Cognitive insight and acute psychosis in schizophrenia

WOS: 000251614600009PubMed ID: 18081624Cognitive insight is a new concept. There are very few data regarding the relationship between cognitive insight and positive symptoms. The goal of the present study was to investigate the impact of acute psychosis (delusions and hallucinations) on overconfidence in judgments and self-reflectiveness of patients with schizophrenia. The Beck Cognitive Insight Scale was used to compare the cognitive insight of schizophrenia patients with (n = 93) and without (n = 45) current psychotic symptoms. Clinical symptoms and clinical insight of the patients were also assessed. The present findings suggest that both overconfidence in judgments and impaired self-reflectiveness are associated with acute psychosis. Only diminished self-reflectiveness seem to be improved following hospitalization. Although overconfidence of schizophrenia patients in their judgments was more severe in schizophrenia patients with psychotic symptoms, self-certainty of schizophrenia patients may be a relatively persistent characteristic that is also present after recovery of psychosis. Studies with larger samples involving follow up for longer periods will be valuable to understand the nature of the relationship between cognitive insight and clinical symptoms of schizophrenia

The Relationship between Alcohol-Cannabis Use and Stressful Events with the Development of Incident Clinical Psychosis in a Community-Based Prospective Cohort

Objective: The aim of this study is to evaluate the associations between alcohol-cannabis use and forensic/stressful events with the risk of incident clinical psychosis during follow-up. Method: A community-based sample (n: 2142) was screened for clinical psychosis (schizophrenia and other psychotic disorders, affective disorders with psychotic features) at baseline and follow-up. Thus, incident clinical psychosis cases to develop during follow-up (individuals with no clinical psychosis at the baseline assessment and with clinical psychosis at the follow-up assessment) were detected (n: 27). These cases and the controls who did not report any psychotic symptoms at the follow-up assessment (n: 1691) were compared for exposure to environmental risk factors during follow-up (total n: 1718). Results: Individuals reporting heavy alcohol drinking or cannabis use during follow-up had significantly higher risk of incident clinical psychosis. The monthly frequency of drinking and cannabis use was also associated with the risk. Higher number of stressful life events exposed predicted higher risk of incident clinical psychosis. The risk of incident clinical psychosis was significantly higher in case of coexistence of two risk factors (heavy drinking, cannabis use, >= 3 stressful events), in comparison with the existence of a single risk factor (17.7 vs. 1.6%, p0.001). Conclusion: Heavy drinking, cannabis use, forensic events and stressful events were associated with the risk of incident clinical psychosis. The coexistence of multiple stressful events and disorders related to abuse of alcohol/cannabis should be considered as a warning for the development of clinical psychosis

Social functioning, theory of mind and neurocognition in outpatients with schizophrenia; mental state decoding may be a better predictor of social functioning than mental state reasoning

WOS: 000242915500002PubMed ID: 17074402Few studies have directly investigated the relationship between theory of mind (ToM) deficits and social functioning in schizophrenia. At the same time, the impact of mental state decoding tasks on social dysfunction has also not yet been investigated. In this study, the relationship between theory of mind deficits and social functioning was investigated among 50 patients with schizophrenia. A mental state decoding task known as 'The Eyes test' and a mental state reasoning task 'The Hinting test' were applied to assess ToM abilities, while the Social Functioning Scale (SFS) was used to assess social functioning. Non-ToM neurocogitive tests were also given to the patients. Results of the study show how theory of mind and working memory performances of patients with good functional outcome proved to be significantly better than those of inadequately functioning patients. Results also indicate that performance on the Eyes test was the best predictor of social functioning and that negative symptoms also contributed to poor social functioning. It is concluded in this study that mental state decoding skills appear to be the most important cognitive mediator of social functioning. (c) 2005 Elsevier Ireland Ltd. All rights reserved

Catechol-O-methyltransferase Val108/158Met gene and alcoholism in Turkish subjects

WOS: 000301993300014Aim: To determine if the functional Val108/158Met polymorphism causes a tendency toward alcohol addiction in Turkish cases. This polymorphism of the catechol-O-methyltransferase (COMT) gene has been associated with many psychiatric disorders, as well as with alcoholism. Materials and methods: The allele and genotype associations of the Val108/158Met polymorphism in 110 Turkish alcoholics and 330 healthy subjects were investigated, constituting our study and control groups, by polymerase chain reaction-restriction fragment length polymorphism. Results: Distribution of the Met/Met genotype was 16.4% to 20.6% and frequency of the Met allele was 36.8% to 39.5% in the study group compared to the control group. The results did not show any significant differences in the genotype distribution and allele frequencies of the polymorphism, neither between the study and the control groups (c(2) = 0.985, P = 0.611 and c(2) = 0.517, P = 0.472) nor between female (c(2) = 0.247, P = 0.884 and c(2) = 0.115, P = 0.735, respectively) and male (c(2) = 0.728, P = 0.695 and c(2) = 0.485, P = 0.486, respectively) alcoholics. The power of the study for genotype analysis was set at 79.1%. Conclusion: The present study shows that the polymorphic Met allele of the COMT polymorphism is not associated with alcoholism in Turkish cases; however, due to the lack of statistical power, this research should be evaluated again with an enlarged study group to confirm the possible association between the polymorphism and alcoholism

Early Onset Schizophrenia Associated With Obsessive-Compulsive Disorder: Clinical Features and Correlates

WOS: 000416337200002PubMed ID: 28976410Objectives Obsessive-compulsive disorder (OCD) is notably a comorbid disorder in patients with schizophrenia. This study aimed to evaluate clinical features and correlates of early onset patients with schizophrenia with OCD. Methods In the present study, we included 10 patients with both schizophrenia and OCD and 19 patients with schizophrenia without OCD. The mean antipsychotic doses the patients needed for treatment are standardized as chlorpromazine equivalent dose. Results The mean antipsychotic doses at first episode were 491 376 mg/d in schizophrenia comorbid OCD group and 290 +/- 209 mg/d in the schizophrenia without OCD group (P = 0.018). This significant difference was also found for the mean doses at the assessment for the study (512.40 +/- 336.22 mg/d in schizophrenia comorbid OCD and 296.05 +/- 147.25 mg/d in patients with schizophrenia without OCD, P = 0.012). There was no statistical difference in the mean scores of Clinical Global Impression and Positive and Negative Syndrome Scale between schizophrenia with and without OCD group, respectively. (Clinical Global Impression: 5 +/- 0.66 vs 4.36 +/- 0.83, P = 0.094; Positive and Negative Syndrome Scale: 67.60 +/- 11.84 vs 69.84 +/- 14.62, P = 0.573). Conclusions Adolescents with schizophrenia and OCD needed more antipsychotic doses for acute exacerbation and the maintenance of reduction of psychosis severity than adolescents with only schizophrenia. We could suggest that OCD comorbidity in schizophrenia is more treatment resistant, although the severity of the schizophrenia was similar between study groups. There was no correlation between OCD and schizophrenia symptoms either

Bilateral keratoconus, acute hydrops and unilateral corneal perforation due to Tourette syndrome

WOS: 000477774300013PubMed ID: 31384164A 27-year-old male with a repetitive behavior of eyeball pressing for six months presented with decreasing visual acuity for three months. Upon arrival his best corrected visual acuity was 0.2 on the right and 0.6 on the left eyes. Scheimpflug camera system demonstrated grade 4 and grade 2 keratoconus, respectively. Psychiatric consultation revealed Tourette syndrome and treatment was started. Despite psychiatric treatment, acute hydrops occurred in both eyes decreasing visual acuity to hand motions bilaterally. Left corneal perforation due to ongoing habit of eyeball pressure was experienced which led the loss of light perception and phtisis bulbi. Although Tourette syndrome is rare, it might cause bilateral acute onset keratoconus when the repetitive movements affect periocular region. Psychiatric treatment should be considered as early as possible in these patients in order to prevent unfavorable complications

Psychotic experiences and mood episodes predict each other bidirectionally:a 6-year follow-up study in a community-based population

WOS: 000462755900006PubMed ID: 30671600BackgroundPsychotic experiences (PEs) are not exclusive to psychotic disorders and highly correlated with mood episodes. In this representative general population-based study, longitudinal bidirectional associations between the extended psychosis phenotype and mood episodes were investigated, accounting for other possible causes.MethodsHouseholds were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighbourhoods at baseline (n=4011) and at 6-year follow-up (n=2185). Participants were interviewed with the relevant sections of the composite international diagnostic interview both at baseline and at follow-up. Sociodemographic, familial and environmental risk factors associated with the extended psychosis phenotype and mood episodes were assessed. Logistic regression and cross-lagged panel correlation models were used for the associations between the extended psychosis phenotype and mood episodes.ResultsPEs were associated with subsequent depressive and manic episodes. There was bidirectionality in that mood episodes were associated with subsequent PEs, and PEs were associated with subsequent mood episodes. The associations occurred in a sub-additive pattern. There were substantial synchronous and cross-lagged correlations between these psychopathology domains, with reciprocally similar cross-lagged correlations. Familial risk and adverse life events were associated with both psychopathology domains, whereas some sociodemographic risk factors and alcohol/cannabis use were associated with only one domain.ConclusionThe sub-additive bidirectional associations between PEs and mood episodes over time and the similarity of cross-lagged correlations are suggestive of mutually causal connections between affective and psychotic domains of psychopathology.Scientific and Technological Council of Turkey 1001 programmeTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [107S053, 112S476]This work is part of the TurkSch project and is funded by the Scientific and Technological Council of Turkey 1001 programme, project nos: 107S053 and 112S476

Psychotic experiences and mood episodes predict each other bidirectionally:a 6-year follow-up study in a community-based population

WOS: 000462755900006PubMed ID: 30671600BackgroundPsychotic experiences (PEs) are not exclusive to psychotic disorders and highly correlated with mood episodes. In this representative general population-based study, longitudinal bidirectional associations between the extended psychosis phenotype and mood episodes were investigated, accounting for other possible causes.MethodsHouseholds were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighbourhoods at baseline (n=4011) and at 6-year follow-up (n=2185). Participants were interviewed with the relevant sections of the composite international diagnostic interview both at baseline and at follow-up. Sociodemographic, familial and environmental risk factors associated with the extended psychosis phenotype and mood episodes were assessed. Logistic regression and cross-lagged panel correlation models were used for the associations between the extended psychosis phenotype and mood episodes.ResultsPEs were associated with subsequent depressive and manic episodes. There was bidirectionality in that mood episodes were associated with subsequent PEs, and PEs were associated with subsequent mood episodes. The associations occurred in a sub-additive pattern. There were substantial synchronous and cross-lagged correlations between these psychopathology domains, with reciprocally similar cross-lagged correlations. Familial risk and adverse life events were associated with both psychopathology domains, whereas some sociodemographic risk factors and alcohol/cannabis use were associated with only one domain.ConclusionThe sub-additive bidirectional associations between PEs and mood episodes over time and the similarity of cross-lagged correlations are suggestive of mutually causal connections between affective and psychotic domains of psychopathology.Scientific and Technological Council of Turkey 1001 programmeTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [107S053, 112S476]This work is part of the TurkSch project and is funded by the Scientific and Technological Council of Turkey 1001 programme, project nos: 107S053 and 112S476