PERSONALITY AND SCHIZOPHRENIA: PSYCHOBIOLOGICAL MODEL AND ITS RELATIONSHIP WITH COMORBIDITY

Personality interacts with psychosocial variables, psychopathology and coping strategies of patients with schizophrenia. Psychobiological model of personality is important for schizophrenia as temperament dimensions, except dimension Persistence, have been associated with different neurotransmitter systems. Comorbidity of psychiatric and somatic disorders and syndromes is generally associated with dimensions high Harm avoidance and low Self-directedness. Variations in other dimensions may also be important. High Harm Avoidance may represent state vulnerability marker for various psychiatric disorders and is associated with appearance of comorbidity in schizophrenia. High Self-directedness may be protective factor for development of various psychiatric as well somatic comorbidity states

PERSONALITY AND SCHIZOPHRENIA: PSYCHOBIOLOGICAL MODEL AND ITS RELATIONSHIP WITH COMORBIDITY

Personality interacts with psychosocial variables, psychopathology and coping strategies of patients with schizophrenia. Psychobiological model of personality is important for schizophrenia as temperament dimensions, except dimension Persistence, have been associated with different neurotransmitter systems. Comorbidity of psychiatric and somatic disorders and syndromes is generally associated with dimensions high Harm avoidance and low Self-directedness. Variations in other dimensions may also be important. High Harm Avoidance may represent state vulnerability marker for various psychiatric disorders and is associated with appearance of comorbidity in schizophrenia. High Self-directedness may be protective factor for development of various psychiatric as well somatic comorbidity states

Psoriasis, Mental Disorders and Stress

Etiology of psoriasis is still not known and comprises a range of assumptions and very complex etiological and pathogenetic mechanisms. Along with genetical predisposition, mental disorders and stresses might have a key role in the occurrence of this disease. Total number of 70 patients suffering from psoriasis were included in the investigation. Generally accepted structured clinical interview (SCID – The Structured Clinical Interview for DSM-IV) was applied in diagnostics of mental disorders. Various mental disorders were found in as many as 90% of patients suffering from psoriasis. The most frequent mental disorders were depressive disorder (19.2%), the posttraumatic stress disorder (17.8%), alcoholism (16.4%), adaptation disorder (15.1%), anxiety – depressive disorders (13.7%) and generalized anxious disorder (9.6%). The authors have concluded that in patients with psoriasis both various mental disorders and various stress events are frequent. The results have implied that there is a link between psoriasis on the one hand and various mental disorders and various stressors on the other. The investigation implies that there is a need to improve multidisciplinary approach in diagnostics and treatment of psoriasis and multi disciplinary team should consist of dermatologist, psychiatrist and psychologist

SMOKING AND SCHIZOPHRENIA

Smoking prevalence for schizophrenic patients is higher than this for general population. More than 60% of schizophrenic patients are current smokers, which contributes to excessive mortality in these patients. The reasons for high frequency of both smoking prevalence and heavy smoking in schizophrenic patients is thought to be at least partially related to enhancement of brain dopaminergic activity, which, in turn, results in behavioral reinforcement due to stimulant effects. Smoking stimulates dopaminergic activity in the brain by inducing its release and inhibiting its degradation. There is also evidence that cigarette smoking can reduce deficits relative to dopamine hypofunction in prefrontal cortex. Recent neuroimaging studies have further contributed the evidence of complex influences of cigarette smoking on brain dopaminergic function. It has been suggested that smoking may be an attempt by schizophrenic patients to alleviate cognitive deficits and to reduce extrapyramidal side-effects induced by antipsychotic medication. Cigarette smoke also increases the activity of CYP 1A2 enzymes, thus decreasing the concentration of many drugs, including clozapine and olanzapine. There is also evidence that smoking is associated with increased clearance of tiotixene, fluphenazine and haloperidol. Given the high frequency of smoking in schizophrenic patients, clinicians need to check smoking status in each patient. Schizophrenic patients who smoke may require higher dosages of antipsychotics than nonsmokers. Conversely, upon smoking cessation, smokers may require a reduction in the dosage of antipsychotics