Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?

Falkenberg, Irina; Valmaggia, Lucia; Byrnes, Majella; Frascarelli, Marianna; Jones, Ceri; Rocchetti, Matteo; Straube, Benjamin; Badger, Steven; McGuire, Philip; Fusar‐Poli, Paolo

doi:10.1016/j.psychres.2015.05.018

Cited by 115 publications

(95 citation statements)

References 68 publications

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“…Recent studies on patients with clinical high-risk states also confirmed high levels of help-seeking [32,33]. Furthermore, in clinical high-risk samples, the trigger for help-seeking in the majority of individuals was found to be concomitant nonpsychotic symptoms such as depression and/or anxiety rather than attenuated or manifest psychotic symptoms [34,35]. …”

Section: Discussionmentioning

confidence: 94%

“Lanthanic Presentation” in First-Episode Psychosis Predicts Long Service Delay: The Challenge of Detecting Masked Psychosis

Kvig

Brinchmann²,

Moe³

et al. 2017

Psychopathology

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Background/Aims: Studies of pathways to care in first-episode psychosis have documented a substantial treatment delay occurring after patients enter mental health services. An initial presentation with neurotic rather than psychotic symptoms is common in first-episode psychosis. The term “lanthanic patient” has been used to refer to patients presenting with a reason for help-seeking that is unrelated to the underlying pathology. The aim of this study is to explore whether a lanthanic presentation is related to prolonged service delay. Methods: The sample comprises 62 patients with recent-onset psychosis. Data on sociodemographic, clinical, help-seeking, and pathway indicators were collected using a comprehensive, semistructured-interview schedule. Results: Service delay accounted for more than half of the overall treatment delay. An initially presenting complaint of neurotic symptoms was related to prolonged service delay. The effect remained after controlling for other potential risk factors of service delay. Conclusion: Anomalous experiences of pleasure, desire, or motivation are common in emerging psychosis. These difficulties are often misinterpreted as complaints of depression and anxiety by health professionals. The presence of such symptoms can introduce a focal vision on the part of health care professionals on the immediate presentation rather than the underlying psychopathology, leading to the underdetection of psychosis.

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Section: Discussionmentioning

confidence: 94%

“Lanthanic Presentation” in First-Episode Psychosis Predicts Long Service Delay: The Challenge of Detecting Masked Psychosis

Kvig

Brinchmann²,

Moe³

et al. 2017

Psychopathology

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“…Firstly, this state is the closest antecedent of psychosis by definition, with onset of the disorder occurring from within a few months of ultra-high-risk diagnosis 110 . Indeed, some ultra-highrisk individuals already present with severe symptoms, including short-lived psychotic episodes 111,112 , affective symptoms 113 and impaired functioning 114 . Secondly, the ultra-high-risk state is intrinsically heterogeneous 10,115 , including different subgroups 115 and varying diagnostic operationalizations 116 .…”

Section: Discussionmentioning

confidence: 99%

What causes psychosis? An umbrella review of risk and protective factors

et al. 2018

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Psychosis is a heterogeneous psychiatric condition for which a multitude of risk and protective factors have been suggested. This umbrella review aimed to classify the strength of evidence for the associations between each factor and psychotic disorders whilst controlling for several biases. The Web of Knowledge database was searched to identify systematic reviews and meta-analyses of observational studies which examined associations between socio-demographic, parental, perinatal, later factors or antecedents and psychotic disorders, and which included a comparison group of healthy controls, published from 1965 to January 31, 2017. The literature search and data extraction followed PRISMA and MOOSE guidelines. The association between each factor and ICD or DSM diagnoses of non-organic psychotic disorders was graded into convincing, highly suggestive, suggestive, weak, or non-significant according to a standardized classification based on: number of psychotic cases, random-effects p value, largest study 95% confidence interval, heterogeneity between studies, 95% prediction interval, small study effect, and excess significance bias. In order to assess evidence for temporality of association, we also conducted sensitivity analyses restricted to data from prospective studies. Fifty-five meta-analyses or systematic reviews were included in the umbrella review, corresponding to 683 individual studies and 170 putative risk or protective factors for psychotic disorders. Only the ultra-high-risk state for psychosis (odds ratio, OR59.32, 95% CI: 4.91-17.72) and Black-Caribbean ethnicity in England (OR54.87, 95% CI: 3.96-6.00) showed convincing evidence of association. Six factors were highly suggestive (ethnic minority in low ethnic density area, second generation immigrants, trait anhedonia, premorbid IQ, minor physical anomalies, and olfactory identification ability), and nine were suggestive (urbanicity, ethnic minority in high ethnic density area, first generation immigrants, North-African immigrants in Europe, winter/spring season of birth in Northern hemisphere, childhood social withdrawal, childhood trauma, Toxoplasma gondii IgG, and non-right handedness). When only prospective studies were considered, the evidence was convincing for ultra-high-risk state and suggestive for urbanicity only. In summary, this umbrella review found several factors to be associated with psychotic disorders with different levels of evidence. These risk or protective factors represent a starting point for further etiopathological research and for the improvement of the prediction of psychosis.

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“…Screening procedures need to be implemented, since it is well known that those who suffer from such symptoms appear reluctant to seek professional help (26) . In particular, only 2 out of 5 people who experience symptoms of mood or anxiety disorders seek assistance form health care professionals during the first year of the onset of the disorder (26) ; this delay may not only jeopardize the quality and safety of delivered care, but may also influence the clinical outcome of such symptoms negatively (27) . With regard to PTSD symptoms, three studies demonstrated data in relation to their frequency.…”

Section: Discussionmentioning

confidence: 99%

Dysfunctional psychological responses among Intensive Care Unit nurses: a systematic review of the literature

Karanikola

Giannakopoulou

Mpouzika

et al. 2015

Rev. esc. enferm. USP

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Objective:To systematically review evidence on dysfunctional psychological responses of Intensive Care Units nurses (ICUNs), with focus on anxiety and depressive symptoms and related factors. Method: A literature search was performed in CINAHL, PubMed and Scopus databases, from 1999 to present, along with a critical appraisal and synthesis of all relevant data. The following key words, separately and in combination, were used: "mental status" "depressive symptoms" "anxiety" "ICU nurses" "PTSD" "burnout" "compassion fatigue" "psychological distress". Results: Thirteen quantitative studies in English and Greek were included. The results suggested increased psychological burden in ICUNs compared to other nursing specialties, as well as to the general population. Conclusions: Studies investigating psychological responses of ICUNs are limited, internationally. Future longitudinal and intervention studies will contribute to a better understanding of the phenomenon.

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Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?

Cited by 115 publications

References 68 publications

“Lanthanic Presentation” in First-Episode Psychosis Predicts Long Service Delay: The Challenge of Detecting Masked Psychosis

“Lanthanic Presentation” in First-Episode Psychosis Predicts Long Service Delay: The Challenge of Detecting Masked Psychosis

What causes psychosis? An umbrella review of risk and protective factors

Dysfunctional psychological responses among Intensive Care Unit nurses: a systematic review of the literature

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