Psychotic Mental Disorders Research Articles

Clinical effectiveness and cost-effectiveness of Structured Psychological Support for people with probable personality disorder in mental health services in England: study protocol for a randomised controlled trial

IntroductionEvidence-based psychological treatments for people with personality disorder usually involve attending group-based sessions over many months. Low-intensity psychological interventions of less than 6 months duration have been developed, but their...

Efficacy of Atypical-Atypical and Atypical-Typical Antipsychotic in Indonesia Psychotic Mental Disorder Patients

It is approximately 7% of Indonesian people undergo psychotic mental disorder or schizophrenia. Special Region of Yogyakarta in Indonesian is on the second rank as the area whose high number of schizophrenia; for about 10 occurrences per 1000 citizens and 80% of patients treated at psychiatric hospital are caused by schizophrenia. A response of a medication therapy can be measured through doctor diagnosis based on the measurement parameter such as The Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) and Global Assessment of Functioning (GAF). Those two parameters are important variables that will be shown objectively by the assessment results. This research aimed to find out the different value of PANSS-EC and GAF, before and after the therapy of atypical-typical and atypical-typical on the schizophrenia patients at Psychiatric Hospital of Grhasia Yogyakarta. The research design here is Prospective Cohort. The criteria of inclusive patient was adults (18-65 years old), being hospitalized, undergoing atypical-atypical and atypical-typical therapy, and possessing complete medical record. The research data were gained from the medical records which then analyzed using univariate test to illustrate the patient distribution. Bivariate test was conducted to compare and correlate the value of PANSS-EC and GAF. The number of samples were 32 patients which were divided into 2 groups; atypical-atypical (n=16) and atypical-typical (n=16). The results showed that the value of PANSS-EC after therapy in both groups experienced a significant decrease (p=0.001). However, there was no significant difference between the two groups of patients with psychotic mental disorders or schizophrenia in a mental hospital and there reseach no significant difference in effectiveness between doses and frecuency of antipsychotic therapy regimens in schizophrenic patients with a significant value of p>0.05

Radix Bupleuri aqueous extract attenuates MK801-induced schizophrenia-like symptoms in mice: Participation of intestinal flora

Schizophrenia (SCZ) is a psychotic mental disorder characterized by cognitive, behavioral, and social impairments. However, current pharmacological treatment regimens are subpar in terms of effectiveness. This study aimed to investigate the function of Radix Bupleuri aqueous extract in SCZ in mouse models. The SCZ mouse model was established by MK-801 injection and feeding of Radix Bupleuri aqueous extract or combined antibiotics. Radix Bupleuri aqueous extract significantly improved the aberrant behaviors and neuronal damage in SCZ mice, upregulated SYP and PSD-95 expression and BDNF levels in hippocampal homogenates, down-regulated DA and 5-HT levels, and suppressed microglial activation in SCZ mice. Moreover, Radix Bupleuri aqueous extract improved the integrity of the intestinal tract barrier. The 16 S rRNA sequencing of feces showed that Radix Bupleuri extract modulated the composition of gut flora. Lactobacillus abundance was decreased in SCZ mice and reversed by Radix Bupleuri aqueous extract administration which exhibited a significant negative correlation with IL-6, IL-1β, DA, and 5-HT, and a significant positive correlation with BDNF levels in hippocampal tissues. The abundance of Parabacteroides and Alloprevotella was increased in SCZ mice. It was reversed by Radix Bupleuri aqueous extract administration, which exhibited a positive correlation with IL-6, IL-1β, and 5-HT and a negative correlation with BDNF. In conclusion, Radix Bupleuri aqueous extract attenuates the inflammatory response in hippocampal tissues and modulates neurotransmitter levels, exerting its neuroprotective effect in SCZ. Meanwhile, the alteration of intestinal flora may be involved in this process, which is expected to be an underlying therapeutic option in treating SCZ.

Gambaran Penggunaan Obat Antipsikotik pada Pasien Skizofrenia di Puskesmas Kota Gorontalo

Schizophrenia is one of the most common forms of psychotic mental disorder, with the main symptoms being the absence of self-understanding (insight) and the inability to assess reality (reality testing ability is disturbed). This study aimed to determine the description of the antipsychotic drug's usage, including the drug classes, types, doses, and medication rules in schizophrenia patients at the Kota Selatan Public Health Center, Gorontalo City. This observational study used secondary data and was conducted retrospectively. Further, data obtained from the medical records of 25 schizophrenia patients were analyzed univariately. The results disclosed that schizophrenia was more experienced by men (60%), more prevalent in the age range of 36-45 years (52%), and unmarried (48%)The most widely used antipsychotic drugs were atypical groups (72%). The most widely used type of drug was Risperidone 2 mg with a rule of use of 2 x 1 (39%) and 1 x 1 (9%). Clozapine, 25 mg. with a rule of 2 x 1 was 14%, and 1 x 1 was 9%. Meanwhile, the had 28% consisting typical group only of chlorpromazine 25 mg with tule of use of 1x 1 (12%), haloperidol with a dose of 1.5 mg with a rule of use of 2 sikzonoate 25 mg/ml with 1 x 1 was 5%.

Osteopenia and osteoporosis associated with hyperprolactinemic antipsychotics

IntroductionThe main role of prolactin is associated mainly with lactogenesis but additionally it participates in several endocrinological and metabolic processes. The prolactin level may be increased with some antipsychotics such as risperidone, paliperidone, and amisulpride increasing the risk of Bone Mineral Mass (BMM) decrease leading to osteopenia and osteoporosis.ObjectivesTo determine the loss of BMM associated with antipsychotic-related iatrogenic hyperprolactinemia (iHPRL) in a sample of patients suffering of chronic psychotic mental disorder and treated with antipsychotics at least for one year.MethodsA cross-sectional observational and epidemiological study in a sample of 140 patients (males 56.9%; females 43.1%; mean age 48 years), receiving antipsychotics was carried out. After giving informed consent, personal data, prolactin level, antipsychotic use and lifestyle were collected. An evaluation of BMM with a central DEXA Scan was performed. The bone mineral density considering the subject´s age and the peak bone mass in the neck of the femur, hip and in the lumbar vertebrae (L1-L4) was obtained. Inclusion criteria: presence of psychotic disorder, age between 18-65 years and treatment with an antipsychotic at least for one year. Statistical analysis was carried out using the statistical software SPSS version 26.0. A significance level α=0.05 was considered throughout the study.Results45 out of 140 patients (32,13%) had some BMM lost (osteopenia). The prevalence of osteoporosis was 5.71% (n=8). The median prolactin level in the sample was 46.1 ng/dL ± 33.1. Patients with hyperprolactinaemia showed a higher frequency of osteopenia/osteoporosis (50% with mild iHPRL and 48% with moderate/severe iHPRL) than those with normal prolactin levels (25.7%). A strong and significant relationship between the presence of osteoporosis and the treatment with risperidone was found (p=0.007).ConclusionsOsteopenia and osteoporosis are associated with hyperprolactinemic antipsychotic. Risperidone was related with a significant increased osteoporosis risk. The rutinary and systematic control of the BMM is crucial in these patients to avoid progressive bone demineralization. Managing strategies should be individualized to avoid bone demineralization and to preserve physical health.Disclosure of InterestNone Declared

A feasibility randomised controlled trial with an embedded qualitative evaluation of perinatal emotional skills groups for women with borderline personality disorder: protocol for the EASE study

BackgroundBorderline personality disorder (BPD) is a severe mental disorder characterised by emotional instability, impaired interpersonal functioning and an increased risk of suicide. There is no clear evidence about how best to help women with BPD during the perinatal period. Perinatal Emotional Skills Groups (ESGs) consist of 12 group sessions, focussing on core skills in emotion regulation, interpersonal effectiveness, distress tolerance and mindfulness and how these skills can best be utilised during the perinatal period. Prior observational research has shown that perinatal ESGs may help women with BPD. We set out to test the feasibility of conducting a randomised controlled trial to investigate the clinical effectiveness of perinatal ESGs.MethodsA two-arm, parallel-group, feasibility randomised controlled trial of Perinatal ESGs in addition to Treatment as Usual (TAU) versus TAU for women aged over 18 years, who are likely to have a diagnosis of BPD and are either pregnant or are within 12 months of having a live birth. We will exclude women who have a co-existing organic, psychotic mental disorder or substance use dependence syndrome; those with cognitive or language difficulties that would preclude them from consenting or participating in study procedures; those judged to pose an acute risk to their baby and those requiring admission to a mother and baby unit. After consenting to participation and completing screening assessments, eligible individuals will be randomly allocated, on a 1:1 ratio, to either ESGs + TAU or to TAU. Randomisation will be stratified according to recruitment centre.Feasibility outcomes will be the proportion of participants: (1) consenting; (2) completing baseline measures and randomised; (3) completing the intervention and (4) completing follow-up assessments. All study participants will complete a battery of self-report measures at 2 and 4 months post-randomisation. A nested qualitative study will examine participants’ and therapists’ experiences of the trial and the intervention.DiscussionEvidence is lacking about how to help women with BPD during the perinatal period. Perinatal ESGs are a promising intervention and if they prove to be an effective adjunct to usual care, a large population of vulnerable women and their children could experience substantial health gains.Trial registrationISRCTN80470632.

Dynamics of ideas about the concept of epileptic psychosis

Introduction: psychosis in epilepsy is more common than in the general population. The frequency of psychotic mental disorders varies from 0,5% to 10%. The article presents the dynamics of the development of the concept of epileptic psychosis, depending on the evolutionary approaches to the study of the problem of mental disorders in epilepsy. Materials and methods: the analysis of Russian—and English language articles in scientific databases on keywords from 1971 to 2011 was carried out. Results: the first systematic descriptions of mental disorders occurring in epilepsy date back to the 19th century. The contribution of foreign and domestic authors to the study of the problem is described. There are six main periods of the concept formation, including the definitions of the concept of epileptic psychosis, the dynamics of clinical manifestations, the role of the influence of biological, personal and social factors in the genesis and development of psychotic disorders in epilepsy. The following risk factors for the development of psychosis are considered: the form of epilepsy; age of onset of seizures, lateralization of the epileptic focus, gender, and drug therapy. Variants of classification approaches to the problem are presented. The article discusses the differences in the systematization of «endoform» syndromes, as well as the parallels between schizophrenia and psychoses in epilepsy. The dynamics of scientific views on the interest in the formation of epileptic psychoses in various parts of the brain: the temporal lobe (amygdala, hippocampus, paralimbic zones and parahippocampal bend), as well as GABA-ergic neurons of the upper tubercles of the quadriplegic, posterior hypothalamus and serotonergic neurons of the dorsal suture and noradrenergic neurons of the blue spot are reflected. The association of psychopathological manifestations with neurophysiological, biochemical, genetic and morphofunctional correlates is noted. The authors‘ interest in psychoses associated with the use of antiepileptic drugs is emphasized. Conclusion: despite all attempts to systematize these conditions, the factors that provoke the development of psychoses in patients with epilepsy, their structure and prognosis remain poorly predictable and require further in-depth study.

Analysis of factors influencing the formation of neurotic disorders in sudents of higher education institutions

The article analyzes the factors influencing the formation of non-psychotic mental disorders (NPD) in students of higher education institutions.The purpose of the study is to analyze the factors influencing the formation of non psychotic mental disorders in students of higher education.Material and methods. We analyzed the results of a survey of 1235 students. Methods applied: clinical, clinical, psychopathological, clinical, epidemiological, clinical and medical history, experimental psychological and statistical methods.
 Results. It has been found that living alone much increases the risk of NPD, namely 2.21 times. Notably, more married students have an NPD of 15.46% versus 3.53% of healthy students (p <0.05). Significantly more students with NPD rated family relationships as "calm, cold" 19.87% versus 4.14% of healthy students (p<0.05). So we can say that cold relationships in the family are factors in the formation of NPD. Significantly more students with NPD recognized interpersonal conflicts in the team as an urgent problem - 96 (30.28%), while only 165 (17.97%) healthy students noted this problem (p <0.05).Conclusions. The identified patterns must be taken into account when building programs for early diagnosis of NPD, as well as when planning individually targeted psychotherapeutic care.

Childhood trauma and adult mental disorder: A systematic review and meta-analysis of longitudinal cohort studies.

To systematically review evidence for the association between trauma experienced in childhood or adolescence, and the subsequent experience of affective or psychotic mental disorders in adulthood. Electronic databases (Scopus, Medline (for Ovid), EMBASE and PsychINFO) were searched for peer-reviewed, longitudinal cohort studies in the English language examining child or adolescent exposure to trauma, and adult-diagnosed depression, anxiety, psychotic disorder or bipolar disorder. A total of 23 manuscripts were retained. Results revealed a significant association between the following childhood exposures and adult mental disorder: bullying (victimhood, perpetration and frequency); emotional abuse; physical neglect; parental loss; and general maltreatment (unspecified and/or multiple trauma exposure). There was some evidence of a dose-response relationship with those exposed to multiple forms of maltreatment having more than three times the odds of developing a mental disorder (Odds ratio = 3.11, 95% CI = 1.36-7.14). There was no significant association found between physical or sexual abuse and adult mental disorder; however, this is likely an artefact of how these adversities were assessed. There is strong evidence of an association between childhood trauma and later mental illness. This association is particularly evident for exposure to bullying, emotional abuse, maltreatment and parental loss. The evidence suggests that childhood and adolescence are an important time for risk for later mental illness, and an important period in which to focus intervention strategies.

Frequency of Self-reported Psychotic Symptoms among 2542 Outpatients at Their First Visit for Mental Health Services

Objective: Psychotic symptoms are prevalent in both clinical settings and the general population. The distribution of psychotic symptoms across patients with different types of psychotic and non-psychotic mental disorders is helpful for understanding symptom specificity. This study aimed to explore the distribution differences of psychotic symptoms in an outpatient population in terms of frequency, age, gender, and psychotic and non-psychotic disorders. Methods: Outpatients were recruited consecutively at their first visit to the Shanghai Mental Health Center. Psychotic symptoms over the preceding year were self-reported through the PRIME Screen-Revised (PS-R) questionnaire. Seven categories of psychotic symptoms were grouped: perplexity and delusional mood (Item-1,5); first rank symptoms (Item-3,6,11); overvalued beliefs (Item-2,4); suspiciousness/persecutory ideas (Item-7), grandiose ideas (Item 8), perceptual abnormalities (Item-9,10), and disorganized communication (Item-12). Comparisons were made with respect to age group, sex, and diagnostic category. Results: Of 2542 outpatients, 1448(57.0%) were screened as positive, which was defined as having two or more symptoms with at least “somewhat agree” scores, ranging from 0 to 6. The threshold of one or more “yes” items was an endorsement to categorize the participant as positive for psychotic symptoms. The frequency of psychotic symptoms declined with age. Younger patients tended to report more psychotic symptoms than older patients(p < .001). Suspiciousness(p = .038) and disorganized communication (p = .004) were more common in females than males. Age, first rank symptoms, suspiciousness/persecutory ideas, grandiose ideas, and perceptual abnormalities were found to significantly differ between psychotic and non-psychotic disorders. Conclusions: Psychotic symptoms appear to be common in the clinical population and represent nonspecific indicators of psychopathology. The difference between psychotic and non-psychotic psychopathologies is more a function of the presence, frequency, and severity of psychotic symptoms.

Du parricide rêvé à l’infanticide réel, ou l’expertise mentale dans tous ses états

The authors describe at length the case of a 33-year-old woman who shot and killed her 9-year-old daughter and attempted suicide immediately afterwards. The judicial inquiry revealed that this infanticidal mother originally intended to kill her own father, who she accused of having sexually abused her in her own childhood and now her daughter, but that unforeseen circumstances changed the mode of operation. She was the subject of seven more or less contradictory psychiatric experts opinions over a period of more than three years before finally being found criminally irresponsible by the court of assizes. She was suffering from delusional psychotic mental disorders at the time of the homicide-suicide. The authors discuss and criticize the conclusions of the experts opinions and instead recommend a multidisciplinary criminological analysis that takes all the objective ans subjective aspects on the case into account.

Level of immune complex reactions in non-psychothotic mental disorders in combatants

The level of immune complex reactions in combatants with non-psychotic mental disorders was studied. A clinical-psychopathological and clinical-biochemical examination of 95 combatants with non- psychotic mental disorders were conducted. In the clinical picture of prolonged depressive reaction, there was a decrease in mood, feelings of sadness, anxiety, anhedonia, asthenic manifestations, detachment, lack of hope, guilt of the survivor. Mixed anxiety-depressive reaction was characterized by low mood, feelings of depression, helplessness, insecurity, feelings of despair, sadness, isolated obsessive fears, doubts about the correctness of decisions and actions that are closely related to anxious thinking in relation to their assessment in the eyes of others. Post-traumatic stress disorder was manifested by low mood, anxiety, internal tension with inability to relax, danger, anxiety, flashback effects, symptoms of intrusion, asthenia, irritability, propensity to affective reactions. It was found that in the examined patients there was an increase in the concentration of circulating immune complexes, mainly due to the most pathogenic fractions of medium and low molecular weight and suppression of phagocytic activity of monocytes. Changes in immune complex reactions were most pronounced in post-traumatic stress disorder.

Structured Psychological Support for people with personality disorder: feasibility randomised controlled trial of a low-intensity intervention.

National guidance cautions against low-intensity interventions for people with personality disorder, but evidence from trials is lacking. To test the feasibility of conducting a randomised trial of a low-intensity intervention for people with personality disorder. Single-blind, feasibility trial (trial registration: ISRCTN14994755). We recruited people aged 18 or over with a clinical diagnosis of personality disorder from mental health services, excluding those with a coexisting organic or psychotic mental disorder. We randomly allocated participants via a remote system on a 1:1 ratio to six to ten sessions of Structured Psychological Support (SPS) or to treatment as usual. We assessed social functioning, mental health, health-related quality of life, satisfaction with care and resource use and costs at baseline and 24 weeks after randomisation. A total of 63 participants were randomly assigned to either SPS (n = 33) or treatment as usual (n = 30). Twenty-nine (88%) of those in the active arm of the trial received one or more session (median 7). Among 46 (73%) who were followed up at 24 weeks, social dysfunction was lower (-6.3, 95% CI -12.0 to -0.6, P = 0.03) and satisfaction with care was higher (6.5, 95% CI 2.5 to 10.4; P = 0.002) in those allocated to SPS. Statistically significant differences were not found in other outcomes. The cost of the intervention was low and total costs over 24 weeks were similar in both groups. SPS may provide an effective low-intensity intervention for people with personality disorder and should be tested in fully powered clinical trials.

Profil Penggunaan Obat Kombinasi Risperidone-Clozapine dan Risperidone dengan Antipsikotik Lain pada Pasien Gangguan Mental Psikotik di Rumah Sakit Jiwa Grhasia Yogyakarta

Approximately 7% of Indonesia's population experience mental disorders psychosis. Yogyakarta Special Region is the second-highest incidence of psychotic mental disorders with a rate of 10 per 1000 population and 80% of those treated in mental hospitals with schizophrenia. Pharmacotherapy management in patients with psychotic mental disorders with the use of antipsychotics, both single and combination. Antipsychotics are classified as atypical antipsychotics and typical antipsychotics. Both groups of antipsychotics have the same pharmacological activity, namely blocking dopamine D2 receptors. The study design is prospective. Inclusion criteria for adult patients (18-65 years), who are inpatient, get risperidone-clozapine antipsychotic therapy and risperidone with other antipsychotics and have complete data. Data obtained from medical records and analyzed with univariate tests to describe the distribution of patients. Bivariate testing to compare the two treatment groups. The number of samples at the end of the study were 32 patients who were divided into 2 groups of antipsychotic antipsychotics, risperidone-clozapine, and risperidone with other antipsychotics. The results of this study show that the therapeutic group that is often used is the combination of risperidone-clozapine compared to risperidone with other antipsychotics in patients with psychotic mental disorders at Yogyakarta Grhasia Mental Hospital.

Значення рівня нейротизму у діагностиці непсихотичних психічних розладів у студентів вищих навчальних закладів

Значення рівня нейротизму у діагностиці непсихотичних психічних розладів у студентів вищих навчальних закладів

Impact of substance use and other risk factor exposures on conviction rates by people with a psychotic illness and other mental disorders

To examine the impact of substance use and other risk factors on conviction rates in people with a psychotic illness (PI) and other mental disorders (OMD) compared to those with no mental illness (NMI). This research is part of a longitudinal record-linked whole-population study of 467,945 children born in Western Australia (WA) between 1980 and 2001. This cohort was identified through linkages between the WA psychiatric case register, WA corrective services data and other state-wide registers. We assessed 184,147 individuals born during 1983-1991 to explore the impact of exposure to a variety of risk factors on conviction rates. People with PI and OMD had higher conviction rates than those with NMI, with unadjusted incidence rate ratios (IRR) of 3.98 (95% CI 3.67-4.32) for PI and 3.18 (95% CI 3.03-3.34) for OMD. Adjusting for substance use reduced the rates by 60% in PI and 30% in OMD: IRRs 1.59 (95% CI 1.45-1.74) and 2.24 (2.12-2.37), respectively. Minimal change was seen when adjusting for other potential risk factors (including socio-demographics, victimisation and parental offending), with adjusted IRRs 1.58 (95% CI 1.43-1.74) for PI and 1.90 (95% CI 1.80-2.02) for OMD. Our analysis shows people with a mental illness have higher rates of conviction than those with NMI. Substance use has a major impact on this rate. Results suggest the need for a greater investment in programs addressing the issue of comorbid substance use with a view to reduce the rate of convictions in this population.

On the problem of prevalence of psychotic disorders in adolescents

Objective To analyze indicators of the referral rate for highly specialized inpatient psychiatric care in adolescents with psychotic disorders. Material and methods Clinical/dynamic and statistical methods were used to study the data of patients, aged 14-17 years, with psychotic mental disorders according to ICD-10, as well as the indicators of their hospitalization in psychiatric consulting and medical institution during the calendar year. Results and conclusion The analysis of 2017 data shows that 6.3% of hospitalized children and adolescents have a psychotic disorder, the vast majority (82.3%) of whom are adolescents, aged 14-17 years (149 patients, including 79 boys, 70 girls). Of 181 patients referred to the hospital with a diagnosis of a psychotic disorder, the preliminary diagnostic judgment was not confirmed during hospitalization in 30 (16.6%) patients, in the course of therapy in 24 (13.3%) cases. The prevalence of patients with endogenous psychoses (about 80% in the structure of schizophrenic process, schizoaffective, affective pathology), the prevalence of older adolescents, gender relations in psychotic disorders of different nosological nature are revealed.

Psychological Support for Personality (PSP) versus treatment as usual: study protocol for a feasibility randomized controlled trial of a low intensity intervention for people with personality disorder

BackgroundPrevious research has demonstrated the clinical effectiveness of long-term psychological treatment for people with some types of personality disorder. However, the high intensity and cost of these interventions limit their availability. Lower-intensity interventions are increasingly being offered to people with personality disorder, but their clinical and cost effectiveness have not been properly tested in experimental studies. We therefore set out to develop a low intensity intervention for people with personality disorder and to test the feasibility of conducting a randomized controlled trial to compare the clinical effectiveness of this intervention with that of treatment as usual (TAU).MethodsA two-arm, parallel-group, single-blind, randomized controlled trial of Psychological Support for Personality (PSP) versus TAU for people aged over 18 years, who are using secondary care mental health services and have personality disorder. We will exclude people with co-existing organic or psychotic mental disorders (dementia, bipolar affective disorder, delusional disorder, schizophrenia, schizoaffective disorder, or schizotypal disorder), those with cognitive or language difficulties that would preclude them from providing informed consent or compromise participation in study procedures, and those who are already receiving psychological treatment for personality disorder. Participants will be randomized via a remote system in a ratio of PSP to TAU of 1:1. Randomization will be stratified according to the referring team and gender of the participant.A single follow-up assessment will be conducted by masked researchers 24 weeks after randomization to assess mental health (using the Warwick and Edinburgh Well-Being Schedule), social functioning (using the Work and Social Adjustment Scale), health-related quality of life (EQ-5D-5 L), incidence of suicidal behavior, satisfaction with care (Client Satisfaction Questionnaire), and resource use and costs using a modified version of the Adult Service Use Schedule. In addition to this, each participant will be asked to complete the patient version of the Clinical Global Impression Scale.Feasibility and acceptability will primarily be judged by study recruitment rate and engagement and retention in treatment. The analysis will focus principally on descriptive data on the rate of recruitment, characteristics of participants, attrition, adherence to therapy, and follow-up. We will explore the distribution of study outcomes to investigate assumptions of normality in order to plan the analysis and sample size of a future definitive trial.DiscussionMost people with personality disorder do not currently receive evidence-based interventions. While a number of high intensity psychological treatments have been shown to be effective, there is an urgent need to develop effective low intensity approaches to help people unable to use existing treatments. PSP is a low intensity intervention for individuals, which was developed following extensive consultation with users and providers of services for people with personality disorder. This study aims to examine the feasibility of a randomized trial of PSP compared to TAU for people with personality disorder.Trial registrationISRCTN Registry, ISRCTN14994755. Registered on 18 July 2017.

Protective effects of Spinacia oleracea seeds extract in an experimental model of schizophrenia: Possible behavior, biochemical, neurochemical and cellular alterations.

Schizophrenia is one of the psychotic mental disorders characterized by symptoms of thought, behavior, and social problems. Newer biomedicine and pharmacotherapy has been investigated for the treatment of various neuropsychiatric disorders in the past few decades. Spinacia oleracea is one of these, reported to have beneficial effect against several neurodegenerative disorders. The present study was carried to explore the protective effects of Spinacia oleracea seed extract (SOEE) in an experimental model of ketamine-induced schizophrenia in mice. Ketamine (50 mg/kg, i.p.) was used to induce stereotyped psychotic behavioural symptoms in mice. Behavioral studies (locomotor activity, stereotype behaviors, immobility duration and memory retention) were carried out to investigate the protective of SOEE on ketamine-induced psychotic symptoms, followed by biochemical, neurochemical and cellular alterations in the brain. Treatment with SOEE for 15 consecutive days significantly attenuated stereotyped behavioral symptoms in mice. Biochemical estimations revealed that SOEE reduced lipid peroxidation and restored total brain proteins. Furthermore, SOEE remarkably reduced dopamine levels, AChE activity & inflammatory surge (serum TNF-α) and increased the levels of GABA and reduced glutathione in mice. The outcomes of the study suggested that SOEE could ameliorate ketamine-induced psychotic symptoms in mice, indicating a protective effect in the treatment of schizophrenia.

Areca nut chewing is associated with common mental disorders: a population-based study.

Forms of habitual substance use including cigarette smoking and alcohol consumption have been documented as risk factors of common mental disorders (CMDs). The effects of areca nut chewing on biophysiological tests, metabolic syndromes, and liver function have been reported previously; however, the relationship between areca nut chewing and CMDs remains unclear. This study examined the association between areca nut chewing and CMDs and explored the relationships between areca nut chewing and biophysiological indicators. A total of 4477 community dwellers who had enrolled in a cohort study and participated in health examinations in 2 consecutive years were selected for analysis in the present study. The community cohort was established in northern Taiwan during 2006-2012. The Chinese health questionnaire (CHQ-12) was used as a self-reported screening instrument to assess the potential for developing psychotic mental disorders (CHQ-12 score ≥ 3) among the community residents. Biophysiological tests performed 1year before CMD assessment were analyzed to examine the causal pathways between areca nut chewing and CMDs. Multiple logistic regression and stratified analyses were performed. A total of 18.23% of the participants were diagnosed as having CMDs. Factors including areca nut chewing [odds ratio (OR) 1.828; 95% confidence interval (CI) 1.165-2.869], sex (women; OR 1.828; 95% CI 1.165-2.869), age (30-49; OR 1.302; 95% CI 1.073-1.579), and socioeconomic status (lower status; OR 1.373; 95% CI 1.084-1.738) were associated with CMDs in a multiple logistic regression model. Areca nut chewers exhibited significantly more triglycerides (220.04 vs. 124.16mg/dL) and white blood cells (65.17 102/μL vs. 60.36 102/μL) and significantly higher diastolic blood pressure (78.83 vs. 75.84mmHg) and glutamic oxaloacetic transaminase (30.30 vs. 25.45U/L) than did the controls. This study demonstrated the association between areca nut chewing and CMDs and its effects on biophysiological tests in a community-based population in Taiwan. The findings suggest the existence of mechanistic effects of areca nut chewing on CMDs exerted through multiple pathways that may interact with pre-existing biophysiological abnormalities. Lifestyle variables should be considered for the prevention and management of mental disorders in the future.