Developmental instability and schizotypy.

INTRODUCTION: It has been suggested that evidence of developmental disturbance of cognition and lateralisation in schizophrenia can be best understood from the perspective of developmental stability (DS), an indicator of the extent to which an individual develops according to a specified ontogenic programme in the presence of environmental noise. Higher levels of fluctuating asymmetry (FA; the difference between right and left side of a quantitative morphological trait such as dermatoglyphics) are thought to reflect less DS. We examined this issue for dimensions of schizotypy. METHODS: Associations between FA, measures of laterality and cognitive function on the one hand, and negative and positive dimensions of schizotypy on the other, were examined in a sample of 260 healthy adolescents aged 11.9-15.6years. FA was measured as a-b ridge count right-left differences. Neuropsychological measures yielded a general cognitive ability score and a frontal function score. Laterality was assessed with the Annett scale. RESULTS: Measures of psychosis proneness were normally distributed. Negative schizotypy was associated with more FA and lower general cognitive ability in a dose-response fashion. The association with FA was more apparent in boys. No associations existed with laterality or frontal function. CONCLUSION: The negative dimension of schizotypy may be associated with early developmental instability, resembling the pattern seen in the negative symptom dimension of schizophrenia. Measures of fluctuating asymmetry may be more sensitive with regard to the schizotypy phenotype than measures of laterality.

Efectividad del tratamiento de la depresión bipolar con venlafaxina y estabilizadores del estado de ánimo / The effectiveness of bipolar depression treatment with venlafaxine and mood stabilizers

Fundamento: Determinar la efectividad y la seguridad del tratamiento con un antidepresivo de acción selectiva sobre la recaptación de serotonina y noradrenalina, la venlafaxina, en las depresiones bipolares. Analizar la capacidad de inducción de manía o hipomanía de dicho fármaco. Pacientes y métodos: Se administraron dosis entre 75 y 375 mg/día de venlafaxina a 30 pacientes que cumplían criterios DSM-IV de depresión mayor y trastorno bipolar I o II con una puntuación superior a 17 puntos en la escala de Hamilton (HAM-D-17). Los pacientes fueron evaluados a las 6 semanas mediante la HAM-D-17, la escala de Young para la manía (YMRS) y la impresión clínica global (CGI). Se mantuvo el tratamiento con estabilizadores del ánimo. Resultados: Por análisis de intención de tratar, un 67 por ciento de los pacientes bipolares deprimidos evidenció una mejoría de sus síntomas depresivos tras 6 semanas de tratamiento, un 59 por ciento cumplió criterios de respuesta y un 33 por ciento de remisión completa. Ocho pacientes (27 por ciento) no terminaron el estudio por presentar un viraje hacia la manía o hipomanía (n = 4; 13 por ciento), pérdida de seguimiento (n = 3; 10 por ciento), o intolerancia (n = 1; 3 por ciento). Los efectos secundarios sólo determinaron la retirada del tratamiento en un caso. Conclusiones: La venlafaxina es un tratamiento efectivo y bien tolerado de las depresiones bipolares. La incidencia de manía o hipomanía durante el tratamiento es relativamente elevada, lo que cuestiona su utilización en casos leves de depresión bipolar. Estos resultados podrían reflejar la alta potencia antidepresiva del fármaco (AU)

Neurological soft signs in adolescents with poor performance on the continous performance test: markers of liability for schizophrenia spectrum disorders?

There is much evidence that neurological soft signs (NSS) are highly prevalent in both adults and children with schizophrenia. In addition, they have been detected as early precursors of a schizophrenic outcome in at-risk subjects. Such findings point to the possible value of NSS as neurointegrative markers in schizophrenia which has been hypothesized to be a neurodevelopmental disease. In our study we used a biobehavioral criterion to select the 'at-risk' group, a sustained attentional deficit as measured by the continuous performance test (CPT). We compared 140 normal adolescents with 162 'CPT-linked vulnerable' adolescents (index subjects) on a battery for the assessment of NSS (including laterality), IQ, frontal lobe function and schizotypy. An association was found between NSS and attentional deficit. Furthermore, index subjects with NSS were characterized by lower IQ scores, poorer performance on frontal lobe tests and greater problems with social interaction. There was also a trend for an association between male sex and both left-handedness and NSS.