1
|
Stickley A, Shirama A, Sumiyoshi T. Psychotic-like experiences and problem drinking among adults in Japan. Drug Alcohol Depend 2024; 260:111319. [PMID: 38788533 DOI: 10.1016/j.drugalcdep.2024.111319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/27/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) are common in the general population and have been linked to alcohol misuse and abuse. However, much of this research has been undertaken in Western countries. To address this deficit, the current study examined the association between PLEs and problem drinking in the Japanese general population. METHODS Data were used from 3717 adults (age 18-89) collected in an online survey in 2023. Information was obtained on PLEs with the PRIME Screen-Revised (PS-R), while problem drinking was assessed with the CAGE questionnaire (where a score of ≥ 2 was used to categorize cases). Logistic regression was used to examine the associations. RESULTS Problem drinking was prevalent in the study sample (12.5%). In an analysis that was adjusted for sociodemographic factors, self-rated health, smoking status and depressive symptoms, PLEs were associated with significantly higher odds for problem drinking in the total sample (OR: 1.70, 95%CI: 1.13-2.55). In a sex-stratified analysis PLEs were not linked to problem drinking in men (OR: 1.16, 95%CI 0.68-2.00), whereas women with PLEs had over 2.8 times higher odds for problem drinking (OR: 2.83, 95%CI: 1.54-5.21). CONCLUSION PLEs are associated with problem drinking in the Japanese general population and this association is especially pronounced in women. As problem drinking has been linked to a number of detrimental outcomes, future research should examine the potential effects of problem drinking in individuals with PLEs.
Collapse
Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan; Japan Health Research Promotion Bureau, 1-21-1, Toyama, Shinnjiku-ku, Tokyo162-8655, Japan
| |
Collapse
|
2
|
Exacerbation of psychosis risk during the COVID-19 pandemic: The disproportionate impact on the lower income population. Psychiatry Res 2022; 307:114319. [PMID: 34864230 PMCID: PMC8628604 DOI: 10.1016/j.psychres.2021.114319] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 12/18/2022]
|
3
|
Damiano RF, Machado L, Loch AA, Moreira-Almeida A, Machado L. Ninety Years of Multiple Psychotic-Like and Spiritual Experiences in a Doctor Honoris Causa: A Case Report and Literature Review. J Nerv Ment Dis 2021; 209:449-453. [PMID: 34037552 DOI: 10.1097/nmd.0000000000001290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Psychotic experiences are common experiences shared by a considerable part of the world's population. Moreover, most of the individuals who report these experiences also report those called spiritual and dissociative phenomena. In specific culture and religious backgrounds, these experiences are frequently seen as a part of normal human experiences, usually called mediumship. We report a case of a famous Brazilian medium with 90 years of experiencing psychotic-like, dissociative and/or spiritual experiences, but coped well with the experiences and never sought psychiatric or psychological assistance. The medium received several honorific prizes, such as doctor honoris causa from different institutions, published more than 200 books, and ran a nonprofit organization that takes care of 5000 people daily. Finally, we review the literature on this topic and stress the urge for more research aiming to distinguish pathological and nonpathological psychotic experiences to avoid overmedicalization and iatrogenic treatments.
Collapse
Affiliation(s)
| | - Liliane Machado
- Institute of Integral Medicine Prof. Fernando Figueira-IMIP, Recife, Pernambuco
| | | | - Alexander Moreira-Almeida
- NUPES (Research Center in Spirituality and Health), School of Medicine, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais
| | - Leonardo Machado
- Postgraduate program in neuropsychiatry and behavioral sciences, Medical Science Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| |
Collapse
|
4
|
Rössler W, Hengartner M, Ajdacic-Gross V, Haker H, Angst J. Lifetime and 12-month prevalence rates of sub-clinical psychosis symptoms in a community cohort of 50-year-old individuals. Eur Psychiatry 2020; 28:302-7. [DOI: 10.1016/j.eurpsy.2012.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 04/24/2012] [Accepted: 05/11/2012] [Indexed: 11/26/2022] Open
Abstract
AbstractBackground:Estimation of prevalence rates of sub-clinical psychosis symptoms can vary considerably depending on the methodology used. Furthermore, discussions are ongoing how prevalence rates may differ across various syndromes.Method:We analyzed data from the prospective Zurich Study, assessing sub-clinical psychosis with a semi-structured clinical interview in a community cohort of 50 years old individuals. The higher-order factors of psychosis symptoms were analyzed with confirmatory factor analysis to validate the a priori specified symptom-structure. Further associations were examined with contingency tables and logistic regressions.Results:The confirmatory factor analysis was consistent with a structure with four higher-order syndromes. Those different syndromes were labeled “thought disorder” (lifetime prevalence = 10.6%), “ego disorder” (4.8%), “hallucination” (9.7%), and “schizotypy” (28.2%). A strong discrepancy was noted between the 12-month prevalence of any symptoms and those considered to be severe. Twelve-month prevalence rates of distressful syndromes ranged from 0.1% for hallucinations up to 6.6% for schizotypy. The most strongly interrelated syndromes were thought disorder and ego disorder (OR = 12.4).Conclusion:Our findings indicate a continuity of sub-clinical psychosis within the general population even though only a small proportion suffers from distressing symptoms. Our analyses showed that the syndromes identified here are similar to those found in full-blown schizophrenia, albeit in an attenuated form.
Collapse
|
5
|
Ragazzi TCC, Shuhama R, Sinval J, Marôco J, Corsi-Zuelli F, Roza DLD, van Os J, Menezes PR, Del-Ben CM. Validation of the Portuguese version of the Community Assessment of Psychic Experiences and characterization of psychotic experiences in a Brazilian sample. ACTA ACUST UNITED AC 2020; 42:389-397. [PMID: 32130403 PMCID: PMC7430378 DOI: 10.1590/1516-4446-2019-0611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/05/2019] [Indexed: 11/24/2022]
Abstract
Objective: We investigated: i) the reliability and validity of a Brazilian version of the Community Assessment of Psychic Experiences (CAPE), developed to detect and characterize psychotic experiences in the general population; and ii) the association between psychotic experiences, childhood adversity, and cannabis use in a population-based sample. Methods: We performed factorial analyses and generalized linear models with CAPE scores as the dependent variable in a sample composed of 217 first-episode psychosis patients, 104 unaffected biological siblings, and 319 non-psychotic population-based participants. Results: After removing seven items from its positive dimension and two items from its negative dimension, a 33-item Brazilian version of the CAPE showed acceptable adjustment indices (confirmatory fit index = 0.895; goodness of fit index = 0.822; parsimony goodness of fit index = 0.761; root mean square error of approximation [RMSEA] = 0.055, p [RMSEA ≤ 0.05] = 0.04) and internal consistency in all its dimensions (> 0.70). Childhood adversity was associated with higher scores in all three dimensions, as well as with total score. Lifetime cannabis use was associated with higher scores only in the positive dimension. Conclusion: The proposed Brazilian version of the CAPE corroborates the tridimensional approach for assessing psychosis-proneness, and the frequency and severity of psychotic manifestations are distributed as a spectrum in the general population.
Collapse
Affiliation(s)
- Taciana C C Ragazzi
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Rosana Shuhama
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jorge Sinval
- Business Research Unit (BRU-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - João Marôco
- William James Center for Research, ISPA, Instituto Universitário, Lisbon, Portugal
| | - Fabiana Corsi-Zuelli
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Daiane L da Roza
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jim van Os
- Department of Psychiatry, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Paulo R Menezes
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Cristina M Del-Ben
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| |
Collapse
|
6
|
Heilskov SER, Urfer-Parnas A, Nordgaard J. Delusions in the general population: A systematic review with emphasis on methodology. Schizophr Res 2020; 216:48-55. [PMID: 31836260 DOI: 10.1016/j.schres.2019.10.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 10/18/2019] [Accepted: 10/20/2019] [Indexed: 11/29/2022]
Abstract
The presence of delusions is considered a key feature of psychosis, but despite the psychopathological centrality of the concept of delusion, its definition and comprehension is a matter of continuing debate. In recent years studies showing that delusions are common in the general population have accumulated and challenged the way we perceive psychotic illness. In this systematic review, we examine the basis of the psychosis continuum-hypothesis, by reviewing a representative section of the original literature that report measures of delusional ideation in the general population, focusing specifically on methodology. Three online databases were systematically searched for relevant studies. After applying criteria of inclusion and exclusion, 17 articles were included for comprehensive review. Estimates of the distribution of delusions in the general population vary substantially, as does the mode of assessment. The methodology relies with few exceptions exclusively on self-report and fully structured interview by lay person. We conclude that measures of delusions in the general population should be interpreted cautiously due to inherent difficulties in methodology. Hypothesizing a continuum of delusion between normality and full-blown psychosis is deemed premature based on the reviewed studies.
Collapse
Affiliation(s)
| | | | - Julie Nordgaard
- Mental Health Center Amager, Gl. Kongevej 33, 1610, Copenhagen V, Denmark; Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark
| |
Collapse
|
7
|
Pignon B, Sescousse G, Amad A, Benradia I, Vaiva G, Thomas P, Geoffroy PA, Roelandt JL, Rolland B. Alcohol Use Disorder Is Differently Associated With Psychotic Symptoms According To Underlying Psychiatric Disorders: A General Population Study. Alcohol Alcohol 2019; 55:112-120. [DOI: 10.1093/alcalc/agz077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/09/2019] [Accepted: 08/21/2019] [Indexed: 01/09/2023] Open
Abstract
Abstract
Aims
Psychotic symptoms can occur in the general population, and alcohol use disorder (AUD) is an identified vulnerability factor. However, it remains unclear how AUD is associated with psychotic symptoms, depending on the underlying psychiatric condition.
We aimed to compare the prevalence of psychotic symptoms among subjects with different types of psychiatric disorders, i.e. unipolar or bipolar disorders, anxiety disorders, psychotic disorders or no psychiatric disorder, depending on whether or not there was an underlying AUD.
Methods
In a 38,694-subject general population study, we compared the likelihood of occurrence of seven types of psychotic symptoms, depending on the AUD status and the underlying psychiatric disorders, after adjustment for age, sex, marital status, education and income levels.
Results
In unipolar depression and anxiety disorders, almost all types of psychotic symptoms were found associated with AUD (odds ratios (ORs) between 1.98 and 2.19). In contrast, in bipolar disorder, only auditory hallucinations were associated with AUD (OR = 2.50). In psychotic disorders, only thought broadcasting was more frequent among subjects with AUD (OR = 1.78).
Conclusion
Our findings in depression and anxiety disorders are in line with the ‘dual diagnosis’ concept, which posits that comorbid psychiatric/addictive disorders form distinctive entities that are more frequently associated with non-specific severity factors, here psychotic symptoms. The co-occurrence of AUD in bipolar/psychotic disorders was not associated with a generalized increased occurrence of psychotic symptoms but altered their manifestations with an increased risk of auditory hallucinations for bipolar disorder and thought broadcasting for psychotic disorders.
Collapse
Affiliation(s)
- Baptiste Pignon
- AP-HP, DHU PePSY, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie; Inserm, U955, Team 15; Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, 51 avenue du Maréchal Delattre de Tassigny, 94000 Paris, France
| | - Guillaume Sescousse
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier; Univ Lyon, UCBL, Inserm U1028, CNRS UMR5292, CRNL, PSYR2, 95 Bd Pinel, Bron F-69500, France
| | - Ali Amad
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille F-59000, France
- Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, Lille F-59000, France
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, Camberwell, London, UK
| | - Imane Benradia
- EPSM Lille Métropole; Centre Collaborateur de l’Organisation Mondiale de la Santé pour la Recherche et la Formation en Santé Mentale; Équipe Eceve Inserm UMR 1123, 211 rue Roger Salengro, F-59 260 Hellemmes, France
| | - Guillaume Vaiva
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille F-59000, France
- Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, Lille F-59000, France
| | - Pierre Thomas
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille F-59000, France
- Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, Lille F-59000, France
| | - Pierre A Geoffroy
- Inserm, U1144, F-75006; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, F-75013; AP-HP, GH Saint-Louis – Lariboisière – F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 200 Rue du Faubourg Saint-Denis, F-75475, Paris cedex 10 75475 and Fondation FondaMental, Créteil 94000, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole; Centre Collaborateur de l’Organisation Mondiale de la Santé pour la Recherche et la Formation en Santé Mentale; Équipe Eceve Inserm UMR 1123, 211 rue Roger Salengro, F-59 260 Hellemmes, France
| | - Benjamin Rolland
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier; Univ Lyon, UCBL, Inserm U1028, CNRS UMR5292, CRNL, PSYR2, 95 Bd Pinel, Bron F-69500, France
| |
Collapse
|
8
|
Loch AA, Freitas EL, Hortêncio L, Chianca C, Alves TM, Serpa MH, Andrade JC, van de Bilt MT, Gattaz WF, Rössler W. Hearing spirits? Religiosity in individuals at risk for psychosis-Results from the Brazilian SSAPP cohort. Schizophr Res 2019; 204:353-359. [PMID: 30266512 DOI: 10.1016/j.schres.2018.09.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/06/2018] [Accepted: 09/17/2018] [Indexed: 12/15/2022]
Abstract
In the last decades, biological and environmental factors related to psychosis were investigated in individuals at ultra-risk for psychosis (UHR) to predict conversion. Although religion relates to psychosis in a variety of ways, it is understudied in subclinical samples. Therefore, we assessed the interplay between religion and prodromal symptoms in 79 UHR and 110 control individuals. They were interviewed with the Duke University Religion Index and the Structured Interview for Prodromal Syndromes (SIPS). Organizational religious activity, a measure of how often someone attends churches/temples, was positively related to perceptual abnormalities/hallucinations (Spearman's rho = 0.262, p = 0.02). This relationship was replicated in a path analysis model (β = 0.342, SE = 0.108, p = 0.002), as well as a link between organizational religious activity and lower ideational richness (β = 0.401, SE = 0.105, p = 0.000) with no influence of sex, age, religious denomination, or socioeconomic class. Intrinsic religious activity was negatively correlated with suspiciousness (SIPS P2) (β = -0.028, SE = 0.009, p = 0.002), and non-organizational religious activity was correlated with higher ideational richness (N5) (β = -0.220, SE = 0.097, p = 0.023). We hypothesize that subjects with subclinical psychosis may possibly use churches and other religious organizations to cope with hallucinations. Indeed, Brazil is characterized by a religious syncretism and a strong influence of Spiritism in the popular culture. The mediumistic idea that some might be able to hear and/or see spirits is probably employed to explain subclinical hallucinations in the lay knowledge. Our results emphasize the importance of assessing religion and other region-specific aspects of various cultures when studying UHR individuals. This sort of assessment would enhance understanding of differences in conversion rates, and would help to transpose prevention programs from high-income countries to other settings.
Collapse
Affiliation(s)
- Alexandre Andrade Loch
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil; Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Brazil.
| | - Elder Lanzani Freitas
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil
| | - Lucas Hortêncio
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil
| | - Camille Chianca
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil
| | - Tania Maria Alves
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil
| | - Maurício Henriques Serpa
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil; Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Brazil
| | - Julio Cesar Andrade
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil
| | - Martinus Theodorus van de Bilt
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil; Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Brazil
| | - Wagner Farid Gattaz
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil; Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Brazil
| | - Wulf Rössler
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, Brazil; Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Brazil; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Department of Psychiatry and Psychotherapy, Charité University of Medicine, Berlin, Germany
| |
Collapse
|
9
|
Abstract
Current diagnostic criteria delineate schizophrenia as a discrete entity essentially defined by positive symptoms. However, the role of positive symptoms in psychiatry is being questioned. There is compelling evidence that psychotic manifestations are expressed in the population in a continuum of varying degrees of severity, ranging from normality to full-blown psychosis. In most cases, these phenomena do not persist, but they constitute risk factors for psychiatric disorders in general. Psychotic symptoms are also present in most non-psychotic psychiatric diagnoses, being a marker of severity. Research revealed that hallucinations and delusions appear to have distinct, independent biological underpinnings-in the general population, in psychotic, and in non-psychotic disorders as well. On the other hand, negative symptoms were seen to be far more restricted to schizophrenia, have other underlying pathophysiology than positive symptoms, predict outcome and treatment response in schizophrenia, and start before the first psychotic outbreak. The current work discusses the concept of schizophrenia, suggesting that a greater emphasis should be put on cases where psychotic symptoms emerge in a premorbid subtly increasing negative/cognitive symptoms background. In those cases, psychosis would have a different course and outcome while psychosis occurring in the absence of such background deterioration would be more benign-probably having no, or a milder, underlying degenerative process. This reformulation should better drive psychopathological classification, face positive symptoms as epiphenomenon of the schizophrenia process, and dishevel stigma from schizophrenia and from delusions and hallucinations.
Collapse
Affiliation(s)
- Alexandre Andrade Loch
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, São Paulo, Brazil
| |
Collapse
|
10
|
Poverty, low education, and the expression of psychotic-like experiences in the general population of São Paulo, Brazil. Psychiatry Res 2017; 253:182-188. [PMID: 28388455 DOI: 10.1016/j.psychres.2017.03.052] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 03/21/2017] [Accepted: 03/29/2017] [Indexed: 11/23/2022]
Abstract
The aim of our study was to assess psychotic-like experiences in the general population aged 18-30 years old of the city of São Paulo, Brazil. A household survey was conducted with 1950 young-adults randomly drawn from the city's general population. The validated 92-item Portuguese version of the Prodromal Questionnaire (PQ) was used for face-to-face interviews. Latent class analysis was conducted. Mean age was of 24 years; 51.1% of the sample was of women. Mean total score on the PQ was 22.06 (SD=17.16). Considering a suggested cut-off of 14 in the positive subscale, 30.8% of individuals were above the threshold for ultra-high risk for psychosis detection. Latent class analysis resulted in a three classes clusterization. Class 1 (20%; n=390) had the highest overall PQ scores (mean=49.31,SD=10.783), class 2 (43%; n=835) had intermediate scores (mean=23.37,SD=6.56), and class 3 (37%; n=721) had the lowest scores (mean=5.81,SD=3.74). Class 1 had significantly more individuals with less education and significantly more individuals with lower socioeconomic class. Poverty and low education might be associated with the psychotic expression in the general population, amplifying their actions on the psychosis gradient in developing countries. The psychosis continuum might be constituted by three distinct quantitatively different classes.
Collapse
|
11
|
Rössler W, Ajdacic-Gross V, Rodgers S, Haker H, Müller M. Childhood trauma as a risk factor for the onset of subclinical psychotic experiences: Exploring the mediating effect of stress sensitivity in a cross-sectional epidemiological community study. Schizophr Res 2016; 172:46-53. [PMID: 26874870 DOI: 10.1016/j.schres.2016.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 01/31/2016] [Accepted: 02/03/2016] [Indexed: 02/06/2023]
Abstract
Childhood trauma is a risk factor for the onset of schizophrenic psychosis. Because the psychosis phenotype can be described as a continuum with varying levels of severity and persistence, childhood trauma might likewise increase the risk for psychotic experiences below the diagnostic threshold. But the impact of stressful experiences depends upon its subjective appraisal. Therefore, varying degrees of stress sensitivity possibly mediate how childhood trauma impacts in the end upon the occurrence of subclinical psychotic experiences. We investigated this research question in a representative community cohort of 1500 participants. A questionnaire, comprising five domains of physical and emotional neglect, as well as physical, emotional, and sexual abuse, was used to assess childhood trauma. Based on different symptoms of subclinical psychotic experiences, we conducted a latent profile analysis (LPA) to derive distinct profiles for such experiences. Path modeling was performed to identify the direct and indirect (via stress sensitivity) pathways from childhood trauma to subclinical psychotic experiences. The LPA revealed four classes - unaffected, anomalous perceptions, odd beliefs and behavior, and combined anomalous perceptions/odd beliefs and behavior, that - except for sexual abuse - were all linked to childhood trauma. Moreover, except for physical abuse, childhood trauma was significantly associated with stress sensitivity. Thus, our results revealed that the pathways from emotional neglect/abuse and physical neglect to subclinical psychotic experiences were mediated by stress sensitivity. In conclusion, we can state that subclinical psychotic experiences are affected by childhood traumatic experiences in particular through the pathway of a heightened subjective stress appraisal.
Collapse
Affiliation(s)
- Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland.
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Helene Haker
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| |
Collapse
|
12
|
Granö N, Karjalainen M, Ranta K, Lindgren M, Roine M, Therman S. Community-oriented family-based intervention superior to standard treatment in improving depression, hopelessness and functioning among adolescents with any psychosis-risk symptoms. Psychiatry Res 2016; 237:9-16. [PMID: 26921045 DOI: 10.1016/j.psychres.2016.01.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 12/01/2015] [Accepted: 01/15/2016] [Indexed: 11/27/2022]
Abstract
The aim of the present study was to compare change in functioning, affective symptoms and level of psychosis-risk symptoms in symptomatic adolescents who were treated either in an early intervention programme based on a need-adapted Family- and Community-orientated integrative Treatment Model (FCTM) or in standard adolescent psychiatric treatment (Treatment As Usual, TAU). 28 pairs were matched by length of follow-up, gender, age, and baseline functioning. At one year after the start of treatment, the matched groups were compared on change in functioning (GAF-M), five psychosis-risk dimensions of the Structured Interview for Psychosis-Risk Syndromes (SIPS), and self-reported anxiety, depression, and hopelessness symptoms (BAI, BDI-II, BHS). FCTM was more effective in improving functioning (20% vs. 6% improvement on GAF-M), as well as self-reported depression (53% vs. 14% improvement on BDI-II) and hopelessness (41% vs. 3% improvement on BHS). However, for psychosis-risk symptoms and anxiety symptoms, effectiveness differences between treatment models did not reach statistical significance. To conclude, in the present study, we found greater improvement in functioning and self-reported depression and hopelessness among adolescents who received a need-adapted Family- and Community-orientated integrative Treatment than among those who were treated in standard adolescent psychiatry.
Collapse
Affiliation(s)
- Niklas Granö
- Department of Psychiatry, Helsinki University Central Hospital, Finland Helsinki University Central Hospital, Jorvi Hospital, Department of Psychiatry, Turuntie 150, 02740 Espoo, Finland; Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland.
| | - Marjaana Karjalainen
- Department of Psychiatry, Helsinki University Central Hospital, Finland Helsinki University Central Hospital, Jorvi Hospital, Department of Psychiatry, Turuntie 150, 02740 Espoo, Finland
| | - Klaus Ranta
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Välskärinkatu 12, 00260 Helsinki, Finland
| | - Maija Lindgren
- Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland
| | - Mikko Roine
- Department of Psychiatry, Helsinki University Central Hospital, Finland Helsinki University Central Hospital, Jorvi Hospital, Department of Psychiatry, Turuntie 150, 02740 Espoo, Finland
| | - Sebastian Therman
- Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland
| |
Collapse
|
13
|
Angermeyer MC, Millier A, Rémuzat C, Refaï T, Schomerus G, Toumi M. Continuum beliefs and attitudes towards people with mental illness: Results from a national survey in France. Int J Soc Psychiatry 2015; 61:297-303. [PMID: 25061023 DOI: 10.1177/0020764014543312] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Whether mental disorders should be considered as categorical or dimensional has found increasing attention among mental health professionals. Only little is known about what the public thinks about this issue. AIMS First, to assess how prevalent the belief in a continuum of symptoms from mental health to mental illness is among the general public. Second, to examine how continuum beliefs are associated with attitudes towards people with mental disorder. METHODS In 2012, an on-line survey was conducted in France (N = 1,600). After the presentation of a case-vignette depicting a person with either schizophrenia or depression, belief in a continuum of symptoms, emotional reactions and desire for social distance related to the person in the vignette were assessed. RESULTS While 58.2% of respondents agreed in a symptom continuum for depression, this percentage was only 28.5% for schizophrenia. In both disorders, continuum beliefs were associated with more pro-social reactions and less desire for social distance. Only in schizophrenia, there was an inverse relationship with the expression of anger. CONCLUSIONS There is increasing evidence of an association between continuum beliefs and positive attitudes towards people with mental illness. Information on the continuous nature of psychopathological phenomena may usefully be included in anti-stigma messages.
Collapse
Affiliation(s)
- Matthias C Angermeyer
- Center for Public Mental Health, Gösing am Wagram, Austria Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | | | | | | | - Georg Schomerus
- Department of Psychiatry, University of Greifswald, Greifswald, Germany HELIOS Hanseklinikum Stralsund, Stralsund, Germany
| | | |
Collapse
|
14
|
Rössler W, Ajdacic-Gross V, Müller M, Rodgers S, Haker H, Hengartner MP. Assessing sub-clinical psychosis phenotypes in the general population--a multidimensional approach. Schizophr Res 2015; 161:194-201. [PMID: 25523751 DOI: 10.1016/j.schres.2014.11.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 10/31/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
Abstract
Several studies have demonstrated that expression of a psychosis phenotype can be observed below the threshold of its clinical detection. To date, however, no conceptual certainty has been reported for the validity and reliability of sub-clinical psychosis. Our main objectives were to assess the prevalence rates and severity of various psychosis symptoms in a representative community sample. Furthermore, we wanted to analyze which latent factors are depicted by several currently used psychosis questionnaires. We also examined how those latent factors for sub-clinical psychosis are linked to psychosocial factors, normal personality traits, and coping abilities related to chronic stress. Most of the eight subscales from the Paranoia Checklist and the Structured Interview for Assessing Perceptual Anomalies had a very similar type of distribution, i.e., an inverse Gaussian (Wald) distribution. This supported the notion of a continuity of psychotic symptoms, which we would expect to find for continuously distributed symptoms within the general population. Sub-clinical psychosis can be reduced to two different factors - one representing odd beliefs about the world and odd behavior, and the other one representing anomalous perceptions (such as hallucinations). Persons with odd beliefs and behavior are under greater burden and more susceptible to psychosocial risks than are persons with anomalous perceptions. These sub-clinical psychosis syndromes are also related to stable personality traits. In conclusion, we obtained strong support for the notion that there is no natural cut-off separating psychotic illness from good health. Sub-clinical psychosis of any kind is not trivial because it is associated with various types of social disability.
Collapse
Affiliation(s)
- Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland.
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Helene Haker
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich & ETH, Zurich, Switzerland
| | - Michael P Hengartner
- Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland; Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Zurich, Switzerland
| |
Collapse
|
15
|
Rössler W, Ajdacic-Gross V, Haker H, Rodgers S, Müller M, Hengartner MP. Subclinical psychosis syndromes in the general population: results from a large-scale epidemiological survey among residents of the canton of Zurich, Switzerland. Epidemiol Psychiatr Sci 2015; 24:69-77. [PMID: 24280150 PMCID: PMC6998132 DOI: 10.1017/s2045796013000681] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/14/2013] [Accepted: 10/15/2013] [Indexed: 11/07/2022] Open
Abstract
Aims. Prevalence and covariates of subclinical psychosis have gained increased interest in the context of early identification and treatment of persons at risk for psychosis. Methods. We analysed 9829 adults representative of the general population within the canton of Zurich, Switzerland. Two psychosis syndromes, derived from the SCL-90-R, were applied: 'schizotypal signs' and 'schizophrenia nuclear symptoms'. Results. Only a few subjects (13.2%) reported no schizotypal signs. While 33.2% of subjects indicated mild signs, only a small proportion (3.7%) reported severe signs. A very common outcome was no 'schizophrenia nuclear symptoms' (70.6%). Although 13.5% of the participants reported mild symptoms, severe nuclear symptoms were very rare (0.5%). Because these two syndromes were only moderately correlated (r = 0.43), we were able to establish sufficiently distinct symptom clusters. Schizotypal signs were more closely connected to distress than was schizophrenia nuclear symptoms, even though their distribution types were similar. Both syndromes were associated with several covariates, such as alcohol and tobacco use, being unmarried, low education level, psychopathological distress and low subjective well-being. Conclusions. Subclinical psychosis symptoms are quite frequent in the general population but, for the most part, are not very pronounced. In particular, our data support the notion of a continuous Wald distribution of psychotic symptoms in the general population. Our findings have enabled us to confirm the usefulness of these syndromes as previously assessed in other independent community samples. Both can appropriately be associated with well-known risk factors of schizophrenia.
Collapse
Affiliation(s)
- W. Rössler
- University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
- University of Zurich and ETHZ, Collegium Helveticum Zurich, Zurich, Switzerland
- Laboratory of Neuroscience – LIM 27, Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - V. Ajdacic-Gross
- University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
- Laboratory of Neuroscience – LIM 27, Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - H. Haker
- University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | - S. Rodgers
- University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - M. Müller
- University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - M. P. Hengartner
- University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| |
Collapse
|
16
|
Rössler W, Hengartner MP, Ajdacic-Gross V, Haker H, Angst J. Impact of childhood adversity on the onset and course of subclinical psychosis symptoms--results from a 30-year prospective community study. Schizophr Res 2014; 153:189-95. [PMID: 24534797 DOI: 10.1016/j.schres.2014.01.040] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 01/13/2014] [Accepted: 01/28/2014] [Indexed: 12/29/2022]
Abstract
The study objective was to examine childhood adversity in association with intra-individual changes and inter-individual differences in subclinical psychosis in a representative community cohort over a 30-year period of observation. We analyzed two psychosis syndromes derived from the SCL-90-R - schizotypal signs and schizophrenia nuclear symptoms - in 335 participants. Participants were repeatedly assessed between 1978 (around age 20) and 2008 (around age 50). We focused specifically on inter-individual differences and intra-individual changes over time by applying structural equation modeling, generalized linear models, and generalized estimating equations. Several weak inter-individual differences revealed that increased schizotypal signs are related to various childhood adversities, such as being repeatedly involved in fights and parents having severe conflicts among themselves. We also found a significant positive association between schizotypal signs and the total number of adversities a subject experienced. This pointed toward a modest dose-response relationship. The intra-individual change in schizotypal signs over time was rather weak, although some adjustment did occur. In contrast, inter-individual schizophrenia nuclear symptoms were mainly unrelated to childhood adversity. However, some striking intra-individual changes in distress were noted over time, especially those linked with severe punishment and the total adversity score. In conclusion, we have confirmed previous positive findings about the association between childhood adversity and subsequent subclinical psychosis symptoms: An increase in adversity is weakly related to an increase of the psychosis symptom load. However, depending on the kind of adversity experienced the psychosis symptom load decreases gradually in adult life.
Collapse
Affiliation(s)
- Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Institue of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil.
| | - Michael P Hengartner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Helene Haker
- University of Zurich & ETH Zurich, Institute for Biomedical Engineering, Translational Neuromodeling Unit, Zurich, Switzerland
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| |
Collapse
|
17
|
Granö N, Karjalainen M, Edlund V, Saari E, Itkonen A, Anto J, Roine M. Changes in depression, anxiety and hopelessness symptoms during family- and community-oriented intervention for help-seeking adolescents and adolescents at risk of psychosis. Nord J Psychiatry 2014; 68:93-9. [PMID: 23421729 DOI: 10.3109/08039488.2013.768294] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Little is known about how symptoms are changed in adolescents who receive treatment in an early detection and intervention service. AIMS The aims of the present research were to study change in depression, anxiety and hopelessness symptoms in a sample of help-seeking adolescents who participated in a community- and family-oriented early intervention programme. METHODS The data was collected in Helsinki University Central Hospital (HUCH), Finland, by the JERI (Jorvi Early psychosis Recognition and Intervention) early intervention team; 85 help-seeking adolescents filled questionnaires of anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory II) and hopelessness (Beck Hopelessness Scale). The PROD screen was used to assess risk of psychosis. RESULTS Paired samples t-test of anxiety, depression and hopelessness showed statistically significant improvement on all scales (P < 0.001) in all participants (n = 85) between baseline and the end of intervention. Improvement was significant on scales of anxiety (P = 0.004), depression (P < 0.001) and hopelessness (P < 0.001) for participants at risk of psychosis (n = 34). Effect sizes were from medium to large for changes. After the treatment, of all participants, 68.8% were at a remission level of symptoms in anxiety, 84.7% in symptoms of depression and 88.2% in symptoms of hopelessness. Of sub-group of participants at risk of psychosis, 58.8% were at a remission level of symptoms in anxiety, 76.4% in symptoms of depression and 79.4% in symptoms of hopelessness. CONCLUSIONS Present results suggest that there is both statistically and clinically remarkable improvement in anxiety, depression and hopelessness symptoms after the intervention. These findings should be considered in the psychiatric care of help-seeking adolescents and adolescents at risk of psychosis.
Collapse
Affiliation(s)
- Niklas Granö
- Helsinki University Central Hospital, Jorvi Hospital, Department of Psychiatry , Turuntie 150, 02740 Espoo , Finland
| | | | | | | | | | | | | |
Collapse
|
18
|
Subramaniam M, Abdin E, Vaingankar JA, Verma S, Chong SA. Latent structure of psychosis in the general population: results from the Singapore mental health study. Psychol Med 2014; 44:51-60. [PMID: 23574702 DOI: 10.1017/s0033291713000688] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Few studies have examined the latent construct of psychotic symptoms or distinguished between the latent construct and its manifest indicators. The current study aimed to investigate the latent structure of psychotic symptoms using factor mixture modeling (FMM) and to use the best-fitting model to examine its sociodemographic and clinical correlates. METHOD The Singapore Mental Health Study (SMHS) was based on an adult representative sample of the Singapore population. Psychotic symptoms were assessed by using the Psychosis Screen section of the Composite International Diagnostic Interview version 3.0 (CIDI 3.0). FMM analyses were applied to determine the latent construct of psychotic symptoms. Sociodemographic and clinical correlates of the latent structure of psychosis symptoms were examined using multiple linear and logistic regression analyses. RESULTS The overall weighted lifetime prevalence of any psychotic experience was 3.8% in the SMHS after excluding subthreshold experiences. The FMM analysis clearly supported the dimensional model of the latent structure of psychotic symptoms. On deriving the total score for 'psychosis symptoms' in accordance with the one latent trait model, and correlating it with sociodemographic factors, we found that female gender, vocational education, current and past smokers were positively associated with the 'psychosis' total score. CONCLUSIONS There is a need for an increased understanding of, and research into, this intermediate state of 'psychosis symptoms' that do not meet diagnostic criteria for psychosis. It is also important to learn more about the group of individuals in the community who may have preserved functioning to elucidate the protective factors that prevent transition to psychosis.
Collapse
Affiliation(s)
- M Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, Singapore
| | | | | | | | | |
Collapse
|
19
|
Granö N, Karjalainen M, Edlund V, Saari E, Itkonen A, Anto J, Roine M. Changes in health-related quality of life and functioning ability in help-seeking adolescents and adolescents at heightened risk of developing psychosis during family- and community-oriented intervention model. Int J Psychiatry Clin Pract 2013; 17:253-8. [PMID: 23485127 DOI: 10.3109/13651501.2013.784791] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Objective. Early intervention has been shown to benefit people at-risk for psychosis, but knowledge about how early intervention benefits all help-seeking adolescents is lacking. The aim of the present study was to study change in health-related quality of life (QoL) and functioning ability in help-seeking adolescents who participate in a community- and family-oriented early intervention program. Methods. The data was collected in Finland by an early-intervention team. Ninety help-seeking adolescents between 12 and 21 years of age filled out a questionnaire on QoL (16D) and functioning ability (GAF), which was assessed by workers at the beginning and at the end of the intervention. A PROD screen was used to assess heightened risk of developing psychosis. Results. QoL and functioning ability showed significant differences (p < 0.001) between the beginning and the end of the intervention, as well in a subgroup of participants at heightened risk of developing psychosis (QoL, p = 0.008; GAF, p < 0.001: n = 35). 35.6% improved over the clinical cut-off point in functioning ability and 48.6% of the subjects at-risk. 53.3% reached clinically significant improvement in QoL and 54.2% of the subjects at heightened risk of developing psychosis. Conclusions. The results suggest that there is both statistically and clinically remarkable improvement in QoL and functioning ability after a need-adapted, family- and community-oriented intervention.
Collapse
Affiliation(s)
- Niklas Granö
- Helsinki University Central Hospital, Jorvi Hospital, Department of Psychiatry , Finland
| | | | | | | | | | | | | |
Collapse
|
20
|
Granö N, Karjalainen M, Edlund V, Saari E, Itkonen A, Anto J, Roine M. Depression symptoms in help-seeking adolescents: A comparison between adolescents at-risk for psychosis and other help-seekers. J Ment Health 2013; 22:317-24. [DOI: 10.3109/09638237.2012.734654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
21
|
Andrade LH, Wang YP, Andreoni S, Silveira CM, Alexandrino-Silva C, Siu ER, Nishimura R, Anthony JC, Gattaz WF, Kessler RC, Viana MC. Mental disorders in megacities: findings from the São Paulo megacity mental health survey, Brazil. PLoS One 2012; 7:e31879. [PMID: 22348135 PMCID: PMC3279422 DOI: 10.1371/journal.pone.0031879] [Citation(s) in RCA: 227] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 01/14/2012] [Indexed: 11/24/2022] Open
Abstract
Background World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. The aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders. Methods and Results A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year. Discussion Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the rapidly expanding Brazilian primary health system should be strengthened. This strategy might become a model for poorly resourced and highly populated developing countries.
Collapse
Affiliation(s)
- Laura Helena Andrade
- Section of Psychiatric Epidemiology-LIM 23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Falkai P, Möller HJ. From generation of biomarkers to treatment and psychosocial aspects of psychosis. Eur Arch Psychiatry Clin Neurosci 2011; 261:457-8. [PMID: 21927833 PMCID: PMC3182324 DOI: 10.1007/s00406-011-0262-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- P. Falkai
- Department of Psychiatry and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - H.-J. Möller
- Psychiatry Hospital, Ludwigs-Maximililans-University Munich, Nussbaumstr. 7, 80336 Munich, Germany
| |
Collapse
|