The alteration of hippocampal and prefrontal structures is linked with schizophrenia cognitive impairment and negative symptoms. the antipsychotics can induced apoptotic mechanisms correlated with the psychopharmacological mechanism of excesive blocking of the D2 receptors. Distress determined increase of the glucocorticoid aggression wich drive to the decrease of neuroprotective capacity at the brain level.

We formed 5 study lots (5 adults rats) and a control lot. the substancies were administrated intraperitoneal, daily, saline solution equivalent to: ziprasidone (1.25mg/kg/day) and haloperidole (0.20mg/kg/day), dexametasone (0.20mg/kg/day):

N1 - Haloperidole; N2 - Dexametasone; N3 - Ziprasidone; N4 - Dexametasone and Haloperidole; N5 - Dexametasone and Ziprasidone; N6 -control lot.

We monitorised the cardiovascular function, respiration and EPS, without signaling any serious deadly adverse event. the rats were sacrificed during the 10th day and 21th day.

Frontal cortex and hippocamp were the most intensely affected even since the 10-th day to the N4 (haloperidole and dexametasone) lot with massive neuronal loss at the VI, V, and IV frontal cerebral layers.

The lots treated with ziprasidone presented significant lesser structural changes in frontal cortex and hippocamp, comparative to haloperidole. the lots treated with dexametasone and ziprasidone (N5) are lesser affected at the cerebral structure level.

Haloperidole has a significant decrease in neuroprotection. Ziprasidone demonstrated an neuroprotective effect.

To track the levels of emotional dysfunction, symptoms, risk and resilience factors and responses to treatment in the Ultra High Risk (UHR) group.

There has been an increasing interest in the study, detection and treatment of individuals at UHR of developing psychosis. MacGorry et al. (2003) have put forward criteria for identifying UHR, who have been found to have a 40% chance of making the transition to psychosis within one year (Yung et al., 1998). Research trials are ongoing to study whether CBT can prevent these individuals from developing psychosis completely, or at least delay its onset (Morrison et al., 2005).

100 participants (16-35 years old) were recruited and assessed from the Early Detection and Intervention Team (ED: IT) over a two-year follow-up period. Inclusion criteria were based on the SIPS (McGlashan et al., 2002). Participants were asked to complete questionnaire measures at baseline, 6-month and 12-month follow-up. the baseline measures were: Beck Anxiety Inventory; Beck Depression Inventory; Dissociative Experience Scale; Social Comparison Scale; Social Phobia Scale; Social Interaction Anxiety Scale and Eysenck Personality Inventory. the follow-up measures were: Trauma and Distress Scale; Childhood Trauma Questionnaire; other as Shamer; MOPS, RAAS: Pathways to care; Premorbid Adjustment Scale; Chart of life events and Schizotypal Personality Questionnaire.

Study is still ongoing.

Our preliminary findings seem to suggest that different risk factors have consistent detrimental effects on mood regulation and symptom contention. It might be possible to manage these factors in at-risk clients in psychological therapy.

The metabolic syndrome MS (visceral obesity, dyslipidaemia, hyperglycaemia, and hypertension), has become one of the major public-health challenges worldwide. Patients with schizophrenia are more likely to suffer from MS that the general population. We have analyzed the prevalence of MS in Spanish patients with schizophrenia and overweight.

The CRESSOB study is a 12-month, prospective, naturalistic study including 110 community mental health clinics selected at random. Each site enrolled four consecutive patients with diagnosis of schizophrenia, according to DSM-IV TR criteria, and overweight (BMI > 25 Kg/m2). to assess the prevalence of MS we have analyzed the baseline results of the CRESSOB study. the National Cholesterol Educational Program (NCEP-ATPIII), the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) definitions were used to established the presence of MS.

A total of 391 patients were enrolled on the study (mean age 40.5 years, 63.8% men). 75.9% of the patients did not meet criteria for remission, using the selected PANSS items. Mean GAF score was 52.7 (SD 15.4). Using the different criteria, 59.0% of males and 58.3% of females fulfilled the NCEP-ATPIII criteria, 71.1% of males and 65.8% of females fulfilled the IDF criteria and 70.1% of males and 65.1% of females fulfilled the AHA/NHLBI criteria.

The MS is highly prevalent in Spanish patients with schizophrenia and overweight. Given the metabolic syndrome is an important risk factor for cardiovascular disease, these patients should receive appropriate clinical monitoring for this syndrome.

To assess the possible impact of deinstitutionalization on the social behaviour of chronic psychiatric patients.

Hall and Baker's REHAB is a comprehensive behaviour rating scale designed to assess social functioning of people with a major psychiatric disorder. REHAB was completed for 58 chronic psychiatric patients (41 men - 17 women, mean age: 57.5±12.5 years) independently by a pair of raters one year before and another pair of raters one year after the patients’ relocation.

Among REHAB's five subscales that assess patients’ general behaviour, “community skills” and “social activity”, showed statistically significant improvement (p< 0.001 for both subscales), “self-care” and “overall impression” showed a mild but not significant change, while “speech disturbance” remained at almost identical levels. Gender was not associated but age correlated negatively with patients’ level of functioning (p=0.009). Regarding REHAB's section that assesses patients’ deviant behaviour, there was a significant decrease in the severity and/or frequency of patients’ self-talking (p=0.021) and a slight non-significant change in patients’ exhibiting physical violence, self-injurious or sexually offensive behaviour; nevertheless it is important to note that 40%-83% of the patients did not present with deviant behaviour to begin with. Gender did not influence results, but physical violence, self-injury and verbal aggression showed moderate negative correlation with age (r=-0.341 to -0.435).

Even though deinstitutionalization does not improve every aspect or psychiatric patients’ social functioning, it reasonably enhances social and community skills and suppresses some of their deviant behaviours.

Alcohol use disorders (AUDs) represent significant comorbidity in schizophrenia. Previous reviews have reported a wide range (12-55%) of dual diagnosis prevalence: however, there is no agreement on overall prevalence. Our aim is to present recent studies of AUD, estimate overall prevalence, and study characteristics affecting the prevalence of AUD.

We conducted a search using three electronic literature databases and a manual search on articles published in 1996-2007. Metaregression was used to study how prevalence is affected by different study characteristics.

Altogether 58 studies met our criteria. the median of current AUD prevalence was 10.1% (IQR=4.6-24.5, 19 studies) and median of lifetime AUD prevalence 22.2% (IQR= 12.1-32.0, 45 studies). in studies using DSM-III-R the median prevalence was higher than in studies using DSM-IV, ICD-9 or ICD-10 (32.3/18.1/10.3/5.9%).

Our systematic literature search found a wide range of prevalence estimates of AUD in schizophrenia patients. Approximately every fifth schizophrenia patient had AUD diagnosis. When contrasted to studies published between 1990-95 our results show a descending trend in AUD prevalence: however, AUDs are still common in schizophrenia patients. the decrease may be explained by changes in diagnostic systems, although it is also possible that other addictive substances, such as cannabis, have replaced alcohol in some countries. other sample characteristics did not affect to the prevalence estimates.

Quality of life (QoL) is considered an important outcome in the treatment of schizophrenia and is linked with clinical and social recovery. Until recently treatments of schizophrenia have focused mainly on reducing positive symptoms, often leaving patients with numerous residual difficulties. It's been expected that atypical antipsychotics improve QoL equally as they improve clinical outcome of the patients with schizophrenia.

To compare clinical improvement and QoL of patients treated with risperidone and clozapine two months after the beginning of treatment.

The sample included 40 patients (17 males and 23 females, mean age 33.1) with diagnosis of schizophrenia according to ICD-X. the patients were treated with either risperidone (n=20) or clozapine (n=20). the PANSS and CGI scales for clinical status were applied at the beginning of the treatment and two months later. the QoL was assessed by the WHOQOL-BREF.

Analysis of data has shown a significant difference for all four domains (physical, psychological, social relationships and environment) at WHOQOL-BREF scale for both medications after two months, but no difference between the two antipsychotics. the patients treated with clozapine had significantly higher scores on PANSS at the beginning of treatment. PANSS and CGI applied after two months have not shown differences between the medications.

Both clozapine and risperidone had equal and statistically significant effect in reducing the symptoms of schizophrenia measured by PANSS and CGI in two months period, as well as in improving the quality of life. However no difference was found between the two medications.

Several studies have already reported increased prevalence of metabolic and cardiovascular risk factors in patients on antipsychotics. This observational aimed to assess the prevalence of metabolic syndrome (MetS) in differently treated patients with schizophrenia.

Patients with schizophrenia (age >=18 years) from 162 psychiatric practices throughout Germany were enrolled if they were either treatment-naive and initiated on antipsychotic therapy, or had received previous antipsychotic treatment and were switched to a new medication. Baseline physical and laboratory parameters were evaluated to assess the prevalence of MetS (American Heart Association's definition). Clopper-Pearson 95%CIs were calculated. Patients were assigned to evaluation cohorts by previous treatment: olanzapine (Olz, N=62), risperidone (Risp, N=67), quetiapine (Quet, N=49), other atypical monotherapy (Atyp, N=103), typical therapy (Typ, N=90), atypical combination (Comb, N=109), treatment-naive (TN, N=162).

The sample included 642 patients, mean age 45.2 ±13.3 years, 325 (50.6%) women. Characteristics for the TN-cohort were: mean BMI 25.3 ±4.5, mean blood triglycerides 157.3 ±122.4 mg/DL, rates of concomitant diseases (28.4%), and prevalence of MetS (24.7%, CI18.3;32.1). in comparison, previously treated patients had a mean BMI: 27.0 ±4.9 (Quet) to 29.3 ±5.4 (Comb), mean triglycerides: 182.4 ±116.9mg/DL (Risp) to 232.3 ±164.3mg/DL (Comb), concomitant diseases: 29.9% (Risp) to 41.7% (Comb), MetS: 42.4% (Risp, CI30.3-55.2) to 57.0% (Comb, CI47.1-66.5).

TN-patients (see above) had a significantly lower prevalence of MetS than the overall sample (42.8 CI 38.9;46.7). Comb-patients showed the highest prevalence of MetS. Typ-patients had a similar prevalence of MetS (43.3, CI32.9;54.2) than patients treated with atypical antipsychotics.

We randomized 40 patients into two groups: usual care (UC) or a nine-session, manualized, antipsychotic adherence intervention (AAI). the AAI attempted to improve adherence by combining three psychosocial techniques:

1. a. education,

2. b. skills training, and

3. c. alliance building.

Sessions employed a semi-structured format to facilitate open communication. the primary outcome was antipsychotic adherence at study end. We obtained qualitative data regarding patient preferences for the duration and modality for receiving the adherence intervention.

Compared to the UC group, a greater proportion of the AAI group was adherent post-intervention based on medication possession ratio, a commonly used measure of medication adherence (85% vs. 66.6%; OR=2.64), a difference that was statistically not significant. the entire AAI group reported that they intended to take medications, and 75% were satisfied with the intervention.

The AAI was feasible and acceptable. Preliminary data on its effectiveness warrant a larger study. Qualitative data shows that patients prefer brief adherence interventions and accept telephone strategies.

From a dimensional point of view, the schizotypal features would be continuously distributed in normal population and individuals with schizophrenia spectrum disorders. in the latter, differences have been found in personality traits between the diagnostic categories of the dimension, and also different schizotypy scores between them. in this study our main objective was to specify the domains and traits of pathological personality that can be considered risk factors for schizotypy.

SPQ and DAPP-BQ were administered to a sample of 91 subjects that were divided in four groups: psychotic patients with schizophrenia spectrum disorders, siblings of patients from this spectrum, patients with personality disorders, and healthy controls.

Patients with personality disorders presented the highest scores of schizotypy measured with SPQ, followed by psychotic patients, siblings, and finally the healthy controls. both groups of patients obtained higher pathological personality scores compared to siblings and controls. in the psychotic patients and their siblings emotional dysregulation, dissocial behavior and inhibition domains correlated with the SPQ factors, while in the personality disorder patients SPQ correlated only with inhibition. the trait social avoidance appears to be a predictive variable of psychometric schizotypy.

Pathological personality underlying the schizotypy of psychotic patients of schizophrenia spectrum and their siblings is different from that of the personality disorder group. Social avoidance is a risk factor for schizotypy measured with SPQ.

The gender differences in aspect of sociodemographic and clinical characteristics have been analyzed in a sample of first admitted patients with acute psychotic disorder in an acute psychiatric hospital.

Retrospective sociodemographic and clinical data regarding first admitted patients diagnosed with acute psychotic disorder were gathered and analyzed.

Of all patients 52.7% were female and 47.3% were male. We analyzed gender differences in age of onset, marital status, education period, employment status, and time between onset of symptoms and admission in hospital. Female patients were older at their first admission than male patients, and more female patients were educated longer than male patients. Female patients tend to be married (30%) and employed (40%) at the time of their admission than male patients (11.1% married and 22.2% employed). the time between onset of symptoms and admission in hospital was longer for the majority of male patients (more than 1 year for 62.9% of men) than for the majority of female patients (0-3 months for 40% of women).

There were gender differences in age of onset, marital status, education period, employment status, time between onset of symptoms and admission in hospital pointing to the role played by biopsychosocials factors in onset of acute psychotic disorder.

To discover whether clozapine is being prescribed and monitored according to accepted guidelines.

Sample size 30 with a diagnosis of Schizophrenia generated from a list of patients attending clozapine clinic. Clozapine levels were done prospectively from December 07 to March 08.

Of 30 patients, 73% were male and 27% female. 57% were prescribed >450 mg once daily and 50% had trough plasma levels >0.60mg/l. Only 21% were within the therapeutic range (as recommended by Clozapine Patient Monitoring System) 0.35-0.60 mg/l. 29% of patients had a plasma level < 0.35 mg/l. Only 10% had plasma levels checked within the last 6 months.Among 8 patients taking more than 600 mg of clozapine, 5 had an anticonvulsant prescribed prophylactically. among 14 patients with a plasma level >0.60 mg/l, only five had an anticonvulsant co-prescribed.

The outcome of this audit has wide implications from a medico-legal perspective. There is significant evidence implicating clozapine in the development of metabolic syndrome as well as potentially serious side effects including seizures. It is important that clozapine plasma levels are checked when therapeutic doses (Maudsley guidance: 450mg once daily) are reached and that anticonvulsant prophylaxis is considered at high plasma levels.