Inverse relationship between serum high density lipoprotein and negative syndrome in antipsychotic-naive schizophrenia

Background: Recent literature suggests a role for apolipoprotein L (apoL) aberrations in the pathogenesis of schizophrenia. ApoL is almost exclusively associated with apolipoprotein A-I in high-density lipoproteins (HDLs). The objective of this study was to examine the correlation between symptom scores and serum HDL in antipsychotic-naive schizophrenia patients. Methods: In this cross-sectional study, 60 antipsychotic-naive schizophrenia patients were systematically examined for their symptom scores, with good inter-rater reliability. Concurrently, an overnight fasting serum lipid profile from these patients was assessed. Results: Serum HDL had a significant inverse correlation with a total negative syndrome score (ρ=−0.43; p=0.001). Conclusions: The study observation supports the potential role for HDL abnormalities in the genesis of negative symptoms in schizophrenia. Clin Chem Lab Med 2010;48:95–8.Peer Reviewe

Pituitary adenoma with hypothalamic involvement: a case of ‘atypical’ atypical depression

Pituitary tumours are known to be associated with neuropsychiatric manifestations; however, it is uncommon for the manifestations to be the sole presenting symptoms. We report a case of 29-year-old male presenting with low mood, decreased attention, forgetfulness, increased sleep, and increased appetite of three months duration. Diagnosis of moderate depression episode with atypical features was considered and started on antidepressant Bupropion up to 300 mg/day to which he showed no improvement. Considering the atypical features and poor response to antidepressants, magnetic resonance imaging (MRI) brain was done which showed pituitary macro adenoma compressing on the hypothalamus. After surgical removal of the tumour, patient’s symptoms improved. Hypothalamic involvement in this patient possibly led to manifestations mimicking atypical depression. This case highlights the importance of considering organic aetiologies in patients presenting with atypical depression

Psychiatric evaluation in dermatology: An overview

Psychodermatology is an exciting field which deals with the close relationship that exists between dermatological and psychiatric disorders. A combined bio-psycho-social approach is essential for effective evaluation and treatment of these conditions. This review aims to give the practicing clinician an overview of psychiatric evaluation in patients with dermatological conditions

Neuroanatomical, Neurochemical, and Neurodevelopmental Basis of Obsessive-Compulsive Symptoms in Schizophrenia

The prevalence of the obsessive-compulsive symptoms in schizophrenia (OCSS) appears to be higher than that expected on the basis of comorbidity rates. Review of brain abnormalities in schizophrenia and obsessive-compulsive disorder (OCD) reveals involvement of similar regions namely the frontal lobe, the basal ganglia, the thalamus, and the cerebellum, in both the disorders. Neurodevelopmental etiopathogenesis has been proposed to explain schizophrenia as well as OCD. Significant overlap in neurotransmitter dysfunction (serotonin, glutamate, and dopamine) has been documented between schizophrenia and OCD. The New-onset obsessive-compulsive (OC) symptoms have been reported with the use of atypical antipsychotics in the schizophrenia patients In this background, OCSS is an emerging area of recent interests. This article attempts to review the literature on the neurobiology of OCSS. Neuroimaging, neuropsychological, and neuromotor abnormalities in OCSS discussed in the context of neurodevelopmental etiopathogenesis suggest glutamate abnormalities in OCSS. Atypical antipsychotic induced OCSS points towards the possible roles of glutamate and serotonin. Dopamine may be responsible for the beneficial role of antipsychotics in the treatment of OCD. In summary, we propose that glutamate, serotonin, and dopamine abnormalities may be the probable basis for OCSS

Clozapine-induced supraventricular tachycardia and its treatment with Verapamil

Clozapine is known to be an effective antipsychotic for schizophrenia. Cardiovascular complications associated with initiation of clozapine include tachycardia, postural hypotension, and myocarditis. Factors associated with development of cardiovascular adverse events are not clearly known, and dose titration has been described to be one among the associated risk factors. We report a case of a 45-year-old man with treatment resistant schizophrenia who developed supraventricular tachycardia during initiation of clozapine and discuss the role of verapamil in its successful management