European Psychiatry
0924-9338
Cơ quản chủ quản: CAMBRIDGE UNIV PRESS , Cambridge University Press
Lĩnh vực:
Psychiatry and Mental Health
Phân tích ảnh hưởng
Thông tin về tạp chí
Các bài báo tiêu biểu
Mapping prodromal psychosis: A critical review of neuroimaging studies Abstract The onset of schizophrenia is usually preceded by a prodromal phase characterized by functional decline and subtle prodromal symptoms, which include attenuated psychotic phenomena, cognitive deterioration and a decline in socio-occupational function. Preventive interventions during this phase are of great interest because of the impressive clinical benefits. However, available psychopathological criteria employed to define a high risk state for psychosis have low validity and specificity. Consequently there is an urgent need of reliable neurocognitive markers linked to the pathophysiological mechanisms that underlie schizophrenia. Neuroimaging techniques have rapidly developed into a powerful tool in psychiatry as they provide an unprecedented opportunity for the investigation of brain structure and function. This review shows that neuroimaging studies of the prodromal phases of psychosis have the potentials to identify core structural and functional markers of an impending risk to psychosis and to clarify the dynamic changes underlying transition to psychosis and to address significant correlations between brain structure or function and prodromal psychopathology. Additionally, neurochemical methods can address the key role played by neurotransmitters such as dopamine and glutamate during the psychosis onset. To conclude, multimodal neuroimaging may ultimately clarify the neurobiology of the prodromal phases by the integration of functional, structural and neurochemical findings.
Tập 27 Số 3 - Trang 181-191 - 2012
Long-term validity of the At Risk Mental State (ARMS) for predicting psychotic and non-psychotic mental disorders Abstract Background The long-term clinical validity of the At Risk Mental State (ARMS) for the prediction of non-psychotic mental disorders is unknown. Methods Clinical register-based cohort study including all non-psychotic individuals assessed by the Outreach And Support in South London (OASIS) service (2002–2015). The primary outcome was risk of developing any mental disorder (psychotic or non-psychotic). Analyses included Cox proportional hazard models, Kaplan–Meier survival/failure function and C statistics. Results A total of 710 subjects were included. A total of 411 subjects were at risk (ARMS+) and 299 not at risk (ARMS−). Relative to ARMS−, the ARMS+ was associated with an increased risk (HR = 4.825) of developing psychotic disorders, and a reduced risk (HR = 0.545) of developing non-psychotic disorders (mainly personality disorders). At 6-year, the ARMS designation retained high sensitivity (0.873) but only modest specificity (0.456) for the prediction of psychosis onset (AUC 0.68). The brief and limited intermittent psychotic symptoms (BLIPS) subgroup had a higher risk of developing psychosis, and a lower risk of developing non-psychotic disorders as compared to the attenuated psychotic symptoms (APS) subgroup (P < 0.001). Conclusions In the long-term, the ARMS specifically predicts the onset of psychotic disorders, with modest accuracy, but not of non-psychotic disorders. Individuals meeting BLIPS criteria have distinct clinical outcomes. Significant outcomes In the long-term, the ARMS designation is still significantly associated with an increased risk of developing psychotic disorders but its prognostic accuracy is only modest. There is no evidence that the ARMS is associated with an increased risk of developing non-psychotic mental disorders. The BLIPS subgroup at lower risk of developing non-psychotic disorders compared to the APS subgroup. Limitations While incident diagnoses employed in this study are high in ecological validity they have not been subjected to formal validation with research-based criteria.
Tập 42 - Trang 49-54 - 2017
Carer perspective on treatment, comorbidities and diagnosis of Paediatric ADHD in France Objectives To examine treatment, comorbidity status and diagnosis among the French sample of the Caregiver Perspective of Pediatric ADHD (CAPPA) survey. Methods Carers in 10 EU countries, including France, completed an Internet survey regarding ADHD diagnosis, treatment and comorbidities. Descriptive statistics were calculated for categorical [n (%)] and continuous variables [mean, standard deviation (SD), median, range]. Results EU carers representing 3688 children/adolescents (6–17 years) with ADHD completed the survey; 486 were from France (median age 10 years, 84% male). Most (77%) French children/adolescents were currently receiving pharmacological treatment(s): 74% stimulant, 15% non-stimulant and 22% antipsychotic. Across countries, stimulant use ranged from 60% (Italy) to 93% (Germany/Netherlands), non-stimulant use from 1% (Germany) to 18% (Sweden) and antipsychotic use from 8% (Germany) to 46% (Italy). Many French children/adolescents received behaviour therapy (BT) after ADHD diagnosis (59%). Among those receiving BT, 52% began prior to starting medication. BT was often discontinued within 6 months (44%) or 6–12 (30%) months. 52% of carers reported ≥ 1 comorbidity; they reported the highest rates of conduct (24%), sleep (11%), eating (6%) and motor-coordination (6%) disorders, and the second-highest rates of anxiety (22%), learning difficulties (15%), oppositional defiant disorder (5%), bipolar disorder (4%) and epilepsy (2%). Time to diagnosis from first doctor's visit averaged 7 months (SD 11, median 3). 81% received a specialist referral. French carers reported the highest perceived difficulty (‘great deal’/’a lot’ of difficulty) obtaining a diagnosis (43%) and a specialist referral (53%). Conclusions This sample of French children/adolescents with ADHD had higher non-stimulant and antipsychotic use than most other countries and higher reports of certain comorbid conditions. Carers perceived greater difficulty in obtaining a diagnosis and seeing a specialist, although time to diagnosis was lower compared with a number of other countries.
Tập 29 - Trang 595 - 2014
Employment and its relationship with functionality and quality of life in patients with schizophrenia: EGOFORS Study
Tập 27 Số 6 - Trang 422-425 - 2012
Psychiatric Family History in Juvenile Psychiatric Patients Introduction: The presence of mental illness in any of the parents can be a stressful factor in the child and be in certain way generator of disease. AIMS describe and quantify the psychiatric family history in patients who were consecutively referred to the outpatient department of children and adolescent psychiatry,mental health community center of collado villalba, Madrid Material and method: Obtain data of a series of cases filing a card of the 18-year-old minor patients who in September, October, November and December, 2007 come for the first time to our mental health community center. Results: The total number of patients were 114. There were psychiatric family history in 36,8% (N=42), the mother was or had been in psychiatric treatment in 28% (N=31)) of the cases, the father in 15% (N=17) and the brothers in 7 % (N=8), the most frequent diagnoses in mothers it were neurosis in 21 % (N=24), toxic abuse in 3,5% (N=4) and personality disorder in 1,8% (N=2), toxic abuse was the most frequent with 8,8% (N=10) in parents, followed by neurosis diagnosed in 4,4% (N=5), the most frequent diagnoses in brothers was the emotional disorder in 4,4,% (N=5). The mean age of parents was 41,34 (SE =6,34), in mothers was 38,43 (SE=6,59). Conclusions: We have to consider the existence of some kind of psychiatric family history in the therapeutic plan of the patient.
Tập 24 - Trang S802 - 2009
Early-life metal exposure and schizophrenia: A proof-of-concept study using novel tooth-matrix biomarkers Abstract Background Despite evidence for the effects of metals on neurodevelopment, the long-term effects on mental health remain unclear due to methodological limitations. Our objective was to determine the feasibility of studying metal exposure during critical neurodevelopmental periods and to explore the association between early-life metal exposure and adult schizophrenia. Methods We analyzed childhood-shed teeth from nine individuals with schizophrenia and five healthy controls. We investigated the association between exposure to lead (Pb2+ ), manganese (Mn2+ ), cadmium (Cd2+ ), copper (Cu2+ ), magnesium (Mg2+ ), and zinc (Zn2+ ), and schizophrenia, psychotic experiences, and intelligence quotient (IQ). We reconstructed the dose and timing of early-life metal exposures using laser ablation inductively coupled plasma mass spectrometry. Results We found higher early-life Pb2+ exposure among patients with schizophrenia than controls. The differences in log Mn2+ and log Cu2+ changed relatively linearly over time to postnatal negative values. There was a positive correlation between early-life Pb2+ levels and psychotic experiences in adulthood. Moreover, we found a negative correlation between Pb2+ levels and adult IQ. Conclusions In our proof-of-concept study, using tooth-matrix biomarker that provides direct measurement of exposure in the fetus and newborn, we provide support for the role of metal exposure during critical neurodevelopmental periods in psychosis.
Tập 36 - Trang 1-6 - 2016
Guilt and depression: Two different factors in individuals with negative symptoms of schizophrenia Abstract Objective: Depression is common among schizophrenia patients and constitutes a major risk factor for suicide. Calgary Depression Scale (CDSS) is the most widely used instrument for measuring depression in schizophrenia. CDSS has never been examined in patients with predominant negative symptoms, thus possibly hindering both accurate assessment and understanding of the underlying mechanisms. The current study is the first to examine CDSS’ structure in this population. Methods: We conducted Principal Component Analysis (n = 184) for the CDSS items. Thereafter, we correlated emerging factors with psychopathological, demographic and side effect variables. We assessed internal consistency and reliability of the emerging factors, as well as demographic correlations. Results: The analysis yielded two factors:depression-hopelessness andguilt . Factors distinctly correlated with separate variables. Removal of item #7 (early waking) improved internal consistency. Thedepression-hopelessness factor had an inverse correlation with negative symptoms, and positive correlation with neuroleptic side effects. Conclusions: CDSS structure indicated of two separate factors, i.e.,depression-hopelessness andguilt , suggesting separate underlying processes. The validity of the scale might benefit from a two-fold structure and the removal/replacement of item #7 (early waking). A noteworthy inverse correlation was found between the depression factor and negative symptoms, as well as a positive correlation between depression factor and neuroleptic side effects.
Tập 28 - Trang 327-331 - 2013
Measuring stigma in children receiving mental health treatment: Validation of the Paediatric Self-Stigmatization Scale (PaedS) Abstract Background: Research on the impact of stigma associated with mental illness in children is scarce. Considering the known negative effects of stigma associated with mental illness in adults, it is crucial to explore the stigma experienced by children who access mental health treatment. However, no scale measuring self-stigmatization in younger children is available to date. This study aimed to develop and validate such a scale, the Paediatric Self-Stigmatization Scale (PaedS). Methods: A total of 156 children (119 receiving outpatient and 37 receiving inpatient treatment), aged 8–12 years, completed the PaedS, the Self-Perception Profile for Children and the Pediatric Quality of Life Inventory (PedsQL – Child Report, ages 8–12). In addition, parents completed the PedsQL (Parent Report for Children, ages 8–12), the Strengths and Difficulties Questionnaire (SDQ) and a modified subscale of the PaedS measuring the children's rejection by others due to their mental health difficulties. Results: A confirmatory factor analysis showed that a four-factor structure, comprising Societal Devaluation, Personal Rejection, Self-Stigma and Secrecy scales, had excellent fit to the data (CFI = 0.95; TLI = 0.95; RMSEA = 0.05). Child-reported PaedS scores were positively correlated with parental-reported PaedS scores and negatively with PedsQL, the SDQ, and 5 out of 6 subscales of the Self-Perception Profile for Children, suggesting adequate convergent validity (all P -values < 0.05). Conclusions: The PaedS is a valid instrument, which is hoped to advance the understanding of self-stigmatization in children with mental health difficulties and contribute to its prevention.
Tập 43 - Trang 1-8 - 2017
Recovery from Trauma-Related Major Depression and Bipolar Disorder During the last few years, most cases of major depression encountered by the author in his private practice proved to be issues of psychological trauma. Among the incriminated traumatic causes, very few were potentially life-threatening events, and some were various forms of sexual abuse; however, most were seemingly trivial experiences that had had deleterious effect on the subject's narcissism or perceived social recognition. It appeared that in all cases where previous psychotherapy or psychiatric treatment had been performed, such trauma had been ignored or overlooked. Amazingly, careful and exhaustive trauma-targeted psychotherapy brought about exceptional relief and eventually recovery from the mood disorder. More amazingly, five cases of apparent bipolar disorder proved to be traumatic disorders. One of these presented with a very typical first manic episode; the other four had been diagnosed with this condition in a psychiatric hospital, they had a documented bipolar history and had received mood-stabilisers or atypical neuroleptics with satisfying results. Here too, careful trauma-centered psychotherapy achieved complete recovery and allowed to stop chemical treatment. Four and a half year follow-up (the longest among these five cases) showed no relapse in any of the five patients, despite the lack of any chemical treatment. Significant case reports will be discussed.
Tập 24 - Trang S634 - 2009