S100B and schizophrenia

The research for peripheral biological markers of schizophrenia, although abundant, has been unfruitful. In the last 2 decades, the S100B protein has made its own room in this area of research. S100B is a calcium‐binding protein that has been proposed as a marker of astrocyte activation and brain dysfunction. Research results on S100B concentrations and schizophrenia clinical diagnosis are very consistent; patients with schizophrenia have higher S100B concentrations than healthy controls. The results regarding schizophrenia subtypes and clinical characteristics are not as conclusive. Age of patients, body mass index, illness duration and age at onset have been found to show no correlation, a positive correlation or a negative correlation with S100B levels. With respect to psychopathology, S100B data are inconclusive. Positive, negative and absence of correlation between S100B concentrations and positive and negative psychopathology have been reported. Methodological biases, such as day/night and seasonal variations, the use of anticoagulants to treat biological samples, the type of analytical technique to measure S100B and the different psychopathological scales to measure schizophrenia symptoms, are some of the factors that should be taken into account when researching into this area in order to reduce the variability of the reported results. The clinical implications of S100B changes in schizophrenia remain to be elucidated.     

Season-dependent symptoms in consultation-liaison patients

INTRODUCTION: We investigated those psychiatric patients whose reason for seeking medical help was primarily a physical condition. Our objectives were to analyse to what extent they suffered from seasonal variation in mood and behaviour during winter, and to examine whether these patients were evenly distributed between the categories of the ICD-10 Classification of Mental and Behavioural Disorders (ICD-10) by their primary diagnosis of mental disorder. METHOD: Patients attending the psychiatric services of a consultation liaison unit were interviewed for diagnosis, and were asked to fill in a questionnaire on seasonal variation in mood and behaviour. RESULTS: Our results suggest that there are many patients fulfilling the criteria based on the Seasonal Pattern Assessment uestionnaire (SPA) for seasonal affective disorder (SAD) or for subsyndromal SAD, not only in the ICD-10 diagnosis category of mood (affective) disorders but also in other disorder categories. CONCLUSION: This observation is of importance to hospital and private clinicians, as it emphasizes the need to assess the clinical picture in detail and to consider treatment alternatives for patients presenting with mental disorder with a seasonal pattern. (Int J Psych Clin Pract 2000; 4:151-154)     

Partial compliance with antipsychotics and its impact on patient outcomes

Partial compliance with antipsychotic medications is a common and complex phenomenon that is underestimated by physicians. The consequences of partial compliance include an increased risk of relapse, rehospitalization and suicide attempts. Stigma, negative attitudes towards medications, cognitive impairment and diminished insight negatively impact treatment adherence. Oral atypical antipsychotics may improve both insight and cognitive function, but compliance with these agents is not assured. Depot conventional antipsychotics ensure medication delivery but are associated with side-effects such as EPS and dysphoria that decrease compliance. Long-acting atypicals provide significant symptom improvement, foster adherence and may help achieve improvement in insight and cognition. Addressing issues of partial and non-compliance is a significant consideration in relapse prevention strategies for patients with schizophrenia, given the devastating consequences associated with psychotic relapses.     

Coexistence of folie communiquée and folie simultanée

Objective. The authors report a case during which they observed serious subtypes of induced delusional psychosis (folie communiquée and folie simultanée) without any common genetic background or premorbid psychosis in the case of the secondary patient. Method. The clinical phenomenology of the case is described. Results. Mild intellectual disability and environmental–psychological factors (social isolation and the symbiotic-like interpersonal relatedness) play an essential aetiological role in the case of the secondary recipient patient. Conclusion. The authors emphasize the importance of subclassification of induced delusional psychosis for further aetiological and clinical research.