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Brain functional connectivity and local coherence in non-converters with clinical high risk for psychosis
IntroductionInvestigation 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.ObjectivesWe 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.MethodsTwenty-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.ResultsCHR 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).ConclusionsOur 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 InterestNone Declared
Journal Article
Inhalant use and psychosis: EXPERIENCE of a moroccan addiction departement
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
Journal Article
Innovations in psychosocial interventions for psychosis : working with the hard to reach
Despite the steady acceptance of psychological interventions for people with psychosis in routine practice many continue to experience problems in their recovery. The need to develop new approaches, particularly for those who are more difficult to engage and have significant co-morbidities is therefore important. This volume positions psychological formulation as a key organising principle for the delivery of care within multidisciplinary teams. The interventions described all have the common theme of supporting recovery and achieving goals that are of primary importance to the service user, which targets them at broader obstacles to recovery.
Book
047 An unusual cause of psychosis
A 24 year old woman was referred with a 3/52 history of headaches, memory problems, paranoia and confabulation.Examination was normal. AMT was 8/10. CT head and CSF were unremarkable. She self-discharged before an MRI. She was felt to have capacity.Four weeks later the psychiatry team sought advice reporting worsening symptoms. This patient was held under section. She reported significant headache, an unusual feature of a primary mental health problem.Anti NMDA of the serum and CSF were arranged (negative) an EEG did not show any concerning findings. During the hospital stay she managed to sneak off twice and was bought back by the police as it was felt that she lacked capacity.MRI revealed a pituitary microadenoma. She was assessed by Endocrinology. Extensive investigations concluded a diagnosis of ‘Cushing disease’. Metyrpaone was administered for Cortisol suppression. Tansphenoidal surgery took place after.On subsequent clinic visits, gradual improvement in the symptoms was reported until ultimately she was completely back to her normal self (around 2/12 post-surgery).DiscussionPsychosis is a rare feature of Cushing disease.1 This case demonstrates the diagnostic difficulties in these cases and the need of involvement and collaboration of different specialties for diagnosis and management.ReferencesMcCallum RW, Parameswaran V, Duffield A, Hoffman L, Burgess JR, Greenaway T. Cushing’s disease presenting as a Schizophreniform psychosis. Endocrine Abstracts (2006):11;P117.
Journal Article
041 Psychosis: a rare manifestation of moyamoya disease in an adult
IntroductionMoyamoya disease is a chronic progressive cerebrovascular occlusive disease with prominent basal collateral vessels which appear hazy like a puff of smoke on angiography. Neuropsychiatric disorders have been reported in 20–60% cases and the most common manifestations include depression, anxiety and other cognitive disorders. However, only a few case reports of onset of a psychotic disorder following a cerebrovascular accident. We present a rare presentation of Moyamoya disease in adulthood.CaseA 44-year-old man from Bangladesh presented with acute psychotic episodes of visual, auditory and tactile hallucinations, paranoia, somatoform disorders and non-epileptic attacks. He had a 3-year history of mental health disorders and was later admitted to the hospital with a headache and hemiparesis secondary to an intraventricular haemorrhage. The neuroimaging showed characteristic appearances of Moyamoya disease. Neurosurgical multidisciplinary meeting discussion opted for conservative management and stroke rehabilitation. Despite the improvement of his neurological deficits, he continued to show apathy, depression, psychogenic attacks with features of executive dysfunction. Due to family history of juvenile death in the family, the patient had genetic testing and was found to have the mutation in the gene Ring finger protein 213 (RNF213).ConclusionThis case highlights the awareness of neuropsychiatric manifestation of Moyamoya disease that could be related to the interruption of the striato-thalamo-cortical circuits. The susceptibility to Moyamoya disease-2 (MYMY2) may be conferred by variation in the RNF213 gene on chromosome 17q25.
Journal Article