The relationship between cortical synaptic terminal density marker SV2A and glutamate early in the course of schizophrenia: a multimodal PET and MRS imaging study.

Loss of glutamatergic terminals is hypothesised to contribute to excitation-inhibition imbalance in schizophrenia, supported by evidence that the normal positive association between glutamate concentrations and synaptic terminal density is not found in patients with chronic schizophrenia. However, it is unknown whether the relationship between synaptic terminal density and glutamate levels is altered early in the course of illness. To address this, we investigated [C]UCB-J distribution volume ratio (DVR) and glutamatergic markers in healthy volunteers (HV) and in antipsychotic-naïve/free patients with schizophrenia (SCZ) recruited from first-episode psychosis services.

Cost-effectiveness of nidotherapy for comorbid personality disorder and severe mental illness: randomized controlled trial.

Aims: Nidotherapy is the systematic modification of the environment to create a better fit for people. This is the first randomized controlled trial of its efficacy in an assertive community team.

Methods: Patients in an assertive outreach team with continued management problems together with comorbid personality disturbance and severe mental illness were randomized to nidotherapy enhanced assertive treatment (up to 12 sessions) or to continued assertive outreach care.

Critical developments in the assessment of personality disorder.

Background: The assessment of personality disorder is currently inaccurate, largely unreliable, frequently wrong and in need of improvement.

Aims: To describe the errors inherent in the current systems and to indicate recent ways of improving personality assessment.

Method: Historical review, description of recent developments, including temporal stability, and of studies using document-derived assessment.

Treatment rejecting and treatment seeking personality disorders: Type R and Type S.

An important distinguishing feature of one group of personality disorders is the wish of the sufferer to seek treatment. For another group this wish is rarely entertained. Although there is some variation between different types of personality disorder the wish to change is not confined to any one diagnostic category.