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PubMed2005

Intellectual disability and psychotic disorders of adult epilepsy.

PURPOSE: To investigate the prevalence, psychopathology, and cognitive functions associated with psychotic disorders among adult epilepsy patients with intellectual disability (ID) based on a multicenter study in Japan. METHODS: The study was divided into three phases: a prevalence study of psychotic disorders among new referrals of epilepsy, a polydiagnostic comparative study of patients with psychotic epilepsy and those with schizophrenia, and a neuropsychological study of patients with psychotic epilepsy and education level-matched controls. RESULTS: Among 336 new referrals of epilepsy, a higher prevalence of psychotic disorders was found among patients with ID (24%) than among those with normal intelligence (6%). The psychotic symptoms and operational diagnoses of psychotic epilepsy patients with ID were similar to those of patients with normal intelligence. A wide range (7-86%) of psychotic epilepsy patients was diagnosed as having schizophrenia, depending on the operational criteria used. Patients with psychotic epilepsy had more disturbances in verbal memory and attention functions than controls. CONCLUSIONS: Epilepsy patients with ID show a predisposition to develop psychotic disorders. Distinguishing their psychotic symptoms from those of schizophrenia is difficult. Subtle cognitive disturbances predispose to psychotic disorders in epilepsy.

Adult↗
PubMed1995

Delineation of acute and transient psychotic disorders in a developing country setting.

BACKGROUND: We examined whether acute transient psychoses can be distinguished from schizophrenia and the affective disorders. METHOD: We studied 46 cases of nonaffective acute psychosis in the Chandigarh Acute Psychosis Study. With respect to separation from schizophrenia, we examined the distribution of duration of the episode. With respect to separation from affective disorders, we assessed the frequency of affective symptoms. RESULTS: Duration was bimodal, suggesting the presence of two distinct conditions of short and long duration. Affective symptoms were minimal, suggesting that these were not atypical affective syndromes. CONCLUSIONS: Acute transient psychoses conform neither with schizophrenia of brief duration nor with atypical affective psychosis, and thus require separate classification as proposed in the ICD-10.

Acute Disease↗
PubMed2006

A randomized controlled trial of a smoking cessation intervention among people with a psychotic disorder.

OBJECTIVE: Despite extremely high rates of smoking among individuals with psychotic disorders and the associated financial and health costs, few studies have investigated the efficacy of smoking cessation interventions among this group. The purpose of this study was to compare an integrated psychological and nicotine replacement therapy intervention for people with a psychotic disorder with routine care alone. METHOD: The authors recruited 298 regular smokers with a psychotic disorder residing in the community and randomly assigned them to a routine care comparison condition (N=151) or an eight-session, individually administered smoking cessation intervention (N=147), which consisted of nicotine replacement therapy, motivational interviewing, and cognitive behavior therapy. Outcome variables included continuous and point-prevalence abstinence rates, smoking reduction status, and changes in symptoms and functioning. RESULTS: While there were no overall differences between the treatment group and comparison group in abstinence rates, a significantly higher proportion of smokers who completed all treatment sessions stopped smoking at each of the follow-up occasions (point-prevalence rates: 3 months, 30.0% versus 6.0%; 6 months, 18.6% versus 4.0%; and 12 months, 18.6% versus 6.6%). Smokers who completed all treatment sessions were also more likely to have achieved continuous abstinence at 3 months (21.4% versus 4.0%). There was a strong dose-response relationship between treatment session attendance and smoking reduction status, with one-half of those who completed the intervention program achieving a 50% or greater reduction in daily cigarette consumption across the follow-ups, relative to less than one-fifth of the comparison subjects. There was no evidence of any associated deterioration in symptoms or functioning. CONCLUSIONS: These findings demonstrate the utility of a nicotine replacement therapy plus motivational interviewing/cognitive behavior therapy smoking cessation intervention among individuals with a psychotic disorder. Further development of more efficacious interventions is required for those who do not respond to existing interventions.

Adult↗
PubMed2002

The general fertility rate in women with psychotic disorders.

OBJECTIVE: This study determined the general fertility rate and age-specific fertility rates for women with psychotic disorders. METHOD: This historical matched-cohort study of patient records from a primary care database (the General Practice Research Database) was carried out for women of childbearing age (15-44 years) with psychotic disorders. RESULTS: The women with psychotic disorders (N=7,936) had a lower overall general fertility rate than the normal comparison subjects (N=23,023), although fertility was only significantly lower in the women aged 25 and above. This lower fertility rate was less marked in women with affective psychoses. There was no evidence that treatment with neuroleptics influenced the fertility rate in women with non-affective psychoses. CONCLUSIONS: This study found markedly lower fertility rates in women with psychotic disorders than in matched normal comparison subjects, particularly in women with non-affective disorders. Knowledge of fertility rates in women with psychotic disorders is fundamental for clinicians and researchers, since it has implications for family planning services, prevention of obstetric complications, child-care support, and hypotheses about the etiology of these disorders.

Adolescent↗
PubMed1986

A DSM-III family study of the nonschizophrenic psychotic disorders.

The authors conducted a blind DSM-III family study based on probands diagnosed from long-term follow-up information as having schizophreniform disorder, schizoaffective disorder, or psychotic affective illness. The pattern of psychopathology in relatives of schizophreniform probands closely resembled that found previously in relatives of schizophrenic probands. Relatives of schizoaffective probands had an excess risk for schizophrenia, other psychoses, and bipolar illness. The pattern of illness found in relatives of the probands meeting Research Diagnostic Criteria for mainly schizophrenic schizoaffective disorder appeared indistinguishable from that of relatives of schizophrenic probands. Relatives of probands with psychotic affective disorder had an excess risk for schizophrenia and for unipolar and bipolar affective disorder.

Depressive Disorder↗
PubMed2005

Detection of Borna disease virus p24 RNA in peripheral blood cells from Brazilian mood and psychotic disorder patients.

BACKGROUND: Borna disease virus (BDV) is a virus that naturally infects a broad range of warm-blooded animals. BDV is an enveloped virus, non-segmented, negative-stranded RNA genome and has an organization characteristic of a member of Bornaviridae in the order of Mononegavirale. In the present work we investigated the presence of BDV p24 RNA in peripheral blood cells from 30 psychiatric patients (19 with mood disorder and 11 with psychotic disorder) and 30 healthy volunteers as the control group. METHODS: All subjects were interviewed by structured diagnostic criteria categorized according to the DSM-IV, Axis I (SCID-V). The presence of BDV p24 RNA was investigated by nested reverse transcriptase PCR (RT-PCR) using specific primers to p24 from BDV. The specificity of the detection was analyzed by the sequencing of PCR products. RESULTS: The mean duration of illness in mood and psychotic patients with p24 RNA of BDV was 25 (+/-12.3) years and the median age was 43.77 (+/-15.2) years. There were no significant differences in gender and age among patients and control group, neither duration of illness among patients with mood and psychotic disorders in the presence or absence of p24 RNA of BDV. We found a frequency of 33.33% (10/30) of BDV-RNA on patient's group and 13.33% (4/30) on control group. The given sequences revealed identity with GenBank database sequence for BDV. CONCLUSION: The detection of a higher level of BDV-RNA in the peripheral blood cells of patients than on control group should help our understanding of the pathogenesis in the disease.

Adolescent↗
PubMed2001

Psychosocial characteristics and needs of mothers with psychotic disorders.

BACKGROUND: It is not known whether mothers with psychotic disorders are clinically and socially distinct from women with psychoses who have not had children. AIMS: To determine the proportion of mothers in an epidemiologically representative population of women with psychotic disorders, to examine the factors associated with having children, and to examine the factors associated with having children 'looked after' by social services. METHOD: Descriptive analysis and two case-control studies. RESULTS: Sixty-three per cent of women with psychotic disorders were mothers. There were no clinical differences between women with or without children, but mothers were more likely to be older and live in unsupported accommodation. Having had a 'looked after' child was associated with Mental Health Act detention, younger age, a forensic history and being Black African. CONCLUSION: Many women with psychoses are mothers. Mothers with psychoses are as disabled and have as many needs as women with psychoses without children.

Adolescent↗