| 1. |
- Alenius, Malin, et al.
(författare)
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Treatmentresponse in psychotic patients classified according to social and clinical needs, drug side effects, and previous treatment; a method to identify functional remission
- 2009
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Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X .- 1532-8384. ; 50:5, s. 453-462
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Various approaches have been made over the years to classify psychotic patients according to inadequate treatment response, using terms such as treatment resistant or treatment refractory. Existing classifications have been criticized for overestimating positive symptoms; underestimating residual symptoms, negative symptoms, and side effects; or being to open for individual interpretation. The aim of this study was to present and evaluate a new method of classification according to treatment response and, thus, to identify patients in functional remission. METHOD: A naturalistic, cross-sectional study was performed using patient interviews and information from patient files. The new classification method CANSEPT, which combines the Camberwell Assessment of Need rating scale, the Udvalg for Kliniske Undersøgelser side effect rating scale (SE), and the patient's previous treatment history (PT), was used to group the patients according to treatment response. CANSEPT was evaluated by comparison of expected and observed results. RESULTS: In the patient population (n = 123), the patients in functional remission, as defined by CANSEPT, had higher quality of life, fewer hospitalizations, fewer psychotic symptoms, and higher rate of workers than those with the worst treatment outcome. CONCLUSION: In the evaluation, CANSEPT showed validity in discriminating the patients of interest and was well tolerated by the patients. CANSEPT could secure inclusion of correct patients in the clinic or in research.
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| 2. |
- Chotai, Jayanti, et al.
(författare)
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Novelty seeking among adult women is lower for the winter borns compared to the summer borns : replication in a large Finnish birth cohort
- 2009
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Ingår i: Comprehensive Psychiatry. - : Elsevier. - 0010-440X .- 1532-8384. ; 50:6, s. 562-566
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Earlier general population studies have shown that novelty seeking (NS) of the Temperament and Character Inventory (TCI) of personality is lower for persons born in winter compared to those born in summer, particularly for women. Here, we investigate if this result can be replicated in another population. METHOD: The Northern Finland 1966 Birth Cohort, comprising 4968 subjects (2725 women, 2243 men), was investigated with regard to the temperament dimensions of the TCI and the season of birth. RESULTS: Novelty seeking and reward dependence (RD) showed significant variations according to the month of birth. We found that women born during winter have significantly lower levels of NS compared to women born during summer, with a minimum for the birth month November and maximum for May. These results are similar to those found in a previous Swedish study. Furthermore, our study showed that men born during spring had significantly lower mean scores of RD compared to men born during autumn, with a minimum for birth month March. This was in contrast to the Swedish study, where the minimum of RD was obtained for the birth month December. CONCLUSION: Women born in winter have lower NS as adults compared to women born in summer. Because NS is modulated by dopamine, this study gives further support to the studies in the literature that show that dopamine turnover for those born in winter is higher than for those born in summer.
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| 3. |
- Eberhard, Jonas, et al.
(författare)
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Remission in schizophrenia: analysis in a naturalistic setting.
- 2009
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Ingår i: Comprehensive Psychiatry. - : Elsevier BV. - 0010-440X .- 1532-8384. ; 50:3, s. 200-208
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the recently defined Positive and Negative Syndrome Scale for Schizophrenia remission criteria in a naturalistic setting of psychotic patients; to identify causal factors that change remission status; and to validate the criteria against global indices of illness, cognitive functions, and social outcome. METHODS: This was a longitudinal naturalistic study of 162 patients, diagnosed with schizophrenia or schizophrenia-related psychotic disorders (mean illness duration, 11 years) and treated with risperidone at study entry. Symptoms, drug treatment, cognitive function, and social outcome were measured at baseline and annually for 5 years. Remission was constructed retrospectively with only indirect data on stability over time. RESULTS: At study entry, 40% of the patients with schizophrenia were in symptomatic remission, stabilizing between 55% and 60% after a few years. The need for hospitalization became less frequent over time; initially 31%, dropping to 7% by years 4 and 5. Many patients went in and out of remission. Remission was strongly associated with global indices of illness, with intact insight and with social outcome (except work/studies) but not with cognition or medication. CONCLUSIONS: In spite of certain weaknesses of the study, we may conclude that current definition of remission is primarily a symptomatic measure, covering a subset of symptoms, some of which are not schizophrenia-specific. Although the definition may be clinically relevant, we must be aware of the risk that the connotation of the word could induce too much focus on symptom control.
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| 4. |
- Meyer, Thomas D, et al.
(författare)
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The Hypomania Checklist (HCL-32) : its factorial structure and association to indices of impairment in German and Swedish nonclinical samples
- 2007
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Ingår i: Comprehensive Psychiatry. - Philadelphia : Saunders Elsevier. - 0010-440X .- 1532-8384. ; 48:1, s. 79-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bipolar disorders are often not recognized. Several instruments were developed but none primarily focused on hypomania. The Hypomania Checklist (HCL) is aimed at the identification of bipolarity in outpatients. Using a German and Swedish sample, we investigated if the factor structure in nonclinical samples is similar to the one reported for outpatient samples. Furthermore, we tested if people who probably had a lifetime history of hypomania report more depression or other signs of impairment and if current depression is associated with lifetime hypomania.Method: In the German study, participants completed the HCL-32 as an online questionnaire that also included questions about lifetime and current depression (n = 695), whereas the Swedish data relied on the paper-and-pencil version of the HCL-32 completed by a ranclorn sample from a representative population sample (n = 408).Results: The factor structure of the HCL-32 was fairly similar in both samples and to the ones presented by Angst et al (J Affect Disord 2005;88:217-33). People reporting "highs" (>= 4 days and experiencing negative consequences) not only endorsed more HCL-32 symptoms but also had higher rates of current and former depression and psychotherapy. Level of current depression was also associated with lifetime hypomanic symptoms.Discussion and limitation: An "active-elated' and "risk-taking/irritable" factor of hypomania can be distinguished with the HCL-32 in clinical and nonclinical samples. Based on our results, the HCL-32 might even be useful as screening toot in nonclinical samples and not only in depressed outpatients. However, our data do not allow estimating sensitivity and specificity of the HCL-32 because structured clinical interviews were not included.
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| 5. |
- Richter, Jörg, et al.
(författare)
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Personality disorder diagnosis by means of the Temperament and Character Inventory
- 2009
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Ingår i: Comprehensive Psychiatry. - Maryland Heights, United States : Saunders Elsevier. - 0010-440X .- 1532-8384. ; 50:4, s. 347-352
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Tidskriftsartikel (refereegranskat)abstract
- Personality disorders (PDs) criteria are still in development. Cloninger's biosocial theory of personality contributed to this discussion. The aim of the study was to explore the relationships between extreme expressions on temperament and an immature character according to Cloninger's assumptions. Eight hundred healthy volunteers and 200 psychiatric inpatients were consecutively recruited each from Sweden and Germany, and were asked to complete the Temperament and Character Inventory, which measures 4 temperament and 3 character dimensions. Patients differed from controls on temperament and character dimensions. The combination of low and very low character scores with extreme scores in either novelty seeking, harm avoidance, or reward dependence was found more often among patients with PD compared with patients without PD and controls; this is more pronounced with an increasing number of extreme temperament scores. The Temperament and Character Inventory represents a useful tool in the diagnostic process of personality disorders.
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