Is Brain Banking of Psychiatric Cases Valuable for Neurobiological Research?

It is widely accepted that neurobiological abnormalities underlie the symptoms of psychiatric disorders such as schizophrenia and unipolar or bipolar affective disorders. New molecular methods, computer-assisted quantification techniques and neurobiological investigation methods that can be applied to the human brain are all used in post-mortem investigations of psychiatric disorders. The following article describes modern quantitative methods and recent post-mortem findings in schizophrenia and affective disorders. Using our brain bank as an example, necessary considerations of modern brain banking are addressed such as ethical considerations, clinical work-up, preparation techniques and the organization of a brain bank, the value of modern brain banking for investigations of psychiatric disorders is summarized

Assessing test anxiety and resilience among Greek adolescents during COVID-19 pandemic

The aim of the present study was to explore the impact of school year’s extension due to the coronavirus pandemic (COVID-19) by addressing test anxiety and by studying the coping strategies adolescents used to overcome it. For the majority of the adolescents the final exams can be a powerful source of stress, since the entrance examinations are required for admission into higher education and further reflect the transition to adulthood. The sample consisted of 67 High School students and the data collection was conducted online due to the imposed measures by the Greek government. Results showed normal or average levels of test anxiety with low self-esteem and fear of a family member contracting the virus identified as significant predictors. Students who participated in the research pointed teachers as the main source of pressure in school exams. Gender differences regarding social media engagement and online video gaming were also detected. Resilience was equally as high among genders [t(63) = 858, p =.324] and the correlation between test anxiety and resilience did not produce a statistically significant result (r = -.178, p = .155)

Fear of COVID-19, anxiety, depression and suicide among elderly patients with chronic physical or mental diseases

Older age renders individuals vulnerable during public emergency crises. Considering that older adults are a highly heterogeneous and continuously growing demographic subgroup, this study aimed to assess the mental health impact of COVID-19 on two groups of older patients: a group of chronic physical disease and a group of chronic mental disease. A total of 102 patients completed the Fear of COVID-19 Scale, the Generalized Anxiety Disorder scale, the Brief Patient Health Questionnaire (PHQ-9) and several questions regarding demographic characteristics. Suicidality was assessed by the 9th item of the PHQ-9. According to the results, older chronic disease patients showed higher levels of fear, whereas anxiety and depressive symptoms were present mainly in the group of older psychiatric patients. Suicidality was reported from a subtotal of 25.4% that was composed of 7.8% chronic disease patients and 17.6% psychiatric patients. Chronic physical disease and higher anxiety predicted more severe COVID-19-related fear

The brief self-control scale: Dimensionality and psychometric properties in Greek young adults

This study aims to investigate the psychometric properties of the Greek version of Brief Self-control Scale (BSCS). This scale is used for the assessing of self-control, which is the ability to control one’s emotions and desires–especially in demanding situations-in order to have more important long-term benefits. Data were collected from a sample of Greek-speaking university students from two different universities (N = 251, M age = 19.86, SD = 2.58, 47% female). A series of CFAs were conducted to compare different potential factor structures that have been proposed in the literature. The results indicate that the revised shortened 7-items BSCS in Greek, as indicated in previous research too, displays a two-factor structure (impulse-control and self-discipline) and these factors show acceptable internal reliability. Also, item factor loadings, thresholds, and intercepts were invariant across females and males (strong measurement invariance). Means of bivariate latent correlations of the BSCS with depression, anxiety, stress, conscientiousness and satisfaction with life were investigated. This study shows that the Greek BSCS is a promising short tool for research on youth’s self-control

PERITRAUMATIC DISTRESS INVENTORY IN THE COURSE OF THE COVID-19 PANDEMIC

The context of the present study was the COVID-19 pandemic, which has become an unprecedented global health emergency inducing a considerable degree of uncertainty, fear, concern, and worry. Peritraumatic reactions may contribute to the development of Acute Post-traumatic Stress Disorder (PTSD) and the prediction of full PTSD. The aim of this study was to validate the Peritraumatic Distress Inventory (PDI) in a Greek sample during the outbreak of COVID-19 pandemic and explore its association with PTSD as assessed by PTSD-8. A total of 2,827 patients completed the PDI along with validated scales measuring post-traumatic, anxiety and depressive symptoms. CFA confirmed both the unifactorial model, with modest fit, and the bifactorial model of PDI with acceptable fit in the Greek sample. The three- and the four-factor models were not supported. Overall, the scale demonstrated good psychometric properties in the Greek population and can be considered a useful instrument to assess elevated stress during traumatic crises.

Disfunção pré-frontoparietal durante o processamento de informação visuoauditiva em pacientes idosos com esquizofrenia crônica e efeitos da medicação

OBJECTIVES: In first-episode schizophrenia patients, functional magnetic resonance imaging (fMRI) has shown prefronto-parietal dysfunction during acoustic and visual stimulation. The aim of this study was to investigate the prefronto-parietal network in elderly schizophrenia patients using the same paradigm. Additionally, we hypothesized favourable effects on brain activation by the atypical antipsychotic clozapine compared to typical neuroleptics. METHODS: We investigated 18 elderly, chronic schizophrenia patients and 21 elderly healthy controls. Nine schizophrenia patients had been medicated with clozapine and 9 had been receiving typical neuroleptics over decades. In addition to assessments with psychopathological and neuropsychological rating scales we used an acoustic and visual stimulation paradigm in a 1.5 Tesla MRI scanner to investigate BOLD-response in different brain areas. RESULTS: Compared to healthy controls schizophrenia patients showed decreased brain activation in the prefrontal and parietal cortex as well as medial anterior cingulate gyrus compared to healthy controls. In these regions, patients medicated with clozapine showed increased BOLD-response compared to patients treated with typical neuroleptics. DISCUSSION: Our study confirmed prefronto-parietal network disturbances in elderly schizophrenia patients thus pointing to the preservation of brain activation deficits and the influence of neurodevelopmental disturbances in chronic schizophrenia until old-age. CONCLUSION: The atypical antipsychotic clozapine seems to facilitate brain activation even in elderly, chronic schizophrenia patients.OBJETIVOS: Em pacientes com primeiro episódio de esquizofrenia, estudos com ressonância magnética funcional (RMf) têm demonstrado disfunção pré-frontoparietal durante estimulação acústica e visual. O objetivo do presente estudo foi investigar a rede pré-frontoparietal em pacientes idosos com esquizofrenia utilizando o mesmo paradigma. Adicionalmente, foram presumidos efeitos favoráveis na ativação cerebral pelo antipsicótico atípico clozapina em comparação a neurolépticos típicos. MÉTODOS: Foram investigados 18 pacientes com esquizofrenia crônica e 21 controles saudáveis idosos. Nove pacientes com esquizofrenia haviam sido medicados com clozapina e nove haviam recebido neurolépticos típicos por décadas. Concomitantemente às avaliações com escalas psicopatológicas e neuropsicológicas foi utilizado um paradigma de estimulação auditiva e visual em um aparelho de ressonância magnética de 1,5 Tesla para investigar a resposta BOLD em diferentes áreas cerebrais. RESULTADOS: Comparados a controles saudáveis, os pacientes com esquizofrenia apresentaram diminuição na ativação cerebral nos córtices pré-frontal e parietal, assim como no giro do cíngulo anterior medial. Nessas regiões, os pacientes medicados com clozapina apresentaram resposta BOLD aumentada em comparação aos pacientes tratados com neurolépticos típicos. DISCUSSÃO: O presente estudo confirmou a presença de distúrbios na rede pré-frontoparietal em pacientes idosos com esquizofrenia, apontando assim para a preservação de déficits de ativação cerebrais e a influência de distúrbios do desenvolvimento neural em esquizofrenia crônica até a velhice. CONCLUSÃO: O antipsicótico atípico clozapina parece facilitar a ativação de áreas cerebrais mesmo em pacientes idosos com esquizofrenia crônica

Training Health Professionals to Support Patients with Appearance-Affecting Conditions

Multidisciplinary health professionals (HPs) are involved in supporting patients who have conditions that affect their appearance. With appearance-associated distress common in this group, acceptance and commitment therapy (ACT) and enhanced communication skills both show effectiveness in helping patients adjust to their conditions. Multidisciplinary HPs are perfectly placed to provide low-level psychological support as paraprofessionals. We present the real-world evaluation of a training programme, ACT Now, which was delivered via the train-the-trainer model to 149 multidisciplinary HPs in six European countries. Trainees completed a 16-item knowledge, attitude and practice survey covering psychoeducation on appearance concerns, ACT applied to the patient group and communication skills, at pre-training, post-training and at 3-or-6-month follow-up. Findings show that trainees’ confidence consistently improved in understanding specific facets of appearance concerns and ACT processes, with largely positive changes in other facets, skewed towards delivery nations in which psychologists delivered the training. Patient communication skills generally improved, though again these were more pronounced in psychologist-led countries. However, an absence of significant improvements in ACT comprehension suggests a challenge in transmitting the ACT model to HPs. Providing more initial training to non-psychologist trainers and embedding post-training skills practice for trainees may help reinforce the ACT component of the training

Gene expression of NMDA receptor subunits in the cerebellum of elderly patients with schizophrenia

To determine if NMDA receptor alterations are present in the cerebellum in schizophrenia, we measured NMDA receptor binding and gene expression of the NMDA receptor subunits in a post-mortem study of elderly patients with schizophrenia and non-affected subjects. Furthermore, we assessed influence of genetic variation in the candidate gene neuregulin-1 (NRG1) on the expression of the NMDA receptor in an exploratory study. Post-mortem samples from the cerebellar cortex of ten schizophrenic patients were compared with nine normal subjects. We investigated NMDA receptor binding by receptor autoradiography and gene expression of the NMDA receptor subunits NR1, NR2A, NR2B, NR2C and NR2D by in situ hybridization. For the genetic study, we genotyped the NRG1 polymorphism rs35753505 (SNP8NRG221533). Additionally, we treated rats with the antipsychotics haloperidol or clozapine and assessed cerebellar NMDA receptor binding and gene expression of subunits to examine the effects of antipsychotic treatment. Gene expression of the NR2D subunit was increased in the right cerebellum of schizophrenic patients compared to controls. Individuals carrying at least one C allele of rs35753505 (SNP8NRG221533) showed decreased expression of the NR2C subunit in the right cerebellum, compared to individuals homozygous for the T allele. Correlation with medication parameters and the animal model revealed no treatment effects. In conclusion, increased NR2D expression results in a hyperexcitable NMDA receptor suggesting an adaptive effect due to receptor hypofunction. The decreased NR2C expression in NRG1 risk variant may cause a deficit in NMDA receptor function. This supports the hypothesis of an abnormal glutamatergic neurotransmission in the right cerebellum in the pathophysiology of schizophrenia

Development and validation of the Greek severe impairment battery

Most neuropsychological batteries, especially those most often used, are unsuitable for the assessment of patients with severe dementia. The Severe Impairment Battery (SIB) was developed for the evaluation of preserved cognitive functions in these patients. The aim of this study was to formulate a Greek version of the SIB and to conduct a first assessment of its use of patients with mild, moderate, or severe Alzheimer's disease (AD), compared to the Mini-Mental State Examination (MMSE). A convenience sample of 42 dementia patients according to DSM-IV-TR criteria and 23 healthy participants was selected. Patients were assessed twice using a Greek translation of the SIB and the Greek version of MMSE. Patients were divided into three severity groups based on grouped by Clinical Dementia Rating (CDR) score and the SIB and MMSE scores were compared. The validity of the SIB was confirmed by evaluating the correlation coefficients between the SIB and Greek-MMSE, grouped by CDR, which were found to be significant. Cronbach's α for the total SIB score and each subscale score showed high significance, and the item-total correlation for each subscale was also acceptable. The test-retest correlation for the total SIB score and subscale scores were significant. The total SIB score and subscale scores were examined according to CDR. The Greek SIB is reliable and valid in differentiating patients with moderate or severe dementia, whereas MMSE loses sensitivity due to a floor and ceiling effect