Perpetrators of homicide with schizophrenia: sociodemographic characteristics and clinical factors in the eastern region of Turkey.

In this study, we aimed to describe the social and clinical characteristics and offense details in a sample of people with schizophrenia convicted of homicide in the eastern region of Turkey. This study was performed in Elazig Mental Hospital between November 2004 and May 2007. We included 43 men and 6 women with schizophrenia convicted of homicide who were hospitalized in the forensic psychiatry unit for compulsory treatment. Preset data recording forms were used. The first part of the forms contained questions regarding the age, sex, marital status, residence, educational status, and occupation of the patients. The second part of the forms included questions about some clinical features of patients with schizophrenia: the presence of schizophrenia in any family member, duration of the disease, subtype of schizophrenia, previous contact with mental health services, types of antipsychotics (first and last drug used), and adherence to antipsychotic medication. The third part of the forms dealt with alcohol-substance abuse and features of the victim (sex of the victim and whether the victim was a stranger, partner, or an ex-partner in the family or an acquaintance). The mean +/- SD age of our patients was 36.98 +/- 10.07 years, and 55.1% of the patients were unmarried. In our sample, 42.9% of the patients were primary school graduates and 75.5% were unemployed. Of the perpetrators, 14.3% never had contact with mental health services. However, 85.7% of patients had previous contact with mental health services. We found that 85.7% of the patients were paranoid subtype and 85.7% were not using their medication regularly and that treatment compliance was considerably low. We found that haloperidol and trifluoperazine were the most preferred antipsychotic drugs, particularly being the first drugs used during treatment (haloperidol, 71.4%; trifluoperazine, 10.2%) and the last antipsychotics used before the offence (haloperidol, 46.9%; trifluoperazine, 20.4%). In 38.8% of cases, schizophrenia was present in the first-degree relatives. We also found that 69.4% of victims were one of the family members. In our sample, 24.5% of patients were using alcohol and 4.1% were using cannabis. It is plausible that rendering more effective communication might allow earlier intervention for unrecognized and possibly unrecognizable risk factors of homicidal acts in people with schizophrenia.

Direct current therapy with/without lidocaine iontophoresis in myofascial pain syndrome.

OBJECTIVES: This study aimed to assess the effectiveness of lidocaine iontophoresis for inactivation of trigger points (TrPs) in the treatment of myofascial pain syndrome (MPS). METHODS: Fifty-eight trigger points (cervical and/or periscapular regions) in 18 female and 2 male patients with MPS were randomly assigned to two groups. These groups were treated with: lidocaine iontophoresis using direct current (3 mA, 10 min) (n: 10, 28 TrPs) or only direct current (n: 10, 30 TrPs). Lidocaine iontophoresis or direct current, followed by stretching and strengthening exercises of each of the involved muscles and postural exercises were given in both groups once daily for ten days. Clinical assessment including cervical range of motion (ROM), TrP pain pressure threshold (PPT) measurement, and manual pain scores (PS), Visual analogue scale-pain (VAS-pain), fatigue and work disability scores were evaluated at baseline, at the end of a 10 session course of treatment and at the end of fourth week. Additionally, Hamilton depression and anxiety rating scales and Nottingham Health Profile (NHP) were used to evaluate and assess depression and anxiety and quality of life, respectively. The subjects were also asked to describe their side effects. RESULTS: PPT, pain scores, VAS-pain were significantly improved in both groups at the end of treatment and during evaluation at fourth week. The improvement of these parameters was not significantly different between groups at the end of treatment. Quality of life (NHP scores) (p<0.016) and depression and anxiety scores (p<0.05) significantly improved with treatment in both groups. CONCLUSION: Direct current therapy with/without lidocaine iontophoresis were determined to be effective treatment modalities in TrP management. These treatment modalities are non-invasive, cost effective and provide long term improvement. Thus, these modalities could be safely used in the management of MPS with minimal side effects, particularly if patients may not accept injection or other treatments (Tab. 3, Ref. 44). Full Text (Free, PDF) www.bmj.sk.

Serum leptin and cholesterol levels in patients with bipolar disorder.

Low cholesterol levels have been reported in patients with manic episodes. Leptin seems to be strongly associated with lipid metabolism. In the present study, therefore, serum total cholesterol and leptin levels were compared in 16 patients with manic episodes, 16 with bipolar I disorder in full remission and 16 healthy controls. The serum total cholesterol and leptin levels were measured and Young Mania Rating (YMRS) and Hamilton Depression Rating Scales (HAM-D) were administered for each subject. Both the patients with manic episodes and the patients with bipolar I disorder in full remission had markedly low serum cholesterol and leptin levels compared with controls, though the difference was more obvious in patients with manic episodes. In addition, there were negative correlations between YMRS scores and serum cholesterol or leptin levels in the patients with manic episodes. Our results suggest that the patients with manic episodes and those with bipolar I disorder in full remission seem to be associated with decreased serum cholesterol and leptin levels.