In recent years efforts of identification of predictors of schizophrenia outcome have been made. Less extensive has been the study of patients' characteristics associated with duration of hospitalization due to acute exacerbation of schizophrenia. Positive and negative symptoms were found both to predict duration of hospitalization whereas the data for other sociodemographic and clinical characteristics are inadequate.

To identify patients' clinical and sociodemographic characteristics associated with duration of hospitalization in acute exacerbation of schizophrenia.

137 inpatients (98 male, 39 female) were included in the study. The association of age, sex, nationality, suicidality, education, marital status, violence and BPRS scores with the length of hospitalization was studied.

The mean age of the participants was 42.1 years ± 12.4 SD and the mean duration of hospitalization was 35 days ± 19.6 SD. No statistically significant association between any factors was found apart from BPRS score. Further analysis for correlation showed positive linear correlation between BPRS score and length of hospitalization (Pearson r = 0.232, p < 0.05).

The severity of symptoms as depicted in BPRS scores is associated with the duration of hospitalization in acute exacerbation of schizophrenia and may serve as predictor of outcome and cost in inpatient populations.

There is little, if any, guidance on how to define duration of acute admissions and how to measure their outcomes. The usefulness of widely used multidimensional scales, such as The Health of the Nation Outcome Scale (HoNOS), remains unclear.

We are conducting this study to assess outcomes through different rating scales and measure their clinical applicability on a busy inner London all-male psychiatric unit.

Sample: 40 inpatients with a psychotic disorder (F2–F3, ICD10).

Measures: HoNOS, Brief Psychiatric Rating Scale (BPRS) and Global Assessment of Function (GAF), administered both on admission and at 4 weeks or discharge, whichever occurs sooner.

13 male patients (age: 36.8 ± 10.1, range: 19–49) have already been recruited. On discharge HoNOS (8.38 ± 6.2), BPRS (26.9 ± 10.0) and GAF (57.5 ± 13.3) demonstrate a significant improvement (t test, p < 0.01) in comparison with admission, 13.6 ± 7.0, 44.4 ± 17.4 and 36.7 ± 7.7, respectively.

We found no correlations between the scales on discharge.

A significant correlation (r = 0.636, p = 0.02) was found between HoNOS improvement and GAF improvement, yet we did not find significant correlations between either BPRS improvement and HoNOS improvement or between BPRS improvement and GAF improvement.

These preliminary results demonstrate that our patients improve over the first 4 weeks of admission. Clinical improvement may encompass two separate but related dimensions, psychiatric symptoms and social functioning. Further work is needed to clarify which scale captures these domains to best inform therapeutic and economic decisions such as length of admission.

A review of studies examining the frequency of depression in schizophrenia found prevalence rates ranging from 7% to 75%. This wide range could be reasoned by the in proper selection of the instruments used for assessment.

To answer a question; is there a relation between the used depression scale and the category of schizophrenia and/or depression.

To compare Hamilton (HAMD) and Calgary (CDRS) depression scales in assessing depression in schizophrenia.

385 schizophrenic patients were recruited from Institute of Psychiatry Ain Shams University hospitals and asked to complete Structured Clinical Interview for Diagnosis section for schizophrenia and depression, socio-demographic sheet, medical history sheet, HAMD, CDRS, and Positive and negative Psychotic Symptoms Scale (PANSS).

Depression was found as; disorder (66.2% by HAMD and 39.2% by CDRS), no depression (18.2% by HAMD and 33.2% by CDRS) and symptoms (15.6% by HAMD and 27.5% by CDRS). Agreement of both scales in diagnosing depressive disorder is higher in chronic schizophrenia (62%) than in acute one (50%) and found mostly in continuous and remittent course. No significant correlation was found between CDRS and PANSS scores, while for HAMD, total score for depression was significantly correlated with all psychotic symptoms scores only in schizophrenic patients with depressive disorder.

CDRS is more valid in classification of depression categories in schizophrenia than HAMD. It is more sensitive and specific instrument for assessing depression in schizophrenia than HAMD. However, HAMD may be suitable with acute schizophrenia and remittent course.

Psychiatric research focuses on development of psychosis and first- episode schizophrenia, early detection and Premorbid adjustment are of interest because it may reduce the heterogeneity of the disorder and may have predictive value.

To study the Premorbid functioning in first episode schizophrenic patients and its relation with symptoms severity, cognitive and executive function as well as it s predictive measure for short term degree of improvement.

Fifty patients diagnosed according to ICD -10 criteria as first episode schizophrenia were conducted to Positive and Negative Syndrome Scale (PANAS), Modified Premorbid Adjustment scale (MPAS), Social Readjustment Rating to evaluate severity and pattern of the symptoms and Premorbid function as well as psychometric assessment including IQ, Wisconsin Card Sorting test (WCST) and Eysenck personality Questioner (EPQ).

Seventy percent of patients showed a disturbance in Premorbid function 38 % had deteriorating Premorbid functioning while 32% have stable poor Premorbid function The deterioration of Premorbid function was statistically correlated with negative symptoms, thought disturbance, and anergia as well as poor total score of WCST and low IQ. Impairment of executive functions were related to severe paranoid symptom and aggression.

Our study emphasized the importance of measuring Premorbid adjustment to people at risk for schizophrenia in order to detect more precisely the earliest symptoms for early prevention of schizophrenic disorder.

The occurrence of sexual dysfunction, including erectile dysfunction (ED) induced by antipsychotic drugs complicates the treatment of schizophrenic patients, particularly because of treatment interruption.

Assessing the prevalence and the associated factors of ED in a population of schizophrenics under antipsychotics.

it's a cross-sectional study including 52 schizophrenic patients (DSM-IV criteria), in a stabilized state (Global assessment of functioning: GAF > 61) for at least 6 months. ED was assessed by the IIEF-5 (International Index of erectile dysfunction).

The average age of this population is 35.77 years. The majority have paranoid schizophrenia form. 29 are under atypical antipsychotics (AA) and 20 under classic antipsychotics (CA), while 3 patients are on combination of the two.

The prevalence of ED is 63.5%, with an average of the IIEF-5= 17.98 ± 4.55. (18.75 (AA) vs 17.45 (CA) [p = 0.34]). Univariate logistic regression showed that the presence of ED is related to the type of schizophrenia (paranoid), and the combination of antipsychotics. However, these two factors appear no more influential after multivariate analysis.

Erectile dysfunction induced by antipsychotics is frequent, it's impact is detrimental to the prognosis of schizophrenia in general. Clinicians should be familiar with the diagnosis, evaluation and Treatment of this side effect.

Genetic factors that modulate the immune response have been implicated as risk factors both for schizophrenia as well as for cognitive impairments (endophenotypes of schizophrenia). Regulation of immune response is mediated by two related receptors: CD28 is a major co-stimulator, whereas CTLA-4 performs negative regulatory functions. Balance of immune response depends on the expression of these regulatory molecules due to their genes polymorphisms.

The study was carried out to investigate the association between polymorphisms of two genes: CTLA-4 (49A/G, −319C/T, CT60 A/G) and CD28 (+17C/T) and frontal lobe functions in patients with schizophrenia.

118 patients diagnosed with schizophrenia (ICD-10) and 352 controls were included in the study. Frontal lobe functioning was assessed by Trail Making Test (TMT) and Stroop Test (SCWT).

There was no significant difference in distribution of genotypes between patients and controls in the polymorphisms of CTLA-4 gene, but in polymorphism of CD28 gene (p = 0,0007). With respect to +17C/T CD28 gene polymorphism there was a trend level difference in performance on TMT: C allel carriers performed worse that T allel carriers (p = 0,054), suggesting weaker executive control function.

Our data support a role of CD28 +17 C/T gene polymorphisms for the predisposition to schizophrenia. Among patients the distribution of genotypes of CD28 gene polymorphism is similar to that found in patients with autoimmune disorders such as: early onset type 1 diabetes and Behçet's disease. Additionally, +17C/T CD28 gene polymorphism might be considered as a risk factor for cognitive impairment in schizophrenia.

Schizophrenia has been associated with disrupted neural networks, which can be documented by the changes in EEG. NMDA antagonists as well as 5-HT2 agonists induce psychosis-like symptoms in animals and humans.

Spectral analyses of NMDA antagonists/5-HT2 agonists have been performed by many authors, however no EEG coherence and spectra was analyzed with a higher number of cortical electrodes.

The aim of this study was to compare the effect of mGlu2/3 agonist, 5-HT2A/D2 antagonist, D2 antagonist and AMPA antagonist on quantitative EEG changes in glutamatergic and serotoninergic animal models of psychosis.

Male Wistar rats were treated with either NMDA antagonist or 5-HT2A agonist. Subsequently mGlu2/3 agonist, 5-HT2A/D2 antagonist, D2 antagonist or AMPA antagonist were applied. Stereotactical implantation of 14 electrodes was performed before EEG recording. During EEG recording, the signal was recorded simultaneously from 12 implanted electrodes located bilaterally in frontal, parietal and temporal regions while the animal's behavior was continuously observed. Subsequent power spectral analysis and the EEG coherences were assessed with the observed passive behaviour.

Agonist of mGlu2/3 receptor normalized power spectral changes induced by ketamine. AMPA antagonist had an only partial effect on power after administration of MK801 without any effect on 2C-B. Both D2 antagonists partially normalized power spectral changes. In EEG coherences, intra- and interhemispheral changes in both animal models of psychosis were not completely normalized by applied treatments.

The presented data will be discussed in relation to data already identified, as well as data found in schizophrenic patients.

Cotard's syndrome is a rare psychiatric syndrome, which is well- known since more than one hundred years. It's core symptom is nihilistic ideation or delusion. In this case report, the effect of culture on forming the symptoms of a female patient with Cotard's syndrome was the matter of concern.

A single case with Cotard's syndrome associated with out of body experience and depersonalization and complicated grief was reported. she believed that she was killed by a superstitious creature named “Aal” in Persian folclor.

Cultural and superstitious beliefs could effect on forming complex constellation of patients symptoms including Cotard's syndrome. The resolution of symptoms might be step by step.

Symptomatic remission is an important outcome of schizophrenia however its association with social functioning (SF) and quality of life (QoL) hasn't been fully recognized.

To assess SF and QoL in association with remission status according to Andreasen criteria.

This was a study of a group 64 patients hospitalized for the first time between 1998 - 2002. They were assessed 1 month following discharge (T. 1), 12 months later (T. 2), 4 – 6 years after T.1 (T. 3) and 7–11 years after T.1 (T. 4).

During the observation 17.2% were remitted (Group 1), 37.5% were remitted or non remitted (Group 2), and 45.3% were non remitted (Group 3). There were differences between the groups however SFS and QL didn't change.

Close association between remission status and SF and QoL suggests that remission status may be a good indicator for SF and QoL in schizophrenia.

The functional deterioration is observed in the majority of the patients with schizophrenia and much importance is given in this diagnosis when a retrospective analysis is carried out on the history of this disease. The value scales have been an important key at the time of detecting deteriorating elements, being these very useful as a screening tool and hence a development control.

The objective is to demonstrate the good management of the use of the scales of which we have available and in this way can value the functionality of the psychotic patients as well as it's evolution.

When choosing the medication, the degree of functionality measured by means of the use of the scales- confirmed a 65% an initial better response to the antipsychotics paliperidona, that in that not used drug, that initially showed an improvement of 40%.

A retrospective study was carried out in the last year with the 82 patients of our CSM with schizophrenia diagnosis, all treated with antipsychotics.The Sample was divided into two groups of 41 patients, those of which besides the medication had been evaluated and followed by means of scales and the other in which they only took medication, with standard pursuit.

The ease of use of scales as well as its great utility should help to promote its routine use to be able to obtain an improvement of the function of the patient and, to optimize the long-term prognosis for patients.

Social support is important for Caregivers of psychotic patient to bear the burden of care.

The purpose of this study was to investigate the influence of sociodemographic factors on caregivers of psychotic patient.

The present study aimed at evaluating the influence of sociodemographic factors in caregivers of psychotic patient who live in Patra, Greece.

89 caregivers of psychotic patients participated to the present study. The Social Support Questionnaire - Short description (SSQ-6) of I. Sarason et al was used. The questionnaire was filled in after a personal interview during the period January - December 2011.

The mean value of subjective perception of social support in the sample was 16,606 (SD = 10.941), while men exhibited a lower score [mean: 15.523 (SD = 13.855] than women [mean: 16.941 (SD = 13.855)]. The mean value of satisfaction from social support was 27.674 (SD = 27.674), while men exhibited a lower score [mean: 24.476 (SD = 8.388] than women [mean: 28.66 (SD = 6.890)]. The SSQ1 was statistically significantly correlated with employment status (r = 0.335, p < 0,001) and self-perception of their health (r = -0. 324, p < 0.005), while the SSQ2 was statistically significantly correlated with educational level caregiver (r = 0.290, p < 0.01) and their monthly income (r = 0.333, p < 0.001).

The results showed that psychotic individual's caregivers have smaller social network and a lower level of satisfaction from social contacts than the general population.

The subclinical characteristics of schizophrenic children have not been sufficiently investigated to present specific evidences. To elucidate the picture of them, and to find out indicators which predict later development of schizophrenia, childhood behaviors of the adult schizophrenia subjects were investigated in a questionnaire-based retrospective study.

Schizophrenia outpatients (n = 30) in his/her twenties and normal healthy subjects (n = 200) were investigated. All patients are diagnosed according to DSM-IV-TR as schizophrenia, and who present now mainly negative symptoms after passing an acute stage. By modified use of the CBCL (Child Behavior Checklist) as a retrospective assessment questionnaire, the parents of the patients and of control subjects rated their childhood behavior.

The hit-rate when classifying the schizophrenic and normal subjects by discriminant function using the syndrome scales of CBCL totaled 89,0%. Notable in an item-level analysis was an extremely attenuated aggression in personal relations in the schizophrenia subjects. Among eight subscales of the CBCL, those of Withdrawal, Social Problems, Attention Problems and Aggressive Behavior contributed most to the accuracy of the prediction of group membership.

The results suggest that subclinical behavioral and psychological characteristics of schizophrenia already exist in the patients' childhood. The quite early detection of schizophrenic children seems possible.

Partial/non-adherence to medication is common amongst patients with schizophrenia. Nurses play an important role in assessing and managing mental health problems and are often involved in helping patients manage and adhere to their medication. As such, the perception of nurses regarding the burden and potential causes of non-adherence is vital in addressing the adherence problem.

The ADHES nurses survey collected opinions of nurses across the EMEA (Europe, Middle East and Africa) region.

To ascertain nurses' perceptions of assessment, potential causes and management of partial/non-adherence to medication in patients with schizophrenia.

The survey was conducted from January-March 2010 in 29 countries across EMEA, comprising 14 questions addressing the issue of partial/non-adherence and the use of long-acting injectable (LAI) antipsychotic medication in patients with schizophrenia.

Results were obtained from 4120 respondents. Nurses estimated high levels of partial/non-adherence (mean 54%) amongst patients with schizophrenia and 85% believed improving medication adherence would have a huge/sizable impact on patient outcomes. 93% believed that continuous medication with an LAI would have long-term benefits for patients with schizophrenia, and that many patients (mean 40%) would prefer LAI medication.

Nurses recognize the issue of partial/non-adherence to medication in patients with schizophrenia. Most nurses believe patients are well informed about LAI antipsychotics, however, approximately a third of nurses believe patients to be poorly informed. There is a need to address the problem of partial/non-adherence in clinical practice with a multidisciplinary approach to avoid suboptimal treatment outcomes in patients with schizophrenia.

Schizophrenia is a serious mental illness that carries a significant burden for families providing care.

The ADHES carers' survey canvassed opinions of families/friends of patients with schizophrenia across Europe.

To ascertain carer attitudes towards schizophrenia, its treatment and treatment adherence.

The survey was conducted from January-April 2011 in 16 European countries, comprising 10 questions relating to the respondents' understanding of schizophrenia, attitudes towards schizophrenia treatments, and perception of the family's/friend's role in supporting patients with schizophrenia.

Results were obtained from 138 respondents. 76% of carers recognized the importance of medication to help patients get better, improve their quality of life (77%) and relationships (74%). 67% of carers responded that they believed schizophrenia treatment damages patients' general health. Two-thirds of the carers reported that treatment adherence was a burden for the patient and over a third of carers indicated that it was a daily struggle to get patients to take their medication. 50% of carers considered the benefits offered by long-acting injectable antipsychotics as very/quite important and thus, could provide a valuable tool in improving treatment adherence. 92% of carers agreed on the importance of family support to boost treatment adherence with education/information deemed important for families and patients alike.

Carers recognize the issues they face in caring for patients with schizophrenia and their role in improving partial/non-adherence to medication, especially to avoid suboptimal treatment outcomes. The important role of family carers should be considered by healthcare professionals when treating patients with schizophrenia.

Many patients with schizophrenia show major difficulties in performing basic social roles. Occupational and social functioning (and independent living) are considered domains of functioning. Improvement in functioning is recognized as an important aim in treatment guidelines and as an outcome by regulatory agencies.

The Europe, Middle East and Africa (EMEA) functioning survey canvassed opinions of psychiatrists (and neurologists with psychiatric backgrounds in Germany) across the region.

To ascertain psychiatrists' perceptions of the clinical importance, assessment and management of functioning amongst their patients with schizophrenia.

The survey comprised 17 questions and was conducted from March-April 2011, in 39 EMEA countries. Respondents' demographics and their opinions regarding personal and social functioning in patients with schizophrenia were collected.

Results were obtained from 3610 clinicians. Psychiatrists reported that they perceived more than two in three of their patients show impaired/very poor levels of functioning. 91% believed that personal and social functioning was an important treatment goal for patients with schizophrenia and 90% believed it was an important goal for patients' families. The majority of psychiatrists assess the personal and social functioning of their patient at each visit but 81% determine the level of functioning through clinical interview. To manage personal and social functioning in their patients, 26% of psychiatrists prefer pharmacological interventions while 47% prefer psychosocial interventions.

Although psychiatrists recognize that functioning is impaired/very poor in patients with schizophrenia, there is still a need to address it as a main treatment goal for patients with schizophrenia.

Recognition deficits in facial affect tend to be regarded as a vulnerability marker in schizophrenia. Unlike complex electrophysiological markers, recognition of facial emotions is relatively easy to assess and could be a useful test to identify individuals at risk.

To assess the recognition of facial emotions in a Tunisian population, confirming deficit in patients with schizophrenia unlike controls, and to a lesser level in their first-degree relatives. Performance of the designed test, as a vulnerability marker, was discussed.

One test was constructed from photographs of a famous actress face representing the Ekman's six basic emotions: happiness, anger, disgust, sadness, fear, and surprise. Maximum score was six. The test involves first the recognition of gender.

This test has been proposed to three groups: one group of patients with schizophrenia (n = 34), a group of first-degree relatives (n = 27) and a control group (n = 57).

Recognition deficits of emotions have been found in both patients and their first-degree relatives. Those recognition deficits were absent in the control group regardless of age, sex and educational level. The results also showed that this test is quite specific (77%) and sensitive (84%).

The findings suggest that patients with schizophrenia and their first-degree relatives are impaired of facial emotion recognition skills when compared with controls. This impairment may be a reflected endophenotype, and the constructed visual test should be used as a screening tool for people at risk of schizophrenia.