The chronic and debilitating nature of schizophrenia creates a disease with marked clinical and economic consequences. Among patients with schizophrenia the prevalence of smoking is significantly higher than in the general populace. Smoking in schizophrenia appears to be associated with increased psychopathology and disability. However, there is a dearth of Nigerian studies attempting to determine the effects of smoking on clinical outcome among patients with schizophrenia. Understanding the effects of smoking on the severity of disability and psychopathology in schizophrenia would help us to plan appropriate psychosocial interventions for these patients

To determine if comorbid smoking in schizophrenia is associated with increased disability and psychopathology.

• To determine the difference in the severity of disability and psychopathology among smokers and non smokers with schizophrenia.

• To determine the association between dosage of antipsychotics prescribed and disability among smokers and non smokers with schizophrenia.

A cross-sectional descriptive study in which 367 out patients with ICD 10 diagnosis of schizophrenia were recruited. Socio-demographic questionnaire, Present State Examination Schizophrenia and Tobacco sections, Positive And Negative Syndrome Scale and World Health Organization Disability Assessment Schedules were administered.

Current smoking was associated with increased disability (t=2.32, p<0.02) among the participants studied.

The results of this study indicate that smoking in Nigerian schizophrenia patients is associated with significant disability. Effective measures to promote smoking cessation in schizophrenia should be implemented in Nigerian patients.

The Enhancing Motivation in Persons with Schizophrenia Group is a manualised programme designed to tackle needs of those on rehabilitation wards of a psychiatric hospital. A number of theoretical models have been utilized to provide important perspectives on factors promoting motivation and behavior change (social learning theory, motivational interviewing, transtheoretical model). These models, along with the use of specific psychological techniques provide the underpinnings for the group.

In terms of pathways of care, it is the first point in the pathway, paving the way for future psychosocial treatment facilities, work and development. It enables patients to gain some understanding about a variety of mental health issues and offer them a space to explore them in relation to their own experiences.

The aims of the programme include provision of a positive non-threatening experience of working in groups, developing an open channel of communication, helping identify personal targets for treatment and help participants identify a rationale for engaging self-change. The programme also provides staff with some experience of each patient, their motivation and capacity to function within a group.

The programme is delivered on the admission by trained psychologists, consisting of 10 one-hour sessions covering a number of topics, with clear pre- and post-assessment.

The group is in the process of being delivered for the fifth time. Feedback, both anecdotally and from formal assessment had been positive.

Staff and patients alike have offered useful feedback and highlighted the utility of the programme in their experience.

Anomalous experiences such as Basic Symptoms (BS) are considered to be the first subjective manifestation of the neurobiological substrate of schizophrenia. Recently it has been outlined indeed, how various aspects of the phenomenological basic self-disorders occurring in schizophrenia may correlate with neurocognitive disturbances.

The purpose of this study is to explore whether a low or high emotional motor resonance occurring in Schizophrenia Spectrum (SzSp) patients is related to patients' clinical features and to their anomalous subjective experiences as indexed by the Bonn Scale for the Assessment of Basic Symptoms (BSABS).

We employed a validated paradigm sensitive in evoking a congruent facial mimicry (measured by means of facial Electromyographic activity, EMG) through multimodal positive and negative emotional stimuli presentation.

Results showed that SzSp patients more resonating with negative emotional stimuli (i.e., Externalizersfor negative emotions), had significantly higher scores in BSABS Cluster 3 (Vulnerability) and more psychotic episodes than patients belonging to the Internalizers group. On the other hand, SzSp patients more resonating with positive emotional stimuli (i.e., Externalizers for positive emotions), scored higher in BSABS Cluster 5 (Interpersonal Irritation) than patients belonging to the Internalizers group.

Drawing upon a phenomenological-based perspective, we shed new light on the abnormal experiences characterizing SzSp conditions, explaining them in terms of a disruption of the normal self-perception conveyed by the more basic, automatic, low-level emotional motor mechanisms. The importance of adopting a trans-domain approach integrating findings from the phenomenological and the neurophysiological levels of analysis is further emphasized.

Are we making the most of Clozapine?

Clozapine treatment remains the gold standard for treatment-resistant schizophrenia. Currently, clozapine use varies worldwide, from as high as 60% of psychotic patients in China to as low as 2 – 3% of psychotic patients in certain areas of the United States and Canada. Many physicians are reluctant, for a variety of reasons, to prescribe clozapine.

1. 1. To highlight to concerns physicians may have about initiating and maintaining Clozapine therapy in patients with treatment – resistant schizophrenia.

2. 2. To understand the adverse effects that are most pertinent to both physicians and their patients

To understand the barriers to prescribing Clozapine.

The authors obtained contact information for all psychiatrists registered with the College of Physicians and surgeons in Ontario, Canada. Physicians were mailed and invitation to complete a questionnaire online, or receive a paper copy, asking about potential barriers to prescribing Clozapine.

The final results of our project are still under analysis but based on the sampling done so far Clozapine therapy is limited in Ontario, Canada due to concerns of potential adverse side effects associated with clozapine therapy. There is also a limitation of access to resources to initiate and maintain patients on clozapine.

Clozapine use is still limited in many countries including Canada. Providing more education about managing the potential adverse effects and easier access to initiating and maintaining clozapine treatment will be helpful in promoting its use.

Hypochondriac symptomatology in structure of schizophrenic spectrum disorders is form of mental pathology which threatens with serious social consequences for personality.

study of adaptive abilities and quality of life of patients suffering from schizophrenia and schizotypal disorder with hypochondriac symptomatology depending on clinical-dynamic features of course of the disease and constitution-morphologic characteristics.

clinical-psychopathological, clinical-dynamic, clinical-follow-up, therapeutic, anthropometric and statistical methods.

Hypochondriac symptomatology affects clinical components of adaptation (at the moment of examination in basic group 50,0% of patients were disabled persons with mental disease, and in comparison group – 32,0%; p<0.05) and social adaptation of patients (in the process of disease social status decreased in 53,3% of patients of basic group, in comparison group – in 36,0%; p<0.05). In basic group more often than in comparison group there were persons with introvert type of adaptation (40,0% and 24,0%, respectively; p<0.05) and with individual compensatory-adaptive defense like 'ecological niche” (30,0% and 8,0%, respectively; p<0.01). During investigation of socially-oriented internal adaptive reactions it was revealed that basic group and comparison group had statistically significant differences regarding number of patients with plastic type (0% and 18,0%, respectively; p<0.001), exaggerated type (68,3% and 46,0%, respectively; p<0.01) and with ignoring type of reaction (5,0% and 16,0%, respectively; p<0.05).

Hypochondriac symptomatology affects clinical and social adaptation preventing from appearance of socially-oriented internal adaptive reactions and promoting more 'immature” compensatory-adaptive defenses and adverse types of adaptation in patients suffering from schizophrenia spectrum disorders.

Interaction of processes of self-stigmatization and rehospitalization in structure of paranoid schizophrenia studied insufficiently well.

Studying of clinical psychological mechanisms of a self-stigmatization phenomenon at patients with paranoid schizophrenia.

Separate out a role of an affective component as key-factor in formation of a self-stigmatization phenomenon. Define a role of compensation mechanisms in formation of "learned helplessness” style.

Retrospective analysis of frequency of hospitalization by information from epicrisis, semiformalized interview, PANSS, the Beck Hopelessness Scale, the Zung Self-Rating Depression Scale, the State-Trait Anxiety Inventory.

The group of patients with an apathy abulia syndrome 65 % is prevailing. We had been found out valid connection between intensity of apathy abulia syndrome in structure of paranoid schizophrenia and frequency of hospitalization 0,60 (p <0,01).

Basis of the frustrating component at an apathy abulia syndrome is personal reaction to a clinical syndrome, which reflected, in the affective sphere of the patient in the depressive affect and the increasing hopelessness level.

With increase of negative symptomatology also increases tensity of adaptation mechanisms 0,88 (p<0,01). The prevailing negative symptomatology perhaps predispose to development of a rehospitalization phenomenon 0,53 (p<0,01).

Rehospitalization phenomenon is one of the main behavioral equivalents indicating to self-stigmatization process, fixing and reproducing the process intensifies apathy abulia syndrome.

Chronic hallucinatory psychosis is a clinical picture described by Ballet in 1912 which is characterized by the presence of mental automatism, chronic hallucinations and secondary delusions. This clinical entity, from the french school, has been neglected in current psychiatry.

The growing influence of international nosology has led to a progressive disuse of the concept of chronic hallucinatory psychosis and patients with such clinical condition have been classified under the diagnosis of paranoid schizophrenia, according to the Anglo-Saxon current classifications. Taking into account that psychopathological features as well as the prognosis differ from schizophrenia (main differential diagnosis) it is important to be aware of this diagnosis in order to avoid a wrong diagnosis of schizophrenia in these patients.

The aim of this poster is to highlight the modernity of Ballet’s concept of chronic hallucinatory psychosis, which can be considered a valid clinical entity as it shows clinical features that differ from other psychoses particularly the schizophrenic.

We report a case of a 40-year-old woman who presented a psychotic disorder ten months ago whose clinical features resemble the classical description of chronic hallucinatory psychosis.

Very few recent studies on chronic hallucinatory psychosis have been carried out, which shows the loss of interest of modern psychiatry in this clinical entity. Further research in this field is needed in order to recognize the viability of this diagnosis and provide patients a better care and therapeutic management.

The gender asymmetry influence on process of pathomorphosis schizophorm symptoms.

To investigate the features of the gender role transformation on process of pathomorphosis schizophorm symptoms.

74 patients with paranoid schizophrenia. Retrospective analysis of medical records, PANSS, questionnaire S. Bem, standardized scale to asses anxiety and depression, questionnaire 'Auto – and hetero-aggression' E.P. Ilyin, correlation and factor analysis.

The paranoid schizophrenia was accompanied by the gender-role transformation: 44% of men had dominated femininity, 31% of female – masculinity. Men with dominating masculinity prevail negative psychopathological symptoms, correlated with masculinity(r=-0,827), auto-aggression(r=0,780) and depression(r=0,763), p≤0,05. Men with dominating femininity had hallucinatory-delusional syndrome, correlated with femininity(r=0,873), p≤0,05. Feminine women had predominantly paranoid and anxiety-depressive symptoms, correlated with auto-aggression(r=-0,870), anxiety(r=0,894), p≤0,05. Masculine women had personality disorders symptoms, correlated with femininity(r=0,994) p≤0,001.

In consequence of investigation the phenomenon of cross-gender accentuation in patients with paranoid schizophrenia was identified. Also, specific type of the gender-role accentuation influences on formation schizophorm complexes and contains affective component, which performs clinical psychological mechanism in definite structures. Men with masculine amplification demonstrated frequently negative psychopathological symptoms, correlated with high average of auto-aggression and depression and low average of masculinity. Men with feminine amplification had positive psychopathological symptoms such as delusion, hallucinations, Kandinsky-Clerambault's syndrome, correlated with feminine component. Women with feminine amplification had paranoid, anxiety-depressive and hypochondriac symptoms, were accompanied reduction of auto-aggression and increase of masculinity. Masculine women had predominantly personality disoders symptoms, correlated with femininity.

Desipte the effective symptomatic treatment of schizophrenia, poor functional outcomes are still a challenge. Neurocognition has been identified for a long time as a main background factor of these. According to the findings the neurocognitive aspects are not suitable to explain all the functional deficits of patients with schizophrenia. For this reason an other aspect of the cognition need to be investigated to understand our patients: the social cognition. The developement of social cognitive interventions has also recieved growing attention in schizophrenia research in the recent years.

We reviewed the literature and collected information about the theoretical background of social cognitive impairments and social cognitive treatments.

Our aim was to produce an integrative overview of the above mentioned theories and present new treatment possibilities.

PubMED suggested relevant studies, exploring the role of social cognitive impairments and efficacy of remediation programmes aimed at improving social cognition.

We got a comprehensive view of psychopathological, neuroanatomical and theoretical aspects. Our findings supported the determinig role of social cognitive impairments in schizophrenia and the importance of new treatment approaches. The overview revealed significant effects of treatments on ToM, emotional recognition, social perception and attributional style.

The social cognition is a notable field of the cognition in schizophrenia. Remediation programs are promising approaches to improve social functioning in schizophrenia, and probably a useful strategy for early treatment in psychosis, however according to our overview more researches are neccessary to elaborate definitional and methodological inaccuracies and eliminate uncertanity of effecacy.

The awareness of one's body constitutes a basic experience of Self which modulates the individual engagement in social interactions. Indeed, Interoception Sensitivity (IS), an index of individual ability to represent one’s own internal body states, is implicated in the autonomic regulation in interpersonal context. Schizophrenia deficits in Self-experience and awareness, which frequently entail anomalies in self-other relationship, capture the ever-growing attention of researchers. Nevertheless, IS and autonomic regulation of schizophrenic patients in social context are completely new and not yet investigated aspects of Schizophrenia.

To investigate whether Schizophrenia could be associated with lower IS and with a dysfunctional autonomic regulation during social interaction.

24 chronic schizophrenia patients, and a matched group of healthy controls, performed a Social and a Non-social task while respiratory sinus arrhythmia (an index of autonomic regulation) was measured. In the Social task participants viewed an experimenter performing a caress-like movement at different distances from their hand. In the Non-social task a metal stick was moved at the same distances from the participants’ hand. As measure of IS, a cardiac Mental Tacking Task was performed.

Comparing to controls, Schizophrenia patients presented lower IS, absence of relation between IS and autonomic regulation, and an anomalous autonomic regulation in social and non-social contexts.

Deficits in Self-experience, associated with Schizophrenia, could be extended to patients’ sensitivity to internal bodily signals. Moreover, the observed altered autonomic regulation will be part of interpersonal interaction deficit frequently associated to Schizophrenia.

Schizophrenia is an extreme mental health disturbance that affects person’s well-being and participation in everyday activities. Participation in meaningful everyday occupations is an important component of recovery from mental illness, the ultimate goal of mental health services. Participation restrictions of people with schizophrenia have been widely investigated through illness symptoms, cognition, and demographic data; however, the resulting explanations were incomplete. Recent studies suggest occurrence of sensory modulation (SM) disorder in schizophrenia that was found affecting everyday participation in other populations.

The study objectives were exploration of SM patterns of people with schizophrenia and their impact on participation in daily life.

The study aimed to compare SM patterns in schizophrenia to healthy population and to investigate their contribution to participation in everyday activities in addition to cognition and schizophrenia symptoms.

Forty nine in-patients with schizophrenia (study group) and 32 adults without mental illness (control group) comprised the study. They were assessed for their participation patterns, sensory modulation processes, cognitive functioning and symptoms severity.

Results indicate significant differences between the study groups in most measurements addressed: participation (diversity: t79=-6.5, p<.001; and satisfaction: t78.8=-2.29, p<.05), sensory modulation scores (t79=6.23, p<.001) and cognitive measurements (Z=-6.57, p<.005). The most contributive parameters for prediction of participation dimensions among people with schizophrenia were negative symptoms severity and general cognitive status (2.535,44<5.06; p<.05; 0.122 =0.3<0.41).

People with schizophrenia experience SM disorder with an under responsive tendency. However, the complex condition of schizophrenia dominates its influence on participation dimensions.

A 28 year old Malawian man, experiencing his first psychotic episode and subsequently diagnosed with Schizophrenia was also identified as having Alpha-Thalassaemia Zero Trait (ATZT). This poster will include the aetiology of his presentation, chromosomal basis of both illnesses and the possible link between psychosis and thalassaemia.

Case-report, Literature review and Discussion.

Mr. X was admitted via A&E after walking through a pane of glass and leaping from the roof of his home. He had a 3-year history of social withdrawal, religious obsession and increasingly bizarre behaviour. This progressively worsened the week prior to his admission. He refused to leave his house, became paranoid about being attacked, did not eat or drink, and walked around naked. He presented with paranoid, persecutory delusions, third person auditory hallucinations and poor insight. He was treated with Risperidone and recovered well.

To the best of our knowledge, this is the first case report on Schizophrenia in a person with ATZT in the UK. We propose that ATZT may have been associated with the development of Schizophrenia. Our literature review revealed studies that suggested micro-deletions on Chromosome 16 increased the risk of Schizophrenia as well as ATZT. We hypothesise that the presence of one abnormality on Chromosome 16 increases the likelihood of other chromosomal abnormalities leading to the risk of developing Schizophrenia.

Further studies are required on the prevalence of schizophrenia in those with ATZT. We recommend increased awareness amongst clinicians about the potential risk of Schizophrenia associated with ATZT.

One of the current concerns in the research on schizophrenia is the relationship between social functioning and emotion recognition abilities, more specifically of the role that this can have, as a potential pathway for building subsequent psychosocial intervention methods.

To establish the precise role that the ability to recognize emotions has on social functioning in subjects with a diagnosis of Schizophrenia.

To help develop psychotherapeutic intervention programs that will increase social functioning.

This paper analyzed a sample of subjects (N=31) with a diagnosis of Schizophrenia (according to the WHO ICD 10), who were selected based on inclusion/exclusion criteria. The following parameters were assessed: socio-demographic (gender, age of onset, level of education, family and professional status), social functioning (SFS scale) and the ability to identify emotions in the eyes (‘Reading the Mind in the Eyes’ test).

The ability of recognizing the emotion ‘anger’ is directly correlated with the ability to communicate and keep interpersonal relations (Spearman R = 0.310, p <0.05), the ability of independence/performance (Spearman R = 0.471, p <0.05), as well as the ability to relax (Spearman R = 0.456, p <0.05) and to engage in social activities (Spearman R = 0.473, p <0.05).

We noted that ‘anger’ is the only emotion that was correlated with social functioning. Anger must be understood beyond its negative connotation, also as a positive element, in the sense of positioning the individual in the society and of taking action in regard to personal needs.

Schizophrenia is not only a mental disorder but also has other components affecting the physical part of the body. Several studies have suggested that neuroinflammatory processes may play a role in schizophrenia pathogenesis, at least in a subgroup of patients.

This poster reported the preliminary results of a project aiming to find schizophrenia biomarkers. We present biological parameters and clinical variables of patients with schizophrenia according to the lab results and the clinical assessments.

Cross-sectional, naturalistic study. Inclusion criteria: DSM-IV diagnosis of schizophrenia; age >17 years; and written informed consent given.

123 patients with schizophrenia. Mean age 40.75 (10.37), 67.5% males. There is relationship between homocysteine(oxidative stress) and psychopathology: PANSS [negative subscale 0.27 (p=0.003), general subscale 0.21 (p=0.028) and Marder factor 0.28 (p=0.003)], NSA [global score 0.24 (p=0.010), and some factors: communication 0.26 (p=0.005), affect 0.28 (p=0.002), motivation 0.30 (p=0.001) and motor retardation 0.27 (p=0.004)]; Functioning [(PSP total score -0.24 (p=0.011) and some PSP factors: work 0.30 (p=0.001), self-care 0.21 (p=0.022)]. However, there is no relationship between C-reactive protein(inflammation) and any clinical variable. On the other hand, there is relationship between: glucose and cognitive impairment; cholesterol and NSA motivation score, cognitive impairment and PSP (total score, self-care and work); triglycerides and HDRS (total score, melancholia factor and vitality factor), NSA motivation score and cognitive impairment.

The negative dimension of schizophrenia is associated with high homocysteine levels, which means an oxidative stress state. As well, a worse functioning level is associated with high homocysteine level.

D-aspartate (D-Asp) is an atypical amino acid that binds to and activates NMDARs. D-Asp occurs abundantly in the embryonic brain of mammals and rapidly decreases after birth, due to the activity of the enzyme D-Aspartate Oxidase (DDO). The agonistic activity of D-Asp on NMDARs and its neurodevelopmental occurrence make this D-amino acid a potential mediator for NMDAR-related alterations observed in schizophrenia. Consistently, substantial reduction of D-Asp was observed in post-mortem schizophrenia brains.

We evaluated the potential contribution of D-Asp as neurodevelopmental modulator of brain circuits and behaviors relevant to schizophrenia.

We analyzed DDO mRNA expression in the post-mortem prefrontal cortex of schizophrenic patients. Moreover, we treated knockout mice for Ddo gene (Ddo-/-) with the NMDAR antagonist phencyclidine to evaluate their schizophrenia-relevant behaviors and circuits. Finally, we assessed cortico-hippocampal connectivity of these mice.

DDO mRNA detection was performed by quantitative PCR. Phencyclidine-induced schizophrenia-like behaviours were assessed through motor activity and prepulse inhibition paradigms. Resting-state and pharmacological fMRI were used to evaluate functional circuits and connectivity.

DDO mRNA expression is increased in frontal samples of schizophrenic patients. In mice, the absence of Ddo gene produces a significant reduction in phencyclidine-induced motor hyper-activity and prepulse inhibition deficit. Furthermore, increased levels of D-Asp in Ddo-/- animals significantly inhibit functional circuits activated by phencyclidine, and affect the development of cortico-hippocampal connectivity networks potentially involved in schizophrenia.

Our data suggest that D-Asp, through the regulation exerted by DDO, may have a role in the pathophysiology of schizophrenia.

Rasd2 is a striatal GTP-binding protein that modulates Akt and mTOR signaling cascades, well known to be highly vulnerable pathways in psychiatric disorders.

We investigated the association of Rasd2 and its genetic variation with a series of prefronto-striatal phenotypes related to psychosis in rodents and humans.

We want to provide evidence that Rasd2 controls the vulnerability to schizophrenia-related behavior induced by psychothomimetic drugs in mice. Moreover, we aim to find genetic variations within the Rasd2 gene that influence a series of brain schizophrenia-related phenotypes in human.

Rasd2 knockout mice were employed to evaluate schizophrenia-like behaviors induced by psychotomimetic drugs like amphetamine and phencyclidine. Furthermore, we investigated if RASD2genetic variations in humans are associated with mRNA expression in post-mortem prefrontal cortex, as well as prefrontal and striatal grey matter volume and physiology during working memory as measured with MRI in healthy subjects. Finally, we assessed RASD2mRNA expression levels in post-mortem brains of patients with schizophrenia and bipolar disorder.

We found that both psychotomimetics triggered greater vulnerability to motor stimulation and to prepulse inhibition deficits in Rasd2 mutants. In humans, we found that a genetic variation (rs6518956) within RASD2 predicts prefrontal mRNA expression as well as prefrontal grey matter volume and prefronto-striatal activity during working memory. Finally, we reported that RASD2 mRNA expression is slightly reduced in post-mortem prefrontal cortex of patients with schizophrenia.

Collectively, our data suggests that RASD2represents a gene of potential interest in psychiatric disorders for its ability to modulate prefronto-striatal phenotypes related to schizophrenia.

Schizophreniais a psychiatric disorder with multiple causes, including genetic, immune, environmental causes of various kinds, which all increase the vulnerability andpredisposition to the disorder. Among them stand out prenatal infections, thusbeing a preventable risk potential factor in our daily clinical practice.

To analyze the relation between prenatal infecions andschizophrenia.

Review of the subject and recent articles on schizophreniain Psychiatric guides and magazines.

After analyzing several studies, it have shown that prenatal infections, where the nervous system is not yet fully developed, may be a risk factorfor the development of schizophreniain adults, in relation with genetically predisposed individuals. Infections such as influenza, especiallyduring the first quarter of gestation;rubella, toxoplasma and herpes simplex virus-type 2 are related topotencially increase risk of suffer schizophrenia.

Prenatal infections, especially in the firstquarter and the periconceptional period, constitute a risk factor inindividuals with vulnerability to develop schizophrenia. Awareness andprevention is important in the pregnant population of the influence of theseinfections on the possible origin of psychotic episodes.