To save 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 saving content to .
To save 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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved 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.
Patients with schizophrenia have deficits in contextual vision. However, results are often very mixed. In some paradigms, patients do not take the context into account and therefore act more veridically than healthy controls. In other paradigms, context impairs performance in patients more strongly than in healthy controls. These mixed results may be explained by differences in paradigms, as well as by small or biased samples, given the large heterogeneity of the disease.
To understand if there are general contextual deficits in schizophrenia.
17 schizophrenia patients and 16 age-matched controls were tested with a combined crowding and uncrowding paradigm.
Schizophrenia patients show qualitatively similar crowding performance as controls. In the uncrowding condition, however, patientsimproved less than controls. We suggest that performance in the various paradigms depends on idiosyncratic aspects of the paradigm in addition to the heterogeneity of the disease.
There are no general impaired mechanisms in schizophrenia. Deficits depend strongly on idiosyncrasies of the specific stimuli.
Schizophrenia is a heterogeneous disease that is strongly influenced by genetic predisposition. A large variety of candidate genes have been identified, each of which, however, explains only a small proportion of the genetic risk for schizophrenia. Due to the complexity of psychiatric diseases, endophenotypes are of primary interest in psychiatric research. Endophenotypes are stable markers in-between the genotype and the phenotype and are thought to be associated with a small number of genes involved in the pathophysiology of the disease.
To characterize a very sensitive candidate endophenotype of schizophrenia spectrum disorders, based on visual backward masking.
We tested first: Schizophrenia patients, their non-affected siblings, healthy controls and second: various populations of the schizophrenia continuum (bipolar and schizoaffective patients), as well as adolescents with psychosis, abstinent alcoholics, and depressive patients with a very sensitive masking technique.
Schizophrenia patients and their siblings show strong performance deficits. Masking performance of relatives was significantly in between the one of patients and controls. Moreover, deficits were stable throughout one year. The shine-through paradigm distinguishes with high sensitivity and specificity between schizophrenic patients, first-order relatives, and healthy controls. Patients with first episode of psychosis, as well as adolescents with psychosis, have shown clear performance deficit. Deficits are specific to the psychosis spectrum and not evident in depressive patients and abstinent alcoholics.
Our results suggest that the shine-through masking paradigm is a potential endophenotype of the schizophrenia spectrum disorders.
Since gaining independence in 1991, Georgia has struggled to transform the old-Soviet mental health care structure into a humane system to meet basic human rights standards.
The current version of the mental health law was introduced in 2007, which instituted the new practice that required court decisions for involuntary hospitalization and several practical procedures.
The Public Defender’s Office (Special reports, 2019-2021) revealed gaps and contradictions within the law that lead to human rights violations and malpractices in involuntary hospitalization.
Currently, the group of Georgian experts with international support from Expertise France- French Development Agency, at the request of the Ministry, are working on the new version of the mental health law, which will be in line with international requirements and standards.
Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.
The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.
We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.
We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
Due to the inresed rate of depression and suicide the problem of correlation between suicidal behavior and symptoms of agitated depression became extremly important. In outpatient settings health professionals tend to underestimate clinical features indicated the increased suicide risk in patients with agitated depression. Inaccurate diagnosis and treatment plan frequently are suggested. Furthermore, agitated depression may occur in healthy person without previous psychiatric history, who has never applied to psychiatrist.In our study we aimed to verify the clinical features of agitated depression, which intensify suicidal trends leading to completed suicide.
From 477 patients with agitated depression we selected 126, who presented high risk of suicide and studded them by using Mood Anxiety Inventory (Greenberger D, Padesky CA (1995). Mind Over Mood. New York: Guildford Press).
On the bases of the structural-dynamic analyses we determine seven clinical variations of agitated-depression with prominent affective, cognitive, psychomotor, somato-algetic and behavioral symptoms.
The most dangerous types with regards of suicidal behavior appeared to be senesthopathic and algetic types and agitated depression with depersonalization and derealization.
There are an increased evidence of co-morbidity between pain, abnormal sensations and depression in heroin addict patients. Such conditions are usually treated by antidepressants, mood stabilizers and rarely by atypical antipsychotics.
Investigation of heroin addict patients in post-abstinent state reviled that low mood, anxiety, tension and guilt feeling increased sensitivity toward pain, which mostly experienced as algetic, coenestetick and hypochondriacal sensations. Algetic symptoms highly correlated with psychopathology. Efficient treatment of psychopathological symptoms decreased pain. Atypical antipsychotic quetiapin monotherapy could be used for treating such conditions.
Since depressive symptoms (SDS) are prevalent under-recognized and clinically important problems in patients with schizophrenia, the pattern of symptoms and associated features of depressive symptoms, as well, as inclusion of psychopathology and neurodynemic variations in personality structure of patients with chronic schizophrenia deserve more investigation.
We aimed to identify clinical and experimental-psychological features of post-schizophrenic depression. The longitudinal study has been designed to investigate patients with paranoid schizophrenia. As a result of the careful clinical and psychological analyses due to psychopathology we defined four types of depression. From which two types of depression – agitated and asthenic prevailed in active phase of schizophrenia and remained two hypochondriac and apathyc mainly occurred during stabilization. This finding would have prognostic value.
Furthermore, we examined personality changes leaded by cognitive symptoms and specified psychopathological and neurodynamical input in alteration of personality structure with word association experiment by A.D. Zurabashvili. As the semantics of trigger words became more complex the qualitative impairment deepened. Lower pathological associations have overcome scanty logical thinking and fluctuation of latency time with thought blocking became prominent.
SSRI (Fevarin, Rexetin) appeared especially effective in treatment of certain type of post-schizophrenic depression.
Over the past years, studies of unaffected first-degree relatives of schizophrenic patients have reported cognitive deficits in the domains of executive functions, memory, and attention. However, these deficits may rely on lower level information processing deficits. Here, we investigated visual information processing with a visual backward masking task. A vernier target was followed by a grating mask. Observers had to indicate the offset direction of the vernier. We determined the SOA between the vernier and the grating onset for schizophrenic patients, their healthy first order relatives, and a healthy control group. Schizophrenic patients needed SOAs about three times longer than healthy controls to reach a predefined criterion level. Backward masking performance of unaffected relatives was significantly better than the one of patients but significantly worse than performance of controls. This result adds further evidence that low level deficits as determined by visual backward masking are endophenotypes of schizophrenia.
Due to the complexity of psychiatric diseases, endophenotypes are of primary interest in psychiatric research. They are stable markers which are assumed to be related to a small number of genes involved in the pathophysiology of the disease. Visual backward masking (BM), like other parameters measuring early information processing, was proposed to be a reliable marker for schizophrenia. Performance deficits in BM are considerably more pronounced in schizophrenic patients and their unaffected relatives compared to controls. As shown before, in the present study BM performance was significantly worse in schizophrenic patients compared to controls; healthy relatives of schizophrenic patients performed intermediately.
Several candidate genes for schizophrenia including nicotinic receptor α7 subunit (CHRNA7), catechol-O-methyltransferase (COMT), dystrobrevin-binding protein 1 (dysbindin, DTNBP1) and metabotropic glutamate receptor 3 gene (GRM3) were investigated for their association with schizophrenia and BM in two independent samples. A strong and reproducible association was observed for CHRNA7 with both diagnosis of schizophrenia and BM performance. In conclusion, BM is an excellent endophenotype which will likely support the search for further candidate genes and related pathophysiological pathways in schizophrenia. Moreover, CHRNA7 has further supported its important role as one of the main candidate genes for schizophrenia.
The cognitive deficits associated with schizophrenia have received increasing attention as potential endophenotypes of the disorder that could potentially discriminate relatives of patients from controls. Endophenotype that is inherited and state – independent should be found in affected family members as well as in nonaffected family members at a higher rate than in the general population.
The current study has attempted to characterize the prevalence, degree and nature of verbal memory deficit in schizophrenia and aimed to study verbal memory task performance in patient with paranoid schizophrenia and their first degree relatives in order to identify, trait cognitive marker of the disorder. Due to this we had studied, whether nonpsychotic relatives of schizophrenic probands had an elevated risk of deficits in cognitive functioning, and, which specific factors such as gender, age, education, illness duration, diagnosis and psychopathological symptoms influenced the tests performance.
Schizophrenia patients showed significant impairment of the verbal memory in all domains. In contrast, their first degree relatives having the same education level as the patients did not differ considerably from healthy controls. These results indicate that, probably, the deficiency of explicit verbal memory is not associated with the diathesis for schizophrenia.
As the test performance did not correlate with severity of symptoms and medication this finding cannot be attributed to the distractibility due to active psychotic symptoms, or treatment effects. Impaired performance on the CVLT task, a measure of explicit verbal working memory, appears to be associated with the cognitive deficits due to the disorder itself.
The aim of our study was to investigate social functioning of patients with first psychotic episode and to determine, how cognitive impairment and psychopathological symptoms could influence these functions over the illness duration.
32 patients with first psychotic episode and 32 healthy controls participated in the study. The diagnoses have been made according the DSM IV-criteria. Psychopathological symptoms were assessed by positive (SAPS) and negative (SANS) symptoms assessment scales and brief psychitric rating scale (BPRS). Cognitive functions such as executive functions, sustained attention, visual perseption have been studied by computerised version of the visual backward masking test, the Wisconsin Card Sorting Test (WCST) and the Continuous Performance Task.
The schizoid personality features of the healthy controls have been investigated by the Schizoid Personality Questionnaire – brief version (SPQ-B brief version). The follow up observation have been provided after 6 and 12 months for both groups. The patients' outcome have been measured by Health and Outcome Scale (HoNOS).
At the baseline the cognitive functions of the patients with first episode psychosis were considerably impaired compared to the healthy controls. Although, have not changed significantly over the two years. Moreover the patients, who have adhered to the treatment regime (treatment as usual) showed prominent improvement at social and symptomatic scales of HoNOS.
The first psychotic episode is an important period for prevention of social deterioration and the treatment adherence is a strong predictors of better social outcome.
The stigma, discrimination and human rights violations that individuals and families affected by mental disorders suffer are intense and pervasive.
In order to study attitude toward mental health problems, more than 1000 population from the different region of Georgia have been interviewed within 3 months (May-July 2015) in their household.
The scope of questions used in the survey were based on the questionnaire proposed by the NHS Information Centre, Mental Health and Community.
The population of Georgia showed high levels of understanding and tolerance of mental disorders. Despite of this, the fear and exclusion toward people with mental illness were almost twice as more, compare to the countries, where community mental health services are developed. More than half of the interviewed reported that institutional care is quite sufficient for providing treatment and suggested that person with mental disorder should not have rights to a job. Social status, income and occupation did not play any role in terms of attitude.
Majority of the respondents thought that mentally ill patient is a person who is violent or who need isolation due to the disturbed or inadequate behavior.
The survey revealed that the attitude toward persons with mental disorders in the republic of Georgia less likely is based on evidence and objective information. The lack of knowledge and awareness of mental health issues increase stigma and discrimination regarding the people with mental health problems and prevent them from the integration into the society.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Email your librarian or administrator to recommend adding this to your organisation's collection.