During threat, interpersonal distance is deliberately increased. Personal space regulation is related to amygdala function and altered in schizophrenia, but it remains unknown whether it is particularly associated with paranoid threat.

We compared performance in two tests on personal space between 64 patients with schizophrenia spectrum disorders and 24 matched controls. Patients were stratified in those with paranoid threat, neutral affect or paranoid experience of power. In the stop-distance paradigm, participants indicated the minimum tolerable interpersonal distance. In the fixed-distance paradigm, they indicated the level of comfort at fixed interpersonal distances.

Paranoid threat increased interpersonal distance two-fold in the stop-distance paradigm, and reduced comfort ratings in the fixed-distance paradigm. In contrast, patients experiencing paranoid power had high comfort ratings at any distance. Patients with neutral affect did not differ from controls in the stop-distance paradigm. Differences between groups remained when controlling for gender and positive symptom severity. Among schizophrenia patients, the stop-distance paradigm detected paranoid threat with 93% sensitivity and 83% specificity.

Personal space regulation is not generally altered in schizophrenia. However, state paranoid experience has distinct contributions to personal space regulation. Subjects experiencing current paranoid threat share increased safety-seeking behavior.

An association between inflammation and behavioral domains of mental disorders is of growing interest. Recent studies reported an association between aggression and inflammation. In this study, we investigated the association between aggressive behavior and inflammatory markers in schizophrenia inpatients.

Adult schizophrenia inpatients without affective symptoms (n = 213) were retrospectively identified and categorized according to their C-reactive protein measurement at admission as either elevated (CRP > 1 mg/dL; n = 57) or normal (CRP < 1 mg/dL; n = 156). The following indicators of aggression were compared: PANSS excitement component (PANSS-EC), restraints and suicidal behavior during hospitalization. Univariate comparisons between elevated and normal CRP levels were performed and multivariate analysis was conducted to control for relevant covariates.

CRP levels significantly correlated with other laboratory markers indicating increased inflammation including leukocyte count and neutrophil to lymphocyte ratio (r = 0.387, P < 0.0001 and r = 0.356, P < 0.0001) respectively. Inpatients with elevated C-reactive protein displayed increased aggressive behavior compared to patients with normal CRP levels (<1 mg/dL). This was manifested by higher rates of restraint during hospitalization (χ2 = 5.22, P = 0.031) and increased PANSS-EC score (U = 5410.5, P = 0.012). Elevated CRP levels were not associated with suicidal behavior. Multivariate analysis revealed that higher PANSS-EC score was associated with elevated CRP after controlling for the covariates age, sex, BMI and smoking.

This study identified a potential biological correlate (inflammation) of a specific behavioral endophenotype (aggression) in schizophrenia inpatients.

Cognitive deficits have been reported during the early stages of bipolar disorder; however, the role of medication on such deficits remains unclear. The aim of this study was to compare the effects of lithium and quetiapine monotherapy on cognitive performance in people following first episode mania.

The design was a single-blind, randomised controlled trial on a cohort of 61 participants following first episode mania. Participants received either lithium or quetiapine monotherapy as maintenance treatment over a 12-month follow-up period. The groups were compared on performance outcomes using an extensive cognitive assessment battery conducted at baseline, month 3 and month 12 follow-up time-points.

There was a significant interaction between group and time in phonemic fluency at the 3-month and 12-month endpoints, reflecting greater improvements in performance in lithium-treated participants relative to quetiapine-treated participants. After controlling for multiple comparisons, there were no other significant interactions between group and time for other measures of cognition.

Although the effects of lithium and quetiapine treatment were similar for most cognitive domains, the findings imply that early initiation of lithium treatment may benefit the trajectory of cognition, specifically verbal fluency in young people with bipolar disorder. Given that cognition is a major symptomatic domain of bipolar disorder and has substantive effects on general functioning, the ability to influence the trajectory of cognitive change is of considerable clinical importance.

To characterize adults with comorbid attention-deficit/hyperactivity-disorder (ADHD) and borderline personality disorder (BPD) with regard to ADHD symptoms, psychopathology, cognitive functioning and psychosocial factors.

A between-group design compared a group of individuals diagnosed with ADHD (n = 40) with a group diagnosed with BPD and who also met the criteria for ADHD (ADHD + BPD) (n = 20).

Significant differences were observed for both childhood and current impulsivity symptoms, whereby ADHD + BPD exhibited increased impulsivity; no differences on self-report and cognitive measures of impulsivity were reported. The ADHD + BPD group scored significantly higher on measures of depression, anxiety and numerous other axis I and II conditions. The ADHD + BPD group scored significantly lower on most measures of intellectual functioning and attention, however largely not on those relating to response inhibition. Furthermore, group differences were observed for psychosocial factors, including education, substance use and criminal record.

Comorbid ADHD and BPD is characterized by more symptoms of impulsivity, additional psychopathology, comparatively lower intellectual and attentional functioning and increased psychosocial difficulties.

To evaluate the effectiveness of the IDF Suicide Prevention Program, implemented since 2006.

Quasi-experimental (before and after) cohort study.

Two cohorts of IDF mandatory service soldiers: the first inducted prior to (1992–2005, n = 766,107) and the second subsequent to (2006–2012, n = 405,252) the launching of the intervention program.

The IDF Suicide Prevention Program is a population-based program, incorporating: reducing weapon availability, de-stigmatizing help-seeking behavior, integrating mental health officers into service units, and training commanders and soldiers to recognize suicide risk factors and warning signs.

Suicide rate and time to suicide in cohorts before and after exposure to the Suicide Prevention Program.

Trend analysis showed lower suicide rates in the cohort after intervention. The hazard ratio for the intervention effect on time to suicide was 0.44 (95% CI = 0.34–0.56, P < .001) among males. Lower risk was associated with: male gender; born in Israel; higher socio-economic status; higher intelligence score; and serving in a combat unit (HR = 0.43: 95% CI = 0.33–0.55).

There was a 57% decrease in the suicide rate following the administration of the IDF Suicide Prevention Program. The effect of the intervention appears to be related to use of a weapon, and being able to benefit from improved help-seeking and de-stigmatization. Future efforts should seek to extend the program's prevention reach to other demographic groups of soldiers. The success of the IDF program may inform suicide prevention in other military organizations and in the civilian sector.

Our aim was to investigate which clinical and socio-demographic factors among adolescent psychiatric patient aged 13–17 are associated with a diagnosis of personality disorder (PD) in young adulthood after discharge from psychiatric hospitalization.

The study sample consisted of 508 adolescents (ages 13–17) admitted to acute psychiatric impatient care between April 2001 and March 2006. DSM IV-based psychiatric diagnoses were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL). The information on hospital treatments either in out- or inpatient settings until the end of 2012 was extracted from the national Care Register for Health Care provided by the Finnish National Institute for Health and Welfare. The follow-up time was 9.2 years (mean, 95% CI 9.0–9.3 yrs).

Altogether 57 (11.2%) of subjects were diagnosed PD in adulthood. Among girls with anxiety disorders in adolescence the risk for PD in adulthood increased to 4.39-fold (95% CI 2.02–9.53). Males with later PD were more likely to be admitted for hospital treatment from child welfare placements (OR 3.23, 95% CI 1.21–8.61). However, axis I disorders in adolescence was not associated with risk for PD among boys.

The results indicate that risk of PD developing later in life is increased among girls with anxiety disorders. A child welfare placement associated with PD in males later in life. These associations in adolescents should be considered in clinical work.

Prior work by our group identified personality profiles associated with psychotic-like experiences (PLE's) in healthy adults that were strikingly similar to those found in schizophrenia patients, with the exception of two key differences. Specifically, higher levels of PLE's were linked to higher persistence and cooperativeness, suggesting that these characteristics might represent personality-based resilience factors. Notably, age and personality were significantly correlated in these data, raising questions about whether healthy children and adolescents would show similar results. To date, no study has examined personality profiles associated with both positive and negative PLE's in healthy children and adolescents using Cloninger's Temperament and Character Inventory (TCI). Thus, this study examined the relationship between TCI dimensions and PLE's in healthy children and adolescents.

The TCI and the Community Assessment of Psychic Experiences (CAPE) were administered to 123 healthy children and adolescents aged 8–18. Multiple regression models were used to examine personality dimensions associated with overall severity of PLE's as well as severity of positive and negative PLE's separately.

Positive, negative, and overall PLE severity were all associated with a personality pattern of higher harm avoidance and lower self-directedness. Negative PLE severity was also associated with lower persistence.

Personality correlates of PLE's in healthy children and adolescents were largely consistent with our past work on PLE's in healthy adults. However, our previously identified resilience factors were notably absent in this sample. These findings may suggest that these personality characteristics have not yet crystallized or emerged to aid in coping with PLE's.

Treatment with antipsychotic medication is thoroughly investigated in schizophrenia and bipolar disorder but is also widely applied for a diversity of off-label conditions, despite an uncertain risk-benefit ratio. This study examined the relationship between antipsychotic prescribing patterns and labor market affiliation, considering both authority approved and off-label prescriptions and the relation to polypharmacy.

Register-based cohort study using a dataset of 71,254 new antipsychotic users with a psychiatric diagnosis. Labor market affiliation and duration of welfare payments were analyzed using linear regression models and duration analysis. The analyses were adjusted for the following confounding variables: age, gender, diagnosis, marital status, length of education, and utilization of mental health care services.

The majority of new antipsychotic users received welfare payments for prolonged periods of time during the observation period, even more so for individuals treated with antipsychotic polypharmacy or other antipsychotic combination regimens. The risk of permanently leaving the labor market was also associated with antipsychotic combination regimen.

Antipsychotic treatment, especially in combination with other antipsychotics or other psychotropic drugs, could serve as a marker of subjects with increased need for support to maintain the labor market affiliation. However, causality cannot be inferred from an observational study because of residual confounding that could not be adjusted for in this study.