Association between happiness and psychopathology in an elderly regional rural population in Crete.

Research has shown that socio-demographic profile and psychopathology symptoms are related to levels of happiness in old age. The aims of this cross-sectional study were: 1) to investigate the effect of recent stressful life events and socio-demographic factors on psychopathological symptoms in elderly residents in mountain regions of Crete, Greece and 2) to explore the mechanism which underlies the relationship between socio-demographic factors and psychopathological symptoms, with levels of happiness in old age. To this end, we used the nine psychopathology dimensions of symptoms as defined in the Symptom Checklist-90-R (SCL-90), while the Holmes and Rahe stress inventory was administered to quantify the stressful life events. A sample of 205 elderly men and women (age=77.1±6.7 years) living in 10 remote rural and isolated villages participated in this study. Data was collected through questionnaires completed upon individual meetings with each participant, with the interviewer's assistance. Each questionnaire included the two aforesaid scales alongside questions on individual socio-demographic characteristics. Analysis of variance was applied to detect socio-demographic factors that have a significant effect on specific psychopathological symptoms. Then, path analysis was applied to quantify the direct and indirect effect of the selected socio-demographic factors on happiness levels. Stressful life events were found to have no statistically significant effect on the presence of specific symptoms (somatization, psychoticism, anxiety) in elderly adults. Furthermore, certain socio-demographic factors (marital status, smoking, family income and social activity) were found to influence happiness, which varied according to the level of psycho-emotional tension. The results suggest that somatization, psychoticism, and phobic anxiety symptoms are psychic reactions independent of recent stressful life events. Our study,despite its regional character, may contribute in the development of appropriate clinical assessment tools and interventions, helping primary care practitioners to approach elderly people living in remote villages in a more appropriate and holistic manner, improving thereby the effectiveness of their interventions.

Phenytoin concentration in head hair sections: a method to evaluate the history of drug use.

Phenytoin (PHT) levels were determined in sections of head hair taken from 60 patients (34 males and 26 females), aged 5 to 69 years, who were regularly receiving the drug. The hair sectional analysis included dissolution, liquid phase extraction procedures, and immunoassay (Abbott TDx) or high-pressure liquid chromatography (HPLC) analytical techniques. The values of PHT levels in the hair from the first section (close to the hair root) to the fifth section for female patients were 18.0, 15.2, 13.1, 11.6, and 10.7 microg/g, respectively, according to HPLC measurements. There were no significantly different results obtained using the immunoassay technique, according to which the mean values of PHT in the hair sections were 17.9, 15.2, 13.1, 11.9, and 10.9 microg/g, respectively, from the first to the fifth sections. The corresponding mean values for male patients by HPLC and immunoassay techniques, respectively, were 17.9, 15.0, 12.5, 12.1, and 12.3 microg/g and 17.8, 14.9, 12.2, 11.9, and 121 microg/g. Generally, a reduction of drug concentrations in hair from the first to the subsequent segments was observed. The hair PHT concentrations were found to be dependent on the dosage (by fluorescence polarization immunoassay: r = 0.987, p < or = 0.02; by HPLC: r = 0.988, p < or = 0.02). Mean dose and assay outcome values by hair color and correlation between hair PHT mean values, daily mean doses of the drug, and patients' age are presented. The differences among doses according to hair color were significant. PHT hair profiles from female and male patients compared with the mean +/- SD concentrations of the hair sections are discussed. The data indicate the possible use of hair section testing as a marker of the dosage history and the compliance of patients receiving long-term treatment with PHT.

Improved statistical classification methods in computerized psychiatric diagnosis.

BACKGROUND: Mainstream psychiatric diagnosis involves mainly sequential, expert-system-derived, logical decision rules. Among the few statistical classification methods that have been sporadically evaluated are Bayes, k-nearest neighbor, and discriminant analysis classifiers. METHODS: A statistical classification method based on artificial neural networks (ANN) with task-specific constrained architectures was applied to a sample of 796 clinical interviews, where the symptom evaluation and the diagnostic judgments were made using the Psychiatric State Examination (PSE) system. The proposed constrained ANN (CANN) method was compared with other statistical classification methods. RESULTS: CANN was found to be superior to all other considered methods, having an overall "correct" classification rate of 80% when applied to test data. Similarly, the concordance coefficients of agreement with the PSE diagnostic categories were all very high. Among the other used methods, discriminant analysis had slightly inferior performance but better generalization capability. CONCLUSIONS: The proposed CANN method has a definite utility in psychiatric diagnosis and requires further evaluation, perhaps alongside other standard classification systems and/or with larger samples.

Core mental state in irritable bowel syndrome.

OBJECTIVE: Psychiatric illness is higher among patients with irritable bowel syndrome (IBS) who seek medical care; however, a specific psychopathology that differentiates patients with IBS from patients with other organic gastrointestinal disorders has not been found. In the study described here, we investigated the predominant psychiatric symptoms in women with IBS. METHODS: The criteria of Manning et al., as modified by Thompson et al., were used to make the diagnoses of IBS. Psychiatric assessment was performed by using a structured interview in 64 women, aged 20 to 70 years, 36 with IBS and 28 with chronic cholelithiasis. Diagnosis of chronic cholelithiasis was made by histopathological examination. The final diagnoses were confirmed by interview after 1 year. The diagnostic system based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was used to make the current diagnoses. The Present State Examination (PSE)-Index of Definition (ID) computer program (CATEGO) was used to define total psychopathology (total PSE score), current clinical severity (ID), and clusters of psychiatric symptoms. RESULTS: No difference in the specific DSM-IV diagnostic categories was found, but there were more total depressive disorders in the IBS group. The ID and total PSE score were high among patients with IBS. Multiple logistic regression analysis showed that duration of gastrointestinal pain, and the symptoms of general anxiety, and hypochondriasis significantly predicted a diagnosis of IBS. CONCLUSIONS: Female patients with IBS are categorized into the general DSM-IV category of depressive disorder, their current psychiatric severity is high compared with that of women with chronic cholelithiasis, and patients with IBS are characterized by the psychiatric syndromes of general anxiety and hypochondriasis. The implications of these findings and areas for future research are discussed.

Carbamazepine levels in head hair of patients under long-term treatment: a method to evaluate the history of drug use.

Carbamazepine (CBZ) concentrations were determined in the sections of head hair from 40 patients (22 males and 18 females), ages 5 to 81, who were receiving this drug systemically. Hair treatment included dissolution, liquid phase extraction procedures, and immunoassay (Abbott TDx) or high-pressure liquid chromatography (HPLC) analytical techniques. The mean values of CBZ levels in the hair from the 1st section (close to hair root) to the 5th section for female patients were 26.82, 19.18, 17.28, 15.09, and 14.62 micrograms/g according to HPLC measurements. Immunoassay gave generally slightly higher results. The mean values of CBZ in the hair sections according to the immunoassay technique were 30.53, 21.90, 19.83, 17.45, and 16.99 micrograms/g, respectively, from the 1st to the 5th sections. The corresponding mean values for male patients by HPLC and immunoassay techniques were 21.97, 17.30, 15.03, 13.02, and 11.21 micrograms/g and 25.98, 20.52, 17.15, 14.87, and 12.31 micrograms/g. Generally, a reduction of drug concentrations in hair from the first to the subsequent segments was observed. Higher amounts of CBZ were deposited in black, untreated hair (e.g., not dyed or permed). CBZ concentrations in hair sections were found to be dependent on the dosage (r = 0.979, p < or = 0.001) but not on the gender. The data indicate the possible use of hair section testing as a marker of the dosage history and the compliance of patients under long-term treatment with CBZ.

Carbamazepine levels in the hair of patients under long-term treatment: a preliminary study.

Carbamazepine (CBZ) levels in the scalp hair of seventeen patients (ten male and seven female), aged from five to forty years old, receiving the drug systematically were determined after hair dissolution and solid-phase extraction procedures using both immunoassay (Abbott TDx) and gas chromatographic (GC) techniques. Carbamazepine levels in hair ranged from 13.9 to 66.3 micrograms/g (mean 26.6 micrograms/g, median 20.9 micrograms/g) according to GC measurements. The immunoassay technique gave slightly higher results (mean 28.0 micrograms/g, median 22.1 micrograms/g). The blood concentrations of carbamazepine, using immunoassay (Abbott TDx) technique, ranged from 2.9 to 10.7 micrograms/ml (mean 6.2 micrograms/ml, median 5.7 micrograms/ml). Our data indicate the possible use of hair testing as a marker of the dosage history of patients under long-term treatment with CBZ.

Electroencephalographic evaluation of children without neuropsychiatric disturbances but with poor school performance.

The estimation of brain function using neurophysiologic methods is of importance because, besides neuropsychiatric diseases, a variety of systemic diseases can influence brain function. Several types of brain dysfunction, resulting from many kinds of influences on the central nervous system, can cause poor school performance. Besides these dysfunctions of organic origin, there may be others that do not have an organic basis but may reflect the adverse effects of the environment. Often, the differential diagnosis between them is difficult. We performed a neurologic examination and an evaluation using the Illinois Test of Psycholinguistic Abilities and questionnaires (Eysenck and Rutter) to assess the personality of 22 poor school performers aged 10 to 12 years and 22 controls with good school performance of similar age. In order to assess the possibility of using quantitative electroencephalographic methods to evaluate nonorganic poor school performers, we estimated the power spectrum and coherence of the electroencephalographic signals at rest and their changes during motor tasks and auditory stimulation. Our results indicate that there were no signs of organicity in the group of poor school performers.

An epidemiological study of the factors influencing poisoning in children aged 0-5 years.

The aim of this cross disciplinary study was to identify the most significant variables related to childhood accidental poisoning. The study was carried out on a representative sample of families living in the Greater Athens Area comprising 1245 children aged up to 5 years. Data were collected by a team of researchers (paediatricians, psychologists and social workers) and involved a structured interview and a paediatric examination. The findings show that childhood poisoning is correlated with: (1) biological variables, such as skeletal anomalies, language disorders, number of recent infections and complications of pregnancy; and (2) social factors, such as father's educational level, monthly family income, and overcrowding. Sex of the child was not found to influence poisoning.

EEG coherence during hemispheric activation in schizophrenics.

We studied the change of EEG alpha-band coherence between resting and motor performance ("reactivity of EEG coherence") in 18 chronic schizophrenics and 30 normal controls, examining differences between left and right hemisphere tasks. Three coherences were examined for each hemisphere. The central-parietal coherence in normals increased on the left for left hemisphere tasks, and decreased on the right for right hemisphere tasks, whereas the patients showed a decrease of both measures, more on the left side. Thus, the interhemispheric difference of central-parietal coherence reactivity was reversed for the schizophrenics (P less than 0.06) and suggested a left-sided deviation. The lateral-percentral and precentral-central coherences showed no left-right deviations of reactivity in the patients. Since coherence increase is considered to be a sign of the coupled function between the studied regions, our findings suggest a defective coordination of left central-parietal regions during a task in schizophrenics.

Epidemiologic research on the role of studying and urban environment in the development of myopia during school-age years.

Four hundred seventy-four Greek male subjects received an ophthalmologic examination and completed a questionnaire. The following were found: (1) the years of studying and urban residence are factors that strongly influence the prevalence of myopia; discriminant factor analysis classified correctly 81% of the subjects into the myopic or the nonmyopic group; (2) the incidence of myopia is significantly higher in the studying v the nonstudying groups; (3) the prevalence of myopia is higher in the more educated group; (4) there is no statistical difference between the orientation of myopes and nonmyopes toward studies or other occupations; (5) although the presence of myopia is determined by the years of studying and urban residence, the degree of myopia is not influenced to a statistically significant level by these factors; and (6) the results indicate that the interaction of these two variables is more significant in their contribution to the onset of myopia than the sum of each variable alone.