It is clear from the results that participants were uncertain about how to support their family members with reducing or stopping antipsychotics and the harms and benefits of doing so. Thus, it might be beneficial for clinicians to provide family members with sufficient information about the above, so they can make an informed decision about the best options for support. Continued monitoring might ensure that the family member does not need to increase their dosage, change antipsychotics, or take antipsychotics again.
Youth at clinical high risk (CHR) for psychosis have high rates of early life trauma, but it is unclear how trauma exposure impacts later negative symptom severity in CHR. The current study examined the association between early childhood trauma and the five domains of negative symptoms (anhedonia, avolition, asociality, blunted affect, alogia).
Early intervention in people with an at-risk mental state (ARMS) for psychosis can prevent the onset of psychosis. Clinical guidelines recommend that ARMS are referred to triage services, and then to Early Intervention (EI) teams in secondary care for assessment and treatment. However, little is known about how ARMS patients are identified and managed in UK primary and secondary care. This study explored patients' and clinicians' views of ARMS patients' care pathways.
Schizophrenia onset in the developmental age has a strong neurodevelopmental burden and is associated with a poorer prognosis. The approach to diagnosis is still based on symptomatic description without objective validation. In this study, we aimed to compare the peripheral blood levels of hypothesized biomarker proteins: brain-derived neurotrophic factor (BDNF), proBDNF, p75 neurotrophin receptor (p75NTR) and S100B between early-onset schizophrenia-spectrum adolescents (n = 45) and healthy controls (n = 34). To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
For people living with psychosis, cognitive impairment is common and can have significant impacts for functional recovery, impacting engagement with treatment and quality of life more broadly. There is now strong evidence for the effectiveness of cognition-focused treatments, such as cognitive remediation to improve clinical and functional outcomes for people with psychosis. However, engagement with treatment has been a long-standing issue in mental health care, including for people with psychosis, who often experience difficulties with motivation. While research on clinical effectiveness of cognition-focused treatment is growing, to date there has been little research focused on the implementation of such treatments and it is not clear how best to support uptake and engagement across diverse mental health settings
Childhood-onset schizophrenia (COS) is a rare and severe form of schizophrenia with an estimated prevalence of 1/10,000. Schizophrenia and Autism spectrum disorder (ASD) have shared phenotypic features and shared genetic etiology. There is growing research surrounding the co-occurrence of psychomotor syndromes like catatonia with neurodevelopmental disorders like ASD or psychiatric disorders like schizophrenia. In 2013, Shorter and Wachtel described a phenomenon of the ‘Iron Triangle’ where COS, ASD, and catatonia often co-occur. The Iron Triangle theory is based on observation of historical case literature, which showed that all three diagnoses in the Iron Triangle were routinely assigned to children and adolescents. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
To review and evaluate the evidence from meta-analytic studies of psychosocial and behavioural interventions for the negative symptoms of schizophrenia. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Cannabis is used by one third of youth in Early Psychosis Intervention (EPI) programs and high dose consumption of the primary constituent Δ-9 tetrahydrocannabinol (THC) is associated with higher risk for relapse in this group. Cannabidiol (CBD) is a secondary cannabis constituent that may have antipsychotic properties, though its health risks are only beginning to be understood. Little is known about the views of youth in EPI programs toward CBD, including their reasons for use and perceptions of risk.
Suicide risk is elevated among individuals at clinical high risk for psychosis (CHR-P). The current study examined variability in suicidal ideation during treatment for individuals at CHR-P.
Consistent with the current literature, this study indicates that standard antipsychotic dosing is best for relapse prevention. Clinicians should resist the urge to utilise low-dose antipsychotic therapy in the early years of schizophrenia requiring hospitalisation.
The authors investigated transitions to schizophrenia spectrum or bipolar disorder following different types of substance-induced psychosis and the impact of gender, age, number of emergency admissions related to substance-induced psychosis, and type of substance-induced psychosis on such transitions. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Disengagement from Early Intervention in Psychosis (EIP) services is pronounced in individuals from racially minoritized or diverse ethnic backgrounds, lesbian, gay, bisexual, transgender, and queer or questioning individuals, and individuals from some religious or spiritual backgrounds. The Early Youth Engagement in first episode psychosis study (EYE-2) is a cluster randomized controlled trial that tests a new engagement intervention.
Psychosis spectrum disorders continue to rank highly among causes of disability. This has resulted in efforts to expand the range of treatment targets beyond symptom remission to include other recovery markers, including social and occupational function and quality of life. Although the efficacy of psychosocial interventions in early psychosis has been widely reported, the acceptability of these interventions is less well-known. This study explores the participant perspective on a novel, psychosocial intervention combining cognitive remediation and social recovery therapy.
New-onset psychosis is always disconcerting and alarming for patients, families, and clinicians. Although some acute psychotic disorders are brief and resolve in a short period of time, others progress to schizophrenia or bipolar disorder and have a long-term impact on people’s mental health and quality of life. Substance-induced psychotic disorders are brief psychotic syndromes triggered by substance use that persist for days or weeks after intoxication has resolved. Abundant evidence suggests that individuals presenting to mental health services with substance-induced psychotic disorders have a significant risk of later transition to schizophrenia or, more zgenerally, to a chronic psychotic disorder. A recent meta-analysis (1) of 25 studies providing substance-specific estimates of transition to schizophrenia spectrum disorders among more than 34,000 individuals with substance-induced psychotic disorder estimated a pooled transition rate of 25% across all substances, with differential rates depending on the substance.
Prospection refers to the ability to simulate and pre-experience future events. Schizophrenia patients have difficulty in anticipating pleasure in future events, but previous studies examined prospection deficits in chronic schizophrenia patients. This study aimed to investigate prospection deficits in first-episode schizophrenia patients.
Syntax, the grammatical structure of sentences, is a fundamental aspect of language. It remains debated whether reduced syntactic complexity is unique to schizophrenia spectrum disorder (SSD) or whether it is also present in major depressive disorder (MDD). Furthermore, the association of syntax (including syntactic complexity and diversity) with language-related neuropsychology and psychopathological symptoms across disorders remains unclear.
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.
Medication adherence of schizophrenic patients is a growing public health problem. We conducted a meta-analysis on the influencing factors of medication compliance in schizophrenic patients.
Although clozapine is the most efficacious medication for treatment-refractory schizophrenia, not all patients will have an adequate response. Optimising clozapine dose using therapeutic drug monitoring could therefore maximise response. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Negative symptoms are core symptoms of schizophrenia which are common throughout the course of the illness. We outline their functional impact, before reviewing the latest research and guidelines on their assessment and treatment. Finally, we discuss conceptual issues related to measurement of negative symptoms and approaches to address these. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.