Koro-Like Symptoms in an Adolescent Female With Schizophrenia.

Koro is a disorder characterized by the fear of genitals shrinking and retracting into the body.1 While it is not included in the cultural concepts of distress in DSM-5, DSM-IV-TR described koro as "an episode of sudden and intense anxiety that the penis (or, in female patients, the vulva and nipples) will recede into the body and possibly cause death." The term koro originates from the Malay language, referring to the retracting motion of the head of turtles or tortoises into their shells. In the United States and Europe, the term genital retraction syndrome is commonly used instead of koro. In classical koro, cultural belief plays a role in its origin and spread, often in epidemics in Asian countries.2 On the other hand, Koro-like syndrome (KLS) has been reported worldwide secondary to medical and psychiatric disorders.2 Similar to koro, KLS is more prevalent in males, with only 3 documented cases in female patients worldwide (Table 1). We present the first case to our knowledge of KLS in an adolescent female patient with schizophrenia. The patient's parents gave consent for the publication of this case report.

High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) in the First Episode of Catatonia: A Series of Four Cases.

Four patients with benzodiazepine non-responsive catatonia were administered repetitive transcranial magnetic stimulation (rTMS) at the left dorsolateral prefrontal cortex at 120% of resting motor threshold, frequency of 10Hz, with a total of 3,000 pulses/session. Patients with mood disorders showed good responses. One patient with chronic resistant schizophrenia had worsening catatonic symptoms during rTMS that responded to electroconvulsive therapy. Maximum response was observed between sessions 8 and 12.

Low-Dose Clozapine in Early-Onset Resistant Schizophrenia: Case Report and 2-Year Follow-up.

Childhood-onset schizophrenia (COS) is considered a rare and severe form of schizophrenia, with onset before age 13 and only half of affected patients responding to nonclozapine antipsychotics.1 These patients with resistant COS show favorable responses to clozapine, but with higher adverse effects than seen in adults. Some resistant cases respond at a lower dose with minimal adverse effects.2 However, it is unclear which patients will respond to a low dose and how long one should wait before increasing the dose of clozapine. We report a patient with resistant COS who showed a favorable but delayed-onset response to low-dose clozapine.

Oxidative stress and level of antioxidant enzymes in drug-naive schizophrenics.

BACKGROUND: Schizophrenia is a chronic illness having varied etiology which affects cognition, emotion, perception, and other aspects of behavior. There are data which show possible role of oxidative stress and disturbance in antioxidant mechanisms in various neurological and neuropsychiatric disorders. MATERIALS AND METHODS: Fifty drug-naive schizophrenic patients, who attended psychiatry outpatient department/inpatient department for the 1(st) time, were selected and compared with 50 age-sex matched healthy controls. The erythrocyte level of malondialdehyde (MDA) - a lipid peroxidation product and marker of oxidative stress, antioxidant enzymes - superoxide dismutase (SOD), glutathione peroxidase (GPX) was estimated. We also correlated the sociodemographic parameters and severity of illness (positive and negative syndrome scale score) with oxidative stress (MDA) and level of antioxidant enzymes (SOD, GPX). RESULTS: The level of oxidative stress (MDA) was increased, and the levels of antioxidative enzymes (GPX and SOD) were decreased in schizophrenic patients as compared to normal healthy controls and the difference was statistically significant. No significant relationships of age, sex, educational status, marital status, and PANNS score with oxidative stress (MDA) and antioxidative enzymes (GPX and SOD) level in schizophrenic patients was found; but there was significant relationship of locality with oxidative stress (MDA) and antioxidative enzymes (GPX and SOD) level in schizophrenic patients was found. Urban population have a higher level of MDA, GPX, and SOD than the rural population. CONCLUSION: Our findings put great emphasis on the weak pro/antioxidant defense mechanisms and its role in the pathophysiology of schizophrenia. We can make recommendations of dietary nutritional supplementation and adjunct antioxidants therapy with antipsychotics to treat schizophrenics.