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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
ILADVOCATE is right about the blood work. Before I was diagnosed with a psychotic disorder, they tested me for all kinds of crap like with MRIs and tests for syphilis and blood deficiencies and such. The psychiatrist who ordered all this stuff seemed disturbed a little that he found nothing wrong and then prescribed an antipsychotic which I refused to take at the time and talked like he had diagnosed me with schizophrenia which back then I had no clue what he was talking about when he said it would get rid of my delusions and such. Since then over the years I learned how to describe it properly and described it accordingly and they diagnosed me with that then and I took the medicine this time because I was scared of myself and I had MRIs yet again and all that crap.
Yes there can be causes of psychosis other than schizophrenia or other psychotic disorders or other factors that would worsen it that are physical. A person at all times should make their psychiatrist aware of any physical disabilities or disorders they have or especially inherited tendencies in the family. Before a person starts medication full blood work is done to rule out other causes of psychosis and generally should be done once a year (I am getting blood work next week) for general health purposes and to check up on long term medication side effects such as liver damage (unless the medication requires monthly tests in which case a person should follow doctor's instructions as regards follow up with blood work). However it should be noted that the standard clinical understanding of schizophrenia and other psychotic disorders is changing and as I've posted there is a whole new generation of antipsychotics in clinical study, the NMDA receptor modulates that are based on increasing glutamate transmission instead of decreasing dopamine transmission. For more information google "Dr. Javitt, glycine". There is also further research into new mood stabilizers and since they have found fish oil to be effective and as I've posted the medication Lovaza which was derived from fish oil is now in clinical study as a mood stabilizer. As happens I'll be starting it today. I do take a mood stabilizer but it doesn't provide enough coverage and Lovaza has shown some efficacy and some psychiatrists use it. There are many promising arenas of research for present and future treatments.
I also have a thread on possible nutritional causes of psychosis.
http://www.medhelp.org/posts/Depression/Psychosis-Caused-By-Magnesium-Deficiency/show/1326478
With the poor reliability of testing in some things, such as magnesium, it makes me question how often it is missed as the cause? Doctors say the loading or tolerance test is the better one for magnesium.
http://www.medhelp.org/posts/Depression/Psychosis-Caused-By-Magnesium-Deficiency/show/1326478
With the poor reliability of testing in some things, such as magnesium, it makes me question how often it is missed as the cause? Doctors say the loading or tolerance test is the better one for magnesium.
I'm still at a loss for detecting this stuff in myself before I reach a full blown relapse. I have to rely on other people to tell me when I'm starting to relapse.
Yes that's worthwhile information. I will bookmark it and read it further. I have experienced some of these trigger points that show concerns before my current recovery and since I still experience mood swings (the psychosis is in "relative remission" with a treatment in Phase 2 FDA study) I know some of those changes in thought patterns can still occur to a certain extent. I keep my psychiatrist updated at any time there are any concerns and always did and its good to have more exact knowledge about what can occur.
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