Clinical Schizophrenia & related Psychoses

Aggressive behaviour represents a challenge in the treatment of patients with schizophrenia, being often associated with clinical predictors of severity of illness such as poor insight, psychotic re-exacerbation, concomitant substance misuse or comorbidity with personality disorders. As psychotic relapses and consequent risk of aggressive behaviour are often associated with a poor compliance, purpose of the present manuscript is to give an overview of the available data about the use of depot antipsychotics for the management of violence in patients with schizophrenia...

Memory impairment in schizophrenia has been linked to abnormal functioning of fronto-temporal networks. In this pilot study, we investigated whether 12-weeks of exercise improved hippocampal-dependent memory functions and resting-state functional connectivity in middle-aged adults with schizophrenia. The exercise regimen was feasible, well-attended, and safe. There was a pre- to post-intervention increase in spatial memory accuracy that was correlated to an increase in hippocampal-prefrontal cortex connectivity...

Previous research on theory of mind suggests that people with schizophrenia have difficulties with complex mentalization tasks that involve the integration of cognition and affective mental states. One of the tools most commonly used to assess theory of mind is the Faux-Pas Test. However, it presents two main methodological problems: 1) the lack of a standard scoring system; 2) the different versions are not comparable due to a lack of information on the stories used. These methodological problems make it difficult to draw conclusions about performance on this test by people with schizophrenia...

BACKGROUND: Treatment-resistant schizophrenia patients frequently need to be managed with clozapine. However, noncompliance is in-part due to complaints of sedation, fatigue, and low energy. There is little literature reporting on the effectiveness and safety of using stimulants to treat clozapine-induced sedation. We report three cases of treatment-resistant schizophrenia where methylphenidate was used to address these common side-effects. METHODS: To evaluate the effectiveness and safety of psychostimulants in treatment-resistant schizophrenia, we reviewed 3 extensively documented cases of clozapine-induced sedation treated with methylphenidate for over 2 years, in addition to reviewing the literature on this topic...

Premenstrual psychosis is a rare phenomenon initiating during or preceding menses, often lasting one to two weeks after the onset of menses. Previous literature shows links between the estrogen decline of the menstrual cycle's late luteal phase and the worsening of preexisting symptomatology in psychosis. There is thought to be a similar etiology in premenstrual psychosis. Current literature describes mostly clinical cases showing successful treatment using oral contraceptives and/or atypical antipsychotics...

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So far, demographic variables have not consistently been found to predict clinical response to antipsychotics. This study examines some differences in response to ziprasidone, which has been shown to be effective, with a better metabolic side effect profile, but was little used in New York State Hospitals. The aim was to study state hospital patients switched to ziprasidone. The results led to questions about different responses in different groups. Subjects from state hospitals who needed a change of antipsychotic participated in this open-label, 8-week trial of up to 240-mg ziprasidone...

No abstract text is available yet for this article.

Bipolar I disorder is a serious and disabling psychiatric illness. It is associated with a significant reduction in quality of life and an increased risk for suicide. Pharmacotherapy is essential for both the acute and maintenance treatment of bi-polar I disorder. While multiple oral medications are recommended for the maintenance treatment, there are not many long-acting injectable medications approved for this indication. New treatments that would improve patient adherence have the potential for decreasing relapses and improving patients' ability to remain functional members of society...

Tardive dyskinesia remains a significant, potentially stigmatizing or crippling adverse effect for any patient treated with an antipsychotic medication. While second- and third-generation antipsychotics have exhibited lower annual incidence rates for tardive dyskinesia than classic or first-generation agents, 3.9% versus 5.5%, the estimated incidence rate is only modestly lower. When coupled with the fact that second- and third-generation antipsychotic medications have come to be employed in treating a wider range of disorders (e...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVES: The Relapse Assessment for Schizophrenia Patients (RASP) was developed as a 6- question self-report screener that measures indicators of Increased Anxiety and Social Isolation to assess patient stability and predict imminent relapse. This paper describes the development and psychometric characteristics of the RASP. METHODS: The RASP and Positive and Negative Syndrome Scale (PANSS) were administered to patients with schizophrenia (N=166) 3 separate times...

In 2013 more than 150,000 Americans died from all types of lung cancer. Small cell lung cancer (SCLC) represents about 13% of all lung cancers and is notoriously associated with paraneoplastic syndromes (PNS). Here we present an interesting case of psychosis associated with one such PNS-- ectopic Cushing syndrome of SCLC. A 56 year old African-American male with no prior psychiatric history who was diagnosed with SCLC two months prior, presented to the ER for treatment of a right arm laceration he sustained while fighting off attackers, with high concern these individuals may have been part of hallucinatory experiences and well-systematized persecutory delusions regarding his wife...

The goal of this 21-year naturalistic study of clozapine treated patients was to examine the cardiovascular risk factors following clozapine initiation and resultant mortality estimates from cardiovascular disease. Data was collected from medical records of clozapine treated patients with schizophrenia or schizoaffective disorder from January 1992 to February 2012. Demographics, clozapine dosage and laboratory results were extracted at 12-month intervals. At clozapine initiation, the mean age of 96 patients was 36...

Almost fifty percent of patients with schizophrenia experience some type of dermatitis. The standard treatment for dermatitis is a topical corticosteroid. Despite their demonstrated effectiveness, topical corticosteroids are associated with various side effects that may limit their use. These include generalized adverse effects from systemic absorption, such as suppression of the hypothalamic-pituitary-adrenal axis. While dose-related, oral corticosteroid-induced psychiatric symptoms, such as psychosis, are well documented, the literature is devoid of cases of topical corticosteroids precipitating psychosis...

Case reports have indicated that pulmonary embolism (PE) can be associated with deaths during episodes of catatonia. A 15-year death registry in Kentucky state psychiatric hospitals was reviewed for deaths during episodes of catatonia. From 2002 to May of 2016, reports of 96 deaths at these state psychiatric hospitals were found and reviewed by the state mortality committee. The charts of the identified catatonic patients were thoroughly reviewed. All 6 deaths occurred during episodes of what Fink and Taylor would call retarded catatonia and Ungvari would call acute stuporous catatonia...

BACKGROUND: Suicide mortality is 12 times higher in psychotic patients compared to the general population. Identifying characteristic of suicidal patients among this group might help in preventing such behavior. AIMS: To assess the predictors of suicidal risk in patients hospitalized due to acute psychosis. METHODS: One hundred and fifty patients (age 18 - 60 years) admitted with acute psychotic features were recruited. Patients were evaluated clinically by The Arabic version of Mini International Neuropsychiatric Interview (M...