Correlates of insight and insight change in schizophrenia.

Various theories have been proposed to account for poor insight in schizophrenia. This study examined the relationships between insight, mood, schizophrenic symptoms and cognitive functioning. The relationship between longitudinal changes in insight and changes in symptoms and mood was also investigated. One-hundred patients with DSM-III-R schizophrenia, recently recovered from a relapse of their illness, were rated on the Insight and Treatment Attitudes Questionnaire (ITAQ), the Positive and Negative Syndrome Scale (PANSS), the Montgomery Asberg Depression Rating Scale (MADRS), the Rivermead Behavioural Memory Test and tests of current and premorbid IQ. A random sample of 53 were then given an educational package (video and booklets) designed to improve their insight. Follow-up ratings on the ITAQ, PANSS and MADRS were subsequently obtained. At baseline, better insight was significantly correlated with lower mood and fewer positive symptoms. It was not related to cognitive functioning. Improvement in insight at follow up was related to worsening of mood, but not to change in positive symptoms. The results are consistent with the concept that poor insight, at least in part, results from the psychotic disease process itself. In addition, they suggest that poor insight may protect against depression in the early stages of recovery from schizophrenia.

Red cell membrane fatty acids, cytosolic phospholipase-A2 and schizophrenia.

Forty subjects with schizophrenia and 40 age- and sex-matched controls were recruited, and blood samples were obtained for analysis of red cell membrane fatty acid composition by capillary gas chromatography. A blood sample was also taken from the same population to test for allelic association between schizophrenia and a polymorphism close to the promoter site of the cytosolic phospholipase-A2 gene which is mapped to chromosome 1q25. The schizophrenic population was heterogeneous with regards age, symptoms severity and treatment. A significantly higher percentage concentration of dihomogamma-linolenic acid (DGLA) was found in the red cell membranes of schizophrenics compared to matched controls. All other fatty acids examined showed no difference from the normal population. No correlation was found between any demographic factor, treatment variable, diet, drug use, alcohol or tobacco consumption which could explain the biochemical findings. A negative correlation was found between the concentration of DGLA in red blood cell (RBC) membranes and severity of symptoms of schizophrenia. In particular, there was a significant correlation (r = -0.41, p = 0.009) between DGLA percentage concentrations and 'disorganised' symptoms. No association was found between schizophrenia and alleles of the polymorphism near the phospholipase-A2 gene or between fatty acid concentrations and the presence of any particular alleles. This study therefore finds support for membrane phospholipid abnormalities in patients with schizophrenia and particular symptom clusters, but does not replicate a previous report of an allelic association between a polymorphism close to the site of the cytosolic phospholipase-A2 gene and schizophrenia.

Time dependency of pyridostigmine-induced growth hormone response.

Growth hormone (GH) plasma levels reflect a balance between stimulation via GH-releasing hormone (GHRH) and inhibition by somatostatin (SS). Steroids influence GH secretion by modulating SS tone. There is a correlation between the diurnal secretion of GH and cortisol (CORT). Pyridostigmine, the acetylcholinesterase inhibitor, increases cholinergic tone, inhibits SS release and increases the release of GH. We investigated the influence of CORT on pyridostigmine-induced GH responses by testing subjects at 9.00 and 14.00 h. Basal (mean +/- SEM) CORT levels at 9.00 and 14.00 h were 251.5 +/- 18.4 nmol/l and 142.7 +/- 6.7 nmol/l, respectively. Pyridostigmine-induced GH responses were greater at 9.00 h than at 14.00 h (8.7 +/- 1.5 mU/l; 3.0 +/- 1.0 mU/l, respectively, [ p < 0.001]). A positive correlation between CORT and delta GH values was demonstrated (p < 0.0004).

Carbon charge exchange analysis in the ITER-like wall environment.

Charge exchange spectroscopy has long been a key diagnostic tool for fusion plasmas and is well developed in devices with Carbon Plasma-Facing Components. Operation with the ITER-like wall at JET has resulted in changes to the spectrum in the region of the Carbon charge exchange line at 529.06 nm and demonstrates the need to revise the core charge exchange analysis for this line. An investigation has been made of this spectral region in different plasma conditions and the revised description of the spectral lines to be included in the analysis is presented.

ITER-relevant calibration technique for soft x-ray spectrometer.

The ITER-oriented JET research program brings new requirements for the low-Z impurity monitoring, in particular for the Be­the future main wall component of JET and ITER. Monitoring based on Bragg spectroscopy requires an absolute sensitivity calibration, which is challenging for large tokamaks. This paper describes both "component-by-component" and "continua" calibration methods used for the Be IV channel (75.9 Å) of the Bragg rotor spectrometer deployed on JET. The calibration techniques presented here rely on multiorder reflectivity calculations and measurements of continuum radiation emitted from helium plasmas. These offer excellent conditions for the absolute photon flux calibration due to their low level of impurities. It was found that the component-by-component method gives results that are four times higher than those obtained by means of the continua method. A better understanding of this discrepancy requires further investigations.

A randomized, controlled trial of a brief interventional package for schizophrenic out-patients.

OBJECTIVE: To evaluate the impact on outcome of a simple educational intervention in schizophrenic patients at risk of relapse. METHOD: At discharge, 114 schizophrenic patients with at least one previous episode were assigned randomly to a simple educational intervention which had no resource implications, or standard care. RESULTS: The intervention failed to improve outcome. While insight and treatment attitudes improved, suicidal ideation increased. Systematic management of treatment-emergent adverse effects offered no benefits, although incapacitation from extrapyramidal side-effects at discharge predicted relapse. CONCLUSION: There are limits to which psychoeducational interventions can be simplified without loss of effectiveness in terms of relapse prevention in schizophrenia. Enhanced insight may be associated with increased suicidal ideation.