Search results for ‘Subject term:"personality disorders"’ Sort:
Results 1 - 3 of 3
Social anxiety disorder in first-episode psychosis: incidence, phenomenology and relationship with paranoia
- Authors:
- MICHAIL Maria, BIRCHWOOD Max
- Journal article citation:
- British Journal of Psychiatry, 195(3), September 2009, pp.234-241.
- Publisher:
- Cambridge University Press
This study aimed to compare the phenomenology of social anxiety disorder in first-episode psychosis with that in a group without psychosis. The relationship between social anxiety and psychosis symptoms was investigated. A sample of people with first-episode psychosis (FEP group) was compared with a sample with social anxiety disorder without psychosis (SaD group). Of the individuals in the FEP group (n = 80) 25% were diagnosed with an ICD–10 social anxiety disorder (FEP/SaD group); a further 11.6% reported severe difficulties in social encounters. The FEP/SaD and SaD groups reported comparable levels of social anxiety, autonomic symptoms, avoidance and depression. Social anxiety in psychosis was not related to the positive symptoms of the Positive and Negative Syndrome Scale (PANSS) including suspiciousness/persecution. However, a significantly greater percentage of socially anxious v. non-socially anxious individuals with psychosis expressed perceived threat from persecutors, although this did not affect the severity of social anxiety within the FEP/SaD group. The majority of those in the FEP/SaD group did not have concurrent persecutory delusions. It is concluded that social anxiety is a significant comorbidity in first-episode psychosis. It is not simply an epiphenomenon of psychotic symptoms and clinical paranoia, and it has more than one causal pathway. For a subgroup of socially anxious people with psychosis, anticipated harm is present and the processes that underlie its relationship with social anxiety warrant further investigation.
Pathways to emotional dysfunction in first-episode psychosis
- Author:
- BIRCHWOOD Max
- Journal article citation:
- British Journal of Psychiatry, 182(5), May 2003, pp.373-375.
- Publisher:
- Cambridge University Press
Emotional dysfunction is pervasive even in non-affective psychosis. Sometimes (and unhelpfully) referred to as 'comorbidity', these disorders include depression, usually accompanied by hopelessness and suicidal thinking; social anxiety, usually accompanied by social avoidance and problems in forming relationships; and traumatic symptoms (post-traumatic stress disorder, PTSD). There is also the distress (fear, anger, shame) attached to the experience of psychotic symptoms.
Predicting engagement with services for psychosis: insight, symptoms and recovery style
- Authors:
- TAIT Lynda, BIRCHWOOD Max, TROWER Peter
- Journal article citation:
- British Journal of Psychiatry, 182(2), February 2003, pp.123-128.
- Publisher:
- Cambridge University Press
Treatment non-adherence and service disengagement are commonly attributed to impaired insight. There is evidence that recovery style (i.e. psychological adjustment) may underlie service engagement. Fifty patients with schizophrenia were assessed during acute psychosis and at 3-month and 6-month follow-ups. Measures included recovery style, psychosis symptoms, insight and service engagement. Sealing-over at 3 months following onset of an episode of psychosis predicted low service engagement at 6 months. Neither insight nor symptoms predicted engagement. The clear shift from integration to sealing-over within the first 3 months was independent of changes in symptoms or insight. Sealing-over between 3 and 6 months was associated with improvement in psychosis symptoms. Recovery style contributed more to engagement than did insight, appears to be dynamic in the short term and is orthogonal to insight. Overall, this study demonstrated the importance of addressing psychological adjustment to psychosis as well as illness status when investigating treatment engagement in people with psychosis.