Present study focuses on metabolic and neuroendocrinologic effects of long-acting injectable risperidone (LAIR) treatment in a naturalistic sample of patients with schizophrenia spectrum disorders.

Twenty three outpatients with schizophrenia or schizoaffective disorder (ICD X) (age 32.3±6.5years, illness duration 8.7±5.1 years, PANSS 78.1±14.7) were included. At the time of evaluation the patients were treated with LAIR for 1.4±0.7 years, average dose 38.6±9.9mg. Total duration of antipsychotic therapy was 8.0±4.8 years. Control group (n=23) were healthy volunteers matched by age, sex and education.In the morning serum we measured leptin, prolactin, cortizol, IGF1, T4, FSH, LH, HbA1c, total cholesterol, HDL, LDL and triglicerides. Both groups were tested by oral glucose load (OGTT), with measuring insulin levels and anthropometric parameters.

In comparison to control group, the patients had higher BMI (p< .001), waist circumference (WC, p=.004), increased leptin (p=.013), prolactin (p< .001), triglycerides (p=.029) and fasting glucose (p=.004). After controlling for BMI, WC and sex, only prolactin (p< .001, ηp2= .50) and leptin (p=.040, ηp2=.13) were significantly increased in the patient group.

This is the first study of LRAI effects on metabolic and neuroendocrine parameters. Our cross-sectional study has shown that the most consistent side effects of LAIR were increased prolactin and leptin, while other deviations might be attributed to confounding covariates. Whether pharmacokinetic and pharmacodynamic advantages of LAIR over oral drug formulation are accompanied with favorable metabolic and neuroendocrine profile remains to be assessed by head to head studies.

This study was supported by a grant from the Ministry of Science, Republic of Serbia (Project 145019).

Traumatic brain injury (TBI) is recently recognized as a risk factor for hypopituitarism, presented most frequently with growth hormone deficiency (GHD). GHD is associated not only with changes in body composition, but also with impaired quality of life, cognitive dysfunctions and some psychiatric sequelae, usually classified as “depression” or “atypical depression”. The impact of GH therapy on mental status is still unknown.

Psychiatric and cognitive functions were tested in six adult GHD subjects at baseline (minimum three years after TBI), reassessed after six months of GH replacement therapy as well as twelve months after discontinuation of GH therapy. Psychiatric and cognitive examinations included semi-structured interviews and three instruments: Symptom-checklist (SCL-90-R), Zung Depression Inventory and standard composite neuropsychological battery.

Six months of GH therapy in GHD TBI patients improved cognitive abilities (particularly verbal and nonverbal memory) and improved psychiatric functioning. Severity of depression decreased, as well as intensity of interpersonal sensitivity, hostility, paranoid ideation, anxiety and psychoticism. In three GHD patients who stopped GH therapy for twelve months we registered worsening of the verbal and nonverbal memory, as well as increase in Zung score and three SCL dimensions: inter-personal sensitivity, anxiety and paranoid ideation.

This preliminary data suggest that GH therapy induced reduction of depression, social dysfunction and improvement in certain cognitive domains in GHD patients after TBI. Our data support the necessity of conducting randomized placebo-controlled trials on the effects of GH therapy on neuropsychological and psychiatric status in GHD TBI patients.

Stigmatization of a psychiatric patient is present both in general population and among health-care professionals.

To determine the attitudes of medical students (MS) towards a person who goes to a psychiatrist, before and after psychiatric rotation, and to compare those attitudes between medical and non-medical students.

The study included 525 MS (2nd and 6th year of studies) and 154 students of law. The study instrument was a 3-part self-reported questionnaire (socio-demographic data, Rosenberg self-esteem scale and a vignette depicting young, mentally healthy person). The experimental intervention consisted of ascribing a “psychiatric label” to only one set of vignettes. All the vignettes (with or without “psychiatric label”) were followed by 14 statements addressing acceptance of a person described by vignette as judged by social distance.

We found more stigmatizing attitudes of the MS in the final year, after psychiatric rotation. The non-medical students had similar tendency to stigmatize as MS before psychiatric rotation. A higher level of stigmatization was evident in regard to a closer relationship between a student and a hypothetic person who goes to a psychiatrist. Neither sex, nor the size of student's place of origin or average academic mark was associated with the tendency to stigmatize.

Psychiatric education can either reinforce stigma or reduce it. Therefore, detailed analyses of educational domains which reinforce stigma should be conducted at the university level, in parallel with national initiative to fight against stigma and discrimination attached to mental health problems and those living with them.

One million people worldwide commit suicide each year; the number of attempters is 20 times larger. The diathesis to suicidal behavior is inherited independently from mental disorders and is most often associated with depression. The importance of serotonergic genes in the genesis of suicidal behavior and depression is assumed. The link between depression and suicidal behavior is hopelessness.

Analyzing the link of certain serotonergic alleles and genotypes with suicidal behavior and depression, as well as with hopelessness.

To analyze the association of chosen serotonergic alleles and genotypes (5HTT LPR, LPR SNP, VNTR2; THP1 A218C, 5HTR1A C1019G; 5HTR2A T102C, C1354 T) with suicidal behavior, depression and hopelessness.

The study included 30 depressed suicide attempters, 30 depressed patients without attempt and 30 healthy controls. Polymerase Chain Reaction method was used to analyze serotonergic gene polymorphisms. Participants were tested with Beck Depression Inventory, Suicidal Intent Scale, Becks Hopelessness Scale.

Two analyzed polymorphisms are associated with depression, but not with suicidal behavior (5HTTintron 2 alele 10 and A218 of the TPH1 gene). Hopelessness is more prominent in depressed suicide attempters.

The results support the role of two serotonergic genes in the genesis of depression. Hopelessness is an important predictor of suicidal behavior. Further investigation of the role of serotonergic genes in various subtypes of suicidal behavior is suggested.

Childbirth and the postpartal period present a form of specific maturational crisis and an extremely vulnerable period for every woman, especially for those who have potential for some psychological disturbances.

We explored sociodemographic and clinical manifestations of women in the postpartal period who were hospitalized at the Institute of Psychiatry, Clinical Center of Serbia.

This retrospective study included 60 patients with psychiatric disorders developed within six months after childbirth. Inclusion criteria were: negative psychiatric hystory, negative history of puerperal episode, and postpartal disorder as a first manifestation of psychiatric disturbances. Patients were diagnosed according to RDC criteria (research diagnostic criteria).

Patients with psychotic features were predominant, average age 23.6; married; mothers of male offspring and with positive family history of psychiatric disorders in 30%. Subacute development of clinical manifestations was noticed, 3.5 weeks after childbirth on average. No psychopathology was observed before third postpartal day. Obstetric manifestations did not influence psychopathology.

Childbirth is a significant risk factor for the expression of mental dysfunction in the puerperal period. The most vulnerable group is women with clinical expression of dysfunction, specific sociodemographic characteristics, and positive family history of psychiatric disorders.

Serotonergic and dopaminergic dysregulation as a core feature of anorexia nervosa, might be amenable to therapeutic modulation by atypical antipsychotics which encompass differing serotonergic and dopaminergic receptor affinities. There were no enough well-controlled clinical trials of antipsychotic medication in AN. Therefore, case reports seem to be of the certain help for clinicians.

Aim of the paper was to present a case of AN diagnosed with (DSM-IV) anorexia nervosa, restricting subtype, who responded well to risperidone treatment.

Psychopathology was evaluated by means of Eating Disorders Inventory (EDI-2) and Symptom Check List 90 (SCL-90-R). Patient was prescribed a starting dose of 0.5 mg/day of risperidone (baseline), with subsequent titration up to 2 mg/day during 6 weeks. Than, drug treatment was stopped.

With 6 weeks treatment on low-doses of risperidone, she started to gain weight during the next month, as well as to improve the attitudes toward eating. Moreover, normalization was evident in terms of body image alteration (BMI= 16.8); anxiety about meals was reduced; frequency of obsessive thoughts about body image decreased.

This case report suggests that the atypical antipsychotic risperidone is associated with significant improvement of AN simptomatology, We suggest that therapy with risperidone might be beneficial for severe AN. However, many questions could be raised: is it a therapy of choice, or it is a second, third or any other line of treatment; is it also beneficial considering further course of the illness; etc…

The core mechanism of maladaptive stress response includs aberrant phosphorylation of the glucocorticoid receptor (GR) at serine 221 (pGR211) or GR serine 226 (pGR226), which enhance or attenuate GR transcriptional activity, respectively. In the current study we tested a hypothesis that alterations in the nuclear levels and/or ratios of GR, pGR211 and pGR226 in peripheral blood mononuclear cells (PBMC) may reflect individual level of distress and/or psychological vulnerability.

In 36 healthy adults we evaluated the relation of total PMBC nuclear level of GR (tGR), pGR221, pGR226 and activated JNK1 (pJNK1) and its relation to environmental stress exposure, self reported distress (Depression Anxiety Stress Scale) and personality traits (Eysenck Personality Questionnaire). Molecular and psychometric data were cross-correlated by SPSS MannWhitney statistics.

In women, self reported distress (DASS score) correlated more with neuroticism, while in men it correlated with environmental stressor. Also, in women, PBMC nuclear tGR level correlated with pGR211, while in men it correlated with pGR226. Cross-analysis of psychometric and molecular data indicated that in women both neuroticism and self reported distress correlated positively with nuclear pGR226, while in men the only correlation was between environmental stressor and pJNK1.

This findings provide preliminary support that the nuclear level of pGR226 and pGR211/pGR226 ratio in PBMC may serve as a measure of affective vulnerability in healthy women, while nuclear level of pJNK1 may reflect environmentaly imposed distress in healthy men. The relevance of these molecular parameters as biomarkers requires broader verification in healthy and in clinical settings.

Quality of life (QoL) in patients with Type 2 diabetes mellitus (T2DM) is an important factor in analyzing of effectiveness in medical and other care. Except for physical discomfort resulting from disease symptoms, diabetic patients also bear mental stress.

To investigate quality of life in patients with T2DM in relation to demographic, clinical, psychological, metabolic and anthropometric characteristics.

97 in- and outpatients of both sexes (<65 years) with endocrinologist-diagnosed T2DM, duration ≥5 years, treated with either oral therapy, insulin or both, were included in this cross-sectional study. The Patient Health Questionnaire (PHQ) was employed for assessment of depression. The Scaling of Life Events was performed for assessment of life events in the past year. The Psychological General Well-Being Scale (WBQ) was used to assess QoL. The Problem Areas in Diabetes (PAID) was employed for assessment of T2DM distress. Laboratory and anthropometric measures (Body mass Index, Waist circumference) were also performed. The exclusion criteria were determined.

Patients with presence of life events (p=0.000), metabolic syndrome (p=0,002), and polyneuropathy (p=0.000) had significantly lower WBQ score in relation to these without (Student's t-test). Considerable correlation between WBQ score and level of education (r=0,231; p=0,023), PHQ (r= −0,811, p=0,000) and PAID score (r= −0,611, p=0,000) (Pearson's Correlation) were found.

Lower level of education, depressive symptoms, and higher level of diabetes distress as well as presence of life events, metabolic syndrome and polyneuropathy were associated with worse QoL in T2DM patients.

Growing evidence in the field of psychoneuroimmunology indicates an interconnection between psychiatric disorders, in particular schizophrenia and mood disorders, and cytokine alternations. Gender and aging are commonly reported to affect cytokine levels, but contrasting conclusions still represent a topic for debate.

Our aim was to investigate the role of age and gender in the serum levels of Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-α), in patients with schizophrenia (SCH) and major depression (MDD).

We measured serum levels of IL-6 and TNF-α in acute exacerbation of illness, in 37 patients with MDD, and compared them to 43 patients with SCH. The serum levels were measured by the enzyme-linked immunosorbent assay (ELISA). All patients fulfilled the ICD-10 criteria.

The significant interaction between gender and psychiatric disorders on serum cytokine levels, and the association between IL-6 and TNF-α and age, in both groups of patients, were not detected. However, when applied the linear regression model with the serum cytokine levels as dependant variable, and age, gender, and psychiatric disorder as independent variables, the significant predictive effect of age on levels of both investigated cytokines was detected. The patients over 35 years of age had higher levels of IL-6 and even significantly lower levels of TNF-α, regardless of the diagnosis.

The results suggest that the aging process could be a relevant factor influencing the immune status of patients with SCH and MDD. Further prospective studies are essential to further investigate biological mechanisms that underlie these multidimensional interconnections.

Treatment with pegylated interferon alpha (PEG-IFN-α) in patients with chronic hepatitis C (CHC) is associated with depression more frequently than in other diseases treated with PEG-IFN-α.

To prospectively evaluate prevalence, severity and course of depressive symptomatology in CHC patients treated with PEG-IFN-α.

Hamilton Depression Rating Scale (HAMD) was used to asses depressive symptoms in 103 subjects with CHC before PEG-IFN-α (mean dose 152.6±25.6 mcg; duration of therapy 48 weeks) and at the follow-up visits (4th, 12th, 24th, 48th, 72th week). Control group included 103 subjects with CHC without PEG-IFN-α.

There was a significant increase in HAMD scores as early as in the 4th week of PEG-IFN-a therapy compared to baseline scores (38.8% vs. 24.3%). The peak of depressive symptomatology was detected in the 12th week (mean HAMD 9.34¤ 6.93), when a half of patients (49.5%) had HAMD above 7. At the end of the treatment (48th week), 38.8 % had HAMD above 7, and in the 72nd week (24 weeks without PEG-IFN-α), prevalence of depressive symptomatology was decreased to the values lower than at baseline (23.3% vs. 24.3%). The majority (28.2%) had mild depression, whereas moderate and severe depressive symptoms were found in 20.4% and 1%, respectively. No change in prevalence of depression was detected in control group.

Present study is the longest follow-up study of depressive symptoms as a side-effect of PEG-IFN-α in CHC. Our data yielded that the severity of the symptoms was mild to moderate and tends to decrease following therapy completion.