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First-episode psychosis

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
Juliana Onwumere, Sandra Sirykaite, Joerg Schulz, Emma Man, Gareth James, Roya Afsharzadegan, Sanna Khan, Raythe Harvey, Jonathan Souray, David Raune
BACKGROUND: The first onset of psychosis can exert a significant negative impact on the functioning and positive wellbeing of family carers. Carer reports of "burnout" have recently been recorded in early psychosis carers, though the literature is scarce detailing our understanding of how burnout relates to the primary experience of caregiving. The current study investigated reports of burnout and its relationship with beliefs about caregiving and wellbeing in a large group of early psychosis carers who were routinely assessed within an early intervention team...
February 12, 2018: Comprehensive Psychiatry
Derek J Fisher, Debra J Campbell, Shelagh C Abriel, Emma M L Ells, Erica D Rudolph, Philip G Tibbo
The mismatch negativity (MMN) is an EEG-derived event-related potential (ERP) elicited by any violation of a predicted auditory "rule," regardless of whether one is attending to the stimuli and is thought to reflect updating of the stimulus context. Redirection of attention toward a rare, distracting stimulus event, however, can be measured by the subsequent P3a component of the P300. Chronic schizophrenia patients exhibit robust MMN deficits, as well as reductions in P3a amplitude. While, the substantial literature on the MMN in first-episode and early phase schizophrenia in this population reports reduced amplitudes, there also exist several contradictory studies...
March 1, 2018: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
H Rebhi, R Damak, W Cherif, S Ellini, M Cheour, F Ellouze
OBJECTIVES: The duration of untreated psychosis is defined as the interval between the first psychotic symptoms and the first starting treatment. The duration of untreated psychosis is highly variable but often prolonged and may be influenced by several factors. Some studies suggested that duration of untreated psychosis is associated with poor outcome. The objectives of this study were to assess the duration of untreated psychosis in a Tunisian cohort and its impact on the quality of life and the cognitive functions of schizophrenic patients at 2 years...
February 27, 2018: L'Encéphale
Bunta Yoshimura, Shinji Sakamoto, Kojiro Sato, Manabu Takaki, Norihito Yamada
AIM: Early clinical response predicts symptomatic remission and recovery in the maintenance treatment phase of first-episode schizophrenia (FES). However, little is known about predictors of symptomatic remission during acute treatment of severely ill patients with FES. Here, we conducted a secondary analysis of our retrospective observational study, which examined response, remission and treatment-resistance rates in seriously ill patients with FES spectrum disorders involuntarily hospitalized and treated with algorithm-based pharmacotherapy...
December 12, 2017: Early Intervention in Psychiatry
Amresh Shrivastava, Megan Johnston, Robbie Campbell, Avinash De Sousa, Nilesh Shah
Background: Low levels of cholesterol have been described in suicide behavior including among those individuals who have an increased tendency for impulsivity. Violent suicide attempters show significantly lower cholesterol levels than nonviolent suicide attempters. The suicide rate is particularly high in the prodromal and early phase of schizophrenia. It is unclear if there is a psychopathological relationship between early psychosis, suicide, and cholesterol levels. The present study examines levels of cholesterol and suicide behavior in a cohort of early psychosis...
October 2017: Indian Journal of Psychiatry
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