Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder.

OBJECTIVE: Brain structural changes in schizoaffective disorder, and how far they resemble those seen in schizophrenia and bipolar disorder, have only been studied to a limited extent. METHOD: Forty-five patients meeting DSM-IV and RDC criteria for schizoaffective disorder, groups of patients with 45 matched schizophrenia and bipolar disorder, and 45 matched healthy controls were examined using voxel-based morphometry (VBM). RESULTS: Analyses comparing each patient group with the healthy control subjects found that the patients with schizoaffective disorder and the patients with schizophrenia showed widespread and overlapping areas of significant volume reduction, but the patients with bipolar disorder did not. A subsequent analysis compared the combined group of patients with the controls followed by extraction of clusters. In regions where the patients differed significantly from the controls, no significant differences in mean volume between patients with schizoaffective disorder and patients with schizophrenia in any of five regions of volume reduction were found, but mean volumes in the patients with bipolar disorder were significantly smaller in three of five. CONCLUSION: The findings provide evidence that, in terms of structural gray matter brain abnormality, schizoaffective disorder resembles schizophrenia more than bipolar disorder.

The Putative Link Between Omodysplasia and Treatment-Resistant Schizophrenia: A Complex Clinical Presentation of a Rare Genetic Disorder.

Genetic and metabolic disorders present unique challenges in understanding the pathophysiology and outcomes of specific symptoms and presentations due to their broad spectrum of manifestations and etiologies. In this case report, we have studied a 26-year-old who was diagnosed with omodysplasia, a rare form of skeletal dysplasia. She exhibits atypical symptoms of psychosis and was diagnosed with schizophreniform disorder at an early age. Various antipsychotic medications were administered; however, minimal to no improvement was noted in the symptoms. On the contrary, she reported adverse effects to some antipsychotics. She continued to exhibit delusions and hallucinations and showed clinical improvement after treatment with olanzapine. Her clinical course was further complicated by the presence of borderline personality traits, which went unnoticed earlier. Here, we would like to highlight the course of her symptoms, the different treatments administered, and the possible link between omodysplasia and treatment-resistant schizophrenia.

Difference between treatment-resistant schizophrenia and clozapine-resistant schizophrenia.

We read the impressive review article "Clozapine resistant schizophrenia: Newer avenues of management" with great enthusiasm and appreciation. The author believes that preventing clozapine resistance from developing may be the most effective treatment strategy for patients with clozapine-resistant schizophrenia (CRS), and optimizing clozapine treatment is a key component. Disentangling the differences between treatment-resistant schizophrenia and CRS is important for studies addressing treatment strategies for these difficult-to-treat populations.

Perceptual Gains and Losses in Synesthesia and Schizophrenia.

Individual differences in perception are widespread. Considering inter-individual variability, synesthetes experience stable additional sensations; schizophrenia patients suffer perceptual deficits in, eg, perceptual organization (alongside hallucinations and delusions). Is there a unifying principle explaining inter-individual variability in perception? There is good reason to believe perceptual experience results from inferential processes whereby sensory evidence is weighted by prior knowledge about the world. Perceptual variability may result from different precision weighting of sensory evidence and prior knowledge. We tested this hypothesis by comparing visibility thresholds in a perceptual hysteresis task across medicated schizophrenia patients (N = 20), synesthetes (N = 20), and controls (N = 26). Participants rated the subjective visibility of stimuli embedded in noise while we parametrically manipulated the availability of sensory evidence. Additionally, precise long-term priors in synesthetes were leveraged by presenting either synesthesia-inducing or neutral stimuli. Schizophrenia patients showed increased visibility thresholds, consistent with overreliance on sensory evidence. In contrast, synesthetes exhibited lowered thresholds exclusively for synesthesia-inducing stimuli suggesting high-precision long-term priors. Additionally, in both synesthetes and schizophrenia patients explicit, short-term priors-introduced during the hysteresis experiment-lowered thresholds but did not normalize perception. Our results imply that perceptual variability might result from differences in the precision afforded to prior beliefs and sensory evidence, respectively.

Monitoring of Plasma Concentration and Analysis of Influential Factors for Paliperidone Palmitate Injection in 37 Patients with Schizophrenia / 中国药房

OBJECTIVE:To explore the influential factors for plasma concentration of paliperidone palmitate injection for pa-tients with schizophrenia. METHODS:37 schizophrenia patients who used Paliperidone palmitate injection and took plasma concentra-tion monitoring in Wuxi Mental Health Center from Sept. 2012 to Jun. 2015 was selected,the results were statistically analyzed,and the influential factors were preliminary explored. RESULTS:Totally 37 times were conducted for the plasma concentration monitoring for paliperidone with the average plasma concentration of(17.72±13.46)ng/ml,and 24 times(accounting for 64.86%)in the range of(10-60 ng/ml);the average plasma concentration of male patients was lower than that of female patients,the difference was statisti-cally significant(P0.05);there was also no significant difference in plasma concentration/dose ratio in patients with different daily dose(P>0.05);the average plasma concentration of patients with combination treatment was higher than that of single drug,the difference was statistically signifi-cant(P0.05). CONCLUSIONS:The plasma concentration of paliperidone palmitate is affected by age,combination treat-ment and other factors,clinic can optimize the therapeutic regimen based on monitoring results of plasma concentration and patients’ symptoms to promote the rational drug use.

Effects of repetitive transcranial magnetic stimulation with theta burst stimulation paradigm on the execu-tive function of schizophrenia patients / 中华行为医学与脑科学杂志

Objective To evaluate the effect of theta burst stimulation( TBS) paradigm of repetitive tran?scranial magnetic stimulation ( rTMS ) on the treatment of schizophrenia through assessing executive function. Methods 60 patients met with DSM?4 and ICD?10 for schizophrenia disorders criteria were enrolled in this study. The group was divided into theta burst stimulation group(research group, n=30) and sham intervention group ( control group, n=30) . The research group and control group were assessed with the Wisconsin card sorting test (WCST) and the go/no?go task by event?related potential(ERPs) before and after 4 weeks treatment. Each test results of all groups before and after treatment were compared with each other respectively. Results Regarding the WCST test,compared with the baseline,the post?rTMS state of the TBS group showed a decrease in the error selec?tion percentage((59.8±14.7)%),the preservative error number(55.3±18.0) and the preservative error percentage (71.3±12.6)%,but the percentage of conceptual level(71.3±12.6)% increased in the TBS group(P0.05).Conclusions The?ta burst stimulation paradigm of rTMS can improve the executive function in schizophrenic patients.