Neurobiological correlates of violence perception in martial artists.

Objectives: The direct exertion as well as the visual perception of violence can have a hedonistic effect and elicit positive arousal in predisposed individuals. This appetitive aspect of aggression in healthy subjects has been neglected in psychiatric research so far.

Methods: Using functional magnetic resonance imaging, we tested whether subjects trained in sports with a violent component (martial arts) show altered brain responses in reward-associated brain areas when compared to controls.

Cognitive and socio-cognitive functioning of chronic non-medical prescription opioid users.

Rationale: Non-medical prescription opioid use (NMPOU) has become a major public health issue in the USA and is also increasing in Europe. However, little is known about neuropsychological associations of NMPOU-specifically regarding social cognition, which is essential for social functioning and treatability of opioid dependence. Previous studies with heroin users and opioid-substituted patients reported deficits in various cognitive functions, but these results are likely confounded by comorbid physical and psychiatric diseases, overdose-associated hypoxia, and adulteration of street heroin.

Multimodal neuroimaging measures and intelligence influence pedophile child sexual offense behavior.

Pedophilia is a heterogeneous disorder for which the neurobiological correlates are not well established. In particular, there are no biological markers identifying individuals with high risk to commit child sexual offense (CSO). Pedophiles with CSO (P+CSO; N = 73), pedophiles without CSO (P-CSO; N = 77), and non-pedophilic controls (NPC; N = 133) were assessed using multimodal structural neuroimaging measures including: cortical thickness (CT), surface area (SA), and white matter fractional anisotropy (FA), as well as full scale IQ (FSIQ) performance.

Gray matter anomalies in pedophiles with and without a history of child sexual offending.

Pedophilia is a psychiatric disorder that is inter-related with but distinct from child sexual offending (CSO). Neural alterations reportedly contribute to both pedophilia and CSO, but until now, no study has distinguished the brain structural anomalies associated with pedophilia from those specifically associated with CSO in pedophilic men. Using high-resolution T1-weighted brain images and voxel-based morphometry, we analyzed the gray matter (GM) volume of the following 219 men recruited at four acquisition sites in Germany: 58 pedophiles with a history of CSO, 60 pedophiles without any history of CSO and 101 non-pedophilic, non-offending controls to control for the effects of age, education level, verbal IQ, sexual orientation and the acquisition site.

Teaching forensic psychiatry in Europe.

Background: Forensic psychiatry was long regarded as sufficiently defined by the laws of a country to be restricted by national boundaries in all but a few areas. European Union (EU) employment rights and travel facilities have changed that within the EU.

Aims: The goal of this research is to explore the role and development of a network of teachers and trainees in forensic psychiatry.

Evaluation of the feasibility of switching from immediate release quetiapine to extended release quetiapine fumarate in stable outpatients with schizophrenia.

This double-blind, double-dummy study (D1444C00146) evaluated the efficacy and safety of switching patients with clinically stable schizophrenia from quetiapine immediate release (IR) to the same dose of once-daily extended release quetiapine fumarate (quetiapine XR). Patients received quetiapine IR 400-800 mg/day twice daily for 4 weeks, and were then randomized (2 : 1) to a once-daily equivalent dose of quetiapine XR or maintained on IR for 6 weeks. The primary variable was the proportion of patients who discontinued treatment owing to lack of efficacy or whose Positive and Negative Syndrome Scale scores increased by at least 20% from randomization to any visit.

Hypermetabolic pattern in frontal cortex and other brain regions in unmedicated schizophrenia patients. Results from a FDG-PET study.

We report results of a FDG-PET study in 10 patients with schizophrenia (6 unmedicated, 4 never medicated) and 12 healthy age-matched controls. The patients met ICD-10 and DSM-IV criteria for schizophrenia and all reported psychotic, "positive" symptoms when tested. Schizophrenic patients had higher absolute CMRGlu values in almost all quantified regions compared to normal subjects.

Is polarity of recurrence related to serum lithium level in patients with bipolar disorder?

Background: Recently published data might indicate that the polarity of recurrence is related to lithium serum levels. To systematically test this hypothesis all published maintenance trials in bipolar disorders were examined with regard to this issue.

Method: Maintenance studies were subdivided in trials with low (i.

Are illness concepts a powerful predictor of adherence to prophylactic treatment in bipolar disorder?

Background: Predicting and preventing premature discontinuation of medication would substantially improve prophylactic treatment of bipolar disorder. Patients' concepts regarding illness proved to have an impact on noncompliance in a retrospective study of patients with affective or schizoaffective illness treated with lithium. The present study is the first to prospectively investigate the influence of illness concepts on adherence of bipolar patients to different medications.

Differing response to antipsychotic therapy in schizophrenia: pharmacogenomic aspects.

Treatment-resistance in schizophrenia remains a public health problem: about 20% to 30% of patients do not respond to antipsychotic therapy. Clozapine has been shown to be effective in about one-third of patients, but the medical risks and weekly blood tests limit its broad application. While the heterogeneity of the disease and the duration of untreated psychosis are important, pharmacogenomic aspects must also be considered.

Concepts in the treatment of bipolar disorder.

Objective: Concepts in the treatment of bipolar disorder are discussed considering clinical practice.

Method: Results of the Multicenter Study of Long-term Treatment of Affective and Schizoaffective Psychoses (MAP) study, a controlled maintenance trial, are interpreted with respect to treatment concepts.

Results: The spectrum of patients diagnosed as bipolar has become more heterogeneous.

Neurotransmitters and signal transduction processes in bipolar affective disorders: a synopsis.

New technologies have led to tremendous progress in understanding what today we call bipolar disorders, whose clinical diagnosis has been refined continuously since Kraepelin first described them. Molecular genetic studies have produced interesting findings, but to date have failed to identify specific genes that are so far responsible for the vulnerability to bipolar disorders. Biochemical studies in combination with pharmacotherapy give hints that the neurotransmitter function and the related signal transduction may be abnormally regulated.

Differential efficacy of lithium and carbamazepine in the prophylaxis of bipolar disorder: results of the MAP study.

In a randomized clinical trial with an observation period of 2.5 years, the differential efficacy of lithium versus carbamazepine was compared in 171 bipolar patients (DSM-IV). In order to investigate the efficacy of the two drugs in clearly defined subsamples, a series of subgroup analyses was carried out.

The prophylactic efficacy of lithium--transient or persistent?

It has been reported recently that the prophylactic efficacy of lithium is a transient phenomenon in many patients. Other studies suggest sustained efficacy against affective recurrences for many years. As this issue is of major therapeutic relevance, published literature considering changes in lithium efficacy over time has been reviewed.

Differential response to lithium and carbamazepine in the prophylaxis of bipolar disorder.

In a randomized, prospective, multicenter study with an observation period of 2.5 years, the differential prophylactic efficacy of lithium versus carbamazepine was compared in 171 patients fulfilling DSM-IV criteria for bipolar disorder. Serum drug levels were 0.

Lithium vs carbamazepine in the maintenance treatment of schizoaffective disorder: a randomised study.

In a randomised multicentre study, the prophylactic efficacy of lithium and carbamazepine was compared in schizoaffective disorder. A total of 90 ICD-9 schizoaffective patients were included in the maintenance phase (2.5 years).

Comparative efficacy of lithium and amitriptyline in the maintenance treatment of recurrent unipolar depression: a randomised study.

The present study, including 81 depressive patients, compares the prophylactic efficacy of lithium and amitriptyline in recurrent unipolar depression over a treatment period of 2.5 years in a randomised multicentre design. Hospitalisation, re-emergence of depressive or subdepressive recurrences, unwanted side-effects and need of concomitant psychotropic medication were considered to indicate treatment failures.

Substance abuse and dependency as a risk factor for delinquency and violent behaviour in schizophrenic patients--how strong is the evidence?

There is increasing evidence that schizophrenics are at a comparatively high risk for delinquency and violent behaviour. There is a need to define risk factors for aggression and violence in schizophrenics. Apart from an apparently higher rate of violent and assaultive behaviour in male schizophrenics, on the psychopathological level, symptoms such as vivid hallucinations or delusions have been proposed as possible risk factors.

The mechanism of action of antidepressants revised.

The discovery of the clinical efficacy of imipramine and of the MAO-inhibitor iproniazid intensively stimulated biochemical-pharmacological research on the mechanism of action of antidepressants. Due to these investigations, until recently an enhanced activity of the central noradrenergic and/or serotonergic transmitter system was considered essential for the clinical antidepressive action. Such enhancement could be achieved either presynaptically by blocking alpha 2-adrenergic receptors, or in the synaptic cleft by inhibiting the transmitter reuptake or the main metabolic enzyme, MAO.

Mean age, sex ratio and psychopathology in alcohol psychoses.

In a retrospective study the case histories of 154 patients with acute alcohol psychosis were examined. The obvious diagnostic criteria in the doctor's differential diagnosis between alcohol withdrawal delirium and alcohol hallucinosis was clouding of sensorium and disorientation. 103 patients were diagnosed as having alcohol withdrawal delirium, 51 patients alcohol hallucinosis.