Executive function in adolescent patients with major depressive episode with psychotic symptoms and childhood trauma / 四川精神卫生

BackgroundThere are differences in executive function between major depressive episode patients with or without psychotic symptoms， and childhood trauma may affect the executive function of patients with major depressive episode. Previous research studies predominantly focused on adult patients with major depressive episode， with a lack of studies specifically focusing on adolescent patients with major depressive episode. ObjectiveTo investigate the differences in executive function among adolescent patients with major depressive episode， with or without psychotic symptoms and childhood trauma. MethodsA total of 112 hospitalized adolescent patients with major depressive episode who met the criteria of the International Classification of Diseases， tenth edition （ICD-10） were included in the study. The participants were recruited from the Department of Child and Adolescent Psychiatry， Shenzhen Kangning Hospital during the period from August 2020 to November 2021. Additionally， 27 healthy controls were recruited through public advertisements. The Cambridge Neuropsychological Test Automated Battery （CANTAB） was used to assess executive function through the administration of the Motor Screening Task （MOT）， Spatial Working Memory（SWM） and Rapid Visual Information Processing （RVP） modules. Childhood Trauma Questionnaire-Short Form （CTQ-SF） was used to assess the trauma type. ResultsCompared with healthy controls， adolescent patients with major depressive episode had a longer mean delay （Z=-3.407， P=0.001） in the MOT task. In the SWM task， the patients had a higher total number of intergroup error responses （Z=-3.291， P=0.001）， a higher total number of intragroup error responses （Z=-3.461， P=0.001）， more total number of double error responses （Z=-3.218， P=0.001）， a higher total error responses （Z=-3.312， P=0.001）， higher strategy scores （Z=-2.437， P=0.015） and longer average delay time （Z=-2.055， P=0.040）. In the RVP task， the patients had fewer hits （Z=-3.196， P=0.001）， more misses （Z=-3.179， P=0.001）， fewer rejections （Z=-2.772， P=0.006）， lower hit probability （Z=-3.187， P=0.001） and lower A´ scores （Z=-3.070， P=0.002）.Compared with adolescent patients with major depressive episode without psychotic symptoms， those with psychotic symptoms had a lower total number of double error responses （Z=-2.566， P=0.010） in SWM task. Compared with adolescent patients with major depressive episode who did not experience emotional neglect， those who experienced emotional neglect had longer average delay time （Z=-3.183， P=0.001） in MOT task， fewer total hits （Z=-2.445， P=0.014）， more total missed reports （Z=-2.467， P=0.014）， lower hit probability （Z=-2.445， P=0.014） and lower A´scores （Z=-2.089， P=0.037） in RVP task. Adolescent patients with major depressive episode who had experienced emotional abuse had longer average delay time in MOT task than those who had not experienced emotional abuse （Z=-2.552， P=0.011）. ConclusionAdolescent patients with major depressive episode exhibit abnormalities in a majority of executive function domains. Specifically， those without psychotic symptoms and with childhood trauma demonstrate significantly impaired executive function. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGS013）， Basic and Applied Basic Research Fund of Guangdong Province （number， 2019A1515110047）， Shenzhen Science and Technology Planning Project （number， JCYJ20190809155019338）］

Effect of home visit based on empowerment education on psychotic symptoms， self-management ability and well-being of schizophrenia patients in home rehabilitation / 四川精神卫生

ObjectiveTo explore the effect of home visit based on empowerment education on psychotic symptoms， self-management ability and well-being of schizophrenia patients in home rehabilitation. MethodsA total of 87 cases of schizophrenia patients who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） and were recovering at home in Caiba town， Yibin city from January to July 2021 were selected by random sampling method as research subjects. They were divided into experimental group （n=43） and control group （n=44） according to the random number table method. The two groups received routine family visits， and the experimental group received family visits based on empowerment education. The intervention cycle of the two groups was 6 months. Before and after the intervention， the severity of psychotic symptoms， self-management ability and well-being of the patients in the two groups were assessed with the Brief Psychiatric Rating Scale （BPRS）， the Schizophrenia Self-Management Instrument Scale （SSMIS） and the Index of Well-Being Scale （IWB）. ResultsAfter intervention， the intra group comparison showed that the BPRS score in the experimental group was lower than that before the intervention （t=4.550， P<0.01）， the SSMIS scores in both groups were higher than those before intervention （t=-17.107， -6.367， P<0.01）， and the IWB score in the experimental group was higher than that before intervention （t=-9.239， P<0.01）. The comparison between groups showed that the BPRS score of the experimental group was lower than that of the control group， and the SSMIS and IWB scores were higher than those of the control group （t=-3.899， 10.564， 9.690， P<0.01）. ConclusionThe implementation of family visit based on empowerment education may help to improve the psychotic symptoms of home rehabilitation schizophrenia， and improve their self-management ability and well-being.

Relato de caso: avaliação do risco de suicídio no transtorno depressivo maior grave com sintomas psicóticos / Case report: evaluation of suicide risk in severe major depressive disorder with psychotic symptoms

Para além de sua sintomatologia clássica, o Transtorno Depressivo Maior (TDM) pode cursar com episódios únicos ou recorrentes de quadros psicóticos, marcados pela presença de delírios e alucinações cujos conteúdos associam-se frequentemente a ideias negativas e depressivas de morte, ruína, culpa e punição merecida. Esta condição está fortemente conectada a alto risco suicida, motivo pelo qual deve-se diagnosticar e intervir de maneira positiva o mais precocemente possível, a fim de que a vida, o sentido e a qualidade de viver do indivíduo possam ser restaurados e preservados. O caso relatado refere-se a uma paciente com diagnóstico atual de TDM grave e recorrente com sintomas psicóticos e alta intencionalidade suicida. Apresenta o humor constantemente deprimido, choro fácil e frequente, hipobulia, distúrbios do sono e sentimentos de menos-valia. Ademais, seu quadro cursa com sonhos e sensações estranhas relacionados a entidades malignas, assim como com alucinações visuais persistentes e delírios religiosos de pecado, culpa exagerada e punição divina. Frente à resistência dos sintomas ao tratamento farmacológico inicial, foram discutidas outras possibilidades de abordagem, conduta e diagnósticos diferenciais paralelamente à avaliação constante do risco de suicídio. [au]

In addition to its classic symptomatology, Major Depressive Disorder (MDD) may go through single or recurring episodes of psychotic events marked by the presence of delusions and hallucinations, with contents which are frequently associated to negative and depressive ideas about death, ruin, guilt and deserved punishment. This condition is strongly linked to high suicide risks, constituting the main reason why it is necessary to diagnose and positively intervene as soon as possible in order to restore and preserve the person's life, meaning and quality of life. The case reported herein refers to a female patient with a current diagnosis of severe and recurrent MDD with psychotic episodes and high suicidal tendencies. This patient constantly presents depressed mood, frequent and easy crying, hypobulia, sleep disorders and devaluation of herself. Furthermore, her case occurs with strange dreams and sensations related to evil entities, along with persistent visual hallucinations and religious delusions of sin, excessive guilt and divine punishment. Due to the symptoms resistance to the initial pharmacological treatment, other possibilities of approach, conduct and differential diagnoses were discussed in parallel to a continual evaluation of the suicide risk. [au]

Psychotic symptoms and its association with substance use disorders among adult prisoners in correctional institution: a facility based cross-sectional study in Southwest Ethiopia

Introduction: The prevalence of psychotic symptoms among prisoners is increasing rapidly throughout the world. It imposes considerable personal and public health burden. In recent years psychotic symptoms among prisoners has been widely emphasized and the current study aimed to assess psychotic symptoms and its association with substance use disorders among adult prisoners in correctional institution in Southwest Ethiopia. Method: Facility based cross-sectional study design was conducted in Jimma Correctional Institution among 336 prisoners selected by systematic random sampling method in June 2017. Data was collected by face-to-face interview using structured questionnaire. Data was analyzed using SPSS version 21.0. Multivariable logistic regression was computed to identify independent associated factors. Results: The prevalence of psychotic symptoms among prisoners was found to be 43%. Poor social support (AOR: 4.12, 95%CI: 1.39-12.66), alcohol use disorder (AOR: 4.03, 95%CI: 1.58-10.27), stressful life events (AOR: 2.19, 95%CI: 1.14-4.21), and common mental disorders (AOR: 5.53, 95%CI: 2.56-11.91) were independently associated with single psychotic symptom. Conclusion: This study showed high prevalence of psychotic symptoms. Psychotic symptoms were significantly associated with poor social support, alcohol use disorder, stressful life events and common mental disorders. It is essential to have screening mechanism and management practice for psychotic symptoms.

Effect of WeChat intervention on medication compliance， psychotic symptoms and recurrence rate of schizophrenic patients in community： a Meta-analysis / 四川精神卫生

ObjectiveTo systematically review the efficacy of intervention by WeChat on medication compliance， psychotic symptom and recurrence rate of schizophrenic patients in community. MethodsDatabases including PubMed， the Cochrane Library， CBM， CNKI， Wanfang Data and VIP were searched electronically from January 1， 2011 to November 1， 2020 to collect randomized controlled trials （RCTs） about the effects of WeChat intervention on community schizophrenic patients. After two reviewers independently screened literature， extracted data and assessed the risk of bias of included studies， the meta-analysis was performed with Stata 12.0 software. ResultsA total of 381 articles were retrieved and finally 10 RCTs were included， including 1 251 patients with WeChat intervention group 641 cases and routine health education group 610 cases. Meta-analysis showed that compared with the conventional health education group， the WeChat intervention group had higher medication compliance （OR=3.05，95% CI：1.98~4.69，P<0.01）， lower PANSS score （SMD=-1.05，95% CI：-1.46~-0.64，P<0.01） and relapse rate （OR=0.34，95% CI：0.24~0.48，P<0.01）. ConclusionThe interactive intervention based on WeChat platform can effectively improve the medication compliance of patients with schizophrenia in the community， help to reduce the severity of psychotic symptoms and the recurrence rate.

Relationship of psychotic symptoms with childhood abuse and psychological resilience in patients with depression / 中华行为医学与脑科学杂志

Objective To explore relationship of psychotic symptoms with childhood abuse and psy-chological resilience in patients with depression. Methods According to whether the psychotic symptoms ex-ist,160 patients with depression were divided into psychotic major depression (PMD group,n=80) and non-psychotic major depression (NMD group,n=80). All patients were assessed with general information ques-tionnaire,the childhood trauma questionnaire(CTQ) and the Conner-Davidson resilience scale( CD-RISC). Using logistic regression analysis to explore the influencing factors of psychiatric symptoms in depressive pa-tients. Results There were significant differences in the emotional abuse (( 17. 80 ± 2. 78), ( 10. 14 ± 1. 46)),the physical abuse ((16. 98±3. 21),(8. 31±1. 24)),the sexual abuse ((8. 74±1. 87),(7. 85± 1. 71)),the emotional neglect (( 21. 46 ± 1. 95), ( 15. 71 ± 2. 12)) and total score of childhood abuse ((81. 98±9. 88),(54. 10±4. 36)) between the two group (F=68. 88,70. 91,2. 91,45. 93,77. 28,all P<0. 01). There were significant differences in the resilience (F=4. 47,P<0. 01),the power ( F=5. 59,P<0. 01),the optimism (F=2. 35,P=0. 033) and total score of psychological resilience ( F=7. 23,P<0. 01) between the two group. Logistic regression analysis showed that attack in early age( B=2. 57,P=0. 024,OR (95%CI)=13. 07(1. 01-169. 54)) was a risk factor for psychotic symptoms in patients with depression. No experience of childhood abuse (B=-1. 95,P=0. 003,OR( 95% CI)= 0. 14(0. 04-0. 52)),the higher psy-chological resilience level(B=-2. 54,P<0. 01,OR(95%CI)=0. 08(0. 02-0. 27)),mild to moderate depres-sion (B=-1. 33,P=0. 013,OR(95%CI)=0. 27(0. 09-0. 76))were protective factors of psychotic symptoms in patients with depression. Conclusion Psychological resilience may be the protective factor for psychotic symptoms in patients with depression while childhood abuse may be a risk factor.

Theory of mind in male methamphetamine addicts and the relationships with their psychotic symptoms / 中国神经精神疾病杂志

Objective To investigate the difference of Theory of Mind (ToM) processing (especially in social-perceptual component and social-cognitive component) in male methamphetamine (METH) addicts, and test whether the deficits of ToM is correlated with their psychotic symptoms or not. Methods Thirty METH addicts with psychotic symptoms (METH-P group), 31 METH addicts with no psychotic symptoms (METH-NP group) and 41 healthy controls (control group) were recruited. Eyes Task and Faux pas Task were used to test the social-perceptual component and social-cognitive component in all participants. The psychotic symptoms of METH addicts were assessed using Brief Psychiatric Rating Scale (BPRS). Results Compared with control group, performance was poor in Eyes Task and Faux pas Questions in both METH-P group and METH-NP group (P＜0.05). Performance in Eyes Task was poorer in METH-P group than in METH-NP group (P＜0.05). There were no significant differences in performance in Faux pas Questions scores between METH-P group and METH-NP group (P＞0.05). Multivariate linear regression analysis demonstrated that BPRS positive symptom score were correlated with Eyes Task scores of METH addicts (β=-0.415, P=0.001). Conclusions METH addicts exhibit deficits in both ToM social-perceptual component and ToM social-cognitive component. METH-associated psychosis are related to the deficit in social-perceptual component of ToM.

Hippocampal Atrophy and Psychotic Symptoms in Patients with Alzheimer's Disease / 신경정신의학

OBJECTIVES: This study examined the difference in the volume or thickness of the medial temporal lobe between Alzheimer's disease patients with psychosis (AD+P) and those without psychosis (AD−P). METHODS: Overall, 31 AD+P patients and 29 AD−P patients were included from the Memory impairment clinics of Pusan National University Hospital in Korea. AD+P was diagnosed according to Jeste and Finkel's proposed diagnostic criteria for psychosis of Alzheimer's disease. AD−P included AD patients with no psychotic symptoms during a 5-year follow-up period. Medial temporal volume or thickness was measured by 3-tesla MRI and freesufer analysis. Analysis of variance was used to examine the difference in the volume or thickness of medial temporal lobe between AP+P and AD−P after controlling for age, gender, education years, Clinical Dementia Rating scale-Sum of Box, and total intracranial volume. RESULTS: The hippocampal volume in AD+P was smaller than that in AD−P. CONCLUSION: These findings suggest that AD+P is associated with a reduced hippocampal volume.

Altered Cortical Thicknesses of Left Pars Opercularis and Left Lateral Occipital Gyrus Can Be Associated with Psychotic Symptoms in Patients with Alzheimer's Disease

OBJECTIVE: The aims of this study was to present an association between the presence of psychotic symptoms and cortical thicknesses/subcortical volumes in patients with Alzheimer's disease (AD). METHODS: Fourteen AD patients with psychotic symptoms and 41 without psychotic symptoms underwent 3T MRI scanning. After adjusting the effects of confounding variables, the cortical thicknesses were compared between the AD patients with and without psychotic symptoms in multiple regions, across the continuous cortical surface. In addition, the subcortical volumes were compared with a structure-by-structure manner. RESULTS: AD patients with psychotic symptoms were characterized by significant smaller cortical thickness of left pars opercularis (F=4.67, p=0.02) and left lateral occipital gyrus (F=6.05, p=0.04) rather than those without psychotic symptoms, after adjusting the effects of age and scores on the Stroop test, non-psychotic items of Neuropsychiatry Inventory and Clinical Dementia Rating, triglyceride level and total intracranial volume. However, there were no significant differences in the subcortical volume between the two groups. CONCLUSION: These results suggest that AD psychosis may reflect more severe deterioration of neuropathologic change in specific brain region.

The Sleep Characteristics of Chronic Schizophrenia Patients with Insomnia in Community-based Mental Health Services / 수면정신생리

OBJECTIVES: To evaluate sleep characteristics and factors associated with sleep disturbance in schizophrenia patients with concurrent active psychotic symptoms and insomnia. METHODS: Schizophrenia patients with insomnia and active psychotic symptoms (n = 63) were recruited from communitybased mental rehabilitative facilities. Sleep scales such as the Korean version of the Insomnia Severity Index (ISI-K) and the Korean Version of the Pittsburgh Sleep Quality Index (PSQI-K) were evaluated and those with ISI-K >15 were included in the study. Psychotic, anxiety and depressive symptoms were rated with the Brief Psychotic Rating Scale (BPRS), the Korean Version of the Anxiety Sensitivity Index (K-ASI), and the Korean Version of the Beck Depression Inventory-I (K-BDI), respectively. Pearson correlation analyses were performed between the sociodemographic data, ISI-K and PSQI-K. Multiple linear regression analysis was conducted to investigate the factors which affected the ISI-K and PSQI-K. RESULTS: The mean ISI-K and PSQI-K scores were 18.1 ± 2.6 and 12.0 ± 2.2, respectively. Pearson correlation analysis showed a negative correlation between age of onset and ISI-K score and positive correlations between BRPS and PSQI-K scores and between K-ASI and both ISI-K and PSQI-K scores. Multiple regression analyses for both ISI-K and PSQI-K with K-ASI, age of onset, and BPRS as covariates revealed K-ASI as the only significant remaining factor. CONCLUSION: Our study suggests that anxiety symptoms are associated with insomnia symptoms in schizophrenia patients regardless of depressive or psychotic symptoms.

Analysis of clinical features and its influencing factors of depression patients with and without psy-chotic symptoms / 中华行为医学与脑科学杂志

Objective To analyze the clinical features and its influencing factors of depression pa?tients with and without psychotic symptoms. Methods According to the presence of psychotic symptoms, 374 patients with major depression were divided into psychotic major depression ( PMD group,79 case) and nonpsychotic major depression ( NMD group,268 case) . All patients completed social demographic question?naire ( including gender,age,marital status,educational level,family history,positive family history of psychi?atric disorder,disease onset age,frequency of attack,times of hospitalization,etc.) and Hamilton's depression scale (HAMD?24). Results Positive family history(PMD group 47/79,NMD group 104/268, P<0.01), psychiatric disorder positive family history(PMD group 19/79,NMD group 26/268, P<0.01) and times of hospitalization(PMD group(2.52±1.29),NMD group(1.39±1.31), P<0.01) in the PMD group were signifi?cantly higher than the NMD group.HAMD total scores(PMD total score(47.85±8.69),NMD total score (43.44±8.51), P<0.01),the factor score of anxiety/somatization(PMD group(11.40±3.28),NMD group (9.19±3.54), P<0.01) and cognitive impairment(PMD group(12.24±3.77),NMD group(9.45±3.68), P<0.01) in the PMD group were significantly higher than the NMD group.Disease onset age(PMD group(30.09 ±5.17),NMD group(35.95±9.06), P<0.01),the course of the disease(PMD group(1.58±0.76),NMD group(3.02±2.87), P<0.01),the factor score of day and night change(PMD group(0.76±0.46),NMD group(1.01±0.51), P<0.01) in PMD group were significantly lower than the NMD. Logistic regression anal?ysis showed the major depression with positive family history of mental disorders( β=3.278) ,attack in early age( β=-2.524),seriously cognitive dysfunction in patients( β=3.836) may indicate the psychotic symp? toms( P<0.05).Conclusion PMD patients more positive family history,psychiatric disorder positive family history,likely to be hospitalization,severe symptoms and attack in early age compared with NMD. With posi?tive family history of mental disorders,attack in early age,seriously cognitive dysfunction in patients with ma?jor depression may indicate the psychotic symptoms.

Epilepsia, psicose e religiosidade – Caso clínico / Epilepsy, psychosis and religiosity – A case report

Os autores apresentam o caso de uma paciente de 61 anos, com antecedentes depressivos e história de síncopes, que desenvolve, no espaço de meio ano, alterações de comportamento pautadas por hiper-religiosidade, ideias delirantes de grandiosidade e fenômenos compatíveis com déjà vu. Nesse contexto, foi referenciada pelo médico de família para a urgência de psiquiatria, tendo sido realizada investigação orgânica e identificada epilepsia do lobo temporal após realização de eletroencefalograma. Foi medicada com valproato de sódio, na dose de 750 mg/dia, com esbatimento progressivo da sintomatologia psicótica. Com este trabalho, os autores pretendem sublinhar a importância da exploração orgânica dos sintomas neuropsiquiátricos, antes de atribuir um diagnóstico psiquiátrico ao paciente.

The authors report the case of a 61 years-old woman, with history of depressive episodes and syncope, who developed hyperreligiosity, grandiose delusions and déjà vu. She was admitted to a psychiatry emergency and the electroencephalogram identified temporal lobe epilepsy. She was medicated with valproate sodium 750 mg/day with remission of psychotic symptoms and return to premorbid function. The purpose of this work is to highlight the importance of organic investigation in the assessment of neuropsychiatric symptoms.

A Rare Case Of Sub-Acute Form Of Marchiafava-Bignami Disease Presenting Predominantly With Psychotic Symptoms

Objective: The objective is to present a rare case of sub-acute form of Marchiafava-Bignami disease presenting with psychosis, minimal cognitive impairment and no clinical neurological signs. Methods: This is a case report of a patient with Marchiafava-Bignami disease presenting to a tertiary care psychiatric hospital in Singapore. A review of the literature of the condition is also presented. Results: The patient presented with prominent psychotic symptoms in the context of chronic alcohol abuse. He also had minimal cognitive impairment and clinically no neurological signs. A working diagnosis of alcohol induced psychotic disorder was made. His psychotic symptoms seemed to be resistant to treatment with antipsychotic medications initially and this led to further investigation by MRI scan of brain which revealed atrophy of corpus callosum and no other significant abnormalities. His psychotic symptoms gradually improved with treatment. He is now placed in an intermediate care setting in the hospital while waiting for a suitable community placement. Conclusions: It is rare for Marchiafava-Bignami disease to present with prominent psychotic symptoms with minimal cognitive impairment and no neurological signs clinically. In patients with a history of chronic alcohol abuse presenting with psychotic disorder, Marchiafava-Bignami disease should be suspected as a diagnostic possibility.

The global efficiency of the brain structural networks and its relationship with the psychotic symptoms in male paranoid schizophrenia / 中华行为医学与脑科学杂志

Objective To explore the differences of the global efficiency of the brain structural networks between the male paranoid schizophrenia and male healthy and its relationship with the psychotic symptoms of the schizophrenia.Methods The diffusion tensor imaging data were obtained from 27 male paranoid schizophrenia patients and 28 male healthy controls.The whole cerebral cortex was parcellated into 90 regions by the anatomical label map.Tractography was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using fiber assignment by continuous tracking(FACT) algorithm.And then the brain structural binary networks were constructed using the complex network theory.The average global efficiency of the brain network and the global efficiency of the nodes of both groups were examined by two sample t-test and its relationship with the psychotic symptoms in the male paranoid schizophrenia was explored by the correlation analysis.Results Compared with control group,the average global efficiency of the brain network of the patients decreased significantly (7.87±0.56,8.17±0.56,P=0.005),and the global efficiency of the nodes in the brain network of the patient decreased significantly in the left superior frontal gyrus (orbital part) (P=0.00025),the left superior parietal gyrus (P=0.00011),the left cuneus (P=0.00012) and the left putamen (P=0.00032),all survived FDR correction.Significant negative correlation was found between the global efficiency of the left putamen and the total scores (r=-0.43,P=0.03),the positive scores (r=-0.41,P=0.03) and the cognitive scores (r=-0.40,P=0.04) of PANSS.Conclusion The decreased global efficiency of the left frontal,parietal and occipital lobes and the subcortical structures lead to the occurrence of schizophrenia.And the reduced efficiency of the subcortical structures is associated with the positive symptoms and the abnormal cognitive function of the patients.

A Case of Withdrawal Psychosis from Internet Addiction Disorder

Similar to substance use disorder, patients with Internet addiction disorder (IAD) show excessive use, tolerance and withdrawal symptoms. We report a case of a patient with withdrawal psychosis who showed persecutory delusion and disorganized behaviors in addition to common withdrawal symptoms such as agitation and irritability. A 25-year-old male developed a full-blown psychotic episode within one day after discontinuing an Internet game that he had been playing for at least eight hours a day for two years. Upon admission, he had no abnormal brain imaging findings and laboratory tests. With antipsychotic medication (quetiapine up to 800 mg), his psychotic symptoms rapidly subsided and after four days of treatment, he no longer showed any signs of psychosis. This case report suggests that brief psychosis can develop during withdrawal from long-term excessive use of an Internet and the central pathology beneath the IAD is more likely a form of addiction than impulse control.

Revisión crítica de la propuesta del DMS-5: el "síndrome de síntomas psicóticos atenuados" / Critical revision of the proposed DSM-5

Se considera la propuesta del Grupo de Trabajo en Psicosis del DSM‑5 de incluir el ®síndrome de síntomas psicóticos atenuados¼ (previamente: ®riesgo de psicosis¼) como categoría diagnóstica. Es un paso necesario, ya que el DSM‑IV no posibilita diagnosticar formas psicóticas menores o en fase inicial, pero el intento evidencia que la nosología actual no permite hacerlo. Los criterios diagnósticos propuestos son semejantes a los criterios nucleares de los trastornos psicóticos del DSM‑IV, con dos variantes: a) que los síntomas son atenuados y con prueba de realidad conservada y b) que la sumatoria propuesta es dimensional y no categorial (estructural), como lo es la sumatoria algorítmica y disyuntiva del DSM‑IV. Para que la construcción de la categoría diagnóstica exprese la realidad clínica que fundamenta la propuesta son necesarios principios psicopatológicos diferentes a los que organizan el proyecto del DSM‑5.

The proposal of the DSM‑5’s Psychosis Work Group to include “attenuated psychotic symp‑toms syndrome” (previously: “psychosis risksyndrome”) as a diagnostic category is consi‑dered. To identify the first phase of psychosisis a necessary step, taking into account thatthe DSM‑IV does not allow to diagnose neitherminor psychotic forms, nor initial phase forms. However, the attempt makes evident that the current nosology does not enable to do so. The suggested diagnostic criteria are similar to the nuclear criteriafor Psychotic Disorders of theDSM‑IV, but with two variants: a) that the symptoms are “in attenuated form with intact reality testing” and b) that the proposed summationis dimensional and not categorical (structural),as well as the algorithmic and disjunctive sum‑mation of the DSM‑IV. In order to build the diagnostic category expressing the clinical reality underlying the proposal of the Psychosis WorkGroup, different psychopathological principlesthan those that organize the draft of the DSM‑5are required.

Rasgos de personalidad en pacientes con esquizofrenia / Personality traits in patients with schizophrenia

In recent years, research on the comorbidity of personality disorders and other clinical conditions has increased. Nevertheless, it is quite surprising that very little research has been done in terms of personality and its disorders in patients with schizophrenia. Most of the studies related to the binomial construct of personality disorders and schizophrenia are limited to the study of premorbid personality, which emphasizes the importance of the interaction between trait-personality disorder-schizophrenia symptoms. The study of personality in patients with schizophrenia suggests several issues that must be considered, including the trait-state interactions and the role of personality in the course of schizophrenia. The conceptual definition of trait emerges from the dimensional classification of models of personality. In this way, knowing that some personality features are present in all individuals, we can assume that their deviation in a quantitative level results in abnormal personality features that constitute personality disorders or even can be expressed as a specific expression of some schizophrenia symptoms. Although there is growing evidence in the knowledge of schizophrenia, there are very few models that include the scientific neurobio-logical evidence of the disease and personality features. An inclusive model may promote our understanding of the relationship between schizophrenia symptoms and the personality features of the patient who suffers the disease. So far, we are still far from reaching scientific consensus to be unanimously shared by all researchers with respect to both issues. Nevertheless, the importance of personality in schizophrenia is undeniable, so future longitudinal that assess personality characteristics since illness onset should be warranted. These studies may be extremely useful to determine personality stability during the course of the illness and may help to determine the prognosis and treatment implications of personality in schizophrenia.

En los últimos años han proliferado las investigaciones y publicaciones sobre la comorbilidad de los trastornos de personalidad con otras entidades clínicas. En este marco sorprende la escasez de estudios que se centren en la personalidad y sus trastornos en los pacientes con esquizofrenia. Las investigaciones llevadas a cabo en el binomio trastorno de personalidad-esquizofrenia se han limitado al estudio de la personalidad premórbida, las cuales se orientan hacia la importancia de la interacción rasgo-trastorno de personalidad-síntomas en la esquizofrenia. El estudio de la personalidad en la esquizofrenia sugiere varias cuestiones que deben ser consideradas, incluyendo las interacciones rasgo-estado y la función de la personalidad en la esquizofrenia. El concepto de rasgo surge en los modelos dimensionales de clasificación de la personalidad. Si consideramos que los rasgos de la personalidad están presentes en todos los individuos, cabría decir que una desviación en el nivel cuantitativo de los mismos caracteriza los rasgos anormales que constituirán los trastornos de personalidad o en una expresión específica de los síntomas de la esquizofrenia. A pesar de los avances crecientes en el conocimiento de la esquizofrenia, existen pocos modelos que integren los avances neurobiológicos con la personalidad, lo cual permitiría un mayor entendimiento de la relación entre los síntomas de la esquizofrenia y la personalidad del individuo que la padece. Hasta el momento, aún nos encontramos lejos de poder alcanzar acuerdos científicos que sean compartidos unánimemente por todos los investigadores con respecto a ambas cuestiones. Sin embargo, la importancia de la personalidad en la esquizofrenia es innegable, lo que hace necesario la realización de estudios longitudinales que evalúen de forma específica las características de la personalidad desde el inicio de la esquizofrenia para poder determinar su estabilidad o variabilidad de acuerdo al curso del padecimiento y sus implicaciones pronósticas y de tratamiento.

A Case of Right Cerebellopontine-Angle Lesion: Psychotic Symptoms and Magnetic Resonance Imaging Findings

Here, we report psychotic symptoms together with a right cerebellopontine-angle lesion. A37-year-old female patient presented with a trigeminal Schwannoma occupying the right cerebellopontine angle. Her psychotic symptoms included auditory hallucinations and delusions of persecution. T1- and T2-weighted images on magnetic resonance imaging (MRI) revealed hyperintense and hypointense areas in the right cerebellopontine angle, respectively. The clinical and neuroimaging reviews in this case suggest that sudden onset of psychotic symptoms at a mature age may be associated with a right cerebellopontine-angle lesion and that MRI should be used to evaluate possible organic bases in patients that present with psychosis.

Clinical applications of quantum resonance spectrometer in schizophrenic symptoms detection / 中华行为医学与脑科学杂志

Objective To investigate if the quantum resonance spectrometer(QRS) can detect the schizophrenic symptoms in clinical applications.Methods According to the result of QRS test and ICD-10 diagnostic criteria and exclusion criteria, subjects were divided into patient( n = 65 ) and control groups( n = 100).11 schizophrenia-related symptoms were detected by QRS.Data was analyzed using SPSS13.0 statistical software statistical significance was set at P＜0.05.Results Sensitivity and specificity of QRS in the schizophrenic symptoms detection respective were hallucinations (0.887,0.851 ), lenovo undisciplined (0.847,0.868 ), thought insertion (0.800,0.843 ), logical thinking perversion ( 0.813,0.879 ), delusions ( 0.873,0.884 ), apathy ( 0.603,0.891 ), will decrease (0.883,0.886), environmental disorientation ( 0.574,0.837 ), self-disorientation ( 0.609,0.802) , double disorientation (0.603,0.843 ) and insight (0.862,0.869).Conclusion QRS detection possess higher authenticity, consistency and the high diagnostic value in the schizophrenic symptoms, special in hallucinations,thought disorder,insight symptoms.

Application of Perphenazine to Treat Psychotic Symptoms of Senile Dementia:31 Case Report / 中国康复理论与实践

@#Objective To observe the effect of small dosage of perphenazine(2～6 mg)on psychotic symptoms of senile dementia.Methods 31 senile cases with psychotic symptoms after dementia(Alzheimer disease or vascular dementia)accepted small dosage of perphenazine in addition of the conventional therapy.They were assessed with Sadoz Clinical Assessment Geriatric(SCAG)and Treatment Emergent Symptom Scale(TESS).Results The score decreased 50%～75%(markedly improved)in 2 cases,25%～50%(improved)in 22 cases,lower than 25%(no improved)in 7 cases.Some mild emergent symptoms have been observed.Conclusion Small dosage of perphenazine is safe and effective in treating psychotic symptoms of senile dementia.