A rare case of hematohidrosis in a patient with paranoid schizophrenia

Hematohidrosis is a very rare yet fascinating clinical entity in which blood is excreted in sweat under extreme physical or emotional stress. The causes can be attributed to variety of etiological factors such as systemic disorders, vicarious menstruation, excessive exertion, and psychogenic and idiopathic causes. Although the episodes are usually self-limiting and do not affect the health status of the patient, the very phenomenon can be quite scary for the patient and family members. Amongst the psychogenic causes, various mental illnesses can result in Hematohidrosis, but it is more commonly reported so far with anxiety spectrum illnesses and depression. The distinctive feature of the case presented by authors is its association with Hematohidrosis and its symptoms of Paranoid Schizophrenia. Objective of this study the association between symptomatology of Paranoid Schizophrenia and its effect on Hematohidrosis After due consent from the patient, relatives and permission from the ethics committee of the institution, clinical history was obtained from the patient interviews. The case was followed longitudinally on each follow up. Appropriate blood investigations were done. Information obtained was compiled to form a case report. The improvement in psychotic symptoms corresponded with reduced frequency of bleeding episodes. As anti-psychotic treatment was initiated, patient started showing improvement in psychotic symptoms. This co-incided with the reduced severity and frequency of Hematohidrosis. Improvement in anxiety associated with psychotic symptoms was most probably responsible for improvement in symptoms of Hematohidrosis.

Esquizofrenia paranoide. Un acercamiento a su estudio a propósito de un caso / Paranoid schizophrenia. An approach to its study on the purpose of a case

RESUMEN La esquizofrenia es una de las enfermedades más invalidantes de los seres humanos, conocida como el «cáncer de la psiquiatría¼. Se impone como un gran reto social debido a su incidencia, su potencial en cronicidad y severidad así como las consecuencias que implica para la familia y la sociedad en general. La alta prevalencia de la enfermedad, de 1/100 habitantes, independientemente de las características sociales o económicas de los diferentes países, hace de esta un factor de gran impacto por su gran repercusión humana, económica y social, pues afecta al ser humano en la etapa más productiva de la vida. En el 75 % de los casos los primeros síntomas de la enfermedad aparecen entre los 16 y 25 años de edad. Por el grado de incapacidad que produce se afectan los estudios, la vida social y laboral. En este trabajo, se muestra a través del estudio de un caso ingresado en el Hospital Psiquiátrico “Antonio Guiteras Holmes”, de Matanzas, las principales afectaciones de esta enfermedad en las esferas afectiva, cognitiva y conductual (AU).

ABSTRACT The schizophrenia is one of the most invaliding diseases of the human beings, known as “the cancer of Psychiatrics.” It is a great social challenge due to its incidence, its potential in chronicity and severity, and also the consequences it implies for the family and society in general. The high prevalence of this disease, 1/100 inhabitants, regardless of the social and economic characteristics of the different countries, makes it a factor of great impact owing its social, economic and human repercussion because it affects the human being during the most productive stage of his life. In 75 % of the cases, the first disease’s symptoms appear between the ages of 16 and 25 years. Because of the disability level it produces, the social and professional life and the studies are affected. In this work, through the study of a case admitted in the Psychiatric Hospital “Antonio Guiteras Holmes”, of Matanzas, the main burdens of this disease in the affective, cognitive and behavioural spheres are shown (AU).

Caso clínico: Esquizofrenia Paranoide / Case report: Paranoid schizophrenia

La esquizofrenia es un trastorno mental severo que afecta el área cognitivo, social y afectivo de quienes lo padecen. El subtipo paranoide es el más frecuente, en el que predominan las ideas de persecución. La presentación de este caso clínico permite orientar a los profesionales de la salud en el reconocimiento temprano de la esquizofrenia paranoide y diferenciarlo de otros trastornos mentales. El presente caso trata de una mujer de 59 años de edad diagnosticada con esquizofrenia paranoide en el Centro Psiquiátrico Sagrado Corazón de Jesús de la Ciudad de Ambato, Ecuador por medio de una anamnesis detallada, basada en criterios diagnósticos de esquizofrenia y los ejes del DSM IV. Actualmente en el Ecuador la esquizofrenia, tiene una prevalencia del 38% del total de los egresos en hospitales psiquiátricos, y un 21,7% de las atenciones en consulta externa. A pesar de estas cifras significativas, existen escasos estudios sobre el tema en Ecuador, por lo cual consideramos prudente la presentación de este caso, para despertar el interés en nuestra comunidad de salud y consolidar conocimientos útiles para la vida laboral del médico, enfocados en mejorar las intervenciones médicas basados en diagnósticos certeros que se enmarquen en el Plan Estratégico Nacional de Salud Mental 2015­2017, acorde con el Ministerio de Salud Pública, enfocados en el objetivo 3 del Buen Vivir que busca mejorar el bienestar y la calidad de vida de la población.

Schizophrenia is a severe mental disorder that affects cognition, social and emotional life of the persons. Paranoid schizophrenia is the most common subtype in which dominates the perception of persecution. The purpose of the present case report is to orientate health professionals to recognize paranoid schizophrenia in early stages and to distinguish this kind of pathology from another mental disorders. The present article reports the clinical case of a 59 year old woman with paranoid schizophrenia from the Psychiatric Center "Sacred Heart of Jesus" of the City of Ambato, Ecuador who has been diagnosed with paranoid schizophrenia by a detailed anamnesis, based in diagnostic criteria for paranoid schizophrenia and the DSM­IV classification. Currently schizophrenia has a prevalence of 38% of the total of psychiatric hospitalizations in Ecuador and a prevalence of 21,7% in ambulatory consultation. Despite these significant numbers there are only a few reports about the paranoid schizophrenia in Ecuador, reason why we consider it from mayor importance to present the following case report, with the intention to awake interest in our health community and strengthen knowledge for the daily work of physicians, focused in medical interventions based in adequate diagnostic procedures and framed in the National Strategic Plan of Mental Health 2015­2017 in accordance with the Ministry of Public Health, guarantying criteria 3 of the "Buen vivir" to improve the well­being and quality of life of the population.

Caso de reunión clínica: trastorno delirante / Case of clinical meeting: delirious disorder

Hombre, 76 años, Jubilado, Soltero sin hijos, Estudios técnicos incompletos. Domicilio: Comuna de Providencia. Diagnóstico: Trastorno Delirante. Ideas delirantes persecutorias relacionadas con personas que viven en su edificio. Amenaza a sus vecinos de piso. Refiere que hablan de él en la televisión. Sospecha que su madrastra y hermanos quieren quedarse con herencia de su padre, quien falleció el año 2006. Antecedente de delirio de persecución aproximadamente a los 30 años. Se logra un control parcial de la sintomatología psiquiátrica y se mantiene trabajando en industria de muebles del padre. Paciente actualmente vive solo, sin pareja ni hijos. No sale de su departamento desde hace dos años. Efectúa compras por teléfono. Visitas de Parientes: Escasa, mayor contacto telefónico.

Case report: Man, Ricardo M. A., 76 years old, Retired, Single without children, Technical studies incomplete. Domicile: Commune of Providence. Diagnosis: Delusional disorder Persecutory delirious ideas related to people living in your building. Threatens his neighbors to the floor. He says they talk about him on TV. She suspects that her stepmother and siblings want to inherit their father, who passed away in 2006. Antecedent of delirium of persecution at approximately 30 years. A partial control of the psychiatric symptomatology is obtained and it is kept working in the father's furniture industry. Patient currently lives alone, without a partner or children. He has not left his apartment for two years. Make purchases by phone. Visits of Relatives: Scarce, greater telephone contact.

Fratricidio y esquizofrenia / Fratricide and Schizophrenia

Introducción: Cuando un hermano asesina a otro, hablamos de fratricidio, o sea, una forma de homicidio raramente vista en la práctica psiquiátrica. Dado que aún es un tema poco estudiado, la literatura científica no lo ha comprendido bien. Objetivo: Relatar el caso de un individuo con esquizofrenia paranoide que, habiendo asesinado a su hermano, fue evaluado en peritaje criminalístico para determinar su responsabilidad penal. Métodos: Se realizó una entrevista psiquiátrica, y el diagnóstico psiquiátrico se estableció con base en la entrevista y la observación de los registros periciales y hospitalarios, con los criterios diagnósticos del DSM-IV-TR. También se realizó una revisión bibliográfica sobre el tema. Resultados: Se consideró inimputable al paciente examinado en virtud de que padecía una enfermedad mental que afectaba por entero a su capacidad de comprensión y determinación con respecto al delito cometido. Conclusiones: El estudio de casos como este puede ilustrar e identificar factores motivadores relacionados con el comportamiento homicida de sujetos con trastornos mentales graves.

Abstract Background: Fratricide is the killing of one's own bother. It's a type of homicide rarely seen on psychiatric practice. This is still a theme which is poorly studied, and not well understood by the scientific literature. Objective: To report a case of a men, with paranoid schizophrenia that murdered his own bother and had a psychiatric forensic evaluation to establish his penal responsibility. Methods: A psychiatric interview was carried out and the psychiatric diagnosis was established based on the interview and analysis of forensic and medical records, using the DSM-IV-TR criteria. Literature review was held about the theme. Results: The examinee was considered not guilty by reason of insanity, due to the presence of a mental disorder that affected her entire understanding and volition of the practiced act. Conclusions: The study of such cases may illustrate and identify motivating factors related to homicidal behavior in individuals with severe mental disorders.

Intervenciones de enfermería para la atención de adultos con esquizofrenia paranoide / Nursing interventions for the care of adults with paranoid schizophrenia

Introducción. Los trastornos mentales tienen una alta prevalencia en todo el mundo y contribuyen de manera importante a la morbilidad, la discapacidad y la mortalidad prematura. Métodos. Con el descriptor “Paranoid Schizophrenia” y el planteamiento de preguntas clínicas, se realizó la búsqueda sistemática en: PUBMED, CUIDEN y algunos sitios web para la revisión de guías clínicas, revisiones sistemáticas, ensayos clínicos, estudios observacionales entre otros, cuyas evidencias y recomendaciones con mayor gradación y fuerza respectivamente, dieran respuesta a la detección y diagnóstico oportuno, intervenciones durante la fase aguda, adherencia terapéutica, identificación y tratamiento de efectos adversos e intervenciones dirigidas a la familia para facilitar la psicoeducación y el autocuidado. Se consideraron documentos en inglés y español publicados en 2010-2015.Resultados. De 20 estudios analizados, la evidencia científica denota que para el diagnóstico de esquizofrenia, es necesario considerar las características del cuadro clínico, antecedentes personales, familiares y factores de riesgo, además del abordaje durante la etapa aguda mediante la seguridad, contención verbal, farmacológica y física. Así mismo, el seguimiento para la detección y tratamiento de efectos adversos derivados del tratamiento farmacológico y el planteamiento de programas que consideren la identidad y cosmovisión de la persona, su familia y los efectos adversos sobre la salud, vida personal, social y económica.Conclusiones. Se deben estandarizar estrategias que faciliten la atención integral farmacológica, psicosocial y de autocuidado, con la finalidad de mejorar la calidad de la atención a personas con trastornos mentales así como de su familia.

Introduction. Mental disorders are highly prevalent worldwide and contribute significantly to morbidity, disability and premature mortality manner.Methods. With the descriptor "Paranoid Schizophrenia" and approach to clinical questions, the systematic search was conducted: PUBMED, CUIDEN and some websites for review of clinical guidelines, systematic reviews, clinical trials, observational studies among others, whose findings and recommendations more gradation and strength respectively, would respond to the detection and timely diagnosis, interventions during the acute phase, adherence, identification and treatment of adverse effects and interventions aimed at facilitating family psycho-education and self-care. documents were considered in English and Spanish published in 2010-2015.Results. 20 studies reviewed, scientific evidence indicates that for the diagnosis of schizophrenia, it is necessary to consider the clinical characteristics, personal history, and family risk factors, in addition to the approach during the acute stage by security, verbal, pharmacological containment and physical. Similarly, monitoring for the detection and treatment of adverse effects from the drug treatment programs and approach to consider the identity and worldview of the person, his family and adverse health effects, personal, social and economic life.Conclusions. Strategies should be standardized to facilitate the pharmacological, psychosocial self-care and comprehensive care in order to improve the quality of care for people with mental disorders and their family.

Introdução. Os transtornos mentais são altamente prevalentes em todo o mundo e contribuir significativamente para a morbidade, incapacidade e mortalidade prematura maneira.Métodos. Com o descritor "esquizofrenia paranóide" e abordagem de questões clínicas, a busca sistemática foi conduzida: PubMed, CUIDEN e alguns sites de revisão de diretrizes clínicas, revisões sistemáticas, ensaios clínicos, estudos observacionais, entre outros, cujas conclusões e recomendações mais gradação e força, respectivamente, iria responder ao diagnóstico de detecção e oportuna, as intervenções durante a fase aguda, a adesão, a identificação e tratamento de efeitos adversos e intervenções destinadas a facilitar família psico-educação e auto-cuidado. documentos foram considerados em Inglês e Espanhol publicado em 2010-2015.Resultados. 20 estudos revisados, evidências científicas indicam que, para o diagnóstico de esquizofrenia, é necessário considerar as características clínicas, história pessoal e fatores de risco familiar, além da abordagem durante a fase aguda de segurança, verbal, contenção farmacológica e física. Da mesma forma, o monitoramento para a detecção e tratamento dos efeitos adversos dos programas de tratamento de drogas e abordagem a considerar a identidade e visão de mundo da pessoa, sua família e efeitos adversos à saúde, vida pessoal, social e económico.Conclusões. As estratégias devem ser padronizados para facilitar a auto-atendimento psicossocial e farmacológico atendimento integral a fim de melhorar a qualidade dos cuidados para as pessoas com transtornos mentais e seus familiares.

The global efficiency of the brain structural networks and its relationship with the psychotic symptoms in male paranoid schizophrenia / 中华行为医学与脑科学杂志

Objective To explore the differences of the global efficiency of the brain structural networks between the male paranoid schizophrenia and male healthy and its relationship with the psychotic symptoms of the schizophrenia.Methods The diffusion tensor imaging data were obtained from 27 male paranoid schizophrenia patients and 28 male healthy controls.The whole cerebral cortex was parcellated into 90 regions by the anatomical label map.Tractography was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using fiber assignment by continuous tracking(FACT) algorithm.And then the brain structural binary networks were constructed using the complex network theory.The average global efficiency of the brain network and the global efficiency of the nodes of both groups were examined by two sample t-test and its relationship with the psychotic symptoms in the male paranoid schizophrenia was explored by the correlation analysis.Results Compared with control group,the average global efficiency of the brain network of the patients decreased significantly (7.87±0.56,8.17±0.56,P=0.005),and the global efficiency of the nodes in the brain network of the patient decreased significantly in the left superior frontal gyrus (orbital part) (P=0.00025),the left superior parietal gyrus (P=0.00011),the left cuneus (P=0.00012) and the left putamen (P=0.00032),all survived FDR correction.Significant negative correlation was found between the global efficiency of the left putamen and the total scores (r=-0.43,P=0.03),the positive scores (r=-0.41,P=0.03) and the cognitive scores (r=-0.40,P=0.04) of PANSS.Conclusion The decreased global efficiency of the left frontal,parietal and occipital lobes and the subcortical structures lead to the occurrence of schizophrenia.And the reduced efficiency of the subcortical structures is associated with the positive symptoms and the abnormal cognitive function of the patients.

Caracterización de pacientes con esquizofrenia / Characterization of patients with schizophrenia

Se realizó un estudio descriptivo y transversal de 74 pacientes con diagnóstico de esquizofrenia, ingresados en la Unidad de Intervención en Crisis del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde noviembre del 2012 hasta igual mes del 2013, a fin de caracterizarles según variables de interés. En la serie predominaron los afectados de 25-34 años (40,5 %), del sexo femenino (60,8 %), trabajadores (39,2 %), así como la forma clínica paranoide (42,0 %). Fueron reingresados 62 enfermos (83,8 %). La esquizofrenia constituyó una causa importante de ingresos en este centro asistencial.

A descriptive and cross sectional study of 74 patients with diagnosis of schizophrenia, admitted in the Unit for Intervention during Crisis from "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba was carried out from November, 2012 to same month of 2013, in order to characterize them according to variables of interest. Those patients affected from 25-34 years (40.5%), female sex (60.8%), workers (39.2%), as well as the paranoid clinical form (42.0%) prevailed in the series. Sixty-two sick persons (83.8%) were readmitted. The schizophrenia constituted an important cause of admissions in this assistance center.

The strength of the nodes of the brain white matter weighted networks and its relationship with the course of disease in male schizophrenia / 中国神经精神疾病杂志

Objective To explore the differences in the strength of the nodes in the brain white matter weighted networks between the male patients with paranoid schizophrenia and male healthy controls, and to analysis the integrity of the white matter fiber tracts that connected to the different brain regions and its relationship with the course of disease. Methods Diffusion tensor imaging (DTI) data were obtained from 25 male patients with paranoid schizophrenia and 26 male healthy controls. The whole brain was parcellated into 90 regions by using the anatomical label map. Tractography was performed in the whole brain of each subject to reconstruct white matter tracts using the FACT algorithm. The brain white matter weighted networks were then constructed using the complex network theory. Results The strength of the nodes in the networks of schizophrenia significantly decreased in the right thalamus (P=0.03, corrected) and the right hes?chl gyrus (P=0.04, corrected). Negative correlation was found between the strength of the right thalamus and the course of disease (r=-0.45, P=0.03). Conclusion The integrity of the white matter fiber tracts connected to the thalamus and tem?poral lobes in the male paranoid schizophrenia is impaired. The lesion of fiber tracts connected to the thalamus is related with the course of disease.

¿Trastorno esquizotípico o esquizofrenia? Evaluación de la responsabilidad penal en un caso de parricidio / Schizotypical Disorder or Schizophrenia? Assessment of Penal Responsibility in a Patricide Case

Resumen Parricidio es el asesinato de uno de los padres. Presentamos el caso de un hombre que, en diferentes momentos, cometió dos asesinatos, uno de ellos parricidio. Se realizó un peritaje psiquiátrico del sujeto para evaluación de responsabilidad penal. Posteriormente también se lo evaluó en un servicio de atención psiquiátrica. Realizada la entrevitsa, el diagnóstico psiquiátrico final se estableció sobre la base de los criterios del DSM-IV-TR y el análisis retrospectivo de los registros de los hospitales y del peritaje. La evaluación de los expertos concluyó que el sujeto analizado sufría una enfermedad mental, en la forma de trastorno esquizotípico, con daños totales en la comprensión y la determinación. Por lo tanto, se lo consideró inimputable. Posteriormente, en una segunda evaluación realizada en un servicio de atención psiquiátrica, el paciente recibió diagnóstico de esquizofrenia paranoide. La determinación de la responsabilidad penal es esencial para encauzar correctamente a las personas condenadas en cualquier sistema de derecho penal para proteger los derechos humanos.

Abstract Patricide is the murder of one of the parents. We report a case of a man who had committed two homicides, at different times, one of them being considered a parricide. He was referred for forensic psychiatric evaluation and later evaluated in a psychiatric assistance service. Psychiatric interview was carried out and the final psychiatric diagnosis was established based on the DSM-IV-TR criteria and retrospective analysis of forensic and clinical records. The court appointed forensic experts concluded that the patient suffered from schizotypical disorder, presenting cognitive and volitive impairment . He was found not guilty by reason of insanity. Later, in a second assessment, being in a psychiatric assistance service, the patient received a diagnosis of paranoid schizophrenia. The determination of criminal responsibility is essential to the proper disposition of convicted persons in any system of criminal law that protects human rights.

Murder through insanity: a forensic perspective

Background: Persons with major mental illness (such as schizophrenia) may commit crime under the influence of psychopathology. Case description: A 35 year old man (accused) killed his mother (victim). An autopsy of victim’s body revealed the cause of death as ‘due to fatal injuries to the brain and neck structures.” With the support of circumstantial evidence and post-mortem report of victim, the inquest officer presented the accused in the court. On receipt of judicial reception order he was subsequently referred to the psychiatrist. The accused was diagnosed as suffering from paranoid schizophrenia and it was found that under the influence of psychosis he committed the crime. The psychotic symptoms were present before the manifestation of violent behaviour, in the form of delusions, hallucinations, and disorganized behaviour. With treatment his psychotic symptoms improved. Discussion: This case illustrates the profile of a person with major mental illness who was never treated, from a forensic perspective. Not all patients are violent; but, the risk is high. Conclusions: Early psychiatric intervention in the form of identification and management may go long way in prevention of violence committed by few patients with major mental illness. There is a need to understand the motivational factors for such violent acts which may help in effective prevention.

Esquizofrenia y trasplante hepático: reporte de un caso / Schizophrenia and liver transplantation: case report

Introducción: El trasplante hepático es un tratamiento disponible para numerosos pacientes con cirrosis hepática, que encuentran en este tratamiento una alternativa médica para mejorar la expectativa y la calidad de vida. La esquizofrenia paranoide es un trastorno psiquiátrico que afecta al 1% de la población general, que produce síntomas psicóticos y cuyo curso crónico, en algunos casos, deteriora significativamente todas las áreas de la vida. Objetivo: Discutir el caso clínico de una mujer a quien se le diagnostica esquizofrenia paranoide durante el protocolo de evaluación para trasplante hepático por cirrosis hepática. Métodos: Reporte de caso. Resultados: Se reporta el caso de una mujer de 47 años con cirrosis hepática, cuya única alternativa para mejorar la expectativa y calidad de vida era acceder a un trasplante hepático. Durante las evaluaciones de rutina por el grupo de trasplantes, el psiquiatra de enlace observa síntomas psicóticos de primer orden y documenta una historia de vida que confirma la presencia de una esquizofrenia paranoide. Discusión y conclusiones: La esquizofrenia paranoide es un trastorno psiquiátrico mayor que puede hacer parte de las comorbilidades médicas de los pacientes que requieren trasplante de hígado y que no constituye una contraindicación absoluta para su realización. En Colombia no se conocen casos similares de trasplante de hígado en pacientes con esquizofrenia. Este es un gran paso en el camino de vencer el estigma que la enfermedad mental impone a los pacientes y permitirles el acceso a la atención médica general que requieren…

Introduction: Liver transplantation is a treatment available for many patients with liver cirrhosis who find in this treatment a way to improve life expectancy and quality of life. Paranoid schizophrenia affects 1% of the general population, produces psychotic symptoms, and runs a chronic course in some cases with significant deterioration in all areas of life. Objective: To discuss the case of a patient with liver cirrhosis diagnosed with paranoid schizophrenia during the evaluation protocol for liver transplantation. Method: Case report. Results: We report the case of a 47-year-old woman with liver cirrhosis whose only alternative to improve life expectancy and quality of life was access to liver transplantation. During routine evaluations the liaison psychiatrist observed first-order psychotic symptoms and documented a life story that confirmed the presence of paranoid schizophrenia. Discussion and Conclusions: Paranoid schizophrenia is a psychiatric disorder common in the general population that can be a part of the medical comorbidities of patients requiring liver transplantation and is not an absolute contraindication to its completion. We are unaware of similar cases of liver transplantation in patients with schizophrenia in our country. We believe this is a big step on the road to overcome the stigma that mentalillness imposes on patients…

Effects of ziprasidone and risperidone on cognitive inhibition function through visual pathway of patients with paranoid schizophrenia / 中华行为医学与脑科学杂志

ObjectiveTo explore the effects of ziprasidone and risperidone on cognitive inhibition function through visual pathway of patients with paranoid schizophrenia.MethodsIn the open-label,flexible-dosage trial,124 patients with paranoid schizophrenia were randomly divided into ziprasidone group (120-160 mg/d)and risperidone group(4-8 mg/d) for treatment of 8 weeks.They were assessed with computerized Color Word Test (CWT) and Continuous Performance Test(CPT) through visual pathway for cognitive inhibition function,Positive and Negative Syndrome Scale for efficacy on baseline and 8th weekend.ResultsAfter treatment with ziprasidone,the error number (3.12 ± 5.23 ),the time per correct answer( ( 1.92 ± 1.38 ) s) of CWT,as well as the doubledigit mistaken number (2.31 ± 3.76)and the three-figure mistaken number( 3.15 ±2.80) of CPT reduced more than those before medication ( (4.60 ± 6.80),( 2.74 ± 1.52 ) s,(3.85 ± 3.62 ),(4.42 ± 3.53 ) ) (P ＜ 0.05 ).In risperidone.group,the double-digit mistake number of CPT(3.39 ± 3.59) after pharmacotherapy reduced more than that before pharmacotherapy(4.23 ± 3.88) (P＜ 0.05).After treatment the time per correct answer of CWT and the mistaken numbers of CPT in ziprasidone group were less than those in risperidone group(P＜ 0.05 ),meanwhile,the scores of PANSS in two groups were significantly lower than those before treatment (P ＜ 0.01 ).ConclusionIt is effective for ziprasidone and risperidone to improve the function of cognitive inhibition on patients with paranoid schizophrenia,but there is more dramatic for ziprasidone in short-term treatment.

Wilson's Disease Can Present As Paranoid Schizophrenia And Mania: Two Cases Reports

Objective: This case report highlights Wilson's disease, a rare genetic disorder involving the liver and brain presenting clinically with psychiatric symptoms as the first manifestation. Method: We present two cases of Wilson’s disease who had the typical symptoms of Schizophrenia and Bipolar mood disorder (mania) respectively. Results: Wilson disease first presentation of psychiatric diagnosis may obscure the diagnosis who later on turned out to be suffering from Wilson’s disease. Conclusion: Although such patients are more commonly seen in neurological and hepatological settings, mental health professionals must keep in mind a high level of suspicion, once first presentations may be of psychiatric nature.

The white matter integrity of treatment-naive, first-episode paranoid schizophrenia: a diffusion tensor imaging study / 中华行为医学与脑科学杂志

Objective To explore the changes of the white matter integrity in paranoid schizophrenia.Methods Diffusion weighted images of the 19 patients' with paranoid schizophrenia and 30 healthy controls'whole brains were acquired with a single-shot echo planar imaging ( EPI ) sequence aligned to the straight axial plane. After preprocessed with DTI-studio and SPM5 software, the fractional anisotropy (FA) images of the two groups were compared by two-sample t-test with SPM5 software. Results Subjects of paranoid schizophrenia demonstrated reduced FA in the right thalamus white matter(x = 18 ,y = - 10,z = 14,cluster = 194, t= -3.27, P=0.000 ) and demonstrated increased FA in the right insula white matter ( x = 34, y = -10, z = 12, cluster = 113, t =4.50, P = 0.004 ). Conclusion Schizophrenia has conflicting changes of white matter integrity in some brain areas.

Remarks on the results of treatment for paranoid schizophrenic patients with electroconvulsive combined neuroleptic therapy

Background: Schizophrenia is a chronic, severe psychotic disease with high incidence. Treatment of schizophrenia with neuroleptic is a major medical advance, but sometime its result is still limited. Objective: To study the effect of electroconvulsive therapy (EC) in treatment of paranoid schizophrenic patients. Subject and methods: 101 paranoid schizophrenic patients treated by neuroleptic alone or neuroleptic combined EC, were treated in the Mental Department of Hospital 103 and Nam Dinh Mental Hospital from May, 2006 to June, 2007. Results and Conclusion: All 100% of the patients had a positive response to EC; the mean times of EC were 7.63\xb11.4 times for one. The regression of hallucination was observed after 4.6\xb11.49 times of EC; delusion after 4.96\xb11.4 times; suicide attempt after 3.25\xb10.96 times and refusing to eat after 4.96\xb12.1 times of EC; insomnia disappeared after 4.96\xb12.1 times of EC. Some side effects of the EC therapy: 100% of patients had orientation disorder; headache with light and moderate level accounted for 69.65% and 26.79%, respectively. Combination therapy made patients more stable, compared to neuroleptic therapy alone (p<0.05).

Seasonsits of the First Onset in Schizophrenia and Mood Disorder: Mainly in Paranoid Schizophrenia and Bipolar I Disorder / 신경정신의학

This study aimed 1) at determining the seasonal pattern of the first onset and 2) at examining different demographic and clinical factors by the seasonality of first onset, for shizophrenia, mood disorder and subtypes of each diagnosis. Finally, the 52 subjects with paranoid schizophrenia were selected from all patients who fulfilled DSM-IV criteria far schizophrenia who had been admitted to the National Seoul Mental Hospital from March 1994 to February 1995. And the 44 subjects with bipolar I disorder were selected from all patients who fulfilled DSM-IV criteria for mood disorder who had been admitted to the hospital from March 1994 to February 1996. This study was done by reviewing the hospital records about season of the first outset, demographic factors(sex, age, occupation, educated period, religion, marital status, residence and socioeconomic status) and clinical factors(age at the first onset, duration of illness, family history, length of admission, frequency of admission and treatment result). The seasonal pattern of the first onset and the different demographic and clinical factors by the season of the first onset in paranoid shizophrenia and I disorder were analyzed. The results were as follows: 1) There was no significant seasonal variation of the first onset for paranoid schizophrenia. 2) There was a significant seasonal variation of the first onset with a maximum in spring for bipolar I disorder. 3) There was no significant seasonal variation of the first onset in case of bipolar I disorder that began with the manic episode. 4) There was nonsignificant seasonal tendency to peak in spring/summer in the case of the first manic episode for bipolar I disorder. 5) There were no significant differences in demographic and clinical factors by the season of the first onset for paranoid schizophrenia and bipolar I disorder.