Associations between psychotic-like symptoms and inattention/hyperactivity symptoms

Objective

Our aim was to study the association between psychotic-like symptoms and inattention/hyperactivity symptoms in a general adolescent population.

Subjects and methods

The sample is based on a population-based prospective mother?Cchild birth cohort, the Northern Finland Birth Cohort 1986. In the 15?C16-year follow-up survey, the adolescents completed the Youth Self-Report questionnaire as well as the PROD-Screen questionnaire that addressed prodromal symptoms of psychosis. Meanwhile, their parents assessed inattention and hyperactive symptoms of their offspring by completing the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviors questionnaire (N?=?5,318). The cross-sectional associations between psychotic-like symptoms and inattention/hyperactivity symptoms were studied with logistic regression models.

Results

The association between negative psychotic-like symptoms and inattention symptoms, especially the dreamy type of inattention symptoms (e.g., difficulties in organizing tasks, losing things, being forgetful), was statistically significant for both genders. Psychotic-like symptoms, however, were not associated with hyperactivity symptoms.

Conclusions

The present findings demonstrate that an association between psychotic-like symptoms and attentional dysfunction, which has been found in clinical samples, is also present in a general adolescent population.     

Identifying schizophrenia and other psychoses with psychological scales in the general population

We study the predictive power and associations of several psychopathology and temperament scales with respect to schizophrenia and other psychotic disorders. Measures of psychopathology (Physical and Social Anhedonia Scales, Perceptual Aberration Scale, Hypomanic Personality Scale, Bipolar II Scale, and Schizoidia Scale) and the Temperament and Character Inventory were included in the 31-year follow-up of the prospective Northern Finland 1966 birth cohort (N = 4926). The Perceptual Aberration Scale was the best scale for concurrent validity in psychoses, and also the best psychopathology scale in terms of discriminant validity. Participants scoring high in hypomanic personality were at the highest risk for developing psychosis during the 11-year follow-up. Harm avoidance was a dominant temperament dimension in individuals with psychosis compared with participants without psychiatric diagnoses. These scales are useful as vulnerability markers in studying psychoses.     

Sex differences in Cloninger's temperament dimensions--a meta-analysis

There have been many comparisons between men and women on psychological characteristics and personality. The Tridimensional Personality Questionnaire and Temperament and Character Inventory developed by Cloninger are used to measure the following temperament dimensions: novelty seeking, harm avoidance, reward dependence, and persistence. Studies using these scales in healthy (nonclinical) populations have reported varying results on sex differences, but there is no meta-analysis of the topic. In this study, meta-analytic methods were used to estimate sex differences in these temperament dimensions and to study the effect of mean age of the sample and location of the study (Asia/other) on possible differences. Studies on healthy populations were systematically collected; the required minimum sample size was 100. The search resulted in 32 eligible studies. Consequently, women scored higher in reward dependence (pooled effect size; Cohen's d = -0.63; z test, P value < .001) and harm avoidance (d = -0.33; P < .001). There were no differences in novelty seeking (d = -0.04; P = .29) or in persistence (d = -0.02; P = .62). The sex difference in reward dependence was significantly smaller in Asian studies. This study was the first one to pool studies on sex differences in Cloninger's temperament dimensions. Women scored consistently higher in harm avoidance in the studies included. Together with similar sex difference found in related traits (eg, depression), this finding supports the validity of this temperament dimension. The given data on sex differences should be taken into account in future studies using these instruments.     

Associations between early development and outcome in schizophrenia--A 35-year follow-up of the Northern Finland 1966 Birth Cohort

Delayed neuromotor development carries an increased risk of developing schizophrenia, and some authors have assumed that risk factors for schizophrenia such as delayed development are also prognostic indicators for patients with established illness. In those who do develop schizophrenia, it is not clear if these same early developmental markers influence the outcome of illness. Our aim was to examine the association between infant developmental milestones and a range of outcomes in patients with schizophrenia. Our sample was drawn from Northern Finland 1966 Birth Cohort and included 109 subjects for whom prospectively collected information on age of learning to stand, walk and talk was available and who had developed schizophrenia by the age 35 years. By utilizing national registers we examined outcomes related to service utilization, educational achievement, and occupational status. Age of illness onset was also analyzed. Based on the diagnostic interview, a subgroup of 59 cases was assessed in clinical examinations on functioning and quality of life. Contrary to a widespread assumption within the field of schizophrenia research, later attainment of developmental milestones was not associated with poor outcome. We conclude that risk factors for schizophrenia are not necessarily prognostic factors.     

A meta-analysis of temperament in axis I psychiatric disorders

This article reports on a meta-analysis of Cloninger's temperament dimensions (novelty seeking, harm avoidance, reward dependence, and persistence) in individuals with lifetime psychiatric disorders compared with controls and on interdisorder comparisons between these disorders. Nine disorders from 75 studies were included in the meta-analyses. The most consistent feature was elevated harm avoidance: compared with the controls, harm avoidance was higher in all diagnostic groups studied except for those with alcohol use disorders. The increase in effect sizes in harm avoidance scores varied from a very large (d = 2.66) in social phobia to a small effect (effect size, d = 0.29) in alcohol use disorders. In other dimensions, differences between cases and controls were relatively small. However, in pairwise comparisons, notable differences also in other dimensions emerged: in novelty seeking, the lowest scores were in social phobia (d = -0.87) and the highest in bulimia nervosa (d = 0.33); in reward dependence, the lowest scores were in schizophrenia (d = -0.36) and the highest in social phobia (d = 0.12); and in persistence, the lowest scores were in social phobia (d = -0.30) and the highest in anorexia nervosa (d = 0.49). The provided data should be taken into account in the future studies on suggestive vulnerability markers for psychiatric morbidity.     

Development of a Research Dedicated Archival System (TARAS) in a University Hospital

Recent healthcare policies have influenced the manner in which patient data is handled in research projects, and the regulations concerning protected health information have become significantly tighter. Thus, new procedures are needed to facilitate research while protecting the confidentiality of patient data and ensuring the integrity of clinical work in the expanding environment of electronic files and databases. We have addressed this problem in a university hospital setting by developing the Tampere Research Archival System (TARAS), an extensive data warehouse for research purposes. This dynamic system includes numerous integrated and pseudonymized imaging studies and clinical data. In a pilot study on asthma patients, we tested and improved the functionality of the data archival system. TARAS is feasible to use in retrieving, analyzing, and processing both image and non-image data. In this paper, we present a detailed workflow of the implementation process of the data warehouse, paying special attention to administrative, ethical, practical, and data security concerns. The establishment of TARAS will enhance and accelerate research practice at Tampere University Hospital, while also improving the safety of patient information as well as the prospects for national and international research collaboration. We hope that much can be learned from our experience of planning, designing, and implementing a research data warehouse combining imaging studies and medical records in a university hospital.     

Outcome and its predictors in schizophrenia within the Northern Finland 1966 Birth Cohort.

PURPOSE: We report clinical and social outcomes of schizophrenia in the longitudinal, population-based Northern Finland 1966 Birth Cohort, and describe associated demographic, developmental and illness-related factors. SUBJECTS AND METHODS: Subjects with DSM-III-R schizophrenia (n=59) were followed prospectively from mid-gestation up to age 35 years. Outcome measures included positive and negative symptoms, psychiatric hospitalisations, social and occupational functioning. Several definitions of good and poor outcome were explored, and developmental, socio-demographic and clinical predictors of outcomes were analysed. RESULTS: Good clinical outcome varied from 10% to 59%, and good social outcome 15-46%, depending on definition. Poor clinical outcome varied 41-77% and poor social 37-54%. Lack of friends in childhood, father's high social class, lower school performance and earlier age of illness onset predicted poor outcomes. DISCUSSION: The outcomes of schizophrenia in this study depended on definitions used but were relatively poor. The age of illness onset, father's social class, school performance and poor social contacts in childhood were only statistically significant predictors. CONCLUSION: Definitions of outcome have a major effect on estimates for proportions of good and bad outcomes and on the predictors of outcomes. However, regardless of which definitions were used, the outcome of schizophrenia in this population-based sample was generally bleak.     

Gender and ethnic origin have no effect on longterm outcome of childhood-onset systemic lupus erythematosus

OBJECTIVE: To investigate the associations of gender and ethnic origin with longterm outcome in childhood-onset systemic lupus erythematosus (SLE). METHODS: The study cohort consisted of 51 patients (13 males and 38 females) with childhood-onset SLE followed for > or = 5 years at the British Columbia Children's Hospital in Vancouver. Fifteen patients were Caucasian, 14 Chinese, 9 East Indian, and 13 patients were of other ethnic backgrounds: none was African-American or Hispanic. Outcome measures assessed retrospectively included Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index score (SDI), SLE-related death, need for dialysis or renal transplantation, and use of intensive immunosuppressive therapy. A SDI > or = 2 was assigned as poor outcome. RESULTS: The median age at diagnosis was 10.8 years and the median duration of followup was 7.2 years. Five-year survival was 100%; 10-year survival was 85.7% (12/14 patients). The median SDI score at last followup was 2.0 (range 0-9); 2.0 for male, 1.5 for female; 2.0 for Caucasian and 2.03 for non-Caucasian patients. Twenty-six out of 51 patients (51%) had poor outcome (SDI score > 2). Three female patients required dialysis: 2 had subsequent renal transplants. Thirty patients received intensive immunosuppressive therapy. The SDI scores, mortality, and need for intensive immunosuppressive therapy were not influenced by either gender or ethnic origin. CONCLUSION: The median SDI score was high for this cohort with childhood-onset SLE. In contrast to other published data, no association of male gender and/or non-Caucasian ethnicity with poor outcome was found in our study cohort.