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P-3-2 Soluble interleukin-6 receptors in schizophrenia: Preliminary results
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P-3 Schizophrenia tetralin (&OH-DPAT), was used to assess the function of the 5-HT1A re ceptors. The animals were sacrificed 24 hours after the last rejection, their brains removed and rapidly dissected and the frontal cortex and the hy pothalamus were stored at - 7 0 ° C for binding studies Results: There were no significant differences between the groups on any of the parameters measured in the "open field" or the elevated plus maze, however significant effects were found on the hypothermic response produced by 8-OH DPAT with the S isomer producing a greater decrease m body temperature than the R isomer (p < 005). Our results suggest that the antidepressant drug Mirtazapme exhibits enantioselective effects on the function of 5-H--1A receptors
P-3 Schizophrenia Effect D,N,Uznadze in paranoid schizophrenics: clinical and treatment perspectives S.V. Pkhidenko. Department of Psychiath4 Dniepropetrovsk State Medical Academy, Dzerginskaya SL, 9 Dniepropetrosk 3220044, Ukrmne A set, to D.N.Uznadze's opinion (1), is a simple, unitary unconscious phe nomenon of mental functioning UnconscLous set determines any conscious person actwlties: person's behavior and motives m different situations. So, set is psychodynamical unconscious feature of mental activity of personality D N.Uznadze proposed an experimental method of fixed set for investigation of unconscious set (1) There are four forms of expedmen tel fixed set: static-inert, static-dynamic Dlast~c mort, plastic-dynamic. Data of other investigations testify that the structural changes of fixed set is a frequent concomitant of schizophrenia The aims of this study were the assessment structure of fixed set +n schizophrenics and to determine psychopharmacology treatment influence on unconscious phenomenon. Subjects were 184 patients who met D S M q l criteria for schizophrenia. 75 were men and 109 were w o m e n The mean age of the group was 3 5 3 years (range, 21 to 61 years) The group had 6 2 previous hospitalizations with a range of 3 to 1 0 The study has begun n a mean of 6 2 years after the patients first hospitalization, with a range of 1 to 10 years Assessment procedures included psychopathologic ratings and experimental method of fixed set by D N Uznadze (1) Schizophrenic patients were tested by method of fixed set twice: during their admission in mental hospital and after the course of psychopharmacologic treatmePt Two groups of schizophrenics depending on forms of fixed set and men tal disorder were differentiated Schizophrenics of the first group had mile level of psychopathology, better-quality remission and high !evel of soc,al functioning. Plastic-dynamic form of fixed set was observed in 69.6% schi zophrenics of this group Onty 5.8% of schizophrenics had static inert forM of fixed set. The second group were formed from 115 chronic schizophre nics. This patients had a high level of negative psychopathologic symptoms thought disorder, associality, alogia, anhedonia, flat affect, avolition, Door social relationships. Patients of the second group had the low level o; socla! functioning Static-inert form of fixed set was revealed in 8 9 6 % schizo phrenics of the second group (compare with the first group) (p < 0.001/ Plastic-dynamic form of fixed set was absent in this group. Data of this study have revealed statistical significance between c;irl cai signs, level of social ~unctionlng and forms of fixed s e t So, structure o1 fixed set is the bmbortance clinical prognostic feature. Structural changes of fixed set after the course of psychopharmacologic treatment have not revealed in schizophrenics of the both groups. The structure of fixed set w a s r e s l s t a n t t o t r e a t m e n t w i t h n e u r o l e p t i c d r u g s Our data provlde support for the proposition that treatment with neuroleptic drugs don't impact on unconscious processes. We hope that these findings will be a stimulus to further work in this area
References Uznadze D N (1939) Untersuchuqgen zur Psychologic der Einstellung Acta P,,ycho!
Soluble interleukin-6 receptors in schizophrenia: preliminary results N. Muller, M EmpI, A. Putz, M. Schwarz, M Ackenhell Psychiatric Hosplta/, Ludwig-Max~mihans University, Nuf~baumstraSe 7, D 80336 MDnchen Intedeukin-6 (iL-6) ~s an actwatmg cytokme, acting synerglsticaliy to I L ] stimulating acute phase proteins, B-col' prohferation and antibody produc tion. in the CNS, !L-6 is released by actwated astocytes and microgqa cells
The IL-6 production in the CNS takes place during autoimmune processes, autochtone IgG production and probably also during stress. In a subgroup of schizophrenics an immune process is suggested to contribute to the pathogenesis (MOiler et al., 1993: MQIter and Ackenheil, 1995) and increased IL-6 blood levels have been described (Ganguli et al., 1994). Soluble IL-6 receptors (slL-6R) probably have own immune regulatory properties. Increased blood levels of slL-6R have been described during inflammatory and autoimmune diseases, especially in inflammatory CNS diseases, too Increased blood levels of IL-6 and slL-6R have also been described in patients suffering from major depression, stimulating the acute phase proteins (Maes et al., 1994) We investigated slL-6-R during the course of neuroleptic treatment in schizophrenic patients. Patients and methods: We investigated 17 (12 m, 5 f) schizophrenic patients without neuroleptic treatment (mean age 33 years) 12 of these patients (7 m, 5 f) were reinvestigated during treatment with neuroleptics before withdrawal from hospital after clinical i m p r o v e m e n t Standardized di agnostics were performed according to the SADS-LA (DSM liI-R diagnosesl 19 healthy orobands (10 m. 9 f), mean age 30 years, served as controls after exclusion of any immunological disorders sIL-6R were estimated with a commercial available sandwich ELISA s y s t e m Results" Patients before neurolebtiC treatment showed significantly increased mean values of slL-6-R {51.8 d: 19.8 ng/ml) compared to both schizophrenic patients during treatment after clinical remission (x - 40.2 2: 106 ng/ml) and healthy controls (x - 4 2 9 :I: I&Q nglml). There could be computed no influence of use of alcohol and smoking, During neuroleptic treatment (mean duration 9 5 :t: 5.9 weeks) slL-6R levels decreased in most of the patients There was no difference in age between the groups. Regarding the negative symptomatology, there was a significant corre lat~on between the decrease in the negatwe symptoms measured by the SANS and the decrease in the slL-6R Discussion: Significant differences m slL-6R between untreated schzophrenic patients and healthy controls, and between batients before aqd during treatment after clinical remission suggests, that the slL-6R val Jes, normalizing during the course of the treatment, maybe a state marker for schizophrenia. The correlation with the negative symptomatology points to a relationship between the degree of negative symptoms and the s]L6R blood levels, i e psychopathological impairment and immunological alterations The results underline that an immune activation takes place in schizophrenia and the acute treatment has antiinflammatory effects.
References Ganguli R, Yang Z, Shurin G, Chengappa R, Brar JS, Gubbi AV, Rabin BS (1994) Serum Interleukin 6 concentration in schizophrenia: elevation associated with duration of ill ness Psychiatry Res 51:1 10 Maes M, Scharpe S, Meltzer HY, Bosmans E, Suy E, Calabrese J, Cosyns P (1993) Relationships of Interleukin-6 activity, acute phase proteins and HPA-axisfunction in severe depression Psychiatry Res 49:11 27 Muller N. Ackenhed M, Hofschuster E, Mempel W, Eckstein R (1993) Cellular immunity, hLA-class I antigens, and family history of psychiatric disorder in endogenous psychoses Psychiatry Res 48:201-217 Muller N, Ackenhell M (1995) The immune system and schizophrenia In: Leonard BE. Mdler K (eds) Stress. the immune system and psych atry Wiley and sons, Chichester, Nv
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Outcome predictors in first episode schizophrenia
Mario Amore, Katia Magnani. Serena D'Ambrosio. Jos~ Mesa Mesa,
Institute of Psych/atry "f? Ottone/Io" University of Bologna VJale Pepoti 540123, Bo/ogna, Italy n a prospective 2-year follow-up of 52 acute schizophrenics, we examined trio predictive significance and relative contribution of historical, genealogical course and chnicai dimensions. Subjects were between 18 and 60 years of age (mean age: 2 5 8 y e a r s , : 1 : 7 5 ) Outcome was measured in terms of age of onset, duration and nature of the disturbance preceding first admission, employment social function, severity of symptomatology, premorbid social functiomng and duration of hospitahzation after imtkal diagnostic evaluation. Patients were recruited over a 24-months period from our inpatient unit. Only patients admitted for first-episode schizophrenia, diagnosed according *.o DSM-tiI-R criteria, entered the study and were followed for up to 2 years. Patients with evidence of organic psychosis, dementia, substance abuse o[ IQ. less than 70 were excluded. Treatment was not controlled to evaluate -elat~onships between treatment and outcome. Patients were assessed with BPRS, CGI, SANS, SAPS, Premorbid Adiustment Scale and SCID-R
P-3 Schizophrenia tetralin (&OH-DPAT), was used to assess the function of the 5-HT1A re ceptors. The animals were sacrificed 24 hours after the last rejection, their brains removed and rapidly dissected and the frontal cortex and the hy pothalamus were stored at - 7 0 ° C for binding studies Results: There were no significant differences between the groups on any of the parameters measured in the "open field" or the elevated plus maze, however significant effects were found on the hypothermic response produced by 8-OH DPAT with the S isomer producing a greater decrease m body temperature than the R isomer (p < 005). Our results suggest that the antidepressant drug Mirtazapme exhibits enantioselective effects on the function of 5-H--1A receptors
P-3 Schizophrenia Effect D,N,Uznadze in paranoid schizophrenics: clinical and treatment perspectives S.V. Pkhidenko. Department of Psychiath4 Dniepropetrovsk State Medical Academy, Dzerginskaya SL, 9 Dniepropetrosk 3220044, Ukrmne A set, to D.N.Uznadze's opinion (1), is a simple, unitary unconscious phe nomenon of mental functioning UnconscLous set determines any conscious person actwlties: person's behavior and motives m different situations. So, set is psychodynamical unconscious feature of mental activity of personality D N.Uznadze proposed an experimental method of fixed set for investigation of unconscious set (1) There are four forms of expedmen tel fixed set: static-inert, static-dynamic Dlast~c mort, plastic-dynamic. Data of other investigations testify that the structural changes of fixed set is a frequent concomitant of schizophrenia The aims of this study were the assessment structure of fixed set +n schizophrenics and to determine psychopharmacology treatment influence on unconscious phenomenon. Subjects were 184 patients who met D S M q l criteria for schizophrenia. 75 were men and 109 were w o m e n The mean age of the group was 3 5 3 years (range, 21 to 61 years) The group had 6 2 previous hospitalizations with a range of 3 to 1 0 The study has begun n a mean of 6 2 years after the patients first hospitalization, with a range of 1 to 10 years Assessment procedures included psychopathologic ratings and experimental method of fixed set by D N Uznadze (1) Schizophrenic patients were tested by method of fixed set twice: during their admission in mental hospital and after the course of psychopharmacologic treatmePt Two groups of schizophrenics depending on forms of fixed set and men tal disorder were differentiated Schizophrenics of the first group had mile level of psychopathology, better-quality remission and high !evel of soc,al functioning. Plastic-dynamic form of fixed set was observed in 69.6% schi zophrenics of this group Onty 5.8% of schizophrenics had static inert forM of fixed set. The second group were formed from 115 chronic schizophre nics. This patients had a high level of negative psychopathologic symptoms thought disorder, associality, alogia, anhedonia, flat affect, avolition, Door social relationships. Patients of the second group had the low level o; socla! functioning Static-inert form of fixed set was revealed in 8 9 6 % schizo phrenics of the second group (compare with the first group) (p < 0.001/ Plastic-dynamic form of fixed set was absent in this group. Data of this study have revealed statistical significance between c;irl cai signs, level of social ~unctionlng and forms of fixed s e t So, structure o1 fixed set is the bmbortance clinical prognostic feature. Structural changes of fixed set after the course of psychopharmacologic treatment have not revealed in schizophrenics of the both groups. The structure of fixed set w a s r e s l s t a n t t o t r e a t m e n t w i t h n e u r o l e p t i c d r u g s Our data provlde support for the proposition that treatment with neuroleptic drugs don't impact on unconscious processes. We hope that these findings will be a stimulus to further work in this area
References Uznadze D N (1939) Untersuchuqgen zur Psychologic der Einstellung Acta P,,ycho!
Soluble interleukin-6 receptors in schizophrenia: preliminary results N. Muller, M EmpI, A. Putz, M. Schwarz, M Ackenhell Psychiatric Hosplta/, Ludwig-Max~mihans University, Nuf~baumstraSe 7, D 80336 MDnchen Intedeukin-6 (iL-6) ~s an actwatmg cytokme, acting synerglsticaliy to I L ] stimulating acute phase proteins, B-col' prohferation and antibody produc tion. in the CNS, !L-6 is released by actwated astocytes and microgqa cells
The IL-6 production in the CNS takes place during autoimmune processes, autochtone IgG production and probably also during stress. In a subgroup of schizophrenics an immune process is suggested to contribute to the pathogenesis (MOiler et al., 1993: MQIter and Ackenheil, 1995) and increased IL-6 blood levels have been described (Ganguli et al., 1994). Soluble IL-6 receptors (slL-6R) probably have own immune regulatory properties. Increased blood levels of slL-6R have been described during inflammatory and autoimmune diseases, especially in inflammatory CNS diseases, too Increased blood levels of IL-6 and slL-6R have also been described in patients suffering from major depression, stimulating the acute phase proteins (Maes et al., 1994) We investigated slL-6-R during the course of neuroleptic treatment in schizophrenic patients. Patients and methods: We investigated 17 (12 m, 5 f) schizophrenic patients without neuroleptic treatment (mean age 33 years) 12 of these patients (7 m, 5 f) were reinvestigated during treatment with neuroleptics before withdrawal from hospital after clinical i m p r o v e m e n t Standardized di agnostics were performed according to the SADS-LA (DSM liI-R diagnosesl 19 healthy orobands (10 m. 9 f), mean age 30 years, served as controls after exclusion of any immunological disorders sIL-6R were estimated with a commercial available sandwich ELISA s y s t e m Results" Patients before neurolebtiC treatment showed significantly increased mean values of slL-6-R {51.8 d: 19.8 ng/ml) compared to both schizophrenic patients during treatment after clinical remission (x - 40.2 2: 106 ng/ml) and healthy controls (x - 4 2 9 :I: I&Q nglml). There could be computed no influence of use of alcohol and smoking, During neuroleptic treatment (mean duration 9 5 :t: 5.9 weeks) slL-6R levels decreased in most of the patients There was no difference in age between the groups. Regarding the negative symptomatology, there was a significant corre lat~on between the decrease in the negatwe symptoms measured by the SANS and the decrease in the slL-6R Discussion: Significant differences m slL-6R between untreated schzophrenic patients and healthy controls, and between batients before aqd during treatment after clinical remission suggests, that the slL-6R val Jes, normalizing during the course of the treatment, maybe a state marker for schizophrenia. The correlation with the negative symptomatology points to a relationship between the degree of negative symptoms and the s]L6R blood levels, i e psychopathological impairment and immunological alterations The results underline that an immune activation takes place in schizophrenia and the acute treatment has antiinflammatory effects.
References Ganguli R, Yang Z, Shurin G, Chengappa R, Brar JS, Gubbi AV, Rabin BS (1994) Serum Interleukin 6 concentration in schizophrenia: elevation associated with duration of ill ness Psychiatry Res 51:1 10 Maes M, Scharpe S, Meltzer HY, Bosmans E, Suy E, Calabrese J, Cosyns P (1993) Relationships of Interleukin-6 activity, acute phase proteins and HPA-axisfunction in severe depression Psychiatry Res 49:11 27 Muller N. Ackenhed M, Hofschuster E, Mempel W, Eckstein R (1993) Cellular immunity, hLA-class I antigens, and family history of psychiatric disorder in endogenous psychoses Psychiatry Res 48:201-217 Muller N, Ackenhell M (1995) The immune system and schizophrenia In: Leonard BE. Mdler K (eds) Stress. the immune system and psych atry Wiley and sons, Chichester, Nv
[
P
•
Outcome predictors in first episode schizophrenia
Mario Amore, Katia Magnani. Serena D'Ambrosio. Jos~ Mesa Mesa,
Institute of Psych/atry "f? Ottone/Io" University of Bologna VJale Pepoti 540123, Bo/ogna, Italy n a prospective 2-year follow-up of 52 acute schizophrenics, we examined trio predictive significance and relative contribution of historical, genealogical course and chnicai dimensions. Subjects were between 18 and 60 years of age (mean age: 2 5 8 y e a r s , : 1 : 7 5 ) Outcome was measured in terms of age of onset, duration and nature of the disturbance preceding first admission, employment social function, severity of symptomatology, premorbid social functiomng and duration of hospitahzation after imtkal diagnostic evaluation. Patients were recruited over a 24-months period from our inpatient unit. Only patients admitted for first-episode schizophrenia, diagnosed according *.o DSM-tiI-R criteria, entered the study and were followed for up to 2 years. Patients with evidence of organic psychosis, dementia, substance abuse o[ IQ. less than 70 were excluded. Treatment was not controlled to evaluate -elat~onships between treatment and outcome. Patients were assessed with BPRS, CGI, SANS, SAPS, Premorbid Adiustment Scale and SCID-R