Sleep disorders are widespread among patients with schizophrenia and contribute to adverse clinical outcomes. Antipsychotic drugs exert varying effects on sleep, and the effects of atypical agents may differ from those of conventional neuroleptics.

To review the literature on the effects of atypical medication on subjective and objective sleep quality in patients with schizophrenia.

A non-systematic literature review of Medline was performed in August 2003 searching the period from January 1985 to August 2003 for studies of the effects of atypical antipsychotics on sleep.

We found published studies of clozapine, olanzapine, and risperidone, but none on quetiapine or ziprasidone. Studies with clozapine showed that it increased total sleep time, sleep efficiency, stage-2 non-rapid eye movement sleep and rapid eye movement (REM) sleep density, and decreased stage-4 sleep, slow wave sleep (SWS) and stage-1 sleep. Single-dose studies with olanzapine have shown that it increases SWS, sleep continuity, total sleeping time, subjective sleep quality, and delta sleep. Long-term studies with risperidone have shown improvements in total sleep, sleep efficiency, sleep continuity, SWS, and stage-2 sleep, and reductions in sleep latency, number of awakenings, and proportion of time awake. These benefits were paralleled by improvements in subjective sleep assessment and psychopathology, and psychosocial functioning.

The evidence presented in this review suggests that atypical antipsychotics exert favorable effects on sleep profile compared with conventional agents, including improvement of subjective sleep quality and modification of specific sleep stages known to be associated with better clinical outcome.

The aim of this study was the assessment of −308G/A tumor necrosis factor (TNF)-α gene polymorphism and intPLA2 gene polymorphism in patients with anorexia nervosa (AN) and healthy controls.

We studied 91 non-related patients with AN and 144 healthy women (blood donors and students). The mean age of women from study group was 18.22 years (SD ± 3.13 years) and from control group was 31.71 years (SD ± 8.22).

Gene polymorphisms were studied with the use of polymerase chain reaction-restriction fragment length polymorphism method. TNF-α gene polymorphism consists of G/A substitution in −308 promoter region. IntPLA2 gene polymorphism is related to intron 1, in which restrictive region is found and recognized by BanI enzyme.

We did not obtain statistically significant differences in the frequency of genotypes and alleles of −308G/A TNF-α polymorphism between the study and control groups (genotypes: P = 0.106, alleles: P = 0.076). We did analogous analysis in the restrictive and bulimic subgroups. We did not observe statistically relevant differences in the frequency of genotypes (P = 0.700) and alleles (P = 0.305). We did not obtain statistically relevant difference in the frequency of genotypes and alleles of intPLA2 gene between the study group and controls (genotypes: P = 0.300, alleles: P = 0.331). We did analogous analysis in both subgroups of AN. We did not observe statistically relevant differences in the frequency of genotypes (P = 0.344) and alleles (P = 0.230).

There was no statistically relevant trend for the association between TNF-α polymorphism and AN. We did not find association between studied polymorphism of intPLA2 gene and risk of AN.

The aim was to evaluate the prevalence of psychiatric morbidity in Polish population.

The national health interview survey was based on entire non-institutionalized Polish population by means of randomized, stratified (urban and rural census tracks) two-stage method (over 39 000 respondents). Prevalence of psychiatric morbidity was based on General Health Questionnaire-12.

Psychiatric morbidity was noted in almost 1/4 of women and 1/5 of men in Poland, with small differences between urban and rural population. Every 10th woman reported such complaints at the age up to 25 years and every second above 75 years of age. Divorced and widowed respondents, irrespective of gender, have psychiatric disorders more frequently than compared groups. Higher prevalence of psychiatric morbidity was noted in out of work and especially disabled persons. The higher the level of education, the lower the frequency of psychiatric morbidity was observed.

Presented survey enabled to evaluate prevalence of psychiatric morbidity in Polish representative sample. Findings should trigger more extended epidemiological studies. The requirement for epidemiological investigations increases in reform-awaiting health care system in Poland, for at least one reason that the improvement of the quality of services is closely associated with a detailed recognition of the problem.

Atypical antipsychotics are increasingly used in the treatment of diverse psychiatric disorders; however, there is little information on the ‘why, when, and how’ of switching between the different atypical antipsychotics currently available.

To review the data on switching and atypical antipsychotics.

A literature search was initially conducted using the key words followed by a search of relevant articles including conference abstracts; relevant pharmaceutical companies were also contacted.

Clinical trial data are limited in terms of parameters measured, and case reports describe specific problems. Few studies are based on real world populations of psychiatric patients over the long-term. Careful patient and drug selections matched to a carefully supervised and appropriate cross titration based upon the pharmacodynamic and pharmacokinetic properties of all of the drugs involved is important to avoid potential complications such as re-emergence or worsening of psychosis and withdrawal, rebound, and emergent phenomena including new or uncovered side-effects. Psychoeducation and involvement of patients and caregivers in the process are also necessary for a successful switch.

Despite the prevalence of switching in real world clinical practice, there is a paucity of data to guide clinicians with respect to effective and safe strategies. There are no criteria defining a successful switch. With the increasing range and formulations of atypical antipsychotics available, there is a rationale for their early use to avoid the practical problems associated with switching from conventional antipsychotics as well as the opportunity to maintain patients on an optimal atypical antipsychotic monotherapy.