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First episode psychosis

Christa Boychuk, Rosemary Lysaght, Heather Stuart
The first episode of psychosis often emerges during young adulthood, when individuals are pursuing important educational and career goals that can become derailed because of the development of major impairments. Past research has neglected the developmental nature of employment and education decisions that young adults with first-episode psychosis make within the context of their lives. The purpose of this grounded theory study was to advance a model of the career decision-making processes of young adults with first-episode psychosis, and the influences that affect their career decision-making...
March 1, 2018: Qualitative Health Research
Christy L M Hui, William G Honer, Edwin H M Lee, Wing Chung Chang, Sherry K W Chan, Emily S M Chen, Edwin P F Pang, Simon S Y Lui, Dicky W S Chung, Wai Song Yeung, Roger M K Ng, William T L Lo, Peter B Jones, Pak Sham, Eric Y H Chen
BACKGROUND: The long-term consequences of discontinuing antipsychotic medication after successful treatment of first-episode psychosis are not well studied. We assess the relation between early maintenance therapy decisions in first-episode psychosis and the subsequent clinical outcome at 10 years. METHODS: This is a 10 year follow-up study, spanning Sept 5, 2003, to Dec 30, 2014, of a randomised, double-blind trial in seven centres in Hong Kong in which 178 patients with first-episode psychosis with full positive symptom resolution after at least 1 year of antipsychotic treatment were given maintenance treatment (n=89; oral quetiapine 400 mg daily) or early treatment discontinuation (n=89; placebo) for 12 months...
March 15, 2018: Lancet Psychiatry
Ashok Malla, Sally Mustafa, Aldanie Rho, Sherezad Abadi, Martin Lepage, Ridha Joober
No abstract text is available yet for this article.
March 2018: Schizophrenia Research
Luisella Bocchio Chiavetto, Roberta Zanardini, Sarah Tosato, Mariacarla Ventriglia, Clarissa Ferrari, Chiara Bonetto, Antonio Lasalvia, Franco Giubilini, Angelo Fioritti, Francesca Pileggi, Michela Pratelli, Michele Pavanati, Angela Favaro, Giovanni De Girolamo, Giovanni Battista Frisoni, Mirella Ruggeri, Massimo Gennarelli
The molecular underpinnings associated to first episode psychosis (FEP) remains to be elucidated, but compelling evidence supported an association of FEP with blood alterations in biomarkers related to immune system, growth factors and metabolism regulators. Many of these studies have not been already confirmed in larger samples or have not considered the FEP diagnostic subgroups. In order to identify biochemical signatures of FEP, the serum levels of the growth factors BDNF and VEGF, the immune regulators IL-1RA, IL-6, IL-10 and IL-17, RANTES/CCL5, MIP-1b/CCL4, IL-8 and the metabolic regulators C-peptide, ghrelin, GIP, GLP-1, glucagon, insulin, leptin, PAI-1, resistin and visfatin were analysed in 260 subjects collected in the GET UP project...
March 13, 2018: Brain, Behavior, and Immunity
Adriana Miyazaki de Moura, Walter Hugo Lopez Pinaya, Ary Gadelha, André Zugman, Cristiano Noto, Quirino Cordeiro, Sintia Iole Belangero, Andrea P Jackowski, Rodrigo A Bressan, João Ricardo Sato
In this study, we employed the Maximum Uncertainty Linear Discriminant Analysis (MLDA) to investigate whether the structural brain patterns in first episode psychosis (FEP) patients would be more similar to patients with chronic schizophrenia (SCZ) or healthy controls (HC), from a schizophrenia model perspective. Brain regions volumetric data were estimated by using MRI images of SCZ and FEP patients and HC. First, we evaluated the MLDA performance in discriminating SCZ from controls, which provided a score based on a model for changes in brain structure in SCZ...
March 6, 2018: Psychiatry Research
Kouta Suzuki, Hidehito Niimura, Ryoko Yamazawa, Takahiro Nemoto, Masaaki Murakami, Masaru Mimura, Masafumi Mizuno
INTRODUCTION: In recent years, the early detection and treatment of the first episode of schizophrenia (FES) has attracted worldwide attention. In Japan, psychiatric care has changed to an open and accessible framework over the past decade. Therefore, the duration of untreated psychosis (DUP) is thought to have been shortened. The purposes of this study were to investigate whether recent DUP periods are shorter than they were 10 years ago and whether the DUP at present differs among psychiatric facilities...
March 7, 2018: Asian Journal of Psychiatry
Alexander Sumich, Anthony Harris, Thomas Whitford, Daniel Hermens, Nadja Heym, John Anderson, Claire Bloxsom, Fraenze Kibowski, Veena Kumari
OBJECTIVE: Right frontal function, as indicated by the N200 component of the event-related potential during target detection, has previously been associated with excitement (excitement, impulsivity, hostility, uncooperativeness) in men with a long-term diagnosis of schizophrenia. The current study investigated excitement in relation to N200 in men who had recently experienced their first episode of psychosis. SUBJECTS AND METHODS: Twenty men who had recently suffered their first psychotic episode underwent a clinical interview and auditory oddball task...
March 2018: Psychiatria Danubina
Tamar Mendelson, William W Eaton
PURPOSE: Prevention of mental disorders is a rapidly growing area of research with substantial potential benefits for population health. This paper reviews the evidence base for prevention of depression, anxiety, and schizophrenia. METHODS: We synthesized evidence from recent systematic reviews and meta-analyses published between 2013 and 2018 on prevention of depression, anxiety, and first-episode psychosis. We included reviews of randomized controlled trials testing psychological, psychosocial, and pharmacological preventive interventions...
March 15, 2018: Social Psychiatry and Psychiatric Epidemiology
Til Wykes, Eileen Joyce, Tjasa Velikonja, Andrew Watson, Gregory Aarons, Max Birchwood, Matteo Cella, Sue Dopson, David Fowler, Kathy Greenwood, Sonia Johnson, Paul McCrone, Jesus Perez, Andrew Pickles, Clare Reeder, Diana Rose, Swaran Singh, Dominic Stringer, Matthew Taylor, Rumina Taylor, Rachel Upthegrove
BACKGROUND: Cognitive problems in people with schizophrenia predict poor functional recovery even with the best possible rehabilitation opportunities and optimal medication. A psychological treatment known as cognitive remediation therapy (CRT) aims to improve cognition in neuropsychiatric disorders, with the ultimate goal of improving functional recovery. Studies suggest that intervening early in the course of the disorder will have the most benefit, so this study will be based in early intervention services, which treat individuals in the first few years following the onset of the disorder...
March 15, 2018: Trials
Jeffrey Olivet, Morgan Haselden, Sarah Piscitelli, Rachael Kenney, Alexander Shulman, Deborah Medoff, Lisa Dixon
AIM: Recent research on first episode psychosis (FEP) has demonstrated the effectiveness of coordinated specialty care (CSC) models to support young adults and their families, yet few tools exist to promote engagement in care. This study aimed to develop a prototype computer-based role-playing game (RPG) designed for young people who have experienced FEP, and conduct a pilot study to determine feasibility and test whether the game improves consumers' attitudes toward treatment and recovery...
March 15, 2018: Early Intervention in Psychiatry
Stefania Schiavone, Luigia Trabace
Recent evidence highlighted a pathogenetic link between redox dysregulation and the early stages of psychosis. Indeed, an increasing number of studies have pointed toward an association between oxidative stress, both at central and peripheral levels, and first psychotic episode. Moreover, basal low antioxidant capacity has been shown to directly correlate with cognitive impairment in the early onset of psychosis. In this context, the possibility to use antioxidant compounds in first psychotic episode, especially as supplementation to antipsychotic therapy, has become the focus of numerous investigations on rodents with the aim to translate data on the possible effects of antioxidant therapies to large populations of patients, with a diagnosis of the first psychotic episode...
March 14, 2018: CNS Neuroscience & Therapeutics
Gerald Jordan, Miriam Kinkaid, Srividya N Iyer, Ridha Joober, Karen Goldberg, Ashok Malla, Jai L Shah
PURPOSE: To explore the unintended impact of a targeted case identification (TCI) campaign for first episode psychosis (FEP) on people not experiencing FEP ("non-cases") with respect to referral patterns and reasons for being a non-case. METHODS: Sources of referral, reasons for being a non-case, and subsequent referral destinations of non-cases were examined before and after a TCI. RESULTS: Following the TCI, a greater proportion of non-cases lived outside the study catchment area...
March 14, 2018: Social Psychiatry and Psychiatric Epidemiology
Danyael Lutgens, Ridha Joober, Srividya Iyer, Martin Lepage, Ross Norman, Norbert Schmitz, Sally Mustafa, Sherezad Abadi, Ashok Malla
BACKGROUND: Specialized early intervention (EI) following a first episode of psychosis (FEP) are effective at reducing negative symptoms, although its trajectory warrants systematic assessment. However, findings are equivocal as to whether extended gains are made post 2 years of EI and whether there is additional benefit of extending EI for an additional 3 years. METHODS: Data on 178 FEP patients, from a randomized controlled trial of a 3-year extension of EI service v...
March 14, 2018: Psychological Medicine
Vibeke Bliksted, Chris Frith, Poul Videbech, Birgitte Fagerlund, Charlotte Emborg, Arndis Simonsen, Andreas Roepstorff, Daniel Campbell-Meiklejohn
Background: Historically, research investigating neural correlates of mentalizing deficits in schizophrenia has focused on patients who have been ill for several years with lengthy exposure to medication. Little is known about the neural and behavioral presentations of theory-of-mind deficits in schizophrenia, shortly after the first episode of psychosis. Methods: We investigated social cognition in 17 recently diagnosed first-episode schizophrenia (FES) patients with little or no exposure to antipsychotic medication and 1:1 matched healthy controls...
March 9, 2018: Schizophrenia Bulletin
Marianne Melau, Nikolai Albert, Merete Nordentoft
AIM: Specialized early intervention (SEI) treatment in meta-analysis has proven to be effective, compared to usual treatment, in treating first-episode psychosis, and the dissemination of SEI services is increasing. A prerequisite for upholding positive effects is to ensure fidelity to the treatment concept once tested. The aim of this study was to map programme fidelity of SEI teams in Denmark by testing a newly developed fidelity scale. METHODS: The 18-item SEI fidelity scale was assessed by visiting SEI teams in person...
March 12, 2018: Early Intervention in Psychiatry
Paweł Krukow, Kamil Jonak, Hanna Karakuła-Juchnowicz, Arkadiusz Podkowiński, Katarzyna Jonak, Magdalena Borys, Michał Harciarek
This study aimed at identifying abnormal cortico-cortical functional connectivity patterns that could predict cognitive slowing in patients with schizophrenia. A group of thirty-two patients with the first-episode schizophrenia and comparable healthy controls underwent resting-state qEEG and cognitive assessment. Phase Lag Index (PLI) was applied as a connectivity index and the synchronizations were analyzed in six frequencies. Pairs of electrodes were grouped to separately cover frontal, temporal, central, parietal and occipital regions...
March 4, 2018: Psychiatry Research
Cristian Mena, Alfonso Gonzalez-Valderrama, Barbara Iruretagoyena, Juan Undurraga, Nicolas A Crossley
BACKGROUND: Failure to respond to antipsychotic medication in schizophrenia is a common clinical scenario with significant morbidity. Recent studies have highlighted that many patients present treatment-resistance from disease onset. We here present an analysis of clozapine prescription patterns, used as a real-world proxy marker for treatment-resistance, in a cohort of 1195 patients with schizophrenia from a Latin-American cohort, to explore the timing of emergence of treatment resistance and possible subgroup differences...
March 8, 2018: Schizophrenia Research
Kristen Thien, Meghan Bowtell, Scott Eaton, Melissa Bardell-Williams, Linglee Downey, Aswin Ratheesh, Patrick McGorry, Brian O'Donoghue
BACKGROUND: The superior efficacy of clozapine in treatment resistant schizophrenia has been clearly demonstrated, yet there are often delays in the commencement of clozapine. In this study, we aimed to determine; the proportion of young people with a first episode of psychosis (FEP) who would be considered eligible for clozapine treatment, the theoretical delay in commencing clozapine and to compare the outcomes of those treated with clozapine to those who were eligible but not treated with clozapine...
March 8, 2018: Schizophrenia Research
Virginie-Anne Chouinard, David C Henderson, Chiara Dalla Man, Linda Valeri, Brianna E Gray, Kyle P Ryan, Aaron M Cypess, Claudio Cobelli, Bruce M Cohen, Dost Öngür
Patients with psychotic disorders are at high risk for type 2 diabetes mellitus, and there is increasing evidence that patients display glucose metabolism abnormalities before significant antipsychotic medication exposure. In the present study, we examined insulin action by quantifying insulin sensitivity in first-episode psychosis (FEP) patients and unaffected siblings, compared to healthy individuals, using a physiological-based model and comprehensive assessment battery. Twenty-two unaffected siblings, 18 FEP patients, and 15 healthy unrelated controls were evaluated using a 2-h oral glucose tolerance test (OGTT), with 7 samples of plasma glucose and serum insulin concentration measurements...
March 9, 2018: Molecular Psychiatry
Chunzhen Tan, Edimansyah Abdin, Wilfred Liang, Lye Yin Poon, Ngar Yee Poon, Swapna Verma
AIM: Early intervention programmes for first episode psychosis (FEP) aim to reduce the duration of untreated psychosis (DUP) and improve functional outcomes. The sustained maintenance of improved outcomes depends largely on patients' adherence to prescribed treatment. This paper examines the prevalence of non-adherence in a cohort of patients with FEP and the sociodemographic and clinical factors associated with non-adherent behaviour. METHODS: The sample included consecutive patients accepted from 2007 to 2012 into the Early Psychosis Intervention Programme (EPIP) in Singapore...
March 9, 2018: Early Intervention in Psychiatry
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