1. WP 4 Translation to clinical practice
ERANET NEURON Project: Linking synaptic dysfunction to disease mechanisms in schizophrenia - a multi-level investigation (SYNSCHIZ)
WP 4 Translation to clinical practice
Obregia Clinical Hospital of Psychiatry

2. OBJECTIVE
The objective of the first phase of the project was the initiation of the patients group.
Start data –

3. METHODS
A. Elaboration of the documents for obtaining the approval from Ethics Committee of the Clinical Hospital Of Psychiatry "Prof. Dr. Alex. Obregia".
Specific documents, which included informed consent for the patient or his / her legal representative and a description of the project, were submitted to the Ethics Commission of the Clinical Psychiatric Hospital "Prof. Dr. Alex. Obregia ".
The Ethics Commission approved the project activities.

4. METHODS
B. Methodology for clinical evaluation of patients with schizophrenia A working protocol was developed for constitution of the patient group.

5. Visit 1
Inclusion criteria: diagnosis of schizophrenia including all subtypes according to DSM IV and ICD 10.
Exclusion criteria: psychoactive substance use that can induce psychosis.
The patient / legal representative is informed about the present study.
The patient / legal representative signs the Informed Consent in 2 copies in the presence of the doctor and keeps a copy.
Patient code
Sex
Date of birth
Ethnicity
Clinical and psychiatric evaluation
Diagnosis: Schizophrenia with all the subtypes according to DSM IV TR and ICD 10
Patient history
Family history
Personal medical history – comorbidities (medical documents to prove) with associated medication
Psychiatric history - data on the age at onset, number of episodes, the degree of remission of inter-episodes symptomatology, the previous neuroleptic treatment, the mentioning of possible suicide attempts
Scales: PANSS, Calgary Scale, Sheehan Disability Scale (SDS), Addenbrooke’s Cognitive Examination
Blood taking for: Complete blood count; Hormones: TSH, fT4, prolactin; Inflammation markers: ESR, CRP; Biochemistry: TGP, TGP, GGT, LDL-cholesterol, HDL-cholesterol, triglycerides, total lipids, glycaemia, HbA1c; Ionogram: Na, K, Cl
Blood for DNA extraction
Setting up a schedule for EEG, MRI

6. RESULTS
In the current stage, 230 patients with schizophrenia were clinically evaluated:
221 - adult patients with paranoid schizophrenia
9 - adolescents with schizophrenia or acute psychosis.

7. The anamnesis included: - history of the disease: onset of symptoms, evolution, trigger factors; - family history: the existence of other relatives with schizophrenia or other mental illness in the patient's family; - personal history: school and professional route, drugs consumption, association of other medical conditions.

8. 49 patients donated blood for genetic studies
43 adults
6 adolescents

9. Adult patients
30 females
13 males

10. Adult patients
Age distribution: 21 – 69 yrs.

11. Adult patients
Familial history positive for psychiatric diseases – 13 patients

12. Adult patients
Comorbidities – 20 patients 7

13. Adult patients Marital status: 5 patients – married
5 patients – divorced
1 patient – widow
31 patients – no partner

14. Adult patients Education 30 – high school 5 - faculty
3 – 10 yrs school
2 – primary school
2 – secondary school

15. Adolescent patients 5 females 1 male Age – 14 – 17 yrs.: 1 – 14 yrs.

16. Adolescent patients
Familial history positive for psychiatric diseases – 3 patients
Personal history – 1 patient – premature birth with mild delayed psychomotor development
5 patients – high school students with good results
1 patient – abandoned the school

17. Schizophrenia in children and adolescents
The study included children and adolescents with schizophrenia or acute psychosis admitted to the Child and Adolescent Psychiatry Clinic from January 2017 to May 2019

18. 116 patients aged from 11 to 17 years
74 males and 42 females

19. 62 of adolescents had at least one first-degree or second-degree relative with psychiatric history.

20. Comorbidities:
- epileptic seizures in 8 children,
- ADHD in 6 children,
- 16 patients associated intellectual disability, mostly the mild form (12 patients).

21. The disorder’s onset was due to the use of drugs in 10 patients.
In most cases (81 patients), the primary symptoms were hallucinations or delusions; other symptoms included social withdrawal, depressive disposition, aggressivity, and negativism.