Cigarette smoking and suicide attempts in psychiatric outpatients in Hungary.

BACKGROUND: Epidemiological and clinical studies have found a significant association between smoking and suicidal behaviour. METHOD: 334 outpatients with DSM-IV diagnosis of unipolar major depression, bipolar (I+II) disorder, schizophrenia, schizoaffective disorder and pure panic disorder were interviewed regarding to their smoking habits and previous suicide attempts. RESULTS: With the exception of panic disorder patients, the rate of prior suicide attempt(s) was much higher among current and lifetime smokers than among never smokers in all diagnostic groups, but the difference was statistically significant only for lifetime smoker unipolar depressives and for current and lifetime smoker schizophrenics. LIMITATIONS: Age, social class and alcohol/caffeine consumption was not controlled and dependent vs nondependent smokers were not distinguished. CONCLUSIONS: The findings support previous results on the strong relationship between smoking and suicidal behaviour in psychiatric (particularly major depressive and schizophrenic) patients.

Paralytic ileus associated with combined atypical antipsychotic therapy.

First- and second-generation antipsychotics commonly cause mild and sometimes severe gastrointestinal motility depression. We discuss a case of a patient who developed paralytic ileus during his treatment with a combination of second-generation antipsychotics. The patient did not receive other medication that could cause depression of intestinal motility than the above-mentioned combination of antipsychotics and no other etiology could be found for the ileus. Furthermore we discuss the theoretical background of antipsychotics induced gastrointestinal motility depression and we provide the literature review of case reports of this topic.

GABAergic neurons immunoreactive for calcium binding proteins are reduced in the prefrontal cortex in major depression.

Post-mortem morphometric studies report reductions in the average density and size of cortical neurons in the dorsolateral prefrontal cortex (dlPFC) and orbitofrontal cortex (ORB) in major depressive disorder (MDD). The contribution of specific neuronal phenotypes to this general pathology in depression is still unclear. Post-mortem sections from the dlPFC and ORB regions of 14 subjects with MDD and 11 controls were immunostained to visualize calbindin-immunoreactive (CB-IR) and parvalbumin-immunoreactive (PV-IR) presumptive GABAergic neurons. A three-dimensional cell counting probe was used to assess the cell packing density and size of CB-IR neurons in layers II+IIIa and PV-IR neurons in layers III-VI. The density of CB-IR neurons was significantly reduced by 50% in depression in the dlPFC and there was a trend toward reduction in the ORB. The size of CB-IR somata was significantly decreased (18%) in depression in the dlPFC with a trend toward reduction in the ORB. In contrast, there was no difference in the density of PV-IR neurons between the depressed and control groups in the dlPFC. The size of PV-IR neuronal soma was unchanged in depressed compared to control subjects in either dlPFC or ORB. In depression, subpopulations of GABAergic neurons may be affected differently in dlPFC and ORB. A significant reduction in the density and size of GABAergic interneurons immunoreactive for calcium binding proteins was found predominantly in the dlPFC region. These cellular changes are consistent with recent neuroimaging studies revealing a reduction in the cortical levels of GABA in depression.

Relationship between obsessive-compulsive symptoms and smoking habits amongst schizophrenic patients.

The rate of smoking is especially high among patients with schizophrenia (SCH) and schizoaffective disorder (SCHAFF). Patients with obsessive-compulsive disorder (OCD) smoke less than the general population. OCD symptoms are more frequent among patients with SCH or SCHAFF than in the general population, but it is still unclear whether schizophrenia patients with OC symptoms suffer from SCH and comorbid OCD, or whether they represent a unique subgroup of SCH with presenting OC symptoms. In our study we hypothetised that the current smoking rate of schizophrenia patients with OC symptoms is lower than in schizophrenia patients without OC symptoms. We assessed OC symptoms with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), general state with the Brief Psychiatric Rating Scale (BPRS) and smoking habits with a questionnaire among 66 patients with SCH or SCHAFF. We formed two groups by dividing patients according to their Y-BOCS score. Group I consisted of patients with Y-BOCS scores under 16, while group II consisted of patients with Y-BOCS scores above 16, and we compared the current smoking rates of the two groups. We found that the rates did not differ significantly, so we came to the conclusion that OC symptoms are not in a tight relationship with smoking habits among patients with SCH/SCHAFF.