Suchergebnisse

Background: Several studies show an association between a long duration of untreated illness (DUI) and poor outcome in schizophrenic patients. DUI, in turn, may be influenced by different variables including specific illness-related factors as well as access to local psychiatric services. Aims: The purposes of the present study were to detect differences in terms of DUI among schizophrenics coming from different geographic areas and to evaluate differences in DUI across diagnostic sub-types. Method: One hundred and twenty-five (125) schizophrenic patients of the Psychiatric Clinic of Milan ( n = 51) and Moscow ( n = 74) were enrolled. SCID-I was administered to all patients and information about DUI was obtained by consulting clinical charts and health system databases, and by means of clinical interviews with patients and their relatives. DUI was defined as the time between the onset of illness and the administration of the first antipsychotic drug. One-way analyses of variance (ANOVAs) were performed to find eventual differences in terms of DUI across diagnostic sub-types. Results: Italian patients showed a longer DUI ( M = 4.14 years, SD = 4.95) than Russians ( M = 1.16 years, SD = 1.43) ( F = 24.03, p < .001). DUI was found to be longer in paranoid schizophrenics ( M = 3.47 years, SD = 4.19) compared to catatonic patients ( M = 0.96 years, SD = 0.94) ( F = 3.56, p = .016). Conclusions: The results of the present study suggest that the different schizophrenic sub-types may differ in terms of DUI, likely due to different clinical severity and social functioning. Studies with larger samples are needed to confirm the data of the present study.

INTRODUCTION: Although schizophrenia (SCZ) and bipolar disorder (BD) share elements of pathology, their neural underpinnings are still under investigation. Here, structural Magnetic Resonance Imaging (MRI) data collected from a large sample of BD and SCZ patients and healthy controls (HC) were analyzed in terms of gray matter volume (GMV) using both voxel based morphometry (VBM) and a region of interest (ROI) approach. METHODS: The analysis was conducted on two datasets, Dataset1 (802 subjects: 243 SCZ, 176 BD, 383 HC) and Dataset2, a homogeneous subset of Dataset1 (301 subjects: 107 HC, 85 BD and 109 SCZ). General Linear Model analyses were performed 1) at the voxel-level in the whole brain (VBM study), 2) at the regional level in the anatomical regions emerged from the VBM study (ROI study). The GMV comparison across groups was integrated with the analysis of GMV correlates of different clinical dimensions. RESULTS: The VBM results of Dataset1 showed 1) in BD compared to HC, GMV deficits in right cingulate, superior temporal and calcarine cortices, 2) in SCZ compared to HC, GMV deficits in widespread cortical and subcortical areas, 3) in SCZ compared to BD, GMV deficits in insula and thalamus (p<0.05, cluster family wise error corrected). The regions showing GMV deficits in the BD group were mostly included in the SCZ ones. The ROI analyses confirmed the VBM results at the regional level in most of the clusters from the SCZ vs. HC comparison (p<0.05, Bonferroni corrected). The VBM and ROI analyses of Dataset2 provided further evidence for the enhanced GMV deficits characterizing SCZ. Based on the clinical-neuroanatomical analyses, we cannot exclude possible confounding effects due to 1) age of onset and medication in BD patients, 2) symptoms severity in SCZ patients. CONCLUSION: Our study reported both shared and specific neuroanatomical characteristics between the two disorders, suggesting more severe and generalized GMV deficits in SCZ, with a specific role for insula and thalamus. ; Funding: PB was partially funded by grants from the Ministry of Health (RF-2011-02352308). Grant support of EM was provided by the European Union's Seventh Framework Programme for research, technological development and demonstration under grant agreement no. 602450 (IMAGEMEND Project). Part of the present study was conducted at the Hospital Universitario MarqueÂs de Valdecilla, University of Cantabria (Santander, Spain), under the following grant support: Carlos III Health Institute PI020499, PI050427, PI060507, Plan Nacional de Drugs Research Grant 2005- Orden sco/3246/2004, SENY Fundacio Research Grant CI 2005-0308007 and FundacioÂn MarqueÂs de Valdecilla API07/011. We wish to acknowledge IDIVAL Neuroimaging Unit for imaging acquirement and analysis. Part of the study was conducted at the Ospedale San Raffaele, Milano, supported by the European Union EU-FP7-HEALTH-F2-2008-222963 "MOODINFLAME" and by the Italian Ministry of Health RF-2011-02350980 projects. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.