Vitamin D deficiency has been associated with an increased risk of depression and schizophrenia in some studies. However, a few epidemiological studies do not show consistent results.

Comparing serum level of Vitamin D, parathyroid hormone, Calcium, and phosphorus in schizophrenic and depressed patients with healthy subjects in Iranian people.

In a cross-sectional study, 100 patients with schizophrenia and 100 major depressed ones in Arak-Iran from October 2009 to April 2010, and also 100 healthy subjects were enrolled. After informed consent, serum levels of Vitamin D, Calcium, Phosphorus, and parathyroid hormone were assessed by using routine laboratory methods.

Data was analyzed by using SPSS V17, one-way ANOVA, the post-hoc test of Tukey and also in general linear models.

The three groups were different in Vitamin D (PValue < 0.001). Post-hoc analysis of Tukey showed that Vitamin D level of healthy participants was significantly higher than depressed patients (PValue < 0.001) and schizophrenics (PValue = 0.001) while there was no significant difference between Vitamin D levels in depressed and schizophrenic patients (PValue = 0.563). Serum levels of Ca, P and PTH were the same in three groups.

Our findings suggest that Vitamin D affects the brain independent of hormonal pathways which regulate serum level of calcium. Lack of difference between the serum levels of Vitamin D in schizophrenia and depression suggests that the independent effect of Vitamin D in the brain is a general effect and is not specific for a region or pathway in the brain.

“High utilizing” schizophrenic patients are a problem in routine inpatient care.

A complex intervention with improved cooperation between in- and outpatient services was applied to 46 “high utilizing” patients after discharge from inpatient care during an intervention phase of 6 months. The study was controlled by a matched group of 47 patients receiving treatment as usual.

The goal of this study was to prevent rehospitalizations and thus optimize satisfaction with treatment and quality of life in patients suffering from schizophrenia.

The intervention was based on a computerized decision support module. Eight psychiatrists in private practices were supplied with this software to obtain guideline-based recommendations according to current psychopathology and clinical state. A local hospital project team arranged specifically suggested interventions. Moderator variables such as socio-demographical aspects or influences of certain interventions to rehospitalization rate were analyzed

Sociodemographical aspects showed no differences between both groups. The rehospitalization rate and the mean length of inpatient treatment were reduced to nearly 50% (Interventiongroup). The rate of readmissions increased in the control group, leading to a difference of 23% between both groups. Cost effectiveness was higher in the interventiongroup than in the controlgroup.

The most important single factor was the participation in coping skills training, but only the guideline consistent complex therapies caused the significant overall result. Satisfaction increased during 6 months and remained constant during 12 months of follow up. The project described an important step to gain evidence for integrated care for patients with schizophrenia.

Social cognition is presently an important focus in rehabilitation of patients wish schizophrenic psychoses. Emotion recognition in one of its different components, the Training of Affect Recognition (TAR) is a therapy program specifically developed aiming at improving affect recognition.

To test if the material of the TAR program in terms a series of facial affect cards is reliable for emotion recognition in a Spanish control population.

A sample of Spanish control subjects were shown the TAR's series of facial affect cards. It includes the following emotions: happiness, sadness, surprise, fear, angry and disgust, and the neutral facial affect. Reliability was assessed by means of the kappa coefficient. Kappa values higher than 0.4 were considered reliable, the following criterion was accepted: kappa values < 0.4, low reliability; 0.4 to 0.75, moderate reliability; > 0.76, strong reliability.

The sample was formed by subjects from the general population with no previous history of psychiatric disorders (n = 20). The following kappa values were obtained: happiness, 0.8406 (CI 0.7744–0.9068), sadness, 0.6171 (CI 0.5377–0.6964), surprise, 0.6582 (CI 0.5859–0.7304), fear, 0.4509 (CI 0.3569–0.5448), angry, 0.6252 (CI 0.5464–0.7040), disgust, 0.7700 (CI 0.6943–0.8456), neutral, 0.5534 (CI 0.4663–0.6404).

In a preliminary study in a sample of 20 Spanish control subjects using the TAR's series of facial affect cards, the six basic emotions and the neutral facial affect were recognized with at least a moderate reliability. A strong reliability was obtained in happiness and disgust, and a moderate reliability in surprise, angry, sadness, neutral, fear.

Data from two, identically designed, placebo-controlled, randomised, double-blind clinical trials (D1444C00132+D1444C00133) for once-daily extended-release quetiapine fumarate (QTP-XR) were pooled and analysed.

Evaluate dose response, efficacy and safety for QTP-XR in schizophrenia.

Post-hoc analysis of data from patients receiving QTP-XR 400, 600, 800 mg/day or placebo. Endpoints: least squares means (LSM) change from baseline to Day 42 in PANSS total and positive and negative subscale scores. No corrections for multiplicity were performed. Adverse events (AEs) were recorded.

914 patients were included; PANSS scores were assessed in the MITT population (n = 889). LSM change from baseline in PANSS total score diverged significantly from placebo at: Day 14 for QTP-XR 800 mg/day (-15.3 vs -12.1 for placebo; p = 0.018); Day 21 for 600 mg/day (-17.3 vs -14.2; p = 0.039); Day 42 for 400 mg/day (-19.2 vs -15.4; p = 0.033).

Jonckheere-Terpstra analysis of change in PANSS total score at Day 42 showed a significant QTP-XR dose response (p = 0.0196; p < 0.001 with placebo). PANSS positive scores diverged by Day 21 for both QTP-XR 800 (-5.7 vs -4.8; p = 0.049) and 600 mg/day (-5.8 vs -4.8; p = 0.046). PANSS negative scores diverged by Day 21 (-4.0 vs -3.2; p = 0.040) and 42 (-4.8 vs -3.6; p = 0.009) for QTP-XR 800 and 600 mg/day, respectively. AEs occurred in 59.4%, 66.5%, 62.1% and 56.2% of patients in the QTP-XR 800, 600, 400 mg/day and placebo groups, respectively. Most common AEs were somnolence, dry mouth, sedation, insomnia, dizziness, headache, constipation and nausea.

QTP-XR was generally well tolerated and demonstrated efficacy that increased with dose in schizophrenia.

Financial support: AstraZeneca.

Effective treatment of FES patients may lead to achievement of long-term remission, decrease the number of relapses and increase the level of social activity and quality of life.

To study some pathophysiological mechanisms of FES.

The group of patients who were investigated clinically and biochemically consists of 26 persons (11 women and 15 men, average age 28.2 ± 9.5 years) with the first psychotic episode (F20.0; F20.3). Some biochemical parameters, representing the monoaminergic systems, and some biophysical parameters, representing reducing-oxidizing processes, were investigated. These parameters in all patients were estimated following the admission and prior to any treatment.

The severity of the disorder on admission to the clinic according to PANSS score was 75,5 ± 2,2 (i.e., moderately severe). Patients with FES were characterized by a significant increase of platelet momnoamine oxidase activity (by 107%; р < 0,01) and decrease of serum semicarbazide-sensitive amine oxidase activity (by 29%; p < 0,001) in comparison to the controls. Both reactive capability of SH-group (Cys-34 residue) of serum albumin, the main source of thiols of plasma and intersticial fluid, measured in reaction with thiol-specific reagent - dithyonitrobenzoic acide, and kinetic coefficient were decreased in FES patients (by 24%; p = 0,02) in comparison to controls.

These results show that FES patients are characterized by pronounced metabolic disturbances.

Patients with schizophrenia have at least 20 years shorter life spam compared with general population that is primarily caused by their cardiovascular morbidity.

The aim of this cross-sectional study was to assess the prevalence of cardiometabolic risk factors in a sample of Czech patients with schizophrenia and related diseases and to predict a risk of premature cardiovascular mortality in this population.

We reviewed data from 129 outpatients treated in specialized outpatient clinic for psychoses. The main collected variables included basic physical parameters (height, weight, waist circumference, blood pressure), smoking habits, laboratory data (glucose level, serum lipids levels) and ECG. Finally, we compared the studied group with a matched sample from general population in Czech Republic regarding the cardiovascular risk factors.

Our results show that the most prevalent risk factors are overweight (70% of patients have BMI over 25), dyslipidaemia (70% of patients) and smoking (43% of patients). According to SCORE diagram, there is a high risk of fatal cardiovascular event in ten years in 10% of the study group. The percentage gets even higher (up to 24%) when the latest European guidelines for cardiovascular disease prevention were used to calculate the risk.

Our outcomes indicate even higher cardiometabolic morbidity in patients with psychoses than referred in literature.

Abnormal task-related activation and connectivity is present in schizophrenia. However, whether it is a trait or state marker and what components of brain networks are affected remains unclear

The aim of the present study was the analysis of functional networks in schizophrenia patients in remission after the first episode.

Twenty-nine patients in remission after the first episode of schizophrenia and 22 healthy controls underwent examination by functional magnetic resonance during Verbal Fluency Tasks. The functional connectivity of brain networks was analyzed using Independent Component Analysis.

The patients showed lower activation of the network implicated in verbal fluency processing, consisting of the fronto-temporo-parietal cortex, the thalamus, caudate nucleus, and cerebellum. They also showed lower deactivation of the medial frontal cortex, temporal neocortex, hippocampus, posterior cingulate, precuneus, and lateral parietal cortex during VFT processing. Moreover, there was abnormal co-operation between individual networks - the patients had a lower anti-correlation between VFT activated and deactivated networks, hyper-connectivity between task-activated networks, and lower connectivity within deactivated networks. This functional abnormality was linked with the magnitude of clinical symptoms, cognitive task performance, and global functioning of the patients.

There is still an abnormal functional connectivity of several brain networks in remission after the first episode of schizophrenia. Therefore, the normalization of functional connectivity should be a target of schizophrenia treatment and a marker of disease stabilization. The effect of different treatment modalities on brain connectivity, together with temporal dynamics of this functional abnormality should be the objective of further studies.

Depressive symptoms are associated with poor outcomes, increased risk of relapse and high suicide rates in patients with schizophrenia and schizoaffective disorder (1, 2).

Assess the efficacy of quetiapine XR (QTP-XR) versus risperidone on depressive symptoms in schizophrenia and schizoaffective disorder.

A randomised, open-label, parallel-group, flexible-dose study (NCT00640562).

LSM change from baseline to Week 12 in Calgary Depression Scale for Schizophrenia (CDSS) (3) score. Secondary endpoints: change in HAM-D and PANSS scores, and adverse events (AEs). No scorrection for multiplicity was done for the secondary endpoints.

216 patients received QTP-XR (n = 109; 400–800 mg/day) or risperidone (n = 107; 4–6 mg/day). From baseline, QTP-XR significantly reduced CDSS, HAM-D and PANSS negative total scores compared with risperidone (QTP-XR vs risperidone: -7.31 versus -5.53, p = 0.0107; -14.68 versus -11.53, p = 0.0005; -8.23 versus -5.45, p = 0.0008, respectively). No major differences in AEs were observed between QTP-XR and risperidone. Four serious AEs were experienced with QTP-XR and 5 with risperidone. Two patients receiving QTP-XR died (unrelated to study drug). Prolactin levels were significantly reduced from baseline with QTP-XR versus risperidone (-9.15 ng/mL and +22.18 ng/mL respectively; p < 0.0001). No important differences were seen in other laboratory parameters.

In this study, QTP-XR was superior to risperidone at reducing depressive symptoms in schizophrenia or schizoaffective disorder according to CDSS, HAM-D and PANSS negative scores.

Sex-related differences in smell identification have been shown in healthy subjects, however, in patients with schizophrenia these findings are still controversial.

We analyzed sex-related differences with respect to smell identification in patients with schizophrenia, their first-degree relatives and healthy controls.

To assess possible sex-related differences in smell identification.

The sample consisted of 51 patients with schizophrenia-spectrum disorders (49% female; mean age 33.1 years; SD: 11), 21 first-degree relatives (61.9% female, age 49.5 years, SD 17.6, one affected, others non-affected) ; mean age 49.5 years; SD: 17.6) and 51 matched healthy controls (49% female; mean age 33 years; SD: 12.1). The Positive and Negative Syndrome Scale (PANSS) and the Mini International Neuropsychiatric Interview (M.I.N.I.) were used to assess psychopathology and diagnosis, respectively. The University of Pennsylvania Smell Identification Test (UPSIT), a standardized, multiple- and forced-choice scratch- and sniff test consisting of 40 items, was administered to all subjects.

We found no significant differences in smell identification between the three groups (p = 0.182). Also, the female and male subgroups did not differ significantly in smell identification (p = 0.105, p = 0.387, respectively). The mean UPSIT scores were 34.4 (SD: 4.1) for healthy women (males: 33.2; SD: 3.5), 32.0 (SD: 5.1) for women with schizophrenia-spectrum disorders (males: 32.5; SD: 4.4), and 34.5 (SD: 2.6) for female first-degree relatives (males: 30.5; SD: 2.8).

We found neither significant differences in smell identification in patients with schizophrenia-spectrum disorders, their first-degree relatives or healthy controls, nor sex-related differences.

Estimate the prevalence of cigarette smoking and some of the related factors among schizophrenic and other hospitalized psychiatric patients.

This was a cross-sectional study on 120 patients hospitalized in Shahid Beheshti hospital in Kerman in 2005. Patients were equally devided in two groups of schizophrenia and other psychiatric disorders. Sampling was based on statistical census and data were collected using a questionnaire including 27 questions on demographic data, psychiatric disorder, smoking cigarettes and other substances, and Fagerstrom test. Data were analyzed by Chi-square and ANOVA tests using SPSS software.

Prevalence and severity of cigarette smoking was 71.6% and 6.47% among schizophrenic and 51.6% and 6.40% among other psychiatric patients, respectively and the difference was not significant. History of withdrawal was 25.6% and 58.1% in the schizophrenia and other disorders respectively and the difference was significant (P < 0.05). Addiction to other substances was 51.6% in schizophrenic and 45% in the other patients and the most prevalent substances in both groups were opium and alcohol. The severity of smoking cigarettes was 6.9 along with other drug abuses and 5.1 in cases with just smoking based on Fagerstrom test and the difference was significant (P < 0.05).

The prevalence of cigarette smoking in both schizophrenia and other psychiatric patients is higher than normal population, but there is no significant difference between these two groups. Schizophrenic patients need persistent supportive and supervising programs for cigarette smoking abuse treatment because of their cognitive, motivate and social problems.

There is an evidence for differential executive function in bipolar type 1 disorder (B1D) and schizophrenia that may tend different cognitive deficits and abnormalities. The objective of this study was to compare the executive function of B1D and schizophrenic patients.

We studied 50 patients with B1D, and 50 schizophrenic participants. All participants completed the Wisconsin Card Sorting Test (WCST) of the Persian version. The participants were match in three basic variables which had most contributions in cognitive conditions in patients. They were Age, educational status and period of illness.

The two patient groups had compared performance on the WCST. In the WCST, schizophrenic patients showed impairment executive function more than B1D patients.

Findings indicated that schizophrenic patients had more dysfunctions executive function than the Bipolar type 1 disorder patients. Although, both disorders may show the impairment in executive function, but the dysfunction in schizophrenia greater than bipolar type 1disorder patients.

The stigma of schizophrenia is well established as a complicating feature of psychiatric treatment. The fight against stigma and discrimination may benefit from individuals’ capacity to counteract stigma (=stigma resistance). In our recently published study[i] stigma resistance emerged as a separate construct. The very nature of stigma resistance, however, is still not fully revealed.

The aim of our study is to shed more light on stigma resistance and gain a better insight in its genesis and impact.

Qualitative interviews are carried out with patients with schizophrenia and schizoaffective disorder following a semi-structured guideline. Transcripts of recorded interviews are coded and analysed thematically using a modified grounded theory approach. Interviews are continued until theoretical saturation is achieved.

Preliminary results relating to the genesis of stigma resistance, its contribution to auto-protection and the concepts of life of a patient, as well as their influence on recovery will be presented.

Finding out more about determinants and consequences of stigma resistance could be a crucial step in improving the effectiveness of interventions targeting stigma and social exclusion.

Although it is well established that patients with schizophrenia demonstrate cognitive impairments, little is known about their complaints concerning their cognition. We investigate the association of these complaints with clinical symptoms, global functioning and cognitive performance.

93 patients with chronic schizophrenia (mean age = 42,59 years, SD = 9,83; mean illness duration = 18,43 years, SD = 11,84) were recruited from one psychiatric department. Their cognitive complaints (Subjective Scale to Investigate Cognition in Schizophrenia-SSTICS), clinical symptoms (Calgary depression scale-CDS, PANSS, GAF), and neuropsychological performance (7 non-verbal CANTAB tests involving psychomotor speed, attention, memory, and executive function and WAIS-III) were assessed at a time that they were able to cooperate with neuropsychological testing. Correlation analyses were performed between SSTICS scores and measures of symptoms, functioning or cognition, using the SPSS.

SSTICS total score positively correlated with CDS total score (Spearman's rho = 0.311, p = 0.03). Positive correlations were also found between the SSTICS items and CDS total score. Similarly, SSTICS total score positively correlated with PANSS total score (Pearson r = 0,294, p = 0.04). PANSS negative and general psychopathology scores (r = 0,219, p = 0.035 and r = 0.333, p = 0.01, respectively), but not PANSS positive scores accounted for this relationship. SSTICS total score negatively correlated with GAF (rho = −0.251, p = 0.017). No significant associations were revealed between SSTICS total scores and PANSS insight item, PANSS cognitive score, CANTAB or WAIS scores.

The complaints of patients with schizophrenia about their cognitive impairments are mostly related to their depressive, negative, general psychopathological symptoms and global functioning, rather than their actual cognitive deficits.

There is currently a variety of initiatives to improve the quality of care for schizophrenia, but there is no established core set of quality indicators in schizophrenia. In 2009, Weinmann and Becker published a set of indicators for quality monitoring of schizophrenia care. This study aims to evaluate the feasibility of these indicators.

Adult schizophrenic patients insured by the Federal Association of Local Health Insurance Funds (AOK) were recruited in two large psychiatric hospitals. Participants were evaluated using PANSS, CGI, Camberwell Assessment of Need-European Version (CAN-EU) and the Verona Service Satisfaction Scale (VSSS) at discharge and after six month. Furthermore, 18-month AOK administrative data was available for all patients included. Feasibility of structural and quality indicators described by Weinmann and Becker (2009) will be tested by applying the full set of indicators.

82 patients with a mean age of 40 and an average GAF score of 44.3 were included. We were able to calculate all indicators. Outpatient data was available with a delay of over six month. Patients had on average 1.6 additional psychiatric diagnoses (S1) and a mean length of stay of 44 days (S6). 67% of the patients were satisfied with the treatment received (Q17). 25% of the patients were re-admitted to an inpatient psychiatric care within 30 days after discharge.

The usage of Quality Indicators seems to be feasible in routine care. However, delay in the availability of outpatient data has to be considered if these indicators are implemented.

In most cases, prodromal changes in behavior, lasting from several days to several years, often precede psychotic disorders and indicate the beginning of psychosis. Prodromal symptoms are nonspecific, making an accurate detection difficult. It is typical that the earlier stadium of the appearance of the disorder, the more insidious the prodromal stage is.

Retrospectively, authors analyzed periods of nonspecific symptoms in ten patients, aged 16 to 20 years, who developed a clinical picture of psychosis.

The most frequent prodromal symptoms in our research were anxiety, irritability and sleep disorder, which were followed by the attention deficit disorder, a sense of confusion and difficulty in dealing with the environment, accompanied by social withdrawal.

Authors pay attention to the cognition and early detection of prodromal symptoms, which gives the opportunity for earlier therapeutic interventions in the course of the disorder and the possibility for a better outcome and prognosis of the disorder.

Event-related potentials are a powerful tool for real-time investigation of the brain’s electrical activity during cognitive processes. There is little data in literature on P 300 evaluation among adolescents suffering from schizophrenia psychosis.

Our goal was to see the relation between the clinical symptoms, improvement of symptoms and medical state on P 300. P 300, were recorded in two adolescent patients - one, with a first episode of psychosis, and another, with long-term diagnosis of schizophrenia. The P 300 wave was evaluated at the begining of the medical treatment and after 8 weeks of medication. We also monitored patient’s clinical state and looked for any improvements on the PANSS.

At the start of the tretman we found a reduced amplitude and a prolonged latency of the P 300 wave. In a follow-up test, a well-formed responses of latency and amplitude, within normal range, were detected in the first case, which coincided with improvements of clinical state and on the PANSS. In the second case, despite an observed clinical improvement and an improvement on the PANSS, the P 300 wave of the patient remained unchanged when compared with the first test.

Our humble results in the context of adolescent schizophrenic psychosis fit in with the fact that the P 300 wave is modulated by changes in positive, but not by changes in negative symptoms or different neuroleptics, which may go to further the claim that the P 300 wave can depend on the clinical state of the patient.

For antipsychotic therapy and for schizophrenia associations with increased prevalence of metabolic syndrome (MetS) have been reported. This post-hoc analysis of a German, prospective, observational study assessed MetS-prevalence at baseline and month-3 in adults with schizophrenia.

Patients previously untreated (UT, N = 108; 60.2% females) or on different antipsychotic therapy (PT, N = 367; 47.7% females) were initiated or switched to new antipsychotic medication at baseline (choice unrestricted). Analyzed were patients with complete metabolic data (fasting blood samples, physical parameters, baseline/month-3) without medication change. Prevalence of MetS (AHA/NHLB-definition) and MetS-factors were determined; 95% confidence intervals (CI) were derived from exploratory ANCOVA analyses, adjusting for treatment group and sex.

PT had significantly higher MetS prevalence at both visits than UT (baseline: 49.9% [CI 44.6;55.1] vs. 25.9% [18.0;35.3]; month-3: 54.5% [49.3;59.7] vs. 32.4% [23.7;42.1]); MetS prevalence increased by 4.6% in PT and 6.5% in UT. At baseline, UT had significantly better values than PT for triglycerides (p = 0.0048), HDL-cholesterol (p = 0.0044), blood pressure (SBP/ DBP; p = 0.0090/0.0067), fasting glucose (P = 0.0304), waist circumference (p=< .0001). At month-3 differences were no longer significant, except for DBP (p = 0.0227). ANCOVA for both groups pooled revealed a significant effect on change from baseline for DBP (p = 0.0227), and a sex effect for fasting triglycerides (p = 0.0006) and HDL-cholesterol (p = 0.0015 in favor of women.

Physical and metabolic parameters initially were better in UT, compared to PT. At month-3, UT and PT values had converged, indicating that antipsychotic treatment may be associated with increased metabolic burden in an at-risk population.

Dysfunctional impulsivity reflects ‘recklessness without deliberation and evaluation of consequences’ and has negative consequences whereas functional impulsivity reflects ‘rapid responding to situational demands in order to maximise one's circumstances’ and often has positive consequences (1).

To examine the functional brain basis of dysfunctional impulsivity in healthy people and in people with schizophrenia.

Thirteen healthy controls and 21 schizophrenia patients (10/21 with serious repetitive violence) underwent fMRI during a Go/ NoGo task. Dysfunctional impulsivity was indexed using the Impulsiveness subscale and functional impulsivity using the Venturesomeness subscale of the Impulsiveness-Venturesomeness-Empathy questionnaire (2).

Violent patients had elevated Impulsiveness scores relative to non-violent patients and controls. Impulsiveness did not correlate significantly with task performance in healthy controls or patients. Impulsiveness, but not Venturesomeness, scores correlated during the NoGO condition with lower activity in the anterior cingulate (AC) in controls, and lower inferior temporal and hippocampal activity in patients.

These findings accord with previously reported associations between reduced hippocampal volume and dysfunctional impulsivity in schizophrenia (3) and, combined with our earlier observations of reduced AC activation during a working memory task in violent antisocial individuals (4), suggest that the influence of dysfunctional impulsivity in antisocial and criminal behaviour is mediated via deficient (inhibitory) functions of the AC and hippocampus.