1
|
Müller H, de Millas W, Gaebel W, Herrlich J, Hasan A, Janssen B, Juckel G, Karow A, Kircher T, Kiszkenow-Bäker S, Klingberg S, Klosterkötter J, Krüger-Özgürdal S, Lambert M, Lautenschlager M, Maier W, Michel TM, Mehl S, Müller BW, Pützfeld V, Rausch F, Riedel M, Sartory G, Schneider F, Wagner M, Wiedemann G, Wittorf A, Wobrock T, Wölwer W, Zink M, Bechdolf A. Negative schemata about the self and others and paranoid ideation in at-risk states and those with persisting positive symptoms. Early Interv Psychiatry 2018; 12:1157-1165. [PMID: 28524542 DOI: 10.1111/eip.12433] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 12/13/2016] [Accepted: 01/19/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND The objective of this study is to test the conflicting theories concerning the association of negative self and other schemata and paranoid ideation. METHODS A risk-based approach, including risk stratification, is used to gain insight into the association of the negative self and other schemata that may be shared by individuals or differentiate between individuals at clinical high risk (CHR) for a first-episode psychosis and those with full-blown psychosis. The dataset includes a sample of individuals at CHR (n = 137) and a sample of individuals with persisting positive symptoms (PPS, n = 211). The CHR sample was subdivided according to a prognostic index yielding 4 CHR sub-classes with increasing risk for transition to psychosis. RESULTS Negative beliefs about the self were associated with paranoid ideation in CHR and a lower risk state. In the highest risk state and full-blown psychosis, there is an association with negative beliefs about others. CONCLUSION These findings are in line with theories suggesting a switch from a predominantly activated negative self-schema to a malevolent others-schema in association with paranoid ideation along the risk-continuum. However, due to methodological limitations these results should be replicated by future studies.
Collapse
Affiliation(s)
- Hendrik Müller
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Walter de Millas
- Department of Psychiatry and Psychotherapy, Charité University Medicine Campus Mitte, Berlin, Germany
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Jutta Herrlich
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-University of Frankfurt am Main, Frankfurt am Main, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Birgit Janssen
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Georg Juckel
- Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Bochum, Germany
| | - Anne Karow
- Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Stefanie Kiszkenow-Bäker
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Stefan Klingberg
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University of Tuebingen, Tuebingen, Germany
| | | | - Seza Krüger-Özgürdal
- Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Bochum, Germany
| | - Martin Lambert
- Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Lautenschlager
- Department of Psychiatry and Psychotherapy, Charité University Medicine Campus Mitte, Berlin, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, Rhineland Friedrich Wilhelms University of Bonn, Bonn, Germany
| | - Tanja Maria Michel
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen, Aachen, Germany
| | - Stefanie Mehl
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Bernhard W Müller
- Department for Psychiatry and Psychotherapy, LVR-Clinic Essen, Faculty of Medicine, University of Duisburg-Essen, Duisburg, Germany
| | - Verena Pützfeld
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Franziska Rausch
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Michael Riedel
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Gudrun Sartory
- Department of Clinical Psychology, University of Wuppertal, Wuppertal, Germany
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen, Aachen, Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, Rhineland Friedrich Wilhelms University of Bonn, Bonn, Germany
| | - Georg Wiedemann
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-University of Frankfurt am Main, Frankfurt am Main, Germany
| | - Andreas Wittorf
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University of Tuebingen, Tuebingen, Germany
| | - Thomas Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University Goettingen, Goettingen, Germany
| | - Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Mathias Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Clinic am Urban and Vivantes Clinic im Friedrichshain, Academic Hospital Charité, Berlin, Germany
| |
Collapse
|
2
|
Cognitive behavioral therapy in 22q11.2 microdeletion with psychotic symptoms: What do we learn from schizophrenia? Eur J Med Genet 2016; 59:596-603. [PMID: 27639442 DOI: 10.1016/j.ejmg.2016.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 09/11/2016] [Indexed: 11/20/2022]
Abstract
The 22q11.2 deletion syndrome (22q11.2DS) is one of the most common microdeletion syndromes, with a widely underestimated prevalence between 1 per 2000 and 1 per 6000. Since childhood, patients with 22q11.2DS are described as having difficulties to initiate and maintain peer relationships. This lack of social skills has been linked to attention deficits/hyperactivity disorder, anxiety and depression. A high incidence of psychosis and positive symptoms is observed in patients with 22q11.2DS and remains correlated with poor social functioning, anxiety and depressive symptoms. Because 22q11.2DS and schizophrenia share several major clinical features, 22q11.2DS is sometimes considered as a genetic model for schizophrenia. Surprisingly, almost no study suggests the use of cognitive and behavioral therapy (CBT) in this indication. We reviewed what should be learned from schizophrenia to develop specific intervention for 22q11.2DS. In our opinion, the first step of CBT approach in 22q11.2DS with psychotic symptoms is to identify precisely which tools can be used among the already available ones. Cognitive behavioral therapy (CBT) targets integrated disorders, i.e. reasoning biases and behavior disorders. In 22q11.2DS, CBT-targeted behavior disorders may take the form of social avoidance and withdrawal or, in the contrary, a more unusual disinhibition and aggressiveness. In our experience, other negative symptoms observed in 22q11.2DS, such as motivation deficit or anhedonia, may also be reduced by CBT. Controlled trials have been studying the benefits of CBT in schizophrenia and several meta-analyses proved its effectiveness. Therefore, it is legitimate to propose this tool in 22q11.2DS, considering symptoms similarities. Overall, CBT is the most effective psychosocial intervention on psychotic symptoms and remains a relevant complement to pharmacological treatments such as antipsychotics.
Collapse
|