Schizotypal Research Articles

A Dynamic Foundation: Aberrations of Sleep Architecture and Its Association With Clinical and Sub-clinical Psychopathology.

This investigation centered on the hypnagogic and hypnopompic wake-sleep/sleep-wake transition states and the associated exploration of hypnagogic and hypnopompic experiences (HHEs), and sleep paralysis (SP) on psychiatric exacerbation and paradoxical masking. The study aims to discern causality by examining how these sleep-related experiences may contribute to the emergence or exacerbation of psychiatric and neurodegenerative conditions, particularly, pertaining tothe clinical or sub-clinical demographic of Schizotypal Personality Disorder (STPD), Mood Disorders, Schizophrenia, Post-Traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), Narcolepsy, Panic Disorder, specific phobias, or heightened psychotic sensitivity. Methodologically, this study employed a comprehensive literature review, drawing from a range of studies across sleep medicine, psychiatry, and psychology, utilizing PubMed-indexed peer-reviewed scientific literature, sourcing from academic institutions, Google Scholar, and open-access publications. This interdisciplinary approach allowed for a nuanced and systematic understanding of the potential links between specific sleep-wake/wake-sleep aberrations and their masking or exacerbation of clinical/sub-clinical psychiatric symptomatology in this particular demographic. Insights gained from the outcome of this study hold promise for advancing understanding of the interrelationship between sleep neurobiology and psychiatric disorders. Additionally, the findings may inform targeted therapeutic interventions tailored to mitigate the impact of sleep-wake disruptions on vulnerable populations. The overarching objective is to bridge current gaps in knowledge, cultivating a more profound understanding with direct implications for both clinical practice and ongoing research endeavors. The study outcomes provide an intriguing understanding of the complex relationship between sleep neurobiology and psychiatric disorders, paving the way for targeted therapeutic interventions to alleviate the effects of sleep-wake disruptions, and addressing critical gaps in knowledge with direct implications for clinical practice and ongoing research.

More than fulfilled expectations: An electrophysiological investigation of varying cause-effect relationships and schizotypal personality traits as related to the sense of agency

The sense of agency (SoA) is central to human experience. The comparator model, contrasting sensory prediction and action feedback, is influential but limited in explaining SoA. We investigated mechanisms beyond the comparator model, focusing on the processing of unpredictable stimuli, perimotor components of SoA, and their relation to schizotypy.ERPs were recorded from 18 healthy participants engaged in button-pressing tasks while perceiving tones with varying causal relationships with their actions. We investigated the processing of non-causally related tones, contrasted this to causally related tones, and examined perimotor correlates of subjective expectancy and experience of agency.We confirmed N100 attenuation for self-generated stimuli but found similar effects for expectancy-dependent processing of random tones. SoA also correlated with perimotor ERP components, modulated by schizotypy.Thus, neural processes preceding actions contribute to the formation of SoA and are associated with schizotypy. Unpredictable events also undergo sensory attenuation, implying additional mechanisms contributing to SoA.

Influence of Betrayal Trauma on Schizoid Personality Pathology

ABSTRACT Schizoid personality pathology is among the most debilitating and enigmatic forms of personality pathology. Some have suggested that a potential etiological influence on schizoid pathology is trauma. Thus far, research on the association between trauma and schizoid pathology has focused primarily on type of trauma (e.g., abuse vs. neglect during childhood) rather than who perpetrated the trauma. This contrasts with recent research on trauma perpetrated by someone upon whom the survivor relies and/or trusts (i.e. betrayal trauma), which many studies show has a uniquely pernicious association with several forms of personality pathology. However, this has not yet been examined with respect to schizoid pathology specifically. In this study, we examined the relative associations between trauma varying degrees of betrayal and schizoid personality pathology in a sample recruited from Amazon’s Mechanical Turk (N = 300) using a Bayesian approach to structural equation modeling. Results suggest that interpersonal trauma in general was associated with higher levels of schizoid pathology. Findings further indicate that for men but not women, trauma with a high degree of betrayal was uniquely associated with schizoid pathology. These findings contribute to the growing body of research suggesting the influence of interpersonal trauma in general and betrayal trauma in particular on personality pathology and have implications for future research on and intervention with people with high levels of schizoid pathology.

The genetic epidemiology of schizotypal personality disorder.

The concept of schizotypal personality disorder (SPD) emerged from observations of personality characteristics common in relatives of schizophrenic patients. While often studied in family designs, few studies and none with genetic measures, have examined SPD in epidemiological samples. We studied individuals born in Sweden 1940-2000 with an ICD-10 diagnosis of SPD with no prior schizophrenia (SZ) diagnosis (n = 2292). Demographic features, patterns of comorbidity, and Family Genetic Risk Scores (FGRS) were assessed from multiple Swedish registries. Prediction of progression to SZ was assessed by Cox models. SPD was rare, with a prevalence of 0.044%, and had high levels of comorbidity with autism spectrum disorder (ASD), OCD, ADHD, and major depression (MD), and increased rates of being single, unemployed and in receipt of welfare. Affected individuals had elevated levels of FGRS for SZ (+0.42), ASD (+0.30), MD (+0.29), and ADHD (+0.20). Compared to cases of schizophrenia, they had significantly lower rates of FGRSSZ, but significantly elevated rates of genetic risk for ASD, MD, and ADHD. Over a mean follow-up of 8.7 years, 14.6% of SPD cases received a first diagnosis of SZ, the risk for which was significantly increased by levels of FGRSSZ, male sex, young age at SPD diagnosis and an in-patient SPD diagnosis and significantly decreased by comorbidity with MD, ASD, and ADHD. Our results not only support the designation of SPD as a schizophrenia spectrum disorder but also suggest potentially important etiologic links between SPD and ASD and, to a lesser extent, ADHD, OCD, and MD.

Quantifying the effects of practicing a semantic task according to subclinical schizotypy

The learning ability of individuals within the schizophrenia spectrum is crucial for their psychosocial rehabilitation. When selecting a treatment, it is thus essential to consider the impact of medications on practice effects, an important type of learning ability. To achieve this end goal, a pre-treatment test has to be developed and tested in healthy participants first. This is the aim of the current work, which takes advantage of the schizotypal traits present in these participants to preliminary assess the test’s validity for use among patients. In this study, 47 healthy participants completed the Schizotypal Personality Questionnaire (SPQ) and performed a semantic categorization task twice, with a 1.5-hour gap between sessions. Practice was found to reduce reaction times (RTs) in both low- and high-SPQ scorers. Additionally, practice decreased the amplitudes of the N400 event-related brain potentials elicited by semantically matching words in low SPQ scorers only, which shows the sensitivity of the task to schizotypy. Across the two sessions, both RTs and N400 amplitudes had good test–retest reliability. This task could thus be a valuable tool. Ongoing studies are currently evaluating the impact of fully deceptive placebos and of real antipsychotic medications on these practice effects. This round of research should subsequently assist psychiatrists in making informed decisions about selecting the most suitable medication for the psychosocial rehabilitation of a patient.

Post-Disaster Community Transition of Psychiatric Inpatients: Lessons from the Fukushima Nuclear Accident.

This study sought to explore factors related to community transition after the mandatory evacuation of psychiatric inpatients to other hospitals owing to the Fukushima Daiichi Nuclear Power Plant accident. A retrospective cohort design was adopted and 391 psychiatric patients were examined. Univariate and multivariate analyses were conducted to confirm the association between the achievement or non-achievement of discharge to community living and their backgrounds (age, gender, evacuation destination, psychiatric diagnoses, and physical complications). Multivariate analysis indicated that patients with psychiatric diagnoses of schizophrenia, schizotypal, and delusional disorders (International Statistical Classification of Diseases and Related Health Problems 10th revision, F20-29), and those with physical diagnoses of the circulatory (I00-95) and digestive (K00-93) systems showed a significant association with the non-attainment of community transition. From these results, we hypothesized that difficulties in the management of medication during and immediately after the extremely chaotic settings of evacuation could have negative effects on the community transitions. Furthermore, another possible concern was that individuals' persistent psychotic status before the accident had been carried over to the destination hospitals. Therefore, pre-disaster daily cooperation across hospitals and challenges for vulnerable psychiatric patients' future community lives are also essential.

Omega-3 Supplementation Reduces Schizotypal Personality in Children: A Randomized Controlled Trial.

Based on a childhood intervention from ages 3 to 5 years that included additional fish consumption and which resulted in reduced schizotypal personality at age 23, we had previously hypothesized that omega-3 could reduce schizotypy. The current study tests the hypothesis that omega-3 supplementation reduces schizotypy in children. In this intention-to-treat, randomized, single-blind, stratified, factorial trial, a community sample of 290 children aged 11-12 years were randomized into Omega-3 Only, Cognitive Behavioral Therapy (CBT) Only, Omega-3 + CBT, and Control groups. Schizotypy was assessed using the SPQ-C (Schizotypal Personality Questionnaire for Children) at 0 months (baseline), 3 months (end of treatment), 6 months (3 months post-treatment), and 12 months (9 months post-treatment). A significant group × time interaction (P = .013) indicated that, compared with Controls, total schizotypy scores were reduced in both Omega-3 Only and Omega-3 + CBT groups immediately post-treatment (d = 0.56 and 0.47, respectively), and also 3 months after supplementation terminated (d = 0.49, d = 0.70). Stronger findings were observed for the interpersonal schizotypy factor, with both omega-3 groups showing reductions 9 months post-treatment compared with the CBT Only group. Schizotypy reductions were significantly stronger for those with higher dietary intake of omega-3 at intake. Sensitivity analyses confirmed findings. Results are unique in the field and suggest that omega-3 can help reduce schizotypal personality in community-residing children. From an epidemiological standpoint, if replicated and extended, these findings could have implications for early prevention of more significant schizotypal features developing later in adolescence. "Healthy Brains & Behavior: Understanding and Treating Youth Aggression (HBB)." ClinicalTrials.gov Identifier: NCT00842439, https://clinicaltrials.gov/ct2/show/NCT00842439.

Anatomo-Morphological Brain Featuresi in Patients with Schizotypal Disorder with Catatoniс Symptoms: A Pilot Study

Background: brain structural peculiarities in different mental disorders are neurobiological indicators that are extremely important both for understanding of the diseases’ pathogenesis and for identifying potentially valid prognostic markers. The aim of this pilot study was to identify the range of brain morphometric parameters in the group of patients with schizotypal disorders with catatonia syndrome. Patients and methods: 33 patients with schizotypal disorder and 33 age-matched mentally healthy subjects underwent high-resolution structural MRI on a 3T Philips Ingenia scanner. Results: there were found widely distributed intergroup differences in form of the smaller gray matter thickness. In this spectrum, a morphometric abnormality of the precentral gyrus, an area of the primary motor cortex localization, previously not noted in the literature on schizotypal disorder, drew special attention. In addition, smaller volume of the nuclei accumbens (included in the processes of choosing actions) was found. Conclusions: this pilot study allowed to reveal some brain elements of the mosaic presumably associated with the manifestation of catatonia syndrome in schizotypal disorder.

A Single Case Multimethod Assessment to Detect Significant Changes in the Psychoanalytic Treatment of Psychosomatic Disorders

Mental disorders with body-centered symptoms, such as somatic, eating, and body dysmorphic disorders, present difficulties in psychotherapy because psychological suffering is manifested in the body rather than expressed verbally. The present study illustrates a single case multi-method investigation sensitive to detecting characteristic change manifestations in the treatment of these disorders. We investigated a treatment of a patient with body dysmorphic disorder. Computerized linguistic measures were applied to 86 sessions to assess changes in symbolic processing; out of the 86 sessions, 40 were analyzed to calculate the proportion of speech focused on bodily symptoms versus on relationships. Changes in personality were assessed using the SWAP-200 on nine sessions from different treatment stages. Measures of linguistic style, speech content, and personality showed marked changes over the treatment. The patient manifested schizoid and schizotypal personality traits that decreased over time, along with an increase in personality high-functioning dimension. The patient’s ability to translate his emotional experience into words steadily increased, switching the primary focus of narratives from bodily symptoms to relationships. A multimethod assessment of the treatment of body dysmorphic disorder shows that improvement in personality functioning is accompanied by a shift from a focus on bodily experiences to a focus on relationships.

The role of the differential outcomes procedure and schizotypy in the recognition of dynamic facial expressions of emotions

Emotional facial expression recognition is a key ability for adequate social functioning. The current study aims to test if the differential outcomes procedure (DOP) may improve the recognition of dynamic facial expressions of emotions and to further explore whether schizotypal personality traits may have any effect on performance. 183 undergraduate students completed a task where a face morphed from a neutral expression to one of the six basic emotions at full intensity over 10 s. Participants had to press spacebar as soon as they identified the emotion and choose which had appeared. In the first block, participants received no outcomes. In the second block, a group received specific outcomes associated to each emotion (DOP group), while another group received non-differential outcomes after correctly responding (NOP group). Employing generalized linear models (GLMs) and Bayesian inference we estimated different parameters to answer our research goals. Schizotypal personality traits did not seem to affect dynamic emotional facial expression recognition. Participants of the DOP group were less likely to respond incorrectly to faces showing Fear and Surprise at fewer intensity levels. This may suggest that the DOP could lead to better identification of the main features that differentiate each facial expression of emotion.

Cognitive Abilities in Schizoid Personality Disorder with and without Borderline Intellectual Functioning: The Burden in Psychopathology

Background: Borderline intellectual functioning (BIF) and schizoid personality disorder (Schizoid PD) are clinical conditions under-researched and poorly understood. The principal aim of this retrospective study was to investigate cognitive abilities in people with BIF and Schizoid PD. Clinical, demographic, and neuropsychological data of forty-seven Schizoid PD participants, with an average age of 35, were analyzed. The sample split into two groups: Schizoid PD with BIF (BIF+: n = 24; intelligence quotient – IQ range: 71-84) and Schizoid PD without BIF (BIF-: n = 23; IQ range: 89-121). A descriptive analysis of the clinical and demographic characteristics of the two groups was performed.
 Methods: Neuropsychological measures (Wechsler Adult Intelligence Scale-Revised – WAIS-R IQ, factor index, subtest scores) and cognitive performance deficits in the two groups were compared using parametric and non-parametric tests, as necessary. Correlation coefficients were calculated for relationships between variables. Regression analyses were conducted to identify predictors associated with negative outcomes, such as substance use behavior.
 Results: The results revealed that the cognitive profile of BIF+ deviated significantly from that observed in BIF-. Peculiar BIF+ dysfunctions were found in the domains of verbal and perceptual reasoning, attention, memory, processing speed, planning, and problem-solving. The verbal IQ had the highest discriminative value for the presence of BIF in patients with Schizoid PD.
 Conclusions: The BIF condition and the verbal comprehension index were the predictors most associated with substance use behavior. Early identification of BIF should be relevant to planning targeted intervention strategies to improve daily life skills and outcomes.

Gender dysphoria and schizotypal personality disorder - clinical case

Gender dysphoria and schizotypal personality disorder - clinical case

Application of International Classification of Functioning, Vital Disabilities and Health to assess the effectiveness of rehabilitation in a psychiatric hospital

BACKGROUND: The International Classification of Functioning, Disability and Health ICF is an important tool for planning, implementing and evaluating the effectiveness of the rehabilitation process. In addition, the use of the ICF makes it possible to objectify the level of quality of medical care. However, this classification is not quite enough used in practice still, including psychiatric practice, where (due to the specifics of these patients) a certain adaptation is required (in terms of choosing the set of the most informative domains).
 AIM: To evaluate the effectiveness of the rehabilitation of patients with mental disorders based on the use of the ICF.
 MATERIALS AND METHODS: Using data from case histories and special questionnaires, 500 patients of the psychiatric hospital were studied — a number of domains included in the ICF were identified and analyzed (domains characterizing “body functions”, “activity and participation”, “environmental factors”): upon admission, on 10th day of treatment, upon discharge. The study was conducted for 6 months by an all-over method. The exclusion criteria were: age under 18 and over 80; the presence of acute psychotic symptoms at the time of examination; the presence of severe cognitive dysfunctions that prevent the assessment of functional limitations, vital activity and health; duration of hospitalization less than 10 days. Statistical analysis of the collected material was carried out using application programs in Microsoft Office Excel.10.
 RESULTS: Among the examined patients, women accounted for 52.6% (263 people). In the age structure, 30.8% (154 people) were patients under 30 years of age; 24.2% (121 people) — 30–39 years old; 13.2% (96 people) — 40–49 years old; 12.8% (64 people) are 50–59 years old and 13.0% (65 people) are 60 years old and older. Average age — 39.5±0.6 years. In the nosological structure, 16.8% (84 people) were patients with organic mental disorders; 12.8% (64 people) — with mental and behavioral disorders associated with the use of psychoactive substances; 19.8% (99 people) — with schizophrenia, schizotypal and delusional disorders; 16.2% (81 people) — with mood disorders; 17.0% (85 people) — with stress-related neurotic disorders and somatoform disorders; 17.4% (87 people) with personality and behavior disorders in adulthood. Upon admission, the following disorders were the most pronounced: mental stability (which occurred in 80.6% of patients — 403 people); regulation of emotions — 390 people (78.0%); control of impulsive impulses — 382 people (76.4%); stability of attention — 388 people (77.6%); switching of attention — 376 people (75.2%); separation of attention — 374 people (74.8%); concentration of attention — 371 people (74.2%); psychomotor control — 354 people (70.8%). During the treatment, the prevalence of all identified disorders significantly decreased (differences in the proportion of patients with various disorders upon admission — on 10th day of treatment — upon discharge are statistically significant with a reliability of more than 95.5%).
 CONCLUSION: This dynamic proves the effectiveness of rehabilitation in general and the importance of nursing intervention in particular.

Pseudoneurotic Symptoms in the Schizophrenia Spectrum: A Longitudinal Study of Their Relation to Psychopathology and Clinical Outcomes.

Nonpsychotic symptoms (depression, anxiety, obsessions, etc.) are frequent in schizophrenia-spectrum disorders and are usually conceptualized as comorbidity or transdiagnostic symptoms. However, in twentieth century foundational psychopathological literature, many nonpsychotic symptoms with specific phenomenology (here termed pseudoneurotic symptoms) were considered relatively typical of schizophrenia. In this prospective study, we investigated potential associations of pseudoneurotic symptoms with diagnostic status, functional outcome as well as psychopathological dimensions of schizophrenia. First-admitted patients (N = 121) diagnosed with non-affective psychosis, schizotypal disorder, or other mental illness were examined at initial hospitalization and 5 years later with a comprehensive assessment of psychopathology. Informed by the literature, we constructed scales targeting pseudoneurotic symptoms and other, more general, nonpsychotic symptoms. Pseudoneurotic symptoms aggregated in schizophrenia-spectrum groups compared to other mental illnesses and occurred at similar levels at baseline and follow-up. They longitudinally predicted poorer social and occupational functioning in schizophrenia-spectrum patients over a 5-year-period but not transition to schizophrenia-spectrum disorders from other mental illnesses. Finally, the level of pseudoneurotic symptoms correlated with disorder of basic self at both assessments and with positive and negative symptoms at follow-up. The scale targeting general nonpsychotic symptoms did not show this pattern of associations. The study supports that a group of nonpsychotic symptoms, ie, pseudoneurotic symptoms, are associated with schizophrenia-spectrum disorders and linked with temporally stable psychopathology, particularly disorder of the basic self. Their prospective association with social and occupational functioning needs replication.

Tinnitus and Psychiatric Disorders (a Clinical Psychopathological Study of Patients without Otorhinolaryngological Pathology)

Background: tinnitus is the perception of acoustic, phantom sounds in the ear and/or head in the absence of an external source. The prevalence of tinnitus is 5–15 % in the population. The occurrence of subjective noise may have a number of possible causes, but the causal relationship between psychiatric disorders and tinnitus remains insufficiently proven, according to previous studies. The aim was to study an acoustic phenomenon of the “ear/head noise” type, comparable with tinnitus symptomatology, in the absence of otorhinolaryngological, neurological, somatic pathologies. Patients and methods: the sample consisted of 12 patients (11 men, 1 woman, mean age 38 ± 8.5 years) who underwent complex psychopathological, pathopsychological, psychometric, otorhinolaryngological, neurological, and instrumental examinations, statistical. The patients met the diagnostic criteria of subjective tinnitus according to ICD-10 classification (code H93.1). Results: the psychopathological qualification of tinnitus in our observations corresponds to psychosensory disorders of the synesthesia type. In the most cases, the ear noise occurred against the background of already long-standing neurotic or overvalued hypochondria. Depending on clinical picture of ear noise, and features of the course of hypochondriacal disorder, the acoustic phenomenon of the “ear / head noises” type was revealed within four nosologies: hypochondriacal schizophrenia, schizotypal disorder, cluster B personality disorder with the phenomenon of hypochondriacal diathesis, paranoid personality disorder with the phenomenon of overvalued hypochondria. Conclusion: the results of the present study, in spite of a limited number of observations, allow us (as a working hypothesis) to propose the following statement: the acoustic phenomenon of the “ear / head noise” type can manifest in psychiatric disorders (psychopathological phenomena of the hypochondriacal circle) duplicating the symptoms of tinnitus at clinical level which, are formed within otolaryngological, neurologicl and somatic pathology. Taking into account these clinical data, hypochondriacal formations appearing in the considered casuistic of the present study, having no base of otorhinolaryngology-related pathology, or internal organ pathology, can be qualified in accordance with the criteria presented in publication A. B. Smulevich et al. (2023) as a part of somatic paranoia. Further comprehensive study of this phenomenon is necessary for more accurate verification of the clinical criteria for differential diagnosis, increasing the efficiency of identifying the pathology under discussion, and determining rational methods of complex treatment, including psychopharmacotherapy and psychotherapeutic modalities.

A Tale of Three Spectra: Basic Symptoms in Clinical-High-Risk of Psychosis Vary Across Autism Spectrum Disorder, Schizotypal Personality Disorder, and Borderline Personality Disorder.

The clinical-high-risk (CHR) approach was developed to prevent psychosis through the detection of psychosis risk. CHR services are transdiagnostic in nature, therefore the appropriate management of comorbidity is a central part of care. Differential diagnosis is particularly challenging across 3 common comorbidities, schizotypal personality disorder (SPD), autism spectrum disorder (ASD), and borderline personality disorder (BPD). Phenomenological research indicates a disturbance of "basic self" may differentiate between these commonly comorbid disorders and can be captured by Huber's basic symptoms (BS) concept. We investigated whether BS vary across these disorders and may inform differential diagnosis in young person's meeting CHR criteria. A total of 685 participants meeting CHR criteria from the NAPLS-3 cohort completed the COGDIS items of the schizophrenia proneness instrument, a measure of BS, as well as the structured interview for DSM-5 (SCID-5). A logistic regression model was used to investigate the variation of COGDIS across SPD, ASD, and BPD, while controlling for age and SIPs positive severity. Meeting COGDIS criteria was positively associated with SPD (OR = 1.72, CI = [1.31-2.28], P = .001) but not ASD nor BPD. Our results indicate that "basic self-disturbance" as indicated by COGDIS differs across SPD, ASD, and BPD. COGDIS may be useful to inform the management of comorbidities in CHR services, by providing insight into subtle subjective experiences that may benefit from disorder-specific interventions.

Are the Symptom Dimensions in Obsessive Compulsive Disorder Related to Thought-Action Fusion, Magical Thinking, and Schizotypal Personality Traits?

This study aimed to investigate the relationship between symptom dimensions within obsessive-compulsive disorder and thought-action fusion, magical thinking, and schizotypal personality traits. This research was designed as a cross-sectional case-control study. The study population involved patients with obsessive-compulsive disorder, and healthy controls who did not exhibit any psychiatric disorders following the Structured Clinical Interview for DSM-IV (SCID-I). Thought-Action Fusion Scale (TAFS), Magical Ideation Scale (MIS), Vancouver Obsessional-Compulsive Inventory (VOCI), Schizotypal Personality Questionnaire (SPQ), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) were administered to all participants. The two groups were compared in terms of sociodemographic variables and scale scores, Spearman's correlation analysis was performed to examine the relationship between TAFS total and all subscale scores, magical thinking, schizotypal personality traits and OCD symptom dimensions scores. The study comprised 37 patients with OCD and 36 healthy controls. The patient group exhibited significantly higher scores in TAF total and all subscales, MIS, SCQ, BDI, and BAI, compared to the healthy control group. Positive correlations between magical ideation scores and VOCI-obsessions and VOCI-hoarding subscale scores and between schizotypal personality scores and VOCI-obsessions, VOCI-hoarding, VOCI-just right, VOCI indecisiveness scores was found. The relationship between symptom dimensions in obsessive-compulsive disorder such as sexual, religious, aggression, hoarding, symmetry/ordering and magical thinking and schizotypal personality traits shows that these variables are among the determining factors for OCD symptoms. .

Predictors of Discharge from Hospital to Supported Accommodation and Support Needs Once in Supported Accommodation for People with Serious Mental Illness in Scotland: A Linked National Dataset Study

Background. Many individuals with serious mental illness live in supported accommodation. Decisions regarding type of supported accommodation required and level of support to meet individual’s needs are crucial for continuing rehabilitation and recovery following admission to hospital. This study aimed to identify personal and contextual predictive factors for (1) discharge from hospital to different levels of supported accommodation and (2) self‐directed support needs of individuals with serious mental illness once they are in supported accommodation in Scotland. Method. Linked data from the Scottish Morbidity Record‐Scottish Mental Health and Inpatient Day Case Section and the Scottish Government Social Care Survey were analysed using multinomial regression and multivariable logistic regression to identify personal and contextual factors associated with accommodation destination at the time of discharge and four self‐directed support needs: personal care; domestic care; healthcare; and social, educational, and recreational. Results. Personal factors (age and having a diagnosis of schizophrenia, schizotypal, or delusional disorder) were associated with individuals moving to supported accommodation with higher levels of support. One contextual factor, compulsory detention when admitted to hospital, decreased the likelihood of moving to any type of supported accommodation. The personal and contextual factors associated with identified self‐directed support needs varied by need. Support provided by the local authority was associated with all self‐directed support needs, with having a diagnosis of schizophrenia, schizotypal, or delusional disorder associated with identifying domestic care, healthcare, and social, educational, and recreational needs, while living in the most deprived areas was associated with identifying healthcare needs. Advancing age and being compulsorily detained decreased the likelihood of identifying social, educational, and recreational needs. Conclusion. The study highlights that older men with a diagnosis of schizophrenia, schizotypal, or delusional disorder require higher levels of support upon discharge from hospital. When living in supported accommodation, having this diagnosis increases the likelihood of identifying support with looking after the home, looking after their health, and social and recreational activities; however, being older decreases the likelihood of identifying support with social and recreational activities.

Schizophrenia spectrum disorders (aspects of psychopathology and clinical taxonomy)

To create a new taxonomy of schizophrenia spectrum disorders (SSD) based on the comparability of the design of SSD and borderline states. The total sample consists of 205 patients with an established diagnosis of SSD (F21; F25; F22 according to ICD-10) collected from studies of the department of borderline mental pathology and psychosomatic disorders of the Federal State Budgetary Institution Mental Health Research Center and the Department of Psychiatry and Psychosomatics of Moscow State Medical University in the period 2014 to 2024. Clinical, psychometric, statistical methods were used. A new two-level model of schizotypal personality disorder (STPD) has been developed: the first level is psychopathic-like disorders of the «Ferschroben» type; the second level are psychopathological disorders (positive, negative, etc.), appearing under their «mask», constituting a «tracing paper» of manifestations of schizophrenia «in miniature». The two-level psychopathological model of STPD is a complex clinical phenotype, including independent but overlapping phenotypic formations: psychopathic-like - the «Ferschroben» type; and basic - schizophreniform disorders. The clinical classification of schizophrenia spectrum disorders has been developed; pseudoneuroses and stress-induced disorders of the endogenous circle are considered in the aspect of the dynamics of STPD.

Mental disorders, social and demographic characteristics of patients with chronic and episodic migraine

To compare socio-demographic, clinical and psychological characteristics and comorbid mental disorders in patients with chronic migraine (CM) and episodic migraine (EM). Eighty patients with migraine (40 with CM (16 men and 24 women, mean age 33.5±6.1 years) and 40 with EM (9 men and 31 women, mean age 31.4±5.7 years) were examined. All patients were interviewed and tested with psychometric methods. Socio-demographic and clinical-psychological characteristics were determined in all patients. The psychiatrist assessed the mental status of patients and diagnosed comorbid mental disorders according to the ICD-10 criteria. Symptoms of depression, high levels of trait and state anxiety, and a tendency to emotional inadequacy of response were more common in CM patients than in EM patients (p<0.05). Mental disorders, predominantly of the anxiety-depressive spectrum, were more common in CM patients than EM patients (OR (95% CI)=2.54 (2.03 to 2.98, p<0.001). Seventy-five percent of CM patients had more than one psychiatric diagnosis, almost a quarter of CM patients had schizotypal disorder, which is significantly higher than in EM patients (OR (95% CI)=1.99; 1.03 to 2.42, p<0.001). There were more unmarried, single (without constant partner), unemployed, high-education patients in the CM group than in the EM group. The negative impact of headache on the daily activity of patients was significantly higher in the CM group than in the EM group (p<0.05). Mental disorders and psychological features (anxiety, depression symptoms, a tendency to emotional inadequacy of response) are more common in CM patients than in EM patients. The presence of these factors may contribute to the chronification of migraine.