Psychosocial impact of undergoing prostate cancer screening for men with BRCA1 or BRCA2 mutations.

OBJECTIVES: To report the baseline results of a longitudinal psychosocial study that forms part of the IMPACT study, a multi-national investigation of targeted prostate cancer (PCa) screening among men with a known pathogenic germline mutation in the BRCA1 or BRCA2 genes. PARTICPANTS AND METHODS: Men enrolled in the IMPACT study were invited to complete a questionnaire at collaborating sites prior to each annual screening visit. The questionnaire included sociodemographic characteristics and the following measures: the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), 36-item short-form health survey (SF-36), Memorial Anxiety Scale for Prostate Cancer, Cancer Worry Scale-Revised, risk perception and knowledge. The results of the baseline questionnaire are presented. RESULTS: A total of 432 men completed questionnaires: 98 and 160 had mutations in BRCA1 and BRCA2 genes, respectively, and 174 were controls (familial mutation negative). Participants' perception of PCa risk was influenced by genetic status. Knowledge levels were high and unrelated to genetic status. Mean scores for the HADS and SF-36 were within reported general population norms and mean IES scores were within normal range. IES mean intrusion and avoidance scores were significantly higher in BRCA1/BRCA2 carriers than in controls and were higher in men with increased PCa risk perception. At the multivariate level, risk perception contributed more significantly to variance in IES scores than genetic status. CONCLUSION: This is the first study to report the psychosocial profile of men with BRCA1/BRCA2 mutations undergoing PCa screening. No clinically concerning levels of general or cancer-specific distress or poor quality of life were detected in the cohort as a whole. A small subset of participants reported higher levels of distress, suggesting the need for healthcare professionals offering PCa screening to identify these risk factors and offer additional information and support to men seeking PCa screening

Hemispheric Asymmetries in Manic-Depressive Patients: Relationship to Hemispheric Processing of Affect.

Reviews research on hemispheric asymmetries in the performance and physiology of manic-depressive patients and asymmetries in processing of affective stimuli. It is concluded that there is substantial evidence of (1) right-sided abnormalities and right-sided hyperarousal in affective illness, (2) a unique right hemisphere involvement in processing of affective stimuli, and (3) left-sided hemispheric specialization for positive affect and right-sided specialization for negative affect. These conclusions are considered in relation to each other, with a view toward integrating the evidence and suggesting avenues for further research. (56 ref

Season of birth and substance abuse: Findings from a large national sample

Background: Season of birth is a putative etiological factor for several psychiatric illnesses. An excess of late winter and early spring births has been demonstrated repeatedly for schizophrenia, which has usually been interpreted as the result of prenatal or infant exposure to seasonally mediated \u27harmful effects,\u27 such as infectious diseases. This study determined whether the seasonal birth rates of substance abusers differed from those of unaffected control groups. Methods: The 1992 National Longitudinal Alcohol Epidemiologic Survey, an interview-based study of 42,862 men and women, provided data to assess the association between quarter year of birth and lifetime diagnoses of substance abuse. Results: Logistic regression revealed decreases in winter births in men with histories of alcohol dependence. The significant interaction of sex with season of birth reflected an excess of fall births among male but not female alcoholics. In contrast, there was no evidence of seasonality of birth among alcohol abusers. Men and women with histories of illicit drug use had excesses of fall birth. Discussion: Birth rates of men with past or present alcohol dependence, and of men and women with histories of illicit drug use, implicated seasonal factors in the pathogenesis of substance abuse. The similar birth patterns of illicit drug users and male alcoholics suggest that they may share some common etiological factor, such as seasonal effects on environmental temperature, hormonal function, or susceptibility to viral infection during pregnancy or early infancy

Hemispheric Asymmetries in Schizophrenia.

Critically reviews the growing literature on hemispheric asymmetries in schizophrenic populations. Studies of lateral asymmetries in schizophrenics are discussed that have employed a wide range of methodologies, including assessment of motor, sensory, electrophysiological, neuropsychological, and structural abnormalities. This research is discussed in relation to 2 theoretical viewpoints, one emphasizing impaired functioning of the corpus callosum and the other positing left hemisphere overactivation and dysfunction in schizophrenic populations. It is concluded that the hypothesis of impaired callosal function has not been adequately tested because of methodological problems, the most serious of which is the failure to show differential deficit. The hypothesis of left hemisphere abnormality has gained consistent support, although methodological problems are noted. This research suggests a structural locus for schizophrenic pathology, which is consistent with the symptomatology of the disorder, and provides avenues for further research. (93 ref

Effect of Alcohol Ingestion on Regional Cerebral Blood Flow.

Regional distribution of cerebral blood flow was assessed in 10 normal social drinkers following consumption of .75 g/kg alcohol and in a control session without alcohol. Alcohol increased blood flow in the gray matter in all brain areas except the left anterior area. The results are discussed in terms of the effect of alcohol on regional cerebral activation

Structural Brain Deficits in Schizophrenia. Identification by Computed Tomographic Scan Density Measurements.

Research has suggested the presence of brain damage as a cause or concomitant of chronic schizophrenia. The most recent research in this area has been the identification of abnormalities in schizophrenia by computed tomographic (CT) scans. A study was done to investigate localized changes in CT scan density numbers in the brains of schizophrenic patients, as opposed to the brains in normal control subjects. Twenty-four normal subjects and 23 schizophrenic patients were tested with CT scans. Density measurements in each area of the brain (left, right, anterior and posterior) were compared to three separate CT scan levels. Of six measurements of anterior left-hemisphere density, it was found that five showed lower density in schizophrenic brains, as compared with normal brains. Of the remaining 18 measurements that evaluated other areas of the brain, only three differentiated between schizophrenic patients and normal subjects. The results support the hypothesis that there are primary structural deficits in some schizophrenic patients, and these deficits are centered in and around the anterior area of the left (dominant) hemisphere. The results also demonstrated further implications