An increasing number of studies have described the relationship between celiac disease and schizophrenia. Based on the reported correlations and the overlapping linkage regions on 19p13, the myosin IXB gene (MYO9B) can be considered a highly relevant positional and functional candidate gene for schizophrenia. The present work was undertaken to investigate the association of the MYO9B gene with schizophrenia in a Chinese population.

A total of 329 patients with schizophrenia and 350 healthy control subjects in a Chinese population were recruited. A PCR-based RFLP protocol was applied to genotype 7 single nucleotide polymorphisms (SNPs), including rs7249490, rs7256689, rs2279007, rs8113494, rs2305767, rs1545620 and rs2305764, in the MYO9B gene to investigate their association with schizophrenia.

The X2 goodness-of-fit test showed that the genotypic distributions of all 7 SNPs were in Hardy-Weinberg equilibrium in both the patient group and the control group. Disease association was shown for rs8113494 (X2=12.77, P=0.0003, OR=1.89, 95% CI 1.33-2.68) and rs1545620 (X2=15.44, P=8.379e-5, OR=1.65, 95% CI 1.29-2.12), while rs2279007 was associated with schizophrenia in the female subjects (X2=4.637, P=0.031, OR=0.69, 95% CI 0.49-0.97) but not in the male subjects (X2=1.082, P=0.299, OR=0.85, 95% CI 0.63-1.15).

The present work shows that the polymorphisms of the MYO9B gene are likely to confer susceptibility to schizophrenia. Because the MYO9B gene has been found to be highly expressed in the tight junction gate, it could be considered as a meeting point for the interaction between environmental and genetic factors in the pathogenesis of schizophrenia.

Hyperglycemia and type 2 diabetes mellitus are more common in schizophrenia than in the general population. Presence of type 2 diabetes would limit the use of many atypical antipsychotics and also as a major risk factor for cardiovascular disease, therefore it is important that the role atypical antipsychotics play in this glucose dysregulation is ascertained.

To analyse current experimental literature on anti-psychotic dysregulation of glucose metabolism; reviewing clinical evidence already available.

PubMed - searched with MeSH term “anti-psychotics”, with additional terms; “schizophrenia”, “diabetes”, “glucose”, “treatment”

The central effects of atypical anti-psychotics that may induce a metabolic dysregulation are mediated by neurotransmitter receptor antagonism, particularly the histamine-1 and serotonin-2C receptors. In the periphery, many of the mechanisms postulated are dependent on weight gain and serum fatty acid level. Resistance to anorexigenic endocrine factors and elevated levels of the orexigenic agents adiponectin and ghrelin, may also be induced by certain anti-psychotics. Anti-psychotics could play a role in accelerating an existing insulin resistance as current literature suggests an existing CSF glucose metabolism dysregulation in anti-psychotic drug naïve patients. Deficits have also been implicated in schizophrenia pathogenesis, raising the possibility of co-morbidity.

The clinical implications of this phenomenon are significant and until anti-psychotics are developed, that minimises this metabolic disturbance, precautions should be taken. Dietary counselling, and administration of anti-diabetic drugs such as Metformin may aid the reduction in insulin resistance while switching to more appriopriate anti-psychotics has been shown to be beneficial.

Delivery of information about his/her disease and its treatment to a schizophrenic patient is essential but no consensus exists concerning to what extent and how to deliver the information.

To study the therapeutic impact of internet mediated knowledge an internet site was built particularly for the use of schizophrenic patients and contained information about pharmacotherapy, symptoms management and patients’ rights.

The patients enrolled in the study were randomly divided into 4 groups. Each of the three study groups was given a task to study different topic (pharmacological treatment, symptoms management or patients’ rights) by means of the internet site. The forth group was a control one. Based on analysis of the questionnaires filled out by the patients before and two weeks after the information delivery we have analyzed whether the site is user friendly, emotional responses of the patients, extent of information catching, satisfaction change and contribution to pharmacotherapy.

Patients diagnosed as suffering from schizophrenia and being hospitalized more than once.

28 patients were enrolled, among them 25 being hospitalized. In the study groups, satisfaction from the therapy has improved after browsing the site. Compliance to pharmacotherapy has improved in the groups that had learned about pharmacotherapy and symptoms management. Compliance did not improve in the group instructed on the patients’ rights and in the control group.

Schizophrenia is a chronic disease. Several etiopathogenic aetiologies have been posed, among them the existence of cerebral inflammation. S100B is a calcium-binding protein, mainly produced and secreted by astrocytes, that mediates the interaction among glial cells and between glial cells and neurons. Serum S100B levels have been proposed as a peripheral marker of brain inflammation.

The aim of this research is to study if the serum level of the protein S100B has relationship with positive psychopathology.

31 paranoid schizophrenic inpatients (22 male and 9 female, 36.7±10.3 years) meeting DSM-IV criteria participated in the study. Blood was sampled by venipuncture at 12:00 and 24:00 hours. Blood extractions were carried out during the first 48 hours after hospital admission. Psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Serum S100B levels were measured by sandwich ELISA techniques.

Correlations between serum levels of S100B protein and PANSS positive scores are shown in the following table. The first figure corresponds to the Pearson's correlation coefficient, while the figure in brackets corresponds to its statistical significance.

Serum levels of S100B protein may be used as a biological marker of positive psychopathology in paranoid schizophrenia.Acknowledgement

The aim of our study was to investigate the impact of aerobic endurance training on cognitive performance, psychopathology and subjective well-being in paranoid schizophrenic inpatients.

37 inpatients who met the ICD-10 criteria for paranoid schizophrenia were randomly assigned to either a controlled endurance training (n = 20) or an occupational therapy program (n = 17). Before randomisation and prior to discharge psychopathological symptoms, subjective well-being and cognitive performance were assessed with a comprehensive neuropsychological test battery and psychometric measures. Patients in the aerobic endurance group received about four times per week a 30 minute training session. In the control group schizophrenic patients participated for an equivalent amount of time in an occupational therapy program.

All patients significantly improved in psychopathologic symptoms and subjective well-being. Additionally significant time effects in cognitive functions, except for attention, could be found in both patient groups. However, significant group by time effects could only be demonstrated for working memory, short term memory and verbal learning with an advantage for the sport group.

Concerning verbal memory functions patients could profit by aerobic endurance training in a clinical setting. As cognitive impairments, especially memory deficits are a core feature of schizophrenic illness aerobic endurance training should be an integral part of treatment programs for schizophrenic inpatients.

The goal of the study was to find the potential causes of psychotic episode recurrence and its first symptoms in rehospitalized patients with schizophrenia.

Patients with schizophrenia, who were urgently hospitalized to KUM Psychiatry clinic and had less than three psychotic episodes, took part in the study (N=97). Medical documentation and a structured questionnaire, designed by the authors, were used to evaluate anamnesis data.

The main causes of relapse were: willful discontinuation of psychopharmacotherapy (50% of the cases), spontaneous relapses without any clear exogenous cause (20%), and onetime alcohol intoxication (8%). The patients and their family members indicated the following first symptoms of relapse: anxiety, fear (73%), sleep disorders (62%), aggression (52%), delusions and/ or hallucinations (37%). The symptoms tended to occur in combinations rather than individually.

Causes and symptoms of schizophrenia relapse differ from patient to patient. It is possible to prevent the relapse knowing the common causes and first symptoms, because most of the patients are able to detect the first symptoms themselves.

The goal of the study to explore nursing demands in patients with schizophrenia disorders with long term maintenance treatment at home.

Research was carried out in four Kaunas primary mental health centers. We used standardized International Mental Health Quality Of Life Scale (QOL-36) questionnaire implemented by Phillip W. Long (2003). Our group was randomly selected and consisted of 123 patients with schizophrenia aging from 18 to 65 years.

Several main problems were disclosed: 46% reduced everyday home activities, 68 % mentioned physical fatigue, apathy- 60%, sleep disorders- 81%, memory and attention disorders- 64%, communication problems- 76%. 25% of respondents had suicidal attempt. There were more suicidal attempts in younger patients than others (p < 0,05). We disclosed statistically confident correlation between disease duration and suicidal attempts (p < 0,05). For the senior patients the most often were communication problems (50%), sleep disorders (55%), memory and attention disorders (53%).

The most frequent nursing demands mentioned by patients are caused by memory and attention disorders, as well as sleep disorders. Those problems most frequently occur among older respondents.

A sample of 67 patients receiving care in community mental health services (day hospital) has been evaluated using the SF-36 scale. The results were compared with the population national values of reference to the same scale.

We found statistically significant differences between groups for the following items: General Health (t =-2,81; p=0,004), Vitality (t =-3,37; P=0,000; Social Functioning t =-4.11; p = 0,000); Emotional Role (t =-2,269; p=0,023) and Mental Health (T =-2,67; p = 0,007).

The studied patients have a worse perception it brings over of his general health that the rest of the Spanish population; likewise they perceive a major detriment as for his social functioning that is a rest of the Spanish population. This way, the physical health of the patients with schizophrenia needs a control and a specific follow-up to guarantee that his life expectancy, his quality of life and his social functioning are similar to those of the general population.

Sertindol it's a very good option for the treatment of the schizophrenia patients with antipsychotics. It brings a safety and efficacy medicine that doesn’t have hardly secondary effects and that gives a better quality of life to this patients.

Affective temperament-based personality traits such as neuroticism have been found to be related to schizophrenia and schizotypy. However, studies thus far have not clarified the differential association of neuroticism with individual schizotypy dimensions and the role it plays in the expression of schizophrenia-spectrum phenomena.

204 nonclinically ascertained participants completed self-report questionnaires assessing neuroticism and the positive and negative schizotypy dimensions, and underwent structured interviews assessing schizophrenia-spectrum psychopathology (psychotic-like experiences, negative symptoms, cluster A personality disorders), mood episodes, substance abuse, and global functioning.

Results indicated that neuroticism predicted positive symptoms of schizophrenia and depression, over and above the effects of both schizotypy dimensions. Also, neuroticism moderated the association of positive schizotypy with interview measures of psychopathology and functioning.

The results of this study support other research indicating that neuroticism is etiologically relevant for spectrum psychopathology and that it cannot be considered solely a ‘secondary effect’ of spectrum disorders. Current psychological models of psychosis can accomodate the finding of neuroticism being a shared vulnerability factor for affective and psychotic disorders.

Paranoia is considered a key characteristic of schizotypy and schizophrenia, although it also shares phenomenological features with social anxiety (e.g., social fear and discomfort). Our first study examined the relation of paranoia with positive and negative schizotypy and with social anxiety. The second study examined the experience of paranoia and social anxiety in daily life using experience sampling methodology (ESM).

Study 2: Participants were 862 university students who completed the Perceptual Aberration, Magical Ideation, Physical Anhedonia, and Social Anhedonia Scales, the Schizotypal Personality Questionnaire, the Paranoia Checklist, the MMPI-2 Persecutory Ideas subscale, and the Social Phobia Scale. Study 1: A subset of 240 participants from study 1 carried palm pilots for 7 days that signaled them randomly 8 times daily to complete brief questionnaires inquiring about their cognitions, affect, activities, and social functioning at the time of the signal.

A series of confirmatory factor analyses indicated that the best fitting model was a four-factor model with positive and negative schizotypy, paranoia, and social anxiety. As hypothesized, the paranoia factor was most strongly associated with positive schizotypy. While some measures of paranoia correlated with negative schizotypy, measures of core features of paranoid ideation were only minimally associated with negative schizotypy. Social anxiety comprised a separate factor outside of schizotypy, but was moderately associated with positive schizotypy and paranoia.

ESM findings indicated that paranoia and social anxiety are differentially experienced in daily life. The results are consistent with a multidimensional model of schizotypy/schizophrenia.

We analyzed the association of age at onset of psychosis(AOP) with having a history of cannabis use in patients with a first episode of non-affective psychosis(FENAP) and investigated the impact on the AOP of exposure to cannabis in adolescence, compared with young adulthood, and of the additional exposure to cocaine.

We recruited 112 consecutive patients with a FENAP. CIDI was used to assess drug use and to define the age at onset of heaviest use(AOHU) of a drug, as the age when drug was used the most for each patient. The effect of cannabis and cocaine AOHU on AOP was explored through Kruskal-Wallis and Mann-Whitney tests, and logistic regression. Sex-adjusted cumulative hazard curves and Cox regression models were used to compare the AOP of patients with and without a history of cannabis use, or associated cocaine use.

AOP was significantly associated with the use of cannabis, independently of sex, use of cocaine, tobacco smoking or excessive alcohol consumption. There was a dose-response relationship between cannabis AOHU and AOP: the earlier the AOHU the earlier the AOP. Hazard curves showed that patients with a history of cannabis use had a higher hazard of having a first episode psychosis than the rest of the patients (sex-adjusted log rank χ2=23.43,df=1, p< 0.001). Their respective median AOP (25th, 75th percentiles) were 23.5 (21,28) and 33.5 years (27,45) (for log-transformed AOP, t=5.6, df=110, p< 0.001).

Our results are in favor of a catalytic role for cannabis use in onset of psychosis.

Substance abuse frequently occurs in schizophrenia and has a poor prognosis. In 85 patients with schizophrenia from a long-term psychiatric hospital we previously examined the clinical impact of substance abuse and found that 48% of patients had comorbid substance use disorders and that they responded less to treatment. Naltrexone has been used in patients without schizophrenia for the treatment of substance use disorder. Consequently, we conducted a double-blind controlled study of adjunctive treatment with naltrexone or placebo in patients with schizophrenia with co-morbid substance use disorders to determine whether naltrexone would improve outcome.

Thirty-seven patients entered the study and were randomized to placebo vs. naltrexone 50mg/day. The monthly assessments included the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), Global Assessment Scale (GAF), and the Quality of Life Scale (QLS). We used an analysis of variance of the change scores between final visit and baseline with the last visit carried over.

All patients improved in PANSS and QLS but those on naltrexone improved less with a statistically significant group difference between the PANSS total (F=6.5, p≤0.03) and general symptom change scores (F=4.2, p≤0.04) when weighted for the Michigan Alcohol Screening (MAS).

Both groups of patients improved in this controlled setting where patients refrained from substance abuse; those on naltrexone improved less, however. As patients with schizophrenia have pervasive neuroreceptor deficits, it is possible that they have deficits in the opioid system suggesting that the addition of the opioid-blocker naltrexone may be counterproductive.