Illness perceptions and personality traits of patients with mental disorders: the impact of ethnicity.

OBJECTIVE: To identify differences and similarities between immigrants of Turkish origin and native German patients in therapeutically relevant dimensions such as subjective illness perceptions and personality traits. METHOD: Turkish and native German mentally disordered in-patients were interviewed in three psychiatric clinics in Hessen, Germany. The Revised Illness Perception Questionnaire (IPQ-Revised) and the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) were used. Differences of scales and similarities by k-means cluster analyses were estimated. RESULTS: Of the 362 total patients, 227 (123 immigrants and 104 native Germans) were included. Neither demographic nor clinical differences were detected. Socioeconomic gradients and differences on IPQ-R scales were identified. For each ethnicity, the cluster analysis identified four different patient types based on NEO-FFI and IPQ-R scales. The patient types of each ethnicity appeared to be very similar in their structure, but they differed solely in the magnitude of the cluster means on included subscales according to ethnicity. CONCLUSION: When subjective illness perceptions and personality traits are considered together, basic patient types emerge independent of the ethnicity. Thus, the ethnical impact on patient types diminishes and a convergence was detected.

Addictive and nonaddictive smoking as related to responsivity to neurotransmitter systems.

In a double-blind crossover design on 36 male smokers, differences in hormone responses to a serotonergic (citalopram) and dopaminergic (bromocriptine) challenge were tested, to compare transmitter responsivities in addicted and pleasure-motivated smokers with respective controls. A general score of smoking addiction, according to DSM IV criteria, was associated with a blunted prolactin decrease to bromocriptine, indicating a possible nicotine-induced desensitization of DA receptors. The single questionnaire-based symptom of tolerance was associated with a blunted cortisol response to citalopram, indicating a particular desensitization of serotonin receptors. Nontolerant but addicted subjects exhibited increased serotonergic responsivity, interpreted as resulting from low serotonin levels associated with lack of impulse control. The questionnaire-based score of pleasure-motivated (='indulgent') smoking was associated with high dopaminergic activity (pronounced prolactin responses), confirming findings obtained in subjects exhibiting reward-related personality factors.