Do paranoid delusions exist on a continuum with subclinical paranoia? A multi-method taxometric study

Background There is widespread interest in whether psychosis exists on a continuum with healthy functioning. Previous research has implied that paranoia, a common symptom of psychosis, exists on a continuum but this has not been investigated using samples including both patients and non-patients and up-to-date taxometric methods. Aim To assess the latent structure of paranoia in a diverse sample using taxometric methods. Method We obtained data from 2836 participants, including the general population as well as at-risk mental state and psychotic patients using the P-scale of the Paranoia and Deservedness Scale. Data were analysed using three taxometric procedures, MAMBAC, MAXEIG and L-MODE (Ruscio, 2016), and two sets of paranoia indicators (subscales and selected items from the P scale), including and excluding the patient groups. Results Eleven of the twelve analyses supported a dimensional model. Using the full sample and subscales as indicators, the MAMBAC analysis was ambiguous. Overall, the findings converged on a dimensional latent structure. Conclusions A dimensional latent structure of paranoia implies that the processes involved in sub-clinical paranoia may be similar to those in clinical paranoia

Momentary displays of compassion and the relationship between psychosis, mood and risk incidents on inpatient wards: an experience sampling study.

Objectives: Psychosis can be thought of as a threat-based experience. Compassion has been shown to be effective in reducing threat, although highly distressed individuals may struggle to be self-compassionate. This study explored the effects of compassionate interactions with staff on inpatients with psychosis. Method: Experience Sampling Method (ESM) was used to investigate the relationships between compassion from staff and paranoia, voice hearing, distress related to psychosis experiences, affect and risk incidents in daily life. Twenty-two service users residing on inpatient mental health wards took part. Baseline measures of compassion, fears of compassion and affect were taken. Participants completed ESM assessments 10 times per day, over 6 days. Results: Compassion from staff was associated with a small increase in voice hearing, but was not associated with paranoia, paranoia-related distress, voice-related distress, negative affect, positive affect, or risk incidents in daily life. Baseline fears of compassion moderated the relationships between compassion from staff and some of the service user outcomes. For inpatients scoring low on fears of compassion, compassionate interactions were associated with increased positive affect and lower paranoia. However, for those scoring high on fears of compassion, this relationship was reversed, and compassionate interactions were associated with higher paranoia and lower positive affect. Conclusion: People with psychosis who have fears of compassion may benefit from receiving support to address these fears in order to experience the benefit from the compassion of staff. The results should be interpreted with caution due to the low number of observations and limited statistical power

Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder:a mixed-methods approach

BackgroundRecovery in mental health is a relatively new concept, but it is becoming more accepted that people can recover from psychosis. Recovery-orientated services are recommended for adult mental health, but with little evidence base to support this. ObjectivesTo facilitate understanding and promotion of recovery in psychosis and bipolar disorder (BD), in a manner that is empowering and acceptable to service users. MethodThere were six linked projects using qualitative and quantitative methodologies: (1) developing and piloting a service user-defined measure of recovery; (2) a Delphi study to determine levels of consensus around the concept of recovery; (3) examination of the psychological factors associated with recovery and how these fluctuate over time; (4) development and evaluation of cognitive–behavioural approaches to guided self-help including a patient preference trial (PPT); (5) development and evaluation of cognitive–behavioural therapy (CBT) for understanding and preventing suicide in psychosis including a randomised controlled trial (RCT); and (6) development and evaluation of a cognitive–behavioural approach to recovery in recent onset BD, including a RCT of recovery-focused cognitive–behavioural therapy (RfCBT). Service user involvement was central to the programme. ResultsMeasurement of service user-defined recovery from psychosis (using the Subjective Experience of Psychosis Scale) and BD (using the Bipolar Recovery Questionnaire) was shown to be feasible and valid. The consensus study revealed a high level of agreement among service users for defining recovery, factors that help or hinder recovery and items which demonstrate recovery. Negative emotions, self-esteem and hope predicted recovery judgements, both cross-sectionally and longitudinally, whereas positive symptoms had an indirect effect. In the PPT, 89 participants entered the study, three were randomised, 57 were retained in the trial until 15-month follow-up (64%). At follow-up there was no overall treatment effect on the primary outcome (Questionnaire about the Process of Recovery total; p = 0.82). In the suicide prevention RCT, 49 were randomised and 35 were retained at 6-month follow-up (71%). There were significant improvements in suicidal ideation [Adult Suicidal Ideation Questionnaire; treatment effect = –12.3, 95% confidence interval (CI) –24.3 to –0.14], Suicide Probability Scale (SPS; treatment effect = –7.0, 95% CI –15.5 to 0) and hopelessness (subscale of the SPS; treatment effect = –3.8, 95% CI –7.3 to –0.5) at follow-up. In the RCT for BD, 67 participants were randomised and 45 were retained at the 12-month follow-up (67%). Recovery score significantly improved in comparison with treatment as usual (TAU) at follow-up (310.87, 95% CI 75.00 to 546.74). At 15-month follow-up, 32 participants had experienced a relapse of either depression or mania (20 TAU vs. 12 RfCBT). The difference in time to recurrence was significant (estimated hazard ratio 0.38, 95% CI 0.18 to 0.78; p < 0.006). ConclusionsThis research programme has improved our understanding of recovery in psychosis and BD. Key findings indicate that measurement of recovery is feasible and valid. It would be feasible to scale up the RCTs to assess effectiveness of our therapeutic approaches in larger full trials, and two of the studies (CBT for suicide prevention in psychosis and recovery in BD) found significant benefits on their primary outcomes despite limited statistical power, suggesting definitive trials are warranted. FundingThe National Institute for Health Research Programme Grants for Applied Research programme

Associations of vitamin D level and severity climacteric syndrome

The aim of the study - to determine the relationship between vitamin D levels and the severity of menopausal syndrome in postmenopausal women.Цель исследования - определить взаимосвязь уровня витамина D и степени тяжести климактерического синдрома у женщин в постменопауз

Results of observation of a family case of thyrotropic hormone resistance syndrome

The purpose of the study was to evaluate the development of children with congenital subclinical hypothyroidism and not receiving hormone replacement therapy in order to select therapeutic tactics.Цель исследования – оценить развитие детей, имеющих врожденный субклинический гипотиреоз и не получающих заместительную гормональную терапию, для выбора терапевтической тактики

A temporal network approach to paranoia : a pilot study

Paranoid beliefs have been conceptualized as a central psychological process linked to schizophrenia and many mental disorders. Research on paranoia has indicated that it is pivotal to consider not only levels but also dynamic aspects of incriminated related mechanisms over time. In the present study, we conceptualized paranoia as a system of interacting elements. To do so, we used temporal network analysis to unfold the temporal dynamics between core psychological paranoia-related mechanisms, such as self-esteem, sadness, feeling close to others, and experiential avoidance. Time-series data of 23 participants with high scores in paranoia and/or interpersonal sensitivity were collected via experience sampling methodology (ESM). We applied a multilevel vector autoregressive (mlVAR) model approach and computed three distinct and complementary network models (i.e., contemporaneous, temporal, and between-subject) to disentangle associations between paranoia-related mechanisms in three different time frames. The contemporaneous model indicated that paranoia and sadness co-occurred within the same time frame, while sadness was associated with both low self-esteem and lack of closeness to others. The temporal model highlighted the importance of feeling close to others in predicting low paranoia levels in the next time frame. Finally, the between-subject model largely replicated an association found in both contemporaneous and temporal models. The current study reveals that the network approach offers a viable data-driven methodology for elucidating how paranoia-related mechanisms fluctuate over time and may determine its severity. Moreover, this novel perspective may open up new directions toward identifying potential targets for prevention and treatment of paranoia-related problems

The attitude of USMU students to vaccination against COVID-19

The aim of the study – to determine the attitude of medical students to vaccination against COVID-19 (motivation, possible problems, post-vaccination reactions).Цель исследования – определить отношение студентов-медиков к вакцинопрофилактике COVID-19 (мотивация, возможные проблемы, поствакцинальные реакции)

Pulseless disease

The article discusses a rare form of large vessel vasculitis – Takayasu arteritis, based on the literature data; the questions of epidemiological, the sequence of diagnostic procedures and treatment tactics are reflectedВ статье рассмотрена редкая форма васкулита крупных артерий - Артериит Такаясу, на основании литературных данных отражены вопросы эпидемиологии, последовательность проведения диагностических процедур и тактики лечени

Epidemiology of bloodstream infections in the burn icu

The study included data on 80 adult patients hospitalized in the ICU of the Yekaterinburg Burn Center in 2018 - 2019, who underwent at least one bacteriological blood test. In a small observational study, bloodstream infection did not lead to an increase in mortality, but is an important factor in increasing the incidence (length of hospitalization and ICU). In 70,5% of cases, the source of bloodstream infections are P. aeruginosa and S. aureus. The duration of standing of the CVC is one of the most important criteria for the development of bloodstream infectionsВ исследование включены данные о 80 взрослых пациентах, госпитализированных в ОРИТ ожогового центра Екатеринбурга в 2018 – 2019 гг, которым было сделано по крайней мере одно бактериологическое исследование крови. В небольшом обсервационном исследовании инфекция кровотока не привела к увеличению летальности, но является важным фактором увеличивающем заболеваемость (длительность госпитализации в стационаре и ОРИТ). В 70,5% случаев источником инфекций кровотока являются P. aeruginosa и S. aureus. Длительность стояния ЦВК один из важнейших критериев, обуславливающих развитие инфекций кровотока