Background: The study was designed to assess the role of coping style and self-esteem in the context of different phases of schizophrenia. Methods: Recurrent Schizophrenia (ReSch) , first-episode schizophrenia patients (FEP), ultra-high risk for psychosis (UHR) patients, and healthy controls (HC) (40 per group) were subjected to in-person clinical interviews. The results of these interviews were then used to gauge coping style and self-esteem using the Coping Styles Questionnaire (CSQ) and the Rosenberg’s Self-Esteem Scale (RSES). Data were analyzed through ANCOVAs and logistic regression analyses. Results: The result s found that positive coping style (CSQ problem-solving and CSQ seeking for help) generally decline with progression through the HC, UHR, and FEP groups,while negative coping style(CSQ fantasy,CSQ repression and CSQ self-blame) generally increase with progression through the HC, UHR,and FEP groups (except that UHR group was slightly lower than HC group in CSQ self-blame).Results for members of ReSch group were in line with those of members of the FEP group in coping style. At the level of self-esteem, the UHR group was similar to the HC group and significantly higher than the FEP group and the ReSch group. Logistic regression analyses indicated that UHR group patients exhibited increased negative coping styles (CSQ fantasy) relative to members of the HC group, but had greater Positive coping style (CSQ problem-solving) than did members of the FEP group. Conclusion: These findings suggest that both UHR individuals experience impaired negative coping styles which expands the understanding of the psychological characteristics of the prodromal group. Further explorations are warranted to develop optimal psychosocial interventions.

Intro: psychotic disorders (PD) and eating disorders (ED) both are highly invalidating, costly and associated with premature death. Researchers call for early detection and intervention. Little is known about co-occurrence and associations between the at risk mental state for psychosis (ARMS) and ED. Objectives: to explore the prevalence of and associations between ARMS and ED-risk. To gain a first explorative insight into the similarities and differences of ARMS profiles in individuals with and without an ED risk score (EDr versus EDnr). Method: a cross sectional observational prevalence study (N=736) in secondary mental health care with a qualitative examination of ARMS profiles (N=47), using an ED screener (SCOFF), psychosis prodromal screener (PQ16) and CAARMS interview (detection of ARMS). We analyzed prevalences, associations (using Fisher’s exact test), and conditional probabilities of frequencies for CAARMS and SCOFF outcomes. We explored differences in ARMS profiles between EDr and EDnr by inspection of CAARMS reports. Results: ARMS and EDr are common across all psychiatric conditions. ED appear to remain largely undetected. Findings demonstrated no significant or conditional association of frequencies between CAARMS and EDr/nr outcome. ARMS items ‘guilt/punishment’ and ‘ideas of reference’ stood out in the EDr group. Conclusions: Be aware of ARMS and psychosis in ED. Pay more attention to possible ED. ARMS and psychosis are equally prevalent in EDr and EDnr, and vice versa. Researchers are encouraged to conduct studies on severity associations and profiles of psychosis spectrum symptoms in the various manifestations of ED.

Background. Mental illnesses mostly occur before 25 years of age when early identification and intervention could delay, ameliorate, or prevent lifelong disability. However, several challenges hinder optimal psychiatric care in youth due to the diversity of presentations, comorbidities, illness courses, and treatment responses. It is increasingly clear that one-size-fits-all approaches will not be effective and personalised approaches are needed to guide therapeutic pathways for individuals. Following precedents in other medical fields, machine learning approaches may address these needs by providing decision support tools that predict diagnoses, prognoses, and therapies. This paper outlines how such a future of augmented care may be facilitated through the establishment of the world’s first ‘Prediction of Early Mental Disorder and Preventative Treatment Centre of Research Excellence’ (PRE-EMPT). Methods. Five key components of the Centre will be addressed, including interdisciplinary collaboration, data harmonization, methods sharing, development of decision support tools, and capacity building. Conclusion. Implementation of research methodology guidelines within the Centre will assist in the production of reproducible, transparent, and open-source techniques and models. When combined, this paper will address key challenges facing the future of psychiatric care for youth and a roadmap of how to address them.

Objectives: The present study aimed to evaluate data from patients admitted to the first-episode psychotic (FEP) outpatient clinic at the Hospital of Clinics of the Federal University of Pernambuco from July 2018 to July 2021, seeking to identify factors related to better clinical outcomes. Methods: This study was conducted using a convenience sample, including all patients between 15 and 65 years of age who were admitted to the FEP outpatient clinic from July 2018 to July 2021. Descriptive statistical analysis was performed using mean and standard deviation or median and interquartile range for continuous quantitative variables, and absolute number/percentage for qualitative variables. Paired T-test, a parametric test, was used to compare PANSS scores upon admission and after 6 months. Spearman’s correlation test was employed to assess the correlation between duration of untreated psychosis (DUP) and treatment response with other variables. Results: The sample consisted of 85.3% male individuals, with 50% of patients aged between 19-30 years, and 82% residing in the metropolitan area of Recife. Seventy percent of patients responded to the treatment implemented by the outpatient clinic, and only 30% required psychiatric hospitalization within 6 months of follow-up. The majority of patients had a history of psychoactive substance use (82.4%); however, the use of these substances did not impact the prognosis within the analyzed sample. The median DUP was 4 weeks, and a shorter DUP was associated with a lower probability of psychiatric hospitalization and a greater treatment response (reduction >50% in PANSS). Conclusion: A shorter DUP was associated with a lower likelihood of psychiatric hospitalization and a greater treatment response. Furthermore, the specialized early psychosis outpatient clinic itself appears to yield positive outcomes, as 70% of the treated patients exhibited a positive treatment response.

Aim: Psychotic disorders and obsessive-compulsive disorder (OCD) commonly co-occur. Likewise, subthreshold psychosis symptoms (clinical high risk for psychosis; CHR-p) and obsessive-compulsive symptoms (OCS) commonly overlap and may be difficult to differentiate. Previous work suggests some notable differences between OCS and psychosis include insight and the content of thoughts and experiences. Methods: The current study explored the overlap between OCS and psychosis symptoms in a CHR-p sample. Results: Results demonstrated 13.5% of the sample experienced co-morbid OCD and CHR-p. Individuals with comorbid OCD and CHR-p experienced no other significant differences in presenting concerns, including psychosis symptoms, social or role functioning, anxiety, or depression. Exploratory factor analyses conducted on the CFOCI-A revealed two subtype factors: 1) checking and counting, and 2) intrusive thoughts and images of harm/guilt. The checking and counting factor was significantly correlated with depression and social anxiety. The intrusive thoughts and images of harm/guilt factor was significantly correlated with unusual thought content, suspiciousness and persecutory ideas, attenuated positive symptoms, and social anxiety. Conclusions: These findings suggest individuals who experience intrusive thoughts and images may be more likely to rate on positive symptoms, while individuals with checking and counting symptoms may not rate on positive symptoms, though may experience greater levels of depression.

Introduction: Anti-myelin oligodendrocyte glycoprotein (MOG) antibody-associated encephalitis is a demyelinating central nervous system disease, whose most common clinical manifestations are optic neuritis, myelitis and acute disseminated encephalitis. However, data on psychotic symptoms in anti-MOG antibody-associated meningitis are still limited. Case description: A 31-year-old female presented with headache, fever, thinking rupture, and dissociative amnesia. Enhancement of the pia mater was found in her magnetic resonance imaging. With antiviral therapies and anti-psychotic treatment, her symptoms didn’t disappear until positive anti-MOG IgG antibody was found in the serum and she received steroid therapy. Conclusion: Psychotic symptoms may be the main manifestation of anti-MOG antibody-associated meningitis. Besides being caused by anti-neuronal antibodies against cell-surface antigens (such as anti-N-methyl-D-aspartate receptor antibodies) and intracellular antigens (such as anti-Hu antibodies), autoimmune psychosis could also occur due to anti-myelin antibodies against MOG. These findings may expand the understanding of this newly described autoimmune disease.

Background: Most young adults experiencing psychosis enter early intervention services for psychosis (EIS) via inpatient services and emergency departments. Referral in this manner is believed to increase young adults’ risk for adverse outcomes while in EIS such as diminished trust and engagement in services. However, little research has empirically examined the impact of young adults’ referral and help-seeking experiences on their subsequent views towards EIS and engagement to services. Methods: This qualitative study involved semi-structured interviews with 12 young adults (mean age = 24.83) within 3-12 months following acceptance to an EIS. Interviews aimed to examine their experiences of help-seeking and referral to EIS as well as the impact of these experiences on their subsequent perception of, and engagement with EIS. Data were analyzed using the Interpretative Phenomenological Analysis approach. Results: 3 superordinate themes emerged: (1) Navigating the Maze of Healthcare (2) Dignity and (3) Impact of Events. Participants with referral pathways involving urgent care services, particularly through involuntary hospitalization, described more adversity during their referral pathway and were more likely to describe help-seeking experiences as contributing to negative views towards EIS and diminished engagement in treatment. Conclusions: The impact of early negative experiences with healthcare on views towards EIS and engagement is evident in participants’ accounts. Sense making was further contextualized by participants’ illness insight, degree of recovery, and social support throughout experiences. Emergent themes highlight the need for psychiatric services to emphasize service users’ dignity and for EIS to provide opportunities for patients to process past negative healthcare experiences to strengthen engagement.

Background: Family peer workers form connections with family/carers and can offer emotional support, psychoeducation and referrals based on their own lived experience. Although an increasing number of family peer support programs exist in the youth mental health sector, they are rarely described or reported on. There is a need for greater documentation of the experiences of family peer workers operating in the healthcare sector, in order to raise awareness of issues currently facing the workforce and support organisations to make positive changes. Methods: We present a detailed description of the family peer support program at Orygen in Victoria, Australia. In doing so, we highlight factors that impact effective program implementation and delivery from the perspectives of four family peer workers and two supervisors. Findings/Conclusions: Organisations should encourage self-care and social connections between family peer workers to reduce impacts of ongoing mental-ill health and workplace burnout and isolation. Staff should be educated about the field of family peer support to improve role clarity and foster a positive team environment. It is vital to develop a comprehensive position description, training program, and onboarding procedures to ensure new employees are adequately equipped. To improve staff retention and compensate those with further education, experience and skills, organisations may consider offering increased remuneration, negotiate longer-term contracts with a potential for a greater number of workdays, and should promote/hire senior lived experience positions. Further research is needed to formally investigate barriers and facilitating factors of program implementation in mental health settings.