The influence of a child's age on the evaluation of smells and their hedonistic assessment.

Olfactory function in children is most commonly evaluated using the odour identification test despite the fact that it is difficult to properly name odorants for young children. The goal of this study was to evaluate the pleasantness rating of odorants by children. The participants were 182 healthy children: the first group included 63 girls and 59 boys (aged 6-7) and the second included 31 girls and 29 boys (aged 11-12). We assessed olfaction using (1) standard method of odorant identification using a U-Sniff test and (2) classifying the hedonic tone of the odorants into 5 categories. The identification test's median differed in younger and older groups of children; the median was 8 and 10 respectively (p < 0.01). The unpleasant hedonic tones were butter, fish and onion. The pleasant hedonic tones were apple, orange and peach. The younger usually categorised hedonic tones as pleasant, compared with the older children, who categorised the odorant's hedonic tones more often as neutral (p < 0.01).Conclusion: This study demonstrated that older children are able to identify odours better than younger ones. The categorisation of hedonic tones differed depending on the subject's age. The younger children tended to categorise odorants as being pleasant and older children as neutral. What is Known: • The test of odour identification is the most popular because it is reliable, practical, rapid and commercially available. • The ability to identify odours improves with age in children. What is New: • The categorisation of hedonic tones differs depending on age. The older children categorise odorants as being neutral significantly more often than younger children do.

Association of arterial hypertension and cognitive impairment in euthymic bipolar disorder.

OBJECTIVES: Cognitive impairment in euthymic phase of bipolar disorder has been documented in many studies. Several factors may contribute to such impairment, e.g. sedative medication, thyreopathy. Metabolic syndrome with its components represents another frequent condition found in bipolar disorder exerting probably adverse impact on cognition. Since it is treatable factor and current literature suggests possible connection with cognitive dysfunction, we aimed to explore such associations to identify promising targets of complex treatment. METHODS: Forty euthymic bipolar patients have been enrolled. Their body and metabolic parameters were measured. Medical history data were collected. Cognition was evaluated using battery of tests. Neuropsychological performance was transformed into neurocognitive composite score. Cognition of subjects was compared dichotomously according to presence or absence of pathological body and metabolic parameters. Correlations of selected parameters and composite score were done. RESULTS: Low neurocognitive score was found in presence of hypertension, metabolic syndrome, abdominal obesity and hyperglycemia. Only connection of hypertension and cognitive score reached sufficient statistical power. Patients presenting hypertension performed worse in all tested domains of cognition when compared with normal blood pressure group. Subjects using lithium performed substantially worse in cognitive tests. However, in comparison with anticonvulsant group, lithium users had markedly longer disorder history as well as longer duration of thymoprofylaxis. No significant correlation of HDRS score, insulinemia or HOMA-IR was found. CONCLUSION: Despite relatively small sample size, noticeable association of hypertension and cognitive impairment was revealed. This might indicate possible way of enhancing cognition in bipolar disorder by treating elevated blood pressure.

Anti-NMDA receptor antibodies in patients with a first episode of schizophrenia.

BACKGROUND: Encephalitis with antibodies against N-methyl-D-aspartate receptor (NMDA-R) is classified as an autoimmune disorder with psychotic symptoms, which are frequently dominant. However, it remains unclear how frequently NMDA-R antibodies lead to a condition that mimics psychosis and first-episode schizophrenia. In our work, we investigated the presence of antibodies against NMDA-R in patients with first-episode psychosis (FEP) in comparison with healthy volunteers. METHODS: This study included 50 antipsychotic-naïve patients with FEP (including 21 women) and 50 healthy volunteers (including 21 women). The mean age of the patients was 27.4 (±7.4) years and that of the healthy controls was 27.0 (±7.3) years. Antibodies against NMDA-R in the serum were detected by immunofluorescence. RESULTS: None of the investigated patients with an FEP and none of the healthy controls showed positive antibodies against NMDA-Rs. CONCLUSION: According to results of studies, a small proportion of patients with an FEP possess antibodies against NMDA-R. However, the extent to which this finding contributes to the etiopathogenesis of the response to antipsychotic medication and whether immunomodulatory therapy is indicated in these cases remains uncertain.

Peripheral endothelial dysfunction as a marker of cardiovascular risk in physically healthy patients with schizophrenia and related psychoses: a matched case control study.

OBJECTIVES: Our aim was to assess endothelial function in physically healthy patients with schizophrenia and related psychoses and to compare the results with healthy controls. Endothelial dysfunction was shown to predict future cardiovascular events in general population so we assumed to find a higher prevalence of endothelial dysfunction in patients with psychosis, as their cardiovascular morbidity is markedly higher than in general population, and to confirm the referred correlation with the traditional cardiovascular (CV) risk factors. DESIGN: We assessed the traditional CV risk factors and endothelial function using non-invasive peripheral arterial tonometry (EndoPAT2000) in 50 stabilized and medicated schizophrenic patients (aged between 18 and 50 years) without any history of cardiovascular diseases and compared the results with 50 age-matched healthy controls. SETTING: Psychiatric Clinic, University Hospital, Hradec Kralove and 2nd Department of Internal Medicine, General University Hospital, Prague, Czech Republic RESULTS: There was no difference in relative hyperaemia index as an endothelial function measure between patients and controls (2.19±0.68 vs. 1.98±0.57, p=NS) and there were also no correlations between reactive hyperaemia index and the traditional CV risk factors, illness duration or psychotic symptoms. On the other hand, the two study groups differed significantly in almost all traditional CV risk factors.

The dynamics of haemostatic parameters in acute psychotic patients: a one-year prospective study.

BACKGROUND: The primary goal of the present study was to replicate our previous finding of increased coagulation and thrombocytes activity in drug-naïve psychotic patients in comparison with healthy controls and ascertain whether the blood levels of thrombogenesis markers further increase over the course of a consecutive one-year antipsychotic treatment. SUBJECTS AND METHODS: We investigated the plasma levels of markers indicating activation of coagulation (D-dimers and Factor VIII) and platelets (soluble P-selectin, sP-selectin) in an antipsychotic-naive group of nineteen men and seventeen women with acute psychosis (age 28.1±8.0 years, body mass index 22.6±4.2), and thirty-seven healthy volunteers matched for age, gender and body mass index. In the patient group, we repeated these assessments after three months and again after one year of antipsychotic treatment. RESULTS: D-dimers (median 0.38 versus 0.19 mg/l; p=0.00008), factor VIII (median 141.5% versus 110%; p=0.02) and sP-selectin (median 183.6 versus 112.4 ng/ml; p=0.00005) plasma levels were significantly increased in the group of patients with acute psychosis prior to treatment compared with healthy volunteers. The plasma levels of sP-selectin varied significantly (p=0.016) in the course of the one-year antipsychotic treatment, mainly between 3 and 6 months after start of therapy. The plasma levels of D-dimers and factor VIII did not change significantly, D-dimers remained elevated in contrast to the healthy controls. CONCLUSIONS: Patients with acute psychosis had increased levels of markers of thrombogenesis in comparison to the healthy volunteers. The haemostatic parameters also remained elevated during the one-year antipsychotic treatment.

The prevalence of cardiometabolic risk factors and the ten-year risk of fatal cardiovascular events in patients with schizophrenia and related psychotic disorders.

BACKGROUND: People suffering from schizophrenia have a significantly shorter lifespan compared to the general population. The majority of deaths are caused by physical diseases, including cardiovascular events. The aim of this cross-sectional study was to predict the risk of premature cardiovascular mortality and assess the prevalence of cardiometabolic risk factors in a sample of Czech patients with schizophrenia and related psychoses. SUBJECTS AND METHODS: We reviewed data from 129 subjects treated in an outpatient clinic that specialised in psychoses. The main collected variables included basic physical parameters (height, weight, waist circumference, blood pressure), smoking habits, laboratory data (glucose level, serum lipid level) and an electrocardiograph (ECG). We calculated the ten-year risk of fatal cardiovascular events using the Systematic Coronary Risk Evaluation (SCORE) chart. RESULTS: The most prevalent risk factors were being overweight (70% of patients had a BMI over 25), dyslipidaemia (70% of patients) and smoking (43% of patients). According to the SCORE diagram, there was a high risk of fatal cardiovascular events over a ten-year period in 10% of the study group. The percentage was even higher (24%) when the latest European guidelines for cardiovascular disease prevention were used to calculate the risk. CONCLUSIONS: Our outcomes indicate even higher cardiometabolic morbidity rates in patients with psychoses than those referenced in the literature.

Comparison of Wisconsin Card Sorting Test results between Czech subjects dependent on methamphetamine versus healthy volunteers.

BACKGROUND: Methamphetamine is a neurotoxic agent. Its chronic abuse may result in cognitive impairment with negative consequences for patients' treatment and rehabilitation. The aim of the study was to compare Wisconsin Card Sorting Test profiles of Czech subjects dependent on methamphetamine with healthy individuals. SUBJECTS AND METHODS: Forty-three hospitalized Czech Caucasian patients including twenty-seven men at the average age of 25.3±5.2 years dependent on methamphetamine for 6.2±3.3 years were assessed by the Wisconsin Card Sorting Test. We used the same neurocognitive test for the comparison group of healthy controls with the same ethnicity (N=52, men N=28, average age of 38.7±12.1 years). We applied the Chi-Square Test, Two-Sample T Test, Mann-Whitney U Test and Kolmogorov-Smirnov Test to compare methamphetamine dependent patients with healthy volunteers. RESULTS: All recorded Wisconsin Card Sorting Test parameters were significantly different in the group of methamphetamine dependent patients versus healthy volunteers (P=0.04-0.006; Mann-Whitney U Test, Two-Sample T Test). The results showed a higher error rate and a smaller achievement quality in the patients as against healthy subjects. We ascertained a significant cognitive deterioration in the patients as compared to healthy volunteers even if the average patients' achievements were in the normal range according to the test norms. CONCLUSIONS: A cognitive impairment was present in the group of patients as compared to healthy controls. Better understanding of neurocognitive symptoms in methamphetamine dependent subjects should help to generate modern therapeutic approaches, both pharmacological and psychosocial, to prevent or attenuate the long-term negative consequences of methamphetamine use disorders.

Cognitive changes in spinocerebellar ataxia type 2.

OBJECTIVES: Cognitive disorders and dementia occur in 19 to 42% of patients with spinocerebellar ataxia type 2 (SCA2). Neuropsychological tests can reveal executive dysfunction, impaired visual and verbal memory, tongue and speech impairment, attention disorders and impaired verbal fluency. METHODS: We performed psychiatric and neuropsychological examinations in 12 patients diagnosed with genetically confirmed SCA2 and 12 healthy volunteers matching the patients in age, gender, and length of education. The level of motor impairment was determined using the brief ataxia rating scale (BARS). The neuropsychological examination focused on testing executive functions, short-term visual and verbal memory, attention, psychomotor tempo, visual motor coordination, learning ability and comprehension ability. The tests were divided into two subgroups according to the difficulty of motor tasks. The cognitive abilities composite score (CACS) was determined by calculating the arithmetic mean of T scores of the respective tests. RESULTS: Patients with SCA2 had significantly lower CACSs (p=0.00005) compared to the healthy volunteers. Patients exhibited impaired performance in both difficult and simple motor tests. The severity of cognitive impairment was related to the age at the onset of the disease (p=0.002) but not to the duration or to the overall BARS score. CONCLUSIONS: Compared to healthy volunteers, patients with SCA2 exhibited significantly worse cognitive performance in all areas tested, including the tests of simple motor tasks. Moreover, the cognitive performance of patients worsened as the difficulty of the motor tasks increased.

Markers of thrombogenesis are activated in unmedicated patients with acute psychosis: a matched case control study.

BACKGROUND: Antipsychotic treatment has been repeatedly found to be associated with an increased risk for venous thromboembolism in schizophrenia. The extent to which the propensity for venous thromboembolism is linked to antipsychotic medication alone or psychosis itself is unclear. The objective of this study was to determine whether markers of thrombogenesis are increased in psychotic patients who have not yet been treated with antipsychotic medication. METHODS: We investigated the plasma levels of markers indicating activation of coagulation (D-dimers and Factor VIII) and platelets (soluble P-selectin, sP-selectin) in an antipsychotic-naive group of fourteen men and eleven women with acute psychosis (age 29.1 ± 8.3 years, body mass index 23.6 ± 4.7), and twenty-five healthy volunteers were matched for age, gender and body mass index. RESULTS: D-dimers (median 0.38 versus 0.19 mg/l, mean 1.12 ± 2.38 versus 0.28 ± 0.3 mg/l; P = 0.003) and sP-selectin (median 204.1 versus 112.4 ng/ml, mean 209.9 ± 124 versus 124.1 ± 32; P = 0.0005) plasma levels were significantly increased in the group of patients with acute psychosis as compared with healthy volunteers. We found a trend (median 148% versus 110%, mean 160 ± 72.5 versus 123 ± 62.5; P = 0.062) of increased plasma levels of factor VIII in psychotic patients as compared with healthy volunteers. CONCLUSIONS: The results suggest that at least a part of venous thromboembolic events in patients with acute psychosis may be induced by pathogenic mechanisms related to psychosis rather than by antipsychotic treatment. Finding an exact cause for venous thromboembolism in psychotic patients is necessary for its effective treatment and prevention.