Introduction
Investigation of resilience mechanisms in patients with clinical high risk for
psychosis (CHR) may inform clinical practice for the development of early intervention
programs. Resilience ...mechanisms in CHR who did not transit to psychosis for a long period of
observation may be more pronounced than in CHR converters.
Objectives
We aimed to compare CHR who did not convert to psychosis for 7.3 ± 1.7 years, patients
with first-episode psychosis (FEP), and healthy controls (HC) in terms of brain functional
connectivity and local coherence.
Methods
Twenty-seven CHR (mean age 27.5 ± 3.1), 24 FEP (mean age 20.6 ± 3.6), and 27 HC (mean
age 27.3 ± 4) underwent resting-state fMRI (3T). All participants were males. Functional
connectivity between 32 regions of interest (components of default mode, sensorimotor,
visual, salience, dorsal attention, frontoparietal, language, and cerebellar networks; CONN
functional network atlas www.nitrc.org/projects/conn) and whole-brain local coherence (LCOR;
Deshpande et al. HBM 2009; 30(1) 13-23) were compared between 3 groups of participants
(one-way ANCOVA) with
post hoc
analyses.
Results
CHR and HC demonstrated higher functional connectivity between the occipital cortex
(visual network) and right rostral prefrontal cortex (salience network) compared to FEP. CHR
also showed higher local coherence in the right calcarine and cuneal cortex than FEP (the
following differences did not survive the correction for multiple comparisons: CHR>HC and
HC>FEP).
Conclusions
Our findings on brain functional connectivity and local coherence may be considered as
the markers of resilience mechanisms in patients with CHR as these parameters were different
between CHR and FEP and were similar in CHR and HC.
The research was supported by RFBR grant project
20-013-00748.
Disclosure of Interest
None Declared
IntroductionInhalants are volatile psychoactive compounds whose effect varies from disorientation, excitement, euphoria to hallucinations. Different opinions have been raised concerning the ...relationship between inhalant use and psychosis and several publications have studied the incidence of psychotic disorders in the context of inhalant use. These studies concluded that using inhalants was independently associated with the development of psychosisObjectivesour aim is to determine the demographic and psychiatric profile of inhalant users previously hospitalized in our departmentMethodsThis is a retrospective descriptive study carried out by analyzing hospitalization records in the addictology department of the psychiatric university hospital Ar-Razi in Salé over a period of one year (from August 2020 to August 2021). The diagnoses are established according to the DSM 5 diagnostic criteria.ResultsSeventeen patients, inhalant users, were recruited after chart review, including 5 women and 11 men (68.7 %). The average age was 24.7 years (16; 41). The majority of the patients were single (81.2%), 62.5 % had a secondary education and 62.5 % were unemployed.The psychiatric evaluation showed that 87% of these patients had a history of incarceration, 50% had a diagnosis of schizophrenia, 12.5% had bipolar disorder and 14.2% had a cluster B personality disorder (DSM 5).The average age of onset of the addictive disorder in this population was 14.4 years and the entire sample was polyaddictive.ConclusionsMore than half of our sample had psychosis associated with their inhalant use disorder. these results are consistent with literature data.Disclosure of InterestNone Declared
The aim of this study is to describe the care pathways for patients with a recent onset of psychosis and to determine whether these routes are significantly affected by ethnicity and causal beliefs ...about this disorder. A total of 252 patients with schizophrenia in outpatient treatment (116 Aymara and 136 Non-Aymara) with a mean age of 35.6 years (SD = 12.5) from public mental health centers in Arica, Chile (33.6 %), Tacna, Peru (33.6 %) and La Paz, Bolivia (32.8 %) and their primary caregivers participated. They were interviewed regarding their help-seeking contacts using a semi-structured questionnaire. Out of the total patients, 64.7 % initially contacted a general practitioner for help, while only 14 % went to see a psychologist and 12 % sought a Yatiri (healers). The main factors associated with avoidance of a different route were the presence of a supportive family member or friend and the presence of a general practitioner. It is concluded that the main route of access to psychiatric services for patients with a recent onset of psychosis among Andean ethnic minorities is through a general practitioner, while a small portion of this population relies on community healers.
Drawing on the conceptual resources provided by Lacanian accounts of melancholia and the death drive, and by means of reference to a clinical case summary and the film Into the Wild, this paper hopes ...to open up new ways of thinking about melancholic psychosis. The paper foregrounds a series of clinical themes that may be grouped under the rubric of "problems in symbolic fixit": difficulties in receiving gifts, inability to mediate relations of intimacy, yearning for anonymity/disappearance, and the condition of the twilight world. These themes, while not obviously associated with Freud's account of melancholia, represent areas of diagnostic priority for a Lacanian approach attuned to the role of symbolic processes and the traumatic "real" object.
The first-line treatment for psychotic disorders remains antipsychotic drugs with receptor antagonist properties at D₂-like dopamine receptors. However, long-term administration of antipsychotics can ...upregulate D₂ receptors and produce receptor supersensitivity manifested by behavioral supersensitivity to dopamine stimulation in animals, and movement disorders and supersensitivity psychosis (SP) in patients. Antipsychotic-induced SP was first described as the emergence of psychotic symptoms with tardive dyskinesia (TD) and a fall in prolactin levels following drug discontinuation. In the era of first-generation antipsychotics, 4 clinical features characterized drug-induced SP: rapid relapse after drug discontinuation/dose reduction/switch of antipsychotics, tolerance to previously observed therapeutic effects, co-occurring TD, and psychotic exacerbation by life stressors. We review 3 recent studies on the prevalence rates of SP, and the link to treatment resistance and psychotic relapse in the era of second-generation antipsychotics (risperidone, paliperidone, perospirone, and long-acting injectable risperidone, olanzapine, quetiapine, and aripiprazole). These studies show that the prevalence rates of SP remain high in schizophrenia (30%) and higher (70%) in treatment-resistant schizophrenia. We then present neurobehavioral findings on antipsychotic-induced supersensitivity to dopamine from animal studies. Next, we propose criteria for SP, which describe psychotic symptoms and co-occurring movement disorders more precisely. Detection of mild/borderline drug-induced movement disorders permits early recognition of overblockade of D₂ receptors, responsible for SP and TD. Finally, we describe 3 antipsychotic withdrawal syndromes, similar to those seen with other CNS drugs, and we propose approaches to treat, potentially prevent, or temporarily manage SP.
The article aims to provide a better understanding of the urban practices of young people living with a diagnosis of psychosis while recovering. I show the way practices are adjusted according to the ...temporal dynamics of psychosis. I argue that the continuous variability of symptoms over the recovery period implies alternately practices of withdrawal and reconquest of the urban space. I first outline participants' reconquest of urban spaces, which starts in well-known places and then extends to less familiar ones. In doing so, I point out the diversity of urban spaces inhabited by participants during the recovery process which includes institutional, private, as well as public places. I then outline the various material, relational and sensory resources available in these spaces. I show how participants use them according to the temporal dynamics. I finally highlight the way participants are gradually getting involved in the relationship with a large array of resources as the intensity of symptoms is reducing. My analysis is based on a three months ethnography in a therapeutic institution in Lausanne.
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