Subjective Memory Impairment (SMI) may hold value in the elderly as a predictor of dementia. There is yet to exist any standard definition of SMI for use in research or for clinical practice.

This study aims to identify previous and current definitions of SMI used in published research and to propose a set of criteria that may help increase SMI's predictive power of future cognitive decline.

Literature searches were conducted across a number of electronic databases including Medline.

515 citations were identified, 336 papers were obtained, of which 44 were selected for containing definitions for SMI. These definitions varied widely in terms of the types of questions used to determine SMI and additional features pertaining to memory complaints included in the definition.

There is no consistency in how SMI is defined. We propose a set of criteria aimed to increase specificity of memory complainers for those at increased risk of dementia. Further research is required to refine and validate the different criteria suggested. An international consent on the necessary criteria by experts in the field might be useful.

To study the association between age at onset and the clinical picture of schizophrenia in an unselected young birth cohort.

The study sample consists of 98 (64 males and 34 females) individuals with DSM-III-R schizophrenia collected from the Northern Finland 1966 birth cohort. Firstly, subjects were divided into very early- and young-onset subgroups by using the median age at onset (22 years in males and 20 in females), as a cut-off point. Secondly, we used age at onset as a continuous variable. Clinical features of schizophrenia were assessed using the Operational Criteria Checklist for Psychotic Illnesses (OCCPI).

Inappropriate affect, positive thought disorder and deterioration from premorbid level of function associate with very early-onset schizophrenia, while slowed activity and dysphoria relate to young-onset. These symptoms correlate significantly with the age at onset.

Differences in the clinical picture associating to the age at onset of schizophrenia are seen early.

These findings indicate that certain symptoms of schizophrenia are dependent on the age at onset, and schizophrenia occurring initially in early life has some typical features. Using the age at onset as a continuous variable is independent of arbitrary cut-off points and produces more explicable results.

To evaluate quality of life and patient preference for schizophrenia treatment in a community based study comparing the use of aripiprazole to the standard of care (SOC).

This open-label, 26-week, multi-centre, randomised study compared aripiprazole with SOC (olanzapine, quetiapine or risperidone) in patients with schizophrenia (DSM-IV-TR criteria). The primary effectiveness variable was the mean total score of the Investigator Assessment Questionnaire (IAQ) at Week 26. The outcome research variables included the Preference of Medicine (POM) questionnaire, the Quality of Life Scale (QLS), and the EuroQoL-5D (EQ-5D). The results from these outcome research variables are the focus of this paper addressing quality of life and patient preference.

A total of 555 patients were randomised to receive aripiprazole (n = 284) or SOC (n = 271). The OC data at Week 26, reported that more respondents rated the study medication as ‘much better’ compared with their previous medication in the aripiprazole group versus SOC for patients (59% vs 35%, P < 0.001) and caregivers (58% vs 30%, P = 0.014). The improvement in QLS total score was also significantly greater in the aripiprazole group compared with SOC – mean change from baseline in QLS total score of 16.21 vs 10.01 (P < 0.001) at Week 26 (OC data set). A greater proportion of patients (93% vs 85%; P = 0.005) in the aripiprazole group had a satisfactory response on the EQ-5D Self Care Scale; all other EQ-5D scores were similar.

The study findings suggest that quality of life and patient medication preference measures were better for aripiprazole than for SOC.

Differences in personality traits have long been acknowledged as potential risk factors in developing psychiatric disorders. Lately, several susceptibility genes of different psychiatric disorders have been linked to personality traits. This has not been done for schizophrenia yet. Neuregulin1 has been repeatedly shown to be associated with schizophrenia and is involved in numerous neurodevelopmental functions such as neuronal migration and myelination. The impact of this gene might also modulate personality traits in healthy subjects.

The NRG1 status of 523 healthy subjects was determined with a single nucleotide polymorphism (SNP8NRG221533) which has been described as a tagging marker being part of the core at-risk haplotype for schizophrenia. Genotype was correlated with personality traits using the NEO-FFI questionnaire.

Subjects with the NRG1 risk allele scored higher on neuroticism (p <.05) and lower on conscientiousness (p <.05). Further, interactions of genotype by gender for extraversion (p <.05), openness (p <.05) and conscientiousness (p <.05) were found with men carrying the risk allele scoring the lowest.

The data indicate that the NRG1 gene which has found to be associated with schizophrenia may also influence personality differences in healthy subjects.

Previous studies of patients with unipolar depression have shown that early decrease of prefrontal EEG cordance in theta band can predict clinical response to various antidepressants. We have now examined whether decrease of prefrontal quantitative EEG (QEEG) cordance value after 1 week of venlafaxine treatment predicts clinical response to venlafaxine in resistant patients.

We analyzed 25 inpatients who finished 4-week venlafaxine treatment. EEG data were monitored at baseline and after 1 week of treatment. QEEG cordance was computed at three frontal electrodes in theta frequency band. Depressive symptoms and clinical status were assessed using Montgomery–Åsberg Depression Rating Scale (MADRS), Beck Depression Inventory-Short Form (BDI-S) and Clinical Global Impression (CGI).

Eleven of 12 responders (reduction of MADRS ≥50%) and only 5 of 13 non-responders had decreased prefrontal QEEG cordance value after the first week of treatment (p = 0.01). The decrease of prefrontal cordance after week 1 in responders was significant (p = 0.03) and there was no significant change in non-responders. Positive and negative predictive values of cordance reduction for response were 0.7 and 0.9, respectively.

The reduction of prefrontal theta QEEG cordance value after first week of treatment might be helpful in the prediction of response to venlafaxine.

Psychopathological heterogeneity in manic syndromes may in part reflect underlying latent classes with characteristic outcome patterns. Differential treatment course and outcome after 12 weeks of treatment were examined for three distinct classes of patients with acute mania in bipolar disorder.

Three thousand four hundred and twenty-five patients with acute mania were divided into three distinct mania classes: ‘Typical’, ‘Psychotic’ and ‘Dual’ (i.e. comorbid substance use) mania. Persistence of class differences and social outcomes were examined, using multilevel regression analyses and odds ratios.

The three classes showed substantial stability post-baseline in the pattern of associations with class-characteristic variables. Psychotic and Dual mania predicted poorer outcome in terms of psychosis comorbidity and overall bipolar and mania severity, while Dual mania additionally predicted poorer outcome of alcohol and substance abuse. Worse social outcomes were observed for both Dual and Psychotic mania.

The identified distinct classes are stable and associated with differential treatment outcome. Overall, Dual and Psychotic mania show less favourable outcomes compared to Typical mania. These findings additionally give rise to concern on the generalisability of randomized clinical trials RCTs.