1, the corresponding scores were 31.4 ± 11.3 and 25.9 ± 13.7. The variations in the Mann-Whitney test were 0.734 at the initial moment and 0.208 at the final moment. The variation in the comparison of the initial moment with the final moment was 0.005 providing statistical significance. For the HAM-D, the mean score went up 4 points in group 2, contrary to a 5.5 points decrease in group 1. CONCLUSION: Data analysis shows that this agent significantly improves depression, but the motor function improved only in the depressed patients. Because of the known anti-dopaminergic property of the 5-HT2c receptors, a possible approach for depression in PD could be the use of 5-HT2c antagonists, similarly to the use of atypical neuroleptics in case of psychotic symptoms.

A Rating Scale for Psychotic Symptoms (RSPS)

1999 ◽  
Vol 38 (2-3) ◽  
pp. 101-122 ◽  
Author(s):  
Guy Chouinard ◽  
Robert Miller
Keyword(s):  
Rating Scale ◽  
Psychotic Symptoms

scholarly journals Cognitive–behavioural therapy for refractory psychotic symptoms of schizophrenia resistant to atypical antipsychotic medication

2005 ◽  
Vol 186 (4) ◽  
pp. 324-330 ◽  
Author(s):  
Lucia R. Valmaggia ◽  
Mark van der Gaag ◽  
Nicholas Tarrier ◽  
Marieke Pijnenborg ◽  
Cees J. Slooff
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Behavioural Therapy ◽  
Controlled Study ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Cognitive Behavioural ◽  
Supportive Counselling ◽  
Treatment Refractory

BackgroundThere is increasing evidence that cognitive–behavioural therapy can be an effective intervention for patients experiencing drug-refractory positive symptoms of schizophrenia.AimsTo investigate the effects of cognitive–behavioural therapy on in-patients with treatment-refractory psychotic symptoms.MethodManualised therapy was compared with supportive counselling in a randomised controlled study. Both interventions were delivered by experienced psychologists over 16 sessions of treatment. Therapy fidelity was assessed by two independent raters. Participants underwent masked assessment at baseline, after treatment and at 6 months' follow-up. Main outcome measures were the Positive and Negative Syndrome Scale and the Psychotic Symptoms Rating Scale. The analysis was by intention to treat.ResultsParticipants receiving cognitive–behavioural therapy had improved with regard to auditory hallucinations and illness insight at the post-treatment assessment, but these findings were not maintained at follow-up.ConclusionsCognitive–behavioural therapy showed modest short-term benefits over supportive counselling for treatment-refractory positive symptoms of schizophrenia.

scholarly journals Clinical Efficacy and Target Engagement of Glutamatergic Drugs: Placebo-Controlled RCTs of Pomaglumetad and TS-134 for Reversal of Ketamine-Induced Psychotic Symptoms and PharmacoBOLD in Healthy Volunteers

2020 ◽  
Author(s):  
Joshua T. Kantrowitz ◽  
Jack Grinband ◽  
Donald C. Goff ◽  
Adrienne C. Lahti ◽  
Stephen R. Marder ◽  
...  
Keyword(s):  
Effect Size ◽  
Metabotropic Glutamate Receptor ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Anterior Cingulate ◽  
Psychotic Symptoms ◽  
High Dose ◽  
Size Estimation ◽  
Target Engagement ◽  
Dorsal Anterior Cingulate Cortex

AbstractWe tested two metabotropic glutamate receptor 2/3 (mGluR2/3) agonist prodrugs – pomaglumetad (POMA) and TS-134 – including a high-dose of POMA that was four times the dose tested in the failed phase schizophrenia III trials – in two proof of mechanism, Phase Ib studies using identical pharmacoBOLD target-engagement methodology.The POMA study was a double-blind, NIMH-sponsored, 10-day study of 80 or 320 mg/d POMA or placebo (1:1:1 ratio), designed to detect d>0.8 sd between-group effect-size differences. The TS-134 study was a single-blind, industry-sponsored, 6-day study of 20 or 60 mg/d TS-134 or placebo (5:5:2 ratio), designed to permit effect-size estimation for future studies. Primary outcomes were ketamine-induced changes in pharmacoBOLD in the dorsal anterior cingulate cortex (dACC) and Brief Psychiatric Rating Scale (BPRS).95 healthy controls were randomized to POMA and 63 to TS-134. High-dose POMA had significant within and between-group reduction in ketamine-induced BPRS total symptoms (p<0.01, d=-0.41; p=0.04, d=-0.44, respectively) but neither POMA dose significantly suppressed ketamine-induced dACC pharmacoBOLD. In contrast, low-dose TS-134 had significant/trend level, moderate to large within and between group effects on BPRS positive symptoms (p=0.02, d=-0.36; p=0.008, d=-0.82, respectively) and dACC pharmacoBOLD (p=0.004, d=-0.56; p=0.079, d=-0.50, respectively) using pooled across-study placebo data.High-dose POMA exerted significant effects on clinical symptoms, but not on target engagement, suggesting a higher dose may yet be needed. TS-134 20 mg showed evidence of symptom reduction and target engagement, indicating a curvilinear dose-response curve. These results warrant further investigation of mGluR2/3 and other glutamate-targeted treatments for schizophrenia.

Abstract TP442: Periventricular Not Deep White Matter Hyperintensities Are Associated With Vascular Cognitive Impairment

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Yan Chen ◽  
Renyuan Liu ◽  
Shuwei Qiu ◽  
Yun Xu
Keyword(s):  
Regression Analysis ◽  
Cognitive Impairment ◽  
White Matter ◽  
Linear Regression ◽  
Cognitive Performance ◽  
White Matter Hyperintensities ◽  
Rating Scale ◽  
Linear Regression Analysis ◽  
Vascular Cognitive Impairment ◽  
Cerebral White Matter

Introduction: Cerebral White matter hyperintensities(WMH) are frequent findings on MRI scan. They are well known to correlate with vascular cognitive impairment(VCI). However, controversies still remain about the relationship between WMH locations and cognitive function across studies. Hypothesis: Periventricular WMHs(PWH) rather than deep WMHs(DWH) are associated with cognitive decline in VCI. Methods: Fifty-nine subjects with WMHs on MRI were divided into three groups, normal control(NC), mild cognitive impairment(MCI) and vascular dementia(VaD), according to clinical manifestation and neuropsychological performance. WMH volumes were evaluated by Fazekas rating scale and segmental volumetric. Correlations between cognitive performance and WMH volumes were determined in virtue of Spearman correlation analysis. Receiver operator characteristic (ROC) curves were generated to define the classification cut-off value of WMH volumes for distinguishing VCI versus normal controls. Multiple linear regression analysis was used to predict cognitive performance with WMH volumes and locations after adjusting for sex ,age and education level. Results: Cognitive capacities were gradually declined from NC through MCI to VaD patients while WMH volumes and Fazekas scores altered oppositely. Both PWH and DWH volumes and Fazekas scores were correlated with cognitive performance, and moreover, WMH volumes were correlated with Fazekas scores. ROC analysis showed a cut-off value of PWH rather than DWH to distinguish VCI from NC(AUC=0.745 and 0.635, p =0.001 and 0.076, respectively). Linear regression analysis demonstrated that only PWH volumes were associated with cognitive performance( p < 0.001). Conclusion: Our study demonstrate that PWHs are independent predictors for vascular contribution in white matter lesions and suggest clinicians that PWH should be emphasized on evaluating vascular cognitive impairment related with white matter load.

Awareness of illness moderates self-assessment of psychotic symptoms

2021 ◽  
pp. 000486742110574
Author(s):  
Luis Martinez Agulleiro ◽  
Renato de Filippis ◽  
Stella Rosson ◽  
Bhagyashree Patil ◽  
Lara Prizgint ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Confidence Interval ◽  
Rating Scale ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Brief Psychiatric Rating Scale ◽  
Schizophrenia Spectrum ◽  
Psychiatric Rating ◽  
Spectrum Disorders ◽  
Psychiatric Rating Scale

Objective: Self-reports or patient-reported outcome measures are seldom used in psychosis due to concerns about the ability of patients to accurately report their symptomatology, particularly in cases of low awareness of illness. The aim of this study was to assess the effect of insight on the accuracy of self-reported psychotic symptoms using a computerized adaptive testing tool (CAT-Psychosis). Methods: A secondary analysis of data drawn from the CAT-Psychosis development and validation study was performed. The Brief Psychiatric Rating Scale and the Scale of Unawareness of Mental Disorders were administered by clinicians. Patients completed the self-reported version of the CAT-Psychosis. Patients were median-split regarding their insight level to compare the correlation between the two psychosis severity measures. A subgroup sensitivity analysis was performed only on patients with schizophrenia spectrum disorders. Results: A total of 159 patients with a psychotic disorder who completed both CAT-Psychosis and Scale of Unawareness of Mental Disorders were included. For the whole sample, CAT-Psychosis scores showed convergent validity with Brief Psychiatric Rating Scale ratings ( r = 0.517, 95% confidence interval = [0.392, 0.622], p < 0.001). Insight was found to moderate this correlation (β = –0.511, p = 0.005), yet agreement between both measures remained statistically significant for both high ( r = 0.621, 95% confidence interval = [0.476, 0.733], p < 0.001) and low insight patients ( r = 0.408, 95% confidence interval = [0.187, 0.589], p < 0.001), while psychosis severity was comparable between these groups (for Brief Psychiatric Rating Scale: U = 3057, z = –0.129, p = 0.897; disorganization: U = 2986.5, z = –0.274, p = 0.784 and for CAT-Psychosis: U = 2800.5, z = –1.022, p = 0.307). Subgroup of patients with schizophrenia spectrum disorders showed very similar results. Conclusions: Insight moderates the correlation between self-reported and clinician-rated severity of psychosis, yet CAT-Psychosis remains valid in patients with both high and low awareness of illness.

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