Newer antipsychotics and the rabbit syndrome

doi:10.1186/1745-0179-3

Validity and reliability of the Structured Clinical Interview for the Trauma and Loss Spectrum (SCI-TALS)

Background. DSM-IV identifies three stress response disorders (acute stress Disorder (ASD), post-traumatic stress Disorder (PTSD) and adjustment disorders (AD)) that derive from specific life events. An additional condition of complicated grief (CG), well described in the literature, is triggered by bereavement. This paper reports on the reliability and validity of the Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS) developed to assess the spectrum of stress response. The instrument is based on a spectrum model that emphasizes soft signs, low-grade symptoms, subthreshold syndromes, as well as temperamental and personality traits comprising clinical and subsyndromal manifestations. Methods. Study participants, enrolled at 6 Italian Departments of Psychiatry located at six sites, included consecutive patients with PTSD, 44 with CG and a comparative group of 48 unselected controls. Results. We showed good reliability and validity of the SCI-TALS. Domain scores were significantly higher in participants with PTSD or CG compared to controls. There were high correlations between specific SCI-TALS domains and corresponding scores on established measures of similar constructs. Participants endorsing grief and loss events reported similar scores on all instruments, except those with CG who scored significantly higher on the domain of grief reactions. Conclusion. These findings provide strong support for the internal consistency, the discriminant validity and the reliability of the SCI-TALS. These results also support the existence of a specific grief-related condition and the proposal that different forms of stress response have similar manifestations

Mood disorders in subjects with bruxing behavior

An investigation was conducted on 105 subjects to assess the existence of an association between mood psychopathology and bruxism. METHODS: Validated clinical criteria were used to diagnose bruxism and a self-report validated questionnaire (MOODS-SR) was filled out by each patient for an evaluation of depression and mania symptoms of mood spectrum. RESULTS: Prevalence of mood psychopathology, as identified by MOODS-SR score> or =60, was significantly higher in bruxers (11/38, 28.9% vs. 6/67, 8.9%; P=0.007). Significant differences between bruxers and non-bruxers also emerged in total MOODS-SR (P=0.001) scores and in total scores of domains evaluating manic (P=0.001) and depressive symptoms (P=0.007). CONCLUSIONS: Support to the existence of an association between bruxism and mood disorders has been provided. Further studies are strongly needed to clarify mechanisms underlying the described association

Mood disorders in subjects with bruxing behavior

Abstract OBJECTIVE: An investigation was conducted on 105 subjects to assess the existence of an association between mood psychopathology and bruxism. METHODS: Validated clinical criteria were used to diagnose bruxism and a self-report validated questionnaire (MOODS-SR) was filled out by each patient for an evaluation of depression and mania symptoms of mood spectrum. RESULTS: Prevalence of mood psychopathology, as identified by MOODS-SR score> or =60, was significantly higher in bruxers (11/38, 28.9% vs. 6/67, 8.9%; P=0.007). Significant differences between bruxers and non-bruxers also emerged in total MOODS-SR (P=0.001) scores and in total scores of domains evaluating manic (P=0.001) and depressive symptoms (P=0.007). CONCLUSIONS: Support to the existence of an association between bruxism and mood disorders has been provided. Further studies are strongly needed to clarify mechanisms underlying the described association

Characteristics of eating disorder patients without a drive for thinness.

OBJECTIVE: The aim of this study was to investigate two samples of patients affected by anorexia nervosa (AN) or bulimia nervosa (BN), respectively, with and without the diagnostic feature of drive for thinness (DT). METHOD: The samples comprised 70 consecutive eating disorder (ED) outpatients at the Department of Psychiatry (University of Pisa) and 106 AN patients admitted to a day hospital in Toronto, Canada. Subjects were assessed on clinical and psychometric parameters. RESULTS: In both countries, 17% of the subjects had low DT as measured by the Eating Disorder Inventory (EDI). They comprised the atypical group and appeared to have less severe psychopathology. DISCUSSION: Weight phobia should not be viewed as critical to the diagnosis of ED and DT could be a culture-bound dimension. Considering the differences between the two groups, the characterization of patients as typical and atypical may be clinically useful

Affective temperament in the eating disorders

In this study, we investigate the affective temperamental characteristics in a sample of ED (eating disorder) patients. METHODS:49 ED patients diagnosed by the SCID (Structured Clinical Interview for DSM-IV), were divided into two groups on the basis of the presence or absence of Binge Eating (restricting-anorexia nervosa [R-AN]= 16; Binge Eaters= 33). All patients were administered the TEMPS-I (Temperament Evaluation Memphis Pisa Semistructured - Interview), to assess affective temperament. A third group of controls (N= 1010), derived from a study with the TEMPS-I on normal subjects, was included for comparison. RESULTS: A full affective temperament was not found in patients of the restricting group. By contrast 24% of the binge eating group had a full affective temperament of one of three types. Comparing the three temperaments for the three groups, only cyclothymic temperament proved to be significant, with higher levels in the binge eating group (p<0.01). CONCLUSIONS:In this study, people with R-AN do not show a full affective temperament. However, people with binge eating, had depressive and hyperthymic temperament, and displayed higher level of cyclothymic temperament than the normal population. The findings of this study add to a growing literature on temperament in people with ED; particularly, they add to the view that may be various paths leading to R-AN, and these may differ from those of binge eating

Predictors of response in a sample of treatment-resistant psychotic patients on clozapine

This study aims at identifying potential predictors of clinical response and functional outcome in 101 neuroleptic-refractory patients with a DSM-III-R diagnosis of schizophrenia (N = 34), schizoaffective disorder (N = 30) or bipolar disorder with psychotic features (N = 37), naturalistically treated with clozapine over a 48-month period. The "clinical response" and "functional outcome" criteria were respectively defined a priori as: a reduction of at least 50 % in the Brief Psychiatric Rating Scale total score in one evaluation with respect to baseline; and a Global Assessment of Functioning Scale score of at least 50. Several clinical and socio-demographic variables were assessed at baseline and only the diagnosis of bipolar disorder was significantly related with the clinical response. Variables significantly related with the functional outcome were female gender, university education and early age at ons