Sustained attention in psychosis:Neuroimaging findings

To provide a systematic review of scientific literatureon functional magnetic resonance imaging(fMRI) stud-ies on sustained attention in psychosis. We searchedPubMed to identify fMRI studies pertaining sustainedattention in both affective and non-affective psycho-sis. Only studies conducted on adult patients using asustained attention task during fMRI scanning wereincluded in the final review. The search was conductedon September 10 th, 2013. 15 fMRI studies met our in-clusion criteria: 12 studies were focused on Schizophre-nia and 3 on Bipolar Disorder Type Ⅰ(BDI). Only halfof the Schizophrenia studies and two of the BDI stud-ies reported behavioral abnormalities, but all of themevidenced significant functional differences in brain re-gions related to the sustained attention system. Alteredfunctioning of the insula was found in both Schizophre-nia and BDI, and therefore proposed as a candidate trait marker for psychosis in general. On the other hand, other brain regions were differently impaired in affective and non-affective psychosis: alterations of cingulate cortex and thalamus seemed to be more common in Schizophrenia and amygdala dysfunctions in BDI. Neural correlates of sustained attention seem to be of great interest in the study of psychosis, highlight-ing differences and similarities between Schizophrenia and BDI.

Differences between delusional disorder and schizophrenia:A mini narrative review

Psychotic syndromes are divided into affective and non-affective forms.Even among the non-affective forms,substantial differences exist.The aim of this relatively brief review is to synthesize what is known about the differences between two non-affective psychoses,schizophrenia and delusional disorder(DD),with respect to clinical,epidemiological,sociodemographic,and treatment response characteristics.A PubMed literature search revealed the following:in schizophrenia,hallucinations,negative symptoms and cognitive symptoms are prominent.They are rare in DD.Compared to schizophrenia patients,individuals with DD maintain relatively good function,and their delusions are believable;many are beliefs that are widely held in the general population.Treatments are generally similar in these two forms of psychosis,with the exception that antidepressants are used more frequently in DD and,for acute treatment,effective antipsychotic doses are lower in DD than in schizophrenia.It is with the hope that the contrasts between these two conditions will aid in the provision of safe and effective treatment for both that this review has been conducted.