In the treatment of patients with schizophrenia on of the most important goals is achieving a proper quality of life. It is interesting what is the relation between the self-feeling of the patients in terms of their psychopathological symptoms, and the quality of their lives.

The purpose of our research was establishing the degree of satisfaction with their lives among patients suffering from schizophrenia. We have also analyzed correlation between the intensity of clinical symptoms and satisfaction with life.

Fifteen patients participated in our research, among them 8 were male and 7 were females, the age scope was from 22 to 63 years old and the average age was 40.

The patients were asked to fill in the Quality of Life Scale (Q Scale) . They filled in also the questionnaire of the Frankfurt Self-feeling Scale (FBS).

Correlation between intensity of clinical symptoms and life quality: The patients assessed the intensity of each of 36 clinical symptoms on the scale from 0 to 3.The results varied from 1 to 108 with the middle score of 80.The correlation degrees between intensity of clinical symptoms and general satisfaction with life were calculated for every symptom. Strong negative correlation was observed between satisfaction with life and: emotional withdrawal, lack of emotion, losing one's self control, lack of concentration, oversensitivity and apathy.

It seems interesting that there is a strong correlation between satisfaction of life and those of the psychopathological symptoms, which are referred to as negative symptoms.

investigation of psychopathology and sexual characteristics in persons with F2 disorders and the syndrome of sexual dysphoria.

Subjects: Group 1: 78 patients (55 male and 23 female). Group 2 (controls): 85 persons with transsexualism (12 male and 73 female). Average age is 25,8 years.

clinical-psychopathological, sexological, statistical

In Group 1 premorbid sensitive (22,4%) and asthenoneurotic (15,8%) features seemed to prevail while in transsexuals the most common premorbid features are harmonious (53,7%) and hyperthymic (18,3%) ones. Child autistic fantasies and neurotic-like symptoms also dominated in Group 1. Only these patients had transient dysmorphophobia, vagrancy and anorexia nervosa in their past, and psychopathic-like syndrome at present (10,4%). Recurrent affective episodes and depressive disorders significantly prevailed among schizophrenic patients. In Group 1, the ideas of changing sex appeared after sensations that the body had changed and after senestho-hypochondriacal experiences. Cross-dressing and using cosmetics was already found in patients of Group 2 younger than 10 years of age. Some characteristic features of psychosexual development were found: only schizophrenic patients showed premature sexual maturation. However, this group also showed significantly disharmonious and late psychosexual development (80,6%). On the other hand, only transsexuals had disharmonious early or late somatosexual development.

The differences found between patients with schizophrenia-spectrum disorders and sexual dysphoria and transsexuals will contribute to differential diagnosis and analysis of different pathogenetic mechanisms of “rejecting one's sex” in different mental disorders.

Subjective, self-rated improvement in patients with schizophrenia spectrum disorders can carry significance as a first-person account of treatment outcome, and can be of importance for the individual patient's acceptance of further treatment. This study assessed the concordance between post-treatment subjective improvement and the observed symptom change after a psychotic episode.

The study sample consisted of 43 younger, primarily first- or second-episode patients. Daily symptom ratings were carried out. Observed symptom change was calculated both as pre-post differences and as symptom trajectories. Subjective improvement was assessed at the end of treatment by using the "Emotional and Behavioural Changes in Psychotherapy Questionnaire" (VEV), a retrospective measure of subjective change.

The findings indicated no significant concordance between pre-post differences in symptoms and self-rated improvement, nor were final levels of symptoms related to subjective improvement. Higher initial and mean symptom levels for positive symptoms were related to a lower degree of subjective improvement. A shorter duration of an initial trend-like improvement in psychosis was shown to be associated with greater subjective improvement.

Subjective assessment of improvement may differ markedly from symptom change. In psychotic episodes, more severe initial positive symptoms as well as a delayed improvement of positive symptoms may be related to a reduced subjective experience of improvement for the duration of the entire episode. The treatment of psychosis should take a possible discordance between subjective and objective change into account.

Evaluate impact of risperidone long-acting injection (RLAI) versus oral antipsychotics on hospitalization outcomes for patients in the electronic Schizophrenia Treatment Adherence Registry (e-STAR) in Spain.

e-STAR is a 2-year, multi-national, prospective, observational study of patients with schizophrenia who initiated on RLAI or an oral antipsychotic. Hospitalization outcomes including number of hospitalizations and number of days in hospital were collected retrospectively (1-year) and prospectively (2 years). Changes in hospital stays and days in hospital were compared between RLAI and oral patients using linear mixed model controlling for age, gender, disease duration, and baseline antipsychotic use patterns.

1,622 patients (63.6% male, mean age 38.4±11.2 years) participated in e-STAR from Spain, 1,345 initiated on RLAI and 277 on oral antipsychotics. RLAI patients had significantly longer disease duration (12.6±9.5 years vs. 10.9±9.7 in oral patients, p<0.01). Average hospital stay at baseline was 5 days longer for RLAI than oral patients. During the study, both treatments showed reductions in mean number of hospitalizations and mean number of days in hospital. Based on the mixed-model regression, RLAI patients, compared to oral patients, had a significantly greater reduction in mean number of hospitalizations (-0.28 vs. -0.18 in followup-year1 and -0.37 vs. -0.20 in followup-year2, p<0.05) and mean number of days in hospital (-17.23 vs. -12.96 in followup-year1 and -18.75 vs. -12.99 in followup-year2, p<0.01).

This 2-year, prospective, observational study showed that compared to oral antipsychotics, RLAI treatment was associated with greater reduction in hospital stays and days in hospital in patients with schizophrenia.

Assess clinical and functioning treatment outcomes of risperidone long-acting injection (RLAI) versus oral antipsychotics for patients participating in the electronic Schizophrenia Treatment Adherence Registry (e-STAR) in Spain.

e-STAR is a 2-year, multi-national, prospective, observational study of patients with schizophrenia who were initiated on RLAI or an oral antipsychotic. Data were collected retrospectively (1-year) and prospectively every three months (2 years). Outcomes included clinical effectiveness measured by Clinical Global Impression of Illness Severity (CGI-S) and patient functioning assessed by Global Assessment of Functioning (GAF) scale. Clinical and functional outcomes are analyzed using a linear mixed model controlling for age, gender, disease duration, baseline hospitalization status and antipsychotic treatment patterns. Results presented are based on the complete e-STAR data from Spain.

1,622 patients (63.6% male, mean age 38.4±11.2 years) participated in e-STAR from Spain, 1,345 were initiated on RLAI and 277 on oral antipsychotics. RLAI treated patients had significantly longer disease duration (12.6±9.5 years vs. 10.9±9.7, p<0.01) than those treated with oral antipsychotics. During the 2-year study, clinical symptoms and functioning improved in both groups. As revealed by the mixed-model regression, RLAI patients, compared to oral patients, had significantly greater improvement on CGI-S scores (-1.10 vs. -0.88, p<0.02) and GAF scores (16.4 vs. 14.6, p<0.03). Baseline hospitalization status and disease duration were significant explanatory variables in the mixed model regression.

This 2-year, prospective, observational study showed that compared to oral antipsychotics, RLAI treatment was associated with greater improvement in clinical symptoms and functioning in patients with schizophrenia.

Evaluate clinical and functional treatment outcomes in patients initiated on risperidone long-acting injection (RLAI) during routine clinical practice and followed up for at least 6-months.

e-STAR is a multi-national, prospective, observational study of patients with schizophrenia who have been initiated with RLAI. Data are collected both retrospectively (1 year) and prospectively (2 years). Clinical outcome measured by Clinical Global Impression-Severity (CGI-S) scale and functioning measured by Global Assessment of Functioning (GAF) scale were assessed at baseline and every 3 months. Results presented are based on data from patients enrolled in e-STAR in Sweden and have at least 6-months of follow-up data available.

To date 102 patients have been enrolled in e-STAR in Sweden, of which 83 had at least 6-months of follow-up data available and were included in this analysis. Majority were male (63.9%) with mean age of 46.3±13.2 years. 71.1% had diagnosis of schizophrenia, 13.3% schizoaffective and 15.7 related psychosis and mean time since diagnosis of 12.5±10.1 years. Most important reasons for switching to RLAI were lack of efficacy (31.3%) and lack of compliance (27.7%) with previous therapy. At 6 months, 92.8% of patients were still on RLAI treatment. Mean CGI-S score significantly decreased from 4.21±1.08 at baseline to 3.60±1.13 at 6 months (p<0.001). Additionally, the mean GAF score significantly improved from 40.7±11.9 at baseline to 51.8±12.8 at 6 months (p=0.006).

These 6-month interim results showed that treatment with risperidone long-acting injection was associated with significant reduction in disease severity and improvement in patient functioning.

To assess the incidence of suicidal ideation, violent behaviour, and deliberate self-harm in patients with schizophrenia 12-months after initiating treatment with risperidone long-acting injection (RLAI) who are enrolled in the electronic-Schizophrenia Treatment Adherence Registry (e-STAR) in the Netherlands.

e-STAR is an international, prospective, observational study of patients with schizophrenia who have been initiated with RLAI. Data are collected retrospectively (1 year) and prospectively (2 years). The incidence of suicidal ideation, violent behaviour, and self-injury was evaluated by the treating physician based on the presence or absence of these events at baseline and prospectively every 3 months. Patients with at least 12 months of available follow-up data from the Netherlands were included in this analysis.

To date a total of 190 patients have been enrolled in the Netherlands and 118 patients with 12 months of available data were analyzed. The majority were male (62.7%) with a mean age of 37.7±11.5 years and a mean time since schizophrenia diagnosis of 11.1±21.5 years. Compared to baseline, statistically significant decreases were observed in the occurrence of suicidal ideation (15.1% to 4.3%, p=0.006) and violent behaviour (12.9% to 2.2%, p=0.006) at 12 months. The incidence of self-injury also decreased from 4.3% to 3.2%, but the reduction was not statistically significant.

These 12-month interim results showed significant decrease in the incidence of suicidal ideation and violent behaviour was observed in patients with schizophrenia after initiating treatment with risperidone long-acting injection.

Attention, working memory (WM), information processing and memory deficits are important features of schizophrenia. WM functions appear to be mediated by the dorsolateral prefrontal cortex (DLPFC). Functional imaging studies have shown a failure to activate the DLPFC during working memory tasks in patients with chronic schizophrenia. The primary aim of this study is to determine whether there are brain activation changes in the dorso-lateral prefrontal cortex (DLPFC) as a result of engaging in a randomized, controlled 12 week course of cognitive remediation therapy (CRT) in inpatients with chronic schizophrenia.

Patients with DSM IV schizophrenia are randomized to a 12 week trial of Cognitive Remediation (CR) using a Computerized CR program (COGPACK) or to a 12-week control condition. Patients receive at baseline and endpoint an fMRI scan with a cognitive task (N-back task), a neuropsychological test battery (MATRICS), functional and symptom assessments.

Preliminary results of this ongoing study show that patients after 12 weeks of CR showed (1) significantly more improvement in WM functions than patients who participated in the control group and (2) improvement in accuracy on the verbal letter 2-back task during the fMRI scan. Signal difference between 2-back and 0-back was not present or only present minimally at baseline (Pre-CR); however, at endpoint (Post-CR) there was signal difference present, which corresponds to an increase in activation in the areas of the DLPFC. This increase in activation pattern may be reflective of the effects of the exposure to the CR intervention.

Treatment with antipsychotic agents may result in changes in body composition. Highly accurate measurement techniques are expensive and may be associated with safety concerns, e.g. radiation exposure. Cheaper alternatives are available, but their accuracy in the patient population of interest has been investigated little.

To compare two methods for estimating body fat % (%BF) in patients treated with atypical antipsychotics.

Data on %BF measured at baseline and 1 month in six patients participating in a randomized trial of olanzapine and sertindole were collected. Eight-electrode bio-electrical impedance (BIA8) and dual energy x-ray absorptiometry (DEXA) equipments were used to measure %BF.

At baseline, the mean %BFBIA8 was 26% compared to 35% for DEXA, indicating a large underestimation by BIA8. After one month, the means were unchanged, although individual patients changed between +1.7 to -1.5%BFBIA, and +1.5 to -1.3%BFDEXA. The assessed median change at one month was similar for the two methods, with an increase of 0.3%BFBIA compared to 0.2%BFDEXA. The median between methods difference was 0%BF (range -3.0 to +1.3).

Large discrepancies in absolute levels of %BF were seen between the two measurement methods. The discrepancies were, however, constant over time. Therefore the change estimates were almost identical. Judging from this small sample, it appears as assessment of change in body composition may be estimated using the cheaper and faster BIA method, although the absolute values may be large underestimates. Caution in the interpretation must be exercised due to the small sample and small magnitude of change.

The features of atypical neuroleptics influence on immune parameters and aspartate and alanine aminotransferases blood serum level of schizophrenics during 6-week therapy.

We examined 52 schizophrenics: 20 patients were treated by quetiapine, 12 - by olanzapine, 10 - by rispolept, 10 - by amisulpride. Scales PANSS and CGI was used at clinical examination. We defined the parameters of cellular, humoral immunity, serum levels of aminotransferases. Control group – 36 healthy people.

The data of favorable influence on positive, negative, general psychopathological symptoms of patients was observed.

Before therapy T-cell immunodeficiency with reduction of CD2+-, CD4+-, CD16+-cells was observed among schizophrenics (comparing to control). Authentically high aminotransferases levels in first point were observed in groups of patients treated by olanzapine and quetiapine.

During 6 weeks of quetiapine treatment indices of аHLA-DR+-cells quantity, CD16+-cells, IgA, IC level tend to those of control indices, the normalization of aminotransferases levels was observed.

During olanzapine treatment the normalization of CD2+-, CD8+-cells was observed; we determined the increase of IgА and IgM in the process of normalization of IgG and IC level. Aminotransferases levels reduced up to control indices.

During rispolept treatment the normalization of lymphocytes, CD4+-, CD16+-cells, was observed; during amisulpride treatment the reduction of CD2+-, аHLA-DR+-lymphocytes the increase of IC level, the normalization of CD16+-cells quantity and the increase of aminotransferases levels was revealed.

Summary: Was observed priority data about render various effects on immune parameters of atypical neuroleptics; dynamics of aminotransferases level which depends on their initial level is revealed.

There are lacking prospective studies in general population of adolescents about symptoms predicting the onset of first episode psychosis.

Members (N= 9,215) of the Northern Finland 1986 Birth Cohort, an unselected general population cohort, were invited to participate in a field survey during 2001, at ages of 15-16 years. The study included a 21-item PROD-screen questionnaire screening prodromal symptoms for psychosis for last six months (Heinimaa et al. 2003). PROD-screen included nine questions for positive and five questions for negative features. The Finnish Hospital Discharge Register was used to find out new cases of hospital treated mental disorders during 2002-2005.

Of the subjects 17 (0.3%) were treated due to first episode psychosis and 95 (1.5%) due to non-psychotic disorder during the follow-up period. Positive symptoms did not associate with the onset of psychosis, but negative symptoms did. 94% of subjects who got psychosis reported negative symptoms. Respective figure for those who were treated for non-psychotic disorder was 48%, and for those ‘healthy’ without psychiatric hospital treatment 46% (Fisher's exact test: psychosis vs. healthy p<0.001, psychosis vs. non-psychosis p<0.001, and non-psychosis vs. healthy p=0.61).

This study may be the only one exploring prospectively in general population features predicting onset of first episode psychosis. The findings emphasize the importance of negative symptoms in the development of neuropsychiatric disorder of first episode psychosis (Weinberger 1995).

The Academy of Finland, the Signe and Ane Gyllenberg Foundation, the Sigrid Juselius Foundation and the Thule Institute, Finland.

This study assesses the relationship of EEG to several aspects of 3 year symptomatic and functional outcome in first episode psychosis.

One hundred and seventeen patients with first episode psychosis had their baseline EEG classified by modified Mayo Clinic criteria as normal, essentially normal or dysrhythmia. Socio-demographic variables, duration of illness and of untreated psychosis and premorbid adjustment were also recorded. Positive and negative symptoms of psychoses, depression, anxiety and global functioning were rated on entry and after three years of treatment.

Patients with a dysrhythmic EEG at entry into treatment showed significantly greater persistence in both positive and negative symptoms of psychoses as well as anxiety and depression over three years. These findings were independent of duration of untreated illness or premorbid adjustment.

An abnormal baseline EEG in patients with first episode psychosis is associated with a poorer symptomatic outcome at three year follow-up.

Axis I anxiety disorders are often comorbid in psychoses and mostly assessed during the hospitalization. In the present study anxiety comorbidity was investigated in 98 patients (with schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features) previously hospitalized for psychotic symptoms.

Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorder Fourth Edition (SCID-P), Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impressions Scale (CGI), were performed during hospitalization (t0) and subsequently in a phase of clinical remission, lasting for at least 6 months besides a stable pharmacological treatment for at least 3 months (t1). Comorbid anxiety disorders were assessed only at t1 in order to avoid the influence of an acute clinical state.

Our sample confirmed that anxiety comorbidity is a relevant phenomenon in psychoses, being present in nearly half of the patients (46.9%). Our specific prevalences were: obsessive-compulsive disorder (OCD) 20.4%, panic disorder (PD) 24.5%, social anxiety disorder (SAD) 19.4%, generalized anxiety disorder (GAD) 2%, post-traumatic stress disorder (PTSD) 0%. In our sample, patients with schizophrenia had a rate of anxiety disorders (73.9%) significantly higher (p<.05) than those with schizoaffective disorder (31.6%) or bipolar disorder (41.1%). Patients with PD or with OCD showed higher severity of illness only at t0; on the contrary, those with SAD demonstrated greater severity at t1.

PD, OCD and SAD resulted frequently comorbid in psychotic patients; SAD more prevalent in schizophrenia with a negative impact on the course of the illness.

Among pituitary adenomas, prolactin-producing pituitary tumors are the most common type which are treated frequently with dopamine agonists in intrasellar types. The onset of a psychotic disorder concomitant with the tumor complicates the diagnostic algorithm of the psychiatric condition and the following therapeutical approach of both of them.

to elucidate on empirical basis the etiology of the psychotic disorder comorbid with pituitary adenoma in order to find an optimal therapeutical resolution to both conditions.

female patient, 25 years old, was hospitalized for psychotic and expansive symptoms which appeared six months after initiation of bromocriptine treatment for prolactin-producing pituitary microadenoma and had a fluctuated course. All investigations excluded the involvement of another organic factors. The difficulty of the case consisted in finding the differentiated etiology of the persistent psychiatric symptomatology: is it bromocriptine induced or is it a primary mental disorder?

the psychiatric symptoms were treated with antipsychotics – quetiapine1000mg/day, but the maintenance dose had to be reduced to half because the prolactin serum level raised. Three months later the patient relapsed and the antipsychotic dose was raised, which induced high prolactin serum level. Bromocriptine dose was raised as the psychiatric condition worsened and the antipsychotic dose was raised again. Finaly bromocriptine swiched to cabergoline 1,5mg/twice a week. The psychotic symptoms diminished and the remission was reached with prolactin serum level maintained within normal limits with cabergoline.

empiric research found that the most probable cause of persistent psychosis is related to the dopamine agonist use.