To evaluate the impact of the “Spanish Consensus on Physical Health in Patients with Schizophrenia” on psychiatrists’ evaluations of the physical health of patients with schizophrenia.

Epidemiological, non-interventional, national, multicentre study, with two retrospective, cross-sectional data collection stages in which 229 psychiatrists evaluated 1193 clinical records of patients with schizophrenia (ICD-10) seen in January and September of 2007.

Mean age of the patients was 39.7 ± 11.6 years, 65.5% were men, diagnosed for schizophrenia 14.0 ± 10.3 years ago. Forty percent of the patients suffer from a concomitant disease, the most prevalent being hypercholesterolemia (46.3%), hypertriglyceridaemia (33.5%) and arterial hypertension (26.0%). The difference in the number of patients who had all the physical measurements taken between the two cross-sectional evaluations was 13.8% (CI: 11.8%, 15.7%). The differences for each parameter were: weight 13.7% (CI: 11.7%, 15.6%), BMI 13.58% (CI: 11.6%, 15.5%), waist circumference 14.0% (CI: 12.0%, 15.39%), lipid profile 2.9% (CI: 1.9%, 3.9%) and glycaemia 2.6% (CI: 1.7%, 3.5%).

These results imply that the dissemination of the “Consensus on Physical Health in Schizophrenia Patients”, and possibly other actions, has made psychiatrists more aware of an integral approach to patients with schizophrenia, promoting increased monitoring of the physical health of these patients.

Although the reliable and valid Peritraumatic Distress Inventory (PDI–C) and Peritraumatic Dissociative Experiences Questionnaire (PDEQ) are useful for identifying adults at risk of developing acute and chronic posttraumatic stress disorder (PTSD), they have not been validated in school-aged children and their predictive values remain unknown in this population. This study aims to assess the psychometric properties of the children versions of these two measures (PDI-C and PDEQ-C) in a sample of French-speaking school-children.

One-hundred and thirty-three consecutive victims of road traffic accidents, aged 8–15 years, were recruited into this longitudinal study via the emergency room. The peritraumatic reactions were assessed at baseline and PTSD symptoms were assessed 1 month later.

Cronbach's alpha coefficients were 0.8 and 0.77 for the PDI-C and PDEQ-C, respectively. The 1-month test-retest correlation coefficient (n = 33) was 0.77 for both measures. The PDI-C demonstrated a two-factor structure while the PDEQ-C displayed a one-factor structure. As with adults, the two measures were intercorrelated (r = 0.52) and correlated with subsequent PTSD symptoms and diagnosis (r = 0.21–0.56; P < 0.05).

The children versions of the PDI and PDEQ are reliable and valid in children.

There is limited guidance regarding effective preventions for post-disaster mental health problems and what kind of support is preferred by disaster survivors.

To describe the use of and satisfaction with support in three Scandinavian countries after the tsunami and analyzing the association between support and posttraumatic stress reactions.

The sample comprises 6772 responders who returned to Scandinavia from the tsunami-struck countries of Southeast Asia in 2004.

Most were satisfied with informal support on site. Support from embassies/consulates was not received well, leaving about 64% of the Danes/Norwegians and 73% of the Swedes dissatisfied. After returning home, support from close relatives rendered highest degree of satisfaction. Consultation with general practitioner (GP) was reported by 63% of Norwegians, 40% of Danes, and 16% of Swedes. Most responders (60–77%) were satisfied with their GP, although Norwegians were least satisfied. Using support was associated with higher levels of posttraumatic stress symptoms.

Informal support was used to a high degree and rendered considerable satisfaction in all three countries, while the use of and satisfaction with formal support varied more. Lack of satisfaction with embassies and consulates may indicate deficiencies in the authorities’ preparedness in assisting disaster stricken citizens abroad.

To provide a review of the available literature about the functional neuroimaging of anorexia nervosa, and to summarize the possible role of neurobiological factors in its pathogenesis.

A systematic review of the literature was performed using PubMed and Medline electronic database (1950–September 2009). Eligible studies were restricted to those involving the main parameters of cerebral activity and functional neuroimaging techniques. Findings of the reviewed studies have been grouped on a diagnostic subtype basis, and their comparison has been interpreted in terms of concordance.

We found a high level of concordance among available studies with regard to the presence of frontal, parietal and cingulate functional disturbances in both anorexia nervosa restricting and binge/purging subtypes. Concordance among studies conducted regardless of the anorexia nervosa subtypes suggests an alteration in temporal and parietal functions and striatal metabolism.

The most consistent alterations in anorexia nervosa cerebral activity seem to involve the dorsolateral prefrontal cortex, the inferior parietal lobule, the anterior cingulate cortex and the caudate nucleus. They may affect different neural systems such as the frontal visual system, the attention network, the arousal and emotional processing systems, the reward processing network, and the network for the body schema.

We studied the associations between Attention Deficit Hyperactivity Disorder (ADHD) symptoms and the neurobehavioral status in two population-based birth cohorts.

Children (n = 467) were assessed by psychologists and teachers for neuropsychological functioning (McCarthy Scales, MCSA), inattention-hyperactivity symptoms (ADHD-DSM-IV form list) and social behavior (California Preschool Social Competence Scale, CPSCS). Regression models were used with covariate adjustment.

Sixteen percent of children had ADHD-DSM-IV symptoms. MCSA scores were linearly associated with ADHD symptom scores (general cognitive Beta = −0.6 [−1.0; −0.3] per symptom), specifically inattention scores (general cognitive Beta = −1.8 [−2.3; −1.2]). CPSCS scores were associated with ADHD symptoms (Beta = −2.19 [−2.5; −1.9]). MCSA scores of executive function, perceptive-performance and quantitative sub-areas had stronger associations with ADHD symptoms.

Preschooler ADHD symptoms are associated with concurrent decrements in neurocognitive and social competence functioning. The association patterns are similar to those found in older children with ADHD symptomology (Marks et al., 2005 [36], Seidman, 2006 [46], Sonuga-Barke et al., 2003 [48], Yochman et al., 2006 [53]).

The threshold to secondary health care should be similar for all patients independent of the underlying disease. This study compared, using a validated health-related quality of life (HRQoL)-instrument, whether the perceived burden of illness is similar in patients admitted for secondary care treatment into a university hospital because of one of six common conditions.

HRQoL, assessed by the generic 15D instrument before elective treatment, was compared in six groups: operative treatment of cataract (n = 219), operative treatment of cervical or lumbar radicular pain (n = 270), hysterectomy due to benign uterine conditions (n = 337), hip or knee replacement surgery (n = 223), coronary angiography due to suspected coronary artery disease (n = 261), and secondary care treatment of depression (n = 89).

Mean (±SD) HRQoL score was clearly highest in patients with benign uterine conditions (0.908 ± 0.071) and lowest in patients with depression (0.729 ± 0.120) (P < 0.001 between the groups). Also all the other groups had a significantly (P < 0.001) higher baseline HRQoL score (ranging from 0.802 to 0.824) than patients with depression. Outcome of treatment, in terms of HRQoL improvement, was in depressive patients at least equal, and in some cases even better, than that in the other groups.

Our results imply that, at least concerning perceived burden of illness, patients with depression are worse off when admitted to secondary care treatment than patients with many somatic conditions. That may be a consequence of poor motivation of depressive patients to seek treatment or that, contradictory to guidelines, the health care system does nor give priority to those worst off and sets a higher threshold for specialized care of patients with depression than of those with common somatic disorders.

To determine whether increased physiological arousal immediately after trauma or at emergency admission can predict post-traumatic stress disorder (PTSD) in motor vehicle accident (MVA) survivors with physical injuries.

We included 119 MVA survivors with physical injuries. In this prospective cohort study, heart rate (HR) and blood pressure (BP) were assessed during ambulance transport (T1) and at hospital admission (T2). One and four months after the accident, we assessed patients for PTSD (Davidson trauma scale, confirmed with the structured clinical interview for DSM-IV axis I disorders). Multivariate logistic regression models assessed the relationship between HR or BP and PTSD.

PTSD was diagnosed in 54 (45.4%) patients at 1 month and in 39 (32.8%) at 4 months. In the multivariate analysis, HR at T1 or at T2 predicted PTSD at 1 month (OR=1.156, 95% CI [1.094;1.221] p < 0.0001). Only HR at T1 (not at T2) predicted PTSD at 4 months (OR=1.059, 95% CI [1.013; 1.108] p = 0.012). Injury severity predicted PTSD at 4 months (OR=1.207, 95% CI [1.085; 1.342] p = 0.001). A cut-off of 84 beats per minute yielded a sensitivity of 62.5% and a specificity of 75.0% for PTSD.

HR measured at the scene of MVA and severity of injury predicted PTSD 4 months later.

Little is known about the excess mortality associated with use of some illicit substances. In particular, this concerns the risks associated with injection drug use and psychiatric disorders.

This study estimated mortality following substance abuse treatment among primary users of cannabis, cocaine, amphetamine, MDMA, and opioids. The risks associated with injection drug use and psychiatric comorbidity were assessed.

A register of individuals in treatment for illicit substance disorders was linked with registers on psychiatric treatment and mortality. The study population consisted of 20581 individuals who received treatment in Denmark between 1996 and 2006. There were 1441 deaths recorded over 111445 person-years of follow-up.

Standardized Mortality Ratios (SMRs) for primary users of specific substances were: Cannabis: 4.9, cocaine: 6.4, amphetamine: 6.0, heroin: 9.1, and other opioids 7.7. For MDMA the crude mortality rate was 1.75/1000 person-years, and the SMR was not significantly elevated. Sharing of syringes was associated with increased mortality in both primary users of opioids (hazard ratio (HR): 1.58 [95% CI 1.22–1.99], p < .001) and cocaine/amphetamine (HR: 9.52 (95% CI 3.94–23.02, p < .001). Overall, psychiatric comorbidity was associated with modestly increased mortality (HR: 1.15 [95% CI 1.03–1.29], p = .012) and in particular for primary users of cocaine/amphetamine (HR: 2.74 [95% CI 1.56–4.80], p < .001).

High SMRs were found among individuals who had received treatment for cannabis, cocaine, amphetamine, and opioid use disorders. Injection drug use was clearly associated with excess mortality, while the impact of psychiatric comorbidity was generally modest.

Associations have been described between lower IQ and serious mental illness. Associations between common mental disorders (CMDs) and IQ have received little research. The objective of this study was to investigate the association between verbal IQ and CMD symptoms and diagnoses, and to investigate the role of potential mediating and confounding factors.

Data were analysed from a British national survey with an analysed sample of 8054 people aged 16–74 years. Associations between verbal IQ (NART) and mental symptoms/disorders (CIS-R) were analysed with covariates including education, social class, income, debt, problem drinking, life events, physical health and relationship quality.

CMD was associated with lower IQ. This association was stronger for depressive disorder/symptoms than for generalised anxiety disorder/symptoms. The most important covariates were education, social class, income and relationship quality.

The association between lower IQ and CMD is partly accounted for by adverse social/socioeconomic conditions. Stronger associations for depression than anxiety may indicate an effect of IQ on the way mental distress is communicated.

Adding another antipsychotic to a treatment regimen was previously used in evaluating the medication's efficacy. Supplementation of depot antipsychotics with oral antipsychotics is particularly meaningful because depot formulations are typically chosen for patients struggling with adherence to oral antipsychotics. This post-hoc analysis assessed supplementation of olanzapine long-acting injection (olanzapine-LAI) with oral olanzapine.

We used 12 months of data from an open-label, single-arm extension study of patients with schizophrenia or schizoaffective disorder (N = 931) treated with olanzapine-LAI. The prevalence, duration, time to first supplementation, and best predictors of oral supplementation were assessed.

Oral supplementation occurred in 21% of patients for a median of 31 days with mean modal dose of 10.8 mg/day. Mean time to first supplementation was shorter for patients who were at least moderately ill at baseline compared to less ill patients (47 vs. 97 days, p < 0.001). Best predictors of oral supplementation included a more severe illness profile at baseline, lower olanzapine-LAI dose prior to oral supplementation, supervised living arrangements, and being African-American.

Supplementation of olanzapine-LAI appears to be infrequent, of relatively short duration, and reserved for more severely ill patients who may require a targeted rescue medication due to signs of impending relapse.

Help-seeking and service utilization depends on the patients’ interpretation of their illness and treatment needs. Worry, denial of illness, need for treatment and need for hospitalization in first-time admitted patients was studied.

New patients in two mental hospitals were consecutively recruited. Three hundred and thirty-four satisfied the inclusion criteria and 251 gave informed consent. One hundred and ninety-six had complete datasets (56% of those eligible).

Demography was recorded with the Minimal Basic Dataset by Ruud et al. (1993) [45]. Experiences of hospitalisation were measured with the Patient's Experience of Hospitalisation Questionnaire by Carskey et al. (1992) [9]. MINI was used for diagnosing and SCL-90-R by Derogatis (1997) [13] for subjective symptoms. Standard multiple regressions were performed with the PEH subscales (Denial, Worry, Need for treatment and Need for hospitalisation) as dependents and demography, diagnosis and SCL-90-R subscales as explanatory variables.

(a) Psychoticism and the diagnosis of schizophrenia were associated with little worrying, denial of illness, of treatment needs and of need for hospitalisation. (b) Anxiety and affective disorders were related to worries, acknowledgement of illness, need for treatment and for hospitalisation.

In contrast to patients with mainly anxiety and affective disorders, psychotic patient tended to deny illness-related worries, that they had an illness and that they needed treatment and hospitalisation. An affective disorder together with suicidal thoughts (not attempts) was a strong drive towards hospital admission.

N-acetylaspartate (NAA) levels and serum brain-derived neurotrophic factor (BDNF) levels in patients with first-episode schizophrenia psychosis and age- and sex-matched healthy control subjects were investigated. In addition, plasma levels of homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) were compared between the two groups.

Eighteen patients (nine males, nine females; age range: 13–52 years) were enrolled in the study, and 18 volunteers (nine males, nine females; age range: 15–49 years) with no current or past psychiatric history were also studied by magnetic resonance spectroscopy (MRS) as sex- and age-matched controls.

Levels of NAA/Cr in the left basal ganglia (p = 0.0065) and parieto-occipital lobe (p = 0.00498), but not in the frontal lobe, were significantly lower in patients with first-episode schizophrenia psychosis than in control subjects. No difference was observed between the serum BDNF levels of patients with first-episode schizophrenia psychosis and control subjects. In regard to the plasma levels of catecholamine metabolites, plasma MHPG, but not HVA, was significantly lower in the patients with first-episode psychosis than in control subjects. In addition, a significantly positive correlation was observed between the levels of NAA/Cr of the left basal ganglia and plasma MHPG in all subjects.

These results suggest that brain NAA levels in the left basal ganglia and plasma MHPG levels were significantly reduced at the first episode of schizophrenia psychosis, indicating that neurodegeneration via noradrenergic neurons might be associated with the initial progression of the disease.

The functional neuroimaging studies of emotion processing in schizophrenia have revealed variable results attributed partly to differential symptomatology and sex of tested patients. The aim of the present study was to investigate the relationship between cerebral activations during exposure to emotional material and schizophrenia symptoms in men versus women.

Fifteen men and 10 women with schizophrenia, equivalent in terms of age, medication and experienced symptomatology, underwent functional MRI during viewing sad and neutral film excerpts. Data were analyzed using Statistical Parametric Mapping Software (SPM2).

Across all the patients there was a significant inverse relationship between negative symptoms and activations in the right prefrontal cortex during processing of sad versus neutral stimuli. In men, activations during sad versus neutral stimuli in the prefrontal, temporal and anterior cingulate cortex, as well as the caudate and cerebellum, were positively correlated with negative symptoms. In women, there were inverse correlations between positive symptoms and activations in the hippocampus, parietal and occipital cortex during the same condition.

Present results confirmed association of prefrontal hypofunction with negative symptoms in schizophrenia. More interestingly, the results revealed a diametrically different pattern of symptom-correlated brain activity in men and women with schizophrenia, suggesting that the processing of sadness is mediated via neurophysiological mechanism related to negative symptoms in men and the mechanism related to positive symptoms in women.

Studies of psychotic-like experiences (PLEs) within community samples of adolescents have explored predominantly positive experiences. There is a paucity of research examining the prevalence and correlates of negative PLEs, and whether particular subtypes of negative PLEs can be identified among the general population of adolescents. This study examined the association of both positive and negative PLEs with depressive symptoms, including detailed analysis of subtypes of positive and negative psychosis dimensions.

A community sample of 777 adolescents (50.9% girls: mean age 14.4 years) completed a questionnaire assessing positive and negative PLEs and depressive symptoms.

Principal component factor analysis identified four factors of positive symptoms (persecutory ideation, grandiose thinking, first-rank/hallucinatory experiences and self-referential thinking), and three factors of negative symptoms (social withdrawal, affective flattening, and avolition). Depressive symptoms were associated positively with persecutory ideation, first-rank/hallucinatory experiences, social withdrawal, and avolition, whereas grandiose thinking related negatively with depressive symptoms. Neither self-referential thinking nor affective flattening related to self-reported depression.

These findings support the view that not all types of positive and negative PLEs in adolescence are associated with depression and, therefore, they may not confer the same vulnerability for psychotic disorders.