RESUMO
Appetitive control is driven by the hedonic response to food and affected by several factors. Heart rate variability (HRV) signals have been used to index autonomic activity and arousal levels towards visual stimuli. The current research aimed to examine the influence of body mass index (BMI), disordered eating behaviors, and sex on the HRV reactivity to food in a nonclinical sample. Thirty-eight healthy male and sixty-one healthy female participants completed questionnaires assessing disordered eating symptoms. HRV was recorded when the participants received visual stimuli of high-calorie food, neutral and negative emotional signals. Generalized estimating equation models were used to investigate the associations between HRV, BMI, disordered eating behaviors, and sex across the three stimulus types. Male participants demonstrated a higher ratio of low-frequency power to high-frequency power (LF/HF) than females across all the stimulus types. An increase in LF/HF reactivity to food signals was observed in all the study subjects. The moderation effect of BMI on LF/HF in response to food signals was also observed. Our study suggests that body weight may play a role in the interaction between sympathetic activity and food stimuli; however, how the interaction between sympathetic activity and food stimuli contributes to diet control warrants further investigation.
Assuntos
Sistema Nervoso Autônomo , Alimentos , Índice de Massa Corporal , Emoções , Feminino , Frequência Cardíaca , Humanos , MasculinoAssuntos
Lúpus Eritematoso Sistêmico/complicações , Esquizofrenia/complicações , Adulto , Anti-Inflamatórios/uso terapêutico , Antipsicóticos/uso terapêutico , Córtex Cerebral/diagnóstico por imagem , Transtornos Cognitivos/diagnóstico por imagem , Transtornos Cognitivos/etiologia , Feminino , Humanos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Escalas de Graduação Psiquiátrica , Esquizofrenia/tratamento farmacológico , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
OBJECTIVE: This study aimed to examine whether subjects with history of suicidal attempts had higher impulsivity as measured by neurocognitive tests and self-report questionnaires. The interrelationships among different impulsivity measures were also explored. METHODS: Fifty-four nonpsychotic psychiatric inpatients, including 24 subjects with previous history of suicidal attempts and 30 comparison subjects without previous suicidal attempts, completed the self-report Barratt Impulsiveness Scale-11-Chinese version (BIS-11-CH) and 2 neuropsychologic tests of impulsivity: the immediate memory task/delayed memory task (IMT/DMT) and the single key impulsivity paradigm (SKIP). RESULTS: The results indicated that subjects with previous suicidal attempts exhibited higher BIS-11-CH factor 2 (lack of self-control/attentional impulsivity) subscore (P = .02) and more commission errors in IMT (P = .03). However, BIS-11-CH scores and performance indices of IMT/DMT and of SKIP did not correlate with each other. CONCLUSIONS: Our findings supported that subjects with previous suicidal attempts had higher impulsivity, which could be revealed by both self-report and neurocognitive measures. However, there is no correlation among self-report, IMT/DMT, and SKIP measures, indicating that they might be measuring different dimensions of impulsivity.
Assuntos
Comportamento Impulsivo/diagnóstico , Testes Neuropsicológicos/estatística & dados numéricos , Determinação da Personalidade/estatística & dados numéricos , Tentativa de Suicídio/estatística & dados numéricos , Adulto , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/epidemiologia , Comorbidade , Feminino , Humanos , Comportamento Impulsivo/epidemiologia , Comportamento Impulsivo/psicologia , Acontecimentos que Mudam a Vida , Masculino , Memória de Curto Prazo/fisiologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Modelos Psicológicos , Inventário de Personalidade/estatística & dados numéricos , Escalas de Graduação Psiquiátrica , Psicometria , Psicotrópicos/uso terapêutico , Índice de Gravidade de Doença , Tentativa de Suicídio/psicologia , Inquéritos e QuestionáriosRESUMO
Neuropsychiatric syndrome is a common and serious clinical manifestation of systemic lupus erythematosus (SLE), occurring in about half of all patients during the course of the disease. We report here a case of obsessive-compulsive symptoms as an unusual manifestation of neuropsychiatric SLE. A 17-year-old girl with SLE was admitted to a medical center with the chief complaint of recent-onset repeated doubt and repetitive checking, which subsided after treatment. She had recurrent and intrusive doubt about losing her belongings and tried to suppress the thoughts by mental acts of praying and repetitive checking. The central nervous system lupus involvement in this patient was confirmed by brain magnetic resonance imaging, which revealed widespread areas of abnormal high signal intensity over the internal capsules and basal ganglia, and focal lesions at the peripheral parenchyma of the frontal and parietal areas. Single photon emission computed tomography also showed decreased perfusion at the left temporal lobe. This supported the hypothesis that basal ganglia abnormalities could be the common pathophysiology of coexisting obsessive-compulsive symptoms and SLE. Moreover, increased awareness of hidden psychopathology, an accepting attitude, and careful probing for obsessive-compulsive symptoms are important while taking care of SLE patients.
Assuntos
Vasculite Associada ao Lúpus do Sistema Nervoso Central/complicações , Transtorno Obsessivo-Compulsivo/etiologia , Adolescente , Diagnóstico Diferencial , Feminino , Humanos , Vasculite Associada ao Lúpus do Sistema Nervoso Central/diagnóstico , Imageamento por Ressonância MagnéticaRESUMO
BACKGROUND/PURPOSE: Depressive illness is highly recurrent, frequently chronic and associated with a high level of functional disability. Studies have shown that depression combined with anxiety is the most common reason for admission worldwide. This study aimed to examine the variables associated with treatment response or length of stay (LOS) among a group of inpatients with major depression. METHODS: The attending psychiatrist rated severity of depression (using the Hamilton Rating Scale for Depression, HAM-D) of the patients (n = 67), and the patients were asked to complete several self-rating scales (including the Beck Depression Inventory, BDI) on admission. Three days before discharge, these assessments were repeated. Logistic regression models were used to examine the variables of remission status (defined by the HAM-D or the BDI) and LOS (dichotomized by a median of 25 days), respectively. RESULTS: The remission rates of depression at discharge defined by the HAM-D (= 7) and the BDI (= 8) were 40% and 16%, respectively. Lower socioeconomic status and less clinical severity at admission were associated with clinicians' objective assessment of remission, while suicide attempt during this index episode was associated with patients' subjective remission. LOS of depressive inpatients was neither related to baseline severity nor to remission status at discharge. Patients with positive family history and more frequent hospitalization were associated with a hospital stay of longer than 25 days. CONCLUSION: There was no evidence to show that patients with a long hospital stay would gain treatment benefits over patients with short stay. This study provides evidence to support that a structured inpatient treatment plan might gain some economic benefits without compromising treatment efficacy. The admission of hospitalization repeaters should be managed optimally based on the considerations of treatment efficacy and its impact on longer hospital stay.
Assuntos
Transtorno Depressivo Maior/terapia , Tempo de Internação , Idoso , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Indução de Remissão , Índice de Gravidade de Doença , Fatores Socioeconômicos , TaiwanRESUMO
BACKGROUND: Despite a growing body of literature reporting eating disorders (EDs) in non-Western countries in recent years, most of these studies are limited to questionnaire-based surveys or case-series studies. This study aimed to investigate the prevalence and correlates of EDs in Taiwanese high-school students. METHODS: The study subjects consisted of all the female high-school students enrolled in the gifted dance class in 2003 in Taiwan (n=655) and non-dance female students randomly chosen from the same school (n=1251). All the participants were asked to complete self-report questionnaires, including the 26-item Eating Attitudes Test (EAT-26) and the Bulimic Investigatory Test Edinburgh (BITE). All the screen positives and an approximate 10% random sample of the screen negatives were then interviewed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders Patient Version (SCID-I/P). RESULTS: The prevalence of individual EDs was much higher in the dance [0.7% for anorexia nervosa (AN), 2.5% for bulimia nervosa (BN) and 4.8% for EDs, not otherwise specified (EDNOS)] than in the non-dance (0.1, 1.0 and 0.7% respectively) students. Multivariate logistic regression analyses revealed that being in the dance class, higher concern about body shape and lower family support were correlates of EDs for all students, whereas lower parental education level was associated with EDs only for non-dance students. CONCLUSION: EDs were more prevalent in the weight-concerned subpopulation. Although AN is still rare, BN has emerged as a comparable prevalent disorder in Taiwan, as in Western countries.