ABSTRACT
Some recent studies show an association between a functional polymorphism of BDNF gene (Val66Met) and the susceptibility to nicotine dependence and we hypothesized that this polymorphism was associated with smoking in both schizophrenia patients and healthy controls. The BDNF Val66Met gene polymorphism was genotyped in 690 chronic male schizophrenia patients (smoker/nonsmoker = 522/169) and 628 male controls (smoker/nonsmoker = 322/306) using a case-control design. Nicotine dependence (ND) was assessed by the cigarettes smoked per day (CPD), the Heaviness of Smoking Index (HSI), and the Fagerstrom Test for ND (FTND). Patients also were rated on the Positive and Negative Syndrome Scale (PANSS). The results showed no significant differences in BDNF Val66Met genotype and allele distributions between the patients and healthy controls or between smokers and nonsmokers in either patients or healthy controls alone. In patient groups, however, the smokers with the Met allele had significantly higher HSI scores (Met/Met: 2.8 ± 1.7 vs. Met/Val: 2.2 ± 1.7 vs. Val/Val: 2.0 ± 1.6, p < 0.01) and a trend toward a significantly higher FTND score (p = 0.09) than those with the Val/Val genotype. In addition, the smokers showed significantly lower PANSS negative symptom and total scores, longer duration of illness and more hospitalizations (all p < 0.05). In the control group, the smokers with the Met allele started smoking significantly earlier than those with the Val/Val genotype (both p < 0.05). These results suggest that the BDNF Val66Met polymorphism may affect a smoker's response to nicotine in both schizophrenia and healthy controls from a Chinese Han population, but with differential effects in different aspects of smoking behaviors.
Subject(s)
Brain-Derived Neurotrophic Factor/genetics , Schizophrenia/genetics , Schizophrenic Psychology , Smoking/psychology , Tobacco Use Disorder/genetics , Adult , Aged , Alleles , Case-Control Studies , Female , Genetic Predisposition to Disease , Genotype , Humans , Male , Middle Aged , Polymorphism, Single Nucleotide , Smoking/genetics , Tobacco Use Disorder/psychologyABSTRACT
Debate continues about whether clear nosologic boundaries can be drawn between schizoaffective disorder (SA), schizophrenia (SP), and bipolar disorder (BPD). This study attempted to clarify these boundaries. A retrospective review of the records of adult psychiatric inpatients with DSM-IV diagnoses of SA (n = 96), SP (n = 245), and BPD (n = 203) was conducted. Patients were assessed at admission and discharge using standardized rating scales (completed by physicians and nurses) and self-report inventories. Differential improvement over time also was examined. Significant differences were found for gender, legal status at admission, age, LOS, episode number, and ethnicity. Overall, SA was rated by clinicians as intermediate between SP and BPD, although SA rated themselves as the most severe. SA was similar to SP on positive symptoms, intermediate on negative symptoms, and similar to BPD on mood- and distress-related symptoms. Independent of diagnosis, differences in change scores from admission to discharge were related to severity level at admission. Although several differences were found in symptom severity across domains, no syndrome was identifiable associated with the diagnosis of SA and the diagnosis was unstable over time, thereby bringing into question the validity of SA as a diagnostic entity.
Subject(s)
Psychotic Disorders/diagnosis , Brief Psychiatric Rating Scale , Diagnosis, Differential , Humans , Observer Variation , Psychiatric Nursing/methods , Psychotic Disorders/epidemiology , Psychotic Disorders/psychology , Reproducibility of Results , Retrospective Studies , Self-Assessment , Surveys and QuestionnairesABSTRACT
This study compared patients diagnosed with Mixed versus Manic Bipolar disorder across the domains of demographic, symptom, and treatment variables. The sample included 152 patients who were admitted to an acute care psychiatric facility within an index period, whose discharge diagnosis was either Bipolar Disorder, Manic Episode (n = 109) or Bipolar Disorder, Mixed Episode (n = 43). No significant differences were found in age, race, episode number, or length of stay. There was a trend toward females being diagnosed with a Mixed Episode and males a Manic Episode. Group differences were found on physician and nurse symptom ratings, with the manic group receiving higher ratings on resistance, psychosis, and conceptual disorganization and the mixed receiving higher scores on depression and anxiety. On self-report measures, the mixed group endorsed greater severity than did the manic group. The mixed group was more likely to be prescribed antidepressants at discharge; however there were no significant differences across other medication. These differences are discussed.
