Emotion recognition and duration of untreated first-episode psychosis among patients in Pakistan

OBJECTIVE

To investigate the impact of duration of untreated psychosis on emotion recognition in patients with first-episode psychosis.

METHODS

A sample of 60 patients with schizophrenia, schizoaffective and substance-induced psychoses were selected from psychiatric inpatients and outpatients of 3 hospitals in Lahore and 1 in Faisalabad, Pakistan. Patients were divided into short (n = 28) and long (n = 32) duration of untreated psychosis groups, according to whether they had had symptoms for < 80 or ≥ 80 weeks, respectively. Emotion recognition ability was assessed with the help of the Urdu version of a computerised experimental FEEL (Facially Expressed Emotion Labeling) test using 6 basic emotional expressions that appeared on a computer screen followed by possible responses.

RESULTS

Patients with prolonged durations of untreated psychosis showed poorer performance in recognition of facial expressions of emotion than those with short durations of untreated psychosis. This was apparent in general and especially for expressions of anger, surprise, and sadness. First-episode psychosis patients showed higher accuracy rates for recognising positive as opposed to negative emotions. The duration of untreated psychosis correlated positively with positive symptoms of psychosis. Symptom distribution differed across categories of psychosis, but there were similarities in patients with schizophrenia and schizoaffective disorders.

CONCLUSIONS

These findings support recourse to early detection and intervention strategies in psychosis and provide valuable information on how first-episode psychosis patients behave in complex emotional and social situations.

Community acquired infections in children on maintenance cyclosporine therapy

Cyclosporine has profound immunosuppressive properties. We reviewed our experience of community acquired infections in 62 children who received the drug from 2 to 36 months. 36 children received the drug for a renal transplant for a mean of 18 months. There were 3 minor and one major episode of infection in this group. The frequency of both minor and major infections in cyclosporine recipients was significantly lower when compared with a group of renal recipients treated with azathioprine. 26 children received cyclosporine for 2 months for resistant nephrotic syndrome. This group had one major and one minor episode of infection. Despite the relative safety of cyclosporine recipients from infectious complications, a more prolonged follow up is necessary.