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Dumas LE, Fernandez A, Auby P, Askenazy F. Relationship between social cognition and emotional markers and acoustic-verbal hallucination in youth with post-traumatic stress disorder: Protocol for a prospective, 2-year, longitudinal case-control study. PLoS One 2024; 19:e0306338. [PMID: 38954699 PMCID: PMC11218996 DOI: 10.1371/journal.pone.0306338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION Auditory-verbal hallucinatory experiences (AVH) have a 12% prevalence in the general pediatric population. Literature reports a higher risk of developing AVH in post-traumatic stress disorder (PTSD). The persistence of AVHs during adolescence represents a risk of evolution into psychotic disorders. Social cognition and emotional markers could be considered prodromes markers of this evolution. The objectives of this prospective observational study are to observe social cognition and emotional markers correlation with the presence and persistence of AVH over two years and with the evolution of PTSD and psychotic diagnosis. METHODS AND ANALYSIS This prospective case-control study, longitudinal over two years (with an interim reassessment at six months and one year), will include 40 participants aged 8 to 16 years old with a diagnosis of PTSD and without a diagnosis of psychosis according to the criteria of DSM-5 (K-SADS-PL). Subjects included are divided into two groups with AVH and without AVH matched by gender, age and diagnosis. The primary outcome measure will be the correlation between social cognition and emotional makers and the presence of AVH in the PTSD pediatric population without psychotic disorders. The social cognition marker is assessed with the NEPSY II test. The emotional marker is assessed with the Differential Emotion Scale IV and the Revised Beliefs About Voices Questionnaire. The secondary outcome measures are the correlation of these markers with the persistence of AVH and the evolution of the patient's initial diagnosis two years later. DISCUSSION The originality of our protocol is to explore the potential progression to psychosis from PTSD by cognitive biases. This study supports the hypothesis of connections between PTSD and AVH through sensory, emotional and cognitive biases. It proposes a continuum model from PTSD to psychotic disorder due to impaired perception like AVH. TRIAL REGISTRATION Clinical trial registration: ClinicalTrials.gov Identifier: NCT03356028.
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Affiliation(s)
- Louise-Emilie Dumas
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
| | - Arnaud Fernandez
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
- Expert Center for Psychotrauma Paca Corse, Nice, France
| | - Philippe Auby
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
| | - Florence Askenazy
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
- Expert Center for Psychotrauma Paca Corse, Nice, France
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Granö N, Lintula S, Therman S, Marttunen M, Lång U, Ranta K. Factor and network analysis of psychosis-like experiences and depressive symptoms in a sample of Finnish adolescents entering psychiatric services. Early Interv Psychiatry 2023; 17:1199-1206. [PMID: 37062875 DOI: 10.1111/eip.13417] [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: 10/01/2022] [Revised: 01/28/2023] [Accepted: 03/28/2023] [Indexed: 04/18/2023]
Abstract
AIM Psychosis-Like Experiences (PLEs) and depressive symptoms are correlated in clinical adolescent populations. However, symptom-level associations between the two phenomena are not clear. METHODS We analysed factor structures of a PLE instrument, the Prodromal Questionnaire-Brief (PQ-B), based on dimensions of positive symptoms of schizophrenia, and a depression measurement instrument, the Beck Depression Inventory (BDI-21A) and performed a network analysis of item-level associations between the two measures. The sample consisted of 417 adolescents (range 13-18 years of age, mean 14.9 years, 72.4% females) entering secondary psychiatric services at Helsinki metropolitan area, Finland. RESULTS Confirmatory factor analysis resulted in adequately fitting 2-factor solution, one for PQ-B and one for BDI-21, with a strong correlation coefficient of 0.605 between the two factors. In the network analysis, PQ-B and BDI-21 both formed their own clusters, and two significant pathways were estimated between PQ-B and BDI-21 clusters: 1. the association between paranoid thinking and distorted body image, and 2. the association between somatic preoccupation and worry about problems of one's mind. CONCLUSIONS Even though on a general, factor level, PLEs and depressive symptoms were strongly correlated, unique associations between symptoms of the two constructs were sparse. These findings should be considered in the psychiatric assessment and in the care of adolescents.
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Affiliation(s)
- Niklas Granö
- Faculty of Medicine, Department of Psychiatry, Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Sakari Lintula
- Faculty of Medicine, Department of Psychiatry, Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Sebastian Therman
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mauri Marttunen
- Faculty of Medicine, Department of Psychiatry, Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Ulla Lång
- Faculty of Medicine, Department of Psychiatry, Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Klaus Ranta
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
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Ceccolini CJ, Friedman-Yakoobian MS, Yen S, West ML. Safety Planning in Context: A Case Study Integrating DBT Techniques and ACT for Overlapping Suicide and Psychosis Risk. Clin Case Stud 2022. [DOI: 10.1177/15346501221139916] [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: 11/27/2022]
Abstract
Suicide risk is markedly higher for clients at clinical high risk for psychosis (CHR-p) compared to the general population. Dialectical behavior therapy (DBT) has a strong evidence base supporting its utility for managing suicide risk. Meanwhile, acceptance and commitment therapy (ACT) has been shown to effectively treat individuals with psychosis symptoms, as well as comorbid anxiety and mood disorders in CHR-p clients. Despite the robust evidence for each of these modalities in addressing concerns around suicidality and psychosis risk independently, there is a paucity of literature on how to support clients experiencing co-occurring suicide and psychosis risk. Such overlapping risk is often central to presenting concerns in CHR-p clients. Our manuscript presents a case example of an integrated DBT-ACT approach to managing risk surrounding both suicide and psychosis symptoms in an outpatient setting. We highlight how an integrated approach may help outpatient providers to implement and modify effective treatment that promotes continued outpatient care focused on goals beyond immediate risk management of both suicide and emerging psychosis. We provide specific examples of DBT techniques and ACT interventions used by a supervised doctoral-level student clinician in treatment with a CHR-p client and discuss implications for future clinical research.
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Affiliation(s)
| | | | - Shirley Yen
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Michelle L. West
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
- University of Colorado – Anschutz Medical Campus, Aurora, CO, USA
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4
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Li B, Hu T, Tang W. The effects of peer bullying and poverty on suicidality in Chinese left behind adolescents: The mediating role of psychotic-like experiences. Early Interv Psychiatry 2022; 16:1217-1229. [PMID: 35192219 DOI: 10.1111/eip.13271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/05/2021] [Accepted: 01/18/2022] [Indexed: 02/05/2023]
Abstract
AIM This study investigated the influence of childhood adversity, such as peer bullying and socioeconomic status, on the suicidal behaviour of left-behind Chinese adolescents to determine whether psychotic-like experiences (PLEs) mediated the associations between these childhood adversities and suicidality; suicidal ideation (serious thoughts about taking one's own life), suicide plans, and suicide attempts. METHODS A representative group of rural adolescents (n = 3346) was recruited from 16 rural high schools in China. Suicidality was assessed using the suicide module from the Mini International Neuropsychiatric Interview Kid. Participants also completed questionnaires on bullying, socioeconomic status, left-behind characteristics, and PLEs. Structural equation modelling was then employed to explore the relationships between these variables. RESULTS Peer bullying, poverty, and left-behind status were all found to significantly increase adolescent suicide risk, the relationships between which were mediated by PLEs. Peer bullying was found to play the most significant role in the PLEs and suicidality, with the risk of suicide increasing with the length of time a child had been left behind. CONCLUSION Adverse life events can lead to a high risk of PLEs, which in turn can increase the risk of suicide. These results could assist in identifying individuals at risk of suicidality and the design of appropriate interventions. The results also highlighted the role PLEs play in suicidality and highlighted the need for further research in this area.
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Affiliation(s)
- Bin Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Wanjie Tang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,Centre for Educational and Health Psychology, Sichuan University, Chengdu, China
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Jay SY, Schiffman J, Grattan R, O’Hare K, Klaunig M, DeVylder J, Karcher NR. A Deeper Dive Into the Relation Between Psychotic-like Experiences and Suicidal Ideation and Behaviors in Children Across the United States. Schizophr Bull 2022; 48:1241-1251. [PMID: 35894236 PMCID: PMC9673253 DOI: 10.1093/schbul/sbac090] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Children who endorse psychotic-like experiences (PLEs) appear to be at a greater risk for suicidal ideation and behavior (SI/SB) compared to their peers who do not endorse PLEs. Despite evidence of differential relations among subtypes of PLEs and SI/SB, the research on which PLE subtypes produce the strongest associations remains mixed. Further, though there is evidence that general psychological distress may help explain the relation between PLEs and SI/SB, no research has investigated the role of distress specific to PLEs in this association. STUDY DESIGN The present study sought to assess the associations among individual Prodromal Questionnaire-Brief Child Version (PQ-BC) items and SI/SB, as well as to explore the role of distress associated with PLEs as a mediator and/or moderator in a demographically diverse sample of children across the United States (N = 11 875). STUDY RESULTS Results revealed that individual items of the PQ-BC may be differentially predictive of lifetime SI (ßs = 0.000-0.098) and SB (ßs=0.002-0.059), even when controlling for sociodemographic variables, internalizing symptoms, and traumatic experiences, with particularly strong associations observed among items indexing thought control, auditory hallucinations, suspiciousness, and nihilistic thinking/dissociative experiences. Item 13, nihilistic thinking/dissociative experiences, displayed the strongest effect sizes. Findings from moderation and mediation models provided evidence consistent with distress as both a partial mediator and moderator of the relation between total PLEs and individual PQ-BC items with SI and SB. CONCLUSIONS Distress specific to PLEs may be an important modifiable risk factor to target in suicide assessment, prevention, and intervention efforts.
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Affiliation(s)
- Samantha Y Jay
- To whom correspondence should be addressed; Department of Psychology, University of Maryland Baltimore County, 1000 Hilltop Circle, Room 402, Sondheim Building, Baltimore, MD 21250, USA; tel: (410) 455-2567, fax: (410)455-3705, e-mail:
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Rebecca Grattan
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Kirstie O’Hare
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Mallory Klaunig
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Nicole R Karcher
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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O'Hora KP, Lin A, Kushan-Wells L, Bearden CE. Copy number variation at the 22q11.2 locus influences prevalence, severity, and psychiatric impact of sleep disturbance. J Neurodev Disord 2022; 14:41. [PMID: 35820809 PMCID: PMC9275284 DOI: 10.1186/s11689-022-09450-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 06/29/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Sleep disturbance is common, impairing, and may affect symptomatology in developmental neuropsychiatric disorders. Here, we take a genetics-first approach to study the complex role of sleep in psychopathology. Specifically, we examine severity of sleep disturbance in individuals with a reciprocal copy number variant (CNV) at the 22q11.2 locus and determine sleep's effect on psychiatric symptoms. CNVs (deletion or duplication) at this locus confer some of the greatest known risks of neuropsychiatric disorders; recent studies suggest the 22q11.2 deletion negatively impacts sleep, but sleep disruption associated with 22q11.2 duplication has not been investigated. METHODS We compared subjective sleep disturbance and its relationship to psychiatric symptoms cross-sectionally and longitudinally over 1 year in 107 22q11.2 deletion (22qDel) carriers (14.56±8.0 years; 50% male), 42 22q11.2 duplication (22qDup) carriers (16.26±13.1 years; 54.8% male), and 88 age- and sex-matched controls (14.65±7.4 years; 47.1% male). Linear mixed models were used to compare sleep disturbance, assessed via the Structured Interview for Psychosis-Risk Syndromes (SIPS), across groups. Next, CNV carriers were categorized as good or poor sleepers to investigate sleep effects on multiple neurobehavioral traits: psychosis-risk symptoms (SIPS), autism-related behaviors (Repetitive Behavior Scale (RBS) and Social Responsiveness Scale (SRS)), real-world executive function (Behavior Rating Inventory of Executive Function (BRIEF)), and emotional/behavioral problems (Child Behavior Checklist (CBCL)). Linear mixed models tested the effect of sleep category and a group-by-sleep interaction on each measure, cross-sectionally and longitudinally. RESULTS 22qDel and 22qDup carriers both reported poorer sleep than controls, but did not differ from each other. Cross-sectionally and longitudinally, poor sleepers scored higher on positive symptoms, anxious/depressed, somatic complaints, thought problems, and aggressive behavior, as well as RBS and SRS total scores. There were significant group-by-sleep interactions for positive symptoms and the majority of CBCL subdomains, in which the difference between good and poor sleepers was larger in 22qDel compared to 22qDup. CONCLUSIONS Our findings indicate that CNVs at the 22q11.2 locus impact sleep which, in turn, influences psychopathology. Sleep disturbances can differentially impact psychopathology, depending on 22q11.2 gene dosage. Our findings serve as a starting point for exploring a genetic basis for sleep disturbance in developmental neuropsychiatric disorders.
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Affiliation(s)
- Kathleen P O'Hora
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, A7-460 Semel Institute, Los Angeles, CA, 90095, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Amy Lin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, A7-460 Semel Institute, Los Angeles, CA, 90095, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Leila Kushan-Wells
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, A7-460 Semel Institute, Los Angeles, CA, 90095, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, A7-460 Semel Institute, Los Angeles, CA, 90095, USA.
- Department of Psychology, University of California, Los Angeles, CA, USA.
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7
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Fekih-Romdhane F, Hallit S, Cheour M, Jahrami H. The nature, consequences, mechanisms, and management of sleep disturbances in individuals at-risk for psychosis. Front Psychiatry 2022; 13:1011963. [PMID: 36203842 PMCID: PMC9530454 DOI: 10.3389/fpsyt.2022.1011963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/05/2022] [Indexed: 11/26/2022] Open
Abstract
There is strong evidence that sleep disturbances are commonly experienced by people with psychosis. Evidence has also shown that sleep disturbances are present since the very early stages of the disease, even during the pre-diagnostic phase. More recently, research involving young individuals at ultra-high risk (UHR) for psychosis documented frequent occurrence of sleep disturbances in this group. The very early onset of sleep disturbances in the course of psychosis has drawn attention to the possible links between sleep parameters and the risk of psychosis. To date, the nature of sleep disturbances characterizing the UHR stage remains unclear, with available studies having yielded mixed findings. In this regard, we performed this review to update the body of literature on the nature of sleep disturbances, their underlying mechanisms, their clinical and functional consequences, the prevention and intervention strategies in the at-risk for psychosis population. Our findings provided further support to the presence of disturbed sleep in UHR individuals as evidenced by subjective and objective sleep measures such as polysomnography, sleep electroencephalograms, and actigraphy. Reviewing the possible mechanisms underlying the relationship between sleep and psychosis emphasized its complex and multifactorial nature which is yet to be determined and understood. Further research is warranted to determine which facets of sleep disturbances are most detrimental to this specific population, and to what extent they can be causal factors or markers of psychosis.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry Ibn Omrane, Razi Hospital, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia.,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry Ibn Omrane, Razi Hospital, Tunis, Tunisia
| | - Haitham Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.,Department of Psychiatry, Ministry of Health, Manama, Bahrain
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8
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Dumas LE, Bonnard-Couton V, Golse B, Askénazy F. [Identifying cognitive and emotional markers in relation to auditory-verbal hallucinations in pediatric population: Physalis study]. Encephale 2021; 48:546-554. [PMID: 34625214 DOI: 10.1016/j.encep.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/16/2021] [Accepted: 06/04/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Auditory-verbal hallucinatory experiences (AVH) represent a prevalence of 12% in the general pediatric population. They are most often considered as a transient and benign developmental phenomenon, associated with mood and anxiety disorders. The persistence of AVHs for several years and into adolescence would represent a poor prognosis of progression into a psychiatric disorder, and more particularly psychotic disorder. The alteration of social and emotional cognitive markers are described as prodromal of this unfavorable progression which should be considered within the continuum between subclinical and clinical signs of the "psychosis phenotype". The objective of this study was to assess these markers in children and adolescents with AVH and their correlation with the presence and persistence of hallucinations. METHODS Multicenter prospective case-control study, longitudinal over 6months. Patients were included based on the presence of HAV on clinical examination. Forty subjects aged 8 to 16years from a clinical pediatric population were included. They were divided into two groups according to the Diagnostic Interview Schedule for Children-Child version (DISC-C): a group with AVH ("AVH+"), and a group without HAV ("AVH-"). A diagnosis of schizophrenia spectrum disorder was a non-inclusion criterion according to the criteria of DSM-5 (K-SADS-PL). This group was matched to the control group without AVH (AVH-) according to sex, age (±6months) and associated psychiatric diagnoses assessed by the MINI-Kid. The marker of social cognition was assessed with the NEPSY II test. The emotional marker was assessed with the self-questionnaires: EED IV, which highlights the emotions currently being felt by the subject, and the BAVQ-R, which categorizes the child's emotions in reaction to AVH. RESULTS No significant link was found between the social and emotional cognition markers and the presence of AVH at T0. At 6months, 50% of subjects in the AVH+ group suffered from persistent AVH and 18% progressed to a diagnosis of schizophrenia spectrum disorder. The persistence of AVH was not significantly correlated with the marker of social cognition, but it was significantly correlated with the presence of negative emotions (sadness, fear, hostility and anger) and inversely correlated with emotions of joy. CONCLUSION In this study, AVH experiences in the pediatric population are not linked to markers of social cognition, but negative emotions appear as early markers of AVH persistence. CLINICALTRIALS. GOV IDENTIFIER NCT02567500.
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Affiliation(s)
- Louise-Emilie Dumas
- Service universitaire de psychiatrie de l'enfance et de l'adolescence (SUPEA), hôpitaux pédiatriques de Nice, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France; CoBTeK laboratory, université Côte d'Azur, 10, rue Molière, 06100 Nice, France.
| | - Valérie Bonnard-Couton
- Service universitaire de psychiatrie de l'enfance et de l'adolescence (SUPEA), hôpitaux pédiatriques de Nice, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France; CoBTeK laboratory, université Côte d'Azur, 10, rue Molière, 06100 Nice, France
| | - Bernard Golse
- Institut contemporain de l'enfance, 30, rue de Bourgogne, 75007 Paris, France
| | - Florence Askénazy
- Service universitaire de psychiatrie de l'enfance et de l'adolescence (SUPEA), hôpitaux pédiatriques de Nice, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France; CoBTeK laboratory, université Côte d'Azur, 10, rue Molière, 06100 Nice, France
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West ML, Guest RM, Carmel A. Comorbid early psychosis and borderline personality disorder: Conceptualizing clinical overlap, etiology, and treatment. Personal Ment Health 2021; 15:208-222. [PMID: 33955194 DOI: 10.1002/pmh.1509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 03/14/2021] [Indexed: 12/15/2022]
Abstract
Despite substantial efforts aimed at the detection and intervention for early symptoms of mental illness, there is relatively limited research on the clinical overlap between borderline personality disorder (BPD) and early psychosis, for example, clinical high risk (CHR) for psychosis, in young people. We present a narrative review of the clinical overlap between BPD and psychosis spectrum symptoms. Both conditions have unstable temporal course, and both are marked by functional impairment, increased suicide risk, and higher rates of psychiatric inpatient services. We then review evidence-based treatments for psychosis and BPD, emphasizing treatments for early presentations of these symptoms and initial research considering treatments for the overlap. Psychotherapies with the strongest empirical support include cognitive behavioral models, with BPD showing limited response to adjunctive pharmacotherapy. We end by discussing specific recommendations for future research, including longitudinal studies to determine the predictors of the course of illness and the development of treatments to target comorbid BPD and CHR symptoms.
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Affiliation(s)
- Michelle L West
- CEDAR Clinic and Research Program, Massachusetts Mental Health Center, Boston, Massachusetts, USA.,Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychiatry, University of Colorado School of Medicine (CUSOM), Aurora, Colorado, USA
| | - Ryan M Guest
- Department of Psychology, Emory University, Atlanta, Georgia, USA
| | - Adam Carmel
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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Mensi MM, Molteni S, Iorio M, Filosi E, Ballante E, Balottin U, Fusar-Poli P, Borgatti R. Prognostic Accuracy of DSM-5 Attenuated Psychosis Syndrome in Adolescents: Prospective Real-World 5-Year Cohort Study. Schizophr Bull 2021; 47:1663-1673. [PMID: 33939829 PMCID: PMC8530398 DOI: 10.1093/schbul/sbab041] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is limited research in adolescents at risk for psychosis. The new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition attenuated psychosis syndrome (DSM-5 APS) criteria have not been validated in this group. We conducted a RECORD-compliant, real-world, prospective, 5-year cohort study addressing clinical profile, transition to psychosis, and prognostic accuracy of DSM-5 APS in help-seeking inpatient/outpatient adolescents accessing Children and Adolescent Neuropsychiatric services at IRCCS Mondino Foundation (Pavia, Lombardy, Italy) between 2012 and 2019. About 243 adolescents (31 early-onset psychosis [EOP]; 110 meeting DSM-5 APS criteria, DSM-5 APS; 102 not meeting psychotic or DSM-5 APS criteria, non-APS) were included. At baseline, DSM-5 APS adolescents (aged 15.4 ± 1.6) had on average 2.3 comorbid disorders (higher than EOP/non-APS, P < .001). DSM-5 APS adolescents had an intermediate psychopathological profile between non-APS/EOP (P < .001) and worsen Clinical Global Impression-Severity than non-APS (P < .001). DSM-5 APS functioning was intermediate between non-APS and EOP. 39.1% of DSM-5 APS were treated with psychotropic drugs (average = 64 days); 53.6% received psychotherapy. Follow-up of DSM-5 APS and non-APS groups lasted 33 and 26 months, respectively (median). The cumulative risk of transition at 1-5 years was 13%, 17%, 24.2%, 26.8%, and 26.8% in the DSM-5 APS group, 0%, 0%, 3.2%, 3.2%, and 3.2% in the non-APS group. The 5-year prognostic accuracy of the DSM-5 APS in adolescent was adequate (area under the curve = 0.77; Harrell's C = 0.736, 95%CI 0.697-0.775), with high sensitivity (91.3%) and suboptimal specificity (63.2%). The DSM-5 APS diagnosis can be used to detect help-seeking adolescents at risk of psychosis and predict their long-term outcomes. Future research should consolidate these findings.
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Affiliation(s)
- Martina Maria Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Silvia Molteni
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,Child Neuropsychiatry Unit, ASST Lariana, Como, Italy
| | - Melanie Iorio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Eleonora Filosi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Elena Ballante
- Department of Mathematics, University of Pavia, Pavia,Italy,BioData Science Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Umberto Balottin
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paolo Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK,To whom correspondence should be addressed; via Mondino 2, 27100 Pavia, Italy; tel: +390382430211, fax: +390382430236, e-mail:
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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Abstract
Suicide is a preventable health problem. Multiple definitions and inconsistent use of the term suicidality can result in failure to properly recognize suicide risk and behavior and confuses suicide research. Clarification of the suicidality concept is needed to facilitate the care for individuals at risk for suicide. Using Rodgers' evolutionary concept analysis method, this analysis describes the breadth and scope of the suicidality concept. Findings indicate suicidality covers a spectrum of suicidal risk and levels of emotional suffering and intent. The analysis does not draw definite conclusions, but outlines a direction for further research.
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Affiliation(s)
- Tamara Pike Keefner
- Nursing, South Dakota State University - College of Nursing, Rapid City, South Dakota, USA
| | - Thomas Stenvig
- Graduate Nursing, South Dakota State University - College of Nursing, Brookings, Rapid City, South Dakota, USA
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12
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Clarke L, Chisholm K, Cappuccio FP, Tang NKY, Miller MA, Elahi F, Thompson AD. Sleep disturbances and the At Risk Mental State: A systematic review and meta-analysis. Schizophr Res 2021; 227:81-91. [PMID: 32646803 DOI: 10.1016/j.schres.2020.06.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/14/2020] [Accepted: 06/20/2020] [Indexed: 11/28/2022]
Abstract
AIMS To synthesise and investigate how sleep disturbances relate to psychotic symptoms, functioning and Quality of Life (QoL) in At Risk Mental State (ARMS) youth. METHOD A comprehensive search of six databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science and CENTRAL) was conducted. Eligible studies provided data on sleep disturbances or disorders in ARMS patients. RESULTS Sixteen studies met the inclusion criteria (n = 1962 ARMS patients) including 7 cross-sectional studies, 2 RCT's and 7 cohort studies. Narrative synthesis revealed that self-reported sleep (e.g., general disturbances, fragmented night time sleep and nightmares) was poorer among ARMS patients compared to healthy controls. In the limited studies (n = 4) including objective measurements of sleep disturbances, ARMS patients experienced higher levels of movement during sleep, more daytime naps and increased sleep latency compared to controls. Furthermore, sleep disturbances were associated with attenuated psychotic symptoms and functional outcomes cross-sectionally and longitudinally. Only one study investigated the relationship between sleep and QoL. The exploratory meta-analysis revealed a significant difference in self-reported sleep disturbances measured by the PSQI (mean difference in score: 3.30 (95% CI 1.87, 4.74), p < 0.00001) and SIPS (mean difference in score: 1.58 (95% CI 0.80, 2.35), p < 0.00001) of ARMS patients compared to control groups. CONCLUSIONS ARMS individuals report impaired sleep quality and reduced sleep quantity compared to healthy controls. However, further research is needed to explore the longitudinal relationship between sleep disruptions and QoL in early psychosis. Significant variations in how sleep is measured across studies highlight a need to assess disturbances to sleep using robust and consistent approaches in this patient group.
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Affiliation(s)
- Latoya Clarke
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK.
| | | | - Francesco P Cappuccio
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK
| | - Nicole K Y Tang
- Department of Psychology, University of Warwick, Coventry, UK
| | - Michelle A Miller
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK
| | - Farah Elahi
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK
| | - Andrew D Thompson
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK
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13
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Bohaterewicz B, Nowicka M, Sobczak AM, Plewka AA, Gaszczyk P, Marek T. Clinical and Psychosocial Characteristics of Adolescent Pediatric Patients Hospitalized after Different Types of Suicidal Behaviors-A Preliminary Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155568. [PMID: 32752251 PMCID: PMC7432877 DOI: 10.3390/ijerph17155568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 01/30/2023]
Abstract
The objective of this study was to examine the clinical characteristics of adolescents hospitalized after a suicide attempt or instrumental suicide-related behavior. Participants included thirty-six adolescents from the pediatric unit of a Polish hospital who made a nonfatal suicide attempt (SAA) or engaged in instrumental suicide-related behavior (IBA), as well as a general population sample (GPS). Psychosocial features were measured using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), the Social and Occupational Functioning Assessment Scale (SOFAS), the Suicide Behaviors Questionnaire–Revised (SBQ-R), the Psychache Scale (TPS), the State–Trait Anxiety Inventory (STAI), the Center of Epidemiological Studies Depression Scale for Children (CES-DC), and the Prodromal Questionnaire (PQ-16). The SAA group scored significantly higher than the IBA group and the GPS in modules related to irritability and anhedonia, voice hallucinations and delusions, suicidal acts, thoughts and ideation, and medical lethality. Additionally, the SAA scored higher on the SBQ-R and PQ-16 compared to the IBA group and the GPS. Although anxiety, mental pain, and depressive symptoms could not independently distinguish between the SAA and IBA groups, psychotic symptoms were more frequently present within the SAA group. The above symptoms may be important to consider when screening for suicide risk in the general population.
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Affiliation(s)
- Bartosz Bohaterewicz
- Department of Psychology of Individual Differences, Psychological Diagnosis, and Psychometrics, Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (B.B.); (M.N.); (A.A.P.)
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 31-007 Cracow, Poland;
| | - Magdalena Nowicka
- Department of Psychology of Individual Differences, Psychological Diagnosis, and Psychometrics, Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (B.B.); (M.N.); (A.A.P.)
| | - Anna M. Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 31-007 Cracow, Poland;
- Correspondence:
| | - Aleksandra A. Plewka
- Department of Psychology of Individual Differences, Psychological Diagnosis, and Psychometrics, Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (B.B.); (M.N.); (A.A.P.)
| | - Patrycia Gaszczyk
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK;
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 31-007 Cracow, Poland;
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14
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Abstract
The lifetime risk of dying by suicide in schizophrenia and related psychoses has been estimated to be approximately between 5% and 7%, though some have estimated that the number is closer to 10%. The highest risk for suicide occurs within the first year after presentation, when patients have a 12 times greater risk of dying by suicide than the general population, or a 60% higher risk compared with patients in other phases of psychosis, although the risk continues for many years. Some 31% of all deaths in first and early episode samples are due to suicide. Studies in individuals at clinical high-risk for psychosis (CHR) or with attenuated positive symptoms also demonstrate that suicidality is common and problematic in these individuals. Therefore, suicide in psychosis is a particularly severe problem. In order to develop interventions aimed at reducing the risk of suicide in psychotic individuals, it will be critical to understand the neurobiology of suicide in psychosis. In this paper, I report on the results of a systematic review of the work done to date on the neurobiology of suicide in psychosis and on suicidality in the CHR period. I will also identify gaps in knowledge and discuss future strategies for studying the neurobiology of suicidality in psychosis that may help to disentangle the links between suicide and psychosis and, by doing so, allow us to gain a greater understanding of the relationship between suicide and psychosis, which is critical for developing interventions aimed at reducing the risk of suicide in psychotic individuals.
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Affiliation(s)
- Ragy R Girgis
- The New York State Psychiatric Institute/Columbia University Irving Medical Center, New York, NY, USA
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15
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DeLuca JS, Andorko ND, Chibani D, Jay SY, Rakhshan Rouhakhtar PJ, Petti E, Klaunig MJ, Thompson EC, Millman ZB, Connors KM, Akouri-Shan L, Fitzgerald J, Redman SL, Roemer C, Bridgwater MA, DeVylder JE, King CA, Pitts SC, Reinblatt SP, Wehring HJ, Bussell KL, Solomon N, Edwards SM, Reeves GM, Buchanan RW, Schiffman J. Telepsychotherapy with Youth at Clinical High Risk for Psychosis: Clinical Issues and Best Practices during the COVID-19 Pandemic. JOURNAL OF PSYCHOTHERAPY INTEGRATION 2020; 30:304-331. [PMID: 34305369 PMCID: PMC8297958 DOI: 10.1037/int0000211] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Early detection and prevention of psychosis has become an international priority. Much of this work has focused on youth presenting with attenuated symptoms of psychosis-those at Clinical High Risk for psychosis (CHR)-given their elevated probability of developing the full disorder in subsequent years. Individuals at CHR may be prone to exacerbated psychological distress during the COVID-19 pandemic and its subsequent physical isolation measures, due to heightened stress sensitivity and comorbid mental health problems. Telepsychotherapy holds promise for reaching this population, especially during the current COVID-19 outbreak. However, there are limited evidence-based guidelines or interventions for use of telepsychotherapy with this population. In this paper, we review common clinical issues for individuals at CHR and how they might be exacerbated by the COVID-19 pandemic; best practices for treatment and adaptations for telepsychotherapy for individuals at CHR; and highlight real clinical issues that we are currently experiencing in a United States-based specialized CHR clinic as we conduct telepsychotherapy via videoconferencing. We conclude with questions for those in the field to contemplate, as well as potential challenges and benefits in using telepsychotherapy with individuals at CHR and their families.
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Affiliation(s)
- Joseph S. DeLuca
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Nicole D. Andorko
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Doha Chibani
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Samantha Y. Jay
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | | | - Emily Petti
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Mallory J. Klaunig
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Elizabeth C. Thompson
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI
| | | | - Kathleen M. Connors
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
| | - LeeAnn Akouri-Shan
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - John Fitzgerald
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Samantha L. Redman
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Caroline Roemer
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | | | | | - Cheryl A. King
- University of Michigan, Departments of Psychiatry and Psychology, Ann Arbor, MI
| | - Steven C. Pitts
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Shauna P. Reinblatt
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
| | - Heidi J. Wehring
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | | | - Natalee Solomon
- Maryland Department of Health, Behavioral Health Administration, Transition-Aged Youth and Young Adult Services, Baltimore, MD
| | - Sarah M. Edwards
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
| | - Gloria M. Reeves
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
| | - Robert W. Buchanan
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Jason Schiffman
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
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16
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Seiler N, Nguyen T, Yung A, O'Donoghue B. Terminology and assessment tools of psychosis: A systematic narrative review. Psychiatry Clin Neurosci 2020; 74:226-246. [PMID: 31846133 DOI: 10.1111/pcn.12966] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022]
Abstract
AIM Phenomena within the psychosis continuum that varies in frequency/duration/intensity have been increasingly identified. Different terms describe these phenomena, however there is no standardization within the terminology. This review evaluated the definitions and assessment tools of seven terms - (i) 'psychotic experiences'; (ii) 'psychotic-like experiences'; (iii) 'psychotic-like symptoms'; (iv) 'attenuated psychotic symptoms'; (v) 'prodromal psychotic symptoms'; (vi) 'psychotic symptomatology'; and (vii) 'psychotic symptoms'. METHODS EMBASE, MEDLINE, and CINAHL were searched during February-March 2019. Inclusion criteria included 1989-2019, full text, human, and English. Papers with no explicit definition or assessment tool, duplicates, conference abstracts, systematic reviews, meta-analyses, or no access were excluded. RESULTS A total of 2238 papers were identified and of these, 627 were included. Definitions and assessment tools varied, but some trends were found. Psychotic experiences and psychotic-like experiences were transient and mild, found in the general population and those at-risk. Psychotic-like symptoms were subthreshold and among at-risk populations and non-psychotic mental disorders. Attenuated psychotic symptoms were subthreshold but associated with distress, risk, and help-seeking. Prodromal psychotic symptoms referred to the prodrome of psychotic disorders. Psychotic symptomatology included delusions and hallucinations within psychotic disorders. Psychotic symptoms was the broadest term, encompassing a range of populations but most commonly involving hallucinations, delusions, thought disorder, and disorganization. DISCUSSION A model for conceptualizing the required terms is proposed and future directions needed to advance this field of research are discussed.
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Affiliation(s)
- Natalie Seiler
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Tony Nguyen
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Alison Yung
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
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17
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Lång U, Mittal VA, Schiffman J, Therman S. Measurement Invariance of Psychotic-Like Symptoms as Measured With the Prodromal Questionnaire, Brief Version (PQ-B) in Adolescent and Adult Population Samples. Front Psychiatry 2020; 11:593355. [PMID: 33584365 PMCID: PMC7873944 DOI: 10.3389/fpsyt.2020.593355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/11/2020] [Indexed: 01/10/2023] Open
Abstract
Valid measurement of group differences in self-reported psychotic-like experiences (PLEs) requires knowing any group-specific measurement properties of the instruments. We investigated the measurement invariance of the 21-item Prodromal Questionnaire-Brief (PQ-B) questionnaire across gender, ethnic minority/majority status, and presence of depressive symptoms in two different US non-clinical undergraduate samples (N = 1,099). For each item, endorsement of the experience and the associated distress were combined for analysis. A unidimensional model of the PQ-B fit the data well. Across genders, the PQ-B showed configural and metric, but not full scalar invariance; there were statistically significant differences in eight thresholds of six items, most being higher endorsement thresholds for self-identified females. Partial scalar invariance was also found for ethnic status, with five thresholds of three items being higher for the minority participants. For depressive symptomatology, defined as the top quintile by the Beck Depression Inventory-II, partial scalar invariance required dropping one item, after which there were statistically significant differences only in two response thresholds. Overall, a wide range of PLE questionnaire items were found to be robust to gender and ethnicity effects, strengthening confidence in found group differences in PLEs. Although full scalar invariance could not be ascertained for any of the group comparisons, the few found scalar differences across groups were small, with minimal impact on group PLE estimates. However, since PLEs are easily conceptually entangled with depression symptoms, similar items should be considered for exclusion if separable constructs are the target of investigation.
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Affiliation(s)
- Ulla Lång
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Vijay Anand Mittal
- Department of Psychology, Northwestern University, Evanston, IL, United States
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, United States.,Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Sebastian Therman
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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18
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Maijer K, Hayward M, Fernyhough C, Calkins ME, Debbané M, Jardri R, Kelleher I, Raballo A, Rammou A, Scott JG, Shinn AK, Steenhuis LA, Wolf DH, Bartels-Velthuis AA. Hallucinations in Children and Adolescents: An Updated Review and Practical Recommendations for Clinicians. Schizophr Bull 2019; 45:S5-S23. [PMID: 30715540 PMCID: PMC6357982 DOI: 10.1093/schbul/sby119] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Hallucinations in children and adolescents are now known to occur on a continuum from healthy to psychopathology-related phenomena. Although hallucinations in young populations are mostly transient, they can cause substantial distress. Despite hallucinations being widely investigated, research so far has had limited implications for clinical practice. The present article has 3 main aims: (1) to review research findings since 2014 (when the last major review of the area was published); (2) to present assessment tools validated to measure hallucinations in children and adolescents; and (3) to discuss therapeutic strategies and clinical issues. We conclude by presenting a tailored care model for clinicians and outline future challenges for research.
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Affiliation(s)
- Kim Maijer
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands,Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands,De Bascule, Amsterdam, the Netherlands,To whom correspondence should be addressed; University Medical Center Utrecht, Psychiatry department, HP A00.241, Heidelberglaan 100, 3485CX Utrecht, the Netherlands; tel: +31 88 7558180, fax: +31 88 755 54 43, e-mail:
| | - Mark Hayward
- School of Psychology, University of Sussex, Brighton, UK,Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, UK
| | | | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland,Developmental NeuroImaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Renaud Jardri
- Univ Lille, CNRS UMR-9193, SCALab (PsyCHIC Team) & CHU Lille, CURE Platform, Fontan Hospital, Lille, France
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Andrea Raballo
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy
| | - Aikaterini Rammou
- School of Psychology, University of Sussex, Brighton, UK,Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, UK
| | - James G Scott
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Australia,Metro North Mental Health, Herston, Australia,Queensland Centre for Mental Health Research, Wacol, Australia
| | - Ann K Shinn
- Psychotic Disorders Division, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Laura A Steenhuis
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research center, Groningen, the Netherlands
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19
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Gasse C, Danielsen AA, Pedersen MG, Pedersen CB, Mors O, Christensen J. Positive predictive value of a register-based algorithm using the Danish National Registries to identify suicidal events. Pharmacoepidemiol Drug Saf 2018; 27:1131-1138. [DOI: 10.1002/pds.4433] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 12/04/2017] [Accepted: 03/06/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Christiane Gasse
- National Centre for Register-based Research; Aarhus University; Aarhus Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH); Aarhus Denmark
| | - Andreas Aalkjaer Danielsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH); Aarhus Denmark
- Psychosis Research Unit; Aarhus University Hospital; Risskov Denmark
| | - Marianne Giørtz Pedersen
- National Centre for Register-based Research; Aarhus University; Aarhus Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH); Aarhus Denmark
| | - Carsten Bøcker Pedersen
- National Centre for Register-based Research; Aarhus University; Aarhus Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH); Aarhus Denmark
- Centre for Integrated Register-Based Research at Aarhus University (CIRRAU); Aarhus Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH); Aarhus Denmark
- Psychosis Research Unit; Aarhus University Hospital; Risskov Denmark
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20
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Fredrick SS, Demaray MK. Peer victimization and suicidal ideation: The role of gender and depression in a school-based sample. J Sch Psychol 2018; 67:1-15. [PMID: 29571526 DOI: 10.1016/j.jsp.2018.02.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 11/16/2017] [Accepted: 02/08/2018] [Indexed: 12/15/2022]
Abstract
The current study investigated the relations among traditional and cyber victimization, depressive symptoms, suicidal ideation, and gender in a school-based sample of 403 9th grade (13 to 16-year-old) adolescents. Path analyses indicated that both traditional victimization and cyber victimization were associated with suicidal ideation indirectly through depressive symptoms. Although there was little evidence of gender differences in the associations among peer victimization and depressive symptoms and suicidal ideation, the relation between depressive symptoms and suicidal ideation was found to be significantly stronger for girls than boys. The current investigation confirms the complexity of the association between peer victimization and suicidal ideation and that depressive symptoms, as well as gender, may play a role in this complex relation. Future research should continue to explore the associations among victimization, depressive symptoms, and suicidal ideation within a social ecological framework.
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Affiliation(s)
- Stephanie Secord Fredrick
- Department of Psychology, Central Michigan University, 1101 S. Franklin, Mt. Pleasant, MI 48859, United States.
| | - Michelle K Demaray
- Department of Psychology, Northern Illinois University, DeKalb, IL 60115, United States.
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