scholarly journals Thought Suppression in Primary Psychotic Disorders and Substance/Medication Induced Psychotic Disorder

2020 ◽  
Vol 18 (1) ◽  
pp. 116
Author(s):  
Cosmin O. Popa ◽  
Razvan Predatu ◽  
Wesley C. Lee ◽  
Petronela Blaga ◽  
Eliza Sirbu ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Thought Suppression ◽  
Traumatic Event ◽  
Behavioral Therapy ◽  
Automatic Thoughts ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Positive Correlation ◽  
Negative Automatic Thoughts ◽  
Psychological Scales

Introduction: First episode-psychosis (FEP) represents a stressful/traumatic event for patients. To our knowledge, no study to date has investigated thought suppression involved in FEP in a Romanian population. Our objective was to investigate thought suppression occurring during FEP within primary psychotic disorders (PPD) and substance/medication induced psychotic disorders (SMIPD). Further, we examined the relationship between thought suppression and negative automatic thoughts within PPD and SMIPD. Methods: The study included 30 participants (17 females) with PPD and 25 participants (10 females) with SMIPD. Psychological scales were administered to assess psychotic symptoms and negative automatic thoughts, along a psychiatric clinical interview and a biochemical drug test. Results: Participants in the PPD group reported higher thought suppression compared to SMIPD group. For the PPD group, results showed a positive correlation between thought suppression and automatic thoughts. For the SMIPD group, results also showed a positive correlation between thought suppression and automatic thoughts. Conclusions: Patients with PPD rely more on thought suppression, as opposed to SMIPD patients. Thought suppression may be viewed as an unhealthy reaction to FEP, which is associated with the experience of negative automatic thoughts and might be especially problematic in patients with PPD. Cognitive behavioral therapy is recommended to decrease thought suppression and improve patients’ functioning.

scholarly journals The effect of the environment on symptom dimensions in the first episode of psychosis: a multilevel study

2014 ◽  
Vol 44 (11) ◽  
pp. 2419-2430 ◽  
Author(s):  
F. J. Oher ◽  
A. Demjaha ◽  
D. Jackson ◽  
C. Morgan ◽  
P. Dazzan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Population Density ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Urban Environments ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Multilevel Regression ◽  
Symptom Dimensions ◽  
Reality Distortion

BackgroundThe extent to which different symptom dimensions vary according to epidemiological factors associated with categorical definitions of first-episode psychosis (FEP) is unknown. We hypothesized that positive psychotic symptoms, including paranoid delusions and depressive symptoms, would be more prominent in more urban environments.MethodWe collected clinical and epidemiological data on 469 people with FEP (ICD-10 F10–F33) in two centres of the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study: Southeast London and Nottinghamshire. We used multilevel regression models to examine neighbourhood-level and between-centre differences in five symptom dimensions (reality distortion, negative symptoms, manic symptoms, depressive symptoms and disorganization) underpinning Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Item Group Checklist (IGC) symptoms. Delusions of persecution and reference, along with other individual IGC symptoms, were inspected for area-level variation.ResultsReality distortion [estimated effect size (EES) 0.15, 95% confidence interval (CI) 0.06–0.24] and depressive symptoms (EES 0.21, 95% CI 0.07–0.34) were elevated in people with FEP living in more urban Southeast London but disorganized symptomatology was lower (EES –0.06, 95% CI –0.10 to –0.02), after controlling for confounders. Delusions of persecution were not associated with increased neighbourhood population density [adjusted odds ratio (aOR) 1.01, 95% CI 0.83–1.23], although an effect was observed for delusions of reference (aOR 1.41, 95% CI 1.12–1.77). Hallucinatory symptoms showed consistent elevation in more densely populated neighbourhoods (aOR 1.32, 95% CI 1.09–1.61).ConclusionsIn people experiencing FEP, elevated levels of reality distortion and depressive symptoms were observed in more urban, densely populated neighbourhoods. No clear association was observed for paranoid delusions; hallucinations were consistently associated with increased population density. These results suggest that urban environments may affect the syndromal presentation of psychotic disorders.

scholarly journals M176. INTESTINAL PERMEABILITY AND LOW-GRADE CHRONIC INFLAMMATION IN SCHIZOPHRENIA: DO THEY INFLUENCE COGNITION AND COGNITIVE RESERVE?

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S203-S204
Author(s):  
Gerard Anmella ◽  
Silvia Amoretti ◽  
Miqueu Alfonso ◽  
Oriol Cuñat ◽  
Gemma Safont ◽  
...  
Keyword(s):  
Chronic Inflammation ◽  
Mediterranean Diet ◽  
Intestinal Permeability ◽  
Cognitive Reserve ◽  
Psychotic Disorders ◽  
Verbal Learning ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Low Grade ◽  
Cross Sectional

Abstract Background Higher intestinal-permeability is known to cause low-grade chronic inflammation, which seems to participate in the development and worsening of psychotic disorders both in first-episode psychosis (FEP) and schizophrenia (SCZ) patients. Moreover, in psychotic disorders, inflammation has been linked to cognition and cognitive reserve (CR). The aim of this study is to assess the relation between intestinal-permeability, low-grade chronic inflammation, cognition and cognitive reserve in psychotic disorders. Methods Observational, cross-sectional and multisite study including four centers in Spain (Grant from Fondo de Investigación Sanitaria, PI17/00246). A total of 500 adult patients with DSM-5 SCZ-spectrum disorder at any stage of the disease were recruited. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Disease severity was assessed using the Clinical Global Impression (CGI) scale and functioning was assessed using the Global Assessment of Functioning (GAF) scale. The intestinal-permeability was estimated with the “Permeable-Intestine-syndrome questionnaire”. The diet was assessed with the “Mediterranean-diet-adherence questionnaire”. Exercise was measured with the “International Physical Activity Questionnaire (IPAQ)”. Cognition was measured with the SCIP-S scale. CR was assessed with the Cognitive Reserve Assessment Scale in Health (CRASH), which is a scale developed to measure CR specifically for patients with severe mental illness. Correlations between CRASH scores and the remainder variables were performed. Results For the present study we included only the subjects who had CRASH score, a total of 112 patients, 42.7% female, aged 40.61±12.4 (mean±SD). Substance use was present in 44.3%. The CRASH score was 33.30±15.72 (mean±SD) and was associated with negative (but not positive) psychotic symptoms assessed by PANSS (PANSS negative; rp=-3.98; p=0.001, PANSS general; rp=-2.13; p=0.038, GAF; rp=0.410; p<0.0001, CGI; rp=-0.30; p=0.002, IPAQ; rs=0.224; p=0.025 and the permeability-scale; rs=-0.266; p=0.008. All cognitive domains (assessed by SCIP-S) were associated to CRASH: verbal learning immediate (rp=0.584; p<0.0001) and differed (rp=0.515; p<0.0001), working memory (rp=0.539; p<0.0001), verbal fluency (rs=0.485; p<0.0001) and processing speed (rp=0.584; p<0.0001). No significant associations were found with Mediterranean-diet scale (rs=0.195; p=0.056), IMC (rs=-0.192; p=0.063), C-reactive protein (rs=-0.104; p=0.278) and the IPAQ-resting scale and permeability-scale (rs=0.119; p=0.244). Discussion

scholarly journals Uncharted Waters: Treating Trauma Symptoms in the Context of Early Psychosis

2019 ◽  
Vol 8 (9) ◽  
pp. 1456 ◽  
Author(s):  
Folk ◽  
Tully ◽  
Blacker ◽  
Liles ◽  
Bolden ◽  
...  
Keyword(s):  
Traumatic Stress ◽  
Psychotic Disorders ◽  
Behavioral Therapy ◽  
Specialty Care ◽  
Early Psychosis ◽  
Psychotic Symptoms ◽  
Trauma Symptoms ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Post Traumatic

Psychosis is conceptualized in a neurodevelopmental vulnerability-stress framework, and childhood trauma is one environmental factor that can lead to psychotic symptoms and the development of psychotic disorders. Higher rates of trauma are associated with higher psychosis risk and greater symptom frequency and severity, resulting in increased hospitalization rates and demand on outpatient primary care and mental health services. Despite an estimated 70% of individuals in the early stages of psychosis reporting a history of experiencing traumatic events, trauma effects (post-traumatic anxiety or depressive symptoms) are often overlooked in psychosis treatment and current interventions typically do not target commonly comorbid post-traumatic stress symptoms. We presented a protocol for Trauma-Integrated Cognitive Behavioral Therapy for Psychosis (TI-CBTp), an approach to treating post-traumatic stress symptoms in the context of early psychosis care. We provided a brief summary of TI-CBTp as implemented in the context of Coordinated Specialty Care and presented preliminary data supporting the use of TI-CBTp in early psychosis care. The preliminary results suggest that individuals with comorbid psychosis and post-traumatic stress symptoms can be appropriately and safely treated using TI-CBTp within Coordinated Specialty Care.

Group CBT for Clients With a First Episode of Schizophrenia

2003 ◽  
Vol 17 (4) ◽  
pp. 375-383 ◽  
Author(s):  
Tania Lecomte ◽  
Claude Leclerc ◽  
Til Wykes ◽  
Jocelin Lecomte
Keyword(s):  
Group Intervention ◽  
Behavioral Therapy ◽  
Self Esteem ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Group Approach ◽  
Satisfaction With Treatment ◽  
Anxiety Depression ◽  
First Episode Of Schizophrenia ◽  
Group Cbt

This article describes the rationale for and the content of a 24-session group cognitive-behavioral therapy (CBT) tailored to the needs of individuals following a first episode of psychosis. The CBT group approach aims to increase coping with psychotic symptoms as well as help clients deal with other clinical realities such as low self-esteem, stress, anxiety, depression, suicide and substance abuse. Qualitative results, regarding process and satisfaction with treatment, are promising and suggest further investigation of this group intervention.

scholarly journals Detecting relapse in youth with psychotic disorders utilizing patient-generated and patient-contributed digital data from Facebook

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
M. L. Birnbaum ◽  
S. K. Ernala ◽  
A. F. Rizvi ◽  
E. Arenare ◽  
A. R. Van Meter ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Warning Signs ◽  
Digital Data ◽  
Classification Model ◽  
Patient Specific ◽  
Psychotic Symptoms ◽  
Rank Test ◽  
First Episode ◽  
Specific Level ◽  
Recent Onset

Abstract Although most patients who experience a first-episode of psychosis achieve remission of positive psychotic symptoms, relapse is common. Existing relapse evaluation strategies are limited by their reliance on direct and timely contact with professionals, and accurate reporting of symptoms. A method by which to objectively identify early relapse warning signs could facilitate swift intervention. We collected 52,815 Facebook posts across 51 participants with recent onset psychosis (mean age = 23.96 years; 70.58% male) and applied anomaly detection to explore linguistic and behavioral changes associated with psychotic relapse. We built a one-class classification model that makes patient-specific personalized predictions on risk to relapse. Significant differences were identified in the words posted to Facebook in the month preceding a relapse hospitalization compared to periods of relative health, including increased usage of words belonging to the swear (p < 0.0001, Wilcoxon signed rank test), anger (p < 0.001), and death (p < 0.0001) categories, decreased usage of words belonging to work (p = 0.00579), friends (p < 0.0001), and health (p < 0.0001) categories, as well as a significantly increased use of first (p < 0.0001) and second-person (p  < 0.001) pronouns. We additionally observed a significant increase in co-tagging (p < 0.001) and friending (p < 0.0001) behaviors in the month before a relapse hospitalization. Our classifier achieved a specificity of 0.71 in predicting relapse. Results indicate that social media activity captures objective linguistic and behavioral markers of psychotic relapse in young individuals with recent onset psychosis. Machine-learning models were capable of making personalized predictions of imminent relapse hospitalizations at the patient-specific level.

scholarly journals Dissociative Amnesia with Dissociative Fugue and Psychosis: a Case Report from a 25-Year-Old Ethiopian Woman

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Liyew Agenagnew ◽  
Elias Tesfaye ◽  
Selamawit Alemayehu ◽  
Mathewos Masane ◽  
Tilahun Bete ◽  
...  
Keyword(s):  
Case Report ◽  
Psychotic Disorders ◽  
Traumatic Event ◽  
Auditory Hallucination ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Therapeutic Interventions ◽  
Psychotic Symptoms ◽  
Dissociative Amnesia ◽  
Scientific World

Introduction. The case after exposure to intense traumatic events manifests signs and symptoms of dissociative amnesia with a dissociative fugue and schizophrenia. The psychotic symptoms we found, in this case, were very complicated and mimicking primary psychotic disorders. Therefore, this might be a good forum for the scientific world to learn from this case report, how psychotic disorders coexist with dissociative disorders, since the literatures in this area are too rare. Main Symptoms and/or Important Clinical Findings. This case report focuses on the case of dissociative amnesia with dissociative fugue and psychosis in a 25-year-old Ethiopian female who lost her husband and three children at the same time during the nearby ethnic conflict. Associated with amnesia, she lost entire autobiographical information, and she also had psychotic symptoms like delusions and auditory hallucination which is related to the traumatic event she faced. The Main Diagnoses, Therapeutic Interventions, and Outcomes. The diagnosis of dissociative amnesia with a dissociative fugue comorbid with schizophrenia was made, and both pharmacological and psychological interventions were given to the patient. After the intervention, the patient had a slight improvement regarding psychotic symptoms but her memory problem was not restored. Conclusions. The observation in this case report brings to the fore that individuals with dissociative amnesia with dissociative fugue can have psychotic symptoms, and it takes a longer time to recover from memory disturbances.

Neuropsychological evidence for abnormal neurodevelopment associated with early-onset psychoses

2012 ◽  
Vol 43 (4) ◽  
pp. 757-768 ◽  
Author(s):  
I. Bombin ◽  
M. Mayoral ◽  
J. Castro-Fornieles ◽  
A. Gonzalez-Pinto ◽  
E. de la Serna ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Cognitive Development ◽  
Psychotic Symptom ◽  
Early Onset ◽  
Healthy Subjects ◽  
Psychotic Disorders ◽  
Brain Maturation ◽  
Psychotic Symptoms ◽  
First Episode

BackgroundThe longitudinal neuropsychological study of first-episode early-onset psychosis (EOP) patients, whose brain maturation is still in progress at the time of illness onset, provides a unique opportunity to compare their cognitive development with that of healthy subjects, in search of specific patterns resulting from the interaction between neurodevelopmental processes and the presence of psychotic disorders.MethodSeventy-five first-episode EOP patients (schizophrenia n = 35; bipolar disorder n = 17; other forms of psychosis n = 23) with a mean age of 15.53 years were assessed with a neuropsychological battery that included measures of attention, working memory, memory and executive functions within 6 months following the onset of the first psychotic symptom (baseline) and 2 years later. Psychotic symptoms were assessed at both times with the Positive and Negative Symptom Scale (PANSS). Seventy-nine healthy subjects matched for age and education served as controls.ResultsEOP patients showed significant cognitive impairment at both baseline and the 2-year follow-up, with no significant differences between diagnostic groups at either time. Both healthy controls and EOP patients improved in all cognitive measures, except for patient working memory. Improvement in patient attention lost significance after controlling for psychotic symptom reduction. No significant time/diagnosis interaction was found among patients (p > 0.405).ConclusionsCognitive impairment in EOP is already present at the first episode, and cognitive development seems to be arrested early in EOP patients compared to their healthy peers, at least for some cognitive functions. These and previous similar results support the neurodevelopmental hypothesis of psychosis.

Duration of untreated psychosis: a critical examination of the concept and its importance

2001 ◽  
Vol 31 (3) ◽  
pp. 381-400 ◽  
Author(s):  
ROSS M. G. NORMAN ◽  
ASHOK K. MALLA
Keyword(s):  
Treatment Outcome ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Critical Examination ◽  
Duration Of Untreated Psychosis ◽  
Relationship Of ◽  
The Relationship

Background. The concept of duration of untreated psychosis (DUP) has recently attracted much interest because of its possible relationship to treatment outcome and implications for preventive efforts with reference to psychotic disorders, especially schizophrenia. In this paper we review critically the literature concerning the concept and its importance.Methods. Articles concerned with measuring DUP and those that have been suggested to provide indirect or direct evidence of the effect of DUP on treatment outcome are reviewed.Results. Evidence thus far suggests that DUP may be related to ease of reducing psychotic symptoms once treatment begins for first episode patients, but there is no evidence of a relationship to likelihood of relapse. There has been little investigation of the relationship of DUP to other long-term outcomes such as negative symptoms and cognitive functioning neither have the possible confounds of DUP been widely investigated or controlled.Conclusions. It is important that there should be more thorough investigations of DUP, its correlates, and the extent to which it does mediate any advantages of earlier intervention.

Change in cannabis use, clinical symptoms and social functioning among patients with first-episode psychosis: a 5-year follow-up study of patients in the OPUS trial

2013 ◽  
Vol 44 (1) ◽  
pp. 117-126 ◽  
Author(s):  
L. Clausen ◽  
C. R. Hjorthøj ◽  
A. Thorup ◽  
P. Jeppesen ◽  
L. Petersen ◽  
...  
Keyword(s):  
Antipsychotic Medication ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Clinical Symptoms ◽  
First Episode Psychosis ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Episode Psychosis

BackgroundSeveral studies indicate that cannabis use among patients with psychotic disorders is associated with worse outcome, but only a few studies have controlled for baseline condition and medication.MethodAt 5-year follow-up, interviews were carried out with 314 first-episode psychosis patients included in the OPUS trial. The patients included were in the age range of 18 to 45 years old and 59% were male. Cannabis use was extracted from the Schedule for Clinical Assessment in Neuropsychiatry. At follow-up, the patients were divided into different groups according to the variable cannabis use: abstainers, stoppers, starters and continuers. Psychotic, negative and disorganized dimensions (ranging from zero to five) were calculated for each of the four groups based on the Schedule for the Assessment of Positive and Negative Symptoms in Schizophrenia.ResultsCannabis users were younger (24.6 years v. 27.4 years, p < 0.001) and had a lower level of education. At the 5-year follow-up, users of cannabis had higher scores on the psychotic dimension [difference 0.97, 95% confidence interval (CI) 0.41–1.53, p = 0.001] and lower levels of the Global Assessment of Functioning (difference 8.26, 95% CI 2.13–14.39, p = 0.01). Those who stopped using cannabis between entry and 5-year follow-up had a significantly lower level of psychotic symptoms at 5-year follow-up even after controlling for baseline level of psychotic symptoms and for insufficient antipsychotic medication (adjusted difference in psychotic dimension –1.04, 95% CI –1.77 to –0.31, p = 0.006).ConclusionsContinuous cannabis use was associated with higher levels of psychotic symptoms after 5 years, and this association was only partly explained by insufficient antipsychotic medication.

Session 9: Self-Coaching

2020 ◽  
pp. 113-126
Author(s):  
Susan E. Sprich ◽  
Steven A. Safren
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Automatic Thoughts ◽  
Cognitive Behavioral ◽  
Cognitive Component ◽  
Negative Automatic Thoughts

This chapter continues the discussion of the cognitive component of cognitive behavioral therapy (CBT) introduced in Chapter 8. It includes instructions regarding how to review thought records and uses a coaching metaphor to discuss various styles of coaching. The chapter concludes with a discussion of how to formulate helpful alternative thoughts to use in place of negative automatic thoughts.

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