Early Diagnosis and Counseling in Adolescents With Subclinical Psychotic Symptoms

2022 ◽  
Vol 2 (1) ◽  
pp. 62-68
Author(s):  
Veronika Ivanova
Keyword(s):  
Early Diagnosis ◽  
Medical Model ◽  
Psychotic Symptoms ◽  
Clinical Psychologist ◽  
Psychotic Episode ◽  
Clinical Approach ◽  
First Psychotic Episode ◽  
Psychotherapeutic Techniques ◽  
Sexual Identification ◽  
Subclinical Psychotic Symptoms

Psychosis is a condition characterized on current diagnostic tests by impairment and may include severe disturbances of cognition, thinking, behaviour, and emotion. The need for early diagnosis and prevention of psychotic episodes in adolescents challenges traditional models of counselling, diagnosis, and treatment. The aim of the present study is to derive the main themes and psychological manifestations in the first psychotic episode in adolescents and to deepen knowledge and raise questions around the specific experiences of psychotic adolescents in order to help the clinical psychologist and psychotherapist in diagnostic and therapeutic counselling. This thus goes beyond the visible behaviour and the medical model that pays little attention to the causal relationships in psychosis and its unconscious components. Thirty-six adolescents (27 girls) with subclinical and clinical psychotic symptoms and 30 adolescents (16 girls) with neurotic symptoms were interviewed. A clinical approach was used – clinical psychological interview followed by psychotherapeutic work. Findings and statements can be found showing that early psychotic signs may change into a more severe adolescent crisis, as well as indications of the nature of anger towards parents, unstable mood and aggressivity. Leading themes in interviews and psychotherapeutic sessions may relate to feelings of insignificance in the world around them, unclear sexual identification, too close a relationship with their mothers, and anxiety about real or symbolic absence such as their mothers’ working away from home for long periods of time. In 79% of the interviews with adolescents with psychotic symptoms, we see a lack of real symbolic play in childhood. suitable for non-psychotic adolescents, in this case to change in the first psychotic episode.****What does this last sentence mean? The importance of early diagnosis is recognized and the known psychotherapeutic techniques must be used. Keywords: early psychosis, adolescent, positive psychotherapy, counselling

scholarly journals Brief psychotic disorder associated with quarantine and mild COVID-19

2020 ◽  
Vol 13 (12) ◽  
pp. e240088
Author(s):  
Peter M Haddad ◽  
Majid Al Abdulla ◽  
Javed Latoo ◽  
Yousaf Iqbal
Keyword(s):  
Psychotic Disorder ◽  
Physical Symptoms ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Psychiatric Medication ◽  
Diagnostic And Statistical Manual ◽  
First Psychotic Episode ◽  
Episode Psychosis ◽  
Brief Psychotic Disorder

A 30-year-old man with no significant previous or family psychiatric history became severely anxious about his health after a positive COVID-19 test. Physical symptoms of COVID-19 were mild, with no evidence of hypoxia or pneumonia, throughout his illness. He was admitted to a quarantine facility. He remained highly anxious, and 1 week later, he developed paranoid delusions and auditory hallucinations (his first psychotic episode). He was treated with lorazepam 1 mg four times a day, mirtazapine 30 mg nocte and risperidone 1 mg two times a day. His psychotic symptoms lasted 1 week. He stopped psychiatric medication after 4 weeks and had remained well when reviewed 3 months later. A Diagnostic and Statistical Manual of Mental Disorders fifth edition diagnosis of brief psychotic disorder with marked stressor (brief reactive psychosis) was made. Anxiety about his health and social isolation appeared the main aetiological factors but an inflammatory component cannot be excluded. The case highlights that first episode psychosis can be associated with mild COVID-19.

Psychoeducation of early psychosis patient's helps to improve on compliance

2011 ◽  
Vol 26 (S2) ◽  
pp. 1418-1418
Author(s):  
A. Solonenko ◽  
I. Khlopina
Keyword(s):  
Public Health ◽  
Health Services ◽  
Medical Rehabilitation ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
Control Group ◽  
Public Health Services ◽  
First Psychotic Episode ◽  
Psychopharmacological Treatment ◽  
The Given

The given clinical-catamnethetic research was carried out on the basis of the department of the first psychotic epizode in « Specialized Clinical Psychiatric hospital №1» of the Department of Public Health Services of Krasnodar territory, Russia on the sample of 286 patients with the first psychotic symptoms who underwent treatment during 2006–2008 years. The medical-rehabilitation programme included psychopharmacological treatment and psychoeducational studies of both patients and their relatives, and a control group (100 individuals). Psychoeducational studies with relatives of the patients of the control group were not organized.The research shows the evident effectiveness of psycho-education of relatives of the patients with first psychotic episode for better patients’ compliance.

scholarly journals M192. SENSITIVITY FOR MOTION IS WEAKENED IN FIRST EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S209-S209
Author(s):  
Francina Badia ◽  
Daniel Linares ◽  
Albert Compte ◽  
Mireia Rosa ◽  
Josep Dalmau ◽  
...  
Keyword(s):  
Motion Perception ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Antipsychotic Treatment ◽  
Healthy Controls ◽  
Exclusion Criteria ◽  
Motion Sensitivity ◽  
First Psychotic Episode

Abstract Background Perceptual spatial suppression is a phenomenon in which the perceived strength of a stimulus in space is reduced when the stimulus is surrounded by other stimuli. For motion perception, two studies so far have suggested that spatial suppression and sensitivity to motion perception is also reduced in patients with schizophrenia. Studies to date have been conducted in patients with chronic schizophrenia, however, whether these abnormalities are present at the onset of the disorder or whether they emerge during the course of the illness has not been examined, and no study has assessed whether these abnormalities are specific to schizophrenia or whether they are present in other psychotic disorders. Furthermore, if reduced spatial suppression and sensitivity for motion in schizophrenia are related to a glutamatergic hypofunction, as suggested by a recent study (Schallmo et al., 2019), these reductions may be more accentuated in patients who fail to respond to first-line antipsychotic treatment. Methods Sample: 33 patients with a first psychotic episode (16 females, age=16.4±0.6) and 17 healthy controls (9 females, age=17.2±0.61). Exclusion criteria for both groups were: intellectual disability according to DSM-V criteria. For healthy controls, exclusion criteria also included having a first degree relative with a history of psychotic disorder, current or past diagnosis of psychiatrics disorders. Instruments: The perceptual test was performed on a tablet, and consisted of a briefly presented grating (small or large) drifted sideways (the direction was chosen at random with equal probability), in which the participant was instructed to report the perceived direction. Clinical assessment at illness onset and 12 week follow-up: Positive and Negative Symptom Scales (PANSS), Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version and Structured Clinical Interview for DSM-IV. Non-response to treatment was defined as lack of 50% reduction in PANSS positive or negative scores at 12 weeks, any change in antipsychotics or need for combinations due to lack of clinical response. Psychophysical analysis: Motion sensitivity was estimated independently of lapses of attention, which were assessed by including trials in which the motion stimulus was easily discriminated. Results Patients and healthy controls were homogeneous in age (t=-.720, p=,537) and sex (X2=0.38, p=0.542). In patients, mean treatment response rates was 56.5%. Patients had similar scores of positive and negative symptomatology (positive symptoms= 21±7,13; negative symptoms= 18,4±8,18; general symptoms= 40,7±13,07). At 12 weeks 43,8% had a diagnosis of affective psychosis (bipolar disorder, depressive disorder with psychotic symptoms). Patients with a first psychotic episode, regardless of diagnosis or response to treatment, had less motion sensitivity than healthy controls (f=6.397, p=0.0148). No significant differences were found between groups in surround suppression and no significant correlations were observed between spatial suppression and clinical symptoms. Discussion To our knowledge, this is the first study to find abnormal motion sensitivity in patients with a first episode of psychosis. Our measure of sensitivity, given that it was not contaminated by lapses, indicates that patients had a genuine motion perception deficit rather than an inability to focus on the task. Our results also suggest that motion sensitivity may not be specific to patients with schizophrenia but may also characterize affective psychoses. Larger studies may be needed to clarify whether there is a relationship between motion sensitivity and severity of symptoms and response to treatment.

Opinions of mothers on the first psychotic episode and the start of treatment of their child

2004 ◽  
Vol 19 (4) ◽  
pp. 226-229 ◽  
Author(s):  
L. de Haan ◽  
K. Welborn ◽  
M. Krikke ◽  
D.H. Linszen
Keyword(s):  
Psychiatric Treatment ◽  
Critical Role ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Recent Onset ◽  
Active Approach ◽  
First Psychotic Episode ◽  
First Occurrence ◽  
First Episode Schizophrenia

AbstractParents, especially mothers, have a critical role in initiating psychiatric treatment for their child with first-episode schizophrenia. Knowledge of attitudes of mothers towards the illness of their child prior to psychiatric treatment and towards the start of treatment is essential for the development of interventions for reducing duration of untreated psychosis (DUP). In the present study, mothers (n = 61) of consecutively admitted patients with recent-onset schizophrenic disorders were interviewed about: their views on the nature of the symptoms at first occurrence of psychotic symptoms in their child and views on the main reason for psychiatric treatment; their perception of problems in initiating psychiatric treatment; and suggestions they might have for getting treatment started at an earlier point in time. About 57% of the mothers did not think that their child had a psychosis at first occurrence of psychotic symptoms. Most of the mothers who immediately thought that their child suffered from a psychotic disorder supposed that this disorder was caused by use of street drugs. About one-third (32.8%) of the mothers thought that the reluctance of patients to acknowledge that they needed help was the major obstacle in initiating psychiatric treatment. More than half of the mothers perceived factors related to the delivery of professional care as problems in initiating psychiatric treatment. Given the reluctance of patients to accept treatment, these problems further complicate the initiating of treatment. Mothers emphasize that a more active approach by professional caregivers could reduce treatment delay.

scholarly journals First psychotic episode, related to COVID-19 pandemic, in a patient with tuberous sclerosis complex

2021 ◽  
Author(s):  
Lina Brahmi ◽  
Hanen BEN AMMAR ◽  
Safa Messaoud ◽  
Ghada Hamdi ◽  
Emira Khelifa ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Tuberous Sclerosis Complex ◽  
Genetic Diseases ◽  
Psychological Impact ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
First Psychotic Episode

The psychological impact of COVID-19 pandemic in patients with genetic diseases such as Tuberous sclerosis complex remains to be misunderstood. We report a case of a patient with Tuberous sclerosis who presented with hallucinations, delusions, and disorganized behavior. He developed psychotic symptoms directly triggered by stress derived from COVID-19 pandemic.

scholarly journals Isotretinoin-induced psychotic episode in a 17-year-old adolescent male

2020 ◽  
Vol 8 ◽  
pp. 2050313X2093134
Author(s):  
Bushra Elhusein ◽  
Walid Elkhaled ◽  
Mohamed Adil Shah Khoodoruth ◽  
Rajeev Kumar ◽  
Majid Al Abdulla
Keyword(s):  
Side Effects ◽  
Young Male ◽  
Adolescent Male ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
First Psychotic Episode ◽  
History Of ◽  
Vitamin A Derivative ◽  
Psychiatric Side Effects ◽  
Psychiatric Manifestations

Isotretinoin, a synthetic vitamin A derivative, is primarily used in the management of severe nodulocystic acne. Since its introduction, isotretinoin has been linked with various psychiatric side effects. In particular, depression and suicidality have been extensively reported as side effects. This case report features a young male who developed a first psychotic episode within 3 months of starting isotretinoin therapy. The patient was hospitalized, and organic pathologies and use of psychoactive substances that could explain his presentation were ruled out. After stopping isotretinoin and starting olanzapine 10 mg, the psychotic symptoms remitted completely within 2 weeks. This case highlights the need for increased vigilance toward psychiatric manifestations of isotretinoin. In addition, it suggests that secondary psychosis should be considered as a differential diagnosis by clinicians, especially in patients with no past psychiatric history or family history of mental illness.

The Initial Evaluation of Psychosis

2010 ◽  
Author(s):  
Michael T Compton ◽  
Beth Broussard
Keyword(s):  
Mental Health ◽  
Health Professional ◽  
Mental Health Professional ◽  
Treatment Plan ◽  
Imaging Study ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
Cognitive Assessments ◽  
Loved One ◽  
First Psychotic Episode

People experiencing a first episode of psychosis and their families sometimes hesitate in seeking mental health evaluation and treatment. One reason may be that they do not know what to expect. In addition, old wives’ tales, stories from the media, or other ideas about what happens to people with psychosis may be frightening. This chapter explains the evaluation provided in a health-care setting when people seek help for a first psychotic episode. A thorough evaluation is the first step for mental health professionals to help people experiencing a first psychotic episode. The main reason for evaluation is to better understand what people with psychosis are experiencing. Just like medical illnesses, early psychosis differs greatly across individuals. It can include many different types of signs and symptoms that are caused by a number of different disorders. So, a thorough evaluation allows the mental health professional to compile all sorts of information, from different perspectives, to arrive at the most appropriate diagnosis and develop the most effective treatment plan. As described in Chapter 3, a thorough evaluation assesses three types of possible causes of psychosis. Are the psychotic symptoms a result of a medical condition that requires treatment? Are they stemming from a substance of abuse? Or, do they indicate a psychiatric illness, such as major depression, bipolar disorder, or a primary psychotic disorder? Importantly, the evaluation can provide families with an explanation for what their loved one is experiencing. It also may help the person with psychosis to feel better understood. This chapter describes the typical evaluation that is provided when someone first comes into a mental health facility with psychosis. Most importantly, interviews and observations allow the mental health professional to understand the nature of the psychotic symptoms, including when they started, how they progressed, etc. In addition to gathering information from the patient, the mental health professional will want to collect any other records that may be helpful and to contact others who know the patient to get their perspectives. The mental health professional will usually do a number of medical and psychological exams, including a physical exam, cognitive assessments, lab tests, and perhaps an electroencephalogram and an imaging study.

First acute psychotic episode: Factors associated with evolution to schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. s814-s814
Author(s):  
N. Halouani ◽  
F. Guermazi ◽  
K. Yaich ◽  
R. Ennaoui ◽  
S. Chouayakh ◽  
...  
Keyword(s):  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
Clinical Factors ◽  
Prodromal Phase ◽  
Single Male ◽  
Factors Associated ◽  
Schizoid Personality ◽  
First Psychotic Episode ◽  
Uncertain Outcome ◽  
Competing Interest

IntroductionThe acute psychotic episode have often a dramatic expression. Although it is easily diagnosed, it is not easy to predict the evolution and much less the prognosis that are of concern both for the therapist and the patients’ families.AimsTo describe the profile of a population of patients with a first psychotic episode. To identify factors correlated with evolution to schizophrenia.MethodsThis is a retrospective study conducted among 55 patients hospitalized for a first acute psychotic episode, in the psychiatry B department during the period extending between January 2010 and December 2015.ResultsThe average age of patients was 26.5. The majority was single male. The prodromal phase was present with predominantly psychotic symptoms (80%). Schizophrenia was the most frequently encountered scalable diagnosis (38%). Some factors are associated with the evolution to schizophrenia. We can mention male gender (P = 0.004) and premorbid schizoid personality (P = 0.047). About correlated clinical factors, we have found an initial symptomatology dominated by loss of interest (P = 0.05), withdrawal and isolation (P = 0.017), impulsivity (P = 0.011), breaking with the usual functioning (P = 0.04), mental automatism (P = 0.033), the delusions of persecution (P = 0.025) and intuitive mechanism (P = 0.023).ConclusionWhen a first acute delusional experience occurs in a young adult, it is always a test of uncertain outcome. However, schizophrenia remains the most feared evolutionary. A better understanding of poor prognosis and early and appropriate management seem paramount to reduce the prevalence of this dreaded evolution.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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