The Greek Program against Stigma and Discrimination because of Mental Illness developed an educational intervention targeting high-school students, as part of a broader anti-stigma campaign. Educational interventions aiming to confront the stigma of schizophrenia are mostly effective in preventing the formation of stereotypes and prejudice against people with schizophrenia (PWS), when implemented in populations open to change, such as high school students. The study aims to evaluate: a) students’ beliefs and attitudes towards PWS and b) the effectiveness of an educational intervention in challenging stereotypical beliefs and discriminatory attitudes towards PWS.

The intervention, a two-hour semi-structured educational program, entailed guided discussions and creative activities facilitating self-expression, such as collective drawing and role-playing. A survey questionnaire was administrated before and after the intervention and at a six months follow-up, in order to identify sources of information about schizophrenia, knowledge about symptoms and treatment options and students’ attitudes.

High-school students hold faulty beliefs about schizophrenia, are unwilling to interact with PWS, embrace stereotypic images of violence and dangerousness about PWS and draw information about schizophrenia mainly from television. The intervention was effective in challenging negative beliefs about PWS and had a significant positive effect on attitudes toward PWS, which - although weakened - remained to a considerable degree at the follow-up measure. A differential effect of students’ demographic characteristics and previous contact with PWS was also found.

Further implementation of the educational intervention is strongly suggested, as its anti-stigma purposes have, so far, attained encouraging results.

Patients with psychotic disorders often suffer from intercurrent major depressive episodes (MDEs). Case reports suggested successful antidepressive treatment with duloxetine, a selective dual reuptake inhibitor of serotonin and norepinephrine (SSNRI). We initiated this open prospective clinical trial in order to evaluate efficacy, safety and tolerability of this approach.

Patients with a psychotic lifetime diagnosis suffering from mildly severe MDEs were treated with duloxetine over a period of 6 weeks. We evaluated effects on mood, monitored the psychotic psychopathology and assessed side effects, basal clinical and pharmacological parameters.

Twenty patients were included and experienced a significant improvement of their MDE during the observation period (CDSS: Calgary Depression Scale for Schizophrenia, HAMD: Hamilton Depression scale). Psychotic positive symptoms remained stably absent while negative syndrome and global psychopathology considerably improved (PANSS: Positive and Negative Syndrome Scale). In general, the treatment was well tolerated, serum prolactin levels stayed unchanged, but pharmacokinetic interactions with a number of antipsychotic agents were observed.

This open prospective evaluation revealed antidepressive efficacy of duloxetine in patients with co-morbid psychotic disorders. With regard to the psychotic disorder, the treatment appears to be safe and well tolerable. Further investigations should involve a randomized control group.

The objective of the given research is an influence of psychoeducational program on an observance of the supporting therapy regimen; on a number of recurrent hospitalizations; on a social adaptation.

92 patients were examined in 6 and 12 months after the discharge by interviewing. The comparison group was 50 patients, with an age, a duration of the disease and a sex, similar to the basic one, but not taking part in psychoeducational program.

As a result of the psychoeducational programs, the schizophrenia patients have following changes. The observance by the patient of the supporting therapy during all catamnestic supervision was improved. The number of recurrent hospitalizations of the patients within a year was reduced. There is a statistically authentic positive dynamics in the field of productive relations during all catamnestic supervision. As against it, in the field of interpersonal relations the reliable positive changes in the basic group were observed only in 6 months after the discharge from a hospital, at examination in 12 months there were no reliable distinctions between the basic and control groups. There were no reliable distinctions between the basic and control groups in the field of sexual relations.

The psychoeducational programs have positive influence on the supporting therapy, they decrease the number of recurrent hospitalizations. The functioning of the patients in the industrial field and the field of interpersonal relations is improved. There is no reliable influence in the field of relations with parents; the organizations of life; sexual relations.

It has been suggested that schizophrenic negative symptoms may be manifestations of regionally deficient CNS dopaminergic activity. We sought to test this hypothesis by openly treating patients on chronic antipsychotic medication who showed prominent negative symptoms with low-dose selegiline.

Eighty patients meeting DSM-IV-TR criteria for chronic schizophrenia with prominent negative symptoms (Positive And Negative Symptoms of Schizophrenia-Negative subtype>15) were studied. Subjects had been kept at their current antipsychotic medication dose levels for at least a month before the study, which was continued unchanged throughout the trial. Over 6 weeks of selegiline treatment, subjects were randomly divided into three subgroups (for one group Selegiline 5 mg/day, for the second 10 mg/day, and for the third placebo was added to the regimen). Patients were assessed through and after 6 weeks by PANSS. Results analyzed with ANOVA and t tests

Eight subjects had significant increase in their positive symptoms and were excluded from the study and 4 patients could not continue the study because of severe side effects. Mean age of patients was 47.62 and mean duration of hospitalization was 8.94 years. Although in both groups who received 5mg/day and 10 mg/day selegiline, in 6 weeks, significant improvement in negative symptoms was seen. But, no significant difference in reduction of negative signs was seen in three subgroups (selegiline 5 mg/day, 10 mg/day, or placebo(P=0.98).

Selegiline was not effective on negative symptoms of schizophrenia for inpatients. This inadequacy was true when seligiline was added to risperidone, or clozapine.

Significant weight increase in schizophrenic patients can impact on compliance and is associated with long-term cardiovascular complications. This study aims to evaluate the effect on weight, overall efficacy, safety and tolerability of combining aripiprazole and clozapine in schizophrenic patients with suboptimal response to clozapine.

This 16-week, multicentre, randomised, double-blind, placebo-controlled study included patients with schizophrenia (DSM-IV-TR) experiencing at least 2.5 kg weight gain and suboptimal efficacy and/or safety on clozapine. Patients were randomised to a combination of aripiprazole (5-15 mg/day) and clozapine or clozapine monotherapy (baseline dose maintained up to 16 weeks). Endpoints included body weight change from baseline to Week 16 (primary), PANSS, CGI-I, IAQ scales, and safety assessments (secondary).

Two hundred and seven patients were randomised (baseline mean weight = 92.4 kg [52-148.4], mean weight gain on clozapine = +14.9 kg [2.5-66], mean clozapine dose = 373.7 mg/d), and 90% and 94% completed the study for combination and monotherapy, respectively. Statistically significant reductions from baseline were observed in both mean body weight (-2.53 kg and -0.38 kg, p<0.001) and waist line (-0.00 cm and -2.00 cm, p<0.001) on combination compared with monotherapy. BMI, fasting total and LDL cholesterol, and CGI-I and IAQ significantly improved on combination. There was no change in PANSS total score. Five patients discontinued for adverse events on combination, and one patient on monotherapy.

Although there was no benefit regarding psychopathological symptoms, combining aripiprazole and clozapine results in significant benefits in terms of weight, BMI and fasting cholesterol in schizophrenic patients suboptimally treated with clozapine monotherapy.

The aim of this study was to construct a rating scale for long-term outcome on the basis of clinical and sociodemographic characteristics in patients with symptoms of psychosis that seek help in psychiatry for the first time.

Patients (n = 153) experiencing their first episode of psychosis were consecutively recruited from 17 psychiatric clinics in Sweden from January 1996 to December 1997 (24 months). Baseline characteristics were assessed with an extensive battery of psychiatric rating scales, as well as the duration of untreated psychosis, family history of psychosis, premorbid characteristics and cognitive functioning. The relationship between baseline characteristics and the 5-year outcome was analyzed using a stepwise logistic regression model.

In the logistic regression analysis five variables were found to have unique contributions in the prediction of outcome. In order of magnitude of the odds ratios these variables were Global Assessment of Functioning (GAF) during the year before first admission, education, actual GAF at first admission, gender and social network. The sensitivity, i.e. correctly identified cases (poor outcome), was 0.84 and the specificity was 0.77, i.e. the correctly identified non-cases (good outcome).

To initiate adequate interventions it is crucial to identify patients with an unfavorable long-term outcome that are experiencing their first episode of psychosis. The predictive rating scale is a feasible tool for early detection of these patients

Optimal management of schizophrenia in adolescents is limited by the lack of available therapies. The efficacy and tolerability of aripiprazole was investigated in this patient population.

This 6-week, randomized, double-blind, placebo controlled trial was conducted at 101 international centers, with a safety monitoring board. 13-17 year-olds with a DSM-IV diagnosis of schizophrenia were randomized to placebo, or a fixed dose of aripiprazole 10 mg or 30 mg reached after a 5 or 11 day titration, respectively. The primary endpoint was mean change from baseline on the PANSS Total score at week 6. Secondary endpoints included the PANSS Positive and Negative subscales, and CGI Improvement score. Tolerabilility assessements included frequency and severity of adverse events, as well as blood chemistries, metabolic parameters and weight gain.

Over 85% of 302 patients completed this study. Both 10 mg and 30 mg doses were superior to placebo on the primary endpoint (PANSS total), with significant differences observed as early as Week 1 (30mg). Both doses showed significant improvement on the PANSS Positive and CGI-I scales; and the 10 mg dose group was superior on PANSS Negative score. Approximately 5% of aripiprazole patients discontinued due to AEs. Weight gain and changes in prolactin were minimal.

10mg and 30mg doses of aripiprazole were superior to placebo in the treatment of adolescents with schizophrenia. Aripiprazole was well tolerated, in general, with few discontinuations due to AEs. EPS was the most common AE. Change in body weight was similar to placebo.

Brain volume abnormalities and oxidative cell damage have been reported to be pathological characteristics of schizophrenia patients. This study aims to assess a potential relationship between these two characteristics in child and adolescent patients with first-episode psychosis.

26 child and adolescent patients with first-episode early-onset schizophrenia, and 78 age- and gender-matched healthy controls were assessed. Magnetic resonance imaging (MRI) scans were used for volumetric measurements of five cerebral regions: gray matter of the frontal, parietal, and temporal lobes, sulcal cerebrospinal fluid (CSF), and lateral ventricles. Oxidative cell damage was traced by means of a systemic increase in lipid hydroperoxides (LOOH).

Lateral ventricle volumes were significantly higher in schizophrenia patients than in controls. In schizophrenia patients, a significant positive relationship was found between oxidative cell damage (LOOH levels) and the abnormal enlargement of the lateral ventricles, after controlling for total intracranial volume, age, gender, daily smoking status, intelligence quotient (IQ), psychopathology, and time since onset of psychotic symptoms. No association was found between brain volumes and oxidative cell damage in control subjects.

Our results suggest that, in patients with first-episode early-onset schizophrenia, enlargement of the lateral ventricles is associated with chronic oxidative cell damage.

evaluate the relation between social interaction and intellect in schizophrenic patients.

Analyzing different international studies the conclusion is that schizophrenic patients doesn't have necessary inferior the coefficient intelligence compare to healthy people, but they can have major difficulties in social interaction.

The selection criteria's for schizophrenic patient were:

1. • Age between 18 and 60

2. • Male and female in equal rate

3. • Different levels of education, preferring patient with elementary, medium and high school education

4. • To be under antipsychotic treatment knowing that treatment doesn't affect social interaction

5. • PANSS Scale to evaluate symptoms.

The schizophrenic group is composed of schizophrenic inpatients from the First Clinic of Psychiatry, Tirgu Mures, followed between the 10-th of October 2006 and the 28-th of May 2007. The tests used for the control group were administered in the same period.

After completing the Baron Cohen test (the reading the mind in the eyes test) and the intelligence Raven test, the statistical evaluation of results was made using Excel and two programs of statistical analysis: SPSS and Graph Pad.

As a general conclusion we can say that there are no differences regarding the intelligence coefficient between the healthy and the schizophrenic patients, but the people suffering from schizophrenia have big difficulties in deciphering other's emotions, in understanding the mental states and the feelings. As a result of this, the schizophrenic patients had a much lower score in tests which involves the using of ToM mechanism, than healthy people.

Patient satisfaction with treatment is a pertinent outcome for evaluating the effectiveness of psychotropic medication. The current study evaluated the psychometric properties of a new multi-item scale of PAtient SAtisfaction with Psychotropic treatment (PASAP).

ESPASS is a, prospective, national observational study conducted in France on adult patients with schizophrenia (n=6007) requiring initiation or switch of antipsychotic medication. Demographics, psychiatric history, clinical status (CGI, IAQ) and pharmacological treatment patterns were recorded by psychiatrists at inclusion, 1, 3 and 6-months. Patients previously treated with an antipsychotic (n=4631) also completed a questionnaire on compliance, sexual problems, satisfaction with care and the 9-item PASAP scale (6 items evaluating their opinion of treatment and 3 items evaluating the prescriber). Each PASAP item is rated on a 5-point Likert scale. Patients who completed the 9-items were called PASAP completers.

63% of patients completed the PASAP scale at inclusion (2924/4631) and 53% at 6-months (2031/3829). PASAP completers were similar to non-completers for gender and marital status but were different for age, income level, duration of psychiatric care and severity of symptoms (p<0.001). Response rate to each item was ≥99%. At inclusion, principal component analysis suggested unidimensionality of the scale (Cronbach alpha=0.84). Inter-item correlation was satisfactory (>0.3) for most items. Responsiveness (sensitivity to change) at 6 months was good with the PASAP (effect size=0.731) and equivalent to the CGI (effect size=0.783).

The psychometric characteristics of the PASAP scale are good. French and English versions are available free on request.

Capgras syndrome is the most common type of delusional misidentification syndromes. In this phenomenon, the patient believes that a familiar person has been replaced by imposter. It has some rare variants. Now one another variant in which, the patient believes in replacement of half of the person is reported. To our knowledge the same history has not been reported.

A middle aged female with impression of schizophrenia was reported. She believed that the lower half of her body has been replaced with another person. She known this person and referred to her as a prostitute imposter, who wants to damage her. She also has tactile hallucination of intercourse which was attributed to her replaced part of body.

Today Capgras syndrome is considered to more prevalent then was thought before, but yet it is not a common condition. Rare variants of this syndromes were identified. Author reported one of these rare variant in an epileptic patient previously. In this variant the patient has the delusion of inanimate doubles. this variant was first reported by Abed and Fewtrell(1990).In another rare variant which was first reported by Breen and Caine,the patient find her/his image in mirror srange. Present case report could considered one of these rare types. Incomplete Capgras syndrome could be suggested a suitable name for this condition.

This study investigated whether a specific planning and evaluation approach called VADO (Skills Assessment and Definition of Goals) resulted in improved personal and social functioning among patients with chronic schizophrenia.

A total of 85 patients with chronic schizophrenia were randomly allocated to the VADO-based intervention or to routine care; 78 completed the program. Interventions were carried out in nine Italian day treatment or residential rehabilitation facilities. Assessment at the beginning of the study and at the one-year follow-up included the Personal and Social Performance scale (PSP) and Brief Psychiatric Rating Scale Version 4.0 (BPRS). Clinically significant improvement was defined as an increase of at least 10 points on the PSP or a decrease of at least 20 percent on the BPRS total score.

At baseline, average PSP scores in the experimental group and in the control group were 33.9±8.1 and 34.0±11.2, respectively. (Possible scores range from 1 to 100, with higher scores indicating better functioning.) At six months, the score improved markedly in the experimental group (40.8±10.9) and minimal change was observed in the control group (35.3±11.6); the difference between groups was significant (difference of 6.9 points compared with 1.3 points; t=2.21, df=81, p<.05). At 12 months, the same trend was observed (difference of 12.0 points compared with 3.5 points), and the difference between groups was both statistically and clinically significant (t=2.99, df=75, p<.01).

A statistically and clinically significant improvement in functioning was observed among patients treated with the VADO approach.

The first National Health and Nutrition Survey (Israeli Ministry of Health, 2004) was carried in accordance with the recommendations of the World Health Organization and the Food and Agriculture Organization. Our survey is the first stage of an ongoing process of monitoring the health and nutrition status of Israeli schizophrenic patients. The information generated from the surveys serves as a basis for the evaluation of health indicators in schizophrenic patients, the monitoring of changes over the time and the identification of sub-population groups at increased risk of morbidity.

The study was approved by the Institutional Review Board. Study population was based on a sample from the schizophrenic patient registry in Abarbanel Mental Health Center (Israel). A face-to-face interview was carried out with the sample person (30 acute and 30 chronic patients completed the interview). The questionnaire included demographic details on the subject and family, questions on health status, alcohol intake, exercise, smoking habits, eating and dieting habits, food supplementation use, knowledge and attitudes regarding nutrition, source of nutrition knowledge and “24-hour food recall”.

BMI of chronic patients [BMI<20.0 in 4 (13.8%) of subjects] was significantly higher then of acute patients [BMI>35.0 in 4 (13.8%) of subjects] (Likelihood ratio=12.8; df=4; p<.012), but were no differences in nutritional status (NS) and eating habits (NS).

The findings provide scintific data wich serve decision and policy makers in the formulation of policy and planning of interventions for improvement of general health, lifestyles and nutritional status of schizophrenic patients.

Quality of life (QOL) has been recognized as an important outcome of schizophrenia treatment. We examined whether global functional status, symptomatology and neurocognition would contribute to quality of life in patients with schizophrenia.

Eighty six stable schizophrenic outpatients (DSM-IV-TR criteria) were included. All patients were receiving antipsychotic treatment. Functioning and clinical assessment included the Global Assessment of Functioning scale (GAF), the Clinical Global Impression scale (CGI), the Positive and Negative Syndrome Scale (PANNS) and the Calgary Depression Scale for Schizophrenia (CDSS). Neurocognition assessment evaluated attentive functions, verbal memory-learning, executive functions and perceptual-motor speed. QOL has been evaluated using an objective measure (Schizophrenia Quality of Life Scale, QLS). Indices correlated with QOL (p<0,005) were then included in a multiple regression analysis using QOL as the dependent variable and the Bonferroni correction.

QLS total score was predicted by global functioning and negative symptoms (F=56,47, p<0,001), which accounted for 57% of the variance. Social activity, intrapsychic functioning and use of objects and participation in activities domains were also predicted by global functioning and negative symptoms whereas instrumental functioning domain were predicted only by global functioning.

Our findings suggest that, in outpatients with schizophrenia, global functioning and negative symptoms seem to play a role on modifying QOL while neurocognition doesn't seem to have a direct impact on QOL.

Neurosyphilis results from infection of the brain, meninges or spinal cord by the spirochete Treponema pallidum and comprises a wide spectrum of clinical and pathological features including psychiatric symptoms. We report the case of a patient who presented with psychotic symptoms and was diagnosed with late syphilis.

A 45-year-old male with anxiety, insomnia, auditory hallucinations, delusions of persecution and mild cognitive impairment of relative recent onset was admitted to the Department of Skin and Venereal Diseases because of serological evidence of syphilis (TPHA 1:320). Upon admission treatment with olanzapine (15 mg/d) was started. Further evaluation yielded positive syphilis serology (TPHA, RPR and FTA-abs) in serum, slight cerebral atrophy in CT and discrete aneurysmatous dilatation of the aortic arch by heart ultrasonography. CSF findings did not satisfy laboratory criteria for the confirmation of diagnosis of active neurosyphilis. Late (tertiary) syphilis with beginning cardiovascular involvement was diagnosed and treatment with benzathin penicillin was administered. Six months later he was readmitted for a follow-up examination. Psychiatric symptoms were improved.

Although quite rare today, neurosyphilis should be considered in the differential diagnosis of patients with psychotic symptoms and positive syphilis serology, as the appropriate treatment depends on early and accurate diagnosis. Moreover, given the wide use of antibiotics, abortive cases of neurosyphilis with atypical presentation forms must also be considered. Finally, this case suggests that in addition to the appropriate antibiosis, treatment with antipsychotics seems to be effective in controlling psychiatric symptoms emerging in the course of late syphilis.

Working memory dysfunctions are considered to be promising intermediate phenotypes, i.e. biological markers, which may help to discover genetic and pathophysiological factors involved in the pathogenesis of schizophrenic and affective psychoses. However, little is known about the possible role of these brain dysfunctions for differential diagnosis, for instance between schizophrenia and bipolar affective disorder. In the present study we directly compared brain activation during verbal working memory task performance in matched groups of schizophrenic and bipolar patients as well as healthy controls.

12 schizophrenic patients, 14 bipolar patients and 14 healthy controls underwent fMRI during a delayed matching to sample task requiring the maintenance of verbal information in working memory. Data were preprocessed and statistically analyzed using standard procedures as implemented in SPM2.

Both schizophrenic and bipolar patients exhibited significantly increased activation in bilateral dorsolateral prefrontal cortex and in right intraparietal cortex. Abnormal hyperactivations that were unique to either schizophrenia or bipolar disorder were found in bilateral caudate nucleus and the right amygdala, respectively.

Compatible with findings from genetic research into the pathogenesis of schizophrenia and bipolar disorder, the present data show both similarities and significant differences between these two diagnostic categories regarding the patterns of abnormal brain activation that may underlie verbal working memory deficits in these patients.