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First Episode Psychosis (first + episode_psychosis)
Selected AbstractsFinding Meaning in First Episode Psychosis: Experience, Agency, and the Cultural RepertoireMEDICAL ANTHROPOLOGY QUARTERLY, Issue 4 2004JOHN AGGERGAARD LARSEN The article examines individuals' attempts to generate meaning following their experiences with psychosis. The inquiry is based on a person-centered ethnographic study of a Danish mental health community program for early intervention in schizophrenia and involves longitudinal interviews with 15 of its participants. The article takes an existential anthropological perspective emphasizing agency and cultural phenomenology to investigate how individuals draw on resources from the cultural repertoire to make sense of personally disturbing experiences during their psychosis. It is suggested that the concept of "system of explanation" has advantages over, for example, "illness narrative" and "explanatory model" when demonstrating how some individuals engage in the creative analytic and theory-building work of bricolage, selecting, adding, and combining various systems of explanation. Delusions are equally derived from the cultural repertoire but are constructed as dogmatic explanations that are idiosyncratic to the individual who holds them. [source] Are multi family groups appropriate for patients with first episode psychosis?ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010A 5-year naturalistic follow-up study Rossberg JI, Johannessen JO, Klungsoyr O, Opjordsmoen S, Evensen J, Fjell A, Haahr U, Joa I, Langeveld J, Larsen TK, Melle I, Rund BR, Simonsen E, ten Velden W, Vaglum P, Friis S, McGlashan T. Are multi family groups appropriate for patients with first episode psychosis? A 5-year naturalistic follow-up study. Objective:, To compare outcome over 5 years for patients who participated in multi family groups (MFGs) to those who refused or were not offered participation. Method:, Of 301 first episode psychotic patients aged 15,65 years, 147 participated in MFGs. Outcome was measured by drop-out rates, positive and negative syndrome scale (PANSS) symptom scores, and duration of psychotic episodes during the follow-up period. Results:, Multi family group participants had a significantly lower drop-out rates at 5-year follow-up than patients who did not participate. However, the MFG participants had significantly less improvement in PANSS positive and excitative symptoms and had significantly longer duration of psychotic symptoms during the follow-up period. Conclusion:, Multi family groups appear to increase the chance of retaining patients in a follow-up study, but adjustment of the programme may be necessary with first episode psychosis patients to meet their needs better. [source] The evolution of depression and suicidality in first episode psychosisACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2010R. Upthegrove Upthegrove R, Birchwood M, Ross K, Brunett K, McCollum R, Jones L. The evolution of depression and suicidality in first episode psychosis. Objective:, To have a clearer understanding of the ebb and flow of depression and suicidal thinking in the early phase of psychosis, whether these events are predictable and how they relate to the early course of psychotic symptoms. Method:, Ninety-two patients with first episode psychosis (FEP) completed measures of depression, including prodromal depression, self-harm and duration of untreated psychosis. Follow-up took place over 12 months. Results:, Depression occurred in 80% of patients at one or more phases of FEP; a combination of depression and suicidal thinking was present in 63%. Depression in the prodromal phase was the most significant predictor of future depression and acts of self-harm. Conclusion:, Depression early in the emergence of a psychosis is fundamental to the development of future depression and suicidal thinking. Efforts to predict and reduce depression and deliberate self-harm in psychosis may need to target this early phase to reduce later risk. [source] Illicit substance use and its correlates in first episode psychosisACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010R. Mazzoncini Mazzoncini R, Donoghue K, Hart J, Morgan C, Doody GA, Dazzan P, Jones PB, Morgan K, Murray RM, Fearon P. Illicit substance use and its correlates in first episode psychosis. Objective:, To determine if substance use (particularly cannabis) is more frequent among first episode psychosis patients and associated with a more problematic clinical presentation. Method:, All first episode psychosis (FEP) patients presenting to secondary services were recruited from London and Nottingham, over 2 years, in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study broad framework. Clinical and sociodemographic variables were assessed using a set of standardized instruments. A schedule was created to retrospectively collate substance use data from patients, relatives and clinicians. Results:, Five hundred and eleven FEP were identified. They used three to five times more substances than general population. Substance use was associated with poorer social adjustment and a more acute mode of onset. Cannabis use did not affect social adjustment, but was associated with a more acute mode of onset. Conclusion:, Cannabis has a different impact on FEP than other substances. Large epidemiological studies are needed to disentangle cannabis effect. [source] Substance misuse over the first 18 months of specialized intervention for first episode psychosisEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2009Jason A. R. Carr Abstract Aim: Examine substance misuse over the first 18 months of first-episode psychosis treatment. Method: Clinicians rated alcohol and drug (mostly cannabis) misuse for 243 individuals followed prospectively. Assessments were completed at baseline and after 3, 6 and 18 months. Interventions relating to substance misuse included ongoing assessment of use, education and counselling to avoid. Results: Alcohol and drug misuse declined significantly between baseline and 3 months, especially among patients with a substance abuse or dependence diagnosis at baseline. Overall, these reductions were maintained over the 18-month follow-up period. The exception was worsening alcohol misuse over time among patients with alcohol abuse or dependence on entry. Conclusions: With good usual care, education and support, alcohol and drug misuse declined significantly during the first months of psychosis treatment. The improvements in drug misuse were generally maintained over the 18-month follow-up, and worsening alcohol misuse over time may be the greater issue. [source] Prediction of twelve-month service disengagement from an early intervention in psychosis serviceEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2007Mark Turner Abstract Aim: The aim is to examine disengagement in an early psychosis treatment service and contrast clinical and demographic variables of patients who disengage against those who do not. Methods: Those with termination of treatment, despite therapeutic need within 12 months of entry (disengagers) (n = 57; 24.6%), were compared with those who remained in treatment at 12 months (n = 175) on a range of clinical and demographic variables collected at admission. After testing the difference between proportions, data analysis was conducted using methods of logistic regression. Results: Alcohol and/or cannabis abuse/dependence, initial diagnosisother than mood disorder, long duration of untreated psychosis, lower Positive and Negative Syndrome Scale total symptoms, and lower insight at referral accounted for 27% of variance in patient ,disengagement' within 12 months. Conclusion: A significant proportion of patients with first episode psychosis disengage from treatment within 12 months. Despite a number of factors being associated with disengagement, prediction using admission factors was poor. Early Intervention in Psychosis Services would benefit from increased attention to alcohol and drug problems, trying to reduce the duration of untreated psychosis, improving psychiatric symptoms and increasing insight in all patients to decrease service disengagement. [source] Sexual health knowledge and risk behaviour in young people with first episode psychosisINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2005Heather Shield ABSTRACT:, The sexual health of clients has been poorly addressed by mental health service providers and sexually transmissible infection (STI) incidence rates are increasing among young people. A self-report questionnaire was used to gather information in order to describe and to conduct a cross-sectional analysis of sexual health knowledge, risk behaviour and STI screening history among young people who have experienced a first episode of psychosis, who present to community-based early psychosis programmes in south-eastern Sydney. STI knowledge was fair and sexual risk practice knowledge was poor regarding anal and oral sex. Women reported significantly more sexual partners than men. When those young people who had had unsafe sex attended for STI screens only, 5% received a complete screen. The survey result indicates a need for sexual health screening education to be conducted for clients. Against a background of escalating rates of HIV, STIs and high risk-taking behaviours among young people, it is essential that mental health staff are provided with the skills and education to address sexual health and harm minimization issues. [source] Gender differences in the prediction of 5-year outcome in first episode psychosisINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2007Maria Mattsson Abstract Objective: To examine gender differences in prediction of long-term outcome in first episode psychosis (FEP). Method: Eighty-one male and 72 female FEP patients were compared regarding the sensitivity and specificity of the Predictive Rating Scale (PRS). The contributions of pre-admission clinical and socio-demographic characteristics to a poor 5-year outcome were analysed for males and females separately. Gender differences in the relations between predictors and outcome were examined using the equality of correlation comparing correlation coefficients. Results: The sensitivity of the PRS was significantly better for males than for females. The following items: ,the highest Global Assessment of Functioning (GAF) the year before first admission ,70' and ,GAF at first admission ,30' explained most of the variance of a poor 5-year outcome for males, whereas for females the corresponding items were ,the highest educational level is compulsory school', ,living with parents' and ,contact with friends ,2,3 times/month'. When the PRS was adapted assigning a weight of two to the item ,the highest educational level is compulsory school' for females, the sensitivity increased. Conclusion: This study revealed that the predictors for poor outcome differ between male and female patients with FEP. Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||