scholarly journals An Observational Cohort of First Episode Psychosis in Iran: The Azeri Recent Onset Acute Phase Psychosis Survey (ARAS Cohort) Study Protocol

2020 ◽  
Author(s):  
Sara Farhang ◽  
Mehrdad Ghaemmaghami ◽  
Gholamreza Noorazar ◽  
Wim Veling ◽  
Ayyoub Malek ◽  
...  
Keyword(s):  
Acute Phase ◽  
Psychotic Disorders ◽  
Clinical Signs ◽  
Cluster Method ◽  
Diagnostic Tools ◽  
First Episode ◽  
Risk And Resilience ◽  
Recent Onset ◽  
Outcome Monitoring ◽  
Resilience Factors

Abstract BackgroundMost of our knowledge about the etiology, course, treatment, and outcome of schizophrenia spectrum and other psychotic disorders stems from Western countries. Data from populations living in other geographical areas and low- and middle-income countries, with different genomes (ethnicity) and exposomes (e.g., culture and social support, drugs of abuse, religion), will add to our knowledge of this complex disorder.MethodsThe Azeri Acute phase/Recent onset psychosis Survey (ARAS) has been initiated to study the course of the disorder in patients with recent onset psychosis using validated diagnostic tools and a comprehensive outcome monitoring system, aiming to reveal indicators for understanding the risk and resilience factors and for choosing the best personalized treatment strategy. All participants will be evaluated for clinical signs and symptoms as well as risk and resilience factors and will be followed up for 1, 3, and 5 years for outcomes in several domains. A hierarchical cluster method will be applied to identify the number of clusters for each outcome. Defined models will be applied to assess the predictive value of cognition on symptomatic and functional outcomes at follow-up.DiscussionThe ARAS cohort will yield significant academic- (research and education) and care-related achievements. ARAS data and experience will have value both in being a useful model for other parts of this region and in expansion of the current available knowledge.

scholarly journals An Observational Cohort of First Episode Psychosis in Iran: The Azeri Recent Onset Acute Phase Psychosis Survey (ARAS Cohort) Study Protocol

2021 ◽  
Vol 12 ◽  
Author(s):  
Sara Farhang ◽  
Mehrdad Ghaemmaghami ◽  
Ali Reza Shafiee-Kandjani ◽  
Seyed Gholamreza Noorazar ◽  
Wim Veling ◽  
...  
Keyword(s):  
Acute Phase ◽  
Psychotic Disorders ◽  
Clinical Signs ◽  
Cluster Method ◽  
Diagnostic Tools ◽  
First Episode ◽  
Risk And Resilience ◽  
Recent Onset ◽  
Outcome Monitoring ◽  
Resilience Factors

Background: Most of our knowledge about the etiology, course, treatment, and outcome of schizophrenia spectrum and other psychotic disorders stems from Western countries. Data from populations living in other geographical areas and low- and middle-income countries, with different genomes (ethnicity) and exposomes (e.g., culture and social support, drugs of abuse, religion), will add to our knowledge of this complex disorder.Methods: The Azeri Acute phase/Recent onset psychosis Survey (ARAS) has been initiated to study the course of the disorder in patients with recent-onset psychosis using validated diagnostic tools and a comprehensive outcome monitoring system, aiming to reveal indicators for understanding the risk and resilience factors and for choosing the best-personalized treatment strategy. All participants will be evaluated for clinical signs and symptoms as well as risk and resilience factors and will be followed up for 1, 3, and 5 years for outcomes in several domains. A hierarchical cluster method will be applied to identify the number of clusters for each outcome. Defined models will be applied to assess the predictive value of cognition on symptomatic and functional outcomes at follow-up.Discussion: The ARAS cohort will yield significant academic- (research and education) and care-related achievements. ARAS data and experience will have value both in being a useful model for other parts of this region and in an expansion of the currently available knowledge.

scholarly journals T152. AZERI RECENT ONSET ACUTE PHASE PSYCHOSIS SURVEY (ARAS COHORT): PRELIMINARY REPORTS FROM AN OBSERVATIONAL COHORT OF FIRST EPISODE PSYCHOSIS IN IRAN

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S288-S289
Author(s):  
Sara Farhang ◽  
Mehrdad Ghaemmaghami ◽  
Gholamreza Noorazar ◽  
Wim Veling ◽  
Ayyoub Malek ◽  
...  
Keyword(s):  
Social Support ◽  
Metabolic Syndrome ◽  
Psychotic Disorder ◽  
Acute Phase ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Episode ◽  
Risk And Resilience ◽  
North West ◽  
Recent Onset

Abstract Background Azeri Acute phase/Recent onset psychosis Survey (ARAS) is the first from central Asia to study the course of patients with recent onset psychosis. The aim is to reveal indicators for understanding the risk and resilience factors, and for choosing the best personalized treatment strategy. Methods The catchment area is north-west of Iran, with the majority having an Azeri ethnic background. All participants are evaluated for clinical signs and symptoms as well as risk and resilient factors and followed up for outcome in several domains. Here we give report of first 100 registered patients (male/female: 1.6). Results Patients are diagnosed with schizophrenia (23), brief psychotic disorder (4), schizophrenifom (9), amphetamine induced psychotic disorder (12), psychotic disorder NOS and schizoaffective (27). The mean score of PANSS was 26.79±20.62. Their mean age is 29.8±11.5. High school diploma or higher was achieved by 45. While 60 were single, 21 were married at the moment and 35 had children. All of patients were Muslims, 30 scored moderate on religiosity and the remaining scored high. Level of multidimensional perceived social support was moderate and high in 80 patients. Only 4 were living alone. Level of internalized stigma was moderate and high in 16 patients. Metabolic syndrome was diagnosed in 11. Almost one third of patients had ever used substance including cigarette (20), alcohol (12), opioids (5), amphetamine (15) and cannabis (5). The most prevalent prescribed medication is risperidone (78). Metabolic syndrome criteria were fulfilled in 16 patients. Discussion Preliminary reports from ARAS cohort shows few differences between Iranian and European patients. Lower rate of metabolic syndrome, substance use (especially cannabis) and higher rate of religiosity, having social support, married situation and having children are noticed.

scholarly journals Detecting relapse in youth with psychotic disorders utilizing patient-generated and patient-contributed digital data from Facebook

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
M. L. Birnbaum ◽  
S. K. Ernala ◽  
A. F. Rizvi ◽  
E. Arenare ◽  
A. R. Van Meter ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Warning Signs ◽  
Digital Data ◽  
Classification Model ◽  
Patient Specific ◽  
Psychotic Symptoms ◽  
Rank Test ◽  
First Episode ◽  
Specific Level ◽  
Recent Onset

Abstract Although most patients who experience a first-episode of psychosis achieve remission of positive psychotic symptoms, relapse is common. Existing relapse evaluation strategies are limited by their reliance on direct and timely contact with professionals, and accurate reporting of symptoms. A method by which to objectively identify early relapse warning signs could facilitate swift intervention. We collected 52,815 Facebook posts across 51 participants with recent onset psychosis (mean age = 23.96 years; 70.58% male) and applied anomaly detection to explore linguistic and behavioral changes associated with psychotic relapse. We built a one-class classification model that makes patient-specific personalized predictions on risk to relapse. Significant differences were identified in the words posted to Facebook in the month preceding a relapse hospitalization compared to periods of relative health, including increased usage of words belonging to the swear (p < 0.0001, Wilcoxon signed rank test), anger (p < 0.001), and death (p < 0.0001) categories, decreased usage of words belonging to work (p = 0.00579), friends (p < 0.0001), and health (p < 0.0001) categories, as well as a significantly increased use of first (p < 0.0001) and second-person (p  < 0.001) pronouns. We additionally observed a significant increase in co-tagging (p < 0.001) and friending (p < 0.0001) behaviors in the month before a relapse hospitalization. Our classifier achieved a specificity of 0.71 in predicting relapse. Results indicate that social media activity captures objective linguistic and behavioral markers of psychotic relapse in young individuals with recent onset psychosis. Machine-learning models were capable of making personalized predictions of imminent relapse hospitalizations at the patient-specific level.

scholarly journals Emerging Psychosis and the Family

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Martin Hambrecht
Keyword(s):  
Psychotic Disorders ◽  
Family System ◽  
Early Adulthood ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Episode ◽  
Psychosocial Risks ◽  
Young Males ◽  
Delayed Treatment ◽  
Clinical Signs And Symptoms

Schizophrenias hold a special position among psychotic disorders. Schizophrenias often start in early adulthood and bear considerable psychosocial risks and consequences. Several years of nonpsychotic clinical signs and symptoms and growing distress for patient and significant others may pass by before definite diagnosis. Young males in particular often experience their first episode while still living in their primary families. Thus, the whole family system is involved. In worldwide initiatives on early detection and early intervention, near-psychotic prodromal symptoms as well as deficits of thought and perception, observable by the affected person himself, were found to be particularly predictive of psychosis. Various psychological and social barriers as well as ones inherent to the disease impede access to affected persons. Building trust and therapeutic alliance are extremely important for counseling, diagnostics, and therapy. The indication for strategies of intervention differs from the early to the late prodromal stage, depending on proximity to psychosis. For psychotherapy versus pharmacotherapy, the first evidence of effectiveness has been provided. A false-positive referral to treatment and other ethical concerns must be weighed against the risks of delayed treatment.

scholarly journals Challenges in the diagnosis and treatment of depression in autism spectrum disorders across the lifespan

2015 ◽  
Vol 17 (2) ◽  
pp. 219-227 ◽  
Keyword(s):  
Depressive Disorders ◽  
Autism Spectrum ◽  
Diagnosis And Treatment ◽  
Diagnostic Tools ◽  
Risk And Resilience ◽  
Level Of Functioning ◽  
Assessment And Treatment ◽  
Resilience Factors ◽  
And Coping ◽  
Core Symptoms

Diagnosis and treatment of comorbid neuropsychiatric illness is often a secondary focus of treatment in individuals with autism spectrum disorder (ASD), given that substantial impairment may be caused by core symptoms of ASD itself. However, psychiatric comorbidities, including depressive disorders, are common and frequently result in additional functional impairment, treatment costs, and burden on caregivers. Clinicians may struggle to appropriately diagnose depression in ASD due to communication deficits, atypical presentation of depression in ASD, and lack of standardized diagnostic tools. Specific risk and resilience factors for depression in ASD across the lifespan, including level of functioning, age, family history, and coping style, have been suggested, but require further study. Treatment with medications or psychotherapy may be beneficial, though more research is required to establish guidelines for management of symptoms. This review will describe typical presentations of depression in individuals with ASD, review current information on the prevalence, assessment, and treatment of comorbid depression in individuals with ASD, and identify important research gaps.

scholarly journals ‘Hot phase’ clinical presentation in arrhythmogenic cardiomyopathy

EP Europace ◽  
2020 ◽  
Author(s):  
Riccardo Bariani ◽  
Alberto Cipriani ◽  
Stefania Rizzo ◽  
Rudy Celeghin ◽  
Maria Bueno Marinas ◽  
...  
Keyword(s):  
Acute Phase ◽  
Tissue Characterization ◽  
Clinical Presentation ◽  
Gene Mutations ◽  
Diagnostic Tools ◽  
First Episode ◽  
Enzyme Release ◽  
Arrhythmogenic Cardiomyopathy ◽  
St Segment Elevation

Abstract Aims The aim of this study is to evaluate the clinical features of patients affected by arrhythmogenic cardiomyopathy (AC), presenting with chest pain and myocardial enzyme release in the setting of normal coronary arteries (‘hot phase’). Methods and results We collected detailed anamnestic, clinical, instrumental, genetic, and histopathological findings as well as follow-up data in a series of AC patients who experienced a hot phase. A total of 23 subjects (12 males, mean age at the first episode 27 ± 16 years) were identified among 560 AC probands and family members (5%). At first episode, 10 patients (43%) already fulfilled AC diagnostic criteria. Twelve-lead electrocardiogram recorded during symptoms showed ST-segment elevation in 11 patients (48%). Endomyocardial biopsy was performed in 11 patients, 8 of them during the acute phase showing histologic evidence of virus-negative myocarditis in 88%. Cardiac magnetic resonance was performed in 21 patients, 12 of them during the acute phase; oedema and/or hyperaemia were detected in 7 (58%) and late gadolinium enhancement in 11 (92%). At the end of follow-up (mean 17 years, range 1–32), 12 additional patients achieved an AC diagnosis. Genetic testing was positive in 77% of cases and pathogenic mutations in desmoplakin gene were the most frequent. No patient complained of sustained ventricular arrhythmias or died suddenly during the ‘hot phase’. Conclusion ‘Hot phase’ represents an uncommon clinical presentation of AC, which often occurs in paediatric patients and carriers of desmoplakin gene mutations. Tissue characterization, family history, and genetic test represent fundamental diagnostic tools for differential diagnosis.

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.

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