Physical anhedonia in the acute phase of schizophrenia

BACKGROUND: The aim of the current study is to investigate the relationship between physical anhedonia and psychopathological parameters, pharmacological parameters or motor side-effects in a sample of inpatients with schizophrenia in an acute episode of their illness. METHOD: Eighty one patients with schizophrenia, consecutively admitted, with an acute episode of their illness, at the Eginition Hospital, Department of Psychiatry, University of Athens, during a one-year period were investigated regarding possible relationships between physical anhedonia, social-demographic data and clinical parameters as well as motor side-effects, induced by antipsychotic agents. All patients were assessed using the Chapman Revised Physical Anhedonia Scale (RPAS), the Positive and Negative Syndrome Scale (PANSS), the Rating Scale for Extrapyramidal Side-Effects (EPSE), the Barnes Akathisia Rating Scale (BARS) and the Abnormal Involuntary Movement Scale (AIMS). Simple cross tabulations were initially employed. Subsequently, multiple regression analysis was performed. RESULTS: Both positive and negative symptoms were associated with physical anhedonia. A positive association between physical anhedonia and the non-paranoid sub-category of schizophrenia was also proved. CONCLUSION: According to these results, it seems that in the acute phase of schizophrenia, physical anhedonia may be a contributing factor to patient's psychopathology

Quetiapine-induced obsessive-compulsive symptoms - A series of five cases

Quetiapine is a novel and atypical antipsychotic agent with scrotonin 5-HT2A antagonism higher than D-2 blockade. However, it has the lowest affinity for serotonin 2A receptors among atypical antipsychotics. Besides its D-2 blockade, it is not as great as seen with risperidone and olanzapine and is even less than that of clozapine. Open-label and controlled trials suggest efficacy of quetiapine as an adjunct therapy in patients with obsessive-compulsive disorder, refractory to treatment with selective scrotonin reuptake inhibitors. There is one report of quetiapine exacerbating obsessive-compulsive symptoms (OCS). We report 5 cases with bipolar I disorder (n = 3), psychotic depression (n = 1), and schizophrenia (n = 1) in which quetiapine produced de novo OCS. The underlying pathogenetic mechanisms and the risk factors for this action of quetiapine and of atypical antipsychotics, in general, are not yet known. The description of 5 patients with different diagnoses supports the issue of OCS exacerbation or induction with atypical antipsychotics. Clinicians’ awareness and close monitoring of the patients is warranted