bluuebunny/crossref_metadata_2025_split huggingface dataset:
is Feigned Psychosis a Pathway to Schizophrenia?
Authors: Almeida J. Traça , da Silva J. Alves , Xavier M. , Gusmão R. 
Published: March 2009

Factitious disorders (FD) are characterized by intentional production of either physical, psychological or mixed symptoms that mimic various clinical syndromes, with no apparent advantage for the individual concerned other than allowing him to assume the sick role. Large body of work has been accumulated on FD, but the majority of published data deal with the physical variant of the disease, with comparable few reports on psychiatric FD. Although there are many different presentations for psychiatric FD, the factitious psychosis subset justifies particular attention. Factitious psychosis may be prodromic of a genuine chronic psychosis, usually in the context of a personality disorder. Published data shows Munchausen psychosis, a severe subset of FD psychosis, with a prevalence of 0.25% of all inpatient admissions and global FD psychosis attaining 4.1% of all diagnosed psychoses, generally with a poor prognosis.The scantiness of studies on the subject of psychiatric FD and factitious psychosis in particular, despite its significant prevalence, coupled with the fact that its recognition embarks on a radically different approach compared with the physical variant, stresses the need for case reporting.We present four clinical cases with discussion of the underlying pathology and outcome, and a systematic review of the literature of FD psychosis case reports. This is followed by further discussion addressing the recognition of factitious psychosis, its etiological contributing factors, management, effects on staff and diagnostic criteria.
Damage to Object Oriented Programming in the Brain Explains many of the Psychopathological Features of Schizophrenia
Authors: Arun C.P. 
Published: March 2009

Introduction:Modern computers often use programs that incorporate a programming technique called Object Oriented Programming (OOP), allowing users to manipulate complex ‘computational objects’ such as menus, screen windows, etc with very little effort, say the click of a mouse. OOP deals with structures called objects and allows time and computational effort saving devices such as inheritance, polymorphism and encapsulation. We examine whether the brain itself may use OOP and if representation of objects suffers a breakdown in schizophrenia.Review of literature:Previous models fail to provide a unifying explanation with a computational basis that could explain the psychopathology in schizophrenia. METHODS Using the object oriented programming language JavaTM we designed a system of self-objects named ‘hand’, ‘action monitor’ etc interacting with non-self objects ‘scissors’, ‘hammer’, ‘wall’, etc. in computational experiments, we allow the ‘action monitor’ to fail; the features of disparate objects are allowed to merge, some features of an object are allowed to be shared with other objects, etc.Results:By transposing only a few lines of code, it is possible to duplicate various features of the psychopathology of schizophrenia.Discussion:Our model can demonstrate overinclusion (overabstraction), concrete thinking (underabstraction), loss of ego boundaries (conjoining of disparate objects), delusions (misattribution of object function), lack of insight (poor monitoring of object activity) and passivity (loss of monitoring and misattribution of object activity).Conclusion:The brain must use the OOP model in its computations. Failure of object representation and manipulation must lie at the core of the psychopathology of schizophrenia.
A Bedside Schizophrenia thought Disorder Scale
Authors: Arun C.P. 
Published: March 2009

Present classification systems for thought disorder lack consistency and require one to remember long-winded definitions limiting their use to research settings. as an extension of recent work in this area (World Congress, 2008), we classify the characteristic thought disorder patterns seen in schizophrenia according to the location of the lesion in notional "threads" of mental computational processes that string speech together. These threads must take both semantics and syntax into consideration in performing their function. When we speak - just as when we write - there is a natural hierarchy topic thread (the topic of the ‘essay’) and multiples of paragraph threads, sentence threads, clause threads, word threads and phoneme threads. Intuitively, we grade the severity of thought disorder depending upon whether a particular thread gets stuck (S), reconnects abnormally (R) or is absent altogether:I.paragraph thread R: Disjointed sentences S: Circumstantiality;II.topic threadR: Tangentiality S: Preoccupatory thinking;III.sentence threads R: Knight's move thinking S: Clause perseveration;IV.clause threads R: Word salad S: Word perseveration, fusion;V.word threads R: Incoherent sounds/ neologisms/ paraphasias S: Phoneme/syllable perseveration;VI.phoneme threads - Failure of production: Mutism.Of course, one must record all the lesions that are present at any given time. This scale incorporates a intuitive progression from mild to severe thought disorder in Schizophrenia. Using the STDS would allow the straightforward ‘bedside’ quantification of the severity of thought disorder and enforce discipline into the thought assessment section of the Mental State Examination.
Shared-induced Paranoid Disorder (Folie á Deux) between Two Sisters. A Case Report
Authors: de Velasco Soriano R. Martínez , Cerezo E. Benítez , Velasco M.F. Pando , Sierra C. Erausquin , Ferrando I. Gobernado , Martín F. Suárez , Ruano A. Soto , Moreno A. Chinchilla 
Published: March 2009

Introduction:Induced delusional disorder (also known as shared paranoid disorder or folie à deux) is an uncommon disturbance characterized by the presence of similar psychotic symptoms in two or more individuals. Most commonly a primary case can be distinguished from other one or more cases, in whom the symptoms are induced. the patients implied in the shared delusional symptoms are frequently linked by close relationship bonds, mostly family ties. Its epidemiology remains unclear, because very few data is available. There are some requirements concerning the persons involved for the development of this disorder:1.Close coexistence and intimate emotional links between the two people are observed;2.The delusional content is plausible and can be based on past events or expectations;3.Typically, the induced individual has an easily influenciable personality.Case report:We describe and comment one case of shared paranoid disorder between a 29 year old schizophrenic patient and her 43 years old sister. both share a persecution and prejudice delusion involving the Chinese community of their hometown. after a few days of inward treatment at separated psychiatric wards, the delusional symptoms in the older sister started to improve.Conclusion:Our intention is making a review on a diagnosis that remains controversial nowadays. Treatment should begin with the separation of the induced and the inducer. Anyhow, a psychopharmacological treatment is required in both individuals. It seems clear, however, that the prognosis of the induced and the inducer is different, according to a variety of factors.
Diagnostic Stability and Clinical Characteristics in First-episode Psychosis
Authors: Berge D. , Mane A. , Salgado P. , Vilarroya O. , Merino A. , Bulbena A. 
Published: March 2009

Introduction:Diagnostic stability in first-episode psychosis shows a wide variability between studies. Amini and cols reported a 50% rate of patients schizophreniform disorder shifting to schizophrenia during the first 12 months period. We report the preliminary follow-up results of our recently ongoing first- episode psychosis unit.Methods:Forty-six patients admitted for a first-episode psichosis to our Inpatient Psychiatric Unit from January 2006 to January 2008 were recruited. Clinical and socio-demographic characteristics were registered during admission period and during the follow-up period.Results:At admission 52% of the first-episode subjects had a diagnosis of psychosis NOS and 32% a schizophreniform disorder diagnosis. after discharge, most of the patients (72%) had a diagnosis of schizophreniform disorder, 16% psychosis NOS and 8% brief psychotic disorder. Six months later, half of the followed-up patients had a schizophreniform disorder diagnosis, and 23% had a diagnosis of schizophrenia. 30% of the patients were drop-outs, mainly referred to other out-patient services. Patients shifting to schizophrenia were younger, predominantly male (75% vs 50% in non-schizophrenia shift), had a lower proportion of university studies and presented a longer hospitalization period at admission. No differences in familial history of psychosis and cannabis use were found. after one-year follow-up period, 50% preserved a schizophreniform disorder diagnosis and 30% were diagnosed as schizophrenia.Conclusions:Schizophrenia spectrum disorders have a high stability in first-episode psychosis during first year follow-up. as in previous studies, male gender is one of the factors that best predicts the shift to schizophrenia.
the ‘schizophrenia Postdrome’: A Study of Low-level Positive Symptoms after Remission of First Episode Schizophrenia
Authors: Burley K. , Upthegrove R. , Birchwood M. , Patterson P. , Skeate A. 
Published: March 2009

Background:Despite remission being the primary objective following the first episode of schizophrenia, clinically stabilised patients are rarely studied.Aims:To assess the extent and fluctuation of low-level positive symptoms in patients who are in remission following their first episode of schizophrenia, and consider whether symptoms displayed are similar to those exhibited in the prodromal population.Methods:Eleven patients who had recovered for at least six months following one episode of schizophrenia and subsequently fulfilled remission criteria were interviewed four times over the course of three months. Interviews were based on the Structured Interview of Prodromal Symptoms (SIPS), an in-depth assessment of low-level symptoms that is widely used in the prodromal group. Data was compared to equivalent results from the prodromal population (with data provided by the local ED:IT service).Results:Over the course of the interviews 73% of participants displayed attenuated positive symptoms, predominantly unusual thought content and suspiciousness. 18% experienced brief limited intermittent psychotic symptoms (BLIPS). Analysis with Friedman's test revealed no significant fluctuation in positive symptoms, indicating that they are stable over time. Furthermore, the symptoms exhibited in the sample were closely comparable to those in the prodromal group in the ED:IT service.Conclusions:The majority of patients in remission are experiencing a form of ‘postdrome’, which appears to be an enduring state. the presence of these symptoms may put patients at an increased risk of relapse. Larger-scale research is required to follow-up this novel preliminary study.Declaration of interest:None.
Paranoid Schizophrenia and Projective Distortion - an Evaluation of Self-concept Disturbance in Paranoid Schizophrenics and Projective Distortion in the Family
Authors: Canta G. 
Published: March 2009

The research main goal is to study patients diagnosed with Paranoid Schizophrenia, more specifically the impact of projective distortion in the self description, and the self-concept disturbance, personality traits and family dynamics, also evaluating the influence of mental representations from both the patient and parents.It is essential to describe the semiology and phenomenology of Paranoid Schizophrenia in adults, the mental representations of these patients and their family psychodynamics. Special attention will be given to self-concept and the representation of family interactions, which several investigations mention as very relevant in Schizophrenia.Projective Distortion is considered to be the result of the interplay of defence mechanisms inside family relationships, conceptualized as an interactional and interpersonal phenomenon.Although there are some studies on the disturbances of self-concept in patients with Paranoid Schizophrenia, it has not been usual to simultaneously analyse both the Projective Distortion operating in the family and its impact on the patient mental representations, something that can be very relevant to therapeutic interventions.There will be presented 5 case studies, using interviews with patients diagnosed with Paranoid Schizophrenia and their parents. These interviews will be conducted and analyzed using the Grounded Theory Method. That analysis aims to isolate significant conceptual categories, and to build a theoretical model which allows the understanding of Projective Distortion.
How “DUP” and “ee” Predict the Dynamic OD Syndromes in the Long - Termcourse of Schizophrenia? [P03-123]
Authors: Cechnicki A. , Polczyk R. , Bielańska A. 
Published: March 2009

Objective:The study in Krakow investigated the way in which EE and DUP correlated with long term outcomes of the treatment and the course of illness.Subjects and methods:58 out of 80 DSM III schizophrenia diagnosed patients took part in 1, 3, 7 and 12 follow-up. the Follow-Up Chart, BPRS, and CFI were used. as the outcome criteria only dynamic of symptoms were included. the dynamic of the symptoms and the relation between DUP and EE were analyzed by repeated measures of ANOVA.Results:1.General, positive and negative syndromes decreased rapidly after the first hospitalization, and increased slightly between 7 and 12 yrs. (ps < 0.001). the negative syndrome decreased less rapidly during the first year.2.The dynamic of general and positive syndrome were modified by the DUP and by EE. in long DUP (general syndrome: p = 0.028; positive syndrome: p = 0.001) the dynamic was worse. High EE subjects had more severe syndromes at the admission. after the first hospitalization their results became as good as in the case of low EE (general syndrome: p = 0.004; positive syndrome: p = 0.044).3.The dynamic of negative syndrome was neither modified by DUP (p = 0.896) or by EE (p = 0.309).Conclusion:The dynamic of general and positive syndromes were modified by DUP during 12 years follow-up and by EE only in acute state in the first episode. the dynamic of negative syndrome was not modified by DUP and EE.
GABRB2 in Schizophrenia and Bipolar Disorder: Disease Association, Gene Expression and Clinical Correlations
Authors: Chen J.-H. , Tsang S.-Y. , Zhao C.-Y. , Pun F.W. , Yu Z.-L. , Mei L.-L. , Lo W.-S. , Ng S.-K. , Liu H. , Stöber G. , Xue H. 
Published: March 2009

Aims:Previously the GABA(A) receptor beta-2 subunit gene GABRB2 was found to be associated with schizophrenia (SCZ). for SNPs and haplotypes in GRBRB2, the associations with bipolar disorder (BPD), the functional consequences on GABRB2 expression and their relationship to demographic and clinical characteristics in BPD and SCZ remain to be elucidated.Method:Case-control analysis was performed for association study of GABRB2 with BPD, and its mRNA expression in postmortem BPD brains was examined using quantitative real-time PCR. Quantitative trait analysis was subsequently employed to assess the covariate effects of demographic and clinical characteristics on genotypic correlation of GABRB2 expression in SCZ and BPD.Results:Significant association of GABRB2 with BPD and reduction in GABRB2 mRNA expression in BPD brains were observed in the present study. Duration of illness (DOI) was found to be a significant covariate for the correlation of the disease-associated SNPs rs1816071, rs1816072 and rs187269 with GABRB2 expression in both SCZ and BPD. for individuals with homozygous major genotypes of these SNPs, while GABRB2 expression increased with age in the controls, it decreased with DOI and age in SCZ, and with DOI in BPD. with age of onset as covariate, these three SNPs were significantly correlated with antipsychotic dosage in SCZ.Conclusion:These results have thus revealed correlations of GABRB2 SNPs and expression not only with the occurrence of SCZ and BPD, but also with the clinical characteristics of patients, therefore providing support for a shared etiological role played by the gene in both diseases.
First Psychotic Episode and Early Intervention: An Opportunity to Change the Course of the Illness
Authors: Coentre R. , Barrocas D. , Chendo I. , Levy P. 
Published: March 2009

Aims:Early intervention in psychosis constitutes an important opportunity to change the classic limited outcome associated with the patients who suffer of psychotic disease.Methods:Based on literature review the authors analyse the evidence for early intervention in first psychotic episode.Results:The evidence for the effectiveness of interventions in early psychosis can be considered in two stages:1.first stage before the onset of full symptoms of psychosis, in people with high risk of developing psychosis or in the prodrome phase of the illness;2.second stage includes the therapeutic focus on the period after the first psychotic episode, reducing the duration of untreated psychosis (DUP) and ameliorate the recovery.Preventing psychosis by intervene in the prodrome or in people with high risk of developing psychosis remains ethically contentious because of the non-specificity of the symptoms. by the contrary there is evidence that early and specialised intervention in first psychotic episode improves outcome. Besides the controversy of the relation between long DUP and poor outcome, there is agreement that clinicians should identify and treat psychosis early with a great impact in patients and their family's life. Effective care during first psychotic episode includes proactive engagement and initiation of low doses of antipsychotics and psychosocial treatments, aiming for maximal symptomatic and functional recovery and the prevention of relapse.Conclusion:There is evidence that early intervention in first psychotic episode improve clinical effectiveness over standard care. Further studies are important to make evidence more robust.
Factors Involved in Treatment Adherence in Psychosis: Importance of Treatment Effectiveness for the Patients
Authors: Coentre R. , Vanelli I. , Chendo I. , Levy P. 
Published: March 2009

Aims:Treatment adherence is crucial to the therapeutic success in psychiatric disorders. Evaluating factors involved in treatment adherence will allow to modify treatment strategies for greater compliance. the aim of the study was to evaluate factors involved in treatment adherence, including subjective patients’ satisfaction.Method:The study included in- and outpatients who met the criteria according to DSM-IV TR of schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, psychosis not otherwise specified, brief psychotic disorder and bipolar disorder. the following questionnaires were applied:1.Demographic and clinical questionnaire;2.Treatment Satisfaction Questionnaire for Medication Version II (TSQM vII);3.Medication Adherence Rating Scale (MARS);4.Schedule for Assessment of Insight (SAI);5.World Health Organization Quality of Life-BREF Scale (WHOQoL-BREF).TSQM vII is a self-reporting questionnaire to assess the major dimensions of patients’ satisfaction with their medication, includes 11 items that make up three specific scales (effectiveness, side-effects and convenience).Results:Twenty patients, between 18 and 65 years of age, were included. an interview was made and the 5 questionnaires were applied. the statistical analysis, using Regression Analysis Stepwise, showed a significant positive correlation between medication adherence, evaluated by MARS, and treatment effectiveness to the patients, evaluated by TSQMvII effectiveness scale (p=0.028). the correlations between the others parameters were not statistically significant.Conclusion:In this study the authors found that the self-experience of treatment effectiveness, which is a major dimension for treatment satisfaction, had a positive correlation with treatment adherence. Strategies to enhance subjective treatment effectiveness are needed to improve medication adherence.
Induced Gamma Band Deficits in Early Psychosis
Authors: Constante M. , Shaikh M. , Williams I. , Murray R. , Bramon E. 
Published: March 2009

Objective:Abnormalities in event related potentials (ERPs) have long been looked at as markers of disease in Schizophrenia. Over recent years there is a trend in the field to move from averaged trials ERPs analysis in the time-voltage domain, to time-frequency single trials analysis. Oscillations in the Gamma band (30-50Hz) have received particular attention in the context of the theories of core deficits in neuronal synchronization in Schizophrenia. in this study we aimed at replicating previously found Gamma band deficits in a sample of Early Psychosis patients.Methods:EEG was collected from 15 patients and 15 age matched controls using an auditory oddball paradigm. Time-frequency analysis in the Gamma band was performed using a Morlet wavelet transform. We tested differences between the groups using the Wilcoxon rank sum test, given the nonparametric nature of the data, to compare each group's average single trial Gamma power, maximizing the signal-to-noise ratio.Results:Patients with Early Psychosis showed, following target tones, a reduction in the total power of Gamma band activation (p< 0.01) as well as in induced Gamma band activation (p< 0.01). This was observed in a late latency interval at 400-500ms. the late burst of Gamma activity was not found in the frequent condition, for neither subjects group.Conclusion:The findings are compatible with previous studies suggesting deficits in the late intrinsically generated cognitive processing of auditory stimuli in Schizophrenia, already present in its early stage. They add further evidence of deficits in neuronal synchronisation in the early stages of psychotic disorders.
Predictors of Metabolic Syndrome in Severe Mental Disorders
Authors: Corominas A. , Cavero M. , Alvarez O. , Reyes M. 
Published: March 2009

Aims:To assess the potential factors related to the development of metabolic syndrome (MS) in patients with chronic mental disorders.Method:Descriptive, cross-sectional study; sample: 140 outpatients with schizophrenia or affective disorders attended for more than 2 years. Dependent variable: metabolic syndrome (Adult Treatment Panel III diagnostic criteria). Independent variables: age, gender, syndromic diagnosis, main treatment, duration of treatment, Global Functioning, type of diet, sedentarism, alcohol consumption, smoking, Primary Care monitoring.Results:43.6% of patients who had an unhealthy diet showed MS, whereas only 25.6% of those patients that followed healthy food habits met criteria for MS (p< 0.05, chi square; OR=1.23, 95% CI =1.01-1.5). Logistic regression identifies type of diet and GAF scores as the only predictive variables for MS. Bivariant analysis confirms previous data concerning the relationship between age and MS, and shows a negative relationship between alcohol consumption and Body Mass Index, and between alcohol and fasting plasma glucose, particularly among young women.Conclusion:The lack of a well-balanced dietetic habit appears to be an essential factor in the development of metabolic syndrome. for its prevention, educational programs addressed to patients with severe mental disorders should focus on healthy diet. A sum of effects of age, diet, central adiposity, estrogenic balance and moderate alcohol consumption might argue for the rest of our results.