The phenomenology of emotion experience in first-episode psychosis.

BACKGROUND: Although it has been suggested that disturbances in emotion experience and regulation play a central role in the aetiology and psychopathology of schizophrenia spectrum disorders, the phenomenology of emotion experience in schizophrenia remains under-researched. SAMPLING AND METHODS: In-depth interviews were conducted twice with each of the 20 participants (firstly at admission and secondly 6 months later). Data collection and analysis were guided by the principles of phenomenological study of lived experience. RESULTS: The emotion experiences described by our participants vary greatly in both quality and intensity, but appear to have a common phenomenology. Anxiety is reported as the basic emotion which buffers, transforms and sometimes supplants all others. Emotions in general are experienced as foreign, unstable and perturbing, thereby contributing greatly to feelings of ambivalence, perplexity and an unstable sense of self in general. CONCLUSIONS: The findings of this study have important therapeutic and theoretical implications because they suggest that emotion experiences in schizophrenia spectrum disorders may underlie a wide range of psychopathological phenomena in both the cognitive and social functioning domains. Due to the relatively small sample size and its selection from psychotherapeutic units, the results may not be generalizable to all schizophrenia patients.

Combined family trio and case-control analysis of the COMT Val158Met polymorphism in European patients with anorexia nervosa.

The high activity Val158 (H) allele of the dopamine-metabolizing enzyme catechol-O-methyltransferase (COMT) was associated with anorexia nervosa (AN) in a recent family trio-based study of patients from Israel. In an attempt to replicate this finding, we performed a combined family trio and case-control study in an European population from seven centers in six different countries (Austria, Germany, Great Britain, Italy [Milan], Italy [Florence], Slovenia, and Spain), together contributing a total of 372 family trios, 684 controls and 266 cases. TDT analyses of high (H) and low (L) alleles in family trios showed that H allele and L allele were each transmitted 101 times (chi(2) = 0, ns). Allele-wise case-control analysis using separate samples simply combined from the centers was also not significant, with the frequencies of the H allele 50% in cases and same in controls. Stratified analysis of data from all centers gave an odds ratio of 0.98 (Cornfield 95% confidence limits 0.78-1.24). Analysis by genotype was likewise not significant (overall chi(2) = 0.42). Because we were not able to support the primary hypothesis that Val158Met is a risk factor for AN, we did not perform secondary analysis of minimum body mass index (mBMI), age at onset or illness subtype (restricting or binge purging anorexia). Overall we found no support for the hypothesis that the Val158 allele of COMT gene is associated with AN in our combined European sample.

Suicidal behaviour and family factors among Dutch and Slovenian high school students: a comparison.

OBJECTIVE: East European countries have much higher suicide rates than West European countries. Whether this also applies for suicidal ideation and suicide attempts is not known. In addition, the role of family factors in relation to suicidal behaviour has not been investigated in East European countries. METHOD: Two representative samples of 19,250 Dutch and 4706 Slovenian high school students were compared on the basis of self-report data. RESULTS: Slovenian students report more suicidal behaviour (ideation and attempts) as well as more unfavourable family circumstances than Dutch students. This applies especially to the death of parent(s), the number of changes in their living situation, and to conflicts between or with parents. CONCLUSION: A relation between family characteristics and suicidal behaviour is established in both samples, but proved to be strongest in Slovenian girls. Complicated cultural and socioeconomic differences between the two countries may account for the reported differences.

Smoking in relation to psychosocial risk factors in adolescents.

OBJECTIVE: The study investigated which psychosocial factors distinguish adolescent smokers from non-smokers, and examined the most important factors correlated with smoking. METHOD: A cross-sectional survey carried out by means of a questionnaire which, in addition to items on family, school, healthy habits, drug abuse and suicidal behaviour, also included a scale of depression (Zung's SDS) and of self-esteem (Rosenberg's SES). Sample. Two thousand one hundred and eleven high school students aged from 17.0 to 18.11 (1,083 girls and 1,028 boys), of whom 221 girls and 239 boys were smokers. RESULTS: The smokers of both sexes differed significantly from the non-smokers in frequency of substance abuse, family dysfunction, suicidal ideation and suicide attempts, attitude towards the harmful effects of smoking, truancy from school, and lesser involvement in sports. With regard to smoking behaviour, the most important predictive factors for adolescents of both sexes proved to be substance abuse, truancy, suicide attempts, a lower estimate of the harmfulness of smoking, and infrequent engagement in sports. Among the girls, predictive factors were also sexual and physical abuse, and binge eating. CONCLUSIONS: Smoking behaviour in adolescence may be part of a pattern of problematic behaviour and may be linked to various psychopathological disturbances.

Gender differences in psychosocial risk factors among Slovenian adolescents.

This study investigated psychosocial risk factors in adolescents and assessed gender differences in the frequency of their occurrence. A specially designed questionnaire, which included validated scales for the evaluation of depression (Zung Self-rating Depression Scale) and self-esteem (Rosenberg Self-Esteem Scale), was administered to a representative sample of Slovenian adolescents. The final sample consisted of 4,590 high school students of both sexes, aged 14 to 19 years. Data analysis revealed several significant gender differences. Girls more often than boys reported family conflict, personal problems, physical inactivity, attempts to control body weight, use of psychoactive drugs, suicidal ideation, and suicide attempts. Their level of depression was higher and self-esteem lower when compared with their male counterparts. Boys more often than girls indicated that they watched a great deal of television, were the victims of peer violence, and drank alcohol.

Characteristics of suicide attempters in a Slovenian high school population.

The study was carried out on a representative sample of Slovenian high school students (n = 3687) of whom 238 (137 girls and 101 boys) have already attempted suicide. Both suicide attempters and nonattempters were assessed by a questionnaire consisting of Zung's (1965) Depression Scale, Rosenberg's (1965) Self-Esteem Scale, sociodemographic data, information on suicide attempt, suicide ideation, family relations, and substance abuse. Statistical analyses indicated that groups differed in the levels of self-esteem, emotional reaction to family problems, running away from home, and substance abuse. The differences in the level of depression, frequency of suicide ideation, family suicide occurrence, smoking, and alcohol use were significant.

Differences between coronary hyperresponsiveness to ergonovine and vasospastic angina.

The objective of the present study was to investigate the differences between coronary hyperresponsiveness without ischemia and vasospastic angina in an ergonovine provocation test using multivariate analysis. We have sometimes experienced a more than 50% narrowing response of vascular diameter without ischemia in a coronary response to ergonovine. We studied 107 patients with less than 50% stenosis in a coronary arteriogram. Their vascular responses to ergonovine were measured and the patients were divided into three groups, as follows: Group 1 had 50% or less vascular narrowing response without ischemia; Group 2 had a vascular hyperresponsiveness of more than 50% narrowing response without ischemia; and Group 3 experienced a hyperresponsiveness with ischemia. The degree of coronary response was found to be related to smoking, inpaired glucose tolerance (IGT) and the Gensini score by multiple regression analysis. A multiple logistic analysis revealed that the Gensini score and smoking were significant predictive factors for Group 3 (odds ratio: 1.20 and 8.97). The only factor different between Group 2 and Group 1 was gender. The coronary hyperresponsiveness to ergonovine without ischemia differs from vasospastic angina in the degree of coronary atherosclerosis and smoking habits. The patients with hyperresponsiveness had similar characteristics to those with atypical chest pain rather than vasospastic angina, except for a gender difference.

Sexual behavior of secondary-school students in Slovenia.

OBJECTIVES: The aim of this study was to analyze the sexual behavior of secondary-school students in Slovenia. METHODS: The research was carried out on a representative sample of 4706 secondary-school students aged 15-19 years in Slovenia. The data were obtained by a self-administered questionnaire in April 1996. RESULTS: The average age of the students was 17.5 years. Most students had experiences in kissing (70%) and caressing (59%); a lower number had experiences in petting (43%). Sexual intercourse had been experienced by 38% of the students. The median age at the first sexual intercourse was 18.5 years. The main motives for the first sexual intercourse were love (45%), accident (22%) and curiosity (15%). Contraceptive methods currently used were condoms (60%), the pill (14%), coitus interruptus (4%), other methods (3%) and no method (19%). According to the students, the most appropriate sources of information on sexuality were friends (26%), parents (19%), different sources (19%) and professionals (15%). CONCLUSION: By the age of 18.5 years, approximately one-half of secondary-school students in Slovenia experience sexual intercourse. Most students currently use effective contraception, condoms being the most popular method. The students expect to receive information about sexuality from friends, parents and professionals, but not from the school environment.

Eating behavior, depression, and self-esteem in high school students.

OBJECTIVE: In a representative sample of 4700 Slovene high school students, we examined their eating behavior and its correlations with some psychosocial and psychological characteristics with the aim of identifying the main risk factors for disordered eating. METHOD: Using a questionnaire which also included Zung's Self-rating Depression Scale and Rosenberg's Self-Esteem Scale, we compared girls (n = 2507) and boys (n = 2193) with regard to their satisfaction with their body weight, weight-reducing activities, and frequency of binge eating. We assessed their family relationships, abuse of alcohol and other psychoactive drugs, suicidal ideation, and suicidal tendences, as well as their level of depression and self-esteem. RESULTS: The results showed significant differences between girls and boys, between groups of those who were satisfied and those who were dissatisfied with their body weight, and also between groups which indulged in frequent binge eating and those which did not. CONCLUSION: Within a general population of adolescents, there is a substantial number of subjects with disordered eating behavior, some part of whom are at high risk for eating disorders.

Self-destructive behavior in adolescents who have not completed a process of mourning: case study.

The article deals with the problem of self-destructive behavior in adolescence through the perspective of family dynamics. Two vignettes describe an uncompleted process of mourning after the loss of a parent in two suicidal adolescents, a girl and a boy. It shows that suicidal behavior may be only a part of a long lasting process which is not always recognized. In both cases dysfunctional family relations did not allow the adolescents to deal properly with their feelings of responsibility, guilt and accumulated inner tension. Characteristic differences are shown between the girl, who is depressed and manifests somatoform disorder and regressive behavior, and the boy, whose unresolved conflicts and anxiety are manifested by conduct disorder.

The major acidic glycolipids from the kidney of the Pacific salmon (Oncorhynchus keta): characterization of a novel ganglioside, fucosyl-N-acetylgalactosaminyl-GM1.

Two fractions of a major ganglioside from the kidney of the pacific salmon, Oncorhynchus keta, were eluted from a DEAE-Sephadex column in the monosialosyl fraction. The faster moving ganglioside (X1) on TLC was separated from the slower moving one (X2) by HPLC using a silica beads column. By methylation analysis, chemical and enzymatic degradation, reaction with monoclonal antibodies, LSIMS, and (1)H-NMR spectroscopy, X1 was determined to be a monosialosyl ganglioside belonging to the ganglio-series with a unique Fucalpha1-3GalNAc linkage at the nonreducing terminal: Fucalpha1-3GalNAcbeta1-3Galbeta1-3GalNAcbeta1-4[ NeuAcalpha2-3]Galbeta 1-4Glcbeta1-1Cer. Analysis of the lipophilic moiety indicated predominance of 24:1 fatty acid in combination with sphingenine. X2 was found to have a glycon structure identical to X1. The ceramide of X2 consisted predominantly of saturated fatty acids (18:0 and 16:0). The tissue concentrations of X1 and X2 in kidney were 3.7 and 2.8 nmol/g, respectively.

Suicide risk in high school students in Slovenia.

The objective of this study was to determine the psychosocial factors which differentiate suicidal adolescents from their nonsuicidal peers. By means of a specially designed questionnaire, distributed to a representative sample of 4686 Slovene high school students of both sexes aged 14-19 years, we assessed their general characteristics, suicidal ideation and behavior, family circumstances, self-appraisal of the problems and ways of solving them, engagement in sport, and exposure to suicide in their close circle. Numerous important differences were established between suicidal and nonsuicidal adolescents. The data gathered will help further research into suicidal behavior in adolescents.

Personality characteristics of adolescents with alcoholic parents.

This study examined personality traits frequently encountered in children in families with at least one alcoholic parent. The sample investigated included 63 adolescents (32 males and 31 females) ranging in age from 12 to 19 years. Twelve self-image variables and eight aggression and anxiety variables were assessed using a battery of psychodiagnostic instruments. The results were compared with those obtained in a control group of 321 age-matched adolescents (160 males and 151 females) growing up in nonalcoholic families. Statistically significant differences between the groups were found in eight self-image variables (impulse control, emotional tone, vocational and educational goals, sexual attitudes, family relationships, psychopathology, and adjustment and depression), in six aggression variables (assault, indirect aggression, verbal aggression, irritability, suspicion, and feelings of guilt), and in both anxiety variables (i.e., anxiety as a state and anxiety as a personality trait. The findings can be functionally applied both to clinical work and to prevention programs for adolescents at risk.

[Exercise-induced thallium-201 myocardial perfusion defects in angina pectoris without significant coronary artery stenosis].

We performed exercise thallium-201 myocardial scintigraphy in 32 patients with angina pectoris to study the incidence of perfusion defects, who had no significant organic stenosis on coronary angiography. None of them had myocardial infarction or cardiomyopathy. Thallium-201 myocardial scintigraphy and 12-lead ECG recording were performed during supine bicycle ergometer exercise. Perfusion defects in thallium-201 scintigrams in SPECT images were assessed during visual analysis by two observers. In the coronary angiograms obtained during intravenous infusion of nitroglycerin, the luminal diameter of 75% stenosis or less in the AHA classification was regarded as an insignificant organic stenosis. Myocardial perfusion defects in the thallium-201 scintigrams were detected in eight (25%) of the 32 patients. Six of these eight patients had variant angina documented during spontaneous attacks with ST elevations in standard 12-lead ECGs. Perfusion defects were demonstrated at the inferior or inferoposterior regions in six patients, one of whom had concomitant anteroseptal defect. The defects were not always accompanied by chest pain. All but one patient demonstrating inferior or inferoposterior defects showed ST depression in leads II, III and aVF on their ECGs, corresponding to inferior wall ischemia. The exception was a case with right bundle branch block. Thus, 25% of the patients with angina pectoris, who had no evidence of significant organic stenosis on their coronary angiograms, exhibited exercise-induced perfusion defects in their thallium-201 scintigrams. Coronary spasms might have caused myocardial ischemia in these patients.

[Sexual dimorphism in the pressor response to l-adrenaline in rats].

The cause of sex differences in the pressor response to l-adrenaline in adult rats (Tomori, 1986) was further examined using normal and castrated adult rats. Blood pressure was determined by the tail-cuff method. A prolonged elevation of blood pressure in male rats shown after an injection of l-adrenaline (50 micrograms/kg, s.c.) was almost completely suppressed by phentolamine (50 micrograms/kg, s.c.), and the slight l-adrenaline-induced increase in blood pressure in female rats was reversed to a decrease by phentolamine. Pretreatment with propranolol (200 micrograms/kg, s.c.) enhanced the pressor action of l-adrenaline in males and enhanced it to a greater extent in females. Castration resulted in a significant decrease in basal pressure in males and no change in females. Pressor responses to l-adrenaline in castrated male and female rats showed a minor alteration. In clonidine (20 micrograms/kg, s.c.)-treated normal rats, l-adrenaline induced an increase in blood pressure in males, but caused a decrease in females. In clonidine-treated castrated male rats, however, l-adrenaline administration induced a decrease in blood pressure. l-Adrenaline injection to yohimbine (1 mg/kg, s.c.)-treated rats induced a prolonged elevation of blood pressure in males and a transient elevation in females as shown in rats treated with l-adrenaline alone. In yohimbine-treated castrated rats, a decrease in the blood pressure was observed in males and a slight increase was observed in females after l-adrenaline administration. The present results suggest that the central pressor regulatory system is involved in the sex difference in pressor response to exogenous l-adrenaline and that androgens play a role to somehow maintain a higher pressor responsiveness to l-adrenaline in male rats.

[Pharmacological studies on the pressor response in adrenal-enucleated rats].

Physiological role of the adrenal medulla was evaluated in the rat with special reference to the age. The adrenal medulla of Wistar-Imamichi male and female rats was enucleated (AdMx) or sham-operated at 3 or 12 weeks of age. Blood pressure was determined by the tail-cuff method. Systolic blood pressure in immature- and adult-AdMx rats increased progressively 5 approximately 6 weeks after the operation. Plasma renin activities in the AdMx male and female rats tended to be lower than those in controls. There was no significant difference in the pressor response to 50 micrograms/kg l-adrenaline (s.c.) between control and AdMx groups. Isoproterenol induced a greater decrease in blood pressure in immature AdMx rats. Administration of 200 micrograms/kg tyramine resulted in a marked increase in blood pressure in the immature AdMx males and in a less marked response in adult AdMx and sham-operated rats. In 24 hr-reserpinized immature AdMx male rats, blood pressure was maintained at approximately 110 mmHg, and tyramine induced a slight increase in the blood pressure. In immaure control male rats, blood pressure showed a decrease to 80 mmHg 24 hr after reserpinization, and no response to tyramine was evident. The results indicated that the lack of an adrenal medulla from the prepuberal age, particularly in male rats, develops alterations in the regulatory system of peripheral noradrenaline release.