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Obsessive-compulsive disorder (OCD) is an ailment of heterogeneous nature. It is believed that the age of onset determines the subtype of juvenile OCD. The objective of our study was to evaluate the rates of symptoms' contents and the age of manifestation of the various OCD symptoms in adolescents and adults with early and late onset of disorder. Both authors independently reviewed the medical charts of patients treated for OCD between 1999 and 2007 in a psychiatric university hospital. Patients were evaluated using the Yale-Brown obsessive-compulsive scale check list (Y-BOCS). The patients were grouped as adolescents (group 1), adults with late onset (group 2) and adults with early onset (group 3). Chi2 was used for nominal variables and the non-parametric Kruskal-Wallis ANOVA for continuous comparisons due to deviations from normality of distribution. A total of 132 patients were enrolled in the study (44 group 1, 43 group 2 and 45 group 3). There were no differences in gender distribution. Religious, sexual and miscellaneous obsessions were more frequent and somatic less frequent in group 1 than in group 2. Contamination compulsions were most seldom found in group 1. Cleaning obsessions were more frequent in group 3 than in group 1. Checking were the rarest and miscellaneous, the most often compulsion among adolescents in comparison to other groups. The symptoms' content in adolescents differed from those observed in adult, both with early and later onset of the disease. The age at onset influences the rates of adult patients' compulsions.

Dysfunction of the glutamatergic system, the main stimulating system in the brain, has a major role in pathogenesis of schizophrenia. The frontal white matter (WM) is partially composed of axons from glutamatergic pyramidal neurons and glia with glutamatergic receptors. The natural amino acid sarcosine, a component of a normal diet, inhibits the glycine type 1 transporter, increasing the glycine level. Thus, it modulates glutamatergic transmission through the glutamatergic ionotropic NMDA (N-methyl-d-aspartate) receptor, which requires glycine as a co-agonist. To evaluate the concentrations of brain metabolites (NAA, N-acetylaspartate; Glx, complex of glutamate, glutamine, and γ-aminobutyric acid (GABA); mI, myo-inositol; Cr, creatine; Cho, choline) in the left frontal WM, Proton Nuclear Magnetic Resonance (1H-NMR) spectroscopy was used. Twenty-five patients randomly chosen from a group of fifty with stable schizophrenia (DSM-IV-TR) and dominant negative symptoms, who were receiving antipsychotic therapy, were administered 2 g of sarcosine daily for six months. The remaining 25 patients received placebo. Assignment was double blinded. 1H-NMR spectroscopy (1.5 T) was performed twice: before and after the intervention. NAA, Glx and mI were evaluated as Cr and Cho ratios. All patients were also assessed twice with the Positive and Negative Syndrome Scale (PANSS). Results were compared between groups and in two time points in each group. The sarcosine group demonstrated a significant decrease in WM Glx/Cr and Glx/Cho ratios compared to controls after six months of therapy. In the experimental group, the final NAA/Cr ratio significantly increased and Glx/Cr ratio significantly decreased compared to baseline values. Improvement in the PANSS scores was significant only in the sarcosine group. In patients with schizophrenia, sarcosine augmentation can reverse the negative effect of glutamatergic system overstimulation, with a simultaneous beneficial increase of NAA/Cr ratio in the WM of the left frontal lobe. Our results further support the glutamatergic hypothesis of schizophrenia.