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Copyright of Clínica Contemporánea: Revista de Diagnóstico Psicológico, Psicoterapia y Salud is the property of Colegio Oficial de Psicologos de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We aimed to investigate insula volumes in patients with schizoaffective disorder with the motivation that schizoaffective disorder has strong resemblance of clinical presentaion with schizophrenia and bipolar disorder and that there have been studies on insula volumes in patients with schizophrenia and bipolar disorder but not in patients with schizoaffective disorder. We hypothesized that patients with schizoaffective disorder would have similar alterations in regard to insula volumes. Eighteen patients with schizoaffective disorder and nineteen healthy controls were included into the study. Insula volumes were measured by using the MRI. the mean volumes of the insula region for both sides were statistically significant smaller in patients with schizoaffective disorder compared to those of healthy ones (P<0.001). In conclusion, our findings suggest that patients with schizoaffective disorder had reduced volumes of the insula region. Beacuse of some limitations, it is required to replicate our present results in this patient group. [ABSTRACT FROM AUTHOR]

Aim. To study the efficacy and safety of intranasal administration of 5mg haloperidol on mild-moderate agitated patients with schizophrenia or schizoaffective disorder in an acute psychiatry unit setting. Method. Design: Pilot study of clinical trial, phase IV, open-label, observer-blind, single-center, randomized a haloperidol-controlled trial comparing intranasal with intramuscular administration. Subjects: 16 patients; 7 intranasal administration, and 9 intramuscular administration. Efficacy measurement: Positive and Negative Syndrome Scale-Excited Component (PANSS-EC); Clinical Global Impressions-Improvement Scale (CGI). Safety measurement: Changes in the ECG registered 5 minutes pre-treatment and 5 minutes post-treatment. Results. Intranasal administration showed more quick action compared with intramuscular on the PANSS-EC (p=0.042) and CGI (p=0.041) 10 minutes after administration, with similar efficacy up to 20, 30, and 60 minutes. There were no significant differences between QTc baseline and post-treatment. Conclusion. Intranasal haloperidol was a rapid, effective, and well-tolerated alternative for reducing acute mild-moderate agitation. [ABSTRACT FROM AUTHOR]

Schizoaffective disorder (SAD) is a psychotic disorder which has presented a certain nosological controversy. Apart from these difficulties, very few studies focused in SAD as a distinct condition from schizophrenia have been found. This lack of specifical studies on SAD results in a lack of specific evidence about treatment. Currently, its treatment is based mainly on the use of antipsychotics, although there are no specific treatment guidelines for SAD. The objective of this review is to establish which are the most recommended treatments according to evidence available, considering clinical variables such as efficacy, safety, adherence, and tolerance as well as the role of these factors in different subtypes of SAD. This exhaustive review examines experimental and observational studies involving patients with a diagnosis of SAD. It was concluded that more clinical trials performed exclusively on patients affected by SAD are needed. Paliperidone, the only drug with authorized use in SAD, is the one that has the highest quality of studies to support its use. Risperidone, olanzapine, aripiprazole and ziprasidone also have randomized clinical trials supporting their efficacy and safety. In treatment-refractory patients, there are observational studies indicating the usefulness of clozapine. Likewise, there is evidence from observational studies showing the usefulness of lithium and carbamazepine during the treatment maintenance phase. It is necessary to establish the role of combined treatment with mood stabilizers and/or antidepressants. [ABSTRACT FROM AUTHOR]

Context: The benefits of psychotropics on the treatment of patients with Schizophrenia, Psychosis NOS, Bipolar and Schizoaffective Disorder are recognized. Adherence to psychotropic regimens is far from satisfactory. Objective: To investigate the effects of group music therapy on the adherence to psychotropic regimens in patients with the above mentioned disorders. Design, setting, and patients: Prospective, randomized controlled trial conducted at four academic medical centers among 85 adults (age ranged between 15 and 65 years) with Schizophrenia (n=38), Psychosis NOS (n=19), Bipolar (n=18) and Schizoaffective Disorder (n=10) diagnosed according to DSM IV criteria. Intervention: Patients were randomly assigned to two groups. None of them had had a previous treatment using group music therapy (GMT). Group 1 (n=42) received 60-min GMT, once a week. Patients participated in the study for 8 weeks. Group 2 (n=43) was accepted as the control group. By consensus, family members (or primary caregivers), psychiatric nurses and psychiatrists, complete the therapeutic adherence assessment, Spanish version (evaluación de la adherencia terapéutica) initially, after the therapy, and at the end of the 6th month, including number of psychotropic medications use, type, frequency and an overall degree of adherence. Main Outcome: % of patients with >80% of adherence using the medication adherence assessment. Results: In group 1, there were statistically significant differences in the degree of medication adherence after the GMT program (73.8% vs. 16.2%, P<0.001). Also, 6 months later in group 1, there was still an improvement in the Medication adherence (69.0% vs. 16.3%, P<0.001). Conclusions: GMT improves overall adherence to psychotropic regimens in patients with Schizophrenia, Psychosis NOS, Bipolar and Schizoaffective Disorder. [ABSTRACT FROM AUTHOR]

Introduction: Within the spectrum of psychiatric illnesses one of the most complex is the schizoaffective disorder due to the fact that both, its diagnosis and pharmacological management are challenging. This disease combines cardinal symptoms of schizophrenia and mood disorders symptoms. The aim of the treatment focuses on improving both psychotic symptoms and mood stabilization. Benzodiazepines are frequently used, and should be gradually reduced in order to prevent either a relapse or withdrawal symptoms. Here, we report the case of a 31-yearold female patient that after a gradual reduction of benzodiazepines and the suspension of clonazepam developed depressive symptoms, which subsided after the drug reinstatement. Case report: A 31-year-old female with no relevant past medical history developed psychotic symptoms that required hospitalization. Maniac symptoms appeared and therefore, the diagnosis was a manic episode with psychotic symptoms. Antipsychotic drugs, a mood stabilizer and benzodiazepines were the treatment used and the patient showed clinical improvement. She was free of clinical manifestations for two years, until the patient presented a psychotic episode without mood symptoms; therefore she was diagnosed with schizoaffective disorder according to the DSM V criteria. After clinical improvement drugs were decreased gradually. Following the suspension of clonazepam the patient had depressive symptoms that disappeared after the reinstatement of the drug. Discussion: The sudden appearance of depressive symptoms was considered as a possible relapse linked to the underlying disease. Strictly speaking, the patient did not meet the criteria for benzodiazepine withdrawal syndrome. The literature reports that in some cases depressive symptoms may be part of this spectrum, however neither a temporality nor any other relevant characteristics were specified. After restarting the drug at the lowest dose that the patient used, total remission of the major depressive disorder was achieved in less than two weeks. This allowed us to establish, at our discretion, a direct link between the suspension of clonazepam and the appearance of these symptoms. Conclusion: Although the management depends on the characteristics of each patient and the physician preferences, it is worth keeping in mind the possibility of unusual symptoms that may appear even by following the correct guidelines established for a correct decrease doses and the suspension of benzodiazepines. [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Our aim was to evaluate treatment safety, tolerability, efficacy and compliance of long-acting injectable risperidone (LAIR) as maintenance treatment in a bipolar and schizoaffective inpatients sample with torpid course due to poor compliance with oral therapy. Methods. 22 inpatients, 14 with a diagnosis of bipolar disorder and 8 with a diagnosis of schizoaffective disorder, were included in this study. They were treated with LAIR, 1 dose every 14 days, and were evaluated for 40 weeks with the Young Mania Rating Scale (YMRS), Hamilton Scale for Depression (HAM-D), UKU-Side Effect Rating Scale and Clinical Global Impression Severity of Illness scales (CGI). Results. Average YMRS scores were reduced significantly from 10.5 at baseline interview to 2.5 at week 40 (p < 0.001). HAM-D and UKU scales did not reach a statistically significant reduction. CGI-S scores were reduced from 3.8 at baseline to 1.5 at week 40 (p < 0.001). Conclusions. LAIR could be an effective maintenance therapy for bipolar and schizoaffective patients with poor compliance with oral treatment. [ABSTRACT FROM AUTHOR]

Introducción: Se describe un estudio abierto de serie de casos diseñado para evaluar la efectividad y seguridad de topiramato como tratamiento coadyuvante del trastorno bipolar fármacorresistente. Pacientes y método: Se reclutaron 21 pacientes con trastorno bipolar según criterios DSM-IV, considerados resistentes a litio, carbamacepina o valproico. Los pacientes dieron consentimiento informado para realizar el tratamiento coadyuvante con topiramato para su sintomatología maníaca (n= 9), depresiva (n= 6), hipomaníaca (n= 3), mixta (n= 2) o esquizoafectiva bipolar maníaca (n= 1). El estudio duró seis semanas durante las cuales el tratamiento eutimizante concomitante se mantuvo constante. Se evaluaron semanalmente a los pacientes con las escalas YMRS, HDRS-17 y CGI. Resultados: De los 21 pacientes iniciales, 15 completaron la totalidad del estudio. Seis pacientes (40% de los que terminaron el estudio, 29% por intención de tratar) fueron considerados como respondedores al tratamiento (reducción > 50% en la escala YMRS o HDRS-17 y disminución de dos o más puntos en la CGI). El tratamiento fue menos efectivo en aquellos pacientes con depresión inicial. El topiramato fue bien tolerado y sólo un paciente abandonó debido a efectos secundarios. El efecto adverso más frecuente fueron las parestesias (n= 2). Diez pacientes experimentaron descenso moderado de peso durante el estudio. La dosis media de topiramato al final del estudio fue de 158 mg/día. Conclusiones: Estos resultados preliminares sugieren que topiramato puede ser útil en el tratamiento del trastorno bipolar, con resultados prometedores incluso en los pacientes más refractarios a otras terapéuticas. [ABSTRACT FROM AUTHOR]