Early- and delayed antipsychotic response and prediction of outcome in 528 severely impaired patients with schizophrenia treated with amisulpride

'Early-onset' studies have shown that symptomatic response often occurs early and that early symptomatic response is predictive for later outcome. Limiting factors of these studies include the restriction on symptomatic outcome, the inclusion of mostly moderately ill patients, and the use of various antipsychotics.

Distinct lake level lowstand in Lake Prespa (SE Europe) at the time of the 74 (75) ka Toba eruption

Abstract. The 74 (75) ka Toba eruption in Sumatra, Indonesia, is considered to be one of the largest volcanic events during the Quaternary. Tephra from the Toba eruption has been found in many terrestrial and marine sedimentary deposits, and acidity peaks related to the eruption have been used to synchronize ice core records from Greenland and Antarctica. Seismic profiles and sedimentological data from Lake Prespa on the Balkan Peninsula, SE Europe, indicate a lake level lowstand at 73.6±7.7 ka based on ESR dating of shells. Tephrostratigraphy, radiocarbon dating and tuning of the total organic carbon content with the NGRIP isotope record, corroborate that the lake level lowstand was a short-term event superimposed on the general cooling trend at the end of MIS 5, most likely at the onset of the Greenland Stadial GS- 20. Acknowledging that tectonic events or karst processes could have triggered this lake level lowstand, the chronological correspondence between the lowstand and the Toba eruption is intriguing. Therefore a Toba-driven short-term shift to aridity in the Balkan region, leading to lake level changes and triggering spatial expansion events in one of the lake’s most abundant benthic species, the carino mussel Dreissena presbensis, cannot be excluded.

Direct linking of Greenland and Antarctic ice cores at the Toba eruption (74 ka BP)

The Toba eruption that occurred some 74 ka ago in Sumatra, Indonesia, is among the largest volcanic events on Earth over the last 2 million years. Tephra from this eruption has been spread over vast areas in Asia, where it constitutes a major time marker close to the Marine Isotope Stage 4/5 boundary. As yet, no tephra associated with Toba has been identified in Greenland or Antarctic ice cores. Based on new accurate dating of Toba tephra and on accurately dated European stalagmites, the Toba event is known to occur between the onsets of Greenland interstadials (GI) 19 and 20. Furthermore, the existing linking of Greenland and Antarctic ice cores by gas records and by the bipolar seesaw hypothesis suggests that the Antarctic counterpart is situated between Antarctic Isotope Maxima (AIM) 19 and 20. In this work we suggest a direct synchronization of Greenland (NGRIP) and Antarctic (EDML) ice cores at the Toba eruption based on matching of a pattern of bipolar volcanic spikes. Annual layer counting between volcanic spikes in both cores allows for a unique match. We first demonstrate this bipolar matching technique at the already synchronized Laschamp geomagnetic excursion (41 ka BP) before we apply it to the suggested Toba interval. The Toba synchronization pattern covers some 2000 yr in GI-20 and AIM-19/20 and includes nine acidity peaks that are recognized in both ice cores. The suggested bipolar Toba synchronization has decadal precision. It thus allows a determination of the exact phasing of inter-hemispheric climate in a time interval of poorly constrained ice core records, and it allows for a discussion of the climatic impact of the Toba eruption in a global perspective. The bipolar linking gives no support for a long-term global cooling caused by the Toba eruption as Antarctica experiences a major warming shortly after the event. Furthermore, our bipolar match provides a way to place palaeo-environmental records other than ice cores into a precise climatic context.