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Recent evidence indicates an improving effect of the co-occurrence of autistic traits and psychotic symptoms on social cognition, but there is no agreement on the effect of the interaction between autistic traits and psychotic proneness on empathy. The aim of this study is to examine the effect of the interaction between autistic traits and positive psychotic experiences on cognitive and affective empathy.

The sample consisted of 420 adults aged between 18 and 60. Assessments were administered anonymously online. Empathic abilities were evaluated by the Interpersonal Reactivity Index (IRI). While Autism Spectrum Quotient (AQ) was applied to measure autistic traits, The Community Assessment of Psychic Experience (CAPE) was used as a measurement of positive psychotic experiences.

A series of regression analyses showed that although AQ and CAPE scores were not correlated with cognitive-IRI, the interaction between these scores predicted cognitive-IRI scores. It was found that the personal distress subscale of IRI was significantly associated with AQ, but this relationship was moderated by CAPE scores.

These findings provide a different perspective on understanding social cognitive impairments in autism, which may have potential clinical implications. Findings also contribute to explaining the individual differences in empathic abilities.

About 4% of all prisoners can be diagnosed with a psychotic disorder, but it is largely unknown how these prisoners function during imprisonment. The present study aimed to describe symptoms of psychotic prisoners during imprisonment and incidents caused by them as well as care provided to these prisoners. A total of 61 prisoners were observed for a maximum of 12 weeks. Results show that poverty of speech and blunted affect significantly decreased over time. The largest group of psychotic prisoners either did not suffer from positive psychotic symptoms or the encountered positive psychotic symptoms exhibited a steady or decreasing pattern during their imprisonment. Reasons for these findings still remain unclear.

The aim of this article is an analysis of the links between race and psychotic illness, psychiatric diagnosis and treatment, as well as psychiatric, police and prison violence against people with mental health problems. The analysis focuses on Black men who are more frequently diagnosed with schizophrenia and other psychotic disorders and who face more brutal treatment than other people with such diagnoses. We have adopted a multidisciplinary approach which draws insights from psychiatry, psychology, and sociology and challenges the biologistic interpretation of “mental illness.” We take into account the United States and Britain – two countries with large Black minorities and an established tradition of research on these groups. Among the crucial findings of this study are the facts that racial bias and stereotypes heavily influence the way Black men with a diagnosis of psychotic illness are treated by the psychiatric system, police and prison staff, and that the dominant approach to psychosis masks the connections between racism and mental health.

The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders (DSM) diagnostic criteria; the prevalence of reported autism spectrum disorders (ASD); and the extent to which assessment of developmental issues is central to the diagnosis of psychotic disorder, in patients discharged with a diagnosis of psychotic disorder and intellectual disabilities.

Of all patients discharged with psychotic disorder during a four‐year period (n=3339), chart reviews were completed on those also diagnosed with intellectual disability or borderline IQ.

The findings if this paper are threefold: only 39 percent of the 41 individuals discharged with a diagnosis of psychotic disorder and intellectual disability met documented DSM criteria for intellectual disability; the prevalence of reported ASD was much lower than expected; and the average number of different discharge diagnoses per individual over time was 4.8. Schizophrenia diagnoses were made early in the diagnostic process and tended to persist even when ASD concerns were documented.

The results support the need to systematically assess the developmental issues of patients with intellectual disability as part of the psychiatric diagnostic formulation. Differential diagnoses of psychotic‐like behaviours seen in people with intellectual disability, and alternative frameworks for understanding these behaviours, which in turn should guide more effective interventions and treatment, are discussed.

The purpose of this paper is to describe experiences of caregivers in managing psychotic symptoms of persons with schizophrenia in various circumstances.

The data were obtained via a focus group and in-depth interviews among caregivers who cared for relatives with schizophrenia for more than five years. Thematic analysis was used for data analysis.

“Making it better” emerged as the main theme describing caregivers’ experiences in trying to manage psychotic symptoms. It comprises four sub-themes including cutting off the wind, protecting from harm, preventing relapses and pulling back to normality. The caregivers gradually learned and adjusted their strategies through trial and error. They tried to stop aggressive and violent behaviors soon after they had begun by giving cool water to their relatives to drink or shower, while expressing their own affect with gently talking. They also dealt with a hardship in protecting the patients, other people, their properties and their own selves from harm resulting from violent behavior. When the psychotic symptoms improved, the caregivers tried to prevent relapses by using various strategies to maintain medication adherence and by soothing their relatives’ mental state. They also tried to pull their relatives back to normal as much as they could by promoting their relatives’ memories and abilities to perform daily functions.

The findings increase knowledge in nursing regarding psychotic symptoms management. The findings can be applied to the development of a program to help caregivers to manage psychotic symptoms effectively in order to promote good clinical outcomes of patients and alleviate the caregivers’ burden.

Acute and transient psychotic disorders (ATPD), introduced in the International Classification of Diseases (ICD-10) diagnostic system in 1992, are not receiving much attention in developing countries. Therefore, the main objective of this article is to review the literature related to the diagnostic stability of ATPD in developing countries. A PubMed search was conducted to review the studies concerned with this issue in the context of developing countries, as diagnostic stability is more of a direct test of validity of psychiatric diagnoses. Four publications were found. According to the literature search, the stability percentage of the ICD-10 ATPD diagnosis is 63-100%. The diagnostic shift is more commonly either towards bipolar disorder or schizophrenia, if any. Shorter duration of illness (<1 month) and abrupt onset (<48 hours) predict a stable diagnosis of ATPD. Based on available evidence, the diagnosis of ATPD appears to be relatively stable in developing countries. However, it is difficult to make a definitive conclusion, as there is a substantial lack of literature in developing country settings.

On average, the National Health Service (NHS) loses annually £360 million in opportunity costs due to non‐attendance of outpatient appointments (Stone et al, 1999). In addition to draining healthcare resources, failure to attend clinical appointments incurs personal costs. Mobile phone technology has been applied successfully to reducing appointment non‐attendance and improving clinical outcomes for patients with physical illnesses. However, it is unclear whether these applications can be extended to patients with severe and enduring mental disorders. We conducted a trust‐wide survey of 141 psychiatric inpatients of the Oxleas NHS Foundation Trust (82% of the Trust's total inpatient population) to establish how many respondents owned a mobile phone (62%), could use text‐messaging services (62%) and were willing to use the latter as a means of communication with the Trust (80%). Compared to patients with psychotic illnesses, those with non‐psychotic illnesses reported higher rates of mobile phone ownership (78% versus 55%, p=0.01), ability to use text messaging (76% versus 56%, p=0.03) and willingness to receive text messages from the Trust (90% versus 76%, p=0.05). The results of the survey were used to inform the planning of a pilot study aimed at reducing non‐attendance rates of outpatient appointments in Oxleas.

The purpose of this paper is to discuss recent papers on trauma, sleep and psychotic experiences to highlight the lack of attention given to sleep.

A search was carried out to find recent papers on psychosis or schizophrenia, trauma and sleep.

Papers tended to focus on trauma and psychosis, or on sleep and psychosis, but not on trauma, sleep and psychosis. The two papers discussed in most detail here focussed on sleep difficulties from either a service user or professional perspective. Both concluded that sleep difficulties need more attention. The author also discussed evidence suggesting that stress and trauma cause sleep difficulties and that these, in turn, are an important cause of psychotic experiences. Severe or prolonged stress may also directly cause some psychotic experiences.

The two main papers highlight for the first time in detail service users’ own experiences of sleep difficulties, and how mental health professionals view them, suggesting more help is needed. Other papers suggest that sleep is overlooked in research into the causes of psychosis. There is growing evidence that people have sleep problems before psychotic experiences, and that many have experienced severe or prolonged stress due to life events and circumstances, often in childhood. Given that stress can interfere with sleep, it is time to investigate further the role of stress and sleep in the development and maintenance of psychosis.

The purpose of this paper is to explore the relationship between attachment style, sub-clinical symptoms of psychosis and aggression in a general population sample.

Using both convenience and snowball sampling, participants in the community (n=213) completed an online questionnaire including previously validated measures of adult attachment, aggression and psychotic experiences.

Results suggested that there were statistically significant correlations between all study variables. Multiple linear regression demonstrated that total psychotic-like experiences and attachment scores significantly predicted variance in total aggression. Moderation approaches revealed that the relationship between psychotic-like events and aggression was stronger in individuals with more insecure attachment styles.

This generalisability of the results is compromised by the sampling methodology and the use of self-report tools. However, the significant results would support larger scale replications investigating similar variables.

This study suggests there is a relationship between psychotic-like experiences (PLEs) and facets of aggression in the general population. These results suggest that attachment is a contributing factor to aggression associated with PLEs, and highlight the need for similar investigations within clinical samples. The results imply that attachment may be a useful construct for explanatory models of the relationship between adverse childhood experiences, psychotic experiences and aggression.

The purpose of this paper is to assess the prevalence and nature of presentation of unipolar depression in individuals with Prader-Willi syndrome (PWS).

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (2009) checklist for systematic reviews was followed where possible.

Seven studies were included in the qualitative synthesis from a total of 261 records identified. The quality of the studies was then assessed: scores for each study design ranged from between 3 and 6 of a possible score total of 6. The frequency of depression ranged between studies from 4 to 22 per cent. four studies showed over 50 per cent of patients appeared to suffer from psychotic symptoms. Low mood, anhedonia and irritability were described as features of depression, although no fixed pattern of psychopathology arose from across the studies (excluding psychosis). This review has provided evidence to suggest that depression is a frequent occurrence in the PWS population. One study found that the incidence of depression differed between the genetic subtypes, raising questions regarding the relationship between genotype and behavioural phenotypes. A high proportion of individuals with depression suffered from psychotic symptoms.

The small number of heterogeneous studies included in this study precluded meta-analysis of the results. This highlights the need for further original research in this field.

An increased awareness of the frequency of depressive symptoms within the PWS population will aid in the timely diagnosis and management of the disorder which will reduce psychiatric morbidity. The noted high proportion of psychotic symptoms associated with depression should raise the index of suspicion with clinicians and aid appropriate management decisions.

This review has provided preliminary evidence for the nature of presentation of unipolar depression in PWS. It has highlighted the possibility of an increased propensity towards depression with psychotic symptoms. There is some suggestion of a differing presentation and course of unipolar depression between the common genetic subtypes of PWS which warrants further investigation.