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Objective Metabolic abnormalities such as diabetes, dyslipidemia, abdominal obesity, metabolic syndrome, and abnormal levels of plasma adipokines have been observed in patients with schizophrenia. This study aimed to investigate the differences and correlations of plasma vaspin levels with metabolic parameters in patients with schizophrenia and to compare with healthy controls. Method We measured plasma levels of vaspin and metabolic parameters of 100 patients with schizophrenia and 95 healthy controls. Patients with schizophrenia were evaluated with the Positive and Negative Syndrome Scale (PANSS) and The Global Assessment of Functioning. Results Mean levels of body mass index, waist circumference, triglyceride, and low-density lipoprotein cholesterol of the patients were statistically higher than those of the healthy controls (p = 0.002, p Conclusions Our study showed a significant relationship and positive correlation between vaspin and PANSS scores in schizophrenia patients with obesity. Vaspin may play an important role in the metabolic processes of patients with schizophrenia.

Medroxyprogesterone acetate (MPA) is a steroidal progestin which is used as a contraceptive, in hormone replacement therapy, dysmenorrhea and amenorrhea. A 19-year-old female with bipolar affective disorder who was started on MPA for the treatment of secondary amenorrhea developed manic episodes while taking MPA pills. She was in remission for three years when MPA was commenced. As manic symptoms emerged following the onset of MPA treatment, risperidone and valproic acid was administered, which was then switched to aripiprazole and lithium treatment because of side effects. The manic episode resolved three weeks after hospital admission. This case report highlights the risk of commencing hormone pills in patients with personal history of affective disorders because of the possibility of MPA-induced manic episode.

Objective: Clozapine is a second-generation antipsychotic used for treatment-resistant schizophrenia. Despite its effectiveness, clozapine is largely underused due to serious side effects such as leukopenia or neutropenia. We aimed to review whether to continue, discontinue or rechallenge clozapine treatment after such haematological side effects. Methods: We reviewed and summarized the literature on the use of clozapine, how to deal with its side effects, and suitable options in case of any haematological problems. Then, we described several cases successfully treated with clozapine and lithium after development of neutropenia or leukopenia Results: We present three patients with treatment-resistant schizophrenia. While they had demonstrated poor response to multiple antipsychotic trials, clozapine was started. Clozapine induced neutropenia; or leukopenia developed in some cases that was successfully reversed after lithium onset. Increased serious side effects related with coprescription of lithium and clozapine were not observed. Conclusion: Lithium increases neutrophil and total white blood cell count as a side effect that may be useful in patients who develop neutropenia or leukopenia while being treated with clozapine.

Caregiver burden is a complex concept that is influenced by many different factors. This study aimed to evaluate caregiving burden in caregivers of schizophrenia patients and to examine the effect of gender and other socio-demographic and clinical characteristics on caregiving burden. This study included 100 (50 female, 50 male) patients, who had been diagnosed with schizophrenia and their caregivers. The Zarit Caregiver Burden Scale (ZCBS), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), and Symptom Checklist-90-Revised (SCL-90-R) were administered to the caregivers. Insight Rating Scale (IRS), Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), Functional Recovery Scale in Schizophrenia (FRSS), Global Assessment Scale (GAS) were administered to the patients. The caregivers of male patients had significantly higher HAM-A, HAM-D, ZCBS total and all subscale, and SCL-90-R total and all subscale scores. The male patients had significantly higher PANSS general psychopathology subscale and CDSS and lower IRS scores. Multiple regression analysis revealed that male patient gender, living in urban areas and HAM-D scores of the caregivers were predictive of ZCBS total scores. This study found that schizophrenia has a significant burden. In addition, male patient and depression level of the caregivers were determined as the predictors of the caregiven burden. [Med-Science 2020; 9(4.000): 806-13]

The aim of this study was to elucidate the chronic effects of tobacco smoking on the P300, a neurophysiological index of cognitive function. Prospective study participants were recruited from a family medicine polyclinic. We selected 32 right-handed smokers who had smoked more than 15 cigarettes per day, by inhalation, for more than 2 years. The control population consisted of 32 right-handed, age-matched healthy individuals who had never smoked. Event-related potentials (ERPs) were recorded with the auditory "oddball" two-tone discrimination task. The data from the central (Cz) and frontal (Fz) electrodes were analyzed. The P300 and N1 amplitudes at Fz were lower in the study population compared to the control group. The early component of ERP, the measure of mental speed (N1) latency at Fz was prolonged in the study group compared to the controls, possibly because early cognitive processes such as sensory input or initial encoding of sensory information were delayed in this group. For those who smoke, a decreased N1 amplitude might indicate delayed information processing and possibly short-term memory disturbance. Thus, chronic tobacco smoking may produce prefrontal cognitive dysfunction.