Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Psychotic Disorders”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2005

Mortality in offspring of parents with psychotic disorders: a critical review and meta-analysis.

OBJECTIVE: Mortality risk in offspring of parents with psychotic disorders is a sensitive and important topic, but evidence on which to base plans for preventive services is limited. The authors synthesized evidence for mortality risk among offspring of parents with psychotic disorders and examined potential modifiers of risk such as offspring age and parental diagnosis. METHOD: Electronic reference and citation databases were searched. Secondary analyses were carried out to generate relative risk estimates and perform post hoc statistical power calculations. A meta-analysis of the association between maternal psychotic disorder and fetal death/stillbirth was conducted. RESULTS: Most of the relevant studies investigated the relationship between exposure to maternal schizophrenia and perinatal or infant mortality outcomes but were not truly population-based and lacked adequate power. Studies published since 1960 generally indicated higher than expected mortality risk in exposed offspring. Meta-analysis indicated an almost twofold higher risk of fetal death/stillbirth among offspring of women with psychoses. Notable gaps in the existing evidence include outcome beyond the first year of life, cause-specific mortality, and effects of exposure to specific parental conditions other than schizophrenia and of exposure to paternal versus maternal disorder. Etiological mechanisms are not fully understood. CONCLUSIONS: Large-scale population-based studies are needed to understand mortality risk in offspring of parents with psychoses. In the absence of etiological evidence, only general preventive measures can be taken. Prevention of offspring mortality at an early age is most likely to be achieved by identification and treatment of maternal disorder and greater provision of support to these vulnerable families.

Adolescent↗
PubMed2006

Clinical and demographic features of treated first-episode psychotic disorders: a Zambian study.

BACKGROUND: There is a relative lack of information about the epidemiology of psychotic disorders in the developing world. The aim of this pragmatic study was to describe the correlates of first-episode psychosis in the central African nation of Zambia. METHOD: Selected clinical and demographic variables were collected on patients with psychotic disorders presenting for the first time at the only psychiatric hospital in Zambia (Chainama Hills College Hospital, Lusaka). RESULTS: During the study period, 160 subjects were admitted to the hospital with the first episode of a psychotic disorder. The male to female sex ratio was 2.5:1, with the median age of first admission for both sexes being 26 years. Half of the subjects had a duration of untreated psychosis one month or less. Recent alcohol and other drug abuse was common in males (56%). Clinical evidence of HIV/AIDs was found in 9% of those admitted. Approximately one-third of the subjects had attended a traditional healer for their psychotic symptoms prior to admission. CONCLUSIONS: Understanding the profile of treated first-episode psychosis in the developing world can help optimize the development of local services. Furthermore, characterizing differences in the epidemiology of psychosis between populations may help generate factors that could influence its cause and course.

Adolescent↗
PubMed2006

Functional adaptation skills training (FAST): a randomized trial of a psychosocial intervention for middle-aged and older patients with chronic psychotic disorders.

OBJECTIVE: Behavioral interventions designed to improve functioning of older patients with schizophrenia and other chronic psychotic disorders have the potential to significantly increase patients' independence and quality of life. This study evaluated a psychosocial intervention designed to improve everyday living skills of middle-aged and older outpatients with chronic psychotic disorders. METHODS: A total of 240 patients with a DSM-IV-based chart diagnosis of schizophrenia or schizoaffective disorder participated in a 24-week, randomized controlled trial comparing a behavioral group intervention called "Functional Adaptations and Skills Training" (FAST; n=124) to a time-equivalent attention-control (AC; n=116) group focused on improving functional skills. RESULTS: Compared to participants randomized to AC, those in the FAST intervention demonstrated significant improvement in everyday living skills (p=.046) and social skills (p=.003), but not medication management skills (p=.268). CONCLUSIONS: Results suggest that middle-aged and older patients with psychotic disorders may benefit from participation in interventions designed specifically to improve functional skills.

Adaptation, Psychological↗
PubMed1999

Early onset psychotic disorders: diagnostic stability and clinical characteristics.

OBJECTIVES: To examine the clinical features and diagnostic stability of early-onset psychotic disorders. METHODS: These data are from a two-year longitudinal prospective study of youth with psychotic disorders. Standardized diagnostic assessments are administered at baseline and at one and two-year's follow-up. RESULTS: Fifty-one subjects have been recruited to date; 18 with schizophrenia, 14 with bipolar disorder, 7 with schizoaffective disorder, 1 with an organic psychosis, and 11 subjects whose symptoms where either questionable and/or did not meet diagnostic criteria for another disorder (classified as psychosis nos). Thirty-nine subjects were reassessed at year one, twenty-four at year two. Three subjects have been lost to follow-up. The study diagnosis was the same as the first onset diagnosis (prior to entering the study) in 50% of subjects. Over the two-year period of the study, the diagnosis remained unchanged in over 90% of subjects. Subjects with schizophrenia had higher ratings of premorbid impairment, including social withdrawal and dysfunctional peer relationships, than those with bipolar disorder. At the one-year follow-up, subjects with schizophrenia and schizoaffective disorder had significantly higher rates of delusions, bizarre behavior, and negative symptoms than those with bipolar disorder. Subjects with bipolar disorder tended to have cyclical courses, whereas those with schizophrenia and schizoaffective disorder were often chronically impaired. Subjects with psychosis nos had higher rates of dissociative symptoms and histories of child maltreatment. CONCLUSIONS: Early-onset psychotic disorders can be reliably diagnosed using standardized assessments and are stable over a two-year period. Compared to bipolar disorder, schizophrenia is associated with a poorer premorbid history, and persistent positive and negative symptoms.

Adolescent↗
PubMed2003

A Canadian programme for early intervention in non-affective psychotic disorders.

OBJECTIVES: To provide a brief overview of the development of clinical services and research for early intervention in psychotic disorders in Canada; to describe components of a comprehensive clinical/research programme for nonaffective psychotic disorders; and to present a summary of results of clinical and social outcomes achieved. METHOD: This is a descriptive paper providing some details of how clinical services are being developed in Canada and concentrating on one particular early intervention programme, Prevention and Early intervention Programme for Psychoses (PEPP) London, Ontario, which is using a historical control design to evaluate the impact of an assertive approach to community case detection. Components of a phase-specific treatment programme and early case detection are described followed by results based on clinical and psychosocial data collected according to a defined protocol. RESULTS: One year outcome for patients treated in PEPP shows use of low dose, pre-dominantly novel antipsychotics and high (81.5%) retention and remission (75%) rates. Highly significant improvements were also reported for self-rated quality of life and cognition. Duration of untreated psychosis (DUP) and premorbid adjustment were associated with improvement in positive and negative symptoms, respectively. Systemic changes to improve access to the service resulted in substantial increases in number of cases treated and a> 50% decline in DUP. CONCLUSIONS: Phase-specific treatment approach and case identification strategies to reduce delay in treatment are likely to substantially improve outcome in nonaffective psychotic disorders compared with what has been reported with traditional approaches.

Canada↗
PubMed2006

Long-term clinical course of patients with acute polymorphic psychotic disorder without symptoms of schizophrenia.

Few studies have investigated the long-term course of patients with acute polymorphic psychotic disorder, despite the clinical relevance. The present study focused on the frequency of acute polymorphic psychotic disorder without symptoms of schizophrenia (F23.0) and the prognosis of patients with the disorder over a long period. A total of 388 inpatients with nonaffective psychosis were examined and cases with F23.0 were retrospectively investigated regarding clinical course over 12 years with reference to clinical charts. A total of 16 cases were diagnosed with F23.0 according to first episode. After 12 years, five cases were rediagnosed with schizophrenia, and one case with borderline-type emotionally unstable personality disorder, although the diagnosis of F23.0 was not changed in 10 older patients. Of the four cases with >2 repeated episodes of F23.0, the same clinical picture as in the first episode was observed in three, while one case showed continuous residual symptoms. F23.0 does not represent a homogeneous clinical entity. In some cases, diagnosis changes to schizophrenia, but others display repeated episodes of F23.0.

Adolescent↗
PubMed2001

Presurgical postictal and acute interictal psychoses are differentially associated with postoperative mood and psychotic disorders.

The authors studied 52 patients who had undergone surgery because of intractable temporal lobe epilepsy. Investigation of postoperative psychiatric illnesses focused on psychotic disorder (293.81 and 293.82) and mood disorder (293.83) due to a general medical condition diagnosed according to DSM-IV criteria. Presurgically, two episodic psychotic syndromes, acute interictal and postictal psychosis, were defined operationally. A correlation was confirmed between presurgical acute interictal psychosis and postsurgical psychotic disorder, as well as between presurgical postictal psychosis and postsurgical mood disorder. An excellent final outcome for postoperative mood disorder in contrast to a less favorable one for psychotic disorder was also suggested.

Acute Disease↗
PubMedDate not supplied

[Evaluation of the incidence of hospitalization of patients with psychotic disorders].

The aim of this study was to assess the administrative incidence of psychotic disorders, i.e. the incidence of first hospitalization for such disorders. Consecutively first-admitted patients hospitalized in 4 departments of Bordeaux's psychiatric hospital were included. Patients fulfilled the following inclusion criteria: no previous psychiatric hospitalization; aged 60 years or less; at least one overt psychotic symptom; clear consciousness. Patients were drawn from a 250,000 inhabitants urban catchment area, with an at risk population of 161,698 inhabitants. DSM IV diagnoses were made using the Mini International Neuropsychiatric Instrument (MINI) as well as all available information collected from the patient, the relatives, and from any other informant. A complementary study was performed in the private psychiatric institutions and in the military Hospital of Bordeaux in order to assess the representativeness of the patients hospitalized in the state hospital. 59 patients were included during one year in the state hospital. The raw incidence rate was 0.37 per 1,000 (95% CI; 0.28-0.46). We used a direct standardization on age to calculate the incidence rates ratio to gender. Men were over-representated in the sample, with a standardized incidence ratio in men compared to women equal to 1.87 (95% CI; 1.25-2.8). Psychotic mood disorders had the highest incidence, with an incidence rate equal to 0.15 per 1,000 inhabitants (95% CI; 0.09-0.21). The incidence rate of DSM IV schizophrenia was lower than that of psychotic mood disorders, and was equal to 0.13 per 1,000 (95% CI; 0.08-0.18). Several studies conducted in European and North-American countries have recently suggested that the incidence of schizophrenia may have decreased in the past decades. Since few French studies on the incidence of such disorders have been carried out, it is not possible to assess whether the incidence of schizophrenia is or not decreasing in France. Further studies on the incidence of psychotic disorders are required in other French regions in order to assess the reproductibility of our results, and to have reference data on the incidence of psychotic disorders in the nineties.

Adolescent↗
PubMed2006

Psychotic disorders among homeless subjects attending a psychiatric emergency service.

BACKGROUND: Homelessness is an increasing problem among subjects with severe mental illnesses and little is known about the characteristics of homeless subjects with psychosis using emergency psychiatric services. The aims of the present study were to assess the frequency of psychotic disorders among subjects attending a psychiatric emergency service and to explore the clinical and demographic characteristics of these subjects and the management proposed by the emergency staff. METHODS: All homeless patients (n=104) consecutively attending a psychiatric emergency service were included over a 6-month period. Patients were categorised according to ICD-10 diagnoses as presenting with psychotic disorder (schizophrenia and other non-affective psychotic disorders) versus other disorders. A random sample of matched non-homeless controls (n=71) was included over the same period. RESULTS: Nearly one out of three homeless subjects (32.7%) presented with a psychotic disorder, a higher proportion than that found in non-homeless subjects (15.7%). Compared to non-homeless subjects with psychosis, homeless subjects with psychosis were more likely to be male and to present with drug use disorder. The likelihood of being hospitalised after attending the psychiatric emergency services did not significantly differ between the two groups. Compared to homeless subjects with other psychiatric disorders, homeless subjects with psychosis were more likely to be single, to have a history of psychiatric hospitalisation and presented less frequently with anxiety or depressive symptoms motivating admission. CONCLUSION: Most homeless subjects with psychosis attending a psychiatric emergency service were already identified as suffering from a severe mental illness, suggesting that homelessness was a consequence of a break in contact with mental health services. Since homelessness is incompatible with the adequate management of psychosis, strategies have to be developed in mental health organisations in combination with outside partnerships, to drastically reduce the frequency of this condition in subjects with psychosis.

Adult↗
PubMed2005

Longitudinal follow-up in acute and transient psychotic disorders and schizophrenia.

We prospectively studied the long-term course of individuals with acute and transient psychotic disorders and a control group with positive schizophrenia matched for age and gender. Follow-up investigations using standardised instruments were performed at three time-points covering 7 years after the index episode or 12 years after the first episode. During follow-up, those with positive schizophrenia experienced a deterioration in their general functioning whereas those with acute and transient psychotic disorders retained their high level of functioning. At the end of the observation period, 12 out of 39 (31%) of those with acute and transient psychotic disorders were functioning well without medication compared with 0 out of 38 with positive schizophrenia.

Acute Disease↗
PubMed2003

How psychotic are individuals with non-psychotic disorders?

BACKGROUND: The objective of this study was to compare, using a self-report questionnaire, the dimensions of psychosis across different patient groups in a community mental health service (CMHS) and in non-patients in the general population. METHODS: The Community Assessment of Psychic Experiences (CAPE) is a 40-item self-report instrument with positive, negative and depressive symptom dimensions. Seven hundred and sixty-two patients and 647 subjects in the general population filled in the CAPE. In 555 of the 762 patients, a DSM-IV diagnosis was made. The following DSM-IV categories were used in the analyses: 1. Schizophrenia and Other Psychotic Disorders (n = 72), 2. Mood Disorders (n = 214), 3. Anxiety Disorders (n = 129). The patient and non-patient groups were compared on the three dimensions of the CAPE using multivariate regression analysis. RESULTS: The patient groups scored significantly higher on the positive, negative and depressive dimensions than the non-patients. Patients with psychotic disorders had the greatest difference in positive psychosis items compared to non-patients (beta = 0.94, 95 % CI: 0.7-1.18), whereas patients with mood and anxiety disorders had the highest depressive symptom scores, and positive symptom scores that were intermediate to that of non-patients and patients with psychotic disorders (mood disorders: beta = 0.53, 95 % CI: 0.39-0.68; anxiety disorders: beta = 0.22, 95 % CI: 0.04-0.39). The CAPE distress score adjusted for the corresponding frequency score was not significantly different between the patient groups, but compared to the general population, patient status did contribute significantly to the level of distress. DISCUSSION: Patients with anxiety and mood disorders had elevated scores on positive psychosis items, indicating that expression of psychosis in non-psychotic disorders is common. The finding of elevated scores of the patient groups on all three dimensions compared to non-patients suggests that the psychopathology associated with psychotic disorders varies quantitatively across DSM-IV categories.

Adult↗
PubMedDate not supplied

Three dimensions of depression in patients with acute psychotic disorders: a replication study.

Depressive symptoms in psychotic disorders are of high relevance but seem to be heterogeneous when assessed with a standard rating scale. The present analysis is a replication study on the dimensionality of the Bech-Rafaelsen Melancholia Scale (BRMES) in acutely psychotic patients with substantial depression defined according to a functional approach across the nosological borders of schizophrenia with major affective symptoms, schizoaffective disorder, depressed subtype, and major depression with psychotic features. The baseline data of 123 patients participating in a multicenter pharmacological trial were evaluated with structural equation models. A previously reported three-dimensional model of the BRMES comprising the facets retardation, depressive core symptoms, and accessory depressive symptoms was cross-validated by confirmatory factor analysis (CFA). The three-dimensional model proved to be superior to one-, two-, or four-factor models with respect to goodness-of-fit (goodness-of-fit index [GFI] = 0.91 and comparative fit index [CFI] = 0.89) and parsimony (adjusted GFI [AGFI] = 0.85). When comparing the present model with the previously reported model, a highly satisfactory correspondence emerged (CFI = 0.87). The results corroborate our previous findings that depression-like symptoms in acutely psychotic patients assessed by the BRMES can best be represented by a three-dimensional model and should not be treated as a homogeneous syndrome.

Acute Disease↗
PubMed2001

Classification of nonschizophrenic psychotic disorders: a historical perspective.

The existence of a group of psychoses that are symptomatologically and prognostically different from schizophrenia and affective psychotic disorders is supported by clinical and epidemiologic evidence. Although such "atypical" psychoses account for up to 10% of all psychotic disorders, their aetiology, pathophysiology, and neuropathology remain insufficiently understood. Moreover, they have been described by different schools of psychiatry a variety of ways, including non-process schizophrenia, schizophreniform psychosis, reactive (or psychogenic) psychosis, bouffées délirantes, and cycloid psychoses, but the extent to which these diagnostic categories overlap or differ has not been systematically explored. Neither Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), nor International Classification of Disease, Tenth Revision (ICD-10), provides adequate diagnostic criteria and classificatory categories for this group of disorders. Special attention to the refinement of the diagnosis and classification of the acute and transient psychotic disorders in future versions of the two classifications will be warranted.

History, 19th Century↗
PubMed2006

Remitting brief psychotic disorder in a 15-year-old male.

We present a case of remitting brief psychotic disorder in a 15 year old male, who had 4 phenomenologically alike episodes consisting of the following symptoms; sudden onset, unstructured delusions, hallucinations, clouding of consciousness, and a rapid return to his premorbid level of functioning. No evidence was found indicating a metabolic disease or a neurological disorder. The diagnostic criteria of brief psychotic disorder were fulfilled, although the clinical picture could not be described adequately by using only DSM-IV criteria. Remitting brief psychosis and the validity of different diagnostic systems are discussed.

Adolescent↗
PubMed2002

Motivations that maintain substance use among individuals with psychotic disorders.

This study quantitatively examined reasons for substance use among individuals with psychotic disorders and explored the relationship of these reasons to substance use problems and dependence. Sixty-nine people with psychotic disorders were interviewed using a battery of questionnaires called the Substance Use Scale for Psychosis (SUSP). Symptoms and medication side effects were also measured. A factor analysis revealed similar motives for substance use (mostly alcohol and cannabis use) as in the general population: "enhancement," "social motives," "coping with unpleasant affect," and "conformity and acceptance." A fifth factor, "relief of positive symptoms and side effects," demonstrated limited reliability. "Coping" and "enhancement" motives were found to lead to substance use problems and dependence. Mediator analysis indicated that worse symptoms lead to stronger motives for substance use, which in turn lead to stronger psychological dependence on that substance. These findings have the potential to inform effective treatment for substance use in psychosis.

Adaptation, Psychological↗
PubMed2002

[Psychotic disorders of sexual and erotic content in different diseases].

The results of long-term (1970-2000) clinical-psychopathological study of 251 patients with different forms of schizophrenia (161 cases), manic-depressive illness (19) and exogenous organic mental disorders (71) are summarized. The dynamics and different manifestations of psychotic disorders of sexual and erotic content described. These disorders were appeared mostly by hallucinations and delusions of various content. Similarity and difference of sexual and erotic symptoms and syndromes for different mental diseases have been determined. The psychoses studied were found to manifest more often in persons with different types of abnormal personality and in those with family history positive for mental disorders as well as in the presence of exogenous pathogenic factors.

Adult↗
PubMedDate not supplied

A comparison of DSM-IV brief psychotic disorder with "positive" schizophrenia and healthy controls.

To determine the psychosocial features, course, and outcome of DSM-IV brief psychotic disorder (BPD) in a comparative study, we recruited a cohort of 26 consecutive inpatients fulfilling DSM-IV criteria of BPD as well as a control group with "positive" schizophrenia (PS) and psychiatrically healthy controls matched for age and sex. Demographic and clinical features were systematically evaluated and follow-up investigations were performed at an average of 2.1 years after the index episode or 7.8 years after onset of the disorder using standardized instruments. The index group of 26 cases represented 2.5% of 1,036 patients treated as inpatients for psychotic disorders or major affective episode during the 5-year inclusion period. Eighty-one percent of the BPD patients were female. Indicators of premorbid functioning slightly favored BPD patients. Age at first episode and episode frequency did not differentiate between BPD and PS patients. Relapse was frequent in both groups. At follow-up BPD patients had a significantly more favorable outcome than patients with PS as evidenced by employment, independent living, social role functioning, psychological impairment, and global functioning. As a group, in many respects BPD patients approached the status of psychiatrically healthy controls. DSM-IV BPD is a psychotic disorder of favorable prognosis despite frequent relapse.

Achievement↗
PubMed2005

Is the psychopathology of acute and transient psychotic disorder different from schizophrenic and schizoaffective disorders?

OBJECTIVE: This study explores psychopathological aspects of acute and transient psychotic disorders (ATPD), a diagnostic category introduced with ICD-10, to elucidate its relationship with schizophrenia and schizoaffective psychoses. METHODS: We recruited all consecutive inpatients fulfilling the ICD-10 criteria of ATPD (F23) during a 5-year period as well as control groups with "positive" schizophrenia (PS) and bipolar schizoaffective disorder (BSAD) matched for gender and age at index episode. For the evaluation of psychopathological parameters during index episode a standardized symptom list was used. Prepsychotic (prodromal) symptoms were also assessed. RESULTS: During the prepsychotic period few differences between the groups were detected. The most important difference between ATPD and the other two other psychotic disorders regarding phenomenology of the full-blown episodes was a higher frequency of "rapidly changing delusional topics", "rapidly changing mood" and anxiety in ATPD. CONCLUSION: ATPD show a characteristic psychopathological picture consistent with earlier concepts such as cycloid psychoses and bouffée délirante. Nevertheless, psychopathology alone is not enough to establish ATPD as an independent nosological entity.

Acute Disease↗