Increase in the peripheral blood methylglyoxal levels in 10% of hospitalized chronic schizophrenia patients.

Increasing evidence indicates that enhanced peripheral carbonyl stress markers exist in subtype of schizophrenia, although it may not be the primary cause. This study aimed to investigate whether plasma concentrations of methylglyoxal, 3-deoxy-glucosone, and glyoxal, which are reactive intermediates of protein metabolism in carbonyl stress, are changed in patients with schizophrenia and can function as potential biomarkers for schizophrenia with enhanced carbonyl stress. Plasma concentrations of these di-carbonyls were simultaneously estimated in 40 patients with schizophrenia and 40 healthy controls. As a result, no statistically significant differences were observed in mean plasma concentrations of three di-carbonyls between patients and controls. However, a remarkable increase in methylglyoxal concentrations was observed in four patients but not in controls. This increase was not found with regard to 3-deoxyglucosone and glyoxal both of patients and controls. Our correlation analysis showed that both the plasma methylglyoxal and glyoxal concentrations were significantly correlated with 3-deoxyglucosone concentrations in 40 patients and 40 controls. However, the plasma methylglyoxal concentrations did not show any significant correlation with the glyoxal concentrations in the patients or the controls. In four patients with extremely high methylglyoxal levels, the plasma methylglyoxal and glyoxal concentrations were not correlated to the 3-deoxyglucosone concentrations. Methylglyoxal is a physiological substrate of the glyoxalase system, and the accelerated accumulation of this compound lowers the glyoxalase I activity. These results suggested that this increase in four patients with high methylglyoxal levels may indicate the presence of a subtype of chronic schizophrenia that is associated with enhanced carbonyl stress.

Social determinants of health in teenage girls involved with sexual exploitation on downtown streets late at night.

The purpose of this study was to chronicle the experiences of teenage girls who stay downtown late at night and are involved in sexual exploitation, and to clarify characteristics of their social circumstances and social determinants of health: socioeconomic status and educational opportunities. Between November 2009 and June 2013, we spoke with 89 adolescents who were loitering late at night in downtown Nagoya, Japan. We focused our research efforts on a case series of 22 girls who were 14-19 years of age and were involved in sexual exploitation. Semi-structured interviews were performed with the use of a questionnaire on the girls' sexual and mental health, families, school life, living conditions, and future aspirations. Along with the questionnaires, we analyzed case series interviews with a qualitative approach (narratives-under-analysis by in-depth understanding in context). Nine girls worked in the sex industry, while thirteen were independent sex workers. Our observations included child maltreatment, unstable families, distressing school life, insufficient education, and inappropriate relationships with gangs and similar organizations. Moreover, an illegal sex market was linked with these gang associations. Despite their severe living conditions, most of them hoped to have happy families someday. To provide support to this vulnerable population and support their life aspirations, improvement of public health, social welfare, education, and school health systems should be considered carefully.

[Psychoanalytic study of social withdrawal: grandiose narcissism and passive aggression due to insufficient maternal containing in childhood].

Two different types of pathology can cause social withdrawal: the narcissistic--schizoid personality organization (NSPO) type and the mild Asperger's syndrome (mild developmental disorders) type. Only the former type can be treated by psychoanalytic psychotherapy. In the childhood of both types, one may find traumatic family environments which will result in social withdrawal (Hikikomori). In the infancy of the NSPO type, the mother fails to function as a sufficient container of the child's emotion, which encourages formation of a schizoid personality organization i.e. the psychic withdrawal (or "psychic retreat" by Steiner, J.). With only a little failure in life events, this may turn into a physical withdrawal for a long time. And in this type of pathology their aggression takes a passive form that hardens their social withdrawal situation. Moreover, the social withdrawal itself serves to reinforce the pathological narcissism.

Low level of parental bonding might be a risk factor among women with prolonged depression: a preliminary investigation.

AIMS: The aim of the present study was to determine whether or not the effect of parenting by the father and mother on outcomes for depression may be different between male and female subjects. METHODS: A total of 115 patients were involved in this investigation: 74 had states of depression that continued for more than 2 years, and 41 had symptoms that remitted within 4 months. The Parental Bonding Instrument (PBI) was used to test for gender differences in the PBI score, the level of education, and the age at which the depression began, using an unpaired t-test. RESULTS: It is suggested that female patients with low paternal care and low levels of education have a higher likelihood of showing symptoms of prolonged depression in a primary episode. No relationship was found among prolongation of depression, educational level, and parental care in male patients. Furthermore, comparing the PBI quadrants established by Parker showed that female patients who were exposed to paternal care as 'Affectionless Control', had a tendency towards a higher risk of prolonged depression than female patients who received 'Optimal Parenting'. CONCLUSION: Especially in female patients, the prolongation of depression is likely a result of low levels of paternal care and low education.

Do children with tuberous sclerosis complex have superior musical skill?--A unique tendency of musical responsiveness in children with TSC.

BACKGROUND: Tuberous sclerosis complex (TSC) is an autosomal dominant disorder that manifests with symptoms that might include mental retardation, epilepsy, skin lesions, and hamartomas in the heart, brain, and kidneys. Anecdotal reports have characterized children with TSC as having high music responsiveness despite their developmental delay. This study is intended to investigate this putative musical skill of children with TSC and to elucidate the presence of non-delayed facets of their development. MATERIAL/METHODS: This study examined 11 children with TSC: 10 children with DSM-IV autism and 92 healthy children who participated as control subjects. Correlation was examined between results obtained using Non-Verbal MMRC, which is a validated musical responsiveness battery, and results of a scientifically accepted standardized pediatric developmental test: the New Edition of the Kyoto Scale of Psychological Development. Inter-rater reliability among the three raters was also assessed. RESULTS: The rhythm or melody score on the Non-Verbal MMRC and DA among children with TSC showed no significant correlation. In contrast, a significant correlation was found among normal children and those with autism. Moreover, the inter-rater reliability was good. CONCLUSIONS: The results demonstrate that children with TSC show high responsiveness to musical stimuli despite otherwise delayed development (e.g., language, cognition, motor skills). This report is the first stating that children with TSC have a unique tendency in terms of correlation between music and developmental age. These findings indicate a non-delayed area of TSC children's development and suggest the use of music as therapeutic intervention.

Effects of switching from conventional antipsychotics to risperidone in Japanese patients with chronic schizophrenia.

Atypical antipsychotics are rapidly evolving to become the standard pharmacotherapy in schizophrenia; however, the trend of switching to such drugs is not necessarily progressing quickly in East Asia. This might be due to the scarcity of evidence for the efficacy of switching from conventional to atypical antipsychotics, which prompted the authors to examine effects of switching from conventional antipsychotics to an atypical drug, risperidone, in Japanese patients. Fifty patients with chronic schizophrenia completed the study in which combination therapy with other antipsychotics was allowed if monotherapy with risperidone was not tolerated. Symptoms were assessed with the brief psychiatric rating scale (BPRS). Switching to monotherapy was achieved in 34 patients (68%). The number of antipsychotics prescribed to each patient was reduced (from 2.1 to 1.4 drugs; P < 0.001) and the use of antiparkinsonian drugs decreased (P < 0.001). The mean BPRS score was also reduced 6 months after initiation of the switch (P < 0.001). Failure in switching to monotherapy was associated with higher dosage of antipsychotics at baseline. Switching from conventional antipsychotics to risperidone reduced schizophrenia symptoms, antiparkinsonian medication, and polypharmacy. However, a portion of patients, particularly those who receive an excessive dosage of antipsychotics, might not tolerate such switching.

Role of imaginary companion in promoting the psychotherapeutic process.

An imaginary companion (IC) has been considered to be a transitory phenomenon sometimes seen in the normal developmental process of children. In recent years, however, it has been observed that ICs are related to various disorders, and their clinical significance is again attracting notice. Although an IC may in certain ways aggravate the patient's symptoms and regression, an IC may also serve to advance the therapy, for example by indicating the location of the patient's troubles, or acting as an intermediary between the therapist and patient. In cases of dissociative (conversion) disorders, it is generally difficult for patients to verbalize their troubles, but the present patients gained insight into themselves by closely examining their ICs. Imaginary companions are not simply entities incidental to the disorder, and by incorporating them into the therapeutic strategy as a presence supporting the patient's growth, it is possible that the psychotherapy may proceed more smoothly.