What's it like to have schizoaffective disorder? Here, Alice describes her journey from being diagnosed and prescribed medication to starting talking therapy with the help of a friend.
Contrary to the notion that neurology but not psychiatry is the domain of disorders evincing structural brain alterations, it is now clear that there are subtle but consistent neuropathological changes in schizophrenia. These range from increases in ventricular size to dystrophic changes in dendritic spines. A decrease in dendritic spine density in the prefrontal cortex (PFC) is among the most replicated of postmortem structural findings in schizophrenia. Examination of the mechanisms that account for the loss of dendritic spines has in large part focused on genes and molecules that regulate neuronal structure. But the simple question of what is the effector of spine loss, ie, where do the lost spines go, is unanswered.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
It is generally believed that after the first episode of schizophrenia, the risk of relapse decreases with time in patients who are stabilized. Many treatment guidelines recommend that after stabilization, antipsychotic treatment should be continued for 1–5 years, and longer exposure should be avoided if possible. However, there is no published evidence to substantiate this view. The authors used nationwide databases to investigate this issue.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
Determining the extent to which relationships between duration of untreated psychosis (DUP) and outcome endure longitudinally across the lifetime course of psychotic illness requires prospective, systematic studies of epidemiologically representative incidence cohorts across decades. Transience, persistence, or heterogeneity in associations between DUP and distinct outcome domains are yet to be investigated over such time frames. To read the full article, log in using your MPFT NHS OpenAthens details.
At its re-birth 30 years ago, the neurodevelopment hypothesis of schizophrenia focussed on aberrant genes and early neural hazards, but then it grew to include ideas concerning aberrant synaptic pruning in adolescence. The hypothesis had its own stormy development and it endured some difficult teenage years when a resurgence of interest in neurodegeneration threatened its survival. In early adult life, it over-reached itself with some reductionists claiming that schizophrenia was simply a neurodevelopmental disease. However, by age 30, the hypothesis has matured sufficiently to incorporated childhood and adult adversity, urban living and migration, as well as heavy cannabis use, as important risk factors. Thus, it morphed into the developmental risk factor model of psychosis and integrated new evidence concerning dysregulated striatal dopamine as the final step on the pathway linking risk factors to psychotic symptoms. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
5-HT6 Receptor Antagonist as an Adjunct Treatment Targeting Residual Symptoms in Patients With Schizophrenia: Unexpected Sex-Related Effects (Double-Blind Placebo-Controlled Trial). 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.
My name is Zara, and my illness struck me at the tender age of 18 and carried on into my adult life. An illness like psychosis challenges your sense of self and how you relate to others and the world around you. I am now passionate about education around psychosis and extinguishing stigma. Here are some of the ways life is different after you've experienced psychosis.
Long-acting injectable antipsychotics (LAI) can optimize adherence for high-risk serious mental illness (SMI). This customized adherence-enhancement approach delivered by social worker interventionists was combined with LAI (CAE-L) of paliperidone palmitate for homeless, poorly adherent individuals with SMI. 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.
Case study. Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://bit.ly/1Xyazai
In the last couple of years, schizophrenia was often discussed as autoimmune disease. Several antibodies were suspected, but so far there has been no proof of Gamma-aminobutyric acid (GABA) receptor antibodies in patients with schizophrenia. Case presentation
In this case report we present a 21-year old woman with schizophrenic symptoms, who showed anti-GABAB1 antibodies when screened by a vast recombinant neurology mosaic on Human Embryonic Kidney Cells 293 (HEK293) cells. The young woman presented with various psychotic symptoms as well as speech and motor ataxia, with the neurological signs starting in childhood.
A Case of Mutism in Noncatatonic Schizophrenia Responding to Small Dose of Fluvoxamine Addition to Clozapine. You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Ritualistic behaviors are common in obsessive compulsive disorder (OCD), while catatonic stupor occasionally occurs in psychotic or mood disorders. Schizoaffective disorder is a specific mental disorder involving both psychotic and affective symptoms. The syndrome usually represents a specific diagnosis, as in the case of the 10th edition of the International Classification of Diseases (ICD-10) or the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, symptom-based diagnosis can result in misdiagnosis and hinder effective treatment. Few cases of ritualistic behaviors and catatonic stupor associated with schizoaffective disorder have been reported. Risperidone and modified electroconvulsive therapy (MECT) were effective in our case.
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.
Parents experiencing psychosis can face challenges in addition to those usually associated with being a parent, with their children at increased risk of negative outcomes. Although a strong evidence base has shown that family interventions for psychosis (FIp) can mitigate distress for adult relatives, techniques described in the systemic and parenting literature to facilitate the inclusion of children in family therapy are largely absent from the FIp literature and training. This study used a three‐round Delphi survey to investigate what experienced FIp clinicians consider to be best practice regarding the inclusion of children in parental FIp.. 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.
Identification of robust biomarkers that predict individualized response to antipsychotic treatment at the early stage of psychotic disorders remains a challenge in precision psychiatry. The aim of this study was to investigate whether any functional connectome-based neural traits could serve as such a biomarker. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
BPS blog post by Christian Jarrett. Hearing voices that don’t exist in the outside world is the most common form of hallucination experienced by people with a diagnosis of schizophrenia or related conditions and it can be very distressing. However, there is a growing recognition that hearing voices is not always pathological. Many mentally well people hear voices (or “auditory verbal hallucinations”) – in fact, around 6-7 per cent of adults in the general population report having had such experiences at some point in their lives.
This has led some experts to propose a “continuum model” in which the same fundamental underlying mechanism leads to hearing voices in healthy people and in patients with a clinical diagnosis, but that for various reasons, such as a traumatic past, the experience is more troublesome and distressing for the patients. However, a new open-access paper in Schizophrenia Bulletin challenges the continuum model, finding an important brain difference between patients who hear voices and voice-hearing healthy controls.
Blogpost. The message from recent surveys is that it’s not just people with a diagnosis of schizophrenia who hear voices in their heads, many people considered mentally well do to. This revelation may have a welcome de-stigmatising effect in terms of how people think about some of the symptoms associated with a diagnosis of schizophrenia, but a new study published in Psychosis asks us to hang on a minute – to say that one “hears voices” can mean different things to different people.
This study aimed to establish a prediction model of quetiapine concentration in patients with schizophrenia and depression, based on real-world data via machine learning techniques to assist clinical regimen decisions. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Most voice hearers report childhood trauma. Many voice hearers report comorbid post-traumatic stress symptoms and that the content of their voices (auditory verbal hallucinations) is directly (voices repeat phrases spoken by perpetrators) or indirectly (voice content and trauma is thematically similar) related to their trauma. The factors that maintain trauma-related voices are unknown, and there is limited research in this area. This study aimed to identify potential maintaining factors of trauma-related voices by reviewing models of post-traumatic stress disorder (PTSD) and positive symptoms of psychosis. Open access article- no login required
Negative symptoms are a primary cause of disability in schizophrenia for which there are no established pharmacotherapies. This study evaluated a novel psychosocial intervention that combined two evidence-based practices—motivational interviewing and cognitive-behavioral therapy (MI-CBT)—for the treatment of motivational negative symptoms. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Psychiatric Rehabilitation Journal Vol. 41, Iss. 2, (Jun 2018): 109-117.
Objective: There is a paucity of accessible, evidence-based tools for caregivers of individuals with schizophrenia. This study examines changes in the self-assessed and caregiver-assessed outcomes of people with schizophrenia after exposure to a cognitive adaptation training (CAT) guide that addressed pragmatic, in-home approaches to offset the cognitive impacts of the illness.. To read the full article, log in using your NHS OpenAthens details.
Open access. Studies analyzing concentration-effect relationships in second-generation antipsychotics have reported contradictory results in chronic schizophrenia. No data are available for the early stages of the disease. The present study aims to evaluate the association between a single olanzapine plasma concentration, clinical response, and severity of adverse effects in first-episode psychosis (FEP); to test the utility of various plasma breakpoints as markers of early response to treatment; and to identify variables affecting olanzapine concentrations.
Guidance on clozapine dosing in treatment-resistant schizophrenia is based largely on data from White young adult males. This study aimed to investigate the pharmacokinetic profiles of clozapine and N-desmethylclozapine (norclozapine) across the age range, accounting for sex, ethnicity, smoking status, and body weight. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The authors sought to characterize the symptoms of patients later hospitalized for psychotic disorders in primary mental health outpatient settings, and to investigate whether these symptoms can be used to predict later onset of psychotic illness. 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
The Internet and mobile technology are changing the way people learn about and manage their illnesses. Little is known about online mental health information seeking behaviour by people with psychosis. This paper explores the nature, extent and consequences of online mental health information seeking behaviour by people with psychosis and investigates the acceptability of a mobile mental health application (app).
Impaired ability to make inferences about what another person might think or feel (i.e., social cognition impairment) is recognised as a core feature of schizophrenia and a key determinant of the poor social functioning that characterizes this illness. The development of treatments to target social cognitive impairments as a causal factor of impaired functioning in schizophrenia is of high priority. In this study, we investigated the acceptability, feasibility, and limited efficacy of 2 programs targeted at specific domains of social cognition in schizophrenia: “SoCog” Mental-State Reasoning Training (SoCog-MSRT) and “SoCog” Emotion Recognition Training (SoCog-ERT).
Negative symptoms and cognitive impairments tend to co-occur in people with schizophrenia. If their association with each other is due, in part, to shared pathophysiology, then this suggests that a single drug could potentially be effective for both domains. The current study was designed to examine this hypothesis. 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.
Open access. Evidence is accumulating that Cognitive Remediation Training (CRT) is effective for ameliorating cognitive deficits experienced by patients with schizophrenia and accompanying functional impairment. There has been no randomized controlled trial of CRT using a nationally representative population of forensic patients, despite the significant cognitive deficits frequently present within this group.
Cognitive remediation is an efficacious treatment for schizophrenia. However, different theoretical approaches have developed without any studies to directly compare them. This is the first study to compare the two dominant approaches to cognitive remediation (training of executive skills and training of perceptual skills) and employed the broadest assessment battery in the literature to date. . Login at top right hand side of page using your MPFT NHS OpenAthens for full text.
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To compare service users’ length of stay, readmission rates and follow up within 7 days of discharge in a mental health Trust using an ICP to direct the care of people diagnosed with schizophrenia with a Trust using a non-ICP method of care planning in England. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
The question of whether there are significant changes in brain anatomy and function at illness onset and over the early course of schizophrenia is a crucial issue with broad implications for prognosis, patient care, and models of illness pathophysiology. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Psychological Medicine; Cambridge Vol. 48, Iss. 13, (Oct 2018): 2101-2115.
Considering existing knowledge on the relationship between certain environmental factors and incidence rates of psychosis, we carried out a systematic review to provide a broad and updated picture of the incidences of different psychotic disorder subgroups worldwide and how some environmental factors influence these rates.. To read the full article, log in using your MPFT NHS OpenAthens details.
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”.
Limited evidence exists regarding fitness-to-drive for people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder (herein simply referred to as ‘mental health conditions’). The aim of this paper was to systematically search and classify all published studies regarding driving for this population, and then critically appraise papers addressing assessment of fitness-to-drive where the focus was not on the impact of medication on driving.
To systematically review the published clinical trials, case series, and case reports on left unilateral (LUL) electrode placement for clinical electroconvulsive therapy (ECT). Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
This systematic review aimed to review neuroimaging studies comparing clozapine-resistant schizophrenia patients with clozapine-responding patients, and with first-line antipsychotic responding (FLR) patients.
Open access. Increasing attention to palliative care for the general population has led to the development of various evidence-based or consensus-based tools and interventions. However, specific tools and interventions are needed for people with severe mental illness (SMI) who have a life-threatening illness. The aim of this systematic review is to summarize the scientific evidence on tools and interventions in palliative care for this group.
Psychological Assessment (Sep 20, 2018). DOI:10.1037/pas0000645
Paranoia can be conceptualized as consisting of a hierarchy of cognitions, ranging from commonly experienced thoughts about less severe perceived threats, up to less common, persecutory thoughts about extreme threats, which are associated with distressing psychosis. This review systematically appraises self-report paranoia questionnaires validated for use among the general population; the type of paranoia assessed, measurement or psychometric properties, and subsequent validation with clinical samples are all considered.. To read the full article, log in using your NHS OpenAthens details.
Novel psychoactive substances (NPS) include synthetic drugs mimicking the effects of illicit drugs, e.g. synthetic cannabinoids, and herbs such as Salvia divinorum. NPS are substances that can trigger hallucinations and other effects altering the mind, and are currently uncontrolled by the United Nations' 1961 Narcotic Drugs/1971 Psychotropic Substances Conventions.
NPS affect brain chemistry that induces the psychoactive effects, such as hallucinations and feeling ‘high’. It is unknown what effects such drugs have on people with severe mental illness (i.e. psychotic illnesses). Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - http://bit.ly/1Xyazai
Pharmacological treatment is the criterion standard in delusional disorder (DD). No second-generation antipsychotic (SGA) is specifically authorized for the treatment of DD. 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.
Open access. In recent decades atypical antipsychotics have increased treatment options available for schizophrenia, however there is conflicting evidence concerning the trade-off between clinical efficacy and side effects for the different classes of antipsychotics. There has been a consistent increase in atypical antipsychotic prescribing compared to typical, despite evidence showing that neither class is superior. This leads to the question of whether prescribers are selective in their uptake of research evidence and clinical guidelines and if so, what influences their choice.. This study aims to identify the factors that contribute to the prescribing choice and how these can be used to aid knowledge translation and guideline implementation.
Motor abnormalities are frequently observed in schizophrenia and structural alterations of the motor system have been reported. The association of aberrant motor network function, however, has not been tested. We hypothesized that abnormal functional connectivity would be related to the degree of motor abnormalities in schizophrenia. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Prader–Willi Syndrome (PWS) is a complex neurogenetic disorder caused by loss of the paternal 15q11.2–q13 locus, due to deletion (DEL), maternal uniparental disomy (mUPD), or imprinting center defects. Individuals with mUPD have up to 60% risk of developing psychosis in early adulthood. Given the increasing evidence for white matter abnormalities in psychotic disorders, we investigated white matter microstructure in children and adolescents with PWS, with a particular emphasis on the DEL and mUPD subtypes. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
As one part of social cognition, emotional intelligence is a controversially discussed construct. Although well founded critique on the conceptualization of emotional intelligence has emerged over the last years, studies about emotional intelligence – especially the ability-based approach by Mayer and Salovey – can persistently be found in schizophrenia research. 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.
Free access. An article in the UK article The Telegraph suggests that events in a person’s life can lead to mental illness (March 28, 2016 by Sarah Knapton, Science Editor, The Telegraph) Most of the information I have read about mental illness implies that mental illness is most often associated with genes, but this new information tells me that it should not be genetics getting all the research.
Recently, I thought of the UK article again when in my home town, a gunman, with seemingly no cause, opened fired and killed a police officer at the local bus station. I wondered what events in his life may have led to this horribly sad situation.
The article and the recent shooting caused me to reflect on what events in my own life might have led to my diagnosis of schizophrenia.
Despite the multitude of longitudinal neuroimaging studies that have been published, a basic question on the progressive brain loss in schizophrenia remains unaddressed: Does it reflect accelerated aging of the brain, or is it caused by a fundamentally different process? The authors used support vector regression, a supervised machine learning technique, to address this question. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Although brain changes in schizophrenia have been proposed to mirror those found with advancing age, the trajectory of gray matter and white matter changes during the disease course remains unclear. The authors sought to measure whether these changes in individuals with schizophrenia remain stable, are accelerated, or are diminished with age. Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
The experiences of school counseling and community mental health teams suggest that incorporating a technology-based screening procedure for early psychosis is feasible. Identifying barriers and facilitators at various stages of the screening procedure may reduce the dropout of clients potentially eligible for early psychosis care.. 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
Whether ACT-DL is beneficial in the long-term for only a sub-group of people experiencing symptoms of early psychosis or all of them seems a question of secondary importance when preliminary evidence shows that it is effective for negative symptoms. Furthermore, the confirmation that providing therapeutic intervention in combination with ACT components is likely to help delay or manage the negative symptoms of early psychosis is imperative for clinicians and health care providers.
The aim of this qualitative study is to explore patients' perspectives on Acceptance and Commitment Therapy for early stages of psychosis. Therefore, we interviewed participants of the INTERACT study, that quantitatively investigated Acceptance and Commitment Therapy in Daily Life (ACT-DL) in combination with treatment as usual, for early stages of psychosis, comparing it to treatment as usual.
The efficacy of acceptance and commitment therapy (ACT) in psychosis has been reported but not for medication-resistant psychosis. You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Acting violently on delusions is a significant clinical problem. Recent research has identified state anger as key component in the pathway from persecutory/threat delusions to serious violence. To determine the magnitude of the effect of delusional anger and to investigate a dose-response relationship we carried out a prospective follow-up study of forensic in-patients discharged into the community. . Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Activating and Sedating Adverse Effects of Second-Generation Antipsychotics in the Treatment of Schizophrenia and Major Depressive Disorder: Absolute Risk Increase and Number Needed to Harm. 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.
Repetitive transcranial magnetic stimulation (rTMS) over the left temporo-parietal region has been proposed as a treatment for resistant auditory verbal hallucinations (AVH), but which patients are more likely to benefit from rTMS is still unclear. This study sought to assess the effects of rTMS on AVH, with a focus on hallucination phenomenology. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
This article examines the clinical, epidemiological and nosological aspects of short-lived psychotic disorders as currently classified under ‘acute and transient psychotic disorders’ in ICD-10 and ‘brief psychotic disorder’ in DSM-5. After describing earlier diagnostic concepts such as bouffée délirante, cycloid psychosis, reactive psychosis and schizophreniform psychosis, we present an overview of the literature and discuss implications for classification, diagnosis and treatment of these conditions, pointing out differences from longer-lasting psychotic disorders. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Stigma and Health Vol. 3, Iss. 1, (Feb 2018): 1-8.
Stigma is a common difficulty for those who experience psychosis as they are viewed as most dangerous, unpredictable, and least likely to recover. In particular, experiences of stigma are yet to be explored with inpatients admitted to psychiatric hospital. The aim of this study was to examine subjective experiences of stigma with acute psychiatric inpatients who experience psychosis.. To read the full article, log in using your NHS OpenAthens details.
Schizophrenia is not a taboo topic anymore. Some aspects of the illness, like hearing voices and delusions (‘positive symptoms’), are increasingly spoken and written about by laypeople. But ‘negative symptoms’ (lack of thought content, motivation, meaningful pleasure and sociability) and the predisposition for people with schizophrenia to get depressed, are still commonly under-appreciated.
Both these domains are often treated by adding an antidepressant to an already-prescribed antipsychotic, but the evidence for this isn’t as comprehensive as we’d like. There have been multiple small studies, but there is little consensus and some subsidiary questions (like whether antidepressants might worsen positive symptoms) remain unanswered. Fortunately for us, a team based in Munich have recently published a systematic review and meta-analysis in the American Journal of Psychiatry, to pull together all of the data in this broad area (Helfer et al, 2016).
Chris Hollis and colleagues' Article1 in The Lancet Psychiatry has many strengths. It addresses an important clinical question: does methylphenidate treatment for ADHD increase the risk of psychosis in patients with and without previous psychotic symptoms. Hollis and colleagues used Swedish national registers to review a large number (n=23 898) of health records, to examine the incidence of psychotic symptoms 12 weeks before, 12 weeks after, and 1 year after starting medication treatment, with a longitudinal within-subject study design. Their results indicated that methylphenidate treatment for ADHD does not increase psychotic symptoms in the short-term or long-term in patients with and without previous psychosis. There is some suggestion in their study that methylphenidate might, in fact, decrease the risk of a psychotic episode, particularly in patients with a history of psychosis. The findings of their study should therefore be reassuring to clinicians. However, as the authors themselves point out, the study has several limitations that could affect the reassuring message.. Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
Open access. Current practice guidelines for schizophrenia care recommend that antipsychotic medication is essential for patients’ long-term maintenance treatment but their non-adherence to this medication is still a main obstacle to relapse prevention. This study evaluated the effects of a motivational-interviewing-based adherence therapy for people with schizophrenia spectrum disorders.
Open access. Antipsychotics are the drugs prescribed to treat psychotic disorders; however, patients often fail to adhere to their treatment, and this has a severe negative effect on prognosis in these kinds of illnesses. Among the wide range of risk factors for treatment nonadherence, this systematic review covers those that are most important from the point of view of clinicians and patients and proposes guidelines for addressing them.
Open access. The STEPWISE trial (STructured lifestyle Education for People WIth SchizophrEnia, schizoaffective disorder and first episode psychosis) is currently evaluating a lifestyle education programme in addition to usual care. However, it is difficult to define what constitutes ‘usual care’. We aimed to define ‘usual care’ for lifestyle management in people with schizophrenia, schizoaffective disorder and first-episode psychosis in STEPWISE study sites. Ten National Health Service (NHS) mental health trusts participated in a bespoke survey based on the National Institute for Health and Care Excellence (NICE) guidance.
Prolactin-related adverse effects contribute to nonadherence and adverse health consequences, particularly in women with severe mental illness. Treating these adverse effects may improve treatment acceptability, adherence, and long-term outcomes.. 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.
Commentary on: Deakin B, Suckling J, Barnes TRE, et al. The benefit of minocycline on negative symptoms of schizophrenia in patients with recent-onset psychosis (BeneMin): a randomised, double-blind, placebo-controlled trial. Lancet Psychiatry 2018;5:885–94.. To read the full article, log in using your NHS OpenAthens details.
Commentary on: Deakin B, Suckling J, Barnes TRE, et al. The benefit of minocycline on negative symptoms of schizophrenia in patients with recent-onset psychosis (BeneMin): a randomised, double-blind, placebo-controlled trial. Lancet Psychiatry 2018;5:885–94.. To read the full article, log in using your NHS OpenAthens details.
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.
Schizophrenia is a severe neuropsychiatric disorder with incomplete remission because of negative and cognitive symptoms in a large proportion of patients. Antipsychotic medication is successful in modulating positive symptoms, but only to a lower extent negative symptoms including cognitive dysfunction. Therefore, development of innovative add-on treatment is highly needed. In this review, recent evidence from clinical studies reveals effects of aerobic exercise on cognitive deficits in schizophrenia patients. 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.
To evaluate the feasibility and effects of integrating aerobic interval training (AIT) in standard care of outpatients with schizophrenia on aerobic capacity and conventional cardiovascular disease (CVD) risk factors.. 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 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.
Psychotherapy54.3 (Sep 2017): 245-251.
Incorporating behavioral activation into psychotherapy with persons with psychosis requires adaptation in its conceptualization and application owing to special deficits in the self-experience. Persons with psychosis often experience a diminished or disorganized sense of self, and have deficits in coherently narrating the experience of the self and in the ability to make sense of how to take action and direct their own lives. Based on a metacognitive model of disability in psychosis, the current paper presents a therapy process of a woman coping with schizophrenia using Metacognitive Reflection and Insight Therapy (Lysaker and Dimaggio, 2014). To read the full article, log in using your NHS OpenAthens details.
We tested the age‐varying associations of cannabis use (CU) frequency and disorder (CUD) with psychotic, depressive, and anxiety symptoms in adolescent and adult samples. Moderating effects of early onset (≤15 years) and sex were tested.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
When the people hospitalized in psychiatric units demonstrate aggression, it harms individuals and creates legal and financial issues for hospitals. Aggression has been linked to inpatient, clinician and environmental characteristics. However, previous work primarily accessed clinicians’ perspectives or administrative data and rarely incorporated inpatients’ insights. This limits validity of findings and impedes comparisons of inpatient and clinician perspectives. Login using your SSSFT NHS OpenAthens details for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you requesting.
People with, and those who are developing, schizophrenia are at increased risk to engage in aggressive behavior (AGB). Some incidents lead to criminal prosecution. Most people with schizophrenia who commit crimes engage in delinquency and/or AGB prior to first episode. A large proportion of these individuals have a history of childhood conduct disorder (CD) and brain abnormalities suggestive of abnormal neural development distinctive from that of others with schizophrenia. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Depressive episodes in schizophrenia constitute a major clinical problem, and treatment success is often limited by treatment-emergent side effects. Agomelatine, an agonist at melatonergic MT1/MT2 receptors and 5-HT2C receptor antagonist, is a new antidepressant with a novel mode of action which constitutes a potential therapeutic option for depression in schizophrenia. 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.
Psychological Services (Mar 13, 2017).
Comorbid alcohol and drug use disorders are treatable and have substantial effects on outcomes and health care utilization in people with schizophrenia. While these substance use disorders (SUDs) are thought to be common in patients with schizophrenia, it has been difficult to characterize prevalence and treatment utilization of this population, since administrative data and medical records may not identify patients with schizophrenia who have an SUD diagnosis. In this study, we used an in-person, population-based survey of 801 individuals with schizophrenia who were in treatment within the Veterans Health Administration (VHA) to inform service delivery for patients with these problems. To read the full article, log in using your NHS OpenAthens details.
The cognitive impairments that are common in schizophrenia are associated with impairments across multiple domains, including attention/vigilance, verbal learning and memory, executive functioning, verbal fluency, and speed of processing. As a result, they are targets for drug development. There is a clear need for pharmacological agents that target cognitive impairment in schizophrenia for which there are currently no approved medications. The α7 nicotinic acetylcholine receptors (α7 receptors) have been shown to play an important role in cognition in animals and humans. Encenicline is an agonist exhibiting priming behaviour at the α7 receptor by potentiating the response to the natural agonist acetylcholine (ACh). Encenicline may work as a neuromodulator, with its impact on cognition mediated in part by modulating multiple …To read the full commentary, log in using your NHS OpenAthens details
The cognitive impairments that are common in schizophrenia are associated with impairments across multiple domains, including attention/vigilance, verbal learning and memory, executive functioning, verbal fluency, and speed of processing. As a result, they are targets for drug development. There is a clear need for pharmacological agents that target cognitive impairment in schizophrenia for which there are currently no approved medications. The α7 nicotinic acetylcholine receptors (α7 receptors) have been shown to play an important role in cognition in animals and humans. Encenicline is an agonist exhibiting priming behaviour at the α7 receptor by potentiating the response to the natural agonist acetylcholine (ACh). To read the full article, log in using your NHS OpenAthens details
Detecting brain abnormalities in clinical high-risk populations before the onset of psychosis is important for tracking pathological pathways and for identifying possible intervention strategies that may impede or prevent the onset of psychotic disorders. Co-occurring cellular and extracellular white matter alterations have previously been implicated after a first psychotic episode. The authors investigated whether or not cellular and extracellular alterations are already present in a predominantly medication-naive cohort of clinical high-risk individuals experiencing attenuated psychotic symptoms.. Login at top right hand side of page using your MPFT NHS OpenAthens for full text.
Altered connectivity of dorsolateral prefrontal cortex (DLPFC) and hippocampus during working memory is considered an intermediate phenotype for schizophrenia (SCZ), but the relevance for other mental disorders with shared genetic background remains unknown. Here we investigated its presence in unaffected first-degree relatives of patients with bipolar disorder (BD) or major depressive disorder (MDD). Furthermore, we aimed to provide an independent replication of this phenotype in first-degree relatives of SCZ patients. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Journal of Abnormal Psychology126.3(Apr 2017): 301-311.
Delay discounting (DD) is a future-oriented decision-making process that refers to whether one is willing to forego a smaller, sooner reward for the sake of a larger, later reward. It can be assessed using hypothetical tasks, which involve choices between hypothetical rewards of varying amounts over delay periods of days to years, or experiential tasks, which involve receiving actual rewards in real time over delay periods of seconds to minutes. Initial studies in schizophrenia have only used hypothetical tasks and have been mixed in finding either elevated or normal levels of DD. To read the full article, log in using your NHS OpenAthens details.
Weight gain associated with antipsychotics in schizophrenia has been an ongoing concern. This meta-analysis examined the efficacy and safety of amantadine as an adjunctive treatment of weight gain in schizophrenia by systematically searching and analyzing randomized controlled trials (RCTs). RCTs comparing adjunctive amantadine with placebo in adult patients with schizophrenia were included in the meta-analysis. 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.
Marie Stenlund’s careful reading of values-based practice and her demonstration of its links with Martha Nussbaum’s Capabilities Framework are innovative theoretically and have potentially important implications for policy and practice in mental health. As she indicates the two approaches converge in a number of key respects. Notably, both recognise the diversity of individual human values. This diversity crucially underpins contemporary person-centred conceptions of recovery in mental health based on quality of life as defined by reference to the values of (to what is important from the perspective of) the person concerned rather than that of a generic professional ‘needs assessment’.1 2. To read the full article, log in using your NHS OpenAthens details.
Commentary. ‘Deprescribing’ here comprises arguments against treating patients who have been psychotic beyond first episode. Nevertheless, four out of five patients relapse, compared with only two of five still taking medication. However, much first-episode psychosis is not schizophrenia, but persistent substance-induced psychotic disorder. Virtually nothing is known about factors which facilitate this in the minority who develop it, nor how to decide if the patient will relapse off medication. Patients who are well, stable and tolerating minimal doses of medication should be the first to suggest that they try to do without it, not us.. 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.
The study aimed to investigate the experience of adults with a diagnosis of psychosis and who have survived childhood physical abuse. We interviewed eight participants and used interpretative phenomenological analysis to generate themes. The main themes were of perceiving an everyday world of aggression and contempt by others, pervasive mistrust, feeling isolated and for some, attacking oneself with hate. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Acceptance and Commitment Therapy for psychosis (ACTp) is an approach that aims to change the relationship an individual with psychosis has with difficult thoughts, emotions and experiences. It promotes the use of acceptance, defusion, mindfulness and focussing on valued outcomes as opposed to struggling with psychotic experiences. This service evaluation project explored service users’ experiences and meanings of ACTp within a medium secure mental health service.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
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).
Hearing voices groups (HVGs) are effective avenues of support for people who hear voices in the general population yet their application and adaptation for people with learning disabilities who hear voices are scarce.. 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.