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Early psychosis

Ian Brockington
A study of several hundred recurrent puerperal psychoses shows that about half of those with known onset recur in the same phase of reproduction, and half have onsets in different phases. Onsets in the same phase are especially a feature of prepartum psychosis and are the strongest indication of a specific trigger operating during pregnancy. Onsets in different phases provide a prima facie case for links between 'puerperal psychosis' and other reproductive onsets. They suggest that the 'picture puzzle' is not just about early onset puerperal psychosis, but a group of related reproductive triggers...
October 17, 2016: Archives of Women's Mental Health
Ian Brockington
In addition to bipolar cycloid episodes, infective delirium and eclamptic psychosis, each of which has characteristic clinical features and course, brief episodes of delirium and stupor are also seen in the immediate aftermath of parturition. Several mothers have had similar episodes developing later in the first 10 days, and some have cyclical disorders with an unusual time base. Bipolar/cycloid disorders can start on day 1 or even earlier.
October 16, 2016: Archives of Women's Mental Health
Kelly K Anderson, Paul Kurdyak
OBJECTIVE: Physician follow-up after a first diagnosis of psychotic disorder is crucial for improving treatment engagement. We examined the factors associated with physician follow-up within 30 days of a first diagnosis of schizophrenia. METHOD: We conducted a retrospective cohort study using linked health administrative data to identify incident cases of schizophrenia between 1999 and 2008 among people aged 14 to 35 years in Ontario. We estimated the proportion of patients who had physician follow-up within 30 days of the index diagnosis...
October 13, 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
M Lambert, V Niehaus, C Correll
This review aims to describe the importance of i) detecting individuals at clinical high-risk for psychosis (schizophrenia) or bipolar disorder, especially in children and adolescents, in order to enable early intervention, and ii) evaluating different intervention strategies, especially pharmacotherapy, during the subsyndromal or "prodromal" stages of these severe and often debilitating disorders. The different approaches regarding the psychotic and bipolar clinical high-risk state are discussed, including reasons and evidence for early (pharmacological) intervention and risks of treatment vs...
October 13, 2016: Pharmacopsychiatry
Charmaine Tang, Mythily Subramaniam, Boon Tat Ng, Edimansyah Abdin, Lye Yin Poon, Swapna K Verma
OBJECTIVE: Early symptomatic response is pertinent in improving outcomes in first-episode psychosis. One of the ways in which this may be achieved is by reducing inappropriate delays in clozapine initiation. This study aimed to examine clozapine prescribing practices among clinicians by establishing the prevalence of clozapine use, identifying baseline clinical and demographic factors that were associated with clozapine use, examining outcomes in clozapine users versus nonusers, and identifying inappropriate antipsychotic prescription patterns prior to clozapine initiation...
October 11, 2016: Journal of Clinical Psychiatry
Suzanne Di Capite, Rachel Upthegrove, Pavan Mallikarjun
BACKGROUND: To determine the "real world" relapse rate in patients with first-episode psychosis (FEP) who had discontinued antipsychotic medication and identify socio-demographic and clinical factors associated with the risk of relapse. METHODS: Quantitative data were obtained via case-note review on 63 patients with FEP who had discontinued antipsychotic medication from Birmingham Early Intervention Service between 2012 and 2015. The follow-up period was until either: an occurrence of a relapse; end of 12-month study period; end of patient's case-note record...
October 13, 2016: Early Intervention in Psychiatry
Cali F Bartholomeusz, Vanessa L Cropley, Cassandra Wannan, Maria Di Biase, Patrick D McGorry, Christos Pantelis
OBJECTIVE: This review critically examines the structural neuroimaging evidence in psychotic illness, with a focus on longitudinal imaging across the first-episode psychosis and ultra-high-risk of psychosis illness stages. METHODS: A thorough search of the literature involving specifically longitudinal neuroimaging in early illness stages of psychosis was conducted. The evidence supporting abnormalities in brain morphology and altered neurodevelopmental trajectories is discussed in the context of a clinical staging model...
October 12, 2016: Australian and New Zealand Journal of Psychiatry
(no author information available yet)
Reports an error in "Psychosis-Predictive Value of Self-Reported Schizotypy in a Clinical High-Risk Sample" by Rahel Flückiger, Stephan Ruhrmann, Martin Debbané, Chantal Michel, Daniela Hubl, Benno G. Schimmelmann, Joachim Klosterkötter and Frauke Schultze-Lutter (Journal of Abnormal Psychology, Advanced Online Publication, Sep 1, 2016, np). In the article, there was an error in the Author Note. The affiliation of Daniela Hubl was incorrectly listed as "University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern...
October 2016: Journal of Abnormal Psychology
Catherine Shiu-Yin Chong, Man-Wah Siu, Condy Hoi-Shuen Kwan, Wing-Chung Chang, Edwin Ho-Ming Lee, Sherry Kit-Wa Chan, Christy Lai-Ming Hui, Fiona Yee-Ki Tam, Eric Yu-Hai Chen, William Tak-Lam Lo
AIM: To explore the changes of functioning in people suffering from first-episode psychosis throughout their first year into an early intervention service, and the baseline predictors of their functioning levels at baseline, 6 and 12 months METHOD: Consecutive subjects presenting to an early intervention service were recruited from 1 February 2013 to 31 May 2015. Information on their socio-demographic status was collected. Structured instruments were used to assess their premorbid functioning, duration of untreated psychosis, psychopathology and insight at baseline...
October 12, 2016: Early Intervention in Psychiatry
Robin E Gearing, Kathryne B Brewer, Irfan Mian, Kiara Moore, Prudence Fisher, Jane Hamilton, James Mandiberg
AIM: The timely identification and treatment of psychosis are increasingly the focus of early interventions, with research targeting the initial high-risk period in the months following first-episode hospitalization. Ongoing treatment after stabilization is also essential in the years following a first-episode psychosis (FEP), but has received less research attention. In this study, variables that could impact continued psychiatric service utilization by adolescents following their FEP and temporal patterns in service utilization are examined...
October 11, 2016: Early Intervention in Psychiatry
Miao Chang, Fay Y Womer, Chuan Bai, Qian Zhou, Shengnan Wei, Xiaowei Jiang, Haiyang Geng, Yifang Zhou, Yanqing Tang, Fei Wang
BACKGROUND: Understanding morphologic changes in vulnerable and early disease state of schizophrenia (SZ) may provide further insight into the development of psychosis. METHOD: Whole brain voxel-based morphometry was performed to identify gray matter (GM) regional differences in 60 individuals with SZ during their first psychotic episode (FE-SZ), 31 individuals at genetic high risk for SZ (GHR-SZ) individuals, and 71 healthy controls. RESULTS: Significant differences were found in several regions including the prefrontal cortex, parietal lobe, temporal lobe, hippocampus, occipital lobe, and cerebellum among the three groups (p<0...
2016: PloS One
Ian Brockington
This article describes periodic monthly psychoses that develop during the early months of pregnancy. It is probable that these are a variety of menstrual psychosis.
October 8, 2016: Archives of Women's Mental Health
Amy McKeever, SueEllen Alderman, Stephanie Luff, Brian DeJesus
Severe and persistent mental illness (SPMI) refers to complex mood disorders that include major depressive disorder with or without psychosis; severe anxiety disorders resistant to treatment; affective psychotic disorders including bipolar affective disorder, schizophrenia, and schizoaffective disorder; and other nonaffective subtypes of schizophrenia. SPMIs affect 1 in 17 people and are among the leading causes of disability and impaired health-related quality of life in the United States. Caring for childbearing women with preexisting SPMI can be challenging for maternal-child health clinicians...
October 2016: Nursing for Women's Health
Sibylle Metzler, Diane Dvorsky, Christine Wyss, Carlos Nordt, Susanne Walitza, Karsten Heekeren, Wulf Rössler, Anastasia Theodoridou
An important aim in schizophrenia research is to optimize the prediction of psychosis and to improve strategies for early intervention. The objectives of this study were to explore neurocognitive performance in individuals at risk for psychosis and to optimize predictions through a combination of neurocognitive and psychopathological variables. Information on clinical outcomes after 24 months was available from 118 subjects who had completed an extensive assessment at baseline. Subjects who had converted to psychosis were compared with subjects who had not...
September 30, 2016: Psychiatry Research
Ian Brockington
Donkin psychoses are eclamptic psychoses without seizures. As symptomatic psychoses resulting from cerebral endothelial damage, they may explain the lucid intervals that sometimes occur between eclampsia and the eruption of psychosis. They have the same features as eclamptic psychoses, with onset during pregnancy or the early puerperium, especially in first-time mothers, a short duration and full recovery in most. The clinical picture is usually delirium, but mania is also seen, and some patients have retrograde amnesia or other cognitive defects...
October 8, 2016: Archives of Women's Mental Health
Andrea Murru, Bernardo Carpiniello
The first psychotic episode is classically viewed as a critical period which management is important in determining the long-term outcome of the schizophrenia (SCZ). For this reason, the duration of untreated illness (DUI), defined as the interval between the onset of the psychiatric disorder and the administration of the first pharmacological treatment, is a clinical variable that has been increasingly investigated due to its potentially modifiable nature and its value as a predictor of outcome. DUI is poorly applicable and highly unreliable in psychosis...
October 4, 2016: Neuroscience Letters
Robin M Murray, Harriet Quigley, Diego Quattrone, Amir Englund, Marta Di Forti
Epidemiological evidence demonstrates that cannabis use is associated with an increased risk of psychotic outcomes, and confirms a dose-response relationship between the level of use and the risk of later psychosis. High-potency cannabis and synthetic cannabinoids carry the greatest risk. Experimental administration of tetrahydrocannabinol, the active ingredient of cannabis, induces transient psychosis in normal subjects, but this effect can be ameliorated by co-administration of cannabidiol. This latter is a constituent of traditional hashish, but is largely absent from modern high-potency forms of cannabis...
October 2016: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
Ian Brockington
It has been known since the eighteenth century that postpartum psychoses can begin several weeks after childbirth, not during the first fortnight. There are almost 400 non-organic episodes in the literature, starting more than 3 weeks after the birth; some of them are recurrent. The distinction of this disorder from early onset puerperal psychosis is supported by the distribution of onsets (which shows a steep fall after 14-15 days), survey data and the association with later pregnancies, not the first. Marcé believed that these late onsets were related to the resumption of menstruation...
October 6, 2016: Archives of Women's Mental Health
Jacqueline Sin, Claire Henderson, Debbie Spain, Catherine Gamble, Ian Norman
BACKGROUND: Recruitment to clinical research studies can prove complex. This is particularly true of mental health research, given factors such as confidentiality, capacity and consent, or when attempting to recruit family members as opposed to service users themselves. AIM: This study investigated the challenges experienced and strategies employed in the recruitment of siblings of people with first episode psychosis using Early Intervention in Psychosis Services (EIPS) in England...
October 6, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Sarah Hope Lincoln, Emily Norkett, Kelsey Graber, Sahil Tembulkar, Nicholas Morelli, Joseph Gonzalez-Heydrich, Eugene D'Angelo
Suicide is the leading cause of premature death in individuals with psychotic disorders. Risk for onset of suicidal behaviors tends to begin in adolescence, remaining high into young adulthood. The present study aims to evaluate the interplay of early onset psychosis and suicide risk by examining suicidal behaviors (ideation, planning, and attempts) in children and adolescents with psychotic disorders (PD) compared to typically developing peers (TD). Twenty five youths were recruited and were diagnostically evaluated for psychosis...
October 1, 2016: Schizophrenia Research
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