Schizophrenic Spectrum Disorders Research Articles

Hair cortisol concentrations in pregnant women with bipolar, depressive, or schizophrenic spectrum disorders.

Maternal cortisol levels in pregnancy may support the growth of or adversely affect fetal organs, including the brain. While moderate cortisol levels are essential for fetal development, excessive or prolonged elevations may have negative health consequences for both the mother and the offspring. Little is known about predictors of altered hypothalamic-pituitary-adrenal (HPA) axis activity during pregnancy. This study examined maternal hair cortisol concentration (HCC) in the 3rd trimester of pregnancy in relation to severe psychopathology. Hair samples were collected from 69 women, 32 with a lifetime diagnosis of severe mental disorders (bipolar I or II disorder, moderate or severe depressive disorder, schizophrenic spectrum disorder), and 37 non-clinical controls. Hair samples were collected during the 3rd trimester, and liquid chromatography tandem mass spectrometry was used for cortisol assessment. Psychiatric diagnosis and current level of symptomatic functioning were assessed using the structured clinical interview from the DSM-5 and the global assessment of functioning scale. Women with a lifetime diagnosis of severe mental illness had significantly elevated HCC compared to controls. Poorer current symptomatic functioning was also significantly associated with elevated HCC in pregnancy. The implications of alterations in HCC on both maternal and infant health need further study.

Сariprazine in the treatment of schizophrenia spectrum disorders in a hospital setting

The aim of the study was to evaluate the possibility of using cariprazine for the treatment of productive and negative symptoms in schizophrenic spectrum disorders in a hospital setting.Materials and methods: A group of 35 patients with leading productive and negative symptoms in patients with schizophrenic spectrum disorders treated in a psychiatric hospital constituted the material of the study. The condition of patients was objectified according to the Clinical Global Impression Scale (CGI-S and CGI-I) and the Positive and Negative Syndrome Scale (PANSS) — at the beginning of the study and in dynamics on the 30th and 60th day of treatment. The mean PANSS score at the beginning of the study was 94.45±14.49 points. After the drug administration, the patients were followed up for up to 60 days.Results: Cariprazine was administered both as first-line treatment and after prior therapy. The dose range was from 1.5 mg to 6 mg daily. In 3 patients (8.57%), cariprazine therapy was discontinued due to the development of adverse events or worsening of the condition. The remaining 32 patients (91.43%) showed positive dynamics.Conclusions: The study showed high efficacy of cariprazine when administered for the treatment of productive and negative symptoms in schizophrenic spectrum disorders in a hospital setting. The drug was well tolerated in the majority of patients.

Clinical and Social Characteristics, Quality of Life, Adherence to Therapy of Out-Patients with Schizophrenic Spectrum Disorders: Cross-Sectional Study

Background: clinical diversity of schizophrenic spectrum disorders determines a variety of long-term management and treatment outcomes of out-patients.Aim of the study: to analyze the interrelationships of clinical and social characteristics, quality of life and adherence to therapy in patients with schizophrenic spectrum disorders.Patients and methods: data of 120 patients observed in a neuropsychiatric dispensary with diagnoses of schizophrenic spectrum disorders (F20, F21, F25 according to ICD-10) were studied.Results: three categories of individuals were identified, taking into account the high degree of intragroup similarity of clinical and social characteristics. Patients of the first group (29%) have a stable-positive characteristics of social adaptation and a high adherence to therapy. They were characterized by a younger age, mainly an attack-like course of the disease with an affective-delusional structure of exacerbations and weakly pronounced personality changes. Significantly more often than patients of other groups, they received therapy with second-generation antipsychotic drugs of prolonged action. Patients of the second group (39%) have the negative dynamic characteristics of social adaptation and a low adherence to therapy. They were characterized by older age, continuous or episodic types of disease course with increasing defect, higher prevalence of moderately and strongly pronounced positive and negative symptoms at the time of remission. Treatment and rehabilitation measures did not give sufficient results, despite the active use of prolonged antipsychotic drugs of the second generation. In this category of patients, there were phenomena of social drift, with the collapse of social ties, loss of work skills. Patients of the third group (32%) were characterized by contradictory characteristics with stable negative characteristics of social adaptation and high adherence to therapy. A significant part of the patients had negative personality changes and often a low-grade course of the disease with a predominance of neurosis-like and depressive symptoms. Receiving for many years mainly therapy with firstgeneration antipsychotics (APP1) and practically not hospitalized in a psychiatric hospital, they found pronounced social isolation, loneliness and feelings of hostility of the surrounding world.Conclusions: the management of out-patients with schizophrenic spectrum disorders represent clinical problems depending of different forms of social adaptation and adherence to therapy, for the effective solution of which it is necessary to optimize complex social rehabilitation measures.

The relationship between bullying and symptom presentation in first-episode psychosis.

Multiple recent studies have indicated that adverse psycho-traumatic experiences are particularly significant, if not the most significant, among the environmental factors that participate in the aetiology of schizophrenic spectrum disorders. The prevalence of bullying in the adolescent population has increased dramatically compared to earlier reports. This may be related to the recent development of communication technology and the use of social media, which have expanded the means by which bullying can be practiced. The present study aims to investigate the association between bullying victimisation and psychotic symptoms in First-Episode Psychosis (FEP) patients, hypothesising that patients who have a bullying history may have increased psychotic symptoms and a more unfavourable early trajectory after treatment as usual compared to patients who do not have a bullying history. Research data were collected from a sample of men and women of the Greek general population aged between 16 and 45 (N=225) who experienced a FEP in the context of the Athens First-Episode Psychosis (FEP) Study. The assessment of bullying was performed using the Retrospective Bullying Questionnaire (RBQ). Assessment of positive and negative psychotic symptoms and general psychopathology was performed using the corresponding subscales of the Positive and Negative Syndrome Scale (PANSS) at baseline and after 4 weeks of treatment as usual. Clinical remission was assessed based on the baseline and follow-up values of the PANSS and on Andreasen's symptomatic criteria. Methodologically, Pearson's chi-square test was used to compare the history of bullying between men and women, while linear and logistic regression models were used to check the correlations between history of bullying and symptom severity at baseline and 4-week follow-up, as well as the correlation between history of bullying and remission. The prevalence of bullying history in our sample of patients (N:225) with a FEP was 51.4% (114/225). Bullying was recorded in our study participants with equal frequency in women and men. According to the analysis results, the patients who had experienced bullying did not present at baseline with significantly increased psychotic symptoms compared to the patients who did not have a history of bullying. In addition, bullying was not associated with reduced remission according to Andreasen's criteria. However, the patients who had experienced bullying were found to have significantly increased negative symptoms (B=1.66; SE=0.70; p=0.018) and increased PANSS total score (B=4.81; SE=2.34; p=0.041) at 4-week follow-up. Our results highlight the persistence of negative and overall symptoms as an impact of bullying on the development of the FEP and align with studies that support the consideration of a history of bullying during both the diagnostic and therapeutic processes.

Pathologies of imagination and affectivity: the genesis of the unconscious in Marc Richir.

In their recent work in phenomenological psychopathology, Andreas Rosén Rasmussen and Joseph Parnas argue that there is an expressive relationship between the anomalies of imagination reported in schizophrenic spectrum disorders (SSDs) and an underlying generative self- or ipseity disorder. The authors build their argument on an updated review of the phenomenological model of consciousness, by which each experience articulates itself in ipseity according to its modality. Therefore, they explain imagination as the figuration of an absent object mediated by the imaginary and accompanied by a sense of irreality. Finally, by drawing on patients' descriptions, Rasmussen and Parnas show that SSD imagination disorders testify to the breakdown of this model of consciousness. In this article, I aim to complexify the scenario summarized above by focusing on the contribution made by the phenomenologist Marc Richir in his late masterwork Phantasia, imagination et affectivité (2004). To this end, I examine the genetic analyses of the pathologies of the imaginary that Richir develops through a non-standard interpretation of Husserl's phenomenology of imagination (in particular, Hua XXIII, text n.16, 1912). In my examination, I aim to unfold an alternative model of consciousness that (a) is based on the gap between the architectonic registers of phantasia and imagination (and the corresponding stages of sense-making and the institution of sense), (b) takes account of the role of affectivity in those registers, (c) places the pathologies of the imaginary in the quasi-empathy that characterizes the missed encounter with the other, and (d) links the institution of these pathologies with the psychoanalytic account of the fixation of the phantasm.

Сognitive Functioning in Patients with the Phenomenon of Anhedonia in the Framework of Affective Pathology and Schizophrenia Spectrum Disorders

Background: anhedonia is a transdiagnostic psychopathological phenomenon, which is assessed as “core” for several diseases at once — first of all schizophrenic and affective spectrum disorders. The problem of clinical features differentiation and identification of anhedonia’s neurobiological mechanisms in the structure of the affective and schizophrenic spectrum disorders is still topical and far from being resolved.The aim of the study: to compare the relationship between the features of neurocognitive functioning and the manifestations of anhedonia among patients with disorders of the schizophrenic and affective spectra.Patients: the sample consisted of 40 patients including 17 patients with schizophrenic spectrum disorders (ICD-10 diagnosis codes F20.01, F20.02, F21.3, F21.4, F25.0, F25.1) and 23 patients with affective disorders (ICD-10 diagnosis code F33, F31).Methods: clinical, psychometric, experimental psychological and statistical.Results: patients with schizophrenia spectrum disorders show lower scores on pleasure anticipation ability and ability to experience pleasure in the social sphere. The affective spectrum group showed a correlation between anticipatory anhedonia and phonetic verbal fluency (r = –0.487; p < 0.01). There was also a correlation between immediate pleasure experience and errors in the Rey figure test (r = –0.349; p < 0.05). Social anhedonia in these patients was associated with phonetic verbal fluency productivity (r = –0.509; p < 0.01) and performance in visual fluency productivity (r = –0.473; p < 0.01). Patients with schizophrenia spectrum disorders had a correlation between anticipatory anhedonia and the Color-Word Interference Test (r = –0.329; p < 0.05) and the Rey Complex Figure Test (r = –0.307; p < 0.05). Consummatory anhedonia was correlated with verbal fluency test (r = –0.511; p < 0.01) and the Rey Complex Figure Test (r = –0.417; p < 0.01). Social anhedonia was correlated with Color-Word Interference Test (r = –0.656; p < 0.01), verbal fluency (r = –0.523; p < 0.01), and story description (r = –0.421; p < 0.01).Conclusion: manifestations of different parameters of anhedonia demonstrate the differences in schizophrenia and affective spectrum disorders. Patients with schizophrenia spectrum disorders have greater difficulties in anticipating pleasure and experiencing pleasure in the social sphere. The ability to anticipate pleasure may be associated with executive function, while the ability to experience pleasure immediately may be associated with memory function. Social anhedonia affects a wide range of cognitive functions.

Prospects of using event-related potentials in medical examination of military mental disorders

Relevance. Considering the demand for additional efficient methods among clinicians to assess military mental health, instrumental methods, including psychophysiological and neuropsychological tools, providing objectifying detection of mental disorders (MD) are of particular importance. Event-related potentials (ERP) are a promising additional method of objectification of psychopathological manifestations, allowing to obtain neurophysiological parameters for processes associated with arbitrary attention, identification and decision-making.Objective. The study provides a generalized analysis of contemporary investigations and research outcomes regarding event-related potentials as a diagnostic tool for mental disorders, its diagnostic and prognostic potential in medical examination of military mental disorders.Methods. To assess the ERP diagnostic informative value, we analyzed over 40 scientific studies published within the last 10 years dealing with event-related potentials and their implementation in MDs, various brain structure damages and associated functional disorders. We also summarized the results of applying this method to study patients’ cognitive abilities and integrative functions.Results and discussion. Our analysis of scientific studies shows that the ERP value differs significantly for various MDs, such as: schizophrenic spectrum disorders, affective disorders, or addictive pathology. The conclusion suggests that the assessment of the parameters associated with various ERP modifications can improve objectivity of diagnostic and prognostic outcomes in military mental disorders.Conclusion. Event-related potentials is a promising method of diagnostic significance to assess severity of perception, attention, short-term memory damage, as well as cognitive disorders. ERP can help determine the boundary values and diagnostic criteria, as well as evaluate treatment efficiency and outcomes in military mental disorders. Moreover, ERP could be a promise as an additional research method to objectify MDs in mental state assessment of the military at military medical examination.

Plasma autoantibodies in patients with Affective and Schizophrenic Spectrum Disorders

Plasma autoantibodies in patients with Affective and Schizophrenic Spectrum Disorders

Реорганизация психиатрической службы и антипсихотическая терапия больных шизофренического спектра

The article discusses the trends in the use of antipsychotic drugs in the treatment of patients with schizophrenic spectrum disorders (RSHS) in the context of the reorganization of the psychiatric service on the example of Moscow. The reform of the psychiatric service (2012-2020) has radically changed the structure of psychiatric care, the system for evaluating its effectiveness and the economic basis. While the number of inpatient beds decreased by more than 3 times, the number of places in day hospitals increased by more than 2 times, the number of visits to a psychiatrist in the outpatient network increased by 2.5 times during the year. During the period under review, the number of repeated hospitalizations of patients with RS in psychiatric hospitals has also significantly decreased. At the same time, stable indicators of the incidence of RS during the considered period of time remain. Simultaneously with the reform of the psychiatric service, there was an increase in the consumption of antipsychotics from 7.6 million Defined Daily Dose (DDD) in 2013 to 12.3 million DDD in 2021, including conventional (KA) and atypical antipsychotics (AA) from 17% to 30% with an outstripping increase in the use of prolonged injectable antipsychotics (primarily AA). If in 2013-2016 AA of prolonged action made up an insignificant part of the total array of prolonged drugs (5-9%), then there was a consistent increase in their use. In 2021 they accounted for 36% of the total volume of prolonged-acting drugs (an increase of 400%), with a general increase in the use of prolonged forms by about 3 times. There was a sevenfold increase in the proportion of injectable forms from the total volume of AA – from 3% (2016) to 23%, and a twofold overall increase in the volume of AA use from 2.5 million DDD (2013) to 5.8 million DDD (2021). It is stated that there has been a stabilization of the system of providing psychiatric care to patients with RSHS with a shift of emphasis to the outpatient link and the widespread introduction of prolonged AA. To the greatest extent, these trends are found in the increasing use of risperidone-const and prolonged forms of paliperidone. It is concluded that the psychiatric service is on the threshold of a new stage of development, which represents a way of personalizing psychiatric care based on an individual approach to the patient.

Experience of clinical use of fluvoxamine for the treatment of comorbid depression in childhood and adolescence

To identify the frequency of administration of fluvoxamine, to determine the main targets of the drug and the expediency of its use in depression of various genesis in children and adolescents. To assess the frequency of prescribing fluvoxamine, 195 medical histories of patients who were inpatients in the children's department of the Mental Health Research Center in 2023 were analyzed. To assess the dynamics of depression during treatment with fluvoxamine, a clinical group was formed of 12 patients aged 10 to 15 years (age 13.1±3.6 years) who received fluvoxamine for the treatment of depression with comorbid obsessive-compulsive and anxiety-phobic disorders. Clinical and psychopathological, psychometric (Hamilton Depression Rating Scale - HDRS) and statistical research methods were used. In total, in 2023, fluvoxamine was received by 20% (n=37) of all inpatient patients of child age (from 7 to 16 years). All patients received combination therapy. The therapeutic targets were comorbid depressive, obsessive-compulsive and anxiety symptoms developing in the structure of nosologically heterogeneous states, with the dominance of schizophrenic spectrum disorders. Against the background of the use of the drug fluvoxamine for 4 weeks in the clinical group, there was a significant reduction in depressive symptoms on the HDRS. Adverse events during complex therapy were observed in 20% of patients, but were not severe, did not require discontinuation of therapy and were unreliably associated with the use of fluvoxamine. The use of the fluvoxamine provides reduction of depressive symptoms within the framework of various nosologies, and is characterized by sufficient safety. The variety of therapeutic targets of the fluvoxamine, including antidepressant, anti-anxiety, cognitive effects, is certainly a significant advantage of the studied fluvoxamine for use in childhood.

Application of Antipsychotic Medication: Gender Differences in Tolerance and Medication Response

This paper covers the role of gender factor in the efficacy and tolerance of antipsychotic therapy in patients with schizophrenic spectrum disorders. The author describes phenomenology of definitions that characterizes differences between male and female sexes. The authors give the data on biological basis of gender differences, frequency of occurrence and clinical features of neuroendocrine dysfunctions (NED) in patients with schizophrenic spectrum disorders during the therapy by first and second generations antipsychotics. It is shown that female patients are more “vulnerable” for some NED. It is emphasized that the problem of tolerance is now more relevant and significant in comparison with the efficacy of antipsychotics, because intolerance or poor tolerance are one of the most common reasons for non-adherence to therapy up to the complete abandonment of it.

Proteomic profile of serum from patients with schizophrenia spectrum disorders.

This article describes the most likely classes of proteins and molecular processes that specifically characterize schizophrenic spectrum disorders such as simple and paranoid schizophrenia, schizotypal disorder, and acute polymorphic psychotic disorder (APPD). The identification of patients’ serum proteins was carried out using mass spectrometry. For patients with paranoid schizophrenia, the proteins responsible for translation and transcription are characteristic. A significant part of the proteins of patients with simple schizophrenia regulate the cell’s main metabolic and transport processes. These are proteins of the receptor system, vesicular transport, and extracellular matrix, which mainly carry out catabolic processes. The proteins of patients with schizotypal disorder mostly coincided with the classes of other patients, apart from chaperone proteins, which were not found in other studied groups. These proteins are mainly involved in anabolic processes. The main classes of proteins found in patients with APPD are responsible for the metabolism of nucleic acids. Active apoptosis processes were also revealed in these patients. These results from our basic knowledge about the molecular mechanisms of the pathogenesis of these disorders.

Efficacy of nutrition education for the increase of symbiotic intake on nutritional and metabolic status in schizophrenic spectrum disorders: A two-arm protocol.

Background/ObjectivesThe microbiota plays a vital role in the two-way communication between the gastrointestinal tract and numerous neuropsychiatric disorders, such as schizophrenia. Besides, the microbiota modulation through the use of psychobiotics (prebiotics and probiotics with nutraceutical action) is related to the improvement of the physical and psychopathological health. The objective to this study was to test the efficacy of prebiotic/probiotic dietary modulation in patients diagnosed with schizophrenia, attending to the nutritional and cardio-metabolic impact.MethodsTwo-arms, double-blind, randomized in balanced blocks clinical trial of 6 months of intervention, will be developed in a group of 50 individuals. The control group will receive conventional dietary advice individually from specialized mental health nurses. In the intervention group, an individual dietetic-nutritional education program with high prebiotic and probiotic content (dairy and fermented foods, green leafy vegetables, high-fiber fruit, whole grains, etc.) will be developed by these nurses. Data will be collected on the psychopathological state, and blood test (at the beginning, at 3 and 6 months). The estimation of intestinal microbiota and the usual nutritional pattern will also be assessed at the beginning and 6 months, using a stool test. To evaluate the degree of adherence, the intervention group will fill a specific weekly record of the main dishes/food consumed. Anthropometric parameters will also be analyzed monthly.DiscussionThe study is anticipated to establish feasibility an adequate dietary modulation with a high simbiotic content, leads to a significant improvement in the nutritional status and cardio-metabolic. Furthermore, it is presumed to reach a degree of evidence that allows establishing nutritional management as an effective therapeutic intervention in the psychopathological treatment of patients with schizophrenia spectrum disorders.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT04366401].

Dynamic Interactive Social Cognition Training in Virtual Reality (DiSCoVR) for adults with Autism Spectrum Disorder: A feasibility study

BackgroundSocial cognitive difficulties in Autism Spectrum Disorder (ASD) can affect the daily lives of people with ASD profoundly, impacting the development and maintenance of meaningful social relations. Social cognition training (SCT) is commonly used for improving social functioning, but lacks ecological validity and the ability to effectively mimic social situations. Development of virtual reality (VR) interventions, focusing on enhancing social cognition, could add to the effectiveness of SCT within ASD care, by offering a safe, interactive and practical training setting, where generalization of knowledge and skills to the real-world are promoted. In this paper, our primary aim is to evaluate the feasibility and acceptance by participants and therapists of the Dynamic Interactive Social Cognition MethodTraining in Virtual Reality (DiSCoVR) protocol as developed for adults with schizophrenic spectrum disorder (SSD), adapted for ASD (DiSCoVR-A). 26 participants, aged 18–63, took part in a pilot study. 22 participants completed baseline and post-assessment, including primary outcome evaluation assessment through a semi-structured interview. Secondary measures focused on social cognition, emotion recognition, mental flexibility, social anxiety, empathy and social responsiveness and were assessed at baseline (T0), post-treatment (T1), and at follow-up (T2) sixteen weeks after completion of the intervention. ResultsOur results show that the majority of participant and therapists found the VR intervention acceptable and feasible, as reported in evaluation questionnaires and interviews. ConclusionThese preliminary findings are promising; however, controlled research is needed to further investigate the effectiveness of VR within social cognition training for adults with ASD.

Evolution of the Affective Catatonia Concept in XIX–XXI Centuries

Background: the connection of catatonic disorders with affective pathology is noted in publications related to the prenosological stage of research in psychiatry. Numerous publications of the last and the current centuries are devoted to clinical studies of the relationship between affective and catatonic symptoms. At the present stage of scientic development, catatonia is considered as a transnological formation, manifesting in the framework of various nosological units, including affective diseases. Aim: analysis of the affective catatonia construct’s development in the period of the XIX–XXI centuries and development of affective-catatonic states, forming in the clinical space of schizophrenia and schizophrenic spectrum disorder, conceptual model. Conclusion: affective-catatonic disorders represent a continuum of psychopathologically differentiated phase-owing state. At one of the continuum pole there are catatonic disorders manifesting in the structure of affective pathology, which is realized at the level of recurrent depressions; at the other pole — affective-catatonic states of more severe psychopathological register, acting in the clinical space of bipolar affective disorder and schizoaffective psychoses. The role of movement disorders in affective-catatonic attacks and phases, as well as the modus of interaction of catatonic disorders with affective ones, also varies widely. In some cases, motor symptoms replace the affective symptoms, on the basis of which they were formed, and completely determine the clinical picture of the state; in others — they only modify the manifestations of affective disorders without altering their syndromic structure.

Effectiveness of Psychosocial Rehabilitation: Innovative Method of Results Assessment

Background: The main problem of evaluating the effectiveness of psychosocial rehabilitation (PSR) is incorrect methods of processing psychometric data obtained with the help of appropriate tools (scales and questionnaires), which are standard used to measure the effectiveness of interventions within the framework of the implementation of PSR procedures. The purpose of the study: 1) а systematic analysis of the problems of assessing the severity of mental disorders and the effectiveness of subsequent PSR; 2) development of cardinal algorithms for processing the initial expert information in order to obtain appropriate numerical criteria for the effectiveness of the PSR. Material and methods: a systematic analysis of domestic and foreign publications, based on the results of their own research on the problems of assessing patients’ conditions, as well as evaluating the effectiveness of a comprehensive long-term PSR program for people with schizophrenia and schizophrenic spectrum disorders in various forms of care (public organization, day hospital, hospital). As methods of information processing, clinical-psychopathological, psychometric, as well as methods of system analysis and the analytic hierarchy process (AHP) were used. Results: an innovative methodology and algorithms for processing expert clinical, psychopathological and psychometric information based on the AHP apparatus have been developed to develop criteria for the effectiveness of PSR. The cardinal difference between the proposed approach and the rank methods of processing initial information is that the results of processing initial expert information are obtained in the fundamental scale of AHP (numerical scale), which ensures the correct integration of psychometric and psychosocial characteristics of patients when considering diagnostic procedures, psychosocial therapy and rehabilitation. Conclusions: the calculations are based on expert assessments of the weight of areas of impaired functioning of patients and the corresponding changes in psychosocial characteristics. This ensures the universality of the methodology and algorithms for evaluating the effectiveness of any rehabilitation interventions: from psychosocial to physiotherapy.

Dopamine receptor DRD1 expression (mRNA, protein level) in peripheral blood lymphocytes and prognosis of antipsychotic therapy

Introduction. There is a problem in predicting the efficacy and safety of antipsychotic therapy. Dopamine receptor D1 is one of the targets of antipsychotics. Peripheral blood lymphocytes (PBL) are the research object of neurotransmission receptors.The objective was to study DRD1 gene expression (mRNA, protein level) in PBL as a possible biomarker of olanzapine and haloperidol therapy prognosis.Methods and Materials. Sample: 106 patients diagnosed with schizophrenic spectrum disorder. Study design: prospective longitudinal follow-up with drug administration by randomization. Assessment of mental status and development of Parkinsonism: Positive and Negative Syndrome Scale (PANSS) and Simpson-Agnus Scale (SAS), respectively. PBL was study material. DRD1 mRNA level was determined by real-time PCR. DRD1 protein concentration in PBL was measured by enzyme immunoassay.Results. Haloperidol (but not olanzapine) treatment for 28 days, leads to DRD1 protein concentration decrease in PBL in a manner dependent on its initial level. DRD1 mRNA level in PBL remained unchanged during the treatment. Patients with effective therapy by olanzapine had lower DRD1 mRNA levels. Side effects of the therapy (Parkinsonism, weight gain) were not associated with studied DRD1 parameters.Conclusions. Haloperidol treatment leads to a decrease of DRD1 protein concentration in PBL, which depends on the initial protein level. Effective olanzapine therapy is associated with reduced DRD1 mRNA level in PBL before the treatment.

Clinical features of the combination of agoraphobia and non-psychotic mental disorders

The review article gives a modern definition of the concept of agoraphobia. Different classification approaches in the typing of agoraphobia are presented. Its role as a factor aggravating the course of non-psychotic mental disorders is shown. The features of its manifestation depending on the nosological affiliation are analyzed. It was revealed that agoraphobia is a predictor of an unfavorable outcome in people with panic disorder. In turn, panic disorder often causes the development of agoraphobia. At the same time, gender and age aspects are noted. The comorbidity of agoraphobia and somato-vegetative type of generalized anxiety disorder is shown. Agoraphobia increases the risk of suicidal behavior in depression, has a high correlation with the severity of personality disorders, especially of the avoidant and dependent type. At the same time, some researchers dispute the point of view that these types of personality disorders are predisposing factors for panic disorder and agoraphobia, based on retrospective data on the premorbid personality structure of patients with anxiety disorders. The relationship between PTSD and panic disorder is emphasized in connection with the emergence of a circular model of the development of feelings of fear, which postulates a similar etiology of anxiety disorders. There is a comorbidity of agoraphobia with disorders of the hypochondriac spectrum: from the degree of fixation to obsessive nature. reduces the effectiveness of therapy for schizophrenic spectrum disorders and the quality of life of patients. The picture of the panic disorder itself with agoraphobia becomes heavier if the patient has chronic alcoholism (in particular, the frequency of seizures increases), while the presence of agoraphobic symptoms leads to a relapse of alcoholic illness, which is explained by taking alcohol to relieve symptoms, and also increases the likelihood of developing dependence on tranquilizers.

Correlation between psychotic risk and depressive “cognitive” symptoms in adolescence

IntroductionPrevention of disorders has become a central element of psychiatric research and clinic. Currently, Ultra High Risk (UHR) criteria are internationally recognized for psychiatric risk assessment. Self Disorders (SD) aroused particular interest because they were found to be specific to schizophrenic spectrum disorders and a marker of vulnerability for psychotic onset.ObjectivesTo evaluate the correlation between psychotic risk and depressive symptoms in at-risk adolescent population.MethodsWe collected data from 80 patients, aged 14-18, with sufficient skills in the Italian language and an IQ ≥70, excluding patients with disorders related to direct effects of a general medical condition or substance. Psychodiagnostic evaluation included K-SADS-PL, SIPS/SOPS, EASE (for the assessment of SDs) and the CDSS (for the assessment of Depression).Results35 subjects have UHR criteria, while 45 do not have a psychotic risk syndrome or psychotic features. Between the two groups there is a significant difference in the total SCORE of EASE, in domains 1, 2 and 5. In addition, a positive correlation between SDs and depressive symptoms emerged, in particular with pathological guilt and with reference ideas of guilt.ConclusionsThe results confirm the validity of SDs for early detection of psychosis. Depressive features appear to be associated with the presence of abnormalities of experience. This results suggest a close care and monitoring of depressive symptoms in adolescence, because they can mask disorders of different nature, particularly pathological guilt and guilty ideas of reference that are depressive “cognitive” symptoms more correlate with psychotic risk.DisclosureNo significant relationships.

New categories of psychiatric disorders related to mild neuroinflammation-autoimmune psychosis, mild encephaliutis

IntroductionThe mild encephalitis hypothesis(ME) ( Bechter 2001, NPBR; updated Bechter 2013,Progr NP&BP) proposed that mild neuroinflammation triggered by infections, autoimmunity, trauma or toxicity (including from stress) might causally underly a spectrum of severe mental disorders (SMDs), especially disorders of the schizophrenic and affective spectrum.ObjectivesThe development from ME hypothesis to the new diagnoses of Autoimmune Psychosis (AP) and a subgroup of Autoimmune Encephalitis (AE) and beyond into future research is reviewed and discussed.MethodsExpert reviewResultsThe subgroup of AE with exclusive or predominant psychiatric symptoms ( compare Graus et al 2016) and all cases of AP ( Pollak et al,Lancet Psychiatry 2020) match the previous poposed ME criteria. AE and AP can now successfully be treated in majority of cases by immune modulatory treatments. These new insights challenge both, the implementation of diagnosis and treatment into clinical reality and forthcoming research on the causality underlying severe mental disorders (SMDs). CSF studies showed in 50-70% of therapy resistant cases of affective and schizophrenic spectrum disorders some abnormalities compatible with mild neuroinflammation ( Bechter et al 2010, J Psych Res), recently confirmed in large patient samples from various university hospitals in Germany ( Endres et al 2018 aso., Rattay et al 2021, aso.).Also post mortem findings are compatible with ME hypothesis in a larger subgroup of SMDs. Open questions of new clinical categorization by refined grading of mild neuroinfalmmation by improved diagnostic methods appear increasingly required, which will be discussed ( Bechter Frontiers Psychiatry 2020).ConclusionsMild neuroinflammation appears causally involved in SMDDisclosureNo significant relationships.