A subgroup of patients with chronic schizophrenia may substantially benefit from sulpiride addition to clozapine.

BACKGROUND The incidence of cancer in patients with schizophrenia has been conversely reported to be higher, lower, or similar to that in the general population. The effects of lifestyle factors such as excess smoking, exposure to neuroleptic medications, and genetic factors that may influence the incidence of cancer in this group are not clear. The current study was performed to evaluate the frequency of cancer in a large cohort of patients with schizophrenia and to determine the standardized incidence ratios (SIRs) of any malignancy in this group. METHODS Data regarding the design, setting, and participants of the current study were analyzed from a cohort of 3226 patients with schizophrenia who were enrolled in the computerized health registry of the Abarbanel Mental Health Center between1993–2003. The mean age of the patients at the time of the diagnosis of cancer was 49 ± 14.7 years, with the majority of patients (61%) being male. All patients with schizophrenia records in the database were combined with the records of the Israeli National Cancer Registry to identify pathologically confirmed cancer comorbidity. The cancer incidence rates among patients with schizophrenia were compared with the expected incidence in an age‐matched and gender‐matched general population sample for the same time interval. RESULTS Among 1247 female patients with schizophrenia, 22 (1.8%) developed breast cancer and 68 (5.5%) developed cancers of any type. Fifty‐two of the 1979 male schizophrenic patients (2.6%) developed cancer. The SIRs were 0.58 (95% confidence interval [95% CI], 0.48–0.69) with a P value of < 0.05 for all cancers in the cohort, and 0.60 (95% CI, 0.37–0.90) for female breast cancer. CONCLUSIONS The results of the current study demonstrate a reduced risk of cancer in patients with schizophrenia. The mechanisms responsible for the lower risk need be investigated further. Cancer 2005. © 2005 American Cancer Society.

Background: Previous studies have suggested that sexual dysfunction may be associated with posttraumatic stress disorder (PTSD). Yet such studies have not examined a full range of sexual functioning and have not accounted for the possibility that medication used to treat PTSD may contribute to sexual dysfunction. Objective: The current study compares the various components of sexual functioning among three groups of males: (1) untreated PTSD patients (n = 15), (2) PTSD patients currently treated with selective serotonin reuptake inhibitor (SSRI) agents (n = 27) and (3) a group of normal controls (n = 49). Methods: All participants completed an 18-item questionnaire for assessment of sexual functioning. Those with PTSD also completed the Impact of Events Scale and the Symptom Check List-90 (SCL-90). Results: Untreated and treated PTSD patients had significantly poorer sexual functioning in all domains (desire, arousal, orgasm, activity and satisfaction) as compared to normal controls. Those treated with SSRI had greater impairment in desire, arousal and frequency of sexual activity with a partner. There was a high correlation between sexual dysfunction among the PTSD group and the anger-hostility subscale of the SCL-90. Conclusions: PTSD appears to be associated with pervasive sexual dysfunction that is exacerbated by treatment with SSRIs. PTSD may represent a heterogeneous syndrome. Patients with PTSD have a high rate of comorbid panic disorder, major depression and anxiety, and it could thus be argued that these comorbid disorders, rather than PTSD, accounted for the observed result. Future research aimed at understanding comorbidity and heterogeneity should help to illuminate the psychobiology of PTSD and eventually guide both medication and psychosocial treatments.

Objective: Falls are an everyday risk for the elderly and their etiology is multifactorial. Because there are little data focusing on falls among elderly psychiatric inpatients, we aimed to retrospectively assess the characteristics of inpatients that had sustained a fall during hospitalization. Methods: Over 4 years, all adverse-event reports of falls were reviewed. Inclusion criteria were age > 65 years and intact cognition. The control group consisted of the previous and next admission of an elderly patient to the same ward. Anti-cholinergic score was calculated for each patient. Results: Of 414 admissions of elderly patients, 34 (8.2%) patients had had a fall. The control group (n = 68) did not differ in mean age, distribution of diagnoses, or use of benzodiazepines, antidepressants, or antipsychotics. Two variables were significantly associated with falls: female gender (68% vs. 39%, p < .05) and anticholinergic burden score (ABS) (mean: 3.7 vs. 2.1, p < .05). Conclusions: Our results support reported findings of higher rates of falls among elderly women and suggest that ABS may be a risk factor for falls.

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The study prospectively evaluated the relationship between sexual dysfunction and urodynamic diagnoses in 100 consecutive female patients referred for urogynecologic evaluation. Sexual function was evaluated by a detailed questionnaire that addressed four phases of the sexual cycle: desire, arousal, orgasm and satisfaction. Each phase of the sexual cycle was assessed separately using a score of 1-4. Total sexual function (TSF) score was calculated by combining the scores of the four examined parameters (range 4-16). Analysis revealed statistically significant (P < 0.05) lower TSF scores in patients with detrusor instability (DI) than in those with genuine stress incontinence, sensory urge or mixed urodynamic diagnoses (8.65 +/- 4 versus 12.22 + 3.6, 10.25 +/- 4.1 and 11.47 +/- 4.1, respectively). Three per cent of the elderly women (>60 years) compared to 29% of the younger women (< or = 60 years) reported urinary incontinence during sexual activity. Sexual function should therefore be routinely evaluated in women presenting with urinary symptoms.

Sexual function following 3,4-Methylenedioxymethamphetamine (MDMA, or 'Ecstasy') consumption was subjectively evaluated in 35 healthy recreational users (20 men and 15 women, aged 21-48 years) with regard to four major domains of sexual activity: desire, erection (lubrication in women), orgasm and satisfaction. Desire and satisfaction were moderately to profoundly increased by MDMA in more than 90% of subjects. Orgasm was delayed but perceived as more intense. Erection was impaired in 40% of the men. It seems that MDMA impairs sexual performance, in spite of enhancement of sexual desire and the perception of greater satisfaction.

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