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With the growing availability of medical data and the enhanced performance of computers, new opportunities for data analysis in research are emerging. One of these modern approaches is machine learning (ML), an advanced form of statistics broadly defined as the application of complex algorithms. ML provides innovative methods for detecting patterns in complex datasets. This enables the identification of correlations or the prediction of specific events. These capabilities are especially valuable for multifactorial phenomena, such as those found in mental health and forensic psychiatry. ML also allows for the quantification of the quality of the emerging statistical model. The present study aims to examine various sociodemographic variables in order to detect differences in a sample of 370 offender patients and 370 non-offender patients, all with schizophrenia spectrum disorders, through discriminative model building using ML. In total, 48 variables were tested. Out of seven algorithms, gradient boosting emerged as the most suitable for the dataset. The discriminative model finally included three variables (regarding country of birth, residence status, and educational status) and yielded an area under the curve (AUC) of 0.65, meaning that the statistical discrimination of offender and non-offender patients based purely on the sociodemographic variables is rather poor. [ABSTRACT FROM AUTHOR]

Background Diagnostic criteria for mental disorders are subject to change. This is particularly true for schizophrenia, whose diagnostic criteria in the current DSM-5 bear little resemblance to what Kraepelin once named "dementia praecox" and Bleuler termed "the schizophrenias." The present study reports results from a survey of experts on two core topics of schizophrenia: (a) whether subsequent editions of the DSM should once again give the Schneiderian first-rank symptoms (FRS; eg, thought broadcasting) the prominent role they had in the DSM-IV and (b) whether the currently quite narrow definition of hallucinations in the DSM-5 requiring them to be vivid and clear and have the full force and impact of normal perceptions should be broadened to incorporate perceptual-like phenomena that the individual can differentiate from proper perceptions but still perceives as real and externally generated. Hypothesis The aim of the survey was to learn about experts' opinions with no clear hypotheses. Study Design International experts on schizophrenia were recruited via various sources and invited to participate in a short online survey. The final sample comprised 136 experts with a subgroup of 53 experts with verified identity and at least 6 years of clinical and/or research experience. Study Results Slightly more experts voted in favor (49.3%) of returning FRS to the prominent role they had in earlier versions of the DSM than against (34.6%). Approximately four out of five experts agreed that the definition of hallucinations in the DSM should be expanded. According to the results, alongside internal symptoms that are phenomenologically indistinguishable from true perceptions, sensory intrusions that the holder is convinced were inserted from another source (ie, not self-generated) should be included in the definition. Conclusions While a large majority of experts recommend a change in the definition of hallucinations, the experts' opinions on FRS are more mixed. We hope that this article will stimulate future studies targeting the diagnostic relevance of these symptoms and encourage discussion about the definition of core psychotic symptoms and the diagnostic criteria for the upcoming edition of the DSM. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a prevalent psychiatric disorder that affects 1% of the global population. Schizophrenia frequently begins in late adolescence or early adulthood, causing significant educational, social, and economic costs for people and society. Functional neuroimaging research on schizophrenia physiopathology has been beneficial. Arterial spin labelling (ASL) is one of functional magnetic resonance imaging (fMRI) technologies that assess brain function without radiation. ASL uses magnetic resonance (MR) imaging to quantify tissue-level brain perfusion non-invasively. Arterial spin labelling (ASL) is one of the functional magnetic resonance imaging (fMRI) technologies that assess the brain function without radiation hazards. ASL uses magnetic resonance (MR) imaging to quantify tissue-level brain perfusion non-invasively. Many publications were performed on role of different advanced MRI techniques in schizophrenia, but our study insisted on the added value of combined ASL and MRS over the conventional MRI in schizophrenic Egyptian population sample. Aim of the work: The purpose of this work was to evaluate the added value of combined ASL-perfusion MRI and MRS in schizophrenic patients. Methods: This prospective case–control study was carried out on two groups: First group was 30 patients who were diagnosed clinically as schizophrenic patients, and second group was 20 healthy volunteers as a control group for comparison in the period from August 2021 till July 2022. Results: The majority of newly diagnosed cases had significant higher positive symptoms than chronic cases. According to arterial spin labelling (ASL) data, rCBF was noticed to be reduced in anterior cingulate, frontal lobe, and parietal lobe of both patients' subgroups but more significant in chronically ill patients. Convergent results of decreased rCBF were also found in the parietal lobe and occipital lobe. Magnetic resonance spectroscopic analysis showed that NAA was decreased in the anterior cingulate cortex, thalami and basal ganglia of the newly diagnosed cases more than chronic cases. The ASL-MRI perfusion accurately detected the hypo-perfusion of different brain regions with sensitivity 100%, specificity 66.67%, positive predictive value 96.43%, negative predictive value 100%, and accuracy 96.67%, while MR spectroscopy showed sensitivity 100%, specificity 33.33%, positive predictive value 93.10%, negative predictive value 100%, and accuracy 93.33% in evaluation of changes of brain metabolites. Conclusion: ASL is a promising functional MRI technique that can produce together with MRS quantitative information about the metabolites of different brain regions. The ASL-MRI appears as a reliable non-invasive technique to measure cerebral blood flow and identify decreased rCBF without any contrast administration, and it could be repeatable which helps in early diagnosis as well as follow-up of the progression of the disease. [ABSTRACT FROM AUTHOR]

The period of time following discharge from an inpatient setting presents a unique window of opportunity for people with psychosis to engage in psychological treatment. In England, The National Institute for Health and Care Excellence (NICE) guidelines outline that every person with a schizophrenia diagnosis should be offered individual Cognitive Behavioural Therapy for psychosis (CBTp) and Family Intervention (FI). This study aimed to explore rates of offer and receipt of NICE recommended therapies for adults with a schizophrenia spectrum disorder diagnosis in the year following discharge from an inpatient unit. We then investigated possible predictors of therapy offer and receipt. We used a large electronic healthcare records database to perform a secondary data analysis. A generalised linear regression model was used to explore possible predictors. Overall, our results showed low rates of offer and receipt of recommended therapies (Any recommended therapy (CBT only, FI only or CBT + FI) received = 39(8%), offered = 70(15%)). Predictor variable results were identified and discussed. The low level of offer and receipt of recommended therapies is concerning given the recommendations in the NICE guidelines for people with psychosis. Our study highlighted the need for more consistent and reliable procedures for recording this information. Further investigation into the reasons for low levels of implementation overall is important to aid the development of recommendations for how this can be improved. [ABSTRACT FROM AUTHOR]

Objective: People with mental health conditions have high rates of chronic physical diseases, partially attributable to lifestyle risks factors. This study examined risk prevalence among community mental health service clients, their readiness and confidence to change, and associations with participant characteristics. Methods: Cross-sectional survey of adult clients from 12 community mental health services across 3 local health districts in New South Wales, Australia, collected from 2021 to 2022. Participants (n = 486) completed a telephone interview determining five risk factors, and readiness and confidence to change these. Multiple binary logistic regression models determined associations between readiness and confidence (for each risk), and participant characteristics (demographics and diagnosis). Results: Participants most commonly reported a diagnosis of schizophrenia (36.7%) or depression (21.1%). Risk factors were prevalent: ranging from 26% (harmful alcohol use) to 97% (poor nutrition). High readiness was greatest for smoking (68%), weight (66%) and physical inactivity (63%), while confidence was highest for changing alcohol use (67%). Two significant associations were identified; females were more likely than males to have high readiness to change nutrition (odds ratio = 1.14, confidence interval = [1.13, 2.34], p = 0.0092), with males more likely to have high confidence to change physical activity (odds ratio = 0.91, confidence interval = [0.45, 0.99], p = 0.0109). Conclusions: Many participants were ready and confident to change risk factors. Gender influenced readiness to change nutrition and physical activity confidence. Training to upskill mental health clinicians in provision of preventive care that builds confidence and readiness levels may aid in supporting positive behaviour change. [ABSTRACT FROM AUTHOR]

Schizophrenia (SCZ) and schizoaffective disorder (SHZ) are psychiatric disorders commonly identified in individuals in their late adolescence or early adulthood. Comorbidities are common, though a concurrent diagnosis of leukemia, one of the most frequently occurring cancers of adolescence, has not yet been described in such cases. This case study outlines the clinical presentation, course, and treatment response of two 17-year-old male adolescents whose psychotic disorders complicated their leukemia treatment. The first patient was diagnosed with leukemia and subsequently with SCZ while undergoing leukemia treatment. The second patient was diagnosed with SHZ prior to the onset of leukemia. The case study will follow the methodology of Robert E. Stake (Abma & Stake, 2014), as the two cases share a leukemia diagnosis and the reported mental health impact connected with cancer-directed treatment. Early identification and treatment are critical for both psychotic disorders and cancers, often impacting the long-term prognosis. However, when co-occurring, their interplay can present unique challenges to care. [ABSTRACT FROM AUTHOR]

When one is seriously ill, the diagnosis given can generate questions about what it means and how to make sense of it. This is particularly the case for psychiatric diagnoses which can convey a biomedical narrative of the sufferer's condition. Making sense of one's diagnosis in such cases can involve changing one's self‐narrative in such a way as to incorporate the belief that one has developed a disease with an unknown cause. To demonstrate the importance of self‐narratives, I outline key themes in narrative theory which have been explored in various ways by philosophers and some psychologists. These theorists emphasise the importance of self‐narratives in creating meaning for their authors. The biomedical narrative associated with a psychiatric diagnosis may conflict with the recipient's previous self‐narratives. This may reduce the recipient's sense of self‐efficacy and induce feelings of hopelessness about recovery. I argue that those receiving a psychiatric diagnosis may consequently be vulnerable to epistemic injustice. In particular, this includes hermeneutical injustice, where individuals lack the ability to understand or articulate their experiences in ways that make sense to them, due to their hermeneutical resources being marginalised by the dominant narrative in a medicalized environment. I consider two possible objections to my claim and offer answers to these. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Nonpsychotic symptoms (depression, anxiety, obsessions, etc.) are frequent in schizophrenia-spectrum disorders and are usually conceptualized as comorbidity or transdiagnostic symptoms. However, in twentieth century foundational psychopathological literature, many nonpsychotic symptoms with specific phenomenology (here termed pseudoneurotic symptoms) were considered relatively typical of schizophrenia. In this prospective study, we investigated potential associations of pseudoneurotic symptoms with diagnostic status, functional outcome as well as psychopathological dimensions of schizophrenia. Study Design First-admitted patients (N = 121) diagnosed with non-affective psychosis, schizotypal disorder, or other mental illness were examined at initial hospitalization and 5 years later with a comprehensive assessment of psychopathology. Informed by the literature, we constructed scales targeting pseudoneurotic symptoms and other, more general, nonpsychotic symptoms. Study Results Pseudoneurotic symptoms aggregated in schizophrenia-spectrum groups compared to other mental illnesses and occurred at similar levels at baseline and follow-up. They longitudinally predicted poorer social and occupational functioning in schizophrenia-spectrum patients over a 5-year-period but not transition to schizophrenia-spectrum disorders from other mental illnesses. Finally, the level of pseudoneurotic symptoms correlated with disorder of basic self at both assessments and with positive and negative symptoms at follow-up. The scale targeting general nonpsychotic symptoms did not show this pattern of associations. Conclusions The study supports that a group of nonpsychotic symptoms, ie, pseudoneurotic symptoms, are associated with schizophrenia-spectrum disorders and linked with temporally stable psychopathology, particularly disorder of the basic self. Their prospective association with social and occupational functioning needs replication. [ABSTRACT FROM AUTHOR]

The objective of the present systematic review is to answer the following question: is there enough scientific evidence to conclude that virtual reality is an effective tool to evaluate and treat the symptoms of people diagnosed with with schizophrenia? Eight systematic literature reviews and one meta-analysis focused on this question have recently been published. However, while they tend toward the conclusion that VR is of value in the evaluation and treatment of people diagnosed with schizophrenic disorders, they have important limitations. We used the PRISMA method. Using the keywords "virtual reality", "video game", "schizophrenia", "therapy" to search in four databases. 31 articles met our selection criteria (with independent double screening). We analyzed the objectives, methods, tools and results of each article. Twenty of the selected articles provide scientific evidence of the effectiveness of VR for evaluating different domains in schizophrenia. The other eleven articles focus on evidence of therapeutic effectiveness of interventions with VR tools. However, because of the diversity of the dimensions evaluated or treated, and of the VR tools used, replication studies are lacking. There is some scientific evidence that VR tools can be effective in the evaluation and treatment of dimensions of schizophrenia, in particular cognitive dimensions. However, additional studies are needed to confirm these results, replicating measures of the same dimensions using the same VR tools. [ABSTRACT FROM AUTHOR]

Background: Despite worldwide concern about the poor physical health of patients with schizophrenia spectrum disorders (SSD), physical health screening rates are low. This study reports nurses' and patients' experiences of physical health screening among people with SSD using the Finnish Health Improvement Profile (HIP-F) and their ideas for implementation improvements. Methods: A qualitative exploratory study design with five group interviews with nurses (n = 15) and individual interviews with patients with SSD (n = 8) who had experience using the HIP-F in psychiatric outpatient clinics. Inductive content analysis was conducted. Results: Two main categories were identified. First, the characteristics of the HIP-F were divided into the subcategories of comprehensive nature, facilitating engagement, interpretation and rating of some items and duration of screening. Second, suggestions for the implementation of physical health screening consisted of two subcategories: improvements in screening and ideas for practice. Physical health screening was felt to increase the discussion and awareness of physical health and supported health promotion. The HIP-F was found to be a structured, comprehensive screening tool that included several items that were not otherwise assessed in clinical practice. The HIP-F was also considered to facilitate engagement by promoting collaboration in an interactive way. Despite this, most of the nurses found the HIP-F to be arduous and too time consuming, while patients found the HIP-F easy to use. Nurses found some items unclear and infeasible, while patients found all items feasible. Based on the nurses' experiences, screening should be clear and easy to interpret, and condensation and revision of the HIP-F tool were suggested. The patients did not think that any improvements to the HIP-F were needed for implementation in clinical settings. Conclusions: Patients with schizophrenia spectrum disorders are willing to participate in physical health screening. Physical health screening should be clear, easy to use and relatively quick. With this detailed knowledge of perceptions of screening, further research is needed to understand what factors affect the fidelity of implementing physical health screening in clinical mental health practice and to gain an overall understanding on how to improve such implementation. [ABSTRACT FROM AUTHOR]

Background: A variety of psychiatric illnesses can develop in children of parents who suffer from bipolar affective disorder. Aims: The purpose of the research was to investigate, among the offsprings of patients diagnosed with schizophrenia and bipolar disorder type I, the prevalence of a variety of psychiatric diseases as well as a range of behavioral abnormalities. Method: This was a cross-sectional observational comparative study. The outpatient psychiatric clinics at Shebin Elkom Mental Health Hospital, Menofia Governorate, Egypt 500 offspring (there were 250 offspring of parents both diagnosed with schizophrenia and 250 offsprings born to parents with bipolar affective disorder). Results: Statistically significant association of male gender with somatic complaints, social problems, and attention problems in the bipolar offspring group. In addition, there was a statistically significant association between female gender and anxiety or depression in the bipolar offspring group. Moreover, there was a statistically significant association between male gender and thought problems and aggressive behavior in the schizophrenia group. Assessment of psychiatric symptoms using K-SADS in relation to gender revealed a statistically significant association of male gender with affective disorder, behavioral disorder, and substance use disorder in the bipolar offspring group. Moreover, there was a statistically significant association between female gender and psychotic disorder in the schizophrenia group. Conclusion: We concluded that offspring with bipolar illness had a significant association with somatic symptoms, anxiety/depressive disorder, social issues, attention problems, and aggressive behavior. Schizophrenia offspring were strongly related to thought issues. [ABSTRACT FROM AUTHOR]

Background: Severe Mental Disorders (SMDs) cause mental health worldwide challenges because of several relapses and extensive recovery periods of hospitalization, which put a lot of economic and social burden on families and governments. Therefore, interventions are necessary to decrease the relapse of these disorders. Aim: This study was conducted to investigate the effect of Information Technology Assisted Relapse Prevention Program (ITAREP) on relapse among people who live with SMDs. Method: This study was a randomized clinical trial with intervention and control groups. ITAREP is a remote intervention based on monitoring the Early Warning Signs (EWS) to decrease the number of potential relapses. Using convenience sampling, people with SMDs admitted to Sina Juneqan Psychiatric Hospital and their caregivers were recruited in this study and randomly allocated to the control and intervention groups. Two checklists of the EWS for the patient and the patient's caregiver were used for monitoring the relapse signs. Data were collected at baseline and 90 days after discharge and were analyzed using t -test and Chi-square statistical tests and linear regression in SPSS software. Results: Fifty-two patients who lived with SMDs participated in this study (26 in the intervention group and 26 in the control group). The two groups were homogeneous regarding age, gender, type of mental disorder, and duration of the disorder. Forty-two males and ten females participated in this research. Most of the participants were diagnosed with schizophrenia. The results showed that the number of relapses in the intervention group was significantly lower than in the control group in the post-test. Conclusion: Social workers, as the case managers and a member of the interdisciplinary psychiatric team, can actively perform follow-up measures after discharge using ITAREP, and it can be expected that these interventions will reduce the number of relapses among patients who live with SMDs. [ABSTRACT FROM AUTHOR]

This study examined hospitalizations in a large, all-payer, nationally representative sample of inpatient hospitalizations in the US and identified differences in rates of hospitalization for conditions by race and ethnicity in autistic adults. Conditions examined included mood disorders, epilepsy, schizophrenia, and ambulatory care sensitive conditions (ACSCs). Compared to white, non-Hispanic autistic adults, Black, Hispanic, Asian or Pacific Islander (API), and autistic adults of another race had lower prevalence of admission for a principal diagnosis of a mood disorder. Conversely, Black, Hispanic, API, and autistic adults of another race had higher odds of admission for epilepsy than white autistic adults. Black and Hispanic autistic adults were more likely to have schizophrenia as a principal diagnosis compared to white autistic adults, but only Black autistic adults had increased odds for admission for an ACSCs compared to white autistic adults. Differences in diagnosis prevalence among hospitalized autistic adults may suggest differential access to comprehensive outpatient care that could prevent such hospitalizations, while also pointing to concerns of differential validity of diagnostic tools and treatment approaches. Insurance policy and programs should prioritize optimizing outpatient care to ensure access to care and emphasize the need for equitable treatment. [ABSTRACT FROM AUTHOR]

As recently as the late 20th century, Schizophrenia, a category of mental illness with widely varying phenotypic symptoms, was believed by psychobiologists to be a genetically based disorder in which the environment played a limited etiological role. Yet a growing body of evidence indicates a strong correlation between schizophrenia and environmental factors. This theoretical paper explores the relationship between highly elevated rates of schizophrenia in some low-income minority communities worldwide and trauma-related dissociative symptoms that often mimic schizophrenia. Elevated rates of schizophrenia in racially and ethnically isolated, inner-city Black populations are well documented. This paper contains evidence proposing that this amplification in the rate of schizophrenia is mediated by childhood trauma, disorganized attachment, and social defeat. Further, evidence demonstrating how these three variables combine in early childhood to incubate dissociative disorders will also be conveyed. The misdiagnosis of dissociative disorders as schizophrenia is theorized to partially mediate the increased rate of schizophrenia in communities that experience high levels of racial/ethnic discrimination. It is argued that this misdiagnosis is often attributable to cultural misunderstanding and/or a lack of knowledge about dissociative disorders [ABSTRACT FROM AUTHOR]

Assess prevalence of serious mental illness (SMI) alone, and co-occurring with Alzheimer disease and related dementias (ADRD), among Medicare beneficiaries in assisted living (AL). Examine the association between permanent nursing home (NH) placement and SMI, among residents with and without ADRD. 2018-2019 retrospective cohort of Medicare beneficiaries in AL. Residents were followed for up to 2 years to track their NH placement. We used data from the Medicare Enrollment Database, the Medicare Beneficiary Summary File, Minimum Data Set, and a national directory of state-licensed AL communities. AL residents were identified using a validated, previously reported 9-digit zip code methodology. A cross-sectional study sample included 289,350 Medicare beneficiaries in 17,265 AL communities across 50 states and in the District of Columbia. The outcome was permanent NH placement: a continuous stay for more than 90 days. Key independent variable was presence of SMI—schizophrenia, bipolar disorder, and major depression. Other covariates included sociodemographic factors and presence of other chronic conditions, including ADRD. A linear probability model with robust SEs, and AL-level random effects, was used to test the association between SMI diagnoses, ADRD, and their interactions on NH placement. More than half (55.65%) of AL residents had a diagnosis of SMI, among them 93.2% had major depression, 28.5% schizophrenia, and 22.2% bipolar disorder. Individuals with schizophrenia and bipolar disorder had a significantly lower probability of NH placement, a 32% and a 15% decrease relative to the cohort mean, respectively. Placement risk was significantly greater for residents with ADRD compared to those without, increasing for those who also had schizophrenia or bipolar disorder, 12.9% and 1.5% relative to the sample mean, respectively. Presence of schizophrenia and bipolar disorder, in conjunction with ADRD, significantly increases the risk of long-term NH placement, suggesting that ALs may not be well prepared to care for these residents. [ABSTRACT FROM AUTHOR]

Le but de ce travail est d'explorer les multiples aspects du « Praecox Feeling » tels qu'il a été décrit par le psychiatre néerlandais H.C. Rümke et développé dans les suites par ses pairs. Nous proposons une présentation historique sur ce sujet allant des premières descriptions aux études les plus récentes. Nous proposons d'y associer des notions voisines telles que les processus de typification et le jugement expert (Gut feeling) en y intégrant des aspects épistémologiques. Le Praecox Feeling a été présenté par Rümke comme le moyen le plus sensible pour diagnostiquer une schizophrénie. Phénomène singulier de la rencontre clinique, il peut être décrit comme une expérience de bizarrerie ou d'étrangeté vécue par le clinicien au contact de son patient. Rümke conclut que le diagnostic de schizophrénie ne se fait pas strictement par une description précise des symptômes, mais en examinant son propre ressenti. De nombreux auteurs et chercheurs ont travaillé sur ce sujet et sont pour la plupart sensibles à une approche phénoménologique. Ainsi, Minkowski, Binswanger ou Tellenbach, parmi d'autres, ont permis d'affiner cette notion en parlant de « diagnostic par intuition », « diagnostic par pénétration » ou encore « diagnostic atmosphérique ». Malgré un abandon progressif de la subjectivité dans le processus diagnostique en psychiatrie, on retrouve dans la littérature contemporaine un regain d'intérêt de telles approches. On peut ainsi citer les processus de typifications ou encore le jugement expert (Gut feeling) qui proposent d'éclairer les mécanismes en jeu via une approche issue en partie des sciences cognitives et sociales. Ainsi, il apparaît que la question du diagnostic et de ses processus dépasse le strict champ psychiatrique pour rejoindre celui de la médecine au sens large. The aim of this review is to explore the multiple aspects of the « Praecox Feeling » as introduced and developed by the Dutch Psychiatrist H.C Rümke in 1941 and re-assessed over the following years by its peers. We present a historical review of this subject from the first description to the most recent research and proposed related notions like typification processes and gut feeling. The Praecox Feeling, as presented by Rümke, may be considered as the most sensible tool in order to diagnose schizophrenia. This phenomenon appears in the in-between of the clinical encounter (i.e. the intersubjective space). It may be felt by the clinician as an experience of bizarreness during the interaction with a patient suffering from schizophrenia. Those feelings suggest fundamental aspects of schizophrenia that can be recognized as a peculiar form of embodiment. Rümke finally concludes that schizophrenia is not diagnosed by strictly examining patients' symptoms, but psychiatrists' own feelings. The recognition of such feelings remains hard to describe explicitly, since it takes place in a very basic (« pre reflexive ») state. However, numbers of researchers tried to explore praecox feeling more accurately. A phenomenological approach, with Minkowski, Binswanger or Tellenbach among others, developed several related terms: "Diagnostic by intuition", "Diagnostic by penetration" or "Atmospheric diagnosis". Although the precocity of the diagnosis is mentioned in Rümke's original paper, it does not precisely define the Praecox Feeling, contributing to the misunderstanding of the Rümke's original formulation. The very notion of Praecox Feeling in terms of psychiatric diagnoses fell into disuse with the development and the widespread diffusion of criteriological approaches, with the risk of an impoverishment of the clinical diagnosis. However, the study of specific subjective perspectives showed a renewed interest over the last decade, especially with the contribution of cognitive and social neurosciences. Furthermore, studies on psychiatrists' daily-practice suggest that the Praecox Feeling is still relevant. Moreover, "the subjective tool" represented by the Praecox Feeling remains as used today as it was fifty years ago, in a pre-DSM III era. Temporal aspects have, nevertheless, lead to several studies suggesting that many clinical indices are identified during the first minutes of a clinical interview, especially for schizophrenia. In order to specify this very intuitive pathway, authors developed and worked on the typifications processes that lead to such feelings, involving diagnosis through prototypes. The passive synthesis of such subtle clinical clues may induce for the clinician a "pattern recognition" phenomenon that reminds a "gestaltic" diagnosis. This specific aspect of typification may not be specific of psychiatry. The "Guts Feeling" is a notion first developed by Dutchs physicians, particularly in General medicine but also among other medicals disciplines, theoretically very close from the notion of intuitive typification. It may allow benefits in term of diagnoses, reassurance or alarm sense. It suggests that clinical experience added to criteriology provides risks reductions. The crucial role of clinical experience in the diagnosis decision making tends to be underexplored, but still represents a crucial aspect of the evidence-based medicine as firstly described. [ABSTRACT FROM AUTHOR]

Background and Aim: Brain-derived neurotrophic factor (BDNF) is a widely studied neurotrophin and is said to be involved in the regulation of many neuronal processes, including neurogenesis, neuronal differentiation, maturation, and survival. Over the years, research has shown a significant variation of serum BDNF levels in schizophrenia with no widespread agreement. Herein, we report on serum BDNF levels in drug-naive patients of schizophrenia in comparison to healthy controls (HC) and correlates of BDNF levels in patients of schizophrenia. Materials and Methods: The study sample consisted of 120 participants with 60 drug-naive patients of schizophrenia and 60 HC. The blood sample of the study subjects was collected and processed serum was analyzed using an enzyme-linked immunosorbent assay kit for BDNF levels. Clinical assessment of patients was done using the Positive and Negative Syndrome Scale (PANSS) and Montreal Cognitive Assessment. Results: Serum BDNF levels were significantly lower in drug-naive patients of schizophrenia as compared to age and sex-matched HC (P -- 0.024). The PANSS total score and positive subscale score were negatively correlated with serum BDNF levels which were statistically significant with P = 0.005 and P = 0.001, respectively. Conclusion: The index study found BDNF levels to be reduced in patients of schizophrenia and BDNF was found to correlate with severity of illness, especially positive symptoms. Thus, developing therapeutic strategies that can activate BDNF signaling may prove beneficial in improving the clinical outcome of schizophrenia. [ABSTRACT FROM AUTHOR]

The network theory of psychological disorders posits that systems of symptoms cause, or are associated with, the expression of other symptoms. Substantial literature on symptom networks has been published to date, although no systematic review has been conducted exclusively on symptom networks of schizophrenia, schizoaffective disorder, and schizophreniform (people diagnosed with schizophrenia; PDS). This study aims to compare statistics of the symptom network publications on PDS in the last 21 years and identify congruences and discrepancies in the literature. More specifically, we will focus on centrality statistics. Thirty-two studies met the inclusion criteria. The results suggest that cognition, and social, and occupational functioning are central to the network of symptoms. Positive symptoms, particularly delusions were central among participants in many studies that did not include cognitive assessment. Nodes representing cognition were most central in those studies that did. Nodes representing negative symptoms were not as central as items measuring positive symptoms. Some studies that included measures of mood and affect found items or subscales measuring depression were central nodes in the networks. Cognition, and social, and occupational functioning appear to be core symptoms of schizophrenia as they are more central in the networks, compared to variables assessing positive symptoms. This seems consistent despite heterogeneity in the design of the studies. [ABSTRACT FROM AUTHOR]

Early-onset schizophrenia (EOS) is an important psychiatric problem characterized by the onset of psychotic symptoms before the age of 18 years. We present the case of a 14-year-old girl who had social anxiety symptoms in the premorbid period and whose psychotic symptoms increased with pandemic restrictions and online education. Our patient's distance from the peer environment and school as well as the fact that she used webcams and online education more frequently in her daily life were risk factors for EOS. In accordance with the case of Truman syndrome, she has delusions that her daily life is secretly filmed and that she is a "TV star." Anti-anxiety treatments were initiated during the pre-pandemic period. After a diagnosis of schizophrenia was made, antipsychotic treatment was initiated. A significant response was observed after paliperidone (extended release) treatment. Close follow-ups revealed decreased delusions and increased functionality. Further studies are required to elucidate whether Truman syndrome and social anxiety are different aspects of a similar spectrum. With increasing digitalization, the direction of psychiatric diseases, including EOS, and measures that can be taken for adolescent mental health in crisis, such as pandemics, should be discussed in future research. [ABSTRACT FROM AUTHOR]

The reading the mind in the eyes test (RMET) – which assesses the theory of mind component of social cognition – is often used to compare social cognition between patients with schizophrenia and healthy controls. There is, however, no systematic review integrating the results of these studies. We identified 198 studies published before July 2020 that administered RMET to patients with schizophrenia or healthy controls from three English-language and two Chinese-language databases. These studies included 41 separate samples of patients with schizophrenia (total n = 1836) and 197 separate samples of healthy controls (total n = 23 675). The pooled RMET score was 19.76 (95% CI 18.91–20.60) in patients and 25.53 (95% CI 25.19–25.87) in controls (z = 12.41, p < 0.001). After excluding small-sample outlier studies, this difference in RMET performance was greater in studies using non-English v. English versions of RMET (Chi [Q] = 8.54, p < 0.001). Meta-regression analyses found a negative association of age with RMET score and a positive association of years of schooling with RMET score in both patients and controls. A secondary meta-analysis using a spline construction of 180 healthy control samples identified a non-monotonic relationship between age and RMET score – RMET scores increased with age before 31 and decreased with age after 31. These results indicate that patients with schizophrenia have substantial deficits in theory of mind compared with healthy controls, supporting the construct validity of RMET as a measure of social cognition. The different results for English versus non-English versions of RMET and the non-monotonic relationship between age and RMET score highlight the importance of the language of administration of RMET and the possibility that the relationship of aging with theory of mind is different from the relationship of aging with other types of cognitive functioning. [ABSTRACT FROM AUTHOR]

Research has highlighted that some types of mental disorders are associated with widespread discrimination and stigma, phenomena that negatively affect adherence. The aim of the present study was to examine the association between stigma and adherence to pharmacological treatment in patients diagnosed with bipolar mood disorder (BD), attention deficit hyperactivity disorder (ADHD) and schizophrenia (SZ). A total of 112 patients (age range: 20-68 years, Median age = 42.08; SD age = 12.02) from Brazil (38.4% ADHD, 34.8% SZ, and 26.8% TB) participated in the study. Treatment adherence was measured using the Medication Adherence Questionnaire, personal stigma by means of the Internalized Stigma of Mental Illness, Stigma Scale, and Perceived Devaluation and Discrimination Scale, and self-esteem with Rosenberg’s Self-Esteem Scale. Results showed an association between personal stigma and treatment adherence for all three types of disorder. The lower the personal stigma, the higher the adherence to treatment. The study highlights the role of stigma and self-esteem in relation to treatment adherence, with possible implications for future psychotherapy for these disorders. [ABSTRACT FROM AUTHOR]

Mental illness definitions and classifications are to a certain extent intrinsically tied to social factors. To empirically examine the impact of sociodemographic factors on patients institutionalized with dementia praecox in the early 20th century, we examined records from Dorothea Dix Hospital (DDH), an asylum in Southeastern United States. Data was extracted from digitally archived handwritten admission ledgers and general casebooks. Of those institutionalized at DDH between 1896-1917, 190 patients were diagnosed with dementia praecox. Clinical characteristics of patients are described using descriptive text analysis. We used regression models to examine the influence of sociodemographic factors on length of stay and release condition from the asylum. Race was not recorded for any patient and presumed White since DDH was not racially integrated until 1960s. Women had a significantly increased odds (OR = 3.8, p = 0.016) of dying in the facility than getting discharged; being single significantly increased the odds of dying in the facility (OR = 6.8, p = 0.002). Marital status predicted length of stay—being single increased the length of stay (b = 5.97, t (159) = 2.43, p = 0.016) adjusting for the effects of gender, age, and education. We report the impact of gender and marital status on patient release condition and length of stay in an asylum in the early 20th century. Results from the historical data we empirically examined are relevant today as women continue to experience disparities in mental health care. Family support was crucial to better outcomes then, as it is today. [ABSTRACT FROM AUTHOR]

Family members living with and caring for a relative diagnosed with schizophrenia may experience severe challenges that can result in secondary stress and influence various life domains. This article is based on a study which aimed to explore and describe the lived experiences of these family members. The study applied a qualitative research approach with phenomenology as the strategy of inquiry. The study implemented voluntary snowball sampling to select participants for the study. Data collection consisted of unstructured interviews followed by thematic analysis to establish the findings of the research. These findings specified the challenges experienced by family members caring for a relative with schizophrenia. The findings also indicated the social support and social work interventions which can mitigate or prevent the adverse effects when family members care for a relative diagnosed with schizophrenia. Effective and comprehensive social work services, which are family sensitive and inclusive, are imperative. Active engagement with both the family carer(s) and relative diagnosed with schizophrenia can contribute to minimising these adverse effects. [ABSTRACT FROM AUTHOR]

The advantages of long-acting injectable antipsychotics (LAIs) in schizophrenia are well studied. However, forensic involvement is common in schizophrenia, and incarcerated individuals are often excluded from clinical trials. Nonadherence and oral medication diversion in forensic populations with schizophrenia, and the relationship between antipsychotic nonadherence and crime support LAI utilization in this subset of patients. Yet, federal regulations limit data generation in forensic populations. This review characterizes data on therapeutic outcomes of LAIs in correctional populations with schizophrenia-spectrum diagnoses. A search for primary literature was conducted in PubMed. Favorable effects of LAIs were observed on adherence, psychiatric symptomatology, patient satisfaction, health care costs, and frequency of criminal charges. Data were primarily retrospective and included small samples and individuals with historical versus current forensic involvement. Although limited, available literature and insights into the correctional system suggest advantages to LAI use in forensic populations. Barriers to conducting research in correctional settings must be addressed to facilitate further data generation. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to use the database of consumers referred to the dual diagnosis shared care service to examine those connections. The Eastern Dual Diagnosis Service, based in Melbourne, Australia, has established a database of consumers with co-occurring mental health disorders and problematic substance use. An examination of mental health and substance-use information obtained over a two-year period in the delivery of dual diagnosis shared care to consumers of mental health services is supporting an improved understanding of substance use and the connections to specific mental health diagnoses of schizophrenia, bipolar disorder and schizoaffective disorder. Design/methodology/approach: This research uses a quantitative approach to review the prevalence of primary substance use and mental health diagnoses for consumers referred to as dual diagnosis shared care. Reviewed are referrals from adult mental health community and rehabilitation teams operating within a mental health and well-being program between January 2019 and December 2020 inclusive. Findings: Of the 387 clients referred to the specialist dual diagnosis shared care, methamphetamine, alcohol and cannabis are associated with 89.4% of the primary mental health diagnosis (PMHD). The most common PMHDs are schizophrenia, schizoaffective disorder and bipolar disorder. The most common PMHD and substance-use connection was schizophrenia and methamphetamine. Nicotine was reported to be used by 84% of consumers and often occurred in addition to another problematic primary substance. Originality/value: Improved dual diagnosis data collection from a community-based clinical mental health service is increasing understanding of the mental health and substance-use relationship. This is now providing clarity on routes of investigation into co-occurring mental health and problematic substance-use trends and guiding improved integrated treatments within a contemporary mental health setting. [ABSTRACT FROM AUTHOR]

Background: Treatment continuation is essential for the optimal management of patients with mental disorders in the community, but treatment and outcome are often undermined by the high rates of service disengagement and treatment non-adherence across all psychiatric diagnoses. The phenomenon may be even more relevant in rural settings. Aims: The aim of the present study was to explore attendance to treatment in first-contact patients in a community-based treatment setting in rural Greece and to explore the associations of treatment attendance with demographic and clinical factors. Method: Data were collected prospectively over a 3-year period, with 1-year follow-up interval. All first-contact cases with the Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia (MMHU I-T), Northwest Greece were considered, but only clinical cases were processed. Results: The sample size consisted of 446 patients, with a mean age 65.4 ± 18.8 years. The rate of 12-month attendance to mental health treatment was 13.5% (60 out of 446 patients). Treatment attendance was found to be correlated with younger age, the diagnosis of schizophrenia-spectrum disorder, and patients' referral by other psychiatric services. First examination over the year 2019 had been significantly inversely associated with treatment engagement. Conclusion: Rates of subsequent attendance after initial assessment in a rural community mental healthcare setting were rather low in the present study. Several variables that have been previously associated with service engagement were found to be related in this study too, whereas other were not. Research on treatment engagement in rural treatment settings should be ongoing to reveal all associated factors. [ABSTRACT FROM AUTHOR]

To assess the role of age (early onset psychosis-EOP < 18 years vs. adult onset psychosis-AOP) and diagnosis (schizophrenia spectrum disorders-SSD vs. bipolar disorders-BD) on the duration of untreated psychosis (DUP) and prodromal symptoms in a sample of patients with a first episode of psychosis. 331 patients with a first episode of psychosis (7–35 years old) were recruited and 174 (52.6%) diagnosed with SSD or BD at one-year follow-up through a multicenter longitudinal study. The Symptom Onset in Schizophrenia (SOS) inventory, the Positive and Negative Syndrome Scale and the structured clinical interviews for DSM-IV diagnoses were administered. Generalized linear models compared the main effects and group interaction. 273 AOP (25.2 ± 5.1 years; 66.5% male) and 58 EOP patients (15.5 ± 1.8 years; 70.7% male) were included. EOP patients had significantly more prodromal symptoms with a higher frequency of trouble with thinking, avolition and hallucinations than AOP patients, and significantly different median DUP (91 [33–177] vs. 58 [21–140] days; Z = − 2.006, p = 0.045). This was also significantly longer in SSD vs. BD patients (90 [31–155] vs. 30 [7–66] days; Z = − 2.916, p = 0.004) who, moreover had different profiles of prodromal symptoms. When assessing the interaction between age at onset (EOP/AOP) and type of diagnosis (SSD/BD), avolition was significantly higher (Wald statistic = 3.945; p = 0.047), in AOP patients with SSD compared to AOP BD patients (p = 0.004). Awareness of differences in length of DUP and prodromal symptoms in EOP vs. AOP and SSD vs. BD patients could help improve the early detection of psychosis among minors. [ABSTRACT FROM AUTHOR]

This scoping review focuses on how the caregiving experience of unpaid carers of persons with schizophrenia (CPSs) is understood in the literature. One hundred and eighteen studies were included. Publications have steadily increased over the past two decades. Most studies were derived from India, the UK, and China and were quantitative research. Financial problems, disruption to social life, and family relationships were commonly evaluated to be objective burdens, while care recipients relapsing, CPSs suffering from violence from care recipients, and experiencing discrimination were identified as subjective burdens. The effectiveness of care services and the positive feelings and physical impacts of CPSs need to be further discussed. [ABSTRACT FROM AUTHOR]

Mood disorders are highly prevalent among orthopedic patients and have been shown to be associated with adverse outcomes after orthopedic surgeries. There has been conflicting evidence regarding the relationship of mental illness with outcomes following total shoulder arthroplasty (TSA). The purpose of this study was to examine the relationship between mental health disorders and postoperative TSA outcomes in patients with anxiety, depression, bipolar disorder, and schizophrenia. Patients with osteoarthritis undergoing a primary TSA over 2010-2021 were identified in the PearlDiver claims database. Patients with anxiety, depression, bipolar disorder, or schizophrenia, identified using the International Classification of Diseases-9 and -10 codes, were compared to a control cohort composed of patients without any of these diagnoses. Two-year surgical outcomes and 90-day medical complications were analyzed via multivariable logistic regression, controlling for age, sex, and Charlson comorbidity index. A total of 96,039 TSA patients were identified. Four thousand eight hundred thirty-nine had an anxiety disorder, 18,936 had depression, 2100 had bipolar disorder, and 437 had schizophrenia. Average cohort age ranged between 61 and 69 years. Patients with anxiety disorders (odds ratio [OR] = 1.12), depression (OR = 1.41), bipolar disorder (OR = 1.85), and schizophrenia (OR = 1.31) were all more likely to experience an emergency department visit within 90 days when compared to the control (P <.05 for all). All groups were also more likely to have various 90-day medical complications (P <.05). Patients with depression (OR = 1.33) and bipolar disorder (OR = 1.44) were significantly more likely to undergo all-cause revision within two years postoperatively (P <.05 for all). Mental illness is associated with worse 90-day postoperative complications after TSA, particularly emergency department visits. These complications not only increase morbidity but also resource utilization and cost of care. As TSA is an elective procedure, shoulder arthroplasty surgeons should ensure patients' mental health is optimized with the care they need to minimize the risk of adverse postoperative complications. [ABSTRACT FROM AUTHOR]

Background Individuals with psychotic symptoms experience substantial morbidity and have shortened life expectancies; early treatment may mitigate the worst effects. Understanding care preceding a first psychotic disorder diagnosis is critical to inform early detection and intervention. Study Design In this observational cohort study using comprehensive information from the Massachusetts All-Payer Claims Database, we identified the first psychotic disorder diagnosis in 2016, excluding those with historical psychotic disorder diagnoses in the prior 48 months among those continuous enrollment data. We reviewed visits, medications, and hospitalizations 2012–2016. We used logistic regression to examine characteristics associated with pre-diagnosis antipsychotic use. Study Results There were 2505 individuals aged 15–35 years (146 per 100 000 similarly aged individuals in the database) with a new psychotic disorder diagnosis in 2016. Most (97%) had at least one outpatient visit in the preceding 48 months; 89% had a prior mental health diagnosis unrelated to psychosis (eg, anxiety [60%], depression [60%]). Many received psychotropic medications (77%), including antipsychotic medications (46%), and 68% had a visit for injury or trauma during the preceding 48 months. Characteristics associated with filling an antipsychotic medication before the psychotic disorder diagnosis included male sex and Medicaid insurance at psychosis diagnosis. Conclusions In this insured population of Massachusetts residents with a new psychotic disorder diagnosis, nearly all had some healthcare utilization, visits for injury or trauma were common, and nearly half filled an antipsychotic medication in the preceding 48 months. These patterns of care could represent either pre-disease signals, delays, or both in receiving a formal diagnosis. [ABSTRACT FROM AUTHOR]

This study investigated sociodemographic and clinical differences between the sexes in individuals affected by schizophrenia-spectrum disorders (SSD) who accessed outpatient mental health services. Within a retrospective cohort of 45,361 outpatients receiving care in Ferrara (Italy) from 1991 to 2021, those with a SSD diagnosis were compared between the sexes for sociodemographic and clinical characteristics before and after the index date (when the ICD-9: 295.*diagnosis was first recorded) to assess early trajectory, age and type of diagnosis, and severity of illness indicated by medication use, hospitalization, and duration of psychiatric care. Predictors of discharge were also investigated. Among 2439 patients, 1191 were women (48.8%). Compared to men, women were significantly older at first visit (43.7 vs. 36.8 years) and at index date (47.8 vs. 40.6) with peak frequency at age 48 (vs. 30). The most frequent last diagnosis recorded before the index date was delusional disorder (27.7%) or personality disorder (24.3%) in men and depression (24%) and delusional disorder (30.1%) in women. After the index date, long-acting antipsychotics and clozapine were more frequently prescribed to men (46.5% vs. 36.3%; 13.2% vs. 9.4%, p < 0.05) and mood stabilizers and antidepressants to women (24.3% vs. 21.1%; 50.1% vs. 35.5%; p < 0.05). Women had fewer involuntary admissions (10.1% vs. 13.6%) and were more likely to be discharged as the time under care increased (p = 0.009). After adjusting for covariates, sex was not a significant predictor of discharge. Our study confirmed that sex differences exist in clinical and sociodemographic characteristics of outpatients with SSD and that gender considerations might influence the rapidity of diagnosis and medications prescribed. These findings highlight the need to implement a women-tailored approach in specialist care programs for psychoses. [ABSTRACT FROM AUTHOR]

People with schizophrenia are at increased risk for contracting HIV and face higher mortality rates compared with the general population. Viral suppression is key to HIV care, yet little is known about this metric among people with HIV and schizophrenia. A chart review was conducted among people with HIV/AIDS and schizophrenia living in San Francisco who had received inpatient mental health services between 2010 and 2016. Demographic, laboratory, medication, encounter, and discharge data were collected, and were compared with all people living with HIV in San Francisco (PLWH-SF). Among 153 people living with HIV and comorbid schizophrenia, 77% were virally suppressed, compared to 67% for all PLWH-SF. Viral suppression for people with comorbid HIV and schizophrenia living in San Francisco appears higher than PLWH-SF. Further research is needed to confirm the association and mechanisms behind better treatment outcomes for people living with HIV and comorbid schizophrenia. [ABSTRACT FROM AUTHOR]

Background: Considering the conterarguement of the optimistic attitude of psychoanalysis and environmental change, the current diagnostic criteria for schizophrenia (i.e., Diagnostic and Statistical Manual of Mental Disorders, 5th edition-text revised [DSM-5-TR], International Classification of Diseases, 11th revision [ICD-11]) are defined under the substantial influences of symptom-based operationalism. The current diagnostic criteria for schizophrenia are occasionally considered as the incorporated characteristic mixtures of the chronicity, positive symptoms, and negative symptoms of Emil Kraepelin, Kurt Schneider, and Eugen Bleuler, respectively. Current Concepts: Concerning the diagnostic criteria for schizophrenia, the two remarkable changes from DSM-IV or DSM-IV-TR to DSM-5 or DSM-5-TR are as follows. First, related to diagnosing schizophrenia, the weighting of Kurt Schneider's first-rank symptoms has been omitted. Second, the defining subtypes (i.e., paranoid, disorganized, undifferentiated, catatonic, and residual) have also been omitted. In addition, catatonia has been newly considered a semi-independent diagnostic entity in DSM-5 or DSM-5-TR. Therefore, from a psychopathological aspect, the operationally defined diagnostic criteria for schizophrenia display several limitations: First, the oblivion of the concept of formal thought disorder, considered as the fundamental symptom of schizophrenia by the greatest psychopathologists, has been deepened. Second, the current diagnostic criteria for schizophrenia have been partly inconsistent with the disease essentialism model. Discussion and Conclusion: Schizophrenia cases are interconnected with 'family resemblance' but not shared by common underlying neurobiological correlates. Herein, in clinical psychiatric practice, with an emphatic approach, phenomenological psychopathology would still be required to evaluate the subjective experiences of an individual with schizophrenia. [ABSTRACT FROM AUTHOR]

Background: More and more studies have confirmed that the heredity plays an important role in mental disorders, especially microRNA. The objective of this research was to explore the level of miR-15a-5p in patients with schizophrenia (SZ), and to evaluate the feasibility of this miRNA as a diagnostic marker of SZ. Methods: The serum level of miR-15a-5p in patients with SZ and healthy people was detected by RT-qPCR. ROC curve was established to evaluate the clinical diagnostic significance of miR-15a-5p in SZ. Pearson correlation coefficient was used to evaluate the correlation between miR-15a-5p level and PANSS score. Logistic regression was used to assess the risk factors of SZ. A rat model of SZ was established, and the effects of miR-15a-5p on the behavior of SZ rats were observed through water maze test and open field test. Results: The serum level of miR-15a-5p in patients with SZ was significantly increased, and ROC analysis revealed that miR-15a-5p had clinical diagnostic value in SZ. High level of miR-15a-5p was positively correlated with the positive symptom, negative symptom and general psychopathology subscore of patients. Logistic regression results showed that miR-15a-5p was a risk factor affecting the occurrence of SZ. Animal studies showed that the serum level of miR-15a-5p was elevated in the SZ rats, and inhibiting the expression of miR-15a-5p has a positive effect on improving the cognitive function and anxiety behavior of SZ rats. Conclusions: Serum miR-15a-5p is a risk factor for SZ, which is of great significance for the diagnosis of SZ. [ABSTRACT FROM AUTHOR]

Posterior cortical atrophy, also called Benson's syndrome or visual variant of Alzheimer's disease, refers to a constellation of neurodegenerative features associated with Alzheimer's disease. The authors describe an unusual case of a patient diagnosed with this condition in addition to paranoid schizophrenia, in a forensic low secure unit. The focus of the article is on the distinctiveness of the presentation, the heterogeneity of symptoms and difficulties encountered in the diagnostic formulation process. [ABSTRACT FROM AUTHOR]

Objectives: Differentiating schizophrenia from mania in acutely psychotic patients can be difficult, but is important in determining immediate and subsequent management. Such differentiation is generally addressed by clinical interviews, but an observational approach may assist. This paper therefore describes the development of a relevant observational measure. Methods: We developed a provisional list of 49 items (weighting features with suggested specificity to schizophrenia and mania) for independent completion by two nurses and judged its ability to predict diagnosis provided by consultant psychiatrists. Results: Eighty-seven psychotic patients were recruited, and 173 completed data sets were analysed. We refined the item set to two sets of 10 items that best-differentiated schizophrenia from mania and vice versa. Optimal differentiation was achieved with a score of at least 7 on both the schizophrenia and mania item sets. Difference scores (i.e. schizophrenia items affirmed minus mania items affirmed) were also generated, with a difference score of +1 (i.e. one or more schizophrenia items being affirmed than mania items) showing optimal differentiation (sensitivity 0.67, specificity 0.82) between the two conditions. Evaluating all potential difference scores, we demonstrated that, as difference scores increased, diagnostic accuracy in identifying each condition was very high. Conclusion: Analyses allow the properties of an observational measure (the 20-item Sydney Psychosis Observation Tool) to be described. While a single cut-off difference score was derived with acceptable discriminatory ability, we also established the capacity of varying difference scores to assign both schizophrenia and mania diagnoses with high accuracy. [ABSTRACT FROM AUTHOR]

Suicide is the leading cause of unnatural death among people with a diagnosis of schizophrenia. Alcohol use is a prevalent comorbid feature of schizophrenia and a modifiable risk factor for suicide. We conducted a prospectively registered (PROSPERO, CRD42022358214) systematic review and meta-analysis to quantify the relationship between alcohol use and suicide-related outcomes in schizophrenia. We searched Medline, Embase, and PsycINFO for cross-sectional, case–control and longitudinal studies using exhaustive terms from database inception to December 2022 inclusive. Computation of odds ratios (ORs) and hazard ratios (HRs) were performed using a random-effects model with DerSimonian–Laird estimation. We also evaluated publication bias, study quality, and performed subgroup analysis and meta-regression. Fifty studies, comprising 65 samples, met eligibility criteria. Overall, alcohol use was associated with suicide (OR 1.38, 95% CI 1.21–1.58; HR = 1.32, 95% CI 1.00–1.74), attempted suicide (OR 1.69, 95% CI 1.45–1.98), and suicidal ideation (OR 1.69, 95% CI 1.22–2.34). While there was no evidence of publication bias, between-sample heterogeneity was moderate in analyses of attempted suicide (I 2 = 39.6%, p = 0.01) and suicidal ideation (I 2 = 56.0%, p = 0.01). Summary effects were significant in all subgroups except for longitudinal studies of attempted suicide (OR 1.60, 95% CI 0.86–3.00) and studies of suicidal ideation using gender combined samples (OR 1.63, 95% CI 0.99–2.67). Alcohol use is significantly associated with suicide-related outcomes in schizophrenia. Clinicians should routinely inquire about alcohol use in mental health services to focus preventative treatment efforts. [ABSTRACT FROM AUTHOR]

Schizophrenia is a chronic, severe mental disorder affecting thoughts, actions, emotions, perception of reality, and relationships. Schizophrenia, affecting around one percent of the adult population, is not as common as other major mental illnesses, but it can be one of the most chronic and disabling conditions. Effective care options include medication, psychoeducation, family interventions, cognitivebehavioural therapy, and psychosocial rehabilitation (e.g., life skills training). This case study highlights the need for facilitating assisted living, supported housing, and employment for individuals with schizophrenia. A recovery-oriented approach, which empowers individuals in treatment decisions, is crucial for patients and their families. [ABSTRACT FROM AUTHOR]

Context: Psychosocial dysfunction is the dysfunction in the various psychosocial areas, such as personal, vocational/occupational, familial, and social, which ultimately depends on the cognitive functioning of an individual. Any disturbances and failure to adjust in one or more areas have a sufficient impact on the patient's quality of life and daily living. For everyday living and maintaining a good quality of life, the influence of the level of dysfunction in different areas needs to be understood, and psychosocial interventions and rehabilitation programs must be designed accordingly to facilitate better psychosocial adjustment. Aims: The aim of this study was to estimate the psychosocial adjustment of individuals with Schizophrenia presenting at the psychiatry outpatient department (OPD) of a teaching hospital. Materials and Methods: A cross-sectional study was conducted at the psychiatry OPD of a tertiary care teaching hospital. Eligible subjects were aged between 18 and 65 years and diagnosed with Schizophrenia according to the International Classification of Diseases-10. Sociodemographic characteristics and current treatment details were obtained. The psychosocial adjustment was assessed using the Psychosocial Adjustment to Illness Scale-interview version. Results: Sixty subjects were included, all with some impairment in one or the other social functioning domain. The domain with the highest proportion of subjects showing marked/severe degrees of disability is the vocational environment. Moderate-to-severe impairment of functioning is seen in the domains of domestic environment, social environment, sexual relationship, and extended family relationships. In the health-care environment, mild impairment is seen among most subjects. Only mild psychological distress was found among those with impaired functioning in this domain. It was also found that individuals with mild adjustment problems had a shorter duration of illness. Variables that showed significant statistical associations (P < 0.05) with poor/severe social adjustment were marital status and duration of illness. Age and Gender had a statistically significant association with psychosocial dysfunction in the social environment domain. Conclusion: This study shows that there is definite and substantial psychosocial dysfunction in definitive areas of personal, familial, social, and vocational spheres in patients with schizophrenia. Psychosocial interventions, along with antipsychotics, are needed to target these areas to improve the overall quality of life of patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A large number of studies have reported that sensory gating disorders represented by P50 inhibition may be involved in the pathophysiological process of schizophrenia. However, few studies have explored the relationship between sensory gating disorders and cognitive dysfunction in patients with schizophrenia. This study aimed to explore sex differences in the relationship between cognitive and P50 deficits in patients with chronic schizophrenia, which has not been reported. A total of 183 chronic schizophrenia patients (128 males and 55 females) and 166 healthy controls (76 males and 90 females) participated in this study. The MATRICS Consensus Cognitive Battery (MCCB) was measured for cognitive function and P50 components for the sensory gating in all participants. The Positive and Negative Syndrome Scales (PANSS) was used to assess the psychopathological symptoms in patients. Female patients performed significantly better than male patients in several cognitive domains of MCCB (all p < 0.01). There were no significant differences in P50 components between male and female patients (all p > 0.05). Further analysis showed that in female patients, latency of S2 was negatively correlated with reasoning and problem-solving domain of MCCB (p < 0.05), and P50 ratio was negatively correlated with social cognition domain of MCCB (p < 0.05). In male patients, there was no any correlation between P50 and cognitive domains of MCCB. Our results suggest that there is a sex difference in the association between P50 deficiency and cognitive impairment in Chinese Han patients with schizophrenia. [ABSTRACT FROM AUTHOR]

The concept of schizophrenia has been contested since its inception. Over the last decades, criticism of the concept has become increasingly mainstream and calls for its abandonment have intensified. Nevertheless, the concept remains widely used and retains taken-for-granted status within much mental health research and practice. The combination of its contested status and continued use raises questions about how it is used and with what implications for people who receive the diagnosis. This study explores how 'schizophrenia' is spoken about by mental health professionals who use the diagnosis in day-to-day practice. Eight interviews with professionals across professions were analysed using Foucauldian Discourse Analysis. Two striking and consistent themes were identified. The first is a discrepancy between the way participants talked about 'schizophrenia' to the interviewer, and the way they described talking about it in clinical encounters. The second is the potentially entrapping impact of the wider discourses participants drew on in talk about clinical encounters. The study concludes with reflections on how those working in the mental health field can break out of this discursive entrapment, and help the people they work with do the same. [ABSTRACT FROM AUTHOR]

This article explores the relationship between Parkinson's and schizophrenia spectrum disorders, discussing not only the possibility that they can be comorbid conditions but that the presence of one could increase the chances of developing the other. They are rarely documented together, other than in relation to medication-induced side effects, and this could be due to diagnostic overshadowing, or the widely held belief that these conditions are not able to co-exist. It also briefly discusses treatment options available and gaps identified for future research. [ABSTRACT FROM AUTHOR]

Background: Family members of people with mental illness (MI) may experience a host of psychological adversities such as increased stress, burden, and reduced wellbeing. However, relatively little is known about siblings. This study aimed to characterise the experience of distress (viz. depressive and anxiety symptoms), burden, and wellbeing in siblings of people with MI. Methods: Studies reporting on quantitative measures of depression, anxiety, burden, or wellbeing in siblings; and/or qualitative findings on siblings' experience were eligible. The literature search was conducted up until 20th October 2022. Results: Sixty-two studies comprising data from 3744 siblings were included. The pooled mean percentage of depressive symptoms fell in the mild range at 15.71 (k = 28, N = 2187, 95% CI 12.99–18.43) and anxiety symptoms fell in the minimal range at 22.45 (k = 16, N = 1122, 95% CI 17.09–27.80). Moderator analyses indicate that siblings of people with a schizophrenia spectrum disorder experience greater depressive symptoms than siblings of people with other types of MI (β = −16.38, p < 0.001). Qualitative findings suggest that individuals may be particularly vulnerable during their siblings' illness onset and times of relapse. Limited communication, confusion about MI, and the need to compensate may contribute to siblings' distress and/or burden. Siblings' experience of wellbeing and caregiving were closely related. Conclusion: This review highlights the complex psychological experience of siblings and the need for greater research and clinical support for this important yet often overlooked cohort. [ABSTRACT FROM AUTHOR]

Background: Tobacco is a highly prevalent substance of abuse in patients with psychosis. Previous studies have reported an association between tobacco use and schizophrenia. The aim of this study was to analyze the relationship between tobacco use and first-episode psychosis (FEP), age at onset of psychosis, and specific diagnosis of psychosis. Methods: The sample consisted of 1105 FEP patients and 1355 controls from the European Network of National Schizophrenia Networks Studying Gene–Environment Interactions (EU-GEI) study. We assessed substance use with the Tobacco and Alcohol Questionnaire and performed a series of regression analyses using case-control status, age of onset of psychosis, and diagnosis as outcomes and tobacco use and frequency of tobacco use as predictors. Analyses were adjusted for sociodemographic characteristics, alcohol, and cannabis use. Results: After controlling for cannabis use, FEP patients were 2.6 times more likely to use tobacco [ p ⩽ 0.001; adjusted odds ratio (AOR) 2.6; 95% confidence interval (CI) [2.1–3.2]] and 1.7 times more likely to smoke 20 or more cigarettes a day (p = 0.003; AOR 1.7; 95% CI [1.2–2.4]) than controls. Tobacco use was associated with an earlier age at psychosis onset (β = −2.3; p ⩽ 0.001; 95% CI [−3.7 to −0.9]) and was 1.3 times more frequent in FEP patients with a diagnosis of schizophrenia than in other diagnoses of psychosis (AOR 1.3; 95% CI [1.0–1.8]); however, these results were no longer significant after controlling for cannabis use. Conclusions: Tobacco and heavy-tobacco use are associated with increased odds of FEP. These findings further support the relevance of tobacco prevention in young populations. [ABSTRACT FROM AUTHOR]

A limited response to clozapine treatment is a familiar clinical scenario in patients with treatment‐resistant schizophrenia. Here, the authors present a case where pharmacogenetic analysis was able to guide clinical management, and the discussion is expanded into the role of clinic genomics in personalised medicine. [ABSTRACT FROM AUTHOR]

Peers with shared lived experience may help people with schizophrenia (PWS) recover in many ways, such as by assisting them to cope with debilitating symptoms, address practical challenges of living, combat stigma, and lessen social isolation. Despite their expansion in practice, peer-delivered services are not yet considered to be evidence-based practice for schizophrenia. This is due in part to the diversity of intervention components across programs, leading to uncertainty about just what these services entail. A focused examination of strategies and intended outcomes will facilitate more effective service design and delivery. To this end, this scoping review systematically examined the published literature describing peer-delivered services reaching PWS. The 22 studies reviewed described 20 unique interventions, representing significant diversity in formats and components, including those focused on psychological coping and practical skills, such as for independent living. Seven of nine studies measuring at least one key outcome (acute care utilization, patient functioning, positive or negative symptoms) found significant effects favoring peer-delivered intervention. Three of four studies measuring negative symptoms reported a reduction, notable considering these are often difficult to change. Results suggest areas for improvement, including a more thorough examination of program components and tailoring to the specific needs of PWS. [ABSTRACT FROM AUTHOR]

Copyright of Long-Term Care Nursing / Pielegniarstwo w Opiece Dlugoterminowej is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)