[The influence of atypical antipsychotics on brain functioning in schizophrenia. A proton magnetic resonance study]. / Wplyw leków antypsychotycznych atypowych na funkcjonowanie mózgu w schizofrenii w obrazie spektroskopii protonowej rezonansu magnetycznego.

INTRODUCTION: The influence of antipsychotic medication on brain alterations in proton magnetic resonance spectroscopy (1H MRS) in schizophrenia can be the explanation of many discrepancies observed in the previous papers. AIM: The aim of this study was the evaluation of antipsychotic medication effect on the metabolite levels in the brain of schizophrenic patients based on 1H MRS examination. METHODS: The group of 32 patients with a diagnosis of schizophrenia according to DSM-IV and 26 healthy controls were included into the study. The patients were examined twice--once after the period of at least 7 days without neuroleptics (baseline) and for the second time at least 4 weeks after stable doses ofneuroleptics (follow-up). 21 patients were receiving risperidone and 11--olanzapine. Proton resonance spectroscopy was performed on a 1.5 MR scanner. Each volume element (voxel) was localised in the left frontal lobe, in the left temporal lobe and in the left thalamus. Metabolite ratios: N-acetylaspartate (NAA) to creatine (Cr) and unsupressed water signal were analysed. Results. We found the significant increase of the NAA/Cr level in the thalamus in the group of patients treated with risperidone, we didn't observe similar changes in the olanzapine group. CONCLUSIONS: Our results confirm that the neuroleptic drugs, especially atypicals, modify brain metabolism measured by 1H MRS. The pattern of the changes suggest a possible neuroprotective influence of the antipsychototic treatment in schizophrenic patients. The small group of the olanzapine treated patients doses not allow to make any conclusions regarding this type of medication.

[Biomarkers of alcohol abuse. Part II. New biomarkers and their interpretation]. / Biomarkery naduzywania alkoholu. Czesc II. Nowe biomarkery oraz ich interpretacja.

An increasing number of new biomarkers of alcohol abuse appear in the literature. The most commonly used biomarkers (5-hydroxytryptophol, fatty acid ethyl esters, ethyl glucuronide, phosphatidyl ethanol, ethyl sulphate, mitochondrial aspartate aminotransferase, carbohydrate deficient transferrin, acetaldehyde adducts, beta-hexosaminidase, and sialic acid) were described. Then other known and less known biomarkers associated with alcohol abuse were described in brief (e.g. acetaldehyde, acetate, methanol, alpha-amino-n-butyric acid, dolichol, proteomics). Their sensitivity and specificity is generally higher than that of traditional biomarkers. The time of detection in biological fluids occur from one day to few months after alcohol consumption. Hence, their usefulness in clinical practice as well as in experimental studies is increasing.

[Biomarkers of alcohol abuse. Part I. Traditional biomarkers and their interpretation]. / Biomarkery naduzywania alkoholu. Czesc I. Biomarkery tradycyjne i ich interpretacja.

Approximately 15% of the Polish population abuse alcohol. Early detection of alcohol problems may prevent their further development and progression. The study reviews traditional biomarkers associated with alcohol abuse. The nature of biomarkers, their practical application and limitations in alcohol abuse detection, in assessment and monitoring of drinking, are reviewed. Despite the limited sensitivity and specificity in alcohol abuse detection, traditional biomarkers remain useful in alcohol abuse detection. They are widely available and relatively inexpensive, providing valuable data on complications of drinking and prognosis as well as on concurrent conditions affected by drinking.

Effect of risperidone and olanzapine on reproductive hormones, psychopathology and sexual functioning in male patients with schizophrenia.

OBJECTIVE: To study the effect of drugs on the hypothalamo-pituitary-gonadal (HPG) axis we compared the endocrine actions of two neuroleptics with different receptor affinity profiles-risperidone and olanzapine in male schizophrenic patients. METHODS: We investigated the levels of prolactin, estradiol, testosterone, LH, FSH and testicular peptide hormone-inhibin B, and we assessed psychopathology (PANSS), sexual function (ASEX) and treatment adherence (DAI-10) in 89 male schizophrenic inpatients treated with olanzapine or risperidone administered orally. The initial and final evaluations were carried out at weeks 3 and 8 after the onset of treatment, respectively. RESULTS: At initial evaluation the mean serum prolactin and inhibin B levels were markedly higher, whereas testosterone level was lower in patients treated with risperidone, than in those treated with olanzapine. In 5 out of 50 subjects from risperidone group (10%) and in 1 from olanzapine group (2.6%) testosterone levels were below the lower limit (<241ng/ml), which reflected Leydig's cell impairment. In one patient receiving risperidone and in three receiving olanzapine, inhibin B level was below 80pg/ml, indicating Sertoli's cell dysfunction. At the final evaluation the mean serum prolactin level was markedly higher in patients taking risperidone, whereas their FSH levels were lower than in patients receiving olanzapine. In all investigated groups, except for the risperidone-hyperprolactinemic group inhibin B levels were negatively correlated with serum FSH. The mean LH, FSH, testosterone and estradiol levels were within the normal reference range at initial and final evaluation. The non-adherence to medications and ASEX scores were significantly higher in risperidone groups. Sexual dysfunction and medication non-adherence was not related to prolactin or gonadal hormone levels. CONCLUSIONS: Risperidone elicited higher PRL elevation than olanzapine. Treatment with this medication can be associated with disturbances in reproductive hormones (testosterone) and gonadotropins (FSH). The cause of olanzapine-elicited reduction of inhibin B level and the lack of negative correlation between FSH and inhibin B in patients with risperidone-induced hyperprolactinemia require further investigation. Patients receiving risperidone showed higher level of sexual dysfunction and treatment non-adherence than those treated with olanzapine.

[Impact of neuroleptic-induced hyperprolactinemia on sexual dysfunction in male schizophrenic patients]. / Wplyw poneuroleptycznej hiperprolaktynemii na wystepowanie zaburzen seksualnych u mezczyzn chorych na schizofrenie.

Human sexual function is complex and effected in many different ways by schizophrenia and the antipsychotic drugs used in its treatment. Although not extensively researched, sexual dysfunction seems to be frequent in patients with schizophrenia, especially in men. They appear, in significant part, to be a direct consequence of dopamine antagonism, combined with indirect effects due to increased serum prolactin (PRL) concentration. All of the typical antipsychotics and risperidone can cause substantial PRL elevation. Hyperprolactinemia in male schizophrenics might decrease libido, cause anorgasmia and lead to erectile dysfunction. These sexual side effects are closely associated with the patients' willingness to take antipsychotics, and can affect compliance.

N-acetylaspartate (NAA) levels in selected areas of the brain in patients with chronic schizophrenia treated with typical and atypical neuroleptics: a proton magnetic resonance spectroscopy (1H MRS) study.

BACKGROUND: NAA, marker of neurons integrity and viability, is one of the most important brain metabolites visible in 1H MRS. In most studies of schizophrenia, the decrease of NAA level was observed in the temporal, frontal lobes and in the thalamus. This finding was observed more often among chronic patients, what suggests the influence of disease duration or the effect of neuroleptic treatment. The aim of the present study was the comparison of NAA levels in brain of schizophrenic patients taking typical and atypical neuroleptics. MATERIAL/METHODS: We analyzed the NAA levels in selected brain areas in 58 schizophrenic patients and 21 healthy controls. 10 patients were treated with typical neuroleptics, 10 patients with clozapine, 17 received olanzapine and 21 - risperidone. 1H MRS was performed on a 1,5 MR scanner with PRESS sequence. Voxels of 2x2x2 cm were localized in the left frontal, left temporal lobe and left thalamus. RESULTS: There were no differences in NAA levels between patients on typical and atypical medications analyzed together and separately (olanzapine, clozapine and risperidone groups). We also did not find any differences between patients taking selected atypical neuroleptics and controls. The NAA level in the thalamus in the group of patients receiving typical antipsychotics was the lowest among all groups and differed significantly from healthy controls. CONCLUSIONS: The results of our study suggest that atypical neuroleptics may have favorable effect on NAA concentration in brain of schizophrenic patients. Decrease in NAA level in patients taking typical medication may be caused by the progression of the disease or by the direct action of these drugs.

[Impact of alcohol dependence on the course and psychopathology of schizophrenia]. / Wplyw uzaleznienia od alkoholu na przebieg i obraz kliniczny schizofrenii.

AIM: The study was undertaken to investigate possible influence of alcoholism on the course and psychopathology of schizophrenia. METHOD: A representative sample of 61 subjects was selected from schizophrenic patients with a history of alcohol dependence (dual diagnosis) registered in the period of 1997-2000. They were compared with 60 control patients with a single diagnosis of schizophrenia. In two groups, with the interview and clinical scales, the onset, course and psychopathology of schizophrenia were assessed. RESULTS: Male patients with schizophrenia and alcohol dependence had a later mean age at onset of mental illness, women--a higher rate of alcohol abuse in the family compared to the control groups. In men with dual diagnosis, the negative symptoms were less prominent. Women with schizophrenia and alcohol dependence reported more depressive symptomatology.

[The effectiveness of psychoeducation in schizophrenic and depressive patients--preliminary report]. / Ocena efektywnosci psychoedukacji w grupach pacjentów psychotycznych i depresyjnych--badanie pilotazowe.

UNLABELLED: Earlier studies suggest that psychoeducation as a form of psychosocial care is of value in improving the patient's attitude towards mental illness as well as in reducing and delaying the relapse rates of both--psychotic and depressive disorders. AIM: The aim of this study was the evaluation of influence of psychoeducation on clinical symptoms, quality of life and drug attitude in schizophrenic and depressive patients. METHOD: 52 patients, aged 18-50 years, hospitalized in the Department of Psychiatry of Medical Academy in Bialystok, were involved in the study. They were randomly assigned into 2 groups: on medication without psychoeducation (12 schizophrenics, 12 depressive patients) and on medication and psychoeducation (16 schizophrenics and 12 depressive patients). The patients were assessed by means of BPRS, BNS, IMHC 2000, Raskin/Covi Scale, DAI-10. The assessment was performed twice--shortly after admission and before discharge from the hospital. RESULTS: The patients in both groups showed improvement in symptoms and in quality of life. Patients on psychoeducation changed their drug attitude positively significantly more often. CONCLUSION: Knowledge about the positive influence of medication on psychiatric symptoms helps to improve compliance and improves the course of disease.

[Mental problems in Lyme disease]. / Problemy psychiczne wystepujace w przebiegu choroby z Lyme.

North-East of Poland is an area endemic for borreliosis. Psychiatric disorders, the most common for the late stage, are more and more frequent manifestations of Lyme disease. The aim of this study is to assess the incidence of different psychiatric complications and identify the spectrum of symptoms and psychopathological syndromes associated with Borrelia burgdorferi infection. Lyme disease causes a variety of psychiatric symptoms. They are less common in skin type of borreliosis manifested by skin erythema.