BDNF as a biomarker in the course and treatment of schizophrenia

Summary Many scientists agree that the genes involved in the aetiology and pathogenesis of psychiatric diseases could serve as biomarkers -biological indicators of the health status. Genetic markers may inform about general predispositions of a person to develop certain diseases, while other biochemical factors, such as concentrations of substances in body fluids, reflect the actual condition of the organism. Researchers involved in studies on schizophrenia are interested in the gene and protein of the brain-derived neurotrophic factor (BDNF) due to the role of this neurotrophin in the process of neurogenesis, synaptogenesis and its influence on the functioning of dopaminergic neurons. Among patients diagnosed with schizophrenia, the BDNF gene polymorphisms and methylation in the promoter sequences were studied. The neurotrophin was also assayed in the blood of patients, also taking into account the effect of pharmacotherapy on the BDNF concentration, and post-mortem in the brains of the patients. The results of current studies are contradictory. The only systematically confirmed observation is the lowered concentration of BDNF in the serum of patients with schizophrenia compared to healthy controls. It seems that so far our knowledge about the BDNF gene expression and the functions of the protein is not sufficient to include BDNF analysis in the clinical assessment of patients with schizophrenia

Deinstitutionalization in Italian psychiatry -the course and consequences Part I. The course of deinstitutionalization -the activity of Basaglia's group

Summary Psychiatric reform in Italy consisted of the implementation of legislative changes derived from anti-institutional experiments conducted by Franco Basaglia and his group in the 60's and 70's of the 20th century. The activity of Basaglia's group was an integral part of the European reform movement of that time, which profited from the economic, cultural and political prosperity for changes in psychiatry. Italian anti-psychiatry has led to the most radical experiment in deinstitutionalization in history. It involved the whole public sector of psychiatry and across a quarter-century resulted in a grand social debate on the situation of the mentally ill and the need for systemic change of their treatment and care. Inspired mainly by phenomenological analysis, Basaglia opted for close emphatic contact with the mentally ill. While the British, French and American anti-psychiatrists contested the psychiatric care system as such, the Italian radicals made an approach to disassemble it from the inside and successfully gained social support for the process of deinstitutionalization. Basaglia promoted his ideas across Europe, including the World Health Organization (WHO) forum