Overview of Schizophrenia and Other Psychotic Disorders

Psychotic Disorders ◽

Public Health Problem ◽

Premature Death ◽

Schizophrenia Spectrum ◽

The Individual

Psychotic disorders are among the most disabling conditions and constitute a major public health problem. Described throughout recorded time, they affect as many as 5% of the population and cause a disproportionate amount of suffering and loss to society. In the chapter on schizophrenia spectrum and other psychotic disorders, the DSM-5 lists delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, and schizoaffective disorder, as well as categories for substance- or medically induced psychotic disorders. The term psychosis indicates that the individual has a severe inability to interpret the surrounding environment in a realistic way. Symptoms include hallucinations, delusions, and bizarre behavior. Psychotic disorders are associated with premature death, mostly attributable to suicide. The pathophysiology and etiology of psychotic disorders are only now beginning to be understood, and treatment for these conditions remains suboptimal. Researchers are currently refining the cause of these symptoms and developing more effective treatments. This review contains 3 tables, and 34 references. Key words: Brief psychotic disorder, delusions, hallucinations, psychosis, schizoaffective disorder, schizophrenia, schizophreniform disorder

Overview of Schizophrenia and Other Psychotic Disorders

10.2310/im.13011 ◽

2020 ◽

Author(s):

James A. Wilcox ◽

Donald W. Black

Keyword(s):

Psychotic Disorder ◽

Psychotic Disorders ◽

Public Health Problem ◽

Premature Death ◽

Schizophrenia Spectrum ◽

The Individual

Psychotic disorders are among the most disabling conditions and constitute a major public health problem. Described throughout recorded time, they affect as many as 5% of the population and cause a disproportionate amount of suffering and loss to society. In the chapter on schizophrenia spectrum and other psychotic disorders, the DSM-5 lists delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, and schizoaffective disorder, as well as categories for substance- or medically induced psychotic disorders. The term psychosis indicates that the individual has a severe inability to interpret the surrounding environment in a realistic way. Symptoms include hallucinations, delusions, and bizarre behavior. Psychotic disorders are associated with premature death, mostly attributable to suicide. The pathophysiology and etiology of psychotic disorders are only now beginning to be understood, and treatment for these conditions remains suboptimal. Researchers are currently refining the cause of these symptoms and developing more effective treatments. This review contains 3 tables, and 34 references. Key words: Brief psychotic disorder, delusions, hallucinations, psychosis, schizoaffective disorder, schizophrenia, schizophreniform disorder

Overview of Schizophrenia and Other Psychotic Disorders

10.2310/fm.13011 ◽

2020 ◽

Author(s):

James A. Wilcox ◽

Donald W. Black

Keyword(s):

Psychotic Disorder ◽

Psychotic Disorders ◽

Public Health Problem ◽

Premature Death ◽

Schizophrenia Spectrum ◽

The Individual

Psychotic disorders are among the most disabling conditions and constitute a major public health problem. Described throughout recorded time, they affect as many as 5% of the population and cause a disproportionate amount of suffering and loss to society. In the chapter on schizophrenia spectrum and other psychotic disorders, the DSM-5 lists delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, and schizoaffective disorder, as well as categories for substance- or medically induced psychotic disorders. The term psychosis indicates that the individual has a severe inability to interpret the surrounding environment in a realistic way. Symptoms include hallucinations, delusions, and bizarre behavior. Psychotic disorders are associated with premature death, mostly attributable to suicide. The pathophysiology and etiology of psychotic disorders are only now beginning to be understood, and treatment for these conditions remains suboptimal. Researchers are currently refining the cause of these symptoms and developing more effective treatments. This review contains 3 tables, and 34 references. Key words: Brief psychotic disorder, delusions, hallucinations, psychosis, schizoaffective disorder, schizophrenia, schizophreniform disorder

Schizophrenia and Other Psychotic Disorders

10.1093/med/9780190265557.003.0017 ◽

2017 ◽

Author(s):

Harvinder Singh ◽

Aarti Gupta

Keyword(s):

Psychotic Disorder ◽

Psychotic Disorders ◽

Medical Condition ◽

Delusional Disorder ◽

General Medical Condition ◽

Brief Psychotic Disorder

In this chapter topics that are reviewed include schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, brief psychotic disorder, psychotic disorder due to a general medical condition, substance-induced psychotic disorder and unspecified psychotic disorder

The concordance of ICD-10 acute and transient psychosis and DSM-IV brief psychotic disorder

Psychological Medicine ◽

10.1017/s0033291702005408 ◽

2002 ◽

Vol 32 (3) ◽

pp. 525-533 ◽

Cited By ~ 57

Author(s):

F. PILLMANN ◽

A. HARING ◽

S. BALZUWEIT ◽

R. BLÖINK ◽

A. MARNEROS

Keyword(s):

Psychotic Disorder ◽

Psychotic Disorders ◽

Good Prognosis ◽

Acute Onset ◽

Not Otherwise Specified ◽

Icd 10 ◽

Dsm Iv

Background. ICD-10 acute and transient psychotic disorder (ATPD; F23) and DSM-IV brief psychotic disorder (BPD; 298.8) are related diagnostic concepts, but little is known regarding the concordance of the two definitions.Method. During a 5-year period all in-patients with ATPD were identified; DSM-IV diagnoses were also determined. We systematically evaluated demographic and clinical features and carried out follow-up investigations at an average of 2·2 years after the index episode using standardized instruments.Results. Forty-two (4·1%) of 1036 patients treated for psychotic disorders or major affective episode fulfilled the ICD-10 criteria of ATPD. Of these, 61·9% also fulfilled the DSM-IV criteria of brief psychotic disorder; 31·0%, of schizophreniform disorder; 2·4%, of delusional disorder; and 4·8%, of psychotic disorder not otherwise specified. BPD showed significant concordance with the polymorphic subtype of ATPD, and DSM-IV schizophreniform disorder showed significant concordance with the schizophreniform subtype of ATPD. BPD patients had a significantly shorter duration of episode and more acute onset compared with those ATPD patients who did not meet the criteria of BPD (non-BPD). However, the BPD group and the non-BPD group of ATPD were remarkably similar in terms of sociodemography (especially female preponderance), course and outcome, which was rather favourable for both groups.Conclusions. DSM-IV BPD is a psychotic disorder with broad concordance with ATPD as defined by ICD-10. However, the DSM-IV time criteria for BPD may be too narrow. The group of acute psychotic disorders with good prognosis extends beyond the borders of BPD and includes a subgroup of DSM-IV schizophreniform disorder.

Antipsychotic polytherapy versus antipsychotic monotherapy in patients with schizophrenia and other psychoses

European Psychiatry ◽

10.1016/s0924-9338(11)72970-4 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1265-1265

Author(s):

N. Morales Alcaide

Keyword(s):

Combination Therapy ◽

Psychotic Disorder ◽

Psychotic Disorders ◽

Controlled Trials ◽

Antipsychotic Therapy ◽

Not Otherwise Specified ◽

Male Patients ◽

The Mean

IntroductionAntipsychotic therapy is the cornerstone of the treatment of psychotic disorders. Although clinical guidelines recommend the use of antipsychotics in monotherapy, the combination of two or more antipsychotics is a common habit in clinical practice, especially in cases resistant to treatment with one antipsychotic, although there are few controlled trials that support this treatment modality.ObjectivesTo analyze the characteristics of antipsychotic therapy in patients admitted to hospitalization with diagnoses of schizophrenia and other psychoses, to determine if there are differences between diagnostic groups.MaterialWe analyzed a sample of 241 patients admitted during 2009, 97 women and 144 men, with schizophrenia and other psychoses.MethodsWe designed a protocol of collecting data based on clinical histories of patients, reflecting the gender, age, diagnosis and treatment regimen (monotherapy or combination therapy), and performed a statistical analysis using SPSS.ResultsOf the sample, 40.2% were females and 59.8% were males. The mean age was 39.7 years old.The diagnosis of schizophrenia was obtained in 60.2% of patients, while the remaining 39.8% were diagnosed with other psychoses (schizoaffective disorder, chronic delusional disorder, schizophreniform disorder, brief psychotic disorder, psychotic disorder not otherwise specified and other.)The combination therapy was used in 62.2% of patients, while the remaining 37.8% were treated with monotherapy.ConclusionsCombination therapy is used more often in male patients and in patients diagnosed with schizophrenia, while monotherapy is used more in women and patients with other psychoses.

M124. ASSOCIATION OF CHRONIC PHYSICAL MULTIMORBIDITY WITH THE EFFICACY OF TREATMENT IN DIFFERENT SCHIZOPHRENIA SPECTRUM DISORDERS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.436 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S182-S182

Author(s):

Igor Filipčić ◽

Ivona Šimunović Filipčić ◽

Žarko Bajić

Keyword(s):

Psychotic Disorder ◽

Cross Sectional Study ◽

Schizophrenia Spectrum Disorders ◽

Cross Sectional ◽

Psychiatric Rehospitalization ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

And Gender ◽

Schizotypal Disorder

Abstract Background Patients with schizophrenia spectrum disorders (SSD) have higher prevalence of chronic physical illness (CPI) and a substantially reduced life expectancy compared with the general population. Despite the increasing amount of research in this area, the effect on psychiatric treatment outcome is still not clear. Some research reported significant associations between several CPIs and different SSD treatment outcomes, whereas the remaining study did not. The objective of the current study is to assess differences in the association of the number of CPI with the overall number of psychiatric rehospitalization in specific SSD diagnosis. Methods We conducted a cross-sectional study of 354 patients diagnosed with SSD (ICD10): 135 schizophrenia, 71 acute and transient psychotic disorder, 57 schizoaffective disorder, 68 unspecified unorganic psychosis, 23 other (persistent delusional disorder, schizotypal disorder). The primary outcome was the association of the number of CPI with the number of psychiatric rehospitalization since the diagnosis, as the surrogate outcome for the treatment success, adjusted for the time from diagnosis, age, and gender of participants. Results Mean number of CPI adjusted for the time from diagnosis, age, and gender was not significantly nor clinically relevantly different between particular SSD diagnosis (F(5,345)=0.70; p=0.620). It was 1.7 in schizophrenia, 1.5 in acute and transient psychotic disorder, 1.4 in schizoaffective disorder, 1.8 in unspecified unorganic psychosis, 1.0 in persistent delusional disorder and 1.9 in schizotypal disorder. The mean number of CPI adjusted for the same three potential confounders was significantly different between particular SSD diagnosis (F(5,345)=2.78; p=0.018). It was 6.7 in schizophrenia, 3.8 in acute and transient psychotic disorder, 7.3 in schizoaffective disorder, 4.8 in unspecified unorganic psychosis. However, the association of the number of CPI with the psychiatric rehospitalizations, adjusted for the previously stated three confounders, was significant and clinically relevant only in participants diagnosed with schizophrenia. In these participants, an increase of one CPI was associated with the 2.3 (95% CI 1.2 to 3.5) more psychiatric rehospitalizations (p<0.001). In participants diagnosed with other specific SSD the association of the number of CPI was not significantly associated with the number of psychiatric rehospitalizations. Moreover, on this particular sample level, it was negative, meaning that more CPI was associated with the lower number of psychiatric rehospitalization in all other SSD except in the case of unspecified nonorganic psychosis. Discussion In this cross-sectional study, we observed that the hypothesis of the effect of the number of CPI on the SSD treatment outcomes is valid only in the case of schizophrenia. Further research is needed to clarify whether additional psychological distress is related to the additional burden of multimorbidity.

Diagnostic validity of ICD-10 acute and transient psychotic disorders and DSM-5 brief psychotic disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.05.028 ◽

2017 ◽

Vol 45 ◽

pp. 104-113 ◽

Cited By ~ 18

Author(s):

A.C. Castagnini ◽

P. Fusar-Poli

Keyword(s):

Psychotic Disorder ◽

Psychotic Disorders ◽

Case Identification ◽

Migrant Populations ◽

Diagnostic Categories ◽

Dsm 5 ◽

Characteristic Family ◽

Icd 10

AbstractBackground:Short-lived psychotic disorders are currently classified under “acute and transient psychotic disorders” (ATPDs) in ICD-10, and “brief psychotic disorder” (BPD) in DSM-5. This study's aim is to review the literature and address the validity of ATPDs and BPD.Method:Papers published between January 1993 and December 2016 were identified through searches in Web of Science. Reference lists in the located papers provided further sources.Results:A total of 295 articles were found and 100 were included in the review. There were only a few studies about the epidemiology, vulnerability factors, neurobiological correlates and treatment of these disorders, particularly little interest seems to exist in BPD. The available evidence suggests that short-lived psychotic disorders are rare conditions and more often affect women in early to middle adulthood. They also are neither associated with premorbid dysfunctions nor characteristic family predisposition, while there seems to be greater evidence of environmental factors particularly in developing countries and migrant populations. Follow-up studies report a favourable clinical and functional outcome, but case identification has proved difficult owing to high rates of transition mainly either to schizophrenia and related disorders or, to a lesser extent, affective disorders over the short- and longer-terms.Conclusions:Although the lack of neurobiological findings and little predictive power argue against the validity of the above diagnostic categories, it is important that they are kept apart from longer-lasting psychotic disorders both for clinical practice and research. Close overlap between ATPDs and BPD could enhance the understanding of these conditions.

Psychotic Disorders and Serious Mental Illness

10.1093/med/9780199392742.003.0019 ◽

2017 ◽

Author(s):

Alexander Thompson ◽

Daniel Williams ◽

Oliver Freudenreich ◽

Andrew Angelino ◽

Glenn Treisman

Keyword(s):

Mental Illness ◽

Serious Mental Illness ◽

Psychotic Disorders ◽

Public Health Problem ◽

Cost Effective ◽

Models Of Care ◽

Effective Care ◽

Psychiatric Conditions ◽

Hiv Aids

The major public health problem that is HIV/AIDS in persons with a serious mental illness is aptly described a “syndemic.” Having HIV/AIDS puts one at much greater risk for developing a serious mental illness. Conversely, having a serious mental illness, such as schizophrenia, bipolar disorder, major depressive disorder, substance use disorder, is associated with many factors that place one at greater risk for contracting and transmitting HIV. And, in both cases of serious mental illness and HIV/AIDS, each disorder creates many new challenges in the management of the other disorder. This chapter addresses these challenges, which center around being able to participate actively and adhere to medication regimens needed to manage both medical and psychiatric conditions. Fortunately, specialized models of care like comprehensive, integrated clinics and nurse care managers are ways to provide effective, satisfying, and cost-effective care to this most vulnerable population.

S131. NEIGHBOURHOOD-LEVEL SOCIAL CAPITAL, MARGINALIZATION, AND THE INCIDENCE OF PSYCHOTIC DISORDERS IN TORONTO, CANADA: A RETROSPECTIVE POPULATION-BASED COHORT STUDY

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.197 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S85-S85

Author(s):

Martin Rotenberg ◽

Andrew Tuck ◽

Kelly Anderson ◽

Kwame McKenzie

Keyword(s):

Social Capital ◽

Psychotic Disorder ◽

Psychotic Disorders ◽

Population Based ◽

Ethnic Concentration ◽

Schizophrenia Spectrum ◽

Neighbourhood Level ◽

Incident Cases ◽

The Impact ◽

The Relationship

Abstract Background Previous studies have shown mixed results regarding the relationship between social capital and the risk of developing a psychotic disorder, and this has yet to be studied in North America. This study aims to examine the relationship between neighbourhood-level social capital, marginalization, and the incidence of psychotic disorders in Toronto, Canada. Methods A retrospective cohort of people aged 14 to 40 years residing in Toronto, Canada in 1999 (followed to 2008) was constructed from population-based health administrative data. Incident cases of schizophrenia spectrum psychotic disorders were identified using a validated algorithm. Voter participation rates in a municipal election were used as a proxy neighbourhood-level indicator of social capital. Exposure to neighbourhood-level marginalization was obtained from the Ontario Marginalization Index. Poisson regression models adjusting for age and sex were used to calculate incidence rate ratios (IRR) for each social capital quintiles and marginalization quintile. Results In the study cohort (n = 640,000) over the 10-year follow-up period, we identified 4,841 incident cases of schizophrenia spectrum psychotic disorders. We observed elevated rates of psychotic disorders in areas with the highest levels (IRR = 1.13, 95% CI 1.00–1.27) and moderate levels (IRR = 1.23, 95% CI 1.12–1.36) of social capital, when compared to areas with the lowest levels of social capital, after adjusting for neighbourhood-level indicators of marginalization. The risk associated with social capital was not present when analyzed in only the females in the cohort. All neighbourhood marginalization indicators, other than ethnic concentration, were significantly associated with risk. Discussion The risk of developing a psychotic disorder in Toronto, Canada is associated with socioenvironmental exposures. Social capital is associated with risk, however, the impact of social capital on risk differs by sex and social capital quintile. Across the entire cohort, exposure to all neighbourhood-level marginalization indicators, except ethnic concentration, impacts risk. Future research should examine how known individual-level risk factors, including immigration, ethnicity, and family history of a mental disorder may interact with these findings.