Prevalence of Anti-nuclear and Anti-phospholipid Antibodies in an Egyptian Cohort with Schizophrenia: A Case-control Study.

BACKGROUND: Psychiatric disorders, including schizophrenia, could herald other manifestation( s) of systemic lupus erythematosus (SLE) potentially hindering timely and optimal management. Moreover, schizophrenia is among the described 'extra-criteria' manifestations of anti-phospholipid syndrome (APS). Hence, screening schizophrenia patients for SLE and APS may pose diagnostic and therapeutic implications. OBJECTIVES: Examine schizophrenia patients with no overt connective tissue disease(s) manifestation( s) for clinical and/or serologic evidence of SLE and/or APS. METHODS: The study included 92 schizophrenia patients (61 (66.3%) males) and 100 age- and gender- matched healthy controls. Both groups were tested for anti-nuclear antibodies (ANAs), antidouble stranded deoxyribonucleic acid (anti-dsDNA) antibodies, complement 3 (C3) and C4, and criteria anti-phospholipid antibodies (aPL) (anticardiolipin Immunoglobulin (Ig) G and IgM, antibeta- 2-glycoprotein I IgG and IgM, and lupus anticoagulant (LAC)). RESULTS: The patients' mean age and disease duration were 28.8 ± 8.1 and 5.7 ± 2.2 years, respectively. The prevalence of ANA positivity, height of titre, and pattern was comparable between patients and controls (p = 0.9, p = 0.8 and p = 0.1, respectively). Anti-dsDNA antibodies and hypocomplementemia were absent in both groups. A significantly higher frequency of positive LAC was observed among patients compared with controls (7.6% vs. 1%, p = 0.02), whereas other aPL were comparable between both groups. None of the patients or controls demonstrated clinically meaningful (medium or high) aPL titres. CONCLUSION: In our study, schizophrenia was solely associated with LAC. Thus, in the absence of findings suggestive of SLE or APS, routine screening for both diseases is questionable.

Late versus Early Onset Depression in Elderly Patients: Vascular Risk and Cognitive Impairment.

BACKGROUND: Three-quarters of patients with major depressive disorder have late-onset depression. Late-onset depression is more often associated with cognitive impairment than earlyonset depression and evidences showed a relationship between vascular factors and late-life depression. OBJECTIVES: To compare cognitive functions between late-onset (&ge;60 years) and early-onset (<60 years) depression in elderly patients and to highlight the effect of vascular risk factors in elderly patients with late and early onset depression. METHODS: This was a cross sectional, case control study with consecutive referral done on eighty elderly patients with depression who were recruited from Geriatric Outpatient Clinic of Psychiatry and Addiction Prevention Hospital, Al Kasr Al-Ainy, Cairo University. They were divided into two groups according to the age of onset of depression: Late Onset Depression (LOD) group and Early Onset Depression (EOD) group. They were cognitively assessed using ACE III, Framingham risk score for vascular risk assessment. RESULTS: Late onset group had worse performance than early onset group regarding memory, verbal fluency, language, visuospatial abilities and had more vascular risk. CONCLUSION: Elderly patients with late onset depression had higher severity of depression as well as they were more cognitively affected regarding memory, verbal fluency, language, and visuospatial abilities. Vascular risk factors especially hypertension and diabetes mellitus were higher elderly patients with late onset depression and affects the severity of depression and degree of cognitive impairment.