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"Pre-psychotic Signals"
Hello,
I came across this in the Journal of Nervous And Mental Disease. I hadn't heard of their being early warning signs of psychosis coming on. I hope people find this helpful.
"The discovery of a mechanism of early identification of prepsychotic signals was replicated in additional studies (Dittmann and Schuttler, 1990), and its importance was described in a first-person account by Leete (1989). A woman in her 50s diagnosed with schizoaffective disorder who was interviewed for our study described how she calls a Crisis Hotline when she perceives that a relapse might be impending.
“I depend on [calling the Crisis Hotline]. I’m trying to keep from going in [the acute hospital unit]. I don’t want to go back there . . . usually when I call crisis and reach out for help and tell them how I am feeling they will either tell me to come to the emergency room or to get my medicine, take my medicine as prescribed, take me a cup of tea or drink a glass of milk and lie down for a while. If that doesn’t work, get up and see if you can go around, be around somebody.”
The principles of monitoring warning signs have been used to develop relapse prevention programs (Herz et al., 2000; Lam et al., 2000; Perry et al., 1999; Scott et al., 2001) that teach a form of anticipatory coping skills in that they focus on helping people prepare for the possible but not yet occurring threat of relapse, and take steps directed to minimizing its negative effect. These programs usually include identifying events and situations that had triggered episodes in the past and making a conscious effort to build a routine that would help the person avoid such events and situations in the future. In addition, one can choose a support person whom they would like to help him or her in case he or she felt that things were not going well, as well as generate a crisis plan to implement in case early warning signs are detected.
The relationship between anticipatory coping and a reduced likelihood of relapse has not been well-studied; however, positive findings for the impact of relapse prevention treatment suggest that learning to use anticipatory coping can reduce the likelihood of having a psychiatric hospitalization and associated consequences (Herz et al., 2000).
Preventive coping refers to the process by which a person builds up resources and resistance “just in case” possible stressors occur in the distant future (Schwarzer, 2001). Unlike reactive coping where the stressor has occurred, and anticipatory coping where there are more specific stressors within a shorter timeline which one is preparing for coping with, preventive coping reflects more general preparatory activities to cope with more unknown possible stressors within a more fluid timeline. Others (Aspinwall and Taylor, 1997) have referred to these types of strategies as proactive coping, but Schwarzer has drawn a distinction between preventive and proactive coping, which we follow in our adaptation of his model.
One example of preventive coping is developing “wellness management skills” (Copeland, 1997; Mueser et al., 2002). These are coping strategies that are used on a regular basis whether or not one is experiencing symptoms. The value and purpose of developing such strategies is that they can help reduce one’s vulnerability to future stress and improve resources for dealing more effectively with stressors that might occur. Typical wellness management strategies reported by people with SMI include routinely accessing social support, following a routine for taking medication, exercising, reducing substance use, and adopting a healthy and balanced lifestyle (Yanos, 2001). The man in his 40s diagnosed with schizophrenia who was interviewed for our study described his use of several preventive coping strategies as follows."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1790964/
---------------------------------
Early Warning Signs
Early warning signs of a psychosis can be defined as subjective
experiences, thoughts, and behaviours of the patient that occur in the phase
preceding a psychotic relapse (Heinrichs & Carpenter 1985; Herz & Melville
1980). The question is now which experiences, thoughts, and behaviours are
characteristic for this phase.
Heinrichs and Carpenter (1985) conducted a prospective study of the
early warning signs of a psychosis in 47 ambulatory patients with
schizophrenia (n=38) or a schizoaffective disorder (n=9). During weekly
appointments with the client, clinicians noted whether or not warning signs
were present that indicated an impending psychotic relapse. On the basis of
this, 32 early warning signs were identified. The ten most common are:
hallucinations (53%),
suspiciousness (43%),
change in sleep (43%),
anxiety (38%),
cognitive inefficiency (26%),
anger/hostility (23%),
somatic symptoms or delusions (21%),
thought disorder (17%)
disruptive inappropriate behaviour (17%),
and depression (17%).
Source:
Recognition of early warning signs in patients with schizophrenia:
A review of the literature
B. van Meijel
M. van der Gaag
R.S. Kahn
M.H.F. Grypdonck
I came across this in the Journal of Nervous And Mental Disease. I hadn't heard of their being early warning signs of psychosis coming on. I hope people find this helpful.
"The discovery of a mechanism of early identification of prepsychotic signals was replicated in additional studies (Dittmann and Schuttler, 1990), and its importance was described in a first-person account by Leete (1989). A woman in her 50s diagnosed with schizoaffective disorder who was interviewed for our study described how she calls a Crisis Hotline when she perceives that a relapse might be impending.
“I depend on [calling the Crisis Hotline]. I’m trying to keep from going in [the acute hospital unit]. I don’t want to go back there . . . usually when I call crisis and reach out for help and tell them how I am feeling they will either tell me to come to the emergency room or to get my medicine, take my medicine as prescribed, take me a cup of tea or drink a glass of milk and lie down for a while. If that doesn’t work, get up and see if you can go around, be around somebody.”
The principles of monitoring warning signs have been used to develop relapse prevention programs (Herz et al., 2000; Lam et al., 2000; Perry et al., 1999; Scott et al., 2001) that teach a form of anticipatory coping skills in that they focus on helping people prepare for the possible but not yet occurring threat of relapse, and take steps directed to minimizing its negative effect. These programs usually include identifying events and situations that had triggered episodes in the past and making a conscious effort to build a routine that would help the person avoid such events and situations in the future. In addition, one can choose a support person whom they would like to help him or her in case he or she felt that things were not going well, as well as generate a crisis plan to implement in case early warning signs are detected.
The relationship between anticipatory coping and a reduced likelihood of relapse has not been well-studied; however, positive findings for the impact of relapse prevention treatment suggest that learning to use anticipatory coping can reduce the likelihood of having a psychiatric hospitalization and associated consequences (Herz et al., 2000).
Preventive coping refers to the process by which a person builds up resources and resistance “just in case” possible stressors occur in the distant future (Schwarzer, 2001). Unlike reactive coping where the stressor has occurred, and anticipatory coping where there are more specific stressors within a shorter timeline which one is preparing for coping with, preventive coping reflects more general preparatory activities to cope with more unknown possible stressors within a more fluid timeline. Others (Aspinwall and Taylor, 1997) have referred to these types of strategies as proactive coping, but Schwarzer has drawn a distinction between preventive and proactive coping, which we follow in our adaptation of his model.
One example of preventive coping is developing “wellness management skills” (Copeland, 1997; Mueser et al., 2002). These are coping strategies that are used on a regular basis whether or not one is experiencing symptoms. The value and purpose of developing such strategies is that they can help reduce one’s vulnerability to future stress and improve resources for dealing more effectively with stressors that might occur. Typical wellness management strategies reported by people with SMI include routinely accessing social support, following a routine for taking medication, exercising, reducing substance use, and adopting a healthy and balanced lifestyle (Yanos, 2001). The man in his 40s diagnosed with schizophrenia who was interviewed for our study described his use of several preventive coping strategies as follows."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1790964/
---------------------------------
Early Warning Signs
Early warning signs of a psychosis can be defined as subjective
experiences, thoughts, and behaviours of the patient that occur in the phase
preceding a psychotic relapse (Heinrichs & Carpenter 1985; Herz & Melville
1980). The question is now which experiences, thoughts, and behaviours are
characteristic for this phase.
Heinrichs and Carpenter (1985) conducted a prospective study of the
early warning signs of a psychosis in 47 ambulatory patients with
schizophrenia (n=38) or a schizoaffective disorder (n=9). During weekly
appointments with the client, clinicians noted whether or not warning signs
were present that indicated an impending psychotic relapse. On the basis of
this, 32 early warning signs were identified. The ten most common are:
hallucinations (53%),
suspiciousness (43%),
change in sleep (43%),
anxiety (38%),
cognitive inefficiency (26%),
anger/hostility (23%),
somatic symptoms or delusions (21%),
thought disorder (17%)
disruptive inappropriate behaviour (17%),
and depression (17%).
Source:
Recognition of early warning signs in patients with schizophrenia:
A review of the literature
B. van Meijel
M. van der Gaag
R.S. Kahn
M.H.F. Grypdonck
Yes well I am aware there are some universities that do standard clinical research in this area and might be able to of help. I believe one is in Ann Arbor. If your doctor is unable to help you and an appropriate specialist is not you could seek a referral. I have seen a research neurologist who then consulted with my neurologist who then discussed the findings with my psychiatrist. That is separate from that kind of treatment but the consult worked in the same manner as a referral had to be given first. There is some continuing research into the area of orthomolecular treatments and its essential to find a practitioner who has knowledge in this area and background.
Very interesting...
This is five months before I had my first psychotic episode...
Bloodwork also shows anemia (iron, folate, and/or B12)
1/08:
Vitamin D, 25-OH, Total: 7ng/ml LOW [ref 20-100]
Vitamin D, 25-OH, D3: 7ng/ml
Vitamin D, 25-OH, D2: <4ng/ml
_____________________________
I read that 7ng/ml is the severe range of deficiency for Vitamin D.
See article:
Vitamin D Deficiency Linked to Psychotic Symptoms in Adolescents
By: MITCHEL L. ZOLER, Internal Medicine News Digital Network
It discusses vitamin D deficiency being common in those with psychosis. Interesting...
This is five months before I had my first psychotic episode...
Bloodwork also shows anemia (iron, folate, and/or B12)
1/08:
Vitamin D, 25-OH, Total: 7ng/ml LOW [ref 20-100]
Vitamin D, 25-OH, D3: 7ng/ml
Vitamin D, 25-OH, D2: <4ng/ml
_____________________________
I read that 7ng/ml is the severe range of deficiency for Vitamin D.
See article:
Vitamin D Deficiency Linked to Psychotic Symptoms in Adolescents
By: MITCHEL L. ZOLER, Internal Medicine News Digital Network
It discusses vitamin D deficiency being common in those with psychosis. Interesting...
Obtaining any blood test for specific conditions can be difficult because any blood test has to be authorized by a doctor. There is no blood test that would at one time comprehensively cover all the potential concerns you are looking for at one time but there are individual blood tests as per the different concerns. A standard blood test can test for a wide variety of deficiencies at once but there are specific blood tests for certain concerns. There are doctors within standard medical practice that have a better understanding of nutritional and other concerns. Its a matter of finding a referral to the appropriate specialist which does take time. I myself had to call a referral hotline to find a psychopharmocologist and it took me years to find a neurologist who was truly of help. Best to look through referral agencies as regards who could help in this regard. Seems like you are doing the right thing. Best of luck.
Doctors just haven't said anything about looking for a cause to my episodes. Other than the thyroid check that I pushed, and there was an abnormality with that which they are periodically checking. I'm having to dig up my files, internet research, and encourage them myself. The psychosis has always been with my poor ability to handle stress, my system is fragile, and my gut says something is deficient.
Is there some kind of doctor that can thoroughly evaluate ALL minerals, vitamins, aminos, blood contents, etc.? Upon asking for some tests, just some, from one of my doctors, she said "we can't do everything; we can't just do whatever you want." Oy vey.
It's strange how hormones and bodily things can affect us mentally. I had PMS recently, and for just that one week prior, just-7-days, there was awful irritability (I practiced a LOT of virtue not to be reactive to anyone), and some awful blues and teariness for no reason. Then PMS ends, and voila, that all passed! Crazy it is!
Is there some kind of doctor that can thoroughly evaluate ALL minerals, vitamins, aminos, blood contents, etc.? Upon asking for some tests, just some, from one of my doctors, she said "we can't do everything; we can't just do whatever you want." Oy vey.
It's strange how hormones and bodily things can affect us mentally. I had PMS recently, and for just that one week prior, just-7-days, there was awful irritability (I practiced a LOT of virtue not to be reactive to anyone), and some awful blues and teariness for no reason. Then PMS ends, and voila, that all passed! Crazy it is!
Yes although medications work in specific manners exactly how neurotransmitters function and how medications effect them is still advancing as regards research. The dopamine hypothesis as regards schizophrenia is well known. The glutamate hypothesis is still under research but clearly effects the specific parts of the brain and their functioning that can be shown to be the origin of the cluster of symptoms of schizophrenia that also would be noted in a Pet scan. Monoamine neurotransmitters are also involved in how MAO inhibitors work a class of anti-depressents that would be used more if it were not for enzyme interactions. However now that Ensam is available in patch form (that is one MAO inhibitor) they are using that more as they are one specific class of anti-depressents that other than that specific side effect is effective and has less of some other side effects than other classes of anti-depressents.
Understanding how treatment works is essential and the appropriate follow up tests can also determine any specific causes that might not otherwise be evident. Blood tests can be very specific. For example as part of a whole series of tests after being ruled out for epilepsy (with an EEG) I was then ruled out for Willson's Disease which required a specific test for daily copper metabolism. Once test results are determined then proper follow up can be as well.
Understanding how treatment works is essential and the appropriate follow up tests can also determine any specific causes that might not otherwise be evident. Blood tests can be very specific. For example as part of a whole series of tests after being ruled out for epilepsy (with an EEG) I was then ruled out for Willson's Disease which required a specific test for daily copper metabolism. Once test results are determined then proper follow up can be as well.
Yes that's true. Adrenal or thyroid conditions can of course cause changes that might otherwise appear mental. That would not mean that a person might not have anxiety disorder as well (which doesn't always require medication, talk therapy and cognitive behavioral therapy can be helpful as well) and talk therapy can be helpful for anyone even if they have no disability. If a person has any concerns about any over riding physical concern that hasn't been sufficiently answered then they should seek a second opinion or see an appropriate specialist. If psychosis or any other changes started with the onset of a specific physical disability then the appropriate doctor would need to follow up, diagnose and treat that. Once those concerns have been addressed with the appropriate physical treatment then they could then decide with their doctor whether a further referral is appropriate and the doctor could be in touch with whom they are referred to. I do have some over riding concerns that are neurological and under clinical study that cause mental changes of their own but I also have a psychiatric disability. One is followed up by a neurologist and the other by my psychiatrist and they both consult regularly which is crucial.
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