OBJECTIVE: Biased attribution styles of assigning hostile intention to innocent others and placing the blame were found in schizophrenia. Attribution styles in individuals at ultra-high risk (UHR) for psychosis, however, have been less studied especially for its association with various psychological factors. We investigated whether UHR individuals show increased hostility perception and blaming bias and explored the associations of these biased styles of attribution with the factor structure of multifaceted self-related psychological variables and neurocognitive performances. METHODS: Fifty-four UHR individuals and 80 healthy controls were assessed by evaluating resilience, self-perception, self-esteem, and aberrant subjective experiences of schizotypy (physical anhedonia, social anhedonia, magical ideation, and perceptual aberration), basic symptoms, and carrying out a comprehensive neurocognitive test battery. Attribution styles were assessed using the Ambiguous Intentions Hostility Questionnaire. RESULTS: UHR individuals, compared with normal controls, showed increased hostility perception and blaming bias. Factor analysis of self-related psychological variables and neurocognitive performances in the entire subject population showed a three-factor solution, which was designated as reflective self, pre-reflective self, and neurocognition. Multiple regression analysis in UHR individuals revealed that hostility perception bias was associated with reflective self and composite blame bias was associated with reflective and pre-reflective self. CONCLUSION: This study supports the emergence of attribution biases in the putative ‘prodromal’ phase of schizophrenia. The associations of biased attribution styles with multifaceted self-related psychological constructs suggest that psychosocial interventions for biased attribution styles in UHR individuals should focus not only on reflective self but also pre-reflective self-related psychological constructs.
Anhedonia ; Bias (Epidemiology)* ; Hostility ; Intention ; Magic ; Psychology ; Psychotic Disorders* ; Schizophrenia ; Self Concept

OBJECTIVE: This study aimed to investigate whether aberrant tendency of noncurrent emotion was present in individuals at ultra-high risk (UHR) for psychosis and to explore its associations with various clinical profiles. METHODS: Fifty-seven individuals at UHR and 49 normal controls were enrolled. The tendency of experiencing noncurrent emotion was assessed using various noncurrent emotional self-reported formats, including trait [Neuroticism and Extraversion of the Eysenck Personality Questionnaire], hypothetical (Chapman’s Revised Physical and Social Anhedonia Scales), and retrospective [Anhedonia-Asociality Subscale of the Scale for the Assessment of Negative Symptoms (SANS)] measures. Self-related beliefs (Self-Perception Scale), clinical positive and negative symptoms (SA Positive Symptoms and SANS), psychosocial function (Global Functioning Scale: Role Function and Global Functioning Scale: Social Function) were also examined. RESULTS: Subjects at UHR for psychosis reported more trait unpleasant and less trait pleasant emotions, more hypothetical physical and social anhedonia, and more retrospective anhedonia than normal controls. In UHR, self-perception was correlated to trait unpleasant emotion and hypothetical physical and social anhedonia. Negative symptoms in UHR were associated with hypothetical physical anhedonia and retrospective anhedonia. Global social functioning was related to trait pleasant emotion, hypothetical physical and social anhedonia, and retrospective anhedonia. Neurocognitive function, positive symptoms, and global role functioning were not related with any noncurrent emotional experience measures in UHR. CONCLUSION: These findings suggest that the aberrant tendency of noncurrent emotional experience may be present at the ‘putative’ prodromal phase and are grossly associated with self-related beliefs and psychosocial functioning but not neurocognitive functioning.
Anhedonia ; Extraversion (Psychology) ; Psychotic Disorders* ; Retrospective Studies ; Self Concept

OBJECTIVES: To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma. METHODS: According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory （NEO-FFI）. RESULTS: The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients （18.7%） of mild craniocerebral trauma （P<0.05）. Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences （P<0.05） in the patients of mild craniocerebral trauma with personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences （ P>0.05） in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma. CONCLUSIONS The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment.
Craniocerebral Trauma/pathology* ; Humans ; Personality ; Personality Disorders/psychology* ; Personality Inventory ; Psychotic Disorders/psychology*

OBJECTIVES: This article aims to describe the development of smartphone application for the case management of patients with schizophrenia. METHODS: Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM) for cognitive-behavioral case management and symptom monitoring. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). RESULTS: The HYM application for clients includes six main modules including Thought record, Symptom record, Daily life record, Official notices, Communication, and Scales. The key module is the 'Thought Record' for self-directed cognitive-behavioral treatment (CBT). When the client writes and sends the self-CBT sheet to the case manager, the latter receives a notification and can provide feedback in real time. 'Communication' and 'Official notices' are useful for promoting communication between case managers and clients with schizophrenia. Ratings in 'Symptom record', 'Daily life record', and 'Scales' modules are stored in graphic or table form representing changes in them and shared with case managers. CONCLUSION: The interactive function of this application is the key characteristics that distinguishes it from other mobile self-treatment tools. This smartphone application may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis.
Case Management* ; Cognitive Therapy ; Early Intervention (Education) ; Gwangju ; Humans ; Mental Health ; Psychiatry ; Psychology ; Psychotic Disorders ; Schizophrenia* ; Smartphone* ; Social Work ; Social Workers ; Weights and Measures

OBJECTIVE: The purpose of this study is to evaluate the relationship of insight with socio-demographic, clinical, and cognitive parameters in schizophrenic patients. METHODS: Seventy-seven patients with schizophrenia were recruited. All subjects completed the Korean version of the revised Insight Scale of Psychosis (KISP) and Multidimensional Scale of Perceived Social Support (MSPSS). Positive and Negative symptom scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Neurocognitive function tests were also administered. RESULTS: Patients that are married or currently living together showed significantly higher levels of insight than those who are divorced, separated, or single. Insight showed positive correlations with CDSS and emotional discomfort factor of PANSS. Insight also had negative correlations with age of onset and family, friend subscales of MSPSS. Total scores of PANSS and neurocognitive functions showed no significant correlations with insight. More severe depressive symptoms, lower perceived social support from friends and family, and younger age of onset were predictor of higher insight. CONCLUSION: The study suggest that impaired insight might be independent from general psychopathology and cognitive function and more influenced by emotional status and social environment.
Age of Onset ; Depression ; Divorce ; Friends ; Humans ; Psychology* ; Psychopathology* ; Psychotic Disorders ; Schizophrenia* ; Social Environment

OBJECTIVES: Nurses and social workers are key persons connecting patients with psychotic disorders to psychiatric treatment. This study investigated the attitude of college students majoring in nursing science and social welfare toward psychiatric medication and stigma toward the mentally ill. METHODS: The study enrolled 553 college students (369 nursing science, 184 social welfare). We administered a five-item questionnaire to assess attitude toward psychiatric medication and a 20-item scale to assess stigma (prejudice regarding the dangerousness of the mentally ill and discrimination against the mentally ill). Factors associated with attitude toward psychiatric medication were identified. In addition, the stigma scale scores were compared with each item on attitude toward psychiatric medication. RESULTS: In the multivariate analysis, students majoring in social welfare had a significantly poorer attitude toward psychiatric medication than those majoring in nursing science. Age, senior grade, and experience to contact the mentally ill were also significantly associated with a good attitude toward medication, while attending psychiatry lectures, having a religion, and gender were not significantly associated with attitude toward psychiatric medication, although they showed relationships in the univariate analyses. For three of the five items, a negative attitude toward psychiatric medication was significantly associated with higher scores on the prejudice and discrimination scales. CONCLUSION: Prejudice toward and discrimination against the mentally ill are closely associated with a negative attitude toward psychiatric medication. An anti-stigma campaign should be developed that includes education to promote knowledge about psychiatric medications and reduce the stigma against the mentally ill. In addition, our findings suggest that experience to contact the mentally ill might improve attitudes toward psychiatric medication.
Dangerous Behavior ; Discrimination (Psychology) ; Education ; Humans ; Lectures ; Mentally Ill Persons ; Multivariate Analysis ; Nursing* ; Prejudice ; Psychotic Disorders ; Surveys and Questionnaires ; Schizophrenia ; Social Welfare* ; Social Workers ; Weights and Measures

OBJECTIVE: To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury (TBI). METHODS: In the current study, 391 subjects who had undergone forensic identification of the organic mental disorders due to TBI were included, both the demographic and post-traumatic information collected. The relevant data were statistically analyzed in those confirmed as organic psychotic syndrome according to Chinese Classification of Mental Disorders 3rd version (CCMD-3). RESULTS: Fifty-two subjects (13.3%) were identified as organic psychotic symptoms. The chi-square test showed that the detectable organic psychotic symptoms were associated with the marriage status, damage nature, injury severity and treatment, and the multivariate logistic regression analysis revealed good fitness of treatment and injury severity with the regression model (OR = 0.044, 95% CI: 0.017-0.114; OR = 2.145, 95% CI: 1.201-3.832, respectively). CONCLUSION The risks of organic psychotic symptoms following TBI can be involved in the alternative of craniotomy for the cases with trauma and moderate brain injury.
Brain Injuries/psychology* ; Humans ; Psychotic Disorders/etiology* ; Risk ; Syndrome

Schizophrenia is a common but complex mental disorder affected by multiple factors. Forensic psychiatric assessment of schizophrenia involves evaluations on many aspects, but there is no effective biological identification index for schizophrenia. Researches indicate that dysfunction of dopaminergic neurotransmission plays an important role in the pathogenesis of schizophrenia. Our study reviews the classification, genetic structure of dopamine receptors and the recent pertinent studies between the dopamine receptors and schizophrenia and its forensic significance.
Forensic Medicine ; Humans ; Mental Disorders ; Polymorphism, Genetic ; Psychotic Disorders ; Receptors, Dopamine/genetics* ; Schizophrenia/genetics* ; Schizophrenic Psychology

OBJECTIVE: To understand the assessment on the criminal responsibility of drug-induced mental disorders and judicial experts' opinions. METHODS: The judicial experts from institutes of forensic psychiatry in Shanghai were selected. They were asked to finish a self-made questionnaire of assessment on the criminal responsibility of drug-induced mental disorders by letters and visits. RESULTS: Most of experts knew the special regulation, "not suitable for evaluation" towards the criminal responsibility of drug-induced mental disorders of the guideline promulgated by Ministry of Justice. Before and after the guideline was issued, no expert made a no-responsibility opinion in such cases. After the guideline was issued, some experts made a full-responsibility or limited-responsibility opinion in such cases. There was a little disagreement among the experts in the case that the crime was unrelated with mental symptoms or the criminals used drugs even though he knew it could induced insanity. But there were still many obvious disagreements among experts in the case that crime was related to such symptoms and person was no ability to debate. Most experts agreed to settle the disagreements with improved legislative perfection. CONCLUSION Most experts are not strictly complying with the assessment guidelines during their practice, and there is still an obvious disagreement towards the criminal responsibility of drug-induced mental disorders.
China ; Crime/psychology* ; Criminals/psychology* ; Data Collection ; Expert Testimony ; Forensic Psychiatry ; Humans ; Liability, Legal ; Male ; Mental Competency ; Mental Disorders/psychology* ; Psychotic Disorders ; Surveys and Questionnaires

OBJECTIVE: To analyze the features of drowning victims with psychiatric disorders to support further investigation on such cases. METHODS: One hundred and five archives of drowning victims with psychiatric disorders from January 2010 to June 2014 in Harbor Public Security Subbureau, Shanghai Public Security Bureau were reviewed. The decedents' general information, autopsy findings, case investigation data and disease histories were statistically analyzed. RESULTS: Of the 105 cases, 104 were suicides. Most decedents were poorly educated. Most suicides occurred in warm climate, and the corpses were usually found within 2 days. Most decedents had no suicide history and notes, but had abnormal mental or behavior changes before suicide. Depression, depression status and schizophrenia were the main types of psychiatric disorders, and only 9 decedents had received regular therapies before their deaths. CONCLUSION Mental disorder is a high risk factor in the drowning victims. Guardians should be aware of psychotic abnormal behaviors, especially during warm climate seasons.
China/epidemiology* ; Depression/epidemiology* ; Depressive Disorder/epidemiology* ; Drowning/psychology* ; Female ; Humans ; Male ; Mental Disorders/psychology* ; Psychotic Disorders ; Retrospective Studies ; Risk Factors ; Schizophrenia ; Seasons ; Suicide/statistics & numerical data*