Non-psychotic Disorders Research Articles

THE CHOICE OF ANTIPSYCHOTICS: CONTEMPORARY KNOWLEDGE

Antipsychotics are a group of psychoactive drugs that eliminate delusions and hallucinations, improve the ability to test reality and lead to the reintegration of psychological functions and enable a return to reality. In addition to antipsychotic, they also have sedative, anxiolytic, antidepressant, antimanic stabilizing, anti-suicidal and antiemetic effects, therefore the drugs are used in the treatment of various other non-psychotic disorders. The objective of this paper is to point out the contemporary findings in the best choice of antipsychotics.We live in the period of psychopharmacology’s rapid progress and our possibilities in the treatment of psychotic disorders are increasing. In recent decades, treatment with antipsychotics has been significantly improved due to the development of new antipsychotics with better therapeutic effect and safer profile of side effects. The basic mechanism of action of antipsychotics is dopamine receptors, with an effect on the noradrenaline, serotonin, histamine, adrenergic, and cholinergic systems, and indirectly on the gamma-aminobutyric acid and glutamine system. All this makes the mechanism of action of antipsychotics extremely complex. There are several different subdivisions of antipsychotics, and in clinical practice the most common division is the so-called typical and atypical. Typical antipsychotics that achieve their mechanism of action by blocking the D2 receptor show effectiveness in the treatment of positive symptoms of schizophrenia, but have a much lower effect in the treatment of negative, affective and cognitive symptoms. They often have significant side effects. Atypical antipsychotics work on both positive and negative symptoms of psychosis. In severe forms of psychosis, they are often insufficient in the treatment of positive symptoms, so we are forced to use a combination of antipsychotics. Although antipsychotic monotherapy is the ideal therapy, in practice we are often forced to combine two or more antipsychotics, as well as combine antipsychotics with other groups of psychopharmaceuticals. It is not easy to answer whether combinations of antipsychotics are useful or not. The key to success is an individual approach, careful selection of the type and dose of antipsychotics, and the inclusion of psycho and socio-therapeutic methods that are indicated in each case individually. Keywords: antipsychotics, choice, contemporary knowledge.

Early Detection of Psychosis in Eating Disorders: Unnecessary or a Useful Addition?

The absence of consensus regarding the presence and interpretation of certain symptoms as indicative of either a psychosis spectrum disorder or an eating disorder (ED) can hinder cooperation amongst treatment programmes for the early detection of psychosis and an ED. This study trans-diagnostically assessed the prevalence and co-occurrence of at-risk mental states for a psychosis (ARMS) or the risk of having an ED (EDr), and it explored the characteristics of ARMS profiles of individuals with an EDr. This cross-sectional and observational-prevalence study used assessment outcomes from an ED screening instrument (SCOFF), a psychosis prodromal screening questionnaire (PQ16) and a CAARMS interview (to evaluate the possibility of ARMS) with newly admitted outpatients aged 16-35 who were referred for various kinds of non-psychotic disorders from a secondary Mental Health Care Centre in the Netherlands. Data analysis consisted of calculating prevalences, associations amongst variables and conditional probabilities. Of the 736 individuals who were screened, an EDr was identified in 51.2% and 49.0% of the participants who scored high on the PQ16, half of whom also completed the CAARMS interview. The results indicated that 53.0% of the participants were classified as not having ARMS, 28.3% as having ARMS and 18.7% as having a psychosis. EDr patients presented with symptoms of a psychotic spectrum disorder, which included both ED-consistent and ED-inconsistent symptoms. There were relatively frequent endorsements of the two subscale items guilt/punishment and ideas of reference. From a trans-diagnostical perspective, the results indicate that collaboration amongst ED programmes and psychosis prevention interventions should be strongly encouraged. Future researchers are encouraged to conduct studies that assess associations amongst and features of psychotic spectrum symptoms in EDs. The unexpectedly high proportion of EDr suggests that a co-morbid ED in other kinds of psychopathology is being overlooked.

Polygenic Risk Assessment for Schizophrenia in Patients with Nonpsychotic Disorders and Attenuated Symptoms of Psychosis: A Pilot Study

Background: significant contribution of genetic factors in the development of schizophrenia is a generally recognized fact. Polygenic risk index for schizophrenia turned out to be an effective tool allowing to draw a dividing line between schizophrenia and mentally healthy control in terms of genetics. Objective: to assess the predictive ability of the polygenic risk score for schizophrenia (SZ-PRS) in adolescent patients with a first depressive episode and attenuated psychotic symptoms (APS). Patients and Methods: sixty adolescent inpatient with a first depressive episode were examined. Based on the presence of APS at admission, patients were divided into two groups: a group with APS and a group without APS. Subgroups of patients in the first group were identified through follow-up observations: those with psychosis manifestation and/or low social functioning and those without manifestation and with high social functioning. Whole-genome genotyping was performed for all participants, and SZ-PRS were calculated. For comparison, a group of patients diagnosed with schizophrenia (n = 879) and a group of mentally healthy individuals (n = 759), who had previously undergone whole-genome genotyping and had their SZ-PRS calculated, were used. Results: SZ-PRS of the APS group occupy an intermediate position between the healthy control and schizophrenia patients, significantly differing from each of them. The group without APS did not differ from the control group, but compared to the group of schizophrenia patients, the SZ-PRS in this group was significantly lower. Comparing subgroups of patients showed that the SZ-PRS in the APS group without psychosis manifestation and social functioning impairment was significantly lower than in the group with schizophrenia manifestation. The APS subgroups with psychosis manifestation and with functioning impairment did not differ significantly from each other or from the schizophrenia group. Conclusion: the results obtained for the first time for the russian population showed that SZ-PRS can be considered as a tool for assessing the risk of developing psychosis or reduced social functioning in patients with APS.

Animal Models of Vascular Cognitive Disorder after Myocardial Infarction: Scoping Review

Vascular cognitive disorders (VCD) are one of the most common forms of non-psychotic mental disorders with a variable phenotype and rate of progression, transformation into vascular dementia. VCD is characterized by development against the background of existing cardiovascular diseases (CVD), which explains the importance of an interdisciplinary approach to their diagnosis and treatment. The study of new mechanisms of development of VCD can help in finding the key to the development of innovative diagnostic methods and personalized treatment approaches. The purpose of this thematic review is to search, generalize and systematize domestic and foreign research in the field of fundamental neurology using methods of modeling VCD in experimental animals. The authors conducted a search for publications in the databases PubMed, Springer, Web of Science, Clinical Keys, Scopus, Oxford Press, Cochrane, e-Library using keywords and their combinations. The publications for 2005-2024 were analyzed, including original studies of VCD and vascular dementia.

Fibromyalgia in patients with non-psychotic mental disorders: Prevalence, associated factors and validation of a brief screening instrument.

Fibromyalgia (FM) is a chronic pain syndrome associated with significant distress and numerous unpleasant consequences. Mental health problems in people with FM have been reported in many studies. People with mental disorders are thought to be at higher risk of FM than the general population, but the prevalence has not been established. We aimed to investigate the prevalence of FM in a representative sample of inpatients with non-psychotic mental disorders. Additionally, we aimed to assess the psychometric properties of the Fibromyalgia Rapid Screening Tool (FiRST) in the Russian-speaking population of people with mental disorders. Consecutive inpatients admitted to the Moscow Research and Clinical Center for Neuropsychiatry for treatment of non-psychotic mental disorders were evaluated for FM by a neurologist and completed the FiRST, Beck Depression Inventory (BDI), and State and Trait Anxiety Inventory (STAI). Of the 1168 patients evaluated 9.0% met the diagnostic criteria for FM. FM was associated with being female, having a diagnosis of unipolar depression, and having higher total scores on the BDI and STAI. The psychometric properties of the FiRST were good (McDonald's omega 0.79, corrected item-total correlation greater than 0.45). An optimal cut-off point with the highest Yuden's index (J = 0.75) was >3 (AUC of 0.89). FM is a common comorbidity in people with non-psychotic mental disorders, associated with being female, having a diagnosis of unipolar depression, and having more severe anxiety and depression. The FiRST can be used for the FM screening with its cut-off >3 in people with non-psychotic mental disorders. It is the first study to determine the prevalence of FM in people with non-psychotic spectrum mental disorders. The study design included a consecutive sample in a real-life setting to avoid bias. In addition, we evaluated the psychometric properties of the FM screening instrument in a population of people with mental disorders and established the cut-off. The specificity of this subpopulation is explained by both the high prevalence of pain symptoms and the overlap of some psychiatric and FM symptoms.

A Systematic Review of Antidepressants and Psychotherapy Commonly Used in the Treatment of Late Life Depression for Their Effects on Cognition

Cognitive dysfunction is common in late life depression (LLD) and is a major risk factor for dementia. Recent studies show limited improvement in cognition with commonly employed treatments for LLD, contradicting the notion that cognition "returns to normal" with treatment. However, findings differ with the treatments used. The aim of this study is to perform a systematic review of studies of antidepressants and psychotherapies commonly employed in LLD to determine their effects on cognition, particularly processing speed, memory, and executive function. We searched for trials of acute phase treatment, in nondemented individuals 60 years and older with unipolar nonpsychotic Major Depressive Disorder, that assessed cognitive performance with neuropsychological tests before and after treatment. We compared the magnitude of change in cognition by examining within group effect sizes. Six antidepressant trials and two psychotherapy trials (both using Problem Solving Therapy)(PST) provided relatively comparable data that allowed for quantitative comparison. Nine other antidepressant trials provided descriptive findings. Sertraline and vortioxetine had significant positive effects on processing speed and memory. Duloxetine had significant effects on memory. The most selective SRIs-citalopram and escitalopram-had minimal effects on cognition and citalopram had adverse effects in depression nonresponders. PST had modest effects on processing speed and no effect on memory. Effects of practice and improvement in depression on cognition are examined. In all but one study, cognition was a secondary outcome and various quality indicators (e.g. blinding cognitive assessment to treatment) were often not reported. As a consequence, these findings must be considered preliminary.

The prevalence of anxiety in pregnant women at Chris Hani Baragwanath Academic Hospital.

Non-psychotic mental disorders are common during the perinatal period. In South Africa, there are few studies on antenatal anxiety and these results vary. Antenatal anxiety does not only add to the burden of perinatal co-morbidity but has subsequent immediate and long-term effects on the mother, birth outcomes and her offspring. The aim of this study was to determine the prevalence of anxiety symptoms in pregnant women during the antenatal period and to determine associated factors. The study was conducted at an antenatal clinic located in Chris Hani Baragwanath Academic Hospital (CHBAH), Soweto, Johannesburg. Data were collected from March to December 2022. This was a prospective, cross-sectional study in which 200 pregnant women were interviewed. A biographical questionnaire and the generalised anxiety disorder questionnaire (GAD-7) were administered. The prevalence of anxiety symptoms in pregnant women attending the antenatal clinic was 33%. Participants with anxiety were younger, employed and had lower perceived social support. Women with planned and wanted pregnancies had a lower prevalence of anxiety. One-third of the pregnant women screened positive for anxiety symptoms on the GAD-7. This is significantly higher compared to other studies carried out in the same facility previously. High-risk groups should be screened for anxiety. This study prompts further studies and guiding policies on routine screening of pregnant women for anxiety and other mental illnesses during pregnancy.

Auditory hallucinations in non-psychotic disorders – an analytical psychological perspective

Although hallucinations are a feature of psychosis, they can present in non-psychotic disorders and may occur in non-pathological states. Jung argues that unconscious complexes underpin hallucinations and further observes that some of the symptoms of ‘hysteric’ patients – including hallucinations – were also common amongst patients with schizophrenia. However, the outward presentation of symptoms was markedly different for each patient group. Jung mobilises his complex theory to explain this difference. We argue that Jung’s understanding of hallucinations applies to contemporary healthcare; it frames how hallucinations may manifest in multiple conditions, not just psychosis. This brief report discusses Jung’s theories and their continued veracity in contemporary contexts.

Approaches to the assessment of the structure and phenomenology of critical awareness in the context of non-psychotic mental disorders

Aim: systematization of the phenomena of critical self-awareness in the context of non-psychotic mental disorders and development of a tool for assessing the profile of its disorders. Materials and methods. In the period of 2020–2023, a prospective study was conducted on a contingent of outpatients with diagnoses established in the conditions of the Department of Borderline Conditions of the Municipal non-commercial enterprise “Regional Clinical Institution for the Provision of Psychiatric Care” of the Zaporizhzhia Regional Council. 75 patients: 38 men, 37 women, mean age 38.9 ± 8.6 years, without exacerbation of severe somatic diseases, without diagnostically significant psychoactive substances use history. Methods: clinical and anamnestic, psychodiagnostic in the form of a semi-structured interview, statistical using α-Cronbach’s coefficient. Results. 27 phenomena were identified as part of 7 separate components of critical self-awareness. Based on the obtained data, a psycho-diagnostic tool was formed in the form of a questionnaire, where a multiple choice question ranked on a 5-point Likert-type scale was formulated for each phenomenon. The reliability of the questionnaire according to the indicator of internal consistency of the subscales according to the Cronbach α coefficient is from “acceptable” 0.7072 to “good” 0.8820. Conclusions. The developed psychodiagnostic questionnaire can be used in further studies aimed at analyzing the problem of critical self-awareness in patients with non-psychotic mental disorders.

Evidence from comprehensive independent validation studies for smooth pursuit dysfunction as a sensorimotor biomarker for psychosis

Smooth pursuit eye movements are considered a well-established and quantifiable biomarker of sensorimotor function in psychosis research. Identifying psychotic syndromes on an individual level based on neurobiological markers is limited by heterogeneity and requires comprehensive external validation to avoid overestimation of prediction models. Here, we studied quantifiable sensorimotor measures derived from smooth pursuit eye movements in a large sample of psychosis probands (N = 674) and healthy controls (N = 305) using multivariate pattern analysis. Balanced accuracies of 64% for the prediction of psychosis status are in line with recent results from other large heterogenous psychiatric samples. They are confirmed by external validation in independent large samples including probands with (1) psychosis (N = 727) versus healthy controls (N = 292), (2) psychotic (N = 49) and non-psychotic bipolar disorder (N = 36), and (3) non-psychotic affective disorders (N = 119) and psychosis (N = 51) yielding accuracies of 65%, 66% and 58%, respectively, albeit slightly different psychosis syndromes. Our findings make a significant contribution to the identification of biologically defined profiles of heterogeneous psychosis syndromes on an individual level underlining the impact of sensorimotor dysfunction in psychosis.

Dynamic and Transdiagnostic Risk Calculator Based on Natural Language Processing for the Prediction of Psychosis in Secondary Mental Health Care: Development and Internal-External Validation Cohort Study

BackgroundAutomatic transdiagnostic risk calculators can improve the detection of individuals at risk of psychosis. However, they rely on assessment at a single point in time and can be refined with dynamic modeling techniques that account for changes in risk over time. MethodsWe included 158,139 patients (5007 events) who received a first index diagnosis of a nonorganic and nonpsychotic mental disorder within electronic health records from the South London and Maudsley National Health Service Foundation Trust between January 1, 2008, and October 8, 2021. A dynamic Cox landmark model was developed to estimate the 2-year risk of developing psychosis according to the TRIPOD (Transparent Reporting of a multivariate prediction model for Individual Prognosis or Diagnosis) statement. The dynamic model included 24 predictors extracted at 9 landmark points (baseline, 0, 6, 12, 24, 30, 36, 42, and 48 months): 3 demographic, 1 clinical, and 20 natural language processing–based symptom and substance use predictors. Performance was compared with a static Cox regression model with all predictors assessed at baseline only and indexed via discrimination (C-index), calibration (calibration plots), and potential clinical utility (decision curves) in internal-external validation. ResultsThe dynamic model improved discrimination performance from baseline compared with the static model (dynamic: C-index = 0.9; static: C-index = 0.87) and the final landmark point (dynamic: C-index = 0.79; static: C-index = 0.76). The dynamic model was also significantly better calibrated (calibration slope = 0.97–1.1) than the static model at later landmark points (≥24 months). Net benefit was higher for the dynamic than for the static model at later landmark points (≥24 months). ConclusionsThese findings suggest that dynamic prediction models can improve the detection of individuals at risk for psychosis in secondary mental health care settings.

A transdiagnostic prodrome for severe mental disorders: an electronic health record study.

Effective prevention of severe mental disorders (SMD), including non-psychotic unipolar mood disorders (UMD), non-psychotic bipolar mood disorders (BMD), and psychotic disorders (PSY), rely on accurate knowledge of the duration, first presentation, time course and transdiagnosticity of their prodromal stages. Here we present a retrospective, real-world, cohort study using electronic health records, adhering to RECORD guidelines. Natural language processing algorithms were used to extract monthly occurrences of 65 prodromal features (symptoms and substance use), grouped into eight prodromal clusters. The duration, first presentation, and transdiagnosticity of the prodrome were compared between SMD groups with one-way ANOVA, Cohen's f and d. The time course (mean occurrences) of prodromal clusters was compared between SMD groups with linear mixed-effects models. 26,975 individuals diagnosed with ICD-10 SMD were followed up for up to 12 years (UMD = 13,422; BMD = 2506; PSY = 11,047; median[IQR] age 39.8[23.7] years; 55% female; 52% white). The duration of the UMD prodrome (18[36] months) was shorter than BMD (26[35], d = 0.21) and PSY (24[38], d = 0.18). Most individuals presented with multiple first prodromal clusters, with the most common being non-specific ('other'; 88% UMD, 85% BMD, 78% PSY). The only first prodromal cluster that showed a medium-sized difference between the three SMD groups was positive symptoms (f = 0.30). Time course analysis showed an increase in prodromal cluster occurrences approaching SMD onset. Feature occurrence across the prodromal period showed small/negligible differences between SMD groups, suggesting that most features are transdiagnostic, except for positive symptoms (e.g. paranoia, f = 0.40). Taken together, our findings show minimal differences in the duration and first presentation of the SMD prodromes as recorded in secondary mental health care. All the prodromal clusters intensified as individuals approached SMD onset, and all the prodromal features other than positive symptoms are transdiagnostic. These results support proposals to develop transdiagnostic preventive services for affective and psychotic disorders detected in secondary mental healthcare.

Assessment of Suicide Risk in Patients with Depressive Episodes Due to Affective Disorders and Borderline Personality Disorder: A Pilot Comparative Study.

This study assessed suicidal risk in patients suffering from non-psychotic depressive disorders within various clinical and nosological forms (F31-F34 mood disorders and F60.31-emotionally unstable personality disorder). Clinical and psychological features were presented, as well as predictors of suicidal risk in patients of these groups. We performed a comparative analysis of the anxiety and depression level, the level of mental pain, fear of death and the severity of anti-suicidal motives in patients with affective disorders and borderline personality disorder (BPD). Based on the results, 100% of patients in these clinical nosological groups were found to have a high level of suicidal risk. Patients with affective disorders have weak anti-suicidal motives and are not fully aware of the consequences of their own death. Patients with BPD have a higher suicidal risk than patients with affective disorders; they are characterized by less pronounced social orientation, demonstrativeness, self-centeredness, less pronounced levels of anxiety and fear of death.

From hallucinations to delusions: A narrative review of psychotic-like experiences and their implications.

Psychotic-like experiences (PLEs) refer to sub-threshold hallucinations and delusions observed in both clinical samples and the general population. Psychotic-like experiences have far-reaching implications for an individual's coping strategies and daily functioning. They are associated with both psychotic and non-psychotic disorders. This article presents a comprehensive review of the current literature on PLEs, incorporating a detailed exploration of the definition, prevalence, risk factors, functional impairments, and comorbid psychiatric disorders. Medline/PubMed and Embase were searched to establish and identify the literature. A total of 108 studies met our inclusion criteria. The genetic and biochemical backgrounds of PLEs are discussed, focusing on gene polymorphisms, changes in brain gyrification and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Psychological factors, such as trauma exposure, emotion regulation difficulties, cognitive biases, and attachment issues, were thoroughly examined, especially in terms of their impact on the emergence of PLEs. Here, we show how important the clinical aspects of developmental PLEs are, underlining the significance of an increased risk of self-harm and suicidal behaviors in those individuals and the comorbidity of psychiatric disorders in enabling clinicians to discern specific areas to observe. Although there is limited evidence on effective protocols for PLE management, various treatment approaches are explained. Despite increased research on PLEs in recent years, further investigation is needed to fully understand the nature of PLEs and to optimize therapeutic strategies. This article consolidates the current knowledge by synthesizing information on PLEs, including risk factors, comorbidities, treatments, and their impact on individual's lives.

Trends in the mental health in children and adolescents in Russia

Introduction. Mental health disorders in the world and the Russian Federation pose a serious problem, and their increase in childhood and adolescence is a determining factor in the development of diseases in later life. The purpose of the study is to analyze the follow up data of official sources on the specifics of the incidence of mental disorders in Russia of a children 0–17 year contingent with a differentiation of 0–14 and 15–17 years. Materials and methods. Materials from official statistics of the Ministry of Health of Russia and Rosstat were used in dynamics for various sections of the study as a whole for the 7-year period over 2015–2021, highlighting the years 2019–2021 to potentially identify the impact of COVID-19 on mental health. The analysis was carried out using statistical, analytical, and other methods. Results. The terminology on the problem was discussed. According to the analysis materials, among the reasons for taking in the Russian Federation under observation with a diagnosis for the first time in life (per 100 thousand population) in the “Mental and behavioural disorders” class. The leading reason for the entire population was “psychosis and dementia” — 55.1%; in children (0–14 years old) and in children, especially adolescents — “non-psychotic mental disorders” — 38.5% and 50.2%, respectively. An increase in childhood disability was revealed, both in general and for the studied reasons. Recommendations substantiated. Research limitations. The research materials are limited to the results of the analysis of official statistical information (indicators of morbidity, disability of the population) for the period of 2015–2021. Conclusion. Based on the research materials, we can conclude that the presented characteristics of the incidence of mental disorders and behavioural disorders in the population of Russia, certain negative trends cannot but cause concern, indicating the need for adequate decisions to be made by all levels of the organization and management to provide effective medical care with preventive measures for the adult and child population in Russia.

Suicide risk in patients with a current depressive episode during the COVID-19 pandemic.

The prevalence of major depressive disorder (MDD) increased during the COVID-19 pandemic. Data on suicidality in these patients during the pandemic period remain scarce. The aim of the study was to determine the prevalence and variables associated with serious suicide risk in Russian inpatients with MDD during the COVID-19 pandemic. A cross-sectional cohort study with consecutive sampling was conducted from January 1, 2021 to December 31, 2021. All patients completed the Mini International Neuropsychiatric Interview (M.I.N.I.) (including the suicidality module), the Beck Depression Inventory, and the State-Trait Anxiety Inventory, and underwent a semi-structured interview to collect relevant demographic and clinical data. Effect sizes for all independent variables and covariates were calculated using partial eta-squared (ηp2). Of the 6757 patients with non-psychotic mental disorders assessed, 1605 (23.7%) had MDD confirmed by the M.I.N.I., of whom 17.8% were at serious risk for suicide according to the M.I.N.I. suicidality module. Factors independently associated with serious suicide risk in Russian inpatients with MDD during the pandemic were younger age (ηp2 = 0.021), greater severity of depression (0.038), higher state anxiety (0.003), and nonsuicidal self-injury (NSSI) (0.066). The same variables, except for state anxiety, were independently associated with suicide risk in the subgroup of MDD patients previously infected with SARS-CoV2. In the COVID-19 pandemic, the proportion of patients with MDD at serious risk of suicide was similar to pre-pandemic data. No associations were found between suicidality in patients with MDD and COVID-related factors. Younger age, greater severity of depression, and especially NSSI were the most significant risk factors for suicide in patients with MDD during the COVID-19 pandemic.

The characteristics and clinical outcomes of a pluripotent high-risk group with the potential to develop a diverse range of psychiatric disorders

BackgroundRecent studies have indicated that clinical high risk for psychosis (CHR-P) is highly specific for psychotic disorders other than pluripotential to various serious mental illnesses. However, not all CHR-P develop psychotic disorder only, and psychosis can occur in non-psychotic disorders as well. Our prospective cohort study aims to investigate the characteristics and clinical outcomes of a pluripotent high-risk group with the potential to develop a diverse range of psychiatric disorders. MethodsThe SPRIM study is a prospective naturalistic cohort program that focuses on the early detection of those at risk of developing serious mental illness, including psychosis (CHR-P), bipolar (CHR-B), and depressive disorder (CHR-D), as well as undifferentiated risk participants (UCHR). Our study has a longitudinal design with a baseline assessment and eight follow-up evaluations at 6, 12, 18, 24, 30, 36, 42, and 48 months to determine whether participants have transitioned to psychosis or mood disorders. ResultsThe SPRIM sample consisted of 90 CHR participants. The total cumulative incidence rate of transition was 53.3% (95% CI 32.5–77.2). CHR-P, CHR-B, CHR-D, and UCHR had cumulative incidence rates of 13.7% (95% CI 3.4–46.4), 52.4% (95% CI 28.1–81.1), 66.7% (95% CI 24.6–98.6) and 54.3% (95% CI 20.5–93.1), respectively. The cumulative incidence of psychosis, bipolar, and depressive disorder among all participants was 3.3% (95% CI 0.8–11.5), 45.7% (95% CI 24.4–73.6), and 11.2% (95% CI 3.1–36.2), respectively. ConclusionsOur study suggests that the concept of pluripotent high-risk for a diverse range of psychiatric disorders is an integrative approach to examining transdiagnostic interactions between illnesses with a high transition rate and minimizing stigma.

Childhood maltreatment and personality disorders in adolescents and adults with psychotic or non-psychotic disorders.

While the attention to personality disorders (PD) and childhood maltreatment (CM) has grown in recent years, there remains limited understanding of the prevalence and distinctions of PD and CM in clinical populations of Chinese adolescents in comparison to adults. A total of 1,417 participants were consecutively sampled from patients diagnosed with either psychotic or non-psychotic disorders in the psychiatric and psycho-counseling clinics at Shanghai Mental Health Center. The participants were categorized into two groups based on their age: adolescents (aged 15-21 years) and adults (aged 22-35 years). PDs were evaluated using a self-reported personality diagnostic questionnaire and a structured clinical interview, while CMs were assessed using the Chinese version of the Child Trauma Questionnaire Short Form. When comparing self-reported PD traits and CM between adolescents and adults, differences emerge. Adolescents, particularly in the psychotic disorder group, exhibit more pronounced schizotypal PD traits (p=0.029), and this pattern extends to non-psychotic disorders (p<0.001). Adolescents in the non-psychotic disorder group also report higher levels of emotional abuse (p=0.014), with a notable trend in physical abuse experiences compared to adults (p=0.057). Furthermore, the most prevalent PDs in the clinical sample are avoidant, borderline, and obsessive-compulsive PDs. Among patients with psychotic disorders, adolescents exhibit higher rates of schizoid, schizotypal, and obsessive-compulsive PDs compared to adults. Logistic regression analyses highlight distinct predictors for psychotic and non-psychotic disorders in adolescents and adults. The findings emphasize distinct differences in PDs and CMs between adolescent and adult groups, shedding light on their potential roles in psychotic and non-psychotic disorders.

A post-traumatic stress disorder in military servicemen and war veterans

Aim. To analyze the characteristics of the incidence of a post-traumatic stress disorder in military servicemen and war veterans in order to search for new methods of diagnosis and treatment. Materials and methods. The analysis of the data of a secret questionnaire of doctors (psychiatrists, neuropathologists) regarding changes in character, complaints about anxiety after returning from the war zone in military servicemen and war veterans was used. Results and discussion. Since the start of russia’s full-scale invasion of Ukraine, there has been a brutal, exhausting war bringing a post-traumatic stress disorder (PTSD) on a par with Ukraine’s leading health problems. By monitoring foreign sources and literature, which more broadly highlight the problems of military personnel and war veterans with experience of working in such harsh conditions, a study on the prevalence of a post-traumatic stress disorder was conducted. Conclusions. Therefore, it is promising to conduct further research to improve understanding of the prevalence of a post-traumatic stress disorder in military servicemen and war veterans, which remains one of the “young” diagnoses in Ukraine and in world psychiatry. In the International Classification of Diseases (ICD-10), it is designated by the code F43. 1 and is included in the section F40-F48 “Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders”.

Identification of Psychosis Risk and Diagnosis of First-Episode Psychosis: Advice for Clinicians.

Early detection of psychotic-spectrum disorders among adolescents and young adults is crucial, as the initial years after psychotic symptom onset encompass a critical period in which psychosocial and pharmacological interventions are most effective. Moreover, clinicians and researchers in recent decades have thoroughly characterized psychosis-risk syndromes, in which youth are experiencing early warning signs indicative of heightened risk for developing a psychotic disorder. These insights have created opportunities for intervention even earlier in the illness course, ideally culminating in the prevention or mitigation of psychosis onset. However, identification and diagnosis of early signs of psychosis can be complex, as clinical presentations are heterogeneous, and psychotic symptoms exist on a continuum. When a young person presents to a clinic, it may be unclear whether they are experiencing common, mild psychotic-like symptoms, early warning signs of psychosis, overt psychotic symptoms, or symptoms better accounted for by a non-psychotic disorder. Therefore, the purpose of this review is to provide a framework for clinicians, including those who treat non-psychotic disorders and those in primary care settings, for guiding identification and diagnosis of early psychosis within the presenting clinic or via referral to a specialty clinic. We first provide descriptions and examples of first-episode psychosis (FEP) and psychosis-risk syndromes, as well as assessment tools used to diagnose these conditions. Next, we provide guidance as to the differential diagnosis of conditions which have phenotypic overlap with psychotic disorders, while considering the possibility of co-occurring symptoms in which case transdiagnostic treatments are encouraged. Finally, we conclude with an overview of early detection screening and outreach campaigns, which should be further optimized to reduce the duration of untreated psychosis among youth.