Despite recent interest in the brain/mind problem and the possible organic correlates of mental disease, relatively few case studies have examined the problem concretely. I examined the effectiveness of neurotherapy for a 68-year-old male schizophrenic patient whose psychotic symptoms displayed qualitative and quantitative changes after a closed-head injury. It was hypothesized that there would be good response to relative beta training applied to regulate the dynamics of brain function.

The patient was diagnosed with schizophrenia in the early 1960s and frequently thereafter hospitalized. Visual hallucinations were the dominant symptom, and art therapy provided some relief, which led to a successful artistic career. In 1989, while actively hallucinating, he suffered a mild TBI in a pedestrian accident, an in consequences, he presented with perseveration, hemispatial neglect, and disturbances of working memory. The patient took part in 20 sessions of relative beta training. Standardized neuropsychological testing and Event Related Potentials (ERPs) before and after the completion of the program were used. As hypothesized, there was marked improvement of neurophysiological, neuropsychological, and psychiatric symptoms, as well as executive dysfunction and behavioral disorders. He also began to paint in a completely different style.

The pathomechanisms of schizophrenia and neurobehavioral disturbances resulting from organic brain damage are not unrelated. Microgenetic theory can provide a basis for explaining the course of symptoms in this and similar cases. Relative beta training produced behavioral changes and small physiological changes. ERPs can be used to assess functional brain changes induced by neurotherapeutic programs.

In this study we sought to explore patterns of neural activity related to the self/other-agency judgment in patients with first-episode schizophrenia spectrum disorders (FES) and healthy controls (HC).

Thirty-five FES patients and 35 age-, gender- and education-matched healthy controls.

A task-related functional connectivity analysis with the use of independent component analysis (ICA).

ICA revealed that the self/other-agency judgment was dependent upon anti-correlated default mode and central-executive networks (DMN/CEN) dynamic switching. This antagonistic mechanism was substantially impaired in FES during the task.

Time-courses of DMN/CEN activity has been analyzed by means of signal power and spectral coherence. There was statistically significant difference in the variable (anti-correlation index, AI) between FES and HC. AI correlated with self-agency judgment task performance in FES.

This finding suggests that the main site of pathology in schizophrenia-spectrum disorders may originate in higher-order regulatory mechanisms subserving DMN/CEN orchestration.

The study was supported by the IGA Ministry of Health, Czech Republic, grant NT/14291.

Since the early description of paranoia, nosology of delusional disorder has always been controversial. The idea of ??unitary psychosis is old but has now taken on new value from the dimensional continuum model of psychosis.

1. To study the psychopathological dimensions of the schizophrenia spectrum. 2. To explore the relationship between the dimensions obtained and the categorical diagnoses. 3 To compare the different diagnoses of the psychosis from a psychopathological and functional point of view.

an observational study with 550 patients was conducted. 373 patients with schizophrenia, 137 patients with delusional disorder, 40 patients with schizoaffective disorder. PANSS was used to assess the psychopathology and GAF for global functioning. Exploratory and confirmatory factor analysis of the PANSS items was performed in order to obtain a dimensional model. The relationship between diagnostic categories and dimensions was subsequently studied with ANOVA tests.

5 Factors,-manic, negative symptoms, depression, positive symptoms and cognition-, similar in composition to other models were obtained. The model yielded the 57.27% of the total variance. The dimensional model obtained was able to explain the differences and similarities between the different categories of the schizophrenia spectrum and the validity of the categories was questioned. The value of the model in order to help establish the diagnosis, prognosis and treatment decision-making was postulated.

The relationship between olfactory and emotional processing is an area of increasing interest in schizophrenia research.

The brain regions like orbitofrontal cortex and amygdala are involved in the processing of olfactory information.

Evaluation of odor identification performance and valence interaction in patients with schizophrenia. Assessment of influence blood concentration of β-endorphin and calcitonin gene-related peptide(CGRP) on odors identification.

50 patients with schizophrenia and 50 healthy controls were included in the study. Schizophrenia symptoms were evaluated using PANSS. University of Pennsylvania Smell Identification Test (UPSIT) was performed in both study groups. Moreover blood concentrations of β-endorphin and CGRP were measured in all participants.

The concentration of CGRP was significantly higher in patients sample (p<0,001). The concentration of β-endorphin was higher but without statistical significance. Controls achieve significantly higher UPSIT score than patients (mean UPSIT 32,48 vs 26,82). Odor identification performance by valence interaction in patients sample revealed significantly more identification errors in response to both pleasant and neutral odors relative to unpleasant odors (p=0,000 vs p=0,055). Patients with higher β-endorphin concentration made more identification errors on pleasant (R_s= −0,292; p= 0.04) and neutral odors (R_s= −0,331; p= 0,019). No relationship between CGRP concentration and UPSIT performance was observed.

Schizophrenic patients present a unique pattern of smell identification characterized by aberrant hedonic ratings for pleasant but not unpleasant odors. Individuals with predominant negative symptoms and higher β-endorphin concentration would also be those with the greatest ability to identify negative odors.

Hospital staff not infrequently question the effectiveness of treating individuals with long DUPs (duration of untreated psychosis). A street assessment is complex to arrange, involves several different agencies, is expensive and often distressing for the individual concerned. We need to be reasonably sure that we are doing more good than harm in admitting someone to hospital in this way. There is little in the published literature regarding this aspect of psychiatric practice.

We selected a consecutive group of street Mental Health Act Assessments by examining the paper records held by our AMPH (Approved Mental Health Professional) service and cross-referencing these with our electronic case records. We looked at several psycho-social outcome measures one year following discharge from hospital.

Although the number is small, the outcomes are overwhelmingly positive, in spite of notions about long DUP being predictive of poor response to treatment. Most of the subjects were in housing and remained in contact with a mental health team.

The assertive treatment of people rough sleeping with psychosis, even with long DUPs and long histories of street sleeping, can be highly effective.

Clozapine-induced electroencephalography (EEG) abnormalities are common. It has been reported that clozapine-induced EEG abnormalities occur in a dose-dependent manner and correlate with the serum concentration of clozapine (C-CLZ). However, the oppositional results were also reported.

The objective of this study was to investigate the relationship between serum level of clozapine and EEG abnormalities.

Twenty-eight patients were recruited in this study, but five patients were excluded because clozapine was discontinued before post-treatment EEG measurement or measurement of C-CLZ. Ultimately, 23 patients (6 males, 17 females) with an average age of 35 years were enrolled. The subjects were divided into EEG normal and abnormal group. C-CLZ and the serum concentration of metabolite of clozapine (N-CLZ) were measured. The correlation between C-CLZ and daily dose of CLZ (D-CLZ), N-CLZ and D-CLZ were evaluated in each group. C-CLZ per D-CLZ (C/D), N-CLZ per D-CLZ (N/D) and the ratio of C-CLZ to N-CLZ (C/N) were compared between the two groups.

74 serum levels were measured. All patients had normal baseline EEGs, and 10 patients later showed EEG abnormalities. There were a significant correlation between C-CLZ and D-CLZ (EEG normal: rs 0.58, p<0.01, EEG abnormal: rs 0.56, p<0.01) and between N-CLZ and D-CLZ (EEG normal: rs 0.53, p<0.01, EEG abnormal: rs 0.57, p<0.01). There were no significant differences between the EEG normal and EEG abnormal groups in C/D, N/D, C/N.

There was no relationship between the serum concentration of clozapine and EEG abnormalities.

The current study tries to understand the psychopathology of passivity and hallucinatory symptoms, which are symptoms sometimes signified by their conscious experience of attaching internally generated contend to external source. This study focuses on the postulated deficit of patients with these symptoms, and suggests that the specific deficit in action awareness is psychopathologically important and wishes to develop a simple task for clincal assessment.

19 healthy control, 19 psychotic patients control and 19 psychotic patients with the relevant symptoms were recruited in the studiy. Their clinical, social, cognitive, side-effect and motor condition were assessed, and the main experiment task was conducted. In the task, the participants were asked to replicate their own actions in conditions: (1) being passively moved; (2) moving voluntarily and (3) being instructed. The inaccuracy of the replication was recorded, and 1 supplementary experiment was conducted for confounders.

After control the confounding factors, such as the cognitive deficit, result from the main and supplementary experiments suggested that patients with passivity experience and hallucinatory symptoms as a group were having deficit in the awareness of their own actions, such that they showed no improvement when acting voluntary compared to when being passively moved; while this improvement were found in other groups. Moreover, this failure in showing improvement was due to their problems in obtaining information about their own actions.

The simple paradigm developed demonstrated that patients with the relevant psychotic symptoms were closely related to a specific deficit in their awareness of actions.

Schizophrenia is a heterogenous disorder, and has often been subtyped on the basis of family history of psychotic disorders. Compared to those without, a positive family history is associated with an earlier age of onset, greater structural brain abnormalities and poorer clinical course. Given recent emphasis on mirror neuron system (MNS) in attempting to explain psychopathology in schizophrenia; present analysis tried to tease out differences in MNS functioning between these two groups.

With ethical approval, ten consenting right-handed patients with schizophrenia (ICD-10-DCR; M=8; Drug-naïve=2) were recruited and divided into two groups of five each (M=4,F=1): those with (age 29.40±5.85 years, duration of illness 50.80±30.84 months) and without (age 29.60±5.77 years, duration of illness 43.20±43.76 months) family history of schizophrenic illness (group difference p>0.05). MNS activity was assessed using event-related desynchronization of EEG Mu waves in response to biological motion on 192-channel EEG Neurofax EEG-1100K.

On comparison, while patients had significantly lower mu suppression compared to controls (p<0.001); two schizophrenia groups did not differ between themselves, neither on MNS activity nor on psychopathology (p>0.05).

Present study replicates finding of a dysfunctional MNS in schizophrenia patients, and represents a preliminary attempt at comparing two groups of symptomatic schizophrenia patients. In both these groups, MNS dysfunctions were comparable, and commensurate with respect to psychopathology. Thus, MNS dysfunction in schizophrenia might either be inherited or acquired. However, this abnormality forms a common base, and ultimate vulnerability marker, for development of psychopathology during active disease states.

Long acting antipsychotics are an effective option in improving treatment adherence, but tardive dyskinesia can be problem in som cases1

Atypical antipsychotics with long acting formulations offer a safer option for extrapyramidal side effects but it is not clear if they are safer in tardive dyskinesia.

We report a 45 year old male patient with 25 year history of schizophrenia aiming to reveal the effects of paliperidone palmitate on oropharyngeal dyskinesia.

Chlorpromazine, haloperidole, zuclopenthixol, olanzapine and quetiapine were the antipsychotics which were used in the last 12 months. The patient had been using olanzapine 20 mg/day, biperiden 4 mg/day and zuclopenthixol decanoate 200 mg every 2 weeks in the index consultation that the oropharyngeal dyskinesia was observed. Olanzapine was discontinued and since there was need for long acting antipsychotics because of the former history of treatment non-adherence, zuclopenthixol was switched to paliperidone palmitate 150 mg every 4 weeks. Abnormal Involuntary Movement Scale was used weekly to score the dyskinetic movements.

Marked improvement in movement disorder was observed after a switch from zuclopenthixol decanoate to paliperidone palmitate.

Long acting atypical antipsychotics may be a preferable option in patients with tardive dyskinesia if treatment non-adherence is a problem.

Patients with schizophrenia are at greater risk for metabolicsyndrome (MetS) and other cardiovascular risk factors.

Determine the prevalence of MetSand its criteria among patients with Schizophrenia (Sz) according to therevised criteria of NCEP ATP III and assess which component contributed to theincreased risk of the MetS in schizophrenia patients.

Case-control study carried out among patients with Schizophrenia (SZ) and healthy subjects above20 years old. Outpatient clinics of the Psychiatry department and Primary Health Care (PHC) Centres in Qatar. The study based on matched by age and gender of 233 cases and 466controls. Face to faceinterviews were conducted using a structured questionnaire followed bylaboratory tests. Metabolic syndrome was defined using the National CholesterolEducation Program – Third Adult Treatment Panel (ATP III).

The prevalence of MetS among schizophrenic patients (36.5%) weresignificantly higher than healthy subjects (18.7%) (p<0.001). The prevalence of MetS in schizophrenicsubjects was reported to be two times higher than in the general population. The MetS components were higher among schizophrenic patients than healthy subjects. Among the components of MetS, centralobesity (63.9%) was the most common criteria among patients compared to healthysubjects (45.7%) (p<0.001). Schizophrenic patients (27%) were significantly obese than the healthysubjects (13.1%). Female schizophrenia patientswere more likely to have three or more metabolic

The metabolic syndrome was highly malities compared to men.

prevalentin patients with schizophrenia. The female gender was significantly associatedwith a higher prevalence of MetS.

Schizophrenia is a mental disorder characterized by social problems and disorders of thought, behaviour and cognitive functions. These impaired cognitive functions may be associated with alterations in resting state functional connectivity in schizophrenia. Therefore, the present study has been carried out to determine the resting state functional brain connectivity changes associated with schizophrenia in all the resting state networks (RSNs) using independent component analysis approach (ICA) and dual-regression based approach.

The objective of this study was to investigate the aberrant resting-state functional connectivity patterns in schizophrenia patients as compared to healthy controls.

35 schizophrenia patients and 31 healthy controls were recruited for the study and scanned by using resting state functional magnetic resonance (rsfMRI). Pre-processing and post-processing of the resting state functional data were performed using the FMRI Expert Analysis Tool (FEAT), which is a part of FSL (FMRIB's Software Library, www.fmrib. ox.ac.uk/fsl).

Our results showed significantly decreased functional connectivity in the regions of left fronto-parietal network, lateral visual network, medial visual network, motor network and default mode network (DMN) in schizophrenia patients as compared with healthy controls.

The overall findings suggest that the alterations in these resting state network connectivity may, in part, contribute to the impairments in cognitive functions associated with schizophrenia. These findings also suggest that aberrant resting state network connectivity contributes to regional functional pathology in schizophrenia and bears significance for core symptoms.

The endophenotype concept of schizophrenia represents an important approach in the exploration of the neurobiology of the illness. An important characteristic of an endophenotype, that it can be found among the healthy, first-degree relatives of patients with schizophrenia.

We evaluated two systematic reviews of studies on two potential endophenotypes (theory of mind and informative morphogenetic variants) to confirm the possibility of them as biological and cognitive markers of the illness.

We planned to explore data from theory of mind and informative morphogenetic variant studies among the relatives of schizophrenia patients.

We evaluated two researches of studies published in PubMed, Medline,Web of Science and PsycINFO between the period of 1968 and 2014 (informative morphogenetic variants studies) and 1980 and 2014 (theory of mind studies).

11 studies on the appearence of informative morphogenetic variants in the relatives of schizophrenia patients were found with mixed results, while 15 studies and two meta-analyses were analysed on theory of mind studies among the first-degree relatives of patients with schizophrenia,the exploration of the latter studies showed also diverse findings.

Futher research is needed to clarify theory of mind and informative morphogentic variant alternations as endophenotypic markers of schizophrenia.

Acknowledgement: This study was supported by the National Brain Research Program Grant no. NAP KTIA NAP-A-II/12.

Schizophrenia is a complex disorder, characterized by both genetic and environmental factors and their interactions. Post weaning social isolation (SI) has been proposed as a model of Schizophrenia. Glutamate hypothesis in schizophrenia produce analogous symptoms. In this regards, reduction in NMDA receptor activity has been hypothesized for induction of schizophrenia in clinical studies. Furthermore, NMDA receptors activation play role in various neurodegenerative diseases including phenomenon of spreading depression (SD). SD plays a pivotal role in glutamate release and its action on the NMDA receptor.

In the present study 24Wistar juvenile rats (65-80 gr) were used.

Animals were classified in three groups as SD treated with Social isolation, social isolation, and sham groups. SI was induced by six week post weaning social isolation of puppies, which followed by four consecutive weeks SD induction in SD-social isolation group. Prepulse inhibition (PPI) test and passive avoidance by shuttle box test have been done at the end of experiment.

Our result from behavioral test suggested that SD induction during for week after six week social isolation may be able to help to ameliorate schizophrenia symptoms. Significant changes in cognition tests were seen in SD induced group in comparison with social isolation group.

data from present study revealed that glutamate level in extracellular space which followed by NMDA receptor activation as well as its expression following SD induction perhaps decrease some neurological characteristics of schizophrenia, which could reveal NMDA protective role on schizophrenic patient.

To explore tolerability, safety and treatment response of flexibly-dosed paliperidone palmitate (PP) in adult patients hospitalized for an exacerbation of schizophrenia.

International 6-week prospective open-label non-interventional study. Outcome parameters were changes in Brief Psychiatric Rating Scale (BPRS) total score, Clinical Global Impression-Severity Scale (CGI-S), Personal and Social Performance Scale (PSP), treatment satisfaction (Medication Satisfaction Questionnaire (MSQ)), Extrapyramidal Symptom Rating Scale (ESRS) scores and treatment-emergent adverse events (TEAEs) from baseline to last-observation-carried-forward endpoint.

367 patients (65.9% male, mean age (±SD) 39.8±12.1 years, 85.8% paranoid schizophrenia) were documented. 91.6% completed the 6-week observation period. Mean time from hospital admission to initiation of PP was 9.4±7.7 days. Mean baseline BPRS total score of 50.2±13.6 improved by -6.5±8.6 at day 8 and by -19.3±12.6 at endpoint; 95% confidence interval [CI]-20.7;-18.0; both p<0.0001. At endpoint, 93.6% of patients were rated as improved in CGI-S. Functioning in PSP significantly improved from 49.4±14.7 at baseline by 14.3±12.4 at endpoint (95% CI 12.9;15.8, p<0.0001). Mean ESRS total score significantly decreased from 3.7±5.9 at baseline to 2.0±4.7 at endpoint (p<0.0001). 6.0% of patients were very or extremely satisfied with their previous antipsychotic medication at baseline, and 46.1% with PP at endpoint. TEAEs reported in ≥2% of patients were tremor (2.5%) and schizophrenia (2.2%).

These data support results from previous randomized controlled and pragmatic studies that flexibly dosed paliperidone palmitate is well tolerated and associated with an early and clinically meaningful treatment response and functional improvement in patients hospitalized for an exacerbation of schizophrenia.

To explore the effect of flexibly dosed paliperidone palmitate (PP) on negative, depression/anxiety, patient functioning and extrapyramidal symptoms in adult non-acute schizophrenia patients previously unsuccessfully treated with oral aripiprazole.

International, prospective 6-month open-label study. Outcomes analyzed were changes from baseline (BL) to last-observation-carried-forward endpoint (EP) in Positive and Negative Syndrome Scale (PANSS) negative subscale, PANSS negative and anxiety/depression Marder factors, patient functioning (Personal and Social Performance Scale (PSP) and Mini International Classification of Functioning (Mini-ICF)) and Extrapyramidal Symptom Rating Scale (ESRS).

: 46 patients were analyzed: 73.9% male, mean age 34.4±9.4 years, 78.3% paranoid schizophrenia, 67.4% completed the study. Mean prior oral aripiprazole dose was 22.7±10.7 mg/day. PANSS negative subscale score decreased from 20.3±5.0 at BL to 17.3±6.1 at EP (mean change -3.0±5.0; 95% confidence interval (CI) of change -4.4;–1.5; p<0.0001). PANSS negative symptoms Marder factor score improved from 19.5±5.8 to 16.6±5.9 (95%CI -4.5;-1.3, p<0.0001) and anxiety/depression Marder factor score improved from 10.3±3.6 to 8.5±2.9 (95%CI -3.0;-0.6, p=0.0031). Extrapyramidal symptoms in ESRS total score improved significantly from BL to EP by -0.6±3.4 (95% CI -1.6;0.4, p=0.0456). Patient functioning significantly improved in PSP (from 58.9±13.4 to 62.9±15.2, p=0.041) and Mini-ICF (from 19.0±7.78 to 16.1±9.84; 95%CI -5.1,-0.7; p=0.0079). The only treatment-emergent adverse event reported in at least 5 patients was anxiety (n=6).

Transition from unsuccessful treatment with oral aripiprazole to flexibly dosed paliperidone palmitate in non-acute schizophrenia patients was well tolerated and associated with significant improvements in negative, depressive, anxiety and extrapyramidal symptoms as well as patient functioning.

Mapping cognitive functions in schizophrenia is important for approaching the etiological background of the disease.

To examine the explicit and the implicit learning processes with experimental psychological methods in neurocognitive subgroups identified by us earlier (Szendi et al, 2010).

To find substantial cognitive differences between the neurocognitive subgroups

Patients with schizophrenia (n=19) and matched healthy control persons (n=11) participated in the study. The patients were recruited randomly from the patient pool which constitued the subject base for the original clustering process, we enrolled n=9 patients from the cluster S, and n=10 from the cluster Z. Besides the comprehensive neuropsychiatric assessment, the explicit learning performances were tested by a verbal learning task, while the implicit learning by the Alternating Serial Reaction Time Task.

While the whole group of patients did not differ from the healthy persons regarding either the explicit or the implicit memory tasks, the performances of the two subgroups of patients showed a double dissociation in these tasks. Whereas patients belonging to cluster S could recall significantly less words in the explicit cued recall test after the word-list learning than patients in cluster Z (and the healthy persons), the performance of patients in cluster Z in the implicit sequence-specific learning fell behind the cluster S (and the healthy group).

The double dissociation of explicit and implicit memory's impairments suggests that the neurocognitive background of the two subgroups of schizophrenia (S vs Z) might substantially differ from each other.

Financial support: KTIA_NAP_13-2-2014-0020

To clarify pathophysiology of schizophrenia it is required to decrease the phenomenological heterogeneity, and one of the possible ways is determining neurobiologically valid subgroups.

Employing two concurrent methods – Deficit and Nondeficit (Carpenter et al., 1988) vs. cluster S and Z (Szendi et al., 2010) – the group of patients was divided into two subgroups, and brain volumetric peculiarities of the whole mixed group of patients and of these subgroups were compared with the healthy controls and each other.

This study aims to possibly reveal the most brain structural anomalies by applying concurrent subgrouping methods of patients, and moreover to confront their validity by the results.

High resolution T1 weighted images were performed on n=21 patients with schizophrenia, living integrated in the society and treated in outpatient care, and n=13 healthy control persons. Localised grey matter volumetric deficits were defined with optimised voxel-based morphometry.

Most areas were revealed in the case of the cluster S, which was characterised by an expansive, bilateral brain structural impairment, which mainly affected the heteromodal and partly the unimodal association cortices.

This suggests that the expansive impairment of the association cortices could have a determining role in the etiopathogenesis of the unfavourable cluster of patients with schizophrenia. In the literature, an extent of damage commensurable to our observations specifically on association areas has never been detected – and our systematic neurocognitive subgrouping method provided the possibility for this.

Financial support for the research was provided by KTIA_NAP_13-2-2014-0020 to Mihály Racsmány.

Conformational changes of human serum albumin (HSA) can disturb its main functions.

To reveal serum albumin disturbances using the high-tech approaches in first episode schizophrenia.

First-episode drug-naïve schizophrenic (FES) patients were investigated. There were employed laser time resolved subnanosecond fluorescence spectroscopy (LTRSFS) using specific albumin fluorescent probe and high resolution nuclear magnetic resonance (NMR) 1H spectroscopy.

There were revealed 3 binding sites in albumin molecule with fluorescent decay time of 1, 3 and 9 nanoseconds (A1, A3 and A9 sites, respectively) in healthy volunteers using LTRSFS approach. There was found significant decrease of fluorescent decay time of probe bound to albumin A3 site of FES patients as compared with controls. It points out on the conformational changes in HSA molecule in FES patients. NMR 1H spectra of blood serum and its albumin fraction of healthy donors and FES patients were studied. There were shown clear differences in NMR 1H spectra between these two groups that points out to the conformational changes of albumin molecule in FES patients and disturbances in albumin transport functions. The reaction ability of thiol groups of albumin molecules in FES patients was significantly lower in comparison with healthy persons. It also points out on disturbances of antioxidant albumin properties in FES patients.

High-tech approaches can be useful for the development of new biomarkers for diagnostic and predicting methods and methods for the evaluation of the efficacy of different types of therapy of mental disorders.