Mental Disorder among Refugees and the Impact of Persecution and Exile: Some Findings from an Out-Patient Population

1996 ◽  
Vol 169 (6) ◽  
pp. 726-732 ◽  
Author(s):  
Nils Johan Lavik ◽  
Edvard Hauff ◽  
Anders Skrondal ◽  
Øivind Solberg
Keyword(s):  
At Risk ◽  
Mental Disorder ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
Main Diagnosis ◽  
Check List ◽  
Post Traumatic ◽  
The Impact

BackgroundRefugees have long been considered at risk for mental disorder. We sought to characterise this risk in an out-patient refugee sample by analysing the relationship between psychiatric symptoms and dysfunction, and between symptoms and the socio-demographic background and stressors specific to this refugee sample.MethodA consecutive sample of 231 refugee patients referred to the psychiatric out-patient unit at the Psychosocial Centre for Refugees, University of Oslo, was examined with a semi-structured interview guide, Brief Psychiatric Rating Scale (BPRS), Hopkins Symptom Check-List (HSCL-25) and a check-list for post-traumatic symptoms (PTSS-10). Global Assessment of Function (GAF) scores were obtained; and the data were analysed using nine predictor variables.ResultsIt was found that 46.6% of the patients had a post-traumatic stress disorder according to the criteria for DSM–III–R as the main diagnosis, while the mean GAF score for the patients was 57.3. Analysis of the GAF and BPRS data did not reveal any predictor of psychotic behaviour. However, torture emerged as an important predictor of emotional withdrawal/retardation. Also, age, gender and no employment or education predicted for anxiety/depression, while refugee status and no employment or school predicted for hostility/aggression.ConclusionsThe results confirm earlier findings that refugees constitute a population at risk for mental disorder. Past traumatic stressors and current existence in exile constitute independent risk factors. However, stressors other than those discussed here appear to be important also, particularly with regard to psychotic symptoms.

Implications of COMT and Subclinical Psychiatric Symptoms on the Phenotypic Variability of 22q11.2 Deletion Syndrome: A Transversal and Longitudinal Approach

2017 ◽  
Vol 41 (S1) ◽  
pp. S82-S83
Author(s):  
S. Guerrera ◽  
M. Armando ◽  
M. Pontillo ◽  
F. Papaleo ◽  
S. Vicari
Keyword(s):  
Negative Symptoms ◽  
Psychiatric Symptoms ◽  
Phenotypic Variability ◽  
22Q11.2 Deletion Syndrome ◽  
Structured Interview ◽  
Deletion Syndrome ◽  
Psychotic Symptoms ◽  
22Q11.2 Deletion ◽  
Comt Polymorphism ◽  
The Impact

Introduction22q11.2 deletion syndrome (22q11.2DS) results from a hemizygous microdeletion on chromosome 22 and is characterized by phenotypic variability. Several studies have been conducted on the impact of COMT functional polymorphism in 22q11DS, suggesting that attenuated psychotic manifestations are frequent in children and adolescents and represent one of the strongest predictors for the onset of psychotic disorder.ObjectivesWe explored possible interaction between COMT polymorphism and subclinical psychiatric symptoms in a 22q11.2DS cohort of 42 participants aged 6 to 26 years: 17 hemizygosity for COMT-Met and 25 hemizygosity for COMT-Val.AimsTo analyse impact of COMT gene in 22q11DS and its related psychiatric correlates.MethodEach participant, genotyped for the catechol O-methyltransferase (COMT) Met/Val polymorphism, underwent structured psychiatric and cognitive assessment. Analysis of positive and negative symptoms was performed by the structured interview for prodromal syndromes (SIPS). Finally, longitudinal data available in a subsample of 24 individuals were used to explore the developmental trajectories of psychotic symptoms one year later.ResultsThere was a significant positive correlation between COMT Val polymorphism and positive symptoms; at follow-up, no significant correlation were found between COMT polymorphism and psychiatric symptoms. No other significant differences were found between groups (Comt/Met-Comt/Val) on any other CBCL or QI score.ConclusionsCOMT and additional genes microdeleted might interact in the susceptibility to schizophrenia in 22q11.2DS: psychotic symptoms might result from an epistatic interaction with other genes. Moreover, gene-environment, in presence of genetic vulnerability could increase the risk of schizophrenia in 22q11DS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals T27. COGNITIVE RESERVE IN CHILD AND ADOLESCENT OFFSPRING OF PATIENTS DIANOSED WITH SCHIZOPHRENIA OR BIPOLAR DISORDER

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S241-S242
Author(s):  
Elena De la Serna ◽  
Patricia Camprodon-Boadas ◽  
Gisela Sugranyes ◽  
Carla Torrent ◽  
Brisa Sole ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Verbal Memory ◽  
Cognitive Reserve ◽  
Protective Factor ◽  
Rating Scale ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
Prodromal Symptoms ◽  
Neuropsychological Variables

Abstract Background Cognitive Reserve (CR) is defined as the ability of the brain to cope and deal with physiological or pathological brain injuries. In the field of psychiatry, higher levels of CR have been associated with lower levels of psychotic symptoms, higher psycho-social functioning and higher cognitive performance, suggesting that CR should be considered as a protective factor (Barnett et al., 2006; Amoretti et al., 2016). This study aims to compare CR levels in a sample of adolescents and young adult offspring of patients with schizophrenia or bipolar disorder who are at high risk of developing these disorders (HR) and compared them with a group of healthy controls (HC). We also assess the utility of CR in predicting clinical and cognitive variables. Methods Participants were 85 HR and 45 HC. A CR proxy was calculated based on premorbid IQ, socio-occupational attainment and social activities. Clinical assessment included: the Structured Interview for Prodromal Symptoms (SOPS), the Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (HDRS). Neuropsychological assessment included: Working Memory, Processing Speed, Verbal Memory, attention and executive functioning. A factorial analysis was conducted in order to obtain a single CR measure. Differences between groups in CR were assessed via MANCOVA and linear regressions were conducted to check the effectiveness of CR in predicting clinical and neuropsychological variables. Results No significant differences were observed in age or gender between HR and HC groups. Socioeconomic status was lower in HR subjects (F=8.100, p=0.005).CR was significantly lower in the HR group than in the HC group (F=17.522; p<0.001). Moreover, the CR proxy was able to correctly classify 72.7% of the sample as either HR or HC. Our proxy was able to predict the following clinical variables in the HR group: negative (F=9.269; p=0.002), and total (F=7.290; p=0.009) prodromal symptoms, the YMRS (F=11.597; P<0.001) and the HDRS (F=12.761; p<0.001). In terms of neuropsychological variables, RC predicted WM (F=9.738; p=0.003), PS (F=4.557; p=0.037) and verbal memory [immediate (F=6.999; p=0.010) and delayed recall (F=10.990; P=0.002)] in the HR sample. Discussion HR subjects have lower CR than controls. CR is associated with clinical and neuropsychological variables. To our knowledge no previous studies have assessed CR in high risk samples. Nevertheless, studies conducted in adult first episode psychotic samples have shown an association between CR and the severity of symptoms.

scholarly journals The Sum of Fears in Cancer Patients Inside the Context of the COVID-19

2021 ◽  
Vol 12 ◽  
Author(s):  
Lucas Bandinelli ◽  
Felipe Ornell ◽  
Lisia von Diemen ◽  
Felix Henrique Paim Kessler
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Health System ◽  
Cancer Patients ◽  
Psychiatric Symptoms ◽  
Therapeutic Strategies ◽  
Cancer Treatments ◽  
Clinical Risk ◽  
Support Strategies ◽  
The Impact

The pandemic resulting from COVID-19 has led to the collapse of the health system in dozens of countries. Parallel to clinical risk, the appearance or intensification of psychiatric symptoms has also been documented. The identification of groups at risk is essential for the establishment of preventive and therapeutic strategies. Cancer patients appear to be especially vulnerable both from a clinical and psychiatric perspective. Problems related to contamination and the cancer treatments themselves are intertwined, causing a sum of patients' fears to arise, which can cause mental effects. This study aims to review and investigate the impact of COVID-19 on the mental health of cancer patients and indicate possible support strategies.

scholarly journals Excessive sleepiness in patients with psychosis: An initial investigation

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245301
Author(s):  
Sarah Reeve ◽  
Bryony Sheaves ◽  
Daniel Freeman
Keyword(s):  
Sleep Disorders ◽  
Psychiatric Symptoms ◽  
Small Sample Size ◽  
Small Sample ◽  
Psychotic Symptoms ◽  
Future Research ◽  
Significant Group ◽  
Clinical Issue ◽  
Excessive Sleepiness ◽  
The Impact

Clinical experience indicates that excessive sleepiness and hypersomnia may be a common issue for patients with psychosis. Excessive sleepiness is typically ascribed to the sedating effects of antipsychotic medications but there may be other potential contributors such as sleep disorders and depression. Furthermore, the impact of excessive sleepiness itself on patients’ symptoms and general wellbeing is yet to be examined. The current study reports an exploratory cross-sectional between-groups comparison of patients with early psychosis fulfilling criteria assessed in a diagnostic interview for problematic excessive sleepiness (n = 14), compared with those not reporting excessive sleepiness (n = 46). There were no differences between the groups in diagnosis, medication type, or antipsychotic medication dosage. There were no significant group differences in sleep duration. Significantly lower activity levels were found in the excessive sleepiness group. Insomnia and nightmares were common in those reporting excessive sleepiness. No significant differences were found in psychiatric symptoms, although data did indicate more severe cognitive disorganisation and grandiosity, but less severe paranoia and hallucinations, in the excessive sleepiness group. Wide confidence intervals and small sample size mean that care should be taken interpreting these results. Overall, this study indicates that excessive sleepiness may not be solely related to medication but also to low levels of activity and other sleep disorders. This is a novel finding that, if replicated, could indicate routes of intervention for this clinical issue. Future research should aim to disentangle directions of effect amongst sleepiness, mood, activity, and psychotic symptoms and investigate possible interventions for excessive sleepiness in psychosis.

scholarly journals Brief Psychotic Disorder During the National Lockdown in Italy: An Emerging Clinical Phenomenon of the COVID-19 Pandemic

2020 ◽  
Author(s):  
Armando D′Agostino ◽  
Simone D’Angelo ◽  
Barbara Giordano ◽  
Anna Chiara Cigognini ◽  
Margherita Lorenza Chirico ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Rating Scale ◽  
Cortical Atrophy ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Behavioral Abnormalities ◽  
Brief Psychotic Disorder ◽  
Psychiatric Rating Scale ◽  
The Impact

Abstract The impact of the COVID-19 pandemic on psychosis remains to be established. Here we report 6 cases (3 male and 3 female) of first-episode psychosis (FEP) admitted to our hospital in the second month of national lockdown. All patients underwent routine laboratory tests and a standardized assessment of psychopathology. Hospitalization was required due to the severity of behavioral abnormalities in the context of a full-blown psychosis (the Brief Psychiatric Rating Scale [BPRS] = 75.8 ± 14.6). Blood tests, toxicological urine screening, and brain imaging were unremarkable, with the exception of a mild cortical atrophy in the eldest patient (male, 73 years). All patients were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) throughout their stay, but 3 presented the somatic delusion of being infected. Of note, all 6 cases had religious/spiritual delusions and hallucinatory contents. Despite a generally advanced age (53.3 ± 15.6), all patients had a negative psychiatric history. Rapid discharge (length of stay = 13.8 ± 6.9) with remission of symptoms (BPRS = 27.5 ± 3.1) and satisfactory insight were possible after relatively low-dose antipsychotic treatment (Olanzapine-equivalents = 10.1 ± 5.1 mg). Brief psychotic disorder/acute and transient psychotic disorder diagnoses were confirmed during follow-up visits in all 6 cases. The youngest patient (female, 23 years) also satisfied the available criteria for brief limited intermittent psychotic symptoms. Although research on larger populations is necessary, our preliminary observation suggests that intense psychosocial stress associated with a novel, potentially fatal disease and national lockdown restrictions might be a trigger for FEP.

scholarly journals Caregiving Burden And Depression Among Caregivers Of Patient With Epilepsy

2019 ◽  
Vol 8 (2) ◽  
pp. 40-44
Author(s):  
S. Shah ◽  
C. Sah ◽  
A. Shahi ◽  
R. KC
Keyword(s):  
Rating Scale ◽  
Structured Interview ◽  
Caregiving Burden ◽  
Significant Burden ◽  
Significant Area ◽  
Collection Data ◽  
High Level ◽  
Patients With Epilepsy ◽  
The Impact

Introduction: The impact of caregiving on caregivers is a significant area to be studied which will directly affect the quality of care given by them to patients with epilepsy. Family caregivers have been described as forgotten patients. The aim of the study was to assess the caregiving burden and depression among caregivers of patient with epilepsy. Material and Method: Descriptive study was conducted among 100 caregivers of adult patients with epilepsy. Samples were selected using purposive sampling. Semi-structured interview schedule, Zarit Burden Interview (ZBI) and Hamilton depression rating scale (HAM-D) were used for data collection. Data was analyzed by descriptive and inferential statistics with SPSS version 20. Results: Among 100 caregivers, 42% reported high mean burden scores on the ZBI and overall 50% of caregivers reported moderate depression on the HAM-D. High level of burden was significantly associated with age of caregivers (p= 0.018) and caregivers’ relationship with patients (p= 0.023). The result suggests that there was statistically significant positive relationship on ZBI vs HAM-D (p≤ 0.01). Conclusion: Caregivers of patients with epilepsy experience significant burden while caring for their relatives and level of burden is positively correlated with depression. The study highlights the need for comprehensive care system recognizing caregivers as “co-client”.

scholarly journals Hardiness Predicts Post-Traumatic Growth and Well-Being in Severely Wounded Servicemen and Their Spouses

2020 ◽  
Author(s):  
Paul T Bartone ◽  
Stephen V Bowles
Keyword(s):  
Military Personnel ◽  
Family Income ◽  
Psychiatric Symptoms ◽  
World View ◽  
Well Being ◽  
Service Members ◽  
Psychological Well Being ◽  
Post Traumatic Growth ◽  
Post Traumatic ◽  
The Impact

Abstract Introduction Thousands of military personnel have suffered severe wounds and traumatic amputations in recent overseas conflicts. They face multiple surgeries and long, painful rehabilitation. Despite the tremendous stress for these servicemen and families, many appear to cope quite well and even thrive despite their devastating wounds. Hardiness is a world view or mindset marked by high levels of commitment and engagement in the world, a strong sense of control, and the tendency to see change as a challenge and opportunity to learn and improve. Previous research has shown that military personnel high in hardiness are at lower risk for post-traumatic stress disorder, depression, and other psychiatric symptoms following combat exposure. This study evaluated the impact of personality hardiness on post-traumatic growth (PTG) and psychological well-being in severely wounded service members and their spouses. Materials and Methods Male volunteers were surveyed while in hospital for severe battle wounds including loss of limbs. All were married, and all spouses also agreed to participate. Participants (N = 44) completed measures of hardiness, PTG, well-being, and neuroticism, and answered a question regarding potential benefits of their experience. Results Hierarchical multiple regression showed that hardiness significantly predicted both PTG and well-being, while controlling for age, education, family income, and neuroticism. Both service members and spouses indicated they experienced benefits in the following areas: strengthened family ties and connections; greater appreciation for and perspective on life; new career and educational opportunities; stronger, more resilient as a person; and formed new relationships, friends, and connections. Conclusion These results suggest that seriously wounded military members and their spouses who are high in hardiness are more likely to experience PTG and psychological well-being following extremely stressful experiences. Hardiness entails positive reframing of negative experiences as opportunities and challenges to overcome, and taking action to solve problems. Training programs to increase hardiness attitudes and related coping skills may thus be beneficial in facilitating healthy adaptation for severely injured patients.

scholarly journals Schizotypal components in people at high risk of developing schizophrenia: early findings from the Edinburgh High-Risk Study

2002 ◽  
Vol 180 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Patrick Miller ◽  
Majella Byrne ◽  
Ann Hodges ◽  
Stephen M. Lawrie ◽  
David G. Cunningham Owens ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Principal Components ◽  
Social Withdrawal ◽  
Risk Groups ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
Emotional Dysfunction ◽  
State Examination

BackgroundThe study of high-risk groups and the development of schizophrenia.AimsTo investigate further schizotypy, measured by the Structured Interview for Schizotypy (SIS), and to examine relationships between schizotypal components, psychotic symptoms on the Present State Examination (PSE) and subsequent schizophrenia.MethodThe SIS and PSE were administered on entry. Schizophrenia onsets were recorded during follow-up.ResultsThe SIS yielded four principal components labelled social withdrawal, psychotic symptoms, socio-emotional dysfunction and odd behaviour. On entry, these differentiated between controls, subjects at risk for schizophrenia with and without symptoms and patients with schizophrenia. Seven of 78 subjects at risk developed schizophrenia within 39 months. This was best predicted by combining the four SIS components.ConclusionsSchizotypy is heterogeneous and may become psychosis, particularly if several of its components are present. As psychosis develops, odd behaviour gives way to psychotic symptoms and social function deteriorates.

scholarly journals Misdiagnosis of post-traumatic stress disorder following severe traumatic brain injury

2005 ◽  
Vol 186 (5) ◽  
pp. 423-426 ◽  
Author(s):  
Ruth E. Sumpter ◽  
Tom M. McMillan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Structured Interview ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Impact

BackgroundThe incidence of post-traumatic stress disorder (PTSD) after traumatic brain injury is unclear. One issue involves the validity of diagnosis using self-report questionnaires.AimsTo compare PTSD ‘caseness' arising from questionnaire self-report and structured interview.MethodParticipants (n=34) with traumatic brain injury were recruited. Screening measures and self-report questionnaires were administered, followed by the structured interview.ResultsUsing questionnaires, 59% fulfilled criteria for PTSD on the Post-traumatic Diagnostic Scale and 44% on the Impact of Events Scale, whereas using structured interview (Clinician-Administered PTSD Scale) only 3% were ‘cases'. This discrepancy may arise from confusions between effects of PTSD and traumatic brain injury.ConclusionsAfter traumatic brain injury, PTSD self-report measures might be used for screening but not diagnosis.

scholarly journals Relationship Between Cognitive and Clinical Insight at Different Durations of Untreated Attenuated Psychotic Symptoms in High-Risk Individuals at Risk

2021 ◽  
Vol 12 ◽  
Author(s):  
LiHua Xu ◽  
Mei Zhang ◽  
ShuQing Wang ◽  
YanYan Wei ◽  
HuiRu Cui ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Power Analysis ◽  
Significant Positive Correlation ◽  
Composite Index ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
Cognitive Insight ◽  
Healthy Control ◽  
The Relationship

Background: This study examines whether cognitive insight is impaired in high-risk individuals with attenuated psychotic symptoms (APS) and explores the relationship between cognitive and clinical insight at different durations of untreated attenuated psychotic symptoms (DUAPS).Methods: The Structured Interview for Psychosis high-risk Syndrome (SIPS) was used to identify APS individuals. APS (n = 121) and healthy control (HC, n = 87) subjects were asked to complete the Beck Cognitive Insight Scale (BCIS). Clinical insight of APS individuals was evaluated using the Schedule for Assessment of Insight (SAI). APS individuals were classified into four subgroups based on DUAPS, including 0–3, 4–6, 7–12, and >12 months. Power analysis for significant correlation was conducted using the WebPower package in R.Results: Compared with HC subjects, APS individuals showed poorer cognitive insight, with lower scores on BCIS self-reflectiveness and composite index (BCIS self-reflectiveness minus BCIS self-certainty). Only when DUAPS was longer than 12 months did the significant positive correlation between cognitive and clinical insight obtain the power about 0.8, including the associations between self-reflectiveness and awareness of illness, self-reflectiveness and the total clinical insight, and composite index and awareness of illness. The positive associations of composite index with awareness of illness within 0–3 months DUAPS and with the total score of SAI when DUAPS > 12 months were significant but failed to obtain satisfactory power.Conclusions: APS individuals may have impaired cognitive insight, demonstrating lower self-reflectiveness. The correlation between cognitive and clinical insight is associated with the duration of untreated attenuated psychotic symptoms.

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