Delusional Themes are More Varied Than Previously Assumed: A Comprehensive Systematic Review and Meta-Analysis.

Background And Hypothesis: Delusions are classified into themes but the range of themes reported in the literature has never been examined and the extent to which they differ in prevalence, or relate to clinical characteristics or cultural variation, remains poorly understood.

Study Design: We identified studies reporting delusional theme prevalence in adults with psychosis and completed two multivariate, multilevel, random-effects meta-analyses: one including data from structured assessment scales only and another also including data from ad hoc and clinical assessments to include themes from a wider range of countries and contexts. Sensitivity and meta-regression analyses examined the association with clinical and methodological variables.

Sub-clinical systemic inflammation as a determinant of admission duration in psychosis.

Background: The immune system may play an important role in the aetiology of psychotic disorders and there is increasing interest in the relationship between immune markers and clinical outcomes in psychosis. The present study investigated whether subclinical systemic inflammation was associated with length of stay in individuals with psychosis admitted to a psychiatric hospital. We tested the hypothesis that a higher level of subclinical systemic inflammation, as measured by the neutrophil-to-lymphocyte ratio (NLR) would be associated with a longer period in hospital.

Effectiveness of antipsychotic drug therapy for treating psychosis in people with epilepsy: A systematic review.

Individuals with epilepsy are at risk of developing preictal, ictal, postictal and interictal psychoses. Antipsychotic drugs (APDs) are the main class of drugs used to treat psychosis and schizophrenia. The efficacy and safety of APDs as a treatment for epileptic psychosis is not well understood.

The association between visual hallucinations and secondary psychosis: a systematic review and meta-analysis.

Introduction: Visual hallucinations are often considered to be suggestive of a secondary cause of psychosis, however, this association has never been assessed meta-analytically. We aimed to compare the presence of visual hallucinations in patients with psychosis due to a primary or secondary cause.

Method: We conducted a meta-analysis of case-control studies directly comparing primary and secondary psychosis.

Pediatric traumatic brain injury as a risk factor for psychosis and psychotic symptoms: a systematic review and meta-analysis.

Background: Psychosis is one of the most disabling psychiatric disorders. Pediatric traumatic brain injury (pTBI) has been cited as a developmental risk factor for psychosis, however this association has never been assessed meta-analytically.

Methods: A systematic review and meta-analysis of the association between pTBI and subsequent psychotic disorders/symptoms was performed.

Early neutrophil trajectory following clozapine may predict clozapine response - Results from an observational study using electronic health records.

Background: Clozapine has unique effectiveness in treatment-resistant schizophrenia and is known to cause immunological side-effects. A transient spike in neutrophils commonly occurs in the first weeks of clozapine therapy. There is contradictory evidence in the literature as to whether neutrophil changes with clozapine are linked to treatment response.

Prevalence of Neuroradiological Abnormalities in First-Episode Psychosis: A Systematic Review and Meta-analysis.

Importance: Individuals presenting with first-episode psychosis (FEP) may have a secondary ("organic") etiology to their symptoms that can be identified using neuroimaging. Because failure to detect such cases at an early stage can have serious clinical consequences, it has been suggested that brain magnetic resonance imaging (MRI) should be mandatory for all patients presenting with FEP. However, this remains a controversial issue, partly because the prevalence of clinically relevant MRI abnormalities in this group is unclear.

What are the barriers and facilitators of clozapine use in early psychosis? A survey of UK early intervention clinicians.

Clozapine is the most effective medication for treatment-resistant psychosis, but evidence points to substantial underuse, especially within early intervention psychosis (EIP) services. We explored clinicians' views on perceived barriers and facilitators to offering patients clozapine within EIP services. A cross-sectional survey was distributed electronically to clinicians practising in EIP services across England.

Serum immune markers and transition to psychosis in individuals at clinical high risk.

Individuals at clinical high risk (CHR) for psychosis have been found to have altered cytokine levels, but whether these changes are related to clinical outcomes remains unclear. We addressed this issue by measuring serum levels of 20 immune markers in 325 participants (n = 269 CHR, n = 56 healthy controls) using multiplex immunoassays, and then followed up the CHR sample to determine their clinical outcomes. Among 269 CHR individuals, 50 (18.

Clozapine for treatment resistance in early psychosis: a survey of UK clinicians' training, knowledge and confidence.

Background: Clozapine is the only medication licenced for patients with psychosis that is resistant to conventional antipsychotic treatment. However, despite its effectiveness, it remains widely underutilised. One contributory factor for this may be clinicians' lack of confidence around the management of clozapine.

Clozapine haematological monitoring for neutropenia: a global perspective.

Aims: Clozapine is licensed for treatment-resistant psychosis and remains underutilised. This may berelated to the stringent haematological monitoring requirements that are mandatory in most countries. We aimed to compare guidelines internationally and develop a novel Stringency Index.

Neuropsychiatric Features of Fregoli Syndrome: An Individual Patient Meta-Analysis.

Objective: Fregoli syndrome is a rare delusion characterized by the belief that familiar people are presenting themselves disguised as others to the affected person. Theories of delusional misidentification have suggested secondary ("organic") underlying mechanisms; however, the pathoetiology of Fregoli syndrome has not been systematically evaluated. The investigators aimed to compare the neuropsychiatric features of Fregoli syndrome in primary and secondary psychoses.

Patients' Experiences of Clozapine for Treatment-Resistant Schizophrenia: A Systematic Review.

Background: Clozapine is the most effective antipsychotic for patients with treatment-resistant schizophrenia (TRS), however, it remains widely under-utilized in clinical practice. To date, relatively little attention has been given to patients' experience of clozapine. By synthesizing the existing literature, we sought to determine the experiences of patients with TRS treated with clozapine.

The clinical relevance of serum versus CSF NMDAR autoantibodies associated exclusively with psychiatric features: a systematic review and meta-analysis of individual patient data.

Background: A variety of psychiatric syndromes are associated with NMDAR autoantibodies; however, their clinical relevance when only present in the serum is unclear. We explored whether patients with CSF NMDAR autoantibodies could be distinguished from patients with serum-only NMDAR autoantibodies.

Methods: The electronic databases MEDLINE, EMBASE, PubMed, and PsycINFO were searched.

Reducing the Risk of Withdrawal Symptoms and Relapse Following Clozapine Discontinuation-Is It Feasible to Develop Evidence-Based Guidelines?

Clozapine is the only antipsychotic that is effective in treatment-resistant schizophrenia. However, in certain clinical situations, such as the emergence of serious adverse effects, it is necessary to discontinue clozapine. Stopping clozapine treatment poses a particular challenge due to the risk of psychotic relapse, as well as the development of withdrawal symptoms.

Clozapine discontinuation withdrawal symptoms in schizophrenia.

Clozapine is an atypical antipsychotic used in treatment-resistant schizophrenia. Whilst clozapine is highly effective, there are some clinical scenarios, such as the emergence of severe side effects, that necessitate its discontinuation. There is an emerging literature suggesting that discontinuing antipsychotics, in particular clozapine, can cause an array of withdrawal symptoms.

Quantitative EEG as a Prognostic Tool in Suspected Anti-N-Methyl- d -Aspartate Receptor Antibody Encephalitis.

Purpose: Anti-N-methyl- d -aspartate receptor (anti-NMDAR) encephalitis is a form of autoimmune encephalitis associated with EEG abnormalities. In view of the potentially severe outcomes, there is a need to develop prognostic tools to inform clinical management. The authors explored whether quantitative EEG was able to predict outcomes in patients with suspected anti-NMDAR encephalitis.

Clozapine Response in Schizophrenia and Hematological Changes.

Background: Clozapine is the only effective medication for treatment-resistant schizophrenia; however, its mechanism of action remains unclear. The present study explored whether its effectiveness is related to changes in hematological measures after clozapine initiation.

Methods: Patients with treatment-resistant schizophrenia commenced on clozapine between January 2007 and December 2014 by the United Kingdom's largest mental health trust were identified from electronic patient records.

Focussing on the fundaments - assessing and treating Clozapine Induced Gastrointestinal Hypomotility.

Clozapine is a second-generation antipsychotic used in treatment-resistant Schizophrenia (TRS). Clozapine Induced Gastrointestinal Hypomotility (CIGH) is the commonest cause of clozapine related death, yet remains under-recognised and under-monitored. To review the pharmacological management of CIGH.

Transient Musical Hallucinations in a Young Adult Male Associated with Alcohol Withdrawal.

We present the case of a 25-year-old male who presented to A&E with isolated musical hallucinations, in the absence of audiological or neurological disease. The patient had a history of recreational drug use and a family history of psychosis. Hallucinations, which were preceded by discontinuation of alcohol and reinitiation of citalopram for depression, resolved spontaneously after three days.

Catatonia and the immune system: a review.

Catatonia is a psychomotor disorder featuring stupor, posturing, and echophenomena. This Series paper examines the evidence for immune dysregulation in catatonia. Activation of the innate immune system is associated with mutism, withdrawal, and psychomotor retardation, which constitute the neurovegetative features of catatonia.