Gender differences in symptomatology in people with psychotic spectrum disorders: protocol for a systematic review and pairwise meta-analysis of observational studies

Gender differences in symptomatology in people with psychosis have been studied extensively in last decades. Previous narrative reviews have shown some evidence of gender differences in depressive, negative and paranoid symptoms, but yielding inconclusive findings. These reviews are limited by not doing systematic searches nor performing quantitative synthesis of the evidence. Therefore, we aimed to systematically investigate if there are gender differences in symptoms in people with psychosis. We describe the protocol for a systematic review and pairwise meta-analysis comparing a range of symptomatic outcome measures between men and women diagnosed with a psychotic spectrum disorder at different stages of the disorder (ultra-high risk for psychosis, early psychosis and established psychosis) in observational studies.

Evaluation of the Executive Functioning and Psychological Adjustment of Child-to-Parent Offenders: Epidemiology and Quantification of Harm

With the aim of ascertaining if child-to-parent offenders have impairments in the executive functions and psychological maladjustment, and to quantify the potential harm and epidemiology, a field study was designed. As for this, 76 juvenile offenders sentenced for child-to-parent violence were assessed in executive functions (Stroop tasks) and psychological adjustment (Minnesota Multiphasic Personality Inventory-Adolescent, MMPI-A). The results showed valid responses for 75 juveniles and that data were not generally biased in line with defensiveness or malingering (differential diagnosis in justice juvenile evaluations). In psychological adjustment, the results revealed a significantly higher maladjustment among offenders on all the basic clinical scales with 23% more symptoms of hysteria than the normative population, 37% more of depressive symptoms, 44% more of hypochondriac symptoms, 68% more of psychopathic deviation symptoms, 46% more of paranoid symptoms, 26% more of psychasthenic symptoms, 24% more symptoms of schizophrenia, 17% more symptoms of hypomania, and 13% more symptoms of social introversion. Epidemiologically, the prevalence rates of clinical deterioration were significantly greater than expected (0.05 in normative sample) in hypochondria (28.0%), depression (29.3%), hysteria (29.3%), psychopathic deviation (60%), paranoia (30.7%), psychasthenia (22.7%), and schizophrenia (25.3%). As for the cognitive functions, the offenders exhibited impairments estimated at 62.0% in word reading, 47.9% in color naming, 45.8% in color-word, and 11.9% in interference and a significantly higher prevalence of caseness than expected in word reading (65%), color naming (71%), and color-word (70.2%). The implications of the results for intervention are discussed.

Virtual Reality-based Interventions for Patients with Paranoia

Background: Paranoia is an important psychiatric symptom with an important effect on daily life. Virtual reality (VR) based treatments are suggested as an effectual treatment for patients with paranoia, facilitating learning. To our knowledge, there is a lack of systematic reviews to evaluate VR-based treatment as a treatment for paranoia or paranoid delusions. This study aimed to review reports that investigate VR-based treatment as a treatment for patients with paranoia.Methods: Studies published up to 20/07/2020 about VR-based interventions for the treatment of patients with paranoid delusions or paranoia were reviewed in five databases including PubMed, Embase, Web of Science, PsycINFO, and Scopus.Results: From the total of 252 initial searches, 6 were included in the study based on inclusion criteria. Four studies were performed as randomized controlled trials and two were before-after studies. All of them showed positive results in the main target, including increased social participation, reduced anxiety, and suspicious ideas and paranoid symptoms. Conclusion: VR-based interventions are effective treatments. Although the use of VR technology is limited for a variety of reasons, including the cost, it improves symptoms in patients with paranoia.

Needs analysis for the personal, social, and psychological adjustment of adolescents at risk of delinquency and juvenile offenders

La literatura ha encontrado que las necesidades no-criminogénicas también son un factor de riesgo de delincuencia juvenil y, por tanto, han de ser objeto de intervención. Se diseñó un estudio de campo con el objetivo de conocer si el ajuste individual, social y psicológico (necesidades no-criminogénicas) difieren entre menores infractores, menores de protección y normalizados. Para ello se evaluó a 450 adolescentes (150 menores de reforma, 150 de protección y 150 normalizados) en el ajuste individual, social y psicológico. Los resultados mostraron un efecto significativo en el ajuste individual, social y psicológico para el factor población. Sucintamente, los menores de protección y reforma manifestaron un mayor desajuste individual en los niveles personal y familiar que los normalizados, y, adicionalmente, los de reforma a nivel social. Asimismo, los menores de protección e infractores exhibieron un mayor desajuste social consistente en más retraimiento social, ansiedad social/timidez y liderazgo que los normalizados, y los menores infractores un menor ajuste social en la consideración hacia los demás que los normalizados. En el ajuste psicológico, los menores de reforma y protección informaron de más sintomatología obsesivo-compulsiva, de sensibilidad interpersonal, depresiva, de hostilidad, de ansiedad-fóbica y psicótica que los normalizados, y los de protección más somática, ansiosa (generalizada) y paranoide que los normalizados. Se cuantificaron los déficits en estas dimensiones para estimar la magnitud de las necesidades. Se discuten las implicaciones teóricas de los resultados y para el diseño de programas de prevención de la delincuencia y de recaídas. Literature has found that non-criminogenic needs also are a juvenile delinquency risk factor and, consequently, should be target of intervention. With the aim of knowing if individual, social and psychological adjustment differ between juvenile offenders and foster care adolescents with normal adolescents was designed. A total of 450 adolescents (150 juvenile offenders, 150 foster care adolescents, and 150 normal adolescents) were evaluated in individual, social and psychological adjustment. The results showed a significant effect in the individual, social and psychological adjustment for the population factor. Succinctly, juvenile offenders and foster care adolescents displayed a higher individual maladjustment in the personal and family level than normal adolescents, and, additionally, juvenile offenders in the social level. Likewise, juvenile offenders and foster care adolescents exhibited a higher social maladjustment consisting in more social withdrawal, social anxiety/shyness, and leadership than normal adolescents; and juvenile offenders revealed less consideration for others than normal adolescents. In psychological adjustment, juvenile offenders and foster care adolescents reported more obsessive-compulsive, interpersonal sensitivity, depression, hostile, phobic-anxiety, and psychotic symptomology than normal adolescent; and foster care adolescent more somatic, anxiety (generalized) and paranoid symptoms than normal adolescents. The deficits in these needs were quantified as to estimate the magnitude of the intervention. Theoretical and practical implications for intervention of the results are discussed

Details of the Contents of Paranoid Thoughts in Help-Seeking Adolescents with Psychotic-Like Experiences and Continuity with Bullying and Victimization: A Pilot Study

Background: Psychosis recognizes an interaction between biological and social environmental factors. Adversities are now recognized to be consistently associated with psychotic-like experiences (PLEs). The purpose of this study was to describe the contents of paranoid symptoms and to focus on their relationship with bullying and victimization in help-seeking adolescents. Methods: Help-seeking adolescents who screened positive for PLEs participated in the study. They performed a battery self-report questionnaire for data collection (paranoia: the Specific Psychotic Experiences Questionnaire (SPEQ); the content of paranoid thoughts: the Details of Threat (DoT); bullying victimization: the Multidimensional Peer Victimization Scale (MPVS); depression: the Children’s Depression Inventory (CDI); and anxiety: the Multidimensional Anxiety Scale (MASC)). Results: The participants were 50 adolescents (52% female; mean age: 170 months). The contents of their paranoid symptoms were related to victimization and, in particular, the certainty of threats was correlated with physical (0.394, p < 0.01) and verbal bullying (0.394, p < 0.01), respectively. The powerfulness of the threats correlated with verbal victimization (0.295, p < 0.05). The imminence of the threats was linked to verbal (0.399, p < 0.01) victimization. Hours under threat correlated with verbal (0.415, p < 0.01) victimization. The sureness of the threat had a moderate correlation with physical (0.359, p < 0.05) and verbal (0.443, p < 0.01) victimization, respectively. The awfulness of the threat was linked to social manipulation (0.325, p < 0.05). Conclusions: We described the content of the persecutory symptoms. The powerfulness, imminence, sureness, and awfulness of threats correlated with the level of physical, verbal and social manipulation victimization. Teachers and family must actively monitor early signs of bullying victimization, and school psychologists should promote preventive and therapeutic intervention. From a social psychiatry perspective, the prevention of bullying victimization is necessary.

RISK FACTORS OF DEVELOPMENT OF HALLUCINATORY-PARANOIDAL DISORDERS IN PATIENTS WITH DEMENTIA OF A MIXED GENESIS

Seventy-two patients with Alzheimer's disease (AD) with late onset and vascular brain disease, dementia with hallucinatory-paranoid symptoms (the main group) were examined. The control group included 61 patients with AD with late onset and vascular disease of the brain without hallucinatory-paranoid symptoms. The risk factors for the development of hallucinatory-paranoid disorders in patients with mixed dementia were determined. These factors included: female gender; age of 78.6 ± 7.3 years old; hereditary burden of personality disorders; genetic predisposition for cognitive disorders; the presence of a neuropathic constitution in childhood; a retardation of a psychophysical development in childhood; low levels of academic performance; absence of family; secondary and secondary speciaized education; a physical type of a job; acute psychogenic factors associated with the worsening of financial conditions, conflicts in the family, and divorce.

Clinical-psychopathological structure of hallucinatory-paranoid disorders during vascular dementia of moderate degrees of severity

41 patients with vascular dementia in the medium stage of development with mixed cortical and subcortical dysfunction with hallucinatory-paranoid symptoms (main group) were examined. The control group consisted of 34 patients with vascular dementia in the medium stage of development without hallucinatoryparanoid disorders. The patterns of clinical and psychopathological manifestations of hallucinatory-paranoid disorders in patients with vascular dementia in the medium stage of development were established, which can be considered as diagnostic criteria for assessing the clinical and psychopathological structure of hallucinatory-paranoid disorders in this pathology. Keywords: dementia, hallucinatoryparanoid symptoms, clinical and psychopathological manifestations

Clinical-psychopathological structure of hallucinator-paranoid disorders during vascular dementia of heavy direction of expression

The purpose of this study is to determine the clinical and psychopathological features of hallucinatory-paranoid disorders in severe vascular dementia. The clinical and psychopathological structure of hallucinatory and paranoid disorders in patients with severe vascular dementia was studied in a group of 34 patients with mixed cortical-subcortical dysfunction with hallucinatory-paranoid symptoms — F01.3 (1-2), which consisted the main group. As a control group, the study involved 29 patients with severe vascular dementia (F01.3), without by hallucinatory-paranoid disorders. To achieve the goal and objectives of the study, a set of research methods was used, including the clinical and psychopathological method, supplemented by the Behavioral Disorders Scale (Bahav-AD), neuropsychiatric questionnaire (NPI), non-cognitive sections of the AD assessment scale (ADAS-Non Cog) and methods of statistical data processing. According to the results of the study, the following symptoms were revealed in the structure of hallucinatory-paranoid disorders in patients with severe vascular dementia: the prevalence of hallucinatory disorders over paranoid and paranoid disorders; the dominance in disorders of perception of frequent visual, auditory and tactile hallucinations of moderate severity; the prevalence of delusional beliefs that “the house is not his house” and the spouse/caretaker is impostors; the predominance of non-deployed, unsystematized and sketchy crazy ideas, that do not tend to expand; a combination of hallucinatory and paranoid disorders with frequent aimless activity of moderately strong severity; frequent generalized anxiety of moderate to severe severity; frequent sleep/wake rhythm disturbances of moderate severity; periodic moderate swagger; pronounced distractibility. The data obtained should be taken into account when conducting differential diagnosis of patients with hallucinatory-paranoid disorders in severe vascular dementia.