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Diagnostics
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Advances in the Diagnosis and Management of Psychosis
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Advances in the Diagnosis and Management of Psychosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 October 2022) | Viewed by 25147

Special Issue Editor

Prof. Dr. Drozdstoi Stoyanov

E-Mail Website
Guest Editor
Department of Psychiatry and Medical Psychology, Research Institute at Medical, University of Plovdiv, 4000 Plovdiv, Bulgaria
Interests: psychopathology; psychological assessment; neurobiology; neuroimaging; genetics; immunology; DSM; mental illness; treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Novel diagnostic biomarkers, emerging from structural, functional neuro-imaging and magnetic-resonance spectroscopy, will be compared in terms of their prediction value with other diagnostic tests, such as genetic, immune-biological, and psychomotor measures. In this Special Issue, we will address the incremental validity of those methods in the context of complex multimodal and machine learning modeling of the signatures of mental disorder, and we will be particularly focused on the relevance of those biomarkers for the early detection of psychosis, direction of new treatment strategies, and monitoring of their effect.

Prof. Dr. Drozdstoi Stoyanov
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Neuro-imaging
  • Machine learning
  • Bio-markers
  • Psychopharmacology
  • Psychosis

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Published Papers (10 papers)

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Editorial

Jump to: Research, Review, Other

3 pages, 191 KiB  
Editorial
Advances in the Diagnosis and Management of Psychosis
by Drozdstoy Stoyanov
Diagnostics 2023, 13(9), 1517; https://doi.org/10.3390/diagnostics13091517 - 23 Apr 2023
Cited by 2 | Viewed by 1361
Abstract
Psychosis research in the contemporary sense of scientific inquiry may be traced as far as the formulation of the “unitary psychosis” concept, or Einheitpsychose, which is usually attributed to Wilhelm Griesinger, Ernst von Zeller, and Heinrich Neumann [...] Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)

Research

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12 pages, 269 KiB  
Article
Sociodemographic and Clinical Correlates Associated with the Frequent Service Users in an Italian Psychiatric Emergency Department
by Andrea Aguglia, Giovanni Pietro Corsini, Alessandra Costanza, Andrea Berti, Edoardo Bruno, Andrea Escelsior, James Sanvi, Alice Trabucco, Eleonora Vai, Andrea Amerio, Gianluca Serafini and Mario Amore
Diagnostics 2023, 13(3), 430; https://doi.org/10.3390/diagnostics13030430 - 25 Jan 2023
Cited by 5 | Viewed by 1488
Abstract
Background: The aim of the present study is to identify the main sociodemographic and clinical correlates associated with frequent service users (FSUs) in an Italian psychiatric emergency department. Methods: This study is an observational and prospective clinical investigation. All subjects (N = 549) [...] Read more.
Background: The aim of the present study is to identify the main sociodemographic and clinical correlates associated with frequent service users (FSUs) in an Italian psychiatric emergency department. Methods: This study is an observational and prospective clinical investigation. All subjects (N = 549) consecutively admitted to the Psychiatric Inpatient Unit of the IRCCS Ospedale Policlinico San Martino ((Genoa, Italy) were recruited over a period of 18 months. Results: On average, FSUs were more likely to be single (75.0% vs. 64.0, p = 0.001), younger (38.79 years ± 14.68 vs. 45.94 years ± 16.94, p = 0.028), with an earlier onset (20.15 years ± 7.22 vs. 29.33 years ± 15.96, p < 0.001), and longer length of hospitalisation (13.65 days ± 12.40 vs. 9.89 ± 10.15, p = 0.006) compared to non-FSUs. While bipolar disorder was the most common primary diagnosis in both FSUs and non-FSUs, cluster B personality disorder was particularly elevated in FSUs (30.3% vs. 10.4%, p < 0.001). Furthermore, FSUs were more prone to substance use disorder (63.6% vs. 40.0%, p < 0.001), particularly cannabis (45.5% vs. 15.3%, p < 0.001), cocaine (33.3% vs. 10.4%, p < 0.001), and heroin (19.7% vs. 5.8%, p < 0.001), and were more likely to have non-suicidal self-injuries (21.2% vs. 6.8%, p < 0.001). FSUs were significantly more likely to be discharged against medical advice (18.2% vs. 5.6%, p < 0.001) or to have at least one escape attempt from the psychiatric ward (12.1% vs. 0.8%, p < 0.001). Conclusions: Specific clinical and social profiles of patients who repeatedly utilised the services of a psychiatric emergency department have been identified. Our findings can be used to develop suitable structures to support and reintegrate FSUs into society and work life. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)
12 pages, 1333 KiB  
Article
Algorithmic Assessments in Deciding on Voluntary, Assisted or Involuntary Psychiatric Treatment
by Gerhard Grobler and Werdie Van Staden
Diagnostics 2022, 12(8), 1806; https://doi.org/10.3390/diagnostics12081806 - 26 Jul 2022
Cited by 1 | Viewed by 1645
Abstract
The challenges in assessing whether psychiatric treatment should be provided on voluntary, assisted or involuntary legal bases prompted the development of an assessment algorithm that may aid clinicians. It comprises a part that assesses the incapacity to provide informed consent to treatment, care [...] Read more.
The challenges in assessing whether psychiatric treatment should be provided on voluntary, assisted or involuntary legal bases prompted the development of an assessment algorithm that may aid clinicians. It comprises a part that assesses the incapacity to provide informed consent to treatment, care or rehabilitation. It also captures the patient’s willingness to receive these treatments, the risk posed to the patient’s health or safety, financial interests or reputation and risks of serious harm to self or others. By following various decision paths, the algorithm yields one of four legal states: a voluntary, assisted, or involuntary state or that the proposed intervention should be declined. This study examined the predictive validity and the reliability of this algorithm. It was applied 4052 times to 135 clinical case narratives by 294 research participants. The legal states yielded by the algorithm had high statistical significance when matched with the gold standard (Chi-squared = 6963; df = 12; p < 0.001). It was accurate in yielding the correct legal state for the voluntary, assisted, involuntary and decline categories in 94%, 92%, 88% and 86% of the clinical case narratives, respectively. For internal reliability, a correspondence model accounted for 99.8% of the variance by which the decision paths clustered together fittingly with each of the legal states. Inter-rater reliability testing showed a moderate degree of agreement among participants on the suitable legal state (Krippendorff’s alpha = 0.66). These results suggest the algorithm is valid and reliable, which warrant a subsequent randomised controlled study to investigate whether it is more effective in clinical practice than standard assessments. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)
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14 pages, 435 KiB  
Article
Validity and Reliability of the Staden Schizophrenia Anxiety Rating Scale
by Werdie Van Staden, Antonia Dlagnekova and Kalai Naidu
Diagnostics 2022, 12(4), 831; https://doi.org/10.3390/diagnostics12040831 - 28 Mar 2022
Cited by 7 | Viewed by 2263
Abstract
In schizophrenia, none of the standard anxiety measures exhibit strong psychometric properties, and all performed poorly against quality assessment criteria. Developed for the schizophrenia population, this study examined the validity and reliability of the Staden Schizophrenia Anxiety Rating Scale (S-SARS) that measures both [...] Read more.
In schizophrenia, none of the standard anxiety measures exhibit strong psychometric properties, and all performed poorly against quality assessment criteria. Developed for the schizophrenia population, this study examined the validity and reliability of the Staden Schizophrenia Anxiety Rating Scale (S-SARS) that measures both specified and undifferentiated anxiety. Among 353 schizophrenia patients, strong correlations with anxiety parameters supported the S-SARS’s convergent validity. Criterion-related validity testing yielded accuracy, sensitivity, and specificity rates of around 95%. Its discriminant validity was observed for measures of depression, psychosis, akathisia, fatigue, vigour, procrastination, behavioural inhibition and activation, and personal growth and initiative. Structural validity was found in a single-factor unidimensional model with a 0.953 factor score. Excellent results were found for internal consistency (Cronbach’s alpha = 0.931; Spearman–Brown coefficient = 0.937; Guttman split-half coefficient = 0.928) and inter-rater reliability (Krippendorff’s alpha = 0.852). It incurred no more than a small error of measurement whereby the observed scores were within 1.54 to 3.58 of a true score on a zero to 50 scale. These strong psychometric properties suggest that the S-SARS is a valid and reliable instrument for measuring specified and undifferentiated anxiety in schizophrenia, providing the means for the accurate measurement of anxiolytic treatment effects. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)
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10 pages, 568 KiB  
Article
Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic Drug
by Georgi Panov Panov
Diagnostics 2022, 12(4), 803; https://doi.org/10.3390/diagnostics12040803 - 25 Mar 2022
Cited by 8 | Viewed by 2596
Abstract
Background: Schizophrenia is a mental illness with a multifactorial etiology and clinical presentation. Treatment is mainly with antipsychotic drugs. Despite the increasing number of antipsychotic drugs, there has been no significant change in the percentage of resistant cases. These data gave us reason [...] Read more.
Background: Schizophrenia is a mental illness with a multifactorial etiology and clinical presentation. Treatment is mainly with antipsychotic drugs. Despite the increasing number of antipsychotic drugs, there has been no significant change in the percentage of resistant cases. These data gave us reason to look for a link between the effect of the first individually selected antipsychotic drug and the established resistance to therapy. Method: An assessment has been made of 105 patients with chronic schizophrenia with consecutive psychotic episodes. The choice of antipsychotic has been made on the basis of clinical features, history of efficacy of previously used neuroleptics, anthropometric features, as well as somatic comorbidities. Accidental use of benzodiazepines in anxiety conditions as well as correctors in indications for extrapyramidal problems have been reported. Assessment was made based on clinical observation as well as on changes in PANSS score. Results: Of the 105 observed patients, the effectiveness of the first antipsychotic effect was found in 46.7% of patients. Follow-up of patients for a period of 12 weeks revealed that 45 (42.8%) of them had resistant schizophrenia, while the remaining 60 (57.2%) achieved clinical remission and initial functional recovery. The effect of the first antipsychotic drug was established in 9 (20%) of the patients with resistant schizophrenia and in 40 (66.57%) of the patients in clinical remission. Conclusion: The evaluation of the first antipsychotic medication is significant for the prognosis of patients with schizophrenia. Its lack of effectiveness indicates a high probability of resistance and can be a good indicator of earlier change and a possible search for more “aggressive” measures to prevent future resistance and possible disability. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)
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Review

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14 pages, 585 KiB  
Review
Mental Health Experts as Objects of Epistemic Injustice—The Case of Autism Spectrum Condition
by Maciej Wodziński and Marcin Moskalewicz
Diagnostics 2023, 13(5), 927; https://doi.org/10.3390/diagnostics13050927 - 1 Mar 2023
Cited by 1 | Viewed by 3015
Abstract
This theoretical paper addresses the issue of epistemic injustice with particular reference to autism. Injustice is epistemic when harm is performed without adequate reason and is caused by or related to access to knowledge production and processing, e.g., concerning racial or ethnic minorities [...] Read more.
This theoretical paper addresses the issue of epistemic injustice with particular reference to autism. Injustice is epistemic when harm is performed without adequate reason and is caused by or related to access to knowledge production and processing, e.g., concerning racial or ethnic minorities or patients. The paper argues that both mental health service users and providers can be subject to epistemic injustice. Cognitive diagnostic errors often appear when complex decisions are made in a limited timeframe. In those situations, the socially dominant ways of thinking about mental disorders and half-automated and operationalized diagnostic paradigms imprint on experts’ decision-making processes. Recently, analyses have focused on how power operates in the service user–provider relationship. It was observed that cognitive injustice inflicts on patients through the lack of consideration of their first-person perspectives, denial of epistemic authority, and even epistemic subject status, among others. This paper shifts focus toward health professionals as rarely considered objects of epistemic injustice. Epistemic injustice affects mental health providers by harming their access to and use of knowledge in their professional activities, thus affecting the reliability of their diagnostic assessments. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)
15 pages, 338 KiB  
Review
Kinesthesia and Temporal Experience: On the ‘Knitting and Unknitting’ Process of Bodily Subjectivity in Schizophrenia
by Camilo Sánchez and Marcin Moskalewicz
Diagnostics 2022, 12(11), 2720; https://doi.org/10.3390/diagnostics12112720 - 7 Nov 2022
Cited by 4 | Viewed by 2033
Abstract
This paper proposes a phenomenological hypothesis that psychosis entails a disturbance of the two-fold process of the indication function of kinesthesia and the presentification function of touch that affects the constitution of bodily subjectivity. Recent functional connectivity studies showed that the increased synchrony [...] Read more.
This paper proposes a phenomenological hypothesis that psychosis entails a disturbance of the two-fold process of the indication function of kinesthesia and the presentification function of touch that affects the constitution of bodily subjectivity. Recent functional connectivity studies showed that the increased synchrony between the right anterior insula and the default mode network are associated with psychosis. This association is proposed to be correlated with the disrupted dynamics between the pre-reflective and reflective temporal experience in psychotic patients. The paper first examines the dynamic nature of kinesthesia and the influence touch and vision exert on it, and then the reciprocal influence with temporal experience focusing on the body’s cyclic sense of temporality and its impact on physiology and phenomenology. Affectivity and self-affection are considered in their basic bodily expressions mainly through the concepts of responsivity and receptivity. The overall constitutive processes referred to throughout the article are proposed as a roadmap to develop body-based therapeutic work. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)
20 pages, 731 KiB  
Review
Motor Imagery: How to Assess, Improve Its Performance, and Apply It for Psychosis Diagnostics
by Alla Chepurova, Alexander Hramov and Semen Kurkin
Diagnostics 2022, 12(4), 949; https://doi.org/10.3390/diagnostics12040949 - 11 Apr 2022
Cited by 22 | Viewed by 4407
Abstract
With this review, we summarize the state-of-the-art of scientific studies in the field of motor imagery (MI) and motor execution (ME). We composed the brain map and description that correlate different brain areas with the type of movements it is responsible for. That [...] Read more.
With this review, we summarize the state-of-the-art of scientific studies in the field of motor imagery (MI) and motor execution (ME). We composed the brain map and description that correlate different brain areas with the type of movements it is responsible for. That gives a more complete and systematic picture of human brain functionality in the case of ME and MI. We systematized the most popular methods for assessing the quality of MI performance and discussed their advantages and disadvantages. We also reviewed the main directions for the use of transcranial magnetic stimulation (TMS) in MI research and considered the principal effects of TMS on MI performance. In addition, we discuss the main applications of MI, emphasizing its use in the diagnostics of various neurodegenerative disorders and psychoses. Finally, we discuss the research gap and possible improvements for further research in the field. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)
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Other

9 pages, 1304 KiB  
Brief Report
Parkinson’s Disease-Related Brain Metabolic Pattern Is Expressed in Schizophrenia Patients during Neuroleptic Drug-Induced Parkinsonism
by Ivan Kotomin, Alexander Korotkov, Irina Solnyshkina, Mikhail Didur, Denis Cherednichenko and Maxim Kireev
Diagnostics 2023, 13(1), 74; https://doi.org/10.3390/diagnostics13010074 - 27 Dec 2022
Cited by 3 | Viewed by 1972
Abstract
Drug-induced parkinsonism (DIP) is a frequent parkinsonian syndrome that appears as a result of pharmacotherapy for the management of psychosis. It could substantially hamper treatment and therefore its diagnosis has a direct influence on treatment effectiveness. Although of such high importance, there is [...] Read more.
Drug-induced parkinsonism (DIP) is a frequent parkinsonian syndrome that appears as a result of pharmacotherapy for the management of psychosis. It could substantially hamper treatment and therefore its diagnosis has a direct influence on treatment effectiveness. Although of such high importance, there is a lack of systematic research for developing neuroimaging-based criteria for DIP diagnostics for such patients. Therefore, the current study was aimed at applying a metabolic brain imaging approach using the 18F-FDG positron emission tomography and spatial covariance analysis to reveal possible candidates for DIP markers. As a result, we demonstrated, to our knowledge, the first attempt at the application of the Parkinson’s Disease-Related Pattern (PDRP) as a metabolic signature of parkinsonism for the assessment of PDRP expression for schizophrenia patients with DIP. As a result, we observed significant differences in PDRP expression between the control group and the groups with PD and DIP patients. Similar differences in PDRP expression were also found when the non-DIP schizophrenia patients were compared with the PD group. Therefore, our findings made it possible to conclude that PDRP is a promising tool for the development of clinically relevant criteria for the estimation of the risk of developing DIP. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)
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55 pages, 1512 KiB  
Systematic Review
Unveiling the Associations between EEG Indices and Cognitive Deficits in Schizophrenia-Spectrum Disorders: A Systematic Review
by Andrea Perrottelli, Giulia Maria Giordano, Francesco Brando, Luigi Giuliani, Pasquale Pezzella, Armida Mucci and Silvana Galderisi
Diagnostics 2022, 12(9), 2193; https://doi.org/10.3390/diagnostics12092193 - 9 Sep 2022
Cited by 15 | Viewed by 2914
Abstract
Cognitive dysfunctions represent a core feature of schizophrenia-spectrum disorders due to their presence throughout different illness stages and their impact on functioning. Abnormalities in electrophysiology (EEG) measures are highly related to these impairments, but the use of EEG indices in clinical practice is [...] Read more.
Cognitive dysfunctions represent a core feature of schizophrenia-spectrum disorders due to their presence throughout different illness stages and their impact on functioning. Abnormalities in electrophysiology (EEG) measures are highly related to these impairments, but the use of EEG indices in clinical practice is still limited. A systematic review of articles using Pubmed, Scopus and PsychINFO was undertaken in November 2021 to provide an overview of the relationships between EEG indices and cognitive impairment in schizophrenia-spectrum disorders. Out of 2433 screened records, 135 studies were included in a qualitative review. Although the results were heterogeneous, some significant correlations were identified. In particular, abnormalities in alpha, theta and gamma activity, as well as in MMN and P300, were associated with impairments in cognitive domains such as attention, working memory, visual and verbal learning and executive functioning during at-risk mental states, early and chronic stages of schizophrenia-spectrum disorders. The review suggests that machine learning approaches together with a careful selection of validated EEG and cognitive indices and characterization of clinical phenotypes might contribute to increase the use of EEG-based measures in clinical settings. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Psychosis)
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