First Episode
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2021 ◽  
Vol 12 ◽  
Giacomo Ciocca ◽  
Tommaso B. Jannini ◽  
Michele Ribolsi ◽  
Rodolfo Rossi ◽  
Cinzia Niolu ◽  

A considerable body of literature reports that individuals with psychotic disorders often suffer from sexual dysfunctions (SDs), with these representing a major unmet need. Long-term antipsychotic drug treatment may be the main cause for SDs in psychotic patients, through a plethora of different mechanisms, including prolactin dyscrasia, histamine-mediated sedation, and serotonin-induced sexual demotivation. However, a few pieces of evidence treat sexuality in patients at risk or the onset of psychosis. For this purpose, we systematically reviewed literature of the last 10 years in order to investigate sexuality in ultra-high risk (UHR) for psychosis and first-episode psychosis (FEP). We included in our review 34 articles fitting our research criteria on SDs in UHR and FEP. Evidence of SDs in the transition from UHR to FEP emerges through the selected studies. In FEP, sexuality is affected by the severity of the psychotic symptoms and, in some cases, by the iatrogenic effects of psychopharmacological treatment. Further experimental and clinical studies should systematically investigate the role of sexual functioning in the transition from UHR to FEP and, consequently, clarify whether or not SDs could be considered a possible marker for the onset of psychosis in at-risk populations. Moreover, psychiatrists and clinical psychologists should take into consideration the role of sexual life in young people with prodromal mental symptoms or at the onset of psychosis. Focusing on a thorough sexual evaluation might be a major challenge that could break down barriers of mental health promotion among young people with schizophrenia-spectrum disorders and therefore achieve better clinical outcomes.

2021 ◽  
Vol 8 (11) ◽  
pp. 1833
Jaishree Krishnappa Muniswamappa ◽  
Sudha Rudrappa ◽  
Pratibha Manjunath Patagar

Background: Seizure is one of the commonest neurological illnesses. About 4-10% of children experience at least one episode in the first 16 years of life. Approximately 30% of children who experience, first afebrile seizure later develop epilepsy. Risk is approximately 20% if neurological examination, electroencephalogram (EEG) and neuroimaging is normal. The objective of the study is to determine the age of onset, etiology of first episode of seizure in children between the age group of 2 months to 18 years and the pattern of EEG changes in the above group of children.Methods: In a prospective single centre observational study at Cheluvamba tertiary care hospital in Mysore, around 80 children who were admitted with first episode of afebrile seizure to our emergency department between October-2020 to July-2021 (10 months) were studied. Seizures defined using international league against epilepsy (ILAE) and EEG was done for all 80 children and their records were analysed.Results: A total of 80 children presenting with first episode of seizure were included in the study. Toddlers represented the major portion of our study with male gender predominance.  Idiopathic seizure was the most common etiology identified (81.2%), followed by meningitis (7.5%). EEG abnormality was seen in 58.7% of the children which was statistically significant (p<0.05). MRI was done in 72.5% of the children, of which abnormality was seen in only 8.6% of the children.Conclusions: Seizure is mainly diagnosed clinically and EEG can be normal in many children. First episode of seizure is common in the age group of 1-3 years. Normal EEG at present may not indicate the non-recurrence in future. Though EEG interpretation is useful, treatment can be started based on clinical diagnosis and has to be individualized. 

2021 ◽  
Vol 12 ◽  
Riccardo Nistri ◽  
Elena Barbuti ◽  
Virginia Rinaldi ◽  
Laura Tufano ◽  
Valeria Pozzilli ◽  

Objective: To describe a temporal association between COVID-19 vaccine administration and multiple sclerosis (MS) relapses.Methods: This case series study was collected in four MS Centres in Central Italy, using data from 16 MS patients who received COVID-19 vaccination and presented both clinically and radiologically confirmed relapses between March and June 2021. We collected patients' relevant medical history, including demographics, MS clinical course, disease-modifying treatment (DMT) received (if applicable), and data from MRI scans obtained after the COVID-19 vaccination.Results: Three out of 16 patients received a diagnosis of MS with a first episode occurring after COVID-19 vaccination; 13 had already a diagnosis of MS and, among them, 9 were on treatment with DMTs. Ten patients received BNT162b2/Pfizer-BioNTech, 2 patients mRNA-1273/Moderna, and 4 patients ChAdOx1 nCoV-19/AstraZeneca. All MS relapses occurred from 3 days to 3 weeks after receiving the first dose of the COVID-19 vaccination or the booster. All patients had evidence of radiological activity on MRI.Discussion: Clinical and radiological findings in these cohort of MS patients confirmed disease re/activation and suggested a temporal association between disease activity and COVID-19 vaccination. The nature of this temporal association, whether causative or incidental, remains to be established.

2021 ◽  
Vol 12 ◽  
Priyanthi B. Gjerde ◽  
Carmen E. Simonsen ◽  
Trine V. Lagerberg ◽  
Nils Eiel Steen ◽  
Ole A. Andreassen ◽  

Background: Schizophrenia is a disorder with considerable heterogeneity in course and outcomes, which is in part related to the patients' sex. Studies report a link between serum lipids, body mass index (BMI), and therapeutic response. However, the role of sex in these relationships is poorly understood. In a cross-sectional sample of first-episode psychosis (FEP) patients, we investigated if the relationship between serum lipid levels (total cholesterol, HDL-C, LDL-C, and triglycerides), BMI, and symptoms differs between the sexes.Methods: We included 435 FEP patients (males: N = 283, 65%) from the ongoing Thematically Organized Psychosis (TOP) study. Data on clinical status, antipsychotics, lifestyle, serum lipid levels, and BMI were obtained. The Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS) were used to assess psychotic and depressive symptoms. General linear models were employed to examine the relationship between metabolic variables and symptomatology.Results: We observed a female-specific association between serum HDL-C levels and negative symptoms (B = −2.24, p = 0.03) and between triglycerides levels (B = 1.48, p = 0.04) and BMI (B = 0.27, p = 0.001) with depressive symptoms. When controlling for BMI, only the association between serum HDL-C levels and negative symptoms remained significant. Moreover, the HDL-C and BMI associations remained significant after controlling for demography, lifestyle, and illness-related factors.Conclusion: We found a relationship between metabolic factors and psychiatric symptoms in FEP patients that was sex-dependent.

Women ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 204-211
Marina Verdaguer-Rodríguez ◽  
Raquel López-Carrilero ◽  
Marta Ferrer-Quintero ◽  
Helena García-Mieres ◽  
Luciana Díaz-Cutraro ◽  

The aim of this study was to explore gender differences in social cognition in a sample of first-episode psychosis (FEP). An observational descriptive study was performed with 191 individuals with FEP. Emotion perception was assessed using the Faces Test, theory of mind was assessed using the Hinting Task, and attributional style was assessed using the Internal, Personal and Situational Attributions Questionnaire. No gender differences were found in any of the social cognitive domains. Our results suggest that men and women with FEP achieve similar performances in social cognition. Therefore, targeting specific needs in social cognition regarding gender may not be required in early interventions for psychosis.

2021 ◽  
Vol 11 (11) ◽  
pp. 1370
Ryan Sai-Ting Chu ◽  
Chung-Mun Ng ◽  
Kwun-Nam Chan ◽  
Kit-Wa Chan ◽  
Ho-Ming Lee ◽  

Emerging evidence has indicated disrupted learned irrelevance (LIrr), a form of selective attention deficit that may contribute to psychotic symptom formation, in schizophrenia. However, previous research mostly focused on chronic patients. There is a paucity of studies on LIrr in first-episode schizophrenia-spectrum disorder (i.e., schizophrenia and schizophreniform disorder; FES), which were limited by small sample size and have produced mixed results. The current study examined a LIrr effect and its relationship with positive symptom severity in 40 briefly-medicated FES patients and 42 demographically-matched healthy controls using a well-validated computerized LIrr paradigm which has been applied in chronic schizophrenia sample. Positive symptoms were assessed by Positive and Negative Syndrome Scale (PANSS) and Psychotic Symptom Rating Scales (PSYRATS). Our results showed that controls demonstrated intact LIrr, with significantly faster learning about previously predictive (relevant) than previously non-predictive (irrelevant) cues. Lack of such normal attention bias towards predictive over non-predictive cues was observed in FES patients, indicating their failure to distinguish between relevant and irrelevant stimuli. Nonetheless, we failed to reveal any significant correlations between learning scores, in particular learning scores for non-predictive cues, and positive symptom measures in FES patients. Learning scores were also not associated with other symptom dimensions, cognitive functions and antipsychotic dose. In conclusion, our findings indicate aberrant LIrr with impaired allocation of attention to relevant versus irrelevant stimuli in briefly-medicated FES patients. Further prospective research is warranted to clarify the longitudinal trajectory of such selective attention deficit and its association with positive symptoms and treatment response in the early course of illness.

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