Structured Clinical Interview For Axis-I Disorders Research Articles

Investigation of the Sensitivity and Specificity of the Persian Version of the New Multidimensional Depression Scale in Diagnosing Depressive Disorder

Objectives: The accuracy of diagnosis in mental disorders, such as depression is the basis of correct treatment. The present study aimed to investigate the sensitivity and specificity of the new multidimensional depression scale in diagnosing depressive disorder. Methods: Two groups of participants were assessed by the new multidimensional depression scale (NMDS) and structured clinical interview for axis i disorders (SCID-I). The experimental group included 55 outpatientswith major depressive disorder selected via the convenience sampling method. The control group included 95 university students recruited via a multi-stage cluster sampling method. Data were analyzed by receiver operating characteristics (ROC) analysis to achieve the cut-off score. Results: Based on the results of the ROC analysis, the cutoff score of 106 was the intersection of the two sensitivity and specificity indices, where these two indices have an optimal relationship. This score simultaneously provided the lowest number of false positives and false negatives compared to other scores. Discussion: It can be acknowledged that the present study supports the clinical efficacy of the new multidimensional depression scale as a screening instrument for diagnosing depressive disorder.

The Relationship between working memory and expressed emotion in the related caregivers of psychotic patients

Objective: To investigate the relationship between Expressed Emotion (EE) and working memory (WM) capacity in the caregivers of patients with psychosis, controlling for the potential confounds, namely, personality traits, subsyndromal psychotic symptoms, burden of care and the patient’s illness severity.
 Materials and Methods: The study covered 152 related caregivers of psychotic patients diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder with a psychotic component. The study continued with 120 participants who met the recruitment criteria. Patients were assessed with a Structured Clinical Interview for Axis I Disorders (SCID-I), the Brief Psychiatric Rating Scale (BPRS), and the Clinical Global Impression Scale (CGI). For related caregivers; SCID-I, Expressed Emotion Scale (EES), Temperament and Character Inventory (TCI); Magical Ideation Scale; Physical Anhedonia Scale; Social Anhedonia Scale; Zarit Caregiver Burden Scale (ZCBS), and Auditory Consonant Trigram Test (ACT) were used. A stepwise regression analysis was employed to analyze the relevant variables that had an independent impact on EES scores.
 Results: There was a significant negative relationship between the ACT and EES scores (r=-.25, p<0.01). The ZCBS score (beta: 0.355, p<0.01), Harm Avoidance subscale of the TCI (beta: 0.231, p<0.01), and CGI overall improvement subscale (beta: 0.237, p<0.01) were independently associated with the EES score.
 Conclusions: There have been few studies investigating the biological basis of this clinical characteristic. The present study found no significant relationship between WM and EE in terms of the effect of WM in the caregivers of patients with psychosis.

Nitric oxide, asymmetric dimethylarginine, symmetric dimethylarginine and L-arginine levels in psychotic exacerbation of schizophrenia and bipolar disorder manic episode.

Objectives:To examine the changes in nitric oxide (NO), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-arginine levels in schizophrenia during acute psychotic exacerbation and in bipolar disorder during mania and to compare those changes to healthy controls.Methods:Thirty schizophrenia patients with acute psychotic exacerbation and 30 bipolar disorder patients with mania, who attended the Psychiatry Department, Erenköy Hospital for Mental and Nervous Diseases, Istanbul, Turkey, in 2010. Thirty healthy controls were included. The diagnosis was made using the Structured Clinical Interview for Axis I Disorders (SCID-I) interviews. Patients’ demographic data were recorded, and NO, SDMA, L-arginine, and ADMA levels were studied.Results:Nitric oxide levels in schizophrenia patients were significantly lower than the control group. Nitric oxide levels in the bipolar group were lower than the control group but the difference was not statistically significant. The levels of SDMA, ADMA, and L-arginine were found to be significantly higher in schizophrenia and bipolar disorder patients than the control group. The disease duration was slightly negatively correlated with NO levels in bipolar patients. In schizophrenia patients, the disease severity was slightly positively correlated with NO levels.Conclusion:Significant changes in NO, SDMA, ADMA, and L-arginine levels in schizophrenia and bipolar disorder patients suggest that NO and inhibitors of NO might be implicated in the neurobiology of schizophrenia and bipolar disorder.

Psychiatric Comorbidity, Sexual Dysfunction, and Quality of Life in Patients Undergoing Hemodialysis: A Case-Control Study.

Due to disabilities caused by the disease and the requirement of dialysis, end-stage renal disease (ESRD) is frequently comorbid with psychiatric disorders, adversely affects quality of life, and causes significant sexual dysfunction (SD). We aimed to investigate the psychiatric comorbidity, quality of life, depression and anxiety levels, and SD in ESRD patients undergoing hemodialysis. Forty-nine patients undergoing hemodialysis treatment in a dialysis center and 44 non-ESRD control subjects selected with snowball sampling were enrolled in the study. All subjects were assessed using Structured Clinical Interview for Axis-I Disorders (SCID-I). Sociodemographic data form, Hospital Anxiety and Depression Scale (HADS), Arizona Sexual Experience Scale (ASEX), and World Health Organization Quality of Life Short Form Turkish Version Scale (WHOQOL-BREF-TR) were applied to both groups. There was no difference between the groups in terms of sex, age, education period, marital status, presence of additional physical illness, and past history of psychiatric disorders. Compared with the control group, HADS depression subscale and ASEX scores were significantly high (p<0.01) in the patient group, and WHOQOL-BREF-TR psychological and physical domain scores were low (p<0.05 and p<0.01, respectively). There was a significant negative relationship between HADS scores and WHOQOL-BREF-TR psychological, environmental, and national environmental scores in the patient group (p<0.05). When the differences between the groups were re-analyzed after controlling HADS depression scores with covariance analysis, the significant difference in ASEX and WHOQOL-BREF-TR physical domain scores between the groups remained, but the significant difference in WHOQOL-BREF-TR psychological domain scores disappeared. The quality of life of ESRD patients was lower, especially in the psychological and physical domains, and psychiatric comorbidities and SD rates were higher than in non-ESRD control subjects. Quality of life is affected by SD. Recognizing and treating depressive symptoms will help improve the quality of life, especially in the psychological domain.

Psychiatric disorders and family functioning in mothers of children admitting to the child psychiatry clinic with temper tantrum

Objective: The aim of this study is to investigate the family functioning and frequency of psychiatric disorders in mothers of pre-school children (between ages 2 and 6) who referred to child and adolescent psychiatry outpatient clinic for anger, mischievousness, unruliness, temper tantrum complaints and who were not diagnosed any psychiatric disorder. Methods: Sixty-two children aged between 2 and 6 years and their mothers were included in the study. The control group consisted of 55 mothers of children who were not admitted to psychiatry clinic and without any psychiatric disorders. Diagnostic interviews of the parents were conducted with Structured Clinical Interview for Axis-I Disorders (SCID-I). Family functioning was evaluated with McMaster Family Assessment Device. Results: The frequency of psychopathology was higher in the mothers of children referred to child psychiatry outpatient clinic with anger, mischievousness, unruliness, and temper tantrum complaints than the controls. At least one psychiatric disorder was diagnosed in 51.6% of mothers of study group, meanwhile this ratio was 26.8% in the control group. More frequent psychiatric disorders were major depressive disorder (27.4%), generalized anxiety disorder (19.4%), and obsessive compulsive disorder (17.7%). Similarly, family functioning perceived by mothers in the study group was poorer than the controls. Conclusion: The results of this study suggested that half of the mothers who brought their children for the behavioral problems to the outpatient clinic were suffering from a psychiatric disorder. The mothers of children, who referred to the child psychiatry outpatient clinic with these complaints, need to be screened for psychiatric symptoms and guide for a psychiatric assistance if necessary.

Levels of nitric oxide, asymmetric dimethyl arginine, symmetric dimethyl arginine,and L-arginine in patients with obsessive-compulsive disorder.

We aimed to investigate and compare to healthy controls the variations in the levels of nitric oxide (NO), asymmetric dimethyl arginine (ADMA), symmetric dimethyl arginine (SDMA), and L-arginine levels in patients with obsessive-compulsive disorder (OCD). We enrolled 30 patients with OCD and 30 healthy controls in the study consecutively. Diagnostic interviews of all participants were conducted with the Structured Clinical Interview for Axis I Disorders (SCID-I), and sociodemographic data of the participants were recorded. Patients scoring 10 points or more on the Yale-Brown Obsessive-Compulsive Scale were enrolled in the study. The NO levels of patients with OCD were increased compared to the control group, but the increase was not statistically significant (P > 0.05). However, patients with OCD had significantly lower levels of ADMA, SDMA, and L-arginine compared with the controls (P < 0.001). We found a significant decrease in ADMA, SDMA, and L-arginine as NO inhibitors between the groups, possibly because of an increase in NO. However, the insignificant increase in NO suggests that ADMA, SDMA, and L-arginine play direct and potentially important roles in OCD biology.

Aging is an Important Cause for a Lack of Understanding of the Main Risk Factor in Cardiac Rehabilitation Patients

Background: Age, one of the key biomarkers among the nonclinical parameters of cardiovascular diseases (CVDs), has the greatest effect on the development and progression of CVDs. Objectives: The current study was done to evaluate the effect of age on cardiac rehabilitation (CR) patients’ attitudes regarding the main cause of their condition. Patients and Methods: The administrative data of this cross-sectional study were obtained from the database of the CR department of a hospital in Iran. The demographic and clinical information of 901 patients was obtained from January 2004 and January 2012 using compiled forms of this database and the structured clinical interview for Axis I Disorders (SCID-I). Univariate analysis of variance and Bonferroni post-hoc analysis were used for the data analysis. Results: After adjusting for gender, it was revealed that significant age differences existed between patients who perceived no specific risk factors (62.43 years) and those who viewed biological (55.0), physiological (57.31), behavioral (57.85), and psychological (57.25) risk factors as the main cause of their condition (P < 0.05). The age differences between those who had no perceived risk factors (62.43) was significantly different from patients perceiving biological (55.0) and environmental (62.03) factors to be the main cause (P < 0.05). Conclusions: Although older patients need more self-care and the quality of this self-care originates from their attitude toward CVD risk factors, their lack of awareness about the main risk factor of their condition is a major challenge for secondary prevention measures. In addition, younger patients’ significant emphasis on biological risk factors as uncorrectable factors can reduce their sense of responsibility toward attempting to control correctable risk factors. Correcting these patients’ attitudes regarding CVD risk factors can result in better responsibility feeling by the patients and can improve treatment outcomes.

The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients

Objective. Cognitive impairment (CI) in multiple sclerosis (MS) can develop any time. CI is associated with the degree of neuronal loss, but disease duration, fatigue, comorbid affective disorder, and drug dose may also affect cognition. Our aim was to assess which cognitive domain was disturbed primarily in mild MS patients and to see whether CI was related with clinical and psychiatric features. Method. Neurological and psychiatric evaluation of 31 MS patients and 31 age, sex, and education-matched healthy controls were made with Structured Clinical Interview for Axis I Disorders (SCID-I). Depression, anxiety, functionality, fatigue, and disability scoring were determined with Hamilton Depression-Anxiety scales, Global Assessment of Functionality, Fatigue Severity and Expanded Disability Status Scales. Cognitive functions were assessed using Mini Mental, Serial Digit Learning, Verbal and Nonverbal Cancellation, Stroop and Rey Auditory Verbal Learning tests. Results. Retrieval from long-term memory and psychomotor speed were significantly worse in MS group. CI was correlated with disease duration, number of attacks, and physical disability but not with depression and anxiety severity. Disease duration predicted disturbances in recall and psychomotor speed, whereas fatigue and disability predicted depression. Conclusion. Psychomotor speed and memory were primarily impaired in MS patients, and CI was closely associated with clinical aspects of MS rather than with depression and anxiety.

PW06-05 The predictive role of anxiety disorders on depressive phenomenology during post-partum period

Aims:To investigate the predictive role of any specific (DSM-IV) Anxiety Disorders (AD) on depressive symptoms and Major or Minor Depressive Disorder (MDD, mDD) during early postpartum period.Method:Women (at the 12th-15th gestational week, N=1066) were recruited in the framework of the Program ‘Perinatal Depression - Research &amp; Screening Unit (PND-ReScU)". Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS), and Axis-I disorders (AD, MDD, mDD) were diagnosed with the Structured Clinical Interview for Axis-I Disorders (SCID-I).Results:Any current AD at baseline (3rd month of pregnancy) was detected in 231 (21.7%). Having at least one current AD, was associated with a greater likelihood of having MDD or mDD during the early postpartum period, even after the adjustment for the confounding factor of having a lifetime history of MDD (RR=3.86 95%CI 1.58-9.42).In particular, women affected by Obsessive Compulsive Disorder (N=17; 1.6%) or Panic Disorder (N=43; 4%) had at higher risk to develop depressive symptoms (EPDS≥13) during the postpartum period than women without these AD (RR=6.9 and 6.7 respectively). As for the risk of developing PPD, the strongest association was found for women with Panic Disorder (RR=7.6 95% CI 2.62-22.0).Conclusions:AD are associated with a greater likelihood to develop depressive symptoms and MDD or mDD during the early postpartum period. Women with current PD have the strongest risk to develop both MDD or mDD and depressive symptoms during early postpartum period compared to other anxiety disorders.

P01-144 The predictive role of anxiety disorders on depressive phenomenology during post-partum period

Aims:To investigate the predictive role of any specific (DSM-IV) Anxiety Disorders (AD) on depressive symptoms and Major or Minor Depressive Disorder (MDD, mDD) during early postpartum period.Method:Women (at the 12th-15th gestational week, N=1066) were recruited in the framework of the Program ‘Perinatal Depression - Research &amp; Screening Unit (PND-ReScU)’. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS), and Axis-I disorders (AD, MDD, mDD) were diagnosed with the Structured Clinical Interview for Axis-I Disorders (SCID-I).Results:Any current AD at baseline (3rd month of pregnancy) was detected in 231 (21.7%). Having at least one current AD, was associated with a greater likelihood of having MDD or mDD during the early postpartum period, even after the adjustment for the confounding factor of having a lifetime history of MDD (RR=3.86 95%CI 1.58-9.42).In particular, women affected by Obsessive Compulsive Disorder (N=17; 1.6%) or Panic Disorder (N=43; 4%) had at higher risk to develop depressive symptoms (EPDS≥13) during the postpartum period than women without these AD (RR=6.9 and 6.7 respectively). As for the risk of developing PPD, the strongest association was found for women with Panic Disorder (RR=7.6 95% CI 2.62-22.0).Conclusions:AD are associated with a greater likelihood to develop depressive symptoms and MDD or mDD during the early postpartum period. Women with current PD have the strongest risk to develop both MDD or mDD and depressive symptoms during early postpartum period compared to other anxiety disorders.

Workshop IV. Aetiopathogenetic factors in Reiter's syndrome. Adjuvant disease: pathology and immune reactivity.

<h3>Objectives:</h3> To examine the changes in nitric oxide (NO), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-arginine levels in schizophrenia during acute psychotic exacerbation and in bipolar disorder during mania and to compare those changes to healthy controls. <h3>Methods:</h3> Thirty schizophrenia patients with acute psychotic exacerbation and 30 bipolar disorder patients with mania, who attended the Psychiatry Department, Erenköy Hospital for Mental and Nervous Diseases, Istanbul, Turkey, in 2010. Thirty healthy controls were included. The diagnosis was made using the Structured Clinical Interview for Axis I Disorders (SCID-I) interviews. Patients’ demographic data were recorded, and NO, SDMA, L-arginine, and ADMA levels were studied. <h3>Results:</h3> Nitric oxide levels in schizophrenia patients were significantly lower than the control group. Nitric oxide levels in the bipolar group were lower than the control group but the difference was not statistically significant. The levels of SDMA, ADMA, and L-arginine were found to be significantly higher in schizophrenia and bipolar disorder patients than the control group. The disease duration was slightly negatively correlated with NO levels in bipolar patients. In schizophrenia patients, the disease severity was slightly positively correlated with NO levels. <h3>Conclusion:</h3> Significant changes in NO, SDMA, ADMA, and L-arginine levels in schizophrenia and bipolar disorder patients suggest that NO and inhibitors of NO might be implicated in the neurobiology of schizophrenia and bipolar disorder.