Questions Is a polygenic score for schizophrenia associated with response to lithium in patients with bipolar affective disorder, and, if so, what are the molecular drivers of this association?. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
This cohort study investigated neighborhood-level factors associated with first-episode psychosis in a predominantly rural population in the East of England.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Open access. People with severe mental illnesses, including psychosis, have an increased risk of cardiovascular disease. We aimed to evaluate the effects of a primary care intervention on decreasing total cholesterol concentrations and cardiovascular disease risk in people with severe mental illnesses.
The authors sought to describe patterns of health care use prior to first diagnosis of a psychotic disorder in a population-based sample.. Login at top right hand side of page using your SSSFT NHS OpenAthens for full text. SSOTP- Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Commentary on: Roffman JL, Petruzzi LJ, Tanner AS, et al. Biochemical, physiological and clinical effects of l-methylfolate in schizophrenia: a randomized controlled trial. Mol Psychiatry 2017 (Epub ahead of print: 14 Mar 2017).. To read the full article, log in using your NHS OpenAthens details.
People with schizophrenia are at risk of receiving poorer end of life care than other patients. They are often undertreated, avoid treatment and are about half as likely to access palliative care. There are limited options for end of life care for this under-serviced group in need. This study aims to address the paucity of research by documenting possible need, experiences of health care service use and factors affecting palliative care use for people with schizophrenia who have advanced life limiting illness.
Open Access Article
This study compared hospital admission rates among adult patients with schizophrenia who switched to antipsychotic monotherapy with lurasidone or quetiapine.
Speech recognition under noisy “cocktail-party” environments involves multiple perceptual/cognitive processes, including target detection, selective attention, irrelevant signal inhibition, sensory/working memory, and speech production. Compared to health listeners, people with schizophrenia are more vulnerable to masking stimuli and perform worse in speech recognition under speech-on-speech masking conditions. Although the schizophrenia-related speech-recognition impairment under “cocktail-party” conditions is associated with deficits of various perceptual/cognitive processes, it is crucial to know whether the brain substrates critically underlying speech detection against informational speech masking are impaired in people with schizophrenia.
The aim was to synthesize recent evidence on schizophrenia illness experience and outcomes and models of care in low and middle-income countries (LMICs). . SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Drugs have been extensively prescribed for the treatment of psychotic symptoms in schizophrenia and related disorders, as well as for the management of psychotic features in delirium, dementia and affective disorders. The aim of this narrative review is to focus on the recent literature on drug treatment in women with psychosis at the transition to menopause and subsequently. . SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Editorial.. To read the full article, log in using your MPFT NHS OpenAthens details. SSOTP (legacy account) - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Negative ‐self and ‐others core schemas have been implicated in the development and maintenance of psychotic experiences. One component of the self‐system is gender‐role strain (GRS; perceived discrepancy between actual self and gender‐role norms). Although the role of gender in the formation of core schemas has been underscored in social and developmental psychology literatures, GRS has not been investigated in relation to psychosis. We examined whether it might be associated with negative schemas and psychotic experiences in women consistent with the trend toward sex‐ and gender‐based analysis (SGBA) in health research.. To read the full article, log in using your MPFT NHS OpenAthens details. SSOTP (legacy account) - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Question Are substance use disorders, in particular cannabis use disorders, associated with conversion from schizotypal disorder to schizophrenia?
Findings In this Danish nationwide, register-based cohort study that identified 2539 participants with incident schizotypal disorder, any substance use disorder was associated with conversion to schizophrenia at a rate of 33.1%; for cannabis use disorders, the conversion rate was 58.2%. Results were statistically significant after controlling for confounders.
Meaning Universal and substance-targeted prevention efforts are needed to reduce conversion to schizophrenia in individuals with schizotypal disorder.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Cognitive impairment in schizophrenia is highly disabling and remains one of the major therapeutic challenges. Agomelatine (AGO), an agonist at melatonergic MT1/MT2 receptors and antagonist at 5-HT2C receptors, increases dopamine and norepinephrine in the prefrontal cortex and may therefore have the potential of improving neurocognition in patients with schizophrenia.. MPFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Acutely occurring, life-threatening side-effects of antipsychotic drugs might contribute to the reduced life expectancy observed in patients with severe mental disorders. We aimed to assess this hypothesis by doing a systematic review and meta-analysis of deaths occurring in placebo-controlled trials of antipsychotic drugs.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Open access. A preregistered systematic review of poststroke psychosis examining clinical characteristics, prevalence, diagnostic procedures, lesion location, treatments, risk factors and outcome. Neuropsychiatric outcomes following stroke are common and severely impact quality of life. No previous reviews have focused on poststroke psychosis despite clear clinical need.
Commentary on : Bergman H, Walker DM, Nikolakopoulou A, et al. Systematic review of interventions for treating or preventing antipsychotic-induced tardive dyskinesia. Health Technol Assess 2017;21:1-218.
What is already known on this topic
Tardive dyskinesia (TD) is a relatively frequent side effect of long-term use of antipsychotics and there is conflicting evidence if the incidence of TD is lower with second-generation antipsychotics (excluding clozapine), compared with first-generation antipsychotics. Until now there is no evidence-based algorithm to prevent or to treat TD.
Do 7-year-old children at familial high risk of schizophrenia spectrum disorders or bipolar disorder have neurocognitive impairments, and how do their neurocognitive profiles differ?. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Aerobic exercise – any activity that gets your heart pumping harder – improves mood, anxiety and memory. It can help people with major depressive disorder, bipolar disorder and anxiety disorder. Now there’s evidence, from a randomised controlled trial published in Frontiers in Psychiatry, that a programme of regular aerobic exercise also reduces psychopathology in people diagnosed with schizophrenia. And it seems to have a particular impact on so-called “negative” symptoms, such as apathy and loss of emotional feeling, which are not improved by standard drug treatments.
The Metacognitions Questionnaire‐30 (MCQ‐30) has been used to assess metacognitive beliefs in a range of mental health problems. The aim of this study is to assess the validity of the MCQ‐30 in people at risk for psychosis.. To read the full article, log in using your MPFT NHS OpenAthens details. SSOTP (legacy account) - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Treatment with most antipsychotics is associated with an increased risk of weight gain and metabolic disturbances. In a randomized trial, we previously demonstrated that 16 weeks of glucagon‐like peptide‐1 receptor agonist liraglutide treatment vs. placebo significantly reduced glucometabolic disturbances and body weight in prediabetic, overweight/obese schizophrenia‐spectrum disorder patients treated with clozapine or olanzapine. The aim of this study was to investigate whether the beneficial effects of the 16‐week intervention were sustained beyond the intervention period.. To read the full article, log in using your MPFT NHS OpenAthens details.
Conclusions: In the first study of its kind, early psychosis service users’ were largely positive about the potential use of DHIs [digital health interventions] supporting and managing mental health. Overall, service users felt that DHIs were a progressive, modern, and relevant platform for health care delivery. Concerns were expressed around privacy and data security and practical barriers inherent within DHIs, all of which require further attention
This study examines if YKL‐40 is increased in individuals with psychotic disorders and if elevated YKL‐40 levels at baseline is associated with subsequent development of type 2 diabetes.. To read the full article, log in using your MPFT NHS OpenAthens details.
Open access. This study determined the effects of a novel combination of vitamin D and probiotic on metabolic and clinical symptoms in chronic schizophrenia.
Numerous studies confirm the coping difficulties of people diagnosed with schizophrenia spectrum disorder, especially those with limited social support. Further, the coping process is itself poorly understood. AIM: Starting from a conceptualization of the adaptation of Roy's model, the aim of this study is to describe the coping process of people with schizophrenia spectrum disorder in the context of an inadequate social support.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
The experience of pre‐onset sub‐threshold psychotic symptoms (STPS, signifying a clinical high‐risk state) in first episode psychosis (FEP) predicts poorer outcomes during treatment, possibly through differential adherence to medication. We explored whether adherence differs between FEP patients with and without pre‐onset STPS.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Open access. Primary brain calcification (PBC), a neurodegenerative disorder with characteristic calcium deposits in the basal ganglia and other brain areas, typically presents with various neurological and psychiatric symptoms in the fourth or fifth decade of life or later. We present the case of a patient with psychiatric manifestations much earlier than usual, in the second decade of life.
Cortical thickness reductions in schizophrenia are irregularly distributed across multiple loci. The authors hypothesized that cortical connectivity networks would explain the distribution of cortical thickness reductions across the cortex, and, specifically, that cortico-cortical connectivity between loci with these reductions would be exceptionally strong and form an interconnected network. This hypothesis was tested in three cross-sectional schizophrenia cohorts: first-episode psychosis, chronic schizophrenia, and treatment-resistant schizophrenia.. Login at top right hand side of page using your MPFT NHS OpenAthens for full text.
Commentary. People with severe mental illness have higher mortality rates, culminating in about 20 years of lost life compared with that of the general population, and momentum is growing to reduce this inequality.1, 2 In the general population, neighbourhood social context is related to mortality, but whether such patterns also exist for people with severe mental illness has received little attention. Understanding this relationship could allow us to tailor social interventions for this distinctive population. The study by Jayati Das-Munshi and colleagues3 in The Lancet Psychiatry represents a welcome step in that direction, linking higher neighbourhood ethnic density to lower mortality rates among people with severe mental illness from ethnic minority backgrounds. These results raise the intriguing possibility that factors associated with ethnic density might promote longevity among people with severe mental illness.. Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
It is salutary to recall that schizophrenia was generally regarded as a functional psychosis, rather than an organic psychosis like dementia, at that time, about 30 years ago. One implication of this diagnostic dogma was that the brain was not expected to look structurally (organically) abnormal in schizophrenia. The first CT studies generated intense controversy by providing disruptive evidence for significant enlargement of the ventricles (1). It is a measure of the theoretical impact of neuroimaging in psychiatry that the prior concept of functional psychosis has been largely abandoned in the face of overwhelming evidence of structural brain imaging abnormalities in schizophrenia. It is now beyond reasonable doubt that the brain does not look structurally normal in schizophrenia, but it remains an open question how best to characterize and interpret the abnormalities disclosed by contemporary MRI research. Login at top right hand side of page using your MPFT NHS OpenAthens for full text.
To explore the temporal dynamic of antidepressant and antipsychotic co‐prescribing in real‐life conditions.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To quantify the risk of hip fracture, thromboembolism, stroke, myocardial infarction,pneumonia, and sudden cardiac death associated with exposure to antipsychotics.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Psychotic symptoms may occur in any dementia, including Alzheimer’s disease (AD), but are particularly common in Lewy body dementia (LBD). The mechanisms of psychotic symptoms are largely unknown. Psychosis has been found to be associated with more severe AD and Lewy body pathology in patients with AD and cerebrovascular disease-related vasculopathy.1 One form of vascular pathology, cerebral amylod angiopathy (CAA), is defined as deposits of amyloid in the vessel walls that increase risk of haemorrhage and ischaemia. CAA contributes to neurodegeneration, but its relation to clinical symptoms and course in dementia is not fully understood.2. To read the full article, log in using your NHS OpenAthens details.
Comment. Many smokers and health-care providers believe that smoking can reduce stress and other symptoms related to poor mental health. In The Lancet Psychiatry, Jentien Vermeulen and colleagues 1 examined the self-medication hypothesis in a prospective cohort study of patients with a non-affective psychosis (n=1094), unaffected siblings (n=1047), and control participants (n=579).. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Researchers continue to build on findings from NIMH’s Recovery After an Initial Schizophrenia Episode (RAISE) program, which investigated the effectiveness of early intervention services for people experiencing first episode psychosis. Two recent studies add to the evidence that team-based early intervention services are feasible in real-world health care settings and result in improved outcomes for patients.
Taking part in regular physical activity is linked to a more positive outlook on general health in people with schizophrenia and bipolar disorder, according to a new report.
Psychological Medicine; Cambridge Vol. 49, Iss. 1, (Jan 2019): 32-48. DOI:10.1017/S0033291718002660
To identify factors which may help or hinder decision-making ability in people with psychosis, we did a systematic review and meta-analysis of their performance on the Iowa and Cambridge Gambling Tasks.. To read the full article, log in using your NHS OpenAthens details.
When each of us entered the field of clinical psychology/psychiatry, we were drawn to the complex and seemingly irrational symptoms displayed by patients with psychosis and their struggles to make sense of the world. These symptoms, which often involved bizarre ideas, were especially puzzling in patients who seemed otherwise intellectually intact. . Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Free access. Between 5% and 10% of people with psychosis will die by suicide, a rate which is 20–75 times higher than the general population. This risk is even greater in those not taking antipsychotic medication. We examined whether negative appraisals of psychotic experiences and negative metacognitive beliefs about losing mental control mediated a relationship between psychotic symptoms and suicidal ideation in this group.
Individualized metacognitive training (MCT+) is a novel psychotherapy that has been designed to specifically target delusional beliefs in people with psychosis. It works by developing an awareness of the implausible content of delusional beliefs, while also targeting the cognitive biases that contribute to their formation and maintenance. It was expected that MCT+ would lead to significantly greater reductions in delusional severity compared to a cognitive remediation (CR) active control condition. . Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
People with schizophrenia experience significant deficits in the kinds of empathic skills that are the foundation for interpersonal relationships. Researchers have speculated that deficits in empathic skills in schizophrenia may be related to disturbances in metacognition and heightened levels of personal distress. To explore this issue, this study examined whether better metacognition and reduced personal distress would be associated with improved performance on cognitive and affective empathy tasks.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Psychological Medicine; Cambridge Vol. 49, Iss. 1, (Jan 2019): 140-148. DOI:10.1017/S0033291718000600
Schizophrenia and autism spectrum disorder (ASD) are currently conceptualized as distinct disorders. However, the relationship between these two disorders has been revisited in recent years due to evidence that they share phenotypic and genotypic expressions. This study aimed to identify ASD traits in patients with schizophrenia, and to define their demographic, psychopathological, cognitive and functional correlates.. To read the full article, log in using your NHS OpenAthens details.
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The Altman Self‐Rating Mania Scale (ASRM) was originally published in 1997 as a self‐rated measure aimed at assessing the severity of manic symptoms [1]. The published ASRM consists of the following five symptom items: i) elevated mood, ii) Increased self‐esteem, iii) decreased need for sleep, iv) pressured speech, and v) psychomotor agitation, which are rated by the patients via endorsement of one of five statements ranging from 0 (symptom not present) to 4 (symptom present in severe degree) [1].. To read the full article, log in using your MPFT NHS OpenAthens details.
Digital health interventions present an important opportunity to improve health care for people with psychosis or bipolar disorder, but despite their potential, integrating and implementing them into clinical settings has been difficult worldwide. This Review aims to identify factors affecting implementation of digital health interventions for people affected by psychosis or bipolar disorder.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Social and occupational impairments contribute to the burden of psychosis and depression. There is a need for risk stratification tools to inform personalized functional-disability preventive strategies for individuals in at-risk and early phases of these illnesses.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Psychological Medicine; Cambridge Vol. 49, Iss. 3, (Feb 2019): 412. DOI:10.1017/S0033291718001010
Background
In patients with schizophrenia, distributed abnormalities are observed in grey matter volume. A recent hypothesis posits that these distributed changes are indicative of a plastic reorganisation process occurring in response to a functional defect in neuronal information transmission. We investigated the structural covariance across various brain regions in early-stage schizophrenia to determine if indeed the observed patterns of volumetric loss conform to a coordinated pattern of structural reorganisation.. To read the full article, log in using your NHS OpenAthens details.
The authors created normative growth charts of amygdala functional connectivity in typically developing youths, assessed age-associated deviations of these trajectories in youths with psychosis spectrum disorders, and explored how these disruptions are related to clinical symptomatology.. Login at top right hand side of page using your MPFT NHS OpenAthens for full text.
The study, funded by the MRC and published in Nature Communications, suggests that being genetically programmed to rise early may lead to greater well-being and a lower risk of schizophrenia and depression. However, despite much previous speculation, the results did not reveal any strong links to diseases such as diabetes or obesity.
Open access. Cardiometabolic health significantly impacts on the mortality of people with severe mental illness. Clozapine has the greatest efficacy for Treatment Resistant Schizophrenia (TRS) but the greatest negative impact on cardiometabolic health. Balancing the risks and benefits of treatment, dignity, autonomy, liberty, mental and physical health can be challenging, particularly when imposing interventions with potentially life threatening adverse events, such as clozapine. We describe the successful administration of clozapine in the face of myocardial infarction, pulmonary embolism and hyperlipidaemia resulting in the termination of long-term seclusion for a gentleman with TRS in high secure psychiatric services.
Holt et al show that a lifestyle intervention did not reduce weight in people with schizophrenia. The STEPWISE trial casts a critical focus on the challenges of improving physical health in people with schizophrenia. The trial underpins efforts to maintain momentum in overcoming the unacceptable health inequalities in this population.. To read the full article, log in using your MPFT NHS OpenAthens details.
Open access. Oculomotor dysfunction is one of the most replicated findings in schizophrenia. However the association between saccadic abnormalities and particular clinical syndromes remains unclear. The assessment of saccadic movements in schizophrenia patients as well as in clinical high-risk state for psychosis individuals (CHR) as a part of schizophrenia continuum may be useful in validation of saccadic movements as a possible biomarker.
Immune dysregulation has been suggested as a pathophysiological pathway in schizophrenia. MRI could aid in investigating this pathological process in more detail. This review aims to provide an overview of recent MRI findings of immune dysregulation in schizophrenia. In addition, we discuss the potential of more recently developed MRI techniques.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
To better understand the overall burden of schizophrenia, we aimed to explore informal caregivers’ experiences by evaluating the current evidence on caregiver and patient characteristics, the type of care provided by caregivers, and the impacts of caregiving on caregivers’ lives.
Psychiatric Rehabilitation Journal (Apr 4, 2019). DOI:10.1037/prj0000353
Objective: Voice-hearers tend to face a high degree of stigma that can impact subjective well-being and social functioning. However, researchers have hypothesized that the content of the voice-hearing experience and its cultural context are relevant to stigma responses. This study experimentally tested how perceptions of voice-hearing experiences change as a function of the voice’s content and the perceiver’s characteristics.. To read the full article, log in using your NHS OpenAthens details.
Psychiatric Rehabilitation Journal (Mar 28, 2019). DOI:10.1037/prj0000352
Objective: Examine preferences for family involvement in psychiatric care in a large, representative sample of veterans in treatment for schizophrenia.. To read the full article, log in using your NHS OpenAthens details.
Editorial. As someone who has studied the behavioral and neurological effects of intensive, targeted auditory training in schizophrenia and who confronts the realities of cognitive dysfunction weekly in my clinical work with patients, I find myself having three different responses to this article. My first response, that of a clinical trialist, is admiration: this really is an elegant and well-conducted study. My second response, that of a clinician, is excitement mingled with impatience: more than 25 years ago, Michael Green (2) challenged us in this very journal to make cognitive remediation a standard treatment for schizophrenia. So why is it taking us so long to get there? And my third response, that of a researcher, includes questions about the perceptual training component of this study and what conclusions we can draw, if any, regarding the usefulness (or nonusefulness) of addressing lower-level sensory processing deficits in schizophrenia spectrum disorders...... Login at top right hand side of page using your MPFT NHS OpenAthens for full text.
Open access. Psychological Medicine; Cambridge Vol. 49, Iss. 13, (Oct 2019): 2186-2196. DOI:10.1017/S0033291718003057
Background
Converging lines of evidence implicate an important role for the immune system in schizophrenia. Microglia are the resident immune cells of the central nervous system and have many functions including neuroinflammation, axonal guidance and neurotrophic support. We aimed to provide a quantitative review of in vivo PET imaging studies of microglia activation in patients with schizophrenia compared with healthy controls.
Open access. Disturbances in trait emotions are a predominant feature in schizophrenia. However, less is known about (a) differences in trait emotion across phases of the illness such as the clinical high-risk (CHR) phase and (b) whether abnormalities in trait emotion that are associated with negative symptoms are driven by primary (i.e. idiopathic) or secondary (e.g. depression, anxiety) factors.
Open access. There are high rates of obesity and low self-esteem in patients with psychosis. The occurrence of negative voice content directly about appearance is therefore plausible. Derogatory comments about appearance are likely to be distressing, increase depression and contribute to social withdrawal.
Open access. Suicide is a leading cause of premature death in people with a diagnosis of schizophrenia. Although exposure to stressors can play a part in the pathways to death by suicide, there is evidence that some people with a diagnosis of schizophrenia can be resilient to the impact of suicide triggers.
The cerebellum is involved in cognitive processing and emotion control. Cerebellar alterations could explain symptoms of schizophrenia spectrum disorder (SZ) and bipolar disorder (BD). In addition, literature suggests that lithium might influence cerebellar anatomy. Our aim was to study cerebellar anatomy in SZ and BD, and investigate the effect of lithium. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To examine the long‐term (up to 10 years) patterns related to cannabis use in a sample of patients with first episode of psychosis (FEP) and the effect that consumption might have on clinical, functioning, and neurocognition at long‐term.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Contrary to the assertion of Paris, diverse indicators suggest that the diagnosis and treatment of dissociative identity disorder (DID) are resurgent rather than retreating. This commentary reviews the evidence that justifies the description of this condition as controversial, including research into dissociative amnesia. The potential harm that can result from a diagnosis of DID and risky treatment techniques, including hypnosis and abreaction, are described. It is suggested that this scientifically unproven and potentially harmful treatment model should be confronted and quelled and its diagnosis and treatment subjected to critical clinical review, including randomised controlled trials, as a matter of urgency. A plea is made for the Royal College of Psychiatrists to update its 1997 guidance document and for professional training to incorporate updated psychological and neurobiological research on human memory.. To read the full article, log in using your MPFT NHS OpenAthens details.
Psychosis is a complex presentation with a wide range of factors contributing to its development, biological and environmental. Psychosis is a feature present in a variety of psychiatric disorders. It is important for clinicians to keep up to date with evidence regarding current understanding of the reasons psychosis may occur. Furthermore, it is necessary to find clinical utility from this knowledge so that effective primary, secondary and tertiary preventative strategies can be considered. This article is the first of a three-part series that examines contemporary knowledge of risk factors for psychosis and presents an overview of current explanations. The articles focus on the psychosis risk timeline, which gives a structure within which to consider key aspects of risk likely to affect people at different stages of life. In this first article, early life is discussed. It covers elements that contribute in the prenatal and early childhood period and includes genetic, nutritional and infective risk factors.. To read the full article, log in using your MPFT NHS OpenAthens details.
The ability to think about future events serves a range of important functions. People with schizophrenia show impairments in future thinking. However, whether these impairments are specific to positive or negative events and to what extent they are associated with impairments in verbal fluency and autobiographical memory remains poorly understood.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
In schizophrenia, the anterior hippocampus is hyperactive and shows reduced task-related recruitment, but the relationship between these two findings is unclear. The authors tested the hypothesis that hyperactivity impairs recruitment of the anterior hippocampus during scene processing.. Login at top right hand side of page using your MPFT NHS OpenAthens for full text.
Schizophrenia is characterized by impaired social interactions and altered trust. In the general population, trust is often based on facial appearance, with limited validity but enormous social consequences. The aim was to examine trust processing in schizophrenia and specifically to examine how people with schizophrenia use facial appearance as well as actual partner fairness to guide trusting decisions.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Antipsychotics may increase serum prolactin, which has particularly been observed with risperidone. Further, hyperprolactinemia has been linked to osteoporosis‐related fractures. Therefore, we investigated fracture risk in a nationwide cohort exposed to antipsychotics.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Clozapine is the only antipsychotic that is effective in treatment-resistant schizophrenia. However, in certain clinical situations, such as the emergence of serious adverse effects, it is necessary to discontinue clozapine. Stopping clozapine treatment poses a particular challenge due to the risk of psychotic relapse, as well as the development of withdrawal symptoms. Despite these challenges for the clinician, there is currently no formal guidance on how to safely to discontinue clozapine. We assessed the feasibility of developing evidence-based recommendations for (1) minimizing the risk of withdrawal symptoms, (2) managing withdrawal phenomena, and (3) commencing alternatives treatment when clozapine is discontinued. To read the full article, log in using your MPFT NHS OpenAthens details.
Cognitive impairment in schizophrenia predicts functional outcomes and is largely unresponsive to pharmacology or psychotherapy; it is thus a critical unmet treatment need. This article presents the impact of remotely completed, intensive, targeted auditory training (AT) vs control condition computer games (CG) in a double-blind randomized trial in young adults with recent-onset schizophrenia. To read the full article, log in using your MPFT NHS OpenAthens details.
Indicated prevention in young people at Clinical High Risk for Psychosis (CHR-P) originated in Australia more than 20 years ago1 and subsequently impacted national and international clinical guidelines2 and diagnostic manuals.3 While the most recent umbrella reviews (reviews of meta-analyses) demonstrated substantial achievements in detection and prognostic assessment of young CHR-P individuals,4 the most updated network meta-analysis found no robust evidence to favor cognitive behavioral therapy (CBT) compared with the control condition (ie, needs-based interventions) To read the full article, log in using your MPFT NHS OpenAthens details.
This research suggests that contrary to popular opinion delaying exposure to cannabis does not appear to reduce the chances of using more of the drug as an older teenager. However, it does suggest that there does not appear to be a strong relationship between developing psychosis as a trigger to stop using cannabis. Again, this won’t come as a surprise to those working with this age group in the mental health or drug field as they will have witnessed this with the young people they encounter as part of their work.
Personal recovery literature has been influential in the conceptualisation of emotional distress and service provision. While personal recovery in psychosis has been well-studied, voice hearing literature has not been reviewed to elucidate recovery processes. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
A consensus definition of clinical recovery in first-episode psychosis (FEP) is required to improve knowledge about recovery rates in this population. To propose criteria for a future consensus definition, this study aims to investigate rates of clinical recovery when using a standard definition (full psychotic symptom remission and adequate functioning for minimum one year) across both affective and nonaffective FEP groups (bipolar spectrum and schizophrenia spectrum disorders).
VR may be an effective environment for psychosis patients with agoraphobia. Although patients are aware that VR environments are not real, they very closely match real-world experiences and allow for greater engagement with treatment (Lambe et al., 2020). Psychosis patients are more likely to enter situations within VR that they would otherwise find incredibly distressing in the real world and this allows a safe space for experimentation (Lambe et al., 2020).
The risk of psychosis hospitalization was lower during antidepressant use as compared to non-use (adjusted Hazard Ratio, aHR, 0.93, 95% CI 0.92–0.95). Antidepressants were associated with a decreased risk of mortality (aHR 0.80, 95% CI 0.76–0.85) and a slightly increased risk of non-psychiatric hospitalization (aHR 1.03, 95% CI 1.01–1.06). In conclusion, these results indicate that antidepressants might be useful and relatively safe to use in this population.
Ultra-high risk (UHR) is considered a forerunner of psychosis, but most UHR individuals do not later convert, yet remain symptomatic, disabled and help-seeking. Thus, there is an increased recognition of the UHR phenotype as a syndrome in itself, rather than merely a risk syndrome. It is therefore essential to investigate outcomes other than transition to psychosis. For this purpose, perceptual aberration appears to be a distinct, as well as a stable and less state-specific vulnerability indicator. We aimed to investigate perceptual aberration and associations with functional, neuro and social cognitive risk factors in an UHR sample.
There are communities in which hearing voices frequently is common and expected, and in which participants are not expected to have a need for care. This paper compares the ideas and practices of these communities. We observe that these communities utilize cultural models to identify and to explain voice-like events—and that there are some common features to these models across communities......To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This study examines associations between premorbid adjustment and comorbid disorders in individuals at ultra-high risk (UHR) for psychosis. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
To quantify CVD-R in people diagnosed with early psychosis and profile their obesity prevalence, lifestyle behaviours and QOL. Secondary aim was to explore associations between lifestyle behaviours/treatment characteristics and CVD-R/QOL.
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This study evaluated the relationship between negative symptoms, daily time use (productive/non-productive activities, PA/NPA), and negative emotions in schizophrenia-spectrum disorders (SSDs): 618 individuals with SSDs (311 residential care patients [RCPs], 307 outpatients) were surveyed about socio-demographic, clinical (BPRS, BNSS) and daily time use (paper-and-pencil Time Use Survey completed twice/week) characteristics.
Based on a number needed to assess (NNA) of 18 for clinically relevant abnormalities, Blackman et al. (2023) conclude that their findings “support the use of MRI as part of the initial clinical assessment of all patients with FEP.” However, due to the authors’ liberal definition of clinical relevance together with the exclusion of patients with a suspected non-psychiatric cause of psychosis in most of the included studies, it remains debatable whether routine screening is warranted for all patients with FEP. Given recent evidence about the prevalence of autoimmune encephalitis as a potential cause of FEP (Scott et al., 2018), there may be other diagnostic procedures that are better warranted than routine neuroimaging in FEP depending on clinical presentation.
This study is important because it raises awareness of available resources, such as HVGs and peer support, from which people who hear voices can access care outside mental health services. The findings can be used to inform further training for professionals working in secondary care mental health services (i.e., CMHTs) and/or those supporting people who hear voices. Healthcare professionals should be aware of the benefits of HVGs and other groups and encourage collaborations between HVGs and the NHS (i.e., via signposting or community referrals).
This study aimed to investigate the relationship between cytokines levels, clinical symptoms and cognitive impairments in CR-TRS patients, both with and without MetS. Open access article - no login required
This study adds epidemiological weight to the implementation of health maintenance strategies and risk management procedures to reduce the risk of violent outcomes in individuals with mental health disorders (specifically, substance use disorder, psychosis, and ‘personality disorders’). The findings highlight how experiences of victimisation and perpetration are more often comorbid, with experiences of both victimisation and perpetration more common than an experience of only one of the outcomes.
Open access. Social networks of patients with psychosis can provide social support, and improve health and social outcomes, including quality of life. However, patients with psychosis often live rather isolated with very limited social networks. Evidence for interventions targeting symptoms or social skills, are largely unsuccessful at improving social networks indirectly. As an alternative, interventions may directly focus on expanding networks. In this systematic review, we assessed what interventions have previously been tested for this and to what extent they have been effective.
The objectives of this study were to (1) analyze the prevalence of diabetes, prediabetes, and antidiabetic medication in patients with psychosis compared with control subjects and (2) determine what factors in patients with psychosis were associated with antidiabetic medication. Open Access Article
Mental Elf Blog post. Our limited understanding of the molecular basis of schizophrenia has restricted our ability to apply research findings in the clinic.
Antipsychotics are the mainstay of treatment, but they have low success rates (~60%), disabling adverse effects, damaging impact on physical health, and poor patient outcomes following ineffective treatment are well documented in the literature. The authors of a new paper published last month in npj Schizophrenia (Martins-de-Souza et al, 2015) examine the effects of antipsychotics on the blood plasma profile of 58 acutely ill schizophrenia patients who were either antipsychotic naive (n=23) or antipsychotic free for >6 weeks (n=35).