Low activity and long rest times are frequent in patients with schizophrenia and are related to increased risk for metabolic disorder. We investigated whether patients who were switched from sedative antipsychotics to sertindole, an antipsychotic drug without sedative effect, were more active than patients with good tolerance to sedative effect of olanzapine.

18 patients with schizophrenia treated with sertindole (9 females, mean age 27.9 ± 4,1, mean dose 15.6 ± 3.0 mg/d) and 18 sex and age matched patients treated with olanzapine (mean dose 15.3 ± 6.5 mg/d) underwent actigraphy for seven days. Daytime sleepiness and sleep quality were evaluated with Epworth Sleepiness Scale (ESS), Athens insomnia scale (AIS) and sleep diaries. PANSS, UKU, BARS scales were used to rate mental state and medication side effects.

At the time of the assessment PANNS score was similar in sertindole (43.6 ± 7.1) and olanzapine (42.3 ± 12.2) groups. The difference in time in bed as measured by actigraphy was not significant between patients treated with sertindole (572.7 ± 54.8 min.) and olanzapine (600.6 ± 53.6 min.). Also mean 24-h-activity was comparable in both groups (86.6 ± 29.6 and 81.6 ± 27.9 units, respectively). There were not any significant differences in AIS and ESS scales.

Although sertindole does not induce sedation, patients who were switched from sedative antipsychotics to sertindole were not more active than patients treated with olanzapine. Adjustment of pharmacological treatment has to be supplemented with non-pharmacological interventions to promote activity in patients with schizophrenia.

Neurological soft signs (NSS) are subtle indicator of brain dysfunction, which are present in excess among patients with schizophrenia. Its clinical significance remains unclear despite extensive researches.

To determine the proportion of schizophrenia patients who have motor NSS and then to compare the performance in verbal fluency between these two groups; with and without motor NSS.

This cross-sectional study utilized the Brief Motor Scale (BMS) to investigate the presence of motor NSS in 80 schizophrenia patients attended Universiti Kebangsaan Malaysia Medical Centre (UKMMC) psychiatric clinic. The diagnosis was confirmed by Mini International Neuropsychiatic Interview (MINI). Symptomatology and abnormal motor movement were assessed using the Brief Psychiatric Rating Scale (BPRS) and Abnormal Involuntary Movement Scale (AIMS) respectively. A brief battery of cognitive tests covering aspects of attention, working memory and executive function was administered. Bivariate and multivariate analyses were applied to look for any relationship between study factors.

Majority of schizophrenia patients (68.8%) in this study have motor NSS. The motor NSS were correlated with verbal fluency, digit span forward, digit span backward, and trail making B but not with trail making A (p < 0.05). However, verbal fluency was the only factor that remained significantly correlated with motor NSS after multivariate analysis.

The assessment of motor NSS represents a brief, inexpensive and meaningful tool in psychiatry. Together with verbal fluency, it has the potential as an illness marker and a link between neurobiological research and clinical practice.

Duration of untreated psychosis (DUP) is a potentially changeable prognostic factor which can also indicate neurodegenerative process in schizophrenia.

To examine the association of DUP with various characteristics of the course of schizophrenia in first episode patients during 5-year follow-up.

One-hundred-fourteen patients with first psychotic episodes who have been treated in naturalistic setting within Early Intervention Centre (Moscow Research Institute of Psychiatry) were included. Clinical, social and neuropsychological parameters were assessed using standardized instruments.

The mean duration of untreated psychotic symptoms before admission was 298.66 ± 447.35 days. According to the analysis DUP was found to be significantly associated with the mode of onset (r = 0.51, p ≤ 0.001) level of remission (r = 0.21–0.30, p ≤ 0.05), severity of positive symptoms and negative symptoms in remission mostly at 2nd, 3d and 4th years of observation, poorer level of social adjustment at the 5th year (r = 0.19, p ≤ 0.05). The effect of DUP remained significant after controlling for age, gender and diagnostic variables.

Moreover, DUP correlated with the parameters of verbal memory, visual memory and spatial functions during the follow-up (r = 0.29–0.36, p ≤ 0.05, r = 0.28–0.30, p ≤ 0.05, respectively). No correlations have been found between DUP and the age of onset, number of relapses and their duration during 5-year follow-up as well as with other neurocognitive parameters (executive functioning, gnosis, praxis, attention).

The results of the study underline the prognostic value of DUP for predicting clinical and functional outcomes. Association between DUP and poor memory domains supports the notion of neurotoxicity of DUP grasping specific brain regions in schizophrenia.

Schizophrenia is a chronic and severe mental illness which is characterized by the development of various detrimental clinical features, and its etiology still remains unknown. Based on the evidence from neurobiological and pharmacological research, dysfunctions in central serotonergic transmission may be involved in the development of schizophrenia. Tryptophan hydroxylase 2 (TPH2), a newly identified isoform of tryptophan hydroxylase (the rate limiting enzyme in the biosynthesis of serotonin), regulates the brain-specific serotonin synthesis.

To further clarify the role of TPH2 in the development of schizophrenia.

We performed a case-control study to examine the association of the TPH2 gene with schizophrenia and its clinical features.

We genotyped three putative functional polymorphisms (rs4570625, rs7305115 and rs4290270) within the gene and carried out a case-control study consisting of 304 schizophrenia patients and 362 healthy subjects. The severity of psychotic symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS).

The frequencies of genotypes and alleles of rs4570625, rs7305115 and rs4290270 did not differ significantly between schizophrenic patients and controls. However, the PANSS positive symptom subcore was significantly associated with rs4570625 (P = 0.022).

These results suggest that rs4570625 of TPH2 may play an important role in the development of positive symptoms in Han Chinese schizophrenic patients.

The relative effect of the atypical antipsychotic drugs and conventional agents on neurocognition in patients with early-stage schizophrenia has not been comprehensively determined.

The present study aimed to assess the cognitive effects of atypical and conventional antipsychotic drugs on neurocognition under naturalistic treatment conditions.

In a 12 months open-label, multicenter study, 698 patients with early-stage schizophrenia (< 5 years) were monotherapy with chlorpromazine, sulpiride, clozapine, risperidone, olanzapine, quetiapine or aripiprazole. Wechsler Memory Scale--Revised Visual Reproduction Test, Wechsler Adult Intelligence Scale Revised Digit Symbol Test and Digit-span Task Test, Trail Making Tests Part A and Part B, and Wisconsin Card Sorting Test were administered at baseline and 12 months follow-up evaluation. The primary outcome was change in a cognitive composite score after 12 months of treatment.

Compared with scores at baseline, the composite cognitive test scores and individual test scores had significant improvement for all seven treatment groups at 12-month follow-up evaluation (all p-values ≤ 0.013). However, olanzapine and quetiapine provided greater improvement than that provided by chlorpromazine and sulpiride in the composite score, processing speed and executive function (all p-values ≤ 0.045).

Both conventional and atypical antipsychotic medication long-term maintenance treatment can benefit congitive function in patients with early-stage schizophrenia, but olanzapine and quetiapine may be superior to chlorpromazine and sulpiride in improving some areas of neurocognitive function.

Cognitive deficits impair social and vocational rehabilitation in schizophrenic patients but little is known to which extend these symptoms are perceived by psychiatrists and how they influence antipsychotic treatment. Therefore, an online survey was performed in four European countries (Germany, Greece, Italy and Spain).

The survey involving 744 psychiatrists and assessed demographic characteristics including vocational status, presenting symptomatology, cognitive dysfunction severity, and current antipsychotic treatement. Methodology is described in full detail by Gorwood (2010).

Out of 3,996 patients, 29% were clinically assessed as having mild, 54% moderate and 17% severe cognitive dysfunction. In the mild dysfunction group, mean time since diagnosis was 9.7 years, 12.0 years in the moderate dysfunction group, and 17.0 years in the severe dysfunction group, and majority were outpatients (74.7%, 57.9% and 56.7%, respectively). The respective mean number of previous episodes was 5.1, 6.2 and 7.2 (6.0 for the total sample). Full or part time employment was reported in 32,2%, 19.1% and 11.8% of the patients, respectively. Olanzapine was the most frequently used antipsychotic in the mild group (21.0%) and severe group (24.9%), and risperidone in the moderate group (23.0%). Ziprasidone was used in 10.2%, 0.8% and 7.1% of subjects.

Cognitive dysfunction is frequently perceived by psychiatrist in every day clinical practice and severely interferes with the vocational status. Major associations between specific antipsychotics and the levels of cognitive impairment were not observed. Irrespective of the level of cognitive dysfunction, > 50% of subjects were outpatients.

Erectile dysfunction (ED) is often associated with a wide array of psychiatric symptoms, although few studies systematically address their specific association with ED determinants.

To explore the relationship between ED (as assessed by SIEDY Structured Interview) and different psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire).

A consecutive series of 1,388 male patients with ED was studied.

Psychiatric symptoms resulted differentially associated with SIEDY domains. Depressive and phobic anxiety symptoms were associated with the relational domain, somatization with the organic one, while free-floating anxiety, obsessive-compulsive, and phobic symptoms were significantly related with higher intrapsychic SIEDYscores. In addition, relevant depressive symptomatology was associated with hypogonadism, the presence of low frequency of intercourse, hypoactive sexual desire (HSD), and conflictual relationships within the couple and the family. Patients with high free-floating anxiety symptoms were younger, and complained of an unsatisfactory work and a conflictual relationship within family. Conversely, subjects with higher phobic anxious symptoms displayed a more robust relational functioning. Similar results were observed in subjects with obsessive-compulsive symptoms, who also reported a lower prevalence of HSD. Finally, subjects with somatization symptoms showed the worst erectile function.

The main value of this study is that it alters various clinicians’ belief that many psychiatric symptoms can be found among ED patients. Systematic testing of patients with ED, through psychiatric questionnaires, is recommended to detect even slight or moderate psychopathological distresses, which specifically associate and exacerbate sexual disturbances.

The relationship between testosterone (T) and psychopathology in subjects with sexual dysfunction has not been completely clarified.

To evaluate the association between T levels and different psychopathological symptoms and traits in men seeking treatment for sexual dysfunction.

A consecutive series of 2,042 heterosexual male patients consulting an outpatient clinic for sexual dysfunction was retrospectively studied. Several hormonal, biochemical, and instrumental parameters were investigated, including testis volume and penile blood flow. Patients were interviewed, prior to the beginning of any treatment, with the previously validated Structured Interview on Erectile Dysfunction (SIEDY), and ANDROTEST (a structured interview for the screening of hypogonadism in patients with sexual dysfunction). They also completed the Middlesex Hospital Questionnaire (MHQ) a brief self-reported questionnaire for the screening of the symptoms of mental disorders in non psychiatric setting.

T levels showed a negative correlation with depressive and anxiety symptoms. Conversely, histrionic/hysterical traits were strongly and positively associated with elevated T. Men with histrionic/hysterical traits had higher androgenization, as suggested by higher total and free T, higher testis volume and a lower ANDROTEST score. They were also characterized by better self-reported sexual functioning and penile blood flow.

In men consulting for sexual dysfunction, histrionic/hysterical traits are associated with higher androgenization and better sexual functioning. Hysteria, previously considered as a typically feminine psychopathological trait, should now be considered as an index of better masculine sexual well-being.

Masturbation is a common, but often neglected, male sexual behavior. Objectives and aims: To investigate the psychobiological correlates of self-reported masturbation in the last 3 months.

A consecutive series of 2,786 heterosexual male patients consulting an outpatient clinic for erectile dysfunction (ED) was studied. Several hormonal, biochemical and instrumental parameters were investigated. Patients were interviewed, prior to the beginning of any treatment, with Structured Interview on Erectile Dysfunction (SIEDY) and ANDROTEST structured interviews. They also completed the Middlesex Hospital Questionnaire.

Among the patients studied, 1,781 (61.9%) reported they had masturbated at least once per month in the preceding 3 months. The frequency of masturbation was inversely related to age (r = -0.329; P < 0.0001) and directly associated with education level (adj r = 0.052, P < 0.05 after adjustment for age). A feeling of guilt during masturbation was reported by 274 (15.4%) patients. After adjusting for age, masturbation was positively associated with testosterone levels, stressful conditions, and both unstable and long-lasting couple relationship. Urogenital problems also increased the chance of masturbation. Reported guiltiness during autoeroticism was associated with psychological disturbances, low prolactin, low testosterone, and increased relational problems.

This study indicates that masturbation is a relatively frequent behavior in male subjects with ED. Inquiring about this sexual behavior is an important issue for understanding overall patients’ sexual attitudes and behavior.

Healthy sexual functioning is an important part of the human experience, but there is a lack of studies regarding sexuality and sexual behavior in schizophrenia and bipolar disorder (García-Portilla, 2010).

To determine the differences on the sexual dysfunction profile between patients with schizophrenia and bipolar disorder.

Naturalistic, cross-sectional, multicentre, validation study. A total of 89 patients with schizophrenia (SQF) and 82 with bipolar disorder (BPD) were evaluated using the Changes in Sexual Functioning Questionnaire Short-Form (CSFQ-14).

Sample description (SQF vs BPD): Mean age (SD) were 39.2 (11.0) vs 46.7 (10.9) (p < 0.001), men were 58.8% vs 41.2% (χ2 = 4.0, df. = 1, p < 0.05), 61.8% vs 38.2% were single (χ2 = 12.8, df. = 1, p < 0.001). Mean (SD) scores on CSFQ-14 scales were (SQF vs BPD): Pleasure 2.2 (1.0) vs 2.6 (1.0) (t = -2.2, p < 0.05), Sexual desire/frequency 5.3 (2.0) vs 5.9 (2.0) (t = -2.0, p < 0.05), Sexual desire/interest 5.7 (2.6) vs 6.9 (3.0) (t = -2.5, p < 0.05), Arousal/excitement 8.6 (3.1) vs 8.9 (3.4), Orgasm/completion 7.9 (3.2) vs 8.8 (3.2), Desire 11.1 (3.9) vs 12.9 (4.4) (t = -2.7, p < 0.05), Arousal 8.6 (3.1) vs 8.9 (3.4), Orgasm 7.9 (3.2) vs 8.8 (3.2) and Total 39.5 (9.7) vs 42.2 (11.0).

Patients with schizophrenia have more difficulty to get pleasure and more problems in the phase of desire (frequency and interest) than the patients with bipolar disorder.

Homosexuality is a constantly debated issue as to whether it is determined at birth or a choice (nature vs. nurture). The works of the Kinsey Reports and Dr. Evelyn Hooker published in the 1950s resulted in the removal of homosexuality from the DSM4 in 1973. Since then, it has been mentioned as an illness only in the context of being a putative exacerbating factor in anxiety states. Recent studies reveal a clear cut neurobiology to sexual orientation.

Neurobiologist Simon LeVay conducted a study of brain tissue samples from 41 human autopsies performed at several hospitals in New York and California. He found a significant size difference of the interstitial nuclei of the anterior hypothalamus between homosexual and heterosexual men.

In addition, Dr. Ivanka Savic-Berglund and Dr. Per Lindström of the Karolinska Institute, Stockholm, performed fMRI and PET measurements of cerebral blood flow. Using volumetric studies, they found significant cerebral size differences between homosexual and heterosexual subjects; the brains of homosexual men resembled heterosexual women and homosexual women resembled heterosexual men. Pheromonal studies also have added to the scientific knowledge of sexuality. Sex-atypical connections were found among homosexual participants. Amygdala connectivity differences were found to be statistically significant and provided evidence towards sexual dimorphism between heterosexual and homosexual subjects. Extensive controls were performed during testing to exclude analytical variability.

A totally evidence-based medicine presentation will provide current data regarding homosexuality showing differences, or similarities, between the brains of homosexuals and heterosexuals.

Orgasm is the most powerful reinforcer of behavior. Feelings can be spiritual in miniorgasm and sensational in complete orgasm. Orgasmic conditioning act as underlying mechanism of development of paraphilias and sex addiction.

An electronic search was made on various database websites including, pubmed, science direct,and etc using key words orgasm, conditioning, paraphilias. It was followed by study of literature in journals and books.

Professional websites produced only couple of studies on orgasmic conditioning. This indicates this topic is not well taken by researchers.

Orgasmic center in brain is located in para ventricular nucleus of anterior hypothalamus and medial preoptic area. Intraorgasmic EEG exhibits visible changes. Orgasm produces euphoria and alleviate anxiety, pain, muscular tension and stress. Orgasm is mediated by dopamine which also act on nucleus accumben. During that process serotonin, endorphin and oxytocin are released. Oxytocin secretion start with arousal and during orgasm reaches its climax. It induces cuddling behavior which serve as basis o f physical and emotional intimacy. Orgasmic conditioning can bring about pairing of neutral stimuli with erotic sensation. Both male and female are capable of achieving multiple orgasms after some training. Prolongation of arousal and multiorgasmic capacity can pronounce its effects. For treatment of paraphilias like fetishism and pedophilias orgasmic condition is utilized. Positive association with healthy objects and activities can be used for treatment of various addictions.

With advanced biological understandings, orgasmic conditioning can be used in novel ways.

As the incidence of depression, both in Poland and the world, has increased in recent years, it seems important to consider it in a wider context, including its comorbidities.

The aim of the study was to assess anxiety, sexual functioning and pain disorders in women with depression.

The study encompassed 41 women, aged 18 - 65 years old, of whom 21 were assigned into the study group and 20 into the control group. The research was based on a two-part questionnaire. The first, general part involved socio-demographic data, basic patient history and sexuality-related questions. The other part was based on standardized tests, such as Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), McGill Pain Questionnaire - short form (SF-MPQ), Beliefs About Pain Control Questionnaire (BPCQ) and Female Sexual Function Index (FSFI).

The two groups were homogenous with regard to mean age, age at menarche and the BMI. The study group had significantly lower FSFI results than the control group, which implies greater severity of sexual disorders. Moreover, a significant positive correlation between depressive disorders (BDI) and pain disorders (McGill scale) was observed in the study group.

Taking into consideration the multitude and severity of sexual functioning disorders and pain disorders in women with depression, careful diagnosis should be attempted in all cases. The participation of a sexologist and doctors of other specialties in both diagnosis and therapy should be considered.

Erectile dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for sexual activity.

ED is a common condition in psychiatric patients, which can modify their quality of life.

The aim of this study is to assess the prevalence and the severity of ED in psychiatric patients.

This naturalistic, observational study was conducted during a six months period. The International Index of Erectile Function (IIEF) 15-item questionnaire was used to assess 144 male inpatients with different psychiatric disorders. IIEF is a brief, cross-culturally valid, self-administered scale for detecting treatment-related changes in patients with erectile dysfunction and addresses the relevant domains of male sexual function: erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. The patients were analyzed by age, psychiatric diagnosis, medication, IIEF scores at admission.

Then mean age was 36.4 years. The lot included 44 patients with Psychotic Disorders, 68 with Mood Disorders, 21 with Alcohol Dependence, 11 with Personality Disorders. Severe ED was registered in 38% of investigated patients, which determined abandon of sexual attempts in 57% of cases; 12% had moderate ED, 15% had mild to moderate ED, 18% had mild ED and 17% had normal sexual function. No orgasm was reported in 32% of patients and 37% had no sexual desire. Under treatment with antipsychotic medication 78% had severe or moderate ED.

Severe ED was correlated with age, also being seen in young patients. ED was correlated with depression, schizophrenia and antipsychotic medication.