The clock-drawing test as a possible indicator of acute psychosis.

The clock-drawing test (CDT) is used widely to evaluate cognitive disorders, but its role in the assessment of psychotic disorders has not been studied. We sought to examine whether the CDT plays a role as an indicator of psychosis and to establish its sensitivity to clinical improvement of psychosis. The CDT was administered twice to 53 hospitalized patients without dementia but with psychosis: once at admission and again before discharge. The CDT scores were calculated in a random order by two independent senior psychiatrists who were blinded to the patients' status (admission or discharge). The inter-rater reliability was high (0.89 at admission, 0.85 at discharge, P<0.01 for both). The severity of psychosis was assessed by the Positive and Negative Syndrome Scale (PANSS). Patients had significantly lower CDT scores at admission than at discharge (2.87±1.39 vs. 3.91±1.08, respectively, P<0.01). The PANSS-total score of the patients showed a significant improvement (84.90±17.77 vs. 69.18±16.23, P<0.01). An inverse correlation was found between CDT performance and psychosis severity, as reflected by the PANSS-positive symptom subscale at admission (R=-0.279, P<0.05). Our findings suggest that the CDT may aid in the assessment of psychotic states and in their clinical monitoring.

Association between corneal temperature and mental status of treatment-resistant schizophrenia inpatients.

INTRODUCTION: Preliminary point-prevalent data suggest that drug-free schizophrenia patients may exhibit increased body/corneal temperature, that antipsychotic drugs (APDs) may decrease body/core temperature and that patients' mental status might be associated with their body/corneal temperature. Hence, we hypothesized that treatment-resistant psychotic APD-treated schizophrenia patients' mental status may correlate with their corneal temperature during a continuous 6-week period. METHODS: Corneal temperature of 12 treatment-resistant schizophrenia inpatients and 16 healthy volunteers was evaluated 2-3 times a week during 6 consecutive weeks using a flir thermal imaging camera. RESULTS: A significant and substantial correlation was found between inpatients' mean weekly Positive and Negative Syndrome Scale (PANSS)'s total scores and their mean weekly corneal temperature during the 6-week study period (r=0.82; n=6 weeks; p=0.043). There was no significant difference in mean 6-week corneal temperature between the patient group and the healthy subjects (34.25+/-0.64 degrees C vs. 34.39+/-0.69 degrees C, respectively; t=1.127, df=131, p=0.26). CONCLUSIONS: This study indicates that treatment-resistant overtly psychotic schizophrenia inpatients' mental status (as assessed by the PANSS) correlates with their corneal temperature. The relevance of these phenomena to the pathophysiology of schizophrenia, the biological mechanism underlying corneal temperature alterations and the possible role of temperature-modulating drugs (neuroleptics or non-neuroleptics) on schizophrenic psychosis merits further large-scale investigation in both medicated- and drug-free schizophrenia patients compared to matched controls.

Altered thermoregulation in ambulatory schizophrenia patients: a naturalistic study.

BACKGROUND: Schizophrenia patients may exhibit alterations in core/body temperature. Hence, we intended to examine the potential existence of thermoregulatory abnormalities in ambulatory schizophrenia patients. METHODS: Anonymous electronic patient record data of the Leumit Health Fund (Israel) were screened for all schizophrenia patients who have no other apparent chronic co-morbidity (mental or non-mental) and had their oral temperature assessed during routine follow-ups (Schiz-rFUs) or for various transitory infectious/inflammatory processes (Schiz-Infect) during the years 1999-2005 (n = 535). The comparison group consisted of a comparable sample (n = 560) of healthy subjects (Control-rFUs and Control-Infect). RESULTS: The sub-group of Schiz-rFUs (n = 216) exhibited significantly lower mean oral temperature compared to the matched group of Control-rFUs (n = 140) (36.72 +/- 0.54 vs. 36.94 +/- 0.64C, respectively; P<0.05). There was no significant difference in mean oral temperatures between the Schiz-Infect (n = 319) and the Control-Infect (n = 420) (37.32 +/- 0.92 vs. 37.28 +/- 0.98C, respectively; NS). CONCLUSIONS: Ambulatory schizophrenia patients without a concomitant infectious/inflammatory process exhibit altered thermoregulation manifested by a substantial (about 0.2 C) and significantly lower oral temperature compared to healthy comparison subjects as well as a potential exaggerated increase in oral temperature during transitory infectious/inflammatory processes. The relevance of these phenomena to the pathophysiology of schizophrenia as well as the potential immune-mediated pathologies in schizophrenia merit further investigation.

Zolmitriptan compared to propranolol in the treatment of acute neuroleptic-induced akathisia: a comparative double-blind study.

Neuroleptic-induced akathisia (NIA) is a common, sometimes incapacitating adverse effect of anti-psychotic medication. Zolmitriptan is a selective 5-HT(1D) agonist. We aimed to determine its anti-NIA efficacy in comparison to propranolol. Thirty-three neuroleptic-treated patients were randomly allocated in a double-blind design to receive either 7.5 mg/d of zolmitriptan or 120 mg/d of propranolol for 3 consecutive days, followed by 3 days without any anti-NIA treatment. Patients were assessed at baseline and on days 3 and 7 by the Barnes Akathisia Rating Scale (BARS), PANSS, HAMD, HAMA, Pulse, and Blood Pressure. Both groups showed improvement of akathisia (BARS) along the treatment period, with significant effect for time but not for group. No significant differences were found between the groups in all other measurements. Taken together, zolmitriptan was found to be as effective as propranolol for the treatment of NIA. Further placebo-controlled studies are warranted.

Trazodone for the treatment of sexual dysfunction induced by serotonin reuptake inhibitors: a preliminary open-label study.

INTRODUCTION: Treatment with selective serotonin reuptake inhibitors (SSRIs) may lead to sexual dysfunction in up to 70% of patients. Because the SSRIs are widely used antidepressants, their propensity to cause sexual dysfunction may affect compliance with therapy and ultimately treatment success. To date, the pathophysiological mechanism of sexual dysfunction caused by SSRIs remains incompletely understood, and the management of SSRIs-induced sexual dysfunction remains unsatisfactory. We suggest that medications that antagonize serotonin receptors such as trazodone may improve sexual dysfunction reverting the stimulation of serotonin receptors by SSRIs. OBJECTIVE: The aim of this study was to investigate the efficacy of trazodone administration in the management of SSRI-induced sexual dysfunction. METHODS: Twenty patients (11 men/9 women) with SSRIs-induced sexual dysfunction were recruited for the study. Trazodone was added to the existing SSRI regimen in open-label fashion for 4 weeks (50 mg for the first week increased to 100 mg until the completion of the study). The improvement in the 4 dimensions of sexual function (desire, erection or lubrication problems in women, ejaculation or orgasm in women, and overall satisfaction by both sexes) was the primary outcome measure of the study. RESULTS: Fifteen subjects completed the study. Results indicated improvement in sexual function and overall clinical improvement (depression, anxiety) as well. Specific gender differences indicated improvement in erectile performance in men and lubrication in women. No correlations were noted between clinical improvement of depression or anxiety and improvement in sexual dysfunction. CONCLUSIONS: The 5-HT2 antagonist, trazodone, may be beneficial in the management of SSRI-induced sexual dysfunction. Large-scale, placebo-controlled, double-blind studies with 5-HT2 antagonists are required to substantiate these preliminary observations.

In vivo occipital-frontal temperature-gradient in schizophrenia patients and its possible association with psychopathology: a magnetic resonance spectroscopy study.

BACKGROUND: Accumulating data suggest that schizophrenia patients' mental status might be modulated by their core/brain temperature. Hence, we intended to assess in vivo brain temperature (Tb) of schizophrenia patients vs. healthy subjects and to evaluate its potential association with patients' mental status. METHODS: Absolute values of Tb were measured in 9 neuroleptic-treated schizophrenia patients and 10 healthy comparison subjects using 1H magnetic resonance spectroscopy (MRS). Values were extracted by measuring the chemical shift between the peaks of water and N-acetyl-aspartate in the 1H MRS spectra. RESULTS: A substantial (about 1.1 degrees C) and significantly higher occipital-frontal temperature-gradient was found in the schizophrenia patients compared to the healthy controls (1.27 degrees C vs. 0.18 degrees C; p=0.032). Furthermore, a trend was found between the above mentioned occipital-frontal temperature-gradient in the schizophrenia patients and the severity of their psychopathology, as assessed by the total Positive and Negative Syndrome Scale (PANSS) scores (r=0.61; p=0.08). CONCLUSIONS: Our findings corroborate previous results indicating putative correlation between core/brain temperature and the mental status of schizophrenia patients, emphasizing the possible role of within patients decreased frontal temperature and a significant occipital-frontal temperature-gradient as modulators of psychopathology. In addition, the MRS technique used for brain temperature assessment seems to be a potential non-invasive method to assess in vivo absolute Tb in schizophrenia.

Risk of readmission in compulsorily and voluntarily admitted patients.

OBJECTIVES: The aim of this study is to examine relationships between hospital admission legal status (voluntary, psychiatrist-ordered, and court ordered), length of stay and risk of hospital readmission. METHODS: The records (1994-2005) of all consecutive admissions (n = 16,016) to one inpatient mental health facility were reviewed. Patients (n = 6,656) were classified into 3 groups at first admission: voluntary (n = 5,442), psychiatrist-ordered (n = 1,067) and court ordered (n = 147). RESULTS: The probability of readmission of the court-ordered and psychiatrist-ordered groups were significantly lower than that of voluntarily admitted patients (P < 0.05). The length of stay at first admission was significantly longer for the court-ordered group than for the others (P < 0.001). As compared with the other groups, court ordered-patients were significantly younger (P < 0.001), had attained fewer years of education (P < 0.001) and included a lower percentage of immigrants (P < 0.05). Significant differences were found in the mean morality age of the three groups (P < 0.005). CONCLUSIONS: As compared with psychiatrist-ordered and voluntarily admitted patients, court ordered patients have a lower probability for hospital readmission, possibly related to longer length of stay.

A significant correlation between ward temperature and the severity of symptoms in schizophrenia inpatients--a longitudinal study.

BACKGROUND: Preliminary data suggest that schizophrenia outpatients' mental status might be affected, at least to some extent, by environmental temperature. To further substantiate the potential role of environmental temperature and schizophrenic symptoms we examined, in a naturalistic design, the relationship between environmental temperature of schizophrenia inpatients (i.e., ward temperature) and their mental status. METHODS: Mean daily temperature of a closed psychiatric ward was monitored for 32 consecutive weeks. Temperature assessments were performed at 3 different locations within the ward at the same hour daily. Mean daily temperature was defined as the average of the 3 values. During each of the 32 weeks of the study, the inpatients were divided into two sub-groups: schizophrenia patients (n=22-34 patients/week) and non-schizophrenia psychotic patients (n=5-12 patients/week). The mental status of all participants was evaluated weekly using the positive and negative syndrome scale (PANSS). All participants were treated with antipsychotics during the entire study period. RESULTS: Schizophrenia patients' total PANSS score, as well as each of the PANSS' subscales (positive, negative, general psychopathology, depression) were positively and significantly correlated with ward temperature (r=0.52-0.64; p=0.002-0.0001). No correlation was found between ward temperature and any of the PANSS' subscales in the non-schizophrenia psychotic subjects. CONCLUSION: Our results suggest that schizophrenia inpatients' mental status might be modulated, at least to some extent, by environmental (i.e., ward) temperature and that this phenomenon is specific to schizophrenia patients. Our findings imply the need for optimally adjusting ward temperature (e.g., about 19 degrees C in this study) for the management of patients with acute psychotic exacerbation of schizophrenia.

Psychological and cytokine changes in children and adolescents undergoing hematopoietic stem cell transplantation.

BACKGROUND: Hematopoietic stem cell transplantation is a therapeutic option of a large variety of diseases. It involves several physiological and psychological changes. Investigations of mood changes in patients undergoing hematopoietic stem cell transplantation are common. There are no studies however, on the relationship between changes in mood and physiological changes in hematopoietic stem cell transplantation in children and adolescents. We investigated the correlation between anxiety, depression and serum Interleukin-1beta (IL-1beta), IL-2 and IL-6. METHODS: Participants, 11 boys and 12 girls, aged 6-18 years, were administered the Children Depression Inventory (CDI) and the Spielberger State Anxiety Inventory for Children (SAIC), at four different points in time: at conditioning time when treatment is initiated (time 1 = T1), on the day of hematopoietic transplantation (T2), on the day of engraftment (T3) and a week after the engraftment (T4). At each of those times serum samples for cytokines determination were collected as well. RESULTS: Up to the time of engraftment depression and anxiety were relatively high but resolved subsequently. Globally, there was a significant time effect for anxiety (p = 0.0082). Namely, scores differ between times. Depression showed a similar trend, though this trend did not reach significance (p = 0.1394). Negative correlation was found between serum IL-1beta, IL-2 and IL-6 levels and anxiety (IL-2 and IL-6) and depression scores (IL-1beta and IL-2) at T4. The complex interaction between cytokines, depression and anxiety in children and adolescents undergoing hematopoietic stem cell transplantation merits further long-term studies under natural conditions and on laboratory models.

Signs of bruxism and temporomandibular disorders among psychiatric patients.

OBJECTIVES: To investigate the prevalence of bruxism and signs of temporomandibular disorders (TMDs) among psychiatric patients compared with a healthy population and to assess the effect of psychiatric medications on the parameters studied. STUDY DESIGN: Subjects included 77 psychiatric patients under treatment at 2 psychiatric hospitals in Israel and 50 healthy individuals (control). One experienced calibrated examiner performed the clinical examination (presence of bruxism and signs of TMD). RESULTS: Abnormal attrition was evident in 46.8% of the psychiatric patients compared with 20% in the controls (P < .005). Significant differences between groups were apparent for mean muscle sensitivity to palpation, joint sensitivity to palpation, and range of mouth opening. There were no differences between groups in the prevalence of joint clicks and no association between time of receiving treatment with dopamine antagonists (or any other psychotropic drugs) and TMD signs and symptoms. CONCLUSION: The higher prevalence of bruxism and signs of TMD in psychiatric patients is a major clinical comorbidity. Whether it is a manifestation of the abnormal central nervous system of psychiatric patients or neuroleptic-induced phenomenon deserves further attention. The exact factors that affect the pain experience in these patients should be evaluated as well.

Corneal temperature in schizophrenia patients.

Most data imply that dopaminergic transmission is essential for proper hypothalamic-mediated core temperature regulation. Altered central dopaminergic transmission is suggested to be involved in the pathophysiology of schizophrenia. Thus, hypothetically, schizophrenia patients might be at increased risk of developing thermoregulatory dysregulation manifested by alterations in core temperature, as well as in peripheral tissue, the temperature of which has been shown to correlate with core temperature (e.g. cornea). Previous small pilot studies of ours showed that schizophrenia patients may exhibit corneal temperature abnormalities. Hence, we assessed corneal temperature in a controlled sample of drug-free ( n =11) and medicated ( n =28) schizophrenia patients compared to healthy comparison subjects ( n =9), using a FLIR thermal imaging camera. Drug-free schizophrenia patients exhibited significantly higher corneal temperature compared to healthy subjects, typical antipsychotic drug (APD)-treated patients ( n =16) and atypical APD-treated patients ( n =12) (37.08+/-1.46 degrees C vs. 33.37+/-2.51 degrees C, 31.08+/-1.43 degrees C and 31.67+/-0.44 degrees C respectively, p <0.0001; p <0.001 vs. each group separately). The healthy comparison subjects and the atypical APD-treated patients exhibited comparable corneal temperatures and these two groups exhibited higher corneal temperatures compared to the typical APD-treated patients ( p <0.01 and p =0.051 respectively). In conclusion, this study indicates that drug-free schizophrenia patients exhibit substantially higher corneal temperature compared to healthy comparison subjects or medicated patients, and that APDs may decrease corneal temperature either to normal (atypical APD) or to subnormal (typical APD) values. The relevance of these phenomena to the pathophysiology of schizophrenia, the biological mechanism underlying drug-induced corneal temperature alterations, the possible role of temperature-lowering drugs (neuroleptics or non-neuroleptics) on schizophrenic psychosis as well as the role of corneal temperature as a tool to evaluate adherence to APD treatment merit further investigation via larger samples of both medicated and drug-free schizophrenia patients compared to matched controlled subjects.

Effects of climate on admission rates of schizophrenia patients to psychiatric hospitals.

Data on admissions of schizophrenia- and schizoaffective disorder patients to Tel-Aviv's seven public psychiatric hospitals during 11 consecutive years were obtained along with relevant meteorological information. Mean monthly admission rates were significantly higher during the summer (for schizophrenia patients) and fall (for schizoaffective patients). Schizophrenia patients' mean monthly admission rates correlated with mean maximal monthly environmental temperature (R = 0.35, N = 132 months, P <0.001). The present study may indicate that persistent high environmental temperature may be a contributing factor for psychotic exacerbation in schizophrenia patients and their consequent admission to mental hospitals.

The 5-HT1D receptor agonist zolmitriptan for neuroleptic-induced akathisia: an open label preliminary study.

Neuroleptic-induced akathisia (NIA) is a common, sometimes incapacitating, adverse side-effect of antipsychotic drugs (APDs). Several non-selective post-synaptic 5-HT2 blockers have shown a beneficial antiakathisic effect. We hypothesized that selective stimulation of the presynaptic 5-HT1D serotonergic inhibitory autoreceptor could also be beneficial in NIA. The study group included eight schizophrenia inpatients with acute or chronic NIA who were treated with unchanged doses of APDs. Participants received, in an open-labelled design, 7.5 mg/day of zolmitriptan (selective 5-HT1D agonist) for 3 consecutive days. Positive and Negative Syndrome Scale and Barnes akathisia scale (BAS) scores were monitored before and at the end of the study. BAS score decreased by 5.25 points following zolmitriptan administration (9.0+/-2.27 to 3.75+/-2.55, t=6.1, d.f.=7, P=0.0005). In one case, the BAS score dropped from a 3-year score >or=9 points (while relatively non-responsive to numerous antiakathisic agents) to 4 points at endpoint. In conclusion, zolmitriptan appears to exert significant and rapid beneficial antiakathisic effect, even in chronic and resistant NIA. Larger, long-term, double-blind, placebo- and comparator- (e.g. propranolol) controlled studies are required to substantiate the efficacy, safety and tolerability of zolmitriptan, as well as the role of serotonergic neurotransmission in NIA.

Donepezil augmentation of clozapine monotherapy in schizophrenia patients: a double blind cross-over study.

Increasing evidence suggests that the cholinergic system is involved in the pathogenesis of schizophrenia. Donepezil, a central cholinesterase inhibitor, improves psychotic symptomatology in demented patients, however, evidence for its role in the management of active psychosis in schizophrenia remains limited. An 18-week double blind cross-over study was conducted in which eight patients were randomly assigned to either donepezil (5 mg/day for the first 4 weeks and 10 mg/day for the following 4 weeks) or placebo as augmentation treatment to clozapine. After this initial phase, there was a 2-week washout period of the study medication after which the same regimen was crossed over at the same dose and for the same period (8 weeks). No significant difference was noted in the total positive and negative symptom scale scores when donepezil was compared with placebo (16.7%+12.97% vs 3.20%+13.94% respectively, p = 0.18). However, three patients improved (>15%) in the total PANSS scores (37.03%, 16.6% and 25.33%) during the donepezil treatment phase, while only one patient improved (20.87%) during the placebo phase. No differences were noted in the Calgary depression scale (p = 0.305), Simpson Angus scale (p = 0.374), clinical global impression-improvement scale (p = 0.23) and clinical global impression-severity of illness scores (p = 0.116). Although this preliminary study failed to demonstrate a clear effect of donepezil augmentation in clozapine treated chronic schizophrenia patients, it seems that the subtle positive effect of donepezil observed in some of our patients should encourage further investigation in a larger sample of this patient subpopulation.

Admission rates of bipolar depressed patients increase during spring/summer and correlate with maximal environmental temperature.

OBJECTIVE: We intended to identify a relationship, if exists, between various climatic factors and the admission rates of bipolar affective disorder depressed patients (BPD) or major depressive disorder patients (unipolar) (UPD) to psychiatric hospitals, as well as potential seasonal variability in hospitalization rates of this population. METHODS: Data on admissions of ICD-9 BPD and UPD patients to Tel Aviv's seven public psychiatric hospitals during 11 consecutive years were collected along with concomitant meteorological information RESULTS: Admissions of 4117 patients with BPD and 1036 with UPD who fulfilled our specific inclusion criteria were recorded. Bipolar depressed, but not UPD, patients exhibited significant seasonal variation (higher spring and summer versus winter mean monthly admission rates), and the admission rates of patients with BPD, but not UPD, correlated significantly with mean maximal monthly environmental temperature CONCLUSIONS: Increased environmental temperature may be a risk factor for evolvement of major depressive episode in patients with bipolar disorder with psychiatric co-morbidity, at least in cases that necessitate hospitalization and at the examined geographic/climatic region of Israel. Further large-scale studies with bipolar depressed patients with and without co-morbid disorders are needed to substantiate our findings and to determine the role of seasonal and climatic influence on this population, as well as its relationship to the pathophysiology of bipolar disorder.

Musical hallucinations: prevalence in psychotic and nonpsychotic outpatients.

BACKGROUND: Musical hallucinations have been considered a rare manifestation of psychotic states or brain and hearing abnormalities. However, an obsessive-compulsive disorder (OCD) assessment tool refers to musical hallucinations and our preliminary study showed that about one third of OCD patients experienced musical hallucinations. AIMS: To elucidate the lifetime prevalence of musical hallucinations among psychotic and nonpsychotic psychiatric outpatients. METHODS: Lifetime experience of musical hallucinations was examined with a specially designed structured interview in 190 consecutive outpatients with diagnoses of anxiety, affective, and schizophrenia disorders. RESULTS: Musical hallucinations occurred in more than one fifth of all diagnoses. The prevalence of musical hallucinations was highest in OCD patients (41%). Musical hallucinations were significantly more frequent with more comorbid disorders, and logistic regression revealed that this finding was mainly due to OCD combined with either social phobia or schizophrenia. CONCLUSION: Musical hallucinations are more common among psychiatric patients than previously reported and are more suggestive of OCD than of other mental disorders.

Lower corneal temperature in neuroleptic-treated vs. drug-free schizophrenia patients.

Antipsychotic drugs (APDs) can decrease core body temperature in schizophrenia patients. Core temperature may correlate with corneal temperature and thus, we hypothesized that neuroleptic-treated schizophrenia patients would display lower corneal temperature compared with drug-free patients. Corneal temperature of 12 typical APD-treated and 9 drug-free male schizophrenia patients was assessed using a FLIR thermal imaging camera. The APD-treated patients exhibited substantially and significantly lower corneal temperature compared with the drug-free patients (31.57 +/- 0.98 degrees C vs. 34.55 +/- 1.65 degrees C; p < 0.0001). Our results suggest that APDs may decrease corneal/core temperature in schizophrenia patients. The relevance of this finding to the pathophysiology of schizophrenia or to the antipsychotic effect of neuroleptics merit further investigation.

Precautionary measures reduce risk of definite neuroleptic malignant syndrome in newly typical neuroleptic-treated schizophrenia inpatients.

Neuroleptic malignant syndrome (NMS) is a potentially lethal antipsychotic drug (APD)-induced thermoregulatory disturbance. We hypothesized that several precautionary measures taken after administeration of APDs might prevent progression to definite NMS. The study group included 657 consecutively admitted drug-free schizophrenia inpatients who received various typical APDs for 28 days. Specific predefined precautionary measures were employed for this group. The comparison group (n=192) consisted of typical APD-treated schizophrenia inpatients in whom such precautionary measures were not imposed. The study group exhibited a significantly lower incidence of definite NMS (1/657=0.2% versus 4/192=2.1%; P=0.01, odds ratio=13.96; 95% confidence interval 1.55-125.63). Antipsychotics were discontinued in 28 patients (28/657=4.3%) from the study group due to NMS (n=1) or early detection of potential NMS-related signs (probable abortive NMS) (n=27). Our findings suggest that specific precautionary measures can effectively reduce the incidence of definite NMS by approximately one order in newly medicated schizophrenia inpatients.

Alternation learning in OCD/schizophrenia patients.

In continuation of our previous studies on orbitofrontal cortex function in obsessive compulsive disorder (OCD) we studied a group of OCD patients with schizophrenia in comparison with a group of schizophrenia patients. In order to test orbitofrontal cortex function we again used an alternation learning task. We found no difference between the two groups in the performance of this task. The relationship between severity of OC symptoms and alternation learning was curvilinear. Thus, in the low range of symptom severity the correlation between alternation learning and symptom severity was negative, while in the high range it was positive. The positive correlation in the severely affected patients is essentially the same as that found in severe "pure" OCD patients, which we have previously reported. We conclude that the data indicate independent orbitofrontal cortex function in OCD, irrespective of comorbidity.

Increased corneal temperature in drug-free male schizophrenia patients.

Schizophrenia patients may exhibit altered body temperature. We hypothesized that drug-free patients may have a higher corneal temperature than normal subjects. The corneal temperature of seven remitted drug-free schizophrenia outpatients and seven healthy volunteers was evaluated with a flir thermal imaging camera. A significantly higher corneal temperature was observed in the patient group (34.60+/-1.89 vs. 33.05+/-0.58 degrees C; P=0.005) and it correlated with their BPRS score (r=0.82; P=0.024). The relevance of these preliminary findings merit further investigation.