Restless legs syndrome following the use of ziprasidone: a case report

Restless legs syndrome(RLS)is a common sleep-related movement disorder characterised by an uncomfortable urge to move the legs that occurs during periods of inactivity.Although there have been many case reports on antipsychotic-induced RLS,ziprasidone has never been reported as a cause of RLS.We present a case of a female patient with schizophrenia who presented with symptoms of RLS following the administration of high doses of ziprasidone added to quetiapine and valproate.The patient’s symptoms of RLS occurred following the administration and titration of ziprasidone to 160 mg,and were relieved upon reducing the dose to 120 mg/day.Other potential causative medications and differential diagnoses that could have caused similar symptoms were excluded.Clinicians should be aware of the potential for ziprasidone-induced RLS.Dopamine and serotonin interaction could be the mechanism underlying ziprasidone-induced RLS.

精神分裂症患者治疗前血清MCP-1水平预测利培酮疗效（英文）

背景:精神分裂症是一种慢性致残性疾病,其发病及治疗可能与炎性细胞因子有关。目前细胞因子预测抗精神病药物疗效的研究尚少。目的:研究细胞因子对抗精神病药物疗效的预测作用。方法:采用横断面与自然观察随访相结合的方法,(1)对比精神分裂症患者组(n=64)基线期和正常对照组(n=53)血清IL-1β、TNF-α和MCP-1水平;(2)探索基线期细胞因子水平对奥氮平或利培酮单药治疗效果的影响。结果:(1)精神分裂症患者治疗前血清MCP-1水平明显高于健康对照组(t=2.62,p=0.010),IL-1β(t=1.43,p=0.154)、TNF-α(t=0.79,p=0.434)未见变化;(2)精神分裂症患者治疗前MCP-1水平与利培酮单药治疗4周后PANSS量表一般病理评分的减少量呈显著负相关(r=-0.658;p﹤0.001),但在奥氮平组中则未发现(r=-0.031;p=0.855);(3)纳入性别、年龄、受教育年限和BMI后等影响因素后,多元线性回归分析发现,基线血清MCP-1水平可作为利培酮单药治疗效果的独立预测因子(校正R2=0.409,β=-0.658,p﹤0.001)。结论:MCP-1可能参与精神分裂症的发生,治疗前血清MCP-1水平可能是利培酮疗效预测的生物标记物。

Intermediary roles of prospective memory and retrospective memory in the comorbidity of depression and pain

Background Patients who suffer comorbidity of major depressive disorder(MDD)and chronic pain(CP)maintain a complex interplay between maladaptive prospective memory(PM)and retrospective memory(RM)with physical pain,and their complications are still unknown.Aims We aimed to focus on the full cognitive performance and memory complaints in patients with MDD and CP,patients with depression without CP,and control subjects,considering the possible influence of depressed affect and chronic pain severity.Methods According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the criteria given by the International Association of Pain,a total of 124 participants were included in this cross-sectional cohort study.Among them,82 depressed inpatients and outpatients from Anhui Mental Health centre were divided into two groups:a comorbidity group(patients with MDD and CP)(n=40)and a depression group(patients with depression without CP)(n=42).Meanwhile,42 healthy controls were screened from the hospital’s physical examination centre from January 2019 to January 2022.The Hamilton Depression Rating Scale-24(HAMD-24)and Beck Depression Inventory-II(BDI-II)were used to evaluate the severity of depression.The Pain Intensity Numerical Rating Scale(PI-NRS),Short-Form McGill Pain Questionnaire-2 Chinese version(SF-MPQ-2-CN),Montreal Cognitive Assessment-Basic Section(MoCA-BC),and Prospective and Retrospective Memory Questionnaire(PRMQ)were used to assess pain-related features and the global cognitive functioning of study participants.Results The impairments in PM and RM differed remarkably among the three groups(F=7.221,p<0.001;F=7.408,p<0.001)and were severe in the comorbidity group.Spearman correlation analysis revealed the PM and RM were positively correlated with continuous pain and neuropathic pain(r=0.431,p<0.001;r=0.253,p=0.022 and r=0.415,p<0.001;r=0.247,p=0.025),respectively.Regression analysis indicated a significant positive relationship between affective descriptors and total BDI-II score(β=0.594,t=6.600,p<0.001).Examining the mediator pathways revealed the indirect role of PM and RM in patients with comorbid MDD and CP.Conclusions Patients with comorbid MDD and CP presented more PM and RM impairments than patients with MDD without CP.PM and RM are possibly mediating factors that affect the aetiology of comorbid MDD and CP.

Increased plasma leptin as a novel predictor for psychopathological depressive symptoms in chronic schizophrenia

Background Depressive symptoms are often seen in schizophrenia. The overlap in presentation makes it difficult to distinguish depressive symptoms from the negative symptoms of schizophrenia. The adipokine leptin was found to be altered in both depression and schizophrenia. There are few studies focusing on the prediction of leptin in diagnosis and evaluation of depressive symptoms in schizophrenia.ObjectiveAims To assess the plasma leptin level in patients with schizophrenia and its relationships with depressive symptoms.Methods Cross-sectional studies were applied to(1) compare the levels of plasma leptin between schizophrenia(n=74) and healthy controls(n=50); and(2)investigate the relationship between plasma leptin levels and depressive subscores.Results(1) Plasma leptin levels were significantly higher in patients with schizophrenia than in healthy controls.(2) Correlation analysis revealed a significant negative association between leptin levels and the depressed factor scores on the Positive and Negative Syndrome Scale(PANSS).(3) Stepwise multiple regression analyses identified leptin as an influencing factor for depressed factor score on PANSS.Conclusion Leptin may serve as a predictor for the depressive symptoms of chronic schizophrenia.

Case report of the treatment and experience of mental disorders due to chronic viral encephalitis

Viral encephalitis is a common clinical condition.Its clinical manifestations are variable and include neurological symptoms and psychiatric abnormalities,which makes clinical diagnosis and treatment difficult.To date,there are only a few reported cases on mental symptoms of chronic viral encephalitis.We present a case of a 16-year old male patient who was previously hospitalised and diagnosed with schizophrenia and treated with aripiprazole 15 mg/day but failed to respond.The patient was then given antiviral therapy and recovered after 2 weeks.Clinicians should be aware of the possbility that chronic mental disorders could be caused by viral encephalitis.In the future,diagnosis of chronic functional mental disorders should include viral encephalitis in the differential diagnosis.

Deep Transcranial Magnetic Stimulation as a Potential Approach for Digital Pain Management in Patients with Psychotic Disorder

Dear Editor,Pain is a common and complex clinical problem which affects 28%-50%of the general population and is responsible for large health-related costs.People with chronic pain often develop nociceptive sensitization,having mood and anxiety disorders as comorbidities.Sustained pain may alter the processing of affective information in the brain,thereby inducing anxio-depressive disorders.