Structured Clinical Interview For DSM-IV Axis I Disorders Research Articles

Unconjugated bilirubin as a state marker in patients with schizophrenia in acute episode: an Egyptian study

BackgroundThere is a substantial body of evidence linking unconjugated bilirubin to schizophrenia. Most of the earlier research has found a statistically significant relationship between the two factors.Aim of the workTo study the level of unconjugated bilirubin in individuals with acute schizophrenia and to investigate its correlation with neuropsychological, psychopathological, and psychosocial aspects of the disorder.Patients and methodsEighty schizophrenia patients were included in the sample, they had multiple previous episodes and were in acute episodes at the time of recruitment. Forty healthy individuals were recruited for the control group. The DSM-IV was used to diagnose the subjects, and the Trail Making Test (TMT), Positive and Negative Syndrome Scale (PANSS), General Assessment of Function (GAF), and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) were used to evaluate the subjects’ social functioning, symptom severity, and cognitive functioning. A blood sample was drawn to measure serum bilirubin level. We analyzed the relationship and correlation of unconjugated bilirubin with the previous scale scores.ResultsCompared to healthy control individuals, who volunteered to participate, schizophrenia patients reported significantly higher levels of both total and indirect bilirubin. One subject (with schizophrenia) had an abnormally elevated total bilirubin level (> 1.2 mg/dL). Neither the direct nor the indirect bilirubin levels (> 0.3 mg/dl or > 1.2 mg/dL) were clinically abnormal in any of the patients. PANSS total score, PANSS N score, and PANSS G score were found to have a statistically significant positive connection with levels of total, direct, and indirect bilirubin. Age, gender, smoking, BMI, Total PANSS, PANSS P, PANSS N, PANSS G, GAF, TMT-A, TMT-B, antipsychotic medication, psychotic disorder duration, and duration of untreated psychosis were not predictive of total or indirect bilirubin levels, according to linear regression analysis. However, Total PANSS, PANSS N, and PANSS G were significantly predictive for direct bilirubin levels.ConclusionA statistically significant difference in total and unconjugated bilirubin mean serum levels between schizophrenia patients and healthy individuals was found. More studies are recommended to revise the contradictory results in literature on the unconjugated bilirubin and Schizophrenia.

Long-Term Outcomes and Cost-Effectiveness of an Internet-Based Self-Help Intervention for Social Anxiety Disorder in University Students: Results of a Randomized Controlled Trial

Social anxiety disorder (SAD) is widespread among university students and is associated with high costs for the society. While unguided internet- and mobile-based interventions (IMIs) may have short-term effects in reducing SAD symptoms, evidence for their long-term efficacy and cost-effectiveness is still limited. The aim of this study is to examine the 6-month outcomes of an IMI for university students with SAD. Participants were recruited via mass mails sent to enrolled students and included if they were at least 18 years old, met the diagnostic criteria of SAD in a structured clinical interview for DSM-IV axis I disorders (SCID-I), and provided written informed consent. In a prospective study designed as a two-armed randomized-controlled trial, 200 students (mean age 26.7 years) diagnosed with SAD were randomly assigned to an IMI or a waitlist control (WLC) condition. The IMI consisted of nine weekly sessions based on the cognitive-behavioral treatment model for social phobia by Clark and Wells. The primary outcome was SAD symptom severity assessed via the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). A health economic evaluation from a societal and healthcare perspective examined the costs related to the symptom-free status and quality-adjusted life years (QALYs) gained. Statistically significant differences in SAD symptom severity previously found at posttreatment favoring the IMI were maintained at a 6-month follow-up [SIAS (Cohen’s d = 0.59 ; 95% CI, 0.30, 0.87) and SPS (Cohen’s d = 0.83 ; 95% CI, 0.54, 1.1)]. From a societal perspective, at a willingness to pay (WTP) of €0, the intervention was found to have a 92% and 93% probability of cost-effectiveness compared with the WLC per symptom-free status and QALY gained, respectively. From a healthcare perspective, the likelihood of cost-effectiveness of the intervention was 97% per symptom-free status at a WTP of €1000 (US$1326) and 96% per QALY gained at a WTP of €6000 (US$7956). This IMI is effective in treating university students with SAD and has an acceptable likelihood of cost-effectiveness compared with WLC from a societal perspective. This intervention can be integrated into university healthcare to reach students with SAD as it is scalable, shows a high probability of cost-effectiveness, and overcomes known treatment barriers. This trial is registered with DRKS00011424.

Synthetic cannabinoids impact on cognitive functions

BackgroundSynthetic cannabinoids SC are now becoming progressively popular among young people worldwide; little is known about their negative effects. Anger, anxiety, hallucinations, and perceptual changes were the most common psychoactive findings. Substance abuse causes cognitive impairment (CI). This study’s goal is to raise public awareness about the dangers that synthetic cannabinoid intoxication poses to public health. As well as the magnitude of CI in synthetic cannabinoids in comparison with healthy controls. The study included 30 synthetic cannabinoids SC addicts and 30 healthy people. The Wechsler memory scale (WMS), the Benton visual retention test (BVRT), and Trail Making Test (TMT) A and B were used to assess cognitive functions. Addiction Severity Index (ASI), Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I), and Structured Clinical Interview for DSM-IV Axis II Disorder (SCID II).ResultsUsing BVRT, (96.7%) of the SC use disorder cases had more impaired performance than controls (0%) (P < 0.001). Almost three quarters of the cases had impaired performance on the trail making tests A and B compared to none of the controls (P < 0.001). Similarly, there was a high statistically significant difference between SC use disorder cases and controls in all domains of the WMS. There was no statistically significant correlation between the cognitive scales (BVRT, WMS and TMT) results in relation to age of SC use patients or duration of use.ConclusionsPatients who used synthetic cannabinoids SC were more likely than controls to develop CI, which manifested as impaired visual, auditory, immediate, delayed, and working memory.

Understanding suicide: Do social support and problem-solving skills really matter?

Purpose: Suicide is a significant public health problem on a global scale. The role of social support and problem-solving skills in suicide needs to be addressed together and comprehensively. In this study, how the perception of social support and all dimensions of problem-solving skills affect suicidal behavior in individuals with suicidal ideation or intention was evaluted.&#x0D; Methods and Materials: A total of 150 individuals including 75 individuals who had attempted suicide and 75 individuals who had not attempted suicide were evaluated. Sociodemographic Data Form, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Beck Anxiety Inventory, Beck Depression Inventory, Problem Solving Inventory (PSI), Multidimensional Perceived Social Support Scale (MPSSS) and Suicide Intent Scale (SIS) were administered to participants.&#x0D; Results: The anxiety and depression scores of the suicide attempt group (SAG) were found to be higher compared to the no suicide attempt group. The total and subscale scores of the MPSSS were lower in the SAG group compared to the no suicide attempt group. Also, the SAG group felt significantly more inadequate in problem-solving compared to the non-attempters. The PSI-Approach-Avoidance scores were statistically significantly higher in individuals under 30 years of age. &#x0D; Conclusion: When suicide remains an important public health issue worldwide, identifying and modifying suicide ideation, intention, attempt, or completed suicide risk factors is crucial in suicide prevention efforts. In suicide prevention, the individual's relationships with their family, friends, and individuals with whom they share emotional connections should be taken into account. Increasing perceived social support and improving problem-solving skills should be included in suicide intervention programs.

Health-related quality of life-based definition of remission from depression among primary care patients.

Depression undermines health-related quality of life (HRQoL). Remission is the central aim of all treatments for depression, but the degree of remission necessary for depressive patients' HRQoL to correspond to the normal range of the general population remains unknown. The Vantaa Primary Care Depression Study prospectively followed-up a screening-based cohort of depressive primary care patients for 5 years. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to diagnose major depressive disorder. HRQoL was measured by the generic 15D instrument at baseline and at 5 years (N = 106, 77% of baseline patients), and compared with the 15D results of an age-standardized general population sample from the Finnish Health 2011 Survey (N = 4,157). Receiver operating characteristic analyses determined the optimal Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) cut-offs for remission, using the 15D score as the construct validator. Remission was defined as the score at which HRQoL reached the general population range (minimum mean - 1 SD). As age may influence HRQoL, patients older and younger than the median 52 years were investigated separately. For HAMD, the optimal cut-off point score was 8.5, for BDI 10.5, and for BAI 11.5. The differences between the findings of the younger and older patients were small. Cross-sectional analysis, small number of patients in the cohort. Depressive primary care patients' HRQoL reaches the normal variation range of the general population when their depression and anxiety scores reach the conventional clinical cut-offs for remission.

Retrospectively assessed childhood trauma experiences are associated with illness severity in mental disorders adjusted for symptom state

Converging evidence suggests that childhood trauma is a causal factor in schizophrenia (SZ) and in bipolar disorders (BD). Here, we investigated whether retrospective reports are associated with severity of illness, independent of current symptom state in a large sample of participants with SZ or BD.We included 1260 individuals (SZ [n = 461], BD [n = 352]), and healthy controls; HC [n = 447]) recruited from the same catchment area. A history of childhood trauma was obtained with the Childhood Trauma Questionnaire (CTQ). Diagnosis and episodes were obtained with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Clinical symptoms (state) were assessed with the Positive and Negative Syndrome scale (PANSS), the Calgary Depression Scale (CDSS). Trait related illness characteristics were assessed with age at illness onset, number of episodes, and lifetime suicide attempts.Patients who reported multiple types of childhood trauma experiences had significantly more severe illness course including an earlier illness onset, more mood episodes, and increased risk of at least one suicide attempt, also after adjusting for current symptom state.Retrospective assessed childhood trauma experiences are associated with illness severity in mental disorders adjusted for symptom state. Our results strengthen the role of childhood trauma in development of psychopathology.

Depression in Diabetic Patients: What Is the Link With Eating Disorders? Results of a Study in a Representative Sample of Patients With Type 1 Diabetes.

Background and PurposeComorbidity between diabetes and depression, and diabetes and eating disorders (ED) conveys significant diagnostic, clinical and therapeutic implications. The present study was conducted on a sample of adult outpatients affected by Type 1 Diabetes (T1DM) to assess lifetime prevalence of ED; current prevalence of depression and Disturbed Eating Behaviors (DEB) and their impact on glycemic control. We hypothesized that patients with depression would have higher rates of lifetime ED and current DEB. We hypothesized a significant and independent association between DEB and the prevalence of depression.Materials and MethodsThe study was carried out using a cross-sectional design in a sample of 172 diabetic patients with T1DM aged from 17 to 55 years. Lifetime prevalence of ED according to DSM-5 criteria was assessed by means of the Module H modified of the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I). The following questionnaires were used: Beck Depression Inventory–IA version (BDI-IA) and Diabetes Eating Problems Survey—Revised (DEPS-R), to assess respectively the current presence of depression and DEB. Socio-demographic, clinical, and laboratory data were also collected.ResultsHigh rates of depression (35.5%) and DEB (19.2%) were observed in our sample of 172 adult outpatients with T1DM. Lifetime history of ED was present in 20.9% of the sample and was more frequently diagnosed in patients with current depression (34.4% vs. 13.9%, p = 0.002). Higher levels of DEB at DEPS-R significantly increased the odds of depression (adjOR: 1.09; 95% CI: 1.03–1.15; p = 0.003). The presence of DEB was associated with poor glycemic control. On the other hand, no association was found between depression and metabolic compensation.ConclusionAdult patients with T1DM and depression should be screened for ED and DEB. Treating DEB could positively impact both mood and glycemic control in this population. Further studies should be carried out on a larger patient population using a longitudinal design and an accurate method of evaluation to explore the complex relationship between diabetes, depression, ED, and DEB. Future research should investigate treatment strategies for DEB in T1DM patients and their impact on both psychopathological and metabolic outcomes.

Impulsivity and psychiatric comorbidity as risk factors for suicide attempts in borderline personality disorder.

BackgroundAddressing the risk of suicidality in borderline personality disorder (BPD) is a crucial issue. The notion that impulsive individuals are more likely to plan for suicide attempts is important for many reasons in both theoretical and clinical decision-making.AimThe aim of this study was to investigate potential risks of suicidality in BPD and to correlate it to impulsivity.SettingThe study was conducted at the Institute of Psychiatry, Ain Shams University and Al Mashfa Private Hospital.MethodsNinety-one participants were included in the study: 30 patients were diagnosed as BPD without axis I comorbidities, 31 BPD patients had psychiatric comorbidities and 30 healthy subjects were assessed by using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II), Suicide Behavior Questionnaire-Revised (SBQ-R), the Arabic version of Barratt’s Impulsiveness Scale-11 (BIS-11) and Global Assessment of Functioning scale.ResultsThere was a significant difference in suicidality using the SBQ-R between the healthy controls and BPDs without and with comorbidities. Healthy controls showed low suicidality in only 3.3%, while it was higher in both groups of BPD. The total score of BIS was as follows: 62.5 (±10.1 SD) in group A, 79.4 (±12 SD) in group B and 80.3 (±12.5 SD) in group C, which denote mild, moderate and moderate-to-severe degree of impulsivity in group A, B and C, respectively. Suicidality was positively correlated with (AI item: lack of span Attention in Attentional Facet) (r = 0.489, p = 0.006), (PI item: lack of self-control in planning facet) (r = 0.401, p = 0.028), as well as (MII item: lack perseverance in holding off impulsive acts in motor facet) (r = 0.471, p = 0.009).ConclusionProper assessment of associated psychiatric comorbidities and impulsivity among BPD patients will help preventing of future suicidal attempts.

Comparison of frontal QRS-T angle in patients with schizophrenia and healthy volunteers

Cardiovascular diseases are the most prominent cause of death in patients with schizophrenia. Frontal QRS-T (fQRS-T) angle is a novel marker of myocardial depolarization and repolarization heterogeneity. Recent studies have indicated that the fQRS-T angle is associated with some cardiovascular abnormalities. This study aimed to investigate the fQRS-T angle and its relationship with symptoms severity in patients with schizophrenia.One hundred-six patients with schizophrenia and sixty-four healthy controls were included in this study. fQRS-T angle and QT interval measurements were calculated for each participant from the automatic report of the 12-lead electrocardiography (ECG) device. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and The Positive and Negative Syndrome Scale (PANSS) were performed on the patients with schizophrenia.Corrected QT (QTc) interval and fQRS-T angle were significantly higher in the patients with schizophrenia than healthy controls (p < 0.001 and p < 0.001, respectively). fQRS-T angle was positively correlated with age (r = 0.43), duration of disease (r = 0.37), and negative symptoms scores (r = 0.39). In linear regression analysis, the disease duration and negative symptom severity were the independent predictors of fQRS-T angle in patients with schizophrenia (t = 3.730, p = 0.003 and t = 2.257, p = 0.023, respectively).The fQRS-T angle may be an important ECG parameter to interpret cardiovascular disease risk in patients with schizophrenia.

Identifying Recent Manic Symptoms by Newly Discharged Patients with Bipolar Disorder.

Background: Bipolar disorder type I is a chronic and recurrent disease and is considered as the ninth nonfatal disease. Identifying the symptoms of the manic episode, which are more likely detected by patients, increases the ability of psychiatrists in diagnosing this disorder. Methods: In this cross-sectional study, a total of 96 patients with bipolar disorder were enrolled from 2 academic psychiatric centers. Then, using the patients’ medical records, demographic data were collected. Further, both the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview and the Young mania rating scale (Y-MRS) scale were also performed. Then, about 27 to 33 days after discharge, the patients were contacted by phone and the SCID-I interview was conducted again. Meanwhile, to make the patients focus on the period from which they have recently improved, the phrase "the recent period of hospitalization" was added to the interview questions and the symptoms were checked. Results: At the beginning of the hospitalization, the most common symptom in the total population was irritable mood (89.5%): in the male population decreased need for sleep (98.2%), and in the female population irritable mood (97.5%). In addition, in the evaluation, about 1 month later, irritable mood (69.7%) and decreased need for sleep (67.7%) were the most common symptoms detected by the patients. In terms of the predictive value of each symptom to the diagnosis of that symptom by the psychiatrist, the highest positive predictive value was related to the symptoms of irritable mood (95.5%), decreased need for sleep (95.4%), and talkativeness (95.2%). However, the highest negative predictive value was related to the symptom of elevated mood (87.5%). Conclusion: The patients who have passed manic episodes are more able to detect some symptoms of this episode. Despite some limitations, it seems that using these statistical findings in practice may promote clinical assessment and diagnosis of bipolar disorder type I by psychiatrists.

Evaluation of The Relationship Between Apelin 36 and Oxidative Stress In Patients With General Anxiety Disorder

Objective: The aim of this study was to evaluate the relationship between apelin-36 and oxidative parameters and Generalized Anxiety Disorder (GAD). Apelin which prevents hippocampal neuronal death is an endogenous ligand for G protein bound APJ receptors in the central nervous system. Oxidative Stress were occurred by free radicals which caused apoptosis in the hypothlamus, hippocampus and amygdala regions of the Central Nervous System (CNS).Methods: In this study, 61 patients diagnosed generalized anxiety disorder at psychiatry polyclinic and 55 control subjects were enrolled. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Hamilton Anxiety Rating Scale (HARS) were used in this study and they were filled by the patients and healthy individuals. Serum apelin-36 level was measured by using an ELISA kit. Total antioxidant status (TAS) and Total Oxidant Status (TOS) in the serum was measured by an automated system. The data were analyzed by using the SPSS.Results: It was found that serum apelin-36, TOS and Oxidative stress index (OSI) levels were significantly lower in patients’ group than controls. In addition, negative correlation was detected between apelin 36 levels and HARS scores, TOS and OSI values in patients’ group. TAS values were found as similar between the patient and control group. There was no correlation between TAS and Apelin 36 in the patient group.Conclusion: In this study it was found that serum apelin-36, TOS and OSI levels were low in GAD. According to the results, Apelin-36 and oxidative stress may play a role in the etiopathogenesis of Generalized Anxiety Disorder.

Theory of Mind in Pre-school Aged Children: Influence of Maternal Depression and Infants' Self-Comforting Behavior.

A milestone of child development is theory of mind (ToM): the ability to attribute mental states, especially beliefs and desires, to other persons and to understand that their behavior is guided by mental states. The learning process about the mental world also takes place in social communication and interaction, beginning in infancy. Infancy is assumed to be a sensitive period for the development of social skills through interaction. Due to limited self-regulatory skills, infants depend on sensitive behavior of their caregivers to regulate affective states and physiological arousal, and in turn, mutually regulated affects allow the infant to gradually acquire the capability to self-regulate negative affective states. Effective and adequate affect regulation is an important prerequisite for environmental interaction and thus for the development of socio-emotional skills. The present study investigated the relation of self-regulatory abilities in infancy and later ToM in pre-school aged children of clinically depressed mothers and healthy controls. The sample comprised of N = 55 mother–child dyads, n = 22 diagnosed with postpartum or lifetime depression according to DSM-IV and n = 33 healthy controls. Mother–infant-interaction was videotaped during the Face-to-Face Still-Face paradigm. At 3 and 42 months postpartum mothers were interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to evaluate maternal psychopathological status according to DSM-IV. At the age of M = 4.0 years, children’s ToM abilities were assessed using content-false-belief and location-false-belief tasks. The results of this study show that contrary to our hypotheses, maternal depression did not impair the development of children’s ToM-abilities per se. Rather, an interaction effect highlights the role of infant’s self-comforting behavior during mother–infant interaction in infancy (3 months postpartum) for ToM-development at pre-school age assessed with the Maxi-task; this association was distinct for female in comparison to male children. The results of this longitudinal study shed light on the discussion, how maternal depression influences child development and point in the direction that self-comforting behaviors in infancy can also be seen as a resource.

Depression and Anxiety Disorders Impact in the Quality of Life of Patients with Inflammatory Bowel Disease.

Objective Anxiety and depression have a negative influence in the quality of life. The aim of the study was to determinate the levels of sensitivity and specificity of the Anxiety and Hospital Depression Scale (HADS) and compare the quality of life in patients with inflammatory bowel disease (IBD) and depression or anxiety. Methods This study included 104 patients with diagnosis of IBD. Each patient received psychiatric intervention with SCID-I (Structured Clinical Interview for DSMIV Axis I Disorders) instrument as a gold standard to stablish the cut-off points of HADS. Quality of life was also evaluated with IBDQ-32. Demographic and clinical variables were collected. Results Most of the patients reported a high quality of life (73.1%, n = 76), while 25.0% (n = 26) express a moderate quality of life. The ROC curves for both psychiatric entities showed an adequate discriminative capacity of the HADS-anxiety dimension (AUC = 0.84, 95%CI = 0.76-0.92) with a limited discriminability of the HADS-depression dimension (AUC = 0.58, 95%CI = 0.46-0.70) using the proposed scoring of 8 as a cut-off point. Conclusions Anxiety and depression impact negatively in the quality of life in Mexican patients with IBD. The Mexican version of HADS had acceptable internal consistency and external validity, with moderate sensitivity and specificity for clearly identifying clinical cases of anxiety and depression in patients with IBD.

Oestrogen therapy for postpartum depression: efficacy and adverse effects. A double-blind, randomized, placebo-controlled pilot study

Background Postpartum depression (PPD) is detrimental to the mother and the family as a whole. Early initiation of appropriate treatment is important. The aim of this pilot study was to evaluate the efficacy and adverse effects of oestradiol treatment. Methods We performed a pilot double-blind, randomized, placebo-controlled study. Major depression was diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and the severity of depression was evaluated using the Edinburgh Postnatal Depression Scale (EPDS). The duration of treatment with sublingual oestradiol hemihydrate (1–3 mg/day) was 12 weeks. Results The treatment group consisted of 16 mothers and the placebo group of 14 mothers. Thirteen mothers in the treatment group and ten in the placebo group recovered from depression during the treatment period as measured with the EPDS (<10). There was no evidence to suggest that oestradiol was more effective than placebo. More mothers in the treatment group than in the placebo group (eight vs. one) received gestagen treatment for irregular bleeding. Oestradiol did not disturb breastfeeding. The mean number of other adverse effects per mother was lower in the treatment group, and these were mostly somatic symptoms. Conclusion Our findings warrant further studies on oestrogen therapy for PPD with and without antidepressant and gestagen therapy, and on adverse effects (including effects on vaginal bleeding and breastfeeding).

Premorbid Characteristics as Predictors of Early Onset Versus Adult Onset in Patients With a First Episode of Psychosis.

Objective: To study the differences in early-life characteristics between patients with an early onset of psychotic disorders (EOP, aged < 18 years) versus adult onset of psychotic disorders (AOP, aged ≥ 18 years) and to identify predictors of earlier onset.Methods: 278 patients with a first episode of psychosis between the ages of 7 and 35 years were recruited as part of a multicenter prospective longitudinal study conducted in Spain between January 1, 2009, and December 31, 2011, with diagnoses made for AOP using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and for EOP using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS). Early-stage factors such as prenatal, perinatal, and other premorbid factors were registered and compared between EOP and AOP patients. To analyze the association between baseline variables and outcome, univariate and multivariate logistic regression models were used, and the association or odds ratios (ORs) for significant risk factors were calculated.Results: 224 patients with AOP (mean ± SD age = 25.6 ± 5.0 years; 65.6% male) and 54 patients with EOP (16.1 ± 1.7 years; 68.5% male) were included. Univariate analysis revealed significant differences between the groups. Specifically, compared to AOP subjects, EOP patients had more frequent obstetric complications (OCs) (P < .001), birth weight < 2.500 g (P < .028), a background of any personal psychiatric disorder (P < .001), a previous diagnosis of attention-deficit/hyperactivity disorder (P = .001), and premorbid IQ < 85 (P < .001). In the multivariate model, only OCs (OR = 5.44), personal psychiatric background (OR = 4.05), and IQ < 85 (OR = 3.96) predicted an onset of the first episode of psychosis before age 18 years.Conclusions: Premorbid factors such as OCs, personal psychiatric background, and IQ < 85 could help predict which patients are more likely to have an early onset of psychosis. Awareness of these factors could help clinicians work to prevent the early transition to psychosis in children and adolescents.

Depression and cognitive distortions in hemodialysis patients with end stage renal disease: A case-control study

Background and objectivesIdentifying cognitive distortions is essential for Cognitive Behavioral Therapy (CBT) that plays a key role in the treatment of depression. Depression seen in patients with End-Stage Renal Disease (ESRD) has not been sufficiently diagnosed and treated. This study aimed to examine the cognitive distortions and schemas of patients diagnosed with ESRD. MethodsFifty-six patients undergoing hemodialysis and forty-seven controls were enrolled in the study. A sociodemographic and clinic data form, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Hospital Anxiety and Depression Scale (HADS), Dysfunctional Attitudes Scale (DAS), Automatic Thoughts Questionnaire (ATQ) were applied to all participants. ResultsThe prevalence of the psychiatric disorder in the case group was significantly higher than the prevalence of the psychiatric disorder in the control group. Compared with the control group, the HADS depression subscale was significantly high in the patient group. There was a positive correlation between the duration of hemodialysis and total scores of DAS as well as the “dependency attitudes” factor among the case group. The “helplessness” subscale scores of the ATQ were significantly higher in the case group compared to the control group. ConclusionsThe duration of hemodialysis was related to dependency attitudes of cognitive distortions among patients with ESRD. Studies investigating cognitive modalities are needed to treat depression more successfully in this population. It will contribute to the Cognitive Behaviour Therapy of ESRD patients when these factors are taken into consideration.

Physical activity and childhood trauma experiences in patients with schizophrenia or bipolar disorders

Background Physical activity promotes resilience and reduces stress. Here we aimed to clarify the impact of physical activity and childhood trauma experiences on current mood and cognitive function in patients with schizophrenia (SZ) or bipolar disorders (BD). Methods Three-hundred-and-six patients with DSM-IV schizophrenia (SZ) or bipolar disorder (BD) were included in the study. Diagnoses were assessed using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Physical activity was measured as hours spent on any regular physical activity per week. All patients underwent a neuropsychological test battery. History of Childhood trauma was assessed using the Childhood Trauma Questionnaire and mood symptoms were assessed with the Inventory of Depressive Symptoms. Results Patients with childhood trauma who were physically inactive (˂90 min per week) had the most severe clinical profile, characterised by the highest depressive symptoms (p ˂ 0.001) and lowest performance on working memory tasks (p ˂ 0.001). Among patients with childhood trauma, those who were physically active (≥90 min per week) had better working memory performance than physically inactive patients (p = 0.02). Discussion A history of childhood trauma was associated with poorer working memory and more depressive symptoms only in patients who were physically inactive, suggesting a possible protective factor of physical activity in severe mental disorder.

The relation of major depression, OCD, personality disorders and affective temperaments with Temporal lobe epilepsy

BackgroundIn patients with temporal lobe epilepsy (TLE), studies demonstrate frequent comorbidity with mood disorders, personality disorders (especially obsessive-compulsive disorder) and major depression, but there are conflicting findings. This study aimed to investigate psychiatric comorbidities and affective temperament among TLE patients and to explore the relationships between obsessive compulsive disorder, other personality disorders, major depression and affective temperament in order to clarify the mediator effect of TLE in these relationships. MethodsThirty patients with TLE and 30 healthy volunteers were included. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II), Hamilton Anxiety (HAM-A) scale, Hamilton Depression (HAM-D) scale, Beck Suicidal Ideation Scale (BSSI) and Yale Brown Obsession Compulsion Scale (YBOCS) were applied and evaluated by a psychiatrist. Additionally, all individuals completed The Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A). ResultsPatients with temporal lobe epilepsy had higher scores in TEMPS-A, HAM-A, HAM-D, YBOCS and BSSI. Major depression, obsessive compulsive disorder and dependent and antisocial personality disorders were prevalent in patients. With respect to affective temperaments, depressive, cyclothymic and anxious temperaments were associated with obsessive compulsive disorder comorbidity; whereas, depressive and anxious temperaments were found to be associated with major depression comorbidity in patients with TLE. Furthermore, cluster A and cluster C personality disorders were associated with affective temperaments in patients with TLE. Affective temperaments had no correlation with illness duration, seizure frequency, depression severity and suicidal thoughts, but obsessions and compulsions. Suicidal thoughts were associated with obsessions and compulsions. ConclusionAffective temperaments are core personality traits with biological background and they may provide a foundation for psychiatric disorders, especially mood disorders. Considering that TLE originates from abnormalities in brain circuitry, it may form a basis for psychiatric disorders. Therefore, psychiatric evaluation to determine comorbidities may be beneficial to increase the quality of life of patients with TLE.

Examination and Comparison of Cognitive and Executive Functions in Clinically Stable Schizophrenia Disorder, Bipolar Disorder, and Major Depressive Disorder.

Background Schizophrenia (SC), bipolar disorder (BD), and major depressive disorder (MDD) are associated with various cognitive and executive dysfunctions. The aim of the present study was to evaluate and compare cognitive and executive dysfunctions in schizophrenia, bipolar disorder, and major depressive disorder. Materials and Methods Sixty-four schizophrenia patients, 68 bipolar patients, 62 patients with major depressive disorder, and 75 healthy individuals participated in the present study. All participants were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Young Mania Rating Scale (YMRS), Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI-II), Trial Making Test (TMT), Four-Choice Reaction Time Task, Ruler Drop Method (RDM), Tower of London (TOL) task, and the Wisconsin Card Sorting Task (WCST). Data were analyzed by chi-square, Kolmogorov-Smirnov, and independent t-tests; ANOVA; and MANOVA. Results In the cognitive function, the scores of SC, BD, and MDD patients were lower than those of healthy individuals. Also, the scores of MDD patients were lower than those of other patients, and the scores of BD patients were lower than those of SC patients. In the executive function, the scores of SC, BD, and MDD patients were lower than those of healthy individuals. Moreover, the scores of the MDD group were higher than those of the BD and SC groups, and the scores of the SC group were higher than those of the BD group. Conclusion Patients with SC, BD, and MDD have poorer cognitive and executive functions than healthy individuals, even when these patients are in a stable state. Assessment of cognitive and executive functions in SC, BD, and MDD patients can help in understanding the pathology of these disorders.

Psychiatric and psychosocial morbidity 1 year after epilepsy surgery.

There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.