Schizophrenia and bipolar disorder are both associated with increased levels of serum lipids compared to healthy controls. However, it is not clear whether patients with schizophrenia differ from bipolar patients in terms of serum lipid concentrations and hyperlipidemia rates.

The serum lipid levels of 160 patients with schizophrenia and 41 patients with bipolar disorder (manic episode), consecutively admitted in an acute psychiatric ward during a 2-year period, were assessed.

There was no significant difference in serum cholesterol, high-density lipoproteins, low-density lipoproteins or triglycerides levels between the two groups of patients, after controlling for age. A considerable rate of schizophrenia patients demonstrated high cholesterol levels (>200mg/dl; 45.6%), whereas 15.6% of them had elevated triglyceride levels (>150 mg/dl). In bipolar patients, the rates for both

hypercholesterolemia and hypertriglyceridemia were 29.3%. The above rates did not differ significantly between the two groups of patients.

Acutely hospitalized patients with schizophrenia and bipolar disorder did not differ in serum lipid concentrations and hyperlipidemia rates.

There is evidence of an abnormal antioxidant defence system in schizophrenia. No such evidence exists for bipolar disorder.

To compare plasma antioxidant levels between patients with a relapse of schizophrenia or bipolar disorder (manic episode).

The serum levels of uric acid and bilirubin were assessed in 160 patients with schizophrenia and 41 patients with bipolar disorder, consecutively admitted in an acute psychiatric ward during a 2-year period.

Uric acid plasma levels were lower in patients with schizophrenia compared to bipolar patients (p=0.024), after adjusting for age. This difference was observed in male patients, while no significant difference was noted in females. The two groups did not significantly differ in plasma bilirubin concentrations. In patients with schizophrenia, uric acid concentrations positively correlated with bilirubin levels (Spearman rho=0.205, p=0.012), while no correlation between these two antioxidants was found in bipolar patients.

Our findings suggest that acutely admitted patients with schizophrenia have lower plasma uric acid levels, but do not differ in bilirubin levels compared to bipolar patients.

Second-generation antipsychotics (SGAs) have emerged as front-line treatment for many psychotic conditions due to reduced risk in extrapyramidal side effects (EPS) and related movement disorders. Available randomized, efficacy and tolerability data comparing conventional and SGA agents in Asian patients with acute exacerbation of schizophrenia are, however, limited.

Our objective was to compare IM/oral ziprasidone (N=130) versus haloperidol (N=122) in a 6-week, randomized study of acute schizophrenia, conducted in 6 Asian countries/districts (Hong Kong, Malaysia, Philippines, Singapore, Taiwan, and Thailand). This study replicated an identically designed randomized trial conducted in Europe and South America (79% Caucasian, (N=600) (1).

At the end of IM treatment (<= 3 days), mean change in BPRS total score was -7.7 in the ziprasidone group compared with -5.8 in the haloperidol (p=0.066), and the magnitude of treatment difference (LS mean -1.9; 95%CI [-3.9, 0.1]) was similar to that observed in (1) (LS mean -2; 95%CI [-3.3, -0.8]). At endpoint, between-group differences in BPRS total score, CGI-S and COVI scores were not significant (p>0.74). Ziprasidone was significantly superior to haloperidol in movement disorder related measures (ESRS and Barnes Akathisia Scales) and EPS adverse event rates (4.6% vs. 22%, respectively, in the IM phase; 20% vs. 61%, respectively, in the IM and oral phases).

These findings demonstrate consistent efficacy and tolerability advantages of ziprasidone over haloperidol in different ethnic groups, and support the use of bridging evidence from foreign studies for Asian patients with schizophrenia.

IOT is a court-ordered treatment in the community. It is used to ensure therapeutic compliance in some patients with severe mental illness. It was proposed for patients with no awareness of illness, high risk of relapse, disrupting behaviour and hospitalization. IOT is being used in the province of Gipuzkoa (Basque Country, Spain) since 1997.

Our objective was to assess the epidemiological and clinical characteristics of the outpatients under involuntary treatment in our province.

This is a retrospective study of the patients under IOT in the province of Gipuzkoa during October 2007 (n=87). The following variables were considered: sex, age, work and living situation, drug abuse, violent behaviours and number of previous hospitalizations.

Gender: male 70.2%; female 29.8 %. Age average: 39.5 (SD 9.6). Living situation: with relatives: 58.7%; alone 20%; in couple: 14.7%; institution: 6.7%. Work situation: inactive 60.8%; protected work 7.8%; incapacitated 3.9%; retired 2%. Diagnosis: schizophrenia 57%; delusional disorder 16.5%; bipolar disorder 8.9%; personality disorder 8.9%; schizoaffective disorder 5.1%; other 3.8%. Drug abuse: none 42.3%; multiple drugs abuse 31%; cannabis 9.9%; amphetamines 1.4%; opiates 1.4%. Violent behaviours: none 39.7%; violence against relatives 37%; violence against others 16.4%; autoaggression: 4.1%; both: 2.7%. Average of previous incomes: 3.79 (SD 3.8).

The most common profile of individuals under IOT in Gipuzkoa was a middle-aged male, affected by a psychotic disorder, drug abuser, with frequent violent behaviours.

Cognitive dysfunction represents an essentials feature of schizophrenia. Patients with schizophrenia have substantial memory deficits.

To examine memory deficits in first episode schizophrenia, characterise the nature of impairment and specify the relationships with the duration of untreated psychosis.

40 first episode schizophrenia patients admitted to the Second Psychiatric Clinic Cluj, Romania and 50 healthy controls were assessed with memory tests from CANTAB battery (Spatial Working Memory, Paired Associates Learning and Spatial Span) and with Rey Auditory Verbal Learning Test. The Positive and Negative Syndrome Scale (PANSS) was used to quantify symptom severity.

Statistical analysis: Results were analysed using SPSS 12 applying ANOVA, ANCOVA, chi square test and Pearson correlations. Duration of untreated psychosis was log10 transformed to reduce skew.

First episode schizophrenia patients scored significantly poorer then healthy subjects on all memory tests. Spatial working memory was impaired due to inadequate strategy use. Worse performance correlated with longer duration of untreated psychosis.

Impairments in memory are already present in first episode schizophrenia patients.

EEX grant 97/2006

In schizophrenic patients,Self – mutilation may have unusual manifestations . Inserting needle in to various parts of body is one of the rare type of self mutilating behavior .. Case presentation : The patient is a 40 years old man with chronic paranoid schizophrenia who is living in the state hospital since 20 years ago. The patient stuck several needles in to his body especially various anatomical region of his face and genitalia .Other forms of self mutilation such as ingestion of thermometer and self injection of aubergine juice were observed in him.

To our knowledge it is one of uncommon self mutilating behavior in a single case. He had inserted needles into parts which he heard hallucinatory voices from them. Other reasons were discussed.

We present the case of a psychotic patient with a previous diagnosis of pellagra, admitted to an acute care unit of Miguel Bombarda Hospital, Lisbon. Pellagra is a systemic disease caused by niacin deficit; its clinical presentation is revised, taking into account psychiatric disease.

We will focus the following items:

1. - definition of pellagra and description of its main clinical symptoms

2. - historical issues of psychiatric symptoms of pellagra

3. - pellagra psychosis – evolution of classifications

4. - neuropsychiatric features of pellagra

5. - diagnosis, treatment and outcome of psychiatric illness of pellagra

Medline Research. Bibliography revision.

Clinical presentation of pellagra includes gastrointestinal, dermatological and neuropsychiatric symptoms.

The first description of pellagra dates back to 1863. In the beginning of the 20th century, approximately 30% of admissions in psychiatry were due to this disorder, which was included in the first classification of mental illness of the American Psychiatric Association.

Pellagra psychosis should be diagnosed in a patient with typical symptoms and signs of pellagra and psychotic symptoms which respond to treatment with niacin.

Pellagra is currently a rare disorder, but the diagnosis should be taken into account in alcoholic patients, undernourished, with anorexia nervosa or tuberculosis treated with isonyazid.

With proper treatment, there is a complete recovery.

To describe a generalizable stochastic-simulation model for schizophrenia treatment related with the cardiovascular associate risk of SGA.

A model to simulate the expected 10-year occurrence of all-type cardiovascular events (CVE) in a hypothetical cohort of 100.000 patients with schizophrenia treated with SGA drugs in Spain was developed. The model considered, as a baseline health state, outpatient treated with SGA with characteristics of patients enrolled in the CLAMORS study; a cross-sectional study in schizophrenia spectrum disorders aimed to ascertain prevalence of metabolic syndrome in such patients together with CHD. Three other states were considered: suffering a CVE, death due to CVE and death due to other causes. The CVE risk for each SGA drugs was estimated through a locally-adjusted Framingham risk equation. Treatment outcomes were simulated using the expected mean change of the cardiovascular (CV) risk factors from the CATIE clinical trial. Death by CVE or others causes were estimated from published literature.

The 10-year rate of CVE following SGA treatment was 0.181, 0.179, 0.176 and 0.172 for olanzapine, quetiapine, risperidone and ziprasidone, respectively. Relative risk was calculated relative to no-treatment, and the corresponding values were 1.03, 1.02, 1.00 and 0.97. The total estimated CVE were 25,269 events; 25,157; 24,883 and 24,514, respectively.

A generalizable, flexible model was developed through stochastic simulation of the CV risk for SGA drugs. The estimated clinical outcomes suggest different levels of CVE risk for each SGA drugs. Ziprasidone showed the lower rate with no association with increased risk for CHD.

The objective of this research is determines the most frequent basic symptom & the most frequent type of schizophrenia in Ardabil hospitals patients.& providing a new classification of basic symptoms in these patients, so that psychiatrics of Ardabil city can use the results of this study to achieve an accurate & also rapid diagnosis of schizophrenia.

This study is a descriptive – analytic one. A sample of 100 patients of both sexes from 17 up to 40 years old was selected. To study the basic symptoms of schizophrenia in them, we used a 44 item questionnaire which was provided through a combination of PANSS & Kitamura questionnaires. To screen the patients with schizophrenia, we used MMPI test. The findings was analyzed by descriptive statistics & through the computer software SPSS. Also a PCA method of factor analysis was used to the hypotheses.

single (62%=49 patients), unemployed (52%=52), with no education (31%=31), negative family history (91%=91), with frequent admission (47%=47). The most frequent basic symptom in these patients was social withdrawal was at second place. the most frequent type was paranoid schizophrenia (44%=44).

The findings have a concordance with results of the last studies about the basic symptoms of schizophrenia & also with DSM-IV & Bleuler& Kraepelin symptoms all of these systems introduce the different fields of a single diagnostic structure rather than antagonist ones.

Anyway, two important factors that were recognized were cognitive disorder. This study suggests that if we recognized emotional symptoms

The objective of this research is studying the basic symptoms in schizophrenic patients and determines the most frequent basic symptom and the most frequent type of schizophrenia in them. Also, providing a new classification of basic symptoms

This study is a descriptive – analytic one. A sample of 100 patients of both sexes(age: 17-4O)was selected. To study the basic symptoms of schizophrenia in them, we used a 44 item questionnaire which was provided through a combination of PANSS (Emsley, 2003) and Kitamura questionnaires. we used MMPI test. The findings were analyzed by descriptive statistics and through the computer software SPSS. Also a PCA method of factor analysis was used to the hypotheses.

single (62%=49 patients), unemployed (52%=52 patients), with no education (31%=31 patients), negative family history (91%=91 patients), with frequent admission (47%=47 patients). The most frequent basic symptom in these patients was attention deficit, and social withdrawal was at second place. Also, the highest frequent type of schizophrenia was paranoid schizophrenia (44%=44 patients).

This study's findings are similar to with the results of the last studies about the basic symptoms of schizophrenia and also with DSM-IV and Bleulerand Kraepelin symptoms . it seems that all of these systems introduce the different fields of a single diagnostic structure rather than antagonist ones.

However, two important recognized factors were cognitive disorder and relationship disorder. This study suggests that if we recognized emotional symptoms and restlessness, we should think of other psychotic disorders.

Against the background of a paradigm shift in the locus of treatment from the hospital to the community, successful housing and re-establishing residential skills therefore are among the main preconditions for the independent living of schizophrenia outpatients. But so far only a few empirically evaluated treatment approaches exist, which specifically focus on improving these skills.

During the last years, we developed a new manualised cognitive-behavioural group therapy program for residential skills (experimental group, EG).

In an international controlled study, the EG was compared to a conventional, unspecific therapy for social skills (control group, CG). EG and CG were conducted in groups consisting of 5-8 patients over a period of 6 month. Assessments were applied before and after therapy and at a 1-year follow-up. Additionally, relapse rates and rehabilitation status were assessed over 5 years after the beginning of therapy. Altogether 54 patients participated in this study (EG: N=26; CG: N=28).

EG patients displayed a significantly higher frequency of change from a high structured in-patient setting to a lower structured outpatient setting and unassisted living compared to CG patients during 5 years of assessment (odds ratio=12.5). Moreover, lower relapse rates, significantly reduced psychopathology and higher treatment motivation of EG patients compared to controls were found. Both treatment groups significantly improved in cognitive and general social functioning.

Due to these results, the newly developed residential skills program could constitute an additional treatment option in the context of multimodal psychiatric rehabilitation.