Academic literature on the topic 'First episode of psychosis'

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Journal articles on the topic "First episode of psychosis"

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Harvey, Samuel B., Kimberlie Dean, Craig Morgan, Elizabeth Walsh, Arsime Demjaha, Paola Dazzan, Kevin Morgan, et al. "Self-harm in first-episode psychosis." British Journal of Psychiatry 192, no. 3 (March 2008): 178–84. http://dx.doi.org/10.1192/bjp.bp.107.037192.

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BackgroundLittle is known about self-harm occurring during the period of untreated first-episode psychosis.AimsTo establish the prevalence, nature, motivation and risk factors for self-harm occurring during the untreated phase of first-episode psychosis.MethodAs part of the æSOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study, episodes of self-harm were identified among all incident cases of psychosis presenting to services in south-east London and Nottingham over a 2-year period.ResultsOf the 496 participants, 56 (11.3%) had engaged in self-harm between the onset of psychotic symptoms and first presentation to services. The independent correlates of self-harm were: male gender, belonging to social class I/II, depression and a prolonged period of untreated psychosis. Increased insight was also associated with risk of self-harm.ConclusionsSelf-harm is common during the pre-treatment phase of first-episode psychosis. A unique set of fixed and malleable risk factors appear to operate in those with first-episode psychosis. Reducing treatment delay and modifying disease attitudes may be key targets for suicide prevention.
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Zanetti, Marcus V., Maristela S. Schaufelberger, Cláudio C. de Castro, Paulo R. Menezes, Márcia Scazufca, Philip K. McGuire, Robin M. Murray, and Geraldo F. Busatto. "White-matter hyperintensities in first-episode psychosis." British Journal of Psychiatry 193, no. 1 (July 2008): 25–30. http://dx.doi.org/10.1192/bjp.bp.107.038901.

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BackgroundWhite-matter hyperintensities have been associated with both schizophrenia and mood disorders, particularly bipolar disorder, but results are inconsistent across studiesAimsTo examine whether white-matter hyperintensities are a vulnerability marker for psychosis or are specifically associated with bipolar disorderMethodT2-weighted magnetic resonance imaging data were acquired in 129 individuals with first-episode psychosis (either affective or non-affective psychoses) and 102 controls who were randomly selected from the same geographical areas. Visual white-matter hyperintensity ratings were used for group and subgroup comparisonsResultsThere were no statistically significant between-group differences in white-matter hyperintensity frequency or severity scores. No significant correlations were found between white-matter hyperintensity scores and duration of illness, duration of untreated psychosis, or severity of psychotic, manic or depressive symptomsConclusionsWhite-matter hyperintensities are not associated with vulnerability to psychosis in general, or specifically with affective psychoses. Further, first-episode psychosis investigations using more quantitative methods are warranted to confirm these findings
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Amini, Homayoun, Javad Alaghband-Rad, Abbas Omid, Vandad Sharifi, Rozita Davari-Ashtiani, Farzad Momeni, and Zahra Aminipour. "Diagnostic Stability in Patients with First-Episode Psychosis." Australasian Psychiatry 13, no. 4 (December 2005): 388–92. http://dx.doi.org/10.1080/j.1440-1665.2005.02199.x.

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Objective: To examine the short-term stability of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) and International Classification of Diseases (10th revision; ICD-10) diagnoses in a group of patients with first-episode psychosis. Method: Sixty patients with first-episode psychosis admitted consecutively to Roozbeh Hospital, Tehran, were sampled; their illnesses could not be attributed to any medical or substance-induced conditions. Patients were assessed at the time of discharge from the hospital, and at 3, 6and 12 month intervals following admission. Ateach visit, two psychiatrists made consensusDSM-IV and ICD10 diagnoses, based on all available information. Stability was discerned as the consistency between diagnoses at the time of discharge and at 12 month follow up. Results: Forty-eight patients completed follow up. Affective psychotic disorders and schizophrenia in both classification systems were highly stable. In addition, all patients with DSM-IV brief psychotic disorder and ICD-10 acute and transient psychotic disorders remained the same at follow up. Conclusions: Affective psychoses and schizophrenia, in line with previous findings, remained stable. Diagnoses of brief psychoses were highly stable as well; this could reflect a non-relapsing course ofacute brief psychoses, especially in developing countries.
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Rogers, Paul. "First episode psychosis." Mental Health Practice 9, no. 3 (November 2005): 37. http://dx.doi.org/10.7748/mhp.9.3.37.s31.

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Sandor, A. "First episode psychosis." BMJ 324, no. 7343 (April 20, 2002): 976a—976. http://dx.doi.org/10.1136/bmj.324.7343.976/a.

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Milton, John, Shazad Amin, Swaran P. Singh, Glynn Harrison, Peter Jones, Tim Croudace, Ian Medley, and John Brewin. "Aggressive incidents in first-episode psychosis." British Journal of Psychiatry 178, no. 5 (May 2001): 433–40. http://dx.doi.org/10.1192/bjp.178.5.433.

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BackgroundRecent research has reported increased risk of aggressive incidents by individuals with psychotic illness.AimsTo examine acts of aggression in first-episode psychosis.MethodSubjects with a first-episode psychosis were ascertained from a defined catchment area (Nottingham, UK) and reassessed at 3 years (n=166) using clinical interview, informants, health care and forensic records.ResultsOf the subjects, 9.6% demonstrated at least one act of serious aggression (defined as weapon use, sexual assault or victim injury) during at least one psychotic episode and 23.5% demonstrated lesser acts of aggression (defined as all other acts of aggression). For all aggressive subjects (33.1%), unemployment (OR=3.6, 95%CI 1.6–8.0), comorbid substance misuse (OR=3.1, CI 1.1–8.8) and symptoms of overactivity at service contact (OR=6.9, CI 2.7–17.8) had independent effects on risk of aggression.ConclusionsWe confirmed some previously reported demographic and clinical associations with aggression in first-episode psychosis but no relationship with specific psychotic symptoms or diagnostic groups was observed.
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Singh, Swaran P., Tom Burns, Shazad Amin, Peter B. Jones, and Glynn Harrison. "Acute and transient psychotic disorders: precursors, epidemiology, course and outcome." British Journal of Psychiatry 185, no. 6 (December 2004): 452–59. http://dx.doi.org/10.1192/bjp.185.6.452.

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BackgroundICD–10 has introduced the diagnostic group acute and transient psychotic disorders (ATPDs; F23). Aims To validate the nosological distinctiveness of ICD–10 ATPDs by following up an inception cohort with first-episode psychosis. Method All patients with first-episode psychosis identified in Nottingham between 1992 and 1994 and diagnosed using ICD–10 criteria were reassessed 3 years later. ATPD outcomes were compared with schizophrenia and affective psychosis. Multivariate analyses were conducted to determine whether acute onset and early remission predicted favourable 3-year outcome in first-episode psychosis. Results Of 168 cases of first-episode psychosis, 32 (19%) received an intake diagnosis of ATPD. The diagnosis of ATPD was stable in women over 3 years, but not in men. Outcomes in ATPD were better than in schizophrenia and similar to affective psychosis. In non-affective psychoses, favourable outcomes were a function of gender and premorbid functioning rather than acute onset and early remission. Conclusions The ICD–10 criteria for ATPDs identify a diagnostically unstable group of disorders. Acute onset and early remission do not independently predict favourable outcome over 3 years in first-episode psychosis.
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Patel, Kamlesh, and Rachel Upthegrove. "Self-harm in first-episode psychosis." Psychiatric Bulletin 33, no. 3 (March 2009): 104–7. http://dx.doi.org/10.1192/pb.bp.108.020362.

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Aims and MethodSuicide in schizophrenia remains frequent. One of the best predictors of suicide, previous self-harm, is increasing in young people. the aim of this case-note review was to investigate the frequency of a history of self-harm for individuals presenting to psychiatric services with a first episode of psychosis in our local area and study their demographic characteristics.ResultsA history of self-harm was found in 32% of the cohort. the predominant method of self-harm was self-laceration. In univariate analyses, age and gender were significant predictors of self-harming behaviour.Clinical ImplicationsThe rate of self-harm among those with first-episode psychosis is high. Efforts to reduce the rate of completed suicide in psychotic illness need to focus on this risk, which often predates contact with psychiatric services. This emphasises again the need for early detection and intervention in psychotic illness.
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Edwards, Jane, Dana Maude, Patrick D. McGorry, Susan M. Harrigan, and John T. Cocks. "Prolonged recovery in first-episode psychosis." British Journal of Psychiatry 172, S33 (June 1998): 107–16. http://dx.doi.org/10.1192/s0007125000297754.

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Background Early identification and specialised treatment of individuals with enduring positive symptoms may assist in alleviating symptoms and has the potential to change the course of illness.Method Prevalence and descriptive data on enduring positive symptoms in two first-episode samples are outlined. Attempts to incorporate the focus of early intervention for persisting psychosis into routine clinical care of individuals with first-episode psychosis are described.Results Of the 227 individuals with first-episode psychosis who were assessed using the Brief Psychiatric Rating Scale at 3/6 months and 12 months following initial stabilisation (from a total sample of 347), 6.6% experienced enduring positive symptoms at all three time points. When the analysis was restricted to schizophrenia, schizophreniform and schizoaffective disorders (n=158) the percentage increased to 8.9%. These patients had significantly longer mean duration of untreated psychosis prior to initiation of treatment and, at 12-month follow-up, significantly higher depression and poorer psychosocial functioning.Conclusions The association of untreated psychosis with treatment resistance supports the argument for early intervention as soon as possible following the onset of psychotic symptoms.
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Karki, B. D., D. Joshi, and A. P. Adhikari. "Stressful Life Events In First Episode Psychosis." Journal of Psychiatrists' Association of Nepal 10, no. 1 (October 14, 2021): 38–42. http://dx.doi.org/10.3126/jpan.v10i1.40346.

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Introduction: First episode psychosis refers to the first time someone experiences psychotic symptoms or a psychotic episode. There are evidences related to the role of major life events and childhood trauma in the development of first episode psychosis. There are few studies regarding the environmental exposure to stressful life events and how these events might influence the onset of a psychotic disorder, and role of perceived stress. This study aimed to identify the relationship between stressful life events and first episode psychosis in Nepalese context. Material And Method: It was a hospital based cross-sectional, descriptive study. A total of 50 cases of first episode psychosis were included and the diagnosis was made according to ICD 10- Diagnostic Criteria for Research and verified by two consultant psychiatrists. Semi Structured Performa was designed to collect the information about the socio demographic data and perceived stress was assessed with Presumptive Stressful Life Events Scale (PSLES). Results: There were 62% female and 38% male patients with first episode psychosis with mean age 26.32 years. Majority of the participants were from rural areas (94%), married (58%), educated up to primary level (38%) and housewife (40%). 60.7% of ATPD had stressful life events (P =0. 000)which was higher than the stressful life events in patient with Schizophrenia (P =0. 005). There was a positive correlation between stressful life events and gender, setting, socioeconomic status and Diagnosis (P <0.05). Conclusion: Results show the relevance of presence of stressful life events as a potent source of perceived stress in first episode psychosis sample. Therefore this study highlights the importance of psychosocial intervention in this vulnerable group for management of illness and might be an important strategy for prevention.
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Dissertations / Theses on the topic "First episode of psychosis"

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Upthegrove, Rachel. "Depression in first episode psychosis." Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/1650/.

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There has been renewed interest into affective symptoms and psychological approaches to schizophrenia and other psychosis, yet no in-depth investigation as to the course, consequences or indeed psychological causes of depression in a phase specific manner in the important first episode. Our understanding of risk and aetiological processes in psychotic illness will only advance once we accurately identify the “end phenotype” of psychotic illness. This series of studies investigates the course of depression in first episode psychosis, its significance in terms of suicidal thinking, and relation to both diagnosis and other symptom domains. Depression in the acute and post psychotic phases is explored, through the importance of the awareness and appraisal of positive symptoms, and diagnosis itself. Significant findings include a pervasive nature of depression throughout the course of first episode psychosis, the predictive nature of prodromal depression and the high prevalence of suicidal acts. Appeasement and engagement with voices, subordination to persecutors and the (ineffective) use of safety behaviours drive a position of entrapment, demoralization and a lack of control. In addition negative illness appraisals are stable and may vary between cultural groups. Implications are explored, in terms of clinical practice, aetiological pathways, potential treatments and intervention strategies
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Billings, J. "Making sense of first episode psychosis." Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1446413/.

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This paper addresses whether the concept of illness perceptions, which has been developed in the arena of chronic physical illness, can be applied to an acute mental illness such as first episode psychosis. Literature related to first episode psychosis and illness perceptions is reviewed and the potential benefits and problems of using the illness perceptions framework when trying to understand how people make sense of a first episode of psychosis are discussed. Finally, areas warranting exploration in further research are highlighted.
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Butjosa, Molines Anna. "Stressful life events and first-episode psychosis." Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/461706.

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Nowadays, advances in affective and social neuroscience have shown how the exposure to environmental factors has an impact on the structure and functioning of the brain being thus, active agents in the formation of an individual’s level of vulnerability. There is an increasing interest in the influence of stress on many diseases including a first-episode psychosis (FEP). From the stress-vulnerability model (Zubin & Spring, 1977) to the current models of neural diathesis-stress (Pruessner et al., 2017), schizophrenia is conceptualised as an episodic disorder in which there is vulnerability and stress due to biological and/or environmental factors. This suggests that patients are likely predisposed to manifesting psychotic episodes induced by the impact of precipitating factors, such as stressful life events (SLEs). In FEP, the role of stressors, specifically SLEs, as predisposing factors or adjuvants to the onset of the disease is relevant. These events are circumstances that occur in the lives of people with an identifiable beginning and end which have the potential to alter their current mental or physical status. However, there are very few studies on SLEs in patients with schizophrenia - and even fewer in patients with FEP-, thereby emphasising the need for such studies. SLEs can be treated as prodromal events, which together with other events, contribute to the appearance of later psychotic symptomatology. Indeed, it is likely that the diversity of environmental factors associated with schizophrenia may be linked to an equal number of different underlying mechanisms. Several studies have evaluated the role of SLEs, but most of the studies include these events as trauma, what makes their research and evaluation more difficult and complicated. This thesis was aimed at achieving adequate and effective early intervention in psychotic disorders since: i) in general, few studies have specifically evaluated SLEs; ii) no studies have analysed the age of onset of FEP in relation to SLEs; iii) no studies have been found about gender differences, family history and psychotic symptomatology in relation to SLEs; and iv) no instruments are available to assess SLEs along the life cycle. The main objective of this thesis was to evaluate the relationship between SLEs and the development of FEP. This objective was developed under three specific objectives: 1) to systematically review the literature available on SLEs and FEP, 2) to evaluate the impact of SLEs and the influence of sociodemographic and clinical variables on the appearance of FEP, and 3) to validate an instrument to measure SLEs in FEP and in a healthy population. The data obtained in this thesis provide more in depth knowledge regarding SLEs and their evaluation and detection as well as the relationship of these events with clinical variables and symptoms in a sample of patients with FEP and healthy controls. The objective of identifying SLEs across the stress-vulnerability model psychosis phenotype continuum may provide insights into the aetiology of this disorder and may lead to the development of strategies for its prevention and treatment. We provide further corroboration that rather than being a correlate of frank psychosis, the variability of SLEs may play an important role in FEP populations and this is of great relevance to the practice of professionals dedicated to detecting, caring for, and treating people with this disease. The work presented in this thesis is framed within the stress-vulnerability model and the clinical staging model, which considers the phenotypic continuum reflecting a shared interactive set of diathesis, psychosocial and sociocultural factors. Currently, few studies have evaluated SLEs in these sample types and there is a need to obtain more in depth information on the influence of SLEs in these populations in which genetics and stress play a relevant role.
Actualment, els avenços en la neurociència afectiva i social han demostrat com l’exposició als factors ambientals influeix en l’estructura i la funció del cervell, essent agents actius en la formació del nivell de vulnerabilitat de l’individu. A més, hi ha un interès creixent en la influència de l’estrès en moltes malalties, incloent un primer episodi psicòtic (PEP). Des del model de vulnerabilitat-estrès (Zubin i Spring, 1977) fins als models actuals de diàtesi- estrès neural (Pruessner et al., 2017), l’esquizofrènia es conceptualitza com un trastorn episòdic en què hi ha vulnerabilitat i estrès a causa de factors biològics i/o ambientals. Això suggereix que probablement els pacients estiguin predisposats a manifestar episodis psicòtics induïts per l’impacte dels factors precipitants, com els esdeveniments vitals estressants (EVEs). En el PEP, és rellevant el paper dels estressors, específicament EVEs, com a factors predisponents o adjuvants a l’aparició de la malaltia. Aquesta tesi tenia com a objectiu aconseguir una intervenció primerenca adequada i efectiva en trastorns psicòtics ja que: i) en general, pocs estudis han avaluat específicament els EVEs; ii) cap estudi ha analitzat l’edat d’aparició de PEP en relació amb els EVEs; iii) no hi ha estudis sobre diferències de gènere, historia familiar i simptomatologia psicòtica en relació amb els EVEs; i per últim, iv) no hi ha instruments disponibles per avaluar els EVEs durant el cicle vital. L’objectiu principal d’aquesta tesi va ser avaluar la relació entre els EVEs i el desenvolupament del PEP. Aquest objectiu es va desenvolupar en tres objectius específics: 1) revisar de forma sistemàtica la literatura disponible dels EVEs i PEP, 2) avaluar l’impacte dels EVEs i la influència de les variables sociodemogràfiques i clíniques sobre l’aparició de PEP, i 3) validar un instrument per mesurar els EVEs en pacients amb PEP i en població sana. Les dades obtingudes en aquesta tesi proporcionen un coneixement més profund sobre els EVEs i la seva avaluació i detecció, així com la relació d’aquests esdeveniments amb variables i símptomes clínics en una mostra de pacients amb PEP i controls sans.
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Goodby, Emmeline. "Future-directed thinking in first episode psychosis." Thesis, Royal Holloway, University of London, 2014. http://digirep.rhul.ac.uk/items/ad1f1379-cc0a-ce62-ccf1-220f68ec8fc3/1/.

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Psychosis encompasses a constellation of symptoms that have far-reaching social, physical and functional consequences for sufferers. One of the key clinical concerns in the management of psychotic illnesses is the risk of suicide, which is greatest in the early stages of psychosis. Hopelessness is consistently associated with risk for suicide but as a concept it is not well defined and is not specific enough to be of use in prediction of suicide. Future-directed thinking, particularly regarding positive future events, constitutes an aspect of hopelessness that is closely associated with risk for suicide. This study employed the Future Thinking Task to investigate whether future-directed thinking in first episode psychosis is significantly different from that of matched controls in performance or content, and to clarify the nature of its association with suicide risk in this patient group. In addition, the association of future-directed thinking with the negative symptoms of psychosis was investigated. The results showed that individuals with psychosis were impaired in future-directed thinking globally, particularly with respect to the coming year. Specific deficits were shown in the domains of relations with other people and personal development and understanding. Associations were shown between future-directed thinking and suicide, and reduced positive future-directed thinking was shown to be strongly associated with increased severity of negative symptoms. The results suggest avenues for novel interventions to improve hopelessness, suicide risk and the severity of negative symptoms in psychotic illness, and thereby improve functional outcomes.
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Ajnakina, Olesya. "First episode psychosis : looking backwards and forwards." Thesis, King's College London (University of London), 2017. https://kclpure.kcl.ac.uk/portal/en/theses/first-episode-psychosis(be65b62b-4c1a-496b-b7bf-3ada607e761d).html.

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Introduction: Psychotic disorders are known for their wide variability in clinical and social outcomes beginning from illness onset and throughout their course. Our current lack of understanding of the origins for this heterogeneity is further compounded by dearth in knowledge on how patients come to the attention of mental health services and methodological incongruity across different studies. Employing samples of first episode psychosis (FEP) patients, the aims of this thesis were to: 1) look back on the pathways to care patients used to enter mental health services and the use of prodromal services in South London; and 2) examine trajectories of the psychotic disorders and potential predictors of their longitudinal outcomes. Methods: Two large samples of patients with FEP (i.e., GAP and EU-GEI) were utilised in this thesis. For the study 1, information on pathways to care undertaken prior to coming to generic services for FEP was extracted from the Biomedical Research Centre (BRC) Case Register Interactive Search (CRIS) system. For studies 2, 3 and 4, using electronic clinical records, extensive information in three domains-clinical, social and service uses-was collated over 4-5 years after contact with mental health services. Results: Only a small fraction of individuals (4.1%) who present with FEP to the main secondary mental health provider have previously been in contact with prodromal services and made a subsequent transition to psychotic disorder; 77% this sub-group of patients entered their pathway to care via referral from General Practice or other health professional. In contrast, 45% of FEP group without prior contact with the prodromal services made first contact with mental health services via emergency services and 18% of this group were referred by the criminal justice system. Further, combining the baseline schizophrenia diagnosis with five symptom dimensions (i.e., positive, negative, excited, disorganised/concrete and depressed dimensions) generated the best model fit for predicting time to first remission. During the 5-year follow up after first contact with mental health services, a higher proportion of Black African and Black Caribbean ethnicity had compulsory re-admissions and instances of police involvement during an admission to a psychiatric unit compared with White British ethnic group. Patients of Black African and Black Caribbean ethnicity did not differ from White British ethnic group in overall functional disability and illness severity, or frequency of remission or recovery during the follow up period. However, patients of Black ethnicity become increasing socially excluded as their illness progress. In a sample of first-episode schizophrenia spectrum patients, 35% of the sample met the criteria for treatment resistance (TR) at the end of the first 5 years of follow up. Of these TR patients, 70% of these were treatment resistant from illness onset. Those who subsequently developed TR were more likely to have an early illness onset (<20 years) compared to those with non-TR. The relationship between an early age of onset (<20 years) and TR was specific to patients of Black ethnicity and patients of male gender. Conclusions: Very few of those who come to FEP services come after being seen for an at-risk-mental state by prodromal services suggesting that the scope for reducing or delaying onset of psychosis by this means may still be limited. My results indicate that supplementing the baseline categorical schizophrenia diagnosis with ratings on five symptom dimensions improves the prediction of delayed treatment response as measured by time to first remission. Further, the longitudinal trajectory of psychosis in patients of Black ethnicity did not show greater clinical or functional deterioration than white patients. However, their course remains characterised by more compulsion, and longer periods of admission. Finally, I showed that for the majority of the TR group, lack of response to antipsychotic treatment is present from illness onset, necessitating a consideration for an earlier use of clozapine.
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Baggott, Eleanor. "Recovery from first-episode psychosis and the role for services beyond first-episode detection." Thesis, University of Warwick, 2010. http://wrap.warwick.ac.uk/36710/.

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Contemporary views of psychosis are more positive about outcomes and the potential for people with psychosis to have experiences of recovery. People who experience psychosis often use NHS services to help them manage their difficulties and specialist psychosis services, like Early Intervention (EI) are now common. However, it is not just secondary mental health services that are important in helping to manage people with psychosis. The first paper explores the role for primary care in managing this client group and systematically reviews the UK literature from 1997 on empirically tested methods of improving the primary care management of this group. The evidence in support of specific methods targeting service users, primary care staff and service organisation remain inconclusive and further research and development of initiatives is needed. This paper critically evaluates the methodological limitations of the research and considers the implications for practice and future research. The second paper reports on an empirical investigation into the experiences of recovery in people who have experienced their first-episode of psychosis. Eight participants were recruited from a UK Early Intervention Service and interviewed using a semi-structured method. Interpretive Phenomenological Analysis was used and seven themes related to recovery emerged from the service users’ accounts. The themes are discussed in relation to the clinical implications for EI services and the methodological limitations and future research directions are considered. The third paper reflects on the experiences of conducting empirical research whilst working clinically within the same service. The impact on the research-practitioner, service user-participant and wider service implications are discussed.
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Meek, Ian Tod. "Satisfaction with antipsychotic medication in first episode psychosis." Thesis, University of East Anglia, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.577566.

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Background: Antipsychotic medication is given in first episode psychosis in a prophylactic sense and also as a treatment. Young people experiencing their first episode of psychosis are generally the most responsive to pharmacological treatment. They are also the most susceptible to adverse events. Avoiding adverse events when individuals first start treatment is particularly important as the person's initial clinical experience may colour their attitude to medication thereafter. What it is like to take antipsychotic medication from the perspective of young people experiencing their first episode of psychosis has received relatively little attention, yet non-adherence in this population is reported to be as high as 50%. Objective: The aim of this study was to determine the experience of taking antipsychotic medication from the perspective of young people experiencing their first episode of psychosis. Methods: A purposive sample of young people with first episode psychosis responded to open-ended questions regarding their experience of taking antipsychotic medication. A thematic analysis was undertaken. Results: Twenty young people reported their experiences of taking antipsychotic medication. Eight themes were identified: [1] it does what is says on the tin; [2] impact on mood; [3] the drugs don't work; [4] side effects; [5] acceptability of medication; [6] weighing up the costs and benefits; [7] impact on activities of daily living; [8] there has to be something else. Conclusion: Young people with psychosis reported a mix of both positive and negative views about antipsychotic medication. Sedation was the most frequently reported and troublesome side effect. Hopes that with the advent of atypical antipsychotics adherence would improve with a less severe side effect profile have clearly not come to fruition. It is important to pay attention to young people's uncensored accounts of what it is really like to take antipsychotic medication. Key words: first episode psychosis, antipsychotic agents, patient satisfaction, qualitative research, patient experience, adherence, adverse events
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O'Donoghue, Emma. "Psychological flexibility in a first episode psychosis sample." Thesis, University of London, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.542325.

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Raune, David John. "Psychosocial stress and the first episode of psychosis." Thesis, King's College London (University of London), 2002. https://kclpure.kcl.ac.uk/portal/en/theses/psychosocial-stress-and-the-first-episode-of-psychosis(7e57bcb0-2b09-488e-bd0a-5cf4e7f630d7).html.

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Kolliakou, Anna. "Patterns of cannabis use in first-episode psychosis." Thesis, King's College London (University of London), 2013. https://kclpure.kcl.ac.uk/portal/en/theses/patterns-of-cannabis-use-in-firstepisode-psychosis(9d70beb1-9b58-4143-9bc6-87065b64866b).html.

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There is ample evidence that patients with psychosis are more likely to use illicit substances than the general population, with cannabis being the most popular. Research has also shown that cannabis use is associated with poor prognostic outcomes in patients with an established psychotic disorder. It is important to understand the reasons patients with psychosis endorse for their cannabis use and findings so far point towards an ‘alleviation of dysphoria’ model rather than the ‘self-medication’ hypothesis. It is not known how the level of motivation to change cannabis use can affect patients’ actual use. Lack of validated readiness to change questionnaires for use with psychotic populations makes it essential to develop and validate such measures. The aim of this thesis was to evaluate the reasons for cannabis use and its effects on psychotic outcomes in a patient cohort with first-episode psychosis. The association between cannabis use and other illicit drug use was also investigated. Readiness to change was evaluated as a predictor of cannabis use outcomes using two questionnaires. The main finding was that cannabis use was not associated with psychotic outcomes but was related to other illicit drug use. With regards to reasons, patients chose enhancement and social motives as most important for their cannabis use providing support for the ‘alleviation of dysphoria’ model. Preliminary analysis showed no clear pattern of association between readiness to change and cannabis use outcome. Utility of two readiness to change measures for use with patients with psychosis was not validated. These findings add to the small evidence base that cannabis use is not associated with prognostic outcomes in psychosis. No evidence for the self medication hypothesis was observed. Readiness to change was not associated with cannabis use outcomes signifying the need for using validated measures to assess motivation in psychotic populations.
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Books on the topic "First episode of psychosis"

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Karena, Meehan, and Murray Robin M, eds. First episode psychosis. London: Martin Dunitz, 1999.

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First episode psychosis. London: Dunitz, 1999.

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Castle, David J. Psychosis in the inner city: The Camberwell first episode study. Hove: Psychology Press, 2000.

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Colosimo, Catherine Ann. The experience of first-episode psychosis and hospitalization. Ottawa: National Library of Canada, 1995.

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Beth, Broussard, ed. The first episode of psychosis: A guide for patients and their families. Oxford: Oxford University Press, 2009.

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J, Castle David, ed. Psychosis in the inner city: The Camberwell first episode study. Hove, East Sussex, UK: Psychology Press, 1998.

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Dana, Maude, and Edwards Jane Ph D, eds. Systematic treatment of persistent psychosis (STOPP): A psychological approach to facilitating recovery in young people with first episode psychosis. London: Martin Dunitz, 2003.

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First episode. London]: Bloomsbury, 2015.

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Schultz, Evelyn. Stress response syndrome in first-episode schizophrenia. Ottawa: National Library of Canada, 2000.

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Fuchs, A. P. Axiom-man: Episode #0 : first night out. Winnipeg, MB: Coscom Entertainment, 2007.

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Book chapters on the topic "First episode of psychosis"

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Freudenreich, Oliver. "First-Episode Psychosis." In Psychotic Disorders, 137–56. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-29450-2_11.

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Aitchison, Kathy J., Karena Meehan, and Robin M. Murray. "Prescribing for a first episode of affective psychosis." In First Episode Psychosis, 67–82. 2nd ed. London: CRC Press, 2022. http://dx.doi.org/10.1201/9780429069956-6.

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Aitchison, Kathy J., Karena Meehan, and Robin M. Murray. "Before the onset of frank psychosis." In First Episode Psychosis, 15–27. 2nd ed. London: CRC Press, 2022. http://dx.doi.org/10.1201/9780429069956-3.

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Aitchison, Kathy J., Karena Meehan, and Robin M. Murray. "Psychosocial approaches - 2 Enhancing recovery and staying well." In First Episode Psychosis, 95–107. 2nd ed. London: CRC Press, 2022. http://dx.doi.org/10.1201/9780429069956-8.

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Aitchison, Kathy J., Karena Meehan, and Robin M. Murray. "Antipsychotics: pharmacology." In First Episode Psychosis, 29–42. 2nd ed. London: CRC Press, 2022. http://dx.doi.org/10.1201/9780429069956-4.

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Aitchison, Kathy J., Karena Meehan, and Robin M. Murray. "Why focus on the first episode?" In First Episode Psychosis, 1–7. 2nd ed. London: CRC Press, 2022. http://dx.doi.org/10.1201/9780429069956-1.

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Aitchison, Kathy J., Karena Meehan, and Robin M. Murray. "The presentation and assessment of the first psychotic episode." In First Episode Psychosis, 9–14. 2nd ed. London: CRC Press, 2022. http://dx.doi.org/10.1201/9780429069956-2.

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Aitchison, Kathy J., Karena Meehan, and Robin M. Murray. "Prescribing for a first episode of schizophrenia-like psychosis." In First Episode Psychosis, 43–66. 2nd ed. London: CRC Press, 2022. http://dx.doi.org/10.1201/9780429069956-5.

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Aitchison, Kathy J., Karena Meehan, and Robin M. Murray. "Psychosocial approaches -1 The acute episode and its aftermath." In First Episode Psychosis, 83–93. 2nd ed. London: CRC Press, 2022. http://dx.doi.org/10.1201/9780429069956-7.

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Barras, Christina, and Juliet Hurn. "First episode psychosis (FEP)." In Psychiatry: Breaking the ICE, 147–53. Chichester, UK: John Wiley & Sons, Ltd, 2015. http://dx.doi.org/10.1002/9781118557211.ch23.

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Conference papers on the topic "First episode of psychosis"

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Oscoz Irurozqui, Maitane, Maria Guardiola-Ripoll, Carmen Almodóvar-Payà, Salavador Sarró, Amalia Guerrero-Pedraza, Edith Pomarol-Clotet, and Mar Fatjó-Vilas. "Cannabis use and genes of endocannabinoid system: their role in psychotic symptoms and cognition in first-episode psychosis." In 22° Congreso de la Sociedad Española de Patología Dual (SEPD) 2020. SEPD, 2020. http://dx.doi.org/10.17579/sepd2020o031.

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Objectives. To evaluate the association of cannabis use, genes of the endocannabinoid system and their interaction on clinical symptoms and cognitive performance in patients with a first-episode of pyschosis. Background. The role of both cannabis use and individual genetic background has been shown in the risk for psychosis. However, the influence of cannabis and variability at endocannabinoid genes on the psychosis outcome still remains inconclusive. Materials and Methods. The sample comprised 43 Caucasian individuals with a first-episode of psychosis (mean age(sd)=25.80(6.39) years, 76.7% males, 51.2% cannabis users).There were no differences in age and sex between cannabis users and non-users. Genetic variability was assessed by genotyping one Single Nucleotide Polymorphism (SNP) in each gene (CNR1-rs1049353 and CNR2-rs2501431). Clinical (PANSS, GAF) and neuropsychological (WAIS, WMS, BADS) scales were administered. Results and conclusions. Genotypic frequencies did not differ between cannabis users and non-users. Cannabis use was associated with better manipulative abilities (IQ-M-WAIS, p=0.029) and better executive function (BADS, p=0.036). CNR1-T allele carriers presented higher disorganized and negative syndrome scores (p=0.001 and p=0.044, respectively). The interaction models evidenced a combined effect of CNR1 and cannabis use on the negative syndrome-PANSS (p=0.037). These results suggest the role of cannabis use and genetic background on cognitive and psychopathological outcomes in first-episode psychosis. However, evidence is still scant, and further investigation in larger samples is needed.
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Oscoz Irurozqui, Maitane, Maria Guardiola-Ripoll, Carmen Almodóvar-Payá, Amalia Guerrero-Pedraza, Edith Pomarol-Clotet, and Mar Fatjó. "CNR2 GENE AND CANNABIS USE INTERPLAY MODULATES MANIPULATIVE ABILITIES IN FIRST-EPISODE OF PSYCHOSIS." In 23° Congreso de la Sociedad Española de Patología Dual (SEPD) 2021. SEPD, 2021. http://dx.doi.org/10.17579/sepd2021o003.

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1. Objectives: While endocannabinoid system seems to be involved in processes underlying psychosis, research about Cannabinoid Receptor 2 gene (CNR2) is scarce and inconclusive. Some few reports indicate that CNR2 plays a role in psychiatric conditions, including depression or drug addiction (Onaivi et al., 2009). We aimed to evaluate the role of CNR2 and its interplay with cannabis on cognition and clinical symptoms in patients with a first-episode of psychosis (FEP). 2. Materials and Methods: the sample comprised 50 Caucasian individuals with a FEP (mean age(sd)=26.14(6.55) years, 76% males, 58% cannabis users). There were no differences in age, sex, premorbid IQ and antipsychotic dose between cannabis users (CU) and non-users (CNU). Neuropsychological (premorbid IQ - TAP-E, current IQ - WAIS, memory - WMS, executive function - BADS) and clinical (psychotic symptoms - PANSS, general functioning - GAF) scales were administered. Genetic variability was assessed by genotyping one Single Nucleotide Polymorphism (SNP) in CNR2 gene (rs2501431) (qPCR, TaqMan). 3. Results and conclusions: genotypic frequencies did not differ between cannabis users and non-users. CNR2 was not associated with PANSS scores.; however, it showed a differential effect on the performance IQ (measured by the matrix reasoning test - WAIS), conditional to the cannabis use (beta=0.73, p=0.02),. In particular, cannabis non-users with the AA genotype (23.53%) showed higher scores (mean(sd)=10.25 (1.87)) than those with at least one copy of the G allele (76.47%, mean(sd)=6.05(0.99); while cannabis users showed scores in the opposite direction (AA (42.31%): 8.21(1.09) and GG/GA (57.69%): 10.28(0.92)). Our results align with previous studies reporting the association of the CNR2 gene with psychiatric diseases (Ishiguro et al. 2007; Onaivi et al., 2008) adding evidence on the interplay of this gene with cannabis use on cognitive outcomes in first-episode psychosis. However, evidence is still scant, and further investigation in larger samples is needed.
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Wang, Danni, Kaiming Zhuo, Yongjun Zhu, Dengtang Liu, and Yao Li. "Abnormal interhemispheric functional interactions in drug-naïve adult-onset first episode psychosis patients." In 2019 41st Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC). IEEE, 2019. http://dx.doi.org/10.1109/embc.2019.8856878.

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"PV-126 - BETWEEN MY MOTHER AND COCAINE: FOLIE A DEUX. A CASE REVIEW." In 24 CONGRESO DE LA SOCIEDAD ESPAÑOLA DE PATOLOGÍA DUAL. SEPD, 2022. http://dx.doi.org/10.17579/abstractbooksepd2022.pv126.

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Introduction: "Folie a deux" is defined as the transference of delusional ideas in individuals with a close and intimate relationship. While the relationship between cocaine use and psychosis is well described in the scientific literature, there are not many studies on how cocaine use affects individuals who share a “folie a deux”. Objective: To identify and compile the different factors that may drive the patient's psychotic episode. Material and methods: Review of the clinical history of a patient admitted to the Salamanca UHB with a diagnosis of substance-induced psychotic disorder. Clinical case: A 41 year old single man, who lives in a farm located in a village with 12,000 inhabitants, was referred with judicial authorisation from a Court of First Instance and Instruction for Psychiatric Assessment. He presented delusional ideation in relation to a neighbour. The Court report included occasional episodes of heteroaggressive behaviour. He also tested positive for cocaine (more than 900 ng/ml) in the hospital admission analysis. Interviewing his mother, who is still living in the same building as said neighbour, there was evidence of an increased delusional ideation in her regard. Results and conclusions: Despite incorporating the delusional ideation into his biography, the patient was able to develop his life away from the original focus. According to the reconstruction of the history, the behavioural alterations usually appeared in the context of consumption. The “folie a deux” develops slowly and is perpetuated chronically by the members who share it. On the other hand, about 60% of drug users have a psychotic episode during their lifetime. The coexistence of these two factors in the context of a psychotic episode opens up several lines of work in intervention and therapeutic orientation.
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Alghamdi, Wajdi, Daniel Stamate, Katherine Vang, Daniel Stahl, Marco Colizzi, Giada Tripoli, Diego Quattrone, Olesya Ajnakina, Robin M. Murray, and Marta Di Forti. "A Prediction Modelling and Pattern Detection Approach for the First-Episode Psychosis Associated to Cannabis Use." In 2016 15th IEEE International Conference on Machine Learning and Applications (ICMLA). IEEE, 2016. http://dx.doi.org/10.1109/icmla.2016.0148.

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Li, Wenli, Qiong Xiang, Dengtang Liu, and Yao Li. "Disrupted Coupling Between NAA and Functional Connectivity in Ventromedial Prefrontal Cortex of Drug-Naïve First-Episode Psychosis." In 2020 42nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) in conjunction with the 43rd Annual Conference of the Canadian Medical and Biological Engineering Society. IEEE, 2020. http://dx.doi.org/10.1109/embc44109.2020.9176293.

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Charles, Rebecca, and Baskaran Sridharan. "33 First episode psychosis in a patient with extensive leukoencephalopathy due to 3-methylglutaconic aciduria type 4." In The British Neuropsychiatry Association – Annual Meeting. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/jnnp-2019-bnpa.33.

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Gorrell, Genevieve, Sherifat Oduola, Angus Roberts, Tom Craig, Craig Morgan, and Rob Stewart. "Identifying First Episodes of Psychosis in Psychiatric Patient Records using Machine Learning." In Proceedings of the 15th Workshop on Biomedical Natural Language Processing. Stroudsburg, PA, USA: Association for Computational Linguistics, 2016. http://dx.doi.org/10.18653/v1/w16-2927.

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Gonçalves, Maria João, Rita André, Joana Romão, Rodrigo Saraiva, Gabriela Andrade, Elsa Fernandes, Manuela Abreu, and Fátima Ismail. "PRIMER EPISODIO PSICÓTICO Y EL CONSUMO DE CANNABIS: ¿CUÁL ES EL IMPACTO EN LA COGNICIÓN?" In 23° Congreso de la Sociedad Española de Patología Dual (SEPD) 2021. SEPD, 2021. http://dx.doi.org/10.17579/sepd2021o020.

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1.Objetivos: La prevalencia del trastorno por uso de cannabis (TUC) es <10% en la población general, llegando a 27,1% en la esquizofrenia. El 64% de personas con primer episodio psicótico (PEP) consumen cannabis, el 30% de los cuales presentan TUC. Los pacientes con diagnosis de PEP tienen mayor probabilidad de presentar consumo de cannabis de alta potencia (THC > 10%). Los déficits cognitivos en pacientes con esquizofrenia (con o sin consumo de cannabis) son determinantes para su funcionamiento, y parecen estar presentes desde el PEP. Revisar el conocimiento actual acerca de la asociación entre TUC y los déficits cognitivos en personas con PEP. 2.Material y métodos: Selección de artículos científicos publicados en los últimos 6 años; recerca en bases de datos utilizando la combinación de términos MeSH: “cannabis use”, “first-episode psychosis”y “cognitive impairment”. 3.Resultados y conclusiones: Los estudios desarrollados se han centrado en la relación entre el consumo de cannabis y cognición en PEP, con la evaluación de funciones neurocognitivas a registrar mayor afección en la atención, memoria verbal y funciones executivas. Sin embargo, algunos resultados han sido contradictorios debido a fatores como: heterogeneidad de cuadros clínicos (hay estudios con un enfoque en psicosis en general, incluyendo psicosis afectivas, mientras que otros se centran específicamente en esquizofrenia o PEP); El cannabis presenta tetrahidrocanabinol (THC) y canabidiol (CBD) que pueden tener efetos opuestos en la cognición. El THC tiene un efeto prejudicial y hay evidencia de que el CBD puede mejorar la cognición. Son necesarios nuevos estudios para evaluar la asociación entre el consumo de cannabis y disfunción cognitiva. Sin embargo, las muestras deben tener un tamaño significativo, uniformidad diagnostica y deben ser controlados los fatores confundentes en las variables evaluadas. Así, deben ser estudiadas las características diferenciales entre cuadros clínicos aisladamente para que los resultados pueden ser verificados y replicados.
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"A Case Study of Life-purpose Orientations in Personalities of Patients with Schitzotypal Disorder and Schisophrenes After their First Psychotic Episode." In Congress on mental health meeting the needs of the XXI century. Gorodets, 2016. http://dx.doi.org/10.22343/mental-health-congress-compendium262-264.

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Reports on the topic "First episode of psychosis"

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McDonagh, Marian S., Jesse Wagner, Azrah Y. Ahmed, Benjamin Morasco, Devan Kansagara, and Roger Chou. Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain: May 2021 Update. Agency for Healthcare Research and Quality (AHRQ), June 2021. http://dx.doi.org/10.23970/ahrqepccerplantpain3.

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Overview This is the third quarterly progress report for an ongoing living systematic review on cannabis and other plant-based treatments for chronic pain. The first progress report was published in January 2021 and the second in March 2021. The draft systematic review was available for public comment from May 19 through June 15, 2021, on the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care website. The systematic review synthesizes evidence on the benefits and harms of plant-based compounds (PBCs), such as cannabinoids and kratom, used to treat chronic pain, addressing concerns about severe adverse effects, abuse, misuse, dependence, and addiction. The purpose of this progress report is to describe the cumulative literature identified thus far. This report will be periodically updated with new studies as they are published and identified, culminating in an annual systematic review that provides a synthesis of the accumulated evidence. Main Points In patients with chronic (mainly neuropathic) pain with short-term treatment (4 weeks to <6 months): • Studies of cannabis-related products were grouped based on their tetrahydrocannabinol (THC) to cannabidiol (CBD) ratio using the following categories: high THC to CBD, comparable THC to CBD, and low THC to CBD. • Comparable THC to CBD ratio oral spray is probably associated with small improvements in pain severity and may be associated with small improvements in function. There was no effect in pain interference or serious adverse events. There may be a large increased risk of dizziness and sedation, and a moderate increased risk of nausea. • Synthetic THC (high THC to CBD) may be associated with moderate improvement in pain severity and increased risk of sedation, and large increased risk of nausea. Synthetic THC is probably associated with a large increased risk of dizziness. • Extracted whole-plant high THC to CBD ratio products may be associated with large increases in risk of withdrawal due to adverse events and dizziness. • Evidence on whole-plant cannabis, low THC to CBD ratio products (topical CBD), other cannabinoids (cannabidivarin), and comparisons with other active interventions was insufficient to draw conclusions. • Other key adverse event outcomes (psychosis, cannabis use disorder, cognitive deficits) and outcomes on the impact on opioid use were not reported. • No evidence on other plant-based compounds, such as kratom, met criteria for this review.
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Tweet, Justin S., Vincent L. Santucci, Kenneth Convery, Jonathan Hoffman, and Laura Kirn. Channel Islands National Park: Paleontological resource inventory (public version). National Park Service, September 2020. http://dx.doi.org/10.36967/nrr-2278664.

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Channel Island National Park (CHIS), incorporating five islands off the coast of southern California (Anacapa Island, San Miguel Island, Santa Barbara Island, Santa Cruz Island, and Santa Rosa Island), has an outstanding paleontological record. The park has significant fossils dating from the Late Cretaceous to the Holocene, representing organisms of the sea, the land, and the air. Highlights include: the famous pygmy mammoths that inhabited the conjoined northern islands during the late Pleistocene; the best fossil avifauna of any National Park Service (NPS) unit; intertwined paleontological and cultural records extending into the latest Pleistocene, including Arlington Man, the oldest well-dated human known from North America; calichified “fossil forests”; records of Miocene desmostylians and sirenians, unusual sea mammals; abundant Pleistocene mollusks illustrating changes in sea level and ocean temperature; one of the most thoroughly studied records of microfossils in the NPS; and type specimens for 23 fossil taxa. Paleontological research on the islands of CHIS began in the second half of the 19th century. The first discovery of a mammoth specimen was reported in 1873. Research can be divided into four periods: 1) the few early reports from the 19th century; 2) a sustained burst of activity in the 1920s and 1930s; 3) a second burst from the 1950s into the 1970s; and 4) the modern period of activity, symbolically opened with the 1994 discovery of a nearly complete pygmy mammoth skeleton on Santa Rosa Island. The work associated with this paleontological resource inventory may be considered the beginning of a fifth period. Fossils were specifically mentioned in the 1938 proclamation establishing what was then Channel Islands National Monument, making CHIS one of 18 NPS areas for which paleontological resources are referenced in the enabling legislation. Each of the five islands of CHIS has distinct paleontological and geological records, each has some kind of fossil resources, and almost all of the sedimentary formations on the islands are fossiliferous within CHIS. Anacapa Island and Santa Barbara Island, the two smallest islands, are primarily composed of Miocene volcanic rocks interfingered with small quantities of sedimentary rock and covered with a veneer of Quaternary sediments. Santa Barbara stands apart from Anacapa because it was never part of Santarosae, the landmass that existed at times in the Pleistocene when sea level was low enough that the four northern islands were connected. San Miguel Island, Santa Cruz Island, and Santa Rosa Island have more complex geologic histories. Of these three islands, San Miguel Island has relatively simple geologic structure and few formations. Santa Cruz Island has the most varied geology of the islands, as well as the longest rock record exposed at the surface, beginning with Jurassic metamorphic and intrusive igneous rocks. The Channel Islands have been uplifted and faulted in a complex 20-million-year-long geologic episode tied to the collision of the North American and Pacific Places, the initiation of the San Andreas fault system, and the 90° clockwise rotation of the Transverse Ranges, of which the northern Channel Islands are the westernmost part. Widespread volcanic activity from about 19 to 14 million years ago is evidenced by the igneous rocks found on each island.
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Additional therapy helps social recovery from first episode psychosis. National Institute for Health Research, February 2018. http://dx.doi.org/10.3310/signal-000558.

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Women and ADHD – Episode 4 ‘ADHD, A Young Person’s Guide’. ACAMH, October 2022. http://dx.doi.org/10.13056/acamh.21203.

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Hosted by Dr. Blandine French, this podcast series focuses on attention-deficit/hyperactivity disorders (ADHD) and is designed to help young people and their families. This episode is the first of a two-part special on Women and ADHD, and Blandine is joined by Dr. Jo Steer. We are delighted to produce this podcast series in partnership with Clinical Partners, the UK’s largest private mental health partnership.
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Flood Situation Report August 2008. Vientiane, Lao PDR: Mekong River Commission Secretariat, September 2008. http://dx.doi.org/10.52107/mrc.ajhz90.

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The August 2008 event was the first regional flood episode for which the RFMMC provided forecasting services. The report discusses water levels, flood discharges, risk occurrence and prospect for rest of the 2008 flood season.
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Phenomenology of Gender Dysphoria in Autism. ACAMH, January 2023. http://dx.doi.org/10.13056/acamh.22473.

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In this ‘Papers Podcast’ episode, we are joined by Dr. Kate Cooper to discuss her JCPP paper ‘Phenomenology of gender dysphoria in autism: a multiperspective qualitative analysis’. Kate is the first author of the paper.
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