Neurocognition may represent an indicator of genetic risk and poor outcome in schizophrenia patients (SCZ) predicting real life functioning.

As cognitive performance of unaffected first-degree relatives (UR) is intermediate between SCZ and healthy controls (HC), neurocognitive impairment may represent a marker of vulnerability to schizophrenia.

To investigate social and neurocognition in all subjects and their impact on functional capacity of patients as markers of vulnerability.

Sample: 922 SCZ, 379 UR and 780 HC. Assessment: MATRICS Consensus Cognitive Battery (neurocognition), Facial Emotion Identification Test and Awareness of Social Inference Test (social cognition) and Specific Level of Functioning Scale (social functioning). Analyses: Structural Equation Model (SEM) analyses to model the impact of all variables on functional outcome.

SCZ scored worse in all domains than UR and HC. UR had significant impairments in all cognitive domains with respect to HC. Cognitive functioning had direct and indirect impacts on functional outcome mainly through social cognition and functional capacity. Social cognition had a direct impact on outcome, independent of neurocognition.

SCZ and UR display similar patterns of social and neurocognition deficits. Our results confirm a strong impact of neurocogniton on functional outcome. Social cognition has become an interesting object of study and its conceptualization as trait variable and the existence of a continuum between SCZ and UR are hypotheses for further research.

The study was carried out within the project “Multicenter study on factors influencing real-life social functioning of people with a diagnosis of schizophrenia” of the Italian Network for Research on Psychoses.

The authors have not supplied their declaration of competing interest.

A consensus definition of symptomatic remission in schizophrenia was recently established based on a fixed threshold for symptom severity and a time component. The objective of this study was to determine the clinical relevance of this definition in a Chinese population and find the predictors of symptomatic remission, functional outcome and cognition.

Seventy-five schizophrenic patients were recruited within a period of 2 years. All patients need to prospectively be followed up in an outpatient clinic for at least 6 months. During this period, it was not allowed to adjust their medications. Three different definitions of symptomatic remission included the Remission in Schizophrenia Working Group (RSWG), clinical global impression (CGI) and brief psychiatric rating scale (BPRS) was evaluated. In addition, the function and cognition was assessed as the measured outcomes. The prediction model of outcomes measurement was used for statistic analysis.

The cumulative percentage of achieving remission criteria among three different definitions of symptomatic remission was 52% in RSWG criteria, 63% in CGI and 65% in BPRS, respectively. In comparison of remitted and non-remitted groups, there were significant differences in sex, education, function and cognition in terms of RSWG definition but not in CGI and BPRS. Female gender and education were two factors for predicting symptomatic remission and function, whereas body mass index and education were two factors for prediction of better cognition.

Our study indicates that the definition of RSWG was more clinical relevant compared with CGI and BPRS in Chinese schizophrenia.

The authors have not supplied their declaration of competing interest.

Schizophrenia (SZ) patients present subtle motor deficits known as Neurological Soft Signs (NSS). Those deficits encompass impairments of motor coordination, sequencing of complex motor acts and sensory integration. It has been shown that SZ patients present also deficits of higher motor functions as implicit motor learning. Growing number of studies indicate that both NSS and implicit motor learning deficits are associated with impairments of common cortico-cerebellar pathways, however relationship between these two deficits has not been evaluated yet.

To assess NSS and implicit motor learning in SZ patients.

To evaluate associations between NSS and implicit motor learning scores in SZ patients.

Twenty schizophrenia patients and 20 healthy controls were examined. Patients were under olanzapine, clozapine or quetiapine treatment. NSS were assessed with Neurological Evaluation Scale (NES). Implicit motor learning were assessed with a use of Serial Reaction Time Task.

SZ patients presented statistically higher NSS scores than healthy controls (P < 0.001) and presented no signs of implicit motor learning. There was statistically significant negative correlation between implicit motor learning score and total score of neurological soft signs (r = −0.44), sequence of motor acts subscore (r = −0.54) and sensory integration subscore (r = −0.47) in SZ patients group (P < 0.05).

There is association between implicit motor learning deficits and neurological soft signs in SZ patients.

The authors have not supplied their declaration of competing interest.

A certain degree of depressive symptoms is common in schizophrenic patients. The assessment and treatment of depressive symptoms in schizophrenia is clinically challenging.

We conducted a cross-sectional study to investigate the depressive dimension of schizophrenic patients.

The aim was to evaluate the effect of pharmacotherapy on depressive symptomatology.

Thirty-four outpatients (18-65 years old) with stable schizophrenia in monotherapy with FGAs or SGAs. We evaluated: depressive symptoms with Calgary Depression Scale for Schizophrenia; positive and negative symptoms (with Positive and Negative Symptom Scale); neurocognition (with Matrics Cognitive Consensus Battery); social cognition (with Facial Emotional Identification Test); social functioning (with Personal and Social Performance Scale and with UCSD Performance-based Skills Assessment). Collected data underwent statistical analyses.

A SGAs therapy was associated with: lower depressive symptoms (mean SGAs group = 4.0; mean FGAs group = 7.86, P < 0.05); lower mean positive symptoms (mean SGAs group = 12.65; mean FGAs group = 17.43, P < 0.05); lower negative symptoms (mean SGAs group = 21.35; mean FGAs group = 29.07, P < 0.05); lower scores on the PANSS-total (mean SGAs group = 71.05; mean FGAs group = 91.86, P < 0.01). After correction for multiple variables, the SGAs group still had significantly lower values towards the FGAs group (P < 0.05).

Our study support the notion that switch from a FGA to a SGA could be a relatively simple first-step for the treatment of this condition. Atypical antipsychotics might exercise antidepressant effects with different potential mechanism including: remission of a FGA-induced depression and action on of 5-hydroxytryptamine, dopamine [other than postsynaptic D2], and α1-noradrenergic receptor sites.

The authors have not supplied their declaration of competing interest.

Second-generation long-acting injectable antipsychotics (LAIs) constitute a valuable alternative for the treatment of schizophrenia and combine advantages of both long-acting injectable drugs and atypical antipsychotics. Realistic, naturalistic studies are necessary to evaluate the impact of LAIs on specific cluster of symptoms.

To collect clinical and functioning outcomes in outpatients with schizophrenia treated with LAIs during a follow-up period of 6 months.

To determine the impact on symptoms and functioning of second-generation LAIs.

It is a 6-month naturalistic, observational, prospective, non-interventional study of patients diagnosed with DSM-V schizophrenia disorder. Clinical data were assessed by the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF). For statistical analysis, we used the Wallwork's five-factor model of the PANSS.

A total of 50 schizophrenia patients (70% male; mean age: 36.2 ± 10.4) referred to the Depot Clinic at Sant’Andrea Hospital in Rome was included. Eight patients received treatment with risperidone LAI (RLAI), 20 with paliperidone-palmitate LAI (PLAI), 10 with olanzapine-pamoate LAI (OLAI) and 12 with aripiprazole LAI (ALAI). LAIs were overall associated with improved functioning and positive symptoms; OLAI, ALAI e PLAI correlated with improved negative symptoms, RLAI, OLAI e PLAI with improved disorganised/concrete symptoms, OLAI e PLAI with improved excited symptoms; ALAI improved depressive symptoms.

Over the 6-month period, LAIs were associated with improved functioning and illness severity in schizophrenia patients with different symptoms profile. Treatment with PLAI and OLAI showed the major clinical advantages, whereas only ALAI correlated with improved depressive symptoms.

The authors have not supplied their declaration of competing interest.

Stigma towards people with mental illness can have very negative consequences for the persons that experience it. So, it becomes strongly necessary to combat this problem.

Evaluate the effectiveness of multiple interventions to reduce stigma against mental illness in a group of high school students.

Quasi-experimental study. Seventy-six students between 16 to 19 years old from 3 schools of southern Madrid State participated. No significant differences in age and gender between groups were found. The quasi-control group was obtained from 3 different classrooms (1 in each school). This group did not go through any treatment. The experimental group had 2 treatments. Treatment “A” consisted in 1 psychoeducation session. Treatment “B” was 1 visit (real or virtual) to the Thyssen-Bornemisza museum. Persons exercising as museum guides had been diagnosed with mental illness. They already were participants in the PCEA program of the CRPS Latina. The instrument to assess stigma was the AQ-27, validated in Spanish.

We found significant reductions of stigma in all dimensions explored: Anger (A vs BC; P < 0.001), Threat (A vs BC; P < 0.001), Fear (A vs BC; P < 0.001), Coercion (A vs BC; P < 0.001) Segregation (A vs BC; P < 0.001) and Avoidance (A vs BC; P < 0.001).

The combination of treatments for intervention on stigma in samples of school students seems to be a very effective option to reduce stigma.

The authors have not supplied their declaration of competing interest.

Current research suggested that avolition in patients with schizophrenia (SCZ) is not due to a deficit of hedonic experience, but to a poor ability to translate pleasurable experiences into motivational states. In line with this hypothesis, several evidences showed a preserved hedonic experience, even in the presence of severe trait anhedonia and avolition in SCZ.

To test the hypothesis that memory dysfunction, generally found in SCZ, could lead to inaccurate representations of emotional experiences and interfere with translation of pleasurable experience in motivation.

The present study was aimed to investigate the relationships between state and trait anhedonia, avolition and cognitive functioning in 35 SCZ.

In SCZ and matched healthy controls (HC) the Temporal experience of Pleasure (TEPS) and Chapman's scales were used to assess trait anhedonia. The MID task was used to assess in-the-moment hedonic experience. Avolition was measured by the Schedule for the Deficit Syndrome. MATRICS Consensus Cognitive Battery was used to assess cognition.

SCZ did not differ from HC on TEPS or on MID task performance but reported higher scores for trait social anhedonia. Trait social anhedonia was associated with memory dysfunction and showed a correlation with avolition.

Our results confirm the disjunction between state and trait anhedonia and demonstrate a relationship of the latter with memory impairment and avolition, suggesting that inaccurate representations of emotional experiences might impede their translation in motivation to act.

The authors have not supplied their declaration of competing interest.

Neural dysconnectivity is hypothesized to be a key element in pathophysiology of schizophrenia. However, the relation of disordered connectivity with the different clinical characteristics of the syndrome is not fully elucidated.

The current research investigated the relations between resting-state EEG Source Functional Connectivity (EEG-SFC) and the two main clusters of negative symptoms derived from the Brief Negative Symptom Scale, the Expressive Deficit (ED) and the Avolition (AV), in subjects with schizophrenia (SCZ) enrolled to the multicentre study of the Italian Network for Research on Psychoses.

Out of 97 chronic, stabilized SCZ included, we selected subjects according the lower and the upper quartile of the ED and AV value distribution: 25 were in upper and 24 in the lower quartile of ED (respectively, HIGH-ED and LOW-ED); 27 were in upper and 24 in the lower quartile of AV (respectively, HIGH-AV and LOW-AV). Fifty-five healthy controls (HC) were included, comparable to SCZ for gender, age and educational level. EEG-SFC analysis was based on the lagged phase synchronization (LPS) computed by eLORETA from 5 minutes resting-state EEG recordings in eyes closed condition. LPS indices were determined for each spectrum band and between all 28 regions of interest (ROI) pairs. Group differences were significant for corrected P-value < 0.05.

SCZ had higher theta band LPS than HC. Respect to LOW-ED, HIGH-ED showed significant increased alpha LPS in fronto-cingulate, para-hippocampal and insular inter-hemispheric ROI pairs. No significant difference emerged between HIGH-AV and LOW-AV.

Subgrouping SCZ according to negative symptom severity reveals heterogeneous patterns of resting-state LPS connectivity.

The authors have not supplied their declaration of competing interest.

Inconsistent data showed that erythrocyte glutathione peroxidase (GPx) activity in schizophrenics is altered.

The aim of this study was to evaluate whether some of the demographic, clinical and therapeutic factors had any significant impact on erythrocyte GPx activity in patients with schizophrenia.

This study included 68 schizophrenic patients and 59 healthy individuals. GPx activity was tested related to patient age, gender, heredity, the onset of the disease, the duration of the disease, the number of episodes, PANSS scores and drug treatment. GPx activity was determined in erythrocyte hemolysates by Ransel commercially available test.

Erythrocyte GPx activity was significantly lower in patients with schizophrenia than in controls. Male patients had significantly lower GPx activity in comparison with those in female ones. Heredity negative patients showed significantly lower enzyme activity compared to control values. Significantly lower GPx activity was obtained independently of the onset of the disease. The patient group having more than one psychotic episode also showed significantly lower GPx activity compared to the control group. The disease duration of more than 1 year caused a significant decrease in enzyme activity. There was a significant difference in GPx activity between patients with different PANSS scores. In patients treated with second generation antipsychotics and in those treated with both first and second generation antipsychotics, GPx activity was significantly lower than in controls.

This study shows that the low erythrocyte GPx activity in schizophrenics depends on patient gender, the number of episodes, disease duration and drug treatment.

The authors have not supplied their declaration of competing interest.

Subjective perceptions of clinical change in patients with schizophrenia are often not congruent to the objective evidence of the same, especially since a lack of insight is part of the symptomatology. However, the exploration of the relationship between clinical judgments from mental health experts and the patients’ perception of symptom change is fairly understudied.

This study aimed to investigate the performance of the Positive and Negative Syndrome Scale (PANSS) as a tool for clinical outcome monitoring in schizophrenia in concordance with the change of self-reported psychopathology assessed with the Frankfurt Complaint Questionnaire (FCQ) in patients with a schizophrenia.

A consecutive sample of patients admitted to a Swiss psychiatric hospital for schizophrenia was assessed with the FCQ at admission and discharge. The PANSS was rated by the responsible clinicians at admission and discharge. Complete data of admission and discharge were available from approximately 60 cases. Reliable change index (RCI) was calculated to determine a clinically meaningful change based on the PANSS scores. Logistic regression models were conducted to explore the link between RCI levels and the change of self-reported perceptions of psychopathology.

Our study found no relationship between the change of PANSS and FCQ from admission to discharge in a sample of patients treated for schizophrenia. Therefore, our findings provide evidence for a large discrepancy between the observed clinical severity and the subjective perception of symptoms in individuals with schizophrenia.

The authors have not supplied their declaration of competing interest.

Autoantibodies (Abs) to different neuronal receptors and DNA were detected in the blood of patients with schizophrenia. Abs hydrolyzing DNA were detected in pool of polyclonal autoantibodies in autoimmune and infectious diseases, such catalytic Abs were named abzymes.

To investigate the level of anti-DNA antibodies and DNA-hydrolyzing activity of IgG from the serum of patients with schizophrenia depending on leading clinical symptoms.

– To measure the concentration of anti-DNA Abs in serum of patients with leading positive and negative symptoms;

– to determine DNA-hydrolyzing activity of IgG.

In our study, 51 patients were included. The levels of antiDNA Abs were determined using ELISA. DNA-hydrolyzing activity was detected as the level(%) of supercoiled pBluescript DNA transition in circular and linear forms. Statistical analysis was performed in “Statistica 9.0”.

Anti-DNA Abs of patients with schizophrenia not only bind DNA, but quite efficiently hydrolyze the substrate. IgG of patient with schizophrenia were shown to possess DNA hydrolyzing activity. It should be noted that DNAase activity of IgG in patients with schizophrenia with a negative symptoms was significantly higher, than in patients with positive symptoms (Table 1).

The data show a correlation with the level of DNase activity and leading symptoms of patients with schizophrenia.

The authors have not supplied their declaration of competing interest.

To increase treatment compliance and consequently to reach clinical and rehabilitation goals in people with schizophrenia is a main challenge in their treatment.

To know the retention in treatment (and reasons for discharge) of people with severe schizophrenia enrolled in a specific, intensive, comprehensive and community programme for them; and also to know treatment (clinical and functional) outcomes.

A 6-year prospective, observational study of patients with severe schizophrenia (ICD 10: F 20; CGI-S ≥ 5) undergoing specific severe mental illness programme (n = 200). Assessment included the Clinical Global Impression-Severity scale (CGI-S), the Camberwell Assessment of Needs (CAN) and the WHO Disability Assessment Schedule (WHO-DAS). Time in treatment and reasons of discharge were measured. Laboratory tests, weight and medications were reported. Hospital admissions were measured.

CGI at baseline was 5.86 ± 0.7. After 6 years 48% of patients continued under treatment (CGI = 4.31 ± 0.8; P < 0.01); 31% were medical discharged (CGI = 3.62 ± 1.6; P < 0.001); DAS decreased in the four areas (P < 0.01) and also CAN (P < 0.01); 7% had moved to other places; 8% were voluntary discharges. Eight patients dead; three of them committed suicide. Forty-five percent of all of them were treated with atypical long-acting antipsychotics, with good tolerability. There were significantly less hospital admissions than during the previous 6 years (P < 0.001).

Retention of severe mentally ill patients with schizophrenia in a specific and intensive care programme was really high; and seemed to help getting in remarkable clinical and functional improvement. Long-acting medication also seemed to be useful on improving treatment adherence, mainly due to their good tolerability.

The authors have not supplied their declaration of competing interest.

Previous studies highlight the difficulty of correctly diagnosing depressive symptoms in schizophrenic patients, as well as the impact on clinical progression among patients who present with both syndromes, worsening treatment adherence and overall prognosis.

To determine the prevalence of depressive symptoms in patients diagnosed with schizophrenia. To analyze the relationship of depressive symptoms with other demographic and clinical variables.

Eighty-four patients diagnosed with schizophrenia according to ICD-10 criteria and treated in an Outpatient Mental Health Clinic were recruited for this study. Symptom severity was assessed using The Positive and Negative Syndrome Scale (PANSS; Kay et al., 1987); classifying patients as positive, negative or mixed schizophrenia subtypes. Data from clinical and sociodemographic variables was obtained from clinical records.

The mean age was 43.2 years (SD: 10.2). Depression is objectively detected in 10.3% of the sample, and presented as subjective depression in 29.5%. The prevalence of depressive symptoms is higher among women, unmarried patients, lower social classes and patients who met criteria for predominantly positive Schizophrenia subtype. Higher prevalence of depressive symptoms was found in patients with a shorter course of disease.

Depressive symptoms present with a high prevalence among patients diagnosed with schizophrenia, especially during the early years of the disease. Given the severe impact of depression on both the evolution and prognosis of patients with severe mental illness, screening and early treatment must be carried out.

The authors have not supplied their declaration of competing interest.

Schizophrenia and other psychotic disorders are associated with high rates of morbidity and mortality, caused by the use of specific treatments as well as health factors directly related to those processes. One of the high-frequency side effects in patients treated with classic and atypical antipsychotics is hyperprolactinemia. It causes alterations in neuroendocrine sphere (amenorrhea, galactorrhea, gynecomastia…), and other mid- and long-term effects (osteoporosis, cardiovascular risk increase and increased risk of developing cancers - specifically in breasts and endometrium).

Check hyperprolactinemia induction by maintained treatment with atypical antipsychotics.

A naturalistic prospective study was conducted following 75 patients on maintenance treatment with a single atypical antipsychotic during 24 months. Anthropometric and laboratory data were collected, along with the presence of different endocrine-metabolic during the 2-year study alterations.

Changes in prolactin levels were found in a large number of patients, with statistically significant differences between 0 (basal) and 24 months (Basal [M = 26.27; SD = 21], 2 years [M = 38.08, SD = 34.65]; t = −2.758; P = 0.013], with hyperprolactinemia increasing from 46.6% of patients at baseline to 65.5% at 2 years, mainly with paliperidone and risperidone long acting injection (statistically significant increase in both cases) (Fig. 1).

Paliperidone and risperidone long acting injectable induce increased prolactin levels in patients in long-term antipsychotic treatment.

The authors have not supplied their declaration of competing interest.

Explore the basis of cortical morphometry in patients with schizophrenia and non-affected siblings by Magnetic Resonance Structural analyzing cortical thickness.

Twenty-nine patients with schizophrenia treated with atypical antipsychotics and clinically stable in the last 6 months were recruited. Twenty-three not affected siblings of patients with schizophrenia and 37 healthy volunteers were recruited. Magnetic Resonance Structural was performed. FreeSurfer the brain imaging software package for analysis of Cortical Thickness is used. In the analysis of group differences in cortical thickness (CT) with the general linear model (GLM), the P-value was established in 0003 following the Bonferroni correction to control for multiple comparisons (seven regions of interest a priori in each hemisphere).

Significant differences in cortical thickness between patients and healthy controls. Differences between groups were calculated by general linear model (GLM) with age and sex as covairables (Table 1).

In applying the correction for multiple comparisons, differences in bilateral-lateral orbitofrontal, medial orbitofrontal-right and left temporal transverse frontal cortex are significant. Our study replicates previous findings and provides further evidence of abnormalities in the cerebral cortex, particularly in the frontal and temporal regions, being characteristic of schizophrenia.

The authors have not supplied their declaration of competing interest.

L. Galindo is a Rio-Hortega-fellowship-(ISC-III; CM14/00111).

We have done a descriptive study of 34 patients hospitalized in psychiatry between January and July 2015 for psychotic active clinic who started treatment with PP or the previous dose was increased.

91.2% of patients admitted for acute exacerbation of their usual pathology and 8.8% for a first episode psychosis. In the CGI scale, all the patients admitted scored as severe or markedly ill; going mostly mildly ill at discharge. For 55.9% of patients, the treatment was changed to PP, 29.4% of the dose was increased PP and 14.7% antipsychotic treatment was started with PP. Among patients change treatment, the main reason was non-adherence (47.4%). 70.6% of our patients were discharged with PP as only antipsychotic and 29.4% which was discharged with another antipsychotic, the most frequent association was of PP with Quetiapine (80%).

PP is a highly effective medicament in the treatment of the schizophrenia that improves the adherence to the treatment, so in our experience and we consider it a medicament to be considered in the early stages of the disease. According to our experience and there are patients who can benefit from better control of symptoms adjusting the dose individually.

The authors have not supplied their declaration of competing interest.

The concept of schizophrenia as a systemic disease includes, not only psychosis, but an increase in somatic comorbidity and cardiovascular risk [1]. Furthermore, it is known the implication of inflammation in the pathogenesis of schizophrenia [2].

To determinate potential inflammatory/metabolic biomarkers of schizophrenia's dimensions.

Sample: 36 outpatients with schizophrenia for less than 11 years, under stable maintenance treatment (mean age [32.25], males [63.9%]) and their 36 matched controls (age [32.53 ± 6.63]; males [72.2%]).

PANSS, Clinical Assessment Interview for Negative Symptoms(CAINS), Calgary Scale(CDS), CGI, Personal and Social Performance Scale(PSP). Biomarkers: C-reactive protein (CRP), homocysteine, glucose, insulin, HOMA-IR (insulin resistance), cholesterol, HDL, LDL, triglycerides.

Biomarkers differences between groups are shown in Table 1. Table 2 shows the correlations found after controlling for Body Mass Index [patients(28.61 ± 5.69);controls(24.64 ± 3.80);p = 0.001] and Smoking [patients(52.8%-yes);controls(5.6%-yes);p = 0.000].

1. CRP, a potential inflammatory biomarker in schizophrenia, is related to depression severity. Homocysteine, representing an oxidative stress, is related to positive, negative, cognitive and depressive symptoms severity, and worse functioning. 2. Patients with schizophrenia have lower HDL–related to negative and cognitive symptoms severity and worse functioning–and insulin resistance – related to worse cognition –.

The authors have not supplied their declaration of competing interest.

Data on clinical outcomes with long-acting antipsychotic treatment in young, newly diagnosed patients with schizophrenia is sparse.

To explore hospitalization, drug utilization and clinical outcomes from medical records of newly diagnosed schizophrenia patients during first 12 months of treatment with once-monthly paliperidone palmitate (PP).

International, multicenter, retrospective, observational study. Outcomes presented: baseline (BL) characteristics and demographics, clinically relevant improvements in disease severity (ie ≥ 20% decrease in PANSS or BPRS total score or CGI-S Change ≥ −2 or CGI-C ≥ 3, with no score showing worsening) and clinically relevant functional improvement (i.e. change in PSP total score ≥ +7 points or change in GAF total score ≥ +20 points, with no score showing worsening) from BL to last-observation-carried-forward endpoint (LOCF-EP) within 12-month documentation period, mean mode PP dose and adverse drug reactions.

Eighty-four patients analyzed: 69% male, mean age at initiation of PP was 24.1 (SD2.7) years, mean BL weight was 78.7 (SD16.0) kg and 80.0 (SD14.7) kg at LOCF-EP, with a mean change of 1.2 (SD3.9) kg; mean time from first psychotic episode to initiation of PP was 5.5 (SD3.3) months. At LOCF-EP 86.6% achieved a clinically relevant improvement (71/84, Kaplan-Meier median time from initiation of PP: 52.4 days). 63.4% achieved a clinically relevant functional improvement (52/84, Kaplan-Meier median time from initiation of PP: 53.1 days). PP mean mode maintenance dose was 96.4 (SD19.8) mg. ADRs reported in ≥ 5% of patients were weight increase 9.1% and hyperprolactinemia 5.7%.

Treatment with once-monthly PP was well tolerated and associated with clinically relevant improvements in disease severity and functioning in young, newly diagnosed schizophrenia patients.

The authors have not supplied their declaration of competing interest.

Little is known about patient characteristics and rehospitalization in newly diagnosed patients with schizophrenia treated with long-acting antipsychotics.

To retrospectively explore hospitalizations, drug utilization and clinical outcomes from medical records of young, newly diagnosed schizophrenia patients during the first 12 months of treatment with once-monthly paliperidone palmitate (PP).

International, multicenter, retrospective, observational study. Outcomes presented are patient characteristics, reason for PP initiation and hospitalization data.

Eighty-four patients were analyzed: mean age (years) at first psychotic episode was 23.8 (SD2.6), 23.9 (SD2.6) at first antipsychotic treatment and 24.1 (SD2.7, range 19-29) at PP initiation. Time between first antipsychotic treatment and PP initiation was 4.8 (SD: 3.4, range: 0-12) months. At PP initiation, 42.9% of patients were in hospital, primarily for the management of the first episode/relapse (97.2%). Reason for PP initiation was: LAT favored over oral treatment for relapse prevention (56%), partial/non adherence with previous oral medication (20.0%), convenience (15.5%) or limited access to health care systems (2.4%). Mean time (days) between admission and initiation of PP, and between initiation of PP and discharge from hospital was 28.8 (SD23.0) and 23.2 (SD24.5), respectively. 96.4% of patients were not hospitalized during the 12-month PP treatment period. 3/84 patients (3.6%) had a single hospitalization of 15.7 (SD: 8.1) days for management of episode/relapse.

In this young, newly diagnosed schizophrenia population, the number of hospitalizations following PP initiation was low. Main reason to initiate PP was clinicians favoring LAT over oral antipsychotic treatment for relapse prevention or due to partial/non adherence with previous oral treatment.

The authors have not supplied their declaration of competing interest.

There is an increasing interest in understanding how antipsychotic treatments work in a real-world-setting. This is especially important with long-acting-antipsychotics, where explanatory trials may not always represent the real-world-population. Observational studies and pragmatic-clinical trials could provide additional information about new therapies, which could inform decision-making processes.

To assess the effectiveness of Paliperidone-Palmitate(PP) in an acute setting within real-world-conditions. Functionality, satisfaction with treatment and pattern of use were also evaluated.

An observational, prospective 6-week follow-up study was performed in acute units including adult patients with acute exacerbation of schizophrenia that started treatment with PP. Data were collected from initiation of PP until week-6 (or patient's discharge if earlier). Clinical-Global Inventory-Severity (CGI-S) was used to assess effectiveness as well as changes in illness severity. Other outcomes included total score on the Personal and Social Performance scale (PSP), patient-satisfaction with medication (MSQ) and tolerability. Student's-t tests were used to assess changes from baseline in CGI-S and PSP.

Two hundred and eighty patients were included in the analysis (mean age: 40.5 ± 12.2 [SD] years). A significant decrease in mean (SD) CGI-S score between baseline (4.7 [0.9]) and endpoint (3.3 [0.9]) (P < 0.0001) was observed. (Note that 21% of patients were discharged on PP-monotherapy). Patient-functioning also significantly improved from baseline to endpoint (P < 0.0001). Seventy-four percent of patients were satisfied (measured by MSQ) at the end of follow-up. Anticholinergic-treatment was less frequent for PP discharged on monotherapy vs. not monotherapy (12.5% vs 21.2% respectively). Overall, PP was well-tolerated. Twenty-five AEs were reported in 20 patients (incidence 7.1%). No serious AEs occurred.

These results support the effectiveness and tolerability of PP in an acute setting under daily-clinical-practice with good acceptance by patients.

The authors have not supplied their declaration of competing interest.