Scielo RSS <![CDATA[The European Journal of Psychiatry]]> vol. 29 num. 3 lang. en <![CDATA[SciELO Logo]]> <![CDATA[<b>The overlap between dissociative symptoms and symptom over-reporting</b>]]> Background and Objectives: The potential link between dissociative symptoms and symptom over-reporting has been given little attention. In two student samples (N’s = 139 and 113) and a clinical sample (N = 21), we examined whether self-reported dissociative symptoms are related to symptom over-reporting. Methods: We relied on different measures of dissociation and over-reporting. In the clinical sample, we looked at whether the well-established link between dissociative symptoms and sleep disturbances would survive if we corrected for symptom over-reporting. Results: Dissociativity correlated with symptom over-reporting in the student samples, but not in the clinical sample. Correcting for over-reporting tendencies did not fundamentally alter the relationships between dissociative symptoms and sleep disturbances in the clinical sample. Conclusions: Our results suggest that the overlap between symptom over-reporting and dissociativity is much more a problem in nonclinical than in clinical samples. <![CDATA[<b>Trajectories of complicated grief</b>]]> Background and Objectives: In the discussion of apparent similarities between symptoms of grief and depression, research and theory have often confounded these two constructs because, as a construct, grief is distinct from depression and because these two constructs may have distinct trajectories. This study examines the trajectories of complicated grief and associated risks and the relationship between trajectories of complicated grief and depression. Design: Longitudinal. Setting: Intervention methods for enhancing family caregiving for persons with dementia. Participants: A total of 221 participants of the Resources for Enhancing Alzheimer’s Caregiver Health project. Measurement: The Inventory of Complicated Grief. Results: The results based on group-based mixture modeling identify two distinct trajectories of grief (persistently high and low) and three distinct trajectories of depression (persistently high, moderate, and low). There were significant differences between the proportion of grief trajectory membership and that of depression trajectory membership, indicating distinct patterns over time. Conclusions: Noteworthy is the significant difference between the proportion of grief trajectory membership and that of depression trajectory membership, indicating differences in distinct patterns over time. <![CDATA[<b>A survey of physician practices in managing people with dementia in Hong Kong</b>]]> Background and Objectives: Managing patients with dementia (PWD) in accordance with established clinical practice guidelines is important in providing optimal care. However, information about the actual processes of diagnosis and treatment is scanty. The objective of this paper is to explore the daily practices and management of PWD by physicians in Hong Kong. Methods: A survey was conducted to explore the practices of local physicians in managing PWD. A questionnaire was sent to the Hong Kong Medical Association, which represents 61% of all locally registered medical practitioners. Results: The Mini-Mental State Examination (MMSE) was the most common screening instrument (89.4%), followed by the Clock drawing test (29.3%). The most frequently used imaging tests were computed tomography (67.9%). Tests for thyroid-stimulating hormones (85.9%) and vitamin B12 (74.9%), as well as the Venereal Disease Research Laboratory Test (74.9%), were frequently performed to rule out reversible causes. Cholinesterase inhibitor (69.7%) and N-Methyl-D-asparate (44.1%) were the most commonly used anti-dementia medications. The most common reason for referring patients to specialists was the “occurrence of severe behavioral and psychiatric symptoms (BPSD)” (59.6%). Discussion: Most physicians in Hong Kong can select cognitive assessment tools, laboratory tests, and imaging tests recommended by several practice guidelines. Primary care physicians should be able to manage PWD who are in stable condition and without severe BPSD. Better education of physicians in the diagnosis and management of dementia is needed to ensure that all physicians practice in ways consistent with the established practice guidelines. <![CDATA[<b>Neurocognitive changes in patients with schizophrenia during relapse and early remission</b>]]> Background and Objectives: Several studies have demonstrated that patients with schizophrenia have impaired cognitive functioning. In the literature there have been controversial results about the cognitive deficits occurring in the different states of the illness. Furthermore, there have been relatively few studies to investigate the associations between neurocognitive deficits and clinical status over time. In order to follow the changes of neurocognitive subfunctions during relapse and early remission (clinically stable state), in the present study patients with schizophrenia were tested in the acute phase and in clinically stable state, and then the results were correlated with clinical symptoms. Methods: Forty-two patients diagnosed with schizophrenia based on diagnostic interviews by clinicians and 43 normal controls were studied. Neurocognitive skills were evaluated with six subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Among patients with schizophrenia, symptom severity was assessed with the Positive and Negative Syndrome Scale (PANSS). Results: Patients with schizophrenia performed significantly worse in all neurocognitive subtests compared to healthy controls at both relapse and clinically stable state. At follow-up these cognitive changes improved, however still marked dysfunctions were observed. The negative symptoms in the PANSS and CANTAB tests were negatively correlated with both results during relapse and clinically stable state. Conclusions: Cognitive impairment exists among patients with schizophrenia compared to healthy subjects during both relapse and early remission suggesting that these deficits might be permanent. <![CDATA[<b>Coprophagia in a patient with borderline personality disorder</b>]]> Background and Objectives: Human coprophagia is a rare phenomenon with severe medical and social consequences. So far, coprophagia has mainly been associated with severe mental retardation, schizophrenia, dementia, and depression. We report a case of coprophagia in a 30-year-old woman with Borderline Personality Disorder (DSM-IV). This case report illustrates the severity of symptoms and maladaptive social consequences of severe personality disorders, comparable to those of patients with schizophrenia. Pharmacological interventions and, particularly intensive psychotherapy might be effective for patients diagnosed with borderline personality disorder displaying severe behavior disorders. The treatment of choice for coprophagia is aversive behavioral intervention. <![CDATA[<b>Oligodendrocyte abnormalities in layer 5 in the inferior parietal lobule are associated with lack of insight in schizophrenia</b>: <b>a postmortem morphometric study</b>]]> Background and Objectives: Previously we reported in layer 3 of the inferior parietal lobule a reduction in the numerical density of oligodendrocytes (Nv Ol), oligodendrocyte clusters (Nv OlC) in BA 39, and in the number of perineuronal oligodendrocytes (N PnOl) in BA 39/40 areas in schizophrenia. These changes were associated with lack of insight. We hypothesized that similar abnormalities might occur in layer 5 in BA 39/40, and they might be associated with lack of insight. Methods: We estimated the Nv Ol, the Nv OlC by optical disector method and the N PnOl in layer 5 in BA 39/40 in Nissl stained sections from 24 males with schizophrenia and 24 normal male controls from the Stanley Parietal Collection. The schizophrenia group was divided into three subgroups based on level of insight: poor, fair or good. Results: We found a significant deficit in the parameters measured in BA 39 in the schizophrenia group and in the subgroup of subjects having poor insight as compared to the control group. In BA 40 the Nv Ol and the Nv OlC were significantly lower in the schizophrenia group compared to controls, and the N PnOl was not changed. Each insight subgroup showed a decreased the Nv Ol and the Nv OlC compared to controls. There were no subgroup differences in BA 39/40. Conclusions: Schizophrenia is characterized by the reduction in the Nv Ol and the Nv OlC in layer 5 of BA 39/40. Oligodendrocyte abnormalities in BA 39 are associated with poor insight in schizophrenia.