Differences in audiovisual integration, as measured by McGurk phenomenon, among adult and adolescent patients with schizophrenia and age-matched healthy control groups.

BACKGROUND: McGurk effect is a perceptual phenomenon that reflects the integration of visual and auditory information during speech perception. Using McGurk effect, the authors examined the audiovisual integration in adolescents and adults with schizophrenia as compared with healthy volunteers. SAMPLING AND METHODS: Thirty hospitalized patients with schizophrenia and 20 age-matched healthy controls were examined for perception of ambiguous audiovisual stimuli. RESULTS: The mean of McGurk-positive responses was significantly lower in adolescent patients with schizophrenia than in healthy adolescents (3.13 +/- 2.09 vs 5.60 +/- 0.7, respectively; t = 3.591, P = .001). The McGurk-positive responses were significantly higher in healthy adolescents than in healthy adults (5.60 +/- 0.7 vs 3.60 +/- 1.43, respectively; t = 3.974, P = .001). No significant difference in McGurk-positive responses was found between adults with schizophrenia and healthy adult individuals, or between adolescent and adults with schizophrenia. Duration of schizophrenia, soft sign status, type of symptoms, and type of antipsychotic medication showed no influence on the audiovisual integration ability. CONCLUSIONS: (I) Age effect: It seems that the audiovisual integrative function increases from childhood to adolescence and decreases from adolescence to early adulthood. (II) Schizophrenia: Audiovisual integration is poor in adolescent and adult patients with schizophrenia. Thus, it seems that schizophrenia is associated with early and persistent impairment in the development of the audiovisual integration ability. (III) Reliance on visual cue stimuli: Although several previous investigations concluded that patients with schizophrenia rely less on visual cue stimuli than healthy controls, our data suggest that this is true only for specific types of visual cue stimuli.

An unusual case of DRESS syndrome.

BACKGROUND: DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is a rare but severe drug reaction. OBSERVATIONS: A 27-year-old male with paranoid schizophrenia was hospitalized with all three diagnostic criteria of DRESS syndrome: cutaneous drug eruption, hematological abnormalities (presence of atypical lymphocytes on blood smear) and systemic involvement (generalized lymphadenopathy and hepatitis). On hospitalization the patient exhibited an unusual fever pattern of high temperatures in the morning hours and lower temperatures towards evening. In this case of a patient who needs life-long therapy, we demonstrated the value of the IFN-gamma release test, which showed positive reactivity to 3 out of 9 suspicious drugs: paracetamol, phenytoin and dypirone, allowing for more therapeutic options. After therapy, at 6-month follow-up the patient is doing well under haloperidol treatment, laboratory values including liver function tests are normal and his skin condition is good. CONCLUSION: We suggest that clinicians take the fever pattern of high temperatures in the morning hours and lower temperatures towards evening into account in a patient presenting with a severe cutaneous drug eruption. An interferone-gamma release test may facilitate identification of drugs responsible for the drug reaction.