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PubMedDate not supplied

Gender differences in social and interpersonal features and personality disorders among Japanese patients with obsessive-compulsive disorder.

This study sought to elucidate the differential effect of gender on clinical features in 40 males and 54 females who met both DSM-III-R and DSM-IV criteria for obsessive-compulsive disorder (OCD). Males had a lower rate of marriage, and a higher rate of major impairment in social or occupational functioning, whereas females were significantly more likely to involve others in their OCD symptoms, such as reassurance-seeking. Although no significant differences were detected in the distribution of OCD symptoms, cluster A personality disorders (PDs), especially schizotypal PD, were more frequently diagnosed in males, and borderline and dependent PDs tended to be more prevalent in females. Thus, gender differences in OCD subjects were prominently observed in social or interpersonal features, which might be consistent with the differential PD pathology between males and females.

Adult↗

PubMed2006

Relative impact of young adult personality disorders on subsequent quality of life: findings of a community-based longitudinal study.

Little is known about long-term prognostic implications of personality disorder (PD) for quality of life (QOL) in the young adult population not selected for psychiatric treatment. The purpose of this study was to determine the association of PDs with QOL assessed after an 11-year interval. PDs were assessed in 1991-1994 at mean age 22, and indicators of QOL were assessed in 2001-2004 at mean age 33 based on a community sample of 588 young adults. Findings indicated that any PD, or a cluster A, B, or C PD each were independently associated with elevated impairment in overall QOL after adjusting for demographic variables, co-occurring Axis I disorder, and physical illness, and PDs in other clusters. Cluster B PD had a greatest adverse impact on QOL. Symptoms of antisocial, borderline, and schizotypal PD symptoms were independently associated with significant reductions in QOL; avoidant, paranoid, and dependent PD symptoms were associated with smaller reductions, not reaching statistical significance. Symptoms of other individual PDs were not associated with reduced QOL. PDs in young adults in the community have an enduring and adverse impact on subsequent QOL that cannot be attributed to physical illness or Axis I psychiatric disorder.

Adult↗

PubMed1999

Psychobiological differences between the aggression and psychoticism dimension.

Since blunted prolactin (PRL) and partly blunted cortisol responses have been reported for subjects with aggressive impulsive disorders as well as with psychopathy, it seemed worthwhile to try to separate the two types of aggression by their biological response. Since, furthermore, cortisol responses are more readily elicited by 5-HT1a challenges and prolactin responses by d-Fenfluramine or uptake inhibitors, these two types of drugs were used to answer the question if these hormone responses are suitable to differentiate between the two types of aggression. Two studies were conducted, one using 15 mg of d-Fenfluramine (d-Fen) in a double-blind placebo-controlled cross-over design in 40 males, the other using 10 mg of Ipsapirone (Ips) and placebo comparing 20 healthy males in each group. In each study subjects were divided according to above and below median aggression and psychoticism scores measured by questionnaire scales and combined into four groups defined by high and low aggression (Ag+/-) and psychoticism (P+/-) scores respectively. Analyses of covariance based an the two personality factors and the drug revealed for d-Fen cortisol nonresponse in P+ as opposed to P- and a blunted PRL response in Ag+ as opposed to Ag-. With Ips the cortisol response was positively related to Ag and not to P, while P+ showed a blunted PRL response not observed in Ag+. Joyfulness and well-being were also differentially affected by d-Fen in high and low P scorers, but not correlated to respective hormone responses. Different hypothalamic mechanism for eliciting the two hormone responses and differences in pre- and postsynaptic receptor sensitivities in the two personality dimensions are inferred from these findings.

Adult↗

PubMed1998

The factor structure of the Anorexia Nervosa Inventory for Self-Rating in a population-based sample and derivation of a shortened form.

The Anorexia Nervosa Inventory for Self-Rating (ANIS) was the first instrument covering aspects of the general psychopathology of eating disorders alongside eating attitudes, but its factorial integrity in non-clinical samples has not yet been investigated. Thus, this report is aimed at assessing the factorial structure of the ANIS with different methods of extraction and rotation. Data from a population-based random sample of German-speaking Italian schoolgirls aged 11-20 years (n = 1402) were used. The instruments included the ANIS and the Eating Behaviour Severity Scale. The internal consistency (Cronbach's alpha of the ANIS and four of its subscales was 0.70-0.88; however, reliability of the subscales "Sexual Anxieties" and "Obsessive-Compulsive Traits" was doubtful in non-clinical female adolescents. The original six factors were convincingly replicated by maximum likelihood extraction and principal component analysis. As some items and subscales showed weaknesses, a shortened 20-item version was derived containing the subscales "Figure Consciousness", "Feelings of Inadequacy", "Adverse Effects of Meals", and "Bulimia". All items showed factor loadings > 0.50 and item-total-correlations between 0.30 and 0.80. Internal consistency of the ANIS-20 total scale (0.90) was remarkable as it was for the subscales (0.70-0.85); discriminant validity as assessed by a cross-validational approach (random split-half samples) was not affected by this abbreviation. In conclusion, both the original ANIS and the ANIS-20 are psychometrically sound instruments. Because brevity is important in screening studies, the short form is recommended.

Adolescent↗

PubMed1993

A comparison of the behavioral effects of oral versus intravenous mCPP administration in OCD patients and the effect of metergoline prior to i.v. mCPP.

In prior studies form three centers, an exacerbation of obsessive-compulsive disorder (OCD) symptoms was reported in some (55%-83%) patients with OCD receiving the serotonergic agonist m-chlorophenylpiperazine (m-CPP) orally, whereas intravenously administered mCPP produced anxiety but no OCD symptom exacerbation. In the present replication attempt, 27 OCD patients were given mCPP either orally (n = 17) or intravenously (n = 10) under double-blind conditions, using identical behavioral rating measures. OCD symptoms were significantly increased after intravenous mCPP (0.1 mg/kg), but not after oral mCPP (0.5 mg/kg). Anxiety and other ratings were markedly elevated after intravenous mCPP administration. After oral mCPP administration, anxiety and most other self-ratings were only slightly elevated in comparison to placebo administration, and behavioral rating increases were no different for the OCD patients compared to age-matched healthy controls. Pretreatment with the potent serotonin (5-HT) antagonist, metergoline, prior to intravenous mCPP was associated with essentially complete blockade of the exacerbation in OCD symptoms and the other behavioral responses in the OCD patients. These results suggest that the behavioral response of OCD patients to mCPP are variable and depend on the route and dose of mCPP. In addition, the ability of metergoline to antagonize the behavioral effects of intravenous mCPP suggests that these responses are mediated by 5-HT1/5-HT2 receptors.

Administration, Oral↗

PubMed1999

Segregation analysis of obsessive-compulsive disorder using symptom-based factor scores.

Obsessive-compulsive disorder (OCD) is a complex psychiatric disorder characterized by recurring obsessions or compulsions that cause significant distress to the patient or significantly interfere with the patient's normal home, work, or social activities [Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC: American Psychiatric Association, 1994]. Twin and family studies have suggested that OCD has a significant genetic component. We performed complex segregation analyses using POINTER with families ascertained through an OCD-affected proband. In an attempt to resolve the phenotypic heterogeneity observed among individuals with OCD these segregation analyses used four factor-analytic symptom dimensions to subset the family sample based upon probands' symptom factor scores. Analysis of the entire sample allowed rejection of only the no transmission model; that model was also rejected in all subsequent analyses. Limiting the analyses to families with at least one OCD-affected member in addition to the proband (the demonstrably familial form of OCD) allowed rejection of all models except the mixed model. Analyses limited to families of high-factor-3 (symmetry and ordering symptoms) probands led to rejection of the polygenic model, indicating the involvement of a major locus. Additionally, the relative risk of OCD or subclinical OCD was 1.7 for relatives of probands with a factor 3 score greater than zero compared with relatives of probands with a low factor score. The symptoms attributed to high factor 3 scores (symmetry and ordering) may constitute a genetically significant symptomatic subtype of OCD. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 88:669-675, 1999.

Aging↗

PubMed1996

School problems in Tourette's syndrome.

BACKGROUND: A retrospective study of 138 children with Tourette's syndrome for associated school problems revealed that at the time of initial evaluation, 64 subjects (46%) experienced a school-related problem. OBJECTIVE: To survey a childhood population with Tourette's syndrome to explore the contributions of neurobehavioral concomitants to academic difficulties. RESULTS: A diagnosis of a specific learning disorder had previously been made in 30 (22%) of 138 children. Among the 108 without a diagnosis of learning disorder, 36 (33%) experienced school difficulties defined as grade retention (16 [15%]) and/or special education placement (41 [38%]). Regression analysis of subjects without a diagnosis of learning disability revealed that the presence of attention-deficit hyperactivity disorder served as a significant predictor of school problems. CONCLUSIONS: Tics represented the primary reason for referral, but did not emerge as a significant predictor of academic problems. Rather, school-related difficulties appeared to be strongly associated with comorbid attention-deficit hyperactivity disorder.

Adolescent↗

PubMed1967