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Movement disorders
Published in Henry J. Woodford, Essential Geriatrics, 2022
Regarding the management of psychosis, all antipsychotic drugs should be avoided due to both the elevated risk of adverse events and the absence of any demonstrated benefit. Reduction of any potentially causative medication (seeTable 9.1) may help with psychosis. For persisting psychotic symptoms, cholinesterase inhibitors might be tried.
Before the onset of frank psychosis
Published in Kathy J Aitchison, Karena Meehan, Robin M Murray, First Episode Psychosis, 2021
Kathy J Aitchison, Karena Meehan, Robin M Murray
A number of factors are associated with an increased risk of psychosis, some of which appear causal. Much evidence suggests that there is considerable overlap in the risk factors which operate across the range of psychoses, and that biological risk factors are more frequently identified in early-onset than late-onset cases.
Persecutory Delusions and the Transition from Clinical High-Risk to Syndromal Psychosis
Published in Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman, Understanding and Caring for People with Schizophrenia, 2020
Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman
Despite taking antipsychotic medications and working through his feelings of hostility toward women and his sister in particular, Mr. S progressed toward a full psychotic illness. Although we initiated antipsychotic medications, and they did help to some degree, there is currently no known way to prevent progression to a syndromal psychotic condition in individuals at clinical high-risk for psychosis. However, as described above, providing medications early is critical in order to decrease the duration of untreated psychosis, which, in Mr. S’s case, was very short.
Cellular and extracellular white matter alterations indicate conversion to psychosis among individuals at clinical high-risk for psychosis
Published in The World Journal of Biological Psychiatry, 2021
Felix L. Nägele, Ofer Pasternak, Lisa V. Bitzan, Marius Mußmann, Jonas Rauh, Marek Kubicki, Gregor Leicht, Martha E. Shenton, Amanda E. Lyall, Christoph Mulert
Patients with schizophrenia and related psychoses suffer from a range of symptoms including hallucinations, delusions, lack of motivation, and cognitive decline (American Psychiatric Association 2013). Early diagnosis and intervention, optimally prior to the onset of psychosis, has the potential to diminish the number of subjects that develop symptoms (Schmidt et al. 2015; Schultze-Lutter et al. 2015). Early identification of at-risk individuals would also be helpful in characterising pathologies that are more closely tied with the aetiology of the disorder, rather than with chronicity effects (Wood et al. 2011; Takahashi and Suzuki 2018). In the early 2000s, clinical high-risk for psychosis (CHR) criteria (Miller et al. 2003; Yung et al. 2005) were established to address the importance of delineating possible clinical and biological features that are related to an increased risk for developing psychosis (Fusar-Poli et al. 2013). These criteria have been used in many research studies and, more importantly, have been translated into early intervention strategies aimed at preventing psychosis-onset (Schmidt et al. 2015). At the same time, recent analyses suggest that transition rates in CHR individuals are ∼30% or even lower (Fusar-Poli et al. 2012; Hartmann et al. 2016), which further highlights the need for identifying additional conversion markers (Fusar-Poli et al. 2015; Cannon 2016; Abu-Akel et al. 2018).
Frequency of Self-reported Psychotic Symptoms among 2542 Outpatients at Their First Visit for Mental Health Services
Published in Psychiatry, 2021
MingLiang Ju, JunJie Wang, LiHua Xu, YanYan Wei, XiaoChen Tang, YeGang Hu, Li Hui, Yi Qiao, JiJun Wang, TianHong Zhang
The clinical diagnostic categories in the current analysis were obtained from outpatient medical records by clinicians. All outpatients had received a clinical diagnosis (or suspected diagnosis) of mental disorders from their psychiatrists using the criteria established in the third edition of the Chinese Classification and Diagnostic Criteria of Mental Disorders (CCMD-3; Chinese Society of Psychiatry, 2001). The CCMD-3 categories were partly based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the International Classification of Diseases (ICD-10). All categories were highly consistent with these international classifications. Four diagnostic categories were applied: 1) psychotic disorder (including schizophrenia, paranoid mental disorders, and schizoaffective psychosis); 2) mood disorder (including mania, bipolar disorder, depression, and dysthymia); 3) anxiety disorder (including phobia, panic disorder, generalized anxiety disorder, and obsessive-compulsive disorder); and 4) others (including personality disorder, adjustment disorder, somatoform disorder, and insomnia).
Personality Traits in Individuals with the Dual Diagnosis of Psychosis and Substance Use Disorders: A Comprehensive Review and Meta-Analysis
Published in Journal of Dual Diagnosis, 2021
Hyeonju Oh, Seon-Kyeong Jang, Hyeon-Seung Lee, Eun-Byeol Lee, Kee-Hong Choi
The comorbidity of substance use and psychotic disorders has consistently been explored in psychotic disorder literature due to its noticeably high prevalence. The literature reports about 40–60% of lifetime substance use comorbidity in psychotic disorders across different nations, the rate of which is three to five times higher than that of the general population (Cantor-Graae et al., 2001; Fowler et al., 1998; Hartz et al., 2014; Hunt et al., 2018; Morgan et al., 2012; Regier et al., 1990; Slade et al., 2009). The significance of co-occurring substance use and psychosis is further highlighted by the debilitating outcomes in various aspects during the pathological course. Substance use with psychotic disorders was related to lower therapeutic compliance, higher rate of relapse, more hospitalizations, homelessness, poorer overall functioning, elevated risk of premature death, and higher mortality (Björkenstam et al., 2012; Malla et al., 2008; Ouellet-Plamondon et al., 2017; Rosen et al., 2008; Schmidt et al., 2011; Swartz et al., 2006). Considering the extensive impact of comorbid substance use in symptomatology and clinical aggravation of psychotic disorders, further understanding of factors and mechanisms contributing to substance use in persons with psychotic disorders is required. In this article, the term psychotic disorder encompasses a range of psychiatric diagnoses that experience psychosis as a major symptom, such as schizophrenia, schizoaffective disorder, schizophreniform disorder, bipolar disorder, major depressive disorder with psychotic features, and brief psychotic episode.