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Objective: Antipsychotic compounds are known to induce sedation somnolence and have expanded clinical indications beyond schizophrenia to regulatory approval in bipolar disorder, treatment-resistant depression, and is being repurposed in infectious diseases and oncology. However, the medical sciences literature lacks a comprehensive association between sedation and somnolence among a wide-range of antipsychotic compounds. The objective of this study is to assess the disproportionality of sedation and somnolence among thirty-seven typical and atypical antipsychotics. Materials and Methods: Patient adverse drug reactions (ADR) cases were obtained from the United States Food and Drug Administration Adverse Events Reporting System (FAERS) between January 01, 2004 and September 30, 2020 for a wide-array of clinical indications and off-label use of antipsychotics. An assessment of disproportionality were based on cases of sedation and somnolence and calculated using the case/non-case methodology. Statistical analysis resulting in the reporting odds-ratio (ROR) with corresponding 95% confidence intervals (95% CI) were conducted using the R statistical programming language. Results: Throughout the reporting period, there were a total of 9,373,236 cases with 99,251 specific ADRs reporting sedation and somnolence. Zuclopenthixol (n = 224) ROR = 13.3 (95% CI, 11.6-15.3) was most strongly associated of sedation and somnolence and haloperidol decanoate long-acting injection (LAI) was not statistically associated sedation and somnolence. Further, among atypical antipsychotic compounds, tiapride and asenapine were the top two compounds most strongly associated with sedation and somnolence. Comprehensively, the typical antipsychotics ROR = 5.05 (95%CI, 4.97-5.12) had a stronger association with sedation and somnolence when compared to atypical antipsychotics ROR = 4.65 (95%CI, 4.47-4.84). Conclusion: We conducted a head-to-head comparison of thirty-seven antipsychotics and ranked the compounds based on the association of sedation and somnolence from ADR data collected throughout 16 years from the FAERS. The results are informative and with recent interests in repurposing phenothiazine antipsychotics in infectious disease and oncology provides an informative assessment of the compounds during repurposing and in psychopharmacology.

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INTRODUCTION: The purpose of this electrophysiological neuroimaging study was to provide a deeper mechanistic understanding of both olanzapine and risperidone pharmacodynamics relative to gender. In doing so, we age-matched 22 men and women and evaluated their resting-state EEG recordings and later used standard low resolution brain Electrotomography to visualize the differences in brain activity amongst the two patient groups. METHODS: In this investigation, electroencephalogram (EEG) data were analyzed from male and female schizophrenia patients treated with either olanzapine or risperidone, both atypical antipsychotics, during their in-patient stay at the Department of Psychiatry. Twenty-two males and females were age-matched and EEG recordings were analyzed from 19 Ag/AgCl electrodes. Thirty-seconds of resting EEG were spectrally transformed in standardized low resolution electromagnetic tomography (sLORETA). 3D statistical non-paramentric maps for the sLORETA Global Field Power within each band were finally computed. RESULTS: The results indicated that, relative to males patients, females schizophrenia patients had increased neuronal synchronization in delta frequency, slow-wave, EEG band located in the dorsolateral prefrontal cortex, within the middle frontal gyrus (t= -2.881, p < 0.03580). These findings suggest that females experience greater dopamine (D2) receptor and serotonin (5-HT2) receptor neuronal blockade relative to age-matched males. Further, our finding provided insight to the pharmacodynamics of second-generation antipsychotics olanzapine and risperidone. CONCLUSION: When compared to male patients, female patients, suffering from schizophrenia, have D2 and 5-HT2 receptors that are blocked more readily than age-matched male schizophrenia patients. Clinically, this may translate into a quicker time to treatment-response in females as compared to male patients.

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INTRODUCTION: The purpose of this investigatory neuroimaging analysis was done to better understand the pharmacodynamics of Lithium by isolating the norepinephrine pathway in the brain. To accomplish this, we compared patients with Bipolar Disorder treated with Lithium to patients diagnosed with Major Depression or Depressive Disorder who are treated with Selective Serotonin Reuptake Inhibitors (SSRIs). METHODOLOGY: We used Standardized Low Resolution Brain Electrotomography to calculate the whole brain, voxel-by-voxel, unpaired t-tests Statistical non-Parametric Maps. For our first electrophysiological neuroimaging investigation, we compared 46 patients (average age = 34 ± 16.5) diagnosed with Bipolar Affective Disorder to three patient groups all diagnosed with Major Depression or Depressive Episode. The first is with 48 patients diagnosed with Major Depression or Depressive Episode (average age = 49 ± 12.9), the second to 16 male depressive patients (average age = 45 ± 15.1), and the final comparison to 32 depressive females (average age = 50 ± 11.7). RESULTS: The results of sLORETA three-dimensional statistical non-parametric maps illustrated that Lithium influenced an increase in neurotransmission in the right Superior Temporal Gyrus (t=1.403, p=0.00780), Fusiform Gyrus (t=1.26), and Parahippocampal Gyrus (t=1.29). Moreover, an increased in neuronal function was found was also identified at the Cingulate Gyrus (t=1.06, p=0.01200). CONCLUSION: We are proposing a translational clinical biological marker for patients diagnosed with Bipolar Disorder to guide physicians during the course of Lithium therapy and have identified neuroanatomical structures influenced by norepinephrine.

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AIM: The aim of this study was a comparison of socio-demographic data of female patients with a diagnosis of purging and restricting type of anorexia nervosa. METHODS: The method of the study was an analysis of the data obtained from 131 case histories of female patients with a diagnosis of anorexia nervosa (40 patients with restrictive type and 91 with a bulimic type of anorexia), treated at the Adolescent Department and the Neurosis Department of the Psychiatry Department of the Medical University of Lublin in the years 1993-2003. The mean age of the investigated patients with a restrictive type of anorexia was 20.8 years, the age of disease onset was 16.5 years, the mean time of disease duration was 3.7 years, mean BMI = 15.4. The mean age of the patients with a bulimic type of anorexia was 21.8 years, the age of disease onset was 17.9 years, the mean time of disease duration was 4.6 years, mean BMI = 15.9. Half of the patients had a secondary level education. 87% were brought up in a full family and the most frequent reason of being brought up by a single parent was the death of another parent. RESULTS: Results of our study revealed relevant differences between female patients with a restrictive type of anorexia and a purging type of anorexia in certain family factors. CONCLUSIONS: (1) Compared to the patients with the restrictive type of anorexia, much more patients with the bulimic type of anorexia assessed their relationships with their mothers negatively. (2) Much more patients with the bulimic type of anorexia compared to the patients with the restrictive type of anorexia, experienced sexual and physical abuse, in most cases caused by their fathers. (3) Alcohol abuse was present in 53% of the fathers of the patients with the bulimic type of anorexia and 30% of the fathers of patients with the restrictive type of anorexia. (4) Mental diseases occurred more often in mothers of women with a restrictive type of anorexia (10%) than the bulimic type (2.2%). (5) Chronic somatic diseases occurred more often in fathers of the patients with a restrictive type of anorexia (12%) than with the bulimic type (2.2%). (6) Compared to the patients with the restrictive type of anorexia, significantly more patients with the bulimic type of anorexia abused alcohol and had a lifetime history of suicide attempt.

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AIM: The aim of this study was an analysis of data collected from the case histories of female patients with a diagnosis of bulimia nervosa, who underwent medical treatment at the Psychiatry Department of the Medical University of Lublin in the years 1993-2003. METHODS: 53 female patients with a mean age of 22 years, the age of disease onset--17.5 years, and mean BMI = 22.3. In this group 58.5% of the patients had secondary level education, primary level--24.5%, vocational--3.8% and higher level education--7%. Most patients were city inhabitants (64.2%), and lived together with their parents (85%). RESULTS: Half of the patients were brought up in a complete family, whilst the most frequent cause of being brought up by a single parent was the death of the other parent (26.4%). In this group 54.7% of the patients continued their studies, 13.2% worked and 32% were unemployed. More than half of the patients assessed their relationship both with their fathers (54.7%) and their mothers (58.5%) negatively. 20.8% of the patients were victims of physical violence and 18.8%--of sexual abuse. Alcohol was abused by 56.6% of their fathers, 7.5% of their mothers and 18.6% of the patients themselves. A life history of suicide was present in 13.2% of the patients. More mothers (13.2%) compared to the patients' fathers (1.9%), suffered from chronic somatic diseases and mental disturbances; 3.8% of the patients' siblings developed eating disorders. In conclusions we compared data received from patients with anorexia nervosa with data from patients with bulimia. CONCLUSIONS: Female patients with a purging type of anorexia are similar to female patients with bulimia in many socio-demographic factors, and at the same time they differ from female patients with a restricting type of anorexia.

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BACKGROUND: Emotion recognition impairments have been demonstrated in schizophrenia, but few studies have examined whether these reflect generalised or specific perceptual deficits or are associated with illness course. AIMS: To examine the nature of emotion recognition abnormalities in patients with schizophrenia at different stages of illness. METHOD: We examined the performance of 50 in-patients with early-stage schizophrenia, 50 with chronic schizophrenia and 50 healthy controls on the Benton Facial Recognition Test, Facial Emotion Recognition Test and Voice Emotion Recognition Test. RESULTS: Patients with chronic schizophrenia were significantly more impaired than other groups on the emotional tasks, even after controlling for impairments in non-emotional stimuli. Individual emotion recognition accuracy for the two sensory modalities was not significantly positively correlated for either group with schizophrenia. CONCLUSIONS: Emotion recognition deficits in schizophrenia are trait features of the disorder and increase with illness duration.

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AIM: A lot of inconsistencies across dimensional studies of schizophrenia(s) are being unveiled. These problems are strongly related to the methodological aspects of collecting data and specific statistical analyses. Psychiatrists have developed lots of psychopathological models derived from analytic studies based on SAPS/SANS (the Scale for the Assessment of Positive Symptoms/the Scale for the Assessment of Negative Symptoms) and PANSS (The Positive and Negative Syndrome Scale). The unique validation of parallel two independent factor models was performed--ascribed to the same illness and based on different diagnostic scales--to investigate indirect methodological causes of clinical discrepancies. METHOD: 100 newly admitted patients (mean age--33.5, 18-45, males--64, females--36, hospitalised on average 5.15 times) with paranoid schizophrenia (according to ICD-10) were scored and analysed using PANSS and SAPS/SANS during psychotic exacerbation. All patients were treated with neuroleptics of various kinds with 410mg equivalents of chlorpromazine (atypicals:typicals --> 41:59). Factor analyses were applied to basic results (with principal component analysis, normalised varimax rotation). Investing the cross-model validity, canonical analysis was applied. RESULTS: Models of schizophrenia varied from 3 to 5 factors. PANSS model included: positive, negative, disorganisation, cognitive and depressive components and SAPS/SANS model was dominated by positive, negative and disorganisation factors. The SAPS/SANS accounted for merely 48% of the PANSS common variances. The SAPS/SANS combined measurement preferentially (67% of canonical variance) targeted positive-negative dichotomy. Respectively, PANSS shared positive-negative phenomenology in 35% of its own variance. The general concept of five-dimensionality in paranoid schizophrenia looks clinically more heuristic and statistically more stabilised.

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Disordered communication of emotions belongs to the primary schizophrenia symptoms. The aim of this study was our attempt of the localisation of the deficits in emotional communication (its decoding and expression) in dimensional models of schizophrenia. The evaluation of emotionality in schizophrenia might be performed indirectly via negative dimension (for instance: apathy, diminished verbal fluency, flat or inappropriate emotional reactions), via excitement (elevated mood) and depression (decreased mood) or via cognitive dimension. Interpretation of emotional phenomena within the cognitive dimension remains an oversimplification. Brain emotional and cognitive systems act independently although they also reveal mutual interactions enabling the control of emotional behaviour via social learning of emotions. To conclude, to date emotional dimension in schizophrenia has not yet received satisfactory explanation which is in line with the complex nature of emotions. Thus the question regarding the location of emotions in dimensional models of schizophrenia still remains open.

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OBJECTIVE: The aim of this study was to examine emotional recognition (prosodic and visual) in anorexia nervosa. METHODS: Thirty people with anorexia nervosa and a comparison group of 30 healthy women were tested with facial and vocal stimuli that expressed specific emotions and they were given a neutral task. RESULTS: The group of women with anorexia nervosa was poor at emotional recognition. This was most marked for negative emotions in faces and for both positive and negative emotions in voices. This decreased ability to recognize negative affect in faces remained even after adjustment for confounding variables such as age, education, and depression. DISCUSSION: People with anorexia nervosa have difficulty recognizing emotions from facial expression and vocal tone. This may contribute to poor interpersonal communication and a lack of empathy, both of which are associated with anorexia nervosa patients.

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AIM: The aim of this study was to compare the self-image and the image of other people in the perception of female patients with anorexia nervosa. METHOD: Thirty women with anorexia nervosa were investigated during hospitalisation in the Psychiatric Department of the Medical School of Lublin. The mean age of patients was 20 years. The Adjective Check List (ACL) of Gough and Heilbrunn was used with the instruction: how you are, how would you like to be, how are the other people. RESULTS: The measurement gave us the possibility to obtain the real and ideal self-image and the real image of the other people. The results showed that there are statistically significant differences between self-image and the image of other people in the perception of anorectic females in connection with self-acceptance, self-control, the need of intraception, nurturance, exhibition, autonomy, aggression, need of abasement, difference, the scale of masculine attributes, the scale of feminine attributes and the scale of the free child. CONCLUSIONS: Significant differences occurred also in the scale based on the results. The final conclusions are as follows: 1) Anorectic females show negative self-image and even a more negative image of other people. 2) According to anorectic females the people are more aggressive, more self-issued, avoiding close contacts, manipulating, tending to gain autonomy and to be in the centre of the group's attention.

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Despite the evidence for impaired perception of negative affect in schizophrenia, there have been a few functional neuroimaging studies so far examining neural responses to facial negative emotional stimuli in this illness. These studies have demonstrated that schizophrenic patients relative to healthy controls fail to activate the amygdala in response to facial expressions of fear, and also during a sadness induction paradigm. These recent findings reflect functional amygdala abnormalities in overt displays of fear in schizophrenic patients. Lack of amygdala activation in obvious aversive stimuli and enhanced amygdalar response to ambiguous stimuli might be explained by an altered threshold at which the amygdala responds to fearful stimuli. Morphological change of bilaterally amygdala volume has been found using MRI although some researchers have found only unilateral reduction or enlargement in the left amygdala. To conclude, brain imaging literature focused on amygdala abnormalities in schizophrenia is full of inconsistencies due to incomplete understanding of the illness itself, different techniques and stimuli used.

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The investigation into neural back-ground of emotions in normal and brain pathology using functional brain imaging techniques (fMRI, PET, SPECT) remains one of the most interesting scientific challenges in the area of psychiatry. The aim of the current study is: 1) to present the recent neuroimaging findings concerning functioning of "emotional brain" in normal and brain pathology with particular emphasis on psychiatric disorders, 2) to consolidate knowledge of neuroimaging techniques and experimental designs used in the assessment of human affect.

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