Psychosis in Women: Time for Personalized Treatment

Early detection and prompt treatment of psychosis is of the utmost importance. The great variability in clinical onset, illness course, and response to pharmacological and psychosocial treatment is in great part gender-related. Our aim has been to review narratively the literature focusing on gender related differences in the psychoses, i.e., schizophrenia spectrum disorders. We searched the PubMed/Medline, Scopus, Embase, and ScienceDirect databases on 31 July 2021, focusing on recent research regarding sex differences in early psychosis. Although women, compared to men, tend to have better overall functioning at psychotic symptom onset, they often present with more mood symptoms, may undergo misdiagnosis and delay in treatment and are at a higher risk for antipsychotic drug-induced metabolic and endocrine-induced side effects. Furthermore, women with schizophrenia spectrum disorders have more than double the odds of having physical comorbidities than men. Tailored treatment plans delivered by healthcare services should consider gender differences in patients with a diagnosis of psychosis, with a particular attention to early phases of disease in the context of the staging model of psychosis onset.

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Hallucinations Under Psychedelics and in the Schizophrenia Spectrum: An Interdisciplinary and Multiscale Comparison

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa117 ◽

2020 ◽

Vol 46 (6) ◽

pp. 1396-1408 ◽

Cited By ~ 1

Author(s):

Pantelis Leptourgos ◽

Martin Fortier-Davy ◽

Robin Carhart-Harris ◽

Philip R Corlett ◽

David Dupuis ◽

...

Keyword(s):

Brain Imaging ◽

Working Group ◽

Future Research ◽

Schizophrenia Spectrum Disorders ◽

Drug Induced ◽

Computational Approaches ◽

Schizophrenia Spectrum ◽

Multidisciplinary Working ◽

Similarities And Differences ◽

Spectrum Disorders

Abstract The recent renaissance of psychedelic science has reignited interest in the similarity of drug-induced experiences to those more commonly observed in psychiatric contexts such as the schizophrenia-spectrum. This report from a multidisciplinary working group of the International Consortium on Hallucinations Research (ICHR) addresses this issue, putting special emphasis on hallucinatory experiences. We review evidence collected at different scales of understanding, from pharmacology to brain-imaging, phenomenology and anthropology, highlighting similarities and differences between hallucinations under psychedelics and in the schizophrenia-spectrum disorders. Finally, we attempt to integrate these findings using computational approaches and conclude with recommendations for future research.

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Exploration of symptom dimensions and duration of untreated psychosis within a staging model of schizophrenia spectrum disorders

Early Intervention in Psychiatry ◽

10.1111/eip.13006 ◽

2020 ◽

Author(s):

Steven Berendsen ◽

Henricus L. Van ◽

Jasper W. Paardt ◽

Olav R. Peuter ◽

Marion Bruggen ◽

...

Keyword(s):

Duration Of Untreated Psychosis ◽

Schizophrenia Spectrum Disorders ◽

Symptom Dimensions ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Staging Model

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Measuring Motivation in Patients with Schizophrenia with Apathy Evaluation Scale (AES). Pilot Study of the Russian Version

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.107 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S274-S274 ◽

Cited By ~ 1

Author(s):

M. Minyaycheva ◽

K. Kiselnikova ◽

L. Movina ◽

I. Gladyshev ◽

O. Papsuev

Keyword(s):

Negative Symptoms ◽

Psychosocial Treatment ◽

Strong Correlations ◽

Schizophrenia Spectrum Disorders ◽

Russian Version ◽

Schizophrenia Spectrum ◽

Psychometric Tool ◽

Spectrum Disorders ◽

Competing Interest ◽

Positive Correlations

IntroductionReduction of mental productivity and motivation in patients with schizophrenia is one of the core features of negative symptoms of schizophrenia spectrum disorders. Lack of motivation affects social functioning and outcomes, reduces effects of psychosocial treatment and rehabilitation.ObjectivesTo research AES abilities in measuring motivation in patients with schizophrenia spectrum disorders. The aim of the study was to investigate correlations of Russian translation of clinician-rated and self-rated versions with PANSS amotivation subscale and negative subscale items.MethodsFifty patients with schizophrenia spectrum disorders were recruited to participate in the study and were assessed with PANSS, AES-C and AES-S by trained raters. Only patients in “stabilized” state that met inclusion criteria of PANSS total score ≤ 80 points were eligible for consecutive AES assessment.ResultsOverall, moderate positive correlations were established between AES-C and PANSS amotivation subscale N2 and N4 items, N6 item and total PANSS negative subscale. No significant correlations with G16 item were registered. AES-C and AES-S versions also showed positive Spearman correlations (r = 0.43; P < 0.05), while no correlations between AES-S and amotivation PANSS items were registered.DiscussionModerately strong correlations between AES-C and PANSS N2, N4 and N6 items show feasibility of AES-C version in terms of measuring motivation in patients with schizophrenia spectrum disorders. Results of AES-S analysis demonstrate certain problems in patients’ abilities in self-assessing motivation. Patients with prevailing paranoid syndrome showed poorer results in AES-S scores.ConclusionsAES-C is a sensitive psychometric tool with good properties in measuring amotivation in patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Clinical Staging in Schizophrenia Spectrum Disorders

10.5772/intechopen.98276 ◽

2021 ◽

Author(s):

Zsófia Borbála Dombi ◽

Ágota Barabássy ◽

Barbara Sebe ◽

István Laszlovszky ◽

György Németh

Keyword(s):

Gold Standard ◽

State Of The Art ◽

Treatment Strategies ◽

Clinical Staging ◽

Schizophrenia Spectrum Disorders ◽

The Past ◽

Schizophrenia Spectrum ◽

Appropriate Treatment ◽

Spectrum Disorders ◽

Staging Model

The aim of this chapter is to summarize the state-of-the-art knowledge of clinical staging in schizophrenia spectrum disorders. Clinical staging has been introduced to psychiatry in the past two decades. Its primary goal is to divide the course of the disorder into recognizable stages based on seriousness, development and symptom characteristics in order to better predict prognosis and to adopt the most appropriate treatment strategies. The first staging model was developed in 1982. Since then several distinct concepts of clinical staging in psychiatry have emerged. To date, there is no clinical consensus regarding which staging model is the gold standard, nonetheless when merging them together an integrated staging concept arises. The integrated staging model of schizophrenia spectrum disorders is composed of four stages. The chapter will introduce the different staging models in a historical order as well as present the integrated staging model detailing the characteristics, timeline and dominating symptoms of each stage. Appropriate treatment strategies for the distinct stages will also be outlined.

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