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4 results

  • Risk of transition to schizophrenia following first admission with substance-induced psychotic disorder: a population-based longitudinal cohort study

  • H. L. Alderson, D. M. Semple, C. Blayney, F. Queirazza, V. Chekuri, S. M. Lawrie
  • Journal:
    Psychological Medicine / Volume 47 / Issue 14 / October 2017
    Published online by Cambridge University Press:
    03 May 2017, pp. 2548-2555
  • Background

    The potential for drugs of abuse to induce acute psychotic symptoms is well recognised. However, the likelihood of transition from initial substance-induced psychotic disorder (SIPD) to chronic psychosis is much less well understood. This study investigated the rate of SIPD transition to schizophrenia (F20), the time to conversion and other possible related factors.

    Methods

    Using data from the Scottish Morbidity Record, we examined all patients (n = 3486) since their first admission to psychiatric hospital with a diagnosis of SIPD [International Classification of Diseases, Tenth Revision (ICD-10) codes F10–F19, with third digit five] from January 1997 to July 2012. Patients were followed until first episode of schizophrenia (ICD-10 code F20, with any third digit) or July 2012. Any change in diagnosis was noted in the follow-up period, which ranged from 1 day to 15.5 years across the groups.

    Results

    The 15.5-year cumulative hazard rate was 17.3% (s.e. = 0.007) for a diagnosis of schizophrenia. Cannabis, stimulant, opiate and multiple drug-induced psychotic disorder were all associated with similar hazard rates. The mean time to transition to a diagnosis of schizophrenia was around 13 years, although over 50% did so within 2 years and over 80% of cases presented within 5 years of SIPD diagnosis. Risk factors included male gender, younger age and longer first admission.

    Conclusions

    SIPD episodes requiring hospital admission for more than 2 weeks are more likely to be associated with later diagnosis of schizophrenia. Follow-up periods of more than 2 years are needed to detect the majority of those individuals who will ultimately develop schizophrenia.

  • Chapter 14 - Antiepileptic drugs and suicide

  • Edited by Michael R. Trimble, Institute of Neurology, London, Bettina Schmitz
  • Book:
    The Neuropsychiatry of Epilepsy
    Published online:
    07 October 2011
    Print publication:
    09 June 2011, pp 143-152

  • Summary

    This chapter presents a short history of postictal psychosis (PIP) studies and established clinical pictures of nuclear PIP. It discusses the interrelationship between PIP and interictal psychosis (IIP), results of neuro-imaging studies of PIP, premorbid predisposition (including family history) or risk factors, and PIP-related peri-ictal phenomena including discussion of PIP subtypes. Four different combinations of PIP and IIP have been recognized: progression of PIP to chronic psychosis; PIP changing into IIP without a break during an episode of psychosis; PIP and IIP episodes occurring in an alternating manner; and PIP episodes follow after remission of IIP episodes. As with SPECT studies, only a few depth-EEG studies during active PIP episodes are available, though the results suggest interesting subtypes. Psychopathological features of PIP are highly suggestive of association with bipolar disorder, which is supported by data from different perspectives.

  • 26 - Disablement associated with chronic psychosis as seen by two groups of key informants: patients and mental health professionals

  • from Part IV - Unmet need: specific issues
  • Edited by Gavin Andrews, University of New South Wales, Sydney, Scott Henderson, Australian National University, Canberra
  • Book:
    Unmet Need in Psychiatry
    Published online:
    21 August 2009
    Print publication:
    06 January 2000, pp 378-389

  • Summary

    This chapter focuses on the opinions concerning the disablement that accompanies alcohol, drug and mental (ADM) disorders. Mental health professionals were selected to represent the major groups of professionals as well as institutions and organizations working in the Weld of mental health in Luxembourg. Abnormalities in psychomotor behavior, physical appearance and speech or communication were listed most frequently as signs that would indicate a person with a psychotic disorder would need help from someone else to do activities of everyday life. According to mental health professionals and patients with a mental disorder, patients with a psychotic disorder are easily recognized by other people. Their disorder is viewed as a highly disabling condition. Most people consider that such people can barely live independently from other people. They are viewed as being unable to perform most activities of daily life and as requiring considerable social assistance.

  • An assessment of the psychoeducational needs of long-term psychiatric patients

  • Pat Gibbons, Grace Hogan, Sheila McGauran
  • Journal:
    Irish Journal of Psychological Medicine / Volume 16 / Issue 3 / September 1999
    Published online by Cambridge University Press:
    13 June 2014, pp. 104-108
    Print publication:
    September 1999

  • Objectives: We aimed to identify which illness related topics were of most interest to chronic psychiatric patients in our catchment area service, and to obtain a baseline measure of the amount of knowledge which patients with schizophrenia had about their illness.

    Method: Patients attending for a minimum of one year were recruited from the outpatient clinic and day centre. Participants completed three instruments: a brief questionnaire which asked about the details of their diagnosis and drug treatment regimen, the ‘Educational Needs Questionnaire’ (ENQ), and a modified form of the ‘Understanding Schizophrenia Scale’ (USS).

    Results: Forty-seven patients with a chronic psychotic illness participated in the study. Despite having attended the service for an average of 14 years, the majority of patients were unable to correctly identify their diagnosis. Most patients were able to name the drugs which they had been prescribed; but were not able to describe the dosage of these drugs. According to the ENQ results, patients expressed most interest in learning about general aspects of their illness, such as ‘how to cope with stress’, and less in how to manage specific illness related symptoms. Similarly, schizophrenia patients were found to know more about general aspects of their illness, such as rehabilitation and non-medical aspects of treatment, than about medication.

    Conclusion: Chronic psychiatric patients, especially those with schizophrenia, have very limited knowledge of their illness and its treatment. The focus of psychoeducation should be extended from insight and compliance to include broader ‘quality of life’ issues which appear to be of more concern to patients themselves. Patient participation in psychoeducation can thus be improved by including topics identified by such instruments as the ENQ. It is encouraging that cognitive deficits and negative symptomatology do not seem to prevent long-term psychiatric patients from benefiting from such inputs.