To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The introduction of the first atypical antipsychotic with a long acting formulation has open new therapeutic options for the treatment of schizophrenic patients. Our objective consists of comparing psychopathology levels and global functioning in patients with paranoid schizophrenia treated in monotherapy either with long-acting injectable risperidone (LAIR) or conventional depot antipsychotics (DA).
Patients attending at the community mental health center during the six-month recruitment period were eligible to enter the study. Scores achieved in positive and negative subscales of PANNS and EEAG scale of (Global Activity Evaluating Scale) were evaluated at baseline and 6 months later. Six patients treated with RLAI and six patients treated with DA were recruited. Data were analyzed both with the real sample (N=6 per group) and extrapoling the same results to a bigger sample size (N=24 per group).
Mean increase in scores for both PANNS positive and negative subscales were lower in patients treated with RLAI that in those treated with DA (positive subscale: 0.018±0.06 vs. 0.048±0.03, RLAI and DA, respectively, p=0.387; negative subscale: 0.232±0.076 vs. 0.3095±0.123, RLAI and DA, respectively, p=0.579). EEAG scores were higher for patients treated with RLAI than those treated with DA (1.250±0.56 vs. 0.333±0.225, p=0.144). When these results are extrapolated to a sample of 24 patients per group, differences in EEAG reach statistical significance (p=0.034).
After 6 months of treatment, patients treated with RLAI tend to show a greater improvement in their global activity than those treated with DA.
Interest in the premorbid personality of schizophrenic patients is well established in the psychiatric literature. The relationship between personality disorders and acute phase proteins (APP) in schizophrenia is not well known.
Investigating the relationship among acute phase proteins and personality disorders in schizophrenic patients in a sample of adult schizophrenic patients under psychiatric treatment in a general hospital health setting.
Material and Methods:
37 adult paranoid schizophrenics undergoing treatment in the University Hospital of the Canary Islands with DSM-IV diagnosis of paranoid schizophrenia are included. Years from onset 9.20 s.d. 6.29, age at onset 19.75 s.d. 4.73. The record of personality disorders as a secondary diagnosis in the medical chart was taking into account. A blood sample as routine standard analysis was carried out in each patient.
In 21 patients (56.7%) a personality disorder, mainly with paranoid and schizotypal traits, was registered. The percentage of each personality disorder is as follows, Schizotypal (16.2%), Paranoid (13.5%), Schizoid (2.7%), Paranoid and Schizotypal (24.3%). The results point to no significant correlation according to APP (C3, C4, alpha2-macroglobulin, alpha1-glicoprotein, ceruloplasmin) in the different diagnostic groups.
Discussion and conclusions:
In our study there is no evidence to support a significant correlation among APP and the different personality disorders in our sample of schizophrenics in spite of a positive correlation of APP and some psychopathology dimensions that has been communicated earlier elsewhere. In order to set some possible specificity of acute phase proteins and other clinical features in schizophrenia further research is required.
Reduced Glutathion Peroxidase (GSH) is a common biologic marker of antioxidant status frequently used in schizophrenic research. Data regarding GSH levels in schizophrenic patients are controversial. Our objective is to study whether or not GSH levels have seasonal or circadian fluctuations in schizophrenic outpatients.
23 clinically stable treated chronic schizophrenic outpatients were studied in summer and winter. The same day in July and January, blood samples were extracted between 8:30 and 9:00 after one night fasting. The same routine was followed during the two experimental sessions.
GSH plasma levels were not significant different between summer and winter. There was no significant difference between nocturnal and diurnal GSH levels in neither winter nor summer.
Plasma GSH does not present seasonal levels either a circadian rhythm.
Malondialdehyde (MDA) is a common biologic marker of oxidative stress used in psychiatric research. Data regarding MDA levels in healthy subjects are controversial. One factor affecting MDA levels may stem from the existence of a circadian rhythm of MDA formation. The objective of this study consists of investigating whether MDA formation has a circadian rhythm of formation in healthy human subjects.
The sample was comprised by 9 healthy male subjects. None of them had a history of medical or neurological disease and routine laboratory parameters were normal. The study was carried out in accordance with the Helsinki Declaration and all subjects gave written informed consent before their inclusion. Blood samples were extracted at 12:00 and 2:00 in December 2004. The same routine was followed during the two experimental sessions. Serum MDA was determined by the thiobarbituric acid reactive substance (TBARS) according to the method of Ohkaba et al (1979).
The sample was comprised by 9 male healthy subjects (age 33.0±11.7). There were significant differences in MDA levels between 12:00 and 2:00 (2.33±1.01 vs. 1.58±0.48, p<0.015).
MDA has a circadian rhythm of formation with higher levels at 12:00 than 2:00. This variation in circadian MDA levels of formation should be accounted when researching in this field.
Some studies have related processing speed with functionality. A more discriminative analysis of different components of this neuropsychological construct is needed.
To measure the performance of a group of patients with schizophrenia in reaction time, processing velocity and sustained attention. To compare the impact on functioning of these three measures.
Ninety-eight outpatients between 18 and 65 years diagnosed with schizophrenia, based on the DSM-V, with a 3-month period of clinical stability, were recruited. Sociodemografic and clinical data were collected: PANSS scale, Akathisia Simpson-Angus Brief Scale, State-Trait Anxiety Inventory (STAI) and Global Functioning Scale (GAF). The following variables were measured: reaction time (SUPERLAB PRO), processing speed (TMT-A, subtest of symbol coding BACS, verbal fluency) and sustained attention (Continuous Performance Test).
Functionality of patients was correlated to Elective Reaction Time (the subject must react to different types of stimuli and to choose between several possible answers) [P = −0.205; P = 0.047], but NOT with Simple Reaction Time [P = 0.109; P = 0.293)]. Functionality was significantly correlated to Symbols Coding (P = 0.328; P = 0.001), and a trend was observed regarding semantic fluency (P = 0.190; P = 0.06) and the TMT-A (P = −0.179; P = 0.08). In CPT, Correct Detection was correlated with GAF score (P = 0.380; P = 0.000) but not omission errors. The model of lineal regression shows a differential impact of every measure in global functioning.
Reaction time, processing speed and sustained attention are different variables and each of them have impact on functioning in schizophrenia.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Influential protocols in the treatment of schizophrenia recommend the use of antipsychotics in monotherapy, although combination is common in clinical practice.
To compare cognitive performance of patients with schizophrenia treated by antipsychotic monotherapy or polytherapy; secondly, to analyze clinical and sociodemographic differences.
Ninety-eight outpatients between 18 and 65 years, diagnosed with schizophrenia, based on the DSM-V were recruited. Seventy were in monotherapy and 28 in antipsychotic combination. Patients with comorbidity, moderate to severe motor impregnation, abuse-substance dependence or serious somatic illness were excluded. Both groups were compared in sociodemographic, clinical and cognitive measures: PANSS scale, short Akathisia Scale Simpson-Angus Scale, State-Trait Anxiety Inventory (STAI), face emotion recognition (FEIT) and global Functioning (GAF), speed processing - through the Trail Making Test, parte A, subtest of symbol coding of the Brief Assessment of Cognition in Schizophrenia (BACS) and Verbal fluency (animals)- and sustained attention (SA)–through the Continuous Performance Test (CPT).
Both groups showed similar age, gender, number of hospitalizations, score in STAI-Trait, STAI-State, ANGUS, GAF, TMT-A, verbal fluency and face emotion recognition. Patients in politherapy had more years of evolution (P 0.047), higher score in positive PANSS (P 0.007), negative PANSS (P 0.008), general PANSS (P 0.001); they showed more detection errors in the CPT (P 0008), and a trend towards less processing speed through the symbol coding (P 0.063), compared to patients in monotherapy.
Antipsychotic polipharmacy is associated with an impairment in sustained attention in patients with schizophrenia.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
As we have noted, the challenge of negotiating peace with justice extends far beyond – and has more to do with – the intrinsic constraints of negotiation than those of transitional justice. Put simply, one cannot reach a proper understanding of the bandwidth for negotiating transitional justice if the analytic starting point is something other than the fact of negotiation.
As we have argued, without understanding what makes negotiations difficult in general, one cannot understand what makes peace negotiations difficult in particular. Likewise, without understanding what makes peace negotiations difficult, one cannot understand what makes negotiating transitional justice an especially difficult component thereof.
While negotiating peace with justice requires the skills of an artist, some science is nevertheless involved. Part I demonstrated how that is so. First, we examined what makes ensuring justice for atrocity crimes more difficult, both normatively and practically, than for other crimes. Three imaginary country situations were presented: one in which there is neither negotiation nor transition out of war; one in which there is transition without negotiation; and one in which there is negotiation without transition. We explained how and why the latter presents the greatest structural constraints of all, in terms of ensuring justice.
The term ‘atrocity crime’, as used here, refers to the international crimes of genocide, crimes against humanity, and war crimes – and could reasonably be extended to include gross human rights violations. Such crimes destroy human dignity, life, or both, and on levels that are usually irreparable. That is because no amount of justice against the perpetrator of such crimes, and no amount of reparation in favour of the victim, can be adequate to redress the harm caused. Morally speaking, every remedy is second best. Restoring the status quo ante is not an option.
In June 2014, before the negotiations in Havana on Point 5 (‘Victims’) of the 2012 General Agreement began in earnest – and thus before Mark Freeman and Iván Orozco formally began their work as independent advisers to the government’s negotiation team – important conversations and decisions regarding victims had already occurred.
Several years into the implementation of Colombia’s 2016 peace agreement, the country is experiencing scores of complications in the application of post-conflict justice mechanisms and much else. No negotiation could have anticipated all, or even most, of these complications. Negotiation and implementation are iterative processes by their very nature. Yet, with the benefit of hindsight, there are some important lessons that are worth summarising – some of which could make a difference in the country’s future, or indeed that of others.