BackgroundSchizophrenia is the collective term for an exclusively clinically diagnosed, heterogeneous group of mental disorders with still obscure biological roots. Based on the assumption that valuable information about relevant genetic and environmental disease mechanisms can be obtained by association studies on patient cohorts of ≥ 1000 patients, if performed on detailed clinical datasets and quantifiable biological readouts, we generated a new schizophrenia data base, the GRAS (Göttingen Research Association for Schizophrenia) data collection. GRAS is the necessary ground to study genetic causes of the schizophrenic phenotype in a 'phenotype-based genetic association study' (PGAS). This approach is different from and complementary to the genome-wide association studies (GWAS) on schizophrenia.MethodsFor this purpose, 1085 patients were recruited between 2005 and 2010 by an invariable team of traveling investigators in a cross-sectional field study that comprised 23 German psychiatric hospitals. Additionally, chart records and discharge letters of all patients were collected.ResultsThe corresponding dataset extracted and presented in form of an overview here, comprises biographic information, disease history, medication including side effects, and results of comprehensive cross-sectional psychopathological, neuropsychological, and neurological examinations. With >3000 data points per schizophrenic subject, this data base of living patients, who are also accessible for follow-up studies, provides a wide-ranging and standardized phenotype characterization of as yet unprecedented detail.ConclusionsThe GRAS data base will serve as prerequisite for PGAS, a novel approach to better understanding 'the schizophrenias' through exploring the contribution of genetic variation to the schizophrenic phenotypes.

In spite of their well known advantages, depot antipsychotics are seldom prescribed in the treatment of schizophrenia. A frequently stated reason is the patient's objection to depot treatment. We questioned 300 patients in nine psychiatric hospitals shortly before their discharge about their preferences in the mode of administration of antipsychotic treatment, taking earlier depot experience into account. 145 patients were naive to depot treatment, 95 had experienced a depot earlier and 60 were currently on a depot medication. Acceptance of depot treatment in relapse prevention was 73% in patients currently being treated with a depot and 45% in depot-experienced patients, compared with 23% in depot-naive participants. Participants, depending on their experience with the formulation, acknowledged suggested potential advantages of depot treatment. Preference of depots as favorable antipsychotic treatment depends on the patient's experience with the formulation. A considerable number of patients would accept a depot drug as a long-term treatment option. The gap between patients' acceptance and the low prescription rates can be narrowed by offering antipsychotic depots to more patients.

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There is considerable evidence that attention deficit/hyperactivity disorder (ADHD) is associated with conduct problems, social maladaptation and delinquent behavior. The "Ottweiler Study" was performed to elaborate the prevalence of ADHD and comorbid disorders in 129 young adult detainees of the juvenile prison of Ottweiler (Germany) according to DSM-IV and ICD-10 criteria. Here we report psychopathological characteristics of 28 inmates, who fulfilled the diagnostic criteria for persisting ADHD, and 37 individuals with neither a history nor current ADHD symptoms. Childhood ADHD symptoms but no current ADHD were present in 64 individuals. The Wender-Reimherr Interview (WRI) based on the Utah criteria for adult ADHD, the NEO-five factor personality inventory (NEO-FFI) and the youth self report/young adult self report (YSR/YASR) according to Achenbach were used for the assessment of psychopathology and the description of behavioral problems. Regarding WRI and YSR/YASR we found a significant increase of emotional and internalizing problems in the ADHD group compared to delinquents without ADHD or ADHD history. ADHD delinquents scored higher on the personality dimension neuroticism, and showed lower scores on the dimensions agreeableness and consciousness. Using discriminant analysis, high scores on the WRI subscales disorganization and attention difficulties and NEO-FFI neuroticism were the best predictors of ADHD diagnosis. The results support prior findings of high ADHD prevalence in prison inmates and suggest that emotional and internalizing abnormalities are prominent problems in this population. Further studies are needed to elucidate the role of ADHD as an independent factor for life-persistent criminality, since specific treatment may help to ameliorate the legal prognosis.

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The interaction of psychopathological states and psychosocial functioning determine the long-term course of schizophrenia and its treatment. To be able to achieve this interplay better, exact assessment of psychosocial functioning is needed besides measurement of psychopathology. Using the Personal and Social Performance (PSP) Scale, examination of the association between psychosocial functioning and psychopathology was conducted in a sample of 103 patients with chronic schizophrenia. Rating instruments were in addition Global Assessment of Functioning Scale and Social and Occupational Functioning Assessment Scale, as well as Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale, and Mini-ICF-APP-Rating for Mental Disorders (Mini-ICF-APP). Besides good psychometric properties for the PSP scale in this chronic sample, we found, as expected, significant associations between the two relevant outcome domains: results showed significant negative correlations between PSP and PANSS. Findings prove the close interplay between social functioning and psychopathology in the chronic course of schizophrenia.

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Despite the seriousness of the suicide attempt, survivors recovered well in about half the cases with no further suicide attempt in any patient. An early psychiatric consultation already on the Intensive Care Unit (ICU) is recommended.