scholarly journals Kaleidoscope

2014 ◽  
Vol 205 (2) ◽  
pp. 166-167 ◽  
Author(s):  
Derek K. Tracy ◽  
Dan W. Joyce ◽  
Sukhwinder S. Shergill
Keyword(s):  
Violent Crime ◽  
Population Based ◽  
The Novel ◽  
Drug Induced ◽  
Persecutory Delusions ◽  
Appropriate Treatment ◽  
Cannabis Extract ◽  
Drug Induced Psychosis ◽  
The Uk

Drugs and violence are often observed as bedfellows; both have been associated with psychosis but the nature and timing of their relationships remains unclear. As part of the UK Prisoner Cohort Study, Keers et al prospectively followed up 967 prisoners convicted of sexual or violent offences (about a quarter of whom had a psychotic illness) in the community after release. Schizophrenia was associated with greater rates of violence, but the risk was mediated by untreated psychosis or when presenting with persecutory delusions – and no other definable psychopathology. Interestingly, drug-induced psychosis did not increase the risk of violence per se, once the substance misuse itself was accounted for. Does treatment have an impact on risk of violence in a population-based sample of patients with psychosis? Fazel et al demonstrated reductions in violent crime in patients during the time they were prescribed antipsychotics. Interestingly, the rates of violent crime were also reduced in patients with bipolar disorder who received mood stabilisers. Therefore, in addition to the effects of antipsychotics and mood stabilisers on relapse rates, their potential effects on violence and crime could be used to make decisions about management for these groups of patients. There is a clearer need for the appropriate treatment of prisoners with psychotic illnesses if their risk of violence is to be moderated. Cannabis is one of the most commonly used social drugs worldwide; it increases risk of psychosis, but there has been little to offer pharmacologically to those dependent upon this most prevalent illicit drug, and various trials of mood stabilisers, antidepressants and α2 adrenergic agonists have generally been disappointing. Allsop et al evaluated the novel cannabis extract nabiximols, containing cannabidiol – which has been shown to attenuate paranoia and euphoria – and tetrahydrocannabinol, delivered as a buccal spray. The active drug group showed statistically significant benefits in reduced withdrawal irritability, depression and cravings and remained longer in treatment. However, both placebo and drug groups showed reduced cannabis use at follow-up, with placebo being as effective as nabiximols in promoting longer-term cessation.

scholarly journals Diagnostic change 10 years after a first episode of psychosis

2015 ◽  
Vol 45 (13) ◽  
pp. 2757-2769 ◽  
Author(s):  
M. Heslin ◽  
B. Lomas ◽  
J. M. Lappin ◽  
K. Donoghue ◽  
U. Reininghaus ◽  
...  
Keyword(s):  
Population Based ◽  
First Episode ◽  
Drug Induced ◽  
Episode Psychosis ◽  
Icd 10 ◽  
Dsm Iv ◽  
Drug Induced Psychosis ◽  
Using Data ◽  
Psychotic Bipolar Disorder

BackgroundA lack of an aetiologically based nosology classification has contributed to instability in psychiatric diagnoses over time. This study aimed to examine the diagnostic stability of psychosis diagnoses using data from an incidence sample of psychosis cases, followed up after 10 years and to examine those baseline variables which were associated with diagnostic change.MethodData were examined from the ÆSOP and ÆSOP-10 studies, an incidence and follow-up study, respectively, of a population-based cohort of first-episode psychosis cases from two sites. Diagnosis was assigned using ICD-10 and DSM-IV-TR. Diagnostic change was examined using prospective and retrospective consistency. Baseline variables associated with change were examined using logistic regression and likelihood ratio tests.ResultsSlightly more (59.6%) cases had the same baseline and lifetime ICD-10 diagnosis compared with DSM-IV-TR (55.3%), but prospective and retrospective consistency was similar. Schizophrenia, psychotic bipolar disorder and drug-induced psychosis were more prospectively consistent than other diagnoses. A substantial number of cases with other diagnoses at baseline (ICD-10, n = 61; DSM-IV-TR, n = 76) were classified as having schizophrenia at 10 years. Many variables were associated with change to schizophrenia but few with overall change in diagnosis.ConclusionsDiagnoses other than schizophrenia should to be regarded as potentially provisional.

scholarly journals Heart rate variability and depressive symptoms: a cross-lagged analysis over a 10-year period in the Whitehall II study

2016 ◽  
Vol 46 (10) ◽  
pp. 2121-2131 ◽  
Author(s):  
V. K. Jandackova ◽  
A. Britton ◽  
M. Malik ◽  
A. Steptoe
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Depressive Symptoms ◽  
General Health Questionnaire ◽  
Antidepressant Medication ◽  
Population Based ◽  
Baseline Heart Rate ◽  
Lower Baseline ◽  
The Uk

BackgroundPeople with depression tend to have lower heart rate variability (HRV), but the temporal sequence is poorly understood. In a sample of the general population, we prospectively examined whether HRV measures predict subsequent depressive symptoms or whether depressive symptoms predict subsequent levels of HRV.MethodData from the fifth (1997–1999) and ninth (2007–2009) phases of the UK Whitehall II longitudinal population-based cohort study were analysed with an average follow-up of 10.5 years. The sample size for the prospective analysis depended on the analysis and ranged from 2334 (644 women) to 2276 (602 women). HRV measures during 5 min of supine rest were obtained. Depressive symptoms were evaluated by four cognitive symptoms of depression from the General Health Questionnaire.ResultsAt follow-up assessment, depressive symptoms were inversely associated with HRV measures independently of antidepressant medication use in men but not in women. Prospectively, lower baseline heart rate and higher HRV measures were associated with a lower likelihood of incident depressive symptoms at follow-up in men without depressive symptoms at baseline. Similar but statistically insignificant associations were found in women. Adjustments for known confounders including sociodemographic and lifestyle factors, cardiometabolic conditions or medication did not change the predictive effect of HRV on incident depressive symptoms at follow-up. Depressive symptoms at baseline were not associated with heart rate or HRV at follow-up in either sex.ConclusionsThese findings are consistent with an aetiological role of the autonomic nervous system in depression onset.

scholarly journals Diagnostic stability in a Dutch psychosis incidence cohort

2004 ◽  
Vol 185 (6) ◽  
pp. 460-464 ◽  
Author(s):  
Natalie D. Veen ◽  
Jean-Paul Selten ◽  
Diede Schols ◽  
Winfried Laan ◽  
Hans W. Hoek ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Population Based ◽  
Schizophrenic Disorder ◽  
Diagnostic Stability ◽  
Face To Face ◽  
Follow Up Study ◽  
Relative Risks ◽  
Diagnostic Interviews ◽  
The Uk

BackgroundNo study outside the UK has examined the diagnostic stability of psychotic disorders in a population-based sample.AimsTo determine diagnostic stability in a Dutch population-based psychosis incidence cohort, to examine the frequencies of diagnostic shifts to and from schizophrenic disorders and to report the revised relative risks of schizophrenic disorders for immigrants.MethodA 30-month follow-up study assessed the cohort (n=181) by means of face-to-face diagnostic interviews.ResultsDiagnostic stability of schizophrenic disorders was high (91%), but lower for other psychotic disorders. At follow-up, the initial diagnosis was adjusted to schizophrenic disorder more often than that the reverse occurred. Almost half (49%) of the patients who were not initially diagnosed as having a schizophrenic disorder received this diagnosis at follow-up. The relative risks for most immigrant groups were stable.ConclusionsSchizophrenic disorders are underdiagnosed, rather than overdiagnosed, at first presentation.

Hip screening in newborns in the UK: what are the latest guidelines?

2021 ◽  
pp. 1-7
Author(s):  
Ayla C Newton ◽  
Marion Bohatschek ◽  
Andreas Rehm ◽  
Elizabeth Ashby
Keyword(s):  
Physical Examination ◽  
Congenital Abnormalities ◽  
Screening Programme ◽  
Developmental Dysplasia ◽  
Special Focus ◽  
Timely Manner ◽  
Appropriate Treatment ◽  
The Uk

The Newborn and Infant Physical Examination screening is a national screening programme which aims to identify infants with congenital abnormalities to minimise the risk of long-term complications. It involves a top to toe examination with special focus on the heart, eyes, testes and hips. The hip component of the Newborn and Infant Physical Examination screen aims to pick up infants with developmental dysplasia of the hips and refer them for appropriate treatment in a timely manner. Guidelines for the hip section of have recently changed. This article reviews these changes, the timings of the follow up and investigations, and the diagnosis and management of developmental dysplasia of the hips.

scholarly journals Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis

2019 ◽  
Vol 50 (9) ◽  
pp. 1452-1462 ◽  
Author(s):  
Paola Dazzan ◽  
Julia M. Lappin ◽  
Margaret Heslin ◽  
Kim Donoghue ◽  
Ben Lomas ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Strong Predictor ◽  
Population Based ◽  
Individual Characteristics ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Symptom Remission ◽  
Symptom Recovery ◽  
The Uk

AbstractBackgroundTo determine the baseline individual characteristics that predicted symptom recovery and functional recovery at 10-years following the first episode of psychosis.MethodsAESOP-10 is a 10-year follow up of an epidemiological, naturalistic population-based cohort of individuals recruited at the time of their first episode of psychosis in two areas in the UK (South East London and Nottingham). Detailed information on demographic, clinical, and social factors was examined to identify which factors predicted symptom and functional remission and recovery over 10-year follow-up. The study included 557 individuals with a first episode psychosis. The main study outcomes were symptom recovery and functional recovery at 10-year follow-up.ResultsAt 10 years, 46.2% (n = 140 of 303) of patients achieved symptom recovery and 40.9% (n = 117) achieved functional recovery. The strongest predictor of symptom recovery at 10 years was symptom remission at 12 weeks (adj OR 4.47; CI 2.60–7.67); followed by a diagnosis of depression with psychotic symptoms (adj OR 2.68; CI 1.02–7.05). Symptom remission at 12 weeks was also a strong predictor of functional recovery at 10 years (adj OR 2.75; CI 1.23–6.11), together with being from Nottingham study centre (adj OR 3.23; CI 1.25–8.30) and having a diagnosis of mania (adj OR 8.17; CI 1.61–41.42).ConclusionsSymptom remission at 12 weeks is an important predictor of both symptom and functional recovery at 10 years, with implications for illness management. The concepts of clinical and functional recovery overlap but should be considered separately.

First episodes of psychosis in Afro-Caribbean and White people

1998 ◽  
Vol 172 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Noriyoshi Takei ◽  
Rajendra Persaud ◽  
Peter Woodruff ◽  
Ian F. Brockington ◽  
Robin M. Murray
Keyword(s):  
Negative Symptoms ◽  
Psychiatric Care ◽  
Population Based ◽  
Consecutive Series ◽  
White People ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Uk ◽  
First Admission

BackgroundThere have been few prospective studies of the long-term outcome of psychosis in people of Afro-Caribbean origin in the UK.MethodWe followed-up a population-based, consecutive series of 34 Afro-Caribbean and 54 White people with psychosis who had been extensively investigated during their first admission in 1973/74. Diagnoses were made by direct interview using the Present State Examination at both first admission and follow-up.ResultsNinety-seven per cent of the original sample were traced. A slightly greater proportion of the Afro-Caribbean people were assigned to the S+ Catego class (schizophrenia), both on first assessment and at follow-up. No difference was found between the two groups in the consistency of diagnosis over the 18 years or in the proportion of patients considered psychotic but Afro-Caribbean people tended to have fewer negative symptoms at follow-up. There were striking differences between the two groups in their experience of psychiatric care; Afro-Caribbean people were more likely to have been readmitted, to have experienced longer hospitalisations, and to have undergone more involuntary admissions than their White counterparts.ConclusionsAfro-Caribbean people who met clinical and research criteria for schizophrenia had a less satisfactory experience of, and response to, psychiatric care over 18 years than their White counterparts.

scholarly journals Change in device-measured physical activity assessed in childhood and adolescence in relation to depressive symptoms: a general population-based cohort study

2020 ◽  
Vol 74 (4) ◽  
pp. 330-335 ◽  
Author(s):  
Mark Hamer ◽  
Praveetha Patalay ◽  
Steven Bell ◽  
G David Batty
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Depressive Symptoms ◽  
Population Based ◽  
Childhood And Adolescence ◽  
Vigorous Activity ◽  
Current Recommendation ◽  
Baseline Activity ◽  
The Uk

AimEvidence for a link between physical activity and mental health in young people is hampered by methodological shortcomings. Using repeat assessments of device-measured physical activity, we examined the association of within-individual variation in free-living activity over 7 years with depressive symptoms.MethodsThis was a prospective cohort study of a nationally representative sample of children born in the UK (n=4898). Physical activity was quantified using accelerometry at ages 7 and 14. The main outcome was depressive symptoms, based on the Short Mood and Feelings Questionnaire, assessed at age 14.ResultsAfter adjustment for socioeconomic status, body mass index and psychological problems at baseline, a higher level of light-intensity activity at age 7 in girls was associated with a lower likelihood of having depressive symptoms at follow-up (OR, 0.79; 95% CI 0.61 to 1.00), although no associations were observed for moderate to vigorous activity or sedentary behaviour. Girls who transitioned from low baseline activity to higher levels at follow-up experienced a lower risk of depressive symptoms (OR, 0.60; 95% CI 0.39 to 0.92) compared with the inactive reference category. Null associations were observed in boys. Participants who consistently met the current recommendation of 60 min/day of moderate to vigorous activity both at 7 and 14 years of age experienced the lowest risk of depressive symptoms (OR, 0.55; 95% CI 0.34 to 0.88).ConclusionTo prevent depressive symptoms in adolescence, policies to increase physical activity from mid-childhood may have utility.

scholarly journals Prevalence and Mortality of Individuals With X-Linked Hypophosphatemia: A United Kingdom Real-World Data Analysis

2019 ◽  
Vol 105 (3) ◽  
pp. e871-e878 ◽  
Author(s):  
Samuel Hawley ◽  
Nick J Shaw ◽  
Antonella Delmestri ◽  
Daniel Prieto-Alhambra ◽  
Cyrus Cooper ◽  
...  
Keyword(s):  
United Kingdom ◽  
Fibroblast Growth Factor 23 ◽  
Later Life ◽  
Population Based ◽  
Real World Data ◽  
The United Kingdom ◽  
Multisystemic Disease ◽  
The Uk ◽  
The Life Course

Abstract Background X-linked hypophosphatemia (XLH) is a rare multisystemic disease with a prominent musculoskeletal phenotype. We aim here to improve understanding of the prevalence of XLH across the life course and of overall survival among people with XLH. Methods This was a population-based cohort study using a large primary care database in the United Kingdom (UK) from 1995 to 2016. XLH cases were matched by age, gender, and practice to up to 4 controls. Trends in prevalence over the study period were estimated (stratified by age) and survival among cases was compared with that of controls. Findings From 522 potential cases, 122 (23.4%) were scored as at least possible XLH, while 62 (11.9%) were classified as highly likely or likely (conservative definition). In main analyses, prevalence (95% CI) increased from 3.1 (1.5–6.7) per million in 1995–1999 to 14.0 (10.8–18.1) per million in 2012–2016. Corresponding estimates using the conservative definition were 3.0 (1.4–6.5) to 8.1 (5.8–11.4). Nine (7.4%) of the possible cases died during follow-up, at median age of 64 years. Fourteen (2.9%) of the controls died at median age of 72.5 years. Mortality was significantly increased in those with possible XLH compared with controls (hazard ratio [HR] 2.93; 95% CI, 1.24–6.91). Likewise, among those with likely or highly likely XLH (HR 6.65; 1.44–30.72). Conclusions We provide conservative estimates of the prevalence of XLH in children and adults within the UK. There was an unexpected increase in mortality in later life, which may have implications for other fibroblast growth factor 23–related disorders.

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