Incidence of first-contact psychosis in São Paulo,
                        Brazil

BackgroundLittle is known about the incidence of first-episode psychosis in urban centres of low- or middle-income countriesAimsTo estimate the incidence of psychosis in São Paulo, a large metropolis of BrazilMethodProspective survey of first-episode psychosis among residents aged 18–64 years resident in a defined area of São Paulo, over a 30-month period (July 2002- December 2004). Assessments were carried out with the SCID–I, and diagnoses given according to DSM – IV criteria. Population at risk was drawn from the 2000 Census dataResultsThere were 367 first-episode cases identified (51% women), and almost 40% fulfilled criteria for schizophrenia or schizophreniform disorder. The incidence rate for any psychosis was 15.8/100 000 person-years at risk (95% CI 14.3–17.6). Incidence of non-affective psychoses was higher among younger malesConclusionsIncidence of psychosis in São Paulo was lower than expected for a large metropolis

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Urbanicity and risk of first-episode psychosis: incidence study in Brazil

The British Journal of Psychiatry ◽

10.1192/bjp.2019.110 ◽

2019 ◽

Vol 215 (6) ◽

pp. 726-729 ◽

Cited By ~ 5

Author(s):

Cristina Marta Del-Ben ◽

Rosana Shuhama ◽

Camila Marcelino Loureiro ◽

Taciana Cristina Carvalho Ragazzi ◽

Daniela Perocco Zanatta ◽

...

Keyword(s):

At Risk ◽

First Episode Psychosis ◽

Incidence Rates ◽

First Episode ◽

World Population ◽

Middle Income ◽

Middle Income Countries ◽

Episode Psychosis ◽

Gender And Age ◽

Lower Population

We estimated the incidence of first-episode psychosis over a 3-year period in a Brazilian catchment area comprising the region's main city, Ribeirão Preto (1 425 306 persons-years at risk), and 25 other municipalities with a total of 1 646 556 persons-years at risk. The incidence rates were estimated and adjusted by gender and age, using the direct standardisation method to the world population as reference. The incidence of psychosis was higher in the younger groups, men, and among Black and minority ethnic Brazilians. Psychosis incidence was lower in Ribeirão Preto (16.69/100 000 person-years at risk; 95% CI 15.68–17.70) compared with the average incidence in the remaining municipalities (21.25/100 000 person-years at risk; 95% CI 20.20–22.31), which have lower population density, suggesting a distinct role for urbanicity in the incidence of first-episode psychosis in low- and middle-income countries.

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Reliability of the Brazilian version of the Camberwell Assessment of Needs (CAN) in first-episode psychosis cases in São Paulo, Brazil

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462006005000026 ◽

2006 ◽

Vol 29 (2) ◽

pp. 160-163 ◽

Cited By ~ 9

Author(s):

Ana Cristina Belizia Schlithler ◽

Marcia Scazufca ◽

Geraldo Busatto ◽

Letícia Maria Silva Coutinho ◽

Paulo Rossi Menezes

Keyword(s):

Intraclass Correlation ◽

First Episode Psychosis ◽

Sao Paulo ◽

Mental Illnesses ◽

First Episode ◽

São Paulo ◽

Rater Reliability ◽

Individualized Care ◽

Brazilian Version ◽

Episode Psychosis

OBJECTIVE: To translate and adapt the Brazilian version of the Camberwell Assessment of Needs schedule for research, and to assess its inter-rater reliability in a sample of first-episode psychosis cases in São Paulo, Brazil. METHOD: A sub-sample of participants included in a study of first-episode psychosis in São Paulo was assessed utilizing the 22 domains of the Brazilian version of the Camberwell Assessment of Needs. The Camberwell Assessment of Needs was applied, tape-recorded and rated by research assistants. An independent rater gave scores to the same participants, based on the recorded interviews. The kappa coefficient and the intraclass correlation coefficient were used to assess inter-rater reliability. RESULTS: Fifty-two subjects were included. For seven domains the inter-rater reliability was almost perfect to total (range: 0.81 to 1.0). The domains with the lowest agreement were transport and benefits. The inter-rater reliability for the total number of needs was excellent (ICC = 0.95). CONCLUSIONS: The inter-rater reliability of the Camberwell Assessment of Needs was similar to what has been found in previous studies. The Camberwell Assessment of Needs showed to be easy to use and reliable with first-episode psychosis individuals. The use of standardized instruments to assess needs of care in Brazil will contribute to the assessment of the effectiveness of treatment and to the planning of individualized care for individuals with mental illnesses.

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Cardiovascular risk factors in patients with first-episode psychosis in São Paulo, Brazil

General Hospital Psychiatry ◽

10.1016/j.genhosppsych.2011.12.010 ◽

2012 ◽

Vol 34 (3) ◽

pp. 268-275 ◽

Cited By ~ 12

Author(s):

Isabela M. Benseñor ◽

André R. Brunoni ◽

Luis Augusto Pilan ◽

Alessandra C. Goulart ◽

Geraldo F. Busatto ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

First Episode Psychosis ◽

Sao Paulo ◽

First Episode ◽

São Paulo ◽

Episode Psychosis

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Cognitive deficits in first-episode psychosis: A population-based study in São Paulo, Brazil

Schizophrenia Research ◽

10.1016/j.schres.2006.09.026 ◽

2007 ◽

Vol 90 (1-3) ◽

pp. 338-343 ◽

Cited By ~ 43

Author(s):

A AYRES ◽

G BUSATTO ◽

P MENEZES ◽

M SCHAUFELBERGER ◽

L COUTINHO ◽

...

Keyword(s):

Cognitive Deficits ◽

Population Based ◽

First Episode Psychosis ◽

Sao Paulo ◽

First Episode ◽

São Paulo ◽

Population Based Study ◽

Episode Psychosis

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Grey matter abnormalities in Brazilians with first-episode psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.191.51.s117 ◽

2007 ◽

Vol 191 (S51) ◽

pp. s117-s122 ◽

Cited By ~ 49

Author(s):

Maristela S. Schaufelberger ◽

Fabio L. S. Duran ◽

Julia M. Lappin ◽

Marcia Scazufca ◽

Edson Amaro ◽

...

Keyword(s):

Grey Matter ◽

First Episode Psychosis ◽

High Income ◽

First Episode ◽

Voxel Based Morphometry ◽

Middle Income ◽

Middle Income Countries ◽

Episode Psychosis ◽

Structural Abnormalities ◽

The Right

BackgroundIn low-and middle-income countries people with schizophrenia are reported to experience better outcomes than those in high-income countriesAimsTo examine structural brain differences in people with first-episode psychosis and controls in BrazilMethodMagnetic resonance imaging using voxel-based morphometry was performed on 122 people with first-episode psychosis and 94 controlsResultsThere were significant decreases in grey matter in the left superior temporal and inferior prefrontal cortices, insula bilaterally and the right hippocampal region in first-episode psychosis (P<0.05, corrected for multiple comparisons). The subgroup of people with schizophrenia (n=62) exhibited a similar pattern of decrease in grey matter relative to controlsConclusionsStructural abnormalities reported in psychosis in high-income countries are also present in first-episode psychosis in Brazil

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Circulating lipids associate with future weight gain in individuals with an at-risk mental state and in first-episode psychosis

10.1101/2020.01.30.20019711 ◽

2020 ◽

Author(s):

Santosh Lamichhane ◽

Alex M. Dickens ◽

Partho Sen ◽

Heikki Laurikainen ◽

Jaana Suvisaari ◽

...

Keyword(s):

At Risk ◽

Weight Gain ◽

High Risk ◽

Psychotic Disorders ◽

First Episode Psychosis ◽

Molecular Signature ◽

First Episode ◽

Baseline Serum ◽

Average Life Span ◽

Episode Psychosis

AbstractPatients with schizophrenia have a lower than average life span, largely due to the increased prevalence of cardiometabolic co-morbidities. Identification of individuals with psychotic disorders with a high risk of rapid weight gain, and the associated development of metabolic complications, is an unmet need as regards public health. Here, we applied mass spectrometry-based lipidomics in a prospective study comprising 48 controls (CTR), 44 first-episode psychosis (FEP) patients and 22 individuals at clinical-high-risk (CHR) for psychosis, from two study centers (Turku/Finland and London/UK). Baseline serum samples were analyzed by lipidomics, while body mass index (BMI) was assessed at baseline and after 12 months. We found that baseline triacylglycerols with low double bond counts and carbon numbers were positively associated with the change in BMI at follow-up. In addition, a molecular signature comprised of two triacylglycerols (TG(48:0) and TG(45:0)), was predictive of weight gain in individuals with a psychotic disorder, with an area under the receiver operating characteristic curve (AUROC) of 0.74 (95% CI: 0.60–0.85). When independently tested in the CHR group, this molecular signature predicted said weight change with AUROC = 0.73 (95% CI: 0.61–0.83). We conclude that molecular lipids may serve as a predictor of weight gain in psychotic disorders in at-risk individuals, and may thus provide a useful marker for identifying individuals who are most prone to developing cardiometabolic co-morbidities.

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The pathways to mental health care of first-episode psychosis patients: a systematic review

Psychological Medicine ◽

10.1017/s0033291710000371 ◽

2010 ◽

Vol 40 (10) ◽

pp. 1585-1597 ◽

Cited By ~ 92

Author(s):

K. K. Anderson ◽

R. Fuhrer ◽

A. K. Malla

Keyword(s):

Mental Health ◽

First Episode Psychosis ◽

Pathways To Care ◽

First Episode ◽

Psychotic Episode ◽

First Psychotic Episode ◽

Episode Psychosis ◽

First Contact ◽

Pathway To Care ◽

Delay In Treatment

BackgroundAlthough there is agreement on the association between delay in treatment of psychosis and outcome, less is known regarding the pathways to care of patients suffering from a first psychotic episode. Pathways are complex, involve a diverse range of contacts, and are likely to influence delay in treatment. We conducted a systematic review on the nature and determinants of the pathway to care of patients experiencing a first psychotic episode.MethodWe searched four databases (Medline, HealthStar, EMBASE, PsycINFO) to identify articles published between 1985 and 2009. We manually searched reference lists and relevant journals and used forward citation searching to identify additional articles. Studies were included if they used an observational design to assess the pathways to care of patients with first-episode psychosis (FEP).ResultsIncluded studies (n=30) explored the first contact in the pathway and/or the referral source that led to treatment. In 13 of 21 studies, the first contact for the largest proportion of patients was a physician. However, in nine of 22 studies, the referral source for the greatest proportion of patients was emergency services. We did not find consistent results across the studies that explored the sex, socio-economic, and/or ethnic determinants of the pathway, or the impact of the pathway to care on treatment delay.ConclusionsAdditional research is needed to understand the help-seeking behavior of patients experiencing a first-episode of psychosis, service response to such contacts, and the determinants of the pathways to mental health care, to inform the provision of mental health services.

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Book Reviews: CBT for Those at Risk of a First Episode Psychosis: evidence-based psychotherapy for people with an “At Risk Mental State” – Erratum

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465815000090 ◽

2015 ◽

Vol 43 (3) ◽

pp. 384-384

Author(s):

C. Collinson

Keyword(s):

At Risk ◽

First Episode Psychosis ◽

Clinical Psychologist ◽

First Episode ◽

Evidence Based ◽

Episode Psychosis ◽

Evidence Based Psychotherapy ◽

At Risk Mental State

Please note the author of this book review is Dr Catherine Campbell, Clinical Psychologist, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, and not Collinson, C. (2015) as cited in the original article. The book review editors extend their sincere apologies to Dr Campbell for this error.

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