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Progress in Neuro-Psychopharmacology and Biological Psychiatry 10/2008; 32(8):2004-5. · 3.25 Impact Factor
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ABSTRACT: This study involved a naturalistic, prospective project assessing objective and subjective dimensions of quality of life (QoL) and the range of its putative determinants in first-episode schizophrenia.
Seventy-four patients, mean age 24.7 years, participated in the study. The patients were assessed 1 month following the first hospitalisation (Time 1), 12 months later (Time 2), and 4-6 years after Time 1 (Time 3). The Social Functioning Scale and World Health Organisation Quality of Life-BREF (WHOQOL-BREF) were applied to evaluate objective and subjective QoL, respectively. The Positive and Negative Syndrome Scale was used to examine psychopathological status, and the Global Assessment Scale was applied to evaluate social adjustment prior to hospitalisation.
The objective and subjective QoL was relatively low at Time 1. Over time, the objective QoL improved in three domains, decreased in one domain, and remained stable in three domains. The subjective QoL did not change. The most important predictors of both dimensions of QoL were psychopathology and duration of untreated psychosis.
Because psychopathology seems to have the greatest impact on the QoL, there is a need to develop community psychosocial treatment to reduce these symptoms and to support patients in the early phase of the disease.
Quality of Life Research 04/2008; 17(2):237-47. · 2.30 Impact Factor
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ABSTRACT: Schizophrenia (SCH) and bipolar affective disorder (BPAD) are complex disorders with significant participation of genetic risk factors. Several lines of evidence point to the role of shared neurobiological mechanisms and common genetic background in SCH and BPAD. Immune disturbances have been suggested as contributing factor in the pathogenesis of both SCH and BPAD. The gene coding cytokine tumor necrosis factor (TNF) has been the object of a number of association studies in SCH, with ambiguous results. Only 3 such studies were performed in BPAD. The aim of our study was to perform a case-control association analysis of the TNF -308G/A polymorphism in a Polish sample of patients with SCH, BPAD and healthy controls.
We genotyped the TNF -308G/A polymorphism (rs1800629) by PCR-RFLP in 348 patients with SCH, 361 patients with BPAD and in 351 controls.
We observed an association of the -308G allele with both SCH (p = 0.008) and BPAD (p = 0.039), and also with a positive family history in patients with SCH (p = 0.048) and BPAD (p = 0.027). For TNF genotypes, the association was only seen in SCH (p = 0.018).
Our results may point to an association of the TNF -308G allele and -308G/G genotype with both SCH and BPAD, and to a relationship of the -308G allele with the risk of SCH and BPAD in patients with a positive family history. TNF could be potentially a susceptibility gene, shared between SCH and BPAD. Complex TNF gene studies--based on multiple single-nucleotide polymorphisms and involving haplotype analysis--are necessary for the clarification of currently contradictory findings.
Neuropsychobiology 02/2008; 57(1-2):88-94. · 2.67 Impact Factor
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Psychiatric Genetics 09/2007; 17(4):245-6. · 2.58 Impact Factor
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ABSTRACT: Polymorphisms in BDNF gene has been proposed, as susceptibility loci for stress-related psychiatric disorders. Several lines of molecular and biochemical evidence point to the role of BDNF in anorexia nervosa (AN). Personality traits may constitute the intermediate phenotypes between genes and vulnerability to AN.
BDNF Val66Met and -270C/T polymorphisms were genotyped in 149 patients with AN and 100 healthy control females. Temperamental traits in all subjects were measured with Temperament and Character Inventory. First in case-control analysis, we assessed, if analyzed genotypes confer risk for AN. Next, the association of BDNF gene variants with personality dimensions in patients and control subjects was analyzed.
No significant differences between patients with anorexia nervosa and controls in frequency of genotypes and alleles were observed. AN patients with Met allele showed higher Harm avoidance (Anova F=4.70; p=0.03) than Val/Val homozygotes. AN patients, who carried the T allele of BDNF -270C/T polymorphism showed higher Persistence (Anova F=4.04; p<0.05) and Harm avoidance (Anova F=7.93; p=0.006) than C/C homozygotes, however after correction for multiple testing only the latter association remained statistically significant. No significant relationship between Val/Met 66 genotype and -270C/T genotype with personality was observed in healthy females.
These results may suggest, that BDNF -270 C/T polymorphism may influence the personality trait associated with higher risk of AN.
Neuro endocrinology letters 04/2007; 28(2):153-8. · 1.30 Impact Factor
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ABSTRACT: The aim of this study was to assess the associations between temperament and character, depressive symptoms and the intensity and the course of ischaemic heart disease.
42 patients with ischaemic heart disease, aged 37-65 years, meeting the ICD-10 diagnostic criteria, participated in this study. The evaluation of temperament and character was performed using Cloninger's Temperament and Character Inventory (TCI), and the intensity of depressive symptoms was assessed with Beck Depression Index (BDI). The clinical features of the illness were evaluated by structuralized interview.
Subjects with ischaemic heart disease presented significant severity of depresive symptoms on BDI (mean 19.9 points). Patients with higher intensity of ischaemic heart disease symptoms (with myocardial infraction, treated with interventional treatment) presented significantly greater severity of depression. Moreover these subjects were characterized with the specific features of temperament and character: higher level of harm avoidance and lower level of reward dependence. The longer duration of the illness was associated with the lower scores of the character trait--the ability to self-transcendence.
The obtained results may indicate, that the worse course of ischaemic heart disease and intensity of the illness are associated with the higher severity of depressive symptoms and with specific traits of temperament and character.
Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2007; 60(5-6):209-14.
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ABSTRACT: Disturbances of serotonergic neurotransmission and temperamental vulnerability have both been implicated in the pathogenesis of anorexia nervosa (AN). We genotyped the -1438 A/G polymorphism in the 5-HT2A receptor gene and serotonin transporter linked-polymorphic region (5-HTTLPR) in 132 adolescent subjects with AN and in 93 healthy controls. Personality dimensions in AN patients were assessed with the Temperament and Character Inventory. In a case-control model, we tested the hypothesis that these genetic variants confer susceptibility to AN. We also analyzed whether two polymorphisms show association with temperamental and character traits. No significant difference was found in the 5-HTTLPR frequency between AN patients and controls; however, there was a statistical trend towards a higher frequency of the A allele of the -1438 A/G polymorphism in patients than in controls (64.9 vs. 56.7%, chi2 test, p=0.08). We also found a significant association between the A allele of this polymorphism and two temperamental traits. Patients homozygous for the A allele showed lower reward dependence than G/G homozygotes, and A/A homozygotes showed lower harm avoidance than heterozygotes. Low reward dependence and harm avoidance were more characteristic of the restrictive-type AN than of other subtypes of the disorder. No association of 5-HTTLPR with personality dimensions in AN patients was observed. Our results may suggest that the A allele of the -1438 A/G polymorphism confers some genetic risk for adolescent AN patients, especially in those with personality traits, which are typical of the restrictive-type AN.
Neuropsychobiology 02/2006; 53(1):33-9. · 2.67 Impact Factor
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ABSTRACT: Brain-derived neurotrophic factor (BDNF) regulates a variety of neuromodulatory processes during development, as well as in adulthood. It has been proposed as a risk factor for schizophrenia. We have investigated a possible association between schizophrenia and the C-270T polymorphism in the brain-derived neurotrophic factor (BDNF) gene in 397 schizophrenic patients and 380 control subjects. The diagnosis of schizophrenia was made for each patient by at least two psychiatrists, using DSM-IV and ICD-10 criteria in structured clinical interviews for DSM-IV Axis I disorders (SCID). No association was found between schizophrenia and the analyzed polymorphism, for either genotype or allele distribution (for genotype: p=0.513, for alleles: p=0.812). Differences were not statistically significant when analyzed separately by sex. For males, the differences for genotype distribution and allele frequency were p=0.078 and p=0.162 respectively and for females: p=0.441 and p=0.315. Thus, our data indicate that variations in the BDNF gene are unlikely to be an important factor in susceptibility to schizophrenia.
Schizophrenia Research 08/2005; 76(2-3):187-93. · 4.75 Impact Factor
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ABSTRACT: Objective: The aim of this study was the assessment of −308G/A tumor necrosis factor (TNF)-α gene polymorphism and intPLA2 gene polymorphism in patients with anorexia nervosa (AN) and healthy controls.Subjects: We studied 91 non-related patients with AN and 144 healthy women (blood donors and students). The mean age of women from study group was 18.22 years (SD ± 3.13 years) and from control group was 31.71 years (SD ± 8.22).Methods: Gene polymorphisms were studied with the use of polymerase chain reaction-restriction fragment length polymorphism method. TNF-α gene polymorphism consists of G/A substitution in −308 promoter region. IntPLA2 gene polymorphism is related to intron 1, in which restrictive region is found and recognized by BanI enzyme.Results: We did not obtain statistically significant differences in the frequency of genotypes and alleles of −308G/A TNF-α polymorphism between the study and control groups (genotypes: P = 0.106, alleles: P = 0.076). We did analogous analysis in the restrictive and bulimic subgroups. We did not observe statistically relevant differences in the frequency of genotypes (P = 0.700) and alleles (P = 0.305). We did not obtain statistically relevant difference in the frequency of genotypes and alleles of intPLA2 gene between the study group and controls (genotypes: P = 0.300, alleles: P = 0.331). We did analogous analysis in both subgroups of AN. We did not observe statistically relevant differences in the frequency of genotypes (P = 0.344) and alleles (P = 0.230).Conclusions: There was no statistically relevant trend for the association between TNF-α polymorphism and AN. We did not find association between studied polymorphism of intPLA2 gene and risk of AN.
Acta Neuropsychiatrica 06/2005; 16(6):290 - 294. · 0.58 Impact Factor
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ABSTRACT: The aim of the study was to compare social functioning of first-admitted schizophrenic patients with healthy controls and evaluate the influence of different variables on social abilities of patients, 1 month after hospitalization (T1) and in 1 year follow-up (T2). A group of 86 schizophrenic patients: 52 male and 34 female; age 25.5; ± 5.8 and a control group of matched 52 male and 34 female subjects were enrolled. Social Functioning Scale (SFS), Positive and Negative Syndrome Scale (PANSS), Global Assessment Scale (GAS) and demographic questionnaire were used. In both T1 and T2 we found similar levels of SFS score in patients (T1- 103.7; T2- 705.5), significantly lower than in healthy controls 117.0 (range 98.6-130.1) (p
Archives of Psychiatry and Psychotherapy 05/2005;
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ABSTRACT: Background: Female patients with anorexia nervosa differ significantly from the control women in various dimensions of personality.Objective: To investigate the personality dimensions measured with the Temperament and Character Inventory (TCI) in adolescent patients with restrictive-type and bulimic/purging-type anorexia nervosa (ANR and ANB, respectively), and contrast them with the results of control females.Methods: Sixty-one patients with anorexia nervosa (36 ANR and 25 ANB) and 60 controls were tested with the TCI. A concomitant assessment of depression, body mass index and age was made to evaluate the possible correlation with personality dimensions.Results: Adolescent ANR patients scored higher in persistence, harm avoidance and cooperativeness, and lower in novelty seeking and self-transcendence than control women. ANB patients scored in the middle between ANR and control females, but differences did not reach the significance level with either group, except for the self-transcendence dimension where they scored significantly higher than those with ANR.Conclusions: The deviations in temperamental profile of adolescent ANR are similar to those reported in adult patients. The ANB adolescent patients with anorexia nervosa show less prominent deviations from the personality of control women. With regard to the character dimension of cooperativeness, adolescents with ANR scored higher than controls, in contrast to the observations in adult patients. This may reflect the effect of illness on the development of character.
Acta Neuropsychiatrica 06/2004; 16(3):169 - 174. · 0.58 Impact Factor
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ABSTRACT: It has been proposed that the Borna Disease Virus (BDV) plays a role in the etiopathogenesis of psychiatric disorders. We assessed BDV seropositivity in Polish psychiatric patients and healthy controls, and the relationship between seropositivity and selected diagnostic and clinical variables.
Serum samples from 946 psychiatric patients with different diagnoses (ICD-10) and 407 psychiatrically healthy controls were assayed. The ECLIA method was used, which enables the assessment of two anti-BDV antibodies: anti-p24 and anti p-40. Data were also collected on diagnosis, age, age at onset, and place of residence.
Only anti-p24 antibodies were found. The seropositivity rates were: 2.4% and 1.0%, respectively, in patients and controls (p=0.1). A significant difference between patients and controls was observed in mental retardation and affective-anxiety spectrum disorders. Seropositivity did not show any association with demographic variables, but it was elevated in patients with recent onset of disease vs. remote onset of disease (10.2% vs. 1.6%; p=0.0003).
Significantly higher anti-BDV seropositivity was found in Polish psychiatric patients with affective-anxiety spectrum disorders and mental retardation than in controls. The association between recent onset disorders and higher anti-BDV response, in the light of recent reports on circulating immune complexes of BDV antigens and antibodies, warrants further studies on the longitudinal course of humoral response to BDV.
Medical science monitor: international medical journal of experimental and clinical research 10/2002; 8(9):CR642-6. · 1.70 Impact Factor
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ABSTRACT: There is evidence for an association between polymorphisms of monoamine transporter genes and temperamental personality traits. Recent findings have shown that interaction of allelic variants of the different genes may contribute to the personality factors. We studied the association between temperamental personality dimensions measured with the Temperament and Character Inventory (TCI) and polymorphisms of the dopamine (DAT), norepinephrine (NET) and serotonin (5-HTT) transporter genes in 127 healthy Polish volunteers. There were no significant differences between means of TCI temperamental dimensions (novelty seeking, reward dependence, persistence and harm avoidance) and the transporter genes compared by ANOVA. There were some significant associations between genotypes and TCI subdimensions. Individuals carrying the A9/A9 DAT genotype have lower RD4 scores (dependence vs. independence) than A10/A10 individuals (3.0 ± 1.4 vs. 3.5 ± 1.3); p = 0.01. Examining 5-HTT gene promoter polymorphism, heterozygous individuals (l/s) and individuals with 44-bp deletion (s/s) scored significantly lower in the HA1 subdimension (anticipatory worry and pessimism vs. uninhibited optimism; 4.3 ± 2.3 vs. 5.5 ± 2.6) in comparison with individuals without deletion (l/l); p = 0.021. The NET transporter gene polymorphism showed no significant association with any of the temperamental TCI subdimensions.
Neuropsychobiology 08/1970; 43(4):248-253. · 2.67 Impact Factor
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ABSTRACT: The aim of the study and was the assessment of Cognitive Remediation Therapy (CRT) in an adolescent anorexia nervosa patient.
CRT cognitive training was performed. Eating Attitudes Test 26 (EAT - 26), Beck Depression Inwentory (BDI), Child Yale - Brown Obsessive - Compulsive Scale (CY - BOCS), Eating Disorders Belief Questionnaire (EDBQ), Wisconsin Card Sorting Test (WCST), Temperament and Character Inventory (TCI) and also Child Heath Questionnaire (CHQ) - assessed by parents, were used before and after the programme.
After CRT completion, an improvement on the level ofpsychopathological symptoms was observed (especially in the EAT- 26 and BDI scales), in WCST some improvement was noticed. In TCI, no significant changes were found. In comparison to the initial assessment, an increased level of dysfunctional beliefs was observed.
Cognitive Remediation Therapy can be used in adolescent patients with anorexia nervosa. This procedure may be related to cognitive and symptomatological improvement.
Psychiatria polska 43(1):115-24. · 0.19 Impact Factor
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ABSTRACT: Attention-deficit hyperactivity disorder (ADHD) begins in early childhood. In this article we review the studies supporting a genetic background of this disorder. ADHD occurs in 3-10% of the general population. Family studies reveal a 5 times more likely frequency of ADHD among first-degree relatives than in the general population. Monozygotic twin concordance rate for ADHD is 81%, whereas for dizygotic twins it is 29%. One of the ADHD predisposing factors is dopaminergic neurotransmission abnormality. According to other studies there is a relationship between polymorphism of dopamine transporter gene (DAT), dopamine receptors genes: DRD2, DRD3, DRD4, DRD5, dopamine-beta-hydroxylase gene (DBH) and catechol-O-methyltransferase gene (COMT) and ADHD. In other articles authors describe abnormalities of the serotonergic system, such as the polymorphism of the serotonin transporter gene (5HTT/SERT), serotonin receptors genes 5HT2A and 5HT1B in the development ofADHD. Another possible factor in ADHD background is the dysregulation of the adrenergic system. The most frequently studied is the connection between polymorphism of norepinephrine transporter gene (NET), adrenergic receptors genes: alpha 2A (ADRA2A), alpha 1C (ADRA1C), alpha 2C and monoamine oxidase A gene (MAO-A).
Psychiatria polska 40(1):19-31. · 0.19 Impact Factor
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ABSTRACT: Recent studies have shown that in the aetiology of attention-deficit hyperactivity disorder (ADHD) genetic factors may be of importance. Biochemical and pharmacological studies reveal a connection between abnormalities of dopaminergic, adrenergic and serotonergic system and ADHD. Therefore genes for enzymes synthesizing or degrading proper neurotransmitters, genes for adequate transporters and receptors and genes for other substances, which altered the level of neurotransmitters, are studied. Many authors describe the connection between ADHD development and the synaptosomal-associated protein 25 (SNAP-25) gene. This protein plays a role in catecholamine secretion. Its higher expression is specific for neurones. SNAP-25 gene mutation may change this protein level, function of synapse and neurotransmitters storage. Acetylcholine receptor alpha4 subunit gene stimulation increases the dopamine level. Therefore this receptor gene may be important in the aetiology of ADHD studies. Other possible factors in ADHD background are substance influence on brain maturation, including N-methyl-D aspartate glutamate receptor 2A gene polymorphism (GRIN2A) and brain derived neurotrophic factor (BDNF) gene. One of the greatest challenges in studying the genetic basis of psychiatric disorders is to find appropriate ways to define the relevant endophenotype. ADHD often coexists with other psychiatric disorders, including specific developmental disorders, conduct disorders, obsessive-compulsive disorder and early onset of bipolar disorder.
Psychiatria polska 40(1):33-42. · 0.19 Impact Factor
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ABSTRACT: Bulimia nervosa (BN) is a common and disabling psychiatric disorder, which affects mainly young females. The basic therapeutic modalities include pharmacotherapy with selective serotonin reuptake inhibitors, cognitive behavioural therapy and combined treatment.
This 12-week open label study was performed to assess the efficacy of buspirone-5-HT1A receptor agonist in the treatment of bulimia, and to compare it with the efficacy of fluoxetine --the standard treatment of BN.
We recruited 57 patients, who were assigned to two treatment groups-fluoxetine (n=35) and buspirone (n=22) At baseline, and after treatment we assessed the serotonin level in serum.
At least 50% reduction in severity of bulimic symptoms was observed in 15/35 (42.9%) patients treated with fluoxetine and in 11/22 (50.0%) patients receiving buspirone. Depressive symptoms (Beck Depression Inventory) decreased significantly in both treatment groups (from 22.8 to 9.6 points in fluoxetine group and from 19.8 to 10.0 in buspirone group; difference between groups- not significant). Side effects, such as headaches and nausea occurred in both groups rarely and did not cause withdrawal from treatment. Statistical trend towards increased serotonin level in serum was observed after treatment with fluoxetine, and was not associated with buspirone administration.
Buspirone may have similar efficacy as fluoxetine in reducing bulimic and depressive symptoms in patients with bulimia, however may not cause significant changes of serotonin level in serum.
Psychiatria polska 40(1):75-82. · 0.19 Impact Factor
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ABSTRACT: Previous studies revealed the possibility of abnormal personality development role in the etiology of eating disorders. It was found that a diagnosis of personality disorders, mostly borderline personality and/or histrionic personality can be made in about 44-46% of bulimic patients. The inconsistencies in identifying personality types using categorical assessment approaches have encouraged a conceptualization of the personality from a dimensional perspective. It was revealed that the Tridimensional Personality Questionnaire (TPQ) and Temperament and Character Inventory (TCI) are useful in studying patients with eating disorders.
The aim of the study was personality dimensions and depression symptoms assessment in bulimic patients.
We studied 36 women with purging type bulimia according to DSM-IV and ICD 10 criteria. The mean age of the studied women was 19.7 years. The control group were 44 healthy women: university and last year high school students (mean age 20.4). We assessed body height, body mass and Body Mass Index (BMI). Severity of depression symptoms was assessed with the use of Beck Depression Index (BDI), and personality dimensions with the use of (TCI).
Women from the study group had higher harm avoidance (HA) scores, which shows that bulimic patients are shy, fearful, doubtful, tend to be inhibited in most social situations. Mood disorders present in the studied women influenced HA scores. The results of the study revealed lower possibilities of self-directness in bulimic patients in comparison with the control group. Negative correlation between BDI and SD scores, shows that a decrease of depression severity may lead to an increase of self-esteem, independence and effectiveness of bulimic patients.
Psychiatria polska 38(1):85-93. · 0.19 Impact Factor
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ABSTRACT: Mood may be considered the module of the human mind, which has evolved to tune the activity ofthe organism to the specific environmental conditions in a better way. In some cases depression may be adaptive, for example in aborting the activity associated with too many obstacles. At the same time hypomania may be related to the capability of mobilising the organism to gain many resources in a short period of time. Severe mood disorders may be related to the genetic variants, eg. of the serotonin transporter or brain-derived neurotrophic factor, which in several situations may give some evolutionary advantage. Affective temperaments, observed in the relatives of patients with affective disorders may be associated with some benefits in the social life. The relationship between early adversities and adult depression may be related to the phenomenon of the stress axis programming, which has deep evolutionary roots. Some infectious factors may cause behaviours similar to the affective symptoms, which may increase their reproductive success. The evolutionary perspective, which is complementary to the current etiopathogenic theories may help in understanding, why genes and traits which
Psychiatria polska 40(3):401-13. · 0.19 Impact Factor
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ABSTRACT: Eating disorders--anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS) occur usually in young females. The significant pathogenic differences between patients who only restrict food, and patients with binge eating and compensatory behaviours, such as vomiting and purging were described. The prevalence of bipolar affective disorders--especially bipolar II and bipolar spectrum disorders (BS) may reach 5% in the general population. About half of the depressive episodes are associated with a "mild" bipolar disorder, and such a diagnosis is suggested by impulsivity and mood-instability. Previously, majority of research on the comorbidity between eating and affective disorders focused on depressive symptomatology, however difficulties in the reliable assessment of hypomania may obfuscate the estimation of the co-occurrence of eating disorders with BS. Epidemiological studies suggest the association between BS and eating disorders with binge episodes (bulimia nervosa, anorexia- bulimic type and EDNOS with binge episodes). Co-occurrence of such disorders with depressive symptoms probably suggests the diagnosis of BS, not recurrent depression. Bulimic behaviours, impulsivity and affective disorders might be related to the impairment of the serotonergic neurotransmission, which may result from the genetic vulnerability and early life trauma. Currently, the first-line pharmacological treatment of co-occurring eating disorders with binge episodes and BS are selective serotonin reuptake inhibitors. However in some cases, the use of mood-stabilising agents as monotherapy or in combination with serotonergic drugs may be helpful.
Psychiatria polska 40(3):455-67. · 0.19 Impact Factor
