Psychosis and Personality Disorders : Unmet Needs in Early Diagnosis and Treatment

This volume offers a detailed and up-to-date analysis of the unmet needs of patients with psychoses and personality disorders. These include the needs associated with early detection of ultra-high-risk populations and first-episode psychosis; recognition of the trajectories of bipolar disorder and schizophrenia, recovery, early intervention, such as the use of LAIs, the conundrum of differential diagnosis in various personality disorders, and unsatisfactory quality of life, even in the presence of symptom control. Intended for clinical psychiatrists and other practitioners interested in mental health, this book helps them to manage the challenges of the diagnostic uncertainty in first-episode psychosis and timely interventions, since the earlier diagnosis is confirmed, the sooner multidisciplinary treatment can be implemented and plans for psychoeducation, and relapse prevention drawn up. Contents 1: Trajectories Toward Bipolar Disorder or Schizophrenia in FEP and High-Risk Mental State 1.1 Introduction 1.2 Genetics 1.3 Cognitive Impairment 1.4 Neuroimaging 1.5 Prodromes 1.6 Conclusions References 2: New Strategies to Improve Cognitive Symptom Domain in the Treatment of Schizophrenia 2.1 Introduction 2.2 Pharmacological Treatment to Improve Cognitive Functioning in Schizophrenia 2.2.1 Cognitive Functioning in Schizophrenia: Focus on Treatment Management 2.2.2 Cognitive Functioning in Schizophrenia: Focus on Metabolic Profile 2.2.3 Cognitive Functioning in Schizophrenia: Focus on First- and Second-Generation Antipsychotics 2.2.4 Cognitive Functioning in Schizophrenia: Focus on Long-Acting Injectable (LAI) Antipsychotics 2.2.5 Cognitive Functioning in Schizophrenia: Focus on Antidepressants 2.2.6 Cognitive Functioning in Schizophrenia: Focus on New Pharmacological Targets 2.3 Non-pharmacological Interventions to Improve Cognitive Functioning in Schizophrenia: Focus on Cognitive Remediation 2.4 What Is Cognitive Remediation and How Does It Work? 2.5 Cognitive Remediation: Focus on Social and Nonsocial Cognition 2.5.1 Cognitive Remediation: Focus on Psychosocial Functioning 2.5.2 Cognitive Remediation: Focus on Clinical Symptoms 2.6 Conclusions and Future Directions References 3: Psychotic Disorders and Substance Abuse Comorbidity: Characteristics and Treatment 3.1 Introduction 3.2 Epidemiology 3.3 Psychosis and (Ab)use of Substances 3.3.1 Psychosis and Cannabis 3.3.2 Psychosis and (Met)Amphetamines 3.3.3 Psychosis and Alcohol 3.3.4 Psychosis and Tobacco 3.4 Mechanisms Underlying Comorbidity 3.4.1 Auto-Medication 3.4.2 Early Childhood Adversity 3.4.3 Common Underlying Neurobiological Factors 3.5 Screening and Diagnosis on SUD 3.6 Treatment 3.6.1 General Aspects 3.6.2 Psychosocial Interventions 3.6.3 Pharmacological Aspects 3.6.3.1 Antipsychotic Medications 3.6.3.2 Medications Used for Substance Abuse Treatment Treatment of Alcohol Use Disorders Smoking Opiate Use Disorders 3.6.4 Organizational Aspects 3.7 Conclusions References 4: Recovery from Psychosis: Definition, Paradoxes, and Clinical Implications 4.1 Introduction 4.2 Historical Views of Outcome from Psychosis: The Rule and Alure of Pessimism 4.3 The Emergence of Recovery as the Expected Outcome from Psychosis 4.4 Two Emerging Challenges or Paradoxes from Research on Recovery from Psychosis 4.5 Metacognition and Paradoxes Posed by the Study of Recovery 4.6 General Implications for Recovery-Oriented Practice and Conclusions References 5: Cluster A Personality Disorders and Potential for Early Intervention in Psychosis: Challenges and Opportunities 5.1 Cluster A Personality Disorders (CAPD): Classification and Symptoms 5.2 Relationship between Cluster A Personality Disorders and Schizophrenia 5.3 Cluster A Personality Disorders and Clinically High-Risk States for Psychosis 5.4 Interventions for Treating Cluster A Personality Disorders 5.5 Pharmacological Interventions for Cluster A Personality Disorders 5.5.1 Non-pharmacological Interventions for Cluster A Personality Disorders 5.6 Challenges and Opportunities for Research and Treatment of Cluster A Personality Disorder 5.7 Conclusions References 6: Risk Factors of Early Onset of Borderline Personality Disorder: A Conceptual Model 6.1 Borderline Personality Disorder: A Complex Diagnosis 6.2 Environmental Factors 6.3 Temperament and Personality Traits 6.4 Early Psychopathological Features 6.5 Brain Imaging Findings in Early-Onset BPD 6.6 Early Treatments 6.7 A Conceptual Model of Risk Factors for Early-Onset BPD References 7: Clinical Evaluation and Intervention of Emerging Psychosis: A Mentalization-Informed Perspective 7.1 SSPDs and Mentalizing: Is There a Connection? 7.2 Risk and Resilience in SSPD: A Developmental Account 7.2.1 Mentalizing in the Premorbid Period 7.2.2 Mentalizing in the CHR Period 7.3 Clinical Implications of an Integrative Mentalization-Informed Perspective on SSPDs 7.4 Conclusion References 8: Personality Disorders and Suicidality 8.1 Introduction 8.1.1 Personality Disorders and Suicidality 8.1.1.1 Developmental Trajectories of Self-injury Behaviors and Borderline Personality Disorders 8.1.1.2 Temperament and Character Correlates of Personality and Suicidality 8.1.2 Eysenck Personality Questionnaire 8.1.3 Temperament and Character Inventory 8.1.4 TEMPS-A 8.1.5 Shedler-Westen Assessment Procedure 8.1.6 The Big Five 8.2 Interpersonal Theory of Suicide 8.3 Conclusions References