Dermatoglyphic Patterns Of Schizophrenic Patients In A Nigerian Population

Introduction: Dermatoglyphic studies have been associated with many physical, behavioural and pathologicaltraits. Ridge patterns are established early in intrauterine life and serve as effective tools in determining thedevelopment of a particular trait. This study was aimed at finding out whether there exists any dermatoglyphicpatterns that could serve as predictive tools in the early detection of schizophrenia in a Nigerian population.Materials and Methods: The study was carried out on 100 Nigerians whose parents and grandparents areNigerians. They were made up of 50 diagnosed schizophrenic patients (25 males and 25 females) recruited fromthe Federal Neuro-Psychiatric Hospital, Uselu, Benin City and 50 healthy controls matched for age and gender.The palms and digits of the subjects were scanned with an HP scanner and images in jpeg format recorded usingan AutoCAD software version 2010 and the images were analyzed for arches, whorls, loops and ridges countedwith atd angles measured using standard methods.Results: There was significant increase in loops and decreased in arches in the schizophrenic when comparedwith the control groups. Also, observed were significant increase in fingerprint patterns on the right 1st digit offemale schizophrenic patients, 3rd, 4th and 5th digits on the left side also in female schizophrenics but only on the4th left digit in male schizophrenics. There was also increase in the mean total finger ridge count (TFRC) in maleschizophrenic patients.Conclusion: These findings are indicative of dermatoglyphic variability between patients with schizophrenia andhealthy controls and could serve as markers in the prediction of schizophrenia in our studied population.

Safety and Effectiveness of Long Acting Injectable Antipsychotic Paliperidone Palmitate Treatment in Schizophrenics : A 24-Week Open-Label Study

OBJECTIVES: We investigated the effectiveness and safety when treated in schizophrenics with paliperidone palmitate, a long acting injectable antipsychotic. METHODS: This was a 24-week open-label study, performed at one center in Korea. The eligible patients with schizophrenia diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria were enrolled. Patients received long-acting paliperidone palmitate injection (234 mg, baseline; 156 mg, week 1 ; then once 4 weeks flexible dosing). Effectiveness assessments were measured by the Positive and Negative Syndrome Scale (PANSS), The Clinical Global Impression Severity Scale (CGI-S), The Personal and Social Performance (PSP) at baseline, week 1, every 4 weeks untill 24 weeks or endpoint. Safety assessments were measured by The Extrapyramidal Symptom Rating Scale (ESRS), body weight (BW) and incidence of adverse events. Oral antipsychotics were stopped or tapered off within next 14 days. RESULTS: Of 20 patients recruited, 9 patients (45%) completed the study. Paliperidone palmitate produced a significant improvement in PANSS total score from baseline to endpoint. The response rate was 75% [mean change (+/- SD) -25.9 +/- 14.4, all p or = 10%) in paliperidone palmitate were anticholinergic adverse event, extrapyramidal symptoms, weight gain, akathisia, insomnia, headache, agitation, anxiety and GI trouble. ESRS score is not statistically significant, but tends to get better at the end of the study when compared to baseline. CONCLUSIONS: Our study results demonstrated maintained effectiveness and safety of paliperidone palmitate treatment in schizophrenics. And provides both clinicians and patients with a new choice of treatment that can improve the outcome of long term therapy. Their potential effectiveness and safety should be better addressed by future randomized-controlled trials.

Sleep characteristics in first-episode schizophrenics and the effects of olanzapine on body weight and sleep-breathing disorder / 中华行为医学与脑科学杂志

Objective To explore the sleep characteristics in first-episode schizophrenics and the effects of olanzapine on body weight and sleep-breathing disorder.Methods 36 first-episode schizophrenics (patient group) and 33 normal controls (control group) were tested with polysomnography(PSG),and compared the difference of PSG,sleep-breathing index and body mass index(BMI) before and after treatment in patient group.Results Before treatment,compared with control group,the patient group had significantly prolonged sleep latency((83.64± 10.62) min vs (29.41 ± 10.05) min),shortened total sleep time ((286.43 ± 17.04) min vs (343.66 ± 16.38)min),decreased sleep efficiency((65.73 ±11.47) vs (86.13 ± 8.15)),increased awake time and arousal number((65.70 ± 10.33) min vs (25.93 ± 9.60) min ; (38.26 ± 6.88) vs (14.40 ± 2.72)) in sleep continuity ; and increased N1 stage ((87.43 ± 11.35) min vs (36.55 ± 6.40) min),decreased N2,N3 stage ((100.53 ± 10.42)minvs (143.35±13.52)min;(49.83±7.51)minvs (87.52±9.74)min) in sleep structure (P ＜ 0.05).After treatment,sleep continuity and sleep structure in patient group were improved,compared with control group,only BMI,arousal index and hypopnea index had statistic difference (P ＜ 0.05).Conclusion The first-episode schizophrenics have both sleep continuity and sleep structure deficits.Although olanzapine treatment can improve sleep quality,long-term use of it may cause overweight and sleep-breathing disorder.

A função básica da mãe (e do analista) em bion e Winnicott, com foco nos conceitos de rêverie e holding / The basic function of the mother (and of the analyst) according to Bion and Winnicott, focusing on the concepts of rêverie and holding / La función básica de la madre (y del analista) en Bion y Winnicott, centrado en los conceptos de rêverie y holding

O presente ensaio analisa os conceitos de rêverie e de holding no interior de suas teorias de origem, afim de discriminá-los um do outro. A partir daí, discute a clínica de esquizofrênicos, tal qual praticada por Bion e Winnicott, evidenciando como esses conceitos-chave definem a função analítica em ambos os autores, impondo diferentes modos de praticar a psicanálise.

This essay analyses the concepts of rêverie and holding in their original theories, in order to discriminate them. Itproceeds to discuss the clinic of schizophrenics such as performed by Bion and Winnicott, showing that those key-concepts define the analytic function in both authors, imposing different ways of practicingpsychoanalysis.

El presente ensayo analiza los conceptos de rêverie y holding en el interior de sus teorías de origen, con el objetivo de distinguir el uno del otro. A partir de ahí, se discute la clínica de los esquizofrênicos, tal y como es practicada por Bion y Winnicott, mostrando que estos conceptos claves determinan la función analítica en ambos autores, imponiendo diferentes prácticas de psicoanálisis.

The effects of olanzapine,clozapine,risperidone and quetiapine treatment on P50 sensory gating in first-ep-isode schizophrenics / 中华行为医学与脑科学杂志

Objective To compare the effects of atypical antipsyehoties treatment on PS0 sensory gating in first-episode schizophrenics. Methods The P50 auditory evoked potential was recorded by using conditioning-testing stimulus paradigm and stimulus train paradigm in 36 normal controls and 53 first-episode schizophrenics be-fore and after treatment,and compare the difference of P50 sensory gating after treatment. Results Before treat-ment, compared with control group, the atypical groups both had statistic difference of T-P50 amplitude ((1.01±0.88)μV, (0.68±0.64)μV, (0.58±0.47)μV), P50 suppression ((0.61±0.27), (0.54±0.22, (0. 59± 0.19)) in conditioning-testing stimulus paradigm and P50 amplitude,P50 suppression evoked by high frequency stimuli in stimulus train paradigm(P < 0.05), but no difference among the atypical groups (P > 0.05). After treat-ment,compared with control group, there was no statistic difference in olanzapine and elozapine groups of T-P50 amplitude and P50 suppression in conditioning-testing stimulus paradigm, but the difference in risperidone and que-tiapine groups still obviously(P<0.05). In stimulus train paradigm, there was no statistic difference of P50 ampli-tude, P50 suppression evoked by high frequency stimuli in every groups (P>0.05). Compared within atypical groups, the difference of P50 amplitude and P50 suppression were both obviously(P<0.05). Conclusion Each a-typical antipsychotic has different effect on P50 sensory gating;and the conditioning-testing stimulus paradigm and stimulus train paradigm P50 sensory gating may reflect different central neuron mechanism.

Follow-up study on executive function of frontal lobe in schizophrenics with and without homicide behaviors / 中华行为医学与脑科学杂志

Objective To explore the characteristics of executive function and the changes of executive function in schizophrenics with and without homicide behaviors during follow-up.Methods Twenty-two schizophrenics with homicide behaviors (homicide group)and twenty-one schizophrenics without homicide behaviors (without-homicide group) were examined by Wisconsin Card Sorting Test(WCST),and followed up 3 months.All patients'clinical symptoms were evaluated by positive and negative symptom scale(PANSS)at the same time.Re-suits (1)At the baseline,homicide group showed higher score in complete lst category(R1st)than without-homicide group((28.64±32.73)vs(11.71±8.10),P=0.027)and no difference on other index.(2)No difference on WCST in homicide group between at the baseline and at three-month treatment (P>0.05).Without-homicide group at the baseline showed higher score in conceptual level responses than that of at three-menth treatment((46.80±27.04)vs.(65.02±21.32),P=0.048).(3)Homicide group at three-month treatment showed lower scores in positive scale,general psychopathology scale,PANSS total,thought disorder,activation,paranoid,aggressive than that of at the baseline(P<0.05).Without-hemicide group at three-month treatment showed lower scores in positive scale,negative scale,general psychopathology scale,PANSS total,thought disorder,activation,aggressive than that of at the haseline(P<0.01).(4)At the baseline,there was no correlation between WCST and PANSS in homicide group,only R1st score correlated with activation positively in without-homicide group(P<0.05).At three-month treatment, homicide group showed the score of failure to maintain set negatively correlated with negative scale,PANSS total, and aggressive(P<0.05).Conclusions Schizophrenics with homicide and without-homicide behaviors show executive function deficits.Homicide group shows more deficits in abstraction capacity than without-homicide group.

The effects of typical and atypical antipsychotics on P50 sensory gating in first-episode schizophrenics / 中国神经精神疾病杂志

Objective To compare the effects of typical and atypical antipsychotics treatment on P50 sensory ga-ting in first-episode schizophrenics.Methods Using conditioning-testing stimulus paradigm and stimulus train paradigm to record the P50 auditory evoked potential in 36 normal controls and in 61 first-episode schizophrenics before and after treat-ment.Patients were categorized into two groups:the typical antipsychotic treatment group(typical group)and the atypical antipsychotic treatment group(atypical group).Results Before treatment,both of the typical and atypical groups had low-er levels of S2-P50 amplitude,P50 suppression in conditioning-testing stimulus paradigm and P50 amplitude as well as P50 suppression evoked by high frequency stimuli in stimulus train paradigm in comparison with controls(P<0.05).After treatment,the typical antipsychotic treatment significantly improved the levels of P50 suppression in the stimulus train para-digm but not the levels of S2-P50 amplitude,P50 suppression in the conditioning-testing stimulus paradigm(P<0.05)whereas the atypical antipsychotic treatment improve the levels of P50 amplitude,P50 suppression in both stimulus train paradigm and the conditioning-testing stimulus paradigm(P<0.05). Conclusions The typical antipsychotic treatment can ameliorate the P50 suppression in stimulus train paradigm,but not in the conditioning-testing stimulus paradigm,whereas atypical antipsychotic treatment can ameliorate P50 suppression in both paradigms.

Relationship of Estrogen to Extrapyramidal Symptoms in Female Schizophrenic Patients

OBJECTIVE: It has been thought that estrogen has neuroleptic like effect in women schizophrenic patients. This study aimed to investigate neuroleptic side-effects severity in women with schizohrenia and to investigate their putative association with variations in sex steroids over menstrual cycle. Based on the estrogen theory, The author hypothesized that parkinsonian side-effects would be exacerbated when estrogen levels were high. METHOD: 26 schizophrenic women were assessed using the ESRS(Extrapyramidal Symptom Rating Scale) and estrogen analysis. Tests were conducted twice, in the mid luteal and mid follicular phase. RESULT: It was hypothesized that high level of estrogen would lead to an exacerbation of parkisonian side-effects but the results indicated that parkinsonian side effects decreased overall when estrogen levels were high. This effects were more marked for the group taking typical neuroleptics than those taking atypical neuroleptics. CONCLUSION: The results of this study suggest that estrogen and progesteron may reduce the severity of neuroleptic indeced extrapyramidal side effects over menstrual cycle in women with schizophrenia. It was concluded that estrogen has different effects on dopamine dynamics in the mesolimbic and mesostriatal pathways according to estrogen, progesteron, catecol estrogen, prolactine.

Research on Micronucleolus and AgNOR of Lymphocyte in Schizophrenics / 中国医师杂志

Objective To study relationship between chromosome un-stability and schizophrenia development. Methods Micronucleolus and silver-stained nucleolar organized regions (AgNOR) in the peripheral blood lymphocytes of 120 patients with schizophrenia and 50 healthy persons were tested. Results The frequency of micronucleolus and the number of the AgNOR in schizophrenics were higher than those in the control(P

Review of Sexual Dysfunction in Male Schizophrenics

OBJECTIVE: There are four possible explanations for the sexual dysfunction of schizophrenics. The first is the possibility or a real structural aspect. The second possibility is that sexual function changes secondary to the illness. The third possibility is that there are medical and sociocultural barriers to sexual expression for chronic schizophrenics. The fourth possibility is that sexual dysfunction due to antipsychotic medication. However, we didn't know the precise cause of sexual dysfunction in schizophrenics. Therefore, the purpose of this study was to explore the mechanism of illness itself and antipsychotics on sexual dysfunction in male schizophrenics. METHODS: The serum prolactin(PRL), testosterone(TST), and the plasma serotonin(5-HT) concentrations were measured by radioimmunoassay and high performance liquid chromatography method for 100 healthy male schizophrenics according to the DSM-IV. Concomitantly, the severity of psychotic symptoms using Clinical Global Impression(CGI), Brief Psychiatric Rating Scale(BPRS), Positive and Negative Syndrome Scale(PANSS), and the severity of side effects for antipsychotics using Extrapyramidal Side Effects Scale(EPSE), Anticholinergic Side Effects Scale(ACSE), the cognitive function using PANSS-Cognitive Function(PANSS-CF), Mini Mental State Exam-Korean(MMSE-K), and sexual dysfunction using Sexual Functioning Questionnaire(SFQ), Questionnaire for Sexual Dysfunction in Men were assessed. The PRL, TST and 5-HT levels of 50 healthy male controls who had no medical, neurological, and psychiatric illnesses were evaluated The sexual function using SFQ(items FGa, FNa) were also assessed. Furthermore, the correlation with age, education, religion economic status, age at onset, duration of illnesses, duration of admission. levels of PRL, TST, 5-HT, antipsychotic dosages, potency, benztropine total duration of medication, EPSE, ACSE, CGI BPRS, PANSS, PANSS-CF MMSE-K and sexual dysfunctions were identified in male schizophrenics. RESULTS: 1) The frequencies of sexual dysfunctions for schizophrenics(80%) were significantly(p<0.001) higher than those for controls(42%). The sexual dysfunctions according to sexual response cycle were low sexual desire '76% 'impairment of achieving erection '75%, 'impairment of maintaining erection'75%, 'impairment of obtaining orgasm'32%, 'impairment in the quality of orgasm'61%, 'impairment of quantity of ejaculate'44%, premature ejaculation'15%, and 'delayed ejaculation'50%. 2) The PRL, 5-HT levels of schizophrenics(28.5+/-20.6ng/ml, 298.5+/-89.1ng/ml) were significantly(p<0.001) higher than those of controls(10+/-5.6ng/ml, 169.2+/-37.8ng/ml), while the TST levels of schizophrenics(4.3+/-1.5ng/ml) and controls(4.5+/-1.2ng/ml) were not significantly different. The sexual dysfunctions of schizophrenics who had abnormal 5-HT levels(4.7+/-1.3 scores) were significantly(p<0.05) higher than those of who had normal 5-HT levels(3.8+/-1.6 scores) on item D7. 3) The sexual dysfunctions of unmarried schizophrenics were significantly(p<0.01 : p<0.05) higher than those of married schizophrenics(6.1+/-2.8 scores, 4.7+/-1.3 scores on item FGa : beta=-0.211 on item FNa). The sexual dysfunctions we positively correlated with the rise of 5-HT levels (r=0.209, p<0.05 on item D4 and r=0.241, p<0.05 on item D7), the higher age at onset(r=0.275, p<0.01 on item FNa : r=-0.202, p<0.05 on item FDa), the longer duration of illesses(r=0.237, p<0.05 on item D6), the longer duration of admission(r=0.234, p<0.05 on item D4 : r=0.328, p<0.05 on item D6), the longer total duration of medication(r=0.237, p<0.05 in item D6). However, age, education, religion, economic status, PRL, TST levels, antipsychotics dosage, potency, benztropine, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K scores were not correlated with increased sexual dysfunctions. CONCLUSIONS: Male schizophrenics have significantly more sexual dysfunction to compare with controls. The high frequencies of sexual dysfunctions were low sexual desire and erectile disorder. The unmarried, higher age at onset, are longer duration of diseases were positively correlated with increased sexual dysfunctions. Also high 5-HT levels were positively correlated with increased sexual dysfunctions. This means that studies of plasma 5-HT levels, albeit questionable indicators of central 5-HT function, offer some additional support for the association of sexual dysfunction with excess 5-HT activity as primary pathology of schizophrenia. Our findings suggest that excess 5-HT activity seems to affect the patient's sexual function.

Insight and Psychopathology in Schizophrenics / 신경정신의학

OBJECTIVES: Patients with poor insight are commonly observed among schizophrenics and they show poor drug compliance and prognosis. This study aimed at examining the characteristics of psychopathology in patients with schizophrenia who have no insight. Understanding the features of inner psychopathology in schizophrenic patients with poor insight, we assumed, could lead to insight-promoting clues. METHODS: The subjects consisted of 69 patients with schizophrenia diagnosed by DSM-IV criteria. For identifying insight level in the patients, Scale to Assess Unawareness of Mental Disorder(SUMD) was applied. After subjects were divided into two groups depending upon insight level, psychopathological differences were evaluated by Kyung Hee-Frankfruter Beschwerde Fragebogen(K-FBF), which was known as one of the subjective psychological tests for the schizophrenics. RESULTS: There was no significant differences in demographic variables, duration of illness, and dose of medication between two groups. However, significantly high rate of involuntary admission and tendency of high frequency of admission were revealed in schizophrenic patients with poor insight. And, also poor insight group showed significantly high scores in the factors of sensorimotor disorder(subscales of psychomotor disorder, perceptual disorder and blocking symptoms included) and in language-cognitive disorder factor(subscales of language disorder and cognitive floating included) compared with patients who have insight. CONCLUSION: We was assumed that lack of insight in schizophrenics could include one of the symptoms based on neuropsychological or neurobiological abnormalities in brain. Moreover, it was revealed that patients with poor insight evaluated themselves as having more serious psychopathologies than patients who had insight. It has been already known that schizophrenic patients who lack in insight are reluctant to taking psychiatric care and lack in awareness of their illness. However, this study suggests that their inner psychopathology associated with insight can be understood with the use of subjective psychological test, i.e. K-FBF. For understanding the schizophrenic patients who lack in insight, not only checking the insight but also applying the subjective test such as K-FBF seems to be helpful.

A Study for Dose-Reduction of Antipsychotics in Chronic Schizophrenics

Conventional high-dose antipsychotics tend to result in more side effects, negative symptoms and dysphoria, and at the same time lower the cognitive function which is already impaired in most schizophrenics. Florid psychotic symptoms, negative symptoms and cognitive impairment greatly impede psychosocial performance and eventual reintegration int society. The reduction of symptom and the improvement of cognitive funtions and social skills are therefore central to the psychiatric rehabilitation process. The purpose of this study was to evaluate the dose-reduction effects of antipsychotics more than 1,500mg equivalent of chlorpromazine. Fifty-one chronic schizophrenics who maintained high-does antipsychotics for more than three months were randomly assigned to two groups : 20 patients comprised the dose-maintaining group and 31 patients made the dose-reduction group. Over a sixteen weekperiod Positive and Negative Syndrome Scale(PANSS), Extrapyramidal Symptom(EPS), Nurses' Observation Scale for Inpatient Evaluation(NOSIE-30), Continuous Performance Test(CPT), Quality of Life(QOL), and haloperidol/reduced haloperidol blood levels were determined at the base line and after 2, 4, 6, 8, 12, 16 weeks to evaluate the dose reduction effects of high-dose antipsychotics. The results were as follows: 1) Dose-reduction is highly effective in reducing positive and negative symptoms, and general psychopathology. Effects were most prominent at 8, 12, 16 weeks. Among the dose reduction group, positive symptoms in positive symptom group and negative symptoms in negative symptom group were more reduced. 2) Extrapyramidal symptoms showed no significant difference between two groups. But EPS was reduced time after time within two groups. 3) Hit rates of Continuous Performance Test, which indicate attentional capacity, increased significantly after dose reduction. 4) Haloperidol and reduced haloperidol blood levels decreased until the 4th week, after which they were constant. 5) Total scores of Nurses' Observation Scale for Inpatient Evaluation were unchanged between the two groups. But among the indices, social interest and personal neatness were improved in the dose-reduction group and retardation was aggrevated in the dose-maintaining group. 6) Total quality of life scores were unchanged between two groups. But in the dose maintaining group, satisfaction scores of attention, autonomy, and interpersonal relationship decreased progressively. These findings suggest that the dose reduction of antipsychotics for chronic schizophrenics on programs of high-dose antipsychotics were effective. Dose reduction should therefore be implemanted to spread the rehabilitation and improve quality of life for chronic schizophrenics.