Natural disasters, such as earthquakes, are traumatic events causing both acute and enduring stress to affected individuals. Psychosocial consequences include posttraumatic stress disorder (PTSD), reactions of anxiety and depression and sleep problems. The island of Cephalonia in Ionian Sea is characterized by its high seismic activity. More specifically, this activity has been considered to be the highest of the Balkan Peninsula and Europe in general. In January and February of 2014 a long sequence of earthquakes, which included two main shocks of 6.1 Richter and 6.0 R, struck the island. The epicenter of the earthquake was the city of Lixouri. A long series of aftershocks measured ≥ 4.0 R followed these main shocks. In total, the number of earthquakes that affected those living in Cephalonia between January 26 and August 2014 when the present study took place, was 2055. Several damages concerning buildings, monuments and churches, stonewalls, road networks and port facilities occurred, but there were no human casualties. The aim of the present study was to assess sleep problems, insomnia in particular in the affected population after the two severe earthquakes in the island of Cephalonia. The assessment was made through the Athens Insomnia Scale (AIS). Sleep problems were assessed for two time points, i.e., retrospectively one month before and six months after the earthquake. In terms of psychopathology, anxiety (STAI - State anxiety) and symptoms of depression (CES-D) were more pronounced in our study population than the expected norm in the community. Correlations with depression (Center for Epidemiological Studies-Depression), anxiety (State-Trait Anxiety Inventory - State Anxiety) and PTSD symptoms (Impact of Event Scale-Revised) were investigated. A significant increase of sleep problems pertaining to insomnia was found (p<0.001). The most frequent complaints were difficulty with sleep induction, awakenings during the night, and sleepiness during the day. Higher STAI - State anxiety, CES-D, and IES-R scores were associated with greater likelihood of having insomnia six months after the earthquake. No other significant associations were detected with several recorded sociodemographic parameters. In conclusion the local population exhibited sleep disturbances 6 months after the earthquake. Sleep problems and ensuing next day dysfunctioning appear to be dependent on the existing psychopathology but independent of sociodemographic factors, and are potentially the result of constant worry due to the continuing seismic activity. Therefore, mental health providers should recognize and manage disordered sleep after earthquakes, although further studies are required to investigate the long-term impact of natural disasters on sleep.

This article is an overview of the literature on Asperger's syndrome and schizophrenia and aim to discuss their similarities and differences. Eugen Bleuler who associated the terms "schizophrenia" and "autism" a century ago, viewed autism as a form of solitude of schizophrenic patients representing withdrawal from reality. Ever since, there has been confusion as to the boundaries between these conditions. Nowadays recent research, from a variety of perspectives-genomics, neurodevelopment, psychiatry, etc. has given new information on these conditions. It is easier to demarcate these two disorders at the extremes, but it is extremely difficult dissociating milder forms of both disorders. Asperger's syndrome (AS), is considered to be a continuous and lifelong disorder with strong heritability, present from early childhood. It is included within the category of autism spectrum disorders and it is usually diagnosed in childhood. Patients with Asperger syndrome are often diagnosed late or they are considered as having schizophrenia. Misdiagnosing Asperger syndrome creates severe problems by preventing effective therapy. A lot of clinical characteristics of Asperger's syndrome are also present in schizophrenia, such as impaired social interaction, disabilities in communication and restricted interests. On the other side some clinical features may facilitate the differential diagnosis, such as the younger age at onset, family history of pervasive developmental disorders, pragmatic aspects of language use, lack of imagination, ect. It is known that symptoms of Asperger's syndrome have some overlap with those of schizophrenia, but less is known about comorbidity between these two syndromes. It is still a question whether autism spectrum disorders in young children can increase the risk for the development of schizophrenia and other psychotic disorders, later in life. Both disorders are of neurodevelopmental origin and genetic factors are prominent. In both neurocognitive deficits as well as deficits in social cognition and social functioning are marked. The boundaries between AS and schizophrenia are still not clear even if this distinction is necessary for the appropriate treatment of the patient and his family. For the writing of the literature review, the following electronic databases were used: PubMed, Scopus, Psycinfo, Cochrane Library, Web of Science and Google Scholar. The key words used were: Asperger's syndrome, schizophrenia, children and adolescents, differential diagnosis, autism spectrum disorders.

Case history:a 69 year old man with drug resistant catatonic schizophrenic disorder was treated at the psychiatric clinic of a general hospital with courses of ECT. In the past he had also responded positively to the same treatment.Course of the treatment: patient was admitted because of catatonic symptoms such as immobility, mutism and negativism. During his two hospitalizations, a total of 48 ECT sessions was given with encouraging results. Namely after the first hospitalization the patient left the hospital in excellent condition, where as in the second occasion results were fair.Treatment:ECT is one of the first somatic therapies in the history of psychiatry. In 1938 Cerletti and Bini administered the first successful treatment of schizophrenia inducing epileptic seizures via electricity. Today ECT is given under general anaesthesia including muscles relaxation, in organized hospital units and thus it is a safe and well tolerated therapy.Conclusion:our case report confirms the fact that in elderly ECT seems to have good results and few side effects.