scholarly journals Insight, duration of untreated psychosis and attachment in first-episode psychosis: prospective study of psychiatric recovery over 12-month follow-up

2014 ◽  
Vol 205 (1) ◽  
pp. 60-67 ◽  
Author(s):  
A. I. Gumley ◽  
M. Schwannauer ◽  
A. Macbeth ◽  
R. Fisher ◽  
S. Clark ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Attachment Security ◽  
First Episode Psychosis ◽  
Adult Attachment Interview ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Episode Psychosis ◽  
The Relationship

BackgroundIncreasing evidence shows attachment security influences symptom expression and adaptation in people diagnosed with schizophrenia and other psychoses.AimsTo describe the distribution of secure and insecure attachment in a cohort of individuals with first-episode psychosis, and to explore the relationship between attachment security and recovery from positive and negative symptoms in the first 12 months.MethodThe study was a prospective 12-month cohort study. The role of attachment, duration of untreated psychosis (DUP), baseline symptoms and insight in predicting and mediating recovery from symptoms was investigated using multiple regression analysis and path analysis.ResultsOf the 79 participants, 54 completed the Adult Attachment Interview (AAI): 37 (68.5%) were classified as insecure, of which 26 (48.1%) were insecure/dismissing and 11 (20.4%) insecure preoccupied. Both DUP and insight predicted recovery from positive symptoms at 12 months. Attachment security, DUP and insight predicted recovery from negative symptoms at 12 months.ConclusionsAttachment is an important construct contributing to understanding and development of interventions promoting recovery following first-episode psychosis.

Toxic psychosis? Duration of untreated psychosis, symptomatology and cognitive deterioration in first episode psychosis

2007 ◽  
Vol 24 (4) ◽  
pp. 145-148 ◽  
Author(s):  
Richard Lawoyin ◽  
Keith Gaynor ◽  
Barbara Dooley ◽  
Elizabeth Lawlor ◽  
Mary Clarke ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Cognitive Deterioration ◽  
Duration Of Untreated Psychosis ◽  
Episode Psychosis ◽  
The Relationship ◽  
Linear Regressions ◽  
Positive And Negative Symptoms

AbstractObjectives: To examine the relationship between cognitive deficits, the duration of untreated psychosis (DUP) and positive and negative symptoms in a first episode psychosis sample.Method: We assessed a consecutive sample of first episode psychosis participants from a catchment area service with a comprehensive neuropsychology battery, a family and service-user based measure of DUP and measures of symptomatology.Results: Using correlations and stepwise linear regressions, we found strong relationships between measures of DUP and positive symptomatology. We found that positive and negative symptoms were associated with different time periods within DUP. However, we did not find evidence of a relationship between DUP and cognitive factors.Conclusions: There was no evidence of a relationship between DUP and cognitive deterioration. However, there does appear to be evidence of a relationship between positive symptoms and aspects of DUP. These results highlight the importance of the heterogeneity of DUP and the potential to reduce positive symptoms through early intervention.

The role of treatment delay in predicting 5-year outcomes in an early intervention program

2011 ◽  
Vol 42 (2) ◽  
pp. 223-233 ◽  
Author(s):  
R. M. G. Norman ◽  
R. Manchanda ◽  
D. Windell ◽  
R. Harricharan ◽  
S. Northcott ◽  
...  
Keyword(s):  
Disability Pension ◽  
Intervention Program ◽  
Negative Symptoms ◽  
Treatment Delay ◽  
First Episode Psychosis ◽  
First Episode ◽  
Early Intervention Program ◽  
Episode Psychosis

BackgroundPast research on the relationship between treatment delay and outcomes for first-episode psychosis has primarily focused on the role of duration of untreated psychosis (DUP) in predicting symptomatic outcomes up to 2 years. In the current study we examine the influence of both DUP and duration of untreated illness (DUI) on symptoms and functioning at 5 years follow-up while controlling for other early characteristics.MethodA total of 132 patients with first-episode psychosis and treated in an early intervention program were prospectively followed up for 5 years. Outcomes assessed included positive and negative symptoms, overall functioning, weeks on disability pension and weeks of full-time competitive employment.ResultsWhile DUP showed a significant correlation with level of positive symptoms at follow-up, this was not independent of pre-morbid social adjustment. DUI emerged as a more robust independent predictor of negative symptoms, social and occupational functioning and use of a disability pension.ConclusionsDelay between onset of non-specific symptoms and treatment may be a more important influence on long-term functioning for first-episode patients than DUP. This suggests the possible value of treating such signs and symptoms as early as possible regardless of the effectiveness of such interventions in reducing likelihood or severity of psychotic symptoms.

scholarly journals Metacognitive capacity and negative symptoms in first episode psychosis: Evidence of a prospective relationship over a 3-year follow-up

2019 ◽  
Vol 10 (1) ◽  
pp. 204380871882157 ◽  
Author(s):  
Stephen Fitzgerald Austin ◽  
Paul H. Lysaker ◽  
Jens Einar Jansen ◽  
Anne Marie Trauelsen ◽  
Hanne-Grethe Lyse Nielsen ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Sense Of Self ◽  
First Episode Psychosis ◽  
First Episode ◽  
Future Research ◽  
Syndrome Scale ◽  
Episode Psychosis ◽  
Negative Syndrome

Negative symptoms can be linked to Bleuler’s concept of splitting or fragmentation of thought, affect, and will. Research has shown a link between disturbances in metacognition and negative symptoms, although relatively few studies have examined this relationship longitudinally. The aim of this article is to examine whether metacognitive capacity among patients with first episode psychosis (FEP) predicted negative symptoms after a follow-up period of 3 years. Metacognition was assessed using the Metacognition Assessment Scale abbreviated and symptoms were assessed using Positive and Negative Syndrome Scale among 59 adults with FEP. Symptoms were then reassessed at a 3-year follow-up. Significant correlations were found between baseline metacognitive scores and the expressive component of negative symptoms as well as for individual negative symptoms such as blunted affect, poor rapport, and alogia at 3-year follow-up after controlling for baseline negative symptoms. Self-reflectivity was significantly correlated with the expressive component of negative symptoms at 3-year follow-up. The results are partly consistent with a Bleulerian model which understands the emergence of negative symptoms as a response in part to the experience of fragmentation, particularly in terms of sense of self and others. Future research should clarify the likely role of metacognition in the development and maintenance of negative symptoms.

scholarly journals Patterns and predictors of hospitalisation in first-episode psychosis

2001 ◽  
Vol 178 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Attila Sipos ◽  
Glynn Harrison ◽  
David Gunnell ◽  
Shazad Amin ◽  
Swaran P. Singh
Keyword(s):  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Psychiatric Services ◽  
First Episode ◽  
Psychotic Episode ◽  
Duration Of Untreated Illness ◽  
Specialist Services ◽  
Increased Risk ◽  
Episode Psychosis

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.

Family involvement in first-episode psychosis

2019 ◽  
pp. 117-130
Author(s):  
Greeshma Mohan ◽  
R. Padmavati ◽  
R. Thara
Keyword(s):  
Treatment Adherence ◽  
Family Involvement ◽  
First Episode Psychosis ◽  
First Episode ◽  
Rapid Urbanization ◽  
Episode Psychosis ◽  
The Family ◽  
Expanding Population

In the Indian secular, pluralistic, and collectivist society, the family is the oldest and the most important institution that has survived through the ages. With rapid urbanization and an ever-expanding population, there is a scarcity of financial and human resources in the area of mental health. Though progressively decreasing in size, families continue to provide a valuable support system, which can be helpful in the management of various stressful situations. Yet, very often this resource is not adequately and appropriately utilized. This chapter describes the role of family involvement in first-episode psychosis, drawing from various research projects carried out by the Schizophrenia Research Foundation (SCARF) and from other Indian centres. It deals with the identification of prodromes, access to care, treatment adherence and follow-up, and stigma.

Cognitive functioning in patients with first-episode psychosis stratified by level of negative symptoms: A 1-year follow-up study

2019 ◽  
Vol 281 ◽  
pp. 112554 ◽  
Author(s):  
Magnus Johan Engen ◽  
Carmen Simonsen ◽  
Ingrid Melle ◽  
Ann Færden ◽  
Siv Hege Lyngstad ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Follow Up Study ◽  
Episode Psychosis

scholarly journals Duration of untreated psychosis and social function: 1-year follow-up study of first-episode schizophrenia

2008 ◽  
Vol 193 (3) ◽  
pp. 203-209 ◽  
Author(s):  
Thomas R. E. Barnes ◽  
Verity C. Leeson ◽  
Stanley H. Mutsatsa ◽  
Hilary C. Watt ◽  
Sam B. Hutton ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Social Function ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Clinical Difference ◽  
Path Analyses ◽  
First Episode Schizophrenia ◽  
The Relationship ◽  
Positive And Negative Symptoms

BackgroundIn first-episode schizophrenia, longer duration of untreated psychosis (DUP) predicts poorer outcomes.AimsTo address whether the relationship between DUP and outcome is a direct causal one or the result of association between symptoms and/or cognitive functioning and social functioning at the same time point.MethodSymptoms, social function and cognitive function were assessed in 98 patients with first-episode schizphrenia at presentation and 1 year later.ResultsThere was no significant clinical difference between participants with short and long DUP at presentation. Linear regression analyses revealed that longer DUP significantly predicted more severe positive and negative symptoms and poorer social function at 1 year, independent of scores at presentation. Path analyses revealed independent direct relationships between DUP and social function, core negative symptoms and positive symptoms. There was no significant association between DUP and cognition.ConclusionsLonger DUP predicts poor social function independently of symptoms. The findings underline the importance of taking account of the phenomenological overlap between measures of negative symptoms and social function when investigating the effects of DUP.

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