scholarly journals Catatonia Associated with Hyponatremia: Case Report and Brief Review of the Literature

2021 ◽  
Vol 17 (1) ◽  
pp. 26-30
Author(s):  
Vaios Peritogiannis ◽  
Dimitrios V. Rizos
Keyword(s):  
Mood Disorder ◽  
Motor Behavior ◽  
Psychiatric Patients ◽  
Specific Treatment ◽  
Serum Levels ◽  
Young Female ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Appropriate Treatment

Background: Catatonia is a syndrome of altered motor behavior that is mostly associated with general medical, neurologic, mood and schizophrenia-spectrum disorders. The association of newly onset catatonic symptoms with hyponatremia has been rarely reported in the literature. Case Presentation: We present a rare case of a young female patient with schizophrenia, who presented with catatonic symptoms in the context of hyponatremia due to water intoxication. The symptoms were eliminated with the correction of hyponatremia. There are only a few reports of hyponatremia-associated catatonia in psychiatric and non-psychiatric patients. Sometimes, catatonic symptoms may co-occur with newly onset psychotic symptoms and confusion, suggesting delirium. In several cases, the catatonic symptoms responded to specific treatment with benzodiazepines or electroconvulsive therapy. Conclusion: Hyponatremia may induce catatonic symptoms in patients, regardless of underlying mental illness, but this phenomenon is even more relevant in patients with a psychotic or mood disorder, which may itself cause catatonic symptoms. It is important for clinicians not to attribute newly-onset catatonic symptoms to the underlying psychotic or mood disorder without measuring sodium serum levels. The measurement of sodium serum levels may guide treating psychiatrists to refer the patient for further investigation and appropriate treatment.

scholarly journals Sex differences in antipsychotic efficacy and side effects in schizophrenia spectrum disorder: results from the BeSt InTro study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sanne Hoekstra ◽  
Christoffer Bartz-Johannessen ◽  
Igne Sinkeviciute ◽  
Solveig K. Reitan ◽  
Rune A. Kroken ◽  
...  
Keyword(s):  
Sex Differences ◽  
Side Effects ◽  
Specific Treatment ◽  
Serum Levels ◽  
Psychotic Symptoms ◽  
Future Research ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
First Choice ◽  
Current Guidelines

AbstractCurrent guidelines for patients with schizophrenia spectrum disease do not take sex differences into account, which may result in inappropriate sex-specific treatment. In the BeSt InTro study, a total of 144 patients (93 men and 51 women) with a schizophrenia spectrum diagnosis and ongoing psychosis were included and randomized to amisulpride, aripiprazole, or olanzapine in flexible dose. This trial is registered with ClinicalTrials.gov (NCT01446328). Primary outcomes were sex differences in dose, dose-corrected serum levels, efficacy, and tolerability. Dosing was higher for men than for women in the aripiprazole group (p = 0.025) and, at trend level, in the olanzapine group (p = 0.056). Dose-corrected serum levels were 71.9% higher in women than in men for amisulpride (p = 0.019) and 55.8% higher in women than in men for aripiprazole (p = 0.049). In the amisulpride group, men had a faster decrease in psychotic symptoms than women (p = 0.003). Moreover, amisulpride was more effective than the other medications in men but not in women. Prolactin levels were higher in women than in men, especially for amisulpride (p < 0.001). Also, women had higher BMI increase on amisulpride compared to the two other antipsychotics (p < 0.001). We conclude that clinicians should be aware of the risks of overdosing in women, especially for amisulpride and aripiprazole. Amisulpride is highly effective in men, but in women, amisulpride showed more severe side effects and may thus not be the drug of first choice. Our study shows that sex differences should be taken into account in future studies on antipsychotics. Future research is warranted to evaluate these preliminary results.

scholarly journals Acoustic speech markers for schizophrenia-spectrum disorders: a diagnostic and symptom-recognition tool

2021 ◽  
pp. 1-11
Author(s):  
J. N. de Boer ◽  
A. E. Voppel ◽  
S. G. Brederoo ◽  
H. G. Schnack ◽  
K. P. Truong ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Structured Interview ◽  
Diagnostic Value ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum Disorder ◽  
Speech Technology ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Abstract Background Clinicians routinely use impressions of speech as an element of mental status examination. In schizophrenia-spectrum disorders, descriptions of speech are used to assess the severity of psychotic symptoms. In the current study, we assessed the diagnostic value of acoustic speech parameters in schizophrenia-spectrum disorders, as well as its value in recognizing positive and negative symptoms. Methods Speech was obtained from 142 patients with a schizophrenia-spectrum disorder and 142 matched controls during a semi-structured interview on neutral topics. Patients were categorized as having predominantly positive or negative symptoms using the Positive and Negative Syndrome Scale (PANSS). Acoustic parameters were extracted with OpenSMILE, employing the extended Geneva Acoustic Minimalistic Parameter Set, which includes standardized analyses of pitch (F0), speech quality and pauses. Speech parameters were fed into a random forest algorithm with leave-ten-out cross-validation to assess their value for a schizophrenia-spectrum diagnosis, and PANSS subtype recognition. Results The machine-learning speech classifier attained an accuracy of 86.2% in classifying patients with a schizophrenia-spectrum disorder and controls on speech parameters alone. Patients with predominantly positive v. negative symptoms could be classified with an accuracy of 74.2%. Conclusions Our results show that automatically extracted speech parameters can be used to accurately classify patients with a schizophrenia-spectrum disorder and healthy controls, as well as differentiate between patients with predominantly positive v. negatives symptoms. Thus, the field of speech technology has provided a standardized, powerful tool that has high potential for clinical applications in diagnosis and differentiation, given its ease of comparison and replication across samples.

scholarly journals Schizophrenia-spectrum psychopathology in obsessive–compulsive disorder: an empirical study

2019 ◽  
Vol 270 (8) ◽  
pp. 993-1002 ◽  
Author(s):  
Andreas Rosén Rasmussen ◽  
Julie Nordgaard ◽  
Josef Parnas
Keyword(s):  
Diagnostic Criteria ◽  
Obsessive Compulsive Disorder ◽  
Psychotic Symptoms ◽  
Main Diagnosis ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Main Research ◽  
Compulsive Disorder ◽  
Diagnostic Potential ◽  
Schizophrenia Spectrum

Abstract The differential diagnosis of obsessive–compulsive disorder (OCD) and schizophrenia-spectrum disorders can be difficult. In the current diagnostic criteria, basic concepts such as obsession and delusion overlap. This study examined lifetime schizophrenia-spectrum psychopathology, including subtle schizotypal symptomatology and subjective anomalies such as self-disorders, in a sample diagnosed with OCD in a specialized setting. The study also examined the differential diagnostic potential of the classic psychopathological notions of true obsession (‘with resistance’) and pseudo-obsession. The study involved 42 outpatients diagnosed with OCD at two clinics specialized in the treatment of OCD. The patients underwent semi-structured, narrative interviews assessing a comprehensive battery of psychopathological instruments. The final lifetime research-diagnosis was based on a consensus between a senior clinical psychiatrist and an experienced research clinician. The study found that 29% of the patients fulfilled criteria of schizophrenia or another non-affective psychosis as main, lifetime DSM-5 research-diagnosis. Another 33% received a research-diagnosis of schizotypal personality disorder, 10% a research-diagnosis of major depression and 29% a main research-diagnosis of OCD. Self-disorders aggregated in the schizophrenia-spectrum groups. True obsessions had a specificity of 93% and a sensitivity of 58% for a main diagnosis of OCD. In conclusion, a high proportion of clinically diagnosed OCD patients fulfilled diagnostic criteria of a schizophrenia-spectrum disorder. The conspicuous obsessive–compulsive symptomatology may have resulted in a disregard of psychotic symptoms and other psychopathology. Furthermore, the differentiation of obsessions from related psychopathological phenomena is insufficient and a conceptual and empirical effort in this domain is required in the future.

Awareness of illness moderates self-assessment of psychotic symptoms

2021 ◽  
pp. 000486742110574
Author(s):  
Luis Martinez Agulleiro ◽  
Renato de Filippis ◽  
Stella Rosson ◽  
Bhagyashree Patil ◽  
Lara Prizgint ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Confidence Interval ◽  
Rating Scale ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Brief Psychiatric Rating Scale ◽  
Schizophrenia Spectrum ◽  
Psychiatric Rating ◽  
Spectrum Disorders ◽  
Psychiatric Rating Scale

Objective: Self-reports or patient-reported outcome measures are seldom used in psychosis due to concerns about the ability of patients to accurately report their symptomatology, particularly in cases of low awareness of illness. The aim of this study was to assess the effect of insight on the accuracy of self-reported psychotic symptoms using a computerized adaptive testing tool (CAT-Psychosis). Methods: A secondary analysis of data drawn from the CAT-Psychosis development and validation study was performed. The Brief Psychiatric Rating Scale and the Scale of Unawareness of Mental Disorders were administered by clinicians. Patients completed the self-reported version of the CAT-Psychosis. Patients were median-split regarding their insight level to compare the correlation between the two psychosis severity measures. A subgroup sensitivity analysis was performed only on patients with schizophrenia spectrum disorders. Results: A total of 159 patients with a psychotic disorder who completed both CAT-Psychosis and Scale of Unawareness of Mental Disorders were included. For the whole sample, CAT-Psychosis scores showed convergent validity with Brief Psychiatric Rating Scale ratings ( r = 0.517, 95% confidence interval = [0.392, 0.622], p < 0.001). Insight was found to moderate this correlation (β = –0.511, p = 0.005), yet agreement between both measures remained statistically significant for both high ( r = 0.621, 95% confidence interval = [0.476, 0.733], p < 0.001) and low insight patients ( r = 0.408, 95% confidence interval = [0.187, 0.589], p < 0.001), while psychosis severity was comparable between these groups (for Brief Psychiatric Rating Scale: U = 3057, z = –0.129, p = 0.897; disorganization: U = 2986.5, z = –0.274, p = 0.784 and for CAT-Psychosis: U = 2800.5, z = –1.022, p = 0.307). Subgroup of patients with schizophrenia spectrum disorders showed very similar results. Conclusions: Insight moderates the correlation between self-reported and clinician-rated severity of psychosis, yet CAT-Psychosis remains valid in patients with both high and low awareness of illness.

scholarly journals A review of autobiographical memory studies on patients with schizophrenia spectrum disorders

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yujia Zhang ◽  
Sara K. Kuhn ◽  
Laura Jobson ◽  
Shamsul Haque
Keyword(s):  
Autobiographical Memory ◽  
Psychotic Symptoms ◽  
Control Group ◽  
Schizophrenia Spectrum Disorders ◽  
Autobiographical Memories ◽  
Memory Specificity ◽  
Autobiographical Memory Specificity ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
The Relationship

Abstract Background Patients suffering from schizophrenia spectrum disorders demonstrate various cognitive deficiencies, the most pertinent one being impairment in autobiographical memory. This paper reviews quantitative research investigating deficits in the content, and characteristics, of autobiographical memories in individuals with schizophrenia. It also examines if the method used to activate autobiographical memories influenced the results and which theoretical accounts were proposed to explain the defective recall of autobiographical memories in patients with schizophrenia. Methods PsycINFO, Web of Science, and PubMed databases were searched for articles published between January 1998 and December 2018. Fifty-seven studies met the inclusion criteria. All studies implemented the generative retrieval strategy by inducing memories through cue words or pictures, the life-stage method, or open-ended retrieval method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines were followed for this review. Results Most studies reported that patients with schizophrenia retrieve less specific autobiographical memories when compared to a healthy control group, while only three studies indicated that both groups performed similarly on memory specificity. Patients with schizophrenia also exhibited earlier reminiscence bumps than those for healthy controls. The relationship between comorbid depression and autobiographical memory specificity appeared to be independent because patients’ memory specificity improved through intervention, but their level of depression remained unchanged. The U-shaped retrieval pattern for memory specificity was not consistent. Both the connection between the history of attempted suicide and autobiographical memory specificity, and the relationship between psychotic symptoms and autobiographical memory specificity, remain inconclusive. Patients’ memory specificity and coherence improved through cognitive training. Conclusions The overgeneral recall of autobiographical memory by patients with schizophrenia could be attributed to working memory, the disturbing concept of self, and the cuing method implemented. The earlier reminiscence bump for patients with schizophrenia may be explained by the premature closure of the identity formation process due to the emergence of psychotic symptoms during early adulthood. Protocol developed for this review was registered in PROSPERO (registration no: CRD42017062643).

Traumatic stress and risk of severe mental illness: A nationwide cohort study

2016 ◽  
Vol 33 (S1) ◽  
pp. S92-S92
Author(s):  
N. Okkels ◽  
B. Trabjerg ◽  
M. Arendt ◽  
C. Bøcker Pedersen
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Mood Disorder ◽  
Posttraumatic Stress ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Spectrum Disorder ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

IntroductionA history of traumatic events is prevalent in people with schizophrenia spectrum disorders and mood disorders. However, little is known about their etiological relationship.ObjectivesTo explore whether patients with acute or posttraumatic stress disorder are at higher risk of developing a schizophrenia spectrum disorder or mood disorder.MethodsIn this prospective cohort study using registers covering the entire Danish population, we used the Danish Psychiatric Central Research Register to identify patients with ICD-10 diagnoses of acute traumatic stress disorder and/or posttraumatic stress disorder. From inpatient and outpatient mental hospitals, we identified 4371 diagnoses with more than 18 million years of follow-up. Main outcomes and measures were relative risks (RR) with 95% confidence intervals (95% CI) of schizophrenia, schizophrenia spectrum disorder, bipolar disorder and mood disorder.ResultsThe incidence of traumatic stress disorder (TSD) has increased steadily from 0.6% in 1996 to 6% in 2012, showed a higher incidence in women and an age distribution with a peak-incidence in early adulthood. We found that diagnoses of TSD increase the risk of schizophrenia (RR 5.85, 95% CI 3.59–8.91), schizophrenia spectrum disorder (RR 3.82, 95% CI 2.38–5.75), bipolar disorder (RR 5.83, 95% CI 3.11–9.83) and mood disorder (RR 4.10, 95% CI 3.15–5.22). Risks were high in the first year after diagnosis of TSD and declined going forward in time.ConclusionsOur findings indicate that acute and posttraumatic stress disorder are etiological risk factors for schizophrenia spectrum disorders and mood disorders. If replicated, this may underline treatment of traumatized patients in prevention of severe mental disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

MOTOR BEHAVIOR ABNORMALITIES IN DRUG-NAïVE PATIENTS WITH SCHIZOPHRENIA SPECTRUM DISORDERS

2010 ◽  
Vol 117 (2-3) ◽  
pp. 187-188
Author(s):  
Virginia Basterra ◽  
Ana M. Sanchez-Torres ◽  
Manuel J. Cuesta ◽  
Victor Peralta
Keyword(s):  
Motor Behavior ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Drug Naïve ◽  
Spectrum Disorders

scholarly journals Protocol for Light-Dark and Activity Rhythm Therapy for sleep: Feasibility and acceptability in Schizophrenia spectrum disorders (L-DART FitSz)

2021 ◽  
Author(s):  
Sophie Faulkner ◽  
Penny E. Bee ◽  
Richard J. Drake
Keyword(s):  
Light Exposure ◽  
Activity Rhythm ◽  
Qualitative Interviews ◽  
Activity Patterns ◽  
Sleep Onset ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Outcome Selection ◽  
Spectrum Disorders

Abstract BackgroundSleep problems are common in people with diagnoses of schizophrenia spectrum disorders (> 50%), even during periods of relative stability of psychotic symptoms. Evidence suggests that people living with schizophrenia spectrum disorders are often keen to improve their sleep, but few non-pharmacological sleep treatments are available to patients in specialist mental health services. It has been proposed that occupational therapists may have the relevant skills for the delivery of behavioural sleep interventions. This mixed method, proof-of-concept study aims to assess the feasibility and acceptability of a new intervention, Light-Dark and Activity Rhythm Therapy (L-DART), to improve sleep in people with schizophrenia spectrum disorder diagnoses.MethodsA single group of 10 service users with schizophrenia spectrum diagnoses and self-reported problems with sleep onset, maintenance, timing or quality will be offered L-DART. L-DART will be delivered over 6–9 in person sessions and 3–6 phonecalls by an occupational therapist. Feasibility measures will comprise recruitment and retention logs, fidelity based on session records, adverse effects, and study attrition. Intervention uptake, engagement and adherence will be measured, and barriers to adherence explored. Acceptability will be assessed though quantitative satisfaction ratings and qualitative interviews. Activity patterns and dynamic light exposure will be measured, as well as self-reported sleep, wellbeing and functioning, to inform outcome selection in a larger trial.DiscussionThe findings will inform any necessary modifications to the intervention and its materials, enabling the development of a stage 2 manual and a therapist training package. The results will support the design of a randomised multi-therapist feasibility trial.Trial registrationISRCTN11998005, assigned registration on 17.02.2020

A systematic review of yoga and schizophrenia spectrum disorders: Implications for recreational therapy practitioners

2018 ◽  
Vol 17 (2) ◽  
pp. 37
Author(s):  
Emilie V. Adams, MS, CTRS, C-IAYT ◽  
Jasmine Townsend, PhD, CTRS
Keyword(s):  
Mental Illnesses ◽  
Psychotic Symptoms ◽  
Recreational Therapy ◽  
Schizophrenia Spectrum Disorders ◽  
Recreation Therapy ◽  
Therapy Program ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Social Skills Deficits

Schizophrenia spectrum disorders (SSDs) are a group of mental illnesses characterized by hallucinations, delusions, disorganized thought; they are often accompanied by cognitive dysfunction, social skills deficits, and low volition. This article reviews the extant literature on the efficacy of using yoga as an adjunct therapy to supplement standard pharmacotherapy and psychotherapy in the treatment and management of SSD. The 16 studies reviewed indicate yoga may be an effective intervention for increasing global cognitive functioning, decreasing psychotic symptoms, and improving quality of life for clients with SSD. Recommendations for integration of yoga into a Recreation Therapy program are outlined.

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