Stressful life events and depression, manic and psychotic symptomatology on the onset of first-episode psychosis: preliminary results

Introduction: First episode psychosis refers to the first time someone experiences psychotic symptoms or a psychotic episode. There are evidences related to the role of major life events and childhood trauma in the development of first episode psychosis. There are few studies regarding the environmental exposure to stressful life events and how these events might influence the onset of a psychotic disorder, and role of perceived stress. This study aimed to identify the relationship between stressful life events and first episode psychosis in Nepalese context. Material And Method: It was a hospital based cross-sectional, descriptive study. A total of 50 cases of first episode psychosis were included and the diagnosis was made according to ICD 10- Diagnostic Criteria for Research and verified by two consultant psychiatrists. Semi Structured Performa was designed to collect the information about the socio demographic data and perceived stress was assessed with Presumptive Stressful Life Events Scale (PSLES). Results: There were 62% female and 38% male patients with first episode psychosis with mean age 26.32 years. Majority of the participants were from rural areas (94%), married (58%), educated up to primary level (38%) and housewife (40%). 60.7% of ATPD had stressful life events (P =0. 000)which was higher than the stressful life events in patient with Schizophrenia (P =0. 005). There was a positive correlation between stressful life events and gender, setting, socioeconomic status and Diagnosis (P <0.05). Conclusion: Results show the relevance of presence of stressful life events as a potent source of perceived stress in first episode psychosis sample. Therefore this study highlights the importance of psychosocial intervention in this vulnerable group for management of illness and might be an important strategy for prevention.

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Visual working memory deterioration preceding relapse in psychosis

Psychological Medicine ◽

10.1017/s0033291716000751 ◽

2016 ◽

Vol 46 (11) ◽

pp. 2435-2444 ◽

Cited By ~ 8

Author(s):

C. L. M. Hui ◽

Y. K. Li ◽

A. W. Y. Li ◽

E. H. M. Lee ◽

W. C. Chang ◽

...

Keyword(s):

Working Memory ◽

Visual Working Memory ◽

Life Events ◽

Stressful Life Events ◽

First Episode Psychosis ◽

Stressful Life ◽

First Episode ◽

Medication Discontinuation ◽

Episode Psychosis ◽

Memory Deterioration

BackgroundRelapse is distressingly common after the first episode of psychosis, yet it is poorly understood and difficult to predict. Investigating changes in cognitive function preceding relapse may provide new insights into the underlying mechanism of relapse in psychosis. We hypothesized that relapse in fully remitted first-episode psychosis patients was preceded by working memory deterioration.MethodVisual memory and verbal working memory were monitored prospectively in a 1-year randomized controlled trial of remitted first-episode psychosis patients assigned to medication continuation (quetiapine 400 mg/day) or discontinuation (placebo). Relapse (recurrence of positive symptoms of psychosis), visual (Visual Patterns Test) and verbal (Letter–Number span test) working memory and stressful life events were assessed monthly.ResultsRemitted first-episode patients (n = 102) participated in the study. Relapsers (n = 53) and non-relapsers (n = 49) had similar baseline demographic and clinical profiles. Logistic regression analyses indicated relapse was associated with visual working memory deterioration 2 months before relapse [odds ratio (OR) 3.07, 95% confidence interval (CI) 1.19–7.92, P = 0.02], more stressful life events 1 month before relapse (OR 2.11, 95% CI 1.20–3.72, P = 0.01) and medication discontinuation (OR 5.52, 95% CI 2.08–14.62, P = 0.001).ConclusionsVisual working memory deterioration beginning 2 months before relapse in remitted first-episode psychosis patients (not baseline predictor) may reflect early brain dysfunction that heralds a psychotic relapse. The deterioration was found to be unrelated to a worsening of psychotic symptoms preceding relapse. Testable predictors offer insight into the brain processes underlying relapse in psychosis.

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Trauma and Migration in First Episode Psychosis

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.067 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S66-S66

Author(s):

S. Tosato ◽

C. Bonetto ◽

I. Tarricone ◽

M. Ruggeri ◽

S. Tomassi ◽

...

Keyword(s):

Life Events ◽

Stressful Life Event ◽

First Episode Psychosis ◽

Stressful Life ◽

First Episode ◽

Targeted Prevention ◽

Biological Stress ◽

Increased Risk ◽

Episode Psychosis ◽

And Migration

IntroductionResearches show that the period of migration, or the migration process itself, may confer an increased risk for psychosis. Some studies have addressed whether the high rates of psychosis found in migrants could be due to higher genetic or environmental risk factors. Facing severe or chronic stress such as trauma, social isolation, low socio-economic status, late-life social adversity may result in long term, sometimes permanent, alterations of the biological stress response system, leading to the onset of psychosis.ObjectivesThis study aims to examine, in a large sample of first episode psychosis patients, whether negative social experiences like stressful life events and difficulties, trauma and isolation have significantly higher frequencies in migrants with respect to natives.MethodsThe present study is conducted within the framework of the EUGEI (European Network of National Schizophrenia Networks Studying Gene Environment Interactions) study, a Europe-wide incidence and case–control study of psychosis conducted in 12 centers chosen to include areas with large first and subsequent generation migrant populations.Data about age, gender, migration history, trauma, life events, ethnicity, social class and family history of mental disorders have been collected.ResultsPreliminary data on the relationship between trauma and migration in first episode psychosis will be presented.ConclusionsSince migration is an important stressful life event, and difficulties in integration in host countries may remain chronic, it is important to identify in each context the most vulnerable minority groups in order to implement targeted prevention interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Stressful and intrusive life events preceding first episode psychosis

Epidemiologia e Psichiatria Sociale ◽

10.1017/s1121189x00000506 ◽

2009 ◽

Vol 18 (3) ◽

pp. 221-228 ◽

Cited By ~ 24

Author(s):

David Raune ◽

Elizabeth Kuipers ◽

Paul Bebbington

Keyword(s):

Life Events ◽

Patient Group ◽

Stressful Life Events ◽

Conflicts Of Interest ◽

Statistical Significance ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

Comparison Groups ◽

First Onset

SUMMARYAim – To test the hypothesis that stressful life events, in particular intrusive events, would cluster before the first onset of psychosis. Method – Forty-one patients with first episode psychosis were interviewed with the Life Events and Difficulties Schedule to assess events in the year before the onset of illness. Events were rated contextually on timing, independence, threat, and intrusiveness. Within-patient group clustering was evaluated, and the patient group was compared with two general population surveys from London. Results – Events were very frequent in the year before the onset of psychosis. Stressful and intrusive events were more common in the three months before onset compared with the previous nine months, although few analyses reached conventional statistical significance. Threatening and intrusive events were much more frequent in patients than in the comparison groups. First episode psychosis patients were strikingly more likely to report an intrusive event in the three months before onset (OR=17.1, 34% v 3%), and also showed an excess between three months and one year before onset (OR=8.1, 11% v 3%). Conclusions – Events may trigger many cases of first episode psychosis. The effect emerges several months before onset, particularly if the events are intrusive. This has both theoretical and clinical implications.Declaration of Interest: DR was supported by a UK Medical Research Council studentship. The authors have no conflicts of interest in writing this paper.

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Holmes-Rahe social readjustment scale and life events involving social defeat in first episode psychosis: preliminary results of a Delphi study

10.26226/morressier.5785edccd462b80296c98fb5 ◽

2016 ◽

Author(s):

Meritxell Tost Bonet

Keyword(s):

Life Events ◽

Delphi Study ◽

Social Defeat ◽

First Episode Psychosis ◽

First Episode ◽

Preliminary Results ◽

Episode Psychosis

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Holmes–Rahe Social Readjustment Rating Scale and life events involving social defeat in first episode psychosis: preliminary results of a Delphi study

European Neuropsychopharmacology ◽

10.1016/s0924-977x(16)31519-x ◽

2016 ◽

Vol 26 ◽

pp. S501-S502

Author(s):

M. Tost ◽

R.M. Gabernet ◽

A. Gutiérrez-Zotes ◽

V. Sánchez-Gistau ◽

M. Solé ◽

...

Keyword(s):

Life Events ◽

Delphi Study ◽

Rating Scale ◽

Social Defeat ◽

First Episode Psychosis ◽

First Episode ◽

Preliminary Results ◽

Episode Psychosis ◽

Social Readjustment Rating Scale

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Positive symptoms in first-episode psychosis patients experiencing low maternal care and stressful life events: a pilot study to explore the role of the COMT gene

Stress ◽

10.3109/10253890.2014.948841 ◽

2014 ◽

Vol 17 (5) ◽

pp. 410-415 ◽

Cited By ~ 9

Author(s):

Elisa Ira ◽

Katia De Santi ◽

Antonio Lasalvia ◽

Chiara Bonetto ◽

Gioia Zanatta ◽

...

Keyword(s):

Pilot Study ◽

Life Events ◽

Maternal Care ◽

Stressful Life Events ◽

First Episode Psychosis ◽

Comt Gene ◽

First Episode ◽

Positive Symptoms ◽

Episode Psychosis

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Does food responsiveness change in people with first episode psychosis (FEP) over a period of 6 months after commencing antipsychotics? Preliminary results

BJPsych Open ◽

10.1192/bjo.2021.682 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S255-S255

Author(s):

Adrian Heald ◽

Mark Shakespeare ◽

Kevin Williamson ◽

Adrianne Close ◽

Adrian Phillipson ◽

...

Keyword(s):

Rating Scales ◽

Eating Behaviour ◽

First Episode Psychosis ◽

Intuitive Eating ◽

First Episode ◽

Antipsychotic Treatment ◽

Loss Of Control ◽

Convenience Sample ◽

Preliminary Results ◽

Episode Psychosis

AimsWe here present preliminary results from our study to understand better the changes in people’ s experience of food in the months after diagnosis with first episode psychosis (FEP). Weight gain often occurs in the weeks/months after diagnosis and is related to an increase in appetite and food intake. Many drugs that are effective in treating psychosis are associated with changes in the way that people experience reward when they eat.The aim of this project is to increase our understanding of exactly why this happens in terms of an individual's experience of food reward and reduced satiety – and therefore how we can help people with FEP to keep their weight down. At this stage we are looking at the feasibility of applying currently available evaluation tools to people in this situation.MethodA convenience sample was used to recruit 10 service users from RDaSH NHS FT Early Intervention Services. This is a feasibility study which will provide data to underpin a fully powered, larger trial.Rating scales applied were:Power of food questionnaire: measures responsiveness to the food environment.Intuitive Eating Scale: measures an individual's tendency to follow their physical hunger and satiety cues.The loss of control over eating scale (LOCES): measures a global sense of whether individuals experience LOC over eating.Dutch Eating Behaviour Questionnaire (DEBQ): measures restrained eating, emotional eating and external eating.ResultThe ages of the participants ranged from 17-26 years. All were started on Olanzapine at the dose of 5 or 10 mg daily.Baseline total scores for the Power of Food (2.47-3.80)/5 (higher score = more responsiveness) and Intuitive Eating scales (2.10-2.62)/5 (higher score = greater tendency to follow hunger and satiety cues) were in the mid-range, while the LOCES scores varied widely from 1.50-2.38/5.The DEBQ restrained subscale score range was 2.40-2.80/5 (higher indicates greater restraint with food) while the DEBQ external subscale ranged from 2.70—3.00/5 (higher = greater tendency to overeat) and the DEBQ emotional subtotal score was 1.92-1.94/5, in keeping with a relatively low emotional drive to eat.ConclusionOur preliminary results reveal at the beginning of antipsychotic treatment a moderate responsiveness to food and tendency to follow hunger/ satiety cues, with scores for Loss of Control of eating in the low to moderate range and a low emotional drive to eat. The difference between these and the follow-up eating behaviour scores will provide important clues as to the precise changes in eating behaviour with anti-psychotic treatment in FEP.

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