Poster #T173 THE PROGNOSTIC SIGNIFICANCE OF EARLY REMISSION OF POSITIVE SYMPTOMS IN FIRST EPISODE PSYCHOSIS

2014 ◽  
Vol 153 ◽  
pp. S350
Author(s):  
Ross M.G. Norman ◽  
Rahul Manchanda ◽  
Raj Harricharan ◽  
Sandra Northcott
Keyword(s):  
Prognostic Significance ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Episode Psychosis

Reduced TMS-evoked fast oscillations in the motor cortex predict the severity of positive symptoms in first-episode psychosis

2021 ◽  
pp. 110387
Author(s):  
Francesco Luciano Donati ◽  
Rachel Kaskie ◽  
Catarina Cardoso Reis ◽  
Armando D'Agostino ◽  
Adenauer Girardi Casali ◽  
...  
Keyword(s):  
Motor Cortex ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Episode Psychosis ◽  
Fast Oscillations

scholarly journals Neuroactive Steroids in First-Episode Psychosis: A Role for Progesterone?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Martino Belvederi Murri ◽  
Flaminia Fanelli ◽  
Uberto Pagotto ◽  
Elena Bonora ◽  
Federico Triolo ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Serum Levels ◽  
First Episode Psychosis ◽  
Neuroactive Steroids ◽  
First Episode ◽  
Positive Symptoms ◽  
Symptom Dimensions ◽  
Episode Psychosis ◽  
Male Patients ◽  
And Gender

Neuroactive steroids may play a role in the pathophysiology of psychotic disorders, but few studies examined this issue. We compared serum levels of cortisol, testosterone, dehydroepiandrosterone, and progesterone between a representative sample of first-episode psychosis (FEP) patients and age- and gender-matched healthy subjects. Furthermore, we analyzed the associations between neuroactive steroids levels and the severity of psychotic symptom dimensions. Male patients had lower levels of progesterone than controls (p=0.03). Progesterone levels were inversely associated with the severity of positive symptoms (p=0.007). Consistent with preclinical findings, results suggest that progesterone might have a role in the pathophysiology of psychotic disorders.

scholarly journals Randomized Controlled Trial of Clozapine and CBT for First-Episode Psychosis with Enduring Positive Symptoms: A Pilot Study

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
J. Edwards ◽  
J. Cocks ◽  
P. Burnett ◽  
D. Maud ◽  
L. Wong ◽  
...  
Keyword(s):  
Pilot Study ◽  
Negative Symptoms ◽  
Controlled Trial ◽  
Treatment Phase ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Treatment Groups ◽  
Episode Psychosis ◽  
Symptomatic Remission

Here we report the results of a pilot study investigating the relative and combined effects of a 12 week course of clozapine and CBT in first-episode psychosis patients with prominent ongoing positive symptoms following their initial treatment. Patients from our early psychosis service who met the inclusion criteria () were randomized to one of four treatment groups: clozapine, clozapine plus CBT, thioridazine, or thioridazine plus CBT. The degree of psychopathology and functionality of all participants was measured at baseline then again at 6, 12 and 24 weeks, and the treatment outcomes for each group determined by statistical analysis. A substantial proportion (52%) of those treated with clozapine achieved symptomatic remission, as compared to 35% of those who were treated with thioridazine. Overall, those who received clozapine responded more rapidly to treatment than those receiving the alternative treatments. Interestingly, during the early treatment phase CBT appeared to reduce the intensity of both positive and negative symptoms and thus the time taken to respond to treatment, as well having as a stabilizing effect over time.

scholarly journals S166. EFFECTIVE CONNECTIVITY OF FRONTOSTRIATAL SYSTEMS IN FIRST-EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S99-S100
Author(s):  
Kristina Sabaroedin ◽  
Adeel Razi ◽  
Kevin Aquino ◽  
Sidhant Chopra ◽  
Amy Finlay ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Nucleus Accumbens ◽  
Effective Connectivity ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Healthy Controls ◽  
Top Down ◽  
Imaging Protocol ◽  
Episode Psychosis

Abstract Background Neuroimaging studies have found dysconnectivity of frontostriatal circuits across a broad spectrum of psychotic symptoms. However, it is unknown whether dysconnectivity within frontostriatal circuits originates from disrupted bottom-up or top-down control signaling within these systems. Here, we used dynamic causal modelling (DCM) to examine the effective connectivity of frontostriatal systems in first-episode psychosis (FEP). Methods A total of 55 FEP patients (26 males; mean [SD] age = 19.24 [2.89]) and 24 healthy controls (15 males; mean [SD] age = 21.83 [1.93]) underwent a resting-state functional magnetic resonance imaging protocol. Biologically plausible connections between eight left hemisphere regions encompassing the dorsal and ventral frontostriatal systems were modelled using spectral DCM. The regions comprise dorsolateral prefrontal cortex, ventromedial prefrontal cortex, anterior hippocampus, amygdala, dorsal caudate, nucleus accumbens, thalamus, and the midbrain. Effective connectivity between groups were assessed using a parametric Bayesian model. Associations between effective connectivity parameters and positive symptoms, measured by the Brief Psychiatric Rating Scale positive subscale, was assessed in the patient group in a separate Bayesian general linear model. Results DCM shows evidence for differences in effective connectivity between patients and healthy controls, namely in the bottom-down connections distributed in the frontostriatal system encompassing the hippocampus, amygdala, striatum, and midbrain. Compared to healthy controls, patients also demonstrated increased disinhibition of the midbrain. In patients, positive symptoms are associated with increased top-down connections to the midbrain. Outgoing connection from the midbrain to the nucleus accumbens is also increased in association with positive symptoms. Discussion Aberrant top-down connectivity in the frontostriatal system in patients is consistent with top-down dysregulation of dopamine function in FEP, as dopaminergic activity in the midbrain is proposed to be under the control of higher brain areas. In patients, increased self-inhibition of the midbrain, as well as symptom associations in both ingoing and outgoing connections of this region, are congruous with hyperactivity of the midbrain as proposed by the dopamine dysregulation hypothesis. Here, we demonstrate that mathematical models of brain imaging signals can be used to identify the key disruptions driving brain circuit dysfunction, identifying new targets for treatment.

Toxic psychosis? Duration of untreated psychosis, symptomatology and cognitive deterioration in first episode psychosis

2007 ◽  
Vol 24 (4) ◽  
pp. 145-148 ◽  
Author(s):  
Richard Lawoyin ◽  
Keith Gaynor ◽  
Barbara Dooley ◽  
Elizabeth Lawlor ◽  
Mary Clarke ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Cognitive Deterioration ◽  
Duration Of Untreated Psychosis ◽  
Episode Psychosis ◽  
The Relationship ◽  
Linear Regressions ◽  
Positive And Negative Symptoms

AbstractObjectives: To examine the relationship between cognitive deficits, the duration of untreated psychosis (DUP) and positive and negative symptoms in a first episode psychosis sample.Method: We assessed a consecutive sample of first episode psychosis participants from a catchment area service with a comprehensive neuropsychology battery, a family and service-user based measure of DUP and measures of symptomatology.Results: Using correlations and stepwise linear regressions, we found strong relationships between measures of DUP and positive symptomatology. We found that positive and negative symptoms were associated with different time periods within DUP. However, we did not find evidence of a relationship between DUP and cognitive factors.Conclusions: There was no evidence of a relationship between DUP and cognitive deterioration. However, there does appear to be evidence of a relationship between positive symptoms and aspects of DUP. These results highlight the importance of the heterogeneity of DUP and the potential to reduce positive symptoms through early intervention.

scholarly journals Developmental influences on symptom expression in antipsychotic-naïve first-episode psychosis

2020 ◽  
pp. 1-12
Author(s):  
Miranda Bridgwater ◽  
Peter Bachman ◽  
Brenden Tervo-Clemmens ◽  
Gretchen Haas ◽  
Rebecca Hayes ◽  
...  
Keyword(s):  
Negative Symptom ◽  
Symptom Severity ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Positive Symptom ◽  
First Episode ◽  
Positive Symptoms ◽  
Symptom Expression ◽  
Age Related ◽  
Episode Psychosis

Abstract Background The neurodevelopmental model of psychosis was established over 30 years ago; however, the developmental influence on psychotic symptom expression – how age affects clinical presentation in first-episode psychosis – has not been thoroughly investigated. Methods Using generalized additive modeling, which allows for linear and non-linear functional forms of age-related change, we leveraged symptom data from a large sample of antipsychotic-naïve individuals with first-episode psychosis (N = 340, 12–40 years, 1–12 visits), collected at the University of Pittsburgh from 1990 to 2017. We examined relationships between age and severity of perceptual and non-perceptual positive symptoms and negative symptoms. We tested for age-associated effects on change in positive or negative symptom severity following baseline assessment and explored the time-varying relationship between perceptual and non-perceptual positive symptoms across adolescent development. Results Perceptual positive symptom severity significantly decreased with increasing age (F = 7.0, p = 0.0007; q = 0.003) while non-perceptual positive symptom severity increased with age (F = 4.1, p = 0.01, q = 0.02). Anhedonia severity increased with increasing age (F = 6.7, p = 0.00035; q = 0.0003), while flat affect decreased in severity with increased age (F = 9.8, p = 0.002; q = 0.006). Findings remained significant when parental SES, IQ, and illness duration were included as covariates. There were no developmental effects on change in positive or negative symptom severity (all p > 0.25). Beginning at age 18, there was a statistically significant association between severity of non-perceptual and perceptual symptoms. This relationship increased in strength throughout adulthood. Conclusions These findings suggest that as maturation proceeds, perceptual symptoms attenuate while non-perceptual symptoms are enhanced. Findings underscore how pathological brain–behavior relationships vary as a function of development.

Premorbid adjustment and remission of positive symptoms in first-episode psychosis

1997 ◽  
Vol 6 (4) ◽  
pp. 212-218 ◽  
Author(s):  
G. P. Amminger ◽  
F. Resch ◽  
R. Mutschlechner ◽  
M. H. Friedrich ◽  
E. Ernst
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Premorbid Adjustment ◽  
Episode Psychosis

Factors influencing relapse during a 2-year follow-up of first-episode psychosis in a specialized early intervention service

2008 ◽  
Vol 38 (11) ◽  
pp. 1585-1593 ◽  
Author(s):  
A. Malla ◽  
R. Norman ◽  
L. Bechard-Evans ◽  
N. Schmitz ◽  
R. Manchanda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Early Intervention ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Adherence To Medication ◽  
Episode Psychosis ◽  
Time To Relapse

BackgroundDifferential association of risk factors associated with relapse following treatment of first-episode psychosis (FEP) have not been studied adequately, especially for patients treated in specialized early intervention (SEI) services, where some of the usual risk factors may be ameliorated.MethodConsecutive FEP patients treated in an SEI service over a 4-year period were evaluated for relapse during a 2-year follow-up. Relapse was based on ratings on the Scale for Assessment of Positive Symptoms (SAPS) and weekly ratings based on the Life Chart Schedule (LCS). Predictor variables included gender, duration of untreated psychosis (DUP), total duration of untreated illness (DUI), age of onset, pre-morbid adjustment, co-morbid diagnosis of substance abuse during follow-up and adherence to medication. Univariate analyses were followed by logistic regression for rate of relapse and survival analysis with the Cox proportional-hazards regression model for time to relapse as the dependent variables.ResultsOf the 189 eligible patients, 145 achieved remission of positive symptoms. A high rate of medication adherence (85%) and relatively low relapse rates (29.7%) were observed over the 2-year follow-up. A higher relapse rate was associated with a co-morbid diagnosis of substance abuse assessed during the follow-up period [odds ratio (OR) 2.84, 95% confidence interval (CI) 1.24–6.51]. The length of time to relapse was not associated with any single predictor.ConclusionsSpecialized treatment of substance abuse may be necessary to further reduce risk of relapse even after improving adherence to medication.

scholarly journals Substance misuse in first-episode psychosis: 15-month prospective follow-up study

2006 ◽  
Vol 189 (3) ◽  
pp. 229-234 ◽  
Author(s):  
D. Wade ◽  
S. Harrigan ◽  
J. Edwards ◽  
P. M. Burgess ◽  
G. Whelan ◽  
...  
Keyword(s):  
Substance Misuse ◽  
First Episode Psychosis ◽  
Patient Admission ◽  
First Episode ◽  
Positive Symptoms ◽  
Follow Up Study ◽  
Increased Risk ◽  
Episode Psychosis ◽  
Time To Relapse

BackgroundWell-designed prospective studies of substance misuse in first-episode psychosis can improve our understanding of the risks associated with comorbid substance misuse and psychosis.AimsTo examine the potential effects of substance misuse on in-patient admission and remission and relapse of positive symptoms in first-episode psychosis.MethodThe study was a prospective 15-month follow-up investigation of 103 patients with first-episode psychosis recruited from three mental health services.ResultsSubstance misuse was independently associated with increased risk of in-patient admission, relapse of positive symptoms and shorter time to relapse of positive symptoms after controlling for potential confounding factors. Substance misuse was not associated with remission or time to remission of positive symptoms. Heavy substance misuse was associated with increased risk of in-patient admission, relapse and shorter time to relapse.ConclusionsSubstance misuse is an independent risk factor for a problematic recovery from first-episode psychosis.

scholarly journals Developmental Influences on Symptom Expression in Antipsychotic-Naïve First-Episode Psychosis

2020 ◽  
Author(s):  
Miranda Bridgwater ◽  
Peter Bachman ◽  
Brenden Tervo-Clemmens ◽  
Gretchen Haas ◽  
Rebecca Hayes ◽  
...  
Keyword(s):  
Negative Symptom ◽  
Symptom Severity ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Symptom Expression ◽  
Cross Sectional ◽  
Age Related ◽  
Episode Psychosis

AbstractIntroductionThe neurodevelopmental model of psychosis was established over 30 years ago; however, the developmental influence on psychotic symptom expression – how a person’s age affects clinical presentation in first-episode psychosis – has not been thoroughly investigated.MethodUsing generalized additive modeling, which allows for linear and non-linear functional forms of age-related change, we leveraged symptom data from a large sample of antipsychotic-naïve individuals experiencing a first episode of psychosis (N=340, 12-40 years, 1-12 visits), collected at the University of Pittsburgh from 1990-2017. We examined relationships between age and severity of perceptual and non-perceptual positive symptoms and negative symptoms. We also tested for age-associated effects on change in positive or negative symptom severity following baseline assessment, and explored the time-varying relationship between perceptual and non-perceptual positive symptoms across adolescent development.ResultsIn the cross-sectional and longitudinal data, perceptual positive symptoms significantly decreased with increasing age (F=7.0, p=0.0007; q=0.003) while non-perceptual positive symptoms increased with increasing age (F=4.1, p=0.01, q=0.02). These relationships remained significant when SES, IQ, and illness duration were included as covariates. There were no developmental effects on change in positive or negative symptom severity (all p>0.25). Finally, an association between severity of non-perceptual and perceptual symptoms developed with increasing age, with a significant association starting at age 18.ConclusionThese findings suggest that as cognitive maturation proceeds, perceptual symptoms attenuate while non-perceptual symptoms are enhanced, reflecting influences of developmental processes on psychosis expression. Findings underscore how pathological brain-behavior relationships vary as a function of development.

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