Social functioning in a first-episode of psychosis: can the existence of affective symptoms influence it?

Ienciu, M.; Romosan, F.; Bredicean, Cristina; Romosan, R.; Moroianu, A.; Pufan, L.; Giurgi-Oncu, Catalina

doi:10.1016/s0924-9338(11)73108-x

Cited by 3 publications

(4 citation statements)

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“…The frequency and duration of psychotic episodes take a toll on the neuropsychology, neurophysiology, and neural structure of the individual, proving early and aggressive intervention as a key element of effective care. [33][34][35] Once a schizophrenia diagnosis is established, together with other comorbidities, clinicians should approach this condition aggressively. The therapeutic intervention should be a multi-disciplinary one, comprising of psychopharmacological elements, as well as psychotherapy and early psychosocial profiling and assistance, such as family support and psychoeducation regarding the disorder and its course, especially during the first years after diagnosis, as these elements have been proven to improve the course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis stability and outcome of psychotic episodes in a Romanian group of children and adolescents

Rad

Stancu²,

Andrei

et al. 2022

Medicine

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Studies on early onset schizophrenia are limited because of their low prevalence but the reported results stated that early onset is associated with a poorer outcome. The present research analyzed the stability rate of the psychotic-related disorders from childhood to adult life. The study was based on an observational, retrospective, descriptive analysis study. The subjects were selected from patients admitted to the pediatric psychiatry ward of “Alexandru Obregia” Psychiatry Hospital between 2009 and 2018 for a psychosis-related disorder, who were 18 years or older at the moment of data collection and who also had admissions into the adult’s psychiatry wards of the hospital. Of the 115 subjects, 93, representing 80.87% of the total, maintained a diagnosis of psychotic spectrum disorder into adulthood. The diagnosis was maintained in 82.4% of cases with onset before 13 years old and 80.6% of cases with onset after the age of 13 years of age. Of the 42 subjects who presented affective symptoms during childhood, 71.43% also presented affective symptoms into adulthood. These findings indicate an important stability rate of psychosis from childhood and adulthood and come in accordance with the theory of overlap between psychotic and affective disorders. The results underline the importance of an accurate diagnosis of early and very early onset schizophrenia (VEOS), the need for early and multimodal intervention, but also the need for long-term management of these patients and continuing research regarding psychotic-related disorders in children and adolescents.

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Section: Discussionmentioning

confidence: 99%

Diagnosis stability and outcome of psychotic episodes in a Romanian group of children and adolescents

Rad

Stancu²,

Andrei

et al. 2022

Medicine

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Section: Joseph Gonzalez-heydrich MDmentioning

confidence: 99%

“…10 Further research regarding effective pharmacological intervention for psychosis in children is needed as repeated and/or prolonged episodes of psychosis may have significant long-term negative impact on the individual's overall functioning. 11 The questions Nick's parents posed regarding his anticipated developmental trajectory are at the heart of most referrals for evaluation. The response must always be prefaced by the acknowledgement that the future can never be definitively predicted, and it is best to appreciate the broader "direction" of the individual's developmental journey and prepare for the anticipated needs of the individual.…”

mentioning

confidence: 99%

Challenging Case: New-Onset Hallucinations and Developmental Regression in a Child with Autism Spectrum Disorder

Sharma,

Pappas,

Gonzalez-Heydrich

et al. 2024

J Dev Behav Pediatr

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CASE: Nick is a 5-year-old boy who began displaying self-stimulating behaviors and decreased social interactions shortly before turning 3 years. At the age of 3.5 years, he was diagnosed with autism spectrum disorder by a local developmental-behavioral pediatrician. His parents recall that the physician described Nick to be “high functioning” and encouraged them to expect that he would attend college and live independently as an adult. Upon receiving the diagnosis, intervention was initiated using an applied behavioral analysis (ABA) approach. With this intervention, he demonstrated initial gains in the use of complex language and improved social interactions. Concerns regarding suspected psychosis emerged just before starting kindergarten when Nick began experiencing ego-dystonic visual and auditory hallucinations. Initially, Nick verbally responded to the hallucinations and vividly described what he was experiencing. Shortly after the onset of these hallucinations, Nick experienced a significant decrease in the frequency and complexity of his expressive language and became more withdrawn. Over time, his hallucinations intensified, and his parents became increasingly fearful for his safety. Various antipsychotic and mood-stabilizing medications, steroids, and immunotherapy have been trialed with limited improvement of his symptoms. An extensive medical evaluation yielded the following: 1. Magnetic resonance imaging of the brain: dilated perivascular spaces. 2. Urine organic acids: ketosis and increased lactic acid. 3. Antinuclear antibody: minimally positive. 4. Vitamin B12: elevated. All other studies, including lumbar puncture, electroencephalogram (awake and asleep), genetic studies (chromosomal microarray, fragile X testing, and whole exome sequencing), metabolic studies, inflammatory markers, and thyroid panel, were negative/normal. Nick is enrolled in a special education classroom within a school that utilizes an ABA-based approach for all students. As part of his educational programming, he receives 25 hours of ABA in a 1:1 setting, 2 hours of speech therapy, 3 hours of occupational therapy, 1 hour of physical therapy, and 30 minutes of music therapy weekly. Current concerns include significant head-banging and thrashing before falling asleep, hyperactivity, unsafe behaviors (e.g., banging on windows, climbing high to reach desired items), aggression toward caregivers, limited ability to complete self-care tasks (e.g., personal hygiene, toileting), significant decline in expressive language, and continued response to internal stimuli. Nick's parents now present to a multidisciplinary center seeking guidance regarding additional therapies/interventions to assist in management of his current developmental and behavioral challenges as well as information regarding his expected developmental trajectory as he reaches adulthood.

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“…Treatment delay can be attributed to various factors, such as the fear of stigma. cultural beliefs, familiar attitudes, and a lack of education [ 12 ]. Hospitalisation is frequently used as a study outcome, and some authors have found that a large portion of patients require readmission after FEP [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Readmission in Young Adults with First-Episode Psychosis: A Multicentric Retrospective Study with a 12-Month Follow-Up

Besana,

Civardi,

Mazzoni

et al. 2024

Clinics and Practice

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Background: A significant number of young individuals are readmitted one or more times shortly after their first episode of psychosis. Readmission may represent a marker of psychopathological vulnerability. Our primary aim was to evaluate the impact of clinical and socio-demographic variables on readmission at 12-month follow-up. Secondly, our goal was to determine whether the use of Long-Acting Injection (LAI) antipsychotics provides notable benefits compared to oral medications in preventing subsequent readmissions. Subjects and methods: 80 patients hospitalised for the first time with a diagnosis of psychotic disorder (ICD-10 criteria) were retrospectively assessed through clinical records. The mean age was 21.7 years. Patients were predominantly male (n = 62, 77.5%), and 55 subjects had at least 8 years of education. 50% of the sample was “NEET” (not in education, employment, or training). Results: 35 patients (43.8%) were discharged with a LAI antipsychotic, while 45 (56.2%) recieved oral antipsychotic therapy. Substance use (p = 0.04) and oral antipsychotics at discharge (p = 0.003) were significantly associated with readmission at 1 year. We did not find any significant predictors of being discharged with LAI therapy. Conclusion: Our findings underlined the importance of identifying patients at risk of readmission in order to prevent future rehospitalization and promote appropriate prevention strategies. LAIs should be considered as a first-choice treatment for patients hospitalised for FEP since they proved to be effective in preventing relapse.

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Social functioning in a first-episode of psychosis: can the existence of affective symptoms influence it?

Cited by 3 publications

References 0 publications

Diagnosis stability and outcome of psychotic episodes in a Romanian group of children and adolescents

Diagnosis stability and outcome of psychotic episodes in a Romanian group of children and adolescents

Challenging Case: New-Onset Hallucinations and Developmental Regression in a Child with Autism Spectrum Disorder

Predictors of Readmission in Young Adults with First-Episode Psychosis: A Multicentric Retrospective Study with a 12-Month Follow-Up

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