Schizophrenia and estrogens

Since the beginning of the 20th Century, psychiatrists have recognized the possible association between schizophrenia and estrogens [1]. Early studies by Kraepelin [2] and Kretschmer [3] described signs of a chronic "hypoestrogenism" in women with schizophrenia, and observations indicating an association between blood estrogen levels and acute psychotic symptomatology have long existed

Therapist-client sex in psychotherapy: attitudes of professionals and students towards ethical arguments

Data suggest that a substantial proportion of psychotherapists engage in therapist-client sex (TCS), violating national and international ethical guidelines. The objective of our study was to find a new and effective starting point for preventive interventions.; Using an online questionnaire, this study explored professionals' attitudes toward aspects of a TCS-case example influencing the tendency to pursue colleagues' TCS, including self-interest and responsibility ascribed to clients.; A total of 421 participants expressed preferences for courses of action and rated given information in a questionnaire. Results indicate that TCS is most often condemned for its inherent carelessness towards clients, its exploitative nature, the abuse of dependency and for counteracting the inherent intention of psychotherapy. Partial responsibility for TCS was attributed to clients by 41.3% of the respondents. Although self-interest related information was rated as an acceptable reason against pursuing TCS, a strong tendency exists to confront an abusive colleague, even at the risk of own disadvantages.; In the detailed discussion ethical arguments against TCS (other than the certainly inflicted, but hardly measurable harm) are elaborated. In particular the incompatibility of TCS with a psychotherapeutic relationship, the responsibility for TCS in the asymmetrical client-therapist relationship and the legitimacy of self-protection are discussed.; Reasoning against TCS can and should be based on explicit, ethical requirements for psychotherapists. Furthermore, integrating the topic in psychotherapists' training is encouraged and a discrete procedure to report a colleague's TCS is requested

What do we really know about late-onset schizophrenia?

Actual knowledge on classical late-onset schizophrenia, i.e. the schizophrenic disorders with onset after age 40 years, is reviewed regarding incidence, symptomatology and course. As is shown, sound empirical knowledge is scarce. Reasons for this are, on the one hand, the conceptual and terminological confusion which has occurred internationally regarding this illness group, and, on the other hand, the methodological limitations of the empirical studies conducted on this clinical picture thus far. If we only draw onclassical late-onset schizophrenia, as originally defined by Bleuler, and primarily on methodologically sound studies, as well as on own studies, we can nevertheless conclude that the term "late-onset schizophrenia” could be omitted. Late-onset schizophrenia does not seem to be a distinct entity, but instead seems to belong to the same illness group as classical schizophrenia with earlier onset. Slight differences in symptomatology and course are probably due to unspecific influences of age. The markedly higher proportion of women among late-onset cases, as well as our finding that symptomatology and course of late-onset women are comparably poor, could possibly be explained by an effect of the female sex hormone oestradio

Prediction of conversion to psychosis in individuals with an at-risk mental state: a brief update on recent developments

So far, only little more than one-third of individuals classified as being at-risk for psychosis have been shown to actually convert to frank psychosis during follow-up. There have therefore been enormous efforts to improve the accuracy of predicting this transition. We reviewed the most recent studies in the field with the aim to clarify whether accuracy of prediction has been improved by the different research endeavors and what could be done to further improve it, and/or what alternative goals research should pursue.; A total of 56 studies published between May 2015 and December 2016 were included, of which eight were meta-analyses. New meta-analytical evidence confirms that established instruments for checking clinical risk criteria have an excellent clinical utility in individuals referred to high-risk services. Within a such identified group of ultra-high-risk (UHR) individuals, especially Brief Limited Intermittent Psychotic Symptoms and Attenuated Psychotic Symptoms seem to predict transition. Further assessments should be performed within the UHR individuals, as risk of transition seems particularly high in those with an even higher severity of certain symptoms such as suspiciousness or anhedonia, in those with lower global or social functioning, poor neurocognitive performance or cannabis abuse. Also, electroencephalography, neuroimaging and blood biomarkers might contribute to improving individual prediction. The most promising approach certainly is a staged multidomain assessment. Risk calculators to integrate all data for an individualized prediction are being developed.; Prediction of psychosis is already possible with an excellent prognostic performance based on clinical assessments. Recent studies show that this accuracy can be further improved by using multidomain approaches and modern statistics for individualized prediction. The challenge now is the translation into the clinic with a broad clinical implementation

Attempted suicide in immigrants from Turkey: A comparison with Swiss suicide attempters.

Background/Aims: Turkish migrants have been shown to have an increased rate of suicide attempts as compared to native local populations and also to people in Turkey. In this study we conducted in-depth interviews with patients regarding their reasons for the attempt. Subjects and Methods: Seventy Turkish immigrants admitted to the emergency unit of the Basel University Hospital after a suicide attempt were interviewed. Seventy Swiss suicide attempters, matched for age and sex, served as a comparator (case-control study). Results: Turkish immigrants showed high rates of suicide attempts. The gender ratio (women/men) was 2.2; 38.6% of all Turkish suicide attempters were women aged between 15 and 25 years. Most patients mentioned problems in their partnerships as the main reason for the suicide attempt (63% of Swiss and 54% of Turkish patients); 14% of the Swiss but none of the Turkish suicide attempters named social isolation as a cause; 9% of the Turkish patients reported ‘threat of loss/rejection of status as refugee’ as the main reason. Immigrants used analgesics more of ten, whilst Swiss patients tended to favour benzodiazepines. Conclusions: Our study suggests that cultural and immigration-specific issues play a role in the suicidal behaviour of immigrants. Turkish women aged between 15 and 25 years seem to be at an especially high risk