Objective: Previous studies indicated that the levels of serum interleukin (IL)-12 at baseline were elevated in obsessive-compulsive disorder (OCD) patients compared with control subjects, suggesting that IL-12 maybe involved in the etiopathogenesis of OCD. Therefore, we study the relationship between 1188A/C polymorphism of IL-12(rs3212227) and OCD in Chinese Han population.

Methods: We genotyped 194 OCD patients and 322 healthy individuals by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), then analyzed the data using case-control association test.

Results: No significant differences were found in 1188A/C genotypic and allelic frequencies between OCD cases and controls (X2 = 2.12, df = 2, P = 0.35 by genotype; X2 = 0.005, df = 1, P = 0.94 by allele).

Conclusions: Our results suggested that there may be lack of an association between OCD and IL-12 1188A/C polymorphism in Chinese Han population.

Background: A well-known technique to assess (psychological) arousal is to measure the skin conductance level (SCL). Although widely used in experimental psychological research, this technique has not been used often in (locked) psychiatric admission settings on patients who are at a high risk of engaging in aggressive behaviour. One of the obvious reasons for this is that measuring skin conductance, until recently, required a substantial amount of equipment.

Methods: As technology developed, it became possible to develop small wearable devices in the form of regular watches to measure the SCL as well as other psycho-physiological parameters. To illustrate the potential this may have for the prevention of aggressive behaviour, a case description is provided of a patient in crisis who became physically aggressive while wearing a skin conductance measurement device.

Results: Interestingly, the SCL of the patient had been rising sharply before the first signs of aggressive behaviour were visible.

Conclusion: Although it concerns an anecdotal case study, this finding suggests that measuring SCL on a continuous basis in patients who are at a high risk of becoming violent, without this procedure having to interfere with their daily life, may open new avenues for preventing aggression at an earlier stage. A large-scale empirical study in a substantial number of (potentially aggressive) patients is needed, however, to investigate the predictive validity of mobile skin conductance assessments on imminent inpatient aggression in a reliable way.

Objective: In this retrospective study, we tested the hypothesis that patients with epilepsy (PWE) with moderate to major depression have more severe memory deficits than PWE with mild depression or no depression.

Methods: Hundred and thirty-nine patients with chronic epilepsy were studied with the Self-Rating Depression Scale (SDS) and a neuropsychological-screening battery the day after admission on a specialised ward for PWE. For this study the data from the Memo-test for verbal memory and from the Benton-test for non-verbal memory were taken into account. For testing of the hypothesis of independence of memory deficits and grade of depression we performed a statistical analysis.

Results: Eighty-three patients (59.7%) had a pathological score in the SDS, but only 36 (25.9%) scored in the range of a moderate to major depression. When all 83 patients with a pathological score in the SDS were taken into account, these patients did not differ on any cognitive measure from those without pathological score in SDS. The only significant association in our study was found between pathological results in immediate verbal recall and a score in the SDS for moderate to major depression (p = 0.038).

Conclusion: Minor depressive symptoms may be a response to chronic illness without any impact on cognitive functioning. Nevertheless, a verbal memory deficit associated with major depression was observed in our study even in the presence of many confounding factors. This may be a hint for an association of severe depressive symptoms with left temporal dysfunction in PWE.

Introduction: Palilalia is an acquired speech disorder characterised by involuntary and spontaneous repetition of words or phrases two or more times in a row. It can occur in a variety of disorders including postencephalic parkinsonism, pseudobulbar palsy, schizophrenia, Gilles de la Tourette syndrome and others.

Clinical Case: We describe a case of a 28-year-old man with refractory schizophrenia that developed palilalia with 300 mg of clozapine. In the patient evaluation we found unspecific alterations in the electroencephalogram, with normal blood tests and cerebral magnetic resonance imaging. Palilalia disappeared with lowering doses of clozapine.

Discussion: The appearance of palilalia induced by clozapine is a rare pharmacologic side-effect which physicians should be familiarised with when evaluating this symptom presentation.

Objectives: The heterogeneity of schizophrenia mainly results from variations in clinical expressions of the disease, such as age at onset, gender differences in onset of illness, symptoms and response to antipsychotic treatment. Enhanced sensitisation of dopamine pathways in males, having consistently an earlier onset, might be implicated as disease modifiers for schizophrenia in males.

Methods: In this study, we performed a case (n = 87)-control (n = 100) association study between the DBH5′-ins/del and DBH-444g/a polymorphisms of the DBH gene and also compared the level of psychotic symptoms between patients with different DBH genotypes/haplotypes with respect to antipsychotic therapeutic response and gender difference.

Results: No significant differences between allele and genotype and haplotype frequencies at either groups (p < 0.05). When the age is considered in patient group, a significant difference was observed between patients with ID genotype and with II genotype (p = 0.018). Patients with ID genotype have been diagnosed as schizophrenics in early ages when compared to II genotype carriers. We also found a significant difference between II and ID genotype (p = 0.007) when the gender had taken into account, showing that the ID genotype carriers had an early onset to schizophrenia.

Conclusions: This association was more significant in male schizophrenia patients than females. Thus, this finding may constitute a novel biological support for the prior finding that onset of schizophrenia varies with gender. The results also showed that critical genetic vulnerability may be associated with the presence or absence of the ID genotype of DBH5′-ins/del.

Objective: Delirium is a common problem, but often misdiagnosed and unidentified. Apart from the manifold clinical picture variable durations can also be an obstacle for its diagnosis.

Methods: We present a case of protracted delirium that has developed after severe somatic illness in association with previously undiagnosed Sheehan's syndrome.

Results: The variety of psychiatric symptoms with initial psychotic disorder and the long run of the disease delayed the diagnosis of delirium and meantime gave reason to assume personality change.

Conclusion: This case report calls attention to the possibility of protracted delirium in patients with neuropsychiatric deficit symptoms that persist subsequent to somatic illness.

Objective: To date no studies have investigated the personality functioning underlying patients diagnosed with polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLOSL) using the performance-based Rorschach test.

Methods: We scored and interpreted the Rorschach protocols of eight carefully diagnosed PLOSL patients according to Exner's Comprehensive System. The structural variables in the Rorschach are organised around the seven dimensions of personality functioning that they assess: coping style and resources, organising information, perceiving events, forming concepts and ideas, handling of emotions, self-perception and interpersonal perception.

Results: As a group PLOSL patients had many personality liabilities when contrasted with typical avoidant non-patient adults. A majority of patients showed an avoidant coping style (Lambda > 0.99), low productivity and poor verbal output in the low number of responses and few Blends. Also, they showed limited available resources to cope with problem-solving test. Problems in organising information efficiently, and perceiving events realistically as well as signs of disturbed thinking and concept formation were observed in many patients. Handling of emotions was characterised by avoidance of emotional stimuli but at the same time poor affect modulation. Capacities to view themselves and others were thoroughly limited.

Conclusions: PLOSL tends to have repercussions throughout the personality functioning. In line with clinical findings and later neuroradiological and neuropathological examinations the Rorschach revealed personality features typical for frontal type of dementia.

Objective: There is an extensive corpus of knowledge about how misinformation may distort autobiographical memories. A diagnostic error can be conceptualised as a form of misinformation.

Methods: The authors discuss the case of a 58-year-old woman who was given a misdiagnosis of Alzheimer's disease.

Results: The patient was deeply convinced that the diagnosis was correct, even when she was confronted with contradictory evidence.

Conclusion: A diagnosis is not a neutral piece of information. It profoundly affects the lives of patients. The consequences of a misdiagnosis may be similar to persistent false memories.

Background: We report a case of a false positive for clozapine, when analysing serum levels using a high-pressure liquid chromatography with ultraviolet (HPLC-UV) detection method.

Methods: A patient not taking clozapine tested positive for clozapine three times in two different samples. This false positive was discovered by chance, because of an administrative error made in the first analytic test request.

Results: The analysis of the first sample with a more specific method [HPLC-tandem mass spectrometry (LC-MS/MS)] showed that no clozapine was present.

Conclusions: It is important to acknowledge that depending on the method employed, a false positive should not be ruled out as a possibility. Moreover, and even more worryingly, it should also be taken into account that clozapine serum levels could be tested erroneously high if the unknown interference is present and the HPLC-UV method is used. Although the interfering compound could not be identified, the possibility of a cross-reaction when analysing serum clozapine levels with the HPLC-UV method warrants urgent attention.

Objective: MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes) is a neurodegenerative disorder caused by mitochondrial dysfunction. Multiple systems of the body, including cognitive function and heart conduction, can be affected by this disorder. We report a case with global cognitive impairment.

Method: A single-case report.

Results: The patient got improved cognitive function, especially visuospatial function, under coenzyme Q10 treatment.

Conclusion: First, coenzyme Q10 may give some benefit to control MELAS. Second, cognitive functions and intellectual abilities decline with disease progression. Routine neuropsychological tests should be performed.