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Purpose: This paper outlines the theoretical and empirical basis for compassion focused therapy (CFT) for psychosis, the gaps in the current knowledge and research, as well as some of the challenges for addressing gaps. It will guide the direction of future work and the steps needed to develop and advance this approach. Method: This paper reviews evidence of how evolutionary models such as social rank theory and attachment theory have greatly contributed to our understanding of psychosis and provide a clear rationale and evidence base for the mechanisms of change in CFT for psychosis. It reviews the evidence for outcomes of compassion training more generally, and early feasibility evaluations of CFT for psychosis. Results: The process evidence shows that people with psychosis have highly active social rank and threat systems, and the benefits of switching into attachment and care systems, which can support emotion regulation and integrative mind states. The outcomes evidence shows that compassion training impacts not only psychological outcomes, but also physiological outcomes such as neural circuits, immune system, and the autonomic nervous system. Within the psychosis field, outcomes research is still in the early days, but there are good indications of feasibility and a clear path forward for the next steps. Conclusions: CFT for psychosis is an approach that integrates biopsychosocial processes, an integration that's evidenced across each aspect of the model, from theoretical foundations (evolution‐informed) to interventions (e.g., body/breath training and relational techniques), to evaluation. Future RCTs are required to understand the effects on biopsychosocial outcomes for people with psychosis. [ABSTRACT FROM AUTHOR]

Background: Global evidence on psychosis is dominated by studies conducted in Western, high-income countries. The objectives of the Study of Context Of Psychoses to improve outcomes in Ethiopia (SCOPE) are (1) to generate rigorous evidence of psychosis experience, epidemiology and impacts in Ethiopia that will illuminate aetiological understanding and (2) inform development and testing of interventions for earlier identification and improved first contact care that are scalable, inclusive of difficult-to-reach populations and optimise recovery. Methods: The setting is sub-cities of Addis Ababa and rural districts in south-central Ethiopia covering 1.1 million people and including rural, urban and homeless populations. SCOPE comprises (1) formative work to understand care pathways and community resources (resource mapping); examine family context and communication (ethnography); develop valid measures of family communication and personal recovery; and establish platforms for community engagement and involvement of people with lived experience; (2a) a population-based incidence study, (2b) a case-control study and (2c) a cohort study with 12 months follow-up involving 440 people with psychosis (390 rural/Addis Ababa; 50 who are homeless), 390 relatives and 390 controls. We will test hypotheses about incidence rates in rural vs. urban populations and men vs. women; potential aetiological role of khat (a commonly chewed plant with amphetamine-like properties) and traumatic exposures in psychosis; determine profiles of needs at first contact and predictors of outcome; (3) participatory workshops to develop programme theory and inform co-development of interventions, and (4) evaluation of the impact of early identification strategies on engagement with care (interrupted time series study). Findings will inform development of (5) a protocol for (5a) a feasibility cluster randomised controlled trial of interventions for people with recent-onset psychosis in rural settings and (5b) two uncontrolled pilot studies to test acceptability, feasibility of co-developed interventions in urban and homeless populations. [ABSTRACT FROM AUTHOR]

Racial and ethnic disparities have been clearly documented in schizophrenia studies, but it is unclear how much research attention they receive among US-based studies published in high-impact journals. The current paper updates Lewine and Caudle's (1999) and Chakraborty and Steinhauer's (2010) works, which quantified how frequently schizophrenia studies included information on race and ethnicity in their analyses. We examined all US-based papers on schizophrenia-spectrum, first-episode psychosis, and clinical high-risk groups, published between 2014 to 2016 in four major psychiatric journals: American Journal of Psychiatry, Journal of the American Medical Association – Psychiatry, Schizophrenia Bulletin, and Schizophrenia Research. Of 474 US-based studies, 62% (n = 295) reported analyses by race or ethnicity as compared to 20% in Lewine and Caudle's (1999) study. The majority of papers (59%) reported sample descriptions, a 42% increase from Lewine and Caudle's (1999) study. Additionally, 47% matched or compared the racial/ethnic composition of primary study groups and 12% adjusted for race (e.g., as a covariate). However, only 9% directly analyzed racial and/or ethnic identity in relation to the primary topic of the paper. While schizophrenia studies report analyses by race and ethnicity more frequently than 20 years ago, there remains a strong need for systematic, nuanced research on this topic. The authors offer recommendations for how to conceptualize and report upon race and ethnicity in schizophrenia research. [ABSTRACT FROM AUTHOR]

The liberalisation of cannabis laws, the increasing availability and potency of cannabis has renewed concern about the risk of psychosis with cannabis. The objective of the WFSBP task force was to review the literature about this relationship. Converging lines of evidence suggest that exposure to cannabis increases the risk for psychoses ranging from transient psychotic states to chronic recurrent psychosis. The greater the dose, and the earlier the age of exposure, the greater the risk. For some psychosis outcomes, the evidence supports some of the criteria of causality. However, alternate explanations including reverse causality and confounders cannot be conclusively excluded. Furthermore, cannabis is neither necessary nor sufficient to cause psychosis. More likely it is one of the multiple causal components. In those with established psychosis, cannabis has a negative impact on the course and expression of the illness. Emerging evidence also suggests alterations in the endocannabinoid system in psychotic disorders. Given that exposure to cannabis and cannabinoids is modifiable, delaying or eliminating exposure to cannabis or cannabinoids, could potentially impact the rates of psychosis related to cannabis, especially in those who are at high risk for developing the disorder. [ABSTRACT FROM AUTHOR]

Introduction: The central-governor model explains the mechanism of endurance exerciseinduced central fatigue, but high-intensity exercise-induced central fatigue has not been investigated yet. This study aimed to research how central fatigue during high-intensity intermittent pedaling alters the neural response, which results in Electroencephalography (EEG) recordings. Methods: We assessed neural response by measuring the alternation of brainwave spectral power during an intermittent high-intensity 60-minute exercise on an ergometer cycle. The cadences were changed every 10 minutes according to intermittent pattern altering (90-120- 60-120-60-90 rpm). EEG was used to analyze altering brain function. Heart Rate (HR), Blood Lactate (BL), and Rating of Perceived Exertion (RPE) were measured after the change in cadences. Results: HR, BL, and RPE increased at a cadence of 120 rpm compared with 60 rpm on the ergometer cycle. The spectral power of EEG, according to cadence x brainwaves, significantly increased (P<0.01) in the alpha and beta frequency ranges with a change in cadences between 60 rpm and 120 rpm. The spectral power of the EEG significantly increased (P<0.01) over the whole frequency range from rest to warming (theta: 251%, alpha: 165%, beta: 145%) and significantly reduced in theta, alpha, and beta (theta: 176%, alpha: 142%, beta: 77%) (P≤0.01). Conclusion: High-intensity exercises (90 and 120 cadences) increased brain function, regardless of fatigue occurrence. High-intensity interval training (HIIT) led to altering the neural response. It would be required to investigate the usefulness of HIIT to treat some of the psychotic disorders. [ABSTRACT FROM AUTHOR]

Little is known about the effectiveness of cognitive behavioral therapy (CBT) specific self-help for psychosis, given that CBT is a highly recommended treatment for psychosis. Thus, research has grown regarding CBT-specific self-help for psychosis, warranting an overall review of the literature. A systematic literature review was conducted, following a published protocol which can be found at: https://www.crd.york.ac.uk/prospero/export%5frecord%5fpdf.php. A search was conducted across Scopus, PubMed, PsycInfo, and Web of Science to identify relevant literature, exploring CBT-based self-help interventions for individuals experiencing psychosis. The PICO search strategy tool was used to generate search terms. A narrative synthesis was conducted of all papers, and papers were appraised for quality. Ten studies were included in the review. Seven papers found credible evidence to support the effectiveness of CBT-based self-help in reducing features of psychosis. Across the studies, common secondary outcomes included depression, overall psychological well-being, and daily functioning, all of which were also found to significantly improve following self-help intervention, as well as evidence to support its secondary benefit for depression, anxiety, overall well-being, and functioning. Due to methodological shortcomings, long-term outcomes are unclear. [ABSTRACT FROM AUTHOR]

Objectives: The portrayal of mental health in the mainstream news media is an important topic for discussion. Concerns about stigmatisation of those suffering from mental ill-health have been expressed for many years, leading to numerous anti-stigma campaigns. Previous Irish studies demonstrated an improvement in the tone and content of articles over time. This study aims to re-evaluate this topic, 19 years after it was last studied. Methods: Four Irish papers including the tabloid, broadsheet, online and compact paper with the highest readership were analysed daily for a 12-week period. Using pre-determined definitions based on previous studies, all articles or headlines incorporating psychiatry-related material were examined for tone, content, utilisation of terminology, reference to self-harm, suicide and violence. Results: In total, 735 articles (2.19/paper/day) were identified and analysed. The majority of articles were found to have a supportive or factual tone. A higher proportion of judgemental or sensationalist articles were found in the tabloid newspaper. An improvement was noted compared to previous Irish studies. A decrease in articles written by mental health professionals was noted. Only 5% of articles portrayed psychotic disorders, with many of these referring to violence. Compliance with relevant guidelines for reporting of suicide was good overall. Conclusion: There has continued to be an improvement in the tone and content of articles since previous Irish studies. The introduction of guidelines within this time may have played a significant role. Psychotic illness received limited coverage and was more likely to be portrayed in a stigmatising manner, guidelines relating to this could be of benefit. Engagement between psychiatrists and the media is important to improve the portrayal of psychotic illness and enhance awareness. [ABSTRACT FROM AUTHOR]

A comparison of the Boston Study Group and the Relationalist's theories of enactments in which I maintain that enactments can be viewed either as an unknowable past expressing itself in present action, or as a process shift coming out of incremental shifts in the fit in here and now interaction. Often, it is difficult to distinguish enactments from any ongoing analytic experience oscillating between defense and revelation on the part of the analyst, analysand, or both. Yet, I agree with Goldin that change is not simply moving along, fitting together better, and reaching a higher level of organization as in infancy. An analytic interchange cannot be understood "separately from the project of grasping experience into words." [ABSTRACT FROM AUTHOR]

The archetype of the self underlies the ego-complex at its root and source in the unconscious. None of these assigns to the self the role that I feel to be so essential in the syndrome. SP 50-52 sp In regard to the method of study of these processes of the archaic, unconscious psyche in psychosis, I find myself baffled as to how to set up anything like a scientific approach to the material. In this hypothesis the model is easy to visualize but difficult to understand in terms of experience; the self is seen in this case as the center of the total psychic organism, and the ego is subsumed within this totality as the center of the field of consciousness only, that is, of contents accessible to consciousness; between the two are the autonomous complexes, which are groupings of contents not accessible to ego-consciousness (Figure 1). Reconstitutive process in the psychopathology of the self1: The following paper by J.W. Perry is published with permission from the Annals of the New York Academy of the Sciences where it was first published in January 1962. The imagery I refer to is a whole class of symbolic representations of centrality and organization, of order and highest authority; I hope to demonstrate that in these we see representations of the self and processes that transform or reorganize the self in the unconscious psyche. [Extracted from the article]

This paper presents TimelinePTC, a web-based tool developed to improve the collection and analysis of Pathways to Care (PTC) data in first episode psychosis (FEP) research. Accurately measuring the duration of untreated psychosis (DUP) is essential for effective FEP treatment, requiring detailed understanding of the patient's journey to care. However, traditional PTC data collection methods, mainly manual and paper-based, are time-consuming and often fail to capture the full complexity of care pathways. TimelinePTC addresses these limitations by providing a digital platform for collaborative, real-time data entry and visualization, thereby enhancing data accuracy and collection efficiency. Initially created for the Specialized Treatment Early in Psychosis (STEP) program in New Haven, Connecticut, its design allows for straightforward adaptation to other healthcare contexts, facilitated by its open-source codebase. The tool significantly simplifies the data collection process, making it more efficient and user-friendly. It automates the conversion of collected data into a format ready for analysis, reducing manual transcription errors and saving time. By enabling more detailed and consistent data collection, TimelinePTC has the potential to improve healthcare access research, supporting the development of targeted interventions to reduce DUP and improve patient outcomes. [ABSTRACT FROM AUTHOR]

In this discussion, certain aspects of the treatment of a severely disturbed patient are considered: (a) the temptation on the part of the analyst to “take sides” against the perverse influence of a pathological organization; (b) the necessity for the analyst to experience, not just understand, the crisis of the patient; and (c) the need for shameless openness in addressing shame states. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Open Dialogue was developed in Finland in the 1980s by clinical psychologist, Jaakko Seikkula. It is a development of family therapy, recognises previous trauma and has proven to be very effective in situations of acute mental illness, and in particular psychosis.Trauma Informed Care is a practice based on the understanding of and responsiveness to the impact of trauma. When people have experienced trauma, they may have difficulties in their everyday life and experience negative physical health outcomes as well as the risk of developing mental ill health.Open Dialogue is aligned to mental health care which aims to be trauma‐informed, person‐centred and rights‐based. Examples exist of the use of both approaches for service delivery with limited evaluation. What the paper adds to existing knowledge?: To our knowledge, no formal evaluation has been made of the use of open dialogue as a Trauma Informed therapy approach to support individuals and their family networks.Although both approaches recognise the impact of trauma on individuals, no study has explored the effectiveness of this treatment combination for use by mental health nurses.This review is timely as it provides insights into contemporary services that are trauma informed and have used Open Dialogue to extend therapy work with individuals and their family/networks.This scoping review was able to determine whether recommendations for clinical practice and training in Open Dialogue with Trauma Informed Care approaches could be identified. What are the implications for practice?: This review provided a broad overview on the current types of trauma‐informed care services incorporating Open Dialogue approaches into their practice.The literature, though sparce, identifies that Trauma Informed Care recognises multiple origins for mental ill health. Open dialogue has an affinity with the common values of mental health nurses. As combined therapies, they are demonstrating usefulness in engaging families and people in their journey towards recovery.Rigid adherence to Open Dialogue focus and delivery as well as training practices could be revised to make them more open to what people and their families wish to discuss. The person with mental ill health and previous trauma should be able to direct the narrative. Trauma Informed Practice principles could be adapted to improve consumer satisfaction with Open Dialogue approaches. Introduction: A large proportion of people who access mental health services have a lived experienced of trauma and are more likely to have a history of complex trauma. Open Dialogue and Trauma Informed Care practices identify previous trauma as a factor related to later psychosis. This scoping review has identified similarities and contrasts in how an Open Dialogue and Trauma Informed Care approach have been combined to complement one another for clinical work with people presenting with psychosis and previous trauma. Aim: We aimed to answer the following research question in this scoping review: What is known of the combined use of Open Dialogue and Trauma Informed Care practice when working with consumers and their family networks? As such, the purpose of this paper was to explore the application to practice and identify if any training existed and been evaluated. Method: This scoping review was based on the Arksey and O'Malley's framework. A comprehensive search was performed across five electronic databases. Grey literature was also searched through Psyche Info and Google Scholar for books, Dissertation and Theses, alongside hand searching of the reference of the studies. Articles searched was from January 2013 to January 2023. Results: Five distinct themes were identified from the literature: (1) Linking open dialogue with trauma, (2) Response to treatment, (3) Empowerment and information sharing, (4) Interpretation by clinical services, (5) Staff training outcomes. Discussion: Some tentative recommendations for practice recognised the individuals' unique story and perspective, suggested that trauma is an important concept to assess. Services practising as Trauma Informed Services that have incorporated an Open Dialogue approach have mixed experiences. The use of Open Dialogue may have some benefits for family work and exploring consumer narratives while building a network of support. However, consumers identified similar frustrations with service delivery as with the family therapy literature. For example, it was difficult to bring family members together and difficult to discuss previous traumatic events in front of family. People experiencing training in Open Dialogue reported it taking a slow pace and not what they were familiar with. Implications for Practice: Open Dialogue can facilitate engagement of consumers and their family networks and greater recognition of the peer workforce to promote collaboration in therapy is needed. Future research should also focus on evaluating the effectiveness of such services and comparing their outcomes across regions. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: There is evidence that social isolation and loneliness is more prevalent in people living with mental illness than in the general population.People living with mental illness frequently experience stigma, discrimination, rejection, repeated psychiatric admissions, low self‐esteem, low self‐efficacy, and increased symptoms of paranoia, depression, and anxiety.There is evidence of common interventions that can be used to improve loneliness and social isolation such as psychosocial skills training and cognitive group therapy. What the paper adds to existing knowledge?: This paper offers a comprehensive assessment of the evidence between mental illness, loneliness, and recovery.The results suggest that people living with mental illness experience elevated levels of social isolation and loneliness leading to poor recovery and quality of life.Social deprivation, social integration and romantic loneliness are related to loneliness, poor recovery, and reduced quality of life.A sense of belonging, ability to trust and hope are important aspects of improved loneliness, quality of life and recovery. What are the implications for practice?: The existing culture in mental health nursing practice needs to be examined to address loneliness in people living with mental illness and its impact on recovery.Existing tools to research loneliness do not consider dimensions in loneliness experience as reflected in the literature.Practice needs to demonstrate an integrated approach to recovery, optimal service delivery and augmentation of evidence‐based clinical practice to improve individual's loneliness, social circumstances, and relationships.Practice needs to demonstrate nursing knowledge in caring for people living with mental illness experiencing loneliness.Further longitudinal research is required to clearly understand the relationship between loneliness, mental illness, and recovery. Introduction: To our knowledge, there are no previous reviews on the impact of loneliness experienced by people aged 18–65, who are living with mental illness and their recovery experience. Aim/Question: To explore the experience and impact of loneliness in people living with mental illness during recovery. Method: An integrative review. Results: A total of 17 papers met the inclusion criteria. The search was conducted using four electronic databases: MEDLINE, CINAHL, Scopus and PsycINFO. Across these 17 papers, participants were most commonly, diagnosed with schizophrenia or psychotic disorders and recruited from community mental health services. Discussion: The review revealed loneliness to be substantial in people living with mental illness and that loneliness affected their recovery, and their quality of life. The review identified many factors that contribute to loneliness including unemployment, financial strain, social deprivation, group housing, internalized stigma and mental illness symptoms. Individual factors such as social/community integration and social network size as well as an inability to trust, a sense of not belonging, hopelessness and lack of romance were also evident. Interventions targeting social functioning skills and social connectedness were found to improve social isolation and loneliness. Implications for Practice: It is vital for mental health nursing practice to employ an approach integrating physical health as well as social recovery needs, optimal service delivery and augmentation of evidence‐based clinical practice to improve loneliness, recovery, and quality of life. [ABSTRACT FROM AUTHOR]

Introduction and aim. Recent functional connectivity studies showed that increased synchrony between the right anterior insula and the default mode network is associated with psychosis. This association is proposed to be correlated with the disrupted dynamics between the pre-reflective and reflective temporal experience in psychotic patients. The aim of the research is to assess the proposed association through the research question: How is the relation between the dynamics, of the right anterior insula, the Default Mode (DMN), Central Executive (CEN) and Salience (SAL) networks, and the dynamic between the implicit pre reflexive and explicit reflexive temporal experience, in schizophrenia patients? The hypothesis is, there is a reciprocal constitutive relation between the functional dynamics of these large-scale brain networks and these temporal, bodily experiences, which is out of synchrony in schizophrenia patients. Material and methods. Sample of 44 patients (n=44, schizophrenia undifferentiated (F20.3 ICD-11, 295.9 DSM-V)), 1-year diagnosis (Max.) & 44 healthy controls, paired by age & sex. Includes a Phenomenologically informed interview and an fMRI scan (breath & heart rate monitoring during the trials). The first trial consists of a resting state fMRI (whole-body MR unit with an eight-channel head coil), and the imaging sequences will be conducted under darkness. The second trial will be the same but the participant will be asked to keep their eyes open while watching the screen, where a digital clock will be presented for 10 minutes. Analysis of literature. A study evidenced that the Ultra High- Risk subjects had greater periods of synchrony between the right anterior insula and the DMN and lost the competitive dynamics between the synchronic activity of the SAL and DMN, and the CEN and insular activity (along with DMN deactivation). Another study suggests that the latter impairment in the triple network dynamics may be associated with the loss of contact with reality suffered by psychotic patients, along with a morbidly excessive awareness of the individual realm; the latter could be associated with the greater synchronic pattern between the right anterior insula and the DMN. Conclusion. It is concluded that DMN activity is associated with the temporal experience. A solid support is offered to the claim that the main temporal disturbance experienced by schizophrenia patients, is associated with disturbed dynamics of the triple network activity. [ABSTRACT FROM AUTHOR]

Introduction and aim. Parkinson's disease is one of the most common neurodegenerative diseases of the central nervous system, mainly affecting the elderly. Symptoms usually appear around the age of 60, before the age of 50 it is rare, while beyond this age the risk of the disease increases by 9% with each decade. The clinical picture is characterized by bradykinesia, rigidity, tremors, postural instability, gait disturbance, and extra- articular symptoms such as anxiety, depression, psychosis, sleep disturbance, salivation, dysphagia. Description of the case. The case report includes a 46-year-old female patient referred to the Neurology Department with suspected Wilson's disease. An ophthalmologic examination prior to hospitalization revealed the presence of a Kayser-Fleischer ring. The woman had been complaining of motor deterioration, fluctuating tremors of the right upper and lower limbs for about 2 years. Physical examination also revealed unsteady increased tension in the right upper limb. Genetic testing and expanded laboratory diagnostics excluded Wilson's disease. An MRI of the head was performed, which detected areas of nonspecific demyelination in periventricular and subcortical locations. Further diagnostics included a DaTSCAN imaging, which confirmed Young -- Onset Parkinson's Disease (YOPD). Conclusion. The differential diagnosis should consider dementia with Lewy bodies, Multiple System Atrophy (MSA), Wilson's Disease (WD), Progressive Supranuclear Palsy (PSP), Corticobasal Degeneration (CBD), spontaneous tremor and secondary Parkinsonian syndromes. The presented case demonstrates the need to carefully analyze the various symptoms presented by the patient regardless of age. [ABSTRACT FROM AUTHOR]

Objectives: Cognitive Behavioural Therapy for Psychosis (CBTp) demonstrates variable and at times mild to moderate effect sizes; thus, its therapeutic processes are important to explore. Establishing a secure therapeutic relationship is one such key process where barriers may exist, including those related to psychotic symptoms and associated stigma. This review synthesizes the available qualitative research pertaining to the experience of the therapeutic relationship from the perspective of those experiencing psychosis. Methods: A systematic review was undertaken using PRISMA guidelines. Search terms included variants of 'psychosis', 'therapy' and 'qualitative'. PsycInfo, CINAHL, EmBase, MedLine and Web of Science were searched, and reference lists were hand‐scanned. Yardley's quality appraisal tool was utilized and Noblit and Hare's seven‐stage process for conducting a meta‐ethnographic review. A line‐of‐argument synthesis is presented. Results: Fourteen papers were identified using inclusion and exclusion criteria. Twelve papers were deemed to have satisfactory quality. The line‐of‐argument synthesis used attachment theory to propose four semi‐distinct stages to establishing a therapeutic relationship: beginning; safety, hope and trust; the practicalities of therapy; and branching out. Findings suggest that the therapist's persona and use of CBTp techniques such as collaboration and shared agency over the process were important in establishing for the patient a sense of self as normal, equal and worthwhile. Conclusions: Attachment security may be an important strand of CBTp and warrants further research and clinical investigation as a process and an outcome. Future research can benefit from increased transparency regarding researcher positionality as a potential source of bias. [ABSTRACT FROM AUTHOR]

In this paper, we describe the challenges of collecting data in the Māori population for automatic detection of schizophrenia using natural language processing (NLP). Existing psychometric tools for detecting are wide ranging and do not meet the health needs of indigenous persons considered at risk of developing psychosis and/or schizophrenia. Automated methods using NLP have been developed to detect psychosis and schizophrenia but lack cultural nuance in their designs. Research incorporating the cultural aspects relevant to indigenous communities is lacking in the design of existing automatic prediction tools and one of the main reasons is the scarcity of data from indigenous populations. This paper explores the current design of the New Zealand health care system and its potential impacts on access and inequities in the Māori population and details the methodology used to collect speech samples of Māori at risk of developing psychosis and schizophrenia. The paper also describes the major obstacles faced during speech data collection, key findings, and probable solutions. [ABSTRACT FROM AUTHOR]

The social defeat hypothesis posits that low status and repeated humiliation increase the risk for psychotic disorders (PDs) and psychotic experiences (PEs). The purpose of this paper was to provide a systematic review of studies on risk of PDs and PEs among lesbian, gay, or bisexual (LGB) people and a quantitative synthesis of any difference in risk. PubMed, PsycINFO, Embase, and Web of Science were searched from database inception until January 30, 2024. Two independent reviewers assessed the eligibility and quality of studies, extracted effect sizes, and noted the results of mediation analyses. Using a random effects model we computed pooled odds ratios (ORs). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The search identified seven studies of PDs and six of PEs. As for PDs, the unadjusted (2.13; 95% confidence interval 0.72–6.34) and covariate-adjusted pooled OR (2.24; 1.72–3.53) were not significantly increased for LGB individuals. After exclusion of a study of limited quality, both the unadjusted pooled OR (2.77; 1.21–6.32) and the covariate-adjusted pooled OR (2.67; 1.53–4.66) were significantly increased. The pooled ORs were increased for PEs: unadjusted, pooled OR = 1.97 (1.47–2.63), covariate-adjusted, pooled OR = 1.85 (1.50–2.28). Studies of PE that examined the mediating role of several variables reported that the contribution of drug abuse was small compared to that of psychosocial stressors. The results of a study in adolescents suggested a protective effect of parental support. These findings suggest an increased psychosis risk for LGB people and support the social defeat hypothesis. [ABSTRACT FROM AUTHOR]

Previous reviews of smoking prevalence among individuals with primary psychosis have largely been internationally focused, with little attention given to within- and among subgroup comparisons of U.S. individuals with such disorders. Nationally, smoking prevalence has been decreasing among the general population. We aimed to review national and divisional samples to determine if this downward trend is being reflected among individuals with primary psychotic disorders, if geographical differences exist, and which demographic characteristics are associated with reported rates. We conducted a systematic search of the PubMed, PsycINFO, and Cochrane databases using a floor of 2010. Studies found during a review of references, and studies previously known to the authors but not found during the initial search, were also reviewed. We found 7 papers which reported the prevalence of smoking among individuals with psychotic disorders, and 2 papers which reported the prevalence of general tobacco and/or vaped nicotine use in this population. One eligible paper was excluded due to the same authors publishing more recent data of the same sample. In all, 1 national and 7 divisional samples were included for analysis. Individuals with psychotic disorders still smoke at rates far higher than the general population. We did not find strong support for a downward trend in smoking in this population but did find support for geographical heterogeneity. Smoking interventions must be tested and implemented nationwide. [ABSTRACT FROM AUTHOR]

Clinicians attempting to use EMDR with clients who experience psychosis may struggle to identify and access the trauma memories underlying the psychotic experiences. This may be due, in part, to the prevailing illness model and the traditional exclusion of psychosis from trials of EMDR. This paper aims to provide suggestions and guidance for clinicians developing their EMDR practice with psychosis. The paper describes five methods that may be useful clinically to identify the trauma memories. In order to support case conceptualisation, a mapping template is introduced and described. As dissociation and avoidance may complicate accessing trauma memories for reprocessing, techniques to work with these in psychosis are described. Future directions for both clinical and research work are considered. [ABSTRACT FROM AUTHOR]

The aim of this scoping review was to identify behavioral disturbances exhibited by patients in post-traumatic amnesia (PTA). While behavioral disturbances are common in PTA, research into their presentation and standardized measures for their assessment are limited. The study protocol was registered with PROSPERO (CRD42021268275). A scoping review of databases was performed according to pre-determined criteria on 29 July 2021 and updated on 13 July 2022. A conventional content analysis was used to examine and categorize behavioral disturbances. Thirty papers met the inclusion criteria, of which 27 reported observations and/or scores obtained on behavioral scales, and 3 on clinician interviews and surveys. None focused exclusively on children. Agitation was the most frequently assessed behavior, and Agitated Behavior Scale was the most used instrument. Content analysis, however, bore eight broad behavioral categories: disinhibition, agitation, aggression, lability, lethargy/low mood, perceptual disturbances/psychotic symptoms, personality change and sleep disturbances. Our study revealed that while standardized assessments of behavior of patients in PTA are often limited to agitation, clinical descriptions include a range of behavioral disturbances. Our study highlights a significant gap in the systematic assessment of a wide range of behavioral disturbances observed in PTA. [ABSTRACT FROM AUTHOR]

There is a long tradition of offering art therapy to inpatients. NICE guidelines (2009 p.25) recommend considering offering 'arts therapies to all people with psychosis or schizophrenia, particularly for the alleviation of negative symptoms'. However art therapy can still be unavailable. This paper describes how art therapy is offered to people on acute inpatient wards, and focuses on their experience of art therapy. A service evaluation was registered and approved by the NHS Trust allowing non – identifiable information collected within the art therapy service. People with acute mental health problems attending art therapy were invited to complete a short survey. The thoughts and experiences of respondents (n = 24) are reported here. The art therapy approach offered is informed by psychodynamic thinking and is adapted to meet the needs of people in acute inpatient settings who may be experiencing psychotic symptoms or have experienced trauma. Results found art therapy to be a positive experience. Themes included the ability for self –expression, to think more clearly, a reduction in stress levels, anxiety, anger, and voice hearing. People receiving art therapy while in hospital reported it to be a helpful part of their treatment and contributed to their overall recovery and discharge. Further views from people receiving art therapy and from staff would be helpful using a different method for example interviewing and focus groups. This paper describes art therapy as it was offered to people while they are staying on acute inpatient wards. We asked people who had attended art therapy for their feedback and we discuss how art therapy was offered in acute wards. The approach and theoretical framework of art therapy in acute inpatient care is explained as well as describing the experiences and views of 24 people who attended art therapy while in hospital and who agreed to take part in the service evaluation. People who used the service commented that they liked the calm atmosphere of the art therapy room and found it allowed time for them to express difficult feelings. People described feeling listened to and one person said it made them feel more human. Feedback indicated attending art therapy could lead to a reduction in symptoms such as anxiety, suicidal thoughts, voice hearing and stress. People using the service said art therapy was a welcome alternative or addition to medication in the treatment of their difficulties. To summarise, the paper describes how attending art therapy offers inpatients an opportunity to express difficult thoughts and feelings in a calm and relaxing setting and people reported that this helped reduce symptoms such as anxiety, suicidal thoughts and stress. [ABSTRACT FROM AUTHOR]

There is a significant diversity in approach to 'resilience' in the context of mental health recovery following experiences of psychosis, varying from clinically measurable outcomes to a personal trait within a recovery 'journey'. Given the contested nature of resilience within mental health literature, this study aimed to complete a scoping review to synthesise understandings of resilience by individuals with experiences of psychosis. Drawing on the holistic and person-centred principles that underpin social work approaches to mental distress, these perspectives are considered in the statutory, policy and critical contexts of British social work, establishing learning for practice. A meta-synthesis of qualitative studies was completed, drawing on searches of five databases (Social Care Online, APA PsychInfo, Cinahl, Medline and Web of Science), identifying twelve relevant papers. A thematic analysis identified three overarching themes (personal, social and professional factors) and eight associated sub-themes (personal responsibility, use of experience, coping strategies, peer support, social relationships, contribution, relationships with professionals and structured support). The study identifies systemic and life-course approaches as empowering service user engagements with psychosis, recovery and resilience, suggesting that the social work profession is well placed to engage with resilience enhancement in the context of mental health recovery. [ABSTRACT FROM AUTHOR]

Background: Reports of increasing presentations of new cases of acute psychosis both locally, nationally and internationally during the COVID-19 pandemic, warranted further investigation. International case reports almost exclusively reported only clinical outcome (e.g. remission of psychotic symptoms), and fail to report on social precipitants or social outcomes. This is a common omission when investigating new psychosis cases such as acute and transient psychotic disorder (ATPD). In order to assess social impacts and outcomes, we conducted a rapid review of recent evidence. Aims: To conduct a rapid review of the recent evidence of social outcomes on new cases of psychosis emerging during the COVID-19 pandemic. Method: Four databases (Medline, Embase, Psychinfo and Cochrane COVID-19) were searched for ATPD, psychosis and social outcomes in adults aged 18+. Duplicates were removed. There were no language limitations. Results: There were 24 papers consisting of 18 original data research papers and 6 reviews. Additionally, 33 papers/letters, reporting on 60 individual cases of psychosis emerging during the COVID-19 pandemic. These two sets of papers were reviewed separately. Many original data research papers and reviews were sub optimal in their quality, with 44% online surveys, with the remainder being routinely collected data. Conclusion: There is a consensus that clinical outcomes of ATPD and other brief psychotic disorders (BPD) are good in the short term. The focus only on symptomatic clinical presentation and outcomes, leaves a gap in our understanding regarding social stressors and longer term social outcomes. ATPD and BPD often may not come to the attention of Early Intervention in Psychosis services, and if they do, are discharged following symptomatic remission. Without an understanding of the social stress factors and social outcomes, opportunities may be missed to prevent increased social disability and future relapse with these presentations. [ABSTRACT FROM AUTHOR]

Introduction: For patients with psychosis, early, intensive therapeutic intervention is thought to improve long-term outcomes. Furthermore, patients with a first-episode psychosis (FEP) who experience a good early response to antipsychotic medication show a clinical and functional benefit over the longer term if they continue low-dose antipsychotic treatment. Lurasidone is an atypical antipsychotic agent which is approved in Europe for the treatment of schizophrenia in adults and adolescents (13–17 years). The efficacy and tolerability of lurasidone have been demonstrated in both antipsychotic-naïve and previously treated patients. Areas Covered: This paper provides a review and commentary regarding the use of lurasidone in patients with FEP. Case studies based on the authors' clinical experiences with lurasidone in real-world practice are provided. Expert Opinion: In our experience, lurasidone has shown efficacy in FEP in different patient profiles, including those with psychoses associated with substance use disorders. Lurasidone provides clinically relevant benefits, especially in patients with affective symptomatology, and has a good tolerability profile. [ABSTRACT FROM AUTHOR]

It is estimated that the incidence of first episode psychotic disorder is about 33 people out of 100,000 each year. Beyond primary psychotic illness (e.g., schizophrenia, schizophreniform disorder), some of these patients will develop psychotic disorder due to a complex interplay of genetics, anatomical variations, traumatic brain injury (TBI), environment, substance use, and/or other causes. A small subset of patients will develop psychotic disorder due to a structural anatomic lesion, such as a CNS tumor. Here we present a 35-year-old male with worsening auditory hallucinations after surgical resection and radiation of a right temporal lobe astrocytoma in the setting of co-morbid methamphetamine usage. This case report helps illustrate how a neuroimaging work-up is important for the first incidence of psychotic disorder and how a tumor can produce a psychotic disorder that persists after oncologic treatment. This paper adds to the literature on the presentation and treatment of post-resection tumor-induced psychotic disorder. [ABSTRACT FROM AUTHOR]

Learning Health Systems (LHSs) strive to continuously integrate innovations and evidence-based practices in healthcare settings, thereby enhancing programmatic and patient outcomes. Duration of untreated psychosis (DUP) is a variable worthy of empirical attention, as the construct has been identified as a leading predictor of psychotic spectrum disorder prognosis and, despite the proliferation of early intervention for psychosis (EIP) teams across the U.S., remains longer than the recommended maximum established by the World Health Organization. Pathways to care are causally implicated as a DUP reduction rate-limiting factor. This paper illustrates a balanced care model, wherein resource-intensive community and clinical services are centralized to support a more efficient, standardized, and direct pathway to EIP care; identification of psychosis and psychotic risk states is made by highly-trained diagnosticians; and measurement-based care across the Learning Health System (LHS) is supported by a central assessment team. The Central Assessment of Psychosis Service (CAPS) streamlines core front-end EIP functions across the LHS, thereby alleviating the burden on EIP teams while enhancing access, equity, efficiency, and quality of the initial psychodiagnostic assessment. CAPS represents an innovative application of the balanced care model that preserves the core functions of the EIP team while task sharing or task shifting resource-intensive activities to an academic medical center partner. We review the five core functions of a centralized referral, screening, and assessment service. Given the potential for centralization to reduce DUP and enhance equity and access across the LHS, this paper will include concrete recommendations for policymakers considering centralizing core functions. [ABSTRACT FROM AUTHOR]

Schizophrenia is a complex heterogenous disorder thought to be caused by interactions between genetic and environmental factors. The theories developed to explain the etiology of schizophrenia have focused largely on the dysfunction of neurotransmitters such as dopamine, serotonin and glutamate with their receptors, although research in the past several decades has indicated strongly that other factors are also involved and that the role of neuroglial cells in psychotic disorders including schizophrenia should be given more attention. Although glia were originally thought to be present in the brain only to support neurons in a physical, metabolic and nutritional capacity, it has become apparent that these cells have a variety of important physiological roles and that abnormalities in their function may make significant contributions to the symptoms of schizophrenia. In the present paper, we review the interactions of brain microglia, astrocytes and oligodendroglia with aspects such as transmitter dysregulation, neuro-inflammation, oxidative stress, synaptic function, the gut microbiome, myelination and the blood–brain barrier that appear to affect the cause, development and treatment of schizophrenia. We also review crosstalk between microglia, astrocytes and oligodendrocytes and the effects of antipsychotics on neuroglia. Problems associated with studies on specific biomarkers for glia in schizophrenia are discussed. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease psychosis (PDP) is one of the most severe and disabling non-motor symptoms in the progression of Parkinson's disease (PD), significantly impacting the prognosis of PD patients. In recent years, there has been an increase in literature on PDP. However, bibliometrics has rarely been applied to PDP research. This study provides an overview of the current state of PDP research and predicts future trends in this field. Methods: The literature search was conducted using the Web of Science Core Collection, with the search terms (Parkinson* AND (psychotic* OR hallucination* OR illusion* OR delusion* OR misperception* OR psychosis OR psychoses)). VOSviewer and CiteSpace software were employed to perform bibliometric analysis and visual representation of the search results. Results: A total of 603 articles were effectively included. Since 2017, there has been a significant upward trend in publications related to PDP. The United States, the United Kingdom, and Canada were the top three contributing countries in terms of publication volume, with France also having a strong influence in this field. Movement Disorders and King's College London included and published the most articles on PDP. The paper titled " Hallucinations in Parkinson's Disease: Prevalence, Phenomenology, and Risk Factors " received the highest number of citations and average citations. Cluster analysis results identified brain, prevalence, connectivity, and atypical antipsychotics as key hotspots in this field. High-frequency keywords were grouped into three themes: neurobiology, therapeutic strategies, and symptom research. Among them, pimavanserin, risk, and functional connectivity have been the most studied areas in the past 7 years and are likely to remain key topics in future research. Conclusion: Research on PDP has garnered increasing attention. This study visualizes PDP research over the past 25 years to analyze global hotspots and trends. It offers researchers a valuable perspective for identifying key topics and understanding research trajectories in this expanding field. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: In inpatient wards, there is a risk that conflicts occur when nursing staff interact with psychotic patients.The Interactive Approach (IA) model is an action‐based model, used in psychiatric settings, to manage conflict situations. What this paper adds to existing knowledge?: The IA model can be used to improve communication between nursing staff and patients in numerous critical situations.Using a structured risk scale to evaluate a conflict can be an effective way to guide action and sort out the different aspects of communication between nursing staff and psychotic patients. What are the implications for practice?: The clarity of an action‐based model will help sort out which interventions are most likely to succeed in each conflict situation.The IA model highlights the importance of understanding and strengthening the patient's perspective, being flexible for each individual patient, and providing the patient with clear information about the situation. Introduction: The Interactive Approach (IA) model is a structured management tool used to improve communication between caregivers and patients in psychiatric care settings. Aim/Question: To examine the nursing staff's experiences of the IA model. How do they use the interventions in conflict situations with psychotic patients? Method: A sample of nursing staff (n = 11) was recruited from three psychosis inpatient care units. Semi‐structured questions covered staff experiences of working with the problem‐solving interventions in the IA model. Transcribed data were analysed by qualitative content analysis. Results: Three categories were defined: (1) 'To apply a flexible approach' describes how staff tried to adapt to each patient and situation; (2) 'Try to understand the person's inner world' describes the importance of active listening and exploring the patient's concerns; and (3) 'To communicate clearly' relates to experiences of clear communication and the setting up of boundaries. Discussion: The risk scale and training in communication skills helped the interaction between staff and patients in conflict situations. Different interventions were used with a focus on maintaining patient alliance. Implications for Practice: The findings highlight the importance of educational efforts and practical training, to prevent violence and the use of coercive measures. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: New parents who have previously experienced psychosis outside and/or following childbirth have an increased likelihood of experiencing an episode during the postpartum period.The decision to try to conceive can be agonising.Receiving care from a specialist perinatal community mental health team can improve outcomes. What does this paper add to existing knowledge?: This article offers a first‐person insight into the steps the author took to minimise the impact of an episode of postpartum psychosis and/or postnatal depression whilst navigating new motherhood. What are the implications for practice?: This lived experience narrative aligns with the evidence base that demonstrates specialist perinatal community mental health services improve outcomes.It highlights the importance of maternity care providers asking about mental health history to identify any previous episodes or family history and offering referral to a specialist perinatal mental health service if available. Introduction: Postpartum psychosis is a life‐changing but treatable condition that usually occurs in the first few days to weeks after childbirth affecting 1–2 in 1000 pregnancies. Those who have experienced psychosis before, either as a single episode, related or unrelated to childbirth or as part of a long‐term mental health condition have a higher likelihood of experiencing an episode in the postnatal period. Aim: In this lived experience narrative the author shares personal experience of planning and navigating pregnancy with a higher likelihood of experiencing postpartum psychosis and postnatal depression around this major life transition due to previous episodes. Methods: The author utilises a first‐person approach to share and reflect on her lived experience. Findings: The author shares her experience of receiving care and some of the steps she took to try to manage the impact of pregnancy and birth on her mental health during this major life transition. She describes how care from a specialist perinatal community mental health team and peer support contributed significantly to her family's well‐being. Discussion: Specialist perinatal community mental health services can improve outcomes for those with a higher likelihood of experiencing postpartum psychosis and postnatal depression by facilitating planning and mitigating some of the risks that could lead to relapse in the perinatal period. [ABSTRACT FROM AUTHOR]

The author discusses aspects related to therapeutic approach to psychosis and reference from Diagnostic and Statistical Manual of Mental Disorders (DSM5). Topics discussed include narrative therapy approach to provide satisfactory result, collaborative approach for producing primary results, and Hearing Voices Network.

The paper reviews the entire spectrum of Artificial Intelligence (AI) in mental health and its positive role in mental health. AI has a huge number of promises to offer mental health care and this paper looks at multiple facets of the same. The paper first defines AI and its scope in the area of mental health. It then looks at various facets of AI like machine learning, supervised machine learning and unsupervised machine learning and other facets of AI. The role of AI in various psychiatric disorders like neurodegenerative disorders, intellectual disability and seizures are discussed along with the role of AI in awareness, diagnosis and intervention in mental health disorders. The role of AI in positive emotional regulation and its impact in schizophrenia, autism spectrum disorders and mood disorders is also highlighted. The article also discusses the limitations of AI based approaches and the need for AI based approaches in mental health to be culturally aware, with structured flexible algorithms and an awareness of biases that can arise in AI. The ethical issues that may arise with the use of AI in mental health are also visited. [ABSTRACT FROM AUTHOR]

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Background and Objectives: The study aims to provide a comprehensive neuropsychological analysis of psychotic spectrum disorders, including schizophrenia, bipolar disorder, and depression. It focuses on the critical aspects of cognitive impairments, diagnostic tools, intervention efficacy, and the roles of genetic and environmental factors in these disorders. The paper emphasizes the diagnostic significance of neuropsychological tests in identifying cognitive deficiencies and their predictive value in the early management of psychosis. Materials and Methods: The study involved a systematic literature review following the PRISMA guidelines. The search was conducted in significant databases like Scopus, PsycINFO, PubMed, and Web of Science using keywords relevant to clinical neuropsychology and psychotic spectrum disorders. The inclusion criteria required articles to be in English, published between 2018 and 2023, and pertinent to clinical neuropsychology's application in these disorders. A total of 153 articles were identified, with 44 ultimately included for detailed analysis based on relevance and publication status after screening. Results: The review highlights several key findings, including the diagnostic and prognostic significance of mismatch negativity, neuroprogressive trajectories, cortical thinning in familial high-risk individuals, and distinct illness trajectories within psychosis subgroups. The studies evaluated underline the role of neuropsychological tests in diagnosing psychiatric disorders and emphasize early detection and the effectiveness of intervention strategies based on cognitive and neurobiological markers. Conclusions: The systematic review underscores the importance of investigating the neuropsychological components of psychotic spectrum disorders. It identifies significant cognitive impairments in attention, memory, and executive function, correlating with structural and functional brain abnormalities. The paper stresses the need for precise diagnoses and personalized treatment modalities, highlighting the complex interplay between genetic, environmental, and psychosocial factors. It calls for a deeper understanding of these neuropsychological processes to enhance diagnostic accuracy and therapeutic outcomes. [ABSTRACT FROM AUTHOR]

While both Attention deficit hyperactivity disorder (ADHD) and schizophrenia are considered to have neurodevelopmental origins with associated impairments in executive functioning, there is a paucity of clinical guidelines pertaining specifically to this comorbidity. We sought to summarize the existing literature on ADHD in early psychosis patients, focusing on issues that would be most relevant to clinical practice. For this narrative review, we completed a search on PubMed and PsycINFO with 22 papers meeting criteria for review. Overall, it appears that a diagnosis of ADHD in childhood increases the risk of the subsequent development of a primary psychotic disorder. This risk may be modified by higher rates of substance use and could be related to shared premorbid risk factors for both conditions, such as obstetrical complications. Stimulant use has been associated with the onset of psychotic symptoms in some individuals, but it is unclear whether certain subgroups are more susceptible. Despite the fact that these two conditions co-occur relatively frequently, there is currently a lack of objective diagnostic tests for ADHD specific to populations with primary psychotic disorders, and a paucity of evidence on whether stimulants are effective for ADHD symptoms in this sub-group. Future research is warranted to investigate whether stimulant treatment confers any additional risks for symptom exacerbation in individuals with primary psychotic disorders taking antipsychotic maintenance treatment. [ABSTRACT FROM AUTHOR]

Introduction Some patients with the diagnosis of a psychotic disorder wish to minimize or avoid medications. Methods We report qualitative and quantitative data on a group of patients as a proof of concept study–that management with minimal or no medication is possible. Patients A series of 60 adult patients presented with psychosis and engaged with us in dialogical psychotherapy, medication, and lifestyle management over at least six months in an effort to minimize or eliminate medication. An additional 209 patients presented for treatment but did not continue for six months. An anonymous, matched comparison group of 60 patients of the same age, socio-economic status, diagnosis, and severity of illness was generated from the electronic health records at another large clinic where one of us also worked (LMM). We quantifed symptom level using the Brief Psychiatric Rating Scale, the Positive and Negative Syndrome Scale, two depression rating scales, the Clinical Global Inventory, and the Revised Behavior and Symptom Identification Scale. Narrative interviews of all 269 patients generated qualitative data. Results Thirty-nine patients managed well without medication; 16 managed well on low-dose medication. Four individuals required progressively higher levels of medication and one decompensated. The overall cost-benefit was favorable in creating fewer hospitalization, crises, and diminished suicidality. Conclusions The results suggest the need for individualized approaches that are client-centered and build upon the previous successes of the person, enroll family and friends in a community effort, and collaborate with those communities to apply those approaches desired by the people themselves. [ABSTRACT FROM AUTHOR]

Delirium is an acute, global cognitive disorder syndrome, also known as acute brain syndrome, characterized by disturbance of attention and awareness and fluctuation of symptoms. Its incidence is high among critically ill patients. Once patients develop delirium, it increases the risk of unplanned extubation, prolongs hospital stay, increases the risk of nosocomial infection, postintensive care syndrome-cognitive impairment, and even death. Therefore, it is of great importance to understand how delirium occurs and to reduce the incidence of delirium in critically ill patients. This paper reviews the potential pathophysiological mechanisms of delirium in critically ill patients, with the aim of better understanding its pathophysiological processes, guiding the formulation of effective prevention and treatment strategies, providing a basis for clinical medication. [ABSTRACT FROM AUTHOR]

Objective: This review aims to synthesize and critically evaluate the existing literature on kratom use and its possible association with induction of psychotic and manic symptoms, in order to identify potential areas for future research that would improve our understanding of the risks of kratom consumption. Methods: An electronic search was performed using five major databases: including PubMed, Scopus, Google Scholar, Web of Science, and PsycINFO. keywords such as kratom, Mitragyna speciosa, mania, psychosis, bipolar disorder, schizophrenia, schizoaffective, case report, and case series. The retrieved articles on initial search were screened based on predefined inclusion and exclusion criteria for this study, and then data synthesis was performed to analyze relevant information from the included studies. Results: Six prior papers were found using (1 case series and 5 case reports). These included 10 cases, involving kratom use association with mania and psychosis. The ages of patients ranged from 28 to 55 years mean age was 38, and (SD 13.74), the majority were males (8 out of 11). Patients had durations of kratom use ranging from 2 wk to 15 years. Significant association was found between kratom use and the worsening of psychotic and manic symptoms in individuals with psychiatric conditions. Conclusions: Our research highlights the possibility of worsening preexisting psychiatric conditions in the context of kratom use. This study emphasizes the need for clinical evaluation of patients for kratom use. Additional research is required to gain a deeper understanding of the potential mental health implications of kratom use, especially among vulnerable populations. [ABSTRACT FROM AUTHOR]

This article from the American Journal of Psychiatry provides a comprehensive overview of various topics related to schizophrenia spectrum disorders and psychosis. It includes studies on the use of antipsychotic medications, the potential adverse events of long-term clozapine treatment, the benefits of hormonal replacement therapy for menopausal women with schizophrenia, the risk of inducing psychosis or mania with prescribed stimulants, neural signatures associated with depressive versus negative symptoms in schizophrenia patients, and gene expression patterns in the prefrontal cortex. The article emphasizes the importance of monitoring and preventing adverse events related to clozapine treatment and highlights the potential benefits of hormonal replacement therapy for menopausal women with schizophrenia. It also discusses the increased risk of developing psychosis or mania with prescribed amphetamines and provides insights into the neural circuitry underlying depressive and negative symptoms in schizophrenia patients. Overall, this article offers valuable information for researchers and individuals interested in understanding and addressing schizophrenia spectrum disorders. [Extracted from the article]

Embracing a history of psychoanalytic thought, this paper reimagines therapeutic practice to honor the dignity and subjectivity of persons with psychosis. Drawing on psychoanalytic perspectives, the author critiques the mechanisms that segregate individuals with severe psychiatric distress, perpetuating isolation and marginalization. Highlighting the institutional circuit that confines many to a cycle of transient care, the paper argues for a psychoanalytic clinic of solidarity that fosters genuine relationality. It critiques prevailing treatment paradigms that prioritize symptom suppression over existential engagement, advocating instead for therapeutic approaches rooted in empathetic presence and mutual recognition. Ultimately, it proposes solidarity as a foundational principle for transformative care that seeks to restore agency and belonging to persons with psychosis. [ABSTRACT FROM AUTHOR]

This paper presents evidence that some—but not all—religious experts in a particular faith may have a schizophrenia-like psychotic process which is managed or mitigated by their religious practice, in that they are able to function effectively and are not identified by their community as ill. We conducted careful phenomenological interviews, in conjunction with a novel probe, with okomfo, priests of the traditional religion in Ghana who speak with their gods. They shared common understandings of how priests hear gods speak. Despite this, participants described quite varied personal experiences of the god's voice. Some reported voices which were auditory and more negative; some seemed to describe trance-like states, sometimes associated with trauma and violence; some seemed to be described sleep-related events; and some seemed to be interpreting ordinary inner speech. These differences in description were supported by the way participants responded to an auditory clip made to simulate the voice-hearing experiences of psychosis and which had been translated into the local language. We suggest that for some individuals, the apprenticeship trained practice of talking with the gods, in conjunction with a non-stigmatizing identity, may shape the content and emotional tone of voices associated with a psychotic process. [ABSTRACT FROM AUTHOR]