Comments on the Northwick Park ‘Functional’ Psychosis Study

1989 ◽  
Vol 154 (3) ◽  
pp. 406-409 ◽  
Author(s):  
G. M. Goodwin ◽  
D. A. W. Johnson ◽  
R. G. McCreadie
Keyword(s):  
Depressive Symptoms ◽  
Depressed Mood ◽  
Mode Of Action ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
Dopamine Antagonist ◽  
Mood Change ◽  
Manic Symptoms ◽  
Functional Psychosis ◽  
Manic Depressive

“Functional psychosis is conventionally subdivided into schizophrenia and manic depressive psychosis. Response to treatment is assumed to be a validating criterion for these diagnoses. The efficacy of pimozide (a dopamine antagonist neuroleptic), lithium, and a combination of the two was compared with that of placebo in a 4-week trial in 120 functionally psychotic patients, each of whom was assessed for psychotic symptoms, manic symptoms, and depressive symptoms. The sample was subdivided into patients with predominantly elevated mood, predominantly depressed mood, and no consistent mood change. Pimozide reduced psychotic symptoms in all groups of patients. The only significant effect of lithium was to reduce elevated mood. Thus dopamine blockade seems relevant to the resolution of psychotic symptoms in all types of ‘functional’ psychosis, but the mode of action of lithium in psychotic patients concerns only mood. Application of standardised classifications of functional psychosis to these data did not change this conclusion.”

Depressed patients with schizophrenic or paranoid symptoms

1980 ◽  
Vol 10 (4) ◽  
pp. 665-675 ◽  
Author(s):  
I. F. Brockington ◽  
R. E. Kendell ◽  
S. Wainwright
Keyword(s):  
Family History ◽  
Affective Disorders ◽  
Final Diagnosis ◽  
Good Prognosis ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
Affective Psychosis ◽  
Manic Depressive ◽  
Paranoid Symptoms ◽  
Definition Of

SYNOPSISFamily history, response to treatment and outcome are reported in a series of 76 patients presenting with both depression and schizophrenic or paranoid symptoms. About 10% of psychotic admissions to the Maudsley and Bethlem Royal Hospitals met a study definition of ‘schizodepressive’ illness. The patients were highly heterogeneous in history, clinical picture and outcome. Many followed a typical schizophrenic course, and others a typical course for affective disorders, but only 4 were given a final diagnosis of manic depressive disease. The best predictors of poor outcome were a mode of onset as an exacerbation of previous psychotic symptoms and the presence of schizophrenic symptoms at some time without depression. The best predictors of good outcome were Stephens' criteria of good prognosis schizophrenia and Kasanin's concept of ‘acute schizo-affective psychosis’. These findings are not easily reconciled with Kraepelin's two entities principle but suggest a continuum of outcome between schizophrenia and unipolar depressive psychosis.

scholarly journals Depressive symptoms are associated with (sub)clinical psychotic symptoms in patients with non-affective psychotic disorder, siblings and healthy controls

2012 ◽  
Vol 43 (4) ◽  
pp. 747-756 ◽  
Author(s):  
R. M. C. Klaassen ◽  
M. Heins ◽  
L. B. Luteijn ◽  
M. van der Gaag ◽  
N. J. M. van Beveren ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Psychotic Disorder ◽  
Depressed Mood ◽  
Negative Symptoms ◽  
Psychotic Symptoms ◽  
Healthy Controls ◽  
Healthy Siblings ◽  
Depressive Episodes ◽  
Positive And Negative Symptoms ◽  
Subclinical Psychosis

BackgroundDepression is a clinically relevant dimension, associated with both positive and negative symptoms, in patients with schizophrenia. However, in siblings it is unknown whether depression is associated with subclinical positive and negative symptoms.MethodDepressive symptoms and their association with positive and negative symptoms were examined in 813 healthy siblings of patients with a non-affective psychotic disorder, 822 patients and 527 healthy controls. Depressive episodes meeting DSM-IV-TR criteria (lifetime) and depressed mood (lifetime) were assessed with the Comprehensive Assessment of Symptoms and History (CASH) in all three groups. In the patient group, the severity of positive and negative psychosis symptoms was assessed with the CASH. In the siblings and healthy controls, the severity of subclinical psychosis symptoms was assessed with the Community Assessment of Psychic Experiences (CAPE).ResultsPatients reported more lifetime depressed mood and more depressive episodes than both siblings and controls. Siblings had a higher chance of meeting lifetime depressive episodes than the controls; no significant differences in depressed mood were found between siblings and controls. In all three groups the number and duration of depressive symptoms were associated with (sub)clinical negative symptoms. In the patients and siblings the number of depressive symptoms was furthermore associated with (sub)clinical positive symptoms. Finally, lifetime depressed mood showed familial clustering but this clustering was absent for lifetime depressive episodes.ConclusionsThese findings suggest that a co-occurring genetic vulnerability for both depressive and psychotic symptomatology exists on a clinical and a subclinical level.

scholarly journals The effect of the environment on symptom dimensions in the first episode of psychosis: a multilevel study

2014 ◽  
Vol 44 (11) ◽  
pp. 2419-2430 ◽  
Author(s):  
F. J. Oher ◽  
A. Demjaha ◽  
D. Jackson ◽  
C. Morgan ◽  
P. Dazzan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Population Density ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Urban Environments ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Multilevel Regression ◽  
Symptom Dimensions ◽  
Reality Distortion

BackgroundThe extent to which different symptom dimensions vary according to epidemiological factors associated with categorical definitions of first-episode psychosis (FEP) is unknown. We hypothesized that positive psychotic symptoms, including paranoid delusions and depressive symptoms, would be more prominent in more urban environments.MethodWe collected clinical and epidemiological data on 469 people with FEP (ICD-10 F10–F33) in two centres of the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study: Southeast London and Nottinghamshire. We used multilevel regression models to examine neighbourhood-level and between-centre differences in five symptom dimensions (reality distortion, negative symptoms, manic symptoms, depressive symptoms and disorganization) underpinning Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Item Group Checklist (IGC) symptoms. Delusions of persecution and reference, along with other individual IGC symptoms, were inspected for area-level variation.ResultsReality distortion [estimated effect size (EES) 0.15, 95% confidence interval (CI) 0.06–0.24] and depressive symptoms (EES 0.21, 95% CI 0.07–0.34) were elevated in people with FEP living in more urban Southeast London but disorganized symptomatology was lower (EES –0.06, 95% CI –0.10 to –0.02), after controlling for confounders. Delusions of persecution were not associated with increased neighbourhood population density [adjusted odds ratio (aOR) 1.01, 95% CI 0.83–1.23], although an effect was observed for delusions of reference (aOR 1.41, 95% CI 1.12–1.77). Hallucinatory symptoms showed consistent elevation in more densely populated neighbourhoods (aOR 1.32, 95% CI 1.09–1.61).ConclusionsIn people experiencing FEP, elevated levels of reality distortion and depressive symptoms were observed in more urban, densely populated neighbourhoods. No clear association was observed for paranoid delusions; hallucinations were consistently associated with increased population density. These results suggest that urban environments may affect the syndromal presentation of psychotic disorders.

Quality of life in individuals with attenuated psychotic symptoms: Possible role of anxiety, depressive symptoms, and socio-cognitive impairments

2017 ◽  
Vol 257 ◽  
pp. 431-437 ◽  
Author(s):  
Tsutomu Takahashi ◽  
Yuko Higuchi ◽  
Yuko Komori ◽  
Shimako Nishiyama ◽  
Mihoko Nakamura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Cognitive Impairments ◽  
Psychotic Symptoms

scholarly journals What Lies Beneath: Exploring Different Depressive Symptoms Across Selected Risk Factors in Icelandic Team Sport Athletes

2021 ◽  
Vol 15 (1) ◽  
pp. 54-79
Author(s):  
Richard Tahtinen ◽  
Hafrun Kristjansdottir ◽  
Daniel T. Olason ◽  
Robert Morris
Keyword(s):  
Depressive Symptoms ◽  
Depressed Mood ◽  
Team Sport ◽  
Depressive Symptomology ◽  
Symptoms Of Depression ◽  
Patient Health ◽  
Emotional Aspects ◽  
Clinically Significant ◽  
Core Symptoms ◽  
Specific Symptoms

The aim of the study was to explore the prevalence of specific symptoms of depression in athletes and to test differences in the likelihood of athletes exhibiting these symptoms across age, sex, type of team sport, and level of competition. A sample of Icelandic male and female team sport athletes (N = 894, 18–42 years) was included in the study. Of the athletes exhibiting clinically significant depressive symptoms on the Patient Health Questionnaire-9, 37.5% did not exhibit core symptoms of depression. Compared with males, females were significantly more likely to exhibit depressed mood, feelings of worthlessness/guilt, and problems with sleep, fatigue, appetite, and concentration. Within males, differences were mostly related to neurovegetative aspects of depression (sleep and appetite), whereas in females, differences were related to cognitive/emotional aspects (e.g., depressed mood, guilt/worthlessness). The findings underline the importance of exploring specific symptoms of depression to provide a richer understanding of depressive symptomology in athletes.

scholarly journals Characteristics of verbal fluency in patients with a primary episode of bipolar affective disorder

2020 ◽  
Keyword(s):  
Depressive Symptoms ◽  
Affective Disorder ◽  
Test Performance ◽  
Verbal Fluency ◽  
High Speed ◽  
Bipolar Affective Disorder ◽  
Rapid Change ◽  
Verbal Fluency Test ◽  
Manic Symptoms ◽  
Fluency Test

A study was conducted using the verbal fluency test of 153 patients with a primary episode of bipolar affective disorder: with prevalence of depressive symptoms (44 men and 75 women), with prevalence of manic symptoms (15 men and 8 women), and with simultaneous presence of depressive symptoms and manic symptoms phase change (6 men and 5 women). Significant impairment of test performance in patients with depression with respect to phonetic and semantic verbal fluency was revealed: the average number of words per letter "K" per 60 sec. in all patients 14,1±2,7 words, in men – 13,8±3,1 words, in women - 14,3±2,4 words, on the letter "P" – 12,5±2,8 respectively words, 12.3±3.2 words, 12.6±2.6 words, "Male Names" – 13.1±2.6 words respectively, 12.8±3.0 words, 13.3±2,4 words; "Fruits / furniture" – 12.0±2.4 words, 11.9±2.8 words, 12.1±2.1 words. Deterioration in the performance of semantic and phonemic verbal fluency test reflects the state of bradypsychism inherent in patients with depressive variant, which manifests a slow thinking rate, difficulty concentrating attention, motor inhibition, deterioration of operational capacity, rapid exhaustion. In patients with a maniacal variant, the high speed of the test is offset by a large number of errors due to the chaotic mental activity, instability and scattering of attention, the difficulty of maintaining focus of attention: the indicators were respectively 21.7±5.7 words, 22.5±5.7 words, 20,3±6.0 words; 20.3±5.6 words, 21.1±5.5 words, 19.0±5.9 words; 20.5±5.4 words, 21.2±5.2 words, 19.1±5.7 words; 19.5±5.4 words, 20.2±5.2 words, 18.1±5.7 words. In patients with mixed variants, the indicators of verbal fluency are reduced due to the influence of complex polymorphic symptoms with rapid change of state: respectively 16.5±5.6 words, 18.2±6.1 words, 14.4±4.8 words; 14.5±5.4 words, 16.2±5.7 words, 12.4±4.8 words; 15.4±5.4 words, 17.0±5.8 words, 13.4±4.8 words; 13.9±5.0 words, 15.5±5.3 words, 12.0±4.3 words. The differences in scores across all subtests in all groups between men and women are statistically insignificant (p>0.05).

scholarly journals Depressive Symptoms and Resilience among Pregnant Adolescents: A Case-Control Study

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Danny Salazar-Pousada ◽  
Dalton Arroyo ◽  
Luis Hidalgo ◽  
Faustino R. Pérez-López ◽  
Peter Chedraui
Keyword(s):  
Depressive Symptoms ◽  
Depressed Mood ◽  
Depression Scale ◽  
Case Control ◽  
Epidemiologic Studies ◽  
Pregnant Adolescents ◽  
Control Approach ◽  
Resilience Scale ◽  
Study Programs ◽  
Adolescents And Adults

Background. Data regarding depression and resilience among adolescents is still lacking.Objective. To assess depressive symptoms and resilience among pregnant adolescents.Method. Depressive symptoms and resilience were assessed using two validated inventories, the 10-item Center for Epidemiologic Studies Short Depression Scale (CESD-10) and the 14-item Wagnild and Young Resilience Scale (RS), respectively. A case-control approach was used to compare differences between adolescents and adults.Results. A total of 302 pregnant women were enrolled in the study, 151 assigned to each group. Overall, 56.6% of gravids presented total CESD-10 scores 10 or more indicating depressed mood. Despite this, total CESD-10 scores and depressed mood rate did not differ among studied groups. Adolescents did however display lower resilience reflected by lower total RS scores and a higher rate of scores below the calculated median (P<.05). Logistic regression analysis could not establish any risk factor for depressed mood among studied subjects; however, having an adolescent partner (OR, 2.0 CI 95% 1.06–4.0,P=.03) and a preterm delivery (OR, 3.0 CI 95% 1.43–6.55,P=.004) related to a higher risk for lower resilience.Conclusion. In light of the findings of the present study, programs oriented at giving adolescents support before, during, and after pregnancy should be encouraged.

The Clinical Distinction between the Affective Psychoses and Schizophrenia

1970 ◽  
Vol 117 (538) ◽  
pp. 261-266 ◽  
Author(s):  
R. E. Kendell ◽  
Jane Gourlay
Keyword(s):  
Turn Of The Century ◽  
Dementia Praecox ◽  
Mixed States ◽  
Defence Mechanisms ◽  
Mood Change ◽  
Psychiatric Classification ◽  
Manic Depressive Psychosis ◽  
Manic Depressive ◽  
Cycloid Psychoses ◽  
Affective Symptoms

The distinction between schizophrenic and affective illnesses has been one of the cornerstones of psychiatric classification ever since Kraepelin introduced the twin concepts of dementia praecox and manic depressive psychosis at the turn of the century. It has also long been recognized that some patients have both schizophrenic and affective symptoms, and various interpretations have been placed on these mixed states. To some continental psychiatrists they constitute a third group of psychoses distinct from both schizophrenia and manic-depressive psychosis—the degeneration psychoses of Kleist or the cycloid psychoses of Leonhard. By others they are regarded as genuine mixed states, with the implication that elements of both schizophrenia and manic depressive illnesses are contributing, perhaps because the genetic or constitutional endowment is mixed, perhaps because two alternative defence mechanisms are being utilized simultaneously. Often, however, mixed symptomatology is simply ignored, either by discounting the schizophrenic symptoms and focusing attention on the mood change, or, as most American psychiatrists do, by glossing over the affective symptoms and regarding the illness as a form of schizophrenia differing in no significant respect from other schizophrenias.

scholarly journals ‘Bipolarity’ in bipolar disorder: Distribution of manic and depressive symptoms in a treated population

2005 ◽  
Vol 187 (1) ◽  
pp. 87-88 ◽  
Author(s):  
Mark S. Bauer ◽  
Gregory E. Simon ◽  
Evette Ludman ◽  
Jurgen Unützer
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Health Maintenance Organisation ◽  
Cross Sectional ◽  
Health Maintenance ◽  
Manic Symptoms ◽  
Clinically Significant ◽  
Sectional Analysis ◽  
Depressive And Manic Symptoms

SummaryCross-sectional analysis of 441 individuals with bipolar disorder treated at a US health maintenance organisation investigated the distribution of manic and depressive symptoms in that illness. Clinically significant depressive symptoms occurred in 94.1% of those with (hypo)mania, while70.1% inadepressive episode had clinically significant manic symptoms. DSM-unrecognised depression-plus-hypomania was over twice as prevalent as DSM-recognised mixed episodes. Depressive symptoms were unimodally distributed in (hypo)mania. Depressive and manic symptoms were positively, not inversely correlated, and their co-occurrence was associated with worse quality of life. Implications for the DSM and ICD nosological systems are discussed.

Sign in / Sign up

Export Citation Format

Share Document