scholarly journals A Case Report on Acute Transient’s Psychotic Disorders

2021 ◽  
pp. 111-116
Author(s):  
Sonali Wawre ◽  
Archana Dhengare ◽  
Pranali Wagh ◽  
Kanchan Bikade ◽  
Aarti Raut ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Diagnostic Category ◽  
Chief Complaint ◽  
Fluid Replacement ◽  
Psychotic Symptoms ◽  
Eye Drops ◽  
Eye Injury ◽  
Eye Care ◽  
Faith Healer ◽  
Slaked Lime

Background: Little is known about acute and transient psychotic disorders (ATPD), a diagnostic category introduced with ICD-10. Case Presentation: Acute transient psychotic disorder is a heterogeneous group of disorders characterised by the acute onset of psychotic symptoms such as delusion, hallucination and perceptual disturbances, and by the severe disruption of ordinary behaviour. Patient history: The Male patient 48 year old who was apparently admitted in AVBRH on date 08/05/2021 with chief complaint was Abnormal behaviour( taking clothes off in public ), irritability, aggressive, muttering and smiling to self from 10 days back. His parents once locked him in a room as they fear he might hurt him. He was taken to a faith healer in Pandarkawda twice by his parents. The Baba gave him some mysterious beats like bracelet to wear which eventually decreased his symptoms for 3 days but the symptoms persisted from the fourth day. This time, the Baba mixed a lemon juice, turmeric powder & kumkuma (a powder made from dried turmeric with a bit of slaked lime) and applied all over him eyes which severely inflamed & burnt his eyes. His eye injury elevated his psychotic symptoms which is why his parents took him to psychiatric OPD in AVBRH. Past History: Patient was apparently asymptomatic 2 yrs back. He was married to a woman of his parent’s choice. His marriage life was stressful and unhealthy. He was underestimated by his wife due to his low qualification and health problem. Clinical Finding: The patient has been undergone with various investigations like culture, blood tests, Physical examination and mental status examination symptomatically with antipsychotic agent and anticonvulsant such as Tab Olanzapine 10mg- HS, Tab Clonazepam 0.5mg – SOS. Medical Management: Antibiotic eye drop homatropine and eye ointment ciprofloxacin. Nursing Management: Administered fluid replacement i.e DNS and RL, eye care was done with betadine and Normal Saline solutions, eye care by administering eye drops and monitored all vital signs hourly. Conclusion: Patient was admitted to hospital with the chief complaint of muttering to self, irritability and eye injury, blisters, pus discharge from eyes and his condition was very critical and patient was admitted in AVBR Hospital ,immediate treatment was started by health team member and all possible treatment were given and now the patient condition is satisfactory.

scholarly journals Cannabinoids, reward processing, and psychosis

2021 ◽  
Author(s):  
Brandon Gunasekera ◽  
Kelly Diederen ◽  
Sagnik Bhattacharyya
Keyword(s):  
Psychotic Disorders ◽  
Neural Substrates ◽  
Brain Regions ◽  
Reward Processing ◽  
Anterior Cingulate ◽  
Psychotic Symptoms ◽  
Dopamine Synthesis ◽  
Future Research ◽  
Drug Challenge ◽  
Psychotomimetic Effects

Abstract Background Evidence suggests that an overlap exists between the neurobiology of psychotic disorders and the effects of cannabinoids on neurocognitive and neurochemical substrates involved in reward processing. Aims We investigate whether the psychotomimetic effects of delta-9-tetrahydrocannabinol (THC) and the antipsychotic potential of cannabidiol (CBD) are underpinned by their effects on the reward system and dopamine. Methods This narrative review focuses on the overlap between altered dopamine signalling and reward processing induced by cannabinoids, pre-clinically and in humans. A systematic search was conducted of acute cannabinoid drug-challenge studies using neuroimaging in healthy subjects and those with psychosis Results There is evidence of increased striatal presynaptic dopamine synthesis and release in psychosis, as well as abnormal engagement of the striatum during reward processing. Although, acute THC challenges have elicited a modest effect on striatal dopamine, cannabis users generally indicate impaired presynaptic dopaminergic function. Functional MRI studies have identified that a single dose of THC may modulate regions involved in reward and salience processing such as the striatum, midbrain, insular, and anterior cingulate, with some effects correlating with the severity of THC-induced psychotic symptoms. CBD may modulate brain regions involved in reward/salience processing in an opposite direction to that of THC. Conclusions There is evidence to suggest modulation of reward processing and its neural substrates by THC and CBD. Whether such effects underlie the psychotomimetic/antipsychotic effects of these cannabinoids remains unclear. Future research should address these unanswered questions to understand the relationship between endocannabinoid dysfunction, reward processing abnormalities, and psychosis.

scholarly journals Relationship Pattern of Personality Disorder Traits in Major Psychiatric Disorders: A Cross-Sectional Study

2021 ◽  
pp. 025371762199953
Author(s):  
Bhavneesh Saini ◽  
Pir Dutt Bansal ◽  
Mamta Bahetra ◽  
Arvind Sharma ◽  
Priyanka Bansal ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Psychiatric Disorders ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Psychiatric Patients ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Sectional Study ◽  
Cross Sectional ◽  
Neurotic Disorders

Background: Normal personality development, gone awry due to genetic or environmental factors, results in personality disorders (PD). These often coexist with other psychiatric disorders, affecting their outcome adversely. Considering the heterogeneity of data, more research is warranted. Methods: This was a cross-sectional study on personality traits in psychiatric patients of a tertiary hospital, over 1 year. Five hundred and twenty-five subjects, aged 18–45 years, with substance, psychotic, mood, or neurotic disorders were selected by convenience sampling. They were evaluated for illness-related variables using psychiatric pro forma; diagnostic confirmation and severity assessment were done using ICD-10 criteria and suitable scales. Personality assessment was done using the International Personality Disorder Examination after achieving remission. Results: Prevalence of PD traits and PDs was 56.3% and 4.2%, respectively. While mood disorders were the diagnostic group with the highest prevalence of PD traits, it was neurotic disorders for PDs. Patients with PD traits had a past psychiatric history and upper middle socioeconomic status (SES); patients with PDs were urban and unmarried. Both had a lower age of onset of psychiatric illness. Psychotic patients with PD traits had higher and lower PANSS positive and negative scores, respectively. The severity of personality pathology was highest for mixed cluster and among neurotic patients. Clusterwise prevalence was cluster C > B > mixed > A (47.1%, 25.2%, 16.7%, and 11.4%). Among subtypes, anankastic (18.1%) and mixed (16.7%) had the highest prevalence. Those in the cluster A group were the least educated and with lower SES than others. Conclusions: PD traits were present among 56.3% of the patients, and they had many significant sociodemographic and illness-related differences from those without PD traits. Cluster C had the highest prevalence. Among patients with psychotic disorders, those with PD traits had higher severity of psychotic symptoms.

scholarly journals Evidence for a Shared Etiological Mechanism of Psychotic Symptoms and Obsessive-Compulsive Symptoms in Patients with Psychotic Disorders and Their Siblings

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0125103 ◽  
Author(s):  
Marije Swets ◽  
Frank Van Dael ◽  
Sabine Roza ◽  
Robert Schoevers ◽  
Inez Myin-Germeys ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms

Frontal Lobe Epilepsy Presenting as a Psychotic Disorder With Delusions and Hallucinations: A Case Study

CNS Spectrums ◽  
1999 ◽  
Vol 4 (9) ◽  
pp. 64-66,82 ◽  
Author(s):  
Bonnie J. Ramsey
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Frontal Lobe ◽  
Psychotic Disorder ◽  
Temporal Lobe ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Frontal Lobe Epilepsy ◽  
Unique Case ◽  
Frontal Lobe Seizures

AbstractAlthough psychotic symptoms are a recognized manifestation of epilepsy, these are more often associated with seizures of the temporal lobe type. While 10% of children with temporal lobe epilepsy develop a psychotic disorder by adulthood, the literature does not report any cases of psychotic disorders associated with frontal lobe seizures in children. This article presents a unique case of a girl whose frontal lobe seizures were associated with delusional psychotic symptoms. Once her seizure disorder was identified through electroencephalography (EEG) and appropriate anticonvulsant therapy was initiated, her associated psychotic symptoms resolved.

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.

Dynamic networks of psychotic symptoms in adults living in precarious housing or homelessness

2021 ◽  
pp. 1-11
Author(s):  
Andrea A. Jones ◽  
Kristina M. Gicas ◽  
Sara Mostafavi ◽  
Melissa L. Woodward ◽  
Olga Leonova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Community Sample ◽  
Dynamic Networks ◽  
Premature Mortality ◽  
Psychotic Symptoms ◽  
Network Measures ◽  
History Of ◽  
Precarious Housing

Abstract Background People living in precarious housing or homelessness have higher than expected rates of psychotic disorders, persistent psychotic symptoms, and premature mortality. Psychotic symptoms can be modeled as a complex dynamic system, allowing assessment of roles for risk factors in symptom development, persistence, and contribution to premature mortality. Method The severity of delusions, conceptual disorganization, hallucinations, suspiciousness, and unusual thought content was rated monthly over 5 years in a community sample of precariously housed/homeless adults (n = 375) in Vancouver, Canada. Multilevel vector auto-regression analysis was used to construct temporal, contemporaneous, and between-person symptom networks. Network measures were compared between participants with (n = 219) or without (n = 156) history of psychotic disorder using bootstrap and permutation analyses. Relationships between network connectivity and risk factors including homelessness, trauma, and substance dependence were estimated by multiple linear regression. The contribution of network measures to premature mortality was estimated by Cox proportional hazard models. Results Delusions and unusual thought content were central symptoms in the multilevel network. Each psychotic symptom was positively reinforcing over time, an effect most pronounced in participants with a history of psychotic disorder. Global connectivity was similar between those with and without such a history. Greater connectivity between symptoms was associated with methamphetamine dependence and past trauma exposure. Auto-regressive connectivity was associated with premature mortality in participants under age 55. Conclusions Past and current experiences contribute to the severity and dynamic relationships between psychotic symptoms. Interrupting the self-perpetuating severity of psychotic symptoms in a vulnerable group of people could contribute to reducing premature mortality.

‘Soother of mind’ – meditation in psychiatric disorders: a narrative review

2021 ◽  
pp. 1-7
Author(s):  
Vinod Kumar ◽  
Shree Raksha Bhide ◽  
Rashmi Arasappa ◽  
Shivarama Varambally ◽  
Bangalore N. Gangadhar
Keyword(s):  
Psychiatric Disorders ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Complete Absorption ◽  
Psychiatric Conditions ◽  
Biological Aspects ◽  
The Mind ◽  
Anxiety Depression ◽  
Meditative Practices

SUMMARY Meditation, a component of ashtanga yoga, is an act of inward contemplation in which the mind fluctuates between a state of attention to a stimulus and complete absorption in it. Some forms of meditation have been found to be useful for people with psychiatric conditions such as anxiety, depression and substance use disorder. Evidence for usefulness of meditation for people with psychotic disorders is mixed, with reported improvements in negative symptoms but the emergence/precipitation of psychotic symptoms. This article narrates the benefits of meditation in psychiatric disorders, understanding meditation from the yoga perspective, biological aspects of meditation and practical tips for the practice of meditation. We also explain possible ways of modifying meditative practices to make them safe and useful for the patient population and useful overall as a society-level intervention.

Postpartum psychosis—important clues to the aetiology of mood disorders

2014 ◽  
Author(s):  
Ian Jones
Keyword(s):  
Mood Disorder ◽  
Psychotic Disorders ◽  
Perinatal Period ◽  
Acute Onset ◽  
Psychotic Symptoms ◽  
Postpartum Psychosis ◽  
Research Strategies ◽  
Pregnancy And Childbirth ◽  
Unipolar Disorder ◽  
Disturbance Of Consciousness

It is of great regret that although corresponding with him at the start of my research career, I never met Channi Kumar face to face. His work, however, as evidenced by this book, remains an important influence on our field. I share his belief in the ‘maternal brain as a model for investigating mental illness’ (Kumar 2001), and this conviction has underlined much of my research. In this chapter I will discuss the concept of postpartum psychosis (PP), explore what we know about the relationship of these episodes to other mood and psychotic disorders, and consider research strategies aimed at understanding the nature of the postpartum trigger. I will argue that the nosological confusion surrounding this condition has been unhelpful and that it is time, perhaps, to consider whether we should revive postpartum psychosis as a diagnostic concept. Episodes of mood disorder in relation to pregnancy and childbirth are very common. In our group we have recently examined the history of perinatal episodes in over 1,500 women with mood disorder who have participated in our genetic studies and find that approximately two thirds of parous women, with both bipolar and unipolar disorder, have experienced a significant mood episode in the perinatal period (Di Florio et al. 2013). PP refers to some of the most severe forms of postpartum psychiatric disorder. Although the boundaries of this condition are not easy to define, the core concept is the acute onset of a manic or affective psychosis in the immediate postpartum period. Depending on the definition employed, the incidence is approximately 1 in 1,000 deliveries (Jones et al. 2010). Women may go from being very well to severely ill within hours. Affective (mood) symptoms, both elation and depression, are prominent, as is a disturbance of consciousness marked by an apparent confusion, bewilderment, or perplexity. As the name suggests, psychotic phenomena occur, with delusions and hallucinations prominent. Some women with severe manic episodes, but who do not show psychotic symptoms, may receive the diagnosis, although it is also possible to reserve the label for those women with frank psychotic presentations.

scholarly journals The Symptom and Domain Structure of Psychotic Disorders: A Network Analysis Approach

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Victor Peralta ◽  
Gustavo J Gil-Berrozpe ◽  
Julián Librero ◽  
Ana Sánchez-Torres ◽  
Manuel J Cuesta
Keyword(s):  
Graphical Models ◽  
Network Structure ◽  
Sampling Method ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Central Position ◽  
Cluster Solution ◽  
Clinical Variables ◽  
Global Strength ◽  
Psychotic Features

Abstract Little is understood about the symptom network structure of psychotic disorders. In the current study, we aimed to examine the network structure of psychotic symptoms in a broad and transdiagnostic sample of subjects with psychotic disorders (n = 2240) and to determine whether network structure parameters vary across demographic, sampling method and clinical variables. Gaussian graphical models were estimated for 73 psychotic symptoms assessed using the Comprehensive Assessment of Symptoms and History. A 7-cluster solution (reality distortion, disorganization, catatonia, diminished expressivity, avolition/anhedonia, mania, and depression) best explained the underlying symptom structure of the network. Symptoms with the highest centrality estimates pertained to the disorganization and, to a lesser extent, negative domains. Most bridge symptoms pertained to the disorganization domain, which had a central position within the network and widespread connections with other psychopathological domains. A comparison of networks in subgroups of subjects defined by premorbid adjustment levels, treatment response, and course pattern significantly influenced both network global strength and network structure. The sampling method and diagnostic class influenced network structure but not network global strength. Subgroups of subjects with less densely connected networks had poorer outcomes or more illness severity than those with more densely connected networks. The network structure of psychotic features emphasizes the importance of disorganization symptoms as a central domain of psychopathology and raises the possibility that interventions that target these symptoms may prove of broad use across psychopathology. The network structure of psychotic disorders is dependent on the sampling method and important clinical variables.

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

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