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atypical psychosis

Zsófia Majláth, Izabella Obál, László Vécsei
Parkinson's disease (PD) is a progressive neurodegenerative disorder with prominent motor and non-motor symptoms. Psychosis develops in over 40% of PD patients and it is one of the most distressing symptoms for patients and caregivers alike. Until recently, atypical antipsychotics, clozapine and quetiapine were used to treat psychotic symptoms, but treatment was associated with substantial concerns for side-effects of clozapine and unfounded efficacy for quetiapine. Extensive research has shown that the antipsychotic effect of these drugs could be attributed to serotonin 2a receptor (5 HT2a) triggered mechanisms...
October 6, 2016: CNS & Neurological Disorders Drug Targets
Aislinn J Williams, Zhenni Wang, Stephan F Taylor
New-onset psychotic symptoms often respond well to antipsychotic treatment; however, symptoms may be difficult to treat when an underlying brain malformation is present. Here, we present a case of atypical psychotic symptoms in the context of a congenital cerebellar malformation (Dandy-Walker variant). The patient ultimately improved with paliperidone palmitate after multiple antipsychotic medication trials (both oral and one long-acting injectable) were ineffective. Neuroimaging may provide valuable diagnostic and prognostic information in cases of new-onset psychosis with atypical features and treatment resistance, even in the absence of neurologic signs and symptoms...
September 23, 2016: Neurocase
Oluwadamilola O Ojo, Hubert H Fernandez
Psychosis in Parkinson's disease (PD) is one of the greatest determinants of nursing home placement and caregiver stress. Traditionally associated with medications with dopaminergic effect, it has now been linked to other medications and other stressors e.g. systemic illnesses. The development of hallucinations in a PD patient can herald the onset of dementia and usually predicts increased mortality risk. Medication reduction in PD psychosis usually reduces the symptoms; however, this comes at the cost of worsening motor function...
October 2016: Current Psychiatry Reports
Pawan Sharma, Rajesh Sagar, Bichitrananda Patra, Lokesh Saini, Sheffali Gulati, Biswaroop Chakrabarty
Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis, only recently first described, is an increasingly well-recognized inflammatory encephalitis that is seen in children and adults. An 11-year old girl admitted to the psychiatry ward with a presentation of acute psychosis was diagnosed with NMDA receptor encephalitis following neurology referral and was treated accordingly. This case highlights psychiatric manifestations in encephalitis and the need for the psychiatrist to have high index of suspicion when atypical symptoms (e...
August 2016: Asian Journal of Psychiatry
Ian McKeith, John-Paul Taylor, Alan Thomas, Paul Donaghy, Joseph Kane
Efforts to clinically diagnose cases having dementia with Lewy bodies (DLB) identify those with a characteristic clinical syndrome (probable DLB) at the expense of missing an equal, if not greater, number of cases who have atypical presentations thought to be associated with coexisting Alzheimer pathologies. This article argues that further efforts should now be made to characterize this atypical group that constitutes cases previously identified postmortem as the Lewy body variant of Alzheimer disease (AD) or as AD with Lewy bodies...
September 2016: Journal of Geriatric Psychiatry and Neurology
Yaroslau Compta, Oscar Ramos-Campoy, Oriol Grau-Rivera, Martí Colom-Cadena, Jordi Clarimón, María José Martí, Ellen Gelpi
Progressive supranuclear palsy (PSP) is a low-prevalence atypical parkinsonism with underlying 4R-tauopathy and a growing number of clinical phenotypes, making its differential diagnosis from other conditions such as Parkinson's disease (PD) and corticobasal degeneration particularly challenging (1,2). Neuronal intermediate filament inclusion disease (NIFID), a sporadic alpha-internexin and fused-in-sarcoma (FUS) proteinopathy, is an even rarer condition with few cases published worldwide. It is most often diagnosed at autopsy, again due to a remarkable clinical heterogeneity ranging from young-onset frontotemporal dementia to PSP-lookalike parkinsonism, among other phenotypes (3-6)...
August 4, 2016: Neuropathology and Applied Neurobiology
Sujith Ramachandran, Benjamin F Banahan, John P Bentley, Donna S West-Strum, Amit S Patel
BACKGROUND: In 2011, the U.S. Department of Health and Human Services sent a letter to state Medicaid directors explaining the need for oversight of psychiatric prescriptions for children with mental health disorders. The National Committee for Quality Alliance proposed 3 quality measures for rating managed care organizations (MCOs) that involve use of second-generation or atypical antipsychotics in children. In order to ensure appropriate use and to effectively manage the use of second-generation antipsychotics in children, MCOs need to better understand the factors that influence medication treatment decisions for children...
August 2016: Journal of Managed Care & Specialty Pharmacy
A Castro, J C Romeu, R Geraldes, J A Pereira da Silva
Systemic lupus erythematosus (SLE) may involve the nervous system but there are no specific biomarkers of neuroSLE. Limbic encephalitis has been rarely associated with SLE. We present a case of a 22-year-old black woman where typical SLE psychosis evolved to an encephalopathy with atypical features, normal MRI, electroencephalogram slowing and frontal and occipito-temporal hypometabolism on fluorodeoxyglucose positron emission tomography (FDG PET).Memory deficits, bizarre behaviour, psychosis, neuromyotonia and movement disorders have been described in autoimmune central nervous system disorders and associated with specific antibodies...
July 17, 2016: Lupus
Emanuel Delille
The category of an "Early Psychosis" refers to a common medical classification. It is an essential part of the knowledge constituting mental health even as it represents a normative category subsuming a set of peculiarities in human behaviour, speech, emotional expression, and mental states that together can be described as a mental disorder. Numerous publications since the 1990s have rendered the "Early Psychosis" into a focus of standardised research, prevention and therapy procedures, while earlier medical practices remained unknown...
2016: Canadian Bulletin of Medical History, Bulletin Canadien D'histoire de la Médecine
Jason Quinn, Nathan J Kolla
OBJECTIVE: Although a minority of persons with schizophrenia (SCZ) commits violent acts, SCZ remains a risk factor for violence. Here, we present a broad overview of evidence-based treatments for violence in SCZ, including biological and psychosocial interventions. METHOD: We conducted MEDLINE and PsychINFO literature searches to retrieve articles relating to treatments for violent, hostile, or aggressive behaviours in SCZ. RESULTS: Clozapine shows the strongest evidence for treating the acute violence of SCZ...
June 22, 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Andres M Kanner, Ana Maria Rivas-Grajales
Psychosis of epilepsy (POE) is a term applied to a group of psychotic disorders with a distinct phenomenology in which potential etiopathogenic mechanisms are believed to be closely related to a seizure disorder. POE can present as interictal psychotic episodes, which may often differ semiologically from primary schizophrenic disorder. They may present as ictal or postictal psychotic episodes and may be the expression of an iatrogenic process to pharmacologic and/or surgical interventions.Epilepsy and POE have a complex and bidirectional relation, as not only are patients with epilepsy at greater risk of developing a psychotic disorder, but patients with a primary psychotic disorder are also at greater risk of developing epilepsy...
June 2016: CNS Spectrums
Rebecca N S Harrison, Robin M Murray, Sang Hyuck Lee, Jose Paya Cano, David Dempster, Charles J Curtis, Danai Dima, Fiona Gaughran, Gerome Breen, Simone de Jong
OBJECTIVES: Clozapine is an atypical antipsychotic primarily prescribed for treatment-resistant schizophrenia. We tested the specific effect of clozapine versus other drug treatments on whole-blood gene expression in a sample of patients with psychosis from the UK. METHODS: A total of 186 baseline whole-blood samples from individuals receiving treatment for established psychosis were analysed for gene expression on Illumina HumanHT-12.v4 BeadChips. After standard quality-control procedures, 152 samples remained, including 55 from individuals receiving clozapine...
October 2016: Psychiatric Genetics
F Malbari, T R Gershon, J H Garvin, J C Allen, Y Khakoo, A S Levy, I J Dunkel
BACKGROUND: Central nervous system (CNS) germ cell tumors account for 3 % of all pediatric brain tumors in the USA. Presenting symptoms are typically location based with pineal tumors presenting with obstructive hydrocephalus and suprasellar tumors with hypothalamic/pituitary dysfunction and ophthalmologic abnormalities. Psychiatric manifestations such as psychosis and behavioral changes are atypical presentations of CNS germ cell tumors, with only 11 previously reported cases. METHODS: This is a retrospective case series describing patients with CNS germ cell tumors with an atypical presentation including psychiatric manifestations...
August 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Ricardo Coentre, Amilcar Silva-Dos-Santos, Miguel Cotrim Talina
Background. No consensus between guidelines exists regarding neuroimaging in first-episode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT) and magnetic resonance imaging (MRI)) in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18-48 years (mean age: 29.6 years), consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI) were retrospectively studied...
2016: PeerJ
K P Singh, Manoj K Singh, Shrikant Gautam
For clinical management of different forms of psychosis, both classical and atypical anti-psychotic drugs (APDs) are available. These drugs are widely prescribed, even during pregnancy considering their minimal extra-pyramidal side effects and teratogenic potential compared to classical APDs. Among AAPDs, risperidone (RIS) is a first-line drug of choice by physicians. The molecular weight of RIS is 410.49 g/mol; hence, it can easily cross the placental barrier and enter the foetal bloodstream. It is not known whether or not AAPDs like RIS may affect the developing placenta and foetus adversely...
April 2016: International Journal of Experimental Pathology
Előd Ernő Nagy, Attila Rácz, Edit Urbán, Gabriella Terhes, Timea Berki, Emőke Horváth, Anca M Georgescu, Iringó E Zaharia-Kézdi
The identification and distinction of the pathological conditions underlying acute psychosis are often challenging. We present the case of a 35-year-old ranger who had no history of acute or chronic infectious disease or any previous neuropsychiatric symptoms. He arrived at the Psychiatry Clinic and was admitted as an emergency case, displaying bizarre behavior, hallucinations, paranoid ideation, and delusional faults. These symptoms had first appeared 7 days earlier. An objective examination revealed abnormalities of behavior, anxiety, visual hallucinations, choreiform, and tic-like facial movements...
2016: Neuropsychiatric Disease and Treatment
Ahmad Abu-Akel, Ian A Apperly, Stephen J Wood, Peter C Hansen, Carmel Mevorach
Atypical responses to salient information are a candidate endophenotype for both autism and psychosis spectrum disorders. The present study investigated the costs and benefits of such atypicalities for saliency-based selection in a large cohort of neurotypical adults in whom both autism and psychosis expressions were assessed. Two experiments found that autism tendencies and psychosis proneness interactively modulated the cost incurred in the presence of a task-irrelevant salient distractor. Specifically, expressions of autism and psychosis had opposing effects on responses to salient information such that the benefits associated with high expressions for autism offset costs associated with high expressions for psychosis...
May 23, 2016: Schizophrenia Bulletin
B de Toffol, K Kanemoto
Psychosis in epilepsy can be categorized in relation to seizures in two main categories: interictal psychosis and postictal psychosis. Postictal psychosis (PIP) is a specific syndrome in relation to seizure activity: a clear temporal relation exists between the psychotic state of sudden onset and a precipitating bout of complex partial or generalized seizures. However, this very specific syndrome is not included as such within the DSM-5, and PIP belongs to the category "Psychotic disorder due to another medical condition"...
May 16, 2016: L'Encéphale
Ahmad M Abu-Akel, Ian A Apperly, Stephen J Wood, Peter C Hansen
The mentalizing network is atypically activated in autism and schizophrenia spectrum disorders. While these disorders are considered diagnostically independent, expressions of both can co-occur in the same individual. We examined the concurrent effect of autism traits and psychosis proneness on the activity of the mentalizing network in 24 neurotypical adults while performing a social competitive game. Activations were observed in the paracingulate cortex and the right temporo-parietal junction (rTPJ). Autism traits and psychosis proneness did not modulate activity within the paracingulate or the dorsal component of the rTPJ...
May 17, 2016: Social Neuroscience
K P Singh, Manoj Kr Singh, Manish Singh
A tremendous increase has been documented in the recent past in prescribing second generation atypical antipsychotic drugs (AAPDs) to the pregnant women with psychosis, considering their reproductive and teratogenic safety. Among AAPDs, risperidone (RIS) ranked third after olanzapine (OLZ) and quetiapine (QUE) used during pregnancy, as OLZ is associated to substantial weight gain in adults and offspring. Although teratogenic safety of RIS has been established, its potential role in developmental neurotoxicity and related neurobehavioral impairments in adolescents has not been documented so far...
August 2016: International Journal of Developmental Neuroscience
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