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EMOTIONAL AND BEHAVIOURAL SYMPTOMS OF PSYCHOPATHOLOGY AMONG ADOLESCENTS WITH PSYCHOTIC-LIKE EXPERIENCES
198
Abstracts
Poster 35 AWARENESS OF WEIGHT STATUS AND DESIRE FOR WEIGHT CHANGE AMONG PSYCHOTIC PATIENTS WITH SEVERE MENTAL ILLNESS Otto Kausch1, Douglas Smith1, Michael DeDonno1, Richard McCormick1, NIkona Thomas2 1 Case Western Reserve University, Cleveland, Ohio, USA; 2Adler School of Professional Psychology, Chicago, Illinois, USA Background: Obesity among patients with chronic mental illness is a significant issue and is coming under increasing scrutiny, especially with studies documenting significant weight gain associated with antipsychotic and mood stabilizing medications. There have been few studies examining the perspectives of patients themselves on their weight status and desire for change. Methods: Northcoast Behavioral Healthcare System is a hospital for the mentally ill in Ohio, consisting of long-term forensic patients as well as acute care patients. Staff asked patients' perceptions of their weight status, their concern about their weight, their level of desire to lose weight, as well as documenting their stages of change for weight loss. All refusals to participate were noted, as well as the patient's most recent BMI (Body Mass Index). We separated patients into two groups – those with psychotic diagnoses (schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features), and non-psychotic disorders (e.g. major depression, adjustment disorder, substance abuse disorders, etc). Results: Eight forensic units and seven acute care units were included in the survey. A total of 259 patients were interviewed. There were 246 completed surveys by patients. Of these, there were 193 psychotic patients, consisting of 153 males (79%), 40 females (21%); 49% black and 49% white. The mean age of the psychotic patients was 42.6. Among 89 psychotic patients, 23.3% of were normal weight (BMI < 25 kg/m2), 30.1% were overweight (BMI>/= 25 kg/m2, < 30), and 46.1% were obese (BMI>/=30). When 177 psychotic patients were asked about their efforts to lose weight, 58.2% were in the precontemplation stage, 7.3% were in the contemplation stage and 35.4% were in the action/maintenance stage. Among the 82 obese psychotic patients, there was no significant difference in the stages of change for weight loss. Among 89 psychotic obese individuals, 7.9% believed they were below their ideal weight, 16.9% believed they were at their ideal weight, 60.7% believed they were above their ideal weight and 14.6% were unsure Among 89 psychotic obese, 52.8% were not concerned about their weight, 22.5% were a little concerned, 15.7% were concerned and 9.0% were very concerned. Among 87 psychotic obese, 43.7% wanted to lose weight, 31.0% did not want to lose weight, and 25.3% were unsure. Discussion: Our research demonstrates that patients with psychotic illness have significant problems with overweight and obesity, and that their perceptions about their weight status vary considerably. These perception disparities may be an important limiting factor to consider when developing interventions to reduce obesity among this patient population.
doi:10.1016/j.schres.2010.02.263
Poster 36 EMOTIONAL AND BEHAVIOURAL SYMPTOMS OF PSYCHOPATHOLOGY AMONG ADOLESCENTS WITH PSYCHOTIC-LIKE EXPERIENCES Ian Kelleher, Jennifer Murphy, Mary Cannon Royal College of Surgeons in Ireland, Dublin, Ireland
Background: Psychotic-like experiences (PLEs) in childhood and adolescence are associated with increased risk for adulthood psychiatric illness, including psychotic disorder. However, little is known about the psychopathological profile associated with PLEs in the general adolescent population. Methods: Behavioural and emotional symptoms were assessed in a general population sample of 681 school-going adolescents aged 11 – 13 years using the Strengths and Difficulties Questionnaire. History of PLEs was assessed using the Adolescent Psychosis-like Symptom Screener (APSS), which has previously been shown to be a valid instrument for identifying PLEs in the general adolescent population. Results: 6.6% of the total sample scored in the abnormal range on the SDQ. Adolescents who reported PLEs were significantly more likely to have an abnormal SDQ score (OR = 4; p < 0.001), including significantly higher rates of emotional, conduct and attention deficit/hyperactivity symptoms and peer problems (all p < 0.001). There were no differences in scores for prosocial behaviour. Discussion: Adolescents with PLEs are at significantly increased risk for a wide range of psychopatholgical problems. Longitudinal research is necessary to determine what effect comorbid emotional and behavioural symptoms have on risk for adulthood psychosis among this population.
doi:10.1016/j.schres.2010.02.264
Poster 37 SELF-REPORTED PSYCHOTIC SYMPTOMS AMONG THE GENERAL POPULATION OF BUENOS AIRES CITY Eduardo A. Leiderman Universidad de Palermo, Buenos Aires, Argentina Background: There is evidence that psychosis is not an all-ornothing phenomenon and that psychotic disorders are continuous with psychotic symptoms in the general population. The aim of this study was to assess the prevalence of psychotic symptoms among the general population of Buenos Aires city. Methods: A sample of 1036 individuals aged 18 to 91 years were surveyed at 15 different neighborhoods of Buenos Aires city. Their psychotic-like experiences were assessed by several questions about unusual experiences in the last week and by the paranoid ideation subscale of the Symptom Cheklist-90 Revised (SCL-90-R). The calculated response rate for the survey was 67.6%. Results: Eighteen percent of the surveyed revealed that they had experienced one or more psychotic symptoms in the previous week. Auditory hallucinations were reported by 7.2% of the surveyed population; visual hallucinations by 9.7%, reference ideation by 5.6%, paranoid ideation by 4.2%, influence experiences by 3.1%, thoughts stolen by 2.8% and thoughts inserted by 1.4%. Three or more psychotic symptoms were reported by 4.6% of the surveyed. Almost half of them were on psychological or psychiatric treatment, a third were medicated and 25% believed they had a mental illness. There were no significant differences by sex or age between the individuals that had psychotic symptoms or not. Almost 19% had an index compatible with risk of having pathology and 0.7% had an index that suggests severe pathology according to the SCL-90-R subscale. There was a significant correlation between the paranoid ideation subscale and the number of psychotic symptoms. Almost 45% of the individuals that reported at least one psychotic symptom had experienced a stressful situation the week before. Compared with persons without psychotic symptoms, individuals with psychotic symptoms were significantly more likely to report recent stressful
Abstracts
Poster 35 AWARENESS OF WEIGHT STATUS AND DESIRE FOR WEIGHT CHANGE AMONG PSYCHOTIC PATIENTS WITH SEVERE MENTAL ILLNESS Otto Kausch1, Douglas Smith1, Michael DeDonno1, Richard McCormick1, NIkona Thomas2 1 Case Western Reserve University, Cleveland, Ohio, USA; 2Adler School of Professional Psychology, Chicago, Illinois, USA Background: Obesity among patients with chronic mental illness is a significant issue and is coming under increasing scrutiny, especially with studies documenting significant weight gain associated with antipsychotic and mood stabilizing medications. There have been few studies examining the perspectives of patients themselves on their weight status and desire for change. Methods: Northcoast Behavioral Healthcare System is a hospital for the mentally ill in Ohio, consisting of long-term forensic patients as well as acute care patients. Staff asked patients' perceptions of their weight status, their concern about their weight, their level of desire to lose weight, as well as documenting their stages of change for weight loss. All refusals to participate were noted, as well as the patient's most recent BMI (Body Mass Index). We separated patients into two groups – those with psychotic diagnoses (schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features), and non-psychotic disorders (e.g. major depression, adjustment disorder, substance abuse disorders, etc). Results: Eight forensic units and seven acute care units were included in the survey. A total of 259 patients were interviewed. There were 246 completed surveys by patients. Of these, there were 193 psychotic patients, consisting of 153 males (79%), 40 females (21%); 49% black and 49% white. The mean age of the psychotic patients was 42.6. Among 89 psychotic patients, 23.3% of were normal weight (BMI < 25 kg/m2), 30.1% were overweight (BMI>/= 25 kg/m2, < 30), and 46.1% were obese (BMI>/=30). When 177 psychotic patients were asked about their efforts to lose weight, 58.2% were in the precontemplation stage, 7.3% were in the contemplation stage and 35.4% were in the action/maintenance stage. Among the 82 obese psychotic patients, there was no significant difference in the stages of change for weight loss. Among 89 psychotic obese individuals, 7.9% believed they were below their ideal weight, 16.9% believed they were at their ideal weight, 60.7% believed they were above their ideal weight and 14.6% were unsure Among 89 psychotic obese, 52.8% were not concerned about their weight, 22.5% were a little concerned, 15.7% were concerned and 9.0% were very concerned. Among 87 psychotic obese, 43.7% wanted to lose weight, 31.0% did not want to lose weight, and 25.3% were unsure. Discussion: Our research demonstrates that patients with psychotic illness have significant problems with overweight and obesity, and that their perceptions about their weight status vary considerably. These perception disparities may be an important limiting factor to consider when developing interventions to reduce obesity among this patient population.
doi:10.1016/j.schres.2010.02.263
Poster 36 EMOTIONAL AND BEHAVIOURAL SYMPTOMS OF PSYCHOPATHOLOGY AMONG ADOLESCENTS WITH PSYCHOTIC-LIKE EXPERIENCES Ian Kelleher, Jennifer Murphy, Mary Cannon Royal College of Surgeons in Ireland, Dublin, Ireland
Background: Psychotic-like experiences (PLEs) in childhood and adolescence are associated with increased risk for adulthood psychiatric illness, including psychotic disorder. However, little is known about the psychopathological profile associated with PLEs in the general adolescent population. Methods: Behavioural and emotional symptoms were assessed in a general population sample of 681 school-going adolescents aged 11 – 13 years using the Strengths and Difficulties Questionnaire. History of PLEs was assessed using the Adolescent Psychosis-like Symptom Screener (APSS), which has previously been shown to be a valid instrument for identifying PLEs in the general adolescent population. Results: 6.6% of the total sample scored in the abnormal range on the SDQ. Adolescents who reported PLEs were significantly more likely to have an abnormal SDQ score (OR = 4; p < 0.001), including significantly higher rates of emotional, conduct and attention deficit/hyperactivity symptoms and peer problems (all p < 0.001). There were no differences in scores for prosocial behaviour. Discussion: Adolescents with PLEs are at significantly increased risk for a wide range of psychopatholgical problems. Longitudinal research is necessary to determine what effect comorbid emotional and behavioural symptoms have on risk for adulthood psychosis among this population.
doi:10.1016/j.schres.2010.02.264
Poster 37 SELF-REPORTED PSYCHOTIC SYMPTOMS AMONG THE GENERAL POPULATION OF BUENOS AIRES CITY Eduardo A. Leiderman Universidad de Palermo, Buenos Aires, Argentina Background: There is evidence that psychosis is not an all-ornothing phenomenon and that psychotic disorders are continuous with psychotic symptoms in the general population. The aim of this study was to assess the prevalence of psychotic symptoms among the general population of Buenos Aires city. Methods: A sample of 1036 individuals aged 18 to 91 years were surveyed at 15 different neighborhoods of Buenos Aires city. Their psychotic-like experiences were assessed by several questions about unusual experiences in the last week and by the paranoid ideation subscale of the Symptom Cheklist-90 Revised (SCL-90-R). The calculated response rate for the survey was 67.6%. Results: Eighteen percent of the surveyed revealed that they had experienced one or more psychotic symptoms in the previous week. Auditory hallucinations were reported by 7.2% of the surveyed population; visual hallucinations by 9.7%, reference ideation by 5.6%, paranoid ideation by 4.2%, influence experiences by 3.1%, thoughts stolen by 2.8% and thoughts inserted by 1.4%. Three or more psychotic symptoms were reported by 4.6% of the surveyed. Almost half of them were on psychological or psychiatric treatment, a third were medicated and 25% believed they had a mental illness. There were no significant differences by sex or age between the individuals that had psychotic symptoms or not. Almost 19% had an index compatible with risk of having pathology and 0.7% had an index that suggests severe pathology according to the SCL-90-R subscale. There was a significant correlation between the paranoid ideation subscale and the number of psychotic symptoms. Almost 45% of the individuals that reported at least one psychotic symptom had experienced a stressful situation the week before. Compared with persons without psychotic symptoms, individuals with psychotic symptoms were significantly more likely to report recent stressful