Karolinska Scales of Personality, cognition and psychotic symptoms in patients with schizophrenia and healthy controls.

BACKGROUND: Studies on both personality dimensions and cognition in schizophrenia are scarce. The objective of the present study was to examine personality traits and the relation to cognitive function and psychotic symptoms in a sample of patients with schizophrenia and healthy controls. METHOD: In total 23 patients with schizophrenia and 14 controls were assessed with the Karolinska Scales of Personality (KSP). A broad cognitive test programme was used, including the Wechsler Adult Intelligence Scales, the Finger-Tapping Test, the Trail Making Test, the Verbal Fluency Test, the Benton Visual Retention Test, the Wisconsin Card Sorting Test and Rey Auditory Verbal Learning Test . RESULTS: Compared with controls, the patients exhibited prominent elevations on KSP scales measuring anxiety proneness and neuroticism (P = 0.000005-0.0001), on the Detachment scale (P < 0.00009) and lower value on the Socialization scale (P < 0.0002). The patients also scored higher on the Inhibition of Aggression, Suspicion, Guilt and Irritability scales (P = 0.002-0.03) while the remaining five scales did not differ between patients and controls. KSP anxiety-related scales correlated with the Positive and Negative Symptoms Scale (PANSS) general psychopathology subscale. Cognitive test results were uniformly lower in the patient group and correlated with PANSS negative symptoms subscale. There was no association between KSP scale scores and PANSS positive or negative symptoms. CONCLUSION: The patients revealed a highly discriminative KSP test profile with elevated scores in neuroticism- and psychoticism-related scales as compared to controls. Results support previous findings utilizing other personality inventories in patients with schizophrenia. Cognitive test performance correlated inversely with negative symptoms.

Psychomotor and cognitive deficits as predictors of 5-year outcome in first-episode schizophrenia.

BACKGROUND: Cognitive deficits are common in schizophrenia but the predictive value of these deficits for long-term outcome in first-episode patients is unclear. AIMS: We aimed to investigate associations of performance in psychomotor and cognitive tests with a 5-year functional and symptomatic outcome. METHODS: After clinical stabilization, patients with a first schizophrenia spectrum diagnosis (n = 46) were assessed for global cognitive function [Synonyms, Reasoning, and Block Design (SRB)], psychomotor speed [Trail Making Test (TMT) and finger tapping] and verbal learning (Claeson-Dahl Verbal Learning Test). The subsequent 5-year outcome regarding independent living, occupational and social function, and symptomatic remission status was assessed. RESULTS: Low psychomotor speed was associated with poor social function 5 years later, with an odds ratio (OR) of 3.37 and a 95% confidence interval (CI) of 1.08-10.51, adjusted for antipsychotic drug use. Better performance on finger tapping with the non-dominant hand was associated with an increased risk of a 5-year symptomatic non-remission (adjusted OR = 0.42, CI 0.19-0.96). Occupational function and independent living were not significantly associated with any of the investigated tests. CONCLUSIONS: Psychomotor speed is associated with a long-term outcome regarding social function and symptom remission in patients with first-episode schizophrenia.

Number of teeth as a predictor of cardiovascular mortality in a cohort of 7,674 subjects followed for 12 years.

BACKGROUND: That oral health is related to the development of different cardiovascular disorders is reported in a number of studies. This study investigates if different parameters of oral health are associated with future mortality in different cardiovascular disorders in a dose-dependent manner. METHODS: A total of 7,674 subjects (3,300 males and 4,374 females; age range 20 to 89 years) received a dental examination by specialists in periodontology between the years 1976 and 2002. Number of remaining teeth, severity of periodontal disease, number of deepened periodontal pockets, and bleeding on probing were evaluated in relation to cause of death. RESULTS: During a median follow-up period of 12 years, 629 of the subjects died. For 299 subjects the cause of mortality was cardiovascular disease (CVD); 167 of these subjects died from coronary heart disease (CHD); 83 died from stroke; and 49 died from aortic aneurysm or congestive heart failure. The causes of death for the remaining 330 subjects were other than CVD. After adjustment for age, gender, and smoking, number of remaining teeth predicted in a dose-dependent manner all-cause mortality and mortality in CVD and in CHD (P <0.0001 for all), but not mortality from stroke (P = 0.15). Cox regression analysis revealed a seven-fold increased risk for mortality from CHD in subjects with <10 teeth compared to those with >25 teeth. Severity of periodontal disease, number of deepened periodontal pockets, and bleeding on probing were not related to mortality in a dose-dependent manner after adjustment for confounders. CONCLUSION: This fairly large, prospective study with a long follow-up period presents for the first time a dose-dependent relationship between number of teeth and both all-cause and CVD mortality, indicating a link between oral health and CVD, and that the number of teeth is a proper indicator for oral health in this respect.

Severity of periodontal disease and number of remaining teeth are related to the prevalence of myocardial infarction and hypertension in a study based on 4,254 subjects.

BACKGROUND: During the past 15 years, mounting evidence for the association between periodontal and cardiovascular disease has been presented in epidemiological studies. The aim of this study was to investigate how the severity of periodontal disease and number of remaining teeth relates to myocardial infarction (MI) and hypertension (HT). METHODS: Self-reported history of HT and MI was collected in 3,352 patients referred to the Department of Periodontology, Gävle County Hospital, and in 902 subjects randomly selected from the general population. Severity of periodontitis was estimated by a combination of the amount of bone loss around each tooth investigated from a full-mouth x-ray, the presence or absence of bleeding on probing (BOP), and involvement of furcations. RESULTS: The severity of periodontitis was significantly associated with HT (prevalence 16%; P<0.0005), even after adjustment for age, gender, number of teeth, and smoking in the total sample, and with MI (prevalence 1.7%, P<0.03) after above-mentioned adjustments, but in middle-aged (40 to 60 years) subjects only. The number of diseased periodontal pockets was related to HT only (P<0.0001), and this relationship remained after the above-mentioned adjustments. The number of teeth was associated with MI (P<0.03) even after correction for age, gender, and smoking but was not related to hypertension. CONCLUSIONS: The severity of periodontal disease was related to HT independent of age but to the prevalence of MI in middle-aged subjects only. The number of diseased pockets was significantly related to HT only. On the other hand, the number of teeth was associated with the prevalence of MI independent of age but not to HT. These data support the view that oral health is related to cardiovascular disease in a dose-dependent manner.