Patients with schizophrenia have an increased risk of venous thromboembolism (VTE). The increased risk is more marked among new users and those prescribed atypical antipsychotic drugs. Platelet activation, changes of plasma coagulation, or fibrinolysis are likely to be responsible for the increase in thrombotic events.

In the prospective ANTRE (ANtipsychotics ThRombosis Embolism) study we investigated the plasma levels of markers indicating activation of platelets (soluble P-selectin), coagulation (factor VIII) and fibrinolysis (D-dimers) in a group of thirty patients (seventeen males) with newly diagnosed psychosis (mean age 28.2, range 18–52 years) and in thirty-one healthy volunteers who were matched for age, gender and body mass index. We measured the haemostatic parameters at the time of patients’ admission) and after three and twelve months during outpatient antipsychotic treatment.

At baseline there were significantly increased plasma levels of sP-selectin (P = 0.0003), D-dimers (P = 0.0007) and factor VIII (P = 0.0076) in the group of patients with acute psychosis as compared to healthy volunteers. After three and twelve months of patients’ follow up we still observed increased levels of sP-selectin and D-dimers. Plasma levels of factor VIII were significantly increased after 3 months, but decreased after 12 months.

We found an increase in markers of activation of haemostasis in patients in acute as well as in chronic stage of psychosis. Our results could explain the possible pathological mechanisms of VTE that are independent from antipsychotic treatment and play a role mainly in the acute phase of the disease.

Many work in the field of sleep research, have lead to the development of hypotheses on the neurobiological mechanisms underlying dream mentation that may prove useful to our understanding of psychosis. From a phenomenological perspective, formal features globally defined as cognitive bizarreness have been shown to be equally represented in the dream and waking mentation of both schizophrenic and manic psychotic patients as in the dreams of healthy subjects.

The objective of this study was to perform a content analysis on a sample of dreams reported by psychotic patients and by a healthy control population.

We want to evaluate whether the dream experience is influenced or not by the state of acute psychosis.

We analyzed 210 dream reports of 72 inpatients ward for an acute psychotic break, 36 males and 36 females. Content analysis was performed by using the Hall/Van de Castle Scale, so the contents of dream reports were grouped into 9 categories (characters, social interactions, activities, emotions, settings, objects, descriptives, fortune/misfortune, success/failure). All contents were then quantified and compared with those found in the healthy control population.

The only statistically significant differences were a lower number of familiar settings in the dreams of female psychotic patients (h = −0.51) and lower aggressivity indices in the dreams of male psychotic patients (h = −0.49).

As dreams are basically the same in patients and controls, we can argue that the dreaming mental activity is not directly influenced by the psychotic mental state.

It is hypothesized that in the etiology of schizophrenia genetic and environmental factors are involved. Between the environmental events linked to the causation of this condition an inmune dysfunction has been described. First degree biological relatives of people with schizophrenia also have an incrased incidence of autoimmune diseases.

The aim of this work was to examine the serum levels of proinflammatory cytokines (IL-1β, sIL-2R IL-6, IL-12p70, TNF-α and IFN-γ) as well as of anti-inflammatory cytokines (IL-4 and IL-10) in male patients with schizophrenia and in their first degree-biological relatives.

Blood samples were obtained from patients with a diagnosis of schizophrenia in a stable psychophatological condition (n = 36), first degree biological relatives of those patients and a healthy control group (n = 26). Serum interleukins were analyzed using a commercial ELISA preparation (Bender MedSystems). We used non-parametric test for statistical analysis.

Patients with schizophrenia showed significantly higher serum levels of proinflammatory cytokines (sIL-2R, IL-6, TNF-α, IFN-γ and IL12-p70) and lower serum levels of the anti-inflammatory cytokine IL-4 than in the healthy control group. The unaffected first-degree relatives showed changes in proinflammatory cytokines (sIL-2R, IL-6 and TNF-α,) in the same way as the corresponding schizophrenia patients, but at a lower level than the healthy control group.

Ours findings suggest that sIL-2R, IL-6 and TNF-a may be biologic vulnerability markers for psychiatric disorders and also these alterations might have an hereditably pattern.

Some psychiatric diagnoses are stigmatizing. In August of 2002, the Japanese Society of Psychiatry and Neurology decided to change the name of schizophrenia in Japanese from seishinbunretsu-byo (‘split mind disease’) to togoshitcho-sho (‘loss of coordination disorder’). The objective of the present study was to investigate whether there was the same movement internationally or not, and how the experts in different countries thought about the term ‘schizophrenia’.

To attempt to gain insight into the thinking concerning this point among international psychiatric authorities, we conducted a survey in 2010. This questionnaire was sent to members of the Section on Schizophrenia of the World Psychiatric Association, the European Psychiatric Association and schizophrenia experts of the Asian Federation of Psychiatric Associations via email. The mean years of the respondents' experiences as psychiatrists was 18.6 years (SD; 10.1).

65% of respondents said that the term “schizophrenia” was not an appropriate term, and 89% replied that it denoted stigma. In addition, 67% replied that “schizophrenia” should be renamed to another term and 59% replied that the new name should convey acceptable scientific concept about the disorder.

The results of this survey were obtained from only 46 experts, although they were from throughout the world. However, we believe that now is the time to think whether the term “schizophrenia” should be changed or not, considering that the release dates of the ICD-11 and DSM-5 are approaching.

Cardiovascular illness may partly explain why patients with schizophrenia die at least 20 years earlier than general population. Monitoring and screening for cardiovascular risk factors was recently recommended in schizophrenia treatment guidelines. High-sensitivity C-reactive protein (hsCRP) is one of the inflammation mediators that has been widely used as a biomarker for predicting the occurrence of future cardiovascular (incl. thromboembolism) events in somatic medicine, but not in psychiatry.

In the prospective ANTRE (ANtipsychotics ThRombosis Embolism) study we investigated the plasma levels of hsCRP and lipids and measured weight and BMI (Body Mass Index) in a group of thirty patients (seventeen males and thirteen females) with newly diagnosed psychosis (mean age 28.2 ± 8.0, range 18–52 years). Control group consisted of thirty-one healthy volunteers matched for age, gender and body mass index. We evaluated the haemostatic parameters at the time of admission and after three and twelve months during antipsychotic treatment.

Weight (mean 67.6 versus 77.2; P = 0.00002), BMI (median 21.6 versus 26.1; P = 0.001), hsCRP (median 1.0 versus 2.5; P = 0.0009), total cholesterol (4.6 versus 5.3; P = 0.016) and atherogenity index (2.1 versus 3.0; P = 0.016) were significantly increased in the study group compared to controls.

We found increased markers of cardiovascular risk in patients with psychosis during first year of treatment. Particularly increase of hsCRP may be associated with cardiovascular events in schizophrenia patients.

Schizophrenia is a very incapacitating mental diseases. A lack of pharmacological adherence drives to an increased relapse and hospitalizations incidence. Strategies focused on improving adherence could benefit patients and improve their quality of life (QoL).

To assess improvements on QoL by increasing treatment adherence.

This was a national, multicentre, open-label randomized clinical trial to evaluate the efficacy of a Short Message Service (SMS) system on improving adherence in schizophrenic patients. Patients in the SMS group received reminders via mobile phone about their medication during the first 3 months after inclusion. Controls were not sent any reminder and received standard care. Adherence was assessed by mean of the 4-item Morisky-Green test (Medication Adherence Questionnaire, MAQ) and attitude towards medication was assessed by the 10-Item Drug Attitude Inventory (DAI-10) at baseline and 3 and 6 months after the inclusion. QoL was assessed by the EuroQol (EQ-5D) questionnaire at the same visits.

Based on Intention To Treat (ITT) population, 100 (39.4%) patients comprised the SMS Group, whereas 154 (60.6%) patients were controls. There were not statistically significant differences on demographic characteristics between both groups. More patients improved their adherence (MAQ) in SMS group compared to the control group [44.0% vs. 28.6% (p = 0.012)]. No significant differences were found regarding attitude towards medication (DAI-10), however improvements in DAI-10 were associated with improvements in EQ-5D [82.5% vs. 64.9% (p = 0.029)].

SMS reminders improved adherence to treatment and improved patients’ outcomes with a positive impact on QoL.

Today we have a large number of articles that investigate oxidative stress and potential role of nitric oxide (NO) in the pathophysiology of schizophrenia and a lot of evidence of altered antioxidant capacity. Interesting scientifically facts is that bilirubin acts as an endogenous scavenger of NO, giving him the role of antioxidant that is reduced in schizophrenia.

Antioxidant properties of bilirubin through its interaction with the nitric propose that bilirubin-nitric oxide as a new biomarker of oxidative / nitrosative stress.

The aim of our study was to investigate possible correlation between serum levels of nitric oxide and bilirubin in patient's whit schizophrenia.

The study was consisted of 50 patients with schizophrenia and 50 healthy controls. We investigated the levels of nitric oxide, which is determined by conversion of nitrate to nitrite and then measuring with Greiss reagent, but only in group patients we measured the mean levels of bilirubin, within of course of illness.

Mean of NO between group patients and controls are statistically significant (CI = 13.31–27.29, t = 5.863, p = 0.0001). The average value of total bilirubin in patients suffering from schizophrenia was presented with SD = 11.77; 6.06 ± 0.86, and is statistically significant differences between the flow of diseases with the level of bilirubin, where the highest values detected markedly with the first hospitalization.

Antioxidant capacity of schizophrenia decreases with the progress of the disease. We can deduce that imbalanced between NO and bilirubin participates in the pathogenesis basis of schizophrenia.

Many patients with schizophrenia are unaware of the symptoms and consequences of their illness. Poor insight has been associated with medication non-adherence, frequent relapses, and poor prognosis.

To assess the effect of daily Short Message Service (SMS) reminders on patients’ insight.

A multicenter, prospective, randomized, controlled study was conducted. Outpatients with at least 18 years old, diagnosis of schizophrenia (DSM-IV), and adherence problems (at least one affirmative answer Morisky Green questionnaire) were included. Participants were randomized to receive a daily SMS reminder on their cell phone to take their medication in the following 3 months or current standard of care. Insight was assessed using the Scale to Assess Unawareness of Mental Disorder (SUMD) at baseline, month 3 and 6.

254 patients were analyzed. Mean age: 39.7 years (SD = 11.03), 66.5% men. Baseline socio-demographic and clinical characteristics were similar between groups. Baseline mean general insight score (SUMD items 1 to 3) was 6.16 (SD = 3.36) in the intervention group and 6.93 (SD = 3.01) in the control group, p = 0.05. At month 3, patients in the intervention group presented a higher insight vs. control: 5.51 (SD = 3.14) and 6.28 (SD = 2.91) respectively. The absolute difference mean SUMD score between groups: −0.77 (95% CI −1.53, −0.01; p = 0.04). Patients in the intervention group persisted with a better awareness of illness three months after stopping SMS (month 6): mean difference score −1.01 (95% CI −1.80, −0.21; p = 0.01).

A SMS-based intervention with daily reminders to take medication showed an insight change in a sample of non-adherent outpatients.

Three clinical “dimensions” are identified for schizophrenia: positive (delusions, hallucinations, thought automatism), disorganization (inappropriate affect, bizarre behavior, formal-thought disorders), negative (affective flattening, alogia, abulia-apathy, anhedonia-asociality).

To evaluate Individual Profile of Functional Asymmetry (IPFA) influence on schizophrenia's clinical polymorphism.

To compare IPFA in 90 healthy subjects and 90 schizophrenic patients in three clinical groups, depending on prevalence of positive, negative symptoms or disorganization.

SAPS/SANS; dichotic listening; test “card with the hole”, “viewing through a telescope”; accuracy of tracking and key press speed tests; SPSS’10.0. The coefficient of right ear (CRE), the coefficient of right hand (CRH) were calculated; seven IPFA types determined by CRH/CRE ratio, depending on function's laterality type and degree.

Patients unlike controls revealed: higher frequency of right-sided hearing asymmetry (50% vs. 22%), higher average values of CRE (9,57% vs. 3,1%) and |CRE| (19,98% vs. 10,63%), higher rates of IPFA types with minimal excess |CRH| over |CRE| (less than 5 times) (30% vs.20%) and “inverted” types (|CRE|>|CRH|) (15.5% vs. 5.5%). Controls were more likely to have large predominance of CRH over CRE (more than 5 times) (17.8% vs. 5.6%).Ambidexterity dominated in “negative” dimension group, right hand prevailed in others. Positive symptoms degree directly correlated with CRE. “Negative” type inversely correlated with CRH and |CRH|.

Increased right-sided hearing asymmetry points to verbal agnosia of signals coming from the left-side auditory space, which is more related to positive symptoms; negative symptoms are more related to motor function's symmetry. Protective and promoting IPFA types determined.

Poor adherence is a major obstacle in the management of patients suffering from schizophrenia. Previous studies on adherence have addressed the role of patients' subjective feelings and attitudes towards treatment. Rebelliousness is a more general cognitive-behavioral trait. No attempt has been made to investigate the correlation between rebelliousness and adherence to treatment.

To evaluate rebelliousness levels and their possible correlation with adherence among patients suffering from schizophrenia-spectrum disorders.

1) Compared rebelliousness levels among healthy subjects, patients suffering from schizophrenia spectrum disorders, and non-psychotic patients.

2) Examine the correlation between levels of rebelliousness and nonadherence among patients.

Rebelliousness was evaluated among 75 patients suffering from schizophrenia or schizoaffective disorder, 53 patients suffering from non-psychotic disorders, and 64 healthy subjects using the Rebelliousness Scale. Patients' adherence was evaluated using the Drug Attitude Inventory (DAI-10).

A significant negative correlation was found in the schizophrenia group between levels of rebelliousness and adherence (r = −.434, p < .001). In a regression model rebelliousness levels were found to be the strongest predictor of adherence (β = −0.236, p < .05) compared with other demographic variables. No significant difference was found in the levels of rebelliousness among the schizophrenia, non-psychotic disorders, or control groups.

Rebelliousness seems to be an independent predictor of adherence, specifically among patients suffering from schizophrenia. If future prospective studies replicate our results the Rebelliousness Scale might serve as an efficient tool to predict adherence.

Although there have been many cross-sectional studies of the relationships between social support and level of functioning for individuals with psychotic disorders, there have been few reported prospective studies.

To examine the importance of social support early in the treatment of individuals with a psychotic disorder as a predictor of functional status at five year follow-up.

Social support of 132 patients with a psychotic disorder was assessed at the time of entry into treatment and one year later. Five year functional outcomes were assessed using the General Assessment of Function (GAF), number of weeks of full-time occupation and weeks on a disability pension during the fourth and fifth year of follow-up.

Social functioning assessed at initiation of treatment and at one year were significant predictors of general functioning, use of disability pension and full-time occupation at five year follow-up. This relationship was independent of other predictors such as gender, age of onset, treatment delay and early symptoms.

Level of social support is an independent predictor of five year outcome for patients at early stages of treatment of psychosis. These findings provide further evidence the probable value of interventions that increase supportiveness of the social environment of those with psychotic disorders.

In the course of schizophrenia, motor disturbances are observed both clinically and subclinically.

The aim of the study is to evaluate graphomotor functions in the patients with schizophrenia treated with atypical and typical neuroleptics, and to compare the parameter values with those of the healthy subjects.

Participants: 30 patients with schizophrenia treated with typical (10 patients) and atypical (20 patients) neuroleptics. The group included 10 women and 20 men (mean age 38.5 ± 10.46 years). The control group consisted of 20 healthy volunteers (8 women and 12 men, mean age 36.75 ± 20.79 years). Features of graphomotor functions were examined by the drawing test and Reitan's Trial Making Test A and B (TMT A and B).

Data analysis indicates that there is no statistically significant difference between the parameter values found in the subjects from atypical neuroleptics treatment group compared to those treated with typical neuroleptics.

It was found that psychomotor functions performance of the patients treated with atypical neuroleptics measured by the drawing test and TMT not differ compared to the performance of the patients treated with typical neuroleptics when compared to the patients treated with typical neuroleptics.

Comparing cognitive functions of the subjects with schizophrenia and those from the experimental group, as measured by the drawing test and TMT, the patients with schizophrenia from the experimental group had worse psychomotor function values in comparison to the subjects from the control group.

The increased prevalence of metabolic syndrome in people with severe mental illness (SMI) is well documented. The International Diabetes Federation (IDF) criteria for metabolic syndrome are three or more of the following: waist circumference ( 80 cm (females), (94 cm (males) OR BMI (30, triglycerides >1.7 mmol/l or on treatment, raised blood pressure (systolic >130 mg Hg or diastolic >85 mm Hg, OR on treatment for hypertension), raised fasting blood glucose (.5.6 mmol/l) OR diagnosed type II diabetes) and reduced HDL cholesterol (< 1.03 mmol/l) OR on treatment.

The IMPACT RCT is a Department of Health funded trial of a health promotion intervention (HPI) delivered by care co-ordinators to people with SMI across South London, Kent and Sussex. The intervention is focussed on improving health by addressing modifiable lifestyle factors such as diet, physical activity, obesity, cigarette smoking, alcohol and substance use.

We investigated the prevalence of metabolic syndrome in a sample of 212 patients for whom we had relevant baseline measures.

Data (weight, BMI, waist circumference, blood pressure, fasting HDL cholesterol, triglycerides and glucose levels) were analysed on 212 patients.

45% of the sample met IDF criteria for metabolic syndrome. Mean BMI was 30.6, glucose 6.4 mmol/L, triglycerides 2.0 mmol/L, HDL 1.2 (mmol/L), waist circumference 105.8 cm, and BP 122/82 mm Hg.

Metabolic syndrome was highly prevalent in this sample, significantly increasing the risk of physical morbidity and potentially lowering life expectancy. There is an unmet need for health promotion interventions in order to lower morbidity and mortality risk in these populations.

To investigate the incidence of schizophrenia in the age group 0 to 18 years from 1971 to 2010, and compare this with the incidence of all psychiatric disorders.

Cases are selected from the Danish Psychiatric Central Research Registry (DPCRR) which includes data from all admissions to psychiatric hospitals in Denmark. The first case group is all diagnosed with an F295 (before 1994) or F20 (after 1994) schizophrenia diagnosis. The second is all incident patients with a psychiatric diagnosis. We calculated incidence rates (IR) for each year 1971–2010.

The mean IR of early onset schizophrenia (EOS) is lower in the period 1971–1993 compared to 1994–2010, for males as well as females. From 1994 to 2010 there is a significant increase in IR. From 1971 to 1993, males have a significantly higher IR than females. From 1994–2010, females have a significantly higher IR than males. Finally, EOS patients are diagnosed at a significantly lower age in the period 1994–2010 compared to 1971–1993, but this difference is not significant when stratified by sex.

There is a general increase in schizophrenia and all psychiatric disorders diagnosed over the four decades that this study spans. There is a change in the sex distribution of EOS between males and females: from an initial male dominance to an even distribution. For all psychiatric diagnosis, male predominance persists throughout the study. The increase cannot be explained by a single factor, e.g. changes in diagnostic system, organizational structure or diagnostic practice.

Expressed emotion is a significant and robust predictor in schizophrenia. High expressed emotion in carers can exacerbate psychotic symptoms in patients with schizophrenia or schizoaffective disorder. More specifically, critical attitudes towards patients by family members have been associated to a higher risk of relapse in the patients.

The aim of the present communication is to report a case of a single 38-year-old woman with the diagnosis of schizoaffective disorder since the age of 17 and to establish a correlation between her several relapses and hospitalizations and the high expressed emotion found in the family members with whom she has always lived.

Case report and review of the literature.

Similarly to this case report, several studies show that patients with schizophrenia/schizoaffective disorder from high expressed emotion households had been hospitalized more often and for longer periods than patients from low expressed emotion households.

High expressed emotion in carers is associated to an increased risk of relapse in patients with schizophrenia or schizoaffective disorder. Family interventions should be focused on improving these interactions after a psychotic relapse.

Schizophrenia is a disorder with chronic course and a need of a long-term antipsychotic treatment to prevent rehospitalizations.

To find a possible association between treatment with different types of antipsychotics and rate of rehospitalizations in patients with schizophrenia spectrum disorders.

To analyze the rate of rehospitalizations in groups of patients treated with typical, atypical and depot antipsychotics.

Data of 1400 patients discharged from hospitalization in 2010 with ICD-10 diagnoses F20.x were obtained from the General Health Insurance Company which covers the majority of the population with chronic mental disorders in Slovakia. The structure of patients according to age and sex represented the whole adult population hospitalized with diagnoses F20.x in Slovakia.

27.4% of patients had 1 to 8 readmissions after the index discharge from hospitalization in the same year. 29347 prescriptions of psychopharmacological drugs were registered for 499886 patient/days in outpatient settings. 14781 prescriptions for antipsychotics consisted of 67.3% prescriptions for p.o. atypical antipsychotics, 16.9% for p.o. typical antipsychotics, 11.5% for atypical depots and 4.2% prescriptions for typical depots. No statistically significant association between prescriptions of particular group of antipsychotics (typical, atypical, depot) and the occurrence of at least one rehospitalization was found.

No association between prescription of certain type of antipsychotic and probability of rehospitalization based on analyses of prescriptions rate could not reflect the clinical reality properly. Further analyses with consideration of dosage, combinations of antipsychotics and rate of prescriptions for individual patient should be done.