Correlations between cortical gyrification and schizophrenia symptoms with and without comorbid hostility symptoms

Introduction: Interest in identifying the clinical implications of the neuropathophysiological background of schizophrenia is rising, including changes in cortical gyrification that may be due to neurodevelopmental abnormalities. Inpatients with schizophrenia can show abnormal gyrification of cortical regions correlated with the symptom severity. Methods: Our study included 36 patients that suffered an acute episode of schizophrenia and have undergone structural magnetic resonance imaging (MRI) to calculate the local gyrification index (LGI). Results: In the whole sample, the severity of symptoms significantly correlated with higher LGI in different cortical areas, including bilateral frontal, cingulate, parietal, temporal cortices, and right occipital cortex. Among these areas, patients with low hostility symptoms (LHS) compared to patients with high hostility symptoms (HHS) showed significantly lower LGI related to the severity of symptoms in bilateral frontal and temporal lobes. Discussion: The severity of psychopathology correlated with higher LGI in large portions of the cerebral cortex, possibly expressing abnormal neural development in schizophrenia. These findings could pave the way for further studies and future tailored diagnostic and therapeutic strategies

Perceived Stress and Life Events in Patients Affected by Schizophrenia and Schizoaffective and Bipolar Disorder: Is There a Role for Self-Reported Basic Symptoms?

Introduction: The stress-diathesis model of psychotic disorders describes, in vulnerable individuals, the role of psychosocial stress in the onset and exacerbation of psychotic symptoms. Another interesting approach to the study of vulnerability in the development of psychosis is represented by the basic symptoms concept. Objective: The present study aims at proposing an integration between these two models and investigating possible associations between psychotic symptoms, basic symptoms, perceived stress, and life events in a sample of patients affected by schizophrenia (SZ), schizoaffective (SA), and bipolar disorder with and without psychotic symptoms. Methods: 112 patients were recruited in two university hospitals. Severity of psychiatric symptoms (Positive and Negative Syndrome Scale, PANSS), basic symptoms (Frankfurt Complaint Questionnaire, FCQ), perceived stress (Stress-related Vulnerability Scale, SVS), and life events (Paykel's interview for recent life events) were assessed. Results: Patients affected by bipolar disorder (both with and without psychotic symptoms) showed a higher number of independent life events (p < 0.01) and tended to report more frequently at least 1 life event in the previous 6 months (p < 0.01) than patients affected by SZ or SA disorder. No differences emerged between the study groups in perceived stress nor in measures of basic symptoms. In the whole sample, a logistic regression analysis showed that the SVS total score (p < 0.05) and PANSS total score (p < 0.001) were associated with the presence of psychotic symptoms. Conclusions: In the study sample, life events and basic symptoms did not play a major role in influencing psychotic symptoms, compared to the subjective perception of stress and the severity of psychopathology. Taken together, these results can be informative for rehabilitation therapies aimed at enhancing resilience and coping strategies in this vulnerable group of patients

Lurasidone: efficacy and safety in the treatment of psychotic and mood disorders

Lurasidone ([3aR,4S,7R,7aS]-2-[(1R,2R)-2-[4-(1,2-benzisothiazol-3-yl)piperazin-1yl-methyl] cyclohexylmethyl]-hexahydro-4,7-methano-2H-isoindole-1,3-dione hydrochloride; Latuda®) is a novel benzisothiazole, second-generation antipsychotic drug developed by Dainippon Sumitomo Pharma Corporation in Japan. Similar to other atypical antipsychotics it has a distinctive pharmacodynamic profile, Areas covered: This review updates reported research findings on the efficacy, safety and tolerability of LRSD for treatment of psychotic and major affective disorders, with meta-analyses. Short-term efficacy of LRSD in schizophrenia is supported by several randomized, controlled trials with daily doses of 40-160 mg, yielding relatively modest symptomatic improvements. Lurasidone has regulatory approval for treatment of undefined duration in schizophrenia. Long-term benefits and effects in schizophrenia, and both short- and long-term use for other psychotic disorders and mania have not been tested. LRSD shows unusual efficacy in acute bipolar depression even without psychotic features. However, trials of adding LRSD to lithium or valproate for bipolar disorder have yielded inconsistent findings. Expert opinion: Available research findings indicate that LRSD is effective and well-tolerated for short-term treatment of schizophrenia, and for acute bipolar depression. It has low risk of inducing weight-gain, metabolic, or cardiac abnormalities, but its risk of akathisia may exceed that of other modern antipsychotics. Needed is adequate long-term testing in schizophrenia and bipolar disorder and testing for other indications, including against alternative treatment