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1.
Psychiatry Res ; 215(2): 323-8, 2014 Feb 28.
Article in English | MEDLINE | ID: mdl-24370335

ABSTRACT

Depressive symptoms are prevalent among individuals at clinical high-risk (CHR) for psychosis. Prior studies have used the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), and the "dysphoric mood" item of the Scale of Prodromal Symptoms (SOPS) to assess depressive symptoms in CHR samples. We compared the psychometric properties of these instruments in a CHR cohort, to support the selection of appropriate depressive symptoms measures in future studies and in clinical settings. Internal consistency was assessed using Cronbach's alpha. Construct validity was assessed through correlations with SOPS items that were expected or not expected to be related to depressive symptoms. Criterion validity was assessed by comparing scores between patients with and without a major depressive disorder diagnosis. We hypothesized based on the schizophrenia literature that the BDI would have superior internal consistency and discriminant validity compared to the HDRS, and that all three measures would show convergent validity and criterion validity. The BDI demonstrated superior internal consistency and construct validity in this at-risk sample. The BDI and HDRS differentiated patients with major depressive disorder, but SOPS dysphoria did not. This has implications for the choice of depression measures in future CHR studies and for the interpretation of past findings.


Subject(s)
Depression/diagnosis , Depressive Disorder, Major/diagnosis , Psychiatric Status Rating Scales , Psychotic Disorders/diagnosis , Schizophrenia/diagnosis , Adolescent , Adult , Female , Humans , Male , Personality Inventory , Psychometrics , Reproducibility of Results , Young Adult
2.
BMC Psychiatry ; 13: 255, 2013 Oct 09.
Article in English | MEDLINE | ID: mdl-24106884

ABSTRACT

BACKGROUND: To investigate whether schizophrenia patients with both suicide attempts and non-suicidal self-harm have earlier age of onset of psychotic and depressive symptoms and higher levels of clinical symptoms compared to patients with only suicide attempts or without suicide attempt. METHODS: Using a cross-sectional design, 251 patients (18-61 years old, 58% men) with schizophrenia treated at hospitals in Oslo and Innlandet Hospital Trust, Norway, were assessed with a comprehensive clinical research protocol and divided into three groups based on their history of suicide attempts and non-suicidal self-harm. RESULTS: Suicide attempts were present in 88 patients (35%); 52 had suicide attempts only (29%) and 36 had both suicide attempts and non-suicidal self-harm (14%). When compared with nonattempters and those with suicide attempts without non-suicidal self-harm, patients with both suicide attempts and non-suicidal self-harm were more frequently women, younger at the onset of psychotic symptoms, had longer duration of untreated psychosis, and had higher levels of current impulsivity/aggression and depression. Patients with both suicide attempts and non-suicidal self-harm were more likely to repeat suicide attempts than patients with suicide attempts only. CONCLUSIONS: Patients with both suicide attempts and non-suicidal self-harm had different illness history and clinical characteristics compared to patients with only suicide attempts or patients without suicidal behavior. Our study suggests that patients with both suicide attempts and non-suicidal self-harm represent a distinct subgroup among patients with schizophrenia and suicidal behavior with their early onset of psychotic symptoms, high rate of repeated suicidal behavior and significant treatment delay.


Subject(s)
Schizophrenia/diagnosis , Schizophrenic Psychology , Self-Injurious Behavior/complications , Suicide, Attempted/psychology , Adolescent , Adult , Aggression/psychology , Cross-Sectional Studies , Depression/complications , Depression/diagnosis , Depression/psychology , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Psychotic Disorders/complications , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Risk Factors , Schizophrenia/complications , Self-Injurious Behavior/psychology , Suicidal Ideation
3.
Schizophr Res ; 140(1-3): 110-3, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22846651

ABSTRACT

Obsessive-compulsive symptoms, particularly aggressive obsessions, are prevalent in schizophrenia patients and associated with other symptom severity, suicidal ideation and functional impairment. In a psychosis-risk cohort, obsessive-compulsive diagnosis and symptoms were assessed in terms of prevalence and content, and for associations with clinical measures. Obsessive-compulsive symptoms were prevalent in the CHR cohort, as was suicidal ideation. The presence and severity of aggressive obsessions were associated with depression, suicidal ideation and social impairment. The high prevalence of aggressive obsessions and associated suicidal ideation in a clinical high risk cohort, and their relationship to depression, is relevant for risk assessment and treatment strategies.


Subject(s)
Depression/etiology , Obsessive-Compulsive Disorder/epidemiology , Obsessive-Compulsive Disorder/psychology , Psychotic Disorders/epidemiology , Psychotic Disorders/psychology , Suicidal Ideation , Adolescent , Adult , Depression/epidemiology , Female , Humans , Male , Obsessive-Compulsive Disorder/diagnosis , Psychiatric Status Rating Scales , Psychotic Disorders/diagnosis , Social Behavior , Young Adult
4.
Compr Psychiatry ; 53(8): 1145-52, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22748971

ABSTRACT

OBJECTIVE: This study explored the clinical characteristics and risk factors of suicidal ideation in a sample of first graders from South Korea. Children's depression and aggression and maternal depression were examined as possible risk factors. METHODS: This study is a school-based, cross-sectional study of 5 elementary schools in Gunpo City, South Korea. Participants were 707 first graders (mean age, 6.54 years) and their mothers. We assessed children's depressive and aggressive symptoms using the Behavior Assessment System for Children-2 (BASC-2) and maternal depression using the Beck Depression Inventory (BDI). Two items from BASC-2 and 1 item from BDI identified children's and maternal suicidal ideation. RESULTS: Twenty-seven (3.8%) children evidenced suicidal ideation. Children with suicidal ideation had higher mean scores of depression domain (10.11 ± 5.34 vs 4.57 ± 3.44, P < .0001) and aggression domain (7.78 ± 3.84 vs 3.80 ± 2.85, P < .0001) on BASC-2 and maternal depression (9.78 ± 6.45 vs 7.28 ± 5.38, P = .02) on BDI. In regression analysis, children's depression (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.07-1.32; P = .001) and aggression (OR, 1.24; 95% CI, 1.08-1.41; P = .002) contributed significantly to children's suicidal ideation, whereas maternal depression was not significantly related to children's suicidal ideation (OR, 0.99; 95% CI, 0.92-1.06; P = .75). CONCLUSIONS: This study demonstrated that even first graders had a considerable prevalence of suicidal ideation and that depression and aggression were associated with suicidal ideation in young children.


Subject(s)
Aggression/psychology , Depressive Disorder/epidemiology , Depressive Disorder/psychology , Suicidal Ideation , Adult , Child , Cross-Sectional Studies , Depressive Disorder/diagnosis , Female , Health Surveys , Humans , Male , Mothers/psychology , Personality Assessment/statistics & numerical data , Psychometrics , Republic of Korea , Risk Factors
5.
Psychophysiology ; 49(9): 1168-78, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22803512

ABSTRACT

Existing 67-channel event-related potentials, obtained during recognition and working memory paradigms with words or faces, were used to examine early visual processing in schizophrenia patients prone to auditory hallucinations (AH, n = 26) or not (NH, n = 49) and healthy controls (HC, n = 46). Current source density (CSD) transforms revealed distinct, strongly left- (words) or right-lateralized (faces; N170) inferior-temporal N1 sinks (150 ms) in each group. N1 was quantified by temporal PCA of peak-adjusted CSDs. For words and faces in both paradigms, N1 was substantially reduced in AH compared with NH and HC, who did not differ from each other. The difference in N1 between AH and NH was not due to overall symptom severity or performance accuracy, with both groups showing comparable memory deficits. Our findings extend prior reports of reduced auditory N1 in AH, suggesting a broader early perceptual integration deficit that is not limited to the auditory modality.


Subject(s)
Evoked Potentials, Visual/physiology , Hallucinations/physiopathology , Schizophrenia/physiopathology , Visual Pathways/physiopathology , Visual Perception/physiology , Adolescent , Adult , Auditory Perception/physiology , Electroencephalography , Female , Hallucinations/complications , Humans , Male , Middle Aged , Recognition, Psychology/physiology , Schizophrenia/complications , Visual Cortex/physiopathology
6.
Arch Suicide Res ; 16(2): 111-23, 2012.
Article in English | MEDLINE | ID: mdl-22551042

ABSTRACT

This study describes the prevalence, clinical characteristics, and gender profile of self-harm in a cross-sectional sample of 388 patients with schizophrenia spectrum disorders. All patients were interviewed and assessed with respect to lifetime self-harm and relevant clinical variables. An overall of 49% of the patients reported self-harm which was associated with female gender, having had a depressive episode, younger age at psychosis onset, alcohol abuse or dependence, current suicidality, awareness of illness, and low adherence to prescribed medication. Higher awareness of having a mental disorder was associated with self-harm in men only, while emotional dysregulation was associated with self-harm in women only. We conclude that while self-harm in patients with schizophrenia spectrum disorders is highly prevalent in both genders, risk factors in men and women differ in several important ways.


Subject(s)
Schizophrenia/complications , Self-Injurious Behavior/epidemiology , Suicide, Attempted/statistics & numerical data , Adult , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Multivariate Analysis , Norway/epidemiology , Prevalence , Risk Factors , Self-Injurious Behavior/psychology , Sex Factors
7.
Compr Psychiatry ; 53(2): 125-9, 2012 Feb.
Article in English | MEDLINE | ID: mdl-21550033

ABSTRACT

BACKGROUND: The association between suicidal behavior and quality of life (QoL) in bipolar disorder (BD) is poorly understood. Worse QoL has been associated with suicide attempts and suicidal ideation in schizophrenic patients, but this relationship has not been investigated in BD. This study tested whether a history of suicide attempts was associated with poor QoL in a well-characterized sample of patients with BD, as has been observed in other psychiatric disorders and in the general population. METHODS: One hundred eight patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BD type I (44 with previous suicide attempts, 64 without previous suicide attempts) were studied. Quality of life was assessed using the World Health Organization's Quality of Life Instrument-Short Version. Depressive and manic symptoms were assessed using the Hamilton Depression Rating Scale-17 items and the Young Mania Rating Scale. RESULTS: Patients with BD and previous suicide attempts had significantly lower scores in all the 4 domains of the World Health Organization's Quality of Life Instrument-Short Version scale than did patients with BD but no previous suicide attempts (physical domain P = .001; psychological domain P < .0001; social domain P = .001, and environmental domain P = .039). In the euthymic subgroup (n = 70), patients with previous suicide attempts had significantly lower scores only in the psychological and social domains (P = .020 and P = .004). LIMITATIONS: This was a cross-sectional study, and no causal associations can be assumed. CONCLUSIONS: Patients with BD and a history of previous suicide attempts seem to have a worse QoL than did patients who never attempted suicide. Poorer QoL might be a marker of poor copying skills and inadequate social support and be a risk factor for suicidal behavior in BD. Alternatively, poorer QoL and suicidal behavior might be different expressions of more severe BD.


Subject(s)
Bipolar Disorder/psychology , Quality of Life/psychology , Suicide, Attempted/psychology , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Suicidal Ideation , Surveys and Questionnaires
8.
Schizophr Bull ; 38(2): 331-7, 2012 Mar.
Article in English | MEDLINE | ID: mdl-20693343

ABSTRACT

BACKGROUND: In the 20th century, catatonia was usually deemed a subtype of schizophrenia. Recently, the nature and classification of catatonia are being reconsidered. This study is the first to describe catatonia using prospectively collected data and to examine how catatonic schizophrenia differs from, or resembles, other types of schizophrenia. METHODS: Data were analyzed in a cohort of 90,079 offspring followed from birth till ages 29-41 years. Proportional hazards models were used, calculating time to first psychiatric hospital admission, to compare risk factors for catatonic schizophrenia vs "other schizophrenia." RESULTS: Of 568 cases of schizophrenia, 43 (7.6%) had catatonic schizophrenia. The sexes were equally at risk for catatonic schizophrenia in contrast to other schizophrenia, for which the incidence was higher in males (1.70, 1.42-2.03, P < .0001). Advancing paternal age had no influence on the risk of catatonic schizophrenia in contrast to other schizophrenia, in which the risk to offspring of fathers age 35+ was 1.27 (1.03-1.57, P = .03) compared with those of younger fathers. Those with catatonic schizophrenia were somewhat more likely to have older mothers (aged 35+) (relative risk = 2.14, 0.85-5.54) while maternal age was not related to other schizophrenia. Both were equally affected by parental history of schizophrenia. Patients with catatonia were significantly more likely to attempt suicide (P = .006). CONCLUSION: Patients with catatonic schizophrenia show a somewhat different profile of risk factors from those with other types of schizophrenia in this cohort and are more likely to attempt suicide. This lends some support to the hypothesis that catatonic schizophrenia may have a distinct etiology.


Subject(s)
Schizophrenia, Catatonic/epidemiology , Schizophrenia, Catatonic/etiology , Schizophrenia/epidemiology , Adult , Cohort Studies , Female , Humans , Male , Maternal Age , Paternal Age , Prospective Studies , Risk Factors , Sex Factors , Suicide, Attempted/statistics & numerical data
9.
Arch Suicide Res ; 15(2): 160-71, 2011.
Article in English | MEDLINE | ID: mdl-21541862

ABSTRACT

Suicide attempters with major depression are at risk for repeat attempts and often do not utilize treatment. Identifying predictors of treatment non-utilization could inform interventions to motivate treatment use and reduce suicide risk in major depression. Two hundred and seventy three participants with a major depressive episode as part of a major depressive disorder or bipolar disorder, were assessed for socio-demographic and clinical characteristics at baseline and again 1 year later to identify predictors of treatment utilization. Treatment utilization rate was high 1 year after initial evaluation (72.5%). Severity of baseline depression, baseline treatment status, and education were associated with treatment utilization at 1 year. Interventions focused on increasing knowledge about depression and treatment efficacy may improve treatment adherence when treating depression.


Subject(s)
Bipolar Disorder/diagnosis , Depressive Disorder, Major/diagnosis , Mental Health Services/statistics & numerical data , Patient Acceptance of Health Care/psychology , Patient Compliance/psychology , Suicide/psychology , Adolescent , Adult , Aged , Bipolar Disorder/psychology , Bipolar Disorder/therapy , Depressive Disorder, Major/psychology , Depressive Disorder, Major/therapy , Diagnostic and Statistical Manual of Mental Disorders , Female , Follow-Up Studies , Humans , Male , Middle Aged , New York , Psychotherapy , Psychotropic Drugs/therapeutic use , Risk Factors , Severity of Illness Index , Socioeconomic Factors , Suicide/statistics & numerical data , Young Adult
10.
J Clin Psychiatry ; 72(6): 861-8, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21367346

ABSTRACT

OBJECTIVE: This study explores the results of mental health screening in Korean first graders in association with the amount of time the children spent in extracurricular education. METHOD: The study included a community sample of 761 boys and girls, with a mean age of 6.6 years, collected from 5 elementary schools in Gunpo-si, South Korea, in July 2007. Primary caregivers completed a questionnaire that included information on demographic characteristics, the amount of time the children spent in extracurricular education and other activities, and an adapted form of the Behavior Assessment System for Children, Second Edition (BASC-2) to screen for mental health problems. RESULTS: These first graders spent a mean of a little over 2 hours each day in extracurricular education. Extracurricular education demonstrated positive correlations with 4 BASC-2 domains, including hyperactivity (r = 0.092, P < .05), aggression (r = 0.073, P < .05), conduct problems (r = 0.073, P < .05) and depression (r = 0.137, P < .01). A positive linear relationship between depression and extracurricular education was also evident in regression analyses (F = 2.25, R(2) = 0.022, P = .001). The relationship held true even when controlling for time spent with parents, time spent with friends, and time spent asleep. Post hoc analyses revealed that children receiving more than 4 hours of extracurricular education per day showed a sharp increase in depressive symptoms as well as a decrease in the amount of time spent with caregivers. CONCLUSIONS: Results of this study demonstrate that excessive amounts of time spent in extracurricular education (greater than 4 hours per day) may be associated with depression in school-aged children. These findings have relevance for mental health screening and educational policy.


Subject(s)
Education , Mental Health , Analysis of Variance , Child , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Education/statistics & numerical data , Educational Status , Family/psychology , Female , Humans , Male , Mental Health/statistics & numerical data , Regression Analysis , Republic of Korea/epidemiology , Schools/statistics & numerical data , Surveys and Questionnaires , Time Factors
11.
J Abnorm Psychol ; 120(1): 88-97, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21319926

ABSTRACT

The heterogeneity of schizophrenia remains an obstacle for understanding its pathophysiology. Studies using a tone discrimination screening test to classify patients have found evidence for 2 subgroups having either a specific deficit in verbal working memory (WM) or deficits in both verbal and nonverbal memory. This study aimed to (a) replicate in larger samples differences between these subgroups in auditory verbal WM; (b) evaluate their performance on tests of explicit memory and sustained attention; (c) determine the relation of verbal WM deficits to auditory hallucinations and other symptoms; and (d) examine medication effects. The verbal WM and tone discrimination performance did not differ between medicated (n = 45) and unmedicated (n = 38) patients. Patients with schizophrenia who passed the tone screening test (discriminators; n = 60) were compared with those who did not (nondiscriminators; n = 23) and healthy controls (n = 47). The discriminator subgroup showed poorer verbal WM than did controls and a deficit in verbal but not visual memory on the Wechsler Memory Scale-Revised (Wechsler, 1987), whereas the nondiscriminator subgroup showed overall poorer performance on both verbal and nonverbal tests and a marked deficit in sustained attention. Verbal WM deficits in discriminators were correlated with auditory hallucinations but not with negative symptoms. The results are consistent with a verbal memory deficit in a subgroup of schizophrenia having intact auditory perception, which may stem from dysfunction of language-related cortical regions, and a more generalized cognitive deficit in a subgroup having auditory perceptual and attentional dysfunction.


Subject(s)
Auditory Perception/physiology , Memory, Short-Term/physiology , Schizophrenia/physiopathology , Analysis of Variance , Attention/physiology , Humans , Neuropsychological Tests , Verbal Learning/physiology
12.
Biol Psychiatry ; 68(7): 634-41, 2010 Oct 01.
Article in English | MEDLINE | ID: mdl-20673873

ABSTRACT

BACKGROUND: Alterations in dopamine D(2)/D(3) receptor binding have been reported in schizophrenia, and a meta-analysis of imaging studies has shown a modest elevation in striatum. Newer radioligands now allow the assessment of these receptors in extrastriatal regions. We used positron emission tomography with [(18)F]fallypride to evaluate D(2)/D(3) receptors in both striatal and extrastriatal regions in schizophrenia. METHODS: Twenty-one patients with schizophrenia and 22 matched healthy control subjects were scanned with an ECAT EXACT HR+ camera. Two-tissue compartment modeling and the reference tissue method gave binding potentials relative to nondisplaceable uptake, total plasma concentration, and free plasma concentration. These were compared between groups in five striatal and eight extrastriatal regions. Several regional volumes were lower in the patient group, and positron emission tomography data were corrected for partial volume effects. RESULTS: Binding potential values differed in three regions between groups. Values for binding potential relative to nondisplaceable uptake from two-tissue compartment modeling in patients and control subjects, respectively, were 28.7 ± 6.8 and 25.3 ± 4.3 in postcommissural caudate, 2.9 ± .7 and 2.6 ± .4 in thalamus, and 1.8 ± .5 and 2.1 ± .7 in uncus. Loss of D(2)/D(3) receptors with age was found in striatal and extrastriatal regions and was greater in neocortex. CONCLUSIONS: Our study found selective alterations in D(2)/D(3) receptors in striatal and extrastriatal regions, consistent with some but not all previously published reports. As previously shown for the striatum, a more sensitive imaging approach for studying the role of dopamine in the pathophysiology of schizophrenia might be assessment of neurotransmitter levels rather than D(2)/D(3) receptor levels in extrastriatal regions.


Subject(s)
Corpus Striatum/diagnostic imaging , Corpus Striatum/metabolism , Receptors, Dopamine D2/metabolism , Receptors, Dopamine D3/metabolism , Schizophrenia/diagnostic imaging , Schizophrenia/pathology , Adult , Age Factors , Analysis of Variance , Antipsychotic Agents/therapeutic use , Brain Mapping , Case-Control Studies , Corpus Striatum/drug effects , Female , Fluorine Radioisotopes/metabolism , Humans , Male , Positron-Emission Tomography/methods , Protein Binding/drug effects , Psychiatric Status Rating Scales , Schizophrenia/drug therapy , Young Adult
13.
Psychophysiology ; 47(6): 1075-86, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20456657

ABSTRACT

To better characterize neurophysiologic processes underlying olfactory dysfunction in schizophrenia, nose-referenced 30-channel electroencephalogram was recorded from 32 patients and 35 healthy adults (18 and 18 male) during detection of hydrogen sulfide (constant-flow olfactometer, 200 ms unirhinal exposure). Event-related potentials (ERPs) were transformed to reference-free current source density (CSD) waveforms and analyzed by unrestricted Varimax-PCA. Participants indicated when they perceived a high (10 ppm) or low (50% dilution) odor concentration. Patients and controls did not differ in detection of high (23% misses) and low (43%) intensities and also had similar olfactory ERP waveforms. CSDs showed a greater bilateral frontotemporal N1 sink (305 ms) and mid-parietal P2 source (630 ms) for high than low intensities. N1 sink and P2 source were markedly reduced in patients for high intensity stimuli, providing further neurophysiological evidence of olfactory dysfunction in schizophrenia.


Subject(s)
Evoked Potentials/physiology , Schizophrenic Psychology , Smell/physiology , Adolescent , Adult , Analysis of Variance , Artifacts , Data Interpretation, Statistical , Electroencephalography , Female , Humans , Hydrogen Sulfide , Male , Middle Aged , Odorants , Olfaction Disorders/etiology , Olfaction Disorders/psychology , Principal Component Analysis , Schizophrenia/complications , Schizophrenia/physiopathology , Young Adult
14.
J Am Acad Child Adolesc Psychiatry ; 49(2): 114-21, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20215933

ABSTRACT

OBJECTIVE: Exposure to suicidal behavior in peers and relatives is thought to increase risk for suicidal behavior in vulnerable individuals, possibly as a result of imitation or modeling. This study examines exposure to suicidal behavior and likelihood of suicide attempt in a high-risk cohort of offspring of a depressed parent. METHOD: A total of 449 offspring of 255 probands with a mood disorder were enrolled in a family study. Probands and offspring were assessed for psychopathology and suicide attempt history, and offspring for suicide exposure. Generalized estimating equations (GEE) and generalized least squares models were used to compare suicide attempt history in exposed and nonexposed offspring as well as characteristics of exposure in exposed offspring suicide attempters and exposed nonattempters. GEE was used to compare exposure occurring before first attempt in attempter offspring and exposure occurring before the same age in matched nonattempter offspring. RESULTS: Offspring reporting exposure to suicidal behavior were four times more likely to report a lifetime suicide attempt compared with unexposed offspring, controlling for age. Suicide attempt status was not associated with age at first exposure, total number or degree (attempt or threat) of exposures, or relationship. Analysis of exposure occurring before age at first suicide attempt found no association between exposure and suicide attempt. CONCLUSIONS: Offspring exposed to suicidal behavior are more likely to report a lifetime suicide attempt than nonexposed offspring. However, when examining the temporal sequence of exposure and attempt, the association is no longer significant, suggesting that imitation is not sufficient explanation.


Subject(s)
Bipolar Disorder/psychology , Child of Impaired Parents/psychology , Depressive Disorder, Major/psychology , Depressive Disorder/psychology , Dysthymic Disorder/psychology , Social Environment , Suicide, Attempted/psychology , Suicide/psychology , Adolescent , Adult , Age Factors , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/genetics , Attention Deficit Disorder with Hyperactivity/psychology , Bipolar Disorder/epidemiology , Bipolar Disorder/genetics , Child , Child of Impaired Parents/statistics & numerical data , Comorbidity , Cross-Sectional Studies , Depressive Disorder/epidemiology , Depressive Disorder/genetics , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/genetics , Dysthymic Disorder/epidemiology , Dysthymic Disorder/genetics , Female , Health Surveys , Humans , Male , Middle Aged , Psychotic Disorders/epidemiology , Psychotic Disorders/genetics , Psychotic Disorders/psychology , Risk Factors , Substance-Related Disorders/epidemiology , Substance-Related Disorders/genetics , Substance-Related Disorders/psychology , Suicide/statistics & numerical data , Suicide, Attempted/statistics & numerical data
15.
Int J Psychophysiol ; 75(2): 194-210, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19995583

ABSTRACT

We previously reported a preserved 'old-new effect' (enhanced parietal positivity 300-800 ms following correctly-recognized repeated words) in schizophrenia over mid-parietal sites using 31-channel nose-referenced event-related potentials (ERP) and reference-free current source densities (CSD). However, patients showed poorer word recognition memory and reduced left lateral-parietal P3 sources. The present study investigated whether these abnormalities are specific to words. High-density ERPs (67 channels) were recorded from 57 schizophrenic (24 females) and 44 healthy (26 females) right-handed adults during parallel visual continuous recognition memory tasks using common words or unknown faces. To identify and measure neuronal generator patterns underlying ERPs, unrestricted Varimax-PCA was performed using CSD estimates (spherical spline surface Laplacian). Two late source factors peaking at 442 ms (lateral parietal maximum) and 723 ms (centroparietal maximum) accounted for most of the variance between 250 and 850 ms. Poorer (76.6+/-20.0% vs. 85.7+/-12.4% correct) and slower (824+/-170 vs. 755+/-147 ms) performance in patients was accompanied by reduced stimulus-locked parietal sources. However, both controls and patients showed mid-frontal (442 ms) and left parietal (723 ms) old/new effects in both tasks. Whereas mid-frontal old/new effects were comparable across groups and tasks, later left parietal old/new effects were markedly reduced in patients over lateral temporoparietal but not mid-parietal sites, particularly for words, implicating impaired phonological processing. In agreement with prior results, ERP correlates of recognition memory deficits in schizophrenia suggest functional impairments of lateral posterior cortex (stimulus representation) associated with conscious recollection. This deficit was more pronounced for common words despite a greater difficulty to recall unknown faces, indicating that it is not due to a generalized cognitive deficit in schizophrenia.


Subject(s)
Face , Recognition, Psychology/physiology , Schizophrenia/physiopathology , Vocabulary , Adolescent , Adult , Analysis of Variance , Cerebral Cortex/physiopathology , Electroencephalography , Evoked Potentials/physiology , Female , Humans , Male , Middle Aged , Photic Stimulation , Principal Component Analysis , Psychomotor Performance/physiology , Reaction Time/physiology , Schizophrenic Psychology
16.
J Nerv Ment Dis ; 197(3): 147-53, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19282679

ABSTRACT

This study examined Drake's model that individuals with schizophrenia with good premorbid adjustment and insight into their illness are more vulnerable to becoming demoralized and therefore suicidal. One hundred sixty-four patients with schizophrenia (N = 115) or schizoaffective disorder (N = 49) were assessed for depressive symptoms and DSM-III-R depression, premorbid functioning, insight and suicidal behavior using The Diagnostic Interview for Genetic Studies and the Premorbid Adjustment Scale. Premorbid adjustment, insight and past MDE did not discriminate attempters from nonattempters, contrary to the model. However, consistent with the model, the interaction between good premorbid adjustment and insight predicted severity of depressive symptoms, and the psychological symptoms of depression significantly differentiated attempters from nonattempters, whereas the somatic symptoms did not. This study provides support for some aspects of the demoralization model.


Subject(s)
Morale , Psychotic Disorders/psychology , Schizophrenia/diagnosis , Schizophrenic Psychology , Suicide, Attempted/psychology , Achievement , Adolescent , Adult , Awareness , Chronic Disease , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Humans , Intention , Models, Psychological , Personality Inventory/statistics & numerical data , Psychiatric Status Rating Scales , Psychometrics , Psychotic Disorders/diagnosis , Social Adjustment , Young Adult
17.
Schizophr Res ; 110(1-3): 24-7, 2009 May.
Article in English | MEDLINE | ID: mdl-19304457

ABSTRACT

This study examined the relationship between having a family history of affective disorder and neuropsychological functioning and PANSS symptoms in schizophrenia patients falling into four exclusive family history groups (affective spectrum disorders, schizophrenia spectrum disorders, both, or neither). Schizophrenia patients with a family history of affective illness had the best performance on IQ tests and executive function measures. Symptoms showed fewer family history group differences. Schizophrenia patients with a family history of affective disorder may be a distinct subtype in the group of schizophrenias and may be biologically more similar to patients with serious affective disorder.


Subject(s)
Cognition Disorders/etiology , Family Health , Mood Disorders/etiology , Schizophrenia/complications , Schizophrenic Psychology , Adult , Female , Humans , Male , Neuropsychological Tests , Psychiatric Status Rating Scales , Young Adult
18.
Schizophr Res ; 108(1-3): 176-81, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19174322

ABSTRACT

INTRODUCTION: Numerous studies point to an association between childhood trauma and the later development of psychotic illness. However, little is known about the prevalence of childhood trauma and its relationship to attenuated positive and other symptoms in individuals at heightened clinical risk for psychosis. METHOD: Thirty clinical high-risk patients (83% male, 43% Caucasian, and with a mean age of 19) were ascertained from the New York metropolitan area and evaluated for prodromal and affective symptoms, and queried regarding experiences of childhood trauma and abuse. RESULTS: Ninety-seven percent endorsed at least one general trauma experience, 83% reported physical abuse, 67% emotional abuse, and 27% sexual abuse. As hypothesized, total trauma exposure was positively associated with severity of attenuated positive symptoms (in particular grandiosity), an effect primarily accounted for by ethnic minority participants, who reported greater exposure to trauma. Trauma exposure was related to affective symptoms only in the Caucasian subgroup. CONCLUSIONS: Childhood trauma was commonly self-reported, especially among clinical high-risk patients from ethnic minorities, for whom trauma was related to positive symptoms. Future areas of research include an evaluation of potential mechanisms for this relationship, including neuroendocrine and subcortical dopaminergic function.


Subject(s)
Mental Disorders/epidemiology , Mental Disorders/genetics , Risk , Stress Disorders, Post-Traumatic/epidemiology , Adolescent , Adult , Female , Humans , Male , Prevalence , Psychiatric Status Rating Scales , Severity of Illness Index , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires , Young Adult
19.
J Clin Psychiatry ; 69(6): 907-15, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18422397

ABSTRACT

OBJECTIVE: Alcohol use and depressive disorders are frequently comorbid. Few studies have assessed the impact of comorbid alcohol use disorders (AUDs) on clinical aspects of major depression. We compared depressed subjects with and without co-occurring AUDs with respect to demographic and clinical parameters. METHOD: 505 individuals participated. 318 subjects had DSM-IV major depressive disorder (MDD) without a history of any alcohol or substance abuse/dependence (MDD only), and 187 individuals had MDD and a history of alcohol abuse/dependence (MDD/AUD). Demographic, clinical, and psychiatric history measures of patients in the 2 groups were examined and compared. The study was conducted from January 1990 to June 2005. RESULTS: MDD/AUD patients were younger at their first psychiatric hospitalization (p = .014), their first major depressive episode (p = .041), and their first suicide attempt (p = .001). They reported more previous major depressive episodes (p = .001), suicide attempts (p = .001), and recent life events (p = .001); and had higher lifetime aggression (p < .001), impulsivity (p < .001), and hostility (p < .001) scores. MDD/AUD patients were also more likely to report tobacco smoking (p < .001), a lifetime history of abuse (p = .004), and a history of AUD among first-degree relatives (p < .001) compared to MDD only patients. MDD/AUD individuals also had higher childhood (p < .001), adolescent (p < .001), and adult (p < .001) aggression scores and reported more behavioral problems during their childhood compared to their counterparts. Logistic regression analysis demonstrates that the number of previous depressive episodes, lifetime aggression, and smoking drive the difference between the groups. CONCLUSIONS: Our findings suggest that comorbid MDD/AUD may result from worse antecedents and lead to early onset, more comorbidity, and a more severe course of illness.


Subject(s)
Alcoholism/epidemiology , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/epidemiology , Adult , Aggression/psychology , Comorbidity , Demography , Depressive Disorder, Major/psychology , Diagnostic and Statistical Manual of Mental Disorders , Disruptive, Impulse Control, and Conduct Disorders/diagnosis , Disruptive, Impulse Control, and Conduct Disorders/epidemiology , Female , Humans , Male , Suicide, Attempted/statistics & numerical data , Tobacco Use Disorder/epidemiology
20.
J Affect Disord ; 94(1-3): 255-9, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16750271

ABSTRACT

UNLABELLED: It is not clear if bipolar disorder I (BPI) and bipolar disorder II (BPII) represent the same disorder on a continuum of severity or two distinct syndromes. Neuropsychological functioning is a means of understanding similarities and differences between diagnostic groups. OBJECTIVE: To compare the neuropsychological functioning of depressed suicide attempters with BPI or BPII and healthy controls. METHODS: Fifty-one individuals with bipolar disorder (BPI n=32, BPII n=19) and a history of suicide attempt were compared with 58 healthy controls with respect to neuropsychological functioning in the following domains: motor functioning, psychomotor performance, attention, memory, working memory, impulsiveness and language fluency. RESULTS: Participants with BPI and BPII performed significantly more poorly than healthy controls on tests of Digit Symbol Test of psychomotor functioning, the N Back Test of working memory and the Go-No-Go Test of impulsiveness. Participants with BPI were significantly worse than controls but not those with BPII on the Test of Verbal Fluency. Participants with BPII performed significantly worse than either controls or those with BPI on the Simple Reaction Time Motor Test and the Stroop Test of attention. CONCLUSION: While participants with both BPI and BPII performed more poorly than healthy controls, individuals with BPII also performed more poorly than those with BPI on some tests suggesting that they may have a unique syndrome. The findings have implications for assessment and treatment in bipolar disorder.


Subject(s)
Bipolar Disorder/diagnosis , Neuropsychological Tests/statistics & numerical data , Suicide, Attempted/psychology , Adolescent , Adult , Bipolar Disorder/classification , Bipolar Disorder/epidemiology , Bipolar Disorder/psychology , Depressive Disorder/diagnosis , Depressive Disorder/epidemiology , Depressive Disorder/psychology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Psychometrics/statistics & numerical data , Reference Values , Reproducibility of Results , Statistics as Topic , Suicide, Attempted/statistics & numerical data
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