Higher Incidence Of Psychosis Research Articles

Diagnosis of Schizophrenia and Psychosis in Māori People Using Speech Assay: A Natural Language Processing Approach

Indigenous peoples and ethnic minorities worldwide have a higher incidence of psychosis, primarily schizophrenia. In New Zealand, Māori individuals experience greater rates of anxiety and depression compared to non-Māori, with a significantly higher incidence of mental illness among Māori. We propose natural language processing (NLP) trained on speech samples from Māori patients as a potential solution to the problem of culturally biased psychometric screening tools for psychosis and schizophrenia. This research examines NLP's ability to diagnose psychosis in Māori patients by analysing speech and language abnormalities as indicators of severe mental illnesses such as schizophrenia. Our research emphasizes the need for inclusive language models and investigates cross-cultural applicability. We employed a three-part method: conducting clinical interviews, pre-processing data with the Natural Language Toolkit (NLTK) and applying language classifiers. The study's results demonstrate the promise of NLP, but limited patient data necessitates further research, including standardizing datasets and integrating NLP with indigenous languages. This research represents a step towards improving diagnostic accuracy and support for Māori people suffering from psychosis, aligning with healthcare's goal of fair and culturally responsive mental health screening.

Cognitive behavioral therapy in 22q11.2 microdeletion with psychotic symptoms: What do we learn from schizophrenia?

The 22q11.2 deletion syndrome (22q11.2DS) is one of the most common microdeletion syndromes, with a widely underestimated prevalence between 1 per 2000 and 1 per 6000. Since childhood, patients with 22q11.2DS are described as having difficulties to initiate and maintain peer relationships. This lack of social skills has been linked to attention deficits/hyperactivity disorder, anxiety and depression. A high incidence of psychosis and positive symptoms is observed in patients with 22q11.2DS and remains correlated with poor social functioning, anxiety and depressive symptoms. Because 22q11.2DS and schizophrenia share several major clinical features, 22q11.2DS is sometimes considered as a genetic model for schizophrenia. Surprisingly, almost no study suggests the use of cognitive and behavioral therapy (CBT) in this indication.We reviewed what should be learned from schizophrenia to develop specific intervention for 22q11.2DS. In our opinion, the first step of CBT approach in 22q11.2DS with psychotic symptoms is to identify precisely which tools can be used among the already available ones. Cognitive behavioral therapy (CBT) targets integrated disorders, i.e. reasoning biases and behavior disorders. In 22q11.2DS, CBT-targeted behavior disorders may take the form of social avoidance and withdrawal or, in the contrary, a more unusual disinhibition and aggressiveness. In our experience, other negative symptoms observed in 22q11.2DS, such as motivation deficit or anhedonia, may also be reduced by CBT. Controlled trials have been studying the benefits of CBT in schizophrenia and several meta-analyses proved its effectiveness. Therefore, it is legitimate to propose this tool in 22q11.2DS, considering symptoms similarities. Overall, CBT is the most effective psychosocial intervention on psychotic symptoms and remains a relevant complement to pharmacological treatments such as antipsychotics.

Older Candidates for Subthalamic Deep Brain Stimulation in Parkinson's Disease Have a Higher Incidence of Psychiatric Serious Adverse Events.

Objective: To investigate the incidence of serious adverse events (SAE) of subthalamic deep brain stimulation (STN-DBS) in elderly patients with Parkinson's disease (PD).Methods: We investigated a group of 26 patients with PD who underwent STN-DBS at mean age 63.2 ± 3.3 years. The operated patients from the EARLYSTIM study (mean age 52.9 ± 6.6) were used as a comparison group. Incidences of SAE were compared between these groups.Results: A higher incidence of psychosis and hallucinations was found in these elderly patients compared to the younger patients in the EARLYSTIM study (p < 0.01).Conclusions: The higher incidence of STN-DBS-related psychiatric complications underscores the need for comprehensive psychiatric pre- and postoperative assessment in older DBS candidates. However, these psychiatric SAE were transient, and the benefits of DBS clearly outweighed its adverse effects.

Caregiving in first‐episode psychosis: social characteristics associated with perceived ‘burden’ and associations with compulsory treatment

High incidence of psychosis and compulsory treatment within black and minority ethnic (BME) groups in the UK remain a concern. Psychosis has an impact on families and family involvement is important in predicting compulsory treatment. We therefore aimed to report the levels and predictors of caregiver burden in first-episode psychosis, in white British, and BME groups of carers, and investigate their relevance to compulsory treatment. A total of 124 caregivers were interviewed soon after the onset of psychosis using the General Health Questionnaire, GHQ-28, the Experience of Caregiving Inventory, the Personal and Psychiatric History Schedule, and the MRC Sociodemographic Schedule. The overall level of distress as measured by GHQ-28 was high (mean 50, SD 11.4). Feelings of carer burden were also high (mean total negative score 72.5, SD 34.8), increased in men, and with carer age. Neither ethnicity nor social class nor social support was associated with distress or burden. Compulsory treatment was predicted by carer burden (as indicated by carer reports of 'problems with services' (OR 1.08; 95% CI 1.01, 1.15; P = 0.023)); this was particularly evident in the black Caribbean group of carers (OR 1.28; 95% CI 1.04, 1.57; P = 0.02) CONCLUSION: Carers of adults with first-episode psychosis experience considerable psychological distress and feelings of burden. There was a specific association between carer burden, specifically in terms of experience of services, and compulsory admission of service users, particularly in the black Caribbean group. Better ways of liaising with carers and targeted efforts to reduce carer burden at illness onset are needed.

P-632 - Socioeconomic status and population density risk factors for psychosis? a prospective incidence and period prevalence study of the maltese islands

Introduction Research suggests that urbanicity and lower socio-economic status are risk factors for psychosis. Aims and objectives To calculate the incidence and period prevalence of patients admitted with psychosis in Malta, and to examine differences between districts. To date, this is the first study of its kind carried out in the Maltese Islands. Methods One year prospective cross-sectional study, including all ICD-10 psychosis patients admitted to any one of the three psychiatric hospitals (n = 180). Results Incidence of hospital admissions due to psychosis was 26.0 at risk per year per 100, 000 population. Period prevalence for 6 years was 41.9 per 100,000 person-years. Highest incidence: Southern-Harbour area (32.1, CI = 31.9–32.3), and lowest incidence: Western District (20.1, CI = 19.9–20.2). The period prevalence was highest in Gozo District (63.9, CI = 63.2–64.7). 5.2% of participants were irregular migrants, having an approximate estimate for incidence of psychosis of 400 per 100,000 person years at risk. Conclusion The high incidence of psychosis may be explained by the fact that Malta is the eighth most densely populated country worldwide. The district with the lowest socio-economic groups were found to have the highest incidence of psychosis, followed by the most densely populated district. Cultural factors, small genetic pool or readily available services could account for the high period prevalence in the Gozo district -a more rural area. Higher education in the Western district area could partially explain the lower incidence. Multiple Stressors and trauma may partially be the reasons for the much higher incidence rate in the irregular immigrant group.

Ethnicity and age at onset in bipolar spectrum disorders.

IntroductionTo determine the influence of ethnicity on the age at onset (AAO) and further understand the significance of AAO as a clinical marker of bipolar and schizoaffective disorders. Admixture analysis was used to identify sub-groups characterized by differences in AAO. Differences in clinical features were analyzed for these sub-groups using multivariate logistic regression. Comparisons were made with previous studies using the 2-Sample Kolmogorov-Smirnov Test. Admixture analysis yielded a combination of 2 normal theoretical distributions with means (SD) of 16.9 (3.6) for the early-onset sub-group and 24.4 (9.2) years for the late-onset sub-group. The sub-groups were divided by a cut-off of 22 years. There were significant differences between the early and late onset bipolar patient populations regarding substance abuse comorbidity (P=.044) and psychotic features (P=.015). Ethnicity did not have a significant influence on the AAO.DiscussionThe associations between early-onset and higher incidence of psychosis and substance abuse in our sample are consistent with other studies exploring the AAO in bipolar disorder. Our findings support the notion of AAO as a clinical marker for the underlying heterogeneity of bipolar spectrum disorders. In particular, we found a strong overlap of early AAO with clinical features associated with greater severity and poor outcome.

Course and outcome of psychosis in black Caribbean populations and other ethnic groups living in the UK: A systematic review

A higher incidence of psychosis has repeatedly been reported in black Caribbean populations in the UK. This has been attributed to a number of biological, psychological and sociocultural causes, including black Caribbean populations having a different illness course and outcome compared to other ethnic populations living in the UK. A systematic review of UK-based quantitative studies, which compared at least two aspects of outcome in black Caribbean populations and other ethnic populations living in the UK, was conducted to assess whether the current body of research suggests that there are differences in the course and outcome of psychoses for these populations. A wide variety of databases were searched using MeSH terms and keywords. Studies were evaluated according to specified inclusion criteria and analysed using predefined scoring criteria. Searches yielded a heterogeneous collection of studies. Large variances in methodological approaches and the quality of studies were reported. Many studies reported little or no difference between black Caribbean and other ethnic populations living in the UK. Emphasis is placed on the unreliability of these findings given the methodological limitations of the studies, and the need for higher-quality research in this area is highlighted.

Perceptions of disadvantage, ethnicity and psychosis

People from Black ethnic groups (African-Caribbean and Black African) are more prone to develop psychosis in Western countries. This excess might be explained by perceptions of disadvantage. To investigate whether the higher incidence of psychosis in Black people is mediated by perceptions of disadvantage. A population-based incidence and case-control study of first-episode psychosis (Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP)). A total of 482 participants answered questions about perceived disadvantage. Black ethnic groups had a higher incidence of psychosis (OR= 4.7, 95% CI 3.1-7.2). After controlling for religious affiliation, social class and unemployment, the association of ethnicity with psychosis was attenuated (OR=3.0, 95% CI 1.6-5.4) by perceptions of disadvantage. Participants in the Black non-psychosis group often attributed their disadvantage to racism, whereas Black people in the psychosis group attributed it to their own situation. Perceived disadvantage is partly associated with the excess of psychosis among Black people living in the UK. This may have implications for primary prevention.

Ethnicity and the Mental Health Act 1983

Black and minority ethnic (BME) patients are disproportionately detained under the Mental Health Act 1983. There has been no systematic exploration of differences within and between ethnic groups, nor of the explanations put forward for this excess. To systematically review detention and ethnicity, with meta-analyses of detention rates for BME groups, and to explore the explanations offered for ethnic differences in detention rates. Literature search and meta-analysis. Explanations offered were categorised, supporting literature was accessed and the strength of the evidence evaluated. In all, 49 studies met inclusion criteria; of these, 19 were included in the meta-analyses. Compared with White patients, Black patients were 3.83 times, BME patients 3.35 times and Asian patients 2.06 times more likely to be detained. The most common explanations related to misdiagnosis and discrimination against BME patients, higher incidence of psychosis and differences in illness expression. Many explanations, including that of racism within mental health services, were not supported by clear evidence. Although BME status predicts psychiatric detention in the UK, most explanations offered for the excess detention of BME patients are largely unsupported.

Psychosis, psychopathy, and homicide: a preliminary neuropsychological inquiry.

This study attempted to statistically distinguish subgroups of murderers with mental disorders from among 26 hospitalized men (mean age=34 years) who were committed to a maximum security forensic hospital. Measures consisted of objective ratings of psychosis and psychopathy and neuropsychological tests of intelligence, memory and attention, executive functions, and academic abilities. Cluster analysis produced two distinct subgroups: one defined by high incidence of psychosis and low level of psychopathy and one by low incidence of psychosis and high level of psychopathy, each corresponding to distinct neuropsychological differences in intellectual abilities, learning disabilities, and social intelligence. In light of this relatively small, highly select group, these novel findings must be viewed as preliminary. Studies of larger cohorts are needed before definitive conclusions can be drawn as to the reliability of these two distinct symptom clusters, each independently validated by neuropsychological measures of intelligence, sociality, and academic abilities.

The Postictal Psychosis of Epilepsy: Investigation in Two Patients

Patients with epilepsy have a higher incidence of psychosis. Epilepsy-related psychotic behaviors include a chronic interictal schizophreniform illness, an "alternating psychosis" which remits with seizure activity, and ictal or perictal psychotic behaviors. In addition, there is an uncommon and less understood psychosis characterized by brief psychotic episodes during the postictal period. This report describes two patients with postictal psychosis and correlates their behavior with the pattern of seizures, electroencephalographic discharges, and anticonvulsant and psychotropic medications. The findings suggest that postictal psychosis results from increased epileptiform activity and continued cerebral dysrhythmia, has a latency in onset and is not due to the immediate postictal delirium, and reflects an exacerbation of underlying psychopathological tendencies. This report further discusses the potential pathophysiological mechanisms and management of this disorder.

Psychopathology in epilepsy: prevalence, phenomenology and management.

Epilepsy is associated with interictal behavioral disturbances. The pattern of specific psychopathology differs from that of other chronic diseases because of the higher incidence of psychosis and characterological disorders. Approximately 7 percent of epileptics develop a chronic atypical psychosis with paranoid and affective features, and this may be more common in patients with a definite temporal lobe focus. Brief psychotic episodes occur and are more directly related to cerebral dysrhythmia. A subgroup of epileptics develop specific personality traits, aggressive behaviors under certain circumstances, and hyposexuality. Affective illness and suicide are also prevalent. There are special issues in the management of psychopathology in the setting of epilepsy such as the relative seizure threshold lowering effects of psychotropic drugs and the behavioral effects of altering the seizure control. This article discusses both diagnostic and management aspects of the interictal psychopathology of epilepsy.

The American Expatriate in South Viet Nam

The author presents case histories of American civilians in South Viet Nam who came to psychiatric attention. Of interest were the patients' frequent past histories of psychiatric illness and their sense of failure elsewhere. The author discusses the high incidence of psychosis, alcoholism, and psychopathic behavior in this population and elucidates some of the motivations of civilians who go to Viet Nam.