Treatment of Diabetic Ketoacidosis Associated With Antipsychotic Medication Literature Review

This work was funded by the Croatian Science Foundation grant No UIP- 2014-09-1245 Biomarkers in schizophrenia - integration of complementary methods in longitudinal follow up of first episode psychosis patients. The authors received no other funding for this work

TCF4 sequence variants and mRNA levels are associated with neurodevelopmental characteristics in psychotic disorders

TCF4 is involved in neurodevelopment, and intergenic and intronic variants in or close to the TCF4 gene have been associated with susceptibility to schizophrenia. However, the functional role of TCF4 at the level of gene expression and relationship to severity of core psychotic phenotypes are not known. TCF4 mRNA expression level in peripheral blood was determined in a large sample of patients with psychosis spectrum disorders (n=596) and healthy controls (n=385). The previously identified TCF4 risk variants (rs12966547 (G), rs9960767 (C), rs4309482 (A), rs2958182 (T) and rs17512836 (C)) were tested for association with characteristic psychosis phenotypes, including neurocognitive traits, psychotic symptoms and structural magnetic resonance imaging brain morphometric measures, using a linear regression model. Further, we explored the association of additional 59 single nucleotide polymorphisms (SNPs) covering the TCF4 gene to these phenotypes. The rs12966547 and rs4309482 risk variants were associated with poorer verbal fluency in the total sample. There were significant associations of other TCF4 SNPs with negative symptoms, verbal learning, executive functioning and age at onset in psychotic patients and brain abnormalities in total sample. The TCF4 mRNA expression level was significantly increased in psychosis patients compared with controls and positively correlated with positive- and negative-symptom levels. The increase in TCF4 mRNA expression level in psychosis patients and the association of TCF4 SNPs with core psychotic phenotypes across clinical, cognitive and brain morphological domains support that common TCF4 variants are involved in psychosis pathology, probably related to abnormal neurodevelopment

EPA guidance on the role and responsibilities of psychiatrists

Psychiatry is that branch of the medical profession, which deals with the origin, diagnosis, prevention, and management of mental disorders or mental illness, emotional and behavioural disturbances. Thus, a psychiatrist is a trained doctor who has received further training in the field of diagnosing and managing mental illnesses, mental disorders and emotional and behavioural disturbances. This EPA Guidance document was developed following consultation and literature searches as well as grey literature and was approved by the EPA Guidance Committee. The role and responsibilities of the psychiatrist include planning and delivering high quality services within the resources available and to advocate for the patients and the services. The European Psychiatric Association seeks to rise to the challenge of articulating these roles and responsibilities. This EPA Guidance is directed towards psychiatrists and the medical profession as a whole, towards other members of the multidisciplinary teams as well as to employers and other stakeholders such as policy makers and patients and their families. (C) 2015 Elsevier Masson SAS. All rights reserved

Association of common genetic variants with risperidone adverse events in a Spanish schizophrenic population

Risperidone non-compliance is often high due to undesirable side effects, whose development is in part genetically determined. Studies with genetic variants involved in the pharmacokinetics and pharmacodynamics of risperidone have yielded inconsistent results. Thus, the aim of this study was to investigate the putative association of genetic markers with the occurrence of four frequently observed adverse events secondary to risperidone treatment: sleepiness, weight gain, extrapyramidal symptoms and sexual adverse events. A series of 111 schizophrenia inpatients were genotyped for genetic variants previously associated with or potentially involved in risperidone response. Presence of adverse events was the main variable and potential confounding factors were considered. Allele 16Gly of ADRB2 was significantly associated with a higher risk of sexual adverse events. There were other non-significant trends for DRD3 9Gly and SLC6A4 S alleles. Our results, although preliminary, provide new candidate variants of potential use in risperidone safety prediction.This study was supported by Fondo de Investigation Sanitaria (FIS) EC07/90393, EC07/90466 and EC07/90604 Grants. Berta Almoguera's work is supported by a Rio Hortega Grant from Instituto de Salud Carlos III. Pedro Dorado is supported by Instituto de Salud Carlos III-FIS and European Union (FEDER) Grant CP06/00030. The contribution from the Extremadura group is coordinated in the frame of the Iberoamerican Network of PharmacogeneticsPeer reviewe

Training in psychiatry throughout Europe

Contains fulltext : 168241.pdf (publisher's version ) (Open Access)Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union Europeenne des Medecins Specialistes (UEMS) has issued as from 2000 a charter of requirements for the training in psychiatry with an additional European Framework for Competencies in Psychiatry in 2009. Yet these have not been implemented throughout Europe. In this paper, the diversity in training throughout Europe is approached from different angles: the cultural differences between countries with regards to how mental health care is considered and founded on, the cultural differences between people throughout Europe in all states. The position of psychotherapy is emphasised. What once was the cornerstone of psychiatry as medical specialty seems to have become a neglected area. Seeing the patient with mental health problems within his cultural context is important, but considering him within his family context. The purpose of any training is enabling the trainee to gain the knowledge and acquire the competencies necessary to become a well-equipped professional is the subject of the last paragraph in which trainees consider their position and early career psychiatrists look back to see whether what they were trained in matches with what they need in the working situation. Common standard for training and certification are a necessity within Europe, for the benefit of the profession of psychiatrist but also for patient safety. UEMS is advised to join forces with the Council of National Psychiatric Associations (NPAs) within the EPA and trainings and early career psychiatrist, to discuss with the users what standards should be implemented in all European countries and how a European board examination could ensure professional quality of psychiatrists throughout the continent

Education in Psychopathology in Europe: Results from a Survey in 32 Countries

Objectives: The aim of the present paper is to assess the current status of training on psychopathology in Europe and to identify the unmet needs of training on psychopathology. Methods: An online survey was carried out during the period July-December 2013. Forty-one representatives of early career psychiatrists of their national associations were invited to participate. Each respondent was asked to provide the collective feedback of the association rather than that of any of its individual officer or member. Results: Thirty-two associations returned the questionnaire out of the 41 contacted (response rate, 78 %). All respondents recognized psychopathology as a core component of training in psychiatry. According to respondents, the primary aims of psychopathology are (a) to assess psychiatric symptoms (47 %), (b) to understand patients' abnormal experiences (33 %), and (c) to make nosographical diagnosis (20 %). A formal training course in psychopathology is available in 29 out of the 32 surveyed countries. In most countries, (a) there is not a defined number of hours dedicated to psychopathology, (b) teaching is mainly theoretical, and (c) a structured training on psychometric tools is missing. At the end of the training, about half of trainees is not satisfied with received training in psychopathology. Conclusions: According to European early career psychiatrists, there is the need to rethink training in psychopathology, which should be at the heart of training in psychiatry and the key element of psychiatric practice. Education in psychopathology is affected by several unmet needs, such as lack of appropriate training in the use of psychometric instruments, lack of supervision, and lack of practical skills