Using ECT in schizophrenia: a review from a clinical perspective.

OBJECTIVES: Despite the fact that many studies have addressed the use of ECT in schizophrenia questions on clinical use remain poorly answered and clinical application is largely based on data originating from depressed patients. METHODS: We review data on the use of ECT in schizophrenic patients drawn from original studies indicated by a Pubmed search and referenced in recent and older expert reviews with a specific focus on four issues: symptom response, technical application, continuation/maintenance ECT and combination with medication. RESULTS: Catatonic patients are the most responsive. Positive symptoms such paranoid delusions and affective symptoms follow. There are indications that ECT may improve responsivity to medication. No particular technical features stand out in studies except lengthier courses, but not for catatonia. Combination with medication appears to be preferable over either treatment alone and effective combination particularly with clozapine is supported by data. Use of continuation and maintenance treatments in responders appears beneficial. CONCLUSION: Certain schizophrenic patients may benefit significantly from the use of ECT. More specific research is required to address particular questions.

Sleep problems in adolescence. A study of senior high school students in Greece.

OBJECTIVES: The aim of this study was to evaluate sleep habits and sleep-related problems in high school adolescent students in Greece through the Athens Insomnia Scale and to assess the relation of these problems to demographic and other variables. METHODS: The Athens Insomnia Scale 5-item version (AIS-5) was administered to 713 adolescent senior high school students in the Greater Athens Area. Data such as age, sex, school records, and time spent per week in school-related and extracurricular activities were collected. RESULTS: The sample's mean sleep duration was 7.5 h, mean bedtime 00.20 a.m. and wake-up time 7.15 a.m. Total sleep time was not affected by gender, but was influenced by time spent in various activities. Sleep complaints were related to delayed sleep, onset latency and insufficient total duration of sleep. Of the respondents, 30% estimated that their sleep onset latency was markedly delayed and 30% reported that their total sleep time was markedly insufficient. Girls complained more than boys, while correlations showed that students with lower academic performance and those in second grade were more likely to have higher AIS-5 scores. CONCLUSIONS: The results show that the sleep time of high school students is dependent on practical matters such as school schedule and other activities, while sleep complaints are related to female gender, bad school performance as well as to the second grade. The difference between actual sleep time and sleep complaints should be considered when studying the sleep of adolescents.