bluuebunny/crossref_metadata_2025 huggingface dataset:
A case of persecutory delusions presenting in a woman with normal pressure hydrocephalus due to idiopathic aqueductal stenosis
Authors: Chatziioannidis S. , Nikolaidis N. , Charatsidou I. , Ramantani E. , Genaris I. , Garyfallos G. , Giouzepas I.
Published: May 2011

Introduction

Normal pressure hydrocephalus due to idiopathic aqueductal stenosis is an abnormal accumulation of CSF in the cerebral ventricles caused by an obstruction in the Sylvian aqueduct. Although NPH typically presents with the progressive ‘triad’ of cognitive impairment, gait disturbance and urinary incontinence it has been described that it rarely manifests with predominant psychotic symptoms.

Objective and method

A clinical case was followed and reviewed to illustrate the psychiatric symptoms in NPH.

Results

A 32-year-old female was admitted to our acute psychiatric department because she exhibited verbal and physical aggressive behavior while being in an agitated state with persecutory delusions. Symptoms appeared and gradually exacerbated over a 5-year period reaching their climax two weeks before admission. The patient's increased body weight and bradykinetic appearance implied the presence of an underlying organic factor. However her endocrinological workup proved normal and her neurological examination revealed no actual focal deficits. An EEG also proved negative for seizure activity and encephalopathy.

Neuropsychological batteries showed mild cognitive impairment and a CT scan revealed considerable dilatation of the ventricular system due to idiopathic aqueductal stenosis. While a conservative approach was chosen for the treatment of NPH our patient was initiated on atypical antipsychotics showing marked improvement of her psychiatric symptomatology.

Conclusions

Patients without a prior psychiatric history who have soft nonlocalising neurological signs and mild cognitive deficits in association with prominent psychotic symptomatology should raise our index of suspicion and prompt the clinician to explore the existence of an organic factor contributing to a behavioral disorder.
Development and validation of polish version of matrics consensus cognitive battery
Authors: Ciołkiewicz A. , Jędrasik M. , Denisiuk M. , Linke M. , Gruszka A. , Zdunek I. , Jarema M. , Wichniak A.
Published: May 2011

Introduction

Neurocognitive deficits account for most of the long-term poor functional outcomes of patients with schizophrenia. Effective treatment of cognitive impairment is the most important challenge in the treatment of this disorder.

Objectives

Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Project produced a battery of 10 tests called the MATRICS Consensus Cognitive Battery (MCCB), designed to asses cognitive treatment effects in clinical trials of patients with schizophrenia.

Methods

In this validation study of Polish version of MCCB, 120 patients with schizophrenia will be investigated. 60 of them will be randomly chosen and examined again after 4 week. Altogether MCCB is going to be applied 180 times on 120 patients. The results will be compared with the results of American standardization study of MCCB (MATRICS-PASS).

Results

Until now 19 patients (12 males, 7 females, mean age 25.63 ± 5.14) have been investigated. Following MCCB T-scores in seven cognitive domains were obtained: attention/vigilance (38.33 ± 9.03), working memory (40.95 ± 14.35), verbal learning (38.11 ± 8.37), visual learning (41.37 ± 10.48), reasoning/problem solving (36.95 ± 10.14), social cognition (35.79 ± 10.67), composite T-score (30.22 ± 12.93).

Conclusions

These preliminary results show that MCCB could be successfully adopted into Polish. After the end of validation process MCCB will be an important research tool in studies aiming at improvement of cognitive functioning in Polish patients with schizophrenia.
Non-adherence to oral antipsychotics in schizophrenia: Relapse and therapeutic strategies in a 12-month observational study
Authors: Ciudad A. , San L. , Bernardo M. , Olivares J.M. , Polavieja P. , Valladares A. , Gilaberte I.
Published: May 2011

Introduction

Non-adherence influences schizophrenia prognosis.

Objectives

To describe the clinical profiles, modifications of the therapeutic strategies and relapse rate of patients with schizophrenia who are at risk of non-adherence to oral antipsychotic (AP) medication.

Methods

A cohort of 597 outpatients whose therapy was modified because of risk of non-adherence to oral AP was followed during 12 months. Authors used Cox regression to analyse the time to relapse.

Results

Patients’ mean (SD) age was 40.1 (11.1) and time since diagnosis was 15.2 (10.0) years; 64% were males. The clinical condition was at least moderate in most patients (CGI-S score ≥4 in 87%). Baseline AP medication was modified in 506 (85%) patients and non-pharmacological therapies in 190 (32%). In both cases, the main reason for modifications was insufficient efficacy. Concomitant medications were modified in 15%. The proportion of patients in AP monotherapy decreased in favour of polytherapy, and 15% started depot formulations.

During 12 months, 90 patients (15%) relapsed. Among relapsing patients, the proportion on monotherapy decreased to 42%, and the depot prescriptions rose to 28%. The risk of relapse was greater among patients with substance use disorder or familial psychiatric antecedents and lower in patients with poor attitude to AP medication or undergoing modifications of their non-pharmacological therapy at baseline.

Conclusions

Non-adherence management was focused on improving efficacy and consisted mainly of modifications of oral AP medication. The recognition and treatment, not necessarily pharmacological, of patients with a poor attitude to medication at baseline might explain their lower risk of relapse.
The potential of support vector machine as the diagnostic tool for schizophrenia: A systematic literature review of neuroimaging studies
Authors: Collins M.P. , Pape S.E.
Published: May 2011

Introduction

Schizophrenia is a relatively common chronic psychotic mental illness, which usually continues throughout life. Current diagnosis is based on a set of psychiatrist-applied diagnostic criteria. There can be considerable differences between diagnostic classification based upon either the set of criteria used, or the individual who applies the criteria. For this reason, the development of an objective test to inform the diagnosis could be highly beneficial.

Objectives

To assess the use of Support Vector Machine (SVM) as a potential diagnostic tool for schizophrenia, with a particular focus on the application of SVM to Magnetic Resonance Imaging (MRI) data.

Aims

To show the use of SVM on MRI data to be a potentially viable diagnostic test.

Method

A systematic literature search was carried out using the PubMed database, Web of Knowledge as well as Google Scholar. This search was conducted using the terms ‘Schizophrenia’, ‘SVM’/‘Support Vector Machine’ and ‘MRI/fMRI’. This was followed by the application of criteria relating to relevance to the desired search topic (as assesed by the author). Ten publications were identified as relevant.

Results

Results showed strong evidence that the application of SVM to MRI data can reliably differentiate between patients with schizophrenia and healthy controls.

Conclusions

The results indicate that using SVM to analyse MRI data can be reliably used to identify schizophrenia, although there is some variability between the results produced. The potential of SVM in application to fMRI (as opposed to structural MRI) data is yet to be fully explored.
Alexithymia and suicide risk among patients with schizophrenia: A cross-sectional study
Authors: De Berardis D. , Marasco V. , Serroni N. , Campanella D. , Olivieri L. , Acciavatti T. , Volpe L. , Di Iorio G. , La Rovere R. , Cicconetti A. , Carano A. , Moschetta F.S. , Di Giannantonio M.
Published: May 2011

Objectives

The aim of the present study was to evaluate the prevalence of alexithymia and its relationships with psychopathological features and suicide risk in a sample of adult patients with a DSM-IV diagnosis of paranoid schizophrenia.

Method

A mixed male-female sample of 60 subjects (30 males and 30 females) was evaluetd with the following rating scales: Toronto Alexithymia Scale (TAS-20), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), Calgary Depression Scale for Schizophrenia (CDSS), Scale for Suicidal Ideation (SSI), State-Trait Anxiety Inventory (STAI). RESULTS. 22 subjects (36.7%) were categorized as alexithymic (TAS-20 scores ≥ 61). Alexithymics showed more severe negative and depressive symptoms and increased suicide risk than nonalexithymics.

However, the results of a linear regression with SSI score as dependent variable showed that Difficulty in Identifying and Describing Feelings dimensions of TAS-20 and higher CDSS scores were significantly associated with higher scores on the Scale for Suicide Ideation. Conclusions: The presence of alexithymia in schizophrenia may be related to higher risk of suicide ideation and more severe depressive symptoms, independently by the severity of positive and negative symptoms. However, results are preliminary and limitations must be considered.
Representational momentum is impervious to kinematic but not dynamic variables in schizophrenic patients
Authors: Pimenta S. , De Sá Teixeira N.A. , Raposo V. , Canhão A.
Published: May 2011

When people are shown a moving object that suddenly disappears and are further instructed to locate its vanishing position, a systematic spatial error in the direction of the motion is observed. Entitled Representational Momentum (RepMo), this phenomenon seems to be influenced by low-level perceptual mechanisms and high-level cognitive aspects alike.

Available neurophysiologic data has pinpointed area MT/V5 as required for the emergence of RepMo, a cerebral structure known to be compromised in schizophrenic patients.

Although much is known about the variables that determine RepMo's magnitude (e.g., target's velocity, implied mass, direction of movement along or against the gravity axis), few studies attempted to measure RepMo with schizophrenic patients and, those that were published, seldom used a systematic manipulation of such variables. The present study intends to fill this gap. Both schizophrenic patients and normal controls participated in a repeated measures experiment where a black square, with 30, 60 or 90 pixels side, was shown moving at a constant velocity of 150, 300 or 450 pixels/s. After covering a distance of 300 pixels, either downwards, upwards, leftwards or rightwards, it disappeared. Participants were required to locate the last seen position, using a mouse that allowed control over a cross-shaped cursor. Results showed that dynamic variables (such as gravity and implied mass) didn’t differ between the groups. Notwithstanding, kinematic variables (velocity) didn’t show any significant effect in the schizophrenic group. These results are discussed within the distinction between perception-for-action and perception-for recognition, thus suggesting an impairment of the former in schizophrenia.
Functional performance in activities of daily living of individuals with a dual-diagnosis of schizophrenia and substance-use disorder
Authors: Desormeaux-Lefebvre M. , Tallant B. , Gelinas I. , Lariviere N.
Published: May 2011

Introduction

Research on functional performance of individuals with schizophrenia and substance use is limited, focusing primarily on cognitive impairments. Research findings are conflicting, making it difficult to understand how these individuals function despite their cognitive impairments. There is a need to use performance-based assessments to understand how individuals with a dual-diagnosis accomplish their daily living activities.

Aims

To describe the functional performance of individuals with a dual-diagnosis in two activities of daily living, using a performance-based assessment.

Objectives

To compare the functional performance of individuals with a dual-diagnosis, in grocery shopping and budgeting.

Methods

This descriptive cross-sectional study included ten participants with a dual-diagnosis of schizophrenia and substance-use disorder, aged 21 to 35, living independently in the community. They were evaluated on two tasks, budgeting and grocery shopping, using the Perceive-Recall-Plan-Perform (PRPP) system of task analysis (Chapparo & Ranka, 2005). The PRPP is a standardized criterion-referenced task-based assessment, and is valuable in describing individuals’ community functioning with regards to information-processing difficulties. Substance use was evaluated with the Addiction Severity Index (McLellan et al., 1989).

Results

Preliminary results indicate lower scores on both tasks, in the planning quadrant of the PRPP, particularly the evaluating sub-quadrant, which involves cognitive monitoring and appraisal processes. This trend occurs despite the participant's prior familiarity with tasks. Conclusions: This study is a first step in describing the functional performance of individuals with a dual diagnosis of schizophrenia and substance use in activities of daily living. This information will lead to improved rehabilitation for these clients.
Eligibility of the patients admitted to psychiatric inpatient units for participation in catie clinical trial
Authors: Diaz M.C. , Morales N. , Ruiz J. , Nieto K. , Iniesta E. , Martín M.A. , Fraguas D.
Published: May 2011

Introduction

Clinical trials (CT) are the main scientific support of the recommendations of pharmacological treatment of patients with schizophrenia. However, CT tend to strengthen the internal validity at the expense of external validity and the ability to generalize the results to the clinical population. For this reason, in recent years have developed large practical clinical trials that expand the inclusion criteria to incorporate as many real patients as possible. The first and most significant of these trials was the CATIE study (Lieberman et al, 2005).

Objectives

To analyze eligibility for participation in CATIE of patients admitted during 2009 in a psychiatric inpatient unit with a diagnosis of schizophrenia.

Methods

A total of 145 patients (27.6% females, mean age 39.6+/−12.8 years), consecutively admitted to an inpatient psychiatric ward with a clinical diagnosis of schizophrenia were assessed to test if they would fulfill criteria for participation in CATIE.

Results

60 (41.4%) patients did not fulfill CATIE inclusion criteria. Mental retardation (n = 22, p < 0.001), absence of informed consent (n = 15, p < 0.001) and refusal to take oral medication (n = 12, p < 0.001) were the main factors responsible for not meeting inclusion criteria.

Meeting the criteria was not significantly related to gender or specific diagnosis.

Conclusions

41.4% of patients admitted to a psychiatric inpatient unit with a diagnosis of schizophrenia did not meet criteria for participation in the CATIE study.
The krapellenian dicotomy in terms of employment outcomes
Authors: Dissanayke L. , Agius M. , Zaman R. , Yoon C.-H.
Published: May 2011

Background

We decided to examine the employment status of all patients with Schizophrenia actively treated by the Bedford East CMHT and compare this to the employment status of all those in the team who suffered from Bipolar Affective Disorder.

Methods

Cases of Schizophrenia and Bipolar Disorder were anonymously identified from a database held by the team and their employment status was established.

Results

124 patients were identified with schizophrenia, 24 with Schizoaffective disorder, and 60 with Bipolar Disorder.

Of the Schizophrenia patients, 91 (73.38%) were unemployed, 15(12%) were employed, 10 (8%) were in voluntary employment and 8 (6.45%) were labelled ‘other’ [housewife, student etc].

Of the Bipolar patients, 32 (53.33%) were unemployed, 14(23%) were employed, 5 (8.3%) were in voluntary employment and 9 (15%) were labelled ‘other’

Of the Schizoaffective patients, 15 (62.5%) were unemployed, 4 (16.66%) were employed, 2 (8.33%) were in voluntary employment and 3 (12.5%) were labelled ‘other’.

Discussion

Employment Outcomes for serious mental illness were poor, however Schizophrenia patients had a lower chance of returning to employment, partly due to the heterogeneity of the condition. Bipolar patients had twice the chance of gainful employment as Schizophrenic ones.

Conclusion

It is particularly difficult to achieve employment for patients with serious mental illness. This adds to the recently made argument for a more assertive approach by the creation of ad hoc chronic psychosis teams who could give ongoing support to aid patients to return to social inclusion and possibly work.
Observation of the effectiveness of a comprehensive and systematic treatment and rehabilitation in the social house. A case report
Authors: Dosiak M.M. , Wozniak J.P.
Published: May 2011

Introduction

The authors present a comprehensive-efficacy of pharmacotherapy and rehabilitation in the social house for people with mental health disorders carried out systematically for many years in the 40 year old patient.

Objectives

Patient 40 years old, male, secondary education, imposed a total inability to work. The first episode of the disease was in his 25 years, a syndrome of depression in a moderate degree, the next episode of schizophrenia-catatonic. In the therapy was used first generation antipsychotics, despite regular medication had not obtained complete remission and frequent exacerbations were the cause of several subsequent hospitalizations. During the last hospitalization in 1997, recognizing the diagnosis was verified with paranoid schizophrenia. After discharge, the patient in accordance with the recommendation began rehabilitation in the social house for people with mental health disorders, which still continue. Because of side effects after the previously used antipsychotic drugs second-generation - ziprasidone was incorporated in 2005. The use of this drug caused a significant decrease in body weight, increased social activity (a return to artistic activities - painting), improving the quality of life. Due to persistent chronic anxiety has been further adjustment of treatment in 2008 included amisulpride and valproate.

Conclusions

The treatment used a comprehensive, full remission of symptoms generation, and a significant reduction in negative symptoms. Currently, the patient actively participates in all activities organized in the environmental treatment of self-help home, living independently in daily activities, carry out the artistic passion of winning prizes at exhibitions and presentations of work.
Relapses of the disease in psychotic patients due to inability to manage stressful situations
Authors: Doulgeraki G. , Graikiotis A. , Theodosi K. , Kavvadia M. , Kavvadias N. , Malatra M. , Pittara A.
Published: May 2011

Introduction

Patients with mental disease are not in touch with their emotions, they do not recognize them and are incapable of finding alternative ways to face life difficulties.

Consequently, anxiety which evolves from stressful situations literally immobilizes them.

Objective

Our aim was to isolate the factors which create stressful situations that lead patients in relapsing.

Method

We studied patients’ inability to cope with their emotions and the stress that follows. We studied 25 patients living in the R.U. “Eurikleia”, 30 patients in follow-up and 50 patients who were hospitalized in the 3rd Psychiatric Department of the Psychiatric Hospital of Athens.

Our therapeutic procedure was the following:

prescription of atypical anti-psychotics

completion of the MMPI

examination of family/personal history

examination of family dynamics/dysfunctions

individualized therapeutic intervention for each patient and family evaluation of the results one year later.

Our intervention comprised of family therapy, setting family roles boundaries, patients’ autonomy, agreement in interventions between family and the therapeutic group and patients’ encouragement to take initiatives concerning their personal life.

Results

Ø

the functionality of the patients had improved

Ø

there was an important restoration of their sociability

Ø

there were still deficits regarding their socialization and professional rehabilitation

Ø

there was improvement regarding their autonomy

Ø

their dependence had been substituted for interdependence.

Conclusions

Through this study the most obvious conclusion we reached at was the necessity of patients’ and their families’ re-education in order to be able to live a meaningful life.
Stressful situations, coping styles and social support in patients suffering from schizophrenia
Authors: Dutczak B. , Bidzan L.
Published: May 2011

Schizophrenia is a disease which obstruct patient's social functioning in regard of their isolation as a symptom and intolerance of society. These patient's life is overfilled by many stressful situations, what is often connected with their state of health. In literature we can easily find many data about influence of stress on backset in schizophrenia, but there is no information about their ability of dealing with stress. It can be very important to take into account their styles of managing with stress in rehabilitation programs and add some training to help them to do it better. Treatment should contains not only pharmacotherapy, but also social support, social training and many changes in the environment to make their life more satisfying.

Methods

-

CISS Coping Inventory for Stressful Situations

-

Questionnaire of Stressful Events

-

BSSS Berlin Social Support Scales

-

PANSS
P03-207 Sexual dysfunction in a tunisian sample of drug free schizophrenic patients: A case-control-study
Authors: El Kissi Y. , Gaabout S. , Laroussi M. , Ayachi M. , Ben Hadj Ali B.
Published: May 2011

Introduction

Sexual dysfunction is reported by up to 80% of schizophrenic patients and seems to be mainly associated with antipsychotic medications.

Objective

This study aimed to compare sexual functioning and sexual dysfunction, as assessed by the Arizona Sexual Experience Scale, in drug naïve or drug free schizophrenic patients and in healthy controls.

Method

A consecutive sample of 109 patients meeting DSM-IV criteria of schizophrenia was constituted in psychiatry department of Sousse Farhat Hached hospital (Tunisia), during a 24 months period. They were drug naïve or drug free for at least three months. 109 age and gender matched, consenting controls were recruited among blood donors attending Farhat Hached hospital during the same period. They were free from psychotic disorders as screened by MINI-Plus. Sexual functioning was assessed using the Arizona Sexual Experience Scale (ASEX) in sexually active patients (N = 84) and controls (N = 94).

Results

There were no statistical differences in sexual dysfunction rates between schizophrenic patients (20.6%) and healthy controls (13.1%), according to usual threshold values. Also, global ASEX score was similar in schizophrenic patients (12.93 ± 4.48) as in healthy controls (12.61 ± 2.60). Besides, different ASEX item scores including sex drive, arousal, vaginal lubrification/penile erection and orgasm have not shown any differences between patients and controls. Only sexual satisfaction score was higher in schizophrenic patients than in healthy controls (2.73 ± 0.95 vs. 2.43 ± 0.77; p = 0.02).

Conclusion

Our results showed a low rate of sexual dysfunction in drug free schizophrenic patients without statistical differences with healthy controls. Only sexual satisfaction was lower in schizophrenic patients.
Sexual Activity and Marital Relationships in a Sample of Tunisian Schizophrenic Patients: Comparison with Healthy Controls
Authors: El Kissi Y. , Laroussi M. , Gaabout S. , Ayachi M. , Ali B. Ben Hadj
Published: May 2011

Background

Sexual activity and marital status have received little attention as an important aspect of schizophrenic patients’ care.

Objective

This study aimed to compare sexual activity, including sexual intercourses with a partner and masturbation, and marital relationships in patients with schizophrenia and in healthy controls.

Materials and method

A consecutive sample of 109 patients meeting DSM-IV criteria of schizophrenia was constituted in psychiatry department of Farhat Hached hospital (Sousse, Tunisia), during a 24 months period. They were drug naïve or drug free for at least three months. 109 age and gender matched, consenting controls were recruited among blood donors. They were free from psychotic disorders as screened by MINI-PLUS. Sexual activity assessment involved sexual intercourses with a partner and masturbation.

Results

Patients with schizophrenia were less often married than healthy controls (18.3% vs. 54.1%; p < 10-3). Also, they had less often a sexual partner (42.2% vs. 70.8%; p < 10-3) than healthy controls. They reported similar rates of sexual activity (77.1% vs. 86.2%), but less regular sexual intercourses (11.1% vs. 48.1%; p < 10-3) than healthy controls. Also, they reported higher rate (59.6% vs. 24.8%; p < 10-3) and higher prevalence during the last month (9.7 ± 9 vs. 5.04 ± 8; p = 0.017) of masturbatory activity.

Conclusion

In spite of lower prevalence of marital relationships, schizophrenic patients reported as frequent sexual activity as healthy controls. This sexual activity seems to be related to higher prevalence of masturbatory activity, which may be explained by their difficulties to be involved in relationship with a sexual partner.
Sexual Function in Untreated then Treated Schizophrenic Patients: a Prospective Study
Authors: El Kissi Y. , Mannai J. , Laroussi M. , Gaabout S. , Ayachi M. , Ben Hadj Ali B.
Published: May 2011

Introduction

High prevalence of impaired sexual function in patients with schizophrenia has been reported by several studies. Various factors were incriminated including the disease itself, the low level of social competence and treatmentside effects.

Objective

To compare sexual function in drug free schizophrenic patients and six months after initializing antipsychotic treatment.

Methods

A consecutive sample of 109 patients meeting DSM-IV criteria of schizophrenia was constituted in psychiatry department of Farhat Hached hospital (Sousse, Tunisia), during a twenty four months period. They were drug naïve or drug free for at least three months. Assessment was performed at two time points:

T0: During an acute phase of the disease as defined by a BPRS global score ≥ 40 T1: six months after antipsychotic treatment.

Assessment of sexual function used the Arizona Sexual Experience Scale (ASEX).

Results

Sexual function was impaired under antipsychotic treatment. In fact, we noticed lower global score of asex (p = 0.03) and lower subscores of drive (p = 0.015), arousal (p = 0.006), erection or vaginal lubrication (p= 0.010), orgasm (p= 0.001) and satisfaction (p= 0.005).

Conclusion

Sexual function was impaired in patients under antipsychotic drugs, according to global score and to diffrent sexual dimensions subscores. This results seem to, prospectively, confirm the implication of treatment in sexual dysfunction occurence among schizophrenic patients.
The Reflection of Lilliputian Hallucinations in Paintings of a Schizophrenic Patient
Authors: Estilaee F. , Nejad A. Ghaffari
Published: May 2011

Since several years ago the relation between art and mental disorders has been interesting for psychiatrists. This relation has more importance when understanding famous painters such as Van Gogh, Paul Gauguin and Louis Wain have had such disorders.

Psychotic patients may project their symptoms into their drawings and use paintings as a way to illustrate their special feelings and thoughts. Without them understanding patient’s world and their symptoms is impossible.

When hallucinations are too amazing to believe and more persecutor than any pain, and when thoughts are so dispersed which other cannot understand and nevertheless, there is no treatment for these boring symptoms, art and specially painting may be a way to relief them.

Lilliputian hallucination is a rare symptom in psychotic patients; a visual type hallucination that things and persons appears smaller than the real size. Patients usually describe them as the persecutor dwarfs or life from another world.

Here we introduce a schizophrenic patient with Lilliputian hallucination who created famous paintings. In these paintings, patient was drawn dwarfs in nearly one inch. They are creatures between man and mouse, sometimes whisper and occasionally walk on his head or body.
Short-Term Messages (SMS) and Content of Delusions in a Schizophrenic Patient
Authors: Estilaee F. , Nejad A. Ghaffari
Published: May 2011

Since the human creation he always has tried to have easier life through invention new technologies. We use technology to reduce our weakness and limitations and become stronger, faster, happier and more intelligent. We use new technologies such as internet and mobile phones to get easier and more available connections to each other. But does the technology give us happier life? Sometimes it seems that the rate of progression in technology is faster than our adaptation to it. Using of newer technologies cause being always accessible but unfortunately it may substitute the real inter personal relations. Despite external comfort it makes newer and serious stresses. Here we introduce a 24 year old, single and 12 class educated woman without previous history of psychiatric problems. She has accustomed with a guy through SMS. They had never visited and never spoken to each other. This relation lasts several months till she begins to gets twofold conception from these SMSes. She believes the meaning of jungle in the SMSes is female genitalia and inability to go to holly shrine is equivalent by sexual intercourse in menstrual period. Patient admitted in our psychiatric ward with schizophrenia impression, she treat with antipsychotic and her symptoms reduce considerably, but in 3 month follow up she still believes have not made mistake in past. In this report, in addition to patient introduction, we discuss about technology and its role to influence on content of delusions in schizophrenia
Childhood Abuse and the BDNF-Val66Met Polymorphism: Evidence for Gene-Environment Interaction in the Development of Adult Psychosis-Like Experiences
Authors: Alemany S. , Arias B. , Aguilera M. , Villa H. , Moya J. , Ibañez M.I. , Vossen H. , Gasto C. , Ortet G. , Fañanas L.
Published: May 2011

Introduction

The well-established relationship between childhood adversity and psychosis is likely to involve other factors such as genetic variants, which could help to understand why not everyone exposed to adverse events develops psychotic symptoms later in life (Van Winkel, et al. 2008; Simmons et al. 2009).

Aims

The present study investigated the influence of childhood abuse and neglect on positive and negative psychosis-like experiences in adulthood and the potential moderating effect of the BDNF-Val66Met polymorphism.

Method

Psychosis-like experiences and childhood adversity were assessed in 533 individuals from the general population.

Results

Childhood abuse showed a strong independent effect on the positive dimension of psychosis-like experiences (B = .16; SE = .05; p = .002). Furthermore, this association was moderated by the BDNF-Val66Met polymorphism (B = .17; SE = .09; p = .004).

Conclusions

Individuals exposed to childhood abuse are more likely to report positive psychosis-like experiences. Met carriers reported more positive psychosis-like experiences when exposed to childhood abuse than did individuals carrying the Val/Val genotype.

Therefore, the observed gene-environment interaction effect may be partially responsible for individual variation in response to childhood abuse.
Cannabis Use and Age at Onset of Psychosis: Further Evidence of Interaction with COMT Val158Met Polymorphism
Authors: Fatjó-Vilas M. , Arias B. , Estrada G. , Muñoz M.J. , Ilia J.M. , Miralles M.L. , Martin M. , Toledo E. , Miret S. , Navarro M.E. , Fañanas L.
Published: May 2011

Introduction

Different studies have confirmed the association between cannabis use and psychosis and, also, the relationship between age at first cannabis use and age at onset of psychosis (Henquet et al 2005, Barnes et al 2006). In a young psychiatric sample, we aimed to investigate the correlation between cannabis use and the age at onset of psychotic and non-psychotic symptoms and whether this relationship is modulated by the genetic variability at COMT, CNR1 and CHRNA7genes.

Methods

The sample comprised 157 Caucasian patients (mean age: 17.01 (3.6)) diagnosed following DSM-IV-TR criteria: 80 patients with schizophrenia-spectrum disorders, 77 patients with affective or conduct disorders. Cannabis use was assessed with UNICA-A and DIGS scales (Nurnberger 1994) and 49% individuals were classified as consumers. SNPs were genotyped using Taqman 5′-exonuclease assays.

Results

We observed a positive relationship between age at first cannabis use and age at onset in, both, schizophrenia-spectrum (β = 1.44 p < 0.001) and other psychiatric disorders (β = 0.56 p < 0.002). An interaction was observed between COMT Val158Met polymorphism and cannabis use specifically within schizophrenia-spectrum disorders’ group (β = −2.72 p = 0.04), with Val/Val genotype carriers showing an earlier age of onset than Val/Met carriers, and these, lower than the Met/Met carriers. No modulation effect of CNR1 or CHRNA7 polymorphisms was observed.

Conclusions

Our results seem to indicate the importance of maturation timing and brain development in which exposition to cannabis occurs. We provide new evidence about the COMT modulation effect on the association between cannabis use and age at onset of symptoms, specifically in individuals affected by schizophrenia-spectrum disorders.
Anxiety sensitivity depending on presence of positive symptoms in psychosis
Authors: Fernândez-Jiménez E. , Pastor-Morales J. , Sanz-Largo V. , Castillo-Gordillo E. , Rivas-Marîn F.
Published: May 2011

Introduction

An important corpus of scientist evidence is linking psychotic activity and anxiety-related processes (Freeman and Garety, 2003).

Objectives

We intended to assess differences in Anxiety Sensitivity dimensions between patients diagnosed by psychosis with and without positive symptoms.

Methods

Participants: 49 patients with DSM psychosis diagnosis (42 men and 7 women; mean age: 40), who attended a Mental Health Rehabilitation Service in 2008, of whom 24 patients had positive symptomatology.

Design, materials and procedure: A Cross-sectional design (one measurement) for a co-relational method of comparison between groups.

We used the Spanish validated Anxiety Sensitivity lndex-3 -ASI 3- (Sandîn et al, 2007), a 18-item Likert self-report that assesses fears of anxious symptoms. It presents a hierarchical structure (a general factor and three subscales -Physical, Cognitive and Social Concerns-). It's also used the first and third items (delusions and hallucinatory behaviour) of The Positive and Negative Syndrome Scale -PANSS- (Kay, Opler and Lindenmayer, 1988) to detect positive symptoms.

Results

Patients with positive symptoms showed a higher sensitivity to cognitive (z = -3.22, p < 0.01) and social anxiety (z = -2.66, p < 0.01), as well as higher punctuations in ASI-total (z = -2.91, p < 0.01), than patients without positive symptoms.

Conclusions

Patients with positive symptoms show significant fears of symptoms of different anxious domains (ASI-total) with regard to patients without this kind of symptomatology. Specially, they are worried about the possibility that concentration difficulties and restlessness lead to mental incapacitation (ASI-cognitive) and about social reactions before their own publicly observable anxiety manifestations (ASI-social).
Quality of Life in Metabolic Risk Patients with Psychosis in Relation to the Population
Authors: Foldemo A. , Ösby U. , Holmberg T.
Published: May 2011

Background

The International Diabetes Federation (IDF)(2004) has defined criteria for metabolic syndrome and in patients with schizophrenia four of ten meet the criteria for having the syndrome. Its important too study more about the influence of metabolic syndrome because there association with high morbidity and increased risk of influence on patients health and the treatment itself The aim of the study was to investigate metabolic risk factors influence on quality of life. The method was a prospective cohort study from specialized psychiatric outpatients departments in Sweden. The study recruits consecutively patients diagnosed with schizophrenia and other long-term psychotic disorders (ICD10). A prospective population based study is serving as a control group. Patients are assessed with a psychiatric questionnaire witch included CGI and GAF. Health-related quality of life assessed using the questionnaire EQ5D both in patients and population and health status with BMI, smoke habits and alcohol consume.

Results

The results on patients (n = 777) and population (n = 7238) showed significant differences in lower EQ5D Index in man especially in younger age. The diagnosis of schizophrenia and schizoaffective were the most common in the patient group (n = 481). In patients was nearly 50% non alcoholic users compared to the control group (=population) were the non consumers was 18%. BMI over 35 were more common in the patient group than in the population 13.2% versus 2.8%.

Conclusion

In conclusion there were differences in quality of life between metabolic risk patients with psychosis and the control group.
Recovery Versus Remission in Schizophrenia and Related Persistent Psychotic Disorders: no Contrasting but Complementary Models
Authors: Parise V. Fricchione , Balletta G. , Landolfi M.R. , Manna G.
Published: May 2011

At present there is no consensus on defining “Recovery” in schizophrenia,while there is an accepted definition of “Remission”. Remission model considers “stability” the treatment primary goal and, once achieved, focus is on mainteining stability and preventing relapse. This model reflects a condition where are absent prominent symptoms but may be present some mild symptoms of schizophrenia, retaining not realistic absence of any symptoms. It would require treating an acute psychotic episode,then there still may be a range of no detectable or persistent and disabling symptoms:remission and level of functioning are related but not the same. Some patients could have good level of functioning despite persistent symptoms and others could meet remission criteria despite considerable impairments. Remission is an obteinable outcome for many psychotic outpatients:the point of departure between manteinance and recovery-oriented model happens only after “stability” is achieved;no one could recover in face of repeated crisis,hospitalisation or unrelenting psychotic symptoms. Unfortunately two causes have resulted in a relative neglect of the concept of recovery from psychotic illness:the divide between mainstream biologically oriented psychiatry and the psychiatric rehabilitation movement;the misunderstanding fact that term “recovery movement” is sometimes construed as anti-medication or anti-psychiatry orientation. Irrefuteble point is that recovery model not rejects the importance of remission:stability and relapse prevention. The recovery model besides asserts that achieving remission is the beginning and not the end of treatment plan:then there will be continued efforts to work with patient,family,caregiver,to continue to achieve further improvements in life goals. The “Recovery” patient-centred model have to be embraced as prymary goal by mainstream organizations and services in Mental Health.
“Mental Illness Awareness in Institutionalized Schizophrenics”
Authors: Gallardo R. , González E. , García F. , Botillo C. , Martínez J.D. , Salgado C. , López R.
Published: May 2011

Our study aimed to compare the mental illness awareness in institutionalized schizophrenics when compared to non institutionalized schizophrenics.

Diagnoses of Schizophrenia was done following the ICD-10 dignosis criteria. We chose a convenience sample of our patients: 74 patients, 69.9% of institutionalized inpatients and a 31.1% of outpatients.

Specific survey applied by the group of investigators aiming to collect socio-demographical data and clinical data, using the following psychometric scales: Scale to Assess Unawareness of Mental Disorder (SUMD), Global Assessment Scale (GAS), and Clinical Global Impression (CGI).

Statistical analysis was performed with SPSS v 15.0, including descriptive statistics and correlation analysis.

Differences found among awareness of response to medication and the awareness of social consequences of mental disorders are statistically significant, being higher in the institutionalized group of schizophrenics.
How do Symptoms and Level of Functioning Affect the Quality of Life in Schizophrenia? a Study on the Community Mental Health Centre of Ferrara (Italy)
Authors: Galuppi A. , Turola M.C. , Nanni M.G. , Mazzoni P. , Grassi L.
Published: May 2011

Introduction

A specific interest regarding quality of life(QoL) of patients with schizophrenia dates back to the de-institutionalisation process. Italy worked on decentralising its mental health services since 1978. It was apparent that capturing psychopathological symptoms alone was not sufficient to reflect relevant outcomes. In particular, information on the social functioning and quality of life is regarded as essential for evaluating long-term outcomes.

Objective

The relationship between Quality of life and global functioning and symptoms in outpatients with Schizophrenia.

Method

In the present study we examined all the subjects with a diagnosis of schizophrenia attending a same Community Mental Health Centre in Northern Italy, in 2008. Each patient completed the WHO QoL Instrument - Brief and was administerd the Brief Psychiatric Rating Scale-24 to assess psychiatric symptoms and the VADO Personal and social Functioning Scale to assess the level of functioning.

Results

The population studied subjects showed an intermediate satisfaction on the overall QoL and health; these data can be juxtaposed to the national standard sample rates. QoL resulted positively associated to personal and social functioning, while it was negatively related to psychiatric symptoms.

Conclusion

The QoL in our study is not extremely negative, though schizophrenia is an often an impairing chronic illness. Furthermore, the present research on social functioning, psychiatric symptoms and QoL in people with schizophrenia suggest that symptoms, but, above all, personal and social functioning are important elements to determine QoL. These studies point to the importance of looking beyond symptom-reduction strategies for improving QoL in schizophrenia.
Functional Outcome in First-Episode-Schizophrenia Receiving Assured Antipsychotic Medication: 52-week Prospective Study with Risperidone Long-Acting Injection
Authors: Garcia J. , Segarra R. , Ojeda N. , Peña J. , Eguiluz I.
Published: May 2011

Introduction

It is well stablished that therapeutic compliance is a fundamental predictive factor in the outcome of first-episode psychosis. Risperidone long-acting injection has demonstrated high remission rates and improvements in treatment adherence.

Objective

1-

To analyse the efficacy of risperidone long-acting injection vs oral atypical antipsychotics in first-episode psychosis.

2-

To describe in both groups the evolution of clinical and cognitive symptoms, functional outcome, quality of life, insight and treatment adherence.

Method

18 patients with a first-episode psychosis treated with long-acting risperidone were compared with 21 first-episode psychosis treated with oral atypical antipsychotic medication. They were matched one on one for age, gender and years of education. All subjects were compared regarding psychopathology and functional outcome terms. Patients were examined with Positive and Negative Syndrome Scale (PANSS) for clinical symptoms. Longitudinal functionality was prospectively assessed with the Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) rating scales.

Results

We found significant differences between both groups in negative symptom severity and global assessment of functioning. There was no statistically significant difference between the two groups in PANSS positive and general components. Negative symptom severity was associated with poorer GAF ratings.

Conclusions

Our data suggest that risperidone long-acting injection assures treatment compliance and therefore could improve clinical and functional outcome.
Predictive Models of Metabolic Syndrome for Patients with Schizophrenic or Bipolar Disorders
Authors: Garcia-Portilla P. , Santamarina S. , Saiz P.A. , Sánchez F. , Diaz-Mesa E. , Iglesias C. , Bobes J.
Published: May 2011

Introduction

Metabolic syndrome is a frequent, severe, undiagnosed physical comorbidity in patients with severe mental disorders.

Aim

To develop a predictive model of metabolic syndrome for patients with schizophrenic or bipolar disorders, useful for both clinical practice and research.

Methods

Naturalistic, one-year follow-up study conducted in Asturias, Spain. A total of 172 patients with schizophrenic (Sch-P) or bipolar (BD-P) disorders (ICD-10 criteria), under maintenance treatment, who gave written informed consent were included. Metabolic syndrome was defined according to the modified NCEP ATP-III criteria. Multivariate Adaptive Regression Splines (MARS), Genetic Algorithms (GA), and Support Vector Machine (SVM) analysis were performed.

Results

Starting from a large set of demographic and clinical variables, and by means of intermediate MARS and GA models, an SVM model able to classify if a patient with schizophrenia or bipolar disorder suffers from metabolic syndrome with an accuracy of 98.68% (sensitivity 100%, specifity 94.4%) was obtained. The final model only needs 6 variables: Sch-P:

(1)

Low HDL-cholesterol,

(2)

Fasting glucose level,

(3)

Family history of obesity,

(4)

Triglyceride level,

(5)

Family history of dyslipidemia, and

(6)

Use of antidepressants; BD-P: (1), (2), (3),

(7)

Use of lipid-lowering medication,

(8)

Use of antipsychotics, and

(9)

Use of mood stabilizers.

Conclusion

We developed a simple and easy to use predictive model to identify metabolic syndrome in patients with schizophrenic or bipolar disorders.
Schizophrenia- a Syndrome of Insulin Impairment
Authors: Diaconeasa A.G. , Ghita C. , Blacioti M. , Spiru L. , Turcu I.
Published: May 2011

Introduction

Schizophrenia is a human specific disease, unknown in other primates. Low adiposity during childhood was associated with a greater risk of developing schizophrenia, but this disease has a higher incidence in the obese children and adults, too.

Objectives

We developed a new hypothesis on the human evolution. According to it, changes in the activity of the IGF1 (insulin-like growth factor1)/insulin pathway (altered in human pathological conditions such as the psychiatric disorders) could be responsible for the appearance of certain specific human traits.

Aims

This hypothesis predicts that schizophrenia should result from a deviation of the normal IGF1/insulin signaling in brain in both directions. A drug that increases insulin resistance should improve the condition in the slim patients and worsen them in the obese patients.

Methods

A multi-center double-blind study on palmitate paliperidone (pp), the major active metabolite of the antipsychotic risperidone (that increases insulin resistance and stimulates weight gain), was conducted. 25–150 mg eq pp was injected intramuscular (into the deltoid muscle or the gluteal muscle) at 1 week interval for 1 year in a double blind study in patients with acute symptoms.

Results

Our preliminary observations based on the Positive and Negative Syndrome Scale (PANSS) total scores showed that the slim patients had statistically the best response to pp and the worse effects were observed in the obese patients. The study is still ongoing.

Conclusions

These results suggest that schizophrenia is a polarized disease with 2 major phenotypes- one with either insulin sensitivity or obesity and insulin resistance.