scholarly journals Case Report: Severe Side Effects Following Treatment With First Generation Antipsychotics While Cariprazine Leads to Full Recovery

2021 ◽  
Vol 12 ◽  
Author(s):  
Maris Taube
Keyword(s):  
Health Care Professionals ◽  
First Generation ◽  
Medication Use ◽  
First Episode Psychosis ◽  
Effective Control ◽  
First Episode ◽  
Negative Experience ◽  
Affective Symptoms ◽  
Episode Psychosis ◽  
Patient Cooperation

Schizophrenia is a psychiatric disorder characterized by positive, negative, cognitive and affective symptoms. Patient cooperation with health care professionals, compliance with the treatment regime, and regular use of medications are some of the preconditions that need to be met for a favorable disease course. A negative experience following the use of a first-generation antipsychotic to treat first-episode psychosis can negatively affect a patient's motivation for further medication use. In the clinical case reported here, cariprazine was able to restore one such patient's confidence in therapy and facilitated their cooperation with the physician, thereby ensuring effective control of negative and positive symptoms and good functioning for a period of 1 year. Cariprazine may be a good option for maintenance therapy following first-episode psychosis, especially in situations in which a patient has had a negative first experience associated with antipsychotic medication use.

Social functioning in a first-episode of psychosis: can the existence of affective symptoms influence it?

2011 ◽  
Vol 26 (S2) ◽  
pp. 1403-1403
Author(s):  
M. Ienciu ◽  
F. Romosan ◽  
C. Bredicean ◽  
R. Romosan ◽  
A. Moroianu ◽  
...  
Keyword(s):  
Marital Status ◽  
Social Functioning ◽  
First Episode Psychosis ◽  
First Episode ◽  
Professional Status ◽  
Family Status ◽  
Affective Symptoms ◽  
Episode Psychosis ◽  
Two Samples ◽  
Instructional Level

IntroductionBesides psychopathological outcome, the outcome in terms of social functioning is of great importance in first-episode psychosis. This paper has analyzed three components of social functioning: instructional level, professional and marital status.ObjectivesThe objective of this paper is to analyze the social functioning after two years of evolution in a sample of subjects with a first-episode psychosis.AimsThe aim is to determine the way in which the presence of affective elements can influence social functioning in a first-episode psychosis.Methods43 subjects with a first-episode psychosis have been divided into 2 samples, according to the existence of (sample A) / the absence of (sample B) affective symptoms (depressive or manic). We have to mention that the affective elements have not fulfilled the ICD 10 criteria for an affective episode. These two samples have been analyzed at onset and after two years of evolution, according to the following parameters: instructional level, professional and marital status.ResultsWe have noticed that there were changes only regarding the professional status and instructional level. After 2 years of evolution, the number of employed subjects was higher in sample A, compared to sample B. All of the subjects in sample A, which were students during their first episode of psychosis, have managed to finish their studies. Family status was not modified in any sample.ConclusionThe existence of affective elements in a first-episode psychosis has an influence only regarding the professional status.

scholarly journals Gender Differences in Schizophrenia and First-Episode Psychosis: A Comprehensive Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Susana Ochoa ◽  
Judith Usall ◽  
Jesús Cobo ◽  
Xavier Labad ◽  
Jayashri Kulkarni
Keyword(s):  
Gender Differences ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Familial Risk ◽  
First Episode Psychosis ◽  
First Episode ◽  
Neuropsychological Profile ◽  
Affective Symptoms ◽  
Episode Psychosis ◽  
Premorbid Functioning

Recent studies have begun to look at gender differences in schizophrenia and first-episode psychosis in an attempt to explain the heterogeneity of the illness. However, a number of uncertainties remain. This paper tries to summarize the most important findings in gender differences in schizophrenia and first-psychosis episodes. Several studies indicate that the incidence of schizophrenia is higher in men. Most of the studies found the age of onset to be earlier in men than in women. Findings on symptoms are less conclusive, with some authors suggesting that men suffer more negative symptoms while women have more affective symptoms. Premorbid functioning and social functioning seem to be better in females than males. However, cognitive functioning remains an issue, with lack of consensus on differences in neuropsychological profile between women and men. Substance abuse is more common in men than women with schizophrenia and first-episode psychosis. In terms of the disease course, women have better remission and lower relapse rates. Lastly, there is no evidence of specific gender differences in familial risk and obstetric complications. Overall, gender differences have been found in a number of variables, and further study in this area could help provide useful information with a view to improving our care of these patients.

scholarly journals Spontaneous Parkinsonism in Antipsychotic-Naive Patients with First-Episode Psychosis

2005 ◽  
Vol 50 (7) ◽  
pp. 429-431 ◽  
Author(s):  
Siow Ann Chong ◽  
Mythily Subramaniam ◽  
Swapna Verma
Keyword(s):  
Intervention Program ◽  
Rating Scale ◽  
Chinese Women ◽  
First Episode Psychosis ◽  
First Episode ◽  
Affective Psychosis ◽  
Asian Patients ◽  
Affective Symptoms ◽  
Episode Psychosis ◽  
Significant Difference

Objective: The purpose of this study was to establish rates of spontaneous parkinsonism (SP) among the different types of psychosis. We hypothesized that the rate would be higher among persons with affective symptoms. Methods: We included in the study consecutive patients admitted to a first-episode psychosis intervention program. We recorded sociodemographic data from interviews with patients and caregivers and from medical records. We used the Simpson–Angus Rating Scale at baseline to assess parkinsonism and a diagnosis of SP was established if the Simpson–Angus score was ≥ 0.3. Results: A total of 174 patients were examined; of these, only 4 (2.3%; 2 Chinese women, 1 Chinese man, and 1 Malay man) had SP. There was a significant difference in the rates of SP in patients with affective psychosis and schizoaffective disorder, compared with those with nonaffective psychoses (15.4% vs 1.2%; χ2 = 10.7, P = 0.001). The 2 groups did not differ significantly in age, duration of untreated psychosis, or sex distribution. Conclusions: The rate of SP in Asian patients with first-episode psychosis was low, and it was significantly higher in those with affective symptoms.

The dimensional structure of first episode psychosis: an exploratory factor analysis

1998 ◽  
Vol 28 (4) ◽  
pp. 935-947 ◽  
Author(s):  
P. D. McGORRY ◽  
R. C. BELL ◽  
P. L. DUDGEON ◽  
H. J. JACKSON
Keyword(s):  
Factor Analysis ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Dimensional Structure ◽  
First Episode ◽  
Factor Solution ◽  
Full Spectrum ◽  
Functional Psychosis ◽  
Affective Symptoms ◽  
Episode Psychosis

Background. Recent research has focused upon the subdiagnostic level in an effort to derive more valid domains of psychotic disorder. This has led to the influential positive–negative dichotomy in schizophrenia being superseded by a three-syndrome model. The strategy of looking for syndromes within poorly validated diagnostic categories, such as schizophrenia, has limitations, particularly since it originated in, and has been largely restricted to, the more chronic subsamples.Method. A representative sample of first episode psychosis (N=509), which includes the full spectrum of functional psychosis, was utilized to re-examine the dimensional structure of functional psychosis from first principles. Patients were assessed with the Royal Park Multidiagnostic Instrument for Psychosis (MIP), a comprehensive procedure that documents the psychopathology of the first episode in a clinically valid manner.Results. Principal axis factor analysis was carried out on the tetrachoric correlation matrix of 92 core psychopathological items. A robust and clinically valid four-factor solution was obtained, comprising depression, mania and only two other factors. The first was a Bleulerian blend of negative symptoms, catatonic/motor symptoms and disorganization. The second was a combination of Schneiderian first rank symptoms, and other hallucinations and delusions. The data thus failed to support the three-syndrome model for non-affective symptoms in this population. A six-factor solution, although partially consistent with other studies, represented a more complex and confusing elaboration of the more clinically valid four-factor solution.Conclusions. The findings have implications for the conceptualization of early psychosis, which need to be explored further in validation studies.

scholarly journals Divergent effects of first-generation and second-generation antipsychotics on cortical thickness in first-episode psychosis

2014 ◽  
Vol 45 (3) ◽  
pp. 515-527 ◽  
Author(s):  
B. R. E. Ansell ◽  
D. B. Dwyer ◽  
S. J. Wood ◽  
E. Bora ◽  
W. J. Brewer ◽  
...  
Keyword(s):  
Cortical Thickness ◽  
First Generation ◽  
Second Generation ◽  
Interaction Analysis ◽  
First Episode Psychosis ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Healthy Controls ◽  
Episode Psychosis ◽  
Second Generation Antipsychotics

BackgroundWhether there are differential effects of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) on the brain is currently debated. Although some studies report that FGAs reduce grey matter more than SGAs, others do not, and research to date is limited by a focus on schizophrenia spectrum disorders. To address this limitation, this study investigated the effects of medication in patients being treated for first-episode schizophrenia or affective psychoses.MethodCortical thickness was compared between 52 first-episode psychosis patients separated into diagnostic (i.e. schizophrenia or affective psychosis) and medication (i.e. FGA and SGA) subgroups. Patients in each group were also compared to age- and sex-matched healthy controls (n = 28). A whole-brain cortical thickness interaction analysis of medication and diagnosis was then performed. Correlations between cortical thickness with antipsychotic dose and psychotic symptoms were examined.ResultsThe effects of medication and diagnosis did not interact, suggesting independent effects. Compared with controls, diagnostic differences were found in frontal, parietal and temporal regions. Decreased thickness in FGA-treated versus SGA-treated groups was found in a large frontoparietal region (p < 0.001, corrected). Comparisons with healthy controls revealed decreased cortical thickness in the FGA group whereas the SGA group showed increases in addition to decreases. In FGA-treated patients cortical thinning was associated with higher negative symptoms whereas increased cortical thickness in the SGA-treated group was associated with lower positive symptoms.ConclusionsOur results suggest that FGA and SGA treatments have divergent effects on cortical thickness during the first episode of psychosis that are independent from changes due to illness.

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