Dear colleagues,
I am delighted to introduce our first issue of 2013 featuring an update on the long-term biological treatment of schizophrenia and original work on emotional processing in personality disorders.
The WFSBP Guidelines for Biological Treatment of Schizophrenia, Part 2, represent an evidence-based update of the first edition published in 2006. Again, they cover options for long-term biological treatment and for management of antipsychotic-induced side effects in adult schizophrenia. Based on a systematic review and evaluation of up-to-date literature, this comprehensive manual provides clinically and scientifically relevant practice recommendations. These may be used world-wide by physicians treating patients with schizophrenia in order to further improve therapy progress, effectiveness and outcomes. My sincere gratitude is expressed to Alkomiet Hasan, secretary of the WFSBP Task Force on Schizophrenia, and to the entire Task Force for their magnificent work.
Heralding the second thematic focus of this issue, Enzi and colleagues investigated the impact of processing emotional stimuli on the neural correlates of simultaneous anticipation of reward in borderline personality disorder (BPD) using functional magnetic resonance imaging (fMRI). Under emotional stimulation, several regions in the brain's reward circuitry were found to show either a disturbed differentiation of reward and non-reward anticipation or a failure of deactivation in BPD patients. The findings indicate wide-ranging consequences of emotional disturbances in BPD, which may include altered reward behaviour and even interpersonal attachment problems.
In another fMRI study, Premkumar and colleagues addressed whether or not criticism from family members is processed differently in healthy individuals depending on the level of schizotypal personality traits. The authors revealed that individuals with high schizotypy, who also had lower current mood, showed less activation mainly in reward-related brain structures during positive compared to neutral comments of their relatives. The results suggest reciprocal effects between perceived relative criticism, mood and neural response to criticism from family members.
The influence of concurrently presented emotional stimuli on the neural representation of working memory processes in comorbid BPD and antisocial personality disorder is covered in a brief report by Prehn and colleagues. The authors broaden existing knowledge by showing that emotionally high salient stimuli were accompanied by slower responses and higher amygdala activation in patients when compared to controls. The findings provide new evidence for enhanced emotional reactivity as a potential crucial factor in the genesis of aggressive behaviour in individuals characterized by affective instability.
Yours sincerely,
Siegfried Kasper, MD
Chief Editor