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”.
Cognitive remediation is currently recommended to treat cognitive and functional impairments in patients with schizophrenia. Recently, treatment of negative symptoms has been proposed as a new target for cognitive remediation. Evidence of reductions in negative symptoms has been described in different meta-analyses. However, treating primary negative symptoms is still an open question. Despite some emerging evidence, more research focused on individuals with primary negative symptoms is indispensable. In addition, more attention to the role of moderators and mediators and the use of more specific assessments is necessary. Nevertheless, cognitive remediation could be considered as one promising option to treat primary negative symptoms.To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Negative symptoms are an important symptom dimension in schizophrenia that are often least responsive to antipsychotic medications. We revisit the current practice of identifying ‘primary’ negative symptoms and suggest that its concept would benefit from a further elaboration of their timing of emergence in relation to the dynamic neurobiological changes to enhance their utility in clinical decision-making and research. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
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.
Early intervention services are the established and evidence-based treatment option for individuals with first-episode psychosis. They are time-limited, and care pathways following discharge from these services have had little investigation. We aimed to map care pathways at the end of early intervention treatment in England to determine common trajectories of care.
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 prognostic prediction of outcomes in individuals at clinical high-risk for psychosis (CHR-P) is still a significant clinical challenge. Among multiple baseline variables of risk calculator models, the role of ongoing pharmacological medications has been partially neglected, despite meta-analytical evidence of higher risk of psychosis transition associated with baseline prescription exposure to antipsychotics (AP) in CHR-P individuals. The main aim of the current study was to test the hypothesis that ongoing AP need at baseline indexes a subgroup of CHR-P individuals with more severe psychopathology and worse prognostic trajectories along a 1-year follow-up period.