To critically review the current literature concerning the possible association between cannabis use and suicide behaviour in clinical (particularly in psychosis) and non clinical samples.

A detailed Pubmed/Medline, Scopus, PsycLit, and PsycInfo search to identify all papers and book chapters focusing on the association between cannabis use, and suicidal behaviour in psychosis during the period between 1980 and 2011 was performed.

Most of studies reported a relevant association between suicidal behaviour and cannabis both in clinical and non clinical samples. However, there were also some studies suggesting a weak (not direct) association between cannabis and suicide. Those who attempt or complete suicide, either in clinical and non-clinical samples, are characterized by having other risk factors such as mood disorders, stressful life events, interpersonal problems, poor social support, lonely lives, and feelings of hopelessness. The association between cannabis use and suicidal behaviour in psychosis resulted still poor investigated. Limitations: It was not possible to perform a meta-analysis due to the excess in the heterogeneity of data. Also, although the effort to summarize the research in this field, the inclusion and exclusion of papers cited in this paper may reflect the authors’ choice.

Cannabis use was a relevant risk factor associated with both suicidal attempts and behaviours in clinical and non clinical samples. Therefore, preventive programs should be directed on reducing cannabis use in both clinical samples and general population. Evidence suggests that targeted suicide prevention programs can be also developed in specific at-risk subgroups.

This study explored the effectiveness of family psycho education in reducing patients’ symptoms as well as on family caregiver burden, and investigated the relationship between patients’ symptoms and caregiver burden.

Seventy Iranian outpatients with a diagnosis of schizophrenia disorder and their caregivers were randomly allocated to the experimental (n = 35) or control groups (n = 35). Patients in the experimental group received antipsychotic drug treatment and a psycho-educational program was arranged for their caregivers. At baseline, immediately post-intervention and one month later, validated tools were used to assess patients’ clinical status and caregiver burden.

Compared with the control group, the case group showed significantly reduced symptom severity and caregiver burden, immediately post-intervention and one month later.

These results suggest that even short-term Psycho-educational Intervention for family members of patients with schizophrenic disorder can improve the outcomes of patients and their families.

Clozapine is indicated for thetreatment of refractory schizophrenia.

Aim of the study was to investigate improvement among schizophrenic male patients after augmentation on clozapine with valproate.

Study group consisted of 24 male, aged 19 to 46 years inpatients and outpatients diagnosed with schizophrenia (DSM-IV criteria) and who had received a single antipsychotic clozapine for at least 4 weeks and with total score of at least 45 on the BPRS. Because no responsive or only partially responsive to clozapine, patients were treated with comminuted therapy clozapine and valproate. The Brief Psychiatric Rating Scale (BPRS), among others: SANS, ASEX, subscale on sexual function of the UKU Side Effects Rating Scale, were administered in at two-week intervals for 8 weeks.

Study exclusion criteria: somatic conditions, Depressive/ subdepressive symptoms, substance abuse; patients did not take medications to improve erectile dysfunction or other medications unless prescribed antipsychotic.

Mean BPRS total and positive symptom subscale scores decreased significantly from baseline to week 4 and week 8 in BPRS total score on to baseline, as were reductions in SANS scores. After 2 weeks on comminuted therapy clozapine and valprote, ASEX scores was decreased. (p = 0, 01).

In patients under clozapine therapy, orgasmic, ejaculatory and erectile dysfunction is more common compared with comminuted therapy clozapine and valproate after 4 weeks (p < 0, 05).

In patients with a suboptimal response to clozapine, the addition of valproate improved overall and positive symptoms of schizophrenia and may provide additional benefit in sexual dysfunction.

Stigma resistance, an individual's capacity to counteract the stigma of mental illness, emerged as a separate construct (Sibitz et al. 2011). However, genesis and importance of this new construct in schizophrenia have not been explored systematically.

Transcripts of recorded interviews with 32 people with schizophrenia were coded and analysed thematically using a modified grounded theory approach.

Stigma resistance varied from individual to individual and changed over time. Happy childhood, supportive family, friends, work and activities facilitated development of stigma resistance and being open about the disorder. Conversely, lack of money, lack of possibilities and a stigmatising environment led to low self-esteem and closeness. It was considered helpful to expose oneself to possibly stigmatising situations, but to save oneself situations that were almost certainly harmful. Negative experiences with being open about the mental disorder towards new friends and partners led to selective openness. Other strategies to counteract stigma were humour, degradation of others, ignoring, being quick-witted, information and fighting negative attitudes. Also, the amount of stigma resistance varied depending on the clinical condition and the acceptance of the disorder and its consequences.

Stigma resistance is a significant and complex issue. Further research should focus on the development of a robust scale for the assessment of stigma resistance to prove its value as an independent variable, as well as an outcome variable of therapeutic interventions and public health action.

Systematic characterization of the first psychotic episodes patients may be important in identifying subgroups of patients with a similar course of illness, and may ultimately facilitate diagnosis, treatment, and predicting outcome. The aim of this study was to characterize a population of first psychotic patients in different domains such as psychopathology, prodromal symptoms, drug abuse and socio - demographic variables.

This was a retrospective study carried out in the Department of Psychiatry of a large University Hospital (Centro Hospitalar São João, Porto, Portugal). Patients enrolled were admitted in the inpatient unit from 2007 to 2011, had experienced a first psychotic episode, and fulfilled criteria for one of the following diagnosis: schizophrenia, schizoaffective disorder, bipolar disorder, drug induced psychosis, acute and transient psychotic disorders, schizophreniform disorder and psychosis NOS (ICD-10 classification). Data were extracted from clinical records. The analysis focuses on clinical, demographic and social variables.

The study is now under statistic evaluation.

The aim of this study was to investigate face recognition in subjects with an at risk mental state for psychosis (ARMS) compared with healthy controls (HC) and patients with schizophrenia (SchP).

We examined the performance of 40 healthy controls, 47 ARMS individuals and 28 patients with schizophrenia using the Emotions Battery of the University of Pennsylvania computerized Neuropsychological Battery. ARMS subjects putatively met early prodromal state of schizophrenia, mainly characterized by the presence of basic symptoms. All ARMS individuals met the risk criterion cognitive-perceptive basic symptoms (COPER) using the SPI-A (Schizophrenia Proneness Instrument, Adult version). The ARMS participants were recruited for this study during the medical check-up before the conscription. All subjects were male. A one-way ANOVA and non-parametric Kruskall-Wallis test were performed to determine group differences.

There were several differences in Emotional processing between ARMS and HC with poorly performance in emotion recognition and discrimination, facial memory tasks in ARMS subjects. At the same time differences between HC and schizophrenia patients were more prominent and significant in most parameters of emotion recognition and discrimination. ARMS subjects had significantly greater reaction times in emotion recognition tasks than HC.

Deficit in emotional processing is related to the presence of basic symptoms and early prodromal state of schizophrenia. The performance of the ARMS group is between that of the schizophrenia patients and control groups.

To study the influence of neurocognitive training as well as long-term use of psychopharmacological drugs with serotoninergic mechanism of action (serdolect, fluvoxamine).

4 groups of patients diagnosed with paranoid schizophrenia were formed with stable therapeutic remission. The first group of patients received serdolect as monotherapy in middle doses, the second group received fluvoxamine in combination with conventional antipsychotics as the treatment of cover in middle doses, the third - took place at the complex of neurocognitive training in combination with conventional antipsychotics as the treatment of cover in middle doses, the comparison group received only conventional antipsychotics.

Study design: Initial evaluation of patients was carried out at the first call, prior to the neurocognitive training. Follow-up study was conducted one month after completion of training programs and the final examination, after a year.

According to the survey indicated an increase in all indicators (the difference with the control group ranged from 3% to 26%), the maximum improvement falls on visual memory, and minimal attention to the function.

The neurocognitive training showed itself as an effective method of correcting neurocognitive deficits. Using drugs with serotoninergic mechanism showed significant improvement in neurocognitive profile of schizophrenia patients.

Individuals with schizophrenia suffer from deficits in social skills, lack of motivation and social rejection. Web-browsing seems to create opportunities to forge social ties, bypassing traditional social skills and rejection.

Assessing web-browsing habits and web based social interaction among individuals with schizophrenia.

1. 1) Comparison of internet use for virtual relationships among patients suffering from psychotic spectrum disorders, non-psychotic patients and healthy subjects.

2. 2) Examining correlation between creating virtual relationships and real-life social interactions among these groups.

The web-browsing habits, social skills and demographic data of 143 patients suffering from Psychotic spectrum disorders were evaluated via the use of self- administered questionnaires, clinical data and information from their computerized medical files. As control groups, similar data were collected from a group of Non-psychotic patients (n = 118) and healthy volunteers (n = 100).

When controlling the demographic data for the three groups, no difference was found in the extent of creating virtual and real-life social interactions via internet use. A trend association could be seen between the Psychotic group and creating virtual relationships. All groups exhibited significant correlations between creating virtual and real-life relationships through the internet. However, the Psychotic group exhibited a higher correlation (r = .76;p < 0.01) than the Non-psychotic group (r = .52;p < 0.01) and the Control group (r = .32;p < 0.01).

This study provides preliminary data regarding internet use for social interaction among individuals with schizophrenia. Our results suggest that these individuals do benefit from internet use, as it seems to enhance their social abilities.

Impaired self-awareness has been noted as a core feature of schizophrenia. Recent neuroimaging studies examining self-referential process in schizophrenia have yielded inconsistent results. We aimed to examine the self-referential neural network using the self- and other-evaluation tasks in schizophrenia.

Fifteen schizophrenia patients and fifteen age-, sex- and parental education-matched healthy subjects underwent functional magnetic resonance imaging. Subjects were required to make a decision whether the sentence described their own personal trait (self-evaluation) and that of their close friends (other-evaluation).

Both patients and healthy groups showed significant activation in multiple brain regions including the medial- and lateral-prefrontal, temporal and parietal cortices during self- and other-evaluation tasks. The control subjects showed higher activations in left posterior cingulate and parahippocampal gyri during self-evaluation than other-evaluation, whereas there was no difference in activated regions between self- and other-conditions in the patients. As compared with the controls, the patients showed higher activations in the right superior frontal and right supramarginal gyri during self-evaluation.

These findings provide evidence for neural basis for deficits in self-awareness in schizophrenia and may underlie core clinical symptomatology of schizophrenia.

The period of two years of continuous stay in a mental hospital is the criterion for determining the long-term hospitalized psychiatric patients. Many of these patients were suffering from schizophrenia.

The aim of this study was to analyze the socio-demographic data of patients caught up in Special Hospital for Psychiatric Disease “G. TOPONICA” who were hospitalized in the continued hospitalization of more than two years and an analysis of the causes of such a long hospitalization.

For this study used a specially designed questionnaire. Analysis comprises surprised at the long-term hospitalized patients SBPB “G. Toponica”.

The data will be presented on the poster.

A long stay in hospital is not just the result only of disease but also to a range of social factors such as family neglect, lack of funds, lack of transitional institutions and so on. It is essential that the length of hospital stay should be reduced to a period that's required to reduce symptoms and psycho social rehabilitation process of a patient to provide a stable life in the community.

Schizophrenia is a clinical syndrome characterized by a heterogeneous mixture of clinical features referred to as psychosis. The age of onset of schizophrenia appears to be 18–25 years for men and 25–35 years for women. Onset after the age of 45 (late onset) is uncommon and after the age of 65 (very late onset) very uncommon.

present and discuss the case of a patient with late onset schizophrenia.

analysis of patient's medical file.

A 76 years old female patient, married, mother of 3, house maid was diagnosed late onset schizophrenia at age 63 at her first Psychiatric appointment. At that time, patient presented systematized bizarre delusions of persecution, auditory hallucinations of two voices arguing with each other and thought broadcasting. She maintained her adequate social functioning and only her nuclear family noticed symptom's onset scheduling a Psychiatric appointment for her. She began treatment with risperidone (2 mg/day). After some weeks of treatment there was complete remission of symptoms. Psychiatric follow-up and risperidone treatment were maintained for 13 years. In the last few months, the patient began the same clinical symptoms she had experienced at age 63. After augmenting risperidone dose there was complete remission of symptoms after 2 weeks.

This clinical case reports a patient with schizophrenia with an onset at age 63 which is an uncommon diagnosis for presenting psychotic patients at this age. Nevertheless, late onset schizophrenia usually has a good therapeutic response to low dose neuroleptic therapy and a good prognosis.

Many clinical and experimental studies indicate an association between the incidence of inflammation during a vulnerable development period of the CNS and an increased risk of the development of psychiatric disorders such as schizophrenia.

To simulate the effects of maternal infectious processes on the development of the brain and determine their postnatal consequences, this study was aimed at describing the behavioural deviations and cytokine profile alterations in rats systemically neonatally exposed to viral/ bacterial components.

To induce inflammation, male rats were injected (i.p.) with lipopolysaccharide (LPS, 2 mg/kg) or with Poly I:C (5 mg/kg) between postnatal day (PD) 4 and 8. All rats were assessed in terms of their prepulse inhibition (PPI) and locomotion on PD 50 and 90. The delayed effect of the neonatal challenge on immune status was evaluated as cytokine expression levels by multiplex immunoassay.

Both LPS and Poly I:C-treated rats had unchanged open field general activity, only LPS induced impairment in PPI. Dysregulation of cytokine expression was documented in the LPS-treated groups: a higher ratio of IL-10/IL-4 and marginally non-significant IL4/TNFalfa on PD 50, with a higher level of IL1A, IL1B, IL4, IL6, GMCSF, IL4/IL2 on PD 90. The expression of cytokines in Poly I:C-treated animals was analogous to the controls.

These findings suggest that neonatal immune activation may have long-lasting effects both on the development of the behavioural phenotype and on the immune Th1/Th2 system.

This work was supported by MHCR MZ0PCP2005 and MEYS CR 1M0517.

The purpose of this study is to examine the factors which influence schizophrenia patients’ levels of insight and functional remission.

In this study, 70 outpatients between the ages of 18–65 who applied to the Karadeniz Technical University Psychiatry Clinic and were diagnosed with schizophrenia according to DSM-IV were evaluated. Patients who have disease which affects the central nervous system, whose CGI disease severity score is above four, who were taken as inpatients to the hospital in the last two months were excluded from the study. The patients were evaluated by using socio-demographic data collection form, clinical interview structured for DSM (SCID-I), the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale (CDS), the Functional Remission of General Schizophrenia Scale (FROGS), Schedule for Assessing the Three Components of Insight (SAI-E) and cognitive test battery.

Patients SAI-E levels were found to be correlated with the PANSS, Stroop Test (ST), Controlled Word Association Test (FAS) and Trail Making Test (TMT) A-B scores. In the regression analysis, FAS scores were the predictor of SAI-E total scores .The FROGS functional levels of patients were found to be related with occupational status, gender, age of onset illness, comorbid psychiatric illness, PANSS, CDS, SAI-E, FAS, TMT, ST and Wisconsin Card Sorting Test scores. In the regression analysis, occupational status, comorbid obsessive compulsive disorder, PANNS negative and general psychopathology and FAS scores were the predictors of patients’ functional status.

The effect of cognitive functioning and insight on the patients’ level of functionality is prominent.

The prodromal phase of schizophrenia is the time interval preceding a first psychotic episode. It begins with the appearance of nonspecific symptoms. It ends with the outbreak of an episode meeting the diagnostic criteria for schizophrenia. This phase is considered a key period in the prognosis of the disease because it provides access to early diagnosis.

Identify the symptoms of the prodromal phase of schizophrenia and point out the duration of their development in a sample of Tunisian patients.

Detect the specifities of prodromal phase in Tunisia.

15 schizophrenia patients with illness duration of less than 3 years were included. All patients were in clinical remission from at least 3 months (PANNS and BPRS). Exclusion criteria were any history of other psychiatric or neurological disorders and alcohol or drug abuse. Prodromal symptoms were assessed with the scale of prodromal symptoms (SOPS) developed by Mc Glashan. It is a heteroquestionnaire for patients and their parents.

The mean duration of prodromal phase was about 2 years with extremes ranging from 6 months to 4 years.

The most severe prodromal symptoms were suspiciousness/ persecutory ideas, social isolation, dysphoric mood and impaired tolerance to normal stress

The most frequent prodromal symptoms were impaired tolerance to normal stress, dysphoric mood, sleep disturbance, social isolation and suspiciousness/ persecutory ideas.

We have not found any difference between male and female.

The prodromal symptoms of schizophrenia found in the Tunisian socio cultural context are similar to those found in other countries.

Research has suggested that schizophrenia involves significant deficits in executive functioning. Yet, the literature has little studied patients with a recent onset of first episode of schizophrenia. Besides, only few studies have focused on symptom-free intervals. Furthermore, previous studies have included patients under polymedication of antipsychotics without any restriction on other psychotropes.

To investigate executive functions in remitted patients with recent onset of first episode of schizophrenia receiving only a monotherapy of antipsychotics.

Executive dysfunction in schizophrenia is not a consequence of the long term course of the disease, of the relapses, of the symptoms or of the polymedication.

25 schizophrenic outpatients with less than 3 years of illness duration and only one psychotic episode were included. All patients received a monotherapy of antipsychotics and none had an antidepressant, mood stabilizer, hypnotics or benzodiazepines. 25 healthy participants were matched according to age and educational level.

Patients were assessed by the Positive and Negative Syndrome Scale. Executive functions were assessed by the Davidson et al. computerized battery designed to manipulate inhibition and cognitive flexibility vary demands on these abilities.

Compared to healthy controls, remitted schizophrenia patients have shown significant differences in the percentage of correct responses and in the reaction time. This indicates a disorder in inhibition and in cognitive flexibility.

Our results reinforce the findings that the executive dysfunction in schizophrenia stands for itself and that it cannot be explained by relapses, duration of the disease and impact of medication or symptoms.

Quality of life (QOL) is very subjective and depends on the context and perception of the insider especially for people with schizophrenia.

To explore the meaning and the component of QOL of person with schizophrenia from the perspectives of patient themselves and family caregivers in the Thai context.

To develop the concept and the components of QOL of persons with schizophrenia based on their perspectives.

This is a qualitative study. The informants were 51 schizophrenic patients and 50 family caregivers from 4 regions of Thailand (northern, north eastern, central and southern regional area). Semi-structured interview was used to elicit the information concerning their life after the disease; the changes that happen; the feelings; and the needs. Thematic analysis was used to analyze the data. This interview guideline was also used to elicit data from the family caregivers.

The quality of life is the degree to which a person with schizophrenia can maintain the capability to live their life in the 7 components, including:

1. 1) everyday life component,

2. 2) residual symptom component,

3. 3) side effect and attitude to treatment component,

4. 4) role and function component,

5. 5) family component,

6. 6) social and community component, and

7. 7) human rights component.

The QOL for person with schizophrenia and its components is differed from the QOL of general population. This could serve as the preliminary data to plan the intervention to strengthen the capability of those afflicted people to enhance their QOL; and to extend the concept of QOL for person with schizophrenia.

Altered sensitivity to pain in schizophrenia has been described in literature, but the knowledge of this issue is insufficient.

Case reports describing schizophrenia patients with painful medical conditions reported little or no pain. In all published studies except one, subjective test methods of pain were used.

The study assessed pain threshold using objective test method and relationship between concentration of β-endorphin, substance P,CGRP and pain insensitivity in schizophrenia. The influence of negative symptoms and cognitive disorders on pain sensitivity was evaluated.

43 patients with schizophrenia, 5 healthy first degree relatives and 34 healthy volunteers were included in the study. All patients were in stable mental state and received neuroleptics. The concentration of β-endorphin, substance P,CGRP was measured and PANSS N , Trail Makin Test and Stroop test were performed. To assess pain threshold nociceptive reflex test (RIII) was used.

Concentration of β - endorphin and CGRP was 20% higher among patients compared with healthy subjects. Study groups did not differ in subjective and objective pain threshold. Negative correlation between Stroop Test performance and subjective pain threshold was found. Negative correlation between TMT performance and nociceptive reflex was observed. A strong negative correlation (p < 0.001) between PANSS N scores and nociceptive reflex was found.

Patients with schizophrenia do not differ in objective pain threshold from healthy control. Insensitivity to pain could be the result of negative symptoms or working memory disorder. It is also possible that increased level of β-endorphin is related to hypoalgesia.

To evaluate the comparative prognosis impact of long acting injectable (LAI) risperidone versus adherence therapy added to oral antipsychotics in chronic schizophrenia.

A group of 30 patients, mean age 38.3, diagnosed with chronic schizophrenia, were admitted in our hospital for acute psychotic episodes related mainly to the insufficient adherence. Patients were either maintained on their prior atypical antipsychotic (n = 14) and adherence enhancement psychotherapy was added or they were switched on risperidone LAI (n = 16). We monitored the evolution of these subjects for 6 months using Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions (CGI-I/S), Global Assessment of Functioning (GAF), as well as patient and caregiver logs for the drug administration and quality of life.

Patients responded better to the risperidone LAI, as PANSS decreased with 42.2 points at week 24, compared to only 34.3 in the combined antipsychotic/psychotherapy group (p < 0.05). CGI-S decreased with 3.4 points (versus 2.3 in the combined approach group, p < 0.05) and GAF increased with 35.9 points (compared to 28.7, p < 0.05). The percentage of missed doses decreased with 65% in the risperidone LAI group and with only 42% in the combined approach group (p < 0.01), compared to pre-baseline values. The perceived quality of life was constantly evaluated as better by patients and caregivers in the injectable risperidone group.

Risperidone LAI is a useful strategy for adherence enhancement in patients treated previously with oral atypical antipsychotics, with psychotic relapses due to non-adherence and it increases the patients life quality.