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Krupa AJ, Chrobak AA, Sołtys Z, Korkosz M, Nowakowski J, Dudek D, Siwek M. Psychological variables associated with resistance to treatment with serotonin and noradrenaline reuptake inhibitors in fibromyalgia. J Psychosom Res 2023; 174:111493. [PMID: 37722212 DOI: 10.1016/j.jpsychores.2023.111493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE The treatment of fibromyalgia (FM) often offers only partial pain relief. Among the most effective drugs for FM pain are serotonin and noradrenalin reuptake inhibitors (SNRI). Few studies investigated the affective temperaments and personality features in FM. Our objective was to explore the associations between the affective temperaments, personality traits, schizotypy and response to SNRI treatment in FM. METHODS 60 FM patients: 30 responsive to SNRI (FM T[+]), 30 non-responsive to SNRI (FM T[-] and 30 healthy controls were recruited. Resistance to SNRI was defined as <30% pain reduction during at least 8-week treatment. Subjects were assessed by physician and filled self-report questionnaires: Temperament Scale of Memphis, Pisa and San Diego- autoquestionnaire, Ten Item Personality Inventory, Oxford-Liverpool Inventory of Feelings and Experiences and Fibromyalgia Impact Questionnaire (FIQ). ANOVA analysis and simple logistic regressions were used to examine the links between psychological variables and lack of response to SNRI. RESULTS FM T[-] presented higher scores in total FIQ and in physical, work, well-being, pain, fatigue/sleep, stiffness domains than FM T[+]. FM T[-] showed higher levels of: irritable and anxious temperaments, neuroticism, schizotypy than FM T[+]. The levels of depressive, irritable and anxious temperaments, introversion, neuroticism and schizotypy were linked to lack of response to SNRI. CONCLUSIONS FM T[+] and FM T[-] differ in clinical presentation and psychological features. The levels of affective temperaments, personality and schizotypal traits are associated with lack response to SNRI in FM.
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Affiliation(s)
- Anna J Krupa
- Department of Psychiatry, Jagiellonian University Medical College, Krakow, Poland; Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Adrian A Chrobak
- Department of Adult Psychiatry, Jagiellonian University Medical College, Krakow, Poland
| | - Zbigniew Sołtys
- Institute of Zoology and Biomedical Research, Laboratory of Experimental Neuropathology, Jagiellonian University, Krakow, Poland
| | - Mariusz Korkosz
- Department of Rheumatology and Immunology, Jagiellonian University Medical College, Krakow, Poland
| | - Jarosław Nowakowski
- Department of Rheumatology and Immunology, Jagiellonian University Medical College, Krakow, Poland
| | - Dominika Dudek
- Department of Adult Psychiatry, Jagiellonian University Medical College, Krakow, Poland
| | - Marcin Siwek
- Department of Affective Disorders, Jagiellonian University Medical College, Krakow, Poland.
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Torrecilla P, Barrantes-Vidal N. The moderating role of hair cortisol in the association of early and recent stress with stress-related phenotypes. Front Psychol 2023; 14:1150142. [PMID: 37416538 PMCID: PMC10320289 DOI: 10.3389/fpsyg.2023.1150142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
BackgroundIncreased hair cortisol concentrations (HCC) have been found in clinical samples of schizophrenia, first episode psychosis and clinical risk for psychosis, but evidence of such is scarce in schizotypy. High HCC are supposed to reflect elevated chronic stress. However, HCC were not directly associated with adversity measures and stress-related phenotypes in previous research. This study tested whether HCC moderated the association between a comprehensive range of psychosocial stressors with several stress-related phenotypes in a sample of nonclinical young adults. It was expected that stressors, either distal (i.e., early-life) or recent, would be associated with subclinical features, particularly for those with elevated HCC, reflecting the effects of a potential biological sensitization to stress.MethodsThe sample comprised 132 nonclinical young adults belonging to the Barcelona Longitudinal Investigation of Schizotypy Study (BLISS). Participants completed a questionnaire of childhood adversity and two complementary measures of recent life events, tapping threatening vs. more general life events. Both the frequency and subjective impact (positive vs. negative) of general life events were also assessed. Psychotic (i.e., schizotypy, suspiciousness) and non-psychotic (i.e., depression, anxiety) subclinical features as well as appraisals of perceived stress were examined. Hierarchical linear regressions and simple slope analyses were computed.ResultsHCC moderated the effects of both early and recent stress on suspiciousness as well as the effects of recent life events on perceived stress, such that those with higher HCC presented increased suspiciousness and perceived stress at higher levels of stress exposure. Positive, but not negative, recent life events were associated with decreased perceived stress and depression, and these associations were moderated by low HCC, indicating a buffering effect for those with a non-impaired HPA axis.ConclusionIn line with the neural diathesis-stress model, results highlight the role of the interplay between the HPA axis and exposure to stressful experiences in exacerbating psychosis features and extend evidence to the nonclinical expression of the psychosis continuum. In addition, findings support the protective effect of positive experiences in decreasing stress appraisals and affective disturbances, which is consistent with emerging research about the relevance of positive factors in reducing the likelihood of psychopathological outcomes.
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Affiliation(s)
- Pilar Torrecilla
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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Choi H, Shin S, Lee G. Effects of Positive Psychotherapy for People with Psychosis: A Systematic Review and Meta-Analysis. Issues Ment Health Nurs 2023; 44:180-193. [PMID: 36920274 DOI: 10.1080/01612840.2023.2174218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
This study evaluates positive psychotherapy's effects on the well-being and psychiatric symptoms of people with psychosis. A systematic search was conducted using 10 electronic databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis was performed using the R 4.2.0 program to estimate the effect size. Seventeen studies were included in the systematic review and 14 in meta-analysis. Positive psychotherapy for people with psychosis had significant effects on subjective and psychological well-being and psychiatric symptoms. Further, country, age, and session were significant moderators. Thus, positive psychotherapy improves the well-being and psychiatric symptoms of people with psychosis.
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Affiliation(s)
- Heeseung Choi
- College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Soyoun Shin
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Gumhee Lee
- College of Nursing, Seoul National University, Seoul, Republic of Korea
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Chu MHW, Lau B, Leung J, Chan SC, Tang B, Lau C, Newby C, Chiu R, Lo WTL, Schrank B, Slade M. Positive psychotherapy for psychosis in Hong Kong: A randomized controlled trial. Schizophr Res 2022; 240:175-183. [PMID: 35030447 DOI: 10.1016/j.schres.2021.12.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/21/2021] [Accepted: 12/25/2021] [Indexed: 10/19/2022]
Abstract
Recovery-oriented practice has been advocated in mental health services in Hong Kong since 2009. Well-being has become an important area of focus for mental health services. Positive Psychotherapy for Psychosis (PPP) is a well-being-focused intervention for use in psychosis, with preliminary evidence from a randomized controlled trial in the United Kingdom of impact on well-being and symptomatology. The aim of this study was to test the effectiveness of PPP on the well-being of people with psychosis in Hong Kong. The study was a randomized controlled trial with two-arm parallel groups. Both groups received treatments as usual, and in addition the intervention group received a 13-session intervention based on a Cantonese Chinese translation of the PPP manual. Intention-to-treat analysis was used. The trial was registered (ANZCTR: ACTRN12620000464965). A total of 154 participants (78 intervention, 76 control) were recruited. As compared to control group, intervention group participants showed significant changes over time on the primary outcome of well-being assessed using the Chinese Short Warwick-Edinburgh Mental Well-being Scale (p = 0.001) and on secondary outcomes of hope (Agency subscale: p = 0.029) and self-efficacy (p = 0.001). Positive Psychotherapy for Psychosis was found to be an effective treatment in improving the well-being and other mental health outcomes for people with psychosis. It can be recommended for use in mental health services to promote recovery.
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Affiliation(s)
- Menza Hon-Wai Chu
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China.
| | - Bien Lau
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Joey Leung
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Sheung Chun Chan
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Betty Tang
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Charles Lau
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | | | - Rose Chiu
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - William Tak-Lam Lo
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Beate Schrank
- Karl Landsteiner University of Health Sciences, Department of Psychiatry, Krems, Austria
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, United Kingdom
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Assessing changes associated in well-being after a psychological intervention for people with paranoid tendencies: An ESM application in clinical practice. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02625-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lucas-Molina B, Pérez-Albéniz A, Satorres E, Ortuño-Sierra J, Domínguez Garrido E, Fonseca-Pedrero E. Identifying extended psychosis phenotypes at school: Associations with socio-emotional adjustment, academic, and neurocognitive outcomes. PLoS One 2020; 15:e0237968. [PMID: 32822380 PMCID: PMC7446872 DOI: 10.1371/journal.pone.0237968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 08/06/2020] [Indexed: 11/26/2022] Open
Abstract
The main goal of the present study was to explore the latent structure of extended psychosis phenotypes in a representative sample of adolescents. Moreover, associations with socio-emotional adjustment, academic achievement, and neurocognition performance across the latent profiles were compared. Participants were 1506 students, 667 males (44.3%), derived from random cluster sampling. Various tools were used to measure psychosis risk, subjective well-being, academic performance, and neurocognition. Based on three psychometric indicators of psychosis risk (schizotypal traits, psychotic-like experiences, and bipolar-like experiences), four latent classes were found: non-risk, low-risk, high reality distortion experiences, and high psychosis liability. The high-risk latent groups scored significantly higher on mental health difficulties, and negative affect, and lower on positive affect and well-being, compared to the two non-risk groups. Moreover, these high-risk groups had a significantly higher number of failed academic subjects compared to the non-risk groups. In addition, no statistically significant differences in efficiency performance were found in the neurocognitive domains across the four latent profiles. This study allows us to improve the early identification of adolescents at risk of serious mental disorder in school settings in order to prevent the incidence and burden associated with these kinds of mental health problems.
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Affiliation(s)
- Beatriz Lucas-Molina
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Alicia Pérez-Albéniz
- Department of Educational Sciences, University of La Rioja, Logroño, Spain
- Programa Riojano de Investigación en Salud Mental (PRISMA), University of La Rioja, Logroño, Spain
| | - Encar Satorres
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Javier Ortuño-Sierra
- Department of Educational Sciences, University of La Rioja, Logroño, Spain
- Programa Riojano de Investigación en Salud Mental (PRISMA), University of La Rioja, Logroño, Spain
| | | | - Eduardo Fonseca-Pedrero
- Department of Educational Sciences, University of La Rioja, Logroño, Spain
- Programa Riojano de Investigación en Salud Mental (PRISMA), University of La Rioja, Logroño, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Department of Psychiatry, University of Oviedo, Oviedo, Spain
- * E-mail:
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Grant P, Hennig J. Schizotypy, social stress and the emergence of psychotic-like states - A case for benign schizotypy? Schizophr Res 2020; 216:435-442. [PMID: 31796309 DOI: 10.1016/j.schres.2019.10.052] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/28/2019] [Accepted: 10/25/2019] [Indexed: 10/25/2022]
Abstract
Schizotypy is a personality-organisation related to schizophrenia-liability as well as the emergence of psychotic symptoms and psychotic-like experiences (PLEs) in non-schizophrenic individuals. It has been suggested that some non-schizophrenic individuals may exhibit PLEs frequently, but in a fashion that is not distressing but life-enhancing ("benign schizotypy"). In schizophrenia and at-risk individuals, however, psychotic symptoms are not only distressing, but also triggered stress. To further investigate questions of causality and examine how PLEs may present as distressing symptoms in some individuals and as benign experiences in others, we explored how schizotypy-facets moderated PLEs-variability under experimentally induced social stress.We performed a standardised social stress-paradigm in 107 healthy adults (77 female, 30 male; average age 22,5 years), measuring changes in psychometrically assessed PLEs and the moderation of changes under stress through positive, negative and disorganised schizotypy. Results suggest two discrete effects: On the one hand, individuals high in disorganised and negative schizotypy showed stress-dependent increases in PLEs; without added effects of positive schizotypy. On the other, individuals low in negative and disorganised schizotypy showed higher levels of PLEs solely as a function of positive schizotypy but not stress. We discuss these findings in light of the fully-dimensional model of schizotypy and hypothesize that PLEs in individuals high in schizotypy-facets suggested to convey risk-for-schizophrenia (negative and disorganised) may reflect qualitatively different entities than PLEs in individuals with low values in these facets, but high expressions of positive schizotypy ("happy schizotypes"). Additionally, we emphasize the importance of not overlooking the disorganised schizotypy-facet in related research.
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Affiliation(s)
- Phillip Grant
- Psychopathology and Psychosis Research, Psychology School, Hochschule Fresenius University of Applied Sciences, Frankfurt a. M., Germany; Faculty of Life Science Engineering, Technische Hochschule Mittelhessen University of Applied Sciences, Giessen, Germany.
| | - Juergen Hennig
- Biological Psychology and Individual Differences, Department of Psychology, Justus-Liebig-University, Giessen, Germany
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Flückiger R, Michel C, Grant P, Ruhrmann S, Vogeley K, Hubl D, Schimmelmann BG, Klosterkötter J, Schmidt SJ, Schultze-Lutter F. The interrelationship between schizotypy, clinical high risk for psychosis and related symptoms: Cognitive disturbances matter. Schizophr Res 2019; 210:188-196. [PMID: 30683524 DOI: 10.1016/j.schres.2018.12.039] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 12/13/2018] [Accepted: 12/20/2018] [Indexed: 02/07/2023]
Abstract
Schizotypy and clinical high risk (CHR) criteria can identify individuals who are at increased risk for developing psychosis in community and patient samples. However, both approaches have rarely been combined, and very little is known about their associations. Therefore, we examined the factorial structure of CHR and related symptoms and schizotypy features as well as their interrelationship for the first time in a comprehensive approach. In a sample of 277 patients (22 ± 6 years) from two early detection services, structural equation modeling including confirmatory factor analysis was performed to test a theory-driven model using four Wisconsin Schizotypy Scales, 14 predictive basic symptoms (BS) of the Schizophrenia Proneness Instrument, and positive, negative, and disorganized symptoms from the Structured Interview for Psychosis-Risk Syndromes. The data fitted well to the six hypothesized latent factors consisting of negative schizotypy, positive schizotypy including perceptual BS, negative symptoms, positive symptoms, disorganized symptoms and cognitive disturbances. As postulated, schizotypy features were significantly associated with positive, negative and disorganized symptoms through cognitive disturbances. Additionally, positive and negative schizotypy also had a direct association with the respective symptom-domain. While the identified factorial structure corresponds well to dimensional models of schizotypy and psychoses, our model extends earlier models by indicating that schizotypy features are associated with positive, negative and disorganized symptoms directly or indirectly via subjective cognitive disturbances. This calls for more attention to subjective cognitive deficits in combination with heightened schizotypy in the early detection and intervention of psychoses - or even of an Attenuated Psychosis Syndrome.
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Affiliation(s)
- Rahel Flückiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
| | - Phillip Grant
- Psychology School, Faculty of Health and Social Sciences, Fresenius University of Applied Sciences, Marienburgstr. 6, 60528 Frankfurt am Main, Germany; Faculty of Life Science Engineering, Technische Hochschule Mittelhessen University of Applied Sciences, Wiesenstr. 14, 35390 Gießen, Germany.
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Straße 62, 50937 Köln, Germany.
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Straße 62, 50937 Köln, Germany.
| | - Daniela Hubl
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
| | - Joachim Klosterkötter
- Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Straße 62, 50937 Köln, Germany.
| | - Stefanie J Schmidt
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland.
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Bergische Landstraße 2, 40629 Dusseldorf, Germany.
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