scholarly journals Early use of electroconvulsive therapy in individuals with first episode psychosis: A case series

Author(s):  
Antra Chandan ◽  
◽  
Vijaya Raghavan ◽  

The use of electroconvulsive therapy (ECT) in various neuropsychiatric disorders has been well accepted. ECT has been proven to be safe and effective in adolescents and in old age. However, only a handful of literature is available on its effectiveness in first episode psychosis (FEP). In this case series, individuals with FEP who received ECT in their 1st month of treatment for various indications were described. During follow-up, subjects showed considerable improvement in their psychopathology and functional outcomes. None of them had any adverse events during or after ECT sessions. Thus, the present case series highlights the usefulness and safety of early use of ECT in individuals with first episode psychosis and its effectiveness in reducing the acute symptoms leading to remission and better outcomes.

2017 ◽  
Vol 47 (14) ◽  
pp. 2461-2471 ◽  
Author(s):  
C. Ouellet-Plamondon ◽  
A. Abdel-Baki ◽  
É. Salvat ◽  
S. Potvin

BackgroundMany studies have concluded that cannabis use disorder (CUD) negatively influences outcomes in first-episode psychosis (FEP). However, few have taken into account the impact of concurrent misuse of other substances.MethodsThis 2-year, prospective, longitudinal study of FEP patients, aged between 18 and 30 years, admitted to early intervention programs in Montreal, Quebec, Canada, examined the specific influence of different substance use disorders (SUD) (alcohol, cannabis, cocaine, amphetamines) on service utilization, symptomatic and functional outcomes in FEP.ResultsDrugs and alcohol were associated with lower functioning, but drugs had a greater negative impact on most measures at 2-year follow-up. Half of CUD patients and more than 65% of cocaine or amphetamine abusers presented polysubstance use disorder (poly-SUD). The only group that deteriorated from years 1 to 2 (symptoms and functioning) were patients with persistent CUD alone. Outcome was worse in CUD than in the no-SUD group at 2 years. Cocaine, amphetamines and poly-SUD were associated with worse symptomatic and functional outcomes from the 1st year of treatment, persisting over time with higher service utilization (hospitalization).ConclusionThe negative impact attributed to CUD in previous studies could be partly attributed to methodological flaws, like including polysubstance abusers among cannabis misusers. However, our investigation confirmed the negative effect of CUD on outcome. Attention should be paid to persistent cannabis misusers, since their condition seems to worsen over time, and to cocaine and amphetamine misusers, in view of their poorer outcome early during follow-up and high service utilization.


2021 ◽  
pp. 1-11
Author(s):  
Priscilla P. Oomen ◽  
Marieke J. H. Begemann ◽  
Bodyl A. Brand ◽  
Lieuwe de Haan ◽  
Wim Veling ◽  
...  

Abstract Background Cognitive deficits may be characteristic for only a subgroup of first-episode psychosis (FEP) and the link with clinical and functional outcomes is less profound than previously thought. This study aimed to identify cognitive subgroups in a large sample of FEP using a clustering approach with healthy controls as a reference group, subsequently linking cognitive subgroups to clinical and functional outcomes. Methods 204 FEP patients were included. Hierarchical cluster analysis was performed using baseline brief assessment of cognition in schizophrenia (BACS). Cognitive subgroups were compared to 40 controls and linked to longitudinal clinical and functional outcomes (PANSS, GAF, self-reported WHODAS 2.0) up to 12-month follow-up. Results Three distinct cognitive clusters emerged: relative to controls, we found one cluster with preserved cognition (n = 76), one moderately impaired cluster (n = 74) and one severely impaired cluster (n = 54). Patients with severely impaired cognition had more severe clinical symptoms at baseline, 6- and 12-month follow-up as compared to patients with preserved cognition. General functioning (GAF) in the severely impaired cluster was significantly lower than in those with preserved cognition at baseline and showed trend-level effects at 6- and 12-month follow-up. No significant differences in self-reported functional outcome (WHODAS 2.0) were present. Conclusions Current results demonstrate the existence of three distinct cognitive subgroups, corresponding with clinical outcome at baseline, 6- and 12-month follow-up. Importantly, the cognitively preserved subgroup was larger than the severely impaired group. Early identification of discrete cognitive profiles can offer valuable information about the clinical outcome but may not be relevant in predicting self-reported functional outcomes.


2001 ◽  
Vol 178 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Attila Sipos ◽  
Glynn Harrison ◽  
David Gunnell ◽  
Shazad Amin ◽  
Swaran P. Singh

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.


2016 ◽  
Vol 173 (1-2) ◽  
pp. 79-83 ◽  
Author(s):  
Wing Chung Chang ◽  
Vivian Wing Yan Kwong ◽  
Gloria Hoi Kei Chan ◽  
Olivia Tsz Ting Jim ◽  
Emily Sin Kei Lau ◽  
...  

2018 ◽  
Vol 28 (10) ◽  
pp. 1161-1172 ◽  
Author(s):  
Rosa Ayesa-Arriola ◽  
Jose María Pelayo Terán ◽  
Javier David López Moríñigo ◽  
Manuel Canal Rivero ◽  
Esther Setién-Suero ◽  
...  

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