Psychiatry Research

Editorial Board

2010-03-30

Tyrosine hydroxylase, interleukin-1β and tumor necrosis factor-α are overexpressed in peripheral blood mononuclear cells from schizophrenia patients as determined by semi-quantitative analysis

2010-03-30

Abstract: The aim of this study is to profile the peripheral biomarkers (tyrosine hydroxylase, TH; interleukin-1β, IL-1β; and tumor necrosis factor-α, TNF-α) for schizophrenia and explore their relations with clinical symptoms. Thirty-nine patients with schizophrenia were evaluated using the Positive and Negative Syndrome Scale (PANSS), and 25 siblings and 30 normal healthy subjects were used as controls. The mRNA expression levels of TH, IL-1β and TNF-α in peripheral blood mononuclear cells, as determined with semi-quantitative reverse transcription-polymerase chain reaction, were all significantly increased in both patients (3-fold) and siblings (2-fold) as compared with normal control. Both IL-1β and TNF-α were significantly correlated with scores on the general psychopathology subscale of the PANSS. A significant positive correlation between IL-1β and TH expression was found in both sibling and normal controls, but not in patients, while a positive correlation between IL-1β and TNF-α was significant in all the groups. These results suggest that TH, IL-1β and TNF-α are overexpressed in the peripheral blood mononuclear cells of schizophrenia patients, perhaps due to the hereditary factors. IL-1β and TNF-α may influence the symptoms of schizophrenia in the cognition dysfunction and anxiety/depression domains of the PANSS.

Increased ratio of 2nd to 4th digit (2D:4D) in schizophrenia

2010-03-30

Abstract: Sex differences in the onset, epidemiology, clinical presentation and neuropathology of schizophrenia suggest that sexual dimorphism in brain development may be relevant to pathogenesis. Sex hormones, in particular testosterone, are considered to be crucial in brain development, but few investigations have examined the potential role of prenatal testosterone in schizophrenia. In this study, we examined a retrospective marker of prenatal testosterone release — 2D:4D finger length ratio (2D:4D), the relative length of 2nd to 4th digit, in 64 Asian patients with schizophrenia and 64 sex-matched controls. No significant difference in mean finger lengths was present, however 2D:4D ratio was significantly different between patients and controls. The effect was primarily seen in males consistent with a ‘less masculinised’ pattern and hypotheses suggesting that schizophrenia may be associated with an abnormality in prenatal circulating testosterone.

Obesity and smoking in patients with schizophrenia and normal controls: A case-control study

2010-03-30

Abstract: Cardiovascular risk factors, especially obesity and smoking are highly prevalent in patients with schizophrenia. Central obesity and the metabolic syndrome are conditions mostly attributed to the use of antipsychotic medication and lifestyle habits, and they constitute a significant health concern. Our study sample included 105 patients suffering from schizophrenia aged 36.25±10.03 and 156 normal control subjects aged 36.03±11.33. All patients were in- or out-patients of a private hospital. Clinical diagnosis was made according to DSM-IV-TR criteria. Height, weight, waist circumference and number of cigarettes smoked daily were recorded. Duration of illness was calculated based on records concerning the age of first onset of psychotic symptoms. Body Surface Area (BSA) and Body Mass Index (BMI) were calculated as well as % body fat, with the use of LifeWise™ Body Fat Analyzers No 63-1525. The results of analysis of variance suggested a significant main effect regarding diagnosis and sex as well as for their interaction. There were significant differences between patients and controls regarding body weight, waist circumference, BMI, BSA and % body fat, with patients, espectially females, being more obese than controls. The results of the present study corroborate the increased prevalence of obesity in schizophrenia. The interpretation of this finding remains unclear.

Confirmation for a delayed inhibition of return by systematic sampling in schizophrenia

2010-03-30

Abstract: Inhibition of return (IOR) is a phenomenon thought to reflect a mechanism to protect the organism from redirecting attention to previously scanned insignificant locations. A number of studies reported altered IOR in schizophrenia patients with a reduction of its amplitude. However, incomplete sampling of stimulus onset asynchronies (SOAs) makes data on IOR time course incomplete. We examined 14 stabilized young patients with recent onset schizophrenia and 16 healthy controls matched for gender, age, and years of education. Schizophrenia patients (13 males, 1 female) had a mean age of 26.3±5.8 years and a mean number of years of study of 9.6±3.6. Their illness had a mean duration of 147 weeks. Patients displayed moderate overall slow reaction times (387 ms) in comparison with controls (322 ms). Onset of IOR was found to be delayed in schizophrenia patients appearing between 700 and 800 ms following the cue onset while it appeared at 300 ms in controls. In patients, IOR was constant up to 1100 ms; however, its amplitude was weak with an average of 6 ms. Validity effects (overall and at each SOA value) were uncorrelated to age, years of study, duration of illness, or total or subscale scores on the Positive and Negative Syndrome Scale.

Minor physical anomalies in women with recurrent unipolar depression

Jadranka Čulav-Sumić, Vlado Jukić — 2010-03-30

Abstract: According to earlier observations, minor physical anomalies (MPAs) are more prevalent in psychotic disorders, especially in schizophrenia, and represent an indicator of abnormal fetal development. Limited research has been conducted on these structural abnormalities among patients with unipolar depression, with and without psychotic features. We hypothesized that the mean total MPA score would be greater in patients with psychotic depression than depressive patients without psychosis and control subjects. An extended scale of MPAs was used to detect the presence or absence of 51 MPAs in women with recurrent unipolar depression with psychotic symptoms (n=50), women with recurrent unipolar depression without psychotic symptoms (n=50) and healthy female controls (n=50). Women with recurrent depression had significantly more MPAs than controls. With regard to MPAs of specific body regions, depressive patients had significantly higher rates of MPAs in the mouth area than control subjects. Higher rates of MPAs were not significantly related to psychotic features of depression. The study results are indicative of possible early neurodevelopmental disturbance in recurrent unipolar depression.

Cognitive estimation in aged patients with major depressive disorder

Agota Barabassy, Ulrike Beinhoff, Matthias W. Riepe — 2010-03-30

Abstract: In everyday life, we often estimate rather than know. It was the goal of this study to assess the effect of depressed mood on cognitive estimation in old age. Cognitive estimation was performed in 44 subjects with major depressive disorder (MDD; DSM-IV) and 48 age-matched healthy subjects (HS). Severity of depressive symptoms was rated with the Montgomery–Åsberg Depression Rating Scale (MADRS, mean=18.6±S.D. 4.85). Estimation tasks comprised the dimensions length (coin diameter), weight (pile of paper), quantity (number of marbles in a glass jar), and time (estimation of time it takes for a marble to roll down a marble track both before and after having observed it). Other than the procedure followed in previous tests on cognitive estimation, the tasks were performed by observing objects rather than pictures thereof. MDD patients overestimated time (before and after observation) and underestimated quantity. Cognitive estimation was not correlated to measures of frontal functioning or semantic knowledge. We conclude that MDD patients in old age are impaired to some extent in cognitive estimation and in the ability to correct themselves, deficits that are likely to affect the performance of everyday activities.

Comorbidity between bipolar disorder and alcohol use disorder: Association of dopamine and serotonin gene polymorphisms

Baseer Yasseen, James L. Kennedy, Laurie A. Zawertailo, Usoa E. Busto — 2010-03-30

Abstract: Bipolar disorder is a chronic mental illness with high prevalence of co-occurring alcohol use disorder. Linkage studies have revealed several candidate genes in the dopaminergic and serotonergic pathways which may be associated with both bipolar and alcohol use disorders. We investigated the relationship between polymorphisms in candidate genes and alcohol use disorder comorbidity in bipolar patients. We performed a retrospective study of a genomic database consisting of 278 bipolar disorder patients. Diagnosis of bipolar disorder was according to the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). RFLP analysis of single nucleotide polymorphisms were performed in dopamine (DRD1, DRD2 and DRD3) and serotonin receptor and transporter genes (5HTTLPR, 5HT1B, 5HT2A, 5HT2C). There were 179 (64%) females in the database. Seventy-one (25.5%) of the bipolar patients were diagnosed as comorbid alcohol use disorder. Chi-square analysis indicated that in female bipolar patients, there was a significant difference in genotype frequency between the bipolar patients with comorbid alcohol use disorder and non-comorbid bipolar patients for the Ser23Cys (rs6318) polymorphism of the 5HT2C gene. Overall, the results indicate a possible association between 5HT2C and alcohol use disorder comorbidity.

Sleep debt and depression in female college students

2010-03-30

Abstract: The objective of the study was to evaluate relationships between sleep habits and depressive symptoms. Pilot study data were collected about sleep schedules, related factors and depression in female college students to find whether their sleep schedules correlate with affective symptoms. In the subsequent main study, similar information was collected under more controlled conditions. Depression was measured using the CES-D (Center for Epidemiologic Studies Depression Scale) and HAM-D-3 (modified Hamilton Depression Rating Scale). Response rates were 31.3% of eligible students for the pilot survey and 71.6% for the main study. Both studies showed that about 20% of students reported weekday sleep debts of greater than 2 h and about 28% reported significantly greater sleep debt and had significantly higher depression scores (P<0.0001) than other students. Melancholic symptoms indicated by high CES-D scores (>24), were observed in 24% of students. Sleep problems explained 13% of the variance for both the CESD scale and the HAM-D-3 scale. Among female college students, those who report a sleep debt of at least 2 h or significant daytime sleepiness have a higher risk of reporting melancholic symptoms than others.

Adolescent dissociation and alexithymia are distinctive but overlapping phenomena

2010-03-30

Abstract: Findings on the association between dissociation and alexithymia in adult populations are inconsistent. Dissociation has also been related to other types of psychopathology. Few studies have been published on these connections among adolescents. We examined the association between Adolescent Dissociative Experiences Scale (A-DES) scores and those for the Toronto Alexithymia Scale (TAS), the 21-item Beck Depression Inventory (BDI-21) and the Youth Self-Report (YSR), as well as subscales of the TAS and the YSR, in a sample of Finnish adolescents aged 13 to 18 years (n=4019). Factor analysis suggested that dissociation can be considered distinctive from other psychopathology. A-DES scores, however, associated strongly with several other scales and subscales measuring psychiatric symptoms. In logistic regression models the strongest associations were observable between the A-DES and TAS subscale ‘difficulty identifying feelings’ (DIF) and the YSR subscale ‘thought problems’. Thus, dissociation and alexithymia can be considered distinctive but overlapping phenomena.

The validity of the Dutch K10 and extended K10 screening scales for depressive and anxiety disorders

2010-03-30

Abstract: The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an extended version (EK10) in screening for depressive and anxiety disorders in primary care. Data are from 1607 participants (18 through 65 years, 68.8% female) of the Netherlands Study of Depression and Anxiety (NESDA), recruited from 65 general practitioners. Participants completed the K10, extended with five additional questions focusing on core anxiety symptoms, and were evaluated with the WHO Composite International Diagnostic Interview (CIDI lifetime version 2.1) to assess DSM-IV disorders (major depressive disorder, dysthymia, generalized anxiety disorder, social phobia, panic disorder, agoraphobia). Reliability (Cronbach's α) of the Dutch K10 was 0.94. Based on Receiver Operating Characteristics (ROC) analysis, the area under the curve (AUC) for the K10 for any depressive and/or anxiety disorder was found to be 0.87. The extended questions on the EK10 significantly improved the detection of anxiety disorders in particular. With a cut-off point of 20, the K10 reached a sensitivity of 0.80 and a specificity of 0.81 for any depressive and/or anxiety disorder. For the EK10, a cut-off point of 20 and/or at least one positive answer on the additional questions provided a sensitivity of 0.90 and a specificity of 0.75 for detecting any depressive and/or anxiety disorder. The Dutch version of the K10 is appropriate for screening depressive disorders in primary care, while the EK10 is preferred in screening for both depressive and anxiety disorders.

Severely stressful events and dementia: A study of an elderly Greek demented population

2010-03-30

Abstract: There is evidence that proneness to experience psychological distress is a risk factor for Alzheimer's disease (AD). In the present study, an attempt is made to examine the possible association between stressful events and cognitive impairment of the elderly, based on a sample of 1271 patients (500 male, 771 female) diagnosed with dementia according to the DSM-IV criteria and 140 age- and gender-matched cognitive healthy subjects. All patients were recruited from the Memory and Dementia Outpatient Clinic of the 3rd University Department of Neurology in “G. Papanikolaou” General Hospital, Thessaloniki, and examined over a period of 7 years. The majority of patients reported a history of a stressful event before the onset of dementia (n=990, 77.9%), while fewer patients reported insidious onset (n=281, 22.1%). The most frequently reported event was the announcement of a life threatening disease (n=472, 37.1%), followed by problems within the family (n=157, 12.4%), spouse death (n = 100, 7.9%), death of a sibling or other beloved person (n=77, 6.1%). Only 55% of the control subjects encountered stressful events, which is significantly different from the percentage of the study group. Our results demonstrate that a stressful event in the elderly could potentially trigger a cognitive decline.

Spatial proximity and the risk of psychopathology after a terrorist attack

Charles DiMaggio, Sandro Galea, Michael Emch — 2010-03-30

Abstract: Previous studies concerned with the relation of proximity to the September 11, 2001 terrorist attacks and subsequent psychopathology have produced conflicting results. The goals of this analysis are to assess the appropriateness of using Bayesian hierarchical spatial techniques to answer the question of the role of proximity to a mass trauma as a risk factor for psychopathology. Using a set of individual-level Medicaid data for New York State, and controlling for age, gender, median household income and employment-related exposures, we applied Bayesian hierarchical modeling methods for spatially aggregated data. We found that distance from the World Trade Center site in the post-attack time period was associated with increased risk of anxiety-related diagnoses. In the months following the attack, each 2-mile increment in distance closer to the World Trade Center site was associated with a 7% increase in anxiety-related diagnoses in the population. No similar association was found during a similar time period in the year prior to the attack. We conclude that spatial variables help more fully describe post-terrorism psychiatric risk and may help explain discrepancies in the existing literature about these attacks. These methods hold promise for the characterization of disease risk where spatial patterning of ecologic-level exposures and outcomes merits consideration.

First-ever admitted psychiatric inpatients in Italy: Clinical characteristics and reasons contributing to admissionFindings from a national survey

2010-03-30

Abstract: The aim of this study was to describe the sociodemographic, clinical and treatment-related characteristics of patients admitted to any acute psychiatric inpatient facilities in Italy for the first time in their life, and to identify reasons contributing to admission. Data from the PROGRES-Acute Project, a national survey on facilities admitting acute psychiatric patients in Italy, were used. A cluster analysis was carried out in order to identify patients' groups sharing similar sociodemographic and clinical characteristics. Among patients admitted during the index period, 337 were at their first-ever admission. Median age at admission was 40, and about 46% of patients were not receiving any treatment in the month prior to admission. Social/work functioning problems, social withdrawal and conflict with family members were the most common reasons contributing to admission. Cluster analysis yielded four patient groups: two groups of younger subjects, differentiating each other for frequency of antisocial behaviors, compulsory admissions, treatment at time of admission and family support; two groups of older subjects, with high rates of affective disorders, who showed remarkable differences with regard to their living situation and family support. Our study shows that first-ever admitted patients represent a highly heterogeneous group. Early intervention research should take this sociodemographic and clinical diversity into account, in order to better allocate resources and develop special intervention programs.

Lifetime prevalence, psychiatric comorbidity and demographic correlates of “hikikomori” in a community population in Japan

2010-03-30

Abstract: The epidemiology of “hikikomori” (acute social withdrawal) in a community population is not clear, although it has been noted for the past decade in Japan. The objective of this study is to clarify the prevalence of “hikikomori” and to examine the relation between “hikikomori” and psychiatric disorders. A face-to-face household survey was conducted of community residents (n=4134). We defined “hikikomori” as a psychopathological phenomenon in which people become completely withdrawn from society for 6 months or longer. We asked all respondents whether they had any children currently experiencing “hikikomori”. For respondents aged 20–49 years old (n=1660), we asked whether they had ever experienced “hikikomori”. A total of 1.2% had experienced “hikikomori” in their lifetime. Among them, 54.5% had also experienced a psychiatric (mood, anxiety, impulse control, or substance-related) disorder in their lifetime. Respondents who experienced “hikikomori” had a 6.1 times higher risk of mood disorder. Among respondents, 0.5% currently had at least one child who had experienced “hikikomori”. The study suggests that “hikikomori” is common in the community population in Japan. While psychiatric disorders were often comorbid with “hikikomori”, half of the cases seem to be “primary hikikomori” without a comorbid psychiatric disorder.

Detecting faked psychopathology: A comparison of two tests to detect malingered psychopathology using a simulation design

Karen Sullivan, Joanne King — 2010-03-30

Abstract: Malingered psychopathology has the potential to be a costly social problem and there is a need for studies that compare the malingering detection capabilities of tests of psychopathology. This study investigated the capacity of two measures to detect simulated psychopathology. Forty-one first-year psychology students were randomly allocated to experimental groups that included malingering and control conditions. Analogue malingerers were given a financial incentive to simulate believable psychological impairment. Controls received standardised test instructions and the prize incentive, contingent on good effort. In a between-group simulation design, group differences on the Personality Assessment Inventory (PAI) and the revised Symptom Checklist-90 (SCL-90-R) were assessed. Group comparisons revealed elevation of the majority of clinical index scores among malingerers and a consistent pattern of results across tests. Analysis of the test operating characteristics of the malingering indices for these measures revealed superior detection of simulated malingering using the PAI, particularly Rogers' Discriminant Function, although classification accuracy of all malingering indexes was improved when adjusted cut-offs were used. Overall, results from this study demonstrate the vulnerability of the PAI and (SCL-90-R) to simulated psychopathology, but also the capacity of these measures to detect such performance when specific indexes are used.

NRG1 and BDNF genes in schizophrenia: An association study in an Italian case-control sample

2010-03-30

Abstract: We tested for associations between five single nucleotide polymorphisms (SNPs) located in the area containing the Neuregulin 1 gene (NRG1) and three SNPs within the brain-derived neutrophic factor gene (BDNF) in an Italian sample consisting of 171 schizophrenia subjects and 349 controls. No association was found for any of the polymorphisms tested, either in single locus or in haplotype analysis.

Catechol-O-methyltransferase val108/158met genotype, major depressive disorder and response to selective serotonin reuptake inhibitors in major depressive disorder

2010-03-30

Abstract: The functional val108/158met polymorphism of the COMT gene (rs4680) was evaluated in major depressive disorder (MDD), and in the treatment response to antidepressants in MDD. We could not demonstrate any significant difference in the distribution of this COMT single-nucleotide polymorphism (SNP) in the treatment response to selective serotonin reuptake inhibitors or between patients with MDD and control subjects.

Sleep disturbance in women with eating disorder: Prevalence and clinical characteristics

2010-03-30

Abstract: The prevalence of sleep disturbance among 400 patients, diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN), was assessed via structured interviews. Sleep disturbance was reported in 50.3% of patients, especially among those with the binge-eating/purging subtype. Patients with sleep disturbance had more disturbing symptoms; including higher binge frequency and vomiting frequency Additional differences were also identified.

Impulse-control disorders in college students

Antje Bohne — 2010-03-30

Abstract: We investigated impulse-control disorders (ICDs), alcohol use and outcome expectancies in students (n=571, 63.9% female, age: M=21.7) using questionnaires. Twenty (3.5%) were positively screened for lifetime ICDs, mostly males (n=16, 80%). Disorder-specific rates ranged between 0 and 1.2%. Differences in alcohol use and expectancies between ICDs and controls did not reach significance.

Extensive elevation of creatine kinase with generic clozapine, but not with Leponex

Rebecca Schennach-Wolff, Susanne Stübner, Michael Riedel, Norbert Müller — 2010-03-30

Mr. M., a 27-year-old man, was hospitalized due to an exacerbation of his paranoid schizophrenia persisting for 8 years. Laboratory tests, a magnetic resonance imaging scan and an electroencephalogram revealed no indication of an organic cause of his recurrent psychotic symptoms. When the patient was earlier treated with several atypical as well as typical antipsychotics, either inadequate symptom control, or multiple adverse effects such as severe sleepiness, extrapyramidal motor side effects and sexual dysfunction were observed. Therefore we decided to treat him with clozapine. At that point, all laboratory results including creatine kinase (CK) (47 U/l) were within the normal range. After 5 days of upwardly titrating the dose of a generic manufactured clozapine to 50 mg, an increase of CK up to 1219 U/l was noted in a routine blood test. The patient did not receive concomitant medication. The increasing CK was not related to trauma or excessive muscle activity. Another blood sample taken 24 h later showed that the CK had risen further to 2763 U/l. Therefore, we stopped the generic clozapine at 50 mg. Despite discontinuation of the treatment with generic clozapine, CK levels continued to increase up to 3644 U/l within the next 2 days. To prevent acute kidney failure, treatment with sodium-chloride infusions 4 l/day was instituted. The CK tapered off to normal levels over the next 6 days. This was the first time the patient had developed CK elevation while receiving antipsychotic treatment.

Interaction of catechol-O-methyltransferase (COMT) Val108/158 Met genotype and risperidone treatment in Chinese Han patients with schizophrenia

Chuan Yuan Kang, Xiu Feng Xu, Hua Liu, Zhen Yu Shi, Hong Hui Xu, Jian Zhong Yang — 2010-03-30

Catechol-O-methyltransferase (COMT) has long been considered as a candidate for vulnerability to schizophrenia in view of both its function and location in the genome (). Data have been reported showing allelic association of the Val158Met polymorphism of the COMT gene with the clinical manifestations and the response to or dose requirements of antipsychotics in schizophrenia (), though negative associations of COMT gene with schizophrenia were found in Chinese Han and other populations (). Therefore, it is hypothesized that the functional polymorphism of the COMT gene could be related to drug response to antipsychotics in Chinese Han schizophrenia because of the role of COMT in dopamine catabolism.

Erratum to “Recognition of facial affect in girls with conduct disorder” [Psychiatry Research 175(3) (2010) 246–251]

Kathleen Pajer, Lisa Leininger, William Gardner — 2010-03-30

The publisher regrets that the incorrect version of was published in this paper. The correct is shown below. The publisher would like to apologize for any inconvenience caused.