People with schizophrenia exhibit low levels of physical activity, which have impact on physical and mental health as well as overall quality of life (QOL). Mental and physical benefits of exercise are known, although the mechanisms through which physical exercise improves schizophrenia symptoms are not fully understood.

To assess the effect of a 16-week exercise program (EP) on the expression of BDNF and S100B biomarkers, physical fitness, health related quality of life and self-perceptions of adults with schizophrenia.

Thirty-five patients with schizophrenia (PwSZ) were divided in three groups Institutionalized Patients (n = 11); Psychosocial Rehabilitation (n = 13); and Control Group (n = 11). The EP consisted of one-hour walking session three times a week during 16 weeks. All participants were assessed before and after EP using the six minutes walking test, a psychological tests battery including MOS Short Form 36, Rosenberg Self-Esteem Scale, Physical Self-Perception Profile, Satisfaction with Life Scale as well as the BDNF and S100B measurements using serum analysis.

No significant statistical differences were found both for BDNF and S100B levels as a result of exercise. Additionally, no significant statistical differences were found for Physical Self-concept and Global Self-esteem changes as a result of the walking program (WP). However, PwSZ showed significant statistical differences on the satisfaction with life (P < 0.05) and on the perceived health related QOL (P < 0.05) in all groups participating in the EP.

In spite of the limited impact of the WP in PwSZ, this group may obtain positive outcomes of the exercise participation based on a more positive attitude towards life.

The authors have not supplied their declaration of competing interest.

Social cognition is considered as a main predictor of functional outcomes and a candidate for endophenotype of schizophrenia. We hypothesize that social cognition capacities follow the course of schizophrenia as a progredient disorder.

To investigate social cognition across different groups of patients with schizophrenia and schizophrenia spectrum disorders.

To evaluate social cognitive impairments in patients with first episode psychoses (FEP), chronic schizophrenia (CS) and schizophrenia-spectrum disorders (SSD).

In a cross-sectional study, 71 patients with FEP, CS and SSD were assessed with a battery of clinical and social cognitive tests. Three key social cognitive domains were assessed: emotion perception, Theory of Mind and attributional style.

Patients with schizoaffective disorder and schizotypal disorder showed better scores in Hinting task (mean ranks: 47.0 and 39.9 respectively) than patients with less favourable forms of schizophrenia (mean ranks: 24.7 and 30.2 respectively) (P = 0.003). Patients with FEP showed better results in Hinting task (18.1 ± 2.4) versus CS patients (17.4 ± 2.0) (P < 0.05). No differences in emotion perception (Ekman-60 task) among FEP and CS patients were detected. Patients with schizoaffective disorder showed better scores in emotional processing comparing to all forms of schizophrenia patients (mean ranks 49.1 vs. 30.1, 34.5, 28.0, P < 0.05). No significant differences in attributional style were registered.

Emotion perception and Theory of Mind domains show different level of impairment across FEP and CS patients and across forms of schizophrenia. Further longitudinal studies to establish how social cognition domains mirror the course and severity of schizophrenia and SSD are needed.

The authors have not supplied their declaration of competing interest.

Long-acting injectable aripiprazole is the most recently introduced depot treatment in schizophrenia.

The objective of this study is to determine the tolerability and safety of this new treatment.

The aim is to provide useful information regarding the use of this new drug.

Our sample consists on 20 patients treated with a monthly dose of long-acting ariprazole. They were previously stabilized on oral aripiprazole before the first injection. The data on tolerability and safety were obtained by face-to-face interviews, using the Hogan Drug Attitude Inventory, the Patient Satisfaction with Medication Questionnaire and the UKU Side Effects Scale.

Our sample consists of 20 patients, with a 50/50 gender distribution and a mean age of 39 years. The average score in the satisfaction scale Hogan was positive (an average of 7.25). In the Patient Satisfaction With Medication Questionnaire, 85% said they were satisfied with the new treatment, compared with 15% who showed some degree of dissatisfaction with the change. Overall, 90% of patients showed a preference for the current treatment compared to the previous. The patients showed good tolerance to medication, with a low score in the UKU scale (total score = 13.5). Side effects did not interfere with daily activity of the patient.

Long acting injectable aripiprazole proved to be a safe treatment, with a good degree of acceptance among patients. These advantages makes of this new drug a useful addition to our kit tool.

The authors have not supplied their declaration of competing interest.

For resistant schizophrenia, the only approved treatment is clozapine. However, clozapine is underused, mainly due to its wide range of side-effects. Secondary effects differ amongst antipsychotics (Leucht et al., 2009). Despite that there is no good evidence that combined antipsychotics offer any advantage over the use of a single antipsychotic, combination increases the frequency of adverse events (Maudsley guidelines).

To compare the side-effect profile between clozapine and non-clozapinepatients.

To provide evidence that clozapine patients do not show a worse side-effects profile.

We cross-sectionally analysed all patients from a Spanish long-term mental care facility (n = 139). Schizophrenic/schizoaffective patients were selected (n = 118) and their treatment was assessed, 31 patients used clozapine. We paired clozapine and non-clozapine patients by sex and age and assessed antipsychotic side effects and possible confounder variables.

Our sample was 27 clozapine patients and 29 non-clozapine patients. 67,9% were male with a mean age of 51.3 (SD 9.6) years. For continuous variables: age, BMI, waist/hip, cholesterol, TG, glucose, prolactin, heart-rate, blood pressure, sleeping hours, the only statistical differences found were lower heart-rate (P = 0.001) in clozapine group and higher salivation subscale of SAS (P = 0.002) in clozapine group. For discrete variables: monotherapy, obesity, overweight, metabolic syndrome or possible confounders as propranolol, laxative, diet, antiglycemiant or insulin, fibrates or statins, antihypertensive or anticholinergic, no statistical differences were found.

We did not find differences in cardiometabolic parameters, which are the main barrier to prescribing clozapine, probably due to the concomitant use of other drugs in both groups.

The authors have not supplied their declaration of competing interest.

Poor adherence to treatment is one of the main problems in health care to psychiatric patients. The second-generation antipsychotics, and the subsequent emergence of the depot forms (long acting formulations) have facilitated this aspect, increasing the time to clinical relapse in patients with schizophrenia.

Determine the time to relapse in a clinical sample of patients diagnosed with schizophrenia treated with paliperidone palmitate over 3 years. Other objectives include the possible reduction in hospital admissions, as well as the possible reduction of psychiatric emergency visits, concomitant medication (benzodiazepines and Biperiden) and the possible increase in drug monotherapy.

This is a study with a sample of 101 patients with schizophrenia who had started treatment with PP (consecutive sampling). Quantified variables in the 12 months prior to the change of PP treatment with variables at 6, 12, 24 and 36 months after initiation of treatment with PP were compared.

At the end of the tracking, 72.22% (73 patients) remained clinically stable, with adequate adherence to treatment and there have been no clinical relapses. It has obtained a statistically significant reduction in the use of concomitant medication, emergency room visits and the average duration of revenues, with no clinical relapse should occur in patients of the sample in the second and third year.

The authors have not supplied their declaration of competing interest.

Tobacco use has been associated with more excitement and agitation symptoms, greater severity of global psychopathology as measured by the Clinical General Impression (CGI) Scale, and psychotic symptoms in patients with schizophrenia.

To assess the effects of nicotine abstinence versus nicotine maintenance on the clinical symptoms of a sample of outpatients smokers diagnosed with schizophrenia.

Sample: 81 outpatients with schizophrenia [72.8% males; mean age (SD) = 43.35 (8.82)] currently smoking tobacco [no. of cigarettes (SD) = 27.96 (12.29)]. Desing: non-randomized, open-label, 6-month follow-up and multi-center study conducted at 3 sites in Spain (Oviedo, Santiago de Compostela and Orense). Instruments: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression for Schizophrenia (CGI-SCH), Hamilton Depression Rating Scale (HDRS). Antropometric measures: Body mass index (BMI) and waist circumference. Vital sings: heart rate. Procedure: Patients were assigned to 2 conditions:

– control group = patients continuing their tobacco use;

– experimental group = patients participated in vareniclina or nicotine patches treatment for smoking cessation.

Patients were evaluated at baseline (all patients smoking) and after 3 and 6 months.

No significant differences (P>.05) were found between groups at baseline evaluation. Likewise, there were no significant differences between smokers and non-smokers after treatment (3 and 6 months follow-up) in their clinical symptomatology (according to PANSS, HDRS and CGI-SCH), anthropometric measures and heart rate.

No significant differences were found in the clinical symptoms after a period of nicotine abstinence. Therefore, clinicians should motivate and help their patients to quit smoking (CIBERSAM - FIS PI11/01891).

The authors have not supplied their declaration of competing interest.

Cognitive impairment is considered the best predictor of functional outcome in psychosis. However, the nature of this relationship still remains to be determined.

To ascertain the relationship of negative symptoms and cognitive impairment with functional outcome in psychosis.

Ninety patients with a DSM-IV psychotic disorder diagnosis and 65 healthy controls were included in the study. We assessed the predominant negative symptoms over the course of illness with the Comprehensive Assessment of Symptoms and History (CASH). Functional outcome was assessed with the Specific Levels of Functioning (SLOF). Cognition was assessed with a set of neuropsychological tests, which were normalised to z-scores (regarding controls’ performance). Then, a Global Cognition Index (GCI) was obtained as a mean of the cognitive domains assessed: processing speed, attention, verbal and visual memory, executive functions, working memory and social cognition. We divided the sample in four groups, considering the presence/absence of negative symptoms (cut-off point of 2 in the CASH), and the presence/absence of cognitive impairment (considering a GCI z-score of–1 as cut-off point). We performed a MANOVA to compare the 4 groups’ functional outcome scores.

Fig. 1 shows the significant differences between groups regarding functional outcome.

The combination of negative symptoms and cognitive impairment has deleterious effects over functionality, but negative symptoms alone are related to functional outcome, independently of cognitive impairment.

The authors have not supplied their declaration of competing interest.

Electroconvulsive therapy is currently used in the management of severe depression, long-term mania and catatonia. Regarding schizophrenia-related psychosis ECT is also an option, but the indication is restrictive to severe cases, drug intolerance or resistant ones. Lack of evidence of cost-effectiveness compared to clozapine, and side effects of ECT techniques before 2003, influenced NICE guidance to not recommend ECT in schizophrenia, but modern ECT machines and procedures are subsequent to 2003. ECT is often performed when clozapine fails to respond in monotherapy or if there is intolerance to antipsychotic side effects. ECT in combination with clozapine seems to have significant results allowing the patients to achieve rapid control of psychotic symptoms with fewer side effects, comparing with antipsychotics-association strategies.

To summarized the latest literature about this field and to present recent data from the Electrovulsivetherapy Unit, in Hospital de Magalhães Lemos, Portugal.

To explore and critically review the controversies of electroconvulsive therapy in the management of drug-resistant schizophrenia.

Retrospective data of an Electroconvulsive Therapy Unit during 2006–2015 was review.

198 ECT treatments in schizophrenic patients were performed in our unit, during 2006–2007, in a total of 647 ECT (30,6%). In 2014–2015, 945 schizophrenic patients received ECT treatment, in a total of 2149 performed ECT (43,9%).

Although guidelines are crucial for the uniform practice of medicine, sometimes is important to be critical about them. The use of ECT in schizophrenia is safe and effective and further research is needed to continue to support this treatment.

The authors have not supplied their declaration of competing interest.

Risk prediction for suicide in schizophrenia is known to be complex. Illness-related risk factors are important predictors, with number of prior suicide attempts, depressive symptoms, active hallucinations and delusions.

To analyze the impact of clinical features of schizophrenia on suicidal behaviour and analyze relationship between violence and suicidality.

We compared a group of 28 suicidal, 32 hetero-aggressive and 60 non-aggressive male patients with schizophrenia. The severity of the psychopathology was assessed using PANSS, hetero-aggressiveness using OAS and suicidality using C-SSRS and InterSePT scales.

Suicidality is in positive correlation with the presence of depression (r = 0.485, P < 0.001) and imperative hallucinations (r = 0.391, P < 0.001) but in negative correlation with total PANSS score (r = –0.297, P < 0.001), impulsiveness (r = –0,237, P < 0.001) and hetero-aggressive behaviour (r = –0.551, P < 0.001). Previous attempt was found in 53% suicidal patients (P = 0.047). Heteroaggressiveness is in positive correlation with total PANSS (r = 0.43, P < 0.001) and impulsive behaviour (r = 0.57, P < 0.001). This study supports the contention that high impulsivity in schizophrenia patients is significant in the etiology of violent but not suicidal behaviour.

In the order to diminish the level of suicide among patients with schizophrenia we must be aware of the importance of depressive symptoms, imperative hallucinations and previous attempts. This study supports the contention that high impulsivity in schizophrenia patients is significant in the etiology of violence but not suicidal behaviour.

The authors have not supplied their declaration of competing interest.

Poor physical health and shorter life expectancy often follows from mental illness. If the disorder starts in childhood/adolescence, the risk of this outcome is even higher. Second generation antipsychotics (SGAs) are suspected to increase cardiovascular risk factors through the development of the metabolic syndrome.

We investigated all the aspects of the metabolic syndrome in drug-naive youth, over a period of 12 months of treatment with SGAs.

This study examines drug-naive youth in their first year of treatment with SGAs, and the possible development of markers of the metabolic syndrome, in a naturalistic setting. We also look at aspects of the patient's disease and environment that may predict which patients are the most at risk for these metabolic derangements.

Thirty-five drug-naive adolescents were recruited after their contact with the Psychosis Team at Department of Child and Adolescent Psychiatry in Odense, Denmark. Measurements were taken at different times over the course of their first year of treatment. The markers included, among others: body mass index, waist circumference, blood pressure, fasting blood glucose, as well as high density, low density and total cholesterol. Factors of the patients’ lifestyle and development were recorded as well.

The results will be presented at the EPA March 2016 in Madrid.

This is, to our knowledge, the first study to include all of the aforementioned aspects in drug-naive adolescents over a 12-month period. Because of this, it may provide us with a unique insight into how, and in which patients, these metabolic changes develop.

The authors have not supplied their declaration of competing interest.

Depression is often observed in schizophrenia, in all phases of the disorder. Age of illness onset and sex have been found to correlate with depressive symptomatology in many but not all studies.

In the present work the relation between depressive symptoms and age of onset and sex was investigated, in a sample of patients with paranoid schizophrenia.

Eighty-eight (88) patients with paranoid schizophrenia according to DSM-IV-TR criteria were examined, 21 of which became ill at ≥35 years of age (late onset), whereas 60 had age of onset < 30 years (young onset). During the active phase the Calgary Depression Scale for Schizophrenia (CDSS) was applied. Comparisons were performed by using the two-tailed Wilcoxon rank-sum and Chi-squared tests.

The percentage of patients with depression (CDSS > 6) in the whole sample was 27.2%. There was a trend for higher scores in early awakening in late onset patients (P = 0.060). In men, there was a trend for heavier depression in late onset patients, and higher scores in early awakening (P = 0.082, 0.019, respectively). In young onset patients, there was a trend for heavier symptomatology in women compared with men, and heavier pathological guilt (P = 0.073, 0.007, respectively), whereas in late onset patients, there was a trend for heavier self depreciation in men (P = 0.072).

Although the frequency of depression does not seem to be influenced by age of onset or sex, more subtle differences are found in the severity of certain depressive symptoms, in relation to these factors, possibly warranting further investigation.

The authors have not supplied their declaration of competing interest.

Sarcosine - glycine transporter inhibitor - increases glycine concentration around NMDA (N-methyl-D-aspartate) receptors. Function of the glutamatergic system in the prefrontal cortex and hippocampus is impaired in schizophrenia, which may lead to negative and cognitive symptomatology.

We evaluated the influence of sarcosine therapy on the concentration of metabolites (NAA, N-acetylaspartate; Glx, complex of glutamate, glutamine and γ-aminobutyric acid (GABA); mI, myo-inositol; Cr, creatine; Cho, choline) in the left dorso-lateral prefrontal cortex (DLPFC) and left hippocampus in patients with stable schizophrenia.

Fifty patients with schizophrenia, treated with constant antipsychotics doses, in stable clinical condition were randomly assigned (25 patients in each group) to administration of sarcosine (2 g) or placebo for six months. 1H-NMR spectroscopy (1.5 T) in both localisations and clinical evaluation (PANSS) was performed before and after sarcosine addition.

Initially we noted no differences in metabolite concentrations between groups. In the left DLPFC, NAA/Cho, mI/Cr and mI/Cho ratios were significantly higher in the sarcosine than the placebo group after six months. In the sarcosine group, NAA/Cr, NAA/Cho, mI/Cr, mI/Cho ratios also increased compared to baseline values. In the placebo group, only the NAA/Cr ratio increased. In the left hippocampus Glx/Cr and Glx/Cho decreased in sarcosine group at the end of our study.

The addition of sarcosine to antipsychotic therapy for six months caused increase of neurons viability (NAA) and neurogilal activity (mI) markers in the left DLPFC and decrease of hyperglutamatergic overstimulation parameters in the left hippocampus with simultaneous improvement of clinical parameters including negative symptoms.

The authors have not supplied their declaration of competing interest.

Deficit of glutamatergic transmission and aberrant function of kynurenine pathway, with disturbed synthesis of glutamate receptors antagonist, kynurenic acid (KYNA) and neurotoxic metabolite of kynurenine, 3-hydroxykynurenine (3-OH-KYN) have been implicated in the pathogenesis of schizophrenia.

Demonstrated by others higher level of KYNA in the brain may cause relative deficiency of glutamate-mediate transmission with resulting behavioural and cognitive changes.

Search for predictors of satisfactory response to antipsychotic treatment based on the analysis of KYNA and 3-OH-KYN serum levels.

Fifty-three patients with chronic schizophrenia and 46 healthy individuals were enrolled in the study. Quantitative analyses of KYNA and 3-OH-KYN were performed using high-pressure liquid chromatography (HPLC) and electrochemical detection, respectively. Clinical assessments (PANSS, SANS, SAPS) and blood analyses were conducted at 3 time-points: during the active phase of disease, after 4 weeks of modified pharmacotherapy, and after reaching remission.

In schizophrenia group, lower levels of KYNA (P = 0.002) and non-altered levels of 3-OH-KYN (p = 0.195), as compared to control, were detected during active phase of disease. Despite clinical improvement, no significant changes in the level of studied metabolites were observed later on. The initial level of 3-OH-KYN correlated negatively (r = –0.368; Spearman's rank) with clinical improvement (negative symptoms) (P < 0.05).

1. The peripheral dysregulation of kynurenine pathway metabolites in chronic schizophrenia manifests as relative increase in the ratio between neurotoxic 3-OH-KYN and neuroprotective KYNA. 2. The higher serum level of 3-OH-KYN during relapse of schizophrenia seems to predict poor response to antipsychotic treatment.

The authors have not supplied their declaration of competing interest.

The relationship between olfactory and emotional processing is an area of increasing interest in schizophrenia research.

Olfactory identification deficits are well described in schizophrenia while the results for pleasantness ratings remain unclear.

Evaluation of odor identification and hedonic judgment related to severity of negative symptoms and β-endorphin concentration.

Fifty outpatients with schizophrenia were included in the study: 25 with negative symptoms (PN) and 25 without predominant negative symptoms (P). They were compared with 23 healthy individuals. In all study groups University of Pennsylvania Smell Identification Test (UPSIT) and odor hedonic evaluation were performed. Clinical symptoms severity was evaluated using PANSS. Plasma concentrations of β-endorphin were assayed in all participants.

PN made more odor identification errors than controls (P = 0.000) and P sample (P = 0.001). Hedonic judgments of unpleasant odors were significantly more pleasant in PN sample than in P (P = 0.03) and controls (P = 0.041). PN had significantly higher concentration of β-endorphin than P sample (P = 0.014) and controls (P = 0.009). No relationship between β-endorphin concentration and odors identification and odor hedonic judgment was found in both patient samples and controls.

Increased level of β-endorphin is related to predominance of negative symptoms but probably it is not involved in olfactory identification performance and hedonic judgment in schizophrenia. Patients with predominant negative symptoms revealed different pattern of pleasantness rating – they experience unpleasant odors as more pleasant. Alterations in smell identification and hedonic judgment could be differentially expressed in some subtypes of schizophrenia.

The author has not supplied his/her declaration of competing interest.

Negative symptoms have long been recognized as a central feature of schizophrenia, which limit recovery, having a strong negative impact on real-life functioning. External validators of the negative symptoms domains might help refining hypotheses on their pathophysiological basis.

The objective of this study was to evaluate, in the context of the multicenter study of the Italian Network for Research on Psychoses, the relationships between auditory event-related potentials (ERPs) components and negative symptom domains in patients with schizophrenia (SCZ).

We examined ERPs recorded during an auditory odd-ball task in 115 chronic stabilized SCZ (78% on second-generation antipsychotics) and 62 matched healthy controls (HC). Negative symptoms were assessed using the Brief Negative Symptom Scale.

Our main findings included significant N100 and P3b amplitude reductions in SCZ compared to HC. P3b amplitude did not correlate with any negative symptom domain, while N100 amplitude correlated with both anhedonia and avolition domains.

Avolition and anhedonia, often clustering in the same factor, are related to abnormalities of early components of the ERPs correlated with perceptual and automatic attention processes. None of the negative symptom domains is associated with abnormalities of the later stages indexed by P3 amplitude.

The authors have not supplied their declaration of competing interest.

Adherence to treatment of mental disorders is one of the key factors influencing its success and, secondarily, the patients’ quality of life and social adaptation.

The cross-sectional study of 90 outpatients diagnosed with psychotic disorders aimed at determining if there was a relationship between discontinuation of medication in the past, current adherence to treatment and self-stigma.

The assessment was made with the objective and subjective Clinical Global Impression – Severity scale, Drug Attitude Inventory, Internalized Stigma of Mental Illness (ISMI) scale and demographic data.

The questionnaires were filled out by 79 patients, of whom 5 handed in incomplete questionnaires. Complete sets of data were obtained from 74 patients. The data analysis showed that the levels of self-stigma as assessed by the total ISMI scores was not statistically significantly correlated with most of the demographic factors (age, age of illness onset, gender, education, marital status, employment, duration of the illness, number of hospitalizations and antipsychotic dosage). However, there was a significant negative correlation with current adherence to treatment.

Adherence to treatment is one of the most important prerequisites for successful therapy. Adherence may be enhanced through better motivation and education of patients on the necessity of adhering to treatment recommendations and the consequences of non-adherent behavior. Important factors in adherence also seem to be patients’ stigmatization and self-stigma. Adherence may be increased by promising self-stigma-reducing strategies performed by systematic psychoeducation of patients or as a part of psychotherapeutic counseling.

The authors have not supplied their declaration of competing interest.

PSY-3011 was a randomized, multicenter, double-blind, non-inferiority study of paliperidone palmitate 3-month injection (PP3M) vs. paliperidone palmitate 1-month injection (PP1M). Adults with schizophrenia were stabilized on PP1M in an open-label (OL) 17-week transition phase. Qualifying subjects at the end of the OL phase were then randomized to PP3M or PP1M in the 48-week double-blind (DB) phase. Healthcare resource utilization (HCRU) between PP3M and PP1M was compared using the HCRU questionnaire during the double-blind (DB) phase.

HCRU was measured at the start of the OL and DB phases, and every 12 weeks during DB until end of study/early withdrawal. Information included hospitalizations, ER visits, day or night clinic stays, outpatient treatment, daily living conditions, and occupational status. Logistic regressions modeled the probability of hospitalization vs. no hospitalization for psychiatric and social reasons, as well as hospitalizations for psychiatric reasons only, during the DB phase. The models controlled for OL baseline hospitalizations, OL phase hospitalizations, and time in study.

The analysis set included 483 subjects randomized to PP3M and 512 subjects to PP1M during the DB phase. The odds of hospitalization for psychiatric/social reasons during 1 year for PP1M subjects were 1.16 times the odds of hospitalization for PP3M subjects (95% CI: 0.70, 1.93, P = 0.56). For psychiatric reasons only, the odds of hospitalization during 1 year for PP1 M subjects were 1.63 times the odds of hospitalization for PP3M subjects (95% CI: 0.88, 3.02, P = 0.12).

PP3M and PP1M demonstrated similar trends in hospitalizations throughout the course of the study.

The authors have not supplied their declaration of competing interest.

Schizophrenia is a severe disease which affects different aspects of behavior, including cognitive functions. The most important fields of cognitive disorders in schizophrenia are working memory, vigilance/attention, learning by oral and visual memory, argument and resolving, analysis rate and social knowledge.

This study was designed to assess the effects of fluvoxamine on cognitive functions of schizophrenic patients.

Thirty-six patients with schizophrenia, all male, were treated with 100 mg fluvoxamine and a second generation anti-psychotic for 4 weeks and before and after treatment, their cognitive functions were assessed by Wechsler-3 memory scale (WMS-revised) and negative symptoms by scale for the assessment of negative symptoms (SANS).

In our study, the average patients’ scores increased in Wechsler-3 memory scale (WMS-revised) before and after receiving fluvoxamine (P < 0.001). This study couldn’t show a statistically significant difference between the patients’ scores in negative symptoms (SANS test) before and after the treatment course (P = 0.59) There was a negative statistically significant correlation found between WMS score before and after the intervention and the level of education, living area and cigarette smoking. Increasing scores in the test was statistically correlated with lower education, cigarette smoking and living in rural area.

Augmented treatment with fluvoxamine, probably has effects on some parts of cognitive abilities of male schizophrenic patients which are assessable by Wechsler-3 memory scale. Therefore further studies on evaluation of fluvoxamine effects in other fields of cognitive abilities like concentration and attention in schizophrenic patients are still required.

The authors have not supplied their declaration of competing interest.

Being a homosexual may be burdened by several psychological problems. This is due to the minority stress that results from feeling excluded and it is characteristic of social minorities. Negative beliefs about their psychosexual orientation and sense of exclusion may be the cause of both depressive disorders and internalized homophobia. These factors can affect the quality of sexual life.

The aim of the study is to analyze the relationship between internalized homophobia, social pain and the severity of depressive symptoms and quality of sexual life.

The study included 103 young adults remaining in permanent homosexual relationships. The study was cross-sectional. The study used Beck Depression Inventory, Social Pain Thermometer, Internalized Homophobia Scale and Quality of Sexual Life Questionnaire.

It observed the significant correlations between the level of internalized homophobia and a sense of social pain and the severity of depressive symptoms. Both internalized homophobia, and severe social pain and depressive symptoms proved to be significant predictors of reduced quality of sexual life of homosexuals.

During the treatment of depressive symptoms and discomfort associated with the sexual life of homosexuals, it is important to take into account the phenomenon of internalized homophobia.

The author has not supplied his/her declaration of competing interest.

To evaluate prevalence, pattern and risk factors of sleep problems in epileptic children.

Eighty-two epileptic children and 40 healthy controlled children were evaluated using children's sleep habits questionnaire – Arabic form and night polysomnography (2 consecutive nights).

Prevalence of sleep problem in epileptic children was 45% and 17% of normal control children with significant difference in sleep latency, total sleep time and number of awaking per night with significant prevalence with partial epilepsy, poly therapy and poor controlled epilepsy.

Sleep problems are common in epileptic children with close relation to partial epilepsy, number of anti epileptic and poor controlled epilepsy. This is important to deal with it in order to better control of sleep problems in such patient.

The authors have not supplied their declaration of competing interest.