The functional sequelae of schizophrenia: consequences of long-term pharmacotherapy and the neurobiology of addiction

This issue contains different aspects of the broad spectrum of clinical psychiatry.

In the paper by Schaub et al. [1], the interplay between psychopathological syndromes and psychosocial functioning in chronic schizophrenia is examined. This is of special importance facing a continuous discussion what our treatment options mean to real life functioning for the patients. On the other hand, it is important to analyse whether psychopathological abnormalities revealed in patients are as important for the patients as to the examiner.

Suffering from schizophrenia means to a substantial proportion of the patients to take antipsychotic agents for a significant proportion of their lifetime, leading to side effects like the metabolic syndrome. Therefore, it is important to have reliable data on the prevalence and clinical correlates of it in patients suffering from schizophrenia as documented by Barbosa et al. [2]. However, not only patients with schizophrenia suffer from the metabolic consequences of long-term pharmacotherapy but also patients with acute depression face similar problems as was outlined by Richter et al. [3]. Along these lines, it should be stressed that the pharmacogenetics of antidepressant treatment will in the near future not only give support in the choice of the right substance looking at the efficacy but furthermore taking the special side effect profile into account [4]. Along these lines, the paper by Illi et al. [5] analyses the connection between 5-HTTLPR and selective serotonin reuptake inhibitors in major depression. Finally concluding this complex, the interest is drawn to a paper by Kikuchi et al. [6] performing an internet survey on patients’ attitude towards side effects of antidepressant treatment.

Linking state-of-the-art electrophysiology with personality traits, Mittermeier et al. [7] examined the role of auditory-evoked potentials in an emotional choice reaction task in relation to personality traits measured by the NEO FFI.

Researching the proteome in major psychiatric illnesses beyond schizophrenia or depression (as laid out in [8]), a recent study analysing the human amygdala found an impact of tubulin on drug-abusing behaviour [9]. In an article in this issue examining the consequences of alcohol abuse, Wedekind et al. [10] analysed S100B and homocysteine in the acute alcohol withdrawal syndrome. These and other neurobiological findings seem to define subgroups of patients with addictive behaviour pointing to the necessity of individualised treatments in alcohol dependents [11].