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At least 73 records · Page 4Linked to original sources
PubMed2005

Development of depressed mood predicts onset of psychotic disorder in individuals who report hallucinatory experiences.

OBJECTIVES: Current psychological theories state that the clinical outcome of hallucinatory experiences is dependent on the degree of associated distress, anxiety, and depression. This study examined the hypothesis that the risk for onset of psychotic disorder in individuals with self-reported hallucinatory experiences would be higher in those who subsequently developed depressed mood than in those who did not. DESIGN: A prospective cohort study of a general population sample. METHODS: A sample of 4,670 individuals with no lifetime evidence of any psychotic disorder were interviewed with the Composite International Diagnostic Interview Schedule (CIDI) at baseline and 1 and 3 years later. At Year 3, individuals with CIDI evidence of psychotic symptoms were interviewed by clinicians to identify potential onset of psychotic disorder. Psychotic disorder was specified at three levels; two involving severity of positive symptoms of psychosis, and one using additional clinical judgment of need for care. RESULTS: Given the presence of hallucinatory experiences at baseline, the increase in risk of having the psychosis outcome at Year 3 was higher in the group with depressed mood at Year 1 than in the group without depressed mood at Year 1 (any level of psychotic symptoms: risk difference 17.0%, 95% CI - 1.7, 35.7; severe level of psychotic symptoms: risk difference 21.7%, 95% CI 3.2, 40.2; needs-based diagnosis of psychotic disorder: risk difference 16.8%, 95% CI 0.4, 33.3). CONCLUSION: The results are in line with current psychological models of psychosis that emphasize the role of secondary appraisals of psychotic experiences in the onset of clinical disorder.

Adult↗
PubMedDate not supplied

[Interesting case of alcoholic psychotic disorder].

In the paper a case of psychotic disorder connected with alcohol abuse is presented. It is interesting because of its abundant symptomatology, classification and typical chronology of events. Worth mentioning is also coexistence of events that unambiguously show psychotic disorders comorbid with those, which may be properly assessed only after objective data are obtained. Case description is provided with appropriate comments.

Adult↗
PubMed2003

Medical outcome of pregnancy in women with psychotic disorders and their infants in the first year after birth.

BACKGROUND: There has been little research into the health of infants of women with psychotic disorders. AIMS: To investigate the antenatal care of mothers with a history of psychotic disorders, obstetric outcomes and the subsequent health of their babies. METHOD: A matched, controlled cohort study was carried out using the General Practice Research Database. Women with a history of a psychotic disorder, who gave birth in 1996-1998, were compared with women matched for age and general practice (199 cases and 787 controls) and their infants. RESULTS: Cases had a higher proportion of stillbirths (OR=4.03, 95% CI 1.14-4.25, P=0.03) and neonatal deaths (P<0.001). There was no difference in gestational age at antenatal booking. Mothers with psychotic disorders were less likely than controls to attend for infant immunisations 90-270 days after birth (RR=0.94, 95% CI 0.88-0.99, P=0.03). There was no significant difference in the rates of accidents and hospital contacts for infants. CONCLUSIONS: There is an increased risk of stillbirth and neonatal death in women with a history of psychotic disorder, and it is therefore important for health care professionals to focus on optimal obstetric care. The physical health of babies who live with mothers with psychotic disorders is not significantly different from that of matched baby controls.

Accidents↗
PubMed2003

Premorbid functioning in early-onset psychotic disorders.

OBJECTIVE: To examine the premorbid characteristics of youths with early-onset psychotic disorders. METHOD: Subjects with early-onset psychotic disorders received an extensive diagnostic evaluation upon entry into the study, including a historic review of premorbid functioning using the Premorbid Adjustment Scale. RESULTS: Youths with schizophrenia (n = 27), bipolar disorder (n = 22), and psychosis not otherwise specified (NOS) (n = 20) were included. High rates of premorbid behavioral problems and academic difficulties were noted across all subjects. Youths with schizophrenia had higher rates of premorbid social withdrawal and global impairment. They also tended to have fewer friends. The psychosis NOS group had significantly higher rates of abuse histories and posttraumatic stress disorder. CONCLUSIONS: Premorbid abnormalities are common features of early-onset psychotic disorders. The social withdrawal and peer problems specific to youths with schizophrenia likely represent early manifestations of negative symptoms. The abuse histories in the psychosis NOS group may explain the atypical nature of their reported psychotic symptoms, which in many cases are likely posttraumatic phenomena.

Adolescent↗
PubMedDate not supplied

Comorbid anxiety disorders and divalproex sodium use among partial hospital patients with psychotic disorders.

We conducted this study to determine anxiety disorder comorbidity and divalproex sodium use among 26 patients with psychotic disorders after their referral to a partial hospital. Each subject was diagnosed by structured interview, and 4 Brief Psychiatric Rating Scale (BPRS) items associated with agitation were assessed: anxiety, hostility, excitement, and tension. Subjects' medical records were then examined to determine discharge diagnoses from referring inpatient facilities as well as current medication use. Although we diagnosed many anxiety disorders, none was identified during hospitalization. Divalproex use was not associated with anxiety disorder frequency. Divalproex patients had significantly lower BPRS anxiety, tension, and excitement scores, as well as total BPRS agitation scores (P < .05). Our findings suggest that anxiety disorders are unrecognized among psychotic patients and that treatment guidelines for concurrent anxiety are needed.

Adult↗
PubMed2000

[Child and adolescents with psychotic disorders. A literature review of psychology and course].

The article is a literature review of psychosis in children and adolescents. Earlier studies point to psychosis in children and adolescence being of the same types as the ones seen in adults. Schizophrenia has an early onset in boys, there are more premorbid dysfunctions, a gradual onset of disease, a number of unspecific symptoms and a poorer prognosis than for adults. For the children with bipolar affective disorder the prognosis is similar to that of adults, and it is better than for the schizophrenics. The relationships between developmental disorders and schizophrenia, and between hyperactivity syndromes and manic-depressive disorders need to be further clarified, as does the validity of the follow-up investigations.

Adolescent↗
PubMed2002

Classifying psychotic disorders: issues regarding categorial vs. dimensional approaches and time frame to assess symptoms.

The study's aims were to empirically derive classes of disorders and dimensional syndromes within psychotic disorders on the basis of the three time frames of symptom assessment and to comparatively examine their external validity. The level of concordance among classes and among dimensions across the time frames was generally low. The external correlates of psychopathological syndromes differed as a function of both type of assessment and the dimensional or categorical approach used. The dimensional approach was more effective than the categorical approach in predicting a set of clinical variables, irrespective of the time frame used to assess the symptoms. It is concluded that classification of psychotic disorders is highly dependent upon the time frame considered to assess symptoms and that dimensional classifications do have higher predictive power than categorical ones.

Adult↗
PubMed2004

Nonschizophrenic psychotic disorders: the case of cycloid psychoses.

BACKGROUND: Cycloid psychosis is a psychiatric disorder known for about 100 years. This disorder is at present partly and simplified represented in the ICD-10. SAMPLING AND METHODS: Over a period of 15 months, 139 consecutively acutely admitted psychotic patients were assessed, by means of different diagnostic instruments, in order to investigate the prevalence and the symptom profile of cycloid psychoses. In addition, the concordance between the diagnoses cycloid psychosis, brief psychotic disorder, and acute polymorphic psychotic disorder with or without symptoms of schizophrenia was calculated. RESULTS: Cycloid psychoses were present in 13% of the patients. There was a significant but small overlap with the DSM brief psychotic disorder and the ICD acute polymorphic psychotic disorder. CONCLUSIONS: This study demonstrates that cycloid psychoses can be identified with the proper diagnostic instruments in a proportion that is also found in other studies. Since this type of psychosis entails a distinct prognosis and may require a specific treatment, its identification is of clinical importance. Limitations are the nature of the psychiatric facility with an inherent bias in the selection of patients and the lack of a long-term evaluation.

Acute Disease↗
PubMed1994

Substance abuse in psychotic disorders: associations with affective syndromes. DSM-IV Field Trial Work Group.

In a sample of 412 patients with psychotic disorders, the authors examined whether comorbid substance use can be reliably diagnosed, is associated with increased rates of affective symptoms and syndromes and specific psychotic symptoms, and is associated with lowered reliability of the DSM-III-R principal diagnosis. Data from the DSM-IV Field Trial for Schizophrenia and Other Psychotic Disorders was analyzed. In this dataset, substance use was scored on a 4-point ordinal scale and reliability was determined using weighted kappa scores. The associations of significant substance use with affective syndromes and symptoms, and psychotic symptoms were analyzed. Kappa statistics were calculated for principal psychotic disorder diagnoses for patients with and without significant substance use. Weighted kappa scores for substance use ratings ranged from 0.27 to 0.96 (median = 0.85). Syndromal depression was significantly associated with current alcohol use in the entire sample and in the subgroup with schizophrenia alone. Grandiose delusions were also associated with substance use. Significant comorbid substance use was not associated with lowered reliability of diagnosing the principal psychotic disorder. These findings support the hypothesis that comorbid substance abuse can be reliably diagnosed and that alcohol abuse is associated with depressive syndromes in patients with psychotic disorders.

Adult↗
PubMed2006

Alcohol abuse partly mediates the association between coronary heart disease and affective or psychotic disorders: a follow-up study in Sweden.

OBJECTIVE: To analyse whether hospitalization for affective or psychotic disorders predicts coronary heart disease (CHD) after accounting for occupation, region and alcohol-related disorders. METHOD: National registers were used to identify all individuals in Sweden aged 25-64 years at first hospitalization for affective or psychotic disorders and aged 25-79 years at first hospitalization for CHD between 1987 and 2001. Standardized incidence ratios (SIRs) were calculated. RESULTS: The association between CHD and affective or psychotic disorders was strongest in the youngest age groups. The overall SIRs varied between 1.39 and 1.68. They were strongly attenuated but remained significant after adjustment for hospitalization because of alcohol-related disorders, especially among women. CONCLUSION: Hospitalization because of affective or psychotic disorders predicts CHD. These associations are partly mediated by alcohol abuse. Clinicians and decision makers should be aware of the increased risk of CHD in these patient groups.

Adult↗
PubMed2005

Beneficial effect of atypical antipsychotics on prefrontal brain function in acute psychotic disorders.

Disturbance of prefrontal brain functions is assumed to be responsible for prominent psychopathological symptoms in psychotic disorders. Treatment with atypical, in contrast to typical antipsychotics is considered as a possible strategy for an improvement of prefrontal brain function. In the present study, response control as a specific prefrontal brain function was assessed by means of the Nogo-anteriorization (NGA) derived from the event-related potentials elicited during a Go-NoGo task in a consecutive sample of 39 patients suffering from acute psychotic disorders (brief psychotic disorders, 298.8, n = 34 and schizoaffective disorders, 295.70, n = 5; cycloid psychoses according to the Leonhard classification). A highly significant positive correlation between the amount of antipsychotic medication in terms of chlorpromazine equivalents per day and the NGA as a measure of prefrontal response control was only found in the subgroup of patients treated exclusively or predominantly with atypical antipsychotics but not for those treated with typical antipsychotics. These results are in line with the notion that atypical antipsychotics may exert a beneficial effect on prefrontal brain function.

Adult↗
PubMedDate not supplied

Adherence to antipsychotic and nonpsychiatric medications in middle-aged and older patients with psychotic disorders.

OBJECTIVE: The prevalence and consequences of nonadherence to antipsychotic medications in schizophrenia and related psychotic disorders have been well described; however, little is known about adherence to medications for nonpsychiatric conditions in patients with psychotic disorders. We wished to determine medication adherence in nondemented middle-aged and older Veterans Affairs outpatients with schizophrenia or other psychotic disorders who had been prescribed oral medications for hypertension, hyperlipidemia, or diabetes. METHODS: Medication adherence was assessed by review of medication fill records for 76 patients aged 40 years and older who had been prescribed an oral antipsychotic in addition to an oral agent for hypertension (N = 60), hyperlipidemia (N = 28), or diabetes (N = 24). Up to 12 months of therapy was reviewed, and a compliant fill rate (the number of adherent fills in proportion to the total number of prescription fills) and cumulative mean gap ratio (the number of days when medication was unavailable in relation to the total number of days) were calculated for each medication. RESULTS: The 12-month mean compliant fill rates for antipsychotics, antihypertensives, antihyperlipidemics, and antidiabetics ranged from 52% to 64%. Nonpsychiatric medication adherence rates were similar in patients on typical vs. atypical antipsychotics and did not correlate significantly with antipsychotic adherence rates. CONCLUSIONS: Nonadherence rates were found to be equally problematic for both antipsychotic and nonpsychiatric medications in middle-aged and older patients with psychotic disorders. Interventions to improve adherence to both antipsychotic and nonpsychiatric medications are needed.

Adult↗
PubMed2004

Suicide and suicide attempts in adolescent-onset psychotic disorders.

Eighty-eight subjects with adolescent-onset psychotic disorders (mean age+/-standard deviation 15.7+/-1.5 years), mainly schizophrenia and affective disorders, were followed up 10.6+/-3.6 years later, rediagnosed (DSM-IV) and assessed with the Positive and Negative Symptom Scale, abuse of drugs including nicotine, the Lancashire Quality of Life Profile and occurrence of suicide or suicide attempts. Four males (4.5% of subjects) had died from suicide while another 25% of the subjects had attempted suicide. Suicide attempts were associated to more depressive symptoms but fewer negative symptoms at first episode, and to number of admissions and to dependence on nicotine at follow-up in a logistic regression. Satisfaction with religion, health, family relations and safety at follow-up were inversely associated to attempting suicide but only satisfaction with religious belief remained after controlling for concurrent symptoms of anxiety and depression.

Adolescent↗
PubMed2006

Evaluation of factors influencing medication compliance in inpatient treatment of psychotic disorders.

RATIONALE: Short- and long-term compliance to prescribed antipsychotic drugs is of particular concern in regard to medication choice and treatment outcome in the care of psychotic disorders. OBJECTIVE: We evaluated patient-related and treatment-related factors associated with medication compliance in inpatients with a diagnosis of schizophrenia, schizoaffective disorder, or other psychotic disorder. METHODS: Within a naturalistic study in seven psychiatric hospitals, individuals with a psychotic disorder were assessed weekly on mental state, social functioning, side effects, and medication compliance. Logistic regression analyses were computed to assess patient and clinical predictors of medication compliance. RESULTS: We found a significant association between medication compliance and substance abuse (OR 0.52, CI 0.32-0.85), involuntary admission (OR 0.60, CI 0.41-0.89), history of aggressive behavior (OR 0.57, CI 0.38-0.85), and no school graduation (OR 0.59, CI 0.41-0.86). Individuals with pronounced paranoid or negative symptoms were also less compliant in taking their prescribed medication. There was no association between the initial inpatient antipsychotic medication regime and patients' compliance. Individuals who switched from a typical to an atypical antipsychotic drug were more compliant than those with their typical antipsychotic drug maintained. Those with higher medication compliance showed significantly greater improvement of their psychiatric symptoms during the inpatient stay. CONCLUSION: Patient-related in addition to disease-related factors may strongly influence medication compliance. Besides more compliance with atypicals supposed by the literature, there may be a higher propensity for atypical drugs to be prescribed to those assumed to be more compliant.

Adult↗
PubMed2004

The psychosocial outcome of pregnancy in women with psychotic disorders.

OBJECTIVE: To investigate the psychosocial outcome of pregnancies in women with a history of psychotic disorder in an epidemiologically representative sample and to determine the predictors of having a baby looked after by social services in the first year of life. METHOD: Historical matched controlled cohort study and nested case control study using the General Practice Research Database (GPRD), an anonymised primary care database, in women with a history of psychotic disorders who gave birth in 1996-1998 (199 cases and 787 controls). RESULTS: Twenty-seven percent of cases had a psychotic episode and a further 38% had nonpsychotic depression in the first year after birth. Women with nonaffective psychoses were at a significantly higher risk of postnatal depression compared with controls (adjusted rate ratio 2.07, 95% CI 1.45-2.96, p<0.001). Cases were well supported with 72% in a cohabiting relationship and only 38% on benefits. The only significant predictor of parenting difficulties was recent contact with psychiatric services. CONCLUSIONS: Women with a history of psychotic disorder are at high risk of psychiatric illness postpartum, particularly a twofold risk of postnatal depression, even if they have not been in contact with psychiatric services during pregnancy. However, this epidemiologically representative sample has better parenting outcomes than has been previously reported for specialist treated cases. Liaison between all professionals involved in the care of mothers with psychotic disorders during and after pregnancy is essential to optimise care for them and their families.

Adolescent↗
PubMed2001

A preliminary study of the impact of long-term psychotic disorder on patients' families.

OBJECTIVE: To assess impact of long term psychotic disorders on caregivers. DESIGN: A questionnaire based, interviewer administered, cross-sectional survey using the translated version of a Burden Assessment scale (BAS). SETTING: Outpatient clinic of the University Psychiatry Unit, National Hospital, Sri Lanka. SAMPLE: 50 caregivers of patients suffering from psychotic disorders for more than 2 years. MEASUREMENTS: The BAS was administered to 50 caregivers to assess degree of distress and domains of concerns. RESULTS: 60% of caregivers felt very anxious and depressed. 54% experienced a financial decline, and 82% felt responsible for meeting the entire financial needs of the patient. 54% felt that their workload increased due to the illness. 58% of the caregivers were parents. CONCLUSIONS: Caregivers of patients with long term psychotic disorders are distressed, and have several concerns. Interventions focused on these will relieve the distress of caregivers and help patients. A majority of caregivers are parents. This has future implications, as many patients are not capable of independent living.

Caregivers↗
PubMed1999

A survey of contact with offspring and assistance with child care among parents with psychotic disorders.

To help improve services for parents with psychotic disorders, patients with such disorders in three treatment agencies in Queensland, Australia, were surveyed about whether they were parents, how much contact they had with their offspring, and who provided assistance with child care. Of the 342 individuals with psychotic disorders who participated in the study, 124 were parents. Forty-eight parents in the study had children under age 16, and 20 of these parents (42 percent) had their children living with them. Most parents relied on relatives or friends for assistance with child care. Barriers to child care services identified by parents were inability to pay, lack of local services, and fear of losing custody of children.

Adult↗