Obsessive-compulsive (OC) symptoms have been observed in a substantial proportion of schizophrenic patients. Different etiopathological origins of OC symptoms make this type of schizophrenia to be a heterogeneous entity in phenomenological as well as in therapeutic aspects. The complex nature of the treatment response in this group of schizophrenic patients is as yet unclear.

We present a large case series study describes our experience with clozapine, risperidone, olanzapine, quetiapine, ziprazidone, amisulpiride, sertindole and paliperidone as a sole agents and in combination with serotonin reuptake inhibitors (SRIs) in patients with OCD-schizophrenia (n = 55) and schizo-obsessive disorder (n = 64).

In patients with OCD-schizophrenia treatment with atypicals (other than clozapine), the better results (significant reduction of OC as well as schizophrenia symptoms) were achieved in combination with SRIs, while olanzapine showed the fastest overall improvement. In schizo-obsessive patients, treatment with atypicals (including clozapine) as monotherapy was the better therapeutic modality, and the risperidone showed the best results. Quetiapine, amisulpiride, sertindole, paliperidone and ziprazidone (as sole agents and with SRIs) were shown as approximately equal in their antipsychotic and antiobsessive activity and overall safety.

The effects of different atypicals (with/without SRIs) on psychotic and OC symptoms are vary, probably due to different origin of OC symptoms. We suggest that:

1) schizo-obsessive patients might be successfully treated with atypicals alone;

2) in OCD-schizophrenia atypicals monotherapy may be less efficient, and in some cases may worsen OC symptoms, so it should be treated concomitantly with SRIs. Further investigations are needed to substantiate our observations.

Religion plays an important role in symptoms phenomenology, attribution and management in the Arab culture. Mentally ill patients in the Arab countries tend to pass through different health care providing filters. Traditional healers form part of the informal and sometimes unofficial health care sector.

Explore the timing of local traditions contacts in regard to diagnosis and treatment, and identify types of local traditions contacts of Iraqi schizophrenic patients.

Hundred Iraqi acute schizophrenic patients, admitted to Ibn-Rushd psychiatric teaching hospital, Baghdad, Iraq, with informative informant were examined. Information list of 3 parts was prepared: 1st part asking about the contact timing with faith healers in regard to diagnosis and treatment; 2nd asking about the types of traditional faith healer contacts; 3rd was asking about the causes of illness.

22% have no any contact, 47% contact faith healer before and after, 7% before, 24% after the diagnosis and treatment. Types of traditional faith healer contacts were: Sayed 37%; visiting Emams 54%; jinn dealers 32%; Daraweesh 17%; witchcraft 3%; and reading Holly Quran 9%. Causes of illness were: life stresses 42%; patient himself 25%; poor faith and belief 14%; weak personality 11%; genetic causes 4%; witchcraft 5%; Jinn possession 11%; and wish of God 13%.

This study explores the importance of religious background in the course of diagnosis and treatment of acute schizophrenia. Psycho-education was needed to increase the awareness of publics about faith, beliefs, traditional healers, and mental illness.

Natural polyamines (putrescine, spermidine and spermine) are low molecular weight highly protonated aliphatic molecules that physiologically modulate NMDA, AMPA/kainate glutamatergic receptors and limbic dopaminergic neurotransmission. Previous studies had demonstrated that polyamine metabolism might be disrupted in schizophrenia, what could potentially be linked to glutamatergic dysfunction. In particular, polyamine levels in blood and fibroblast cultures from patients with schizophrenia had previously been found to be higher than in healthy controls. Indeed, a significant positive correlation between blood polyamine levels and severity of illness may exist.

In order to test potential differences in blood polyamine levels between drug-free schizophrenia in-patients (n = 12), and healthy controls (n = 26, blood donors), spermidine (spd), spermine (spm), and spermidine/spermine index (spd/spm) were determined using HPLC after dansylation.

No significant differences were found between groups (t = 0,974; df = 36; P = 0,337 for spd, t = l0, 52; df = 36; P = 0,959 for Spm, and, t = 0, 662; df = 36; P = 0,512 for spd/spm).

Though we couldn’t replicate previous findings suggesting disturbances in blood polyamine levels in schizophrenia, this issue may be a promising target. Future research should take into account possible factors such as sex, nutritional state, and stress.

This study aims to validate a self-administered, multidimensional QoL instrument based on the point of view of caregivers of individuals with schizophrenia.

Data were collected through the departments of six psychiatric hospitals in France (n = 246). The item reduction and validation processes were based on both item response theory and classical test theory.

The S-CGQoL contains 25 items describing seven dimensions (Psychological and Physical Well-Being; Psychological Burden and Daily Life; Relationships with Spouse; Relationships with Psychiatric Team; Relationships with Family; Relationships with Friends; and Material Burden). The seven-factor structure accounted for 74.4% of the total variance. Internal consistency was satisfactory; Cronbach's alpha coefficients ranged from 0.79 to 0.92 in the whole sample. The scalability was satisfactory, with INFIT statistics falling within an acceptable range. In addition, the results confirmed the absence of DIF and supported the invariance of the item calibrations.

The S-CGQoL is a self-administered QoL instrument that presents satisfactory psychometric properties and can be completed in 5 min, thereby fulfilling the goal of brevity sought in research and clinical practice.

Social isolation is a factor associated to mortality and morbidity in general population.

This symptom has been considered as prodrome in ‘high-risk mental states’ for a possible development of psychosis. Social isolation is a frequent problem in psychotic patients visited by mobile crisis unit (EMSE).

To describe the differences between psychotic patients with social isolation with patients without it.

A descriptive observational and cross-linked study in patients with diagnostic of psychotic disorder visited by EMSE from 2004 to 2010. The sample was divided in two groups; present and absence of social isolation as the main problem. We evaluated demographic and clinical variables including the aggressive behaviour and violence scale (AVAT) and positive and negative syndrome scale (PANSS).

N: 662 subjects (61.3% men; mean age 44+-16 years) with psychotic disorder. 15.1% present social isolation like the main problem against 84.9% who present others main problems: delusion/hallucination (44.7%), behaviour disturbance (18.1%) and agitation/aggressivity (14%).

Patients with social isolation are mostly men (72%, p < 0.05), live with family (79.4%, p < 0.05), are less aggressive (AVAT 2.77 p < 0.05) than psychotic patients that are not isolated. The punctuation in subscale negative syndrome of PANSS is higher (26.19 versus 20.25, p0.001).

This study concludes that patients with psychotic disorder and social isolation are mainly men and they have less aggressivity and predominantly negative syndrome. These results are important to improve the multidisciplinary therapeutic approach.

Metabolic abnormalities have historically been associated with illness such as schizophrenia. However, many studies found aripiprazole has a safer metabolic profile and metabolic neutral for schizophrenic patient.

This is a prospective 24 weeks follow-up study. The primary objective of this study was to investigate the improvements in metabolic syndrome parameters observed in patients who were switched from other antipsychotics.

Patients with schizophrenia treated with antipsychotic who were having abnormal metabolic parameters were switched to aripiprazole. They were analyzed to quantify clinically significant changes in metabolic parameters. At baseline, weight, waist circumference, blood pressure and fasting blood sugar were assessed. Fasting lipid profile was taken for total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides at baseline. The same assessments were repeated at 4-weeks, 12-week and 24-week. Paired t-test and last observation carried forward (LOCF) were used for the statistical analysis.

Preliminary results for those who completed 12 weeks follow up were presented.

46 schizophrenic patients with 26 (56.5%) male and 20 (43.5%) female have completed the 12 weeks follow up. There was statistically significant reduction in mean weight (73.3 ± 19.2 kg) to (71.2 ± 20.5 kg), mean BMI (27.1 ± 5.4) to (26.2 ± 6.0), mean waist circumference for male (96.2 ± 14.1 cm) to (92.9 ± 17.9), mean triglycerices (1.86 ± 0.83 mmol) to (1.59 ± 0.54 mmol).

In short-term, switching to aripiprazole treatment resulted in clinically significant improvements in weight, BMI, waist circumference in male, and triglycerices in at-risk patients.

The aim of the study was to find genetic markers which can influence on susceptibility of paranoid schizophrenia and the treatment efficiency measured by the PANSS. We analyzed genes polymorphisms: DRD2 (Taq 1A, in egzon 8, - 141 C ins/del), DAT, GRIK3, SERT, 5HT2A, MAO-A, COMT.

One hundred and ninety one patients with the diagnosis of paranoid schizophrenia were recruited as study group. To obtain the diagnosis meeting the criteria to ICD-10 we used the polish version of CIDI - Composite International Diagnostic Interview. Exclusion criteria included serious neurological disorders, major somatic disorders impairing cognitive functions and diagnosed mental impairment. The intensity of psychopathological symptoms was examined using the PANSS. Genomic DNA was extracted from leucocytes using the Miller's salting method. Polymorphisms were studied by the PCR method.

Statistical analyses were performed by the Statistica computer program, specifically Pearson's chi-square test. Associations between the treatment progress and the genotype were studied by analysis of variance (ANOVA).

We didn’t find associations between investigated genes polymorphisms and susceptibility of paranoid schizophrenia. Probably, there is no influence of studied polymorphisms on the treatment efficiency.

No differences were found in the genotypes distribution in investigated genes polymorphisms between the whole schizophrenics and the control group. No association was found between any particular genotype and the effect of antipsychotic treatment.

A question at issue of clinical psychiatry and psychopharmacology is efficiency of multi-class polypharmacy, adjunctive polypharmacy, augmentation and total polypharmacy in longtime treatment of schizophrenia. It is very important question of pharmacoeconomisc, compliance evaluation, prevention of exacerbation with succeeding hospitalization and social impairment.

4 casual samples of patients with the diagnosis of schizophrenia by ICD 10 (F20), undergoing treatment in out-patient conditions for 3 years. Each sample included 50 patients (25 men and 25 women).

1. 1 sample - therapy by combinations of typical and atypical antipsychotics 2 generation,

2. 2 sample - therapy by combinations of antipsychotics and antidepressants,

3. 3 sample - therapy by combinations of antipsychotics and tranquillizers,

4. 4 sample - monotherapy of typical or atypical antipsychotics.

To establish dependence of effect of therapy on aggravation (exacerbation) a schizophrenia from number and combinations of psychotropic preparations.

The clinical-psychopathological method, a comparative statistical method - processing of results was spent by means of SPSS program.

As a result of research it is revealed that efficiency of therapy reliably does not differ in all 4 groups.

Research calls into question expediency of polypharmacy in prevention of exacerbation at a schizophrenia which, probably, is necessary to replace with dynamic monotherapy depending on a leading syndrome at exacerbation.

Researching from a symptom approach avoids possible spurious associations, given the co-occurrence of symptoms in a disorder (Costello, 1992). Here, we deepen the evidenced relationships among anxiety, delusions and hallucinations.

We intended to assess differences in Anxiety Sensitivity dimensions between patients with psychosis depending on presence/absence of hallucinations and/or delusions.

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 7 only deluded, 6 only hallucinated, 11 deluded-hallucinated and the remaining 25 neither hallucinated nor deluded.

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- (Sandín 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.

All analysis were accepted at p < .05. Patients only hallucinators showed a higher anxiety sensitivity in Social Subscale than non-hallucinative/non-delusional patients; the former presented lower punctuations in ASI-total and ASI-cognitive than patients with hallucinations and delusions. The latter showed a higher anxiety sensitivity in Cognitive Subscale than patients who only deluded.

It's hypothetized that both delusional and hallucinative activity is necessary for emergence of cognitive anxiety sensitivity.

Age at onset of psychosis (AAO) may be younger in patients with cannabis use disorders (CUD) compared to those without CUD (NCUD). Most previous studies did not control for potential confounders, did not report effect sizes and included mostly adult patients from non-representative samples.

Controlling for relevant confounders, differences in AAO between patients with and without lifetime CUD were analysed in a large epidemiologically based cohort of 606 first-episode psychosis (FEP) patients (age 14 to 29 years) admitted within three years to the Melbourne Early Psychosis Prevention and Intervention Centre. Data were collected from medical files using a standardized scale.

Overall, AAO was not significantly different in CUD (n = 449; 74.1%) compared to NCUD, neither univariate nor when controlling for gender and premorbid functioning. However, AAO was younger in those with early CUD (starting before age 14) compared to NCUD (F(1) = 11.3; p = 0.001; partial η2 = 0.042). When considering the subgroups of early versus late onset psychosis, AAO was even later in early onset psychosis patients with CUD compared to those with NCUD (F(1) = 8.4; p = 0.004; partial η2 = 0.072). These findings were consistent for patients with non-affective psychoses, in those with CUD without other substance use disorders and in those with CUD explicitly starting in the pre-psychotic phase. Notably, 89.1% started cannabis before the onset of psychotic symptoms.

CUD starting before age 14 was associated with an earlier AAO at a small effect size, but only in adult onset FEP patients.

Schizophrenia has often been associated with a reduced skin flush response to niacin. Blunted response suggests potential disturbance in phospholipid metabolism.

We performed niacin skin tests in patients with schizophrenia, their first-degree relatives and healthy controls.

To examine possible differences in skin flush response to niacin.

We examined 51 patients (female 49%, age 33.1 years, SD 11), with schizophrenia-spectrum disorders, 51 matched healthy controls (female 49%, age 33 years, SD 12.1), and 21 first-degree relatives (female 61,9%, age 49,5 years, SD 17,6, one affected, others non-affected). The Positive and Negative Syndrome Scale and the Mini International Neuropsychiatrie Interview were used to assess psychopathology and diagnosis, respectively. The non-invasive niacin skin flush test was used to assess vasodilatative reaction to four different concentrations of niacin on the forearms of subjects.

We found no differences in total scores on the niacin skin flush test between the three groups (p = 0.774). Mean scores were 60.27 (SD 14.2) in healthy controls, 58.84 (SD 10.2) in patients and 58.48 (SD 9.4) in first-degree relatives.

Contrary to our expectations we did not find a significantly blunted niacin skin flush reaction in patients with schizophrenia-spectrum disorders compared to healthy controls or 1st degree relatives.

To explore tolerability and treatment response in adult patients with recently diagnosed (<5 years) and chronic (>5 years) schizophrenia treated with flexible doses of paliperidone ER.

International prospective open-label 6-month study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), patient functioning and treatment-emergent adverse events (TEAEs).

Of 713 recently diagnosed patients, most were male (60.9%), mean age was 33.6 ± 11.2 years and mean time since diagnosis was 2.3 ± 1.7 years. Chronic patients (n = 1003) were predominantly male (59.2%) with a mean age of 43.8 ± 11.4 and mean time since diagnosis of 15.6 ± 9.2 years. 70.4% and 71.7% of patients completed the study, respectively. Mean mode doses of paliperidone ER were similar between recently diagnosed and chronic patients (7.0 ± 2.9 mg/day and 7.2 ± 2.9 mg/day). 63.1% of recently diagnosed and 60.8% of chronic patients switching due to lack of efficacy with their previous antipsychotic had a >20% improvement in PANSS total score at endpoint, and improvement with other switching reasons was consistently numerically higher in recently diagnosed patients. The rate of patients with mild or no functional impairment increased from 17.7% to 39.8% in recently diagnosed and from 14.4% to 32.9% in chronic patients. TEAEs reported in >5% were insomnia (10.7% and 8.1%), anxiety (8.6% and 6.0%) and somnolence (5.8% and 3.4%), respectively.

These data suggest that both recently diagnosed and chronic patients previously unsuccessfully treated with other oral antipsychotics may benefit from paliperidone ER, with a tendency for recently diagnosed patients showing some higher treatment response in psychotic symptoms and patient functioning.

To explore tolerability and treatment response in adult patients with recently diagnosed (≤5 years) and chronic (>5 years) schizophrenia treated with flexible doses of paliperidone ER.

International prospective open-label 6-month study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), patient functioning and treatment-emergent adverse events (TEAEs).

Of 713 recently diagnosed patients, most were male (60.9%), mean age was 33.6 ± 11.2 years and mean time since diagnosis was 2.3 ± 1.7 years. Chronic patients (n = 1003) were predominantly male (59.2%) with a mean age of 43.8 ± 11.4 and mean time since diagnosis of 15.6 ± 9.2 years. 70.4% and 71.7% of patients completed the study, respectively. Mean mode doses of paliperidone ER were similar between recently diagnosed and chronic patients (7.0 ± 2.9 mg/day and 7.2 ± 2.9 mg/day). 63.1% of recently diagnosed and 60.8% of chronic patients switching due to lack of efficacy with their previous antipsychotic had a ≥20% improvement in PANSS total score at endpoint, and improvement with other switching reasons was consistently numerically higher in recently diagnosed patients. The rate of patients with mild or no functional impairment increased from 17.7% to 39.8% in recently diagnosed and from 14.4% to 32.9% in chronic patients. TEAEs reported in ≥5% were insomnia (10.7% and 8.1%), anxiety (8.6% and 6.0%) and somnolence (5.8% and 3.4%), respectively.

These data suggest that both recently diagnosed and chronic patients previously unsuccessfully treated with other oral antipsychotics may benefit from paliperidone ER, with a tendency for recently diagnosed patients showing some higher treatment response in psychotic symptoms and patient functioning.

We recruited patients with schizophrenia four weeks post-discharge from Zomba mental hospital and followed them for six months to find out if care and support had an impact on their staying well and avoid relapse in their local communities.

To establish skills and knowledge family members hold to take care of their schizophrenic relative.

We hypothesized that good support and care would be positively associated with good recovery and reduced relapse rate among schizophrenic patients.

This Study was carried out in Zomba city and areas surrounding Zomba mental hospital. We used both quantitative and qualitative approach to research; simple random sampling was used to get a sample of 70 participants in this study. In-depth interviews were used to collect data from discharged schizophrenic patients while focus group discussion was used to get views of family members and nurses who take part in provision of care and support.

Our findings indicate that where patients following discharge receive good support and care from family members the rate of relapse becomes low and patients also live a more productive life in society. However, 31% of family members felt they had no knowledge as how to handle their sick relative at home hence they were unsure on what to do to help.

We recommend to intensify carer educatioin order to equip guardians with necessary knowledge which will in the long run reduce re-admissions and hence congestion in mental hospitals.

First Rank Symptoms (FRS) - a group of intriguing experiences characterized by striking breach of ‘self versus non-self’ boundaries - have had a critical influence on the diagnosis of schizophrenia. Inferior Parietal Lobule is implicated in the pathogenesis of FRS in Schizophrenia. However, the role of Planum Parietale (PP) in the genesis of FRS is yet to be examined.

This first time study (to the best of our knowledge), aims to examine antipsychotic-naïve schizophrenia patients for the effect of FRS status on volume of PP.

In this study we examined the volume of PP in antipsychotic-naïve schizophrenia patients (n = 32; M:F = 16:16) in comparison with age, sex, and handedness matched (as a group) healthy comparison subjects (n = 34; M:F = 16:18) using valid method with good inter-rater reliability.

Female Schizophrenia patients showed significant volume reduction in right PP in comparison with female healthy controls (F = 7.2; p = 0.01). However, male patients did not. There was a significant effect of schneiderian FRS in female patients in that those who had FRS had significantly smaller volume of right PP than healthy controls (F = 3.8; p = 0.03); where those female patients who were FRS negative did not differ. Left PP volume did not differ between patients and controls.

Current study supports previous studies which have implicated the role of parietal lobe in pathogenesis of FRS. Specific role of PP in FRS generation and possible implication of sex differences needs further systematic studies.

As evidenced by ongoing research and partial effectiveness of the antipsychotics on cognitive and negative symptoms, the search is on for drugs that may improve these domains of functioning for someone suffering from schizophrenia.

To do a sytematic review to find out if acetylcholinesterase inhibitors could be used for schizophrenia condisering there use in dementia for cognitive symptoms.

The aim of review was to determine the clinical effects, safety and cost effectiveness of acetylcholinesterase inhibitors for treating patients with schizophrenia.

We searched the Cochrane Schizophrenia Group’s Register and references of all identified studies were inspected. We included all clinical randomised trials comparing acetylcholinesterase inhibitors with antipsychotics or placebo either alone or in combination for schizophrenia and schizophrenia-like psychoses. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random-effects model. For continuous data, we calculated weighted mean differences (WMD) again using random-effects model.

The acetylcholiesterase inhibitor plus antipsychotic showed benefit over antipsychotic and placebo in the mental state, cognitive domain and tolerability. No difference was noted between the two arms in other outcomes. The overall rate of participants leaving studies early was low and showed no clear difference between the two groups.

The results seem to favour the use of acetylcholiesterase inhibitors in combination with antipsychotics in different oucomes, but because of the various limitations, this review highlights the need for large, independent, well designed, conducted and reported pragmatic randomised studies.

The Changsha study identifies adult, non-psychotic relatives of patients with schizophrenia who show deficits in neurocognitive, social, clinical and other dimensions, and who meet proposed diagnostic criteria for a liability syndrome for schizophrenia (’schizotaxia’).

To define and validate schizotaxia.

To develop and validate diagnostic criteria for schizoaxia, and to reduce its symptoms using risperidone.

We investigated whether a low dose (2.0 mg) of risperidone, a second generation antipsychotic medication, could attenuate negative symptoms, neurocognitive deficits, and other measures of clinical and social function in subjects who met our research criteria for schizotaxia. One hundred eighty nine relatives were assessed at the Mental Health Institute, Second Xiangya Hospital, in Changsha, China. Eighty six of these individuals met criteria for schizotaxia, and 36 agreed to enter a 6-week, double-blind, placebo-controlled protocol.

ANCOVAs using age and gender as covariates showed significant improvement in the risperidone group (n = 20) on neurocognitive function (Wisconsin Card Sorting Test Total Errors and Perseverative Errors) and on a self-report measure of social function (Social Adjustment Scale), compared to the placebo-control group (n = 16). Effect sizes were small to medium. Notably, risperidone effect sizes were larger (medium to large) in a subset of subjects (risperidone = 15; placebo = 10) whose membership in the schizotaxic group was confirmed by cluster analysis.

The results are generally consistent with previous open-label investigations of risperidone administration in subjects with schizotaxia, and provide evidence that significant neurocognitive and clinical problems are amenable to remediation in non-psychotic relatives of people with schizophrenia.