Plasma S-100B protein in Chinese patients with schizophrenia: comparison with healthy controls and effect of antipsychotics treatment

PURPOSE: To examine the possibility that structural damage to the brain may play a role in the pathogenesis of schizophrenia by measuring the level of plasma S-100B, a calcium-binding protein found predominantly in the cytosol of glial cells. METHOD: Fifty-seven Chinese psychiatric inpatients who met DSM-IV diagnosis of schizophrenia and 60 healthy controls were enrolled in the study. Patients were assessed with the Positive and Negative Symptoms Scale (PANSS) at admission and at 12 weeks after treatment. Plasma samples were collected from patients and controls and S-100B protein was assayed using ELISA. RESULTS: (1) 29 of 57 patients (50.9%) showed increased S-100B level compared to the mean level of 60 healthy controls (p<0.005) vs. only 1 of 60 (1.67%) controls. The S-100B levels of unmedicated (0.119+/-0.059microg/L) and medicated patients (0.117+/-.0.057microg/L) were significantly higher than controls (0.067+/-0.022microg/L, both p<0.001), and S-100B levels of unmedicated patients were higher than those of medicated patients (p=0.024); (2) at admission, S-100B level was positively correlated with total score of PANSS (r=0.269, p=0.043), especially with negative subscore of PANSS (r=0.306, p=0.021), but the correlation was no longer present after patients were treated by anti-psychotic agents. CONCLUSION: The S-100B levels of patients with schizophrenia are significantly higher than that of healthy controls, and the S-100B level is associated with severity of psychopathology, particularly negative symptoms, indicating that patients with schizophrenia may suffer structural damage to central nervous system. The concentration of S-100B may also be associated with treatment progress.     

Sexuality in young patients with Parkinson's disease: a population based comparison with healthy controls

Answers from a multiple choice questionnaire on the opinions about public sexual attitudes, on emotion from personal sexual practice, on personal sexual function, and on general health perception were compared between 121 patients with Parkinson's disease (mean age 45 years) and 126 age and sex matched community derived controls. Patients were more dissatisfied with their present sexual functioning and relationship, and perceived their general health as poorer than the controls, whereas opinions about public sexual attitudes were only marginally different. No differences were found for sexual function. Further analysis showed that the perception of sexual functioning and general health in younger patients with Parkinson's disease is considerably influenced by depression and state of unemployment.     

Unstable EEG-vigilance in patients with cancer-related fatigue (CRF) in comparison to healthy controls

Abstract

Objectives. Cancer-related fatigue (CRF) is associated with tiredness and sleepiness. It remains unclear, whether such complaints are associated with neurophysiological signs of sleep proneness or a state of neurophysiological hyperarousal in which the patient finds it difficult to relax and to initiate sleep. Therefore the goal of this study is to compare the electroencephalographic (EEG)-vigilance regulation of patients with CRF and healthy controls. Methods. A 15-min resting EEG with eyes closed was recorded in 22 patients with CRF and 22 matched healthy controls. Consecutive 1-s segments were classified into seven different vigilance stages ranging from high alertness to relaxed wakefulness (stage 0, A1, A2, A3) and further on to drowsiness (B1, B2/3) and sleep onset (stage C). Results. Results showed that patients with CRF revealed a higher number of vigilance stages A3 (mean 15.26 vs. 6.67%, P = 0.004) dropped significantly earlier to vigilance levels A3 (drop after 130.8 vs. 533.3 s, P = 0.000) and B2/3&C (407.8 vs. 604.1 s, P = 0.035) and showed significantly more transitions between vigilance stages (46.0 vs. 31.1%, P = 0.003) in comparison to healthy controls. Conclusions. These findings suggest an unstable vigilance regulation in patients with CRF and provide a neurophysiological framework for the reported efficacy of psychostimulants in CRF.     

A comparison of autonomic function in patients with inflammatory bowel disease and in healthy controls

We evaluated autonomic function, symptoms and psychological parameters in patients with ulcerative colitis (UC), Crohn's disease (CD) and matched controls to assess whether UC patients have greater basal sympathetic autonomic activity. Outpatients with UC (n = 15), CD (n = 13) and healthy controls (n = 28) underwent spectral analysis of heart rate variability to assess cardiac autonomic function, a methacholine challenge to assess cholinergic pulmonary responsiveness, and questionnaires assessing disease severity, anxiety and depression. UC but not CD patients had greater sympathetic activity than controls with increased absolute (6600 vs 5884; P = 0.04) and relative (62.8%vs 54.8%; P = 0.02) low frequency areas. This was not because of increased overall autonomic nervous system (ANS) activation and was independent of disease activity. In UC patients, trait (personality-related) anxiety correlated strongly with disease symptoms (R = 0.84; P < 0.001) and quality of life (R = -0.81; P < 0.001) while situational (state) anxiety did not. In CD patients, ANS measures were similar to controls and disease activity was unrelated to psychological measures. Cholinergic pulmonary responsiveness was normal in both UC and CD patients. UC patients have an increased sympathetic ANS activity which is independent of symptom severity. In these patients symptom severity is strongly associated with measures of personality related (but not current) anxiety.     

Rightward bias in right hemisphere infarct patients with or without thrombolytic treatment and in healthy controls

Right hemisphere (RH) infarct patients have a tendency to begin visual scanning from the right side of a given stimulus. Our aim was to find out whether RH patients with (T+) or without (T?) thrombolytic treatment and healthy controls differ in their starting points in three cancellation tasks. Our sample comprised of 77 patients and 62 controls. Thirty-four patients received thrombolysis. Rightward orientation bias was more evident in the T??group than in the T+ group. The T+ group showed a robust tendency to start all cancellation tasks more often on the right side than the controls. Regardless of whether they had visual neglect, patients in the T+ group showed still defective rightward orienting, possibly indicating residual attentional problems. The analyses of starting points in visual cancellation tasks provide additional information on residual symptoms of attention difficulties after stroke.     

Rightward bias in right hemisphere infarct patients with or without thrombolytic treatment and in healthy controls

Right hemisphere (RH) infarct patients have a tendency to begin visual scanning from the right side of a given stimulus. Our aim was to find out whether RH patients with (T+) or without (T-) thrombolytic treatment and healthy controls differ in their starting points in three cancellation tasks. Our sample comprised of 77 patients and 62 controls. Thirty-four patients received thrombolysis. Rightward orientation bias was more evident in the T-?group than in the T+ group. The T+ group showed a robust tendency to start all cancellation tasks more often on the right side than the controls. Regardless of whether they had visual neglect, patients in the T+ group showed still defective rightward orienting, possibly indicating residual attentional problems. The analyses of starting points in visual cancellation tasks provide additional information on residual symptoms of attention difficulties after stroke.     

Anorectal function in patients with collagenous colitis in active and clinically quiescent phase,in comparison with healthy controls

Background Collagenous colitis (CC) is characterized by chronic watery diarrhea, a macroscopically normal colonic mucosa but typical microscopic inflammation. Chronic mucosal inflammation of the colon and rectum has earlier been associated with altered visceral sensitivity, but anorectal function has never been reported in cases of CC. Methods Fifteen patients with CC in active phase recorded their symptoms. The severity of inflammation was determined in mucosal biopsies. Anorectal function was assessed and compared with that of 15 healthy volunteers of corresponding age and matched for gender. After 6 weeks of budesonide treatment when the patients were in clinical remission anorectal function was re‐assessed. Key Results All patients had inflammation also in rectum. Patients in active phase had, during rectal balloon distension a higher rectal sensory threshold for the feeling of first sensation, compared with controls (P = 0.02). There were no differences in rectal sensory threshold for the feeling of urgency or maximum distension, between patients with CC in active phase and healthy controls. Rectal volume at first sensation was significantly greater in patients than in controls (P = 0.02), but there were no differences at urgency or maximum distension. Twelve of 15 patients completed 6 weeks of budesonide treatment and all went into clinical remission. No differences in anorectal function were measured when patients had active disease, compared with clinical remission. Conclusions & Inferences Collagenous colitis was not associated with rectal hypersensitivity or disturbed anal function despite rectal inflammation. On the contrary, the sensation threshold for light rectal pressure was elevated in patients with active CC.     

Abnormal P600 in obsessive-compulsive disorder. A comparison with healthy controls

Recently, the P600 component of the event-related potential (ERP), a waveform that is thought to be generated and/or modulated by the anterior cingulate gyrus and basal ganglia has been considered as an index of second pass-parsing processes of information processing, having much in common with working memory (WM) operation. Moreover, dysfunction of these brain structures as well as WM deficits have been implicated in the pathophysiology of obsessive-compulsive disorder (OCD). The present study is focused on P600 elicited during a WM test in OCD patients compared with healthy controls. Twenty drug-free OCD patients and an equal number of normal subjects matched for age, sex and educational level were studied via a computerized version of the Wechsler digit span test. Auditory P600 was measured during the anticipatory period of this test. The patient group, as compared with healthy controls, showed significantly enhanced amplitudes of P600 at the right temporoparietal area and prolonged latencies at the right parietal region. Moreover, the memory performance of patients was significantly impaired. These findings may indicate that OCD patients manifest abnormal aspects of second pass-parsing processes of information processing as they are reflected by P600 amplitudes and latencies.     

Self-report and laboratory measures of impulsivity in patients with schizophrenia or schizoaffective disorder and healthy controls

This study examined self-reported impulsivity and aggression and performance on the stop-signal task in patients with schizophrenia or schizoaffective disorder and healthy volunteers. Compared to controls, patients had higher scores on interview and questionnaire measures of impulsivity and aggression and showed increased stop-signal reaction time and greater response variability. These findings are consistent with a specific impairment in response inhibition in schizophrenia.     

A comparison of life events in patients with unipolar disorder or bipolar disorder and controls

Objective

The present study aimed to explore the association between stressful life events (LEs) and the development of affective psychopathology.

Method

Thirty patients with unipolar disorder and 30 patients with bipolar disorder were compared to 60 matched healthy controls in regard to the rate of stressful LEs. Assessment measures included the Beck Depression Inventory, the Adult Life Events Questionnaire, and the Childhood Life Events List.

Results

The entire sample of affective patients had more LEs in general, more negative LEs, and more loss-related LEs in the year preceding their first depressive episode as compared with normal controls. Subjects with unipolar disorder had more positive LEs and more achievement LEs, whereas subjects with bipolar disorder had more uncontrollable LEs in the year preceding the first depressive episode. The relationship between LEs and manic episodes was prominent in the year preceding the first manic episode, with subjects with bipolar disorder reporting more LEs in general and more ambiguous events in that year. Almost no significant differences on LE frequency were observed in the year before the last depressive and manic episodes in the patient groups with unipolar and bipolar disorder. A significant relationship was found between childhood LEs and the development of affective disorders in adulthood, with patients with unipolar disorder exhibiting less positive and achievement LEs.

Conclusions

In both the unipolar and the bipolar groups, the major impact of LEs on the onset of affective disorders was found in the year before the first depressive or manic episodes. This suggests that the accumulation of stressful LEs at this crucial period contributes to the precipitation of a pathological response mechanism. Once established, this mechanism would be reactivated in the future by even less numerous and less severe stressors, compatible with the kindling hypothesis.     

Body composition in patients with schizophrenia: Comparison with healthy controls

ABSTRACT: BACKGROUND: Recently, a relationship between obesity and schizophrenia has been reported. Although fat mass and fat-free mass have been shown to be more predictive of health risk than body mass index, there are limited findings about body composition among patients suffering from schizophrenia. The aim of this study was to compare the body composition of schizophrenia patients with that of healthy subjects in Japan. METHODS: We recruited patients (n = 204), aged 41.3 +/- 13.8 (mean +/- SD) years old with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis of schizophrenia who were admitted to psychiatric hospital using a cross-sectional design. Subjects' anthropometric measurements including weight, height, body mass index (BMI), and medications were also collected. Body fat, percentage (%) body fat, fat-free mass, muscle mass, and body water were measured using the bioelectrical impedance analysis (BIA) method. A comparative analysis was performed with schizophrenic subjects and 204 healthy control individuals. RESULTS: In a multiple regression model with age, body mass index, and dose in chlorpromazine equivalents, schizophrenia was significantly linked with more body fat, higher percentage body fat, lower fat-free mass, lower muscle mass, and lower body water among males. In females, schizophrenia had a significant association with lower percentage body fat, higher fat-free mass, higher muscle mass, and higher body water. CONCLUSIONS: Our data demonstrate gender differences with regard to changes in body composition in association with schizophrenia. These results indicate that intervention programs designed to fight obesity among schizophrenic patients should be individualized according to gender.     

Assessing illness representations of breast cancer: a comparison of patients with healthy and benign controls

OBJECTIVE: Illness representations of cancer may comprise inaccurate information, misconceptions, or negative conceptualizations of the disease, which may influence screening behaviors. This study examined the differences between healthy women's and breast cancer patients' representations of breast cancer. METHODS: The cross-sectional design involved 147 consecutive women free from breast diseases, or with benign breast conditions, and 102 patients with breast cancer recruited from the outpatient breast clinic of a public cancer hospital. Respondents completed a modified version of the Illness Perception Questionnaire (IPQ) that assessed six dimensions of illness representations of breast cancer. RESULTS: Multiple comparison tests revealed that nonmalignant women's illness representations were characterized by weak beliefs concerning breast cancer curability/controllability, combined with an overestimation of the negative physical, social, and economic consequences of breast cancer. Moreover, these women held stronger beliefs about the role of environmental factors (radiation exposure, diet, and pollution) in breast cancer causation and expressed greater disagreement on the role of chance in the onset and course of the illness. CONCLUSION: Illness representations of breast cancer appear to play a significant role in determining the unfavorable and exaggerated way in which laywomen perceive breast cancer. This is discussed within the framework of the social construction of the disease, which portrays breast cancer as a fatal and disfiguring disease, and the strong influence lay literature and the media exert on it.     

A comparison of euthymic bipolar patients with unaffected first-degree relatives and healthy controls in terms of neuropsychological functions

Objective. Cognitive dysfunction in bipolar disorder (BD) is well established in the literature. The neurocognitive deficits have been considered to be endophenotypic markers of BD, and studies have examined whether neurocognitive deficits exist in first-degree relatives of individuals with BD I. We hypothesized that performance in tests of neurocognitive function would be impaired in euthymic BD I patients and their unaffected first-degree relatives compared to that of healthy controls. Methods. We compared the performance of bipolar patients, their first-degree relatives, and healthy controls in a battery of neurocognitive tests to reveal possible endophenotypes of BD. A diagnostic interview and neuropsychological test battery were administered to 30 BD I patients, 55 of their unaffected first-degree relatives and 32 healthy controls. Results. The patients and their first-degree relatives were significantly impaired in executive function assessed using the Wisconsin Card Sorting Test (WCST) and Trail Making Test-B (TMT-B) relative to the controls (WCST; perseverative errors: p < 0.0005, categories completed: p = 0.002, TMT-B; p = 0.002). There were no significant differences between the groups in terms of attention, psychomotor speed, verbal memory, or learning. Conclusion. Our study suggests that the deficits in executive function may be endophenotypic markers of genetic vulnerability to BD I.     

Infection, treatment and immune response in patients with bipolar disorder versus patients with major depression, schizophrenia or healthy controls

Hinze-Selch D. Infection, treatment and immune response in patients with bipolar disorder versus patients with major depression, schizophrenia or healthy controls. Bipolar Disord 2002: 4(Suppl. 1): 81–83. ©Blackwell Munksgaard, 2002
Bipolar disorder is the least studied among the three major psychiatric disorders of schizophrenia, major depression and bipolar disorder. Furthermore, investigations on infection and immunity in bipolar disorder make up only a small portion of the sparse research done on this disorder. However, there are reports that modulation of the immune system and certain infections might be associated with bipolar disorder and that there might be differences between bipolar and the other disorders. The purpose of this paper is to briefly review published data on these issues in bipolar versus the other disorders, and to present an ongoing clinical study on the putative involvement of infection with the parasite Toxoplasma gondii in these three major psychiatric disorders.     

A comparison of cognitive structure in schizophrenia patients and healthy controls using confirmatory factor analysis

There is evidence that cognitive task performance breaks down into the same broad domains in schizophrenia as in healthy populations. However, this does not mean that the domains are independent of one another or that the interrelationships among domains are the same between groups. We used confirmatory factor analysis (CFA) to compare the latent structure of a broad neuropsychological battery in schizophrenia patients (n = 148) and healthy controls (n = 157). Main analyses examined the fit of a hierarchical six-factor model, in which associations among the factors were assumed to reflect their strong shared relationship to a general cognitive ability factor. The model incorporated the factors of verbal comprehension, perceptual organization, verbal memory, spatial memory, processing speed, and executive/working memory. The hierarchical model provided a good overall fit to data from both groups. However multiple groups CFA revealed significant differences in factor loadings between groups, reflecting a more generalized latent structure of cognitive ability in schizophrenia. This was also evident in higher bivariate correlations among cognitive domain composite scores calculated from the observed test data. Cognitive ability, as reflected in test performance, appears to be more unitary in schizophrenia than in healthy subjects. This finding may have measurement and treatment implications.