Transition to schizophrenia in acute and transient psychotic disorders

BackgroundThe diagnostic category of acute and transient psychotic disorders (ATPD) was introduced in ICD-10. Subsequent studies have called into question its validity and reliability.AimsTo determine the pattern of diagnostic revision to schizophrenia in first-ever diagnosed ATPD.MethodUsing data drawn from the Scottish Morbidity Record, we estimated incidence and diagnostic change in first-ever diagnosed ATPD in Scottish hospitals between January 1997 and December 2010 (n= 2923).ResultsThe average incidence of ATPD was 4.1 per 100 000 population per year. Diagnostic stability was estimated at 53.9% over an average of approximately 4 years of observation. The most common diagnostic shift was to schizophrenia (12.6%), over an average of 1.7 years. Estimates of the transition risks for schizophrenia were 80% at 2.8 years and 90% at 4.6 years. Longer first admission to hospital, younger age at onset and male gender were associated with increased risk and earlier development of schizophrenia.ConclusionsRoutinely collected data suggest that approximately one in eight individuals with first-ever diagnosed ATPD will develop schizophrenia within 3–5 years. Those at high risk of transition may benefit from monitoring for possible diagnostic change.

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Adolescent cannabis use, baseline prodromal symptoms and the risk of psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.2017.52 ◽

2018 ◽

Vol 212 (4) ◽

pp. 227-233 ◽

Cited By ~ 21

Author(s):

Antti Mustonen ◽

Solja Niemelä ◽

Tanja Nordström ◽

Graham K. Murray ◽

Pirjo Mäki ◽

...

Keyword(s):

Substance Use ◽

General Population ◽

Birth Cohort ◽

Psychotic Disorders ◽

Temporal Order ◽

Population Based ◽

Cannabis Use ◽

Prodromal Symptoms ◽

Increased Risk ◽

Icd 10

BackgroundThe association between cannabis use and the risk of psychosis has been studied extensively but the temporal order still remains controversial.AimsTo examine the association between cannabis use in adolescence and the risk of psychosis after adjustment for prodromal symptoms and other potential confounders.MethodThe sample (n = 6534) was composed of the prospective general population-based Northern Finland Birth Cohort of 1986. Information on prodromal symptoms of psychosis and cannabis use was collected using questionnaires at age 15–16 years. Participants were followed up for ICD-10 psychotic disorders until age 30 years using nationwide registers.ResultsThe risk of psychosis was elevated in individuals who had tried cannabis five times or more (hazard ratio, (HR) = 6.5, 95% CI 3.0–13.9). The association remained statistically significant even when adjusted for prodromal symptoms, other substance use and parental psychosis (HR = 3.0, 95% CI 1.1–8.0).ConclusionsAdolescent cannabis use is associated with increased risk of psychosis even after adjustment for baseline prodromal symptoms, parental psychosis and other substance use.Declaration of interestNone.

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Association between height and the risk of primary brain malignancy in adults: A nationwide population-based cohort study

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab098 ◽

2021 ◽

Author(s):

Stephen Ahn ◽

Kyungdo Han ◽

Jung Eun Lee ◽

Sin-Soo Jeun ◽

Yong Moon Park ◽

...

Keyword(s):

National Health ◽

Asian Population ◽

Population Based ◽

Health Examination ◽

National Health Insurance System ◽

Increased Risk ◽

Icd 10 ◽

Korean National Health Insurance ◽

Using Data ◽

Brain Malignancy

Abstract Purpose The association between height and the risk of developing primary brain malignancy remains unclear. We evaluated the association between height and risk of primary brain malignancy based on a nationwide population-based database of Koreans. Methods Using data from the Korean National Health Insurance System cohort, 6,833,744 people over 20 years of age that underwent regular national health examination were followed from January 2009 until the end of 2017. We documented 4,771 cases of primary brain malignancy based on an ICD-10 code of C71 during the median follow-up period of 7.30 years and 49,877,983 person-years. Results When dividing the population into quartiles of height for each age group and sex, people within the highest height quartile had a significantly higher risk of brain malignancy, compared to those within the lowest height quartile (HR 1.21 CI 1.18–1.32) after adjusting for potential confounders. We also found that the risk of primary brain malignancy increased in proportion with the quartile increase in height. After analyzing subgroups based on older age (≥ 65) and sex, we found positive relationships between height and primary brain malignancy in all subgroups. Conclusions This study is the first to suggest that height is associated with increased risk of primary brain malignancy in the East-Asian population. Further prospective and larger studies with precise designs are needed to validate our findings.

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Is the psychopathology of acute and transient psychotic disorder different from schizophrenic and schizoaffective disorders?

European Psychiatry ◽

10.1016/j.eurpsy.2005.02.001 ◽

2005 ◽

Vol 20 (4) ◽

pp. 315-320 ◽

Cited By ~ 24

Author(s):

Andreas Marneros ◽

Frank Pillmann ◽

Annette Haring ◽

Sabine Balzuweit ◽

Raffaela Blöink

Keyword(s):

Psychotic Disorders ◽

Diagnostic Category ◽

Control Groups ◽

Prodromal Symptoms ◽

Schizoaffective Disorders ◽

Cycloid Psychoses ◽

Gender And Age ◽

Icd 10 ◽

Nosological Entity ◽

Symptom List

AbstractObjectiveThis study explores psychopathological aspects of acute and transient psychotic disorders (ATPD), a diagnostic category introduced with ICD-10, to elucidate its relationship with schizophrenia and schizoaffective psychoses.MethodsWe recruited all consecutive inpatients fulfilling the ICD-10 criteria of ATPD (F23) during a 5-year period as well as control groups with “positive” schizophrenia (PS) and bipolar schizoaffective disorder (BSAD) matched for gender and age at index episode. For the evaluation of psychopathological parameters during index episode a standardized symptom list was used. Prepsychotic (prodromal) symptoms were also assessed.ResultsDuring the prepsychotic period few differences between the groups were detected. The most important difference between ATPD and the other two other psychotic disorders regarding phenomenology of the full-blown episodes was a higher frequency of “rapidly changing delusional topics”, “rapidly changing mood” and anxiety in ATPD.ConclusionATPD show a characteristic psychopathological picture consistent with earlier concepts such as cycloid psychoses and bouffée délirante. Nevertheless, psychopathology alone is not enough to establish ATPD as an independent nosological entity.

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Incidence of schizophrenia in Nottingham

The British Journal of Psychiatry ◽

10.1192/bjp.171.2.140 ◽

1997 ◽

Vol 171 (2) ◽

pp. 140-144 ◽

Cited By ~ 45

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.

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Association between parent mental health and paediatric TBI: epidemiological observations from the 1987 Finnish Birth Cohort

Injury Prevention ◽

10.1136/injuryprev-2017-042624 ◽

2018 ◽

Vol 25 (4) ◽

pp. 283-289 ◽

Cited By ~ 3

Author(s):

Michael Lowery Wilson ◽

Olli Tenovuo ◽

Mika Gissler ◽

Simo Saarijärvi

Keyword(s):

Mental Health ◽

Mood Disorders ◽

Psychotic Disorders ◽

Brain Injuries ◽

Maternal Mental Health ◽

Traumatic Brain Injuries ◽

Parental Mental Illness ◽

Behavioural Disorders ◽

Increased Risk ◽

Icd 10

BackgroundThis study examined whether parental mental illness has implications for child risk for traumatic brain injuries (TBI).MethodData on 60 069 Finnish children born in 1987 and their parents were examined for demographic and mental health-related variables in relationship with paediatric TBI. Altogether, 15 variables were derived from the cohort data with ICD-10 F-codes being available for mental health diagnoses for all parents. Bivariate and multivariate analyses were carried out using inpatient and outpatient diagnoses of child TBI.ResultsPaternal disorders due to psychoactive substance use (F10–F19) was associated with an increased inpatient TBI (OR=1.51; CI=1.07 to 2.14). Mood disorders (F30–F39) were associated with higher rates of outpatient TBI (OR=1.42; CI=1.06 to 1.90). Paternal personality and behavioural disorders (F60–F69) were linked with a twofold increase in risk across both categories of child TBI (OR=2.35; CI=1.41 to 3.90) and (OR=2.29; CI=1.45 to 3.61), respectively. Among the maternal mental health factors associated with child TBI, schizophrenia and other non-mood psychotic disorders (F20–F29) were associated with an increase in inpatient traumatic brain injuries (iTBI) (OR=1.78; 1.22 to 2.59). Mothers having mood disorders (F30–F39) were more likely to have had a child who experienced an iTBI (OR=1.64; CI=1.20 to 2.22). Mothers with personality and behavioural disorders (F60–F69) were also found to have had children with an increased risk for iTBI (OR=2.30; CI=1.14 to 3.65).ConclusionTaken together, these data should call attention to methods and strategies designed to augment and support caregiving environments with modalities that can foster mutually supportive households in cooperation with parents who have been diagnosed with a mental disorder.

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The Role of Cannabinoids in Schizophrenia: Where Have we Been and Where are we Going?

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.117 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S277-S277

Author(s):

J. Reis ◽

G. Pereira

Keyword(s):

Cannabinoid Receptors ◽

Psychotic Disorders ◽

Cannabis Sativa ◽

Therapeutic Potential ◽

Age At Onset ◽

Synthetic Cannabinoids ◽

The Other ◽

Other Hand ◽

Increased Risk

IntroductionSeveral studies have shown that both endocannabinoid system (ECS) and synthetic cannabinoids (SC) might be involved in schizophrenia.ObjectivesTo review recent literature on the role of cannabinoids in schizophrenia. The review includes the evidence of cannabis use as a risk factor for the development of schizophrenia, but also the preliminary evidence for the use of cannabinoid-based compounds in the treatment of psychosis.MethodsThe authors made an online search on PubMed for clinical trials and reviews published in the last 12 months, using the keywords: “cannabinoids”, “endocannabinoids”, “phytocannabinoids” and “schizophrenia”.ResultsThe use of Cannabis sativa is associated with increased risk of developing psychotic disorders, including schizophrenia, and earlier age at onset of psychosis. Δ9-Tetrahydrocannabinol (THC) has multiple actions in the brain development, including impairment of neuroplasticity, dysregulation of dopamine and glutamate signaling, and, possibly, neurotoxicity. The ECS has been implicated in psychosis both related and unrelated to cannabis exposure. Cannabinoid receptors type 1 (CB1 R) and type 2 (CB2 R), as well as the endogenous ligand N-arachidonoylethanolamine (AEA) and 2-arachidonylglycerol (2-AG) levels, are most likely to be involved in the pathophysiology of this disorder. On the other hand, the antipsychotic effects of some cannabinoids have been investigated in recent studies. Cannabidiol (CBD) and Δ9-tetrahydrocannabivarin (THCV) may have therapeutic potential for the treatment of psychosis.ConclusionsEmerging evidence suggests an important role of ECB system and SC on schizophrenia. On the other hand, recent studies have shown some phytocannabinoids might represent therapeutic promises in this disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Adolescent Self-Poisoning

Crisis ◽

10.1027//0227-5910.24.2.79 ◽

2003 ◽

Vol 24 (2) ◽

pp. 79-84 ◽

Cited By ~ 14

Author(s):

David M. Reith ◽

Ian Whyte ◽

Greg Carter ◽

Michelle McPherson

Keyword(s):

Psychotic Disorders ◽

Premature Death ◽

Fold Increase ◽

Male Gender ◽

Mental Illnesses ◽

Cohort Design ◽

Hazard Ratios ◽

Self Harm ◽

Using Data

Abstract: Previous self-harm has been identified as a risk factor for subsequent suicide by adolescents. The objective of the study was to identify further risk factors for subsequent premature death and suicide in a population of adolescents presenting with self-poisoning. A longitudinal cohort design using data-linkage of consecutive adolescent patients presenting to the Hunter Area Toxicology Service, a regional toxicology service for Newcastle, Australia, with the National Death Index of the Australian Institute of Health and Welfare was used. A total of 441 adolescents aged 10 to 19 years presented with self-poisoning over 5 years from January 1991 to December 1995, with follow-up to March 2001. There were 14 deaths total, eight of which were likely suicides. There was a 22-fold increase in suicide rate for males and a 14-fold increase for females compared with age-normalized population rates. Adjusted hazard ratios (95% CI) for premature death were male gender 3.77 (1.11-12.78), nonaffective psychotic disorders 16.3 (3.83-69.34) and the mental illnesses of childhood 6.12 (1.68-22.23). There was a similar pattern for suicide: Male gender, nonaffective psychotic disorders, and the mental illnesses of childhood confer greater risk for subsequent suicide or premature death in this population.

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Cigarette Smoking Is Associated with Increased Risk of Malignant Gliomas: A Nationwide Population-Based Cohort Study

Cancers ◽

10.3390/cancers12051343 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1343

Author(s):

Stephen Ahn ◽

Kyung-Do Han ◽

Yong-Moon Park ◽

Jung Min Bae ◽

Sang Uk Kim ◽

...

Keyword(s):

Cigarette Smoking ◽

Malignant Gliomas ◽

Population Based ◽

Dependent Manner ◽

National Health Insurance System ◽

Cancer History ◽

Increased Risk ◽

Icd 10 ◽

Never Smokers ◽

Using Data

The association between cigarette smoking and the risk of developing malignant glioma (MG) remains unclear. We aimed to evaluate this potential association in a large general population, using a well-established and validated longitudinal nationwide database. Using data from the Korean National Health Insurance System cohort, 9,811,768 people over 20 years old without any cancer history in 2009 were followed until the end of 2017. We documented 6100 MG cases (ICD-10 code C71) during the median follow-up period of 7.31 years. Current smokers had a higher risk of developing MG (HR = 1.22, CI: 1.13–1.32) compared with never-smokers, after adjusting for confounders. This association was stronger for those who smoked ≥ 20 cigarettes daily (HR = 1.50, CI: 1.36–1.64). Furthermore, having 30 or more pack-years of smoking over the course of one’s lifetime was associated with an increased risk of developing MG in a dose-dependent manner, compared with never-smokers (HR = 1.31, CI: 1.16–1.48 for 30–39 pack-years of smoking; HR = 1.36, CI: 1.17–1.59 for 40–49 pack-years of smoking; HR = 1.68; CI: 1.44–1.95 for ≥ 50 pack-years of smoking). These results suggest that cigarette smoking may be associated with developing MG. Further prospective studies could help elucidate this association.

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Cerebrospinal fluid findings in patients with psychotic symptoms—a retrospective analysis

Scientific Reports ◽

10.1038/s41598-021-86170-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tim W. Rattay ◽

Pascal Martin ◽

Debora Vittore ◽

Holger Hengel ◽

Idil Cebi ◽

...

Keyword(s):

Psychotic Disorders ◽

Age At Onset ◽

Thyroid Tissue ◽

Classification Systems ◽

Oligoclonal Bands ◽

Psychotic Symptoms ◽

Csf Biomarkers ◽

Etiological Factors ◽

Csf Analysis ◽

Icd 10

AbstractIn current international classification systems (ICD-10, DSM5), the diagnostic criteria for psychotic disorders (e.g. schizophrenia and schizoaffective disorder) are based on symptomatic descriptions since no unambiguous biomarkers are known to date. However, when underlying causes of psychotic symptoms, like inflammation, ischemia, or tumor affecting the neural tissue can be identified, a different classification is used ("psychotic disorder with delusions due to known physiological condition" (ICD-10: F06.2) or psychosis caused by medical factors (DSM5)). While CSF analysis still is considered optional in current diagnostic guidelines for psychotic disorders, CSF biomarkers could help to identify known physiological conditions. In this retrospective, partly descriptive analysis of 144 patients with psychotic symptoms and available CSF data, we analyzed CSF examinations' significance to differentiate patients with specific etiological factors (F06.2) from patients with schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F2). In 40.3% of all patients, at least one CSF parameter was out of the reference range. Abnormal CSF-findings were found significantly more often in patients diagnosed with F06.2 (88.2%) as compared to patients diagnosed with F2 (23.8%, p < 0.00001). A total of 17 cases were identified as probably caused by specific etiological factors (F06.2), of which ten cases fulfilled the criteria for a probable autoimmune psychosis linked to the following autoantibodies: amphiphysin, CASPR2, CV2, LGl1, NMDA, zic4, and titin. Two cases presented with anti-thyroid tissue autoantibodies. In four cases, further probable causal factors were identified: COVID-19, a frontal intracranial tumor, multiple sclerosis (n = 2), and neurosyphilis. Twenty-one cases remained with "no reliable diagnostic classification". Age at onset of psychotic symptoms differed between patients diagnosed with F2 and F06.2 (p = 0.014), with the latter group being older (median: 44 vs. 28 years). Various CSF parameters were analyzed in an exploratory analysis, identifying pleocytosis and oligoclonal bands (OCBs) as discriminators (F06.2 vs. F2) with a high specificity of > 96% each. No group differences were found for gender, characteristics of psychotic symptoms, substance dependency, or family history. This study emphasizes the great importance of a detailed diagnostic workup in diagnosing psychotic disorders, including CSF analysis, to detect possible underlying pathologies and improve treatment decisions.

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No correlation of serum cholesterol levels with measures of violence in patients with schizophrenia and non-psychotic disorders

European Psychiatry ◽

10.1016/s0924-9338(99)00157-1 ◽

1999 ◽

Vol 14 (6) ◽

pp. 346-348 ◽

Cited By ~ 21

Author(s):

T. Steinert ◽

M. Woelfle ◽

R.P. Gebhardt

Keyword(s):

Serum Cholesterol ◽

Animal Studies ◽

Psychotic Disorders ◽

Epidemiological Studies ◽

Psychiatric Admission ◽

Cholesterol Levels ◽

Increased Risk ◽

The Social ◽

Icd 10 ◽

Overt Aggression Scale

SummaryEpidemiological studies, animal studies, and clinical studies yielded conflicting results concerning a supposed association between increased risk for suicide and violence, and low serum cholesterol levels. Until now, no data has been available for patients with schizophrenia, a disorder with a well-known increased risk of violence. Correlations of serum cholesterol levels at admission and measures of violence were investigated in 103 consecutively admitted patients (44 males, 59 females) of a general psychiatric admission unit. Seventy subjects were diagnosed as suffering from schizophrenia or schizoaffective disorder (ICD-10 F 20, F25), and 33 were diagnosed as suffering from non-psychotic disorders (mainly personality disorders). The level of total exhibited violence during the inpatient treatment period was measured in each patient by the Modified Overt Aggression Scale (MOAS), the Social Dysfunction and Aggression Scale (SDAS), the Staff Observation Aggression Scale (SOAS), and the Violence Scale (VS). Correlations of all violence measures were high (0.75–0.90), but no correlation was found with cholesterol levels, neither for psychotic nor for non-psychotic subjects, neither for men nor for women. The hypothesis of associations of violence and cholesterol levels is not supported by the data.

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