首次脑梗死患者和正常健康者血清超敏C-反应蛋白的性别差异及其意义

目的探讨首次脑梗死患者与正常健康体检者血清超敏C-反应蛋白(hsCRP)的性别差异及意义。方法选取1 3 8例首次脑梗死患者(NIHSS评分<5分)作为脑梗死组,将其分为男性组和女性组。选取1 5 0例健康体检者作为正常组,亦分为男性组和女性组。检测各组患者血清hsCRP水平。结果脑梗死组血清hsCRP水平明显高于正常组(P<0.05)。男性脑梗死组与女性脑梗死组血清hsCRP相比较差异无统计学意义(P>0.0 5)。男性正常组与女性正常组血清hsCRP相比较,男性组高于女性组,差异有统计学意义(P<0.0 5)。男性脑梗死组与男性正常组血清hsCRP相比较差异无统计学意义(P>0.0 5)。女性脑梗死组与女性正常组血清hsCRP相比较差异有统计学意义(P<0.0 5)。结论血清hsCRP水平存在性别差异。炎症反应与女性脑梗死的发病可能有着更为密切的联系。     

Impact of early lifetime trauma in later life: depression among Holocaust survivors 60 years after the liberation of Auschwitz.

RATIONALE: Holocaust survivors, who experienced trauma 60 years ago, provide an opportunity to explore the impact of early lifetime trauma in later life and, in particular, the interplay of depression and posttraumatic stress disorder (PTSD). In this study, the authors contrast depressed Holocaust survivors (HD), nondepressed Holocaust survivors (HND), and older depressed persons (CD). METHODS: The sample consisted of 36 consecutive Holocaust survivors (mean age: 79 years) treated in a primary care practice, among whom 20 (56%) were diagnosed as having a major depressive disorder and 16 as nondepressed; 18 depressed non-Holocaust Jewish primary care patients served as controls (mean age: 84 years). The authors examined nine clinical and social variables. The Kruskal-Wallis, Mann-Whitney U, and chi(2) tests were used to contrast the groups. The authors used a conservative significance level of .01. RESULTS: In contrast to the CD group, the HD group was significantly older, more likely to report PTSD and guilt symptoms, to have higher Beck Anxiety Inventory (BAI) and Brief Psychiatric Rating Scale (BPRS) scores, and to have more impaired social functioning. In contrast to the HND group, the HD group was significantly more likely to report PTSD and guilt feelings, to have higher Hamilton Depression Scale (HAM-D), BAI, and BPRS scores, and to have more impaired social functioning. In contrast to the CD group, the HND group was significantly more likely to have PTSD symptoms and to have lower HAM-D and BPRS scores. CONCLUSIONS: The prevalence of depression and PTSD symptoms were very high among survivors. Depressed survivors had significantly worse psychologic and social functioning than depressed controls. Depressed survivors had more PTSD symptoms than nondepressed survivors, although it is unclear as to the causal direction of the relationship between depression and PTSD.     

Violent women,blame attribution,crime, and personality

BACKGROUND: The attribution of blame for criminal act has an impact, both on the way the offender must come to terms with the offence and on the risk of recidivism. Blame attribution has been found to be related to the type of crime and personality. AIMS: This study examined the relationship of blame attribution and feelings of guilt in violent female offenders, according to factors related to crime, background and personality. METHODS: The Gudjonsson Blame Attribution Inventory (BAI) and the Defense Style Questionnaire (DSQ) were administered to 58 violent female offenders. The Hare Psychopathy Checklist-Revised (PCL-R), Structured Clinical Interview II for DSM-IV (SCID II) and clinical interviews were used for assessment. RESULTS: Lower scores of guilt feelings were found in women than has been reported for men. The feelings of guilt were higher in homicide than in other violent crimes, but lower in the cases where women had committed prior violent crimes. No differences were found between psychiatric patients and prisoners. The duration of hospitalisation and incarceration did not result in differences in blame attribution and guilt, but when the victims survived, guilt feelings seemed to increase with the passing of the time. External attribution was related to motives of crime, but traumatic experiences did not have a crucial impact upon blame attribution. The attribution of blame and the amount of guilt feelings were found to be related to personality. Women scoring high on psychopathy reported less guilt than women with low scores. The corresponding result was not obtained in the group of women with antisocial personality disorder, who, however, showed an unexpectedly low use of external attribution. CONCLUSION: The results suggest that it might be difficult for women to cope with the violent offence and that the characteristics of psychopathy seems to have a crucial impact on the guilt feelings and consequently on coping with the crime in female offenders.     

The influence of age on guilt expression in major depression

To test the hypothesis, based on clinical observation, that older depressed patients express less guilt than younger ones, the authors evaluated 39 patients with major depression aged 55 years or older (mean = 67.0) and compared them to 38 depressed patients under age 55 (mean = 35.4). The results were generally in accord with the hypothesis. On observer ratings (Hamilton Depression Scale), however, it was primarily older men who expressed guilt less frequently than younger men (p = 0.01). On self-ratings (Beck Depression Inventory), the significant differences were among women; older women employed milder expressions of guilt (p = 0.02) and fewer expressions of feelings of failure than younger women (p = 0.025). These findings suggest that age may influence the expression of guilt in patients with major depressive disorder, and that the age effect may differ in the two sexes.     

Facial expression in male and female schizophrenia patients

This study investigated gender differences in facial expression as a reaction to various emotional stimuli in two groups of schizophrenia patients. The first group consisted of hospitalized patients (22 men and 13 women) who were tested at three points in time. The second group consisted of outpatients (21 men, 8 women) who were tested at two points in time. In addition, the facial behaviour of two control groups was investigated (17 men and 12 women; 18 men and 14 women, respectively). Facial activity was videotaped, whilst participants watched emotion-eliciting video clips and participated in an emotion-inducing interview, and measured using the Facial Action Coding System. In agreement with our expectations, schizophrenia patients showed significantly less facial activity overall than healthy control participants. Contrary to expectations, however, female patients did not display more facial activity compared to male schizophrenia patients. This finding contrasts with those of healthy participants in previous studies where women tended to show more facial activity than men. It was further expected that in non-psychotic patients (i.e. outpatients), gender differences would be more clearly apparent and female schizophrenia patients would show considerably more facial activity than male patients, with findings more or less comparable to the gender differences found in healthy controls. However, no significant interaction was found between patient group (in- vs. outpatients) and gender. The different explanations for these findings are considered in this study.     

Sex differences in biopsychosocial correlates of binge eating disorder: a study of treatment-seeking obese adults in primary care setting

Objective

Although community-based studies suggest equivalent levels of physical and psychological impairment by binge eating disorder (BED) in men and women, men with BED are still underrepresented in clinical studies. This study aimed to provide a comprehensive analysis of sex differences in biopsychosocial correlates of treatment-seeking obese patients with BED in primary care.

Method

One hundred-ninety obese adults (26% men) were recruited in primary care settings for a treatment study for obesity and BED.

Results

Very few significant sex differences were found in the developmental history and in current levels of eating disorder features, as well as psychosocial factors. Women reported significantly earlier age at onset of overweight and dieting and greater frequency of dieting. Men reported more frequent strenuous exercise. Men were more likely than women to meet criteria for metabolic syndrome; men were more likely to show clinically elevated levels of triglycerides, blood pressure, and fasting glucose levels.

Conclusion

Despite few sex differences in behavioral and psychosocial factors, metabolic problems associated with obesity were more common among treatment-seeking obese men with BED than women. The findings highlight the importance of including men in clinical studies of BED and active screening of BED in obese men at primary care settings.     

Age-related gender differences in reporting ictal fear: analysis of case histories and review of the literature

To determine if there are age or gender-related differences in reporting fear as a symptom of epileptic seizure, all clinical charts of patients evaluated at the "C. Munari - Epilepsy Surgery Center" of Milan from 1990 to June 2005 were analyzed, looking for patients with ictal fear. Among the 2,530 clinical charts examined (1,330 male and 1,200 female), 265 patients were found with ictal fear (100 men, 165 women). The gender difference in reporting ictal fear was not so marked in the pediatric age group (98 girls, 74 boys), whereas in adult patients the difference was significant (158 women, 83 men). Interestingly, more men than women (14:3) had ictal fear during childhood that disappeared during adulthood. The literature review confirmed that ictal fear is significantly more common in women, though there is no gender difference in the pediatric age group.     

Development of personality disorders in children and adolescents with obsessive-compulsive disorder A 6- to 22-year follow-up study

Forty-seven people with admissions in childhood for obsessive-compulsive disorder (OCD) and 49 child psychiatric controls were followed up in young adulthood and assessed for DSM-III-R personality disorders with the Structured Clinical Interview for DSM-III-R Personality Disorders. The number of personality disorders in OCD patients did not differ significantly from the number in controls. The most common personality disorder was avoidant personality disorder (significantly more frequent than in controls), whereas obsessive-compulsive personality disorder (OCPD) was not found more often in the OCD group. Subjects with OCD in adulthood seemed to have OCPD more often than childhood OCD patients with no OCD at follow-up. In the whole group, histrionic personality disorders were more common in women than in men and OCPD more common in men than in women, whereas borderline personality disorder was most common among women in the OCD group. The presence of a personality disorder in adulthood could not be correlated with such childhood factors as social background, symptoms or age of onset of OCD.     

Alcohol consumption and alcoholism in an urban population in central Sweden

A representative selection of 2,283 individuals, 18-65 years old, in "former" Stockholm County, were examined by psychiatrists in 1970-71. The total of non-participants was 12%. The alcohol consumption pattern and the prevalence of the diagnosis alcoholism for the last 12 months are reported. Significantly more men than women confirmed "very high" and "high" consumption, respectively. The diagnosis alcoholism was given to 4.8% men and 1.4% women. Significantly more women in social class I than in II and III, as significantly more men in social class I than in II stated "very high" or "high" consumption. Social consequences of alcohol consumption, in the form of entries in the Penal Register of the National Board of Excise (Kontrollstyrelsens straffregister) for the years 1965-71, were, on the other hand, found significantly more frequently among men in social class III than in social classes I and II.     

Mental symptoms,hostility features and stressful life events in people with cancer

Hostility features, mental symptoms, and stressful life events were investigated in 100 patients (59 men and 41 women) suffering from cancer. Fifty-seven healthy men (n= 26) and women (n= 31) were used for comparison purposes. The assessment instruments were the Hostility and Direction of Hostility Questionnaire, the Delusions Symptoms States Inventory/states of anxiety and depression and a modified version of the Schedule of Life Experiences. Women patients reported lower scores than healthy women on total hostility, but men patients reported higher scores than healthy men. Introverted hostility was increased in both male and female patients, but due to different patterns: in women due to lower scores on extroverted hostility subscales, especially acting-out hostility, whereas in men due to higher scores on introverted hostility subscales, especially guilt. Female patients, compared with healthy women, reported significantly higher scores on the depressive and anxiety subscales, whereas in the man the differences were not statistically significant even though patients reported higher scores than normals. On the Schedule of Life Experiences, female patients reported statistically significant higher scores than healthy women.     

Le sentiment de culpabilité et de honte chez les survivants de l’Holocauste

Participants in the study were Jewish Holocaust survivors (n = 89). A total of 70 respondents constituted the trauma group. The remaining 19 participants were regarded as the controls. The control group consisted of persons of Jewish nationality who had experienced the trauma of anti-Semitic persecution, but their life had not been directly threatened. The aim of the study was to find out whether feelings of guilt and shame are still present in narratives of the Holocaust survivors, years after their traumatic experiences. A quantitative analysis of responses concerning guilt and shame feelings revealed no significant differences between the study group and the controls. The paper presents a historical outline of thought regarding survivors’ guilt and shame. Combining data reported in the literature and contemporary narratives of the survivors, it can be hypothesized that we are confronted with a dynamic process of the survivor's working through grief and bereavement. An open question remains whether the bereavement process can be completed in survivors – it is difficult to complete because of the extent of trauma. Completion of the process is perhaps possible, but requires more time, besides, some conditions must be fulfilled first – particularly, a place for the Jewish Holocaust should be acknowledged and affirmed not only in personal narratives, but also in social discourse.     

Sex differences and similarities in the management and outcome of stroke patients

BACKGROUND AND PURPOSE: Previous studies have documented sex differences in the management and outcome of patients with cardiovascular disease. However, little data exist on whether similar sex differences exist in stroke patients. We conducted a study to determine whether sex differences exist in patients with acute stroke admitted to Ontario hospitals. METHODS: Using linked administrative databases, we performed a population-based cohort study. The databases contained information on all 44 832 patients discharged from acute-care hospitals in Ontario between April 1993 and March 1996 with a most responsible diagnosis of acute stroke. The main outcomes measured consisted of sex differences in comorbidities, the use of rehabilitative services, the use of antiplatelet therapy and anticoagulants (in elderly stroke survivors aged > or =65 years only), discharge destination, and mortality. RESULTS: Male stroke patients were more likely than female stroke patients to have a history of ischemic heart disease (18.1% versus 15.3%, respectively; P<0.001) and diabetes mellitus (20.1% versus 18. 7%, respectively; P<0.001), whereas female patients were more likely than male patients to have hypertension (33.8% versus 30.0%, respectively; P<0.001) and atrial fibrillation (12.9% versus 10.2%, respectively; P<0.001). There were no sex differences in the usage of in-hospital rehabilitative services. The overall 90-day postdischarge use of aspirin and ticlopidine was similar in stroke survivors aged 65 to 84 years. However, among stroke survivors aged > or =85 years, men were more likely than women to receive aspirin (36. 0% versus 30.7%, respectively; P<0.001) and ticlopidine (9.2% versus 6.8%, respectively; P=0.007). Use of warfarin was similar for the two sexes. Men were more likely than women to be discharged home (50. 6% versus 40.9%, respectively; P<0.001) and less likely to be discharged to chronic care facilities (16.8% versus 25.2%, respectively; P<0.001). The risk of death 1 year after stroke was somewhat lower in women than men (adjusted odds ratio 0.939, 95% CI 0.899 to 0.980; P=0.004). The mortality differences were greatest among elderly stroke patients. CONCLUSIONS: Elderly men are more likely than elderly women to receive aspirin and ticlopidine and equally like to receive warfarin after a stroke. Despite these differences, elderly women have a better 1-year survival after a stroke.     

Facial Emotion Recognition in Schizophrenia: The Impact of Gender

Objective

Previous studies reported gender differences for facial emotion recognition in healthy people, with women performing better than men. Few studies that examined gender differences for facial emotion recognition in schizophrenia brought out inconsistent findings. The aim of this study is to investigate gender differences for facial emotion identification and discrimination abilities in patients with schizophrenia.

Methods

35 female and 35 male patients with schizophrenia, along with 35 female and 35 male healthy controls were included in the study. All the subjects were evaluated with Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEDT), and Benton Facial Recognition Test (BFRT). Patients'' psychopathological symptoms were rated by means of the Positive and Negative Syndrome Scale (PANSS).

Results

Male patients performed significantly worse than female patients on FEIT total, and negative scores. Male controls performed significantly worse than female controls on FEIT total and negative scores. On all tasks, female patients performed comparable with controls. Male patients performed significantly worse than controls on FEIT, and FEDT.

Conclusion

Women with schizophrenia outperformed men for facial emotion recognition ability in a pattern that is similar with the healthy controls. It could be claimed that male patients with schizophrenia need special consideration for emotion perception deficits.     

EEG fast frequency activity in the sons of alcoholics

The EEGs of young (21-25-year-old) sons of alcoholics and their matched controls (n = 24 pairs) were computer evaluated to assess activity in the 12-20 Hz (beta) range. Subjects were blindly exposed to ethanol and placebo drinks while EEG was gathered at baseline and 90 min postconsumption. Men with alcoholic fathers [family history positive (FHP)] displayed significantly more beta activity at 90 min postethanol consumption than the men who had no alcoholic relatives [family history negative (FHN)]. In addition, when subjects were sorted into "low" and "moderate" drinkers depending on their drinking practices, additional differences were found between groups. Within the FHN subjects, moderate drinkers were found to have significantly more energy in the beta frequencies at both baseline and at 90 min postdrug than low drinkers. However, though family history positive subjects had overall increases in 12-20 Hz activity compared with the FHN subjects, no significant differences were found between moderate and low drinkers within the FHP population. Taken together, these studies suggest that drinking practices and a familial history for alcoholism can modify the beta content of the EEG in the 12-20 Hz range in young men.     

Sex-linked differences in cortisol, ACTH and prolactin responses to 5-hydroxy-tryptophan in healthy controls and minor and major depressed patients

Some researchers have found that the administration of 5-hydroxytryptophan (5-HTP) results in increased cortisol secretion in major depressives but not in healthy controls. Other authors observed gender-related differences in cortisol responses to 5-HTP in major depressives. In order to investigate the pituitary/adrenal responsivity to 5-HTP, the authors measured cortisol, adrenocorticotropic hormone (ACTH) and prolactin (PRL) in 30 healthy controls and in 90 depressed patients; the hormone levels were determined in baseline conditions and 60, 90 and 120 min after 125 mg L-5-HTP (orally, non-enteric coated). We found that healthy men had significantly higher cortisol responses to L-5-HTP than healthy women. In the major depressives with melancholia and/or psychotic features these differences were reversed: women exhibited significantly higher cortisol and PRL responses than men. In the female group the most severely depressed patients had increased cortisol and PRL responses to L-5-HTP. The amplitudes of the cortisol, ACTH and PRL responses to L-5-HTP were significantly and positively correlated. It was concluded that the central serotonergic regulation of ACTH and PRL is significantly different between the sexes and between healthy controls, minor depressives and severely depressed patients.     

Gender differences in psychological effect of the August 1999 earthquake in Turkey

Disasters traumatically expose normal populations to severe threats to life, deaths of relatives and massive environmental destruction. Epidemiological studies found that women would be more vulnerable to disaster than men. In this study, we examined gender differences in short-term psychological effect of the 1999 earthquake in Turkey on adult survivors. A total of 184 subjects (79 males and 105 females) who used a psychiatric service were interviewed within 6-10 weeks after the earthquake. All subjects were assessed using a modified version of the Mississippi Scale for Posttraumatic Stress Disorder, the Beck Depression Inventory, the Beck Hopelessness Scale, and four subscales (depression, anxiety, hostility and somatization) of the Symptom Check List (SCL-90-R). Women had higher mean total Mississippi Scale scores than men (84.29 vs. 78.72; P<0.05). Women scored higher on the Beck Depression Inventory and the Beck Hopelessness Scale than men (respectively 16.3 vs. 10.4; P<0.001 and 7.5 vs. 6.0; P<0.05). Women had significantly higher depression (1.40 vs. 0.94; P<0.001), anxiety (1.46 vs. 1.12; P<0.05) and somatization (1.31 vs. 0.84; P<0.001) subscale scores of the SCL-90-R than men. These findings indicate that women may experience more severe psychological reactions than men after a disastrous earthquake.     

Relationship between cortisol and age-related memory impairments in Holocaust survivors with PTSD

RATIONALE: Holocaust survivors with PTSD appear to show an accelerated aging effect as evidenced by their performance on tests of explicit memory, and also show more exaggerated patterns on age-related alterations in cortisol release over the diurnal cycle than Holocaust survivors without PTSD and nonexposed subjects. To investigate the implications of age-related HPA axis alterations on cognition, we examined correlations between parameters reflecting circadian cortisol release and implicit and explicit memory performance. METHODS: Nineteen Holocaust survivors with PTSD (7 men, 12 women), 16 Holocaust survivors without PTSD (7 men, 9 women), and 28 non-exposed healthy comparison subjects (13 men, 15 women) collected salivary samples at six times over the diurnal cycle, and were tested with Paired Associates and Word Stem Completion Tests. RESULTS: Negative correlations were observed between several measures of salivary cortisol concentrations and explicit memory in Holocaust survivors with PTSD after adjusting for IQ, years of education and current age reflecting poorer performance in association with higher cortisol levels. This relationship was absent in Holocaust survivors without PTSD and in demographically-comparable subjects who were not exposed to the Holocaust or other extremely traumatic events. CONCLUSION: The significantly different relationship between cortisol and memory performance in these groups suggests that the neuropsychological impairments observed in Holocaust survivors with PTSD may reflect an interaction of PTSD and aging effects.     

Long-term psychosexual adjustment of acute leukemia survivors: impact of marrow transplantation versus conventional chemotherapy.

Psychosexual sequelae associated with surviving acute leukemia treated with conventional chemotherapy or with chemotherapy followed by bone marrow transplantation (BMT) were investigated in 70 patients who were off treatment for at least 1 year. Assessment of psychosexual function included frequency of sexual activity, satisfaction, body image, gender role identity, and adjustment in sexual relations. No differences between BMT and conventional chemotherapy survivors were found on any of these measures, despite the high probability of gonadal impairment with BMT. Compared with physically healthy norms, women survivors generally reported decreased sexual frequency and satisfaction, whereas both men and women survivors reported poorer body image. Longer time since completing cancer treatment predicted greater frequency of sexual activity in women but poorer body image for both men and women. Those survivors who reported decreased sexual frequency, satisfaction, and poorer body image reported greater psychological distress and decreased energy. Results indicate that psychosexual sequelae in survivors of leukemia occur frequently and warrant intensive investigation, particularly to address the need for an intervention in those most distressed.     

Sex difference in symptomatology of manic episode

Objective

Studies addressing sex differences in the symptoms and course of bipolar affective disorder had been investigated across different phase of bipolar affective disorder. There are few studies in manic phase that have reported inconsistent results. Therefore, we investigated sex difference in symptom presentation of manic episode.

Methods

A total of 150 male and 50 female subjects meeting criteria for manic episode according to International Statistical Classification of Diseases, 10th Revision Diagnostic Criteria for Research, giving written informed consent, were included for the study. Those with comorbid major medical or psychiatric disorders were excluded. All the patients were assessed on Scale for Manic States.

Results

Multivariate analysis of variance using all the items of Scale for Manic Symptoms showed significant sex difference (Pillai's Trace F_20,179 = 5.154, P < .001), with large effect size (η² = .365). In men, there was significantly higher motor activity, psychosis, grandiosity, contact, and humor, whereas mood lability, depressed mood, guilt, suicide, anxiety, and dress scores were higher in women. Discriminant analysis showed that 84% of men and 72% of women could be correctly classified using the Scale for Manic Symptoms. Stepwise logistic regression analysis showed anxiety, guilt, and dress positively predicted female sex and the model explained 24% to 36% of variance.

Conclusion

Symptom presentation of mania differs across sex and a predominance of anxiety and depressive symptoms was found in women, whereas increased psychomotor activity was prevalent in men.     

Gender differences in suicide methods

Introduction

Gender differences in suicide completion rates have been attributed to the differences in lethality of suicide methods chosen by men and women, but few empirical studies have investigated factors other than demographic characteristics that might explain this differential.

Methods

Data from the 621 suicides in Summit County, Ohio during 1997–2006 were disaggregated by gender to compare known correlates of suicide risk on three methods of suicide—firearm, hanging and drug poisoning.

Results

Compared to women, men who completed suicide with firearms were more likely to be married and committed the act at home. Unmarried men were likelier to hang themselves than married men, but unmarried women were less likely to hang themselves than married women. Men with a history of depression were more likely to suicide by hanging, but women with depression were half as likely to hang themselves compared to the women without a history of depression. Men with a history of substance abuse were more likely to suicide by poisoning than men without such history, but substance abuse history had no influence on women’s use of poisoning to suicide. For both sexes, the odds of suicide by poisoning were significantly higher for those on psychiatric medications.