Incidence of schizophrenia in Nottingham

1997 ◽  
Vol 171 (2) ◽  
pp. 140-144 ◽  
Author(s):  
J. Brewin ◽  
R. Cantwell ◽  
T. Dalkin ◽  
R. Fox ◽  
I. Medley ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Diagnostic Category ◽  
Incidence Rates ◽  
World Health ◽  
First Episode ◽  
Episode Psychosis ◽  
Real Change ◽  
Icd 10 ◽  
Health Organization ◽  
Methodological Considerations

BackgroundSeveral studies have reported a decline of up to 50% in the incidence of schizophrenia over recent decades. We aimed to measure changes in the incidence and diagnostic patterns of first-episode psychosis by comparing two Nottingham cohorts, identified in two equal periods separated by 14 years.MethodTwo prospectively ascertained cohorts of first-episode psychotic disorder were identified over the time periods 1978–80 and 1992–94. The earlier cohort was of the World Health Organization Determinants of Outcome of Severe Mental Disorder (DOSMD) ten-country study. The later cohort was obtained using similar methodology. Both groups were diagnosed using ICD-10 diagnostic criteria and age-standardised incidence rates were compared.ResultsThe standardised incidence rate for all psychotic disorders rose slightly from 2.49 to 2.87 per 10 000 population per year, but the F20 classification fell significantly by over a third (1.41 to 0.87 per 10 000 per year). The second study group (1992–1994) included a greater diversity of psychotic diagnoses compared with the first, in particular an increased proportion of acute and drug-related psychoses.ConclusionsMethodological considerations call for caution in interpreting such data, but we conclude that the significant fall in the narrowly defined diagnostic category of schizophrenia reflects a real change in the syndromal presentation of psychotic disorders.

The Inter-Rater and Test-Retest Reliabilities of Prodromal Symptoms in First-Episode Psychosis

1996 ◽  
Vol 30 (4) ◽  
pp. 498-504 ◽  
Author(s):  
Henry J. Jackson ◽  
Patrick D. McGorry ◽  
Susan Harrigan ◽  
Jenepher Dakis ◽  
Lisa Henry ◽  
...  
Keyword(s):  
Field Trial ◽  
American Psychiatric Association ◽  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
World Health ◽  
First Episode ◽  
Prodromal Symptoms ◽  
Episode Psychosis ◽  
Dsm Iv ◽  
Health Organization

Objective: As part of the DSM-IV field trial for psychotic disorders, the authors endeavoured to determine the reliability of the DSM-IV prodromal features for schizophrenia in a first-episode sample. Method: Fifty first-episode psychotic patients were assessed using a semi-structured instrument to determine the presence/absence of nine prodromal symptoms. Inter-rater reliability data were calculated for 25 of the patients, and test-retest data were calculated for the remaining 25 patients. Results: Levels of reliability were poor. Conclusions: The results lend some support to American Psychiatric Association and World Health Organization decisions to omit specific criteria for prodromal features from their respective nosologies.

scholarly journals Acute and transient psychotic disorders: precursors, epidemiology, course and outcome

2004 ◽  
Vol 185 (6) ◽  
pp. 452-459 ◽  
Author(s):  
Swaran P. Singh ◽  
Tom Burns ◽  
Shazad Amin ◽  
Peter B. Jones ◽  
Glynn Harrison
Keyword(s):  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
Acute Onset ◽  
Favourable Outcome ◽  
First Episode ◽  
Affective Psychosis ◽  
Episode Psychosis ◽  
Icd 10 ◽  
Premorbid Functioning ◽  
Better Than

BackgroundICD–10 has introduced the diagnostic group acute and transient psychotic disorders (ATPDs; F23). Aims To validate the nosological distinctiveness of ICD–10 ATPDs by following up an inception cohort with first-episode psychosis. Method All patients with first-episode psychosis identified in Nottingham between 1992 and 1994 and diagnosed using ICD–10 criteria were reassessed 3 years later. ATPD outcomes were compared with schizophrenia and affective psychosis. Multivariate analyses were conducted to determine whether acute onset and early remission predicted favourable 3-year outcome in first-episode psychosis. Results Of 168 cases of first-episode psychosis, 32 (19%) received an intake diagnosis of ATPD. The diagnosis of ATPD was stable in women over 3 years, but not in men. Outcomes in ATPD were better than in schizophrenia and similar to affective psychosis. In non-affective psychoses, favourable outcomes were a function of gender and premorbid functioning rather than acute onset and early remission. Conclusions The ICD–10 criteria for ATPDs identify a diagnostically unstable group of disorders. Acute onset and early remission do not independently predict favourable outcome over 3 years in first-episode psychosis.

Psychotic Disorders in ICD-11

2013 ◽  
Vol 10 (01) ◽  
pp. 11-17 ◽  
Author(s):  
J. Zielasek ◽  
H.-R. Cleveland ◽  
W. Gaebel
Keyword(s):  
Psychotic Disorders ◽  
Reliability And Validity ◽  
Field Trials ◽  
World Health ◽  
Icd 10 ◽  
Health Organization ◽  
The Impact ◽  
Research Domain ◽  
Specific Working

SummaryWithin the efforts to revise ICD-10, the World Health Organization (WHO) has appointed a disorder-specific Working Group on the Classification of Psychotic Disorders (WGPD). The WGPD has proposed several changes to the classification criteria of schizophrenia and other primary psychotic disorders in order to increase the clinical utility, reliability and validity of the diagnostic classification. The main proposals include changes to the chapter title, the replacement of existing schizophrenia subtypes with symptom specifiers, stricter diagnostic criteria for schizoaffective disorder, a reorganization of the delusional disorders and the acute and transient psychotic disorders, as well as the revision of course specifiers. These proposed revisions are subject to field trials with the aim of studying whether they will lead to an improvement of the classification system in comparison to its previous version. The proposals are compared with revisions of the according DSM-5 chapter. The impact of novel results from neuroscience and genetics on the current proposals is discussed, also with respect to future classification strategies such as the Research Domain Criteria (RDoC) project.

Neighbourhood characteristics and the incidence of first-episode psychosis and duration of untreated psychosis

2016 ◽  
Vol 46 (7) ◽  
pp. 1367-1378 ◽  
Author(s):  
B. O'Donoghue ◽  
J. P. Lyne ◽  
L. Renwick ◽  
A. Lane ◽  
K. Madigan ◽  
...  
Keyword(s):  
Social Capital ◽  
Incidence Rate ◽  
Psychotic Disorders ◽  
Social Deprivation ◽  
First Episode Psychosis ◽  
Incidence Rates ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Episode Psychosis ◽  
Neighbourhood Characteristics

BackgroundThe incidence of psychotic disorders varies between geographical areas and it has been hypothesized that neighbourhood-level factors may influence this variation. It is also plausible that the duration of untreated psychosis (DUP) is associated with neighbourhood characteristics. The aims of this study were to determine whether the incidence of first-episode psychosis (FEP) and the DUP are associated with the level of social deprivation, fragmentation, social capital and population density.MethodAll individuals with a FEP from a geographical defined catchment area over a 5-year period were included. Age-standardized incidence rates were calculated for each neighbourhood factor.ResultsA total of 292 cases of FEP were included in the study and 45% had a diagnosis of a schizophrenia-spectrum disorder. The age standardized incidence rate of FEP in the most deprived area was 72.4 [95% confidence interval (CI) 26.4–162.7] per 100 000 person-years compared with 21.5 (95% CI 17.6–26.0) per 100 000 person-years in the most affluent areas. This represents a 3.4-fold increase in FEP incidence in the most deprived areas. The incidence of FEP was also increased in neighbourhoods that were more socially fragmented [incidence rate ratio (IRR) = 2.40, 95% CI 1.05–5.51, p = 0.04] and there was a trend for the incidence to be increased in neighbourhoods with lower social capital (IRR = 1.43, 95% CI 0.99–2.06, p = 0.05). The median DUP was 4 months and was higher in more socially fragmented neighbourhoods.ConclusionsThe incidence of psychotic disorders is related to neighbourhood factors and it may be useful to consider neighbourhood factors when allocating resources for early intervention services.

scholarly journals Duration of remitting psychoses with acute onset

2000 ◽  
Vol 176 (6) ◽  
pp. 576-580 ◽  
Author(s):  
Ramin Mojtabai ◽  
Ezra Susser ◽  
Vijoy K. Varma
Keyword(s):  
Early Detection ◽  
World Health Organization ◽  
Psychotic Disorders ◽  
Acute Onset ◽  
World Health ◽  
Outcome Study ◽  
The World ◽  
Icd 10 ◽  
Health Organization

BackgroundThe acute and transient psychotic disorders (ATPD) in ICD–10 advanced the nosology of remitting psychoses with acute onset. But the proposed criteria for ATPD – especially in regard to duration – are tentative and need to be validated.AimsTo evaluate: (a) the duration of remitting psychoses with acute onset; (b) the applicability of the ATPD criteria for these cases; and (c) differences in duration and ATPD diagnoses across sociocultural settings.MethodData from the World Health Organization Determinants of Outcome study were used.ResultsThe 98 cases of remitting psychoses with acute onset had a modal duration of 2–4 months, with 43% falling in this range. Mainly because of this, few met the ATPD criteria. Duration and diagnostic findings were similar across settings.ConclusionsATPD criteria need refinement, especially in regard to duration. Further studies aimed at early detection and assessment of onset and duration of these disorders are needed.

Diagnostic Stability in Patients with First-Episode Psychosis

2005 ◽  
Vol 13 (4) ◽  
pp. 388-392 ◽  
Author(s):  
Homayoun Amini ◽  
Javad Alaghband-Rad ◽  
Abbas Omid ◽  
Vandad Sharifi ◽  
Rozita Davari-Ashtiani ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
International Classification Of Diseases ◽  
First Episode Psychosis ◽  
Classification Systems ◽  
First Episode ◽  
Episode Psychosis ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Dsm Iv

Objective: To examine the short-term stability of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) and International Classification of Diseases (10th revision; ICD-10) diagnoses in a group of patients with first-episode psychosis. Method: Sixty patients with first-episode psychosis admitted consecutively to Roozbeh Hospital, Tehran, were sampled; their illnesses could not be attributed to any medical or substance-induced conditions. Patients were assessed at the time of discharge from the hospital, and at 3, 6and 12 month intervals following admission. Ateach visit, two psychiatrists made consensusDSM-IV and ICD10 diagnoses, based on all available information. Stability was discerned as the consistency between diagnoses at the time of discharge and at 12 month follow up. Results: Forty-eight patients completed follow up. Affective psychotic disorders and schizophrenia in both classification systems were highly stable. In addition, all patients with DSM-IV brief psychotic disorder and ICD-10 acute and transient psychotic disorders remained the same at follow up. Conclusions: Affective psychoses and schizophrenia, in line with previous findings, remained stable. Diagnoses of brief psychoses were highly stable as well; this could reflect a non-relapsing course ofacute brief psychoses, especially in developing countries.

scholarly journals Change in incidence rates for psychosis in different ethnic groups in south London: findings from the Clinical Record Interactive Search-First Episode Psychosis (CRIS-FEP) study

2019 ◽  
pp. 1-10 ◽  
Author(s):  
Sherifat Oduola ◽  
Jayati Das-Munshi ◽  
Francois Bourque ◽  
Charlotte Gayer-Anderson ◽  
Jason Tsang ◽  
...  
Keyword(s):  
Ethnic Group ◽  
Ethnic Groups ◽  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
Incidence Rates ◽  
First Episode ◽  
Black African ◽  
Episode Psychosis ◽  
Clinical Records ◽  
Over Time

Abstract Background A higher incidence of psychotic disorders has been consistently reported among black and other minority ethnic groups, particularly in northern Europe. It is unclear whether these rates have changed over time. Methods We identified all individuals with a first episode psychosis who presented to adult mental health services between 1 May 2010 and 30 April 2012 and who were resident in London boroughs of Lambeth and Southwark. We estimated age-and-gender standardised incidence rates overall and by ethnic group, then compared our findings to those reported in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses (ÆSOP) study that we carried out in the same catchment area around 10 years earlier. Results From 9109 clinical records we identified 558 patients with first episode psychosis. Compared with ÆSOP, the overall incidence rates of psychotic disorder in southeast London have increased from 49.4 (95% confidence interval (CI) 43.6–55.3) to 63.1 (95% CI 57.3–69.0) per 100 000 person-years at risk. However, the overall incidence rate ratios (IRR) were reduced in some ethnic groups: for example, IRR (95% CI) for the black Caribbean group reduced from 6.7 (5.4–8.3) to 2.8 (2.1–3.6) and the ‘mixed’ group from 2.7 (1.8–4.2) to 1.4 (0.9–2.1). In the black African group, there was a negligible difference from 4.1 (3.2–5.3) to 3.5 (2.8–4.5). Conclusions We found that incidence rates of psychosis have increased over time, and the IRR varied by the ethnic group. Future studies are needed to investigate more changes over time and determinants of change.

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.

scholarly journals Dysregulation of complement and coagulation pathways: emerging mechanisms in the development of psychosis

2021 ◽  
Author(s):  
Meike Heurich ◽  
Melanie Föcking ◽  
David Mongan ◽  
Gerard Cagney ◽  
David R. Cotter
Keyword(s):  
High Risk ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Clinical Symptoms ◽  
First Episode Psychosis ◽  
Specific Protein ◽  
First Episode ◽  
Clinical High Risk ◽  
Blood Proteins ◽  
Episode Psychosis

AbstractEarly identification and treatment significantly improve clinical outcomes of psychotic disorders. Recent studies identified protein components of the complement and coagulation systems as key pathways implicated in psychosis. These specific protein alterations are integral to the inflammatory response and can begin years before the onset of clinical symptoms of psychotic disorder. Critically, they have recently been shown to predict the transition from clinical high risk to first-episode psychosis, enabling stratification of individuals who are most likely to transition to psychotic disorder from those who are not. This reinforces the concept that the psychosis spectrum is likely a central nervous system manifestation of systemic changes and highlights the need to investigate plasma proteins as diagnostic or prognostic biomarkers and pathophysiological mediators. In this review, we integrate evidence of alterations in proteins belonging to the complement and coagulation protein systems, including the coagulation, anticoagulation, and fibrinolytic pathways and their dysregulation in psychosis, into a consolidated mechanism that could be integral to the progression and manifestation of psychosis. We consolidate the findings of altered blood proteins relevant for progression to psychotic disorders, using data from longitudinal studies of the general population in addition to clinical high-risk (CHR) individuals transitioning to psychotic disorder. These are compared to markers identified from first-episode psychosis and schizophrenia as well as other psychosis spectrum disorders. We propose the novel hypothesis that altered complement and coagulation plasma levels enhance their pathways’ activating capacities, while low levels observed in key regulatory components contribute to excessive activation observed in patients. This hypothesis will require future testing through a range of experimental paradigms, and if upheld, complement and coagulation pathways or specific proteins could be useful diagnostic or prognostic tools and targets for early intervention and preventive strategies.

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