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Background This study attempts to replicate in a Chinese population an earlier UK report that eye movement abnormalities can accurately distinguish schizophrenia (SCZ) cases from healthy controls (HCs). It also seeks to determine whether first-episode SCZ differ from chronic SCZ and whether these eye movement abnormalities are enriched in psychosis risk syndrome (PRS). Methods The training set included 104 Chinese HC and 60 Chinese patients with SCZ, and the testing set included 20 SCZ patients and 20 HC from a UK cohort. An additional 16 individuals with PRS were also enrolled. Eye movements of all participants were recorded during free-viewing, smooth pursuit, and fixation stability tasks. Group differences in 55 performance measures were compared and a gradient-boosted decision tree model was built for predictive analyses. Results Extensive eye-movement abnormalities were observed in patients with SCZ on almost all eye-movement tests. On almost all individual variables, first-episode patients showed no statistically significant differences compared with chronic patients. The classification model was able to discriminate patients from controls with an area under the curve of 0.87; the model also classified 88% of PRS individuals as SCZ-like. Conclusions Our findings replicate and extend the UK results. The overall accuracy of the Chinese study is virtually identical to the UK findings. We conclude that eye-movement abnormalities appear early in the natural history of the disorder and can be considered as potential trait markers for SCZ diathesis. [ABSTRACT FROM AUTHOR]

Importance: Impaired cognitive function in schizophrenia is associated with poor functional outcomes, but the role of rare coding variants is unclear.Objective: To determine whether ultrarare constrained variants (URCVs) are associated with cognition in patients with schizophrenia.Design, Setting, and Participants: Linear regression was used to perform a within-case genetic association study of URCVs and current cognition and premorbid cognitive ability. A multivariable linear regression analysis of the outcomes associated with URCVs, schizophrenia polygenic risk score, polygenic risk score for intelligence and schizophrenia associated copy number variants on cognitive ability was performed. Exome sequencing data from 802 participants with schizophrenia were assessed for current cognition using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery and for estimated premorbid IQ using the National Adult Reading Test. Individuals were recruited from clinical and voluntary mental health services in the UK. Those with a diagnosis of intellectual disability or a neurological disorder known to affect cognition were excluded. Data collection occurred between 2007 and 2015. Data were analyzed between April 2020 and March 2022.Main Outcomes and Measures: Association between URCVs, current cognition, and current cognition adjusted for premorbid IQ.Results: Of the 802 participants, 499 (62%) were men and 303 (38%) were women; mean (SD) age at interview was 43.36 (11.87) years. Ultrarare constrained variants (n = 400) were associated with lower current cognition scores (β = -0.18; SE = 0.07; P = .005). In the univariable analysis, premorbid IQ was associated with URCVs (β = -0.12; SE = 0.05; P = .02) and partly attenuated the association with current cognition (β = -0.09; SE = 0.05; P = .08). Multivariable analysis showed that measured genetic factors combined accounted for 6.2% of variance in current cognition, 10.3% of variance in premorbid IQ, and supported outcomes of URCVs associated with current cognition independent of premorbid IQ (β = -0.10; SE = 0.05; P = .03).Conclusions and Relevance: The findings of this study suggest that URCVs contribute to variance in cognitive function in schizophrenia, with partly independent associations before and after onset of the disorder. Although the estimated effect sizes were small, future studies may show that the effect sizes will be greater with better annotation of pathogenic variants. Genomic data may contribute to identifying those at particularly high risk of cognitive impairment in whom early remedial or preventive measures can be implemented. [ABSTRACT FROM AUTHOR]

Background and hypothesis No objective tests are currently available to help diagnosis of major psychiatric disorders. This study evaluates the potential of eye movement behavior patterns to predict schizophrenia subjects compared to those with major affective disorders and control groups. Study design Eye movements were recorded from a training set of UK subjects with schizophrenia (SCZ; n  = 120), bipolar affective disorder (BPAD; n  = 141), major depressive disorder (MDD; n  = 136), and healthy controls (CON; n  = 142), and from a hold-out set of 133 individuals with proportional group sizes. A German cohort of SCZ (n  = 60) and a Scottish cohort of CON subjects (n  = 184) acted as a second semi-independent test set. All patients met DSMIV and ICD10 criteria for SCZ, BPAD, and MDD. Data from 98 eye movement features were extracted. We employed a gradient boosted (GB) decision tree multiclass classifier to develop a predictive model. We calculated the area under the curve (AUC) as the primary performance metric. Study results Estimates of AUC in one-versus-all comparisons were: SCZ (0.85), BPAD (0.78), MDD (0.76), and CON (0.85). Estimates on part-external validation were SCZ (0.89) and CON (0.65). In all cases, there was good specificity but only moderate sensitivity. The best individual discriminators included free viewing, fixation duration, and smooth pursuit tasks. The findings appear robust to potential confounders such as age, sex, medication, or mental state at the time of testing. Conclusions Eye movement patterns can discriminate schizophrenia from major mood disorders and control subjects with around 80% predictive accuracy. [ABSTRACT FROM AUTHOR]

Background: To determine the baseline individual characteristics that predicted symptom recovery and functional recovery at 10-years following the first episode of psychosis. Methods: AESOP-10 is a 10-year follow up of an epidemiological, naturalistic population-based cohort of individuals recruited at the time of their first episode of psychosis in two areas in the UK (South East London and Nottingham). Detailed information on demographic, clinical, and social factors was examined to identify which factors predicted symptom and functional remission and recovery over 10-year follow-up. The study included 557 individuals with a first episode psychosis. The main study outcomes were symptom recovery and functional recovery at 10-year follow-up. Results: At 10 years, 46.2% (n = 140 of 303) of patients achieved symptom recovery and 40.9% (n = 117) achieved functional recovery. The strongest predictor of symptom recovery at 10 years was symptom remission at 12 weeks (adj OR 4.47; CI 2.60–7.67); followed by a diagnosis of depression with psychotic symptoms (adj OR 2.68; CI 1.02–7.05). Symptom remission at 12 weeks was also a strong predictor of functional recovery at 10 years (adj OR 2.75; CI 1.23–6.11), together with being from Nottingham study centre (adj OR 3.23; CI 1.25–8.30) and having a diagnosis of mania (adj OR 8.17; CI 1.61–41.42). Conclusions: Symptom remission at 12 weeks is an important predictor of both symptom and functional recovery at 10 years, with implications for illness management. The concepts of clinical and functional recovery overlap but should be considered separately. [ABSTRACT FROM AUTHOR]

The aetiology of the increased risk of mental illness in migrant populations, including psychotic disorders, remains unclear. Studies have shown positive associations between prolonged psychosocial adversity experienced in such populations and the development of schizophrenia. This case report describes a Black‐African migrant woman who presented with first episode psychosis. [ABSTRACT FROM AUTHOR]

Background: The interaction between positive, negative and depressive symptoms experienced by people with schizophrenia is complex. We used longitudinal data to test the hypothesis that depressive symptoms mediate the links between positive and negative symptoms. Methods: We analyzed data from the European Schizophrenia Cohort, randomly sampled from outpatient services in France, Germany and the UK (N = 1208). Initial measures were repeated after 6 and 12 months. Depressive symptoms were identified using the Calgary Depression Scale for Schizophrenia (CDSS), while positive and negative symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Latent variable structural equation modelling was used to investigate the mediating role of depression assessed at 6 months in relation to the longitudinal association between positive symptoms at baseline and negative symptoms at 12 months. Results: We found longitudinal associations between positive symptoms at baseline and negative symptoms at 12 months, as well as between both of these and CDSS levels at 6 months. However depression did not mediate the longitudinal association between PANSS scores; all the effect was direct. Conclusions: Our findings are incompatible with a mediating function for depression on the pathway from positive to negative symptoms, at least on this timescale. The role of depression in schizophrenic disorders remains a challenge for categorical and hierarchical diagnostic systems alike. Future research should analyze specific domains of both depressive and negative symptoms (e.g. motivational and hedonic impairments). The clinical management of negative symptoms using antidepressant treatments may need to be reconsidered. [ABSTRACT FROM AUTHOR]

Objective: This study seeks to quantify the treatment goals of people recently diagnosed with schizophrenia and explore their impact on treatment plan. Methods: People aged 18-35 years with a confirmed diagnosis of schizophrenia within the past 5 years were surveyed in the UK, Germany, and Italy. Treatment goals were assessed via a validated best-worst scaling instrument, where participants evaluated subsets of 13 possible treatment goals identified using a balanced incomplete block design. Participants identified the most and least important goals within each task. Data were also collected on current treatment and preference for daily oral versus long-acting injectable (LAI) treatment. Hierarchical Bayes was used to identify preference weights for the goals, and latent class analysis was used to identify segments of people with similar goals. The segments were compared with the current treatment and preference for oral versus LAI treatment. Results: Across 100 participants, the average age was 26 years, 75% were male and 50% were diagnosed within 2 years ago. Overall, preferences were most favorable for reduced disease symptoms, think clearly, reduced hospitalizations, reduced anxiety, and take care of self. A total of 61% preferred oral medication and 39% LAI. Two groups were identified with different treatment goals; 50% of participants emphasized clinical goals, including reduced disease symptoms (preference weight =19.7%), reduced hospitalizations (15.5%), and reduced anxiety (10.5%). The other 50% emphasized functional goals, including improved relationships with family/friends (11.4%), increased interest in work (10.6%), experiencing a fuller range of emotions (8.4%), and ability to socialize (7.5%). Those emphasizing functional goals were more likely to be on LAI (44% versus 26%; p=0.059) and preferred LAI (46% versus 32%; p=0.151). Conclusions: People with recent-onset schizophrenia may focus more on clinical goals or functional goals, a discussion of which may help facilitate patient engagement. [ABSTRACT FROM AUTHOR]

Psychosis symptoms (delusions and hallucinations) are multifactorial in origin and, in later life, occur in the context of schizophrenia, delirium, dementia, delusional and schizophrenia-like disorders, mood disorders, and alcohol or substance abuse. The current article provides a clinical overview of very late–onset (after age 60) schizophrenia-like psychosis (VLOSLP), summarizing the literature on treatment options and reflecting on the role of psychiatric–mental health nurses (PMHNs). Increased awareness of the clinical presentation, key features, and evidence-based treatment options will assist PMHNs to confidently recognize this often underdiagnosed disorder and adopt a more assertive role in terms of engagement and follow up. Pragmatic research involving individuals with VLOSLP is required to increase the evidence base for treatment and improve outcomes of care. [ABSTRACT FROM AUTHOR]

BackgroundSodium nitroprusside (SNP) has been reported to rapidly reduce psychotic symptoms in patients with schizophrenia. This has the potential to revolutionize treatment for schizophrenia. In this study, we tested the hypothesis that SNP leads to a reduction in psychotic symptoms and an improvement in spatial working memory (SWM) performance in patients with schizophrenia.MethodThis was a single-centre, randomized, double-blind, placebo-controlled trial performed from 27 August 2014 to 10 February 2016 (clinicaltrials.gov identifier: NCT02176044). Twenty patients with schizophrenia aged 18–60 years with a diagnosis of schizophrenia or schizoaffective disorder were recruited from psychiatric outpatient clinics in the South London and Maudsley NHS Trust, London, UK. Baseline symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) and the 18-item Brief Psychiatric Rating Scale (BPRS-18), and SWM was assessed using the CANTAB computerized test. Participants received either an infusion of SNP (0.5 μg/kg per min for 4 h) or placebo and were re-assessed for symptoms and SWM performance immediately after the infusion, and 4 weeks later.ResultsSNP did not lead to any reduction in psychotic symptoms or improvement in SWM performance compared to placebo.ConclusionsAlthough this study was negative, it is possible that the beneficial effects of SNP may occur in patients with a shorter history of illness, or with more acute exacerbation of symptoms. [ABSTRACT FROM PUBLISHER]

In 41 patients with schizophrenia, we used neuroanatomical information derived from structural imaging to identify patients with more severe illness, characterised by high symptom burden, low processing speed, high degree of illness persistence and lower social and occupational functional capacity. Cortical folding, but not thickness or volume, showed a high discriminatory ability in correctly identifying patients with more severe illness. [ABSTRACT FROM AUTHOR]

BackgroundA lack of an aetiologically based nosology classification has contributed to instability in psychiatric diagnoses over time. This study aimed to examine the diagnostic stability of psychosis diagnoses using data from an incidence sample of psychosis cases, followed up after 10 years and to examine those baseline variables which were associated with diagnostic change.MethodData were examined from the ÆSOP and ÆSOP-10 studies, an incidence and follow-up study, respectively, of a population-based cohort of first-episode psychosis cases from two sites. Diagnosis was assigned using ICD-10 and DSM-IV-TR. Diagnostic change was examined using prospective and retrospective consistency. Baseline variables associated with change were examined using logistic regression and likelihood ratio tests.ResultsSlightly more (59.6%) cases had the same baseline and lifetime ICD-10 diagnosis compared with DSM-IV-TR (55.3%), but prospective and retrospective consistency was similar. Schizophrenia, psychotic bipolar disorder and drug-induced psychosis were more prospectively consistent than other diagnoses. A substantial number of cases with other diagnoses at baseline (ICD-10, n = 61; DSM-IV-TR, n = 76) were classified as having schizophrenia at 10 years. Many variables were associated with change to schizophrenia but few with overall change in diagnosis.ConclusionsDiagnoses other than schizophrenia should to be regarded as potentially provisional. [ABSTRACT FROM AUTHOR]

Previous research has highlighted increased risk for schizophrenia in Afro-Caribbeans as well as over-representation in the prison population. This small-scale study examined the relationship between criminality, ethnicity, and psychosis-proneness in a male prison sample. Twenty British Caucasian and 20 Afro-Caribbean prisoners were divided into equal sub-groups of violent and non-violent offenders. Participants completed measures of schizotypy, delusional ideation, and hostility. Afro-Caribbean offenders scored more highly on negative schizotypy and delusional ideation than their Caucasian counterparts. Violent offenders scored more highly on the positive symptoms of schizotypy than non-violent prisoners. Both ethnicity and violent offending may be relevant factors when considering vulnerability to psychosis in the offending population. [ABSTRACT FROM AUTHOR]

BackgroundIt has been proposed that the relationship between childhood trauma and hallucinations can be explained by dissociative processes. The present study examined whether the effect of childhood trauma on hallucination-proneness is mediated by dissociative tendencies. In addition, the influence of dissociative symptoms on a cognitive process believed to underlie hallucinatory experiences (i.e. reality discrimination; the capacity to discriminate between internal and external cognitive events) was also investigated.MethodPatients with schizophrenia spectrum disorders (n=45) and healthy controls (with no history of hallucinations; n=20) completed questionnaire measures of hallucination-proneness, dissociative tendencies and childhood trauma, as well as performing an auditory signal detection task.ResultsCompared to both healthy and non-hallucinating clinical controls, hallucinating patients reported both significantly higher dissociative tendencies and childhood sexual abuse. Dissociation positively mediated the effect of childhood trauma on hallucination-proneness. This mediational role was particularly robust for sexual abuse over other types of trauma. Signal detection abnormalities were evident in hallucinating patients and patients with a history of hallucinations, but were not associated with pathological dissociative symptoms.ConclusionsThese results are consistent with dissociative accounts of the trauma-hallucinations link. Dissociation, however, does not affect reality discrimination. Future research should examine whether other cognitive processes associated with both dissociative states and hallucinations (e.g. deficits in cognitive inhibition) may explain the relationship between dissociation and hallucinatory experiences. [ABSTRACT FROM PUBLISHER]

Abstract: According to classic and contemporary social theory, the community is crucial to how individuals respond to the onset of health problems. Cultural response to symptoms provides the foundation for lay diagnosis; offers a gauge for marking individual and societal health literacy; and reflects the cultural embeddedness of modern medical knowledge. Using data collected between 2004 and 2007 from the Stigma in Global Context – Mental Health Study (SGC-MHS) on the recognition of schizophrenia from vignettes describing individuals meeting DSM-IV criteria, we examine the nature and correlates of lay diagnosis. Focusing on Western societies in the SGC-MHS, we ask three questions regarding problem recognition in Bulgaria (N = 255), Cyprus (N = 253), Germany (N = 382), Hungary (N = 352), Iceland (N = 291), Spain (N = 327), Great Britain (N = 289), and the United States (N = 449): (1) What is the cross-national variation in recognition of schizophrenia as a mental illness? (2) Is lay diagnosis associated with individuals’ socio-demographic characteristics and/or their evaluation of underlying causes? (3) Are lay diagnoses likely to shape the nature and direction of the illness career? We find lay diagnosis of “mental illness” to be high across these Western nations with some, though modest, difference across countries. Variation for the more specific diagnosis of “schizophrenia” is greater, though fairly consistent in country ordering. Lay diagnoses are shaped most consistently by attributions, inconsistently by socio-demographics, and generally associated with respondents’ treatment recommendations and expected outcomes. In light of assumptions about public beliefs and knowledge that often underlie research, community efforts, clinical programs, and health policy, these findings suggest that a greater understanding of the complexities of lay diagnosis is warranted. [Copyright &y& Elsevier]

Background: Previous epidemiological studies have shown a high incidence of schizophrenia in African-Caribbeans in the UK, but not in Asians. Aims: We investigated the hypothesis that cultural adherence might protect the Asians against the stress of living in a majority white culture. Methods: The Culture and Identity Schedule (CANDID) was given to patients with a diagnosis of schizophrenia making their first contact with psychiatric services, and to a matched group of controls randomly selected from the general population. Results: While the Asian patients displayed no drift away from the traditional values as espoused by their controls, the African-Caribbean patients were less traditional than their controls. Conclusions: The fact that a movement away from their traditional culture distinguishes African-Caribbean patients with a severe psychiatric illness, schizophrenia, from their mentally healthy controls strongly favours marginalization over biculturalism as an interpretation of this shift. [ABSTRACT FROM AUTHOR]

Abstract: A recent systematic review concluded that cannabis use increases risk of psychotic outcomes independently of confounding and transient intoxication effects. Furthermore, a model of the association between cannabis use and schizophrenia indicated that the incidence and prevalence of schizophrenia would increase from 1990 onwards. The model is based on three factors: a) increased relative risk of psychotic outcomes for frequent cannabis users compared to those who have never used cannabis between 1.8 and 3.1, b) a substantial rise in UK cannabis use from the mid-1970s and c) elevated risk of 20 years from first use of cannabis. This paper investigates whether this has occurred in the UK by examining trends in the annual prevalence and incidence of schizophrenia and psychoses, as measured by diagnosed cases from 1996 to 2005. Retrospective analysis of the General Practice Research Database (GPRD) was conducted for 183 practices in England, Wales, Scotland and Northern Ireland. The study cohort comprised almost 600,000 patients each year, representing approximately 2.3% of the UK population aged 16 to 44. Between 1996 and 2005 the incidence and prevalence of schizophrenia and psychoses were either stable or declining. Explanations other than a genuine stability or decline were considered, but appeared less plausible. In conclusion, this study did not find any evidence of increasing schizophrenia or psychoses in the general population from 1996 to 2005. [Copyright &y& Elsevier]

Abstract: AKT1 (V-akt murine thyoma viral oncogene homolog 1) is involved in intracellular signalling pathways postulated as of aetiological importance in schizophrenia. Markers in the AKT1 gene have also recently been associated with schizophrenia in two samples of European origin and in Japanese and Iranian samples. Aiming to replicate these findings, we examined ten SNPs spanning AKT1 in a UK case-control sample (schizophrenia cases n =673, controls n =716). These included all SNPs previously reported to be associated in European, Japanese and Iranian samples, alone or in haplotypes, as well as additional markers defined by the Haploview Tagger program (pair-wise tagging, minimum r 2 =0.8, minor allele frequency=0.02). We found no association with single markers (min p =0.17). We found weak evidence for association (p =0.04) with a four marker haplotype reported as significant in the original positive European sample of Emamian et al. [Emamian, E.S., Hall, D., Birnbaum, M.J., Karayiorgou, M., Gogos, J.A., 2004. Convergent evidence for impaired AKT1-GSK3beta signaling in schizophrenia. Nat. Genet. 36, 131–137] and also an overlapping three marker haplotype (p =0.016) that had previously been reported as significant in a Japanese sample. Nominal p-values for these haplotypes did not survive correction for multiple testing. Our study provides at best weak support for the hypothesis that AKT1 is a susceptibility gene for schizophrenia. Examination of our own data and those of other groups leads us to conclude that overall, the evidence for association of AKT1 as a susceptibility gene for schizophrenia is weakly positive, but not yet convincing. [Copyright &y& Elsevier]

Abstract: This study examined the institutional outcomes (12 weeks post-admission) of 134 male patients with DSM-IV schizophrenia assessed using the Psychopathy Checklist: Screening Version (PCL: SV) in a medium secure unit in the UK. High psychopathy scorers (HP) were more likely to be violent, non-compliant with programmes, engage in substance misuse violations, have criminal attitudes/peers and have low levels of insight into risk and violence. Psychopathy was also a modest predictor of institutional outcome in these domains. [Copyright &y& Elsevier]

Background: No study outside the UK has examined the diagnostic stability of psychotic disorders in a population-based sample.Aims: To determine diagnostic stability in a Dutch population-based psychosis incidence cohort, to examine the frequencies of diagnostic shifts to and from schizophrenic disorders and to report the revised relative risks of schizophrenic disorders for immigrants.Method: A 30-month follow-up study assessed the cohort (n=181) by means of face-to-face diagnostic interviews.Results: Diagnostic stability of schizophrenic disorders was high (91%), but lower for other psychotic disorders. At follow-up, the initial diagnosis was adjusted to schizophrenic disorder more often than that the reverse occurred. Almost half (49%) of the patients who were not initially diagnosed as having a schizophrenic disorder received this diagnosis at follow-up. The relative risks for most immigrant groups were stable.Conclusions: Schizophrenic disorders are underdiagnosed, rather than overdiagnosed, at first presentation. [ABSTRACT FROM AUTHOR]

Objective: To describe the development and validation of the Clinical Global Impression-Schizophrenia (CGI-SCH) scale, designed to assess positive, negative, depressive and cognitive symptoms in schizophrenia. Method: The CGI-SCH scale was adapted from the CGI scale. Concurrent validity and sensitivity to change were assessed by comparison with the Positive and Negative Symptom Severity (PANSS) and Global Assessment of Functioning (GAF) scales. To evaluate inter-rater reliability, all patients were assessed by two clinicians. Results: Symptoms were assessed in 114 patients. Correlation coefficients between the CGI-SCH and the GAF and PANSS scores were high (most above 0.75), and were highest for positive and negative symptoms. Reliability was substantial (intraclass correlation coefficient, ICC > 0.70) in all but one dimension (depressive dimension, ICC = 0.64). Conclusion: The CGI-SCH scale is a valid, reliable instrument to evaluate severity and treatment response in schizophrenia. Given its simplicity, brevity and clinical face validity, the scale is appropriate for use in observational studies and routine clinical practice. [ABSTRACT FROM AUTHOR]

Previous studies have shown high rates of schizophrenia among the Afro-Caribbean population in Britain. In order to assess the role of genetic factors in the aetiology of this phenomenon, we have used a standardised family history method (FHRDC) to compare lifetime morbidity risks for first-degree relatives of Afro-Caribbean and white patients with RDC schizophrenia admitted in Central Manchester between 1982 and 1988. Lifetime morbidity risk for parents of Afro-Caribbean subjects was 8.9%, and for parents of white patients 8.4%. For the siblings of black probands, however, the risk was 15.9%, as compared with 1.8% for white siblings (P < 0.05). Among siblings of UK-born Afro-Caribbean probands, morbid risk was even higher at 27.3% (P = 0.001). High rates among siblings of younger Afro-Caribbean patients are consistent with previous reports of a higher incidence in the UK-born. These observations suggest that schizophrenia among Afro-Caribbeans is no less familial than for the remainder of the population, but that the increased frequency of the disorder is due to environmental factors which are most common in the Afro-Caribbean community, and capable of precipitating schizophrenia in those who are genetically predisposed. [ABSTRACT FROM AUTHOR]

The article presents a paper discussed during the molecular biology symposium in Great Britain, investigating the genetic connection in the etiology of psychosis. According to the author, despite acknowledgment on the genetic contribution to psychosis by most authorities, some experts claim that genetic connection is still obscure and no connection has been concretely established. However, advocates of the genetic connection argue that genetic determination has to be considered because no external or environmental precipitant of the psychosis had been proven either. Meanwhile, discussion on the possible strategies to be employed in the search and identification of the psychosis gene and the problems associated with the issue of genetic linkage of the psychosis gene are presented.

The mental states of 92 inpatients with chronic schizophrenia were assessed on two occasions 4 years apart. The relationship between the two ratings was examined in the 84 patients who were either consistently on or consistently off neuroleptics. Negative features were more stable than positive, but were not irreversible. Every feature examined was shown to resolve in some cases. [ABSTRACT FROM AUTHOR]

The article presents a questionnaire study which aims to assess the new state of experienced English psychiatric opinion on the diagnosis and treatment of schizophrenia in Great Britain. The study used a postal questionnaire method which consists a list of possible treatment measures for schizophrenia and indications for various treatment choices. The findings indicate that there is a consensual agreement on major symptom importance in which the choice of treatment showed agreement on major treatment possibilities.

The article focuses on the study that established the concepts of schizophrenia, a mental illness, which usually affects adolescents in Great Britain. The study found out that the difficulty of concept formation of the illness occurred regularly and severely for schizophrenics. Furthermore, the study emphasizes the importance of molecular biology in searching for biological differences between normals and schizophrenics. It is stated that the data were not inconsistent with quantitatively subdominant genetic inheritance of a conceptualizing difficulty of homozygotes which has higher penetration of schizophrenia.

The article discusses the clinical guideline issued by the National Institute for Health and Clinical Excellence (NICE) in Great Britain for schizophrenia and psychosis. It states that the guideline covers the recognition and management of the disease in children and young adults up to 18 years old. The applicability of the guidelines to all professionals in primary, community and other health and social sectors is also emphasized.

Hearing voices can be distressing, but for some services users the experience may be supportive. Joanne Harrison and colleagues consider whether nurses' attitudes towards service users who hear voices can at times be disempowering and unhelpful. [ABSTRACT FROM AUTHOR]

The article recommends the re-introduction of diagnostic codings for patients with non-organic and non-affective psychosis in Great Britain. The lack of codings within ICD-10 or DSM-IV would be fine is a satisfactory alternative diagnosis had been included for the psychoses formerly known as late paraphrenia and late schizophrenia. But there are uncertainty about the diseases' relationship with schizophrenia, delusional disorders and atypical affective psychoses.

Background: A higher proportion of African-Caribbean people in the UK are diagnosed with schizophrenia spectrum disorders than other ethnic groups. High levels of shame and stigma at individual and community levels contribute to delayed access to care, potentially increasing the duration of untreated psychosis and so worsening outcomes. Inferior access, more coercive care, and worse outcomes have created a 'circle of fear' of mental health services within African-Caribbean communities. This further discourages early engagement with statutory services and increases the burden of care for families living with schizophrenia. Providing tailored and relevant information about psychosis (psychoeducation) has the potential for improving outcomes for patients and families. However, there are no culturally appropriate psychoeducation programmes for African-Caribbeans in the UK. We aim to determine whether an e-learning resource, co-produced with African-Caribbean stakeholders to improve knowledge about psychoses, would be culturally acceptable and accessible to members of this population. Methods: A pilot randomised controlled trial of the feasibility of co-producing and testing a novel e-learning resource to improve knowledge about and attitudes towards schizophrenia in African-Caribbean families. We will seek to recruit 40 participants, aged ≥ 16 years, either to receive the intervention or as controls. They will self-refer or be referred via inpatient and wellbeing services, family and carers' forums, statutory community mental health teams, and voluntary sector/non-governmental agencies (NGOs). Participants will complete the Ca-KAP, ASMI, and SF-12. Acceptability will be explored qualitatively via focus groups and individual semi-structured interviews. Discussion: The proposed trial will demonstrate the feasibility of conducting a fully powered RCT to evaluate the efficacy of an e-learning resource about schizophrenia with African-Caribbean families. Qualitative work will explore the intervention's accessibility and barriers/facilitators to participation, including attitudes to randomisation. These data will facilitate further refinement of the intervention. Trial registration: ISRCTN11394005, retrospectively registered 20/03/2018. [ABSTRACT FROM AUTHOR]

Treatment-resistant schizophrenia is a major health problem in the UK with the majority of patients treated with clozapine. In up to 70% of cases there is only a partial response to clozapine with continuing refractory symptoms. We describe two cases in a UK mental health service where minocycline was found to be useful and well tolerated as an augmentation agent with clozapine in the improvement of previously resistant positive and negative symptoms. [ABSTRACT FROM AUTHOR]

The article offers information on various issues related to hospital admission for schizophrenia and bipolar disorder. By referring to one study, it is suggested that circulatory and respiratory diseases were leading causes of death. The article also talks about the absolute risk of death within a year of inpatient care.

Editorial. Focuses on the impact of early diagnosis of schizophrenia on a patient's social development. Annual public cost of schizophrenia in Great Britain; Obstacles to early detection; Primary goals of early treatment; Services required by patients during their first schizophrenic episode.

DTI studies in schizophrenia have consistently reported decreased fractional anisotropy (FA, an index of white matter microstructure) in patients. There is little evidence as to the genetic or environmental determinants of this difference however. Studies of twins with schizophrenia allow us to estimate these influences. We report a cross-sectional case control study of twins with and without schizophrenia. We recruited mono- and di-zygotic twins concordant and discordant for DSM schizophrenia from across the United Kingdom, referred by their treating psychiatrists. We recruited healthy control twins from the Institute of Psychiatry Volunteer Twin Register and by national media advertisements. Clinical diagnoses were confirmed using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version (Spitzer and Endicott, 1978). Zygosity was confirmed by DNA analysis. Eleven pairs of monozygotic twins concordant for schizophrenia, 10 pairs of monozygotic and seven pairs of dizygotic twins discordant for schizophrenia, 24 pairs of healthy monozygotic twins and 20 pairs of healthy dizygotic twins were recruited. Subjects were scanned with an optimized DTI sequence at 1.5T. Scans were warp-corrected, masked, and FA calculated at each voxel. FA maps were then co-registered to a study-specific FA template using SPM2 and group differences calculated on segmented white-matter FA maps using non-parametric XBAM_v3.4. Results are presented of analyses comparing twins with schizophrenia with their well co-twin, linear trend analyses comparing healthy controls with well di and mono-zygotic co-twins, and a heritability analysis of the healthy controls. [Copyright &y& Elsevier]

The article reports on the study that indicates more genes linked to schizophrenia in Great Britain. It claims that 49 genes that are linked to schizophrenia were discovered with the use of microarray technology to establish the expression of over 30,000 mRNA transcripts from post-mortem brains. The results may aid in improving diagnosis and subsequent early treatment of schizophrenia by the development of new blood tests.