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Biomedical subjects

Pekka Tani

Publications and source records attributed to Pekka Tani.

At least 19 recordsLinked to original sources
PubMed2006

Sleep architecture in homicidal women with antisocial personality disorder--a preliminary study.

The aim of the present study was to characterize sleep in severely violent women with antisocial personality disorder (ASP) as the primary diagnosis. Participants for this preliminary study were three drug-free female offenders ordered to undergo a forensic mental examination in a maximum security state mental hospital after committing homicide or attempted homicide. Ten healthy age- and gender-matched controls consisted of hospital staff with no history of physical violence. The most striking finding was the increased amount of slow wave sleep, particularly the deepest sleep stage, S4, in women with ASP. This finding is in agreement with previously reported results in habitually violent male criminals with ASP. Severe female aggression seems to be associated with profound changes in sleep architecture. Whether this reflects specific brain pathology, or a delay in the normal development of sleep patterns in the course of aging, needs to be clarified. From the perspective of sleep research, the biological correlates of severe impulsive violence seem to be similar in both sexes.

Adult↗
PubMed2006

Increased deep sleep in a medication-free, detoxified female offender with schizophrenia, alcoholism and a history of attempted homicide: effect of concomitant administration of quetiapine and citalopram.

BACKGROUND: An increased amount of deep sleep has been shown to be associated with antisocial personality disorder. This phenomenon has also been observed in a habitually violent female offender with schizophrenia and alcohol dependence. AIM: To evaluate sleep patterns in this patient and compare them with those of healthy, pro-social women of similar age, and in the same patient over time after treatment. METHOD: Multiple measures of sleep were taken over two consecutive nights with the presenting patient and with three age-matched healthy women. One year after the patient was established on atypical antipsychotic (quetiapine), and antidepressant (SSRI) medication (citalopram) her sleep evaluation was repeated. In each case only the second night's recordings were used in analyses. RESULTS: The patient differed significantly from the three healthy women on most sleep measures. After a year on the medication, the patient's sleep had improved and the non-REM sleep measures had come into the normal range. She had also shown a sustained clinical and behavioural improvement. DISCUSSION AND IMPLICATIONS: The literature suggests that both drugs had a part to play in the improvements in sleep, symptomatology and behaviour. The possibility that improvement in deep sleep is secondary to citalopram and that it is this that was specifically associated with violence reduction seems worthy of further study.

Adult↗
PubMed2006

Clinical neurological abnormalities in young adults with Asperger syndrome.

Children with Asperger syndrome (AS), a neurodevelopmental disorder falling in the autism spectrum disorders, have an increased rate of neurological abnormalities, especially in motor coordination. While AS is a lifelong condition, little is known about the persistence of neurological abnormalities in adulthood. Twenty young adults with AS were compared with 10 healthy controls using a structured clinical neurological rating scale. The score for neurological abnormalities was higher in the AS group. In addition, a subscore for neurological soft signs indicating defective functioning of the central nervous system with a non-localizing value was significantly higher in the AS subjects. This preliminary study indicates that neurological abnormalities, soft signs in particular, represent a non-specific vulnerability factor for AS. Consistent with other features of AS, neurological abnormalities seem to persist into adulthood.

Adult↗
PubMed2005

Looking for pyromania: characteristics of a consecutive sample of Finnish male criminals with histories of recidivist fire-setting between 1973 and 1993.

BACKGROUND: As pyromania is a rare diagnosis with questionable validity, we aimed to describe a forensic psychiatric population of arson recidivists. METHODS: The medical records as well as the forensic psychiatric examination statements of 90 arson recidivists referred for pretrial psychiatric assessment in Helsinki University Hospital Department of Forensic Psychiatry between 1973 and 1993 were reviewed. RESULTS: The most important diagnostic categories of arson recidivists were personality disorders, psychosis and mental retardation, often with comorbid alcoholism. In all, 68% of arsonists were under alcohol intoxication during the index crime. Psychotic as well as mentally retarded persons with repeated fire-setting behaviour were mostly "pure arsonists"--persons guilty only of arsons during their criminal careers. Arson recidivists with personality disorder, in contrast, often exhibited various types of criminal behaviour and arson appeared to be only one expression of a wide range of criminal activity. Comorbid alcoholism was apparently a more rarely observed phenomenon among pure arsonists than in "nonpure arsonists". We found only three subjects fulfilling the present diagnostic criteria for pyromania. CONCLUSION: Using the criteria of the DSM-IV-TR, pyromania must be regarded as an extremely rare phenomenon. Especially the question of substance intoxication as an exclusion criterion for pyromania should be reconsidered.

Adolescent↗
PubMed2005

Childhood inattention and hyperactivity symptoms self-reported by adults with Asperger syndrome.

BACKGROUND: Increasing public awareness of the adult manifestations of developmental neuropsychiatric disorders, like Asperger syndrome and attention deficit hyperactivity disorder (ADHD), has provoked an increasing number of persons to seek assessment for the first time in adulthood. As these disorders have their origin in childhood, instruments for retrospective evaluation of childhood behavior are needed. SAMPLING AND METHODS: In this preliminary study, 20 adults with Asperger syndrome filled in the Wender-Utah Rating Scale for ADHD to describe retrospectively their childhood behavior. RESULTS: Fourteen out of 20 adults with Asperger syndrome self-rated above the cut-off limit for ADHD. The median total score was also higher than that reported in normal populations in previous studies. When compared with 10 controls, patients with Asperger syndrome scored higher in almost all individual items. CONCLUSIONS: A high score on the Wender-Utah rating Scale for ADHD in this patient group might be a sign of true comorbidity with ADHD, an indication of overlapping features typical of both disorders, or a result of other psychiatric comorbidity originating already in childhood. Moreover, there are no data about the proper cut-off limit for ADHD in these subjects. Therefore, one should be cautious when applying this scale beyond its original context of comparison between adults with ADHD, unipolar depression and healthy controls.

Adolescent↗
PubMed2005

Quantitative electroencephalographic measures in homicidal men with antisocial personality disorder.

Many symptoms of antisocial personality disorder have been proposed to be related to decreased daytime vigilance. To explore this hypothesis, quantitative analyses were conducted of the electroencephalographic (EEG) activity of drug-free and detoxified homicidal male offenders with antisocial personality disorder as the primary diagnosis. Subjects comprised 16 men recruited from a forensic psychiatric examination in a special ward of a university psychiatric hospital. Fifteen healthy age- and gender-matched controls with no criminal record or history of physical violence consisted of hospital staff and students. An overall reduction of alpha power was observed in the waking EEG of offenders. A bilateral increase in occipital delta and theta power was also found in these individuals. This study provides further support to the growing evidence of brain dysfunction in severe aggressive behavior. Homicidal offenders with antisocial personality disorder seem to have difficulties in maintaining normal daytime arousal. Decreased vigilance, together with social and psychological variables, may explain their aberrant behavior in everyday life. New studies are, however, needed to specify the vigilance problems of this patient group.

Adult↗
PubMed2005

Higher plasma ACTH levels in adults with Asperger syndrome.

OBJECTIVE: The aim of this preliminary study was to characterize the levels of plasma adrenocorticotropic hormone (ACTH) and cortisol in adult patients with Asperger syndrome (AS). METHODS: Twenty medication-free individuals with high-functioning AS were recruited from a clinic specialized in autism spectrum disorders. Ten age-matched healthy persons (hospital staff or students) with no neuropsychiatric disorders served as controls. Blood samples for the assessment were collected at 8:00 a.m. RESULTS: The patients with AS had significantly higher plasma-ACTH values than did the healthy controls. Plasma-cortisol levels were similar in both groups. CONCLUSION: Increased plasma-ACTH levels are associated with AS. Future studies are needed to clarify whether this finding is a biological consequence of chronic anxiety and elevated stress, or a sign of facilitated response to an acute novel stressor.

Adolescent↗
PubMed2005

Actigraphic assessment of sleep in young adults with Asperger syndrome.

A high prevalence of subjective insomnia in adults with Asperger syndrome has been reported. In the present study the sleep quality of these patients was studied using wrist actigraphy. Nineteen adults with Asperger syndrome and frequent feelings of insomnia were compared with 10 controls devoid of neuropsychiatric disorders and subjective sleep problems during six consecutive nights. The patients had similar actigraphic sleep profile to the controls. The subjective low sleep quality in patients was not reflected in actigraphic assessment of sleep. This finding suggests that pervasive anxiety inherent in persons with Asperger syndrome predisposes them to insomnia complaints.

Adult↗
PubMed2004

Increased deep sleep in a medication-free, detoxified female offender with schizophrenia, alcoholism and a history of attempted homicide: case report.

BACKGROUND: Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Both schizophrenia and alcoholism are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep, the physiologically significant, refreshing part of the sleep. Antisocial behaviour with severe aggression, on the contrary, has been reported to associate with increased deep sleep reflecting either specific brain pathology or a delay in the normal development of sleep patterns. The authors are not aware of previous sleep studies in patients with both schizophrenia and antisocial personality disorder. CASE PRESENTATION: The aim of the present case-study was to characterize the sleep architecture of a violent, medication-free and detoxified female offender with schizophrenia, alcoholism and features of antisocial personality disorder using polysomnography. The controls consisted of three healthy, age-matched women with no history of physical violence. The offender's sleep architecture was otherwise very typical for patients with schizophrenia and/or alcoholism, but an extremely high amount of deep sleep was observed in her sleep recording. CONCLUSIONS: The finding strengthens the view that severe aggression is related to an abnormal sleep pattern with increased deep sleep. The authors were able to observe this phenomenon in an antisocially behaving, violent female offender with schizophrenia and alcohol dependence, the latter disorders previously reported to be associated with low levels of slow wave sleep. New studies are, however, needed to confirm and explain this preliminary finding.

Adult↗
PubMed2004

Lower limb motor restlessness in Asperger's disorder, measured using actometry.

The movement disturbances and brain imaging findings in Asperger's disorder (AD) suggest a dopaminergic deficit in movement regulation. Movement disorders of different etiologies have been quantified and specified with actometry. We compared 10 AD patients with 10 healthy controls, measuring their rest-activities by actometry. The lower limb motor activity was significantly higher in the AD group. They also displayed a rhythmic, periodic movement pattern similar to akathisia. These findings suggest a hypothesis of idiopathic akathisia and a special sensitivity to adverse effects of neuroleptic drugs.

Adolescent↗
PubMed2004

Neurological soft signs in homicidal men with antisocial personality disorder.

Neurological soft signs (NSS) are characterized by abnormalities in motor, sensory, and integrative functions. NSS have been regarded as a result of neurodevelopmental dysfunction, and as evidence of a central nervous system defect, resulting in considerable sociopsychological dysfunction. During the last decade there has been growing evidence of brain dysfunction in severe aggressive behavior. As a symptom, aggression overlaps a number of psychiatric disorders, but it is commonly associated with antisocial personality disorder. The aim of the present study was to examine NSS in an adult criminal population using the scale by Rossi et al. [29]. Subjects comprised 14 homicidal men with antisocial personality disorder recruited from a forensic psychiatric examination. Ten age- and gender-matched healthy volunteers as well as eight patients with schizophrenia, but no history of physical aggression, served as controls. The NSS scores of antisocial offenders were significantly increased compared with those of the healthy controls, whereas no significant differences were observed between the scores of offenders and those of patients with schizophrenia. It can be speculated that NSS indicate a nonspecific vulnerability factor in several psychiatric syndromes, which are further influenced by a variety of genetic and environmental components. One of these syndromes may be antisocial personality disorder with severe aggression.

Adult↗
PubMed2004

Asperger syndrome, alexithymia and perception of sleep.

Two research traditions, the one on Asperger syndrome (AS) and the other on alexithymia, have produced similar findings independently of each other indicating a possible association between these two phenomena. Both conditions are also associated with impaired initiation and continuity of sleep. Twenty AS adults were compared with 10 healthy controls using the Toronto Alexithymia Scale and the Basic Nordic Sleep Questionnaire. AS subjects were significantly more alexithymic and reported lower sleep quality as compared with controls. AS and alexithymia are associated although the mediating factors are unknown. It is possible that alexithymic traits predispose to anxiety, which in turn lowers the sleep quality in AS adults. Alternatively, low sleep quality might be due to AS itself.

Adult↗
PubMed2004

ADHD and sleep in homicidal men with antisocial personality disorder.

A history of attention deficit hyperactivity disorder (ADHD) is commonly found in subjects with antisocial personality disorder (ASP). Besides ASP, childhood ADHD also predicts drug abuse disorders and criminal activity in adulthood. Childhood ADHD and ASP appear to be the only psychiatric disorders reported to be associated with an increase in deep sleep. The aims of the present study were to retrospectively measure the childhood ADHD of habitually violent men with ASP and Cloninger type 2 alcoholism, and to characterize the possible relationship between childhood ADHD and sleep architecture in these men. The subjects of the study consisted of 14 homicidal offenders recruited from a forensic psychiatric examination. Ten age- and gender-matched healthy volunteers served as controls. Childhood ADHD symptoms were measured using the Wender-Utah Rating Scale (WURS). The main findings were that violent offenders with ASP had significantly higher mean WURS scores compared with controls, and both the absolute and percentage amount of stage 4 sleep as well as delta and theta powers in this sleep stage were positively correlated with the WURS scores. The present study supports the idea that childhood ADHD is associated with the abnormal sleep architecture in habitually violent men with ASP. These two disorders seem to share, at least partly, the same central nervous system deficit.

Adolescent↗
PubMed2004

Sleep in young adults with Asperger syndrome.

Asperger syndrome (AS) is a neurodevelopmental disorder belonging to autism spectrum disorders. Both children and adults with AS have subjective impairment in the initiation and continuity of sleep, and studies using objective assessment are sparse. Twenty young AS adults with frequent complaints of low sleep quality were compared to 10 age-, gender- and education-matched controls without sleep complaints using polysomnography and spectral power analysis of slow-wave sleep. AS subjects displayed a similar polysomnographic profile as compared with controls. In spectral power analysis, a statistically nonsignificant trend towards decreased relative delta power and increased theta power in slow-wave sleep was found in the AS group. It seems that nonorganic insomnia, due to anxiety inherent in AS, is responsible for the low sleep quality in these subjects.

Adult↗