Efficacy and Safety of Paliperidone Palmitate Treatment in Patients With Schizophrenia: A Real-World Multicenter, Retrospective, Mirror-Image Study.

PURPOSE: The aim of the study was to assess efficacy and safety of paliperidone palmitate (PP) in schizophrenic patients using real-life data. METHODS: This national, multicenter, retrospective, and mirror-image study was performed reviewing the medical records of patients in 18 centers. Adult schizophrenic patients receiving PP treatment (n = 205) were enrolled. Patients' data covering the last 12 months before the initial PP injection and the period until the end of study with at least 12 months after the initial PP injection were evaluated. Patients' characteristics, scale scores, and adverse events were recorded. RESULTS: Nonadherence to prior medication was the most frequent reason for switching to PP treatment. Comparing with the period before PP treatment, the rate of patients visiting the hospital for relapse (79.5% vs 28.9%, P < 0.001) and the median number of hospitalizations (2 vs 0, P < 0.001) were lower during PP treatment. During PP treatment, the Positive and Negative Syndrome Scale score decreased by 20% or more (response to treatment) in 75.7% of the patients. The frequency of adverse events did not differ between the period before and during PP treatment. Improvement in functionality was higher in those with disease duration of 5 years or less. CONCLUSIONS: Paliperidone palmitate is effective and safe in treatment of schizophrenic patients and in switching to PP treatment in patients with schizophrenia, which reduced the percentage of patients admitted to the hospital for relapse and the median number hospitalization, and has positive effects on functionality.

Schizophrenia and Bipolar Affective Disorder: a Dimensional Approach.

AIM: Schizophrenia (SCH) and bipolar affective disorder (BAD) are currently classified separately according to the DSM (The Diagnostic and Statistical Manual of Mental Disorders) and ICD (International Statistical Classification of Diseases and Related Health Problems) standardized diagnostic guidelines. However, the validity of this categorical approach is controversial because psychotic symptoms may be observed in both diagnoses. The purpose of this study was to compare the clinical and social characteristics in a sample group consisting of patients diagnosed with SCH or BAD to help demonstrate the basic difficulty in the current classification of SCH and BAD as two etiologically distinct diseases. SUBJECTS AND METHODS: The study sample group consisted of 102 patients diagnosed with SCH and 92 patients diagnosed with BAD. All of the participants were evaluated by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition with regard to beginning symptoms of the disease, the symptoms and signs of active disease period within total disease duration, continuining residual symptoms in intermediate period. The patients were administered the Positive and Negative Syndrome Scale, the Quality of Life Enjoyment and Satisfaction Questionnaire and the Social Functioning Scale. RESULTS: The SCH and BAD groups in this study were statistically similar in terms of sex, length of education, age at disease onset, attempted suicide, quality of life and social functioning. CONCLUSION: Our study findings indicated that the course of disease in patients with BAD-1, in which psychotic features predominate and which exhibits a recurring course, shares various characteristics with SCH. It can be concluded that further phenomenological and neurobiological evaluations are required for intermediate cases with similiar clinical characteristics with schizophrenia and bipolar disorders.

A comparison of euthymic bipolar patients with unaffected first-degree relatives and healthy controls in terms of neuropsychological functions.

OBJECTIVE: Cognitive dysfunction in bipolar disorder (BD) is well established in the literature. The neurocognitive deficits have been considered to be endophenotypic markers of BD, and studies have examined whether neurocognitive deficits exist in first-degree relatives of individuals with BD I. We hypothesized that performance in tests of neurocognitive function would be impaired in euthymic BD I patients and their unaffected first-degree relatives compared to that of healthy controls. METHODS: We compared the performance of bipolar patients, their first-degree relatives, and healthy controls in a battery of neurocognitive tests to reveal possible endophenotypes of BD. A diagnostic interview and neuropsychological test battery were administered to 30 BD I patients, 55 of their unaffected first-degree relatives and 32 healthy controls. RESULTS: The patients and their first-degree relatives were significantly impaired in executive function assessed using the Wisconsin Card Sorting Test (WCST) and Trail Making Test-B (TMT-B) relative to the controls (WCST; perseverative errors: p < 0.0005, categories completed: p = 0.002, TMT-B; p = 0.002). There were no significant differences between the groups in terms of attention, psychomotor speed, verbal memory, or learning. CONCLUSION: Our study suggests that the deficits in executive function may be endophenotypic markers of genetic vulnerability to BD I.

Do the obsessive-compulsive symptoms have an effect in schizophrenia?

OBJECTIVE: Schizophrenia presents with different symptom domains and functionality during its course. Obsessive-compulsive (OC) symptoms in schizophrenia have many themes to be clarified. Our aim was to compare schizophrenia patients with and without OC symptoms in terms of symptom domains, cognitive functions, and quality of life. METHOD: Sixty-two patients who met schizophrenia diagnosis were assessed with Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition consecutively over a period of 12 months in the setting of an outpatient clinic at medical university hospital. Yale-Brown Obsessive-Compulsive Scale, Scale for the Assessment of Negative Symptoms, Scale for the Assessment of Positive Symptoms, and neuropsychologic tests were used. Quality of life was assessed with Quality of Life Scale for Patients with Schizophrenia. RESULTS: Obsessive-compulsive symptoms along with schizophrenia were present in a considerable number in our sample (35.5%). Level of psychotic symptoms was more severe and quality of life was lower in schizophrenia patients with OC symptoms. A positive correlation was found between obsessions and delusions. Moreover, there was a positive correlation between compulsions and total Scale for the Assessment of Positive Symptoms score and bizarre behaviors subscore. There was no difference between the 2 groups regarding neurocognitive functions. The level of quality of life of schizophrenic patients with OC symptoms was lower. Besides, no correlation was found between OC symptoms and neurocognition and quality of life. CONCLUSIONS: The findings of this study indicate that schizophrenia patients with OC symptoms had severe psychotic symptoms with a distinctive clinical picture including good neurocognition but poor functioning.

The Relationship of Insight with Psychopathology and Neuropsychological Functioning in Patients with Schizophrenia.

OBJECTIVE: The aim of this study was to investigate the relationship of the different dimensions of insight with clinical variables, symptom severity, and cognitive functions in patients with schizophrenia. METHOD: In this cross-sectional descriptive study,  66  out  patients that applied to the Karadeniz Technical University, Psychiatry Clinic and were diagnosed with schizophrenia according to DSM-IV were evaluated. The patients were evaluated with Structured Clinical Interview for DSM (SCID-I), the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), and the Schedule for Assessing the Three Components of Insight (SAI). Wisconsin Card Sorting Test, Verbal Fluency Test, Trail Making Test A and B and Rey Auditory Verbal Learning Test were applied to assess the cognitive function of each patient. RESULTS: The insight levels of the patients that were evaluated with SAI were found to be correlated with PANSS positive, negative, and general psychopathology symptom severity as well as Verbal Fluency Test and Trail Making Test A and B scores. In the multiple linear regression analysis, PANSS positive, Verbal Fluency Test and Trail Making Test A scores were determined the contributors of SAI total score. CONCLUSIONS: The relationship between insight and clinical symptoms may change depending on the course of the disease and severity of symptoms. These findings emphasize the importance of frontal executive function in the relationship between insight and cognitive functions.

Sexual Dysfunction and Childhood Trauma In Female Patients With Fibromyalgia.

BACKGROUND: Fibromyalgia (FM) is a rheumatological diseases characterized by diffuse pain and stiffness accompanied with fatigue, insomnia and headache. Physical and psychological factors were implicated in sexuality of patients with FM. There are few studies investigating the effect of childhood trauma on sexuality of patients with FM. The aim of this study is to investigate effect of childhood trauma on sexuality of FM. METHODS: Thirty-six patients with FM and 29 healthy females were included in this study. The patients with FM and healthy controls were assesed in terms of sociodemographic and clinical variables, sexual function and childhood traumas. RESULTS: The healthy controls had significantly longer duration of marriage with higher rate of marriage by arrangement. Communication subscale score was significantly higher in patients with FM. General and emotional trauma scores were significantly higher in patients with FM. There was no correlation between the scores of GRSSS, CTQ and FIQ. CONCLUSION: The type of marriage and duration of marriage were important sociodemographic variables concerning sexuality in FM. This study indicated that childhood trauma was not a related factor in sexuality of FM.

[Adverse Effects of Medication and Quality of Life in Patients Receiving Second Generation Antipsychotics: A Comparison of Long Acting Injectable and Oral Therapies]. / Ikinci Kusak Antipsikotik Kullanan Hastalarda Ilaç Yan Etkileri ve Yasam Kalitesi: Uzun Etkili Enjeksiyon ve Agizdan Alinan Tedavilerin Karsilastirilmasi.

OBJECTIVE: Maintenance treatment with antipsychotic drugs for patients with schizophrenia is highly effective in decreasing the recurrence rate of the disease. In the current study, we aimed to compare long-acting second generation antipsychotic drug injections and oral forms of second generation antipsychotic drugs in terms of their adverse effects on quality of life. METHOD: Forty-one patients receiving second generation antipsychotic drugs and 139 patients diagnosed with schizophrenia or schizoaffective disorder were treated with oral second generation antipsychotic drugs and enrolled in the study. All patients were evaluated with Positive and Negative Symptoms Scale (PANNS), extrapyramidal symptom rating scale (ESRS) and UKU, and Quality of Life Enjoyment and Satisfaction questionnaire (Q-LES-Q). RESULTS: The impact of adverse effects of oral second generation antipsychotic drugs on the daily performance of patients with schizophrenia or schizoaffective disorder was found to be significantly higher than that of the long acting injection antipsychotic drugs. The quality of life of patients receiving long acting second generation antipsychotic drug injection was significantly higher when compared with that of the patients treated with oral second generation antipsychotic drugs. CONCLUSION: The results of this study showed that the long-acting second generation antipsychotic injection treatment was superior to second generation oral forms of antipsychotic drugs in terms of adverse effects and measures of quality of life. Further studies with specific design and the supplementation of larger samples are needed.

[The Relationship of Interleukin-18 and Interleukin-6 Levels with Cognitive Functions in Bipolar Disorder]. / Bipolar Bozuklukta Interlökin-18 ve Interlökin-6 Sitokin Seviyelerinin Bilissel Islevler ile Iliskisi.

OBJECTIVE: Impairment in immune functions is proposed as a key factor in the cognitive decline in bipolar disorder (BD) however there is scarcity of research on the impact of inflammation on cognitive functions. Our aim is to compare IL-18 and IL-6 levels in BD patients and controls and to study the relationship between IL-18 and IL-6 levels and cognitive impairment METHOD: Thirty-six euthymic BD-I patients and 38 age, sex and educational level matched healthy controls were enrolled in the study. All participants were evaluated with neurocognitive tests. The plasma IL-6 and IL-18 levels of both groups were measured with ELISA kits. RESULTS: There was no statistically significant difference between IL-6 and IL-18 levels of patient and healthy control groups. In the patient group, IL-18 level was positively correlated with completed categories score wheras there was a negative correlation with perseverative response and perseverative errors. Moreover IL-18 level was positively correlated with immediate recall, delayed recall and learning scores while there was a negative correlation with stroop interference scores. No correlation was found between IL-6 level and neuropsychological test scores in the patient group. CONCLUSION: This is the first study that investigates the relation of IL-18 with cognitive functions. Possible detrimental or protective effects of IL-18 in BD is not yet clear, however the positive association of IL-18 level and neuropsychological test scores might indicate a neuroprotective role of IL-18 in the euthymic period of BD which is the closest state to physiological condition.

[Current Clinical Variables in Schizophrenia Cases with Suicide Attempt History]. / Intihar Girisimi Öyküsü Olan Sizofreni Olgularinda Simdiki Klinik Degiskenler.

OBJECTIVE: High suicide risk was shown to be related with depression and low quality of life in studies investigating clinical variables related to suicidal behavior. The aim of this study was to investigate the effects of a suicide attempt on clinical presentation by comparing sociodemographic variables, clinical signs, symptoms of depression, quality of life, social functionality, and reported adverse drug reactions in schizophrenic patients with and without suicide. METHOD: Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale (CDS), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Social Functioning Scale (SFS), and Udvalg for Kliniske Undersøgelser Side Effect Rating Scale (UKU) were administered to 115 patients with schizophrenia. RESULTS: 44.3% of patients had at least one suicide attempt. Among sociodemographic variables, a family history of suicide, smoking, and total duration of disease were significantly higher in patients with suicide history than without. Scores of CDS and UKU subscores were significantly higher, and quality of life and social occupation in social functionality were significantly lower in patients with a history of suicide. In correlation analysis, CSD was negatively correlated with Q-LES-Q and independency/performance subscore of SFI, and positively correlated with UKU-Neurological subscore. DISCUSSION: In line with this data, suicidal behavior may be suggested to affect clinical presentation and course characteristic of schizophrenic patients. Additional treatments towards factors that may impact on the clinical course and social support programs might be suggested for these patients.

[The life threatening adverse effects of psychotropic drugs: a case report]. / Psikotrop Ilaçlarin Yasami Tehdit Eden Yan Etkileri: Olgu Sunumu.

Neuroleptic malignant syndrome (NMS) is a rare idiosyncratic reaction to antipsychotic drugs that is potentially fatal. Characteristic features of NMS are hyperthermia, muscular rigidity, severe autonomic dysregulation and disturbed consciousness. Signs and symptoms of serotonin syndrome (SS) can be grouped into four inclusive categories that are almost identical to those of NMS. Clinically, NMS and SS share many features, suggesting different spectrums of a similar disorder. To make a distinction between the two is often difficult because of a large clinical overlap. We present a case of a 42-year-old male with a history of schizophrenia that developed signs and symptoms inconsistent with either NMS or SS after intramuscular administration of 2 typical antipsychotics along with 1 dose of a selective serotonin reuptake inhibitor (SSRI). The patient abruptly developed the clinical features in just 24 h. The patient presented with altered mental status and increased levels of creatinine phosphokinase. Twelve days of intensive care unit treatment was chiefly supportive and included bromocriptine. The final outcome was positive with complete disappearance of the symptoms. The treatment for both NMS and SS is similar. The therapeutic interventions primarily consist of removing the suspected agent and providing supportive care. We present this case to highlight some controversial issues concerning the life threatening adverse effects of psychotropic drugs, which illustrate the spectrum concept.

[Incidence of postpartum depression in Trabzon province and risk factors at gestation]. / Trabzon Il Merkezinde Dogum Sonrasi Depresyon Sikligi ve Gebelikteki Iliskili Demografik Risk Etmenleri.

OBJECTIVE: Risk of depression increases in some periods of the women's life and postpartum period is one of these periods. Women in the risk group should be followed-up both prenatally and postnatally. The aim of this study is to investigate the incidence and risk factors of postpartum depression in Trabzon province. METHOD: Among all pregnants in the third trimester of gestation attending to six primary health care centers belonging to Trabzon province and the Hospital of Obstetrics and Pediatrics were informed about the study and of these 316 person who accepted to attend the study were applied Sociodemographic Questionnary, General Health Inventory, Beck Anxiety Inventory, Beck Depression Inventory. Of these 192 women (75%) were reached at the first visit. At sixth-eighth weeks of postpartum, above mentioned inventories, excluding Sociodemographic Questionnary but additionally Edinburgh Postnatal Depression Scale, were applied to 152 of these women (79%). All tests were re-applied to 132 (68.7%) women at their sixth month after delivery. RESULTS: Incidence of DSD according to Edinburgh Postnatal Depression Scale was found 28.1% in Trabzon province. Reported depression after previous pregnancies, scores equal or above five in General Health Inventory in pregnancy and high scores in Beck Anxiety Inventory were determined as predictors of postpartum depression in the study population. CONCLUSION: As being the first follow up study of investigating the incidence of postpartum depression by a scale prepared to used this area, these findings are important to guide the further studies in connected with matter.

Validity and Reliability of the Turkish Version of Needs Based Biopsychosocial Distress Instrument for Cancer Patients (CANDI).

BACKGROUND: Needs based biopsychosocial distress instrument for cancer patients (CANDI) is a scale based on needs arising due to the effects of cancer. OBJECTIVES: The aim of this research was to determine the reliability and validity of the CANDI scale in the Turkish language. PATIENTS AND METHODS: The study was performed with the participation of 172 cancer patients aged 18 and over. Factor analysis (principal components analysis) was used to assess construct validity. Criterion validities were tested by computing Spearman correlation between CANDI and hospital anxiety depression scale (HADS), and brief symptom inventory (BSI) (convergent validity) and quality of life scales (FACT-G) (divergent validity). Test-retest reliabilities and internal consistencies were measured with intraclass correlation (ICC) and Cronbach-α. RESULTS: A three-factor solution (emotional, physical and social) was found with factor analysis. Internal reliability (α = 0.94) and test-retest reliability (ICC = 0.87) were significantly high. Correlations between CANDI and HADS (rs = 0.67), and BSI (rs = 0.69) and FACT-G (rs = -0.76) were moderate and significant in the expected direction. CONCLUSIONS: CANDI is a valid and reliable scale in cancer patients with a three-factor structure (emotional, physical and social) in the Turkish language.

The effects of edaravone in ketamine-induced model of mania in rats.

Bipolar disorder is a chronic disease characterized by recurring episodes of mania and depression that can lead to disability. This study investigates the protective effects of edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one), a drug with well-known antioxidant properties, in a model of mania induced by ketamine in rats. Locomotor activity was assessed in the open-field test. Superoxide dismutase (SOD), catalase (CAT) and thiobarbituric acid reactive substances (TBARS) levels were measured in order to evaluate oxidative damage in the rat hippocampus and prefrontal cortex. Increased locomotor activity (hyperlocomotion) was observed at the open-field test with ketamine treatment (25 mg/kg, i.p., 8 days). Edaravone (18 mg/kg) treatment did not prevent hyperlocomotion in the mania model induced with ketamine in rats, but lithium chloride (47.5 mg/kg, i.p., positive control) did prevent hyperlocomotion. Edaravone and lithium chloride treatments were found to reduce the increase in SOD and CAT activity following ketamine administration in a non-significant manner but caused no change in TBARS levels.

Trazodone induced galactorrhea: a case report.

Trazodone is a heterocyclic antidepressant that exerts its effect via the inhibition of selective serotonin reuptake and the antagonism of 5-HT2A and 5-HT2C receptors. Antidepressant-induced galactorrhea and increases in prolactin levels have rarely been reported. Trazodone can potentiate the serotonergic activity of citalopram. To our knowledge, no cases of galactorrhea associated with use of trazodone have been reported to date. This report describes a unique case of the development of galactorrhea following the addition of trazodone (100 mg/day, 2 weeks) to the treatment of a patient who was receiving citalopram (40 mg/day, 6 weeks) therapy for a diagnosis of depressive disorder, which improved upon the discontinuation of trazodone.

[The Prevalence of Night Eating Syndrome among Outpatient Overweight or Obese Individuals with Serious Mental Illness]. / Agir Ruhsal Bozuklugu Olan Kilolu veya Obez Ayaktan Hasta Grubunda Gece Yeme Sendromu Yayginligi.

OBJECTIVE: This study aimed to determine the prevalence of Night Eating Syndrome (NES) among overweight or obese patients with serious mental illness and its relationship with insomnia and quality of life. METHODS: This study included 158 overweight or obese patients diagnosed with schizophrenia, schizoaffective disorder, and bipolar disorder (according to DSM-IV criteria) that were not in the active disease period. A clinical interview and Night Eating Questionnaire (NEQ) were used to assess the prevalence of NES among those in the study group. Body mass index (BMI), sleep quality, and quality of life measures were also evaluated for each patient. RESULTS: Twelve patients (7.6%) were diagnosed with NES via clinical interview while 26 (16.5%) were diagnosed by having ≥25 points in the NEQ. There were no statistically significant differences between the NES and non-NES groups with respect to age, gender, education and body mass index. However, quality of life scores were lower while the severity of insomnia scores were higher in patients with NES. CONCLUSION: The prevalence of NES is higher among overweight or obese patients with serious mental illness when compared to prevalence data in a general population, as demonstrated by previously published studies. Night eating behavior may be related to insomnia and poor quality of life measures. The recognition of NES among patients with severe mental disease is essential to promote prevention of obesity and insomnia as related to night eating behavior.

The relationship between traumatic childhood experiences and proclivities towards substance abuse, self-esteem and coping strategies.

OBJECTIVE: The aim of this study was to compare people with substance use disorder with healthy controls in terms of childhood abuse, proclivity towards substance abuse, coping skills and self-esteem as well as the correlation between experiences of abuse in childhood and these variables. METHOD: The study group included 41 subjects diagnosed with substance use disorder, who had been sentenced under the respective laws as a result of crimes relating to substance use and possession, and the control group. A sociodemographic Data Form, SCID-I, Childhood Trauma Questionnaire, COPE, Substance Abuse Proclivity Scale and Rosenberg Self-Esteem Scale were applied to all participants. RESULTS: Childhood trauma history was observed to be more common in the study group than in the control group. When the childhood trauma questionnaire was evaluated, the scores for physical abuse were found to be significantly higher in the study group. COPE subscale scores for mental disengagement, focusing on problems and expressing emotions, active coping, coping through religion and emotional social support usage were significantly lower in the study group. The study group's results on the Substance Abuse Proclivity Scale were found to be higher than those of the control group. On the Rosenberg Self Respect Scale, the study group's scores were higher while the control group was more likely to have high self respect. CONCLUSION: People with substance use disorder are more likely to have a childhood history of physical abuse, higher proclivity towards substance abuse and lower self esteem. The level of abuse increases the level of emotion-based coping while decreasing levels of problem-based coping. There is support for the view that that traumatic childhood experiences are one of the psychosocial risk factors related to, although not specific to substance use.

The effects of sertraline on blood lipids, glucose, insulin and HBA1C levels: A prospective clinical trial on depressive patients.

BACKGROUND: In this study, we aimed to investigate the possible effects of sertraline on blood glucose and lipid levels as risk factors for cardiovascular disease in depressive patients. METHODS: Eight male and twelve female depressive patients, diagnosed according to DSM-IV criteria, were included in this study. The subjects aged 19-50 years, did not smoke, and had normal body mass index (BMI), homeostasis model assessment-estimated insulin resistance (HOMA-IR) values, blood pressure, blood glucose, insulin and lipid levels. Sertraline therapy (50 mg/day) was started. Patients with diabetes mellitus, heart disease, pregnancy, and those taking other drugs were excluded from the study. Blood glucose, insulin, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and triglyceride values were measured in patients before, and at the 4(th), 8(th) and 12(th) weeks after treatment with sertraline. Moreover, HbA1C levels were measured at the beginning and at the end of the treatment (at 12(th) weeks). RESULTS: There were no significant differences in physical examination (blood pressure, BMI, body weight, height, waist circumference) and laboratory findings (glucose, HDL-C, LDL-C, HOMA-IR and HbA1C levels) at the 12(th) week after of treatment with sertraline compared to pretreatment values. However, insulin levels at the 4(th), 8(th) and 12(th) weeks significantly increased compared with pretreatment values. Likewise, triglyceride levels at the 8(th) and 12(th) weeks significantly increased compared with pretreatment values. CONCLUSIONS: Sertraline-treated patients have to be followed up for blood insulin and triglyceride levels. In addition, their treatment plan needs to be adjusted as necessary to prevent possible metabolic changes.

Reexamination of the characteristics of the deficit schizophrenia patients.

The aim of this study was to reexamine and compare the characteristics of the deficit and nondeficit schizophrenic patients. This cross-sectional study consisted of 62 in- and out-patients, 18-65 years of age, diagnosed with schizophrenia according to DSM-IV. The sociodemographic variables, premorbid adjustment, clinical course and general functioning level in the past five years were evaluated by utilizing the appropriate sections of Comprehensive Assessment of Symptoms and History (CASH). In addition, GAF, the Schedule for the Deficit Syndrome (SDS), Positive and Negative Syndrome Scale (PANSS), Montgomery Asberg Depression Scale (MADRS), the Neurological Evaluation Scale (NES) and the Simpson Angus Extrapyramidal Side Effects (EPS) Rating Scale, Trail A and B, Verbal Fluency, Stroop, Block Design and Finger Tapper tests were administered. Using the SDS, 19 patients (30.6 %) were categorized as deficit; 43 (69.4 %) were categorized as nondeficit. The deficit patients were worse on the Functioning During Past Five Years score of CASH. The PANSS and MADRS mean scores were not significantly different between the two groups, except a higher level of negative symptoms observed in the deficit group. NES scores were also significantly higher in the deficit group. However, sociodemographic and other clinical variables, neurocognitive measures and EPS symptoms did not show any significant difference between the two groups. Our findings suggest that the deficit schizophrenia is a distinct subgroup comprised of patients who have more negative symptoms, neurological impairment and poor functioning which may have a common underlying pathology.