There is preliminary evidence that cognitive functioning is influenced by premorbid adjustment. The goal of this study was to examine to what extent premorbid adjustment patterns are related to cognitive functioning in a cohort of first-episode psychosis.

Seventy-seven neuroleptic-naïve patients with a first-episode of psychosis underwent clinical and neuropsychological assessments at baseline, 1 month and at 6 months of follow-up. Cognitive measurements included were: Verbal Fluency Test, Trail Making-B Test, Wechsler Memory Test, Reaction Time task, Wisconsin Card Sorting Test (WCST) perseverative errors. Patterns of premorbid functioning were categorised in two groups: ‘stable-good’ group and ‘poor and declining’ group, using the Cannon-Spoor Premorbid Adjustment Scale.

No significant associations were found between premorbid adjustment change scores and cognitive variables in the stable-good adjustment group. Patients with premorbid deterioration change score in premorbid adjustment between childhood and early adolescence was associated significantly with lower improvement at the follow-up in the Wechsler Memory Test (r=-0.511; p=0.009) and Reaction Time task (r=0.435; p=0.030). Moreover, change score in premorbid adjustment between early and late adolescence was significantly associated with lower improvement in perseverative errors (r=-0.455; p=0.022).

Deterioration of premorbid adjustment was significantly associated with lower improvement of cognitive improvement at the 6 months follow-up in a first episode psychosis. This lower cognitive improvement varied with the timing of the deterioration process in premorbid adjustment. Early adolescence premorbid deterioration was associated with less improvement in attentional and memory tasks. And premorbid deterioration in the late adolescence was related to lower improvement on executive tests.

schizophrenia can occur in any person even talented individuals. Several painters had schizophrenia. Van Gogh is a well known example Method: A single schizophrenic patient with several paintings is presented. Results/Discussion :Patients with schizophrenia may try to portray their special feelings and experiences. As many of patients have trouble to communicate with others verbally, paintings can be a suitable way for them to make others able to understand them. Broyan Chanley and Phyllis Jones were two talented artists who try to do so. In this presentation we present a schizophrenic patient who tried to describe his psychotic symptoms in paintings. He had also rare Lilliputian hallucination which was reflected in his works.

The phenomenon of the deficit of the inhibitory reaction to the latter of two stimuli presented to the patient with schizophrenia may result in a stronger affective priming effect in the case of schizophrenia patients. This effect may be defined as the change in reaction time needed to respond to an experimental stimulus, due to the characteristics of another stimulus preceding it.

33 patients diagnosed with schizophrenia took part in the experiment. At the time of testing, all patients were being treated with atypical neuroleptics. The results of the experimental group were compared to the results of a control group, which consisted of healthy participants, and matched the experimental group according to sex and age.

All participants completed a handedness test. For mood assessment, The Profile of Mood State was administered. The experimental task consisted of pairs of words which appeared on a computer screen. The participant was then asked to react to the latter word on the screen and categorize it as either positive or negative.

A supraliminal affective priming effect was observed both in the experimental and the control group. (bigger effect in the experimental group). Patients with schizophrenia were more depressive than healthy participants. The priming effect in the experimental group was stronger for negative than for positive stimuli. In the group of patients treated with risperidon, the priming effect was statistically significant only for negative stimuli.

To describe possible differences in cognitive performance in smoking versus non-smoking patients with first-episode psychosis and to determine the presence of smoking-related cognitive enhancement.

Sixty-two patients with first-episode psychosis were assessed with a neuropsychological battery that included computerized measurements of attention, working memory, and executive functioning. Patients were grouped into two categories: non-smokers (0 cigarettes/day; n=31) and smokers (20 or more cigarettes/day; n=31).

Groups were paired for sociodemographic and clinical data. In the sustained attention task, smokers exhibited shorter reaction times than non-smokers (p=0.026) and presented a significantly lower % of omissions (p=0.046). No differences were found in the % of commissions. Similarly, in the working memory task, smokers exhibited shorter reaction times than non-smokers (p=0.020) and presented a significantly lower % of omissions (p=0.002), with no differences in the % of commissions. Compared to non-smokers, smokers needed significantly less time to complete the Stroop interference task (p=0.013) with no significant differences in the % of correct responses. No differences were detected between groups in the Wisconsin Card Sorting Test.

Cigarette smoking is associated with less marked attentional and working memory deficits in first-episode psychosis and may constitute a self-medication behavior for remediation of neuropsychological dysfunction. This may be relevant for developing new pharmacotherapies for cognitive deficits in psychosis.

The primary objective was to assess the long-term tolerability of sertindole.

An open-label, flexible-dose, 6 to 18 month study sertindole was conducted at 68 European centres. Patients had a primary diagnosis of schizophrenia (DSM-III-R), and had previously completed an 8-week sertindole/haloperidol comparative study. The long-term tolerability of sertindole was assessed as the proportion of patients reporting an AE judged to be possibly or probably related to sertindole treatment and laboratory parameters, vital signs, and ECG. Long-term response to treatment was evaluated using PANSS and CGI-S.

295 patients entered the study. 56% of patients received 16 mg sertindole.151 patients completed at least 6 months of treatment. 85 patients withdrew prematurely; withdrawal of informed consent (n=37), lack of efficacy (n=23), and AEs (n=6). 243 patients reported AEs during the study. The most frequent AEs were: asthenia (16%), decreased ejaculatory volume (14%) and metabolic disorder/weight gain (12%). No statistically significant changes in laboratory values or vital signs were observed. Sertindole treatment was associated with a reduction in prolactin, the QTc interval was increased in the 8-week study and decreased over time during the extension study. There was a further treatment-related improvement from the acute study baseline in total PANSS and component subscale scores and CGI-S score.Conclusions: The effective dose for most patients was 16 mg/day. The tolerability profile of sertindole was similar to that seen in earlier studies. The low withdrawal rate due to AEs (2%), indicates that sertindole is well tolerated beyond acute treatment.

Childhood behavioral characteristics have not been fully investigated in patients with schizophrenia. 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.

Twenty-five schizophrenia outpatients in his/her twenties and normal healthy subjects (n = 100) were investigated. All patients are diagnosed according to DSM-IV-TR as schizophrenia, and who presents now mainly negative symptoms after passing an acute stage. By modified use of the Child Behavior Checklist (CBCL) as a retrospective assessment questionnaire, the parents of the patients and of control subjects rated their childhood behavior.

Among eight subscales of the CBCL, those of Withdrawal, Depression/Anxiety, Social Problems, and Attention Problems were significantly associated with schizophrenia, although any of these scores were not in clinical range. A discriminant analysis using all items of CBCL correctly classified 96.5% of the population. Notable in an item-level analysis was an extremely attenuated aggression in personal relations in the schizophrenia subjects.

It was suggested that subclinical behavioral and psychological characteristics of schizophrenia already exist in the patients' childhood, among which lack of aggressive behaviors might be one of the core features.

To assess sociodemographic characteristics, including education, usual residence, employment status and income among schizophrenia patients in Europe.

The Client Sociodemographic and Service Receipt Inventory was evaluated in schizophrenia patients treated with aripiprazole versus standard of care (SoC). 555 patients were equally randomized to aripiprazole (10-30 mg/day) or SoC (olanzapine 5-20 mg/day, or quetiapine 100-800 mg/day or risperidone 2-8 mg/day, [up to 16 mg/day]) for 26 weeks.

At baseline, 67% of the patients were single, 15% married and 12% widowed. The average years of education was 11.2: 24% of the patients received primary education or less, 50% secondary education; 21% further education and only 8% reached university. Of this population, 35% lived alone, 33% lived with relatives other than parents, and 14% lived with their husband/wife. More patients in the aripiprazole than the SoC group were employed (18.5% vs. 19. 9%), while a similar proportion were unemployed (28.8% vs. 25.8%). Among the patients who work (n=105), only two have a managerial position: 35% of patients are on a state pension. The main income source across all countries was state benefit and pension (74%). Only 15% of patients had an effective salary. During the 3 months prior to baseline, patients missed ~18.5 days (50%) from work due to illness.

Despite improvements in the management of psychosis with second-generation antipsychotics, the social and rehabilitation aspects of schizophrenia warrant further attention.

Deficits in antisaccade and smooth pursuit eye movements are promising endophenotypes in genetic studies of schizophrenia. Patients with schizophrenia and their relatives have worse performance on these tasks compared to healthy subjects. These oculomotor impairments may be caused by the same brain dysfunctions underlying many of the symptoms of schizophrenia. This study aimed to validate antisaccade and smooth pursuit eye movements as endophenotypes in a genetically homogenous Icelandic sample to use them for studying potential risk genotypes in schizophrenia.

Patients with schizophrenia (N=116) and healthy controls (N=108) matched for age and gender underwent infrared oculographic assessment (sampled at 500Hz) of antisaccades and smooth pursuit (at target velocities of 0.25, 0.50 and 0.75Hz).

On the antisaccade task, patients displayed significantly more reflexive errors, longer antisaccade latency, and reduced antisaccade amplitude gain compared to controls. However, spatial error and the variability of amplitude gain and spatial error did not differ between groups. On the smooth pursuit task, patients had significantly lower velocity gain and more frequent saccades during pursuit. Group differences in velocity gain increased with increasing target velocity. Internal consistency of performance was high for all variables in both groups except for antisaccade spatial error in patients (Cronbach's alpha >0.77 for antisaccades and >0.85 for smooth pursuit).

Our findings confirm the existence of robust oculomotor deficits in schizophrenia in a large sample. These measures can therefore be used as valid endophenotypes in future studies of potential schizophrenia risk genotypes in the genetically homogenous Icelandic population.

The prospect of early identification of psychotic development before the first overt psychosis confronts us with novel problems, not encountered in clinical work with psychotic patients. The target of prevention, usually “psychosis”, is a fuzzy concept with indeterminate boundaries and unclear content. Consequently, the prospective setting of early detection and intervention is rife with problems both of conceptual (What are the meanings inherent in the diagnostic concepts we use?) and of ethical (What are the consequences thereof?) nature. In this paper I will discuss the grammatical features of various conceptualizations of pre-stages of psychotic disorders, specifically their clinical, nosological and existential significance. This discussion has relevance for both diagnostic practices and ethical debate on the early intervention agenda.

Conceptual analysis. Material source for this analysis was representative literature and publications from the time period 1990-2006. Five different conceptualizations of pre-stages of psychotic disorders were investigated as to their their clinical, nosological and existential significance.

“At-risk-mental state” emerged as the most prudent and contextually relevant formulation of psychosis risk in preventive setting as it implies clinical significance, is nosologically a weak concept and does not directly imply mental disordedness or psychoticism, thus retaining some degree of existential neutrality. The shortcomings of other available options were described.

This conceptual analysis provides us with a meaningful tool for distinguishing the differential clinical, nosological and ethical implications of available (forthcoming)conceptualizations of early stages of psychosis.

Interest in the premorbid personality of schizophrenic patients is well established in the psychiatric literature. The relationship between personality disorders and acute phase proteins (APP) in schizophrenia is not well known.

Investigating the relationship among acute phase proteins and personality disorders in schizophrenic patients in a sample of adult schizophrenic patients under psychiatric treatment in a general hospital health setting.

37 adult paranoid schizophrenics undergoing treatment in the University Hospital of the Canary Islands with DSM-IV diagnosis of paranoid schizophrenia are included. Years from onset 9.20 s.d. 6.29, age at onset 19.75 s.d. 4.73. The record of personality disorders as a secondary diagnosis in the medical chart was taking into account. A blood sample as routine standard analysis was carried out in each patient.

In 21 patients (56.7%) a personality disorder, mainly with paranoid and schizotypal traits, was registered. The percentage of each personality disorder is as follows, Schizotypal (16.2%), Paranoid (13.5%), Schizoid (2.7%), Paranoid and Schizotypal (24.3%). The results point to no significant correlation according to APP (C3, C4, alpha2-macroglobulin, alpha1-glicoprotein, ceruloplasmin) in the different diagnostic groups.

In our study there is no evidence to support a significant correlation among APP and the different personality disorders in our sample of schizophrenics in spite of a positive correlation of APP and some psychopathology dimensions that has been communicated earlier elsewhere. In order to set some possible specificity of acute phase proteins and other clinical features in schizophrenia further research is required.

The enzyme catechol-O-methyl transferase (COMT) is significantly involved in dopamine's catabolism, especially in the prefrontal cortex. The association between several schizophrenic phenotype traits and the presence of prefrontal hypodopaminergia is well known. The purpose of this study was to determine if variations in the gene that encodes this enzyme constitute a risk factor for the development of schizophrenia in our Spanish patient sample.

the study included a total of 199 Spanish male DSM-IV-TR schizophrenic patients and a sample of 186 male healthy controls. Genotyping was performed using Single Strand Conformation Polymorphism (SSCP) of amplified fragments by DNA polymerase chain reaction (PCR). Statistical analysis was done using SPSS (V. 11.0), PHASE (V. 2.0) software and Genetic Data Analysis (GDA).

our results indicate that the homozygous genotypes for Val108/158Met polymorphism are more prevalent in schizophrenic patients than in control population (62% vs. 50%; p: 0.04); regarding the C610G polymorphism, no differences were observed in this sample.

our findings warrant the study of COMT gene in independent samples in order to establish the possible correlation of variants of this gene and the development of schizophrenia in Spanish male population.

The prevalence of metabolic syndrome is increased 2-3 fold in people with severe mental illness (SMI) yet monitoring of physical health in the individuals is poor, despite clear guidance from NICE.

To assess whether monitoring of metabolic complication of people with SMI had occurred within the last year. To assess the prevalence of undiagnosed metabolic syndrome in SMI

100 patients with SMI involving both community and in-patient settings were audited. The prevalence of metabolic syndrome was assessed in 50 previously unmonitored patients.

In the audit, the 100 psychiatric notes had details of the following assessments: blood pressure (n=32), glucose (n=16), lipids (n=9) and weight (n=2). Twenty-six of 50 (52%) patients were subsequently found to fulfil the IDF definition for metabolic syndrome. Three had previously undiagnosed diabetes based on fasting glucose concentration. Metabolic syndrome was associated with increasing age (p=0.03) but not clinical setting, diagnosis, antipsychotic medication, gender, smoking status, alcohol or illicit drug use. 22% of patients had a family history of diabetes.

There is a high prevalence of undiagnosed metabolic syndrome in people with SMI. Improved screening of metabolic complications should lead to better identification and treatment of this clinical problem.

A new functional Single Nucleotide Polymorphism (Ala72Ser) in the COMT Gene was discovered recently. The purpose of our study is to examine the association between Ala72Ser and Val158Met functional polymorphisms in COMT gene and homicidal behavior in schizophrenia.

DNA was genotyped for the Ala72Ser and Val158Met SNPs of the COMT gene in a sample of 90 schizophrenic patients who committed homicide (H-SCZ) and 83 schizophrenic patients who had never committed homicide (NH-SCZ).

A statistically significant difference was found in genotype distribution and allele frequencies in SNP Ala72Ser of COMT gene between H-SCZ and NH-SCZ group.. In haplotype analysis, the frequency of the combination of high-high activity allele (Ala-Val) was fewer in H-SCZ group than in NH-SCZ group (p=0.000657).

Our study showed a highly significant association between a COMT haplotype of two functional SNP and aggressive behavior in schizophrenia.

Evaluation of initial treatment course in schizophrenic patients after transition to RIS-CONSTA under clinical routine conditions seems important for understanding of long-term disease stability.

Pretreated moderate-to-severely ill schizophrenic in-patients were switched to RIS-CONSTA (i.m. two-weekly). Assessments included reasons for transition, co-medication, PANSS, NOSIE, AE, EPMS. Study completion criteria were clinical stability with RIS-CONSTA and/or discharge within/maximum 12 weeks. Criteria for stable adjustment were (1)RIS-CONSTA was the only high-potency/atypical antipsychotic, (2)stable/improved CGI, (3)stable RIS-CONSTA dosage since previous visit.

Prospective naturalistic study with 290 patients (Mean age 40.3y; 56.2% male). Causes for transition were insufficient efficacy (46.9%), tolerability (13.8%), compliance (70.4%), initiation of long-term treatment (70.3%). At discharge n=123 (43.8%) patients were judged as clinically stable (S), n=167 (56.2%) as not stable (NS). Median hospitalization duration (S-group) was 42, for NS-group 28 days. PANSS and NOSIE revealed clinical and psychosocial amelioration in favor of S-group. Most common AEs were EPMS (both groups), although total EMPS-score improved in 63% during the study. Variables that correlated with given definition for stability were not identified.

A shorter stay in hospital for clinically NS-patients with schizophrenia may be due to several factors [e.g. higher need of patients for discharge (prior to remission) leading to "revolving door effect", low potential for long-term remission, lack of therapeutic adherence, pressure of external health care providers]. These results raise the question, whether extended hospitalization of NS-patients may foster clinical stability. This study suggests effectiveness and improved tolerability (EPMS) of RIS-CONSTA in moderate-to-severely ill patients with schizophrenia.

Reduced Glutathion Peroxidase (GSH) is a common biologic marker of antioxidant status frequently used in schizophrenic research. Data regarding GSH levels in schizophrenic patients are controversial. Our objective is to study whether or not GSH levels have seasonal or circadian fluctuations in schizophrenic outpatients.

23 clinically stable treated chronic schizophrenic outpatients were studied in summer and winter. The same day in July and January, blood samples were extracted between 8:30 and 9:00 after one night fasting. The same routine was followed during the two experimental sessions.

GSH plasma levels were not significant different between summer and winter. There was no significant difference between nocturnal and diurnal GSH levels in neither winter nor summer.

Plasma GSH does not present seasonal levels either a circadian rhythm.

The introduction of the first atypical antipsychotic with a long acting formulation has open new therapeutic options for the treatment of schizophrenic patients. Our objective consists of comparing psychopathology levels and global functioning in patients with paranoid schizophrenia treated in monotherapy either with long-acting injectable risperidone (LAIR) or conventional depot antipsychotics (DA).

Patients attending at the community mental health center during the six-month recruitment period were eligible to enter the study. Scores achieved in positive and negative subscales of PANNS and EEAG scale of (Global Activity Evaluating Scale) were evaluated at baseline and 6 months later. Six patients treated with RLAI and six patients treated with DA were recruited. Data were analyzed both with the real sample (N=6 per group) and extrapoling the same results to a bigger sample size (N=24 per group).

Mean increase in scores for both PANNS positive and negative subscales were lower in patients treated with RLAI that in those treated with DA (positive subscale: 0.018±0.06 vs. 0.048±0.03, RLAI and DA, respectively, p=0.387; negative subscale: 0.232±0.076 vs. 0.3095±0.123, RLAI and DA, respectively, p=0.579). EEAG scores were higher for patients treated with RLAI than those treated with DA (1.250±0.56 vs. 0.333±0.225, p=0.144). When these results are extrapolated to a sample of 24 patients per group, differences in EEAG reach statistical significance (p=0.034).

After 6 months of treatment, patients treated with RLAI tend to show a greater improvement in their global activity than those treated with DA.

To evaluate changes in the use of non-antipsychotic concomitant medication related to schizophrenia in patients enrolled in e-STAR in Belgium (B), Spain (S) and Australia (A) who were initiated on RLAI.

e-STAR is a secure web-based, international, long-term (1 year retrospective and 2 year prospective) ongoing observational study of schizophrenia patients who initiate a new antipsychotic drug during their routine clinical management. Data reported here are for patients enrolled to date in B, S and A who had information available about the use of concomitant medication at baseline and at 6 months after the start of RLAI.

Of 1,605 evaluable patients (B, n=180; S, n=919; A, n=506), 73.7% received concomitant non-antipsychotic medication at baseline. This proportion had reduced to 60.3% at 6 months after the start of RLAI (82.2% to 71.7% for B, p<0.001; 72.8% to 54.8% for S, p<0.001; 72.3% to 66.2% for A, p=0.01). Reductions between baseline and 6 months were overall: for anticholinergics 29.4% to 17.0% and for antidepressants 22.9% to 19.3% (each p<0.05 for B; p<0.001 for S); for mood stabilisers 17.6% to 15.8% (p=0.01 for S); for benzodiazepines 48.9% to 39.0% (p<0.001 for S; p=0.002 for A); for somatic medication 16.9% to 16.0%. Conclusions. Following the start of RLAI, the use of concomitant non-antipsychotic medication for the management of symptoms associated with schizophrenia or its treatment declined significantly at 6 months compared to baseline.