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Psychotic Features (psychotic + feature)

Distribution by Scientific Domains

Medical Sciences	94%

Selected Abstracts

Can personality traits help us explain disability in chronic schizophrenia?

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2006
ANDRÉS HERRÁN md
Abstract, Psychotic features have been considered the main determinant of psychosocial function in schizophrenia. However, other variables are likely to affect dysfunction in these patients. The authors' hypothesis is that personality traits in outpatients with chronic schizophrenia differ from traits found in the healthy population and may be associated with disability in this disorder. A total of 62 patients with schizophrenia were evaluated with the Eysenck Personality Questionnaire (EPQ) and the Tridimensional Personality Questionnaire (TPQ). Psychotic features were measured with the help of the Positive and Negative Syndrome Scale (PANSS). Disability was assessed with the Disability Assessment Schedule (DAS). A total of 43 healthy subjects were used as controls for personality measurements. Normative data for the study population was also used to evaluate results in patients. Patients with schizophrenia had higher levels of neuroticism (median in percentile 65) and lower levels of extraversion (median in percentile 25) than the healthy population. Results of the TPQ showed higher harm avoidance and lower reward dependence levels compared to the healthy population. After multiple regression tests, negative symptoms were the strongest predictor of disability in patients with schizophrenia. Neuroticism contributed independently to the DAS overall behavior and global judgement subscales scores (more negative symptoms and higher neuroticism resulted in worse functioning), but not to the social role subscale. Outpatients with chronic schizophrenia showed high levels of neuroticism, harm avoidance, and introversion. Neuroticism significantly contributes to the long-term deficits found in patients with schizophrenia. [source]

Psychotic features in borderline patients: is there a connection to mood dysregulation?

BIPOLAR DISORDERS, Issue 4 2005
Benvenuti A
Objective:, To investigate the relationship between lifetime mood and psychotic spectrum features in patients with borderline personality disorder (BPD). Method:, The study sample consisted of BPD patients with (n = 39, BPD-M) or without (n = 21, BPD-noM) lifetime mood disorders. The diagnostic assessment was conducted with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). The diagnosis of BPD was made clinically and then confirmed by Gunderson's diagnostic interview for borderlines. Subjects were also administered the Structured Clinical Interview for Psychotic Spectrum (SCI-PSY) and the Mood Spectrum self-report questionnaire (MOODS-SR). Results:, BPD-M had significantly higher scores than BPD-noM on the ,lifetime' mood spectrum subdomains ,depressive mood' and ,depressive cognition'. The two groups did not differ on the scores of psychotic spectrum except for higher ,hypertrophic self-esteem' scores in BPD-noM. In BPD-noM both the depressive and the manic-hypomanic component of mood spectrum were significantly correlated with the ,delusion' subdomain of the psychotic spectrum. The depressive component was correlated with ,depersonalization/derealization' and the manic-hypomanic component was correlated with ,hypertrophic self-esteem'. In BPD-M, the manic-hypomanic component of mood spectrum was correlated with different subdomains of the psychotic spectrum: ,hypertrophic self-esteem', ,self-reference', ,interpretive attitude', ,anger/overreactivity, ,unusual and odd thoughts', ,illusions', ,delusions', ,hallucinations' and ,catatonia'. The depressive component of mood spectrum was ,uncorrelated' with the subdomains of the psychotic spectrum. Conclusions:, Our data support the hypothesis that ,lifetime' manic-hypomanic mood dysregulations are correlated with psychotic spectrum features in borderline patients. The assessment of these spectrum features in borderline patients may be useful to inform treatment choices. [source]

Encephalopathy with combined lithium-risperidone administration

ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2008
K. Boora
Objective:, Lithium-neuroleptics induced encephalopathy is a rare drug interaction. Here I am reporting a patient who developed reversible encepatholopathy with lithium-risperidone combination. Method:, A single case report. Result:, A patient of bipolar disorder, who presented with manic symptoms with psychotic feature, started with a combination of lithium and risperidone. Within few days, the patient developed encepatholopathy, which reversed upon discontinuation of lithium and risperidone. Conclusion:, Combining lithium and neuroleptic is useful in treatment of bipolar disorder. However, encepatholapthy can be anticipated to result when lithium is used with high potency anti-psychotic such as haloperidol and risperidone and there are baseline EEG abnormalities. [source]

Hydrophobia as a rare presentation of Cotard's syndrome: a case report

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2002
A. G. Nejad
Objective:,To discuss a case of Cotard's syndrome in a 65-year-old male patient who refused to eat and drink. Method:,A single case is presented. Results:,The patient was especially sensitive to water and showed panic reactions when he was offered a glass of water. These symptoms began when he deluded himself to believe that his stomach shrunk. Diagnosis was major depressive disorder with psychotic feature based on DSM-IV. Conclusion:,Hydrophobia as a symptom of Cotard's syndrome was not reported before. This symptom is often known as evidence of rabies but may be seen in Cotard's syndrome. [source]

The relationship between childhood trauma history and the psychotic subtype of major depression

ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2010
B. A. Gaudiano
Gaudiano BA, Zimmerman M. The relationship between childhood trauma history and the psychotic subtype of major depression. Objective:, Increasing evidence exists linking childhood trauma and primary psychotic disorders, but there is little research on patients with primary affective disorders with psychotic features. Method:, The sample consisted of adult out-patients diagnosed with major depressive disorder (MDD) at clinic intake using a structured clinical interview. Patients with MDD with (n = 32) vs. without psychotic features (n = 591) were compared as to their rates of different types of childhood trauma. Results:, Psychotic MDD patients were significantly more likely to report histories of physical (OR = 2.81) or sexual abuse (OR = 2.75) compared with non-psychotic MDD patients. These relationships remained after controlling for baseline differences. Within the subsample with comorbid post-traumatic stress disorder, patients with psychotic MDD were significantly more likely to report childhood physical abuse (OR = 3.20). Conclusion:, Results support and extend previous research by demonstrating that the relationship between childhood trauma and psychosis is found across diagnostic groups. [source]

Validity of ,post-traumatic stress disorder with secondary psychotic features': a review of the evidence

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009
M. H. Braakman
Objective:, To review the evidence from empirical studies regarding the validity of ,post-traumatic stress disorder with secondary psychotic features' (PTSD-SP) as a separate diagnostic entity. Method:, The authors performed a review tracing publications between 1980 and January 2008. Results:, Twenty-four comparative studies were included. These studies indicate that PTSD-SP is a syndrome that comprises PTSD-symptoms followed in time by the additional appearance of psychotic features. The psychotic features are not confined to episodes of re-experiencing, but remain present continuously. PTSD-SP seems to have some biological features differentiating it from schizophrenia and PTSD, e.g. there are differences in smooth pursuit eye movement patterns, concentrations of corticotropin-releasing factor and dopamine ,-hydroxylase activity. Conclusion:, There is currently not yet full support for PTSD-SP as a nosological entity. However, the delineation of PTSD-SP from other psychiatric syndromes is notable and biological studies seem to support the validity as a separate diagnostic entity. [source]

Milnacipran plasma levels and antidepressant response in Japanese major depressive patients

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 4 2003
Hisashi Higuchi
Abstract The relationship between antidepressant effects and plasma levels of milnacipran was studied in 49 cases of major depression without psychotic features during 6 weeks of milnacipran treatment. The daily dose of milnacipran was 50,mg/day for the first week, and up to 100,mg/day thereafter. Depressive symptoms were evaluated by the Montgomery and Åsberg depression rating scale (MADRS) before treatment and at 1, 2, 4 and 6 weeks after the beginning of this study. Thirty-four patients (69.4%) were responders (defined as a 50% or greater decrease in the baseline MADRS score). Significant differences of MADRS scores were seen from 1 week after the beginning of this study (p,=,0.004, unpaired t -test) between responders and nonresponders. The mean plasma milnacipran level of responders, 82.0,±,29.4,ng/ml, was similar to that of non-responders, 78.6,±,23.1,ng/ml; there was no significant difference between responders and nonresponders. Neither a significant linear nor a curvilinear relationship was obtained between the final MADRS score and the plasma levels of milnacipran. Although there was no significant relationship between the plasma levels of milnacipran and the antidepressant response, milnacipran should be considered an efficacious agent in the treatment of major depressive patients. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Association study between cannabinoid receptor gene (CNR1) and pathogenesis and psychotic symptoms of mood disorders,

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 3 2001
Shih-Jen Tsai MD
Abstract Cannabis can induce mood change and sometimes psychotic symptoms in normal persons. In brain, the main active ingredient of cannabis acts via the cannabinoid CB1 receptor (CNR1) which is located on chromosome 6q14-15. Linkage studies have suggested the presence of a bipolar disorder susceptibility locus on chromosome 6q. In this population based association study, we tested the hypothesis that a microsatellite polymorphism in the promoter region of the CNR1 gene confers susceptibility to mood disorders and psychotic features. We genotyped the CNR1 gene is 154 mood disorder patients and 165 normal controls. The results showed that the triplet repeat polymorphism in the promoter region of the CNR1 gene was not likely to be involved in the pathogenesis or in the psychotic symptoms of mood disorders. © 2001 Wiley-Liss, Inc. [source]

Associations Between Coerced Anal Sex and Psychopathology, Marital Distress and Non-Sexual Violence

THE JOURNAL OF SEXUAL MEDICINE, Issue 7 2009
Parvaneh Mohammadkhani PhD
ABSTRACT Background., There is a dearth of scientific data on anal intercourse in heterosexual relationships. Likewise, anal sex within marital relationships has yet to be fully explored. Objectives., Among a representative sample of married women in the Iranian capital, Tehran, we aimed to determine the association of self-reported coerced anal sex with: (i) self-reported coerced vaginal sex; (ii) self-reported non-sexual violence; (iii) psychopathology; and (iv) marital attitude. Method., The data presented here were obtained from the Family Violence Survey conducted in Tehran in 2007. A total of 230 married Iranian women were selected via a multi-cluster sampling method from four different randomized regions. The subjects' sociodemographic data, psychological distress (Symptom Check List; SCL-90-R), personality, and relationship characteristics (Personal and Relationships Profile), and marital attitude (Marital Attitude Survey) were gathered. In addition, the participants' self-reported histories of lifetime victimization through all types of violence by the husband, including coerced anal and vaginal sex as well as psychological and physical assault (Conflict Tactic Scales-Revised; CTS-2), were collected. Results., There were associations between self-reported victimization through coerced anal and vaginal sex (P < 0.001), psychological (P < 0.001), and physical aggression (P < 0.001). Those reporting to have been forced into anal intercourse cited higher rates of paranoid and psychotic features, jealousy, attribution of problems to one's own behavior, conflict, and male dominance, as well as lower expectations of improvement in one's marital relationship. Conclusion., In marital relationships, women are at a higher risk of coerced anal sex if subjected to other types of sexual or non-sexual violence. Higher rates of psychopathology and poorer marital relationships are also allied to self-reported anal sexual coercion. Mohammadkhani P, Khooshabi KS, Forouzan AS, Azadmehr H, Assari S, and Lankarani MM. Associations between coerced anal sex and psychopathology, marital distress and non-sexual violence. J Sex Med 2009;6:1938,1946. [source]

Memory functioning in familial bipolar I disorder patients and their relatives

BIPOLAR DISORDERS, Issue 2 2009
Seema Quraishi
Objective:, The aim of this study was to compare the memory function of patients with familial bipolar I disorder (BD I) who had shown psychotic features, their non-psychotic, non-bipolar first-degree relatives, and normal controls. Method:, We assessed 38 patients with a lifetime diagnosis of BD I who had experienced psychotic symptoms, 49 of their non-psychotic, non-bipolar first-degree relatives, and 44 controls. Patients and relatives were from families multiply affected with functional psychotic illness. A five-subtest short form of the Wechsler Adult Intelligence Scale,Revised and three Wechsler Memory Scale subtests were administered to all participants. Results:, BD I patients showed deficits in verbal memory and verbal learning but not in visual memory. Compared to controls, relatives showed worse verbal learning at a statistically significant or suggestive level and performed significantly worse in both immediate and delayed verbal memory. Similar to patients, there were no differences between the relatives and control group for visual memory. Conclusion:, Impaired verbal memory and learning were found in patients and their relatives. These deficits may represent candidate endophenotypic markers for bipolar disorder. [source]

Polarity at illness onset in bipolar I disorder and clinical course of illness

BIPOLAR DISORDERS, Issue 1 2009
Liz Forty
Objectives:, Studies have suggested that episode polarity at illness onset in bipolar disorder may be predictive of some aspects of lifetime clinical characteristics. We here examine this possibility in a large, well-characterized sample of patients with bipolar I disorder. Methods:, We assessed polarity at onset in patients with bipolar I disorder (N = 553) recruited as part of our ongoing studies of affective disorders. Lifetime clinical characteristics of illness were compared in patients who had a depressive episode at first illness onset (n = 343) and patients who had a manic episode at first illness onset (n = 210). Results:, Several lifetime clinical features differed between patients according to the polarity of their onset episode of illness. A logistic regression analysis showed that the lifetime clinical features significantly associated with a depressive episode at illness onset in our sample were: an earlier age at illness onset; a predominantly depressive polarity during the lifetime; more frequent and more severe depressive episodes; and less prominent lifetime psychotic features. Conclusions:, Knowledge of pole of onset may help the clinician in providing prognostic information and management advice to an individual with bipolar disorder. [source]

Efficacy of a protein kinase C inhibitor (tamoxifen) in the treatment of acute mania: a pilot study

BIPOLAR DISORDERS, Issue 6 2007
Carlos A Zarate Jr
Objectives:, Considerable preclinical biochemical and behavioral data suggest that protein kinase C inhibition would bring about antimanic effects. Notably, the structurally highly dissimilar antimanic agents lithium and valproate, when administered in therapeutically relevant paradigms, attenuate protein kinase C inhibition function. There is currently only one relatively selective protein kinase C inhibitor that crosses the blood,brain barrier available for human use , tamoxifen. Our group recently conducted a single-blind study with tamoxifen in acute mania and found that it significantly decreased manic symptoms within a short period of time (3,7 days). In this study, we investigated whether antimanic effects can be achieved with a protein kinase C inhibitor in subjects with mania. Methods:, In a double-blind, placebo-controlled study, 16 subjects with bipolar disorder, manic or mixed, with or without psychotic features, were randomly assigned to receive tamoxifen (20,140 mg/day; n = 8) or placebo (n = 8) for three weeks. Primary efficacy was assessed by the Young Mania Rating Scale. Results:, Subjects on tamoxifen showed significant improvement in mania compared to placebo as early as five days, an effect that remained significant throughout the three-week trial. The effect size for the drug difference was very large (d = 1.08, 95% confidence interval 0.45,1.71) after three weeks (p = 0.001). At study endpoint, response rates were 63% for tamoxifen and 13% for placebo (p = 0.12). Conclusions:, Antimanic effects resulted from a protein kinase C inhibitor; onset occurred within five days. Large, controlled studies with selective protein kinase C inhibitors in acute mania are warranted. [source]

Differential working memory impairment in bipolar disorder and schizophrenia: effects of lifetime history of psychosis

BIPOLAR DISORDERS, Issue 2 2006
David C Glahn
Background:, Although bipolar disorder and schizophrenia have long been viewed as distinct illnesses, there is growing evidence that these two complex diseases share some common genes, which may manifest as overlapping neuropsychological impairments. Although working memory dysfunction has been proposed to be central to the pathophysiology of schizophrenia, it has received less attention in studies of bipolar disorder. Method:, We applied measures of working memory to patients with schizophrenia (n = 15), patients with schizoaffective disorder (n = 15), patients with psychotic (n = 11) and non-psychotic (n = 15) bipolar disorder, and demographically matched healthy subjects (n = 32), in order to determine the extent to which these groups show common or unique impairments. Results:, While patients with bipolar disorder (with and without psychotic features) and those with schizophrenia/schizoaffective disorder were impaired on backward digit span, only patients with a lifetime history of psychotic features, regardless of diagnosis, were impaired on spatial delayed response task. Conclusions:, Backward digit span performance is comparable in bipolar disorder and schizophrenia, and may be an appropriate endophenotypic marker that cuts across diagnostic categories. In contrast, spatial working memory performance clearly distinguishes non-psychotic bipolar disorder patients from patients with functional psychosis. [source]

Ethnic differences in symptom presentation of youths with bipolar disorder

BIPOLAR DISORDERS, Issue 1 2006
Nick C Patel
Objective:, To compare symptom profiles of African-American and white adolescents with a diagnosis of bipolar disorder. Method:, Adolescents, aged 12,18 years at their first psychiatric hospitalization, with a DSM-IV diagnosis of bipolar disorder, manic or mixed, were evaluated on measures of manic, depressive, and positive symptoms of psychosis. Ethnic differences in symptom profiles were examined using multivariate analysis of covariance, and specific symptoms contributing to the difference were analyzed. Results:, Ethnic differences existed in manic and positive symptom profiles, but not depressive symptoms. Compared with the white cohort, African-American youths were diagnosed more frequently as having psychotic features, and had higher ratings for auditory hallucinations. Conclusions:, Similar to adults, symptom expression in adolescent bipolar disorder may differ between ethnic groups. Future studies are needed to replicate these findings and explore possible explanations. [source]

Review and meta-analysis of the phenomenology and clinical characteristics of mania in children and adolescents

BIPOLAR DISORDERS, Issue 6 2005
Robert A Kowatch
Objective:, Using predetermined criteria for study quality and methods, a literature review and meta-analysis of seven reports about pediatric bipolar disorder (BPD) was conducted to determine if there is a consistent picture of the phenomenology and clinical characteristics of BPD in children and adolescents. Methods:, Searches were conducted in MedLine and PsycINFO using the terms mania, BPD, children and adolescents, and was limited to published articles in peer-reviewed journals. Seven reports were selected that met the following criteria: a systematic method for the elicitation and reporting of symptoms and clinical characteristics of subjects; subjects were interviewed by a trained researcher or clinician; ages 5,18 years; use of a diagnostic system, either DSM or RDC for categorization; a consensus method for the establishment of the diagnosis of BPD. Results:, Most DSM-IV symptoms of mania were common in the children and adolescents with BPD with the most common symptoms being increased energy, distractibility, and pressured speech. On average, four of five bipolar cases also showed threshold levels of irritable mood and grandiosity, and more than 70% of all cases showed elated/euphoric mood, decreased need for sleep, or racing thoughts. Roughly 69% of cases also showed poor judgment, whereas only half of bipolar cases demonstrated flight of ideas, and slightly more than one-third showed hypersexuality or psychotic features. Conclusions:, The clinical picture that emerges is that of children or adolescents with periods of increased energy (mania or hypomania), accompanied by distractibility, pressured speech, irritability, grandiosity, racing thoughts, decreased need for sleep and euphoria/elation. [source]