The European Journal of Psychiatry

Cognitive deficits in hospitalized and never hospitalized remitted unipolar depressive patients

Background and Objectives: Little is known about the differences between patients managing depression on an outpatient basis as compared with hospitalized ones. This study investigated the performance of attention, executive function and verbal memory during remission from unipolar depressive episodes and compare patients with and without history of hospitalization. Methods: The sample of participants who had undergone one or more hospitalizations (hospitalized, N = 46) as well as in a sample without hospitalization (never hospitalized, N = 46) and controls (N = 92) were used. The Auditory Verbal Learning Test (AVLT) and the Trail Making Test (TMT) were administrated to test this hypothesis. Results and conclusion: The hospitalized sample had similar results in all four neuropsychological variables in comparison with the never hospitalized group, and both groups had some lower results in comparison with controls. In comparison with the controls, hospitalized sample had mean cognitive deficits of 34% (28-41%), the never hospitalized group had a mean of 20% (21-35%). Contrary to previous reports we have found no meaningful differences between the two patient groups.

Pathological Internet use and psychiatric disorders: A cross-sectional study on psychiatric phenomenology and clinical relevance of Internet dependency

Background and Objectives: With the Cyberspace´s exponential growth of influence questions arise about its mental impacts. The presented study examines the question whether the dependent use of the Internet can be understood as an impulse control disorder, an addiction or as a symptom of other psychiatric conditions. Methods: Internet dependent patients seeking for psychiatric assistance and fulfilling the criteria for pathological Internet use (PIU) were examined with the Structured Clinical Interview according to DSM-IV (SCID), and a variety of questionnaires including the Barratt Impulsiveness Scale (BIS), the Beck Depression Inventory (BDI) and the Dissociative Experience Scale (DES). The patient group was compared to a matched group of healthy controls. Results: The adult patient-group consisted of 25 subjects, 76% male, with a mean age of 29.36 years. Average time spent in Cyberspace was 6.47 h/d, mostly in online-role-playing games. According to SCID I and BDI, 19 patients (76%) suffered from a depressive syndrome, with 10 cases of major depressive disorder (40%) and 8 cases of adjustment disorder with depression (32%). Six patients (24%) suffered from a comorbid anxiety disorder. Compared to controls, the patient group presented significantly higher levels of depression (BDI), impulsivity (BIS) and dissociation (DES). Conclusions: PIU shares common psychopathological features and comorbidities with substance related disorders. Therefore, it might be seen as a diagnostic entity in itself in a spectrum of behavioural and substance dependencies. Especially Internet role play may contain an addictive potential for adolescents and adults with subclinical psychopathology.

Eating attitudes and weight concern among Chinese middle-age women: A comparison between different age and BMI groups

Background and Objectives: Few studies have been conducted to explore eating behavior and weight concern among middle-aged women. Methods: Participants were a sample of 236 Chinese women aged 30-52. Outcome measures were various symptoms related to eating disorders, the weight concern and psychological characteristics subscales of the Eating Disorder Inventory-2 questionnaire (EDI-2). Independent variables were age, education level and BMI. ANOVA-Test and Linear Regression were performed. Results: A group of women (N = 132, 78%) with normal weight (19 < BMI < 24) showed dissatisfaction with their weight and wanted to reduce it. Overweight and obese women scored significantly higher on the subscale Body Dissatisfaction on the EDI-2 than women with lower BMI. In comparison to the older group (50-59), the younger group (30-39) and middle-aged group (40-49) expressed the desire to lose weight with a lower BMI. Conclusions: In comparison to age, the BMI had a stronger impact on the psychological and behavioral traits related to the eating disorders among a group of middle-aged Chinese women.

Late effect of the Second Lebanon War: Level of exposure and rates of comorbidity of posttraumatic stress symptoms and depresisve symptoms among Israelis from Northern and Center Israel

Background and Objectives: The objective of the present study was to examine comorbidity of posttraumatic stress disorder symptoms and depressive symptoms in the aftermath of war related stress among two groups differentiated by their level of exposure to the war. Methods: 336 Israeli citizens were assessed using a convenience sample creating two groups from Northern and Central Israel. The former were exposed to missile attacks while the latter were indirectly exposed to war-related stress. The participants provided demographical information and filled a battery of questionnaire that assessed their physical health, mental health, and subjective well-being. Results: The Northern group exhibited higher level of comorbidity, depressive symptoms and past satisfaction. Moreover, higher levels of depressive symptoms, psychosomatic symptoms and lower satisfaction with life in the past were associated with higher levels of PTSD symptoms. Conclusions: Our findings suggest that the long-term effect of war is more salient when examining comorbidity of PTSD and depressive symptoms rather than when examining PTSD or depressive symptoms alone. In line with the dose-response model, it can be assumed that higher exposure to war related stress is related to higher levels of exposure that may lead to a long lasting vulnerability as it appears in a combination of PTSD symptoms and depressive symptoms two years later.

Williams Syndrome: The extent of agreement between parent and self report of psychological difficulties

Background and Objectives: People with Williams syndrome (WS) have been reported by their carers to have problems with attention, anxiety and social relationships. People with WS have been shown to report their anxieties. This study extends our knowledge of how people with WS see themselves in terms of behaviour and social relationships. Methods: A survey using self and parent report forms of the Strengths and Difficulties Questionnaire. Results: Both parents and individuals with WS (N = 31) reported difficulties in emotional disorder and hyperactivity symptoms and strengths in prosocial behaviours such as altruism and empathy. They disagreed about peer problems. Conclusions: People with WS understand some but not all of their difficulties. In particular they fail to recognize their social difficulties which may lead them to be vulnerable to exploitation.

Gender differences in incipient psychosis

Background and Objectives: To describe gender differences in a group of patients with first-episode psychotic in different aspects: socio-demographic features, characteristics of the phases prior to disease onset (premorbid and prodromic periods), clinical manifestation of psychotic symptoms and possible corresponding cognitive alterations after disease onset, using the age at onset of first psychotic episode as a control variable. Methods: Longitudinal study of 53 consecutive cases with a first psychotic episode. Inclusion criteria: two or more psychotic symptoms; age between 7 to 65 years old; first consultation to the medical center of study; less than 6 months since the first contact to the medical service; and less than a year of symptoms´ evolution. The methodologic assessment includes: a socio-demographic questionnaire and an extensive battery of tests to assess premorbid/prodromic, clinical and cognitive characteristics. We perform mean differences tests to analyze continuous variables (non-parametric U-Mann-Whitney and t-Student test) and chi-square test for categorical variables (SPSS 16.0). Results: In the group of patients under 18 years, men showed higher scores in adjustment premorbid (U = 54.0, p = 0.050), more neurological soft signs (U = 31.0 p = 0.003), more negative psychotic symptoms (U = 48.5, p = 0.051) and worse insight (U = 30.0, p = 0.003) than women (after 8 weeks of psychotic episode onset). Conclusions: We found gender differences in most of the variables analyzed when age at onset was controlled. These differences should be taken into account to learn more about the different types of onset of the disease, its prevention and possible improvements in therapeutic approach. Our findings suggest that younger men with an earlier onset of psychotic episode have more alterations in the stages prior to the onset of the disease supporting the neurodevelopmental hypothesis for gender differences.